A Fertile Ground for Ambiguities: Casual Sexual Relationships Among Portuguese Emerging Adults.

Casual sexual relationships (CSRs) are frequent relationship experiences in young adulthood that provide opportunities for many to explore sexual relationships and to construct their sexual identity. Empirical research on casual sex is still lacking outside North-American countries, despite evidence pointing to the need to contextualize sexual interactions in their own sociocultural context. In order to better understand casual sexual relationships, these should be examined in with novel samples in other countries where a "hookup culture" as it is described in the North-American university campus is apparently absent. Through a qualitative study, we explored what casual sexual relationships consist of according to the perceptions of Portuguese college students (N = 35). The thematic analysis of eight focus group interviews resulted in the generation of six themes, three of which are presented here: (1) What CSRs are, regarding features and types of CSRs, (2) Why individuals engage in CSRs, focusing on positive and negative motivations, and (3) What one gets from CSRs, focusing on positive and negative outcomes of CSRs. Our findings showed that Portuguese emerging adults are familiarized with CSRs, particularly with one-night stand, friends with benefits and "curte"/hookup. Sexual interactions associated with other CSRs, such as booty call or fuck buddies, were mentioned but rarely associated with a distinctive label and established characteristics. Participants described the CSRs in a partially overlapping manner presenting some areas of ambiguity, such as with regard to sexual exclusivity and still-unlabeled sexual interactions. CSRs are generally evaluated as positively motivated and mainly beneficial. This study adds to the literature around casual sexual relationships by exploring and describing CSRs in a different sociocultural context, as well as indicating directions for future research in order to better prepare and empower young adults in their sexual and relational trajectories.

Physical activity promotion in community pharmacies: pharmacists' attitudes and behaviours.

BACKGROUND: Health systems and their professionals play a key role in the promotion and maintenance of behaviours contributing to increased physical activity levels. Pharmacists are well placed within communities, making them an accessible source to provide brief advice to people on how to be more physically active. OBJECTIVE: This study aimed to characterize physical activity promotion actions taking place in the Portuguese community pharmacies, as well as the major facilitators and barriers faced by pharmacists in their daily practice. METHODS: A cross-sectional study based on an online questionnaire targeting community pharmacists was developed based on COM-B model and the Theoretical Domains Framework (TDF) and distributed by email to 94% of the Portuguese pharmacies. RESULTS: In total, 396 complete responses from community pharmacists were obtained. Three out of four participants reported to promote physical activity in their daily routine, of which 87.7% reported doing it in only a few attendances. The majority (92.3%) mentioned to provide information orally, with walking being the activity most promoted (99.4%). More active and younger pharmacists were more likely to promote physical activity. Nearly all pharmacists (98.7%) believed it was important or very important to practice regular physical activity for the health, but only 41.4% of the respondents were able to correctly identify the WHO general recommendations for physical activity. The lack of coordination with other healthcare professionals (M=3.35; SD=1.11), lack of interest by customers (M=3.25; SD=1.09) and lack of time (M=3.06; SD=1.10) were the main barriers to physical activity promotion, all scoring above the scale mid-point (i.e., 3). CONCLUSIONS: Physical activity promotion in the Portuguese community pharmacies is still not present as daily activity. Younger pharmacists seem to be a generation that better understand this need and could easily integrate this practice in their daily routine. Possibilities for including pharmacies and pharmacists as promoters of physical activity in the primary health care sector in the future are discussed in the light of these findings.

IC-Behavior: An interdisciplinary taxonomy of behaviors.

