Search

Background and Objectives: AIDS is a public health problem for which screening tests are recommended for prevention. This study aimed to determine the impact of an educational intervention based on the precaution adoption process model on HIV screening. Materials and Methods: A semi-experimental study was conducted on 120 third and fourth-year nursing students in Sabzevar city in 2019 using random sampling. Data collection tools, researcher-made questioner with appropriate validity and reliability, included demographic information, awareness, and constructs of the precaution adoption process model. Data was collected before, two weeks, and two months after the intervention in intervention and control groups. Data was analyzed using SPSS19 software and tests including Chi-square, independent t-test, GEE, and multiple linear regression. Results: In the present study, 21.7%, 35%, 28.3%, and 15% of students were in stages 2, 3, 4, and 5, respectively. After the intervention, 55% of individuals in the intervention group progressed to stage 6 (action). The educational intervention increased awareness by 4%, sensitivity by 6%, perceived benefits by 16%, and self-efficacy. Additionally, the behavior of the intervention group improved more than three times compared to the control group (P=0.028). Conclusion: The study results indicated that the educational intervention to students, despite being implemented at various stages of the model, increased the likelihood of them moving closer to the stage of performing the behavior. Therefore, designing educational interventions to promote the target group from stages of non-engagement or decision-making to HIV testing is recommended. [ABSTRACT FROM AUTHOR]

Purpose: Assess the stage of readiness and barriers to ACP engagement among young adults in the United States utilizing the Precaution Adoption Process Model (PAPM). Methods: A cross-sectional survey design was utilized to survey U.S. adults aged 18–35 through an online marketplace workforce (N = 414). Results: Most (94.7%) had not engaged in comprehensive ACP. Young adults aged 18–29 reported higher perceived barriers scores to complete ACP than those aged 30–35. The perceived barriers score was significantly associated with stage of readiness for ACP (p =.004); those who were unaware (stage 1) or did not want to engage in ACP (stage 4) reported more barriers to ACP engagement. Conclusion: The PAPM is a useful framework for assessing barriers and tailoring programs for ACP engagement. Future research should further assess barriers for young adults to engage in ACP, particularly relating to stages of readiness. [ABSTRACT FROM AUTHOR]

Background: Little is known about the adoption by athletic administrators (AAs) of exertional heat illness (EHI) policies, and the corresponding facilitators and barriers of such policies within high school athletics. This study describes the adoption of comprehensive EHI policies by high school AAs and explores factors influencing EHI policy adoption. Hypothesis: We hypothesized that <50% of AAs would report adoption of an EHI policy, and that the most common facilitator would be access to an athletic trainer (AT), whereas the most common barrier would be financial limitations. Study Design: Cross-sectional. Level of Evidence: Level 4. Methods: A total of 466 AAs (82.4% male; age, 48 ± 9 years) completed a validated online survey to assess EHI prevention and treatment policy adoption (11 components), as well as facilitators and barriers to policy implementation. Access to athletic training services was ascertained by matching the participants' zip codes with the Athletic Training Locations and Services Project. Policy adoption, facilitators, and barriers data are presented as summary statistics (proportions, interquartile range (IQR)). A Welch t test evaluated the association between access to athletic training services and EHI policy adoption. Results: Of the AAs surveyed, 77.9% (n = 363) reported adopting a written EHI policy. The median of EHI policy components adopted was 5 (IQR = 1,7), with only 5.6% (n = 26) of AAs reporting adoption of all policy components. AAs who had access to an AT (P = 0.04) were more likely to adopt a greater number of EHI-related policies, compared with those without access to an AT. An AT employed at the school was the most frequently reported facilitator (36.9%). Conclusion: Most AAs reported having written EHI policy components, and access to an AT resulted in a more comprehensive policy. Clinical Relevance: Employment of an AT within high school athletics may serve as a vital component in facilitating the adoption of comprehensive EHI policies. [ABSTRACT FROM AUTHOR]

