Determinants of the intention to participate in a programme of plasma donation for fractionation among men who have sex with men.

BACKGROUND AND OBJECTIVES: Several approaches are currently under study to contribute to efforts to allow men who have sex with men (MSM) to donate blood. One of these approaches involves implementing a programme of plasma donation for fractionation, with a quarantine period. The goal of this article is to identify the determinants of intention to participate in the plasma donation programme among MSM in Montreal, Canada. MATERIALS AND METHODS: Based on the theory of planned behaviour, a questionnaire was developed to measure MSM's intention to donate plasma and identify influencing factors. A multiple linear regression analysis was conducted to identify the determinants of intention to donate plasma. RESULTS: Respondents' (N = 933) intention to donate plasma in the next six months was moderate. The multiple linear regression model explained 55% (P < 0·001) of the variation of intention. Intention was predicted by attitudes (ß = 0·34, P < 0·001), perceived behavioural control (ß = 0·28, P < 0·001), aged under 35 years (ß = 0·26, P < 0·001), history of blood donation (ß = 0·24, P < 0·001), subjective norm (ß = 0·21, P < 0·001), income above $40,000 (ß = 0·20, P < 0·001), moral norm (ß = 0·18, P < 0·001) and higher level of involvement in various issues LGBTQ+ communities are fighting for (ß = 0·09, P < 0·001). CONCLUSION: Our analyses show that intention to donate plasma within the proposed programme is associated with personal, social and structural factors, but more strongly predicted by factors related to the theory of planned behaviour. Our results also highlight the importance of involving MSM; community acceptability of the plasma donation programme would probably be higher if MSM felt respected and party to the decisions.

Psychosocial determinants of adherence to oral antidiabetic medication among people with type 2 diabetes.

AIMS AND OBJECTIVES: The aim of this study was to identify the psychosocial determinants of adherence to oral antidiabetic medication, according to the Theory of Planned Behaviour (TPB). BACKGROUND: Appropriate adherence to oral antidiabetic medication contributes to long-term glycaemic control. However, glycaemic control is often poor in people with type 2 diabetes, mainly due to the poor adherence to oral antidiabetic agents. DESIGN: Prospective study with 2 waves of data collection, based on STROBE checklist was conducted. One hundred and fifty-seven adults with type 2 diabetes, in chronic use of oral antidiabetic agents, composed the sample. At baseline, self-reported measures of medication adherence (proportion and global evaluation of adherence) and of metabolic control (glycated haemoglobin) of diabetes were obtained. METHODS: The TPB main constructs (attitude, subjective norm and perceived control) and related beliefs were measured. Adherence and metabolic control measurements were obtained in a two-month follow-up (n = 157). RESULTS: Attitude and subjective norm, together, explained 30% of the variability in intention; their underlying belief-based measures (behavioural and normative beliefs) explained 28% of the variability in intention. In addition, intention predicted behaviour at follow-up. However, when added to the prediction model, past behaviour was the only explanatory factor of adherence behaviour. CONCLUSION: Adherence behaviour to oral antidiabetic medication was predicted by intention, which, in turn, was determined by attitude and subjective norm. In order to promote adherence to oral antidiabetic agents, health professionals should include motivational strategies as well as strategies targeted to attitude and subjective norm when designing interventions. RELEVANCE TO CLINICAL PRACTICE: The nonadherence to antidiabetic medication contributes to lack of control of diabetes and ensuing complications. The comprehension of the factors explaining the variability in medication adherence can inform the design of theory-based interventions aimed at promoting this behaviour.

'One step closer': Acceptability of a programme of plasma donation for fractionation from men who have sex with men.

BACKGROUND AND OBJECTIVES: In Canada, Héma-Québec is considering the possibility of allowing men who have sex with men (MSM) to donate plasma for fractionation combined with a mandatory quarantine period. This study aims to assess the acceptability and operational feasibility of the programme in the targeted population. MATERIALS AND METHODS: Seven focus groups with MSM (N = 47) were conducted in Montréal, regarding their beliefs underlying attitudes, subjective norms and perceived behavioural control relating to intention to participate in a programme of plasma donation for fractionation. A theoretical thematic content analysis was realized. RESULTS: Participants brought up benefits of the programme. Some are altruistic (help others, save lives, contribute as citizens), while others are linked to what it could bring to their community (progress, opportunity to include MSM in blood donation programmes, acknowledgement of MSM's contributions to the well-being of others). However, even if the programme is in accordance with their altruistic values, it clashes with their values of equality and social justice. Many disadvantages were raised (discrimination and stigmatization of MSM, the fact that their blood is presented as being not as good as the blood of others). Facilitating factors and barriers to participation were put forward in terms of programme characteristics and sites where donations would be made. CONCLUSION: The findings suggest some interest in the programme of plasma donation for fractionation, but this is significantly tempered by the fact that differential treatment for MSM would continue and that their demands regarding access to whole blood donation are still unmet.