Academic disciplines are often organized according to the behaviors they examine. While most research on a behavior tends to exist within one discipline, some behaviors are examined by multiple disciplines. Better understanding of behaviors and their relationships should enable knowledge transfer across disciplines and theories, thereby dramatically improving the behavioral knowledge base. We propose a taxonomy built on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF), but design the taxonomy as a stand-alone extension rather than an improvement to ICF. Behaviors considered important enough to serve as the dependent variable in articles accepted for publication in top journals were extracted from nine different behavioral and social disciplines. A six-step development and validation process was employed, leading to the final taxonomy. A hierarchy of behaviors under the top banner of Engaging in activities/participating, reflective of ICF's D. hierarchy was constructed with eight immediate domains addressing behaviors ranging from learning, exercising, self-care, and substance use. The resulting International Classification of Behaviors (IC-Behavior), provides a behavior taxonomy targeted towards the interdisciplinary integration of nomological networks relevant to behavioral theories. While IC-Behavior has been labeled v.1.0 to communicate that it is by no means an endpoint, it has empirically shown to provide flexibility for the addition of new behaviors and is tested in the health domain.

Physical activity promotion in community pharmacies: pharmacists’ attitudes and behaviours

Background: Health systems and their professionals play a key role in the promotion and maintenance of behaviours contributing to increased physical activity levels. Pharmacists are well placed within communities, making them an accessible source to provide brief advice to people on how to be more physically active. Objective: This study aimed to characterize physical activity promotion actions taking place in the Portuguese community pharmacies, as well as the major facilitators and barriers faced by pharmacists in their daily practice. Methods: A cross-sectional study based on an online questionnaire targeting community pharmacists was developed based on COM-B model and the Theoretical Domains Framework (TDF) and distributed by email to 94% of the Portuguese pharmacies. Results: In total, 396 complete responses from community pharmacists were obtained. Three out of four participants reported to promote physical activity in their daily routine, of which 87.7% reported doing it in only a few attendances. The majority (92.3%) mentioned to provide information orally, with walking being the activity most promoted (99.4%). More active and younger pharmacists were more likely to promote physical activity. Nearly all pharmacists (98.7%) believed it was important or very important to practice regular physical activity for the health, but only 41.4% of the respondents were able to correctly identify the WHO general recommendations for physical activity. The lack of coordination with other healthcare professionals (M=3.35; SD=1.11), lack of interest by customers (M=3.25; SD=1.09) and lack of time (M=3.06; SD=1.10) were the main barriers to physical activity promotion, all scoring above the scale mid-point (i.e., 3) (AU)

Parental perceptions and practices regarding sugar intake by school-aged children: A qualitative study with Portuguese parents.

Excessive sugar intake is one of the factors contributing to the alarming rates of childhood obesity and overweight in Portugal. Children's preferences and food consumption patterns are largely determined by the foods that are more familiar to them. Parents and caregivers are responsible for shaping children's eating habits since they are the ones who choose the food available in the household. The present study explores parental perceptions about sugar and sugar intake and its consequences on children's health. Moreover, we also examined the practices that parents use to regulate their children's diet, namely, to promote the consumption of desired foods (e.g., vegetables) and limit the intake of undesired food (e.g., sweets), and the perceived barriers and facilitators of sugar intake regulation. To this end, 42 interviews were conducted with parents of school-aged children (ages 6-10 years). A thematic analysis revealed that parents perceive sugar as highly negative (e.g., "evil", "poison", "addiction") and its consumption as harmful (e.g., hyperactivity; overweight). Nonetheless, the view that sugary food consumption is not necessarily problematic was also common. Indeed, most parents considered that sugar intake should be regulated but not forbidden. To control the intake of sugary foods (e.g., sodas, cookies), they reported using strategies such as restriction, explanation, or negotiation. Several barriers to sugar intake regulation were identified (e.g., birthday parties, parents' lack of knowledge), but also a few facilitators (e.g., bringing food from home to school). Our findings may inform the development of interventions or policies to promote healthier eating habits in school-age children.

Clear-Cut Terms and Culture-Sensitive Characteristics of Distinctive Casual Sexual Relationships in Portuguese Emerging Adults.

