Determinants of parents' decision to vaccinate their children against rotavirus: results of a longitudinal study.

Rotavirus disease is a common cause of health care utilization and almost all children are affected by the age of 5 years. In Canada, at the time of this survey (2008-09), immunization rates for rotavirus were <20%. We assessed the determinants of a parent's acceptance to have their child immunized against rotavirus. The survey instruments were based on the Theory of Planned Behavior. Data were collected in two phases. In all, 413 and 394 parents completed the first and second interviews, respectively (retention rate 95%). Most parents (67%) intended to immunize their child against rotavirus. Factors significantly associated with parental intentions (Phase 1) were as follows: perception of the moral correctness of having their child immunized (personal normative belief) and perception that significant others will approve of the immunization behavior (subjective norm), perceived capability of having their child immunized (perceived behavioral control) and household income. At Phase 2, 165 parents (42%) reported that their child was immunized against rotavirus. The main determinant of vaccination behavior was parental intention to have their child vaccinated, whereas personal normative beliefs influenced both intention and behavior. The acceptability of the rotavirus vaccine will be higher if health promotion addresses parental knowledge, attitudes and beliefs regarding the disease and the vaccine.

Canadian paediatricians' opinions on rotavirus vaccination.

Rotavirus is the leading cause of dehydration and hospitalization due to gastroenteritis (GE) in young children. Almost all children are affected by the age of 5 years. Two safe and effective rotavirus vaccines are available for clinical use in Canada. In the context where rotavirus vaccination is recommended, but not publicly funded, we have assessed paediatricians' knowledge, attitudes and beliefs (KAB) regarding rotavirus disease and its prevention by vaccination. A self-administered anonymous questionnaire based upon the Health Belief Model and the Analytical framework for immunization programs was mailed to all 1852 Canadian paediatricians. The response rate was 50%. The majority of respondents rated consequences of rotavirus infection for young patients as moderate. Sixty-six percent considered that rotavirus disease occur frequently without vaccination and 62% estimated that the disease generates a significant economic burden. Sixty-nine percent of respondents considered rotavirus vaccines to be safe and 61%, to be effective. The reduction of severe GE cases was seen as the main benefit of rotavirus vaccination, while the risk of adverse events was the principal perceived barrier. Fifty-three percent (53%) indicated a strong intention to recommend rotavirus vaccines. In multivariate analysis, main determinant of paediatricians' intention to recommend rotavirus vaccines was the perceived health and economic burden of rotavirus diseases (partial R(2)=0.49, p<0.0001). More than half of surveyed paediatricians were willing to recommend rotavirus vaccines to their patients, but the proportion of respondents who had a strong intention to do so remains low when compared to several other new vaccines. As with other new vaccines, rotavirus vaccine uptake risks to remain low in Canada as long as it is not publicly funded.

[Models of health behavior]. / Les modèles, de comportements de santé.

One of the challenges for health professionals is to understand how individuals adopt and maintain healthy behaviours that lead to a better quality of life. This review of health behaviour models will help nurses determine appropriate interventions, and enhance programs that promote health and prevent sickness in individuals or groups of individuals. In order to establish priorities and to prevent omitting important points in planning such health programs, many theoretical and conceptual models have attempted to explain health behaviours as well as the indicators of compliance. The purpose of this article is to summarise the most utilised health behaviour models, to offer a schematic representation, and to explain the advantages and disadvantages of each model. Until now, no article had reviewed these models into the same work. This article will be of assistance to nurse researchers and clinicians working in health prevention, who are interested in choosing a health behaviour model to plan a scientific research, or to develop a clinical program. The models are presented according to the following classifications: cognitive value expectation; theories of personality; communication theories; models of program planning; and models of integration.

Measuring the compliance behavior of adolescents wearing orthopedic braces.