Increasing nondonors' intention to give blood: addressing common barriers.

BACKGROUND: Recruiting new donors is a challenging experience for most blood collection agencies. A modest proportion of the population is eligible to give blood and few of these individuals volunteer. The goal of this study was to examine the effects of brief behavioral interventions on nondonors' intention to give blood, by addressing some commonly reported obstacles. STUDY DESIGN AND METHODS: A total of 244 young adults who were eligible to give blood but had never done so participated in the study. They were assigned randomly to an applied tension (AT) instruction condition, a relaxation instruction condition, a Web browsing condition, or a no-treatment control condition. After the 20-minute experimental intervention, half watched three short injection and blood draw videos and the others sat quietly. Intention to give blood and different cognitive constructs associated with blood donation were measured using a Theory of Planned Behavior questionnaire. RESULTS: Participants in all three active conditions had significantly greater increases in intention to donate blood compared to controls, although those who learned AT had greater increases than Web browsing. Bootstrapping tests of mediation indicated particular importance of increased perceived behavioral control in AT and relaxation treatment effects. Follow-up analyses revealed a significant association between degree of within-session increase in intention and subsequent blood clinic attendance. CONCLUSION: These results suggest that simple interventions can be effective in increasing nondonors' intention to donate blood and, perhaps, actual attendance. The mediational analyses suggest that interventions can selectively target different barriers associated with blood donation.

The Impact of Asking Intention or Self-Prediction Questions on Subsequent Behavior: A Meta-Analysis.

The current meta-analysis estimated the magnitude of the impact of asking intention and self-prediction questions on rates of subsequent behavior, and examined mediators and moderators of this question-behavior effect (QBE). Random-effects meta-analysis on 116 published tests of the effect indicated that intention/prediction questions have a small positive effect on behavior (d+ = 0.24). Little support was observed for attitude accessibility, cognitive dissonance, behavioral simulation, or processing fluency explanations of the QBE. Multivariate analyses indicated significant effects of social desirability of behavior/behavior domain (larger effects for more desirable and less risky behaviors), difficulty of behavior (larger effects for easy-to-perform behaviors), and sample type (larger effects among student samples). Although this review controls for co-occurrence of moderators in multivariate analyses, future primary research should systematically vary moderators in fully factorial designs. Further primary research is also needed to unravel the mechanisms underlying different variants of the QBE.

Validity and reliability of a brief self-reported questionnaire assessing fruit and vegetable consumption among pregnant women.

BACKGROUND: Short instruments measuring frequency of specific foods, such as fruit and vegetable (FV), are increasingly used in interventions. The objective of the study was to verify the validity and test-retest reliability of such an instrument among pregnant women. METHODS: Pregnant women from the region of Quebec City, Quebec, Canada, were recruited through e-mails sent to female students and employees of the local university from October 2014 to April 2015. To assess the validity of the fruit and vegetable questionnaire (FVQ) developed by Godin et al. (Can J Public Health 99: 494-498, 2008), pregnant women were asked in a first mailing to complete the FVQ assessing FV intake over the past 7 days and a 3-day estimated food record. A subsample (n = 33) also gave a fasting blood sample and completed a validated semi-quantitative FFQ administered by a trained registered dietitian during a visit at the research center. FV intakes for all instruments were calculated in terms of servings of FV based on Canada's Food Guide definition of a serving of fruit or vegetable. In order to assess its test-retest reliability, respondents were asked to complete the FVQ 14 days later in a second mailing. RESULTS: Forty-eight pregnant women from all three trimesters completed the questionnaires in the first mailing. FV intake assessed using the FVQ was correlated to FV consumption measured using the food record (r = 0.34, p = 0.0180) and the FFQ (r = 0.61, p = 0.0002). Results were similar when controlling for energy intake and the experience of nausea in the past month. Only ß-cryptoxanthin was significantly correlated to FV intake assessed by the FFQ when adjusted for the presence of nausea (r = 0.35, p = 0.0471). Data on the test-retest reliability was available for 44 women and the intra-class coefficient for the FVQ was 0.72 at a mean 28-day interval. CONCLUSIONS: The FVQ has acceptable validity and test-retest reliability values, but seems to underestimate FV servings in pregnant women. It represents an interesting alternative for researchers or clinicians interested in estimating quickly FV intake among pregnant women, such as in large trials or during prenatal visits. The FVQ should however be coupled with other self-reported measures, such as a food record, for assessing precise individual FV intake.

