Development of a self-report measure to assess sleep satisfaction: Protocol for the Suffolk Sleep Index (SuSI).

Good sleep is essential for health but there is no consensus on how to define and measure people's understanding of good sleep. To date, people's perceptions of a good night's sleep have been, almost exclusively, conceptualized under the lens of sleep quality, which refers to objective characteristics of good sleep, such as such as ease and time needed to fall asleep, hours of sleep, and physical symptoms during sleep and upon awakening. A related, yet different construct, sleep satisfaction, refers to perceived positive affect about one's sleep experience and has, to date, received little attention. This research focuses on sleep satisfaction, rather than sleep quality, and aims to develop a self-report measure to assess sleep satisfaction in an English adult population. As the measure will be developed in Suffolk, England, and its primary intended users are Suffolk community members, it is labelled the Suffolk Sleep Index (SuSI). The SuSI will draw from principles of community-based participatory research, following a seven-phase developmental process comprising literature review, interviews with Suffolk community members, synthesis of literature review and interview findings, pre-testing, pilot-testing, scale evaluation, and refinement. The present research will also investigate indices related to sleep satisfaction, including the community's general health status, lifestyle factors and socio-economic status. The research will add to the limited, yet emerging body of research on perceived sleep satisfaction and its measurement. To our knowledge, a valid and reliable sleep satisfaction self-report measure has not been developed in the United Kingdom previously.

Beliefs and Experiences of Individuals Following a Zero-Carb Diet.

The adoption of carbohydrate-restrictive diets to improve health is increasing in popularity, but there is a dearth of research on individuals who choose to severely restrict or entirely exclude carbohydrates. The present study investigated the beliefs and experiences of individuals following a diet that severely limits, or entirely excludes, dietary carbohydrates, colloquially known as a 'zero-carb' diet, for at least 6 months. Zero-carb dieters (n = 170) recruited via a social networking site completed an online qualitative survey prompting them to discuss their motives, rationale, and experiences of following a low-carb diet. Transcripts of participants' responses were analyzed using inductive thematic analysis. Results revealed that participants' decision to follow a zero-carb diet was driven by health concerns and benefits. Participants expressed a strong social identity and belongingness to online zero-carb communities. Participants reported strong intentions to follow the diet indefinitely. Shortcomings of the diet centered on experienced stigma; lack of support from healthcare providers and significant others; limited access to, and high cost of, foods; and limited scientific data on the diet. Further research into the benefits and shortcomings of zero-carb diets across settings and populations is warranted, and guidelines for healthcare professionals on how to support individuals following a zero-carb diet are needed.

How best to reduce unhealthy risk-taking behaviours? A meta-review of evidence syntheses of interventions using self-regulation principles.

Self-regulation is a key antecedent of health and behaviour-change interventions have utilised self-regulation approaches to promote health. The present study used a novel methodology, a nested meta-review, to: (a) integrate and summarise information from evidence syntheses of diverse self-regulation interventions to reduce risk-taking, in the behavioural domains of smoking, alcohol and drug use, unhealthy eating, externalising problem behaviours, and sexual risk-taking; (b) identify intervention features implicated in risk-taking prevention or reduction; and (c) provide recommendations for future research and practice. Searches of eight databases yielded 21 eligible evidence syntheses, 15 taking a primarily social-cognitive strategy (k = 1,103 total studies), and 6 taking a primary trait/developmental strategy (k = 119); total N > 650,000. Intervention features most frequently associated with reduced risk-taking included: delivery of multiple components through (either, or a mix of) group, individual, computer, and one-one-one delivery; screening and pharmacotherapy, where relevant; targeting only one behavioural outcome; provision of counselling, stress-management, skills-training, self-monitoring, self-control and impulsivity training, and personalised feedback; identification of barriers and 'resolution' of barriers; tailoring to age and ethnicity; and, also, incorporating social support by peers. Some of these patterns were more visible in meta-analyses with higher methodological quality. Recommendations for research and practice are offered.

An integrated model of condom use in Sub-Saharan African youth: A meta-analysis.

OBJECTIVE: We tested an integrated social-cognitive model derived from multiple theories of the determinants of young people's condom use in Sub-Saharan Africa. The model comprised seven social-cognitive antecedents of condom use: Attitudes, norms, control, risk perceptions, barriers, intentions, and previous condom use. METHOD: We conducted a systematic search of studies including effects between at least one model construct and intended or actual condom use in young people from sub-Saharan African countries. Fifty-five studies comprising 72 independent data sets were included and subjected to random-effects meta-analysis. Demographic and methodological variables were coded as moderators. Hypotheses of the integrated model were tested using meta-analytic structural equation modeling. RESULTS: The meta-analysis revealed significant nontrivial sample-weighted correlations among most model constructs. Moderator analyses revealed differences in six correlations for studies that included a formative research component relative to studies that did not. There was little evidence of systematic moderation of relations among model constructs by other candidate moderators. Meta-analytic structural equation models revealed significant direct effects of attitudes, norms, and control on condom use intentions, and of intention, control, and barriers on condom use. Including past condom use increased explained variance in condom use intentions and behavior but did not attenuate model effects. There were also significant indirect effects of attitudes, norms, and control on condom use through intentions. CONCLUSIONS: Findings provide preliminary evidence to support the integrated condom use model in sub-Saharan African youth. The model provides guidance on potential targets for improving the effectiveness of condom promotion interventions. (PsycINFO Database Record

Using meta-analytic path analysis to test theoretical predictions in health behavior: An illustration based on meta-analyses of the theory of planned behavior.