Casual sexual relationships (CSR) are increasingly common but limited empirical research has addressed their terminology and distinctive characteristics. This study sought to identify the most clear-cut terms and to consider how culture-sensitive characteristics distinguish casual sexual relationships among Portuguese emerging adults (N = 262, 18-29 years old). We combined two qualitative studies - one by association and another by free recall - to ascertain the clarity of the terms, plus a quantitative study to further characterize and differentiate them. Participants were asked to match descriptions of CSRs with the respective terms by which they are known (Study 1). The same was investigated using an evocation task requesting that participants produce the terms by which the described CSRs are known (Study 2). Binary logistic regressions were performed to analyze the associations between encounters and labels chosen, taking the effect of gender and age into account. In the third study, participants rated the degree to which eight characteristics were present in the types of CSR, a simultaneous task that led to greater understanding of their descriptive and differentiating characteristics. Multivariate analysis of variance was used, with gender and age as covariates. We conclude that two types of CSR - friends with benefits and one-night stand - and, to a lesser extent, making out, are understood and associated with consensual labels, also found by free-recall. These CSRs proved to be distinct, as they are understood as more different than similar in a set of psychoemotional, behavioral, and sexual characteristics. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12119-021-09859-0.

A qualitative study about college students' attitudes, knowledge and perceptions regarding sugar intake.

Excessive sugar intake has been associated with multiple health conditions (e.g., higher risk for non-communicable diseases). Hence, health organizations have issued guidelines defining the maximum daily intake of free or added sugars. However, data from several countries suggests that these guidelines are rarely met, particularly by young adults. For example, almost half of Portuguese adolescents and young adults exceed the recommended sugar intake. In this work, we aim to further explore college students' attitudes, knowledge, and perceptions about sugar intake, as well as about sugar intake guidelines. A thematic analysis on data from five focus groups (N = 40) indicated that participants reported difficulty in the comprehension of added/free sugars definition and sugar intake recommendations. Overall, attitudes toward sugar were ambivalent. Sugar was simultaneously perceived as pleasurable and needed, but also as addictive and harmful. Although aware of the potential negative health outcomes associated with excessive sugar intake, most participants did not perceive being at risk due to their youth, exercise habits, or type of diet. The few concerns expressed were mostly associated with the negative impact of high sugar intake on body image (e.g., weight gain). The main barriers to reducing sugar intake identified were environmental (e.g., time restrictions, food available at the university). Still, participants could identify several individual strategies to effectively regulate sugar intake. By identifying knowledge gaps and sources of bias related to sugar consumption, our findings are useful to inform future interventions aiming to address the problem of high sugar intake among university students.

Knowledge and acceptance of interventions aimed at reducing sugar intake in Portugal.

OBJECTIVE: Governments worldwide have been implementing interventions aimed at improving citizens' dietary habits. Examining how individuals perceive these interventions is relevant for promoting future policies in this area, as well as informing the way they are designed and implemented. In the current study, we focused on interventions aimed at reducing sugar intake in Portugal, given the current high sugar consumption patterns in the population. DESIGN: Online survey to assess which interventions are the most salient and receive greater public support. SETTING: Portugal. PARTICIPANTS: 1010 (76·7 % female, MAge 36·33, sd 13·22). RESULTS: Data from a free-recall task showed that only about one-third of participants reported knowing about these interventions, namely those related to taxation, weight restrictions in individual sugar packets and limited availability of products with high sugar content. We also found evidence of high support for the eight interventions presented (except for replacing sugar by artificial sweeteners), positive attitudes towards the need of reducing sugar intake in the Portuguese population and high agreement with the importance of reducing sugar intake across all age groups, particularly among children. Participants also indicated paying attention to the amount of sugar in their diets and a low self-reported frequency of consumption of high sugary foods and beverages. A hierarchical regression analysis suggested that these variables were significantly associated with the overall acceptance of interventions, independently of social-demographic variables (i.e., age, education and sex). CONCLUSION: By examining how people perceive and accept different interventions targeting the reduction of sugar intake, the current work aims to support policymaking in this domain.

The Effect of Mobile Text Messages and a Novel Floss Holder on Gingival Health: A randomized control trial.