Psychosocial determinants of nurses' intention to practise euthanasia in palliative care.

BACKGROUND: Most studies on euthanasia fail to explain the intentions of health professionals when faced with performing euthanasia and are atheoretical. RESEARCH OBJECTIVE: The purpose of this study was to identify the psychosocial determinants of nurses' intention to practise euthanasia in palliative care if it were legalised. RESEARCH DESIGN: A cross-sectional study using a validated anonymous questionnaire based on an extended version of the Theory of Planned Behaviour. PARTICIPANTS AND RESEARCH CONTEXT: A random sample of 445 nurses from the province of Quebec, Canada, was selected for participation in the study. ETHICAL CONSIDERATIONS: The study was reviewed and approved by the Ethics Committee of the Centre hospitalier universitaire de Québec. FINDINGS: The response rate was 44.2% and the mean score for intention was 4.61 ± 1.90 (range: 1-7). The determinants of intention were the subjective (odds ratio = 3.08; 95% confidence interval: 1.50-6.35) and moral (odds ratio = 2.95; 95% confidence interval: 1.58-5.49) norms. Specific beliefs which could discriminate nurses according to their level of intention were identified. DISCUSSION: Overall, nurses have a slightly positive intention to practise euthanasia. Their family approval seems particularly important and also the approval of their medical colleagues. Nurses' moral norm was related to beneficence, an ethical principle. CONCLUSION: To our knowledge, this is the first study to identify nurses' motivations to practise euthanasia in palliative care using a validated psychosocial theory. It also has the distinction of identifying the ethical principles underlying nurses' moral norm and intention.

The use of the Godin-Shephard Leisure-Time Physical Activity Questionnaire in oncology research: a systematic review.

BACKGROUND: The Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) is one of the most often used questionnaires in oncology research, yet modifications to the scale are done with little evidence of psychometric testing. This study aimed to (i) document the frequency of use of the questionnaire for ranking (i.e., level of activity) and classification (i.e., active versus insufficiently active) purposes, (ii) summarize how the GSLTPAQ is used in terms of item content and scoring, and (iii) evaluate the extent to which validity evidence supports the use of the scale among cancer survivors. METHODS: A systematic review was conducted with evidence drawn from English-written articles published between January 1(st) 1985 (year the GSLTPAQ was published) and December 31, 2014. A search of six databases, a scan of reference list of included articles, and a cited reference search identified articles that reported using the GSLTPAQ among cancer survivors. RESULTS: A total of 212 articles were retrieved. The GSLTPAQ was used for classifying cancer survivors into active and insufficiently active categories in 51 % of the articles. Moreover, a modified version of the questionnaire was used in 81 % of the research studies. Three studies reported validity evidence based on the relationship between the scores on the GSLTPAQ (i.e., leisure score index, LSI) and accelerometer or pedometer-derived activity data. Validity evidence supporting the use of the GSLTPAQ for assessing changes in LSI was computed from six randomized trials. CONCLUSIONS: The use of the GSLTPAQ for classification purpose in oncology research is common. Standardization in the use and interpretation of the GSLTPAQ in oncology research is warranted. Although limited, there is support for using the original form of the GSLTPAQ and interpreting the LSI for ranking cancer survivors from the lowest to highest levels of leisure-time physical activity.

Psychosocial determinants of physicians' intention to practice euthanasia in palliative care.

