The purpose of this study was to identify the population prevalence across the stages of change (SoC) for regular physical activity and to establish the prevalence of people at risk. With support from the National Institutes of Health, the American Heart Association, and the Robert Wood Johnson Foundation, nine Behavior Change Consortium studies with a common physical activity SoC measure agreed to collaborate and share data. The distribution pattern identified in these predominantly reactively recruited studies was Precontemplation (PC) = 5% (± 10), Contemplation (C) = 10% (± 10), Preparation (P) = 40% (± 10), Action = 10% (± 10), and Maintenance = 35% (± 10). With reactively recruited studies, it can be anticipated that there will be a higher percentage of the sample that is ready to change and a greater percentage of currently active people compared to random representative samples. The at-risk stage distribution (i.e., those not at criteria or PC, C, and P) was approximately 10% PC, 20% C, and 70% P in specific samples and approximately 20% PC, 10% C, and 70% P in the clinical samples. Knowing SoC heuristics can inform public health practitioners and policymakers about the population's motivation for physical activity, help track changes over time, and assist in the allocation of resources.
This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book examines the interface between lived personal experiences and broader social factors in cross-cultural marriages. It examines in various ways the entwined factors influencing choice of spouse; identities and perceived differences, romanticized or otherwise; differing definitions and expectations of marriage and family; and how people in such families perceive and cope with mismatched expectations and cultural diversity. The book explores the resourcefulness with which daily situations are acted on, affecting the lives and lifestyles of those involved in mixed marriages. It provides a Study of Women in Cross-Cultural Marriages', is a preliminary study of what sort of person marries out, and why some people should choose an outsider as spouse. The book relates how mixed families structure their daily lives.
To assess efficacy of 2 worksite health promotion interventions.Randomly assign 3 fire stations to (a) team-based curriculum, (b) individual counselor meetings, and (c) control.Both interventions were feasible and acceptable, and they resulted in significant reductions in LDL cholesterol. The team approach significantly increased coworker cohesion, personal exercise habits, and coworkers' healthy behaviors. The one-on-one strategy significantly increased dietary self-monitoring, decreased fat intake, and reduced depressed feelings.Although both interventions promoted healthy behaviors, specific outcomes differed and reflected their conceptual underpinnings. The team-based curriculum is innovative and may enlist influences not accessed with individual formats.
The purpose of this study was to accumulate behavioral validity evidence for physical activity Stage of Change (SOC).Nine studies used a common physical activity SOC measure and examined self-report, objective, and performance physical activity indicators to accumulate behavioral validity evidence for SOC. Type of measure, the strength of the expected relationship between the measure and SOC, and the predicted SOC differences were examined. Validity evidence for the SOC was also examined by population and sampling method.Validity evidence for physical activity SOC was classified with respect to the type of measurement instrument and the hypothesized magnitude of the relationship between the measure and the SOC.Physical activity SOC was found to be behaviorally valid as evidenced by self-reported physical activity, self-reported exercise, self-reported sedentary behaviors, pedometers, and physical functioning. Physical activity SOC does not appear to be related to physical fitness or weight indicators.This study highlights a successful multi-site collaboration. Physical activity data from nine large-scale, health trials was combined and accumulated behavioral validation evidence for the physical activity SOC.
A. Bellg, B. Borrelli, et al. (2004) previously developed a framework that consisted of strategies to enhance treatment fidelity of health behavior interventions. The present study used this framework to (a) develop a measure of treatment fidelity and (b) use the measure to evaluate treatment fidelity in articles published in 5 journals over 10 years. Three hundred forty-two articles met inclusion criteria; 22% reported strategies to maintain provider skills, 27% reported checking adherence to protocol, 35% reported using a treatment manual, 54% reported using none of these strategies, and 12% reported using all 3 strategies. The mean proportion adherence to treatment fidelity strategies was .55; 15.5% of articles achieved greater than or equal to .80. This tool may be useful for researchers, grant reviewers, and editors planning and evaluating trials.
Treatment fidelity plays an important role in the research team's ability to ensure that a treatment has been implemented as intended and that the treatment has been accurately tested. Developing, implementing, and evaluating a treatment fidelity plan can be challenging. The treatment fidelity workgroup within the Behavior Change Consortium (BCC) developed guidelines to comprehensively evaluate treatment fidelity in behavior change research. The guidelines include evaluation of treatment fidelity with regard to study design, training of interventionists, delivery and receipt of the intervention, and enactment of the intervention in real-life settings. This article describes these guidelines and provides examples from four BCC studies as to how these recommended guidelines for fidelity were considered. Future work needs to focus not only on implementing treatment fidelity plans but also on quantifying the evaluations performed, developing specific criteria for interpretation of the findings, and establishing best practices of treatment fidelity.
Motivational Interviewing (MI) has been established as an effective psychotherapeutic treatment for problem drinking in clinical settings. Consequently, there is a growing interest in applying MI to facilitate change across other health behaviors, such as tobacco use, eating habits, and physical activity in a variety of community-based research settings. These extended applications pose new challenges regarding implementation and evaluation. For instance, investigators must consider how best to train intervention counselors; implement strategies for preserving the MI spirit, despite limited client contact time; incorporate adjunctive strategies that support brief MI sessions; and develop a plan for monitoring and evaluating MI treatment fidelity. This article highlights specific examples of how several behavior change research projects applied MI across a variety of settings and populations, provides lessons learned from our experience as a collaborative workgroup, and offers strategies for consideration in future community-based research.
State interference with the right of its citizens to free choice of spouse encompasses delays and refusals to grant entry and temporary residence visas to the foreign spouse, delays and refusal to grant permission to marry, and restrictions on the foreign spouse's rights to reside and work in Germany. The vast majority of foreigners now living in Germany are thus recruited workers and their families, or the succeeding generations of such people. Marriages to non-Germans have increased slowly but steadily since the end of the Second World War. German men marry out far less frequently than do German women. Historically, the rise of nation-states has meant that within the debate about citizenship rights and duties, certain membership criteria have become important politically, legally and ideologically, such as the notion of sharing a common culture or common values. The German romantics of the nineteenth century played a key role in deliberately creating a sense of overarching identity.
Objective: PHLAME's (Promoting Healthy Lifestyles: Alternative Models' Effects) objective was to assess and compare two means to promote healthy lifestyles. Methods: Prospective trial among 599 firefighters randomized by station to 1) team-centered curriculum, 2) one-on-one motivational interviewing (MI), and 3) controls. Assessment included dietary behavior, physical activity, weight, and general well-being at baseline and 12 months. Program effects were determined using an analysis of covariance (ANCOVA) based approach, and models for relationships were evaluated with path analysis. Results: Both interventions were acceptable and delivered with high fidelity. The team and MI programs increased fruit and vegetable consumption (P < 0.01 and 0.05, respectively) and general well-being (P < 0.01). Significantly less weight gain occurred in both (P < 0.05). A cross-sectional model was consistent with mediation differing between interventions. Conclusions: Both a team-centered and individual-oriented intervention promoted healthy behaviors. The scripted team curriculum is innovative, exportable, and may enlist influences not accessed with individual formats.