The World Health Organization named suicide prevention a global imperative with the media playing an integral role in it. By employing the Precaution Adoption Process Model (PAPM) and Agenda-Setting Theory as the theoretical framework, this study aimed to examine the coverage on suicide by The Star, which is an English-language daily with the largest circulation in Malaysia. A five-year (2014–18) range of news coverage was assessed for its adherence to the Malaysian guidelines for media reporting on suicide. The findings showed that the coverage on suicide by The Star was mostly in the form of straight news, whereby articles performed the disseminator role of news media providing facts or quote sources, without including journalists' interpretation on the suicide incidents. The most common source quoted in the coverage were authorities such as police and government officials. The overall adherence of The Star's suicide coverage with Malaysian guidelines for media reporting on suicide was mixed. Adherence was adequate (>60 per cent) on some items of the guidelines but extremely low (<18 per cent) for other specific recommendations. The practical implications of the findings are discussed with regard to the implementation and monitoring of media guidelines for suicide reporting, as well as professional education and training of journalists and media–mental health professionals liaison. [ABSTRACT FROM AUTHOR]

• About 20 % of people > 50 years sampled in England (N = 2,004) had not yet decided to have the COVID-19 booster vaccine. • Stage theory captures qualitative differences in those who have not had the COVID-19 booster vaccine. • Improving knowledge of vaccine safety and effectiveness is a priority in the vaccine hesitant. • Less financial security and less social pressure is associated with being unengaged in decision to have booster vaccine. • More negative vaccine attitudes, vaccine type, and not being of white British ethnicity is associated with being undecided. COVID-19 continues to pose a threat to public health. Booster vaccine programmes are critical to maintain population-level immunity. Stage theory models of health behaviour can help our understanding of vaccine decision-making in the context of perceived threats of COVID-19. To use the Precaution Adoption Process Model (PAPM) to understand decision-making about the COVID-19 booster vaccine (CBV) in England. An online, cross-sectional survey informed by the PAPM, the extended Theory of Planned Behaviour and Health Belief Model administered to people over the age of 50 residing in England, UK in October 2021. A multivariate, multinomial logistic regression model was used to examine associations with the different stages of CBV decision-making. Of the total 2,004 participants: 135 (6.7%) were unengaged with the CBV programme; 262 (13.1%) were undecided as to whether to have a CBV; 31 (1.5%) had decided not to have a CBV; 1,415 (70.6%) had decided to have a CBV; and 161 (8.0%) had already had their CBV. Being unengaged was positively associated with beliefs in their immune system to protect against COVID-19, being employed, and low household income; and negatively associated with CBV knowledge, a positive COVID-19 vaccine experience, subjective norms, anticipated regret of not having a CBV, and higher academic qualifications. Being undecided was positively associated with beliefs in their immune system and having previously received the Oxford/AstraZeneca (as opposed to Pfizer/BioNTech) vaccine; and negatively associated with CBV knowledge, positive attitudes regarding CBV, a positive COVID-19 vaccine experience, anticipated regret of not having a CBV, white British ethnicity, and living in East Midlands (vs London). Public health interventions promoting CBV may improve uptake through tailored messaging directed towards the specific decision stage relating to having a COVID-19 booster. [ABSTRACT FROM AUTHOR]

The demand for transplantable organs has outpaced the supply. Thus, 20 Americans die every day while waiting for an organ. Although most adults support organ donation, 42% are not registered. The rate is even lower among young adults who are not enrolled in/never graduated from college. The aim of this study was to use the Integrated Behavior Model (IBM) to identify factors that predicted organ donation registration among a racially diverse sample of non-student young adults. The study was observational and cross-sectional. Proportional allocation was used to identify a racially diverse sample of 550 non-student, young adults from ten states in the U.S. with the lowest registration rates. A valid and reliable survey was designed, pilot-tested, and administered. A total of 407 young adults completed the survey (74%). Only 19% were registered donors. Caucasians were more likely to be registered donors than racial minorities, χ² (3, N = 407) = 15.19, p = 0.002. Those with more positive direct attitudes toward registration were 1.5 times more likely to be registered than those who had negative direct attitudes. Among non-registrants, indirect descriptive norm and direct attitude were statistically significant predictors of behavioral intention. Moreover, those who knew someone who donated an organ and knew someone who needed a transplant were nearly three times more likely to intend to register in the next year. The IBM proved useful in elucidating factors that predicted intention to register among non-student young adults. The IBM should be used by those who desire to increase registration rates. [ABSTRACT FROM AUTHOR]

