scholarly journals Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study (Preprint)

2017 ◽  
Author(s):  
Carolyn M Yeager ◽  
Kotaro Shoji ◽  
Aleksandra Luszczynska ◽  
Charles C Benight
Keyword(s):  
Self Efficacy ◽  
Outcome Expectations ◽  
Trauma Survivors ◽  
Trauma Recovery ◽  
Trauma Symptoms ◽  
Perceived Need ◽  
Distress Symptoms ◽  
Health Action ◽  
Action Process ◽  
Ehealth Intervention

BACKGROUND There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. OBJECTIVE The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. METHODS Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. RESULTS The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). CONCLUSIONS Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.

scholarly journals Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study

2018 ◽  
Vol 5 (2) ◽  
pp. e29 ◽  
Author(s):  
Carolyn M Yeager ◽  
Kotaro Shoji ◽  
Aleksandra Luszczynska ◽  
Charles C Benight
Keyword(s):  
Self Efficacy ◽  
Outcome Expectations ◽  
Trauma Survivors ◽  
Trauma Recovery ◽  
Trauma Symptoms ◽  
Perceived Need ◽  
Distress Symptoms ◽  
Health Action ◽  
Action Process ◽  
Ehealth Intervention

Background There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. Objective The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. Methods Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. Results The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). Conclusions Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.

scholarly journals Predicting Change in Posttraumatic Distress Through Change in Coping Self-Efficacy After Using the My Trauma Recovery eHealth Intervention: Laboratory Investigation (Preprint)

2018 ◽  
Author(s):  
Charles C Benight ◽  
Kotaro Shoji ◽  
Carolyn M Yeager ◽  
Pamela Weisman ◽  
Terrance E Boult
Keyword(s):  
Self Efficacy ◽  
Online Survey ◽  
Trauma Survivors ◽  
Trauma Recovery ◽  
Professional Help ◽  
Posttraumatic Distress ◽  
Stress Symptoms ◽  
Self Help ◽  
Self Talk ◽  
Ehealth Intervention

BACKGROUND Technology offers a unique platform for delivering trauma interventions (ie, eHealth) to support trauma-exposed populations. It is important to evaluate mechanisms of therapeutic change in reducing posttraumatic distress in eHealth for trauma survivors. OBJECTIVE This study evaluated a proactive, scalable, and individually responsive eHealth intervention for trauma survivors called My Trauma Recovery. My Trauma Recovery is an eHealth intervention aiming to support trauma survivors and consisting of 6 modules: relaxation, triggers, self-talk, professional help, unhelpful coping, and social support. It was designed to enhance trauma coping self-efficacy (CSE). We tested 3 hypotheses. First, My Trauma Recovery would decrease posttraumatic stress symptoms (PTSS). Second, My Trauma Recovery would increase CSE. And last, changes in CSE would be negatively correlated with changes in PTSS. METHODS A total of 92 individuals exposed to trauma (78/92, 85% females, mean age 34.80 years) participated. Our study was part of a larger investigation and consisted of 3 sessions 1 week apart. Participants completed the baseline online survey assessing PTSS and CSE. Each session included completing assigned modules followed by the online survey assessing CSE. PTSS was remeasured at the end of the last module. RESULTS PTSS significantly declined from T1 to T9 (F1,90=23.63, P<.001, η2p=.21) supporting the clinical utility of My Trauma Recovery. Significant increases in CSE for sessions 1 and 2 (F8,83=7.51, P<.001) were found. No significant change in CSE was found during session 3 (N=92). The residualized scores between PTSS T1 and T9 and between CSE T1 and T9 were calculated. The PTSS residualized score and the CSE residualized score were significantly correlated, r=–.26, P=.01. Results for each analysis with a probable PTSD subsample were consistent. CONCLUSIONS The findings of our study show that participants working through My Trauma Recovery report clinically lower PTSS after 3 weeks. The results also demonstrate that CSE is an important self-appraisal factor that increased during sessions 1 and 2. These improvements are correlated with reductions in PTSS. Thus, changes in CSE may be an important mechanism for reductions in PTSS when working on a self-help trauma recovery website and may be an important target for eHealth interventions for trauma. These findings have important implications for trauma eHealth interventions.

scholarly journals Predicting Change in Posttraumatic Distress Through Change in Coping Self-Efficacy After Using the My Trauma Recovery eHealth Intervention: Laboratory Investigation

10.2196/10309 ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. e10309 ◽  
Author(s):  
Charles C Benight ◽  
Kotaro Shoji ◽  
Carolyn M Yeager ◽  
Pamela Weisman ◽  
Terrance E Boult
Keyword(s):  
Self Efficacy ◽  
Online Survey ◽  
Trauma Survivors ◽  
Trauma Recovery ◽  
Professional Help ◽  
Posttraumatic Distress ◽  
Stress Symptoms ◽  
Self Help ◽  
Self Talk ◽  
Ehealth Intervention

