Publications by year
In Press
Hillier-Brown FC, Summerbell CD, Moore HJ, Wrieden WL, Adams J, Abraham C, Adamson A, Araújo-Soares V, White M, Lake AA, et al (In Press). A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis.
BMC Public Health,
17(1).
Abstract:
A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis.
BACKGROUND: Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. METHODS: a systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1) and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2). RESULTS: a total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. CONCLUSIONS: Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business, sell ready-to-eat meals, can be engaged in implementing interventions to promote healthier ready-to-eat-food. These proprietors are generally positive about such interventions, particularly when they are cost neutral and use a health by stealth approach.
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Long L, Abraham C, Paquette R, Shahmanesh M, Llewellyn C, Townsend A, Gilson R (In Press). Brief interventions to prevent sexually transmitted infections suitable for in-service use: a systematic review.
Prev Med,
91, 364-382.
Abstract:
Brief interventions to prevent sexually transmitted infections suitable for in-service use: a systematic review.
BACKGROUND: Sexually transmitted infections (STIs) are more common in young people and men who have sex with men (MSM) and effective in-service interventions are needed. METHODS: a systematic review of randomized controlled trials (RCTs) of waiting-room-delivered, self-delivered and brief healthcare-provider-delivered interventions designed to reduce STIs, increase use of home-based STI testing, or reduce STI-risk behavior was conducted. Six databases were searched between January 2000 and October 2014. RESULTS: 17,916 articles were screened. 23 RCTs of interventions for young people met our inclusion criteria. Significant STI reductions were found in four RCTs of interventions using brief one-to-one counselling (2 RCTs), video (1 RCT) and a STI home-testing kit (1 RCT). Increase in STI test uptake was found in five studies using video (1 RCT), one-to-one counselling (1 RCT), home test kit (2 RCTs) and a web-based intervention (1 RCT). Reduction in STI-risk behavior was found in seven RCTs of interventions using digital online (web-based) and offline (computer software) (3 RCTs), printed materials (1 RCT) and video (3 RCTs). Ten RCTs of interventions for MSM met our inclusion criteria. Three tested for STI reductions but none found significant differences between intervention and control groups. Increased STI test uptake was found in two studies using brief one-to-one counselling (1 RCT) and an online web-based intervention (1 RCT). Reduction in STI-risk behavior was found in six studies using digital online (web-based) interventions (4 RCTs) and brief one-to-one counselling (2 RCTs). CONCLUSION: a small number of interventions which could be used, or adapted for use, in sexual health clinics were found to be effective in reducing STIs among young people and in promoting self-reported STI-risk behavior change in MSM.
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Abraham C (In Press). Charting variability to ensure conceptual and design precision: a comment on Ogden (2016).
Health Psychol Rev,
10(3), 260-264.
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Price LRS, Wyatt K, Lloyd J, Dean S, Creanor S, Abraham C, Hillsdon M (In Press). Children’s compliance with wrist worn accelerometry within a cluster randomised controlled trial: Findings from the Healthy Lifestyles Programme (HeLP).
Pediatric Exercise Science Full text.
Chng S, White M, Abraham C, Skippon S (In Press). Commuting and wellbeing in London: the roles of commute mode and local public transport connectivity.
Prev Med,
88, 182-188.
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Commuting and wellbeing in London: the roles of commute mode and local public transport connectivity.
OBJECTIVES: to explore the relationships between commute mode, neighbourhood public transport connectivity and subjective wellbeing. METHOD: the study used data on 3630 commuters in London from wave two of Understanding Society (2010/11). Multivariate linear regressions were used to investigate how commute mode and neighbourhood public transport connectivity were associated with subjective wellbeing for all London commuters and for public transport commuters only. Subjective wellbeing was operationalized in terms of both a positive expression (life satisfaction measured by a global single-item question) and a more negative expression (mental distress measured by the General Health Questionnaire). Logistic regression was also used to explore the predictors of public transport over non-public transport commutes. RESULTS: After accounting for potentially-confounding area-level and individual-level socioeconomic and commute-related variables, only walking commutes (but not other modes) were associated with significantly higher life satisfaction than car use but not with lower mental distress, compared to driving. While better public transport connectivity was associated with significantly lower mental distress in general, train users with better connectivity had higher levels of mental distress. Moreover, connectivity was unrelated to likelihood of using public transport for commuting. Instead, public transport commutes were more likely amongst younger commuters who made longer distance commutes and had comparatively fewer children and cars within the household. CONCLUSION: the findings highlight the heterogeneity of relationships between commute mode, public transport connectivity and subjective wellbeing and have implications for intervention strategies and policies designed to promote commuting behaviour change.
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Long L, Abraham C, Paquette R, Shahmanesh M, Llewellyn C, Townsend A, Gilson R (In Press). Erratum to "Brief interventions to prevent sexually transmitted infections suitable for in-service use: a systematic review" [Prev. Med. 91 (2016) 364-382].
Prev Med,
96, 163-164.
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Elliott LR, White MP, Taylor AH, Abraham (In Press). How do brochures encourage walking in natural environments in the UK? a content analysis.
Health Promotion InternationalAbstract:
How do brochures encourage walking in natural environments in the UK? a content analysis
Although walking for leisure can support health, there has been little systematic attempt to consider how recreational walking is best promoted. In the UK, local authorities create promotional materials for walking networks, but little is known about whether they effectively encourage walking through persuasive messaging. Many of these materials pertain to walks in natural environments which evidence suggests are generally visited less frequently by physically inactive individuals. Consequently the present study explores whether and how recreational walking brochures use persuasive messages in their promotion of walks in natural environments. A coding taxonomy was developed to classify text in recreational walking brochures according to five behavioural content areas and 87 categories of potentially persuasive messages. Reliability of the taxonomy was ascertained and a quantitative content analysis was applied to 26 brochures collected from Devon, UK. Brochures often provided information about an advertised route, highlighted cultural and aesthetic points of interest, and provided directions. Brochures did not use many potentially effective messages. Text seldom prompted behaviour change or built confidence for walking. Social norm related information was rarely provided and there was a general lack of information on physical activity and its benefits for health and well-being. The limited range of message strategies used in recreational walking brochures may not optimally facilitate walking in natural environments for inactive people. Future research should examine the effects of theory-informed brochures on walking intentions and behaviour. The taxonomy could be adapted to suit different media and practices surrounding physical activity in natural environments.
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Denford S, Lakshman R, Callaghan M, Abraham C (In Press). Improving public health evaluation: a qualitative investigation of practitioners' needs.
BMC Public Health,
18(1).
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Improving public health evaluation: a qualitative investigation of practitioners' needs.
BACKGROUND: in 2011, the House of Lords published a report on Behaviour Change, in which they report that "a lot more could, and should, be done to improve the evaluation of interventions." This study aimed to undertake a needs assessment of what kind of evaluation training and materials would be of most use to UK public health practitioners by conducting interviews with practitioners about everyday evaluation practice and needed guidance and materials. METHODS: Semi-structured interviews were conducted with 32 public health practitioners in two UK regions, Cambridgeshire and the South West. Participants included directors of public health, consultants in public health, health improvement advisors, public health intelligence, and public health research officers. A topic guide included questions designed to explore participants existing evaluation practice and their needs for further training and guidance. Data were analysed using thematic analyses. RESULTS: Practitioners highlighted the need for evaluation to defend the effectiveness of existing programs and protect funding provisions. However, practitioners often lacked training in evaluation, and felt unqualified to perform such a task. The majority of practitioners did not use, or were not aware of many existing evaluation guidance documents. They wanted quality-assured, practical guidance that relate to the real world settings in which they operate. Practitioners also mentioned the need for better links and support from academics in public health. CONCLUSION: Whilst numerous guidance documents supporting public health evaluation exist, these documents are currently underused by practitioners - either because they are not considered useful, or because practitioners are not aware of them. Integrating existing guides into a catalogue of guidance documents, and developing a new-quality assured, practical and useful document may support the evaluation of public health programs. This in turn has the potential to identify those programs that are effective; thus improving public health and reducing financial waste.
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Lloyd J, Dean S, Creanor S, Abraham C, Hillsdon M, Ryan E, Wyatt KM (In Press). Intervention fidelity in the definitive cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP) trial: findings from the process evaluation.
Int J Behav Nutr Phys Act,
14(1).
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Intervention fidelity in the definitive cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP) trial: findings from the process evaluation.
BACKGROUND: the Healthy Lifestyles Programme (HeLP) was a novel school-located intervention for 9-10 year olds, designed to prevent obesity by changing patterns of child behaviour through the creation of supportive school and home environments using dynamic and creative delivery methods. This paper reports on both the quantitative and qualitative data regarding the implementation of the HeLP intervention in the definitive cluster randomised controlled trial, which was part of the wider process evaluation. METHODS: Mixed methods were used to collect data on intervention uptake, fidelity of delivery in terms of content and quality of delivery of the intervention, as well as school and child engagement with the programme. Data were collected using registers of attendance, observations and checklists, field notes, focus groups with children and semi-structured interviews with teachers. Qualitative data were analysed thematically and quantitative data were summarized using descriptive statistics. RESULTS: all 16 intervention schools received a complete or near complete programme (94-100%), which was delivered in the spirit in which it had been designed. of the 676 children in the intervention schools, over 90% of children participated in each phase of HeLP; 92% of children across the socio-economic spectrum were deemed to be engaged with HeLP and qualitative data revealed a high level of enjoyment by all children, particularly to the interactive drama workshops. Further evidence of child engagment with the programme was demonstrated by children's clear understanding of programme messages around marketing, moderation and food labelling. Thirteen of the intervention schools were deemed to be fully engaged with HeLP and qualitative data revealed a high level of teacher 'buy in', due to the programme's compatability with the National Curriculum, level of teacher support and use of innovative and creative delivery methods by external drama practitioners. CONCLUSION: Our trial shows that it is possible to successfully scale up complex school-based interventions, engage schools and children across the socio-economic spectrum and deliver an intervention as designed. As programme integrity was maintained throughout the HeLP trial, across all intervention schools, we can be confident that the trial findings are a true reflection of the effectiveness of the intervention, enabling policy recommendations to be made. TRIAL REGISTRATION: ISRCTN15811706.
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Armstrong M, Morris C, Abraham C, Tarrant M (In Press). Interventions utilising contact with people with disabilities to improve children's attitudes towards disability: a systematic review and meta-analysis.
Disabil Health J,
10(1), 11-22.
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Interventions utilising contact with people with disabilities to improve children's attitudes towards disability: a systematic review and meta-analysis.
BACKGROUND: Children with disabilities are often the target of prejudice from their peers. The effects of prejudice include harmful health consequences. The Contact Hypothesis has previously shown to promote positive attitudes towards a range of social groups. OBJECTIVE: to conduct a systematic review and meta-analysis on the effectiveness of school-based interventions for improving children's attitudes towards disability through contact with people with disabilities. METHODS: a comprehensive search was conducted across multiple databases. Studies were included if it evaluated an intervention that aimed to improve children's attitudes towards disability and involved either direct (in-person) or indirect (e.g. extended) contact with people with disabilities. Data were synthesised in a meta-analysis. RESULTS: Twelve studies met the inclusion criteria. of these, 11 found significant effects: six used direct contact, two used extended contact, two used parasocial (media-based) contact and one used guided imagined contact. One parasocial contact intervention found no significant effects. Three meta-analyses showed direct contact (d = 0.55, 95% CI 0.20 to 0.90) and extended contact (d = 0.61, 95% CI 0.15 to 1.07) improved children's attitudes; there was no evidence for parasocial contact (d = 0.20, 95% CI -0.01 to 1.40). CONCLUSIONS: Direct, extended, and guided imagined contact interventions are effective in improving children's attitudes towards disability; there was no evidence for parasocial contact.
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Bardus M, Smith JR, Samaha L, Abraham C (In Press). Mobile and Web 2.0 interventions for weight management: an overview of review evidence and its methodological quality.
Eur J Public Health,
26(4), 602-610.
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Mobile and Web 2.0 interventions for weight management: an overview of review evidence and its methodological quality.
BACKGROUND: the use of Internet and related technologies for promoting weight management (WM), physical activity (PA), or dietary-related behaviours has been examined in many articles and systematic reviews. This overview aims to summarize and assess the quality of the review evidence specifically focusing on mobile and Web 2.0 technologies, which are the most utilized, currently available technologies. METHODS: Following a registered protocol (CRD42014010323), we searched 16 databases for articles published in English until 31 December 2014 discussing the use of either mobile or Web 2.0 technologies to promote WM or related behaviors, i.e. diet and physical activity (PA). Two reviewers independently selected reviews and assessed their methodological quality using the AMSTAR checklist. Citation matrices were used to determine the overlap among reviews. RESULTS: Forty-four eligible reviews were identified, 39 of which evaluated the effects of interventions using mobile or Web 2.0 technologies. Methodological quality was generally low with only 7 reviews (16%) meeting the highest standards. Suggestive evidence exists for positive effects of mobile technologies on weight-related outcomes and, to a lesser extent, PA. Evidence is inconclusive regarding Web 2.0 technologies. CONCLUSIONS: Reviews on mobile and Web 2.0 interventions for WM and related behaviors suggest that these technologies can, under certain circumstances, be effective, but conclusions are limited by poor review quality based on a heterogeneous evidence base.
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Warmoth K, Tarrant M, Abraham C, Lang IA (In Press). Older adults' perceptions of ageing and their health and functioning: a systematic review of observational studies.
Psychol Health Med,
21(5), 531-550.
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Older adults' perceptions of ageing and their health and functioning: a systematic review of observational studies.
Many older people perceive ageing negatively, describing it in terms of poor or declining health and functioning. These perceptions may be related to older adults' health. The aim of this review was to synthesise existing research on the relationship between older adults' perceptions of ageing and their health and functioning. A systematic search was conducted of five electronic databases (ASSIA, CINAHL, IBSS, MEDLINE and PsycINFO). Citations within identified reports were also searched. Observational studies were included if they included perceptions of ageing and health-related measures involving participants aged 60 years and older. Study selection, data extraction and quality appraisal were conducted using predefined criteria. Twenty-eight reports met the criteria for inclusion. Older adults' perceptions of ageing were assessed with a variety of measures. Perceptions were related to health and functioning across seven health domains: memory and cognitive performance, physical and physiological performance, medical conditions and outcomes, disability, care-seeking, self-rated health, quality of life and death. How ageing is perceived by older adults is related to their health and functioning in multiple domains. However, higher quality and longitudinal studies are needed to further investigate this relationship.
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White R, Abraham C, Smith J, White MP, Staiger PK (In Press). Recovery under sail: Rehabilitation clients’ experience of a sail training voyage.
Addiction Research and Theory,
In press Full text.
Eyre V, Lang C, Smith S, Jolly C, Wingham J, Abraham C, Green C, Warren F, Britten N, Greaves C, et al (In Press). Rehabilitation Enablement in Chronic Heart Failure-a facilitated self-care rehabilitation intervention in patients with heart failure with preserved ejection fraction (REACH-HFpEF) and their caregivers: Rationale and protocol for a single centre pilot randomised controlled trial (Protocol).
BMJ Open Full text.
Warmoth KM, Tarrant M, Abraham, Lang (In Press). Relationship between perceptions of ageing and frailty in English older adults.
Psychology, Health and Medicine,
23(4), 465-474.
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Wood CE, Hardeman W, Johnston M, Francis J, Abraham C, Michie S (In Press). Reporting behaviour change interventions: do the behaviour change technique taxonomy v1, and training in its use, improve the quality of intervention descriptions?.
Implement Sci,
11(1).
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Reporting behaviour change interventions: do the behaviour change technique taxonomy v1, and training in its use, improve the quality of intervention descriptions?
BACKGROUND: Behaviour change interventions are likely to be reproducible only if reported clearly. We assessed whether the behaviour change technique taxonomy version 1 (BCTTv1), with and without training in identifying BCTs, improves the clarity and replicability of written reports of observed behaviour change interventions. METHODS: Three studies assessed effects of using and training in the use of BCTTv1 on the clarity and replicability of intervention descriptions written after observing videos of smoking cessation interventions. Study 1 examined the effects of using and not using BCTTv1. Study 2 examined the effects of using BCTTv1 and training in use of BCTTv1 compared no use and no training. Study 3 employed a within-group design to assess change in descriptions written before and after training. One-hundred and 66 'writers' watched videos of behaviour change interventions and wrote descriptions of the active components delivered. In all studies, the participants' written descriptions were evaluated by (i) 12 'raters' (untrained in BCTTv1) for clarity and replicability and (ii) 12 'coders' (trained in BCTTv1) for reliability of BCT coding. Writers rated the usability and accessibility of using BCTTv1 to write descriptions. RESULTS: Ratings of clarity and replicability did not differ between groups in study 1 (all ps > 0.05), were poorer for trained users in study 2 (all ps
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Sani AS, Abraham C, Denford S, Ball S (In Press). School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis.
BMC Public Health,
16(1).
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School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis.
BACKGROUND: School-based sexual health education has the potential to provide an inclusive and comprehensive approach to promoting sexual health among young people. We reviewed evaluations of school-based sexual health education interventions in sub-Saharan Africa to assess effectiveness in reducing sexually transmitted infections and promoting condom use. METHODS: We searched ten electronic databases, hand-searched key journals, and reference lists of included articles for potential studies. Data were extracted on outcomes, intervention characteristics, methods and study characteristics indicative of methodological quality. Where possible, data were synthesized using random effect meta-analysis. Intervention features found predominantly in effective interventions were noted. RESULTS: the initial search retrieved 21634 potentially relevant citations. of these, 51 papers reporting on 31 interventions were included. No evaluation reported statistically significant effects on the incidence or prevalence of Human Immunodeficiency Virus and Herpes Simplex Virus 2 infections. However, intervention participants reported statistically significant greater condom use in both randomised controlled trials and non-randomised trials for short (less than 6 months) follow-up periods (OR = 1.62, 95 % CI = 1.03-2.55 and OR = 2.88, 95 % CI = 1.41-5.90 respectively). For intermediate (6-10 months) and long-term (more than 10 months) follow-up periods, the effect was statistically significant (OR = 1.40, 95 % CI = 1.16-1.68) and marginally significant (OR = 1.22, 95 % CI = 0.99-1.50) among the randomised trials respectively. Only 12 of the 31 interventions reported implementation details, out of which seven reported on fidelity. CONCLUSION: School-based sexual health education has the potential to promote condom use among young people in sub-Saharan Africa. However, further work is needed to develop and evaluate interventions that have measurable effects on sexually transmitted infections.
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van Beurden S, Greaves CJ, Smith J, Abraham S (In Press). Techniques for Modifying Impulsive Processes Associated with Unhealthy Eating: a Systematic Review.
Health Psychology,
In PressAbstract:
Techniques for Modifying Impulsive Processes Associated with Unhealthy Eating: a Systematic Review.
Objective: This systematic review aimed to; (i) identify and categorize techniques used to modify or manage impulsive processes associated with unhealthy eating behavior, (ii) describe the mechanisms targeted by such techniques and (iii) summarize available evidence on the effectiveness of these techniques.
Methods: Searches of 5 bibliographic databases identified studies, published in English since 1993, that evaluated at least one technique to modify impulsive processes affecting eating in adults. Data were systematically extracted on study characteristics, population, study quality, intervention techniques, proposed mechanisms of action and outcomes. Effectiveness evidence was systematically collated and described without meta-analysis.
Results: Ninety-two studies evaluated 17 distinct impulse management techniques. They were categorized according to whether they aimed to (1) modify the strength of impulses, or (2) engage the reflective system or other resources in identifying, suppressing or otherwise managing impulses. Although higher quality evidence is needed to draw definitive conclusions, promising changes in unhealthy food consumption and food cravings were observed for visuospatial loading, physical activity, and if-then planning, typically for up to 1-day follow-up.
Conclusions:. A wide range of techniques have been evaluated and some show promise for use in weight management interventions. However, larger-scale, more methodologically-robust, community based studies with longer follow-up times are needed to establish whether such techniques can have a long-term impact on eating patterns.
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Hillier-Brown FC, Summerbell CD, Moore HJ, Routen A, Lake AA, Adams J, White M, Araujo-Soares V, Abraham C, Adamson AJ, et al (In Press). The impact of interventions to promote healthier ready-to-eat meals (to eat in, to take away or to be delivered) sold by specific food outlets open to the general public: a systematic review.
Obes Rev,
18(2), 227-246.
