Can the Multi-Theory Model (MTM) of Health Behavior Change Explain the Intent for People to Practice Meditation?

Meditation is gaining popularity as adjuvant therapy for many chronic ailments, mental well-being, and spiritual growth. Behavioral theories have been underutilized in understanding meditation behavior. This study aimed to test if a fourth-generation multi-theory model (MTM) could explain the intent for starting and maintaining meditation behavior in a sample of US adults. A face and content valid 48-item instrument based on MTM was administered in a cross-sectional design through an online survey (n = 330). Internal consistency (Cronbach's alpha > 0.70) and construct validation using structural equation modeling of the subscales were all acceptable. Hierarchical multiple regression revealed that, after controlling for demographic covariates, the MTM constructs of participatory dialogue (ß = 0.153; P = .002) and behavioral confidence (ß = 0.479; P < .001) were statistically significant in predicting intent for starting meditation behavior and accounted for 32.9% of the variance. Furthermore, after controlling for demographic covariates, the MTM constructs of emotional transformation (ß = 0.390; P < .001) and changes in the social environment (ß = 0.395; P < .001) were statistically significant and accounted for 52.9% of the variance in the intent for maintaining meditation behavior. Based on this study, it can be concluded that MTM offers a pragmatic framework to design, implement, and evaluate evidence-based (theory-based) meditation behavior change interventions.

Testing Multi-Theory Model (MTM) in Explaining Sunscreen Use among Florida Residents: An Integrative Approach for Sun Protection.

Florida residents have the second highest incidence of skin cancer in the nation. Sunscreen usage was found to be the one of the most effective integrative health approaches for reducing risk of skin cancer. Given the limited information on the likelihood of adopting and continuing sunscreen usage behavior, this cross-sectional study aimed to examine the correlates of initiating and sustaining sunscreen usage behavior among Florida dwellers, using the fourth-generation, multi-theory model (MTM) of behavior change. A web-based survey containing 51 questions was emailed to Florida residents aged 18 years or above, who were randomly selected from the state voter file. Psychometric validity of the survey instrument was established using structural equation modeling, and Cronbach's alpha values were calculated for assessing the internal consistency. An independent-samples-t-test and hierarchical multiple regression tests were used to analyze the data. The results indicated that participants who engaged in sunscreen usage behavior, participatory dialogue (ß = 0.062, p < 0.05), behavioral confidence (ß = 0.636, p < 0.001), and changes in the physical environment (ß = 0.210, p < 0.001) were statistically significant and accounted for 73.6% of the variance in initiating sunscreen usage behavior. In addition, the constructs of emotional transformation (ß = 0.486, p < 0.001) and practice for change (ß = 0.211, p < 0.001), as well as changes in the social environment (ß = 0.148, p < 0.001) were significant predictors of maintaining sunscreen usage behavior and contributed to 59% of variance in sustenance. These findings offer a valuable insight regarding the applicability of MTM models to guiding public health interventions promoting sunscreen usage and preventing UV radiation risk and related skin cancer.

Exercise for Toxicity Management in Cancer-A Narrative Review.

Although the treatment of cancer is more effective now than ever, patients with cancer still face acute and chronic toxicities such as fatigue, cardiotoxicity, pain, cognitive impairment, and neurotoxicity. In this narrative review, we briefly discuss the use of exercise for toxicity management in patients with cancer, biological mechanisms underlying the toxicities and the effects of exercise, barriers that patients- especially underserved patients-face in adopting and adhering to exercise programs, and new technologies to overcome barriers to exercise. Our conclusions and clinical suggestions are: (1) exercise is safe and effective for treating many toxicities; (2) patients can benefit from a variety of exercise modalities (e.g., walking, cycling, resistance bands, yoga); (3) exercise should be started as soon as possible, even before treatments begin; (4) exercise should be continued as long as possible, as a lifestyle; and (5) barriers to exercise should be identified and addressed, (e.g., continually encouraging patients to exercise, using mobile technology, advocating for safe communities that encourage active lifestyles). Future research should inform definitive clinical guidelines for the use of exercise to ameliorate toxicities from cancer and its treatment.

Yoga for the Management of Cancer Treatment-Related Toxicities.

PURPOSE OF REVIEW: To (1) explain what yoga is, (2) summarize published literature on the efficacy of yoga for managing cancer treatment-related toxicities, (3) provide clinical recommendations on the use of yoga for oncology professionals, and (4) suggest promising areas for future research. RECENT FINDINGS: Based on a total of 24 phase II and one phase III clinical trials, low-intensity forms of yoga, specifically gentle hatha and restorative, are feasible, safe, and effective for treating sleep disruption, cancer-related fatigue, cognitive impairment, psychosocial distress, and musculoskeletal symptoms in cancer patients receiving chemotherapy and radiation and cancer survivors. Clinicians should consider prescribing yoga for their patients suffering with these toxicities by referring them to qualified yoga professionals. More definitive phase III clinical trials are needed to confirm these findings and to investigate other types, doses, and delivery modes of yoga for treating cancer-related toxicities in patients and survivors.

The effects of high-dose calcitriol and individualized exercise on bone metabolism in breast cancer survivors on hormonal therapy: a phase II feasibility trial.

INTRODUCTION: Cancer treatment-induced bone loss (CTIBL) is a long-term side effect of breast cancer therapy. Both calcitriol and weight-bearing exercise improve bone metabolism for osteoporotic patients, but are unproven in a breast cancer population. We used a novel high-dose calcitriol regimen with an individualized exercise intervention to improve bone metabolism in breast cancer survivors. METHODS: We accrued 41 subjects to this open label, 2 × 2 factorial, randomized feasibility trial. Breast cancer survivors were randomized to receive the following: (1) calcitriol (45 micrograms/week), (2) individualized exercise with progressive walking and resistance training, (3) both, or (4) a daily multivitamin (control condition) for 12 weeks. Primary outcomes included changes in biomarkers of bone formation, bone resorption, and the bone remodeling index, a composite measure of bone formation and resorption. Safety measures included clinical and biochemical adverse events. A main effect analysis was used for these endpoints. RESULTS: Hypercalcemia was limited to three grade I cases with no grade ≥ 2 cases. Among exercisers, 100% engaged in the prescribed aerobic training and 44.4% engaged in the prescribed resistance training. Calcitriol significantly improved bone formation (Cohen's d = 0.64; p < 0.01), resulting in a non-significant increase in the bone remodeling index (Cohen's d = 0.21; p = 31). Exercise failed to improve any of the bone biomarkers. CONCLUSIONS: Both calcitriol and exercise were shown to be feasible and well tolerated. Calcitriol significantly improved bone formation, resulting in a net increase of bone metabolism. Compliance with the exercise intervention was sub-optimal, which may have led to a lack of effect of exercise on bone metabolism.