Background Technology offers a unique platform for delivering trauma interventions (ie, eHealth) to support trauma-exposed populations. It is important to evaluate mechanisms of therapeutic change in reducing posttraumatic distress in eHealth for trauma survivors. Objective This study evaluated a proactive, scalable, and individually responsive eHealth intervention for trauma survivors called My Trauma Recovery. My Trauma Recovery is an eHealth intervention aiming to support trauma survivors and consisting of 6 modules: relaxation, triggers, self-talk, professional help, unhelpful coping, and social support. It was designed to enhance trauma coping self-efficacy (CSE). We tested 3 hypotheses. First, My Trauma Recovery would decrease posttraumatic stress symptoms (PTSS). Second, My Trauma Recovery would increase CSE. And last, changes in CSE would be negatively correlated with changes in PTSS. Methods A total of 92 individuals exposed to trauma (78/92, 85% females, mean age 34.80 years) participated. Our study was part of a larger investigation and consisted of 3 sessions 1 week apart. Participants completed the baseline online survey assessing PTSS and CSE. Each session included completing assigned modules followed by the online survey assessing CSE. PTSS was remeasured at the end of the last module. Results PTSS significantly declined from T1 to T9 (F1,90=23.63, P<.001, η2p=.21) supporting the clinical utility of My Trauma Recovery. Significant increases in CSE for sessions 1 and 2 (F8,83=7.51, P<.001) were found. No significant change in CSE was found during session 3 (N=92). The residualized scores between PTSS T1 and T9 and between CSE T1 and T9 were calculated. The PTSS residualized score and the CSE residualized score were significantly correlated, r=–.26, P=.01. Results for each analysis with a probable PTSD subsample were consistent. Conclusions The findings of our study show that participants working through My Trauma Recovery report clinically lower PTSS after 3 weeks. The results also demonstrate that CSE is an important self-appraisal factor that increased during sessions 1 and 2. These improvements are correlated with reductions in PTSS. Thus, changes in CSE may be an important mechanism for reductions in PTSS when working on a self-help trauma recovery website and may be an important target for eHealth interventions for trauma. These findings have important implications for trauma eHealth interventions.

Engagement, Predictors, and Outcomes of a Trauma Recovery Digital Mental Health Intervention: Longitudinal Study (Preprint)

2021 ◽  
Author(s):  
Carolyn M. Yeager ◽  
Charles C. Benight
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Self Efficacy ◽  
Longitudinal Research ◽  
Outcome Expectations ◽  
Model Fit ◽  
Symptom Reduction ◽  
Trauma Recovery ◽  
Adequate Model ◽  
Latent Construct

BACKGROUND Worldwide, exposure to potentially traumatic events is extremely common and many will develop posttraumatic stress disorder (PTSD) along with other disorders. Unfortunately, considerable barriers to treatment exist. One promising approach to overcoming treatment barriers are digital mental health interventions (DMHIs). Yet, engagement with DMHIs is a concern and theoretically based research in this area is sparse and often inconclusive. OBJECTIVE The focus of this study was on the complex issue of DMHI engagement. Based on the social cognitive theoretical (SCT), the conceptualization of engagement and a theoretically based model of predictors and outcomes were investigated using a DMHI for trauma recovery. METHODS A 6-week longitudinal study with a national sample of trauma survivors was performed that measured engagement, predictors of engagement, and mediational pathways to symptom reduction while using a trauma recovery DMHI (NT1 = 915, NT2 = 350, NT3 = 168, NT4 = 101). RESULTS Confirmatory factor analysis of the engagement latent construct of duration, frequency, interest, attention, and affect produced an acceptable model fit, (χ² = 8.35, df = 2, P = .015, CFI = .973, RMSEA = .059, 90% CI = [.022, .103]. Using the latent construct, the longitudinal theoretical model demonstrated adequate model fit, CFI = .929, RMSEA = .052, 90% CI [.040, .064] and indicated that engagement self-efficacy (β = .35, P < .001) and outcome expectations (β = .37, P < .001) were significant predictors of engagement (R2 = 39%). The relationship between engagement and outcomes was mediated by both activation self-efficacy (β = .80, P < .001), and trauma coping self-efficacy (β = .40, P < .001), which predicted a reduction in PTSD symptoms (β = -.20, P = .017). CONCLUSIONS The results of this study may provide a solid foundation toward formalizing the nascent science of engagement. The engagement conceptualization consisted of general measures of attention, interest, affect, and usage that could be applied to other applications. The longitudinal research model supported two theoretically based predictors of engagement, engagement self-efficacy and outcome expectancies. Two task specific self-efficacies, activation and coping, proved to be significant mediators between engagement and symptom reduction. Taken together, this model can be applied to other DMHIs to understand engagement as well as predictors and mechanisms of action. Ultimately, this could help improve the design and development of engaging and effective trauma recovery DMHIs.

