Predisposing, enabling and reinforcing factors associated with opioid addiction helping behaviour in tri-state Appalachian counties: application of the PRECEDE-PROCEED model-cross-sectional analysis.

OBJECTIVES: The overdose epidemic was designated a 'Public Health Emergency' in the USA on 26 October 2017, bringing attention to the severity of this public health problem. The Appalachian region remains substantially impacted by the effects from years of overprescription of opioids, and subsequently opioid non-medical use and addiction. This study aims to examine the utility of the PRECEDE-PROCEED model constructs (ie, predisposing, reinforcing and enabling factors) to explain opioid addiction helping behaviour (ie, helping someone who has an opioid addiction) among members of the public living in tri-state Appalachian counties. DESIGN: Cross-sectional study. SETTING: Rural county in the Appalachian region of the USA. PARTICIPANTS: A total of 213 participants from a retail mall in a rural Appalachian Kentucky county completed the survey. Most participants were between the ages of 18 and 30 years (n=68; 31.9%) and identified as men (n=139; 65.3%). PRIMARY OUTCOME MEASURE: Opioid addiction helping behaviour. RESULTS: The regression model was significant (F (6, 180)=26.191, p<0.001) and explained 44.8% of the variance in opioid addiction helping behaviour (R2=0.448). Attitude towards helping someone with opioid addiction (B=0.335; p<0.001), behavioural skills (B=0.208; p=0.003), reinforcing factors (B=0.190; p=0.015) and enabling factors (B=0.195; p=0.009) were all significantly associated with opioid addiction helping behaviour. CONCLUSIONS: PRECEDE-PROCEED model constructs have utility to explain opioid addiction helping behaviour among individuals in a region greatly impacted by the overdose epidemic. This study provides an empirically tested framework for future programmes addressing helping behaviour related to opioid non-medical use.

Orthobiologic Interventions for Muscle Injuries.

Muscle injuries represent a common problem in active populations. Orthobiologics continue to be studied for their ability to improve muscle healing. To date, the basic science research for treating muscle injuries with platelet-rich plasma or stem cell remains novel. Furthermore, there are even fewer clinical studies on these topics, and their findings are inconclusive. Reviewing the literature, muscle injuries treated with ultrasound-guided leukocyte-rich PRP injections appear to have the strongest evidence. Scar formation remains a major barrier in muscle injury healing, and there is optimism for future orthobiologic treatments that target the downregulation of TGF-B, resulting in decreased scar development.

Using the Multitheory Model to Predict Initiation and Sustenance of Physical Activity Behavior Among Osteopathic Medical Students.

CONTEXT: The multitheory model (MTM) is a newly developed fourth-generation theoretical framework that addresses both initiation and sustenance of health behavior change. Studies have shown that the MTM is efficacious in predicting a range of health behaviors. OBJECTIVE: To assess the utility of the MTM in predicting initiation and sustenance of physical activity behavior among osteopathic medical students. METHODS: In this cross-sectional study, a volunteer convenience sample was recruited from an osteopathic medical school student population at a university in the southeastern region of the United States. An online survey was used to collect self-reported data on sociodemographic information and MTM constructs. Multiple linear regression using the enter method for modeling was performed to determine the predictive ability of the MTM constructs. RESULTS: Of the 135 participants, 52.6% were women and 67.7% were white. The initiation model explained 25.8% of the variance (adjusted R2=0.238). Behavioral confidence was a statistically significant predictor of initiation of physical activity behavior change. The sustenance model explained 41.7% of the variance (adjusted R2=0.402). Changes in social environment and emotional transformation were statistically significant predictors of sustenance of physical activity behavior change. CONCLUSION: The MTM appears to be a robust theoretical framework for designing behavior change interventions to increase physical activity among osteopathic medical students.

Utilizing Multi-Theory Model in Determining Intentions to Smoking Cessation Among Smokers.