Abstract:
The impact of interventions to promote healthier ready-to-eat meals (to eat in, to take away or to be delivered) sold by specific food outlets open to the general public: a systematic review.
INTRODUCTION: Ready-to-eat meals sold by food outlets that are accessible to the general public are an important target for public health intervention. We conducted a systematic review to assess the impact of such interventions. METHODS: Studies of any design and duration that included any consumer-level or food-outlet-level before-and-after data were included. RESULTS: Thirty studies describing 34 interventions were categorized by type and coded against the Nuffield intervention ladder: restrict choice = trans fat law (n = 1), changing pre-packed children's meal content (n = 1) and food outlet award schemes (n = 2); guide choice = price increases for unhealthier choices (n = 1), incentive (contingent reward) (n = 1) and price decreases for healthier choices (n = 2); enable choice = signposting (highlighting healthier/unhealthier options) (n = 10) and telemarketing (offering support for the provision of healthier options to businesses via telephone) (n = 2); and provide information = calorie labelling law (n = 12), voluntary nutrient labelling (n = 1) and personalized receipts (n = 1). Most interventions were aimed at adults in US fast food chains and assessed customer-level outcomes. More 'intrusive' interventions that restricted or guided choice generally showed a positive impact on food-outlet-level and customer-level outcomes. However, interventions that simply provided information or enabled choice had a negligible impact. CONCLUSION: Interventions to promote healthier ready-to-eat meals sold by food outlets should restrict choice or guide choice through incentives/disincentives. Public health policies and practice that simply involve providing information are unlikely to be effective.
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Smith JR, Louis WR, Abraham C (In Press). When and how does normative feedback reduce intentions to drink irresponsibly?. An experimental investigation.
Addiction Research and Theory Full text.
2018
Sani AS, Abraham C, Denford S, Mathews C (2018). Design, implementation and evaluation of school-based sexual health education in sub-Saharan Africa: a qualitative study of researchers’ perspectives.
Sex Education,
18(2), 172-190.
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Design, implementation and evaluation of school-based sexual health education in sub-Saharan Africa: a qualitative study of researchers’ perspectives
© 2017 Informa UK Limited, trading as Taylor. &. Francis Group. This study investigated facilitators and challenges to designing, implementing and evaluating school-based sexual health education in sub-Saharan Africa, using interviews with intervention designers and researchers. At the pre-planning and planning stages, participants reported that facilitating factors included addressing the reproductive health needs of participants, contextual (culture, religion, economic and social) considerations and the adoption of holistic approach to sexuality education. Lack of open communication about sexual health matters between young people and adults; concerns that sexual health education could encourage sexual activity; and inadequate funding, were key barriers. Implementation was facilitated by the involvement of relevant stakeholders, the training of facilitators and adopting strategies to overcome resistance to sexual health education. The provision of structured, detailed lessons plans and monitoring with supportive supervision optimised fidelity of delivery. Barriers to implementation included facilitators’ resistance to teaching safe sex promotion and logistical challenges in school environments. Participants also reported that the validity of self-reported adolescent sexual behaviour (as part of evaluation) may be improved by complementing well-designed self-report surveys with computerised audio devices for data collection, qualitative interviews and participant observation. Study findings generate recommendations to improve future forms of school-based sexual health education i n sub-Saharan Africa.
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Lloyd J, Creanor S, Logan S, Green C, Dean SG, Hillsdon M, Abraham C, Tomlinson R, Pearson V, Taylor RS, et al (2018). Effectiveness of the Healthy Lifestyles Programme (HeLP) to prevent obesity in UK primary-school children: a cluster randomised controlled trial.
The Lancet Child and Adolescent Health,
2(1), 35-45.
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Effectiveness of the Healthy Lifestyles Programme (HeLP) to prevent obesity in UK primary-school children: a cluster randomised controlled trial
© 2018 the Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background Although childhood overweight and obesity prevalence has increased substantially worldwide in the past three decades, scarce evidence exists for effective preventive strategies. We aimed to establish whether a school-based intervention for children aged 9–10 years would prevent excessive weight gain after 24 months. Methods This pragmatic cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP), a school-based obesity prevention intervention, was done in 32 schools in southwest England. All state-run primary and junior schools in Devon and Plymouth (UK) with enough pupils for at least one year-5 class were eligible. Schools were assigned (1:1) using a computer-generated sequence to either intervention or control, stratified by the number of year-5 classes (one vs more than one) and the proportion of children eligible for free school meals ( < 19% [the national average] vs ≥19%). HeLP was delivered to year-5 children (ages 9–10 years) over 1 year, and included dynamic and interactive activities such as physical activity workshops, education sessions delivered by teachers with short homework tasks, drama sessions, and setting goals to modify behaviour (with parental support and one-to-one discussions with HeLP coordinators). The primary outcome was change in body-mass index (BMI) standard deviation score (SDS) between baseline and 24 months, analysed in children with BMI data available for both timepoints. This study is registered with the International Standard Randomised Controlled Trial register, number ISRCTN15811706, and the trial status is complete. Findings Between March 21, 2012, and Sept 30, 2013, 32 eligible schools with 1324 children were recruited, of which 16 schools (676 children) were randomly assigned to the HeLP intervention and 16 schools (648 children) to control. All schools that began the trial completed the intervention, and 1244 children (628 in intervention group and 616 in control group) had BMI data at both baseline and 24 months for the primary outcome analysis. Mean BMI SDS was 0·32 (SD 1·16) at baseline and 0·35 (1·25) at 24 months in the intervention group, and 0·18 (1·14) at baseline and 0·22 (1·22) at 24 months in the control group. With adjustment for school-level clustering, baseline BMI scores, sex, cohort, and number of year-5 classes and socioeconomic status of each school, the mean difference in BMI SDS score (intervention–control) at 24 months was −0·02 (95% CI −0·09 to 0·05), p=0·57. One parent reported an adverse event related to their child's eating and activity behaviours, but agreed for the child to continue trial participation after discussion with the chief investigator. Interpretation Despite a theoretically informed and extensively piloted intervention that achieved high levels of engagement, follow-up, and fidelity of delivery, we found no effect of the intervention on preventing overweight or obesity. Although schools are an ideal setting in which to deliver population-based interventions, school-based interventions might not be sufficiently intense to affect both the school and the family environment, and hence the weight status of children. Future research should focus on more upstream determinants of obesity and use whole-systems approaches. Funding UK National Institute for Health Research, Public Health Research Programme.
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Borek AJ, Abraham C, Greaves CJ, Tarrant M (2018). Group-Based Diet and Physical Activity Weight-Loss Interventions: a Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Appl Psychol Health Well Being,
10(1), 62-86.
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Group-Based Diet and Physical Activity Weight-Loss Interventions: a Systematic Review and Meta-Analysis of Randomised Controlled Trials.
BACKGROUND: Many weight-loss interventions are delivered in groups but evidence on their effectiveness, and characteristics associated with effectiveness, is limited. We synthesised evidence on (1) design and delivery of group-based weight-loss interventions; (2) effectiveness; and (3) associations between intervention characteristics, change techniques, and effectiveness. METHODS: Five online databases were searched to May 2017 for randomised controlled trials (RCTs) of group-based diet and/or physical activity interventions for overweight/obese adults (BMI ≥ 25). Intervention characteristics were synthesised narratively. Mean differences (MD) in weight loss were calculated using a random-effects meta-analysis, and sub-group analyses were conducted to identify moderators of effectiveness. RESULTS: Forty-seven RCTs reporting 60 evaluations of group-based interventions were included. MD in weight loss between intervention and control groups was -3.49 [95% CI -4.15, -2.84], -3.44 [-4.23, -2.85], and -2.56 kg [-3.79, -1.33] at follow-ups closest to 6, 12, and 24 months, respectively. Explicitly targeting weight loss, men-only groups providing feedback and dietary goals were significantly associated with greater effectiveness (p <. 05). CONCLUSIONS: Diet and physical activity interventions delivered in groups are effective in promoting clinically meaningful weight loss at 12 months. Intervention design and effectiveness vary considerably between studies, and evidence on what optimises the effectiveness of group-based weight-loss interventions remains limited.
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Borek AJ, Abraham C (2018). How do Small Groups Promote Behaviour Change? an Integrative Conceptual Review of Explanatory Mechanisms.
Appl Psychol Health Well Being,
10(1), 30-61.
Abstract:
How do Small Groups Promote Behaviour Change? an Integrative Conceptual Review of Explanatory Mechanisms.
BACKGROUND: Small groups are used to promote health, well-being, and personal change by altering members' perceptions, beliefs, expectations, and behaviour patterns. An extensive cross-disciplinary literature has articulated and tested theories explaining how such groups develop, function, and facilitate change. Yet these theoretical understandings are rarely applied in the development, description, and evaluation of health-promotion, group-based, behaviour-change interventions. METHODS: Medline database, library catalogues, search engines, specific journals and reference lists were searched for relevant texts. Texts were reviewed for explanatory concepts or theories describing change processes in groups, which were integrated into the developing conceptual structure. This was designed to be a parsimonious conceptual framework that could be applied to design and delivery. RESULTS: Five categories of interacting processes and concepts were identified and defined: (1) group development processes, (2) dynamic group processes, (3) social change processes, (4) personal change processes, and (5) group design and operating parameters. Each of these categories encompasses a variety of theorised mechanisms explaining individual change in small groups. CONCLUSION: the final conceptual model, together with the design issues and practical recommendations derived from it, provides a practical basis for linking research and theory explaining group functioning to optimal design of group-based, behaviour-change interventions.
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van Beurden SB, Simmons SI, Tang JCH, Mewse AJ, Abraham C, Greaves CJ (2018). Informing the development of online weight management interventions: a qualitative investigation of primary care patient perceptions.
BMC Obes,
5Abstract:
Informing the development of online weight management interventions: a qualitative investigation of primary care patient perceptions.
Background: the internet is a potentially promising medium for delivering weight loss interventions. The current study sought to explore factors that might influence primary care patients' initial uptake and continued use (up to four-weeks) of such programmes to help inform the development of novel, or refinement of existing, weight management interventions. Methods: Semi-structured interviews were conducted with 20 patients purposively sampled based on age, gender and BMI from a single rural general practice. The interviews were conducted 4 weeks after recruitment at the general practice and focused on experiences with using one of three freely available weight loss websites. Thematic Analysis was used to analyse the data. Results: Findings suggested that patients were initially motivated to engage with internet-based weight loss programmes by their accessibility and novelty. However, continued use was influenced by substantial facilitators and barriers, such as time and effort involved, reaction to prompts/reminders, and usefulness of information. Facilitation by face-to-face consultations with the GP was reported to be helpful in supporting change. Conclusions: Although primary care patients may not be ready yet to solely depend on online interventions for weight loss, their willingness to use them shows potential for use alongside face-to-face weight management advice or intervention. Recommendations to minimise barriers to engagement are provided.
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Chng S, Abraham C, White MP, Hoffmann C, Skippon S (2018). Psychological theories of car use: an integrative review and conceptual framework.
Journal of Environmental Psychology,
55, 23-33.
Abstract:
Psychological theories of car use: an integrative review and conceptual framework
© 2017 Elsevier Ltd Personal car use is increasing globally and is an important contributor to poor air quality and global greenhouse gas emissions. Although individuals have little direct control over some emission sources (e.g. heavy industry), they can modify their car use thereby reducing their own contribution. There have been many attempts to understand the psychology of personal car use and identify ways in which individuals might be encouraged to adopt more environmentally friendly travel modes. The aims of this study were (1) to review available psychological theories and models and their applications to understanding car use, (2) to assess the quality of empirical tests of relevant theories and (3) to develop an integrated conceptual overview of potentially modifiable antecedents that could inform future intervention design and further theoretical research. Fifteen psychological theories were identified from thirty-two unique studies but most theories were applied only once. Although two theories in particular (the Comprehensive Action Determination Model and Stage Model of Self-Regulated Behaviour Change) are both relatively comprehensive and have empirical support, our review suggests there are mechanisms of behavioural regulation relevant to car use that are not included in either theory. Integrating theories, we developed an integrative conceptual framework, referred to as the CAr USE (or CAUSE) framework of cognitive and emotional antecedents of car use. This framework is likely to be applicable to other ecologically-relevant behaviour patterns. Implications for research and practice are discussed.
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Goffe L, Penn L, Adams J, Araujo-Soares V, Summerbell CD, Abraham C, White M, Adamson A, Lake AA (2018). The challenges of interventions to promote healthier food in independent takeaways in England: qualitative study of intervention deliverers' views.
BMC PUBLIC HEALTH,
18 Author URL.
2017
Denford S, Abraham C, Callaghan M, Aighton P, De Vocht F, Arris S (2017). A review of Grey and academic literature of evaluation guidance relevant to public health interventions.
BMC Health Serv Res,
17(1).
Abstract:
A review of Grey and academic literature of evaluation guidance relevant to public health interventions.
BACKGROUND: Public Health evaluation is essential to understanding what does and does not work, and robust demonstration of effectiveness may be crucial to securing future funding. Despite this, programs are often implemented with poor, incomplete or no evaluation. Public health practitioners are frequently required to provide evidence for the effectiveness of their services; thus, there is a growing need for evaluation guidance on how to evaluate public health programs. The aim of this study is to identify accessible high-quality, evaluation guidance, available to researchers and practitioners and to catalogue, summarise and categorise the content of a subset of accessible, quality guides to evaluation. METHODS: We systematically reviewed grey and academic literature for documents providing support for evaluation of complex health interventions. Searches were conducted January to March 2015, and included academic databases, internet search engines, and consultations with academic and practicing public health experts. Data were extracted by two authors and sent to the authors of the guidance documents for comments. RESULTS: Our initial search identified 402 unique documents that were screened to identify those that were (1) developed by or for a national or international organization (2) freely available to all (3) published during or after 2000 (4) specific to public health. This yielded 98 documents from 43 organisations. of these, 48 were reviewed in detail. This generated a detailed catalogue of quality evaluation guidance. The content included in documents covers 37 facets of evaluation. CONCLUSIONS: a wide range of guidance on evaluation of public health initiatives is available. Time and knowledge constraints may mean that busy practitioners find it challenging to access the most, up-to-date, relevant and useful guidance. This review presents links to and reviews of 48 quality guides to evaluation as well as categorising their content. This facilitates quick and each access to multiple selected sources of specific guidance.
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Lloyd J, Creanor S, Price LRS, Abraham C, Dean S, Green C, Hillsdon M, Pearson V, Taylor R, Tomlinson R, et al (2017). Trial baseline characteristics of a cluster randomised controlled trial of a school-located obesity prevention programme; the Healthy Lifestyles Programme (HeLP) trial.
BMC Public Health Full text.
Hoffmann C, Abraham C, White MP, Ball S, Skippon SM (2017). What cognitive mechanisms predict travel mode choice? a systematic review with meta-analysis.
Transport Reviews,
37(5), 631-652.
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Pound P, Denford S, Shucksmith J, Tanton C, Johnson AM, Owen J, Hutten R, Mohan L, Bonell C, Abraham C, et al (2017). What is best practice in sex and relationship education? a synthesis of evidence, including stakeholders' views.
BMJ Open,
7(5).
Abstract:
What is best practice in sex and relationship education? a synthesis of evidence, including stakeholders' views.
OBJECTIVES: Sex and relationship education (SRE) is regarded as vital to improving young people's sexual health, but a third of schools in England lacks good SRE and government guidance is outdated. We aimed to identify what makes SRE programmes effective, acceptable, sustainable and capable of faithful implementation. DESIGN: This is a synthesis of findings from five research packages that we conducted (practitioner interviews, case study investigation, National Survey of Sexual Attitudes and Lifestyles, review of reviews and qualitative synthesis). We also gained feedback on our research from stakeholder consultations. SETTINGS: Primary research and stakeholder consultations were conducted in the UK. Secondary research draws on studies worldwide. RESULTS: Our findings indicate that school-based SRE and school-linked sexual health services can be effective at improving sexual health. We found professional consensus that good programmes start in primary school. Professionals and young people agreed that good programmes are age-appropriate, interactive and take place in a safe environment. Some young women reported preferring single-sex classes, but young men appeared to want mixed classes. Young people and professionals agreed that SRE should take a 'life skills' approach and not focus on abstinence. Young people advocated a 'sex-positive' approach but reported this was lacking. Young people and professionals agreed that SRE should discuss risks, but young people indicated that approaches to risk need revising. Professionals felt teachers should be involved in SRE delivery, but many young people reported disliking having their teachers deliver SRE and we found that key messages could become lost when interpreted by teachers. The divergence between young people and professionals was echoed by stakeholders. We developed criteria for best practice based on the evidence. CONCLUSIONS: We identified key features of effective and acceptable SRE. Our best practice criteria can be used to evaluate existing programmes, contribute to the development of new programmes and inform consultations around statutory SRE.
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2016
Warmoth K, Lang IA, Phoenix C, Abraham C, Andrew MK, Hubbard RE, Tarrant M (2016). 'Thinking you're old and frail': a qualitative study of frailty in older adults.
Ageing and Society,
36(7), 1483-1500.
Abstract:
'Thinking you're old and frail': a qualitative study of frailty in older adults
© 2015 Cambridge University Press. Many older adults experience what is clinically recognised as frailty but little is known about the perceptions of, and attitudes regarding, being frail. This qualitative study explored adults' perceptions of frailty and their beliefs concerning its progression and consequences. Twenty-nine participants aged 66-98 with varying degrees of frailty, residing either in their homes or institutional settings, participated in semi-structured interviews. Verbatim transcripts were analysed using a Grounded Theory approach. Self-identifying as 'frail' was perceived by participants to be strongly related to their own levels of health and engagement in social and physical activity. Being labelled by others as 'old and frail' contributed to the development of a frailty identity by encouraging attitudinal and behavioural confirmation of it, including a loss of interest in participating in social and physical activities, poor physical health and increased stigmatisation. Using both individual and social context, different strategies were used to resist self-identification. The study provides insights into older adults' perceptions and attitudes regarding frailty, including the development of a frailty identity and its relationship with activity levels and health. The implications of these findings for future research and practice are discussed.
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Abraham C, Smith JR (2016). A FRAMEWORK FOR DESIGNING BRIEF COMMUNICATIONS TO PROMOTE HEALTH-RELATED BEHAVIOUR CHANGE.
Author URL.
Denford S, Abraham C, Campbell R, Brusse H (2016). A comprehensive review of reviews of school-based interventions to improve sexual-health.
Health Psychology Review Full text.
Bardus M, van Beurden SB, Smith JR, Abraham C (2016). A review and content analysis of engagement, functionality, aesthetics, information quality, and change techniques in the most popular commercial apps for weight management.
Int J Behav Nutr Phys Act,
13Abstract:
A review and content analysis of engagement, functionality, aesthetics, information quality, and change techniques in the most popular commercial apps for weight management.
BACKGROUND: There are thousands of apps promoting dietary improvement, increased physical activity (PA) and weight management. Despite a growing number of reviews in this area, popular apps have not been comprehensively analysed in terms of features related to engagement, functionality, aesthetics, information quality, and content, including the types of change techniques employed. METHODS: the databases containing information about all Health and Fitness apps on GP and iTunes (7,954 and 25,491 apps) were downloaded in April 2015. Database filters were applied to select the most popular apps available in both stores. Two researchers screened the descriptions selecting only weight management apps. Features, app quality and content were independently assessed using the Mobile App Rating Scale (MARS) and previously-defined categories of techniques relevant to behaviour change. Inter-coder reliabilities were calculated, and correlations between features explored. RESULTS: of the 23 popular apps included in the review 16 were free (70%), 15 (65%) addressed weight control, diet and PA combined; 19 (83%) allowed behavioural tracking. On 5-point MARS scales, apps were of average quality (Md = 3.2, IQR = 1.4); "functionality" (Md = 4.0, IQR = 1.1) was the highest and "information quality" (Md = 2.0, IQR = 1.1) was the lowest domain. On average, 10 techniques were identified per app (range: 1-17) and of the 34 categories applied, goal setting and self-monitoring techniques were most frequently identified. App quality was positively correlated with number of techniques included (rho = .58, p
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Sani AS, Abraham C, Denford S, Ball S (2016). Are sexual health programmes in sub-Saharan African schools effective in promoting condom use and preventing sexually-transmitted infections including HIV? a systematic review and meta-analysis.
HIV MEDICINE,
17, 30-30.
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Borek A, Abraham C, Greaves C, Tarrant M (2016). CHANGE PROCESSES AND EFFECTIVENESS IN GROUP-BASED WEIGHT LOSS INTERVENTIONS.