BACKGROUND: Euthanasia remains controversial in Canada and an issue of debate among physicians. Most studies have explored the opinion of health professionals regarding its legalization, but have not investigated their intentions when faced with performing euthanasia. These studies are also considered atheoretical. The purposes of the present study were to fill this gap in the literature by identifying the psychosocial determinants of physicians' intention to practice euthanasia in palliative care and verifying whether respecting the patient's autonomy is important for physicians. METHODS: A validated anonymous questionnaire based on an extended version of the Theory of Planned Behavior was mailed to a random sample of 445 physicians from the province of Quebec, Canada. RESULTS: The response rate was 38.3% and the mean score for intention was 3.94 ± 2.17 (range: 1 to 7). The determinants of intention among physicians were: knowing patients' wishes (OR = 10.77; 95%CI: 1.33-86.88), perceived behavioral control-physicians' evaluation of their ability to adopt a given behavior-(OR = 4.35; 95%CI: 1.44-13.15), moral norm-the appropriateness of adopting a given behavior according to one's personal and moral values-(OR = 3.22; 95%CI: 1.29-8.00) and cognitive attitude-factual consequences of the adoption of a given behavior-(OR = 3.16; 95%CI: 1.20-8.35). This model correctly classified 98.8% of physicians. Specific beliefs that might discriminate physicians according to their level of intention were also identified. For instance, physicians' moral norm was related to the ethical principle of beneficence. CONCLUSIONS: Overall, physicians have weak intentions to practice euthanasia in palliative care. Nevertheless, respecting patients' final wishes concerning euthanasia seems to be of particular importance to them and greatly affects their motivation to perform euthanasia.

Virtual intervention to support self-management of antiretroviral therapy among people living with HIV.

BACKGROUND: Living with human immunodeficiency virus (HIV) necessitates long-term health care follow-up, particularly with respect to antiretroviral therapy (ART) management. Taking advantage of the enormous possibilities afforded by information and communication technologies (ICT), we developed a virtual nursing intervention (VIH-TAVIE) intended to empower HIV patients to manage their ART and their symptoms optimally. ICT interventions hold great promise across the entire continuum of HIV patient care but further research is needed to properly evaluate their effectiveness. OBJECTIVE: The objective of the study was to compare the effectiveness of two types of follow-up--traditional and virtual--in terms of promoting ART adherence among HIV patients. METHODS: A quasi-experimental study was conducted. Participants were 179 HIV patients on ART for at least 6 months, of which 99 were recruited at a site offering virtual follow-up and 80 at another site offering only traditional follow-up. The primary outcome was medication adherence and the secondary outcomes were the following cognitive and affective variables: self-efficacy, attitude toward medication intake, symptom-related discomfort, stress, and social support. These were evaluated by self-administered questionnaire at baseline (T0), and 3 (T3) and 6 months (T6) later. RESULTS: On average, participants had been living with HIV for 14 years and had been on ART for 11 years. The groups were highly heterogeneous, differing on a number of sociodemographic dimensions: education, income, marital status, employment status, and living arrangements. Adherence at baseline was high, reaching 80% (59/74) in the traditional follow-up group and 84% (81/97) in the virtual follow-up group. A generalized estimating equations (GEE) analysis was run, controlling for sociodemographic characteristics at baseline. A time effect was detected indicating that both groups improved in adherence over time but did not differ in this regard. Improvement at 6 months was significantly greater than at 3 months in both groups. Analysis of variance revealed no significant group-by-time interaction effect on any of the secondary outcomes. A time effect was observed for the two kinds of follow-ups; both groups improved on symptom-related discomfort and social support. CONCLUSIONS: Results showed that both interventions improved adherence to ART. Thus, the two kinds of follow-up can be used to promote treatment adherence among HIV patients on ART.

The Godin-Shephard leisure-time physical activity questionnaire: validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories.

This study provided validity evidence for the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) to classify respondents into active and insufficiently active categories. Members of a fitness center [45 women and 55 men; mean (SD) age=45.5 (10.6) yr.] completed the questionnaire. Using only moderate and strenuous scores, those with a leisure score index≥24 were classified as active; those with a score≤23 were classified as insufficiently active. VO2max, percentage of body fat, and electronic records of fitness center attendance were the validation variables. In a visit to the fitness center, participants completed the GSLTPAQ and a certified exercise specialist performed a physical fitness evaluation. A multivariate analysis of covariance (MANCOVA) indicated the group of respondents classified as active had higher VO2max and lower percentage of body fat than the group of respondents classified as insufficiently active. An analysis of covariance (ANCOVA) indicated the group of respondents classified as active had higher electronic records of fitness center attendance than the group of respondents classified as insufficiently active. Therefore, these pieces of validity evidence support the use of the questionnaire's classification system among healthy adults.