Theory of Planned Behavior and Stages of Change Models

2017 ◽  
Author(s):  
Jeffrey J. Martin
Keyword(s):  
Theory Of Planned Behavior ◽  
Planned Behavior ◽  
Stages Of Change ◽  
Outcome Expectations ◽  
Future Research ◽  
Change Models ◽  
Efficacy Outcome ◽  
Health Action ◽  
Research Findings ◽  
Action Process

The theory of planned behavior (TPB) and stages of change (SOC) models have been used to predict physical activity (PA) in people with disabilities. The purpose of this chapter is to give an overview of the TPB and SOC models and the research findings stemming from testing them in people with impairments. The health action process approach (HAPA), designed with individuals with disabilities, is also introduced, along with suggested future research using the HAPA. The HAPA is in many ways a meta-theory, as it incorporates many constructs from theories discussed here and in other chapters. For instance, various forms of self-efficacy, outcome expectations, coping, planning, and social support are all included in the HAPA. In addition, the HAPA includes a three-stage model in which people are labeled as pre-intenders, intenders, or actors. Researchers intending to use the SOC theories and the TPB should know that they have come under criticism, and these criticisms are addressed in the chapter.

scholarly journals Implementation of Health Action Process Approach to Improve Dietary Adherence in Type 2 Diabetic Patient

Jurnal NERS ◽  
2016 ◽  
Vol 10 (2) ◽  
pp. 272
Author(s):  
Kusnanto Kusnanto ◽  
Iqlima Dwi Kurnia ◽  
Dwi Indah Prasetia
Keyword(s):  
Blood Sugar ◽  
Self Efficacy ◽  
Process Approach ◽  
Diabetic Patients ◽  
Dietary Adherence ◽  
Health Action Process Approach ◽  
Health Action ◽  
Action Process ◽  
Type 2 Diabetic

Introduction: Type 2 diabetic patients usually unsuccessful to follow the diet recommendation due to lack of motivation, memory and intention. This study attempts to increase the motivation and also to improve intention in dietary adherence through the implementation of Health Action Process Approach (HAPA). Method: This study was a quasy-experiment. The population were type 2 diabetic patients in Puskesmas Krian Sidoarjo in March-April 2015. Respondents were only 16 and had been divided into experiment and control group. The independent variable was the implementation of HAPA. The dependent variable were self-efficacy, dietary adherence and blood sugar levels. The instruments in this study were questionnaires and blood sugar monitoring devices. Data were analyzed using statistical wilcoxon sign rank test and mann whitney u  test with significance level α ≤ 0.05. Result: Wilcoxon sign rank test showed there were differences between pre and post test significantly on self-efficacy (p=0.014), dietary adherence  (p=0.025), blood sugar levels (p=0.009) in  experiment group, while no significant differences in control group. Mann Witney U test showed that there was significant difference on dietary adherence (p=0.002) between two groups. Discussion: In conclusion, the implementation of HAPA can improve dietary adherence in type 2 diabetic patient. Further, following studies are expected with large number respondents and identify the whole variables in the HAPA theory.Keywords: Health Action Process Approach (HAPA), self efficacy, dietary adherence, blood glucose, Diabetes Mellitus (DM)

scholarly journals Combination of Home Care Pharmacy Approach and Nurse’s Health Action Process Approach on Self Care Management and Self Efficacy in Elderly With Hypertension

2020 ◽  
Vol 4 (2) ◽  
pp. 134
Author(s):  
Linda Juwita ◽  
Ninda Ayu Prabasari ◽  
Restry Sinansari
Keyword(s):  
Home Care ◽  
Self Efficacy ◽  
Care Management ◽  
Self Care ◽  
Rank Test ◽  
Care Approach ◽  
Health Action ◽  
Wilcoxon Sign Rank ◽  
Sign Rank Test ◽  
Action Process

