Aart N Mudde

• dr.
• Open University of the Netherlands

Objective: To provide insight into the motivational working mechanisms (i.e. mediators) of an effective physical activity (PA) intervention for adults aged over fifty. Design: The mediation model (N = 822) was investigated in an RCT for the total intervention population, participants who were not norm-active at baseline (targeting PA initiation) an...

These longitudinal studies in older adults targeted mediated relationships between habit and physical activity (PA). In The Netherlands two independent studies were conducted among 1976 (Study 1: Mage=63.63, SD=8.66, 30% functional limitations) and 2140 (Study 2: Mage=62.75, SD=8.57, 45% functional limitations) adults aged 50 years or older. Cross-...

Intensive behavioral counseling interventions combined with nicotine replacement therapy have increased smoking abstinence rates in cardiac patients, but little is known about their feasibility when initiated upon hospital admission and continued post-discharge. The current study was an evaluation of the use, appreciation, and fidelity of two post-...

Physical activity is associated with many health benefits that are important for older adults. These health benefits can only be obtained and preserved when physical activity is maintained over a long period of time. Habit formation has been proposed as a way to ensure long-term maintenance of physical activity. Intention, action planning, and phys...

Background Without assistance, smokers being admitted to the hospital for coronary heart disease often return to regular smoking within a year. Objective This study assessed the 12-month effectiveness of a telephone and a face-to-face counselling intervention on smoking abstinence among cardiac patients. Differential effects for subgroups varying i...

Smoking cessation is the most effective action for cardiac patients who smoke to improve their prognosis, yet more than one-half of cardiac patients continue to smoke after hospital admission. This study examined the influence of action plans, coping plans and self-efficacy on intention to quit and smoking cessation in cardiac patients. Cardiac pat...

The objectives of this study were to determine the accuracy of smoking cessation self-reports by cardiac patients who participated in a smoking cessation program, and to determine which patient characteristics are associated with an inaccurate self-report during a follow-up interview 12 months after the start of the program. Smoking cessation self-...

This study examined the cost-effectiveness and cost-utility of two smoking cessation counseling interventions differing in their modality for patients diagnosed with coronary heart disease from a societal perspective. In a randomized controlled trial conducted in Dutch hospital wards, cardiac patients who smoked prior to admission were allocated to...

Background: Physical inactivity is a significant predictor of several chronic diseases, becoming more prevalent as people age. Since the aging population increases demands on healthcare budgets, effectively stimulating physical activity (PA) against acceptable costs is of major relevance. This study provides insight into long-term health outcomes...

Background The adverse health effects of insufficient physical activity (PA) result in high costs to society. The economic burden of insufficient PA, which increases in our aging population, stresses the urgency for cost-effective interventions to promote PA among older adults. The current study provides insight in the cost-effectiveness and cost-u...

Smoking cessation is the most effective action for cardiac patients who smoke to improve their prognosis, yet more than one-half of cardiac patients continue to smoke after hospital admission. This study examined the influence of action plans, coping plans and self-efficacy on intention to quit and smoking cessation in cardiac patients. Cardiac pat...

This study provides insight in the effectiveness of a print-delivered and a Web-based physical activity (PA) intervention (with or without additional environmental information on local PA possibilities) among people aged over 50. Intervention groups (print-delivered basic [PB; n = 439], print-delivered environmental [PE; n = 435], Web-based basic [...

The handgrip strength of geriatric patients can be measured when the patient is hospitalized. This article elaborates on the intrinsic and extrinsic factors which have a direct or indirect influence on handgrip strength. For the best results the tests need to be taken in the best circumstances with attention to individual differences and the age of...

The public health impact of health behaviour interventions is highly dependent on large-scale implementation. Intermediaries-intervention providers-determine to a large extent whether an intervention reaches the target population, and hence its impact on public health. A cross-sectional study was performed to identify the correlates of intermediari...

This study provides insight into the long-term efficacy (i.e. 12 month results) of the Web-based or print-delivered tailored Active Plus intervention (with and without environmental approach) to promote physical activity (PA) among the over-fifties. Differences in effect among subgroups are studied as well. Intervention groups (i.e. print-delivered...

Purpose: This study tested the long-term effectiveness of two smoking cessation interventions in cardiac patients and differential effects for socio-economic status (SES) and patients' motivation to quit. Methods: In this Dutch randomized controlled trial conducted from 2009 to 2012, hospitalized cardiac patient smokers were assigned to Usual Care...