Emergency action plans (EAPs) are considered best practice for the preparation of catastrophic events in sports and, when adequate, can effectively improve patient outcomes. The EAPs should include a collaboration of all personnel involved in the sporting activities, with high school coaches being well-positioned to implement these plans. Therefore, coaches can have a direct influence on the health and safety of their athletes through their involvement in an emergency response. The purpose of this study was to evaluate the understanding and adoption of EAPs as reported by coaches. A web-based questionnaire assessed adoption of an EAP; decisional stages for adoption of components of an EAP; and various characteristics (e.g., access to an athletic trainer facilitators and barriers). A total of 720 responses were included in this study. Nearly 25% of coaches reported being unaware if their school had an EAP, and coaches were more likely to adopt a comprehensive EAP if their school had access to an athletic trainer. A majority of coaches perceived financial assistance as a facilitator and financial limitations as a barrier for EAP implementation. The findings of this investigation illustrate the need for improved coaches' educational awareness of emergency preparedness strategies within the high school setting. [ABSTRACT FROM AUTHOR]

Background: Korean American (KA) women have experienced higher prevalence and lower survival rates of breast cancer (BC) than other ethnic groups in the United States. However, BC screening rates for KA women remain significantly lower than the national target (81.1%) specified by Healthy People 2020. Few studies have explained how the decision to adopt BC screening occurs and progresses and what factors contribute to this decision among KA women. This study used Weinstein's Precaution Adoption Process Model (PAPM) as a theoretical framework to examine characteristics and factors associated with the decisional stage of mammography adoption. Methods: A cross-sectional self-report survey was administered among KA women (N = 308) ages 50–80 from the Atlanta metropolitan area. A total of 281 KA women completed the survey, answering questions about socio-demographics, health-related information, mammography history, doctor recommendation, BC screening knowledge, self-efficacy for BC screening, decisional balance scores on attitudes and beliefs pertaining to mammography, and the seven-stage PAPM. Results: KA women reported a low rate of mammography uptake with about 24% and 35% of the participants undergoing mammography within the last year and two years, respectively. KA women in stages 5 (decided yes), 6 (action), and 7 (maintenance) were likely to have increased screening-related knowledge, positive decisional balance, and regular medical check-up compared to those in stages 1 (unaware), 2 (unengaged), and 3 (deciding). Conclusion: This study highlights important factors that could potentially facilitate BC screening among KA women in Georgia. The findings also provide implications for interventions and practice for increasing mammography screening among medically underserved populations. [ABSTRACT FROM AUTHOR]

Summary: We investigated the factors associated with readiness for initiating osteoporosis treatment in women at high risk of fracture. We found that women in the contemplative stage were more likely to report previously being told having osteoporosis or osteopenia, acknowledge concern about osteoporosis, and disclose prior osteoporosis treatment. Introduction: Understanding factors associated with reaching the contemplative stage of readiness to initiate osteoporosis treatment may inform the design of behavioral interventions to improve osteoporosis treatment uptake in women at high risk for fracture. Methods: We measured readiness to initiate osteoporosis treatment using a modified form of the Weinstein Precaution Adoption Process Model (PAPM) among 2684 women at high risk of fracture from the Activating Patients at Risk for OsteoPOroSis (APROPOS) clinical trial. Pre-contemplative participants were those who self-classified in the unaware and unengaged stages of PAPM (stages 1 and 2). Contemplative participants were those in the undecided, decided not to act, or decided to act stages of PAPM (stages 3, 4, and 5). Using multivariable logistic regression, we evaluated participant characteristics associated with levels of readiness to initiate osteoporosis treatment. Results: Overall, 24% (N = 412) self-classified in the contemplative stage of readiness to initiate osteoporosis treatment. After adjusting for age, race, education, health literacy, and major osteoporotic fracture in the past 12 months, contemplative women were more likely to report previously being told they had osteoporosis or osteopenia (adjusted odds ratio [aOR] (95% CI) 11.8 (7.8–17.9) and 3.8 (2.5–5.6), respectively), acknowledge concern about osteoporosis (aOR 3.5 (2.5–4.9)), and disclose prior osteoporosis treatment (aOR 4.5 (3.3–6.3)) than women who self-classified as pre-contemplative. Conclusions: For women at high risk for future fractures, ensuring women's recognition of their diagnosis of osteoporosis/osteopenia and addressing their concerns about osteoporosis are critical components to consider when attempting to influence stage of behavior transitions in osteoporosis treatment. [ABSTRACT FROM AUTHOR]