Introduction: There are still many hypertensive patients with uncontrolled hypertension and experiencing barriers to self-care. This study attempts to increase motivation and intention in self-care management and self-efficacy through the implementation combination of home pharmacy care approach and Health Action Process Approach (HAPA). This study aimed to know the combination of the Home Care Pharmacy Approach and Nurse's HAPA on self-care management and self-efficacy in the elderly with hypertension. Methods: It was a pre-experimental study that used one group pretest post-test design approach with the population, 60 people. Inclusion criteria were respondents with average blood pressure ≥140/90 mmHg for two measurements. The sampling used a purposive sampling technique. The independent variable was the HAPA and Home Care Pharmacy. The dependent variable is self-care management and self-efficacy. Study instruments are questionnaire self-efficacy, self-care management, standard operating procedures, and HAPA Home Care Pharmacy. Data were analyzed by using paired t-test and Wilcoxon Sign Rank Test with significance paired α ≤ 0.05. Results: Statistical paired t-test showed there was an increase in self-care management (p = 0.006). Statistical Wilcoxon Sign Rank Test showed there was no influence on the home pharmacy care approach and HAPA on self-efficacy (p=0.753). Conclusions: It could be concluded that the implementation of collaboration in-home pharmacy care approach and HAPA improves self-care management. However, these interventions do not affect increasing self-efficacy. The excellent collaboration between healthcare providers will help patients maintain good health during treatment.

scholarly journals Predicting physical activity change in cancer survivors: an application of the Health Action Process Approach

2021 ◽  
Author(s):  
Sarah J. Hardcastle ◽  
Chloe Maxwell-Smith ◽  
Martin S. Hagger
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Self Efficacy ◽  
Risk Perceptions ◽  
Action Planning ◽  
Process Approach ◽  
Equation Modeling ◽  
Health Action Process Approach ◽  
Health Action ◽  
Action Process

Abstract Purpose Previous research has not examined the utility of the Health Action Process Approach (HAPA) to predict physical activity (PA) change in cancer survivors. The aim of the study was to investigate the efficacy of a HAPA-based model in predicting temporal change in moderate-to-vigorous physical activity (MVPA) in cancer survivors. Methods Participants enrolled in the Wearable Activity Technology and Action Planning (WATAAP) trial completed validated questionnaires (n = 64) to assess HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, and intention) and wore an ActiGraph to measure PA at baseline, 12 weeks, and 24 weeks later. Data were analyzed using variance-based structural equation modeling with residualized change scores for model variables. Results Consistent with predictions, changes in action self-efficacy (β = 0.490, p < 0.001, ES = 0.258) and risk perceptions (β = 0.312, p = 0.003, ES = 0.099) were statistically significant predictors of intention change over time. Changes in intention (β = 0.217, p = 0.029, ES = 0.040) and action planning (β = 0.234, p = 0.068, ES = 0.068) predicted changes in MVPA. Overall, the model accounted for significant variance in intention (R2 = 0.380) and MVPA (R2 = 0.228) change. Conclusions Changes in intention and action planning were important correlates of MVPA change over 24 weeks. Further, changes in action self-efficacy and risk perceptions predicted changes in intention. Implications for cancer survivors: interventions that foster risk perceptions and self-efficacy, strengthen intentions, and promote action planning may be effective in promoting sustained PA change in cancer survivors.

Determinants of effective nurse-patient communication based on the health action process approach in Yazd hospitals

2019 ◽  
Vol 40 (3) ◽  
Author(s):  
Mohammad Ali Morowati Sharifabad ◽  
Mohammad Rafati Fard ◽  
Mojtaba Fattahi Ardakani ◽  
Ali Dehghani Ahmadabad ◽  
Ahmad Sotudeh
Keyword(s):  
Self Efficacy ◽  
Effective Communication ◽  
Process Approach ◽  
Patient Communication ◽  
Public Hospitals ◽  
Equation Modeling ◽  
Health Action Process Approach ◽  
Significant Difference ◽  
Health Action ◽  
Action Process

Abstract Background Nurse-patient communication is one of the most important care relationships that affects the treatment process. The health action process approach (HAPA) has been used to explain a number of behaviors. However, this approach has not been used to explain nurse-patient communication. Therefore, this study was conducted to investigate effective nurse-patient communication using this approach. Materials and methods In this cross-sectional study, 300 nurses from public hospitals in the center of Iran were enrolled in the study. A researcher-developed questionnaire was used to measure the HAPA constructs. The data were analyzed using Pearson’s correlation coefficient and one-way analysis of variance with least significant difference (LSD) post hoc tests in SPSS as well as structural equation modeling using AMOUS software. Results In the motivation phase, risk perception, outcome expectancies and task self-efficacy predicted 19% of variance in intention to communicate effectively. In the volitional phase, planning and action self-efficacy predicted 22% of variance in effective communication. The scores of HAPA constructs were different depending on the levels of effective communication. Conclusions The model can serve as a reference framework to promote effective nurse-patient communication.

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