Cognitive determinants of weight control by dietary patterns among postmenopausal women with osteoporosis: An application of theory of planned behavior

Background: In this study, we aimed to assess the cognitive determinants of weight control behaviors by dietary patterns among postmenopausal women with osteoporosis. Methods: This cross-sectional study, based on the theory of planned behavior (TPB) was conducted from July to December 2017 among 240 postmenopausal women with osteoporosis in Tabriz, Iran. A validated and reliable TPB-based instrument, namely Weight-CuRB, and the food frequency questionnaire (FFQ) were used. Results: The results of exploratory factor analysis (EFA) indicated three dietary patterns (total variance explained=24.44%); healthy (n=71), mixed (n=78), and western (n=91). In addition, food items consumed by participants were classified into twenty-two food groups for dietary pattern analysis. In the healthy and western dietary patterns, attitude (β: 0.140, P<0.001) and subjective norms (SNs) (β: 0.498, P<0.01) were the only predictors of weight control behavior, respectively. In the women with healthy and western patterns, the TPB-based variables altogether explained 11% and 16% of variations in the behavior, respectively. Among all patients, the TPB-based variables explained 12.2% of variations in weight control behavior, within which SNs were the only significant predictor of the behavior (β=-0.199, P<0.01). Conclusion: Our findings highlighted the remarkable role of dietary patterns in the associations between weight control and its cognitive determinants. Dietary patterns should be considered while designing weight control educational interventions among women with osteoporosis. In such interventions, promoting SNs and perceived behavioral control (PBC) should be considered as the core strategies to promote the behaviors among the patients who follow an unhealthy diet.

Predicting Decisional Determinants of Physical Activity Among Older Adults: An Integrated Behavior Approach

Objectives The present study applied the Integrated Behavior Change Model to investigate how behavioral decisions are predicted, namely, intention, planning, and habits, with respect to physical activity. Methods: Participants were older adults (ages 65+) residing in the U.S. ( N = 667) who completed online measures of behavioral determinants (autonomous motivation, perceived behavioral control, subjective norms, attitudes, intention, habit, and consistency), in addition to past behavior. Results: A structural equation model revealed that intention was predicted by past behavior and social-cognitive determinants. Social cognitive determinants mediated between past behavior and habit, as well as between autonomous motivation and habit. Intention mediated between past behavior and planning. Discussion: This study highlights the importance of multiple processes (social cognitive, habit/automatic, and post-intentional/planning) that formulate physical activity intentions. Mediation pathways revealed the importance of autonomous motivation for establishing intentions and habit. Facilitating these processes among older adults could be effective for promoting physical activity.

Healthcare worker mental models of patient care tasks in the context of infection prevention and control

Objective: Understanding the cognitive determinants of healthcare worker (HCW) behavior is important for improving the use of infection prevention and control (IPC) practices. Given a patient requiring only standard precautions, we examined the dimensions along which different populations of HCWs cognitively organize patient care tasks (ie, their mental models). Design: HCWs read a description of a patient and then rated the similarities of 25 patient care tasks from an infection prevention perspective. Using multidimensional scaling, we identified the dimensions (ie, characteristics of tasks) underlying these ratings and the salience of each dimension to HCWs. Setting: Adult inpatient hospitals across an academic hospital network. Participants: In total, 40 HCWs, comprising infection preventionists and nurses from intensive care units, emergency departments, and medical-surgical floors rated the similarity of tasks. To identify the meaning of each dimension, another 6 nurses rated each task in terms of specific characteristics of tasks. Results: Each HCW population perceived patient care tasks to vary along 3 common dimensions; most salient was the perceived magnitude of infection risk to the patient in a task, followed by the perceived dirtiness and risk of HCW exposure to body fluids, and lastly, the relative importance of a task for preventing versus controlling an infection in a patient. Conclusions: For a patient requiring only standard precautions, different populations of HCWs have similar mental models of how various patient care tasks relate to IPC. Techniques for eliciting mental models open new avenues for understanding and ultimately modifying the cognitive determinants of IPC behaviors.

Social-Cognitive Determinants of HIV Testing Among Tuberculosis Infected Patients in Kassala State, Sudan

Background: Use of HIV testing and counselling (HTC) services remains low among TB patients in Sudan. Identifying the social-cognitive (sub) determinants associated with HTC uptake is essential before developing interventions to promote uptake. This study aims to assess the sub-determinants of intention to use and actual behaviour of using HTC services among TB patients in Sudan and to ascertain the most relevant beliefs to inform future interventions.Methods: A cross-sectional study was carried out in five health facilities selected randomly in Kassala State. First, a small elicitation study (N = 25) was conducted to inform the Reasoned Action Approach (RAA) based questionnaire. A total of 411 TB patients completed the survey questionnaire. Confidence Interval Based Estimation of Relevance analysis (CIBER) was employed to establish the sub-determinants' relevance.Result: The studied beliefs explained 38–52% of the variance in the intention and 20–35% in the behaviour variance. The beliefs that “Using HTC services increases my fear of being tested positive for HIV” and “Using HTC services increases my fear of losing my partner if I have a positive test result” were negatively associated with intentions and use of HTC services; and both were highly relevant for intervention. The belief “If I use HTC services, I would know my HIV status” was positively associated with intentions and use of HTC services. However, it was less relevant for intervention. Perceived susceptibility to HIV infection was not associated with intention and only weakly associated with use of HTC services. Its relevance was low for intervention.Conclusions: The study showed that the social-cognitive beliefs (sub-determinants) vary in their relationship with the intention and use of HTC services among TB patients; with variable relevance for intervention. Interventions to enhance the use of HTC services should address the most relevant beliefs to maximise the effectiveness of interventions. Further studies are needed to identify other relevant sub-determinants of HTC use behaviour.

Structure Analysis of Factors Influencing the Preference of Ridesplitting

Ridesplitting is a new form of for-hire service that riders with similar origins and destinations are matched to the same vehicle in real-time via Internet. However, the market share of ridesplitting only accounts for a small fraction of total travel. Understanding cognitive factors affecting ridesplitting preference would be helpful in designing its market measures, regulations, and incentives to achieve high-level customer attractions. This paper identifies the cognitive determinants affecting ridesplitting preference and their inner relationships via the structural equation model. The data from an online survey conducted in Shanghai were implemented for model calibration. The modal fitness results are reasonable, and the path coefficients are significant, exhibiting that the proposed hypothesis cannot be rejected. Specifically, attitude towards incentives and management issues, perceived benefit, and perceived usefulness appear to be strong active driving forces that encourage the desire to adopt ridesplitting.

Information or Habit: What Health Policy Makers Should Know about the Drivers of Self-Medication among Romanians

We use the Knowledge, Perceptions and Practices framework to analyze determinants of three types of self-medication practices in Romania: (1) self-medication in the case of cold/flu/viral infections; (2) taking non-prescribed medicine in general; and (3) self-medication based on recommendations by others. We analyzed 706 responses to an online survey and used a factor-based Partial Least Squares algorithm (PLSF) to estimate the relationships between each type of self-medication and possible predictors. Our results show that self–medication is strongly predicted by non-cognitive behavioral factors such as habits and similarity of symptoms, while cognitive determinants such as knowledge and understanding of potential risks are not significantly associated with self-medication behaviors. This paper identifies nonlinear relationships among self-medication practices and its predictors and discusses how our results can help policymakers calibrate interventions with better accuracy.