This paper reports the observed difference between two measures of compliance in wearing an orthopedic brace among teenagers affected by idiopathic scoliosis. The first measure was obtained with a small device called a "compli-o-meter" that was developed specifically for this purpose. When fastened to an orthopedic brace, this instrument determines the brace's actual wearing time. The second compliance measure was derived from a questionnaire-interview administered to the participants. The subjects were 40 female teenagers aged between 10 and 16 years who had been wearing an orthopedic brace for 18 months or less. While the compliance rate reported by the participants averaged 88%, the actual rate measured by the compli-o-meter was only 33%. Pearson's correlation was r = .33, with a significance of p < .05 between these two measurements. Care should be exerted in assessing the therapeutic efficiency of an orthopedic brace based exclusively on a patient's reported compliance level. In particular, basing a recommendation to change the brace based solely on this information may result in erroneous and serious therapeutic actions. The efficiency of orthopedic braces should be assessed on objective measures of the actual compliance rate wherever possible.

[Adoption and maintenance of health behavior: the challenge of treatment compliance]. / L'adoption et le maintien d'un comportement de santé: le défi de l'assiduité au traitement.

The aim of this article is to give an overview of the different concepts related to the phenomenon of regularity so as to better outline it in the context of a medical treatment. The attitudes, the beliefs, the perception of the personal control as well as the motivation are presented as the different factors influencing the adoption and upholding of a health behaviour. The recent conception of the learning process and the active role given to the learner have led to the recognition of the fact that, in order to have an effective learning process, the learner must become involved in the self management and self control of his own learning process. Whatever the chosen strategy, an educative intervention focused on the knowledge can only be efficient if it enables the person to increase his (her) control.

Canadian ethnocultural communities facing AIDS: overview and summary of survey results from phase 111

This paper describes the survey results reporting demographic profiles, behaviours, opinions beliefs, attitudes and intentions related to condom use for three Canadian ethnocultural communities (Latin American, English-speaking Caribbean and South Asian) participating in the Ethnocultural Communities facing AIDS Study. Specific recommendations are presented for HIV-prevention programming based on the research results (AU).

Understanding use of condoms among Canadian ethnocultural communities: methods and main findings of the survey

The aim of this study was to understand the intention to use a condom for each instance of sexual intercourse with a new partner in three of Canada's non-dominant ethnocultural communities: Latin American (N=346), English-speaking Caribbean (N=358), and South Asian (N=355). All respondents were recruited from multiple ethnocultural venues using predetermined sampling frames and quotas for each community. Anonymous questionnaire assessing culturally specific theoretical constructs were completed. This paper presents the methodology and the main findings. The high quality of the results of this study demonstrate the advantage of establishing strong partnerships with members of communities being studied (AU)

Understanding use of condoms among Canadian ethnocultural communities: methods and main findings of the survey.

The aim of this study was to understand the intention to use a condom for each instance of sexual intercourse with a new partner in three of Canada's non-dominant ethnocultural communities: Latin American (N = 346), English-speaking Caribbean (N = 358), and South Asian (N = 355). All respondents were recruited from multiple ethnocultural venues using predetermined sampling frames and quotas for each community. Anonymous questionnaires assessing culturally specific theoretical constructs were completed. This paper presents the methodology and the main findings. The high quality of the results of this study demonstrate the advantage of establishing strong partnerships with members of communities being studied.

PIP: During April-May 1994, in Canada, 346 members of the Latin American community aged 18-49, 358 members of the English-speaking Caribbean community aged 16-49, and 355 members of the South Asian community aged 18-45 completed a questionnaire developed by the Research Group on Psychosocial Aspects of Health Behavior at Laval University in Quebec. This study aimed to identify the variables influencing intention to use a condom for each instance of sexual intercourse with a new partner in three nondominant ethnocultural communities. 81% of Latin Americans, 75% of the Caribbeans, and 71% of the South Asians intended to use a condom for each instance of sexual intercourse with a new partner during the next 3 months. Yet, among people who had had sex with a new partner in the last year, only 30% of Latin Americans, 28% of the Caribbeans, and 47% of South Asians always used a condom. Significant predictors of intent to use a condom in each instance of sexual intercourse with a new partner were personal normative belief (a measure of the personal feelings of moral obligation or responsibility to use or refuse to use a condom), perceived behavioral control, and role beliefs (p .0001). For the Latin American community, these three constructs explained 70.7% of the variance (partial R2 = 51.1% for personal normative belief, 10% for role beliefs, and 4.1% for perceived behavioral control). For the English-speaking Caribbean community, they explained 51% of the variance (partial R2 = 35.7% for personal normative belief, 11.9% for perceived behavioral control, and 3.5% for role beliefs). For the South Asian community, they accounted for 76% of the variance (partial R2 = 63.5% for perceived behavioral control, 9.4% for personal normative belief, and 3.1% for role beliefs). These findings serve as a basis for recommendations for the prevention of HIV transmission among the participating ethnocultural communities.