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Armstrong M, Morris C, Abraham C, Ukoumunne OC, Tarrant M (2016). Children's contact with people with disabilities and their attitudes towards disability: a cross-sectional study.
Disabil Rehabil,
38(9), 879-888.
Abstract:
Children's contact with people with disabilities and their attitudes towards disability: a cross-sectional study.
PURPOSE: to explore the association between children's self-reported contact with people with disabilities and attitudes towards them, as well the potential mediating influence of anxiety about interacting with people with disabilities and empathy for them. METHOD: 1881 children, aged 7-16 years, from 20 schools in South West England completed a survey assessing their contact with people with disabilities and their attitudes towards them. Anxiety about interacting with people with disabilities and empathy towards them were examined as potential mediators. Gender, school year, perceived similarity between people with and without disabilities, proportion of children with additional needs at the school and socioeconomic status (SES) were assessed as moderators. A random effects ("multilevel") regression model was used to test the contact-attitude association and moderation, and path analysis was used to test for mediation. RESULTS: Participants with more self-reported contact reported more positive attitudes towards disability (p
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van Beurden SB, Greaves CJ, Smith JR, Abraham C, Lawrence N (2016). FACILITATING WEIGHT LOSS WITH THE IMPULSEPAL APP': a FEASIBILITY STUDY.
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Borek A, Abraham C, Greaves C, Tarrant M, Smith JR (2016). HOW DO DIABETES PREVENTION GROUPS GENERATE INDIVIDUAL CHANGE?.
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Abraham C, Conner M, Jones F, O'Connor D (2016).
Health psychology: Second edition.Abstract:
Health psychology: Second edition
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Conner M, Abraham C, Prestwich A, Hutter R, Hallam J, Sykes-Muskett B, Morris B, Hurling R (2016). Impact of goal priority and goal conflict on the intention–health-behavior relationship: Tests on physical activity and other health behaviors.
Health Psychology,
35(9), 1017-1026.
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Denford S, Abraham S, Smith J, Morgan-Trimmer S, Lloyd J, Wyatt K (2016). Intervention design and evaluation: behaviour change imperatives. In Spotswood F (Ed)
Beyond behaviour change Key issues, interdisciplinary approaches and future directions, Bristol: Policy Press, 49-70.
Abstract:
Intervention design and evaluation: behaviour change imperatives
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Smith JR, Borek A, Abraham C, Greaves C, Morgan-Trimmer S, Gillison F, Jones M, Keable J, Tarrant M, McCabe R, et al (2016). MECHANISMS OF ACTION IN GROUP INTERVENTIONS (MAGI) STUDY: INITIAL FINDINGS AND a CONCEPTUAL FRAMEWORK.
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Greaves CJ (2016). Optimising self-care support for people with heart failure and their caregivers: development of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention using intervention mapping.
Pilot and Feasibility Studies,
2, 1-1.
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Armstrong M, Morris C, Tarrant M, Abraham, Horton M (2016). Rasch analysis of the Chedoke–McMaster Attitudes towards Children with Handicaps scale.
Disability and Rehabilitation Full text.
Tang JCH, Abraham C, Greaves CJ, Nikolaou V (2016). Self-directed interventions to promote weight loss: a systematic review and meta-analysis.
Health Psychol Rev,
10(3), 358-372.
Abstract:
Self-directed interventions to promote weight loss: a systematic review and meta-analysis.
Many self-directed weight-loss interventions have been developed using a variety of delivery formats (e.g. internet and smartphone) and change techniques. Yet, little research has examined whether self-directed interventions can exclusively promote weight loss. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library were systematically reviewed for randomised controlled trials evaluating self-directed interventions in relation to weight-loss outcomes in adults. Standardised mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random effects model. Twenty-seven trials incorporating 36 comparisons met our inclusion criteria. Participants using self-directed interventions lost significantly more weight (MD = -1.56â€
kg, CI -2.25, -0.86 ranging from 0.6 to 5.3â€
kg) compared to those in the minimal intervention or no-treatment groups (3.1-month follow-up median). The majority of interventions were internet based (18 evaluations) and these were effective at 3 months (MD = -1.74â€
kg, CI -2.65, -0.82 ranging from 0.6 to 4.8â€
kg) (SMD = -0.48, 95% CI -0.72, -0.24, I(2) = 82%; p
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Graber R, de Visser R, Abraham C, Memon A, Hart A, Hunt K (2016). Staying in the 'sweet spot': a resilience-based analysis of the lived experience of low-risk drinking and abstention among British youth.
Psychol Health,
31(1), 79-99.
Abstract:
Staying in the 'sweet spot': a resilience-based analysis of the lived experience of low-risk drinking and abstention among British youth.
OBJECTIVE: the aim of this study was to understand how and why young people drink less or not at all when with their peers. Understanding the subjective experiences of moderate or non-drinkers may help identify protective processes facilitating resilience to cultural norm and influences that encourage excessive alcohol consumption among young people. DESIGN: Semi-structured interviews were conducted with 25 moderate- or non-drinkers aged 17-25 years (13 young women) living in South East England. Interviews explored recent experiences of social situations and encounters that did or did not involve alcohol. Transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS: Analysis identified six conceptually coherent themes clustering within a superordinate theme of a healthy experience of moderate alcohol use or abstention: 'the sweet spot'. These themes were: feeling good in the body, feeling like you can be who you are, feeling like you belong, making a free choice, enjoying the moment, and feeling safe and secure. CONCLUSIONS: This resilience-based analysis showed how non-drinking and moderate-drinking may be experienced as a positive and proactive choice. Understanding the subjective experiences of young people may aid development of specific, realistic interventions to promote moderate drinking and abstention among young people in drinking cultures.
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van Beurden SB, Greaves CJ, Smith JR, Abraham C (2016). TECHNIQUES FOR MODIFYING IMPULSIVE PROCESSES ASSOCIATED WITH UNHEALTHY EATING: a SYSTEMATIC REVIEW.
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Smith JR, Greaves C, Abraham C, Thompson JL, Taylor R, Jones M, Kok M, Armstrong R, Coleman S, Solomon-Moores E, et al (2016). THE COMMUNITY-BASED PREVENTION OF DIABETES (COMPOD) TRIAL OF THE VOLUNTARY SECTOR-LED LIVING WELL, TAKING CONTROL (LWTC) DIABETES PREVENTION PROGRAMME.
Author URL.
Abraham C (2016). TOWARDS SYSTEMATIC AND COMPREHENSIVE CHARACTERISATION OF THE CONTENT OF BEHAVIOR CHANGE INTERVENTIONS.
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Traina SB, Mathias SD, Colwell HH, Crosby RD, Abraham C (2016). The Diabetes Intention, Attitude, and Behavior Questionnaire: evaluation of a brief questionnaire to measure physical activity, dietary control, maintenance of a healthy weight, and psychological antecedents.
PATIENT PREFERENCE AND ADHERENCE,
10, 213-222.
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Sheeran P, Rothman A, Abraham C, Klein W (2016). UNDERSTANDING WHAT WORKS IN INTERVENTIONS DESIGNED TO CHANGE HEALTH BEHAVIOUR: NEW APPROACHES TO LINKING THEORY RESEARCH DESIGN, AND EVIDENCE.
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Lake AJ, Browne JL, Rees G, Abraham C, Speight J (2016). USING MULTIPLE RESEARCH METHODS TO DEVELOP a TAILORED EYE HEALTH LEAFLET FOR YOUNG ADULTS WITH TYPE 2 DIABETES.
Author URL.
2015
Borek AJ, Abraham C, Smith JR, Greaves CJ, Tarrant M (2015). A checklist to improve reporting of group-based behaviour-change interventions Biostatistics and methods.
BMC Public Health,
15(1).
Abstract:
A checklist to improve reporting of group-based behaviour-change interventions Biostatistics and methods
© 2015 Borek et al. Background: Published descriptions of group-based behaviour-change interventions (GB-BCIs) often omit design and delivery features specific to the group setting. This impedes the ability to compare behaviour-change interventions, synthesise evidence on their effectiveness and replicate effective interventions. The aim of this study was to develop a checklist of elements that should be described to ensure adequate reporting of GB-BCIs. Methods: a range of characteristics needed to replicate GB-BCIs were extracted from the literature and precisely defined. An abbreviated checklist and a coder manual were developed, pilot tested and refined. The final checklist and coder manual were used to identify the presence or absence of specified reporting elements in 30 published descriptions of GB-BCIs by two independent coders. Reliability of coding was assessed. Results: the checklist comprises 26 essential reporting elements, covering intervention design, intervention content, participant characteristics, and facilitator characteristics. Inter-rater reliability for identification of reporting elements was high (95 % agreement, Mean AC1 = 0.89). Conclusion: the checklist is a practical tool that can be used, alongside other reporting guidelines, to ensure comprehensive description and to assess reporting quality of GB-BCIs. It can also be helpful for designing group-based health interventions.
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Wood CE, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Michie S (2015). Applying the behaviour change technique (BCT) taxonomy v1: a study of coder training.
Transl Behav Med,
5(2), 134-148.
Abstract:
Applying the behaviour change technique (BCT) taxonomy v1: a study of coder training.
Behaviour Change Technique Taxonomy v1 (BCTTv1) has been used to detect active ingredients of interventions. The purpose of this study was to evaluate effectiveness of user training in improving reliable, valid and confident application of BCTTv1 to code BCTs in intervention descriptions. One hundred sixty-one trainees (109 in workshops and 52 in group tutorials) were trained to code frequent BCTs. The following measures were taken before and after training: (i) inter-coder agreement, (ii) trainee agreement with expert consensus, (iii) confidence ratings and (iv) coding competence. Coding was assessed for 12 BCTs (workshops) and for 17 BCTs (tutorials). Trainees completed a course evaluation. Methods improved agreement with expert consensus (p
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Michie S, Wood CE, Johnston M, Abraham C, Francis JJ, Hardeman W (2015). Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data).
Health Technol Assess,
19(99), 1-188.
Abstract:
Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data).
BACKGROUND: Meeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) - the 'active ingredients', for example goal-setting, self-monitoring of behaviour. BCTs are 'the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs' (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012;6:1-6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health. OBJECTIVE: (1) to develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development. DESIGN AND PARTICIPANTS: Four hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs. Development of the taxonomy involved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts; hierarchical structure of the list was developed using inductive 'bottom-up' and theory-driven 'top-down' open-sort procedures (n = 36); training in use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) was evaluated by changes in intercoder reliability and validity (agreement with expert consensus); evaluating the taxonomy for coding interventions was assessed by reliability (intercoder; test-retest) and validity (n = 40 trained coders); and evaluating the taxonomy for writing descriptions was assessed by reliability (intercoder; test-retest) and by experimentally testing its value (n = 190). RESULTS: Ninety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a 'bottom-up' open-sort procedure; there was overlap between these and groupings produced by a theory-driven, 'top-down' procedure. Both training methods improved validity (both p
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Armstrong M, Morris C, Abraham C, Ukoumunne OC, Tarrant M (2015). Children’s contact with people with disabilities and their attitudes towards disability: a cross-sectional study.
Disability and Rehabilitation Full text.
Taylor RS, Hayward C, Eyre V, Austin J, Davies R, Doherty P, Jolly K, Wingham J, Van Lingen R, Abraham C, et al (2015). Clinical effectiveness and cost-effectiveness of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) facilitated self-care rehabilitation intervention in heart failure patients and caregivers: rationale and protocol for a multicentre randomised controlled trial.
BMJ Open,
5(12).
Abstract:
Clinical effectiveness and cost-effectiveness of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) facilitated self-care rehabilitation intervention in heart failure patients and caregivers: rationale and protocol for a multicentre randomised controlled trial.
INTRODUCTION: the Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) trial is part of a research programme designed to develop and evaluate a health professional facilitated, home-based, self-help rehabilitation intervention to improve self-care and health-related quality of life in people with heart failure and their caregivers. The trial will assess the clinical effectiveness and cost-effectiveness of the REACH-HF intervention in patients with systolic heart failure and impact on the outcomes of their caregivers. METHODS AND ANALYSIS: a parallel two group randomised controlled trial with 1:1 individual allocation to the REACH-HF intervention plus usual care (intervention group) or usual care alone (control group) in 216 patients with systolic heart failure (ejection fraction
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Elliott LR, White MP, Taylor AH, Abraham (2015). Content analysis of outdoor walking brochures: the development of a behavioural-theory informed coding scheme.
Devine-Wright H, Abraham C, Onya H, Ramatsea S, Themane M, Aarø LE (2015). Correlates of condom use and condom-use motivation among young South Africans.
Journal of Applied Social PsychologyAbstract:
Correlates of condom use and condom-use motivation among young South Africans
© 2015 Wiley Periodicals, Inc. A survey of South African secondary school students aged 12-17 years (n = 893) included measures designed to investigate relationships between beliefs about HIV/AIDS, condom use, interpersonal relationships, and two dependent measures: motivation to use condoms and reported condom use. We predicted that motivation would be an important correlate of reported condom use and that traditional cultural beliefs included in social cognition models would predict condom use motivation. Hierarchical multiple regression showed that 10% of the variance in reported condom use was accounted for by condom use motivation and age. Condom self-efficacy, beliefs about condoms and injunctive norms accounted for much of the variance. Other beliefs included susceptibility to HIV and attribution of HIV to asexual sources such as witchcraft indicating that an expanded model of modifiable cognitions may be optimal when designing HIV interventions among young South Africans.
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Abraham C, Denford S, Dean S, Greaves C, Lloyd J, Tarrant M, White M, Wyatt K (2015). Designing Interventions to Change Health-related Behaviour. In Richards D, Hallberg IR (Eds.) Complex Interventions in Health: an Overview of Research Methods, Routledge, 103-110.
Denford S, Abraham C, Smith J, Lloyd J, White M, Tarrant M, Wyatt K, Greaves C, Dean S (2015). Designing and evaluating behavior change interventions to promote health. In Reynolds KJ, Branscombe NR (Eds.) The Psychology of Change: Life Contexts, Experiences, and Identities, New York: Psychology Press, Taylor & Francis, 151-169.
Bailey J, Mann S, Wayal S, Abraham C, Murray E (2015). Digital media interventions for sexual health promotion-opportunities and challenges: a great way to reach people, particularly those at increased risk of sexual ill health.
BMJ,
350 Author URL.
Abraham C, Onya H, Aarø L, Smith JR, Devine-Wright H, Wubs A, Ramatsea S, Themane M, Mashamba J (2015). Evaluation of a culturally-situated, research-based HIV-prevention program in South African Schools (symposium presentation). European Health Psychology Society Conference.
Kurz T, Gardner B, Verplanken B, Abraham C (2015). Habitual behaviours or patterns of practice: Explaining and changing repetitive climate-relevant actions.
Wiley Interdisciplinary Reviews: WIREs Climate Change,
6, 113-128.
Abstract:
Habitual behaviours or patterns of practice: Explaining and changing repetitive climate-relevant actions
Understanding human behaviour lies at the heart of responses to climate change. Many environmentally-relevant behaviour patterns are frequent, stable, and persistent. There is an increasing focus on understanding these patterns less in terms of deliberative processes and more in terms of habits and routines embedded in everyday life. Examinations of the ‘habitual’ nature of environmentally-consequential activities have been approached from two theoretically distinct perspectives. From a social psychological perspective, ‘habit’ is studied as an intra-individual psychological construct that sustains ingrained behaviour patterns in stable settings and obstructs adoption of more environmentally-friendly alternatives. Sociologists from the social practice tradition, in contrast, have sought to highlight the ways in which resource intensive ‘habitual practices’ become established and maintained in society through a commingling of material, procedural and socio-discursive elements. We reflect critically upon key theoretical differences underpinning these two approaches to repetitive behaviours. We review empirical work from both traditions that speaks to the relevance of ‘habitual behaviour patterns’ central to addressing climate change. Finally, we examine how changes in habits are theorized and operationalised within both social psychological and social practice approaches, and practical implications for promoting environmentally sustainable societies.
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Tang J, Abraham C, Stamp E, Greaves C (2015). How can weight-loss app designers' best engage and support users? a qualitative investigation.
British Journal of Health Psychology,
20(1), 151-171.
Abstract:
How can weight-loss app designers' best engage and support users? a qualitative investigation
© 2014 the British Psychological Society. Objectives This study explored young adults' experiences of using e-health internetbased computer or mobile phone applications (apps) and what they valued about those apps. Design and methods a qualitative design was used. Semi-structured interviews were conducted with a community sample of 19 young adults who had used a publicly available phone or internet-based application. Transcripts were analysed using thematic analysis. Results Participants valued an attractive user interface. Structure, ease of use, personalised features and accessibility (including dual phone-computer access) were all important to participants and users indicated that continued use depended on these design features. Many believed that a focus on calorie counting was too limiting. Some users mentioned behaviour change strategies and known behaviour change techniques utilised by apps including; self-monitoring, goal setting and behavioural feedback. Only a few users reported positive changes in physical activity levels. Conclusions Use of particular design features and application of evidence-based behaviour change techniques could optimise continued use and the effectiveness of internet/smart phone interventions. Statement of contribution What is already known on this subject? E-health is increasingly used to deliver weight loss/control programs. Most e-health programs have not been founded on evidence-based designs and it is unclear what features and functions users find useful or not so useful. What does this study add? Weight loss app users valued structure, ease of use, personalised features and accessibility. Goal setting and feedback on calorie intake/energy balance were the most widely used behaviour change techniques. Designers should consider an extensive food database, a food scanner, and provision of diaries.
Abstract.
Tang J, Abraham C, Stamp E, Greaves C (2015). How can weight-loss app designers' best engage and support users? a qualitative investigation.
Br J Health Psychol,
20(1), 151-171.
Abstract:
How can weight-loss app designers' best engage and support users? a qualitative investigation.
OBJECTIVES: This study explored young adults' experiences of using e-health internet-based computer or mobile phone applications (apps) and what they valued about those apps. DESIGN AND METHODS: a qualitative design was used. Semi-structured interviews were conducted with a community sample of 19 young adults who had used a publicly available phone or internet-based application. Transcripts were analysed using thematic analysis. RESULTS: Participants valued an attractive user interface. Structure, ease of use, personalised features and accessibility (including dual phone-computer access) were all important to participants and users indicated that continued use depended on these design features. Many believed that a focus on calorie counting was too limiting. Some users mentioned behaviour change strategies and known behaviour change techniques utilised by apps including; self-monitoring, goal setting and behavioural feedback. Only a few users reported positive changes in physical activity levels. CONCLUSIONS: Use of particular design features and application of evidence-based behaviour change techniques could optimise continued use and the effectiveness of internet/smart phone interventions. Statement of contribution What is already known on this subject? E-health is increasingly used to deliver weight loss/control programs. Most e-health programs have not been founded on evidence-based designs and it is unclear what features and functions users find useful or not so useful. What does this study add? Weight loss app users valued structure, ease of use, personalised features and accessibility. Goal setting and feedback on calorie intake/energy balance were the most widely used behaviour change techniques. Designers should consider an extensive food database, a food scanner, and provision of diaries.
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Van Beurden S, Greaves CJ, Smith JR, Abraham S (2015). Identifying techniques for modifying impulsive influences on eating behaviour: a systematic review (oral presentation). European Health Psychology Conference.
Pearson M, Chilton R, Wyatt K, Abraham C, Ford T, Woods HB, Anderson R (2015). Implementing health promotion programmes in schools: a realist systematic review of research and experience in the United Kingdom.
Implement Sci,
10Abstract:
Implementing health promotion programmes in schools: a realist systematic review of research and experience in the United Kingdom.
BACKGROUND: Schools have long been viewed as a good setting in which to encourage healthy lifestyles amongst children, and schools in many countries aspire to more comprehensive, integrated approaches to health promotion. Recent reviews have identified evidence of the effects of school health promotion on children's and young people's health. However, understanding of how such programmes can be implemented in schools is more limited. METHODS: We conducted a realist review to identify the conditions and actions which lead to the successful implementation of health promotion programmes in schools. We used the international literature to develop programme theories which were then tested using evaluations of school health promotion programmes conducted in the United Kingdom (UK). Iterative searching and screening was conducted to identify sources and clear criteria applied for appraisal of included sources. A review advisory group comprising educational and public health practitioners, commissioners, and academics was established at the outset. RESULTS: in consultation with the review advisory group, we developed four programme theories (preparing for implementation, initial implementation, embedding into routine practice, adaptation and evolution); these were then refined using the UK evaluations in the review. This enabled us to identify transferable mechanisms and enabling and constraining contexts and investigate how the operation of mechanisms differed in different contexts. We also identified steps that should be taken at a senior level in relation to preparing for implementation (which revolved around negotiation about programme delivery) and initial implementation (which centred on facilitation, support, and reciprocity-the latter for both programme deliverers and pupils). However, the depth and rigour of evidence concerning embedding into routine practice and adaptation and evolution was limited. CONCLUSIONS: Our findings provide guidance for the design, implementation, and evaluation of health promotion in schools and identify the areas where further research is needed.