Electronic health record acceptance by physicians: testing an integrated theoretical model.

OBJECTIVE: Several countries are in the process of implementing an Electronic Health Record (EHR), but limited physicians' acceptance of this technology presents a serious threat to its successful implementation. The aim of this study was to identify the main determinants of physician acceptance of EHR in a sample of general practitioners and specialists of the Province of Quebec (Canada). METHODS: We sent an electronic questionnaire to physician members of the Quebec Medical Association. We tested four theoretical models (Technology acceptance model (TAM), Extended TAM, Psychosocial Model, and Integrated Model) using path analysis and multiple linear regression analysis in order to identify the main determinants of physicians' intention to use the EHR. We evaluated the modifying effect of sociodemographic characteristics using multi-group analysis of structural weights invariance. RESULTS: A total of 157 questionnaires were returned. The four models performed well and explained between 44% and 55% of the variance in physicians' intention to use the EHR. The Integrated model performed the best and showed that perceived ease of use, professional norm, social norm, and demonstrability of the results are the strongest predictors of physicians' intention to use the EHR. Age, gender, previous experience and specialty modified the association between those determinants and intention. CONCLUSIONS: The proposed integrated theoretical model is useful in identifying which factors could motivate physicians from different backgrounds to use the EHR. Physicians who perceive the EHR to be easy to use, coherent with their professional norms, supported by their peers and patients, and able to demonstrate tangible results are more likely to accept this technology. Age, gender, specialty and experience should also be taken into account when developing EHR implementation strategies targeting physicians.

Participation in regular leisure-time physical activity among individuals with type 2 diabetes not meeting Canadian guidelines: the influence of intention, perceived behavioral control, and moral norm.

BACKGROUND: Most people with type 2 diabetes do not engage in regular leisure-time physical activity. The theory of planned behavior and moral norm construct can enhance our understanding of physical activity intention and behavior among this population. PURPOSE: This study aims to identify the determinants of both intention and behavior to participate in regular leisure-time physical activity among individuals with type 2 diabetes who not meet Canada's physical activity guidelines. METHOD: By using secondary data analysis of a randomized computer-tailored print-based intervention, participants (n = 200) from the province of Quebec (Canada) completed and returned a baseline questionnaire measuring their attitude, perceived behavioral control, and moral norm. One month later, they self-reported their level of leisure-time physical activity. RESULTS: A hierarchical regression equation showed that attitude (beta = 0.10, P < 0.05), perceived behavioral control (beta = 0.37, P < 0.001), and moral norm (beta = 0.45, P < 0.001) were significant determinants of intention, with the final model explaining 63% of the variance. In terms of behavioral prediction, intention (beta = 0.34, P < 0.001) and perceived behavioral control (beta = 0.16, P < 0.05) added 17% to the variance, after controlling the effects of the experimental condition (R (2) = 0.04, P < 0.05) and past participation in leisure-time physical activity (R (2) = 0.22, P < 0.001). The final model explained 43% of the behavioral variance. Finally, the bootstrapping procedure indicated that the influence of moral norm on behavior was mediated by intention and perceived behavioral control. CONCLUSION: The determinants investigated offered an excellent starting point for designing appropriate counseling messages to promote leisure-time physical activity among individuals with type 2 diabetes.

Predicting first lifetime plasma donation among whole blood donors.

BACKGROUND: The aim of the study was to predict a first lifetime plasma donation among whole blood donors. STUDY DESIGN AND METHODS: A sample of 252 whole blood donors, who never donated plasma, completed the study questionnaire assessing intention, attitudes, subjective norm, and perceived behavioral control toward giving plasma. The dependent variables were intention to give plasma and first lifetime plasma donation within 6 months. RESULTS: At 6 months, 57 individuals had made 98 plasma donations. First lifetime plasma donation was predicted by intention (p < 0.05) and age (50+ years, p < 0.05). Intention was determined by attitudes (p < 0.001) and perceived behavioral control (p < 0.001). CONCLUSION: Promotional strategies to recruit new plasma donors should target individuals aged 50 years and more. Such strategies should be coupled with actions to lower the perceived barriers and highlight the perceived advantages of becoming a plasma donor.

Implementation intentions intervention among temporarily deferred novice blood donors.