• Awareness of HPV is only just over 50% in parents whose children will soon be eligible for vaccination. • More parents of girls than boys said they would vaccinate their child against HPV. • Fathers, and parents of boys were more likely to be undecided about HPV vaccination. • Potentially modifiable HPV vaccine attitudes were strong predictors of intention to vaccinate. School-based HPV vaccination in the UK will soon be extended to boys. Based on other countries' experience, uptake may initially be lower in boys than girls. We assessed HPV vaccine attitudes and decision-making in parents of boys and girls, to explore sex differences and inform public health messages. We carried out a cross-sectional population-based survey using home-based interviews in spring 2019. Participants were adults in England and Wales, with a child in school years 5–7 (aged 9–12 and eligible for HPV vaccination within 3 years). Measures included awareness of HPV and the vaccine, demographic factors, previous vaccine refusal and (after exposure to brief information) whether participants would allow their child to have the HPV vaccine (decided to vaccinate; decided not to vaccinate; undecided). We also assessed vaccine attitudes. Data were weighted to adjust for non-response. Multinomial logistic regression was used to explore predictors of deciding to (or not to) vaccinate compared with being undecided. Among 1049 parents (weighted n = 1156), 55% were aware of HPV and the girls' vaccination programme, but only 23% had heard of plans to vaccinate boys. After information exposure, 62% said they would vaccinate their child, 10% would not, and 28% were undecided. Parents of girls were more willing to vaccinate than parents of boys (adjusted odds ratio: 1.80 (1.32–2.45)). Positive attitudes and HPV/vaccine awareness were significantly independently associated with deciding to vaccinate. Previous vaccine refusal for a child was the strongest predictor of not wanting the HPV vaccine. Our findings suggest a need for public health campaigns to raise awareness of plans to extend HPV vaccination to boys. Reassuringly only 10% of all parents were unwilling to vaccinate and our data suggest further information, including about safety and efficacy, may be important in supporting undecided parents to make the decision to vaccinate. [ABSTRACT FROM AUTHOR]

Introduction: For Korean Americans (KAs), colorectal cancer (CRC) screening rates remain lower than the national target. This study aimed to examine factors predicting decisional stage of CRC screening adoption among older KAs using the precaution adoption process model. Method: Convenience sampling was employed to recruit KAs aged 50 to 75 years from the Atlanta metropolitan area in the United States. A total of 433 KAs completed a cross-sectional survey that collects information on sociodemographics, CRC screening history, a physician's recommendation, knowledge, self-efficacy, and decisional balance pertaining CRC screening, and precaution adoption process model stage. Results: Higher scores of decisional balance (odds ratio [ OR ] = 1.34), having a physician's recommendation (OR = 8.61), and having regular annual medical checkups (OR = 4.44) were significantly associated with higher decisional stage compared with lower stage, controlling for other variables. Discussion: Intervention research should incorporate consideration of individuals' decisional stage to move KAs forward from not engaging the screening to maintaining regular participation in CRC screening. [ABSTRACT FROM AUTHOR]

Objective: According to the precaution adoption process model, cervical screening nonparticipants represent a heterogeneous group including those who are unaware of, unengaged with, or undecided about screening, as well as intenders and decliners. We aimed to explore beliefs about cervical screening among these different types of nonparticipant.Methods: Semistructured interviews were carried out with women aged 26 to 65 years living in Britain (n = 29). Women were purposively sampled to represent different nonparticipant types. Interviews were transcribed verbatim, and data were analysed thematically using framework analysis.Results: The salience of some barriers to screening varied between different types of nonparticipant. Bad experiences were prominent in the discussions of women who had decided not to attend, while practical barriers were more prominent among intenders. There was also some overlap between nonparticipant types. For example, many of the undecided women described not wanting to go for screening, but with less certainty than decliners. Some intenders (particularly those who had not been screened before) described not really wanting to attend but feeling they ought to. Women's views on the invitation/reminder process also varied; intenders and maintainers appreciated written reminders and general practitioner (GP) prompts but decliners sometimes perceived these as "badgering." Throughout the interviews, women described changing views on screening in the wider context of ageing and motherhood.Conclusions: The salience of screening barriers varies by nonparticipant type, offering possibilities for tailored interventions. However, the fluidity of women's stage of screening adoption might have implications for this approach to intervention design. [ABSTRACT FROM AUTHOR]