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Abraham C (2015). Mapping modifiable mechanisms in health promotion research: a commentary on Sniehotta, Presseau, and Araújo-Soares. Health Psychology Review, 9(2), 160-164.
Bardus M, Smith JR, Samaha L, Abraham C (2015). Mobile Phone and Web 2.0 Technologies for Weight Management: a Systematic Scoping Review.
J Med Internet Res,
17(11).
Abstract:
Mobile Phone and Web 2.0 Technologies for Weight Management: a Systematic Scoping Review.
BACKGROUND: Widespread diffusion of mobile phone and Web 2.0 technologies make them potentially useful tools for promoting health and tackling public health issues, such as the increasing prevalence of overweight and obesity. Research in this domain is growing rapidly but, to date, no review has comprehensively and systematically documented how mobile and Web 2.0 technologies are being deployed and evaluated in relation to weight management. OBJECTIVE: to provide an up-to-date, comprehensive map of the literature discussing the use of mobile phone and Web 2.0 apps for influencing behaviors related to weight management (ie, diet, physical activity [PA], weight control, etc). METHODS: a systematic scoping review of the literature was conducted based on a published protocol (registered at PROSPERO: CRD42014010323). Using a comprehensive search strategy, we searched 16 multidisciplinary electronic databases for original research documents published in English between 2004 and 2014. We used duplicate study selection and data extraction. Using an inductively developed charting tool, selected articles were thematically categorized. RESULTS: We identified 457 articles, mostly published between 2013 and 2014 in 157 different journals and 89 conference proceedings. Articles were categorized around two overarching themes, which described the use of technologies for either (1) promoting behavior change (309/457, 67.6%) or (2) measuring behavior (103/457, 22.5%). The remaining articles were overviews of apps and social media content (33/457, 7.2%) or covered a combination of these three themes (12/457, 2.6%). Within the two main overarching themes, we categorized articles as representing three phases of research development: (1) design and development, (2) feasibility studies, and (3) evaluations. Overall, articles mostly reported on evaluations of technologies for behavior change (211/457, 46.2%). CONCLUSIONS: There is an extensive body of research on mobile phone and Web 2.0 technologies for weight management. Research has reported on (1) the development, feasibility, and efficacy of persuasive mobile technologies used in interventions for behavior change (PA and diet) and (2) the design, feasibility, and accuracy of mobile phone apps for behavioral assessment. Further research has focused exclusively on analyses of the content and quality of available apps. Limited evidence exists on the use of social media for behavior change, but a segment of studies deal with content analyses of social media. Future research should analyze mobile phone and Web 2.0 technologies together by combining the evaluation of content and design aspects with usability, feasibility, and efficacy/effectiveness for behavior change, or accuracy/validity for behavior assessment, in order to understand which technological components and features are likely to result in effective interventions.
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Wingham J, Frost J, Britten N, Jolly K, Greaves C, Abraham C, Dalal H, REACH-HF research investigators (2015). Needs of caregivers in heart failure management: a qualitative study.
Chronic Illn,
11(4), 304-319.
Abstract:
Needs of caregivers in heart failure management: a qualitative study.
OBJECTIVES: to identify the needs of caregivers supporting a person with heart failure and to inform the development of a caregiver resource to be used as part of a home-based self-management programme. METHODS: a qualitative study informed by thematic analysis involving 26 caregivers in individual interviews or a focus group. RESULTS: Three distinct aspects of caregiver support in heart failure management were identified. Firstly, caregivers identified needs about supporting management of heart failure including: coping with the variability of heart failure symptoms, what to do in an emergency, understanding and managing medicines, providing emotional support, promoting exercise and physical activity, providing personal care, living with a cardiac device and supporting depression management. Secondly, as they make the transition to becoming a caregiver, they need to develop skills to undertake difficult discussions about the role; communicate with health professionals; manage their own mental health, well-being and sleep; and manage home and work. Thirdly, caregivers require skills to engage social support, and voluntary and formal services while recognising that the long-term future is uncertain. DISCUSSION: the identification of the needs of caregiver has been used to inform the development of a home-based heart failure intervention facilitated by a trained health care practitioner.
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Good A, Harris PR, Jessop D, Abraham C (2015). Open-mindedness can decrease persuasion amongst adolescents: the role of self-affirmation.
British Journal of Health Psychology,
20(2), 228-242.
Abstract:
Open-mindedness can decrease persuasion amongst adolescents: the role of self-affirmation
© 2014 the Authors. British Journal of Health Psychology published by John Wiley. &. Sons Ltd on behalf of British Psychological Society. Objectives. Self-affirmation (e.g. by reflecting on important personal values) has been found to promote more open-minded appraisal of threatening health messages in at-risk adults. However, it is unclear how self-affirmation affects adolescents and whether it has differential effects on the impact of these messages amongst those at relatively lower and higher risk. The current study explored moderation by risk. Design. Participants were randomly assigned to either a self-affirmation or a control condition before receiving a health message concerning physical activity. Methods. Older adolescents (N = 125) completed a self-affirmation or control writing task before reading about the health consequences of not meeting recommendations to be physically active for at least 60 min daily. Most of the sample did not achieve these levels of activity (98%, N = 123). Consequently, the message informed these participants that - unless they changed their behaviour - they would be at higher risk of heart disease. Participants completed measures of responses to the message and behaviour-specific cognitions (e.g. self-efficacy) for meeting the recommendations. Results. For relatively inactive participants, self-affirmation was associated with increased persuasion. However, for those who were moderately active (but not meeting recommendations), those in the self-affirmation condition were less persuaded by the message. Conclusions. Whilst self-affirmation can increase message acceptance, there are circumstances when the open-mindedness it induces may decrease persuasion. The evidence provided in this study suggests that caution may be needed when recommendations are challenging and it could be considered reasonable to be sceptical about the need to change behaviour.
Abstract.
Good A, Harris PR, Jessop D, Abraham C (2015). Open-mindedness can decrease persuasion amongst adolescents: the role of self-affirmation.
Br J Health Psychol,
20(2), 228-242.
Abstract:
Open-mindedness can decrease persuasion amongst adolescents: the role of self-affirmation.
OBJECTIVES: Self-affirmation (e.g. by reflecting on important personal values) has been found to promote more open-minded appraisal of threatening health messages in at-risk adults. However, it is unclear how self-affirmation affects adolescents and whether it has differential effects on the impact of these messages amongst those at relatively lower and higher risk. The current study explored moderation by risk. DESIGN: Participants were randomly assigned to either a self-affirmation or a control condition before receiving a health message concerning physical activity. METHODS: Older adolescents (N = 125) completed a self-affirmation or control writing task before reading about the health consequences of not meeting recommendations to be physically active for at least 60 min daily. Most of the sample did not achieve these levels of activity (98%, N = 123). Consequently, the message informed these participants that - unless they changed their behaviour - they would be at higher risk of heart disease. Participants completed measures of responses to the message and behaviour-specific cognitions (e.g. self-efficacy) for meeting the recommendations. RESULTS: for relatively inactive participants, self-affirmation was associated with increased persuasion. However, for those who were moderately active (but not meeting recommendations), those in the self-affirmation condition were less persuaded by the message. CONCLUSIONS: Whilst self-affirmation can increase message acceptance, there are circumstances when the open-mindedness it induces may decrease persuasion. The evidence provided in this study suggests that caution may be needed when recommendations are challenging and it could be considered reasonable to be sceptical about the need to change behaviour. Statement of contribution What is already known on this subject? Self-affirmation can facilitate open-mindedness and sensitivity to whether health messages suggest high or low risk on the basis of current behaviour. What does this study add? Demonstrates that self-affirmation effects can be moderated by the extent of failure to meet recommendations. Shows that self-affirmation can be associated with less persuasion when challenging health guidelines are used.
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Abraham C, Wood CE, Johnston M, Francis J, Hardeman W, Richardson M, Michie S (2015). Reliability of Identification of Behavior Change Techniques in Intervention Descriptions.
Annals of Behavioral Medicine,
49(6), 885-900.
Abstract:
Reliability of Identification of Behavior Change Techniques in Intervention Descriptions
© 2015, the Society of Behavioral Medicine. Purpose: the aim of this paper is to assess the frequency of identification as well as the inter-coder and test–retest reliability of identification of behavior change techniques (BCTs) in written intervention descriptions. Methods: Forty trained coders applied the “Behavior Change Technique Taxonomy version 1” (BCTTv1) to 40 intervention descriptions published in protocols and repeated this 1 month later. Results: Eighty of 93 defined BCTs were identified by at least one trained coder, and 22 BCTs were identified in 16 (40 %) or more of 40 descriptions. Good inter-coder reliability was ob served across 80 BCTs identified in the protocols: 66 (80 %) achieved mean prevalence and bias-adjusted kappa (PABAK) scores of 0.70 or greater, and 59 (74 %) achieved mean scores of 0.80 or greater. There was good within-coder agreement between baseline and 1 month, demonstrating good test–retest reliability. Conclusions: BCTTv1 can be used by trained coders to identify BCTs in intervention descriptions reliably. However, some frequently occurring BCT definitions require further clarification.
Abstract.
Abraham C, Wood CE, Johnston M, Francis J, Hardeman W, Richardson M, Michie S (2015). Reliability of Identification of Behavior Change Techniques in Intervention Descriptions.
Annals of Behavioral MedicineAbstract:
Reliability of Identification of Behavior Change Techniques in Intervention Descriptions
Purpose: the aim of this paper is to assess the frequency of identification as well as the inter-coder and test–retest reliability of identification of behavior change techniques (BCTs) in written intervention descriptions. Methods: Forty trained coders applied the “Behavior Change Technique Taxonomy version 1” (BCTTv1) to 40 intervention descriptions published in protocols and repeated this 1 month later. Results: Eighty of 93 defined BCTs were identified by at least one trained coder, and 22 BCTs were identified in 16 (40 %) or more of 40 descriptions. Good inter-coder reliability was observed across 80 BCTs identified in the protocols: 66 (80 %) achieved mean prevalence and bias-adjusted kappa (PABAK) scores of 0.70 or greater, and 59 (74 %) achieved mean scores of 0.80 or greater. There was good within-coder agreement between baseline and 1 month, demonstrating good test–retest reliability. Conclusions: BCTTv1 can be used by trained coders to identify BCTs in intervention descriptions reliably. However, some frequently occurring BCT definitions require further clarification.
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de Visser RO, Graber R, Hart A, Abraham C, Scanlon T, Watten P, Memon A (2015). Using qualitative methods within a mixed-methods approach to developing and evaluating interventions to address harmful alcohol use among young people.
Health Psychol,
34(4), 349-360.
Abstract:
Using qualitative methods within a mixed-methods approach to developing and evaluating interventions to address harmful alcohol use among young people.
OBJECTIVE: This article illustrates how qualitative methods can be used in the development and evaluation of behavior change interventions. Although many campaigns advise young people to drink responsibly, few clarify how to convert this general advice into specific behavioral strategies. Resilience-based approaches argue that treating young non-drinkers and moderate drinkers as "experts" in responsible alcohol use may facilitate co-creation of acceptable interventions that focus on how to change behavior. METHOD: Four distinct phases of intervention development were linked to past research and future developments. RESULTS: First, analysis of correlates of alcohol use using data from a survey of 1,412 people aged 16-21 indicated that alcohol harm-reduction interventions should help young people to develop skills and strategies to resist alcohol. Second, interpretative phenomenological analysis of 25 interviews with people purposively selected from among the survey sample identified general strategies and specific tactics used by young people to manage opportunities to drink. Third, insights from the first 2 phases and past qualitative research guided development of video resources to be use in school-based alcohol education to illustrate strategies and tactics for moderate or non-use of alcohol. Fourth, 18 focus groups with students and teachers were used to evaluate the video: structured thematic analysis indicated that after revision the video would be a valuable addition to school-based alcohol education. CONCLUSIONS: Findings from the 4 phases highlight the value of using different qualitative and quantitative methods as part of a program of work designed to inform the development, refinement, and evaluation of health psychology interventions.
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2014
Smith JR, Murray NJ, Greaves CJ, Abraham S, Hooper L (2014). A systematic review of intervention studies using Health Action Process Approach (HAPA) model components to target behaviours for preventing and managing chronic diseases (oral presentation). European Health Psychology Conference.
Michie S, Johnston M, West R, Abraham C, Hardeman W, Wood C (2014). DESIGNING BEHAVIOR CHANGE INTERVENTIONS: THE BEHAVIOUR CHANGE WHEEL AND BEHAVIOR CHANGE TECHNIQUES.
ANNALS OF BEHAVIORAL MEDICINE,
47, S157-S157.
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Abraham C, Johnson BT, de Bruin M, Luszczynska A (2014). Enhancing reporting of behavior change intervention evaluations.
J Acquir Immune Defic Syndr,
66 Suppl 3, S293-S299.
Abstract:
Enhancing reporting of behavior change intervention evaluations.
: Many behavior change interventions for the prevention and treatment of HIV have been evaluated, but suboptimal reporting of evaluations hinders the accumulation of evidence and the replication of interventions. In this article, we address 4 practices contributing to this problem. First, detailed descriptions of the interventions and their implementation are often unavailable. Second, content of active control group content (such as usual care or support designed by researchers) often varies markedly between trials; yet, descriptions of this content are routinely omitted. Third, detailed process evaluations revealing the mechanisms by which interventions generate their effects, and among whom, frequently are not available. Fourth, there is a lack of replication in other contexts, which limits knowledge of external validity. This article advances recommendations made by an international group of scholars constituting the Workgroup for Intervention Development and Evaluation Research (WIDER), which has developed brief guidance to journal editors to improve the reporting of evaluations of behavior change interventions, thereby serving as an addition to reporting statements such as CONSORT. Improved reporting standards would facilitate and accelerate the development of the science of behavior change and its application in implementation science to improve public health.
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de Visser RO, Hart A, Abraham C, Graber R, Scanlon T, Memon A (2014). How alike are young non-drinkers, former-drinkers, low-risk drinkers, and hazardous drinkers?.
Addict Behav,
39(8), 1258-1264.
Abstract:
How alike are young non-drinkers, former-drinkers, low-risk drinkers, and hazardous drinkers?
The aim of this study was to examine whether - in terms of personality characteristics and beliefs--former-drinkers and people who have never consumed alcohol exist on a continuum that includes low-risk drinkers and hazardous drinkers, or are distinct groups. An online questionnaire hosted on a secure server was completed by 1418 young people (642 men and 776 women) aged 16-21 living in South-East England. Participants' scores on the Alcohol Use Disorders Identification Test (AUDIT) were used to classify them as non-drinkers, former-drinkers, low-risk drinkers or hazardous drinkers. Multinomial logistic regression identified eight significant multivariate correlates that explained 39% of the variance in men's AUDIT category membership (χ(2)(24) = 263.32, p <. 01), and seven significant multivariate correlates that explained 41% of the variance in women's AUDIT category membership (χ(2)(21) = 332.91, p <. 01). The results suggest that non-drinkers and former-drinkers are more similar to each other than they are to both low risk and hazardous drinkers. We should not, therefore, treat these groups of young people as representing a drinking continuum. In particular, interventions for high risk young drinkers may be more effective if distinguished from general campaigns intended for all young people.
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Abraham C (2014). Mapping modifiable mechanisms in health promotion research: a commentary on Sniehotta, Presseau, and Araújo-Soares. Health Psychology Review
Rizzoli R, Abraham C, Brandi ML (2014). Nutrition and bone health: Turning knowledge and beliefs into healthy behaviour.
Current Medical Research and Opinion,
30(1), 131-141.
Abstract:
Nutrition and bone health: Turning knowledge and beliefs into healthy behaviour
Primary osteoporosis prevention requires healthy behaviours, such as regular physical exercise and adequate dietary intakes of calcium, vitamin D and protein. Calcium and vitamin D can decrease postmenopausal bone loss and prevent fracture risk. However, there is still a high prevalence of calcium and vitamin D insufficiency in women aged 50+ years. Dietary sources of these nutrients are the preferred choice, and dairy products represent a valuable dietary source of calcium due to the high content, high absorptive rate and relatively low cost. Furthermore, dairy products also contain other key nutrients including vitamin D, phosphorus and protein that contribute to bone health. Studies of women's beliefs and behaviours with respect to osteoporosis highlight poor knowledge of the importance of dietary nutrient intakes and low concern regarding bone health. Osteoporosis educational programmes exist to help women change behaviours relevant to bone health. Such programmes can have positive influences on women's knowledge, attitudes, perceived norms, motivation and behaviours. Increased awareness of the consequences of low calcium and vitamin D intakes may promote women's attitudes towards dietary sources, in particular dairy products, and lead to better adherence to health recommendations. Increasing dietary nutrient intakes through educational initiatives should be further developed to aid the prevention of osteoporosis and the efficacy of osteoporosis management. © 2014 Informa UK Ltd.
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Forster AS, Forbes LJL, Abraham C, Warburton FG, Douglas E, Ramirez AJ (2014). Promoting early presentation of breast cancer: a preliminary evaluation of a written intervention.
Chronic Illness,
10(1), 18-30.
Abstract:
Promoting early presentation of breast cancer: a preliminary evaluation of a written intervention
Objectives: Older women are more likely to delay presentation with breast cancer, which contributes to poorer survival. We evaluated a written intervention that was designed to provide women with the knowledge, motivation, confidence and skills to present promptly with breast cancer symptoms. Methods: We assessed acceptability and understanding of the intervention by interviewing 43 women. We used their responses to refine the intervention. We tested the effect of the intervention on breast cancer awareness, confidence and intentions to check breasts and perceived barriers to help-seeking using a self-report questionnaire administered to 61 women prior to and one month after receiving the intervention. Quantitative data were analysed using the McNemar test. Results:Women were not made anxious by the intervention and understood its messages. At one month, a greater proportion of women knew that breast cancer risk increases with age, identified. < 5 non-lump symptoms and reported breast checking at least monthly in comparison to before the intervention was implemented. Discussion: the intervention does not induce anxiety, is understandable, and appears to increase breast cancer awareness. The results provide justification for a more rigorous trial to test efficacy. © the Author(s) 2013.
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Aarø LE, Mathews C, Kaaya S, Katahoire AR, Onya H, Abraham C, Klepp KI, Wubs A, Eggers SM, De Vries H, et al (2014). Promoting sexual and reproductive health among adolescents in southern and eastern Africa (PREPARE): Project design and conceptual framework.
BMC Public Health,
14(1).
Abstract:
Promoting sexual and reproductive health among adolescents in southern and eastern Africa (PREPARE): Project design and conceptual framework
Background: Young people in sub-Saharan Africa are affected by the HIV pandemic to a greater extent than young people elsewhere and effective HIV-preventive intervention programmes are urgently needed. The present article presents the rationale behind an EU-funded research project (PREPARE) examining effects of community-based (school delivered) interventions conducted in four sites in sub-Saharan Africa. One intervention focuses on changing beliefs and cognitions related to sexual practices (Mankweng, Limpopo, South Africa). Another promotes improved parent-offspring communication on sexuality (Kampala, Uganda). Two further interventions are more comprehensive aiming to promote healthy sexual practices. One of these (Western Cape, South Africa) also aims to reduce intimate partner violence while the other (Dar es Salaam, Tanzania) utilises school-based peer education. Methods/design. A modified Intervention Mapping approach is used to develop all programmes. Cluster randomised controlled trials of programmes delivered to school students aged 12-14 will be conducted in each study site. Schools will be randomly allocated (after matching or stratification) to intervention and delayed intervention arms. Baseline surveys at each site are followed by interventions and then by one (Kampala and Limpopo) or two (Western Cape and Dar es Salaam) post-intervention data collections. Questionnaires include questions common for all sites and are partly based on a set of social cognition models previously applied to the study of HIV-preventive behaviours. Data from all sites will be merged in order to compare prevalence and associations across sites on core variables. Power is set to.80 or higher and significance level to.05 or lower in order to detect intervention effects. Intraclass correlations will be estimated from previous surveys carried out at each site. D iscussion. We expect PREPARE interventions to have an impact on hypothesized determinants of risky sexual behaviour and in Western Cape and Dar es Salaam to change sexual practices. Results from PREPARE will (i) identify modifiable cognitions and social processes related to risky sexual behaviour and (ii) identify promising intervention approaches among young adolescents in sub-Saharan cultures and contexts. Trial registrations. Controlled Trials ISRCTN56270821 (Cape Town); Controlled Trials ISRCTN10386599 (Limpopo); Clinical Trials NCT01772628 (Kampala); Australian New Zealand Clinical Trials Registry ACTRN12613000900718 (Dar es Salaam). © 2014 Aarø et al.; licensee BioMed Central Ltd.