Canadian ethnocultural communities facing AIDS: overview and summary of survey results from phase III.

This paper describes the survey results reporting demographic profiles, behaviours, opinions, beliefs, attitudes, and intentions related to condom use for three Canadian ethnocultural communities (Latin American, English-speaking Caribbean and South Asian) participating in the Ethnocultural Communities Facing AIDS Study. Specific recommendations are presented for HIV-prevention programming based on the research results.

Health risk appraisal in an occupational setting and its impact on exercise behavior.

The aim of this study was to evaluate the impact of a health risk appraisal (HRA) activity on exercise intention and behavior modification. In a mixed experimental and quasiexperimental design, three groups of subjects were formed: (1) preintervention, (2) postintervention, and (3) control. In the experimental design, the results showed that the employees in the postintervention group had, immediately after the HRA activity, an increased intention to exercise regularly compared with the employees in the preintervention group. According to the quasiexperimental design, the employees exposed to the HRA activity did not, 2 months later, report regular exercise behavior that differed from that of the employees in the comparison group. It is suggested that an HRA activity should be supplemented with regular additional interventions over a given period of time to be successful in supporting the process of translating exercise intention into behavior.

Active living in communities: understanding the intention to take up physical activity as an everyday way of life.

The purpose of this study was to identify psychosocial factors influencing the intention to incorporate physical activity into daily routine. The subjects were 353 residents from New Brunswick aged 15 to 80 years. The intention to be active was explained by current physical activity habit (beta = 0.563, p < 0.0001), age (beta = -0.197, p < 0.0001), attitude toward the behaviour (beta = 0.164, p < 0.0001), and the obligation felt to perform the behaviour (beta = 0.155, p < 0.0001). These variables explained 52% of the variability in intention. MANOVAs revealed significant differences between high and low intenders concerning the perceived consequences of carrying out the behaviour (p < 0.0001) and the evaluation of these consequences (p < 0.01). It is suggested that a social marketing program should promote the concept that "walking every day for 15 consecutive minutes is fun and healthy; it will make me feel better, more energetic, and more relaxed, not to mention that it should contribute to the improvement of my physical condition while I enjoy the outdoors".

[Important obstacles in the buying of condoms]. / Etude de l'importance des obstacles à l'achat de condoms.

This study identifies the most important barriers to buying condoms and their effect on the intention to buy condoms. A total of 99 high school students and 97 members of a physical fitness centre agreed to participate and completed a self-administered questionnaire. The most frequently reported barriers are embarrassment (26%), reluctance to be seen (21%), lack of money (16%), and problems of choosing from the available condoms (11%). One quarter of the subjects indicated they would not buy condoms when confronted with any one of these barriers.

University students' intention to seek medical care promptly if symptoms of sexually transmitted diseases were suspected.

The aim of this study was to identify the factors explaining intention to seek medical care promptly if STD symptoms were suspected. A random sample of 1617 undergraduate students completed a questionnaire assessing intention, attitude, perceived norm among friends, perceived behavioral control, and risk of disease, along with different socio-demographic variables. The regression of intention on all variables yielded an adjusted R2 of 0.32 (P < 0.0001). The factors explaining this variance were the perceived advantages, easiness, and social norm among friends regarding seeking medical care promptly, age, and gender. Perception of risk to delay seeking medical care and perceived personal risk of getting STDs were not significant variables. Overall, the results indicate the need to develop programs for male first-year students. These programs will have to influence the attitude, that is, the perceived advantages of seeking medical care promptly if STD symptoms are suspected. Seeking advice from students' friends, and perception of these friends as a significant reference source if STD symptoms are suspected, should also be promoted.