Purpose: The purpose of this study was to evaluate the effects of using mobile text messages and a novel floss holder as compared to finger flossing or the novel floss holder alone, on the psychological, behavioral, and clinical parameters of patients with gingivitis.Methods: A total 165 adults were assessed for eligibility and 144 met the criteria for randomization into three groups: Finger Floss (FF, n=43), Novel Floss Holder (NFH, n= 40), and Novel Floss Holder plus Text Messages (NFH+TM, n= 61) following a dental hygiene consultation appointment. Gingival bleeding points were measured on probing (BOMP) at baseline and four months later by a calibrated dental hygienist, blinded to the experimental groups. Participants also self-reported their oral hygiene behaviors, and indicated psychological determinants of behavior change prior to the dental hygiene consultation and at four months. Descriptive statistics and repeated measures analysis of variance (ANOVA) were used to compare groups over time.Results: Two subjects dropped out of the study making the total number of participants 142. At the four month follow-up, the NFH group and the NFH+TM groups demonstrated significantly higher levels of self-reported flossing, action self-efficacy, intention, action planning, and action control. The NFH+TM group showed lower levels of bleeding and higher levels of oral hygiene and recovery self-efficacy than the other groups, in addition to higher levels of maintenance self-efficacy as compared to the FF group.Conclusions: The use of a novel floss holder, NFH, was shown to improve the behavioral and psychological determinants of periodontal health four months after introduction of the device. However the clinical measures of BOMP only improved significantly when used in conjunction with text messages (NFH+TM). The use of a consciousness awareness technique,TMs, in combination with a novel device, may help patients to reach therapeutic objectives and contribute to the management of periodontal pathologies such as gingivitis.

Self-regulation in oral hygiene behaviours in adults with gingivitis: The mediating role of coping planning and action control.

AIM: This study investigates the joint role of volitional predictors of oral hygiene behaviours of flossing and brushing in adults with gingivitis, framed by the Health Action Process Approach model (HAPA). MATERIALS AND METHODS: In a longitudinal online survey, 201 participants aged 18-75, of which 56.7% were women, completed assessments at baseline(T1), 2 weeks(T2) and 4 months(T3). Oral hygiene behaviours(OH) (brushing and flossing) and social cognitive determinants of behaviour in the HAPA: action and maintenance self-efficacy(ASE & MSE), intention(INT), coping planning(CP) and action control(AC) were evaluated. Structural equation modelling was used to test a series of three nested models. In Model 1, action self-efficacy would determine MSE and INT, and INT would determine OH; in Model 2, INT would determine both CP and AC and the two OH behaviours; and in Model 3, CP and AC would be sequential mediators between INT and OH. RESULTS: Model 3, predicting a mediating process from intention to behaviour via coping planning and action control, showed the best fit according to the fit indices and explained more of the variance in dental hygiene. The mediating role of coping planning and action control between intention and oral hygiene behaviours was thus confirmed. Importantly, coping planning did not mediate between intention and oral hygiene behaviours, which means that oral hygiene intention influences action control through coping planning, and both sequentially mediate this influence on behaviour. CONCLUSIONS: For individuals who are not yet following the recommendations for specific oral hygiene behaviours, coping planning and action control represent psychological mechanisms by which intentions are put into practice.

Development of a formal system for representing behaviour-change theories.

Use of natural language to represent behaviour-change theories has resulted in lack of clarity and consistency, hindering comparison, integration, development and use. This paper describes development of a formal system for representing behaviour-change theories that aims to improve clarity and consistency. A given theory is represented in terms of (1) its component constructs (for example, 'self-efficacy', 'perceived threat' or 'subjective norm'), which are labelled and defined, and (2) relationships between pairs of constructs, which may be causal, structural or semantic. This formalism appears adequate to represent five commonly used theories (health belief model, information-motivation-behavioural skill model, social cognitive theory, theory of planned behaviour and the trans-theoretical model). Theory authors and experts judged that the system was able to capture the main propositions of the theories. Following this proof of concept, the next step is to assess how far the system can be applied to other theories of behaviour change.

