Social cognitive determinants of physical activity among retired older individuals: An application of the health action process approach

Objective. The identification of the determinants of physical activity (PA) among older adults is an important avenue of research. To date, although the health action process approach (HAPA) has proven to be a valid framework for the prediction of PA among heterogeneous sample of both middle‐aged and older adults in rehabilitation and work settings, no studies have specifically considered its predictive value among older adults in their retirement years. Therefore, drawing upon the HAPA, the present study aimed to identify the social cognitive determinants of PA involvement among retired older adults. Design. A 6‐month prospective design was employed. Method. Participants were retired older individuals (N= 120), members of a French university‐based organization, aged from 53 to 83 years (Mean = 65.38 years; SD= 5.63). They were administrated measures of risk perception, action self‐efficacy, outcome expectancies, and PA intention at baseline (T1) and of planning, coping self‐efficacy, and PA behaviour 6 months later (T2). Results. Path analyses revealed that, in the motivational phase, action self‐efficacy and risk perception, but not outcome expectancies, were positively related to PA intention. In the volitional phase, PA intention and coping self‐efficacy, but not planning, were positive predictors of PA behaviour. Conclusion. The present study contributes to existing knowledge as the first to apply the HAPA for the prediction of PA among retired older adults. It confirms that it provides a useful framework for the understanding of the social cognitive processes underlying this behaviour for this age group.     

Gender power imbalance and differential psychosocial correlates of intended condom use among male and female adolescents from Venda,South Africa

Objectives. In South Africa, a gender power imbalance exists which may prevent women from negotiating safe sexual encounters. In this study we tested which constructs from Protection Motivation Theory (PMT) and the Theory of Planned Behavior (TPB) under these circumstances were most related to condom use intention. We hypothesized that in a situation of gender power imbalance self‐efficacy would be a more salient correlate of intended condom use for females, while for males attitude to condoms and subjective norm would be more important. Design. This study employed a cross‐sectional questionnaire design. Method. Male participants (N = 94) and female participants (N = 101) from Venda, South Africa completed standard, multi‐item, reliable measures of TPB constructs (condom‐related attitude, subjective norm, perceived behavioural control, intention) and PMT constructs (vulnerability, severity, fear, response‐efficacy, self‐efficacy) and reported their past condom use behaviour. Results. Regression analysis indicated that among males attitude to condoms and subjective norm were significantly related to intended condom use. Among females attitude and self‐efficacy were significantly related to intended condom use. Conclusion. The findings indicate that in a situation of gender power imbalance psychosocial correlates of intended condom use differ for males and females. Gender‐specific analysis of determinants of condom use may be more appropriate in a situation of gender power imbalance.     

Self‐Efficacy Predicts Physical Activity in Individuals With Fibromyalgia1

The purpose of the current study was to prospectively examine the relationship between physical activity patterns and psychosocial predictors in a sample of individuals with fibromyalgia (FM). Individuals with FM (N= 61) tracked their physical activity over a 1 ‐month period and completed baseline and endpoint questionnaires. Self‐efficacy provided the framework for the investigation, with both self‐efficacy and intention examined as predictors of physical activity. Exploratory analyses examined the addition of attitude and social influence as predictors of intention and behavior. The results supported the importance of self‐efficacy as a direct prospective predictor of the physical activity of FM individuals. Future research should examine whether maintaining strong intentions is helpful or realistic in motivating physical activity as a treatment option for individuals with FM.     

With a little help from my goals: Integrating intergoal facilitation with the theory of planned behaviour to predict physical activity

Objective . Integration of a multiple goal theory approach into the theory of planned behaviour (TPB) to investigate how the perceived facilitating and conflicting relationships in multiple goal pursuit predict performance of a health‐related behaviour. Design . Prospective design with 8‐week follow‐up. Methods . At baseline, perceived intergoal facilitation and intergoal conflict were measured using personal projects analysis supplemented with standard TPB measures for physical activity (PA). Self‐reported PA was measured at follow‐up 8 weeks later. N=137 participants completed measures at both time points (55.4% response rate at follow‐up). Results . Hierarchical regression showed that perceived intergoal facilitation, but not intergoal conflict, directly predicted PA beyond intention and perceived behavioural control (PBC), accounting for more than 4% of additional variance in PA. Intergoal facilitation had an indirect effect on intention through attitude and PBC, and intention partially mediated the effect of intergoal facilitation on behaviour. Conclusion . The perceived facilitating effect of pursuing other personal goals predicts the performance of a health‐related behaviour over and above single behaviour‐focused social cognitions.     