Abstract.
Borek A, Abraham S, Smith JR, Tarrant M, Greaves C (2014). Reporting of group-based behavioural interventions: a checklist and tool for assessing the quality of descriptions (oral presentation). European Health Psychology Society Conference.
Tang J, Abraham C, Greaves C, Yates T (2014). Self-directed interventions to promote weight loss: a systematic review of reviews.
J Med Internet Res,
16(2).
Abstract:
Self-directed interventions to promote weight loss: a systematic review of reviews.
BACKGROUND: a wide range of self-directed weight-loss interventions are available, providing users with a variety of tools delivered through various formats to regulate weight-related behavior patterns. However, it is unclear how effective self-directed interventions are and how they promote weight loss and weight maintenance. OBJECTIVE: a systematic review of reviews was conducted to examine the effectiveness of such interventions and to identify intervention content associated with effectiveness. METHODS: MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library for systematic reviews were searched from 2000-2012 for reviews of the effectiveness of self-directed interventions on weight loss and weight maintenance in adults. Two reviewers used predefined inclusion criteria to select relevant reviews and assess their quality using the Overview Quality Assessment Questionnaire (OQAQ). We extracted data on effectiveness and on relationships between intervention characteristics and effectiveness. RESULTS: Twenty reviews were included and quality assessed. Findings relevant to self-directed interventions, including interactive websites, smartphone applications, and text messaging (short message service, SMS) were summarized. Findings were mixed but promising. For example, one review of Internet-based interventions found that, when used in conjunction with standard weight loss programs, these interventions resulted in a significant average increase in weight loss of 1.5 kg over evaluation periods. Unfortunately, only 7 of 20 reviews were of high methodological quality according to OQAQ scores, and only 4 employed meta-analyses. Few reviews linked intervention content to effectiveness. CONCLUSIONS: Current evidence suggests that self-directed interventions can independently promote weight loss and can augment interventions involving personal contact. Particular change techniques and delivery modes including individualized feedback, email counseling, and online social support appear to enhance effectiveness. Further reviews of the content of self-directed weight-loss intervention studies are needed to clarify which change techniques delivered through which delivery formats optimize intervention effectiveness.
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Ashurst EJ, Jones RB, Abraham C, Jenner M, Boddy K, Besser REJ, Hammersley S, Pinkney J (2014). The Diabetes App Challenge: User-Led Development and Piloting of Internet Applications Enabling Young People with Diabetes to Set the Focus for Their Diabetes Consultations.
JOURNAL OF MEDICAL INTERNET RESEARCH,
16(11).
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Macmillan M, Tarrant M, Abraham C, Morris C (2014). The association between children's contact with people with disabilities and their attitudes towards disability: a systematic review.
Developmental Medicine and Child Neurology,
56(6), 529-546.
Abstract:
The association between children's contact with people with disabilities and their attitudes towards disability: a systematic review
Aim: the aim of this review was to systematically review and synthesize observational evidence of associations between children's naturally varying contact with people with disabilities and their attitudes towards disability. Method: a comprehensive search was conducted acro ss multiple databases. Studies were included if they measured children's contact with people with disabilities and their attitudes towards disability. Qualitative research and studies that experimentally varied the amount of contact children had were excluded. Data were synthesized in a narrative review. Results: There were 35 studies that met the inclusion criteria: 22 of these reported a statistically significant association between contact with people with disabilities and more positive attitudes towards disability; two studies reported a negative association between contact and attitudes; and 11 studies reported no association. Incomplete reporting of the methods and results across studies limited the conclusions that could be drawn. Interpretation: Studies identified in this review generally indicate that children's contact with people with disabilities is associated with more positive attitudes towards disability. There is a need for more rigorous research to examine the effect of children's contact with people with disabilities on their attitudes towards disability. © 2013 Mac Keith Press.
Abstract.
MacMillan M, Tarrant M, Abraham C, Morris C (2014). The association between children's contact with people with disabilities and their attitudes towards disability: a systematic review.
Dev Med Child Neurol,
56(6), 529-546.
Abstract:
The association between children's contact with people with disabilities and their attitudes towards disability: a systematic review.
AIM: the aim of this review was to systematically review and synthesize observational evidence of associations between children's naturally varying contact with people with disabilities and their attitudes towards disability. METHOD: a comprehensive search was conducted across multiple databases. Studies were included if they measured children's contact with people with disabilities and their attitudes towards disability. Qualitative research and studies that experimentally varied the amount of contact children had were excluded. Data were synthesized in a narrative review. RESULTS: There were 35 studies that met the inclusion criteria: 22 of these reported a statistically significant association between contact with people with disabilities and more positive attitudes towards disability; two studies reported a negative association between contact and attitudes; and 11 studies reported no association. Incomplete reporting of the methods and results across studies limited the conclusions that could be drawn. INTERPRETATION: Studies identified in this review generally indicate that children's contact with people with disabilities is associated with more positive attitudes towards disability. There is a need for more rigorous research to examine the effect of children's contact with people with disabilities on their attitudes towards disability.
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Hillier-Brown FC, Moore HJ, Lake AA, Adamson AJ, White M, Adams J, Araujo-Soares V, Abraham C, Summerbell CD (2014). The effectiveness of interventions targeting specific out-of-home food outlets: Protocol for a systematic review.
Systematic Reviews,
3(1).
Abstract:
The effectiveness of interventions targeting specific out-of-home food outlets: Protocol for a systematic review
© 2014 Hillier-Brown et al. Background: Eating out of the home has been associated with higher intakes of energy and fat and lower micronutrient intakes, as well as the development of obesity. Out-of-home food outlets (OHFOs) and the foods obtained from these outlets are an ideal target for interventions to improve diet and tackle obesity. This systematic review will explore the evidence for the effectiveness of promoting healthy behaviour through interventions that modify food practices in specific OHFOs.Methods/Design: We will search the databases MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA and the NHS Economic Evaluation Database for studies that have evaluated interventions conducted in an OHFO that aim to promote healthier menu offerings. OHFOs which are not openly accessible to the general public and supermarkets will be excluded. Included study designs will be randomised controlled trials, non-randomised controlled trials, controlled before-after studies, interrupted time series studies and evaluations of single interventions where outcome measures were assessed at least once pre and post-intervention (repeated measures studies).Discussion: This systematic review aims to synthesise the available evidence with regard to interventions that aim to change specific OHFOs in order to promote healthier menu offerings. The findings of this review will provide information on the types of interventions that have been evaluated and the context in which they are set, and provide insights into what interventions, and intervention functions, are most effective in different OHFO settings, along with any important innovation, implementation and cost implications.The review has been registered with PROSPERO (registration no. CRD42013006931).
Abstract.
Abraham C, Sheeran P (2014). The health belief model. In (Ed)
Cambridge Handbook of Psychology, Health and Medicine, Second Edition, 97-102.
Abstract:
The health belief model
Abstract.
Clarke A, Mitchell A, Abraham C (2014). Understanding donation experiences of unspecified (altruistic) kidney donors.
Abstract:
Understanding donation experiences of unspecified (altruistic) kidney donors
Abstract.
Clarke A, Mitchell A, Abraham C (2014). Understanding donation experiences of unspecified (altruistic) kidney donors.
Br J Health Psychol,
19(2), 393-408.
Abstract:
Understanding donation experiences of unspecified (altruistic) kidney donors.
OBJECTIVES: Kidney donation from a living donor to an unknown recipient has been legal in the UK since 2006. Yet there is little research into the experiences of unspecified kidney donors (UKDs) in interaction with the health care systems. DESIGN: This article explores the experiences of 14 UKDs recruited through four regional transplant co-ordinating centres in England. At interview, they were invited to share their donation stories and discuss the antecedents, social, and psychological processes involved. Interviews were audio-taped and transcribed. METHODS: Transcripts were analysed using a grounded theory approach employing a constant comparison methodology. Themes emerging from the data were named to form categories organized around the central focus of the research, forming an analytical story of UKDs' experiences. RESULTS: Two major categories emerged: 'connected to others' and 'uneasy negotiations with others'. 'Connected to others' encompasses the motivations and psychological and social consequences of UKD. 'Uneasy negotiations with others' refer to the concerns and conflicts that arose during the donation process. CONCLUSIONS: This study highlights the importance of social relationships on the process and outcomes of UKD. These UKDs report both intra- and interpersonal benefits from donation. The donation process, however, also created interpersonal stress, and conflicting messages about the acceptability of their donation were experienced in UKDs' personal lives and in their interactions with health care services. Findings are discussed with reference to the wider literature on UKD and altruism and in relation to implications for clinical practice. STATEMENT OF CONTRIBUTION: What is already known on this subject? Unspecified living kidney donation is an under-researched area with only three research papers published worldwide that report on the motivations and experiences of donors. These studies indicate that donors endorse pro-social values and receive positive interpersonal and intrapersonal benefits from donation. What does this study add? UKDs' experiences are made explicit and provide a framework for future research. Social connections (capital) are an important precursor to and outcome from donation. Assumptions of pathological motivations were encountered by donors in their personal life and within the NHS.
Abstract.
Author URL.
Abraham C (2014). Use of multiple research methods to specify mechanisms regulating health-related behaviour patterns and identify techniques capable of changing those mechanisms. Australian Psychologist, 49(3), 139-141.
de Visser RO, Hart A, Abraham C, Memon A, Graber R, Scanlon T (2014). Which alcohol control strategies do young people think are effective?.
Drug Alcohol Rev,
33(2), 144-151.
Abstract:
Which alcohol control strategies do young people think are effective?
INTRODUCTION AND AIMS: the aims of this study were to examine young people's belief in the effectiveness of various alcohol control strategies and to identify demographic, attitudinal and behavioural correlates of perceived effectiveness. DESIGN AND METHODS: an online questionnaire hosted on a secure server was completed by 1418 men and women aged 16-21 years living in South-East England. It assessed the perceived effectiveness of various alcohol control strategies. Key correlates included sensation seeking, impulsivity, conscientiousness, alcohol outcome expectancies, drink refusal self-efficacy, perceived peer alcohol use and Alcohol Use Disorders Identification Test scores. RESULTS: the most effective strategies were perceived to be enforcing responsible service legislation, strictly monitoring late-night licensed premises and teaching alcohol refusal skills. Greater belief in the effectiveness of alcohol control strategies was expressed by older participants, those who consumed less alcohol and those who expected more negative outcomes from alcohol consumption. DISCUSSION AND CONCLUSIONS: the data suggest that in order to increase the perceived effectiveness of alcohol control strategies, we may need to address young people's beliefs about the negative outcomes of alcohol use. Strategies that young people believe are effective may be easier to implement, but this does not imply that unpopular but effective strategies should not be tried.
Abstract.
Author URL.
De Visser RO, Hart A, Abraham C, Memon A, Graber R, Scanlon T (2014). Which alcohol control strategies do young people think are effective?.
Drug and Alcohol Review,
33(2), 144-151.
Abstract:
Which alcohol control strategies do young people think are effective?
Introduction and Aims: the aims of this study were to examine young people's belief in the effectiveness of various alcohol control strategies and to identify demographic, attitudinal and behavioural correlates of perceived effectiveness. Design and Methods: an online questionnaire hosted on a secure server was completed by 1418 men and women aged 16-21years living in South-East England. It assessed the perceived effectiveness of various alcohol control strategies. Key correlates included sensation seeking, impulsivity, conscientiousness, alcohol outcome expectancies, drink refusal self-efficacy, perceived peer alcohol use and Alcohol Use Disorders Identification Test scores. Results: the most effective strategies were perceived to be enforcing responsible service legislation, strictly monitoring late-night licensed premises and teaching alcohol refusal skills. Greater belief in the effectiveness of alcohol control strategies was expressed by older participants, those who consumed less alcohol and those who expected more negative outcomes from alcohol consumption. Discussion and Conclusions: the data suggest that in order to increase the perceived effectiveness of alcohol control strategies, we may need to address young people's beliefs about the negative outcomes of alcohol use. Strategies that young people believe are effective may be easier to implement, but this does not imply that unpopular but effective strategies should not be tried. © 2014 Australasian Professional Society on Alcohol and other Drugs.
Abstract.
2013
de Visser RO, Wheeler Z, Abraham C, Smith JA (2013). 'Drinking is our modern way of bonding': Young people's beliefs about interventions to encourage moderate drinking.
Psychology and Health,
28(12), 1460-1480.
Abstract:
'Drinking is our modern way of bonding': Young people's beliefs about interventions to encourage moderate drinking
Efforts to discourage excessive alcohol use among young people can only be effective if the target audience is exposed to, attends to, and comprehends key messages. The aim of this study was to examine age and sex differences in drinking motives to better inform development of targeted interventions to reduce alcohol-related harm. Thirty individual interviews and 12 group interviews were conducted with English 13-25 year olds. Interviewees gave multiple motivations for drinking - especially those related to image and reputation, and played down the health implications of heavy drinking. Negative aspects of drinking - caring for drunk friends, being cared for when drunk and suffering through hangovers with friends - were considered to offer opportunities for closer interpersonal bonding than other social activities. Respondents distanced themselves from 'problem' drinkers, but disapproved of others' problematic drinking or antisocial behaviour. Narrative messages demonstrating the social consequences of excessive consumption were preferred to single, static messages emphasising risk or harm. Interviewees noted that interventions must use an engaging tone or pitch: they considered many campaigns to be patronising or preaching. A lack of consensus between age and sex groups highlighted a need for multifaceted, multi-modal approaches that utilise mobile technologies and new media. © 2013 Taylor. &. Francis.
Abstract.
de Visser RO, Wheeler Z, Abraham C, Smith JA (2013). 'Drinking is our modern way of bonding': young people's beliefs about interventions to encourage moderate drinking.
Psychol Health,
28(12), 1460-1480.
Abstract:
'Drinking is our modern way of bonding': young people's beliefs about interventions to encourage moderate drinking.
Efforts to discourage excessive alcohol use among young people can only be effective if the target audience is exposed to, attends to, and comprehends key messages. The aim of this study was to examine age and sex differences in drinking motives to better inform development of targeted interventions to reduce alcohol-related harm. Thirty individual interviews and 12 group interviews were conducted with English 13-25 year olds. Interviewees gave multiple motivations for drinking - especially those related to image and reputation, and played down the health implications of heavy drinking. Negative aspects of drinking - caring for drunk friends, being cared for when drunk and suffering through hangovers with friends - were considered to offer opportunities for closer interpersonal bonding than other social activities. Respondents distanced themselves from 'problem' drinkers, but disapproved of others' problematic drinking or antisocial behaviour. Narrative messages demonstrating the social consequences of excessive consumption were preferred to single, static messages emphasising risk or harm. Interviewees noted that interventions must use an engaging tone or pitch: they considered many campaigns to be patronising or preaching. A lack of consensus between age and sex groups highlighted a need for multifaceted, multi-modal approaches that utilise mobile technologies and new media.
Abstract.
Author URL.
Macmillan M, Abraham C, Morris C, Tarrant M (2013). Determinants of children's attitudes towards disabled people.
PSYCHOLOGY & HEALTH,
28, 257-257.
Author URL.
Abraham C (2013). Developing and applying behaviour change component classification systems.
PSYCHOLOGY & HEALTH,
28, 16-16.
Author URL.
van Dongen A, Abraham C, Ruiter RAC, Veldhuizen IJT (2013). Does Questionnaire Distribution Promote Blood Donation? an Investigation of Question-Behavior Effects.
ANNALS OF BEHAVIORAL MEDICINE,
45(2), 163-172.
Author URL.
Abraham C (2013). FROM KNOWLEDGE AND BELIEFS TO BEHAVIOUR CHANGE.
Author URL.
Borek A, Abraham C, Greaves C, Tarrant M (2013). Group-based weight-loss programmes: a systematic review.
Author URL.
Richardson M, Abraham C (2013). Modeling antecedents of university students' study behavior and grade point average.
Journal of Applied Social Psychology,
43(3), 626-637.
Abstract:
Modeling antecedents of university students' study behavior and grade point average
Two prospective surveys tested theory-based models of university students' study behavior and grade point average (GPA). The theory of planned behavior (TPB) and personality systems interaction (PSI) theory were tested. The TPB fitted the data for self-reported study but was less useful when applied to GPA. Some support for PSI theory was found although results varied for study behavior verses GPA. In Study 1, an interaction between volitional competency and subjective norm explained unique variation in study behavior controlling for TPB variables and past behavior. In Study 2, implicit attention control had a direct effect on GPA after the TPB variables and past achievement were controlled. Implications for interventions designed to improve tertiary-level academic achievement are discussed. © 2013 Wiley Periodicals, Inc.
Abstract.
Van Dongen A, Ruiter R, Abraham C, Veldhuizen I (2013). Predicting blood donation maintenance: the importance of planning future donations.
TransfusionAbstract:
Predicting blood donation maintenance: the importance of planning future donations
Background: Interventions to retain blood donors need to target the most influential and changeable factors. This study tested antecedents of three successive donation decisions. Study Design and Methods: Participants were donors who had donated for the first time 1year previous (n=1018). Intention to continue donating, vasovagal reactions, deferral, anxiety, and planning failure were measured. Analyses distinguished between 1) those who registered for donation after questionnaire completion, versus those who did not; 2) those who did or did not register for donation a second time after questionnaire completion; and 3) those who did or did not register for donation a third time after questionnaire completion. Results: Three logistic regression analyses showed that the first donation decision was influenced by intention (odds ratio [OR] , 1.70; 95% confidence interval [CI], 1.30-2.21), number of donations made in the first year (OR, 2.35; 95% CI, 1.81-3.06), vasovagal reactions (OR, 0.92; 95% CI, 0.87-0.97), and planning failure (OR, 0.81; 95% CI, 0.70-0.95). The second donation decision was influenced by intention (OR, 1.44; 95% CI, 1.06-1.95) and planning failure (OR, 0.67; 95% CI, 0.57-0.78), while the third decision was influenced only by planning failure (OR, 0.85; 95% CI, 0.73-1.00). Conclusion: This indicates that for new donors, retention efforts should focus on the promotion of a positive intention and decreasing vasovagal reactions. However, decreasing planning failure could be an even better investment since planning seems to determine long-term retention. © 2013 American Association of Blood Banks.
Abstract.
Jellema IJ, Abraham C, Schaalma HP, Gebhardt WA, Van Empelen P (2013). Predicting having condoms available among adolescents: the role of personal norm and enjoyment.
British Journal of Health Psychology,
18(2), 453-468.
Abstract:
Predicting having condoms available among adolescents: the role of personal norm and enjoyment
Objectives Having condoms available has been shown to be an important predictor of condom use. We examined whether or not personal norm and goal enjoyment contribute to predicting having condoms available in the context of cognition specified by the theory of planned behaviour (TPB). Design Prospective survey study, with a baseline and follow-up measurement (at 3 months). Methods Data were gathered using an online survey. In total 282 adolescents (mean age = 15.6, 74% female adolescents) completed both questionnaires. At baseline, demographics, sexual experience, condom use, TPB variables, descriptive norm, personal norm, and enjoyment towards having condoms available were measured. At T2 (3 months later) having condoms available was measured. Direct and moderating effects of personal norm and goal enjoyment were examined by means of hierarchical linear regression analyses. Results Regression analyses yielded a direct effect of self-efficacy and personal norm on condom availability. In addition, moderation of the intention-behaviour relation by goal enjoyment added to the variance explained. The final model explained approximately 35% of the variance in condom availability. Conclusions Personal norm and goal enjoyment add to the predictive utility of a TPB model of having condoms available and may be useful intervention targets. Statement of contribution What is already known about this subject? Having condoms available is an important prerequisite for actual condom use. The theory of planned behaviour has successfully been applied to explain condom availability behaviour. The theory of planned behaviour has been criticized for not adequately taking into account affective motivation. What does this study add? Personal norm and goal enjoyment add to the predictive utility of the model. Personal norm explains condom availability directly, enjoyment increases intention enactment. Personal norm and goal enjoyment th erefore are useful intervention targets. © 2012 the British Psychological Society.