BACKGROUND: Implementing a cervical cancer prevention program requires an exploration of certain behaviors concerning this disease. This study is aimed to evaluate the psychometrics of a questionnaire that enquired about the factors involved in Precaution Adoption Process Model (PAPM) for cervical cancer among suburban women in Bandar Abbas, south of Iran. MATERIALS AND METHODS: The primary draft of the questionnaire was developed with a review of the related literature on cervical cancer and the constructs affecting PAPM, with 68 items. The face validity, content validity ratio (CVR), and content validity index (CVI) of the questionnaire were approved by a panel of 10 experts. The internal consistency and test-retest reliability of the questionnaire were estimated too. Field testing sample included 300 women recruited from a women's healthcare center in suburban areas of Bandar Abbas in the south of Iran. Exploratory factor analysis was used to evaluate validity, and Cronbach's alpha coefficient was estimated for reliability. RESULTS: After the face validation, 11 items were eliminated. Once CVR was estimated, two items were discarded. The remaining items had a CVR >0.79. All had a CVI >0.79. Six items were eliminated in the factor analysis. The final questionnaire included 49 items organized in 8 factors including awareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, social norms, fear, and self-efficacy. Principal component analysis with varimax rotation indicated eight main components that explained 56.25% of the variance. Reliability assessment showed a good internal consistency for all subscales and the Cronbach's alpha score ranged between 0.82 and 0.90. The test-retest reliability showed that the correlation coefficients (between 0.81 and 0.89) were significant at the 0.01 level for all sub-scales. CONCLUSIONS: The final questionnaire was a new instrument comprised the effective constructs of PAPM and had a high reliability and validity. Thus, this questionnaire is recommended to be used to explore and enhance preventive behaviors of cervical cancer.

Although the proper installation and maintenance of carbon monoxide (CO) and smoke alarms can protect individuals from residential CO-related and fire-related injuries, these devices are underutilized. We describe characteristics associated with self-reported CO and smoke alarm use of parents recruited from a pediatric emergency department to improve CO alarm use. Parents of children ≤ 18 years (N = 299) reported socio-demographic characteristics and CO and smoke alarm ownership and practices. We assigned participants to a behavioral profile and a Precaution Adoption Process Model stage based on their self-reported CO and smoke alarm use. Most participants (71%) did not have CO alarms in their homes, but reported owning at least one working smoke alarm (98%). Participants who reported "perfect" CO alarm behavior (defined as having a working CO alarm, one near a sleeping area, with batteries replaced every 6 months; 9%) were more likely to earn a higher income, own their home, and have lived at their current residence for at least 2 years. Participants who reported "perfect" smoke alarm behavior (defined as having a working smoke alarm on every level, with batteries replaced every 6 months; 49%) were more likely to rent their home, receive federal assistance, and have lived at their current residence for at least 2 years. Interventions to increase correct CO alarm use are necessary. [ABSTRACT FROM AUTHOR]

A survey of adolescents ( N = 1,488) documented Facebook use and experience with cyber bullying. The study found that 84 % of adolescents (middle school through college undergraduates) use Facebook, and that most users log on daily. While 30 % of the sample reported being cyber bullied, only 12.5 % quit using the site, and only 18 % told a parent or school official about the abuse. Up to 75 % of middle school Facebook users have experienced cyber bullying. The current study was the first to apply the Precaution Adoption Process Model (PAPM) to cyber bullying or to test the model with children and adolescents. Results suggest that most adolescents are aware of cyber bullying and acknowledge it as a problem in their school. About half of the adolescents did not progress beyond Stage 2 of the PAPM (aware of the problem, but haven't really thought about it). Adolescents also exhibited optimistic bias, believing they were less likely than peers to become cyber bullied. Implications for prevention education are discussed. [ABSTRACT FROM AUTHOR]

The Planned Risk Information Seeking Model ( PRISM) was employed to explain people's information-seeking intentions in the context of hydraulic fracturing. Stages from the Precaution Adoption Process Model ( PAPM) were included in the analysis as a moderator. The PRISM fit the data well. Moreover, results showed overall model differences among people who have not decided to take action on hydraulic fracturing, people who have decided to take action, and people who have decided not to take action. Findings provided justifications for tailored messages to encourage information seeking among the varying publics. [ABSTRACT FROM AUTHOR]