The protection motivation theory within the stages of the transtheoretical model – Stage‐specific interplay of variables and prediction of exercise stage transitions

Objective Two different theories of health behaviour have been chosen with the aim of theory integration: a continuous theory (protection motivation theory, PMT) and a stage model (transtheoretical model, TTM). This is the first study to test whether the stages of the TTM moderate the interrelation of PMT‐variables and the mediation of motivation, as well as PMT‐variables' interactions in predicting stage transitions. Design Hypotheses were tested regarding (1) mean patterns, stage pair‐comparisons and nonlinear trends using ANOVAs; (2) prediction‐patterns for the different stage groups employing multi‐group structural equation modelling (MSEM) and nested model analyses; and (3) stage transitions using binary logistic regression analyses. Method Adults (N=1,602) were assessed over a 6 month period on their physical activity stages, PMT‐variables and subsequent behaviour. Results (1) Particular mean differences and nonlinear trends in all test variables were found. (2) The PMT adequately fitted the five stage groups. The MSEM revealed that covariances within threat appraisal and coping appraisal were invariant and all other constrains were stage‐specific, i.e. stage was a moderator. Except for self‐efficacy, motivation fully mediated the relationship between the social‐cognitive variables and behaviour. (3) Predicting stage transitions with the PMT‐variables underscored the importance of self‐efficacy. Only when threat appraisal and coping appraisal were high, stage movement was more likely in the preparation stage. Conclusions Results emphasize stage‐specific differences of the PMT mechanisms, and hence, support the stage construct. The findings may guide further theory building and research integrating different theoretical approaches.     

Adherence to physical and mental activity interventions: coping plans as a mediator and prior adherence as a moderator

Objective. Adherence to behavioural intervention programmes is a necessary condition for beneficial outcomes to be achieved. This study tested whether social cognitive variables and coping plans predict adherence. Design and methods. Adherence was examined in a randomized controlled trial with healthy older women (age range: 70–93 years), who were randomized to a physical (N= 86) or a mental (N= 85) activity intervention. Intentions, self‐efficacies, coping plans, and objectively measured adherence levels were assessed. A moderated mediation analysis evaluated the power of coping plans to translate intention into behaviour, depending on levels of prior adherence. Results. Adherence to the physical activity programme (65%) was significantly lower than adherence to the mental activity programme (84%, p < .001). Intentions (β= .22) weakly predicted adherence in the initiation period of the physical activity programme (6 weeks); pre‐action self‐efficacy predicted adherence in the initiation period of the mental activity programme (β= .35). In both groups, coping plans predicted mid‐period adherence (10 weeks) and long‐term adherence (20 weeks), moderated by prior adherence (all ps < .01). Coping plans mediated the relationship between intentions and behaviour only in the exercise condition. Conclusions. Instructing older individuals to generate coping plans facilitated their adherence to physical and mental activity programmes. This effect was larger for participants with lower levels of prior adherence – and may have prevented them from dropping out of the programme.     

Spontaneous implementation intentions and impulsivity: Can impulsivity moderate the effectiveness of planning strategies?

Objective. Self‐initiated plans relating to when, where, and how behaviour will be performed have been shown to be effective in promoting goal progress. The current study (N =256) explored whether any impact of self‐initiated implementation intentions on the avoidance of snacking was moderated by impulsivity. Design and methods. The study employed a prospective design. At Time 1, participants reported the extent to which they had formed self‐initiated implementation intentions to avoid eating high‐calorie snacks. At Time 2, participants reported their snack consumption over the preceding 2 weeks and completed a measure of impulsivity. Results. Impulsivity (urgency) moderated the effect of self‐initiated implementation intentions on snack consumption. Specifically, self‐initiated implementation intentions benefited the avoidance of snacking most for those low in impulsivity and least for those high in impulsivity. Conclusion. The findings suggest that impulsivity might form an important boundary condition to the effectiveness of self‐initiated implementation intention formation in relation to snacking.     