BACKGROUND: Approximately 12% to 15% of blood donors are temporarily deferred from giving blood because they fail relevant medical criteria. Temporary deferral has a profound negative impact on subsequent donation. To our knowledge, an implementation intentions intervention has never been tested among temporarily deferred donors. We hypothesized that return rates would be higher among participants exposed to an implementation intentions intervention compared to those in a control condition that is mere measurement of related cognitions. STUDY DESIGN AND METHODS: Participants were assigned to implementation intentions or mere measurement conditions; whether or not participants received a temporary interdiction on giving blood was measured. A total of 956 novice donors were temporarily deferred (n = 490, in the implementation intentions condition; n = 466, in the mere measurement condition). Participants in the implementation intentions condition formed if-then plans to overcome three common barriers to blood donation: forgetting to attend, fitting the opportunity to give blood into one's schedule, and organizing transportation to the donation venue. Participants in the mere measurement condition did not form plans. RESULTS: Participants in the implementation intentions condition had a 19% greater chance of returning to give blood again within the 4 years after their first lifetime donation compared to participants in the mere measurement condition (p = 0.04) when controlling for sex and attempt at which participants were deferred. CONCLUSION: The results of this study indicate that implementation intentions could be a useful strategy for promoting donor return among temporarily deferred novice blood donors.

Omega-3 fatty acids status in human subjects estimated using a food frequency questionnaire and plasma phospholipids levels.

BACKGROUND: Intakes of omega-3 (n-3) fatty acids (FA) are associated with several health benefits. The aim of this study was to verify whether intakes of n-3 FA estimated from a food frequency questionnaire (FFQ) correlate with n-3 FA levels measured in plasma phospholipids (PL). METHODS: The study sample consisted of 200 French-Canadians men and women aged between 18 to 55 years. Dietary data were collected using a validated FFQ. Fasting blood samples were collected and the plasma PL FA profile was measured by gas chromatography. RESULTS: Low intakes of n-3 long-chain FA together with low percentages of n-3 long-chain FA in plasma PL were found in French-Canadian population. Daily intakes of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) were similar between men and women. Yet, alpha-linolenic acid (ALA) and total n-3 FA intakes were significantly higher in men compared to women (ALA: 2.28 g and 1.69 g, p < 0.0001, total n-3 FA: 2.57 g and 1.99 g, p < 0.0001; respectively). In plasma PL, DPA and DHA percentages were significantly different between men and women (DPA: 1.03% and 0.88%, p < 0.0001, DHA: 3.00% and 3.43%, p = 0.0005; respectively). Moreover, DHA (men: r = 0.52, p < 0.0001; women: r = 0.57, p < 0.0001) and total n-3 FA (men: r = 0.47, p < 0.0001; women: r = 0.52, p < 0.0001) intakes were positively correlated to their respective plasma PL FA levels. In women, EPA (r = 0.44, p < 0.0001) and DPA (r = 0.23, p = 0.02) intakes were also correlated respectively with EPA and DPA plasma PL FA percentages. CONCLUSION: Estimated n-3 long-chain FA intake among this young and well-educated French-Canadian population is lower than the recommendations. Further, FFQ data is comparable to plasma PL results to estimate DHA and total n-3 FA status in healthy individuals as well as to evaluate the EPA and DPA status in women. Overall, this FFQ could be used as a simple, low-cost tool in future studies to rank n-3 FA status of individuals.

Staying in school for lunch instead of eating in fast-food restaurants: results of a quasi-experimental study among high-school students.

OBJECTIVE: Following the adoption of food policies replacing unhealthy products by healthy foods in school, the present study tested the effectiveness of an intervention aimed at encouraging high-school students to stay in school for lunch instead of eating in fast-food restaurants. DESIGN: A 12-week multi-strategy intervention targeting specific determinants of behaviour was evaluated via a quasi-experimental pre- and post-intervention design. A self-administered questionnaire was employed based on the theory of planned behaviour. SETTING: An experimental (n 129) and a control school (n 112) in central Canada. SUBJECTS: High-school students aged 12 to 17 years. RESULTS: Compared with control school students, those in the experimental school significantly increased the mean number of days that they stayed in school for lunch (relative risk = 1.55; 95 % CI 1.06, 2.27; P = 0.024), as well as the proportion who remained in school for lunch every day (relative risk = 1.21; 95 % CI 1.04, 1.40; P = 0.014). Among the psychosocial variables targeted, only self-efficacy appeared to be influenced by the intervention, mainly because of a decline in control group values. Mediation analysis indicated a significant mediating effect of self-efficacy on the mean number of days that students stayed in school for lunch (bias-corrected and accelerated point estimate = 0.079; 95 % CI 0.0059, 0.1958). CONCLUSIONS: These results suggest that interventions aimed at enhancing self-efficacy can successfully contribute to students staying in school during lunch time. Such interventions should be considered in obesity prevention programmes adapted to high-school students.