Natural disasters have caused many deaths and disabilities in human communities. One way to mitigate the impact of the disasters is the community based disaster preparedness programs against such incidents. The aim of this study is to encourage people to provide disaster survival kits. This randomized controlled study has evaluated the effectiveness of an eight-week Precaution Adoption Process Model-based disaster preparedness education program in 221 personnel in Ahwaz Carbon factory. The results have showed that after intervention, the training group showed significant positive progress in stages and seventeen subjects of the intervention group provided disaster survival kits. Our survey showed that the perceived benefits and barriers could predict the adaption stage. These results have supported the educational program based on the precaution adoption process model encouraging participants to provide disaster survival kits. [ABSTRACT FROM AUTHOR]

Objective Few patients participate in cancer support groups despite their benefits. This study investigated the importance of Theory of Planned Behaviour variables in predicting group participation, relative to disease impact, existing support, coping and demographic variables. Methods Longitudinal study of patients with colorectal, lung or prostate cancer recruited from a specialist oncology centre. Patients self-completed surveys at baseline and six-month follow up. Baseline measures included Theory of Planned Behaviour (TPB) variables, distress and control over cancer (IPQ-R), coping (Brief COPE), social support (MSPSS), health related quality of life (EORTC QLQ-C30) and readiness to participate (PAPM). Group participation and recommendations to participate were measured at follow up. Univariable and Random Forest analyses investigated predictors of baseline readiness to participate and participation by six-month follow up. Results N=192 patients completed baseline questionnaires. N=13 participated in a group and N=59 did not by six-month follow up. Baseline readiness to participate was associated with inadequate support and positive views of support groups. Lower cognitive functioning, recommendations and readiness to participate predicted group participation by six-month follow up. Conclusion and practice implications Practitioners may facilitate group participation by promoting positive views of groups, recommending participation and focusing on patients experiencing greater disease impact and less existing support. [ABSTRACT FROM AUTHOR]

This study aimed to apply the Construal Level Theory (CLT) to increase the relaxation adoption as a coping behavior in adolescents with premenstrual syndrome (PMS). The theory offers a framework that assumes decision-making about adoption of any given behavior depends on perceived temporal distance from the desired or recommended behavior and thus individual might perceive any information or intervention, at two levels (low or high). In doing so, a trial was conducted on 1578 high school students suffering from PMS. The Precaution Adoption Process Model was applied to categorize students in six stages, based on their intention to adopt a behavior. The focus of this study was on students who were in stage 3 of the model (undecided to adopt a behavior that was relaxation). Overall, 411 students were identified and randomly assigned to the three study groups: Group 1 (n = 98) who received a CLT-driven intervention containing detailed information about relaxation (low-level construal, LLC); group 2 (n = 150) who received a CTL-driven intervention containing general information about relaxation (high-level construal, HLC); and group 3 (n = 163) who received nothing (control group). The progression from stage 3 toward stage 6 (action) was considered as the desired outcome and it was hypothesized that LLC intervention would be more effective than HLC intervention. Compared to participants in the control group, participants in the high and low construal groups were significantly more likely to advance to the action stage (P < 0.001). In addition, students in the low construal group had made an apparent higher stage progression as compared to the high construal group, although this difference was not statistically significant (P = 0.33). The findings suggest that, for people who are undecided to adopt a new health action, LLC intervention might be more effective. [ABSTRACT FROM AUTHOR]

Our mandate, as Lamaze International childbirth educators, is to assist women in making healthy pregnancy, birth, and parenting choices. Being mindful of health promotion theory and using learning tasks and dialogue education to provide information creates a collaborative Lamaze class where the teacher is the facilitator and the learners are accountable for their learning. This column offers Lamaze educators a deeper understanding of adult learners and our roles in their birth education. [ABSTRACT FROM AUTHOR]

According to the Centers for Disease Control and Prevention (CDC), 25 percent of people living with HIV in the United States in 2006 were age 50 and older. HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the population of people over age 50, but few interventions have been established. The ecological perspective, which integrates intrapersonal, interpersonal, organizational, community, and policy factors, was used to review the current interventions and propose possible new HIV/AIDS prevention efforts for older adults. Intrapersonal interventions are often based on the health belief model. The precaution adoption process model was explored as an alternative intrapersonal theory for modeling prevention efforts. Community interventions using diffusion of innovations theory are fully explored, and new interventions are proposed as an option for preventing HIV/AIDS in older adults. An agenda for future research and interventions is proposed. Social workers will be at the forefront of the effort to prevent HIV/AIDS in older adults. They must accept this responsibility, propose interventions, and evaluate their effectiveness. [ABSTRACT FROM AUTHOR]

The article offers information on the mobile safety center (MSC) that offers education and reduced-cost safety products to low-income urban families in the U.S. As stated, MSC is a mobile unit similar to the hospital-based safety center and was formulated to serve the community in settings such as clinics and community events. It is developed through a community partnership and is staffed by health educators from national organizations including American Academy of Pediatrics and the National Fire Protection Association. In addition, it offers safety products such as safety gates and car safety seats and provides a free car seat installations and referrals to the Baltimore City Fire Department's Free smoke alarm installation program.