Characteristics of in‐vitro phenotypes of glutamic acid decarboxylase 65 autoantibodies in high‐titre individuals

Previous studies have indicated phenotypical differences in glutamic acid decarboxylase 65 autoantibodies (GADA) found in type 1 diabetes (T1D) patients, individuals at risk of developing T1D and stiff‐person syndrome (SPS) patients. In a Phase II trial using aluminium‐formulated GAD₆₅ (GAD‐alum) as an immunomodulator in T1D, several patients responded with high GADA titres after treatment, raising concerns as to whether GAD‐alum could induce GADA with SPS‐associated phenotypes. This study aimed to analyse GADA levels, immunoglobulin (Ig)G1–4 subclass frequencies, b78‐ and b96·11‐defined epitope distribution and GAD₆₅ enzyme activity in sera from four cohorts with very high GADA titres: T1D patients (n = 7), GAD‐alum‐treated T1D patients (n = 9), T1D high‐risk individuals (n = 6) and SPS patients (n = 12). SPS patients showed significantly higher GADA levels and inhibited the in‐vitro GAD₆₅ enzyme activity more strongly compared to the other groups. A higher binding frequency to the b78‐defined epitope was found in the SPS group compared to T1D and GAD‐alum individuals, whereas no differences were detected for the b96·11‐defined epitope. GADA IgG1–4 subclass levels did not differ between the groups, but SPS patients had higher IgG2 and lower IgG4 distribution more frequently. In conclusion, the in‐vitro GADA phenotypes from SPS patients differed from the T1D‐ and high‐risk groups, and GAD‐alum treatment did not induce SPS‐associated phenotypes. However, occasional overlap between the groups exists, and caution is indicated when drawing conclusions to health or disease status.     

Determinants of condom use among a random sample of single heterosexual adults

Objectives. The aim of this study was to identify the determinants of single heterosexuals' use of condoms during each sexual intercourse. Design. Cohort of individuals followed over a period of 2 years. Methods. Respondents were 574 single heterosexual individuals who answered questions during a telephone interview. Results. Attitude, perceived behavioural control, self‐efficacy and moral norm explained 65% of the variance in intentions to use condoms (p <.0001). The determinants of condom use at 1 year follow‐up (27% explained variance) were perceived behavioural control, past behaviour, and the interaction between intention and intention stability. At 2 years follow‐up, the significant determinants were past behaviour and intention by intention stability. In the present study, intentions to use condoms which remained stable across time were strong predictors of condom use (at 1 year: β=.42, p <.0001; at 2 years: β=.39, p <.003), while unstable intentions were not (at 1 year: β=.02, ns; at 2 years: β=.19, ns). Conclusion. Intention stability is a major determinant of the accuracy of intention for the prediction of subsequent behaviour.     

Comparing the validity of informant and self‐reports of personality using laboratory indices of emotional responding as criterion variables

Personality traits relate to risk for psychopathology and can inform predictions about treatment outcome. In an effort to obtain a comprehensive index of personality, informant reports of personality are sometimes obtained in addition to self‐reports of personality. However, there is limited research comparing the validity of self‐ and informant reports of personality, particularly among those with internalizing psychopathology. This is important given that informants may provide an additional (and perhaps different) perspective on individuals’ personality. The present study therefore compared how both reports of positive affectivity (PA) and negative affectivity (NA) relate to psychophysiological and subjective measures of emotional responding to positive and negative stimuli. Given that our sample (n = 117) included individuals with no history of psychopathology, as well as individuals with major depressive disorder (MDD) and/or panic disorder (PD), we were also able to explore whether these internalizing diagnoses moderated the association between personality reports and measures of emotional responding. Informant‐reported PA predicted physiological responses to positive stimuli (but not negative). Informant‐reported NA predicted physiological responses to negative stimuli (but not positive). Self‐reported personality did not predict physiological responding, but did predict subjectively measured emotional responding (NA for negative responding, PA for positive responding). Diagnoses of internalizing psychopathology (PD or MDD) did not moderate these associations. Results suggest self‐ and informant reports of personality may each provide valid indices of an individual's emotional response tendencies, but predict different aspects of those tendencies.     