This study provides insight into the use and appreciation of a tailored physical activity intervention for people aged over 50 years in different intervention conditions (i.e. printed versus web-based and basic versus environmental). Participants (within a clustered randomized controlled trial) received printed or web-based-tailored advice three ti...

Smoking cessation interventions for cardiac patients need improvement given their weak effects on long-term abstinence rates and low compliance by nurses to implementation. This study tested the effectiveness of two smoking cessation interventions against usual care in cardiac patients, and conditional effects for patients' motivation to quit and s...

This longitudinal study examined whether habit strength moderates the intention-physical activity (PA) relationship in older adults, within the framework of the attitude-social influences-efficacy (ASE) model and the theory of planned behaviour (TPB). A total of 1836 older adults (M (age) = 62.95 years, SD (age) = 8.17) completed a questionnaire on...

Background The Internet has the potential to provide large populations with individual health promotion advice at a relatively low cost. Despite the high rates of Internet access, actual reach by Web-based interventions is often disappointingly low, and differences in use between demographic subgroups are present. Furthermore, Web-based interventio...

There is no more effective intervention for secondary prevention of coronary heart disease than smoking cessation. Yet, evidence about the (cost-)effectiveness of smoking cessation treatment methods for cardiac inpatients that also suit nursing practice is scarce. This protocol describes the design of a study on the (cost-)effectiveness of two inte...

The Active Plus project is a systematically developed theory- and evidence-based, computer-tailored intervention, which was found to be effective in changing physical activity behavior in people aged over 50 years. The process and effect outcomes of the first version of the Active Plus project were translated into an adapted intervention using the...

Low-cost (e.g., computer-tailored) interventions with sustained effects are needed to increase and maintain physical activity in older adults. This study examined the long-term efficacy of 2 computer-tailored physical activity interventions for older adults and its psychosocial and environmental mediators. A clustered randomized controlled trial (N...

Important health benefits can be derived when low-cost (e.g., computer-tailored) physical activity interventions for older adults demonstrate sustained effects. The purpose of the study was to conduct in-depth analysis on the long-term efficacy of two tailored physical activity interventions for older adults. A randomized controlled trial (n = 1,97...

Purpose The purpose of this paper is to test the effectiveness of a computer‐tailored smoking cessation intervention, distributed through 75 Dutch general practices (GP) and 65 pharmacies (PH) in a randomised control trial. Design/methodology/approach Respondents receive a tailored letter or a thank you letter (control condition). Main outcome mea...

The aim of this study was to explore the working mechanisms of a computer tailored physical activity intervention for older adults with environmental information compared to a basic tailored intervention without environmental information. A clustered randomized controlled trial with two computer tailored interventions and a no-intervention control...

Important health benefits can be obtained if effective low-cost interventions promoting physical activity, especially among older adults, are developed. This RCT investigated the efficacy of two tailored physical activity interventions in promoting awareness, initiation, and maintenance of physical activity among older adults compared to a wait-lis...

Understanding the determinants of changing physical activity among older adults is crucial for effective intervention development. The aim of this study was to review and update the evidence relating to the determinants of physical activity initiation and maintenance among older adults, and to explore the main similarities and dissimilarities in de...

Limited data are available on the development, implementation and evaluation processes of physical activity promotion programmes among older adults. More integrative insights into interventions describing the planned systematic development, implementation and evaluation are needed. The purpose of this study is to give an integrative insight into th...

Determinants and the theoretical methods, practical strategies and tools used in both interventions to increase recreational PA.

Determinants and the theoretical methods, practical strategies and tools used only in the intervention plus to increase recreational PA.

To develop effective interventions to stimulate physical activity (PA), insight into its underlying variables is needed. The aim of this study was to obtain an overview of the most relevant determinants of awareness, initiation and maintenance of PA among the over-fifties by means of a three-round Delphi study. In the first round, 17 key-experts ou...

A prospective study focused on self-efficacy as a predictor for smoking cessation. Subjects were 123 Dutch participants in a 3-week smoking cessation group program. Before and after treatment perceived self-efficacy was measured by questionnaire. Three measures related to self-efficacy were used: a 17-item perceived ability scale (PAS), a 10-item p...

Purpose The paper seeks to identify determinants of general practice staff's intention to further implement a smoking cessation expert system, a computer‐generated tailored intervention, following their participation in an effectiveness study. Design/methodology/approach Written questionnaires based on the I‐Change Model, a socio‐cognitive model,...