Abstract.
Good A, Harris P, Jessop D, Abraham C (2013). Self-affirmation promotes open-minded rejection of challenging health messages.
PSYCHOLOGY & HEALTH,
28, 99-99.
Author URL.
Tang J, Abraham C, Greaves C, Yates T (2013). Self-directed interventions to promote weight loss: a systematic review.
PSYCHOLOGY & HEALTH,
28, 319-319.
Author URL.
Poltawski L, Abraham C, Forster A, Goodwin VA, Kilbride C, Taylor RS, Dean S (2013). Synthesising practice guidelines for the development of community-based exercise programmes after stroke.
Implement Sci,
8Abstract:
Synthesising practice guidelines for the development of community-based exercise programmes after stroke.
BACKGROUND: Multiple guidelines are often available to inform practice in complex interventions. Guidance implementation may be facilitated if it is tailored to particular clinical issues and contexts. It should also aim to specify all elements of interventions that may mediate and modify effectiveness, including both their content and delivery. We conducted a focused synthesis of recommendations from stroke practice guidelines to produce a structured and comprehensive account to facilitate the development of community-based exercise programmes after stroke. METHODS: Published stroke clinical practice guidelines were searched for recommendations relevant to the content and delivery of community-based exercise interventions after stroke. These were synthesised using a framework based on target intervention outcomes, personal and programme proximal objectives, and recommended strategies. RESULTS: Nineteen guidelines were included in the synthesis (STRIDES; STroke Rehabilitation Intervention-Development Evidence Synthesis). Eight target outcomes, 14 proximal objectives, and 94 recommended strategies were identified. The synthesis was structured to present best practice recommendations in a format that could be used by intervention programme developers. It addresses both programme content and context, including personal factors, service standards and delivery issues. Some recommendations relating to content, and many relating to delivery and other contextual issues, were based on low level evidence or expert opinion. Where opinion varied, the synthesis indicates the range of best practice options suggested in guidelines. CONCLUSIONS: the synthesis may assist implementation of best practice by providing a structured intervention description that focuses on a particular clinical application, addresses practical issues involved in programme development and provision, and illustrates the range of best-practice options available to users where robust evidence is lacking. The synthesis approach could be applied to other areas of stroke rehabilitation or to other complex interventions.
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Warmoth K, Tarrant M, Lang I, Abraham C (2013). THINKING YOU'RE OLD AND FRAIL: a QUALITATIVE STUDY OF OLDER ADULTS' BELIEFS REGARDING FRAILTY.
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Wyatt KM, Lloyd JJ, Abraham C, Creanor S, Dean S, Densham E, Daurge W, Green C, Hillsdon M, Pearson V, et al (2013). The Healthy Lifestyles Programme (HeLP), a novel school-based intervention to prevent obesity in school children: study protocol for a randomised controlled trial.
Trials,
14Abstract:
The Healthy Lifestyles Programme (HeLP), a novel school-based intervention to prevent obesity in school children: study protocol for a randomised controlled trial.
BACKGROUND: over the last three decades there has been a substantial increase in the proportion of children who are overweight or obese. The Healthy Lifestyles Programme (HeLP) is a novel school-based intervention, using highly interactive and creative delivery methods to prevent obesity in children. METHODS/DESIGN: We describe a cluster randomised controlled trial to evaluate the effectiveness and cost effectiveness of HeLP. The intervention has been developed using intervention mapping (involving extensive stakeholder involvement) and has been guided by the Information, Motivation, Behavioural Skills model. HeLP includes creating a receptive environment, drama activities, goal setting and reinforcement activities and runs over three school terms. Piloting showed that 9 to 10 year olds were the most receptive and participative. This study aims to recruit 1,300 children from 32 schools (over half of which will have ≥19% of pupils eligible for free school meals) from the southwest of England. Participating schools will be randomised to intervention or control groups with baseline measures taken prior to randomisation. The primary outcome is change in body mass index standard deviation score (BMI SDS) at 24 months post baseline. Secondary outcomes include, waist circumference and percent body fat SDS and proportion of children classified as overweight or obese at 18 and 24 months and objectively measured physical activity and food intake at 18 months. Between-group comparisons will be made using random effects regression analysis taking into account the hierarchical nature of the study design. An economic evaluation will estimate the incremental cost-effectiveness of HeLP, compared to control, from the perspective of the National Health Service (NHS)/third party payer. An in-depth process evaluation will provide insight into how HeLP works, and whether there is any differential uptake or engagement with the programme. DISCUSSION: the results of the trial will provide evidence on the effectiveness and cost effectiveness of the Healthy Lifestyles Programme in affecting the weight status of children. TRIAL REGISTRATION: ISRCTN15811706.
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Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Eccles MP, Cane J, Wood CE (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions.
Annals of Behavioral Medicine,
46(1), 81-95.
Abstract:
The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions
Background: CONSORT guidelines call for precise reporting of behavior change interventions: we need rigorous methods of characterizing active content of interventions with precision and specificity. Objectives: the objective of this study is to develop an extensive, consensually agreed hierarchically structured taxonomy of techniques [behavior change techniques (BCTs)] used in behavior change interventions. Methods: in a Delphi-type exercise, 14 experts rated labels and definitions of 124 BCTs from six published classification systems. Another 18 experts grouped BCTs according to similarity of active ingredients in an open-sort task. Inter-rater agreement amongst six researchers coding 85 intervention descriptions by BCTs was assessed. Results: This resulted in 93 BCTs clustered into 16 groups. of the 26 BCTs occurring at least five times, 23 had adjusted kappas of 0.60 or above. Conclusions: "BCT taxonomy v1," an extensive taxonomy of 93 consensually agreed, distinct BCTs, offers a step change as a method for specifying interventions, but we anticipate further development and evaluation based on international, interdisciplinary consensus. © 2013 the Society of Behavioral Medicine.
Abstract.
Van Dongen A, Abraham C, Ruiter RAC, Veldhuizen IJT (2013). The influence of adverse reactions, subjective distress, and anxiety on retention of first-time blood donors.
Transfusion,
53(2), 337-343.
Abstract:
The influence of adverse reactions, subjective distress, and anxiety on retention of first-time blood donors
Background: This study investigated the effects of adverse events (i.e. needle reactions, fatigue, and vasovagal reactions) and feelings of distress and anxiety on retention of first-time blood donors. All effects were explored separately for men and women. STUDY DESIGN AND METHODS: First-time blood donors (n = 2438) received a questionnaire, asking them about their experience of adverse events, subjective distress, and anxiety at their first donation. Provision of a second donation was checked approximately 18 months later. After exclusion of nonresponders and donors who did not experience an adverse event, 1278 first-time donors were included in the logistic regression analyses. Results: Nine percent of donors who experienced an adverse event at their first donation did not return for a second donation. Vasovagal reactions decreased retention in both males and females (men - odds ratio [OR], 0.45; 95% CI, 0.23-0.89; women - OR, 0.71; 95% CI, 0.51-0.98). Fatigue decreased retention in males only (OR, 0.62; 95% CI, 0.42-0.91), and subjective distress decreased retention in females only (OR, 0.77; 95% CI, 0.65-0.92). CONCLUSION: in addition to decreasing vasovagal reactions, retention interventions could productively target coping with fatigue and reducing subjective distress after adverse reactions. © 2012 American Association of Blood Banks.
Abstract.
van Dongen A, Abraham C, Ruiter RAC, Veldhuizen IJT (2013). The influence of adverse reactions, subjective distress, and anxiety on retention of first-time blood donors.
Transfusion,
53(2), 337-343.
Abstract:
The influence of adverse reactions, subjective distress, and anxiety on retention of first-time blood donors.
BACKGROUND: This study investigated the effects of adverse events (i.e. needle reactions, fatigue, and vasovagal reactions) and feelings of distress and anxiety on retention of first-time blood donors. All effects were explored separately for men and women. STUDY DESIGN AND METHODS: First-time blood donors (n = 2438) received a questionnaire, asking them about their experience of adverse events, subjective distress, and anxiety at their first donation. Provision of a second donation was checked approximately 18 months later. After exclusion of nonresponders and donors who did not experience an adverse event, 1278 first-time donors were included in the logistic regression analyses. RESULTS: Nine percent of donors who experienced an adverse event at their first donation did not return for a second donation. Vasovagal reactions decreased retention in both males and females (men-odds ratio [OR], 0.45; 95% CI, 0.23-0.89; women-OR, 0.71; 95% CI, 0.51-0.98). Fatigue decreased retention in males only (OR, 0.62; 95% CI, 0.42-0.91), and subjective distress decreased retention in females only (OR, 0.77; 95% CI, 0.65-0.92). CONCLUSION: in addition to decreasing vasovagal reactions, retention interventions could productively target coping with fatigue and reducing subjective distress after adverse reactions.
Abstract.
Author URL.
Borek A, Abraham C, Greaves C, Tarrant M (2013). The role of group processes in facilitating change in group-based health interventions.
Author URL.
Tang J, Abraham C, Greaves C (2013). Understanding adults' experiences of internet-based weight loss/maintenance interventions: a qualitative study.
Author URL.
2012
Gardner B, Abraham C, Lally P, de Bruijn G-J (2012). 'The Habitual Use of the Self-report Habit Index': a Reply.
ANNALS OF BEHAVIORAL MEDICINE,
43(1), 141-142.
Author URL.
Johnston M, Michie S, Abraham C, Francis J, Hardeman W, Eccles M, Richardson M, Cane J (2012). AN 87-ITEM TAXONOMY OF BEHAVIOR CHANGE TECHNIQUES: BUILDING AN INTERNATIONAL CONSENSUS FOR THE REPORTING OF BEHAVIOR CHANGE INTERVENTIONS.
Author URL.
van Dongen A, Abraham C, Ruiter RAC, Schaalma HP, de Kort WLAM, Dijkstra JA, Veldhuizen IJT (2012). Are lapsed donors willing to resume blood donation, and what determines their motivation to do so?.
Transfusion,
52(6), 1296-1302.
Abstract:
Are lapsed donors willing to resume blood donation, and what determines their motivation to do so?
BACKGROUND: This study investigated the possibility of rerecruiting lapsed blood donors. Reasons for donation cessation, motivation to restart donation, and modifiable components of donation motivation were examined. We distinguished between lapsed donors who had passively withdrawn by merely not responding to donation invitations and donors who had contacted the blood bank to actively withdraw. STUDY DESIGN AND METHODS: a cross-sectional survey was sent to 400 actively lapsed donors and to 400 passively lapsed donors, measuring intention to restart donation and psychological correlates of restart intention. The data were analyzed using multiple regression analyses. RESULTS: the response rate among actively lapsed donors was higher than among passively lapsed donors (37% vs. 25%). Actively lapsed donors typically ceased donating because of physical reactions, while passively lapsed donors quit because of a busy lifestyle. Nonetheless, 51% of actively lapsed responders and 80% of passively lapsed responders were willing to restart donations. Multiple regression analysis showed that, for passively lapsed donors, cognitive attitude was the strongest correlate of intention to donate in the future (β=0.605, p
Abstract.
Author URL.
Abraham C, Britten N, Dean S, Greaves C, Lloyd J, Poltawski L, Wyatt KM (2012). Creating Change that Counts: Evidence-led Co-creation as a Pathway to Impact. European Health Psychologist, 14(3), 64-69.
Abraham C (2012). Creating Change that Counts: Evidence-led Co-creation as a Pathway to Impact.
PSYCHOLOGY & HEALTH,
27, 1-1.
Author URL.
Crutzen R, Peters G-JY, Abraham C (2012). DATA SHARING AMONG TRIALISTS What about trialists sharing other study materials?.
BRITISH MEDICAL JOURNAL,
345 Author URL.
Michie S, Johnston M, Abraham C, Francis J, Hardeman W, Eccles M (2012). Developing a true (hierarchical) taxonomy of behaviour change techniques.
PSYCHOLOGY & HEALTH,
27, 91-91.
Author URL.
van Dongen A, Abraham C, Ruiter RAC, Veldhuizen IJT (2012). Does Questionnaire Distribution Promote Blood Donation? an Investigation of Question-Behavior Effects. Annals of Behavioral Medicine, 1-10.
Goodwin V, Poltawski L, Kilbride C, Abraham C, Taylor RS, Forster A, Dean SG (2012). Exercise for Stroke survivors: a synthesis of evidence-based guidelines.
JOURNAL OF AGING AND PHYSICAL ACTIVITY,
20, S245-S245.
Author URL.
Mann E, Abraham C (2012). Identifying Beliefs and Cognitions Underpinning Commuters' Travel Mode Choices.
Journal of Applied Social Psychology,
42(11), 2730-2757.
Abstract:
Identifying Beliefs and Cognitions Underpinning Commuters' Travel Mode Choices
Interventions to reduce car use have shown limited success, in part due to limitations in models of transport choices. The theory of planned behavior (TPB) has provided a useful predictive model of car use but the specific beliefs that underpin TPB-specified cognitions are less well understood. In this study, 229 university employees responded to a questionnaire and then reported their commuting choices 1 week later. Intention and perceived behavioral control (PBC) predicted car use (R 2 =.79). Intention was predicted by attitude, subjective norm, PBC, and moral norm (R 2 =.56). Beliefs could not be differentiated into attitudinal and PBC constructs, but seven beliefs predicted TPB cognitions. A similar model was tested for public transport use. The results identify key targets for future interventions. © 2012 Wiley Periodicals, Inc.
Abstract.
Pearson M, Chilton R, Woods HB, Wyatt K, Ford T, Abraham C, Anderson R (2012). Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK).
Syst Rev,
1Abstract:
Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK).
BACKGROUND: School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems. METHODS/DESIGN: a realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK). The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting). Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a 'reality check' on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health.
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Graham-Rowe E, Gardner B, Abraham C, Skippon S, Dittmar H, Hutchins R, Stannard J (2012). Mainstream consumers driving plug-in battery-electric and plug-in hybrid electric cars: a qualitative analysis of responses and evaluations.
Transportation Research Part A: Policy and Practice,
46(1), 140-153.
Abstract:
Mainstream consumers driving plug-in battery-electric and plug-in hybrid electric cars: a qualitative analysis of responses and evaluations
Plug-in electric vehicles can potentially emit substantially lower CO 2 emissions than internal combustion engine vehicles, and so have the potential to reduce transport emissions without curtailing personal car use. Assessing the potential uptake of these new categories of vehicles requires an understanding of likely consumer responses. Previous in-depth explorations of appraisals and evaluations of electric vehicles have tended to focus on 'early adopters', who may not represent mainstream consumers. This paper reports a qualitative analysis of responses to electric cars, based on semi-structured interviews conducted with 40 UK non-commercial drivers (20 males, 20 females; age 24-70years) at the end of a seven-day period of using a battery electric car (20 participants) or a plug-in hybrid car (20 participants). Six core categories of response were identified: (1) cost minimisation; (2) vehicle confidence; (3) vehicle adaptation demands; (4) environmental beliefs; (5) impression management; and, underpinning all other categories, (6) the perception of electric cars generally as 'work in progress' products. Results highlight potential barriers to the uptake of current-generation (2010) plug-in electric cars by mainstream consumers. These include the prioritization of personal mobility needs over environmental benefits, concerns over the social desirability of electric vehicle use, and the expectation that rapid technological and infrastructural developments will make current models obsolete. Implications for the potential uptake of future electric vehicles are discussed. © 2011 Elsevier Ltd.
Abstract.
Tang J, Abraham C, Greaves C, Yates T (2012). Mapping behaviour change techniques to modes of delivery to enhance weight loss initiation and maintenance.
PSYCHOLOGY & HEALTH,
27, 337-337.
Author URL.
Llewellyn C, Abraham C, Miners A, Smith H, Pollard A, Benn P, Fisher M (2012). Multicentre RCT and economic evaluation of a psychological intervention together with a leaflet to reduce risk behaviour amongst men who have sex with men (MSM) prescribed post-exposure prophylaxis for HIV following sexual exposure (PEPSE): a protocol.
BMC Infect Dis,
12Abstract:
Multicentre RCT and economic evaluation of a psychological intervention together with a leaflet to reduce risk behaviour amongst men who have sex with men (MSM) prescribed post-exposure prophylaxis for HIV following sexual exposure (PEPSE): a protocol.
BACKGROUND: Post-exposure prophylaxis (PEP) following sexual exposure to HIV has been recommended as a method of preventing HIV infection in the UK. Men who have sex with men (MSM) are the group most affected by HIV in the UK and their sexual risk taking behaviour is reported to be increasing. One-to-one behavioural interventions, such as motivational interviewing (MI) have been recommended to reduce HIV in high risk groups. The Information, Motivation and Behavioral skills (IMB) model has been shown to provide a good basis for understanding and predicting HIV-relevant health behaviour and health behaviour change, however the IMB has yet to be applied to PEP after risky sexual exposure. The primary aim of this trial is to examine the impact of MI augmented with information provision and behavioural skills building (informed by the IMB Model), over and above usual care, on risky sexual behaviour in MSM prescribed PEP after potential sexual exposure. A secondary aim of this research is to examine the impact of the intervention on adherence to PEP. This study will also provide estimates of the cost-effectiveness of the intervention. METHODS: a manualised parallel group randomised controlled trial with economic evaluation will be conducted. The primary outcome is the proportion of risky sexual practices. Secondary outcomes include: i) Levels of adherence to PEP treatment; ii) Number of subsequent courses of PEP; iii) Levels of motivation to avoid risky sexual behaviours; iv) Levels of HIV risk-reduction information/knowledge; v) Levels of risk reduction behavioural skills; vi) Diagnosis of anal gonorrhoea, Chlamydia and/or HIV. 250 participants will be asked to self-complete a questionnaire at four time points during the study (at 0,3,6,12 months). The intervention will consist of a two-session, fixed duration, telephone administered augmented MI intervention based on the IMB model. A newly developed treatment manual will guide the selection of persuasive communication strategies as appropriate for each participant and will be based on underlying change mechanisms specified by the IMB theoretical framework. Information provision and skills building will also be included in the intervention package through the use of information leaflets and tailored action plans. Fidelity of intervention delivery will be assessed. DISCUSSION: the results from this NIHR funded study will identify whether it is appropriate and cost-effective to intervene using one-to-one telephone calls with MSM seeking PEP. If the intervention is effective, further work will be needed on training staff to deliver the intervention competently. TRIAL REGISTRATION NUMBERS: UKCRN ID:11436; ISRCTN00746242.
Abstract.
Author URL.
Richardson M, Abraham C, Bond R (2012). Psychological Correlates of University Students' Academic Performance: a Systematic Review and Meta-Analysis.
PSYCHOLOGICAL BULLETIN,
138(2), 353-387.
Author URL.
Full text.
Luszczynska A, Abraham C (2012). Reciprocal relationships between three aspects of physical self-concept, vigorous physical activity, and lung function: a longitudinal study among late adolescents.
Psychology of Sport and Exercise,
13(5), 640-648.
Abstract:
Reciprocal relationships between three aspects of physical self-concept, vigorous physical activity, and lung function: a longitudinal study among late adolescents
Objectives: This prospective study, of older adolescents, investigated relationships between three aspects of physical self-concept, vigorous physical activity and lung function. In particular, physical competence, general appearance evaluations and body areas satisfaction were expected to predict subsequent physical activity, which, in turn, was expected to explain variation in lung function. In line with the reciprocal effect model, bi-directorial relationships were also tested. Gender was expected to moderate hypothesized relationships. Design: a longitudinal design, with three measurement points (baseline, 2-month follow-up, and 14-month follow-up) was employed. Method: 551 late adolescents (15-18 years old) provided self-reported data on physical activity, physical competence, body areas satisfaction, and appearance evaluation. Body weight, height, and a lung function index (forced expiratory volume in 1 s, FEV 1 ) were measured at baseline and at the 14-month follow-up. Results: Moderated mediation analyses indicated that physical competence at baseline predicted vigorous physical activity (2-month follow-up) among young men and women. Baseline body satisfaction and appearance evaluation were also related to vigorous physical activity (2-month follow-up) and this relationship was stronger for men. Vigorous physical activity predicted FEV 1 (14-month follow-up) and this relationship was stronger among women. The reciprocal pattern of relationships was not confirmed. Conclusions: Findings suggest that health promoting interventions should focus particularly on vigorous physical activity among young women, for example by boosting their physical competence. © 2012 Elsevier Ltd.