Enteroviruses and type 1 diabetes: towards a better understanding of the relationship

Environmental factors, especially viruses, are involved in the initiation or the acceleration of type 1 diabetes (T1D) pathogenesis. Epidemiological data strongly suggest that enteroviruses, such as coxsackievirus B4 (CV‐B4), can be associated with T1D. It has been demonstrated that enterovirus infections were significantly more prevalent in at risk individuals, such as siblings of diabetic patients, when they developed anti‐β‐cell autoantibodies or T1D, and in recently diagnosed diabetic patients, compared with control subjects. The isolation of CV‐B4 from the pancreas of diabetic patients strengthened the hypothesis of a relationship between the virus and the disease. Studies performed in vitro and in vivo in animal models helped to discover mechanisms of the infection of pancreas and other tissues, potentially able to play a role in the pathogenesis of T1D. Interestingly, it cannot be excluded that enteroviruses behave as half‐devil half‐angel since experimental studies suggest that, in certain conditions, these agents would be able to protect individuals against the disease. All of the plausible mechanisms by which enterovirus may be related to T1D will be reviewed here. Copyright © 2010 John Wiley & Sons, Ltd.     

Low programmed cell death‐1 (PD‐1) expression in peripheral CD4+ T cells in Japanese patients with autoimmune type 1 diabetes

Programmed cell death‐1 (PD‐1) is a co‐stimulatory molecule that inhibits T cell proliferation. We aimed to clarify PD‐1 expression in CD4⁺ T cells and the association between PD‐1 expression and the 7785C/T polymorphism of PDCD1, with a focus on the two subtypes of type 1 diabetes, type 1A diabetes (T1AD) and fulminant type 1 diabetes (FT1D), in the Japanese population. We examined 22 patients with T1AD, 15 with FT1D, 19 with type 2 diabetes (T2D) and 29 healthy control (HC) subjects. Fluorescence‐activated cell sorting (FACS) and real‐time PCR were utilized to analyse PD‐1 expression quantitatively. Genotyping of 7785C/T in PDCD1 was performed using the TaqMan method in a total of 63 subjects (21 with T1AD, 15 with FT1D and 27 HC). FACS revealed a significant reduction in PD‐1 expression in CD4⁺ T cells in patients with T1AD (mean: 4·2 vs. 6·0% in FT1D, P = 0·0450; vs. 5·8% in T2D, P = 0·0098; vs. 6·0% in HC, P = 0·0018). PD‐1 mRNA expression in CD4⁺ T cells was also significantly lower in patients with T1AD than in the HC subjects. Of the 63 subjects, PD‐1 expression was significantly lower in individuals with the 7785C/C genotype than in those with the C/T and T/T genotypes (mean: 4·1 vs. 5·9%, P = 0·0016). Our results indicate that lower PD‐1 expression in CD4⁺ T‐cells might contribute to the development of T1AD through T cell activation.     

An exploration of the motivation of pregnant women to perform pelvic floor exercises using the revised theory of planned behaviour

Objectives. To investigate the motivation of pregnant women towards the practice of pelvic floor exercises during pregnancy using the revised Theory of Planned Behaviour (RTPB), incorporating measures of past behaviour. Design. Longitudinal cohort study. Methods. Women (n= 289) attending antenatal clinics in the North‐East of Scotland were interviewed in the third trimester of pregnancy regarding their practice of pelvic floor exercises. Beliefs and attitudes about the exercises were investigated by self‐administered questionnaire using the RTPB as a framework. A follow‐up postal questionnaire was sent between 6 and 12 months after delivery. Results. TPB variables (attitude, subjective norm, and self‐efficacy) explained 53.1% of the variance in intention to practise pelvic floor exercises during pregnancy. Perceived vulnerability to incontinence (attitude to the current behaviour) had no relationship with intention. Measures of past behaviour significantly improved the percentage of explained variance in intention. Confidence in ability to perform pelvic floor exercises correctly (self‐efficacy) reliably predicted subsequent practice. Conclusions. Future compliance with pelvic floor exercises may be enhanced by effective instruction to enhance confidence in ability to contract the correct muscles and promotion of measures to help establish a habit of exercising the pelvic floor muscles.     