OBJECTIVE: Synthesizing research on social cognitive theories applied to health behavior is an important step in the development of an evidence base of psychological factors as targets for effective behavioral interventions. However, few meta-analyses of research on social cognitive theories in health contexts have conducted simultaneous tests of theoretically-stipulated pattern effects using path analysis. We argue that conducting path analyses of meta-analytic effects among constructs from social cognitive theories is important to test nomological validity, account for mediation effects, and evaluate unique effects of theory constructs independent of past behavior. We illustrate our points by conducting new analyses of two meta-analyses of a popular theory applied to health behaviors, the theory of planned behavior. METHOD: We conducted meta-analytic path analyses of the theory in two behavioral contexts (alcohol and dietary behaviors) using data from the primary studies included in the original meta-analyses augmented to include intercorrelations among constructs and relations with past behavior missing from the original analysis. RESULTS: Findings supported the nomological validity of the theory and its hypotheses for both behaviors, confirmed important model processes through mediation analysis, demonstrated the attenuating effect of past behavior on theory relations, and provided estimates of the unique effects of theory constructs independent of past behavior. CONCLUSIONS: Our analysis illustrates the importance of conducting a simultaneous test of theory-stipulated effects in meta-analyses of social cognitive theories applied to health behavior. We recommend researchers adopt this analytic procedure when synthesizing evidence across primary tests of social cognitive theories in health.

Moderators of the effect of psychological interventions on depression and anxiety in cardiac surgery patients: A systematic review and meta-analysis.

Cardiac surgery patients may be provided with psychological interventions to counteract depression and anxiety associated with surgical procedures. This systematic review and meta-analysis investigated whether intervention efficacy was impacted by type of cardiac procedure/cardiac event; control condition content; intervention duration; intervention timing; facilitator type; and risk of bias. MEDLINE, EMBASE, and PsycINFO were searched for randomized controlled trials comparing anxiety and depression outcomes, pre and post psychological and cardiac interventions. Twenty-four studies met the inclusion criteria for the systematic review (N = 2718) and 16 of those were meta-analysed (N = 1928). Depression and anxiety outcomes were reduced more in interventions that lasted longer, were delivered post-surgery, and by trained health professionals. Depression (but not anxiety) was reduced more when the experimental intervention was compared to an 'alternative' intervention, and when the intervention was delivered to coronary artery bypass graft patients. Anxiety (but not depression) was decreased more when interventions were delivered to implantable cardioverter defibrillator patients, and were of 'high' or 'unclear' risk of bias. In addition to estimating efficacy, future work in this domain needs to take into account the moderating effects of intervention, sample, and study characteristics.

Factors underlying the success of behavioral HIV-prevention interventions for adolescents: a meta-review.

The purpose of this meta-review was to identify characteristics of successful HIV prevention interventions for adolescents based on quantitative (i.e., meta-analyses) and qualitative reviews published to date, and to inform intervention utilization and future development. To that end, we were guided by principles of triangulation. Searches of seven electronic bibliographic databases yielded five meta-analyses and six qualitative reviews that satisfied the selection criteria. Reviews were subjected to careful content analysis. All reviews reported that behavioral interventions had positive outcomes on at least one of the following outcomes: HIV-related knowledge, subjective cognitions and beliefs enabling safer sex, abstinence, delaying next sexual intercourse, decreasing number of sexual partners, and actual condom use. Four categories, suggesting factors more prominently linked to intervention success, emerged: behavior change techniques (e.g., cognitive-behavior and motivation enhancement skills training); recipient characteristics (e.g., age, vulnerability to contracting STIs/HIV); prominent design features (e.g., use of theory, formative research); and socio-ecological features (e.g., supportive school environment). Future interventions would benefit from conducting preliminary formative research in order to enable optimal implementation of all these factors.

The theory of planned behaviour as a framework for predicting sexual risk behaviour in sub-Saharan African youth: A critical review.

Amongst the psychological theories that have been used to help understand why people have unprotected sex, the Theory of Planned Behaviour (TPB: Ajzen 1991) has earned a prominent position. This article is a critical review of 11 peer-reviewed studies conducted in sub-Saharan Africa during 2001 to 2009, which used the TPB as a model of predicting sexual risk behaviour in young people. All the studies revealed the predictive ability of the TPB in urban, rural, and traditional African settings, with R (2) coefficients ranging between 0.14 and 0.67. With data comparing favourably to those obtained in the international literature, these studies indicate that the TPB can be used to study sexual risk intentions and behaviour in sub-Saharan African youth, and question arguments against the theory's use in non-Western settings.

Predictors of non-condom use intentions by university students in Britain and Greece: The impact of attitudes, time perspective, relationship status, and habit.

OBJECTIVE: This study investigated the impact of socio-cognitive factors (attitudes and norms), time perspective (TP), relationship status (RS), and past sexual behaviour on intended non-condom use in 104 Greek and 93 British university undergraduates. METHOD: Data were obtained by a self-report questionnaire. Data analysis included correlation, regression and ANOVA procedures. RESULTS: Attitudes were the strongest predictors of non-condom use intentions for participants who had casual relationships or were single (i.e. unstable relationship context), and past behaviour was the strongest predictor of non-condom use intentions for those who perceived themselves to be in an exclusive relationship (i.e. stable relationship context). Past behaviour was the strongest predictorof intended non-condom use in relation to all the variables of this study. TP managed to predict non-condom use intentions and moderate the attitudes-intentions relationship. In terms of temporal influences, participants high in fatalistic TP were strongly inclined not to use condoms, irrespective of their attitudes, but TP did not differ as a function of culture. CONCLUSIONS: Our data revealed the value of considering the combined effects of relationship status, habit and attitudes, when investigating undergraduate non-condom use intentions and designing interventions. The construct of TP was introduced as a meaningful addition to sexual risk research.