Redefining the school nurse role: an organizational perspective.

PURPOSE: This paper aims to identify organizational readiness for change towards adoption of a redefined role of the school nurse as a strategic option in the context of a health promoting school approach. This new role is consistent with planned change directed at life habits and life conditions. DESIGN/METHODOLOGY/APPROACH: A questionnaire based on a modified version of the organizational readiness for change (ORC) framework was e-mailed to 122 top and middle managers (response rate of 74 percent) in 42 local health organizations in the Province of Quebec, Canada, during the fall of 2009. FINDINGS: In total, 90 percent of participants perceived the proposed role as a solution to fulfil their school health program needs, especially to plan and integrate health promotion projects. The lack of resources and nursing support emerged as factors hampering the capacity of school nurses to play such a role. RESEARCH LIMITATIONS/IMPLICATIONS: Additional implications of the ORC framework are needed in order to better address organizational readiness for complex changes in specific health-related settings. PRACTICAL IMPLICATIONS: Access to information technology and the development of computer skills would help enhance this encompassing role in health promotion. ORIGINALITY/VALUE: Findings have the potential to better inform health authorities regarding the new role of the school nurse as a strategic option in health promotion. This study also provides an application of the theoretical framework showing the need for additional empirical tests.

The effects of a phone call prompt on subsequent blood donation among first-time donors.

BACKGROUND: A strategy used by blood centers to retain donors is to place phone call reminders. However, among first-time donors, no studies have tested the effect of this strategy. This was the aim of this study among individuals who had recently given their first lifetime blood donation. STUDY DESIGN AND METHODS: A quasi-experimental study using a nonequivalent control group was adopted; participants in the control group were donors with blood types B+ and AB+, since these individuals are not phoned by the blood agency. A total of 1604 first-time donors aged 18 to 70 years from the province of Quebec, Canada, were assigned to the experimental (n = 870) or the control (n = 734) group. Participants in the experimental group were phoned a few days before they had a new opportunity to give blood while those in the control condition were not phoned. RESULTS: In the experimental condition, 48.3% of the donors attempted to give blood during the 12-month follow-up period compared to 38.0% in the control condition. The hazards of the first blood donation attempt among donors who were phoned were 32% higher compared to the hazards of those who were not phoned (p = 0.0004). CONCLUSION: The results of this study indicate that a first phone call reminder about the upcoming opportunity to give blood again has a significant positive effect on return rates among first-time donors.

The effect of mere-measurement of cognitions on physical activity behavior: a randomized controlled trial among overweight and obese individuals.

BACKGROUND: The promotion of physical activity among an overweight/obese population is an important challenge for clinical practitioners and researchers. In this regard, completing a questionnaire on cognitions could be a simple and easy strategy to increase levels of physical activity. Thus, the aim of the present study was to test the effect of completing a questionnaire based on the Theory of Planned Behavior (TPB) on the level of physical activity. METHODS: Overall, 452 overweight/obese adults were recruited and randomized to the experimental or control group. At baseline, participants completed a questionnaire on cognitions regarding their participation in leisure-time physical activity (experimental condition) versus a questionnaire on fruit and vegetable consumption (control condition). The questionnaires assessed the TPB variables that are beliefs, attitude, norm, perception of control, intention and a few additional variables from other theories. At three-month follow-up, leisure-time physical activity was self-reported by means of a short questionnaire. An analysis of covariance with baseline physical activity level as covariate was used to verify the effect of the intervention. RESULTS: At follow-up, 373 participants completed the leisure-time physical activity questionnaire. The statistical analysis showed that physical activity participation was greater among participants in the experimental condition than those in the control condition (F(1,370)=6.85, p=.009, d=0.20). CONCLUSIONS: Findings indicate that completing a TPB questionnaire has a significant positive impact on subsequent participation in physical activity. Consequently, asking individuals to complete such a questionnaire is a simple, inexpensive and easy strategy to increase the level of physical activity among overweight/obese adults.