Multiple risk expert systems interventions: impact of simultaneous stage-matched expert system interventions for smoking, high-fat diet, and sun exposure in a population of parents.

Cancer Prevention Research Center, University of Rhode Island, Kingston, RI 02881-0808, USA.
Health Psychology (Impact Factor: 3.95). 10/2004; 23(5):503-16. DOI: 10.1037/0278-6133.23.5.503
Source: PubMed

ABSTRACT Three stage-based expert system interventions for smoking, high-fat diet, and unsafe sun exposure were evaluated in a sample of 2,460 parents of teenagers. Eighty-four percent of the eligible parents were enrolled in a 2-arm randomized control trial, with the treatment group receiving individualized feedback reports for each of their relevant behaviors at 0, 6, and 12 months as well as a multiple behavior manual. At 24 months, the expert system outperformed the comparison condition across all 3 risk behaviors, resulting in 22% of the participants in action or maintenance for smoking (vs. 16% for the comparison condition), 34% for diet (vs. 26%), and 30% for sun exposure (vs. 22%). Proactive, home-based, and stage-matched expert systems can produce significant multiple behavior changes in at-risk populations where the majority of participants are not prepared to change.

Download full-text


Available from: Wayne F Velicer, Jul 04, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective. To test the impact of a theory-based, SMS (text message)-delivered behavioural intervention (Healthy Text) targeting sun protection or skin self-examination behaviours compared to attention control. Method. Overall, 546 participants aged 18-42 years were randomised using a computer-generated number list to the skin self-examination (N = 176), sun protection (N = 187), or attention control (N = 183) text messages group. Each group received 21 text messages about their assigned topic over 12 months (12 weekly messages for 3 months, then monthly messages for the next 9 months). Data were collected via telephone survey at baseline, 3, and 12 months across Queensland from January 2012 to August 2013. Results. One year after baseline, the sun protection (mean change 0.12; P = 0.030) and skin self-examination groups (mean change 0.12; P = 0.035) had significantly greater improvement in their sun protection habits (SPH) index compared to the attention control group (reference mean change 0.02). The increase in the proportion of participants who reported any skin self-examination from baseline to 12 months was significantly greater in the skin self-examination intervention group (103/163; 63%; P < 0.001) than the sun protection (83/173; 48%) or attention control (65/165; 36%) groups. There was no significant effect of the intervention for participants' self-reported whole-body skin self-examination, sun tanning, or sunburn behaviours. Conclusion. The Healthy Text intervention was effective in inducing significant improvements in sun protection and any type of skin self-examination behaviours.
    Preventive Medicine 12/2014; 71. DOI:10.1016/j.ypmed.2014.12.009 · 2.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study compared, in treatment and control groups, the phenomena of coaction, which is the probability that taking effective action on one behavior is related to taking effective action on a second behavior. Pooled data from three randomized trials of Transtheoretical Model (TTM) tailored interventions (n=9461), completed in the U.S. in 1999, were analyzed to assess coaction in three behavior pairs (diet and sun protection, diet and smoking, and sun protection and smoking). Odds ratios (ORs) compared the likelihood of taking action on a second behavior compared to taking action on only one behavior. Across behavior pairs, at 12 and 24 months, the ORs for the treatment group were greater on an absolute basis than for the control group, with two being significant. The combined ORs at 12 and 24 months, respectively, were 1.63 and 1.85 for treatment and 1.20 and 1.10 for control. The results of this study with addictive, energy balance and appearance-related behaviors were consistent with results found in three studies applying TTM tailoring to energy balance behaviors. Across studies, there was more coaction within the treatment group. Future research should identify predictors of coaction in more multiple behavior change interventions.
    Preventive Medicine 03/2012; 54(5):331-4. DOI:10.1016/j.ypmed.2012.02.017 · 2.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Instruments available for a person-centered assessment of the causes of well-being and ill-being are described. Monitoring at the level of symptoms of illness and past lifestyle behavior has failed to promote change in well-being in a strong and consistent way. Therefore, we illustrate a way of assessing the interactions among multiple aspects of the causes of well-being. For example, at least three distinct aspects of human well-being are known to interact synergistically to promote health - neurobiological plasticity, self-regulatory functioning and virtue. The neglect of any one of the ternary aspects of well-being impedes understanding and treatment of the whole person. Each aspect can be reliably measured using quantitative and qualitative techniques to facilitate treatment planning and analysis of their interactions as a complex adaptive system, although further work is needed to clarify the content and structure of each aspect.
    09/2011; 31(4). DOI:10.5750/ijpcm.v1i3.99