A minority of child abuse cases is recognized by professionals, making the role of non-professional bystanders essential. The stages of change construct, as proposed by the Transtheoretical Model, may provide a useful approach to explain non-professional helping behavior. The objective of this study was to test the applicability of the stages of ch...

This study aims to determine differences in samples of adult smokers recruited by passive or active recruitment in community pharmacy (PP and AP) or passive recruitment in general practice setting (PG), then comparing these samples to an unrecruited cohort of Dutch smokers. The three recruited samples were compared on demographics, smoking behaviou...

Few studies describe the factors associated with smoking behaviour in Portuguese adolescents. Hence, smoking prevention activities are not based on research findings. This study analyses the differences between smokers and nonsmokers and factors associated with smoking behaviour in a sample of Portuguese adolescents. A questionnaire was administrat...

The object of this study was to investigate the influence of gender and the additional protective quality of action plans on the occurrence of relapse in smokers after a pharmacy-based minimal intervention strategy. Respondents received a written baseline questionnaire, based on the I-Change Model, and were contacted 3 months after baseline by tele...

Pre-contemplators, contemplators and preparers have previously been described by distinct scores on pros, social influence and self-efficacy, the Ø pattern. The objective of this study was to replicate this pattern in a sample of adult smokers (n = 554), to longitudinally observe stage sequence and identify predictors for forward and backward stage...

To investigate intention to adopt a new smoking cessation expert system as well as outline perceived barriers by general practitioners (GPs) to adopt this expert system, a written questionnaire was sent to 771 registered GPs. Respondents, representing 34.8% of the registered GPs, were classified as adopters (34.2%), doubters (36.2%) or non-adopters...

The European Smoking Prevention Framework Approach (ESFA) study in six countries tested the effects of a comprehensive smoking prevention approach after 24 (T3; N = 10,751) and 30 months (T4; N = 9,282). The programme targeted four levels, i.e. adolescents in schools, school policies, parents and the community. In Portugal, 12.4% of the T1 non-smok...

Despite intensive efforts, most smoking prevention interventions have had disappointing results. In the present paper, the assumption underlying these efforts that smoking initiation is the result of a rational decision or plan, is questioned. The process of adolescent smoking initiation is described, based on a recently conducted series of studies...

In this study, determinants of tobacco use among Gambian youths were examined. A cross-sectional school-based survey was conducted among 282 students, aged 14-18. The potential determinants were derived from the core constructs of the Theory of Planned Behavior and the ASE model. Moreover, various measures of knowledge and media influence were adde...

The present study tested the use and validity of a stage model of adolescent smoking initiation. The model aims to identify adolescents who are currently not smoking, but who are cognitively predisposed to start smoking in the future. Research on subtypes within the precontemplation stage of adolescent smoking initiation and the concept of suscepti...

Objectives: To investigate predictors of smoking cessation and relapse in Dutch adults. Method Smokers were invited by pharmacy staff to fill in a written questionnaire about smoking behaviour and cessation. Two follow-ups by telephone (respectively 3 and 12 months after baseline) were also conducted. The theoretical basis of this questionnaire was...

Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Sel...

A dearth of longitudinal research has been observed regarding the measurement of the behavioral process of adolescent smoking initiation. The present study operationalizes the leading model on the process of smoking initiation, including two stages of nonpersistent smoking behavior that were previously unlabelled. An instrument was developed that d...

The European Smoking Prevention Framework Approach (ESFA) resulted in a smoking prevention project for six European countries. It included activities on four levels: adolescents, schools, parents and out-of-school activities. Common goals and objectives were developed, but countries were also able to include additional objectives. National diversit...

A smoking prevention project in six European countries (European Smoking prevention Framework Approach) was developed, featuring activities for adolescents, schools and parents, including out-of-school activities. Consensus meetings resulted in agreement between the countries on goals, objectives and theoretical methods. Countries' specific objecti...

This study assessed the relationship between the smoking behavior of adolescents and the smoking status of their parents and friends among adolescents from six European countries. A longitudinal study collected data from 15 705 adolescents on their own smoking status, and that of their parents, best friend and friends in general. Cross-sectional re...

The vast majority of adult smokers take up the habit during adolescence and most continue to smoke for the rest of their lives. In order to reduce the prevalence of this highly health-compromising behaviour those factors which are associated with smoking in early adolescence need to be determined so that appropriate action can be taken. The study w...