Abstract.
Abraham C, Good A, Huedo-Medina TB, Warren MR, Johnson BT (2012). Reliability and Utility of the SHARP Taxonomy of Behaviour Change Techniques.
PSYCHOLOGY & HEALTH,
27, 1-2.
Author URL.
Brown KE, Abraham C, Joshi P, Wallace LM (2012). Sexual health professionals' evaluations of a prototype computer-based contraceptive planning intervention for adolescents: Implications for practice.
Sexual Health,
9(4), 341-348.
Abstract:
Sexual health professionals' evaluations of a prototype computer-based contraceptive planning intervention for adolescents: Implications for practice
Background: This paper aims to demonstrate how an online planning intervention to enhance contraceptive and condom use among adolescents was viewed by sexual health professionals. It identifies feedback that has facilitated improvement of the intervention both in terms of potential effectiveness and sustainability in practice. The data illustrate how professionals' feedback can enhance intervention development. Method: Ten practitioners (two male; eight female) representing a range of roles in sexual health education and healthcare were given electronic copies of the prototype intervention. Interviews were conducted to elicit feedback. Transcripts of the interviews were subjected to thematic analysis. Results: Practitioners provided positive feedback about the intervention content, use of on-line media, the validity of planning techniques and the inclusion of males in contraceptive planning. Issues with rapport building, trust, privacy, motivation, and time and resources were raised, however, and the promotion of condom carrying was contentious. Conclusions: Professionals' feedback provided scope for developing the intervention to meet practitioners' concerns, thus enhancing likely feasibility and acceptability in practice. Ways in which particular feedback was generalisable to wider theory-based and online intervention development are explored. Some responses indicated that health practitioners would benefit from training to embed theory-based interventions into sexual health education and healthcare. © 2012 CSIRO.
Abstract.
Gardner B, Abraham C, Lally P, De Bruijn GJ (2012). The habitual use of the self-report habit index': a reply. Annals of Behavioral Medicine, 43(1), 141-142.
Gardner B, Abraham C, Lally P, de Bruijn GJ (2012). Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index.
International Journal of Behavioral Nutrition and Physical Activity,
9Abstract:
Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index
Background: the twelve-item Self-Report Habit Index (SRHI) is the most popular measure of energy-balance related habits. This measure characterises habit by automatic activation, behavioural frequency, and relevance to self-identity. Previous empirical research suggests that the SRHI may be abbreviated with no losses in reliability or predictive utility. Drawing on recent theorising suggesting that automaticity is the 'active ingredient' of habit-behaviour relationships, we tested whether an automaticity-specific SRHI subscale could capture habit-based behaviour patterns in self-report data.Methods: a content validity task was undertaken to identify a subset of automaticity indicators within the SRHI. The reliability, convergent validity and predictive validity of the automaticity item subset was subsequently tested in secondary analyses of all previous SRHI applications, identified via systematic review, and in primary analyses of four raw datasets relating to energy-balance relevant behaviours (inactive travel, active travel, snacking, and alcohol consumption).Results: a four-item automaticity subscale (the 'Self-Report Behavioural Automaticity Index'; 'SRBAI') was found to be reliable and sensitive to two hypothesised effec ts of habit on behaviour: a habit-behaviour correlation, and a moderating effect of habit on the intention-behaviour relationship.Conclusion: the SRBAI offers a parsimonious measure that adequately captures habitual behaviour patterns. The SRBAI may be of particular utility in predicting future behaviour and in studies tracking habit formation or disruption. © 2012 Gardner et al.; licensee BioMed Central Ltd.
Abstract.
Crutzen R, Peters GJY, Abraham C (2012). What about trialists sharing other study materials?. BMJ (Online), 345(7887).
2011
Atwell K, Abraham C, Duka T (2011). A parsimonious, integrative model of key psychological correlates of UK university students' alcohol consumption.
Alcohol Alcohol,
46(3), 253-260.
Abstract:
A parsimonious, integrative model of key psychological correlates of UK university students' alcohol consumption.
AIMS: to examine the predictive utility of psychological correlates of alcohol consumption identified in previous (US-dominated) research for a UK student sample and construct an integrative model predictive of alcohol dependency in a sample of first-year undergraduate students. METHODS: a self-report questionnaire completed by 230 students measured stable and modifiable correlates of alcohol dependence. Stable correlates included age when first regularly drinking (age of onset), personality traits and religiosity. Modifiable measures included drinking motives, self-efficacy, alcohol-related expectancies, prototype perceptions and normative beliefs. RESULTS: the final multivariate model highlighted the importance of age of onset, sensation-seeking and a series of social cognitive measures including: social drinking motives, confidence in the ability to drink within government guidelines (self-efficacy) and the perceived quantity and frequency of alcohol consumed by university friends. Beta-coefficients indicated that self-efficacy and social drinking motives were particularly important predictors. A significant interaction was observed between age of onset and self-efficacy. Earlier onset was associated with higher levels of alcohol dependence for low and moderate, but not high levels of self-efficacy. CONCLUSION: the model presented here could be used to identify students at risk of alcohol dependence and inform the design of campus-based interventions.
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Author URL.
Good A, Abraham C (2011). Can the effectiveness of health promotion campaigns be improved using self-efficacy and self-affirmation interventions? an analysis of sun protection messages.
Psychol Health,
26(7), 799-818.
Abstract:
Can the effectiveness of health promotion campaigns be improved using self-efficacy and self-affirmation interventions? an analysis of sun protection messages.
Health-risk communications frequently target self-efficacy in order to encourage adaptive responses. Research has also indicated that self-affirmation may be a useful supplementary or alternative intervention technique. This study compared the effects of self-efficacy, self-affirmation and a combination of these techniques for two risk messages. Young British females (N=677) read about ultraviolet light and skin cancer or skin ageing ('photoageing') and were randomly assigned to a single intervention (self-affirmation/self-efficacy), the combined intervention or no intervention. The efficacy intervention led to greater message acceptance and perceived risk in both the cancer and photoageing conditions, while the only main effect of self-affirmation was on acceptance of the photoageing message. However, self-affirmation moderated the effect of efficacy information. For photoageing messages, efficacy information was associated with greater message acceptance only amongst self-affirmed participants, but the opposite occurred for skin cancer messages. Although these findings should be interpreted cautiously, they imply that health promoters should select efficacy information if only one intervention is used but that self-affirmation can influence responsiveness to efficacy interventions for particular messages.
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Graham-Rowe E, Skippon S, Gardner B, Abraham C (2011). Can we reduce car use and, if so, how? a review of available evidence.
Transportation Research Part A: Policy and Practice,
45(5), 401-418.
Abstract:
Can we reduce car use and, if so, how? a review of available evidence
Transport accounts for nearly a quarter of current energy-related carbon dioxide emissions with car travel constituting more than three quarters of all vehicle kilometres travelled. Interventions to change transport behaviour, and especially to reduce car use, could reduce CO 2 emissions from road transport more quickly than technological measures. It is unclear, however, which interventions are effective in reducing car use and what the likely impact of these interventions would be on CO 2 emissions. A two-stage systematic search was conducted focusing on reviews published since 2000 and primary intervention evaluations referenced therein. Sixty-nine reviews were considered and 47 primary evaluations found. These reported 77 intervention evaluations, including measures of car-use reduction. Evaluations of interventions varied widely in the methods they employed and the outcomes measures they reported. It was not possible to synthesise the findings using meta-analysis. Overall, the evidence base was found to be weak. Only 12 of the 77 evaluations were judged to be methodologically strong, and only half of these found that the intervention being evaluated reduced car use. A number of intervention approaches were identified as potentially effective but, given the small number of methodologically strong studies, it is difficult to draw robust conclusions from current evidence. More methodologically sound research is needed in this area. © 2011 Elsevier Ltd.
Abstract.
Abraham C (2011). Designing more effective behaviour change interventions.
PSYCHOLOGIST,
24(12), 893-894.
Author URL.
Abraham C, Johnson BT (2011). Editors' introduction to the special issue on health promotion interventions.
Psychol Health,
26(2), 129-132.
Author URL.
Abraham C, Sheeran P, Henderson M (2011). Extending social cognition models of health behaviour.
Health Educ Res,
26(4), 624-637.
Abstract:
Extending social cognition models of health behaviour.
A cross-sectional study assessed the extent to which indices of social structure, including family socio-economic status (SES), social deprivation, gender and educational/lifestyle aspirations correlated with adolescent condom use and added to the predictive utility of a theory of planned behaviour model. Analyses of survey data from 824 sexually active 16-year-olds (505 women and 319 men) tested three hypotheses. Firstly, social structure measures will correlate with behaviour-specific cognitions that predict condom use. Secondly, cognition measures will not fully mediate the effects of social structural indices and thirdly, the effects of cognitions on condom use will be moderated by social structure indices. All three hypotheses were supported. SES, gender and aspirations accounted for between 2 and 7% of the variance in behaviour-specific cognitions predicting condom use. Aspirations explained a further 4% of the variance in condom use, controlling for cognition effects. Mother's SES and gender added an additional 5%, controlling for aspirations. Overall, including significant moderation effects, of social structure indices increased the variance explained from 20.5% (for cognition measures alone) to 31%. These data indicate that social structure measures should to be investigated in addition to cognitions when modelling antecedents of behaviour, including condom use.
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Author URL.
Michie S, Abraham C, Eccles MP, Francis JJ, Hardeman W, Johnston M (2011). Strengthening evaluation and implementation by specifying components of behaviour change interventions: a study protocol.
IMPLEMENTATION SCIENCE,
6 Author URL.
Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, Schwarz P, IMAGE Study Group (2011). Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions.
BMC Public Health,
11Abstract:
Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions.
BACKGROUND: to develop more efficient programmes for promoting dietary and/or physical activity change (in order to prevent type 2 diabetes) it is critical to ensure that the intervention components and characteristics most strongly associated with effectiveness are included. The aim of this systematic review of reviews was to identify intervention components that are associated with increased change in diet and/or physical activity in individuals at risk of type 2 diabetes. METHODS: MEDLINE, EMBASE, CINAHL, PsycInfo, and the Cochrane Library were searched for systematic reviews of interventions targeting diet and/or physical activity in adults at risk of developing type 2 diabetes from 1998 to 2008. Two reviewers independently selected reviews and rated methodological quality. Individual analyses from reviews relating effectiveness to intervention components were extracted, graded for evidence quality and summarised. RESULTS: of 3856 identified articles, 30 met the inclusion criteria and 129 analyses related intervention components to effectiveness. These included causal analyses (based on randomisation of participants to different intervention conditions) and associative analyses (e.g. meta-regression). Overall, interventions produced clinically meaningful weight loss (3-5 kg at 12 months; 2-3 kg at 36 months) and increased physical activity (30-60 mins/week of moderate activity at 12-18 months). Based on causal analyses, intervention effectiveness was increased by engaging social support, targeting both diet and physical activity, and using well-defined/established behaviour change techniques. Increased effectiveness was also associated with increased contact frequency and using a specific cluster of "self-regulatory" behaviour change techniques (e.g. goal-setting, self-monitoring). No clear relationships were found between effectiveness and intervention setting, delivery mode, study population or delivery provider. Evidence on long-term effectiveness suggested the need for greater consideration of behaviour maintenance strategies. CONCLUSIONS: This comprehensive review of reviews identifies specific components which are associated with increased effectiveness in interventions to promote change in diet and/or physical activity. To maximise the efficiency of programmes for diabetes prevention, practitioners and commissioning organisations should consider including these components.
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Rivis A, Abraham C, Snook S (2011). Understanding young and older male drivers' willingness to drive while intoxicated: the predictive utility of constructs specified by the theory of planned behaviour and the prototype willingness model.
Br J Health Psychol,
16(Pt 2), 445-456.
Abstract:
Understanding young and older male drivers' willingness to drive while intoxicated: the predictive utility of constructs specified by the theory of planned behaviour and the prototype willingness model.
OBJECTIVE: the present study examined the predictive utility of constructs specified by the theory of planned behaviour (TPB) and prototype willingness model (PWM) for young and older male drivers' willingness to drive while intoxicated. DESIGN AND METHODS: a cross-sectional questionnaire was employed. Two hundred male drivers, recruited via a street survey, voluntarily completed measures of attitude, subjective norm, perceived behavioural control, prototype perceptions, and willingness. RESULTS: Findings showed that the TPB and PWM variables explained 65% of the variance in young male drivers' willingness and 47% of the variance in older male drivers' willingness, with the interaction between prototype favourability and similarity contributing 7% to the variance explained in older males' willingness to drive while intoxicated. CONCLUSIONS: the findings possess implications for theory, research, and anti-drink driving campaigns.
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Author URL.
2010
Paulweber B, Valensi P, Lindstrom J, Lalic NM, Greaves CJ, McKee M, Kissimova-Skarbek K, Liatis S, Cosson E, Szendroedi J, et al (2010). A European evidence-based guideline for the prevention of type 2 diabetes.
Hormone and Metabolic Research,
42(Suppl.1), S3-S36.
Abstract:
A European evidence-based guideline for the prevention of type 2 diabetes
Background: the prevalence and socioeconomic burden of type 2 diabetes (T2DM) and associated co-morbidities are rising worldwide. Aims: This guideline provides evidence-based recommendations for preventing T2DM. Methods: a European multidisciplinary consortium systematically reviewed the evidence on the effectiveness of screening and interventions for T2DM prevention using SIGN criteria. Results: Obesity and sedentary lifestyle are the main modifiable risk factors. Age and ethnicity are non-modifiable risk factors. Case-finding should follow a step-wise procedure using risk questionnaires and oral glucose tolerance testing. Persons with impaired glucose tolerance and/or fasting glucose are at high-risk and should be prioritized for intensive intervention. Interventions supporting lifestyle changes delay the onset of T2DM in high-risk adults (number needed- to-treat: 6.4 over 1.8-4.6 years). These should be supported by inter-sectoral strategies that create health promoting environments. Sustained body weight reduction by >= 5% lowers risk. Currently metformin, acarbose and orlistat can be considered as second-line prevention options. The population approach should use organized measures to raise awareness and change lifestyle with specific approaches for adolescents, minorities and disadvantaged people. Interventions promoting lifestyle changes are more effective if they target both diet and physical activity, mobilize social support, involve the planned use of established behaviour change techniques, and provide frequent contacts. Cost-effectiveness analysis should take a societal perspective. Conclusions: Prevention using lifestyle modifications in high risk individuals is cost-effective and should be embedded in evaluated models of care. Effective prevention plans are predicated upon sustained government initiatives comprising advocacy, community support, fiscal and legislative changes, private sector engagement and continuous media communication.
Abstract.
Johnston M, Michie S, Francis J, Eccles M, Abraham C, Hardeman W, Dixon D (2010). DEVELOPING a NOMENCLATURE FOR BEHAVIOUR CHANGE INTERVENTIONS.
INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE,
17, 71-72.
Author URL.
Gardner B, Abraham C (2010). Going green? Modeling the Impact of environmental concerns and perceptions of transportation alternatives on decisions to drive.
Journal of Applied Social Psychology,
40(4), 831-849.
Abstract:
Going green? Modeling the Impact of environmental concerns and perceptions of transportation alternatives on decisions to drive
A theory-of-planned-behavior-based model of intra-city driving incorporating cognitions concerning non-car transportation use, personal and descriptive norms, and the environment was tested. Participants were 190 residents of a UK city with good non-car travel infrastructure. Intention predicted 57% of the variance in behavior. In addition, 49% of intention variance was predicted by car-use attitudes, perceived behavioral control, descriptive norms, non-car-use attitudes, subjective norms, and personal norms. Concern and efficacy for reducing car-related environmental problems were associated with non-car attitudes and personal norms. Results demonstrate the importance of modeling transportation choice on cognitions relating to both car use and alternative transportation. © 2010 Copyright the Authors. Journal compilation © 2010 Wiley Periodicals, Inc.
Abstract.
Lemmens KPH, Ruiter RAC, Abraham C, Veldhuizen IJT, Schaalma HP (2010). Motivating blood donors to recruit new donors: Experimental evaluation of an evidence-based behavior change intervention.
Health Psychology,
29(6), 601-609.
Abstract:
Motivating blood donors to recruit new donors: Experimental evaluation of an evidence-based behavior change intervention
Objective: a sustainable, evidence-based intervention to motivate current blood donors to recruit new donors was evaluated using a quasi-experimental, in-service trial at three donation centers. Design: Participating blood donors in three conditions (N = 734), received (1) an evidence-based leaflet designed to enhance recruitment motivation and five postcards facilitating recruitment and donor registration, (2) five postcards alone, or (3) no materials. Main Outcome Measures: Self-reported donor recruitment by donors was measured at 1-week and 6-week follow-up. Results: at 1-week and at 6-week follow-up, donors in both intervention conditions reported talking to more people about donation and asking more people to donate than control participants. Intervention participants also reported persuading more people to register as a donor than control participants. Results indicated that postcards plus leaflet was somewhat more effective than the postcards alone. Donors' intentions to recruit at 1-week follow-up mediated the behavioral effects at 6-week follow-up. Conclusion: Motivating and facilitating recruitment of new blood donors through existing donors has the potential to continually replenish the donor population. © 2010 American Psychological Association.
Abstract.
De Bruin M, Viechtbauer W, Schaalma HP, Kok G, Abraham C, Hospers HJ (2010). Standard care impact on effects of highly active antiretroviral therapy adherence interventions: a meta-analysis of randomized controlled trials.
Archives of Internal Medicine,
170(3), 240-250.
Abstract:
Standard care impact on effects of highly active antiretroviral therapy adherence interventions: a meta-analysis of randomized controlled trials
Background: Poor adherence to medication limits the effectiveness of treatment for human immunodeficiency virus. Systematic reviews can identify practical and effective interventions. Meta-analyses that control for variability in standard care provided to control groups may produce more accurate estimates of intervention effects. Methods: to examine whether viral load and adherence success rates could be accurately explained by the active content of highly active antiretroviral therapy (HAART) adherence interventions when controlling for variability in care delivered to controls, databases were searched for randomized controlled trials of HAART adherence interventions published from 1996 to January 2009. A total of 1342 records were retrieved, and 52 articles were examined in detail. Directly observed therapy and interventions targeting specific patient groups (ie, psychiatric or addicted patients, patients. < 18 years) were excluded, yielding a final sample of 31 trials. Two coders independently retrieved study details. Authors were contacted to complete missing data. Results: Twenty studies were included in the analyses. The content of adherence care provided to control and intervention groups predicted viral load and adherence success rates in both conditions (P <. 001 for all comparisons), with an estimated impact of optimal adherence care of 55 percentage points. After controlling for variability in care provided to controls, the capacity of the interventions accurately predicted viral load and adherence effect sizes (R 2 =0.78, P=.02; R 2 =0.28, P <. 01). Although interventions were generally beneficial, their effectiveness reduced noticeably with increasing levels of standard care. Conclusions: Intervention and control patients were exposed to effective adherence care. Future meta-analyses of (behavior change) interventions should control for variability in care delivered to active controls. Clinical practice may be best served by implementing current best practice. ©2010 American Medical Association. All rights reserved.
Abstract.
2009
Abraham C, Graham-Rowe E (2009). Are worksite interventions effective in increasing physical activity? a meta-analytic review.
PSYCHOLOGY & HEALTH,
24, 71-71.
Author URL.
Abraham C, Graham-Rowe E (2009). Are worksite interventions effective in increasing physical activity? a systematic review and meta-analysis.
Health Psychology Review,
3(1), 108-144.
Abstract:
Are worksite interventions effective in increasing physical activity? a systematic review and meta-analysis
Worksite interventions have the potential to reach a broad and captive audience and overcome one of the most widely cited barriers to increasing physical activity (PA), namely, a lack of time. A systematic review and random effects, metaanalysis assessed the effectiveness of worksite interventions to enhance PA. Thirty-seven intervention evaluations reporting 55 unique interventions met our inclusion criteria. Results indicate that, overall, worksite interventions have small, positive effects on PA and this effect is smaller when fitness, as opposed to self-report, outcome measures are reported (ds 0.15 versus 0.23). Worksite interventions targeting PA specifically as opposed to general lifestyle change were found to be more effective whether evaluated in terms of increased fitness (0.29 versus 0.08) or increased self-reported PA (0.27 versus 0.14). Those promoting walking as opposed to other forms of PA were also more effective (0.54 versus 0.16). Interventions providing individually tailored information or instructions were not found to be more effective, but there was evidence that specific goal setting and goal review techniques may enhance fitness gains.