Purpose. To explore psychosocial correlates and predictors of stage transitions in the precaution adoption process model (PAPM) for fruit intake. Design. A cohort completed three electronic questionnaires, at baseline (time 0), 35 days later (time 1), and another 32 days later (time 2). Setting. Secured Internet Web site. Subjects. A cohort of 735 adults was formed from a random sample of an existing Internet panel. The mean age was 37.5 years, 51 % were women, and 90% were of Dutch origin. Most respondents (48%) had a medium level of education. Measures. Precaution adoption process model stage, risk perception, perception of own fruit intake level, attitude, pros, cons, subjective norms, social support, modeling, self-efficacy, and fruit intake (assessed using a food frequency questionnaire). Analysis. Cross-sectional differences in psychosocial variables and fruit intake across PAPM stages at baseline were analyzed using analysis of variance with Tukey multiple comparisons tests. Predictors of PAPM stage transitions between time 0 and time 1 and between time 1 and time 2 were analyzed using logistic regression analysis. Results. Factors related to attitude and social influences may be important if one is to decide to act, whereas strong self-efficacy may also be required for acting on the decision to act. Conclusion. Although the results should be replicated in a larger and more representative sample, the PAPM seems a good framework for studying fruit intake. [ABSTRACT FROM AUTHOR]

Summary: In the neurology literature it is well established that anti-epileptic drugs (AEDs) lead to bone loss (osteopenia and osteoporosis). Several large epidemiologic studies have found twice the fracture rate in persons with epilepsy compared to the non-epilepsy population. While an increasing level of awareness for preventative measures and screening by neurologists and primary care physicians are recommended, so far no one has attempted to address how knowledge related to calcium and exercise, health beliefs (based on the Health Belief Model) and self-efficacy (confidence in abilities) impact osteoprotective behaviors in epilepsy, based on the Precaution Adoption Process Model (PAPM). The seven-stage PAPM, unlike other health behavior theories where a person is either practicing or not practicing the behavior, conceptualizes behavior change as dynamic and occurring over time. Validated instruments were used to assess knowledge, health beliefs, self-efficacy and stages of the precaution adoption process for four osteoprotective behaviors. For dietary calcium; exercise knowledge and calcium self-efficacy predicted higher stages of precaution adoption. For calcium supplements; age perceived susceptibility for osteoporosis and perceived benefits of calcium predicted higher stages. Exercise adoption stage was most predicted by exercise knowledge and health motivation. For DEXA screening adoption; age and perceived susceptibility predicted higher stages. This study provides hints how persons with epilepsy could be influenced to move from the unaware/unengaged positions into to the stages of adoption and maintenance for osteoprotective behaviors. [Copyright &y& Elsevier]

The article presents abstracts of studies related to health psychology. They include "The Freshman Year of College: Critical Period for Weight Gain?" "Prevalence and Psychosocial Parameters of Smoking in Cypriot College Students" and "The Impact of Online Support Group Participation Among HIV-Positive Individuals."

Injury prevention education for pregnant women may be beneficial for infants' safety. Currently, knowledge about the scope of an expectant mother's intent to prevent injury is limited. The objective of this study was to determine pregnant women's intentions to implement infant injury prevention strategies. From May to June 2017, a self-administered questionnaire based on the precaution adoption process model was distributed among pregnant women who participated in a parenting preparation class in a city, Tokyo. Pregnant women's intentions to implement the following eight kinds of safety practices were measured: three practices regarding suffocation, two regarding falls, one safety practice for burns, one for accidental ingestion, and one for traffic accidents. Among 132 respondents (response rate: 83.5%; mean age: 33.4 years; mean gestational age: 29 weeks), the most common unawareness issue was "Make sure that there is no space between the mattress and bed frame" (68.2%), followed by "Use a firm mattress or futon" (38.5%) and "Keep soft objects away from the baby's head in the baby's sleep area" (31.8%); 58% or more women reported having already "decided to implement" the other five practices. Safety practices that pregnant women were mostly unaware of were for preventing suffocation, despite this being a leading cause of death in terms of unintentional infant injury. In comparison, the safety practices for falls, burns, and accidental ingestion were more known to pregnant women. The pregnant women's intention to implement injury prevention for infants varied by safety practices. These findings could be used to improve the focus of antenatal education programs for the prevention of infant injury.