Objetivo: Describir los factores asociados con el consumo de tabaco y la intención de fumar en el futuro en una muestra representativa de escolares de primer curso de educación secundaria en Barcelona. Sujetos y métodos: Se seleccionaron 37 escuelas al azar para participar en la evaluación de un programa europeo de prevención del tabaquismo (Europe...

Objective: To describe the factors asssociated with smoking and intention to smoke among a representative sample of first-grade pupils of secondary education (12-13 years old) in Barcelona. Subjects and methods: 37 secondary schools were randomly selected to evaluate the impact of a European-wide smoking prevention program (European Smoking prev...

Current research on the continuum of smoking initiation has largely focused on phases of progressing frequency of smoking. To gain more insight into reasons some adolescents do, and others do not, proceed to advanced levels of smoking behavior, a continuum in which two categories of ex-smoking are proposed is examined. Standardized scores on psycho...

The present study examined the existence of three possible subtypes within the precontemplation stage of smoking acquisition: committers, immotives, and progressives. The sample of the study included young people from six European countries (mean age = 13 years) who had never smoked regularly (n = 21 535). A cross-sectional design was used to asses...

Until recently, Dutch general practitioners contributed little to tobacco control. This is due to several factors, among which is the lack of a feasible intervention program for adult smokers. Such a minimal contact behavioral intervention, using the Stage-of-Change concept, is now available. Effectiveness was tested in a randomized trial. Twenty-t...

From a theoretical and practical point of view, it is worthwhile to utilize the full potential of prevention of child abuse. However, prevention strategies in the field of child abuse were generally limited to prevention by means of interpersonal communications. This paper seeks to address this lacuna. A case-study is presented by describing and an...

An important risk factor, single as well as combined with other factors, for the development of cancer is tobacco smoking. In the Netherlands 37% of the adult men smoke, and 30% of the women. It is estimated that 20% of the now living population will eventually die from the consequences of smoking. Besides stimulating youngsters not to take up smok...

This study examined the reach, effectiveness, and cost-effectiveness of a mass media-led smoking cessation campaign including television shows, a television clinic, a quit line, local group programs, and a comprehensive publicity campaign. A random sample of baseline smokers (n = 1338) was interviewed before and after the campaign and at a 10-month...

The purpose of this study was to assess adoption, implementation and maintenance of a guided supermarket tour program of nutrition education by Dutch Public Health Services (PHSs), and the factors associated with program dissemination. A first questionnaire was sent to all 60 PHSs, and measured program adoption, perceived program attributes, and ch...

The ASE model, an integration of social psychological models, states that motivational phases and the transition from one phase to another can be predicted by behavioral determinants. The goal of the present study was to replicate the so-called O pattern that was found in earlier Dutch studies. In four cross-sectional studies (N = 918, N = 354, N =...

Cross-sectional studies integrating motivational stages with expectancy value models have suggested that contemplating smokers perceive more advantages of quitting and social support than precontemplators. Moreover, smokers preparing to quit were found to differ from precontemplators and contemplators by having higher self-efficacy expectations.Usi...

In order to study whether the Stages of Change concept of the Transtheoretical Model is applicable to fruit, vegetable and fat intake, data on two different study populations were analysed. Two methods of classifying stages of change were compared in both study populations. The first, more traditional, classification method was based on intentions...

Inhaled medication is commonly prescribed for the treatment of asthma and chronic obstructive pulmonary disease (COPD), but is often not properly used by patients. A total of 316 patients suffering from asthma or COPD took part in a study that evaluated how patients utilized their metered-dose inhaler (MDI) or dry powder inhaler, using a standardiz...

Although the results of self-help and group treatments for smoking cessation are known, the cost effectiveness and participants' characteristics of these treatments remain mostly undetermined. Consecutive samples of 84 self-help manual requesters and 83 group participants in a Dutch community-based smoking cessation program were subjected to teleph...

Until 1990, smoking cessation interventions in the Netherlands were limited. The utility and effectiveness of community-based smoking cessation programs have not been examined. In a treatment city (Den Bosch) a multicomponent community-based smoking cessation intervention was implemented in which local mass media and general practitioners draw smok...

Proefschrift Rijksuniversiteit Limburg, Maastricht. Met lit. opg. - Met een samenvatting in het Nederlands.

Self-efficacy is defined as the estimation of the person about his/her ability to perform a specific behavior. The important role of self-efficacy in health education is argued, illustrated with Dutch research, which shows that self-efficacy is an important determinant of health behavior, of future health behavior and of health behavior change....