Physical activity, sedentary behavior, and childhood obesity: a review of cross-sectional studies.

This systematic review examined the associations of physical activity (PA) and sedentary behavior to childhood overweight and obesity in cross-sectional studies from the last 10 years. Cross-sectional approaches are cost-effective methods for identifying relationships that can then be followed by longitudinal studies to establish temporality and create targeted interventions. The 17 selected studies contained a variety of measures of PA and sedentary behavior. PA was related negatively to child weight status in some studies; however, it was not associated in others. In general, sedentary behaviors were positively associated with weight status. However, gender differences appeared in some studies for each variable. Limitations of cross-sectional approaches were discussed, as was the need for more accurate measures of PA, sedentary behavior, and body composition.

Psychosocial predictors of intentions to comply with bariatric surgery guidelines.

An increasing body of research suggests that many patients have difficulty adopting the eating guidelines after weight-loss surgery, thereby reducing the long-term success of the procedure. Given such difficulties, it is possible that the typical preoperative education regarding post-surgical eating behavior guidelines is ineffective in motivating some individuals to comply. Presently, no accurate predictors of intentions to comply with post-bariatric surgery guidelines have been identified. In the present pilot study, a psychosocial intervention based on protection motivation theory (PMT) was presented to patients undergoing bariatric surgery. PMT is a well-established preventive health model that has been utilized in a variety of health domains. Participants for this study were recruited before undergoing bariatric surgery, and were randomly assigned to one of two groups: PMT group vs. control. In addition to routine messages from the bariatric surgeon, participants in the PMT group received an intervention based in PMT that focused on the importance of adhering to post-surgical eating behavior guidelines and how best to adhere to these guidelines. Participants in the control group received standard of care information from the bariatric surgeon. Results indicated that the PMT intervention did not have a significant impact. However, follow-up analyses revealed that two aspects of PMT, perceived self-efficacy and perceived threat of not following the guidelines, predicted patients' intentions to comply with post-surgical guidelines. Findings are discussed in terms of the methodological compromises that resulted from the applied research setting as well as promising avenues for future investigation.

Living Well with Living Wills: Application of Protection Motivation Theory to Living Wills Among Older Caucasian and African American Adults.

Using protection motivation theory, we examined racial differences in intent to complete a living will, rational problem solving (e.g., information seeking), and maladaptive coping responses (i.e., wishful thinking) to a health crisis. Sixty healthy, older adults without living wills responded to written vignettes, including information about living wills as an effective coping mechanism to avoid a health crisis. Use of adaptive coping responses predicted intent to execute a living will. A significant race-by-threat interaction predicted use of rational problem solving, with Caucasians more likely to seek information in response to perceived threat in comparison with African Americans. A significant race-by-adaptive-coping interaction predicted maladaptive coping, indicating that Caucasians were more variable in their maladaptive responses. The effectiveness of health care messages regarding living wills for older adults may be enhanced by focusing on racial differences in response to perceived health threat and perceived adaptive coping information.

Protection motivation theory and stages of change in sun protective behavior.

This study examined the usefulness of the stage of change model and protection motivation theory (PMT) in creating brief persuasive appeals to promote healthy sun-behavior. College women (N = 254) read one of four essays that manipulated the level of threat and coping appraisal. The transition from the precontemplation to contemplation stage was promoted by threat appraisal information, but transition from contemplation to the preparation stage occurred only when individuals were provided with both high threat and high coping information. Thus, brief communications based on PMT may create attitudes leading to behavior change when later, more intensive, interventions are introduced.

Effects of a psychosocial intervention on breast self-examination attitudes and behaviors.

An educational intervention to promote breast self-examinations (BSEs) among young women was tested. In a group (intervention versus control) x time (Session 1 versus Session 2) mixed design, 172 college females were randomly assigned to either an intervention or control condition. Both groups attended two sessions; the second session was 48 hours after the first. The intervention consisted of an essay, lecture, video portraying young survivors of breast cancer, group discussions, self-test and instructions on performing BSEs. The control group had the same format; however, the information was focused on nutrition and exercise. Participants in the intervention group scored higher on rational problem solving and behavioral intentions, suggesting that the intervention increased adaptive responses to breast cancer threat. Conversely, control participants scored significantly higher on maladaptive reactions (e.g. hopelessness, avoidance and fatalistic religiosity) to breast cancer threat. For intervention participants, the initial decline in maladaptive reactions remained stable at 3-month follow-up, but adaptive reactions decreased. Intervention participants had greater confidence in performing BSEs compared with controls but performed them on an irregular basis. Results were interpreted in terms of protection motivation theory, a model that applies the social psychology of persuasion to preventive health.

Effects of coping information and value affirmation on responses to a perceived health threat.

In this study, we examined the effects of coping information and self-affirmation on an individual's response to threatening health information. A total of 202 women college students read an essay containing threatening information about breast cancer. The essay described their population as being at risk for breast cancer and included both pictures of cancerous breasts and vivid descriptions of chemotherapy treatments. Participants were randomized into either the low-affirmation condition or the high-affirmation condition when they first arrived. In addition, half of the participants were randomly assigned to receive coping information that described breast self-examinations as an effective method of detecting breast cancer and focused on the importance of early detection. Participants who received coping information scored lower on maladaptive behaviors (avoidance, hopelessness, religiosity), suggesting that coping information plays a role in decreasing maladaptive behaviors. No significant differences were found between the low-affirmation and high-affirmation conditions. Supplemental analyses indicated that vicarious exposure to breast cancer (having a friend, relative, or mother diagnosed with breast cancer) affected how individuals interpret threatening health information. Participants with previous exposure scored higher on the adaptive coping modes (behavioral intentions, rational problem solving) and 1 maladaptive coping mode (religiosity) when compared to individuals without previous exposure. In addition, participants in the high-affirmation condition with previous exposure scored higher on avoidance and hopelessness than those without previous exposure. The results suggest that coping information and previous exposure are factors that need to be considered when presenting threatening health information.