BACKGROUND: Smoking is a risk factor for lung cancers, and a myriad of other acute and chronic ailments. The purpose of this study was to predict initiation and sustenance of smoking cessation among smokers using a fourth-generation behavioral framework, multi-theory model (MTM) of health behavior change. METHODS: A convenience sample of smokers from a shopping mall in rural, Appalachian Kentucky county was invited to participate in this cross-sectional study. A 38-item, face and content validated, MTM-based survey instrument was administered to the participants. RESULTS: A total of 148 participants completed the study. The mean age of the participants was 35.53 (SD = 14.52) years. Most were male (58.1%) and Caucasian (95.9%). Participants reported smoking for an average of 16.45 (SD = 13.12) years. Participatory dialogue (ß = 0.235, P = .003) and behavioral confidence (ß = 0.305, P = .005) were significant predictors of intention for initiation for smoking cessation behavior. Emotional transformation (ß = 0.319, P = .001) was a significant predictor of intention for sustenance for smoking cessation behavior. DISCUSSION: Two of the MTM constructs for initiation and one of the MTM constructs for sustenance of change accounted for a moderate amount of variance in initiation and sustenance of smoking cessation behavior among community members in a rural, Kentucky county. MTM has utility for predicting both initiation and sustenance of smoking cessation behavior. Future interventions using MTM constructs should be developed for smoking cessation behavior change.

Using a Multitheory Model to Predict Initiation and Sustenance of Fruit and Vegetable Consumption Among College Students.

CONTEXT: Consuming a diet rich in fruits and vegetables offers numerous health benefits. However, many college students do not consume the recommended amount of fruits and vegetables daily. OBJECTIVE: To predict change in fruit and vegetable consumption behavior among college students who were not eating the recommended amount of fruits and vegetables using the multitheory model (MTM) of behavior change. METHODS: In this cross-sectional study, a 38-item face-, content-, and construct-valid survey was sent to college students at a large university in the southeastern United States. Students were included in the analysis if they were aged at least 18 years and ate less than 5 cups of fruits and vegetables per day. The survey was broken into sections based on the MTM constructs of initiation of behavior change (participatory dialogue, behavioral confidence, and changes in physical environment) and sustenance of behavior change (emotional transformation, practice for change, and changes in social environment). Stepwise multiple regression was conducted to predict behavior change regarding fruit and vegetable consumption. RESULTS: Of the 5000 potential respondents, 175 completed the survey and were included in the analysis. Behavioral confidence and changes in physical environment were statistically significant predictors of the intention to initiate fruit and vegetable consumption (F2,173=59.700; P<.001) and accounted for 40.2% of the variance. Emotional transformation, practice for change, and changes in social environment were statistically significant predictors for the intention to sustain fruit and vegetable consumption (F3,171=26.374; P<.001) and accounted for 30.4% of the variance. CONCLUSION: Survey results showed that the MTM is a useful framework for designing behavior change interventions to promote fruit and vegetable consumption among college students.

Skin Cancer Knowledge, Attitudes, and Practices among Chinese Population: A Narrative Review.

Skin cancers are becoming a substantial public health problem in China. Fair skin and increased exposure to ultraviolet B (UVB) rays from the sun are among the most substantial risk factors for skin cancer development, thus making the Chinese people vulnerable to this group of diseases. The purpose of this article is to present a narrative review of the knowledge, attitudes, and practices (KAP) related to skin cancers within the Chinese population. A systematic electronic search of MEDLINE (PubMed), CINAHL, ScienceDirect, and Google Scholar databases yielded nine articles that met the inclusion criteria. The review found that although sunscreen application was a commonly used method of skin protection among the general Chinese population, educational interventions enhancing current knowledge and attitudes about the effects of UVB rays on skin from undue sun exposure were limited in many smaller communities of the country. Hence, there is an essential need to design effective, evidence-based educational programs promoting sun protection behaviors in both congregated and sparsely populated areas of China.