The theory of planned behaviour and binge drinking: Assessing the moderating role of past behaviour within the theory of planned behaviour

A sample of 398 undergraduate students completed questionnaires assessing the main constructs of the theory of planned behaviour (TPB) in relation to binge drinking, as well as past binge drinking behaviour. Of these, 273 were followed up at 1 week. Regression analyses revealed attitude, self‐efficacy, and perceived control (negative relationship) to be predictive of binge drinking intentions. Intention and self‐efficacy were, in turn, predictive of binge drinking at 1‐week follow‐up. Past behaviour was found to explain additional variance in intention and behaviour. In addition, past behaviour was found to moderate the attitude–intention and intention–behaviour relationships, such that weaker relationships were observed with increasing frequency of past behaviour. The results are discussed in relation to the need to develop and test alternative measures of habit. The implications of the findings for interventions to encourage more appropriate drinking behaviour are outlined.     

The acceptance of SARS-CoV-2 rapid antigen self-testing: A cross-sectional study in China

Compared with the nucleic acid amplification test (NATT), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen self-testing (RAST) has advantages in speed and convenience. However, little is known about people's acceptance and influencing factors for SARS-CoV-2 RAST. A cross-sectional study was conducted from April 21 to 30, 2022 in China. The χ² test and multivariate logistic regressions were used to identify the influencing factors. The structural equation model was used to test the extended protective motivation theory (PMT) model hypotheses. Among the total of 5107 participants, 62.5% were willing to accept the SARS-CoV-2 RAST. There were significant differences in acceptance among different residences (p < 0.001), educational level (p < 0.001), occupation (p < 0.001), monthly income (p < 0.001), travel frequency (p < 0.05), and feelings about NATT (p < 0.001). Response efficacy (β = 0.05; p = 0.025) and self-efficacy (β = 0.84; p < 0.001) had a positive effect, while response cost showed a negative effect (β = −0.07; p < 0.001). The public's major concerns about SARS-CoV-2 RAST are its reliability, testing method, price, and authority. Overall, a moderate intention to use SARS-CoV-2 RAST was found among the Chinese population. The extended PMT can be used for the prediction of intention to accept the RAST. We need to take measures to increase people's acceptance of SARS-CoV-2 RAST.     

Predicting adherence to eye patching in children with amblyopia: An application of protection motivation theory

Objectives: This study reports an application of protection motivation theory (PMT) to the prediction of parental adherence to eye patching recommendations for children with amblyopia over a 2‐month period. The study also considered the role of past behaviour in PMT. Design and methods: A total of 151 parents of children with amblyopia who were attending follow‐up appointments for orthoptic treatment participated. They completed questionnaires based on PMT to assess their beliefs about amblyopia and eye patching. Of the parents, 105 were contacted again at 2‐month follow‐up to obtain a measure of adherence to the recommended treatment for their child. Results: PMT was found to be predictive of adherence intentions and behaviour at 2‐month follow‐up. Regression analyses revealed perceived vulnerability, response efficacy and self‐efficacy to be significant predictors of protection motivation, whereas perceived vulnerability and response costs were significant predictors of adherence behaviour. Past adherence behaviour was found to have a direct effect on future adherence behaviour over and above the influence of PMT. Conclusions: The results are discussed in relation to the sufficiency of PMTas a model of adherence behaviour. The practical implications for attempts to increase adherence to eye patching among children with amblyopia are outlined.     

1α,25‐dihydroxyvitamin D3 acts via transforming growth factor‐β to up‐regulate expression of immunosuppressive CD73 on human CD4+ Foxp3– T cells