Background: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors., Methods: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model., Results: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ≥ 9 correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ≤ 4 correct answers). Interestingly, among current smokers, only those who correctly responded to ≥ 9 of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation., Conclusion: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking., Competing Interests: Disclosure: The authors have no potential conflicts of interest to disclose.

Despite being an effective cancer prevention strategy, human papillomavirus (HPV) vaccination in Canada remain suboptimal. This study is the first to concurrently evaluate HPV vaccine knowledge, attitudes, and the decision-making stage of Canadian parents for their school-aged daughters and sons. Data were collected through an online survey from a nationally representative sample of Canadian parents of 9-16 year old children from August to September 2016. Measures included socio-demographics, validated scales to assess HPV vaccine knowledge and attitudes (using the Health Belief Model), and parents' HPV vaccination adoption stage using the Precaution Adoption Process Model (PAPM; six stages: unaware, unengaged, undecided, decided not, decided to, or vaccinated). 3779 parents' survey responses were analyzed (1826 parents of sons and 1953 parents of daughters). There was a significant association between child's gender and PAPM stage of decision-making, with parents of boys more likely to report being in earlier PAPM stages. In multinomial logistic regression analyses parents of daughters (compared to sons), parents of older children, and parents with a health care provider recommendation had decreased odds of being in any earlier PAPM stage as compared to the last PAPM stage (i.e. vaccinated). Parents who were in the 'decided not to vaccinate' stage had significantly greater odds of reporting perceived vaccine harms, lack of confidence, risks, and vaccine conspiracy beliefs. Future research could use these findings to investigate theoretically informed interventions to specifically target subsets of the population with particular attention towards addressing knowledge gaps, perceived barriers, and concerns of parents., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: HPV vaccination decision-making is a complex process that is influenced by multiple psychosocial determinants. Given the change in policy recommendation to include males in routine HPV vaccination, our goals were to assess the HPV vaccination uptake in Canada, to understand where Canadian parents were situated in the HPV vaccine decision-making process for their son, how they changed over time and which psychosocial determinants were relevant for this process.Methods: We used an online survey methodology and collected data from a nationally representative sample of Canadian parents of boys aged 9-16 at baseline (T1, February 2014) and at 9 months' follow-up (T2). Our analyses were guided by the Precaution Adoption Process Model (PAPM), a theoretical health behavior model that classifies parents in one of six stages: unaware, unengaged, undecided, decided not to vaccinate, decided to vaccinate and those who had already vaccinated their sons. Rigorous methods were used to filter out careless responders: response variance, bogus items, psychometric antonyms and psychometric synonyms.Results: At T1 and T2, we received 3,784 and 1,608 respectively completed questionnaires; after data cleaning 3,117 (T1) and 1,427 (T2) were retained. Less than 3% of boys were vaccinated at both time points. At both T1 and T2, most parents (over 70%) belonged to the earlier vaccination adoption stages: 57% were unaware (T1) and 15.3% (T2); 20.9% were unengaged (T1) and 32.4% (T2); and 9.1% were undecided (T1) and 25.2% (T2). At follow-up, 37.7% of participants did not move from their initial PAPM decision-making stage. Most parents (55%) preferred to receive information from their healthcare provider (HCP) but only 6% (T1) and 12% (T2) had actually spoken with a HCP about the HPV vaccine for their son.Conclusions: HPV vaccination uptake in Canadian boys was very low in the absence of a publicly funded HPV vaccination programs for boys. Optimal HPV information preferences were identified and can be used in interventions to increase HPV knowledge and increase HPV vaccine uptake. Intentions to vaccinate or planning to speak to one's HCP did not translate into action for most parents over the 9-month follow up; this finding is critical to consider to inform implementation strategies. Methodological challenges are described and suggestions for future research are offered. [ABSTRACT FROM AUTHOR]