An eight-month randomized controlled trial on the use of intra-oral cameras and text messages for gingivitis control among adults.

OBJECTIVE: To investigate the effects of using an intra-oral camera (IOC) during a dental hygiene consultation and mobile text messages (TM) between appointments on clinical, behavioural and psychological parameters of patients with gingivitis. MATERIALS AND METHODS: Patients were randomly assigned into four conditions: IOC, TM, IOC + TM and control, and examined at three assessment points over eight months (N = 142). Bleeding on marginal probing (BOMP), dental hygiene (brushing and flossing) and social cognitive determinants of behaviour change (outcome expectancies, action and volitional self-efficacy, intention, planning and action control) were evaluated in an examiner-blind controlled study. Mixed-effects modelling was employed to examine changes in study outcomes. Mediations by the psychological determinants were inspected for the effect on treatment groups in clinical parameters and behaviour. RESULTS: Compared to the control group, all treatment conditions improved dental hygiene and revealed a significant decrease in BOMP from baseline to 4 months, maintained at 8 months; this was clinically relevant in the IOC + TM group, where individuals had more positive outcome expectancies as well as higher levels of action self-efficacy and intention from baseline to four months, maintained at eight months. Volitional self-efficacy was reinforced in all treatments. The psychological determinants did not prove to be the mechanisms responsible for these effects. CONCLUSIONS: A multiple-strategy benefit from using the IOC in consultation and TM between appointments improves clinical, behavioural and psychological parameters of periodontal health four months after treatment, maintained at eight months' follow-up. Insights are provided for the efficacy of the images and text messages for oral hygiene changes.

Evaluating the effectiveness of behavior change techniques in health-related behavior: a scoping review of methods used.

Behavior change interventions typically contain multiple potentially active components: behavior change techniques (BCTs). Identifying which specific BCTs or BCT combinations have the potential to be effective for a given behavior in a given context presents a major challenge. The aim of this study was to review the methods that have been used to identify effective BCTs for given behaviors in given contexts and evaluate their strengths and limitations. A scoping review was conducted of studies that had sought to identify effective BCTs. Articles referring to "behavio(u)r change technique(s)" in the abstract/text were located, and ones that involved identification of effective BCTs were selected. The methods reported were coded. The methods were analyzed in general terms using "PASS" criteria: Practicability (facility to apply the method appropriately), Applicability (facility to generalize from findings to contexts and populations of interest), Sensitivity (facility to identify effective BCTs), and Specificity (facility to rule out ineffective BCTs). A sample of 10% of the studies reviewed was then evaluated using these criteria to assess how far the strengths and limitations identified in principle were borne out in practice. One hundred and thirty-five studies were identified. The methods used in those studies were experimental manipulation of BCTs, observational studies comparing outcomes in the presence or absence of BCTs, meta-analyses of BCT comparisons, meta-regressions evaluating effect sizes with and without specific BCTs, reviews of BCTs found in effective interventions, and meta-classification and regression trees. The limitations of each method meant that only weak conclusions could be drawn regarding the effectiveness of specific BCTs or BCT combinations. Methods for identifying effective BCTs linked to target behavior and context all have important inherent limitations. A strategy needs to be developed that can systematically combine the strengths of the different methods and that can link these constructs in an ontology of behavior change interventions.

Education differences in cancer fatalism: The role of information-seeking experiences.

Cancer fatalism is the belief that cancer is uncontrollable and lethal. Individuals with less education are more likely to hold fatalistic beliefs about cancer, but the mechanism accounting for the relationship is unknown. We tested whether negative health information seeking experiences explain this relationship. Structural equation modeling was used to test this relationship across three datasets from the Health Information National Trends Survey. Across all datasets, the model showed good fit: Cycle 1 (coefficient of determination = .11, comparative fit index = .96, root mean square error of approximation = .047), Cycle 2 (coefficient of determination = .06, comparative fit index = .96, root mean square error of approximation = .046), and Cycle 3 (coefficient of determination = .08, comparative fit index = .95, root mean square error of approximation = .052). The link between lower education level and higher cancer fatalism was partially mediated by negative health information seeking experiences.