Vitamin D deficiency is associated with increased incidence and severity of various immune‐mediated diseases. Active vitamin D (1α,25‐dihydroxyvitamin D3; 1,25(OH)₂D3) up‐regulates CD4⁺ T‐cell expression of the purine ectonucleotidase CD39, a molecule that is associated with the generation of anti‐inflammatory adenosine. Here we aimed to investigate the direct impact of 1,25(OH)₂D3 on expression of the downstream ecto‐5′‐nucleotidase CD73 by human CD4 T cells, and components of the transforming growth factor‐β (TGF‐β) pathway, which have been implicated in the modulation of CD73 by murine T cells. At 10^?8 to 10^?7 m , 1,25(OH)₂D3 significantly increased expression of CD73 on peripheral human CD4⁺ T cells. Although 1,25(OH)₂D3 did not affect the mRNA expression of latent TGF‐β₁, 1,25(OH)₂D3 did up‐regulate expression of TGF‐β‐associated molecules [latency‐associated peptide (LAP), glycophorin A repetitions predominant (GARP), GP96, neuropilin‐1, thrombospondin‐1 and α_v integrin] which is likely to have contributed to the observed enhancement in TGF‐β bioactivity. CD73 was highly co‐expressed with LAP and GARP following 1,25(OH)₂D3 treatment, but unexpectedly, each of these cell surface molecules was expressed primarily on CD4⁺ Foxp3^– T cells, rather than CD4⁺ Foxp3⁺ T cells. Notably, neutralization of TGF‐β significantly impaired 1,25(OH)₂D3‐mediated induction of CD73. Collectively, we show that 1,25(OH)₂D3 enhances expression of CD73 on CD4⁺ Foxp3^– T cells in a process that is at least partially TGF‐β‐dependent. These data reveal an additional contributing mechanism by which vitamin D may be protective in immune‐mediated disease.     

Patient outcomes of genetic counseling: Assessing the impact of different approaches to family history collection

No studies have yet evaluated whether different modalities for the collection of family history data influence patient outcomes of genetic counseling. We retrospectively compared outcomes of genetic counseling between patients whose family history (Fhx) was collected (1) via telephone prior to their appointment (FhxPrior) or (2) during the appointment (FhxDuring). We used a psychiatric genetic counseling clinic database, where information about demographics and Fhx timing is recorded, and patients complete the Genetic Counseling Outcomes Scale (GCOS, measuring empowerment) and Illness Management Self‐Efficacy Scale (IMSES) immediately prior to (T1) and 1 month after their appointment (T2). We used ANCOVA to evaluate the effect of the Fhx method on patient outcomes at T2. Complete data were available for 240 patients and were used for analysis (FhxPrior, n = 206; FhxDuring, n = 34). GCOS and IMSES scores increased from T1 to T2 (P < .0005 and P = .004, respectively). Although there was no difference between groups for GCOS (P = .412), T2 IMSES scores were significantly higher for FhxPrior than FhxDuring after controlling for T1 scores (P = .011). Our data suggest that obtaining Fhx via telephone prior to genetic counseling may lead to greater increases in patients’ self‐efficacy as compared to obtaining Fhx during the genetic counseling appointment.     

Comparative and correlative assessments of cytokine,complement and antibody patterns in paediatric type 1 diabetes

One of the most widespread and effective environmental factors is the infection with enteroviruses (EVs) which accelerate β cell destruction in type 1 diabetes (T1D). This study represented a comparison between diabetic EV⁺ and EV^– children as well as correlation analysis between autoantibodies, T1D markers, cytokines, complement activation products and anti‐coxsackievirus (CV) immunoglobulin (Ig)G. EV RNA was detected in Egyptian children with T1D (26·2%) and healthy controls (0%). Detection of anti‐CV IgG in T1D‐EV⁺ resulted in 64% positivity. Within T1D‐EV⁺, previously diagnosed (PD) showed 74 versus 56% in newly diagnosed (ND) children. Comparisons between populations showed increased levels of haemoglobin A1c (HbA1c), C‐reactive protein (CRP), nitric oxide (NO), glutamic acid decarboxylase and insulin and islet cell autoantibodies [glutamic acid decarboxylase autoantibodies (GADA), insulin autoantibodies (IAA) and islet cell cytoplasmic autoantibodies (ICA), respectively], interferon (IFN)‐γ, tumour necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL ?10, IL ?12, IL ?17, C3d and sC5–9 in T1D‐EV⁺ versus T1D‐EV^–. Conversely, both IL‐20 and transforming growth factor (TGF‐β) decreased in T1D‐EV⁺ versus EV^–, while IL‐4, ?6 and ?13 did not show any changes. Correlation analysis showed dependency of accelerated autoimmunity and β cell destruction on increased IFN‐γ, IL‐12 and IL‐17 versus decreased IL‐4, ?6 and ?13. In conclusion, IFN‐γ, IL‐12 and IL‐17 played an essential role in exacerbating EV⁺‐T1D, while C3d, sC5b ?9, IL‐10 and ?20 displayed distinct patterns.