Abstract.
Kelly MP, Abraham C (2009). Behaviour change: the NICE perspective on the NICE guidance. Psychology and Health, 24(2), 131-133.
Richardson M, Abraham C (2009). Conscientiousness and achievement motivation predict performance.
European Journal of Personality,
23(7), 589-605.
Abstract:
Conscientiousness and achievement motivation predict performance
A prospective survey was conducted to identify predictors of university students' grade point average (GPA) using separate samples of female (N=472) and male (N=142) students over 9 months. Big five personality traits and achievement motivation were measured. Correlations show that conscientiousness (C) and achievement motivation explained variation in GPA. Latent variable structural equation modelling showed that the effect of C on GPA is fully mediated by achievement motivation for both female and male students. Invariant factor and structural mediation models across the female and male groups are also reported. Finally, the mediation model is shown to remain significant after scholastic achievement is controlled. The findings are interpreted within the framework of Neo-Socioanalytic theory. © 2009 John Wiley. &. Sons, Ltd.
Abstract.
Michie S, Abraham C, Whittington C, McAteer J, Gupta S (2009). Effective Techniques in Healthy Eating and Physical Activity Interventions: a Meta-Regression.
Health Psychology,
28(6), 690-701.
Abstract:
Effective Techniques in Healthy Eating and Physical Activity Interventions: a Meta-Regression
Objective: Meta-analyses of behavior change (BC) interventions typically find large heterogeneity in effectiveness and small effects. This study aimed to assess the effectiveness of active BC interventions designed to promote physical activity and healthy eating and investigate whether theoretically specified BC techniques improve outcome. Design: Interventions, evaluated in experimental or quasi-experimental studies, using behavioral and/or cognitive techniques to increase physical activity and healthy eating in adults, were systematically reviewed. Intervention content was reliably classified into 26 BC techniques and the effects of individual techniques, and of a theoretically derived combination of self-regulation techniques, were assessed using meta-regression. Main Outcome Measures: Valid outcomes of physical activity and healthy eating. Results: the 122 evaluations (N = 44,747) produced an overall pooled effect size of 0.31 (95% confidence interval = 0.26 to 0.36, I 2 = 69%). The technique, "self-monitoring," explained the greatest amount of among-study heterogeneity (13%). Interventions that combined self-monitoring with at least one other technique derived from control theory were significantly more effective than the other interventions (0.42 vs. 0.26). Conclusion: Classifying interventions according to component techniques and theoretically derived technique combinations and conducting meta-regression enabled identification of effective components of interventions designed to increase physical activity and healthy eating. © 2009 American Psychological Association.
Abstract.
Full text.
Michie S, Abraham C, Johnston M (2009). Health Psychology Training: the UK Model. In (Ed) Health Psychology in Practice, 5-45.
Michie S, Abraham C (2009).
Health Psychology in Practice.Abstract:
Health Psychology in Practice
Abstract.
Michie S, Abraham C (2009). Health Psychology in Practice: Introduction. In (Ed) Health Psychology in Practice, 1-4.
Fife-Schaw C, Abraham C (2009). How much behaviour change should we expect from health promotion campaigns targeting cognitions? an approach to pre-intervention assessment.
Psychology and Health,
24(7), 763-776.
Abstract:
How much behaviour change should we expect from health promotion campaigns targeting cognitions? an approach to pre-intervention assessment
For those planning interventions based on social cognition models, it is usually not clear what impact on behaviour will follow from attempts to change the cognitions specified in these models. We describe a statistical simulation technique to assess the likely impact of health promotion targeting Theory of Reasoned Action (TRA)-based predictors of condom use. We apply regression-based simulation techniques to data from the SHARE project (n=756 Scottish adolescents) to assess the potential impact of changes in cognitions on condom use. Results support the predictive utility of TRA-based models of psychological antecedents of condom use but also provide a cautionary warning about the magnitude of behaviour change likely to be achieved by interventions based on such models. © 2009 Taylor. &. Francis.
Abstract.
Abraham C, Sheeran P, Henderson M (2009). Integrating social structure and social cognition measures in explaining adolescent condom use.
PSYCHOLOGY & HEALTH,
24, 71-71.
Author URL.
Lemmens KPH, Abraham C, Ruiter RAC, Veldhuizen IJT, Dehing CJG, Bos AER, Schaalma HP (2009). Modelling antecedents of blood donation motivation among non-donors of varying age and education.
British Journal of Psychology,
100(1), 71-90.
Abstract:
Modelling antecedents of blood donation motivation among non-donors of varying age and education
Understanding blood donation motivation among non-donors is prerequisite to effective recruitment. Two studies explored the psychological antecedents of blood donation motivation and the generalisability of a model of donation motivation across groups differing in age and educational level. An older well-educated population and a younger less well-educated population were sampled. The studies assessed the role of altruism, fear of blood/needles and donation-specific cognitions including attitudes and normative beliefs derived from an extended theory of planned behaviour (TPB). Across both samples, results showed that affective attitude, subjective norm, descriptive norm, and moral norm were the most important correlates of blood donation intentions. Selfefficacy was more important among the younger less well-educated group. Altruism was related to donation motivation but only indirectly through moral norm. Similarly, fear of blood/needles only had an indirect effect on motivation through affective attitude and self-efficacy. Additional analyses with the combined data set found no age or education moderation effects, suggesting that this core model of donation-specific cognitions can be used to inform future practical interventions recruiting new blood donors in the general population. Copright © the British Psychological Society.
Abstract.
Abraham C, Kelly MP, West R, Michie S (2009). The UK National Institute for Health and Clinical Excellence public health guidance on behaviour change: a brief introduction.
Psychol Health Med,
14(1), 1-8.
Abstract:
The UK National Institute for Health and Clinical Excellence public health guidance on behaviour change: a brief introduction.
In October 2007, the National Institute for Health and Clinical Excellence (NICE) published 'Guidelines for Behaviour change at population, community and individual levels' (National Institute of Health and Clinical Excellence. Behaviour change at population, community and individual levels (Public Health Guidance 6), 2007, from http://www.nice.org.uk/Guidance/PH6). This article provides a brief overview of, and introduction to, the guidance focussing on three of its recommendations. First, the guidance outlines skills and competencies required by those involved in the design and evaluation of behaviour change interventions (BCIs). Second, it specifies a series of key psychological change targets which should be considered in interventions intended to change individual behaviour. Third, it highlights the need to plan intervention design and evaluation so that intervention components or techniques are linked directly to causal process which account for change. In addition, the guidance outlines a research agenda. Based on an analysis of the limitations of the available evidence base, research recommendations advise researchers on how to improve the quality of research into BCIs (including evaluations) and thereby advance the science of behaviour change.
Abstract.
Author URL.
Abraham C (2009). Using Theory in Research. In (Ed) Health Psychology in Practice, 63-82.
Abraham C, Gardner B (2009). What psychological and behaviour changes are initiated by 'expert patient' training and what training techniques are most helpful?.
Psychol Health,
24(10), 1153-1165.
Abstract:
What psychological and behaviour changes are initiated by 'expert patient' training and what training techniques are most helpful?
The Expert Patient Programme (EPP) is a lay-led, group-based, self-management training course available through the UK National Health Service for persons with long-term health conditions. Thirty-two patients who attended EPP courses in East London were interviewed about their experiences. Grounded theory coding of transcripts was employed to identify recurring accounts. Thematic analysis was used to theorise and organise participants' accounts, identifying commonly reported changes, helpful techniques and disappointments and frustrations. Results highlighted the role of information provision, especially face-to-face information exchange as well as the impact of in-class instruction and modelling of physical skills. Personal goal setting, using graded tasks, self-monitoring and goal review were regarded as the most useful techniques. Adoption and use of these self-management techniques depended on the establishment of an empathic and self-validating interpersonal context. Findings also imply that EPP may not be ideal for all participants and suggested modifications and improvements are discussed.
Abstract.
Author URL.
2008
Abraham C, Michie S (2008). A taxonomy of behavior change techniques used in interventions.
HEALTH PSYCHOLOGY,
27(3), 379-387.
Author URL.
Full text.
Michie S, Abraham C (2008). Advancing the science of behaviour change: a plea for scientific reporting. Addiction, 103(9), 1409-1410.
Michie S, Abraham C, Whittington C, McAteer J (2008). Behavior matters: What works in self-regulation interventions?.
INTERNATIONAL JOURNAL OF PSYCHOLOGY,
43(3-4), 558-558.
Author URL.
Abraham C (2008). Beyond stages of change: Multi-determinant continuum models of action readiness and menu-based interventions.
Applied Psychology,
57(1), 30-41.
Abstract:
Beyond stages of change: Multi-determinant continuum models of action readiness and menu-based interventions
The merits of modelling action readiness as a series of stages is discussed, focusing on the Health Action Process Approach (HAPA) which postulates a motivational stage (for non-intenders) and a volitional stage (for intenders). The HAPA helpfully clarifies that the relationship between self-efficacy and action may be different for inexperienced intenders and experienced actors. This model also usefully distinguishes between different types of planning undertaken by intenders and it is suggested that further specification of planning tasks could explain why some intenders act while others do not. Despite the advantages of the HAPA, it is argued that the distinction between intenders and non-intenders is fuzzy and unstable and that demarcation of the stage boundary is arbitrary. A multi-determinant, multi-goal continuum approach is recommended. Such modelling recognises graded discontinuities throughout the development of action readiness from attitude formation to behaviour change maintenance. It is argued that menu-based interventions designed to deliver different messages and materials to people with different action-readiness deficits may be more cost effective than stage-tailored interventions. © 2007 International Association for Applied Psychology.
Abstract.
Sheeran P, Armitage C, Mann E, Abraham C (2008). Does changing attitudes, norms, or self-efficacy cause health behaviour change?.
INTERNATIONAL JOURNAL OF PSYCHOLOGY,
43(3-4), 351-351.
Author URL.
Sibley E, Abraham C (2008). Does the health belief model provide a good theoretical basis for effective behaviour change interventions?.
PSYCHOLOGY & HEALTH,
23, 25-25.
Author URL.
Abraham C, Sibley E (2008). Does the health belief model provide a good theoretical basis for effective behaviour change interventions?.
INTERNATIONAL JOURNAL OF PSYCHOLOGY,
43(3-4), 351-351.
Author URL.
Greaves CJ, Sheppard K, Abraham C, Evans P, Roden M, Schwarz P, Grp IGD (2008). Health psychology in action: Preventing type 2 diabetes: Recommendations on achieving lifestyle change from the IMAGE guideline development project.
PSYCHOLOGY & HEALTH,
23, 17-17.
Author URL.
Lemmens KPH, Abraham C, Ruiter RAC, Veldhuizen IJT, Bos AER, Schaalma HP (2008). Identifying blood donors willing to help with recruitment.
Vox Sanguinis,
95(3), 211-217.
Abstract:
Identifying blood donors willing to help with recruitment
Background and Objectives: Social influence shapes behaviour and donors are ambassadors for blood banks. Donors are role models for family and friends and, therefore, so may be able to help with donor recruitment. Materials and Methods: a questionnaire was used to assess donors' willingness to engage in donor recruitment. Measures included willingness to recruit new donors and antecedents of recruitment motivation based on the theory of planned behaviour (TPB). Results: More than half of our participants were willing to try to recruit friends and family (57%). Self-efficacy was the most important correlate of intention to recruit as were cognitive attitude and experience with the blood bank. The findings suggest that the TPB provides a good basis for understanding cognitive antecedents of donors' willingness to recruit other donors. Conclusion: Results suggest that using existing donors to recruit new donors could be an efficient and cost-effective way to recruit additional donors. This approach warrants further investigation. © 2008 the Author(s).
Abstract.
Gardner B, Abraham C (2008). Psychological correlates of car use: a meta-analysis.
Transportation Research Part F: Traffic Psychology and Behaviour,
11(4), 300-311.
Abstract:
Psychological correlates of car use: a meta-analysis
This meta-analysis synthesised quantitative research into potentially modifiable psychological correlates of car use and intentions to drive. Online psychology and transportation databases were searched, and inclusion criteria applied to potentially relevant records. An ancestry approach was also employed to search selected publications. Meta-analyses of effect size rs were performed on 23 unique study datasets. Results generally supported the predictive utility of variables derived from the Theory of Planned Behaviour, though cognitions towards not driving displayed uniformly larger effects than were observed for car use cognitions. There was also a strong effect of habit on behaviour. Support for effects of pro-environment cognitions on driving was weak. However, a dearth of available evidence limited our findings and precludes development of clear evidence-based recommendations for intervention design. Directions for future research are discussed. © 2008 Elsevier Ltd. All rights reserved.
Abstract.
Hill CA, Abraham C (2008). School-based, randomised controlled trial of an evidence-based condom promotion leaflet.
Psychology and Health,
23(1), 41-56.
Abstract:
School-based, randomised controlled trial of an evidence-based condom promotion leaflet
A condom use promotion leaflet was designed for use with older teenagers in schools. The text targeted a series of cognitive and behavioural antecedents of condom use identified in the literature. Given previous evidence that motivational incentives can enhance the effectiveness of health promotion leaflets, the leaflet was presented in conjunction with a quiz and prize draw. Students were randomly assigned to either the intervention condition or a (no leaflet or incentive) control condition. Measures were taken immediately, pre-intervention and 4 weeks later from 404 students. The 20-min intervention successfully promoted six of the eight measured cognitions, namely (1) attitude towards using condoms with a new partner (2) attitude towards using condoms with a steady partner (3) normative beliefs in relation to preparatory actions (4) self-efficacy in relation to both preparatory actions and (5) condom use (6) intention to use condoms, as well as three measured preparatory actions, that is, purchasing condoms, carrying condoms and discussing condom use. The intervention did not increase condom use with steady or new partners but power to test intervention impact on condom use was curtailed.
Abstract.
Peters GJY, Kok G, Abraham C (2008). Social cognitive determinants of ecstasy use to target in evidence-based interventions: a meta-analytical review.
Addiction,
103(1), 109-118.
Abstract:
Social cognitive determinants of ecstasy use to target in evidence-based interventions: a meta-analytical review
Aims: the health hazards and prevalence of ecstasy use have been documented in two decades of research, but no review reporting on potentially modifiable antecedents of use is available. The aim of this study was to integrate systematically research identifying cognitive correlates of ecstasy use. Such research has the potential to identify targets for evidence-based interventions designed to discourage use. Methods: the databases PsycINFO and MedLine were searched, inclusion criteria applied to resulting hits, and descendency and ancestry approaches applied to the selected publications. Reported associations between cognitive determinants, including intention to use and ecstasy use measures, were synthesized by calculating a weighted mean effect size, r. Results: the pattern of associations lent support both to the theory of planned behaviour (TPB) and the expectancy approach as descriptions of potentially useful determinants. Attitudes were associated most strongly with intention and use, followed by subjective norm and perceived behavioural control. Conclusions: Consideration of the strength of associations and the potential modifiability of identified cognitions suggests that evidence-based interventions to discourage ecstasy use should target negative expectancies, perceived behavioural control and anticipated regret, and consider tailoring perceived behavioural control elements. © 2007 the Authors.
Abstract.
Abraham C, Michie S, Whittington C, McAteer J (2008). Specifying self-regulation intervention techniques in the context of healthy eating.
INTERNATIONAL JOURNAL OF PSYCHOLOGY,
43(3-4), 575-575.
Author URL.
Abraham C, Davidson KW, Kaplan RM, Michie S, Johnson BT, Schaalma H, Johnston M (2008). Standardising Behaviour Change Intervention Reports and Manuals.
PSYCHOLOGY & HEALTH,
23, 39-39.
Author URL.
Abraham C (2008). Symposium 10: Improving the science of behaviour change intervention evaluations.
PSYCHOLOGY & HEALTH,
23, 38-38.
Author URL.
Henderson M, Ecob R, Wight D, Abraham C (2008). What explains between-school differences in rates of smoking?.
BMC PUBLIC HEALTH,
8 Author URL.
2007
Hill C, Abraham C, Wright DB (2007). Can theory-based messages in combination with cognitive prompts promote exercise in classroom settings?.
Soc Sci Med,
65(5), 1049-1058.
Abstract:
Can theory-based messages in combination with cognitive prompts promote exercise in classroom settings?
A randomised control trial evaluated the effectiveness of a theory-based persuasive leaflet designed to encourage students to undertake at least one additional physical exercise session a week. Participants were 503 secondary school students attending a school in South-East England. The leaflet was written to target potentially modifiable cognitive antecedents of exercise specified by the Theory of Planned Behaviour. It was separately augmented with two cognitive change techniques, resulting in three intervention conditions, leaflet alone; leaflet plus motivational quiz, and leaflet plus implementation intention prompt, as well as a no-leaflet control condition. Cognitions and behaviour were measured immediately before and 3 weeks after intervention. The results showed that all three-leaflet interventions significantly increased reported exercise, intention to exercise and related cognitions, compared to the control condition, but did not differ in their impact. Mediation analysis showed that intervention effects on exercise were partially mediated by intentions and perceived behavioural control.
Abstract.
Author URL.
Luszczynska A, Gregajtys A, Abraham C (2007). Effects of a self-efficacy intervention on initiation of recommended exercises in patients with spondylosis.
J Aging Phys Act,
15(1), 26-40.
Abstract:
Effects of a self-efficacy intervention on initiation of recommended exercises in patients with spondylosis.
An intervention designed to enhance preaction self-efficacy beliefs (i.e. beliefs about ability to initiate behavior despite anticipated barriers during the initiation period) was tested in patients with spondylosis in relation to initiation of exercises recommended by a consultant in orthopedic rehabilitation. Sixty patients (age 28-83 years; 44% men) with spondylosis who had not previously performed exercises recommended for degenerative spine diseases were randomly assigned to a control (education session) or intervention group. Three weeks later, intervention patients performed recommended exercises more frequently than controls. Regression analysis for all patients showed that preintervention, preaction self-efficacy predicted exercise. Age and preintervention self-efficacy moderated the intervention effects. Among older patients, only those with weak preintervention, preaction self-efficacy beliefs benefited from the intervention, whereas among younger patients, only those with strong preintervention, preaction self-efficacy beliefs benefited from the intervention.
Abstract.
Author URL.
Kelley K, Abraham C (2007). Health promotion for people aged over 65 years in hospitals: nurses' perceptions about their role.
J Clin Nurs,
16(3), 569-579.
Abstract:
Health promotion for people aged over 65 years in hospitals: nurses' perceptions about their role.
AIM: to identify nurses' beliefs about health promotion and its delivery in routine care of people aged over 65 years. BACKGROUND: Regardless of age, health promotion interventions can enhance health and, in general, older people are motivated to take such preventive action. The National Service Framework for Older People sets the promotion of healthy living as a standard for UK National Health Service Trusts. However, the delivery of health promotion is 'haphazard'; patients aged over 65 years rarely report receiving health promotion, and reports from nurses suggest they are unsure how to deliver effective health promotion. METHOD: a theory-based survey of all nurses working in a department specializing in the care of people aged over 65 years, 41% of questionnaires were returned. RESULTS: the majority of nurses identified examples of health promotion and 88% judged health promotion to be effective and worthwhile. Three quarters of the sample viewed health promotion as part of their role and most of the respondents were confident in their ability to provide health promotion. However, the respondents also reported that health promotion was not appropriate for all their patients and considered it an increasingly difficult task as people got older. Organizational barriers to the routine provision of health promotion were identified. CONCLUSION: Nurses working on wards for people aged over 65 years are mostly positive about integrating health promotion into their everyday work. However, for health promotion to be routinely implemented, all nursing staff need to feel confident in undertaking the task and believe it is worthwhile. Health promotion needs to be awarded greater importance by hospital management to ensure that it does not conflict with other work priorities. Until this happens the provision of health promotion in hospitals will remain sporadic and lack conviction. RELEVANCE TO CLINICAL PRACTICE: with an increasing older population nurses need to be confident and proficient at implementing health promotion to patients aged over 65 years. This survey demonstrates that nurses need more training and support to achieve this.
Abstract.
Author URL.
Henderson M, Wight D, Raab GM, Abraham C, Parkes A, Scott S, Hart G (2007). Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: Final results of cluster randomised trial.
British Medical Journal,
334(7585), 133-136.
Abstract:
Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: Final results of cluster randomised trial
Objective: to assess the impact of a theoretically based sex education programme (SHARE) delivered by teachers compared with conventional education in terms of conceptions and terminations registered by the NHS. Design: Follow-up of