When Is Congruency Helpful? Interactive Effects of Frame, Motivational Orientation, and Perceived Message Quality on Fruit and Vegetable Consumption.

Health messages framed to be congruent with people's motivational orientation have been shown to be generally effective in promoting health behavior change, but some inconsistencies have been found. This study tested whether the perceived quality of a health message moderated the congruency effect in the domain of fruit and vegetable (FV) consumption. Undergraduate participants (N = 109) read a health message promoting FV intake in which the frame (gain vs. loss) was either congruent or incongruent with their approach/avoidance motivational orientation. Perceived message quality and intention to increase FV intake were assessed after message exposure, and self-reported FV intake was assessed one week later. A significant interaction between congruency and perceived message quality was found on both intention and FV intake. When messages were congruent, higher intentions and FV intake were observed when perceived message quality was high, but the reverse pattern was observed when perceived message quality was low. The findings support the potential utility of using congruently-framed messages to promote fruit and vegetable consumption, while also underscoring the necessity of using high-quality messages in order for congruency to influence health-related behaviors.

Psychological, behavioral, and clinical effects of intra-oral camera: a randomized control trial on adults with gingivitis.

OBJECTIVES: To evaluate the effects of using an intra-oral camera (IOC) during supportive periodontal therapy (SPT), on the psychological, behavioral, and clinical parameters of patients with gingivitis, outlined by evidence and a theory-based framework. METHODS: A group of 78 adult patients with gingivitis receiving an SPT was randomized into two groups: IOC and control. Bleeding on Marginal Probing (BOMP), self-reported dental hygiene behaviors, and psychological determinants of behavior change (outcome expectancies, self-efficacy, and planning) and IOC opinion were evaluated 1 week before or during the appointment and 4 months later. Repeated-measures anova was used to compare groups over time. RESULTS: Almost all the patients brushed their teeth daily, while 78% either never or hardly ever used dental floss. The IOC group showed significant improvements in BOMP index (P < 0.001), self-reported flossing (P < 0.05), and self-efficacy (P < 0.05) compared to the control group. CONCLUSIONS: The use of IOC significantly improves clinical, behavioral, and psychological determinants of periodontal health 4 months after treatment.

Communicating to increase public uptake of pandemic flu vaccination in the UK: Which messages work?

BACKGROUND: Vaccination is considered the most effective preventive measure against influenza transmission, yet vaccination rates during the 2009/10 influenza A/H1N1 pandemic were low across the world, with the majority of people declining to receive the vaccine. Despite extensive research on the predictors of uptake of influenza vaccination, little research has focused on testing the effectiveness of evidence and theory-based messages. AIMS: To examine the persuasiveness of messages promoting vaccination and antiviral use either as health-enhancing or as risk-reducing, as well as messages which conveyed evidence-based information about the costs and benefits of vaccination, or which applied anticipated regret as a motivator for vaccine uptake. METHOD: We conducted 11 focus groups with forty-one members of the general population in England including young and older adults, those with lower education, parents, and those with elevated health risk. The data were analysed using thematic analysis. RESULTS: The factual, evidence-based messages were well received with participants finding them the most convincing and useful, particularly where they gave cost-benefit comparisons. Health-enhancing messages were received with scepticism and concern that the messages were not honest about the potential lack of safety of vaccination. In contrast, risk-reduction messages were perceived as being more balanced and credible. Messages aiming to elicit feelings of anticipated regret for not getting vaccinated were generally perceived as patronising and unprofessional. CONCLUSIONS: Vaccination messages should be kept brief, but convey balanced, evidence-based information, and be transparent in their communication of potential side-effects. The general public seem to prefer messages that are factual and emphasise the costs and benefits of vaccination, particularly with regards to vaccine safety.

Increasing the intent to receive a pandemic influenza vaccination: Testing the impact of theory-based messages.

OBJECTIVE: Vaccination is an effective preventive measure to reduce influenza transmission, especially important in a pandemic. Despite the messages encouraging vaccination during the last pandemic, uptake remained low (37.6% in clinical risk groups). This study investigated the effect of different types of messages regarding length, content type, and framing on vaccination intention. METHOD: An online experiment was conducted in February 2015. A representative sample of 1424 people living in England read a mock newspaper article about a novel influenza pandemic before being randomised to one of four conditions: standard Department of Health (DoH) (long message) and three brief theory-based messages - an abridged version of the standard DoH and two messages additionally targeting pandemic influenza severity and vaccination benefits (framed as risk-reducing or health-enhancing, respectively). Intention to be vaccinated and potential mediators were measured. RESULTS: The shortened DoH message increased vaccination intention more than the longer one, by increasing perceived susceptibility, anticipated regret and perceived message personal relevance while lowering perceived costs, despite the longer one being rated as slightly more credible. Intention to be vaccinated was not improved by adding information on severity and benefits, and the health-enhancing message was not more effective than the risk-reducing. CONCLUSION: A briefer message resulted in greater intention to be vaccinated, whereas emphasising the severity of pandemic influenza and the benefits of vaccination did not. Future campaigns should consider using brief theoretically-based messages, targeting knowledge about influenza and precautionary measures, perceived susceptibility to pandemic influenza, and the perceived efficacy and reduced costs of vaccination.

Emphasizing the losses or the gains: Comparing situational and individual moderators of framed messages to promote fruit and vegetable intake.

Health messages are a commonly used way to promote changes in dietary habits but their efficacy could be enhanced by strategies such as the way in which the presented arguments are framed. This study aimed to test the effectiveness of framed messages (gain vs. loss) on behavioural intention and fruit and vegetable (FV) intake, comparing predictions based on prominent theoretical perspectives on message framing (function of the health behaviour and recipients' motivational orientation) and by further exploring the role of baseline intentions as a potential moderator of the framing effects. Undergraduate students (N = 180) completed the three assessment points in time. At baseline, individual moderators (motivational orientation and intentions) and fruit and vegetable intake were assessed. One week later, participants were randomly assigned to the loss or gain-framed message and indicated their intentions for FV intake the following week. A week later, FV intake over the previous week was assessed. The gain-frame was not conducive, per se, to higher intentions or behaviour. Having intention as the outcome, only baseline intentions moderated the effects of message frame. When considering FV intake as the outcome, both motivational orientation and baseline intentions moderated the effects of message frame, with the loss-frame promoting higher FV intake among individuals who were prevention-oriented and had higher baseline intentions. Findings suggest that the success of framed messages for FV intake depends upon the recipient's characteristics, such as motivational orientation, baseline intentions, and cultural background, with implications for health communication interventions.

Health messages to promote fruit and vegetable consumption at different stages: A match-mismatch design.

OBJECTIVE: To examine the effectiveness of matching health messages promoting fruit and vegetable intake to the Health Action Process Approach stages of change. DESIGN: In a randomised controlled trial, 205 undergraduate students (non-intenders n = 123; intenders n = 82) were exposed to one of three health messages, targeted at non-intenders, intenders and controls. MAIN OUTCOME MEASURES: Three longitudinal assessments of stage, fruit and vegetable intake, and social-cognitive determinants were obtained. RESULTS: Stage-specific effects of the interventions were confirmed. For self-efficacy, a stage by health message crossover interaction emerged, with both non-intenders and intenders in the matched conditions scoring higher in self-efficacy. Furthermore, in line with predictions, non-intenders in the matched condition showed higher risk perception, outcome expectancies, intention, and stage progression immediately after message exposure, and lower levels of action planning and coping planning a week later in the mismatched condition, but for these outcomes no differences across conditions were obtained among intenders. Multiple mediation analyses confirmed the facilitating role of self-efficacy and behavioural intention among non-intenders. CONCLUSIONS: Stages should be considered when designing health messages, although more interactive interventions for intenders and extended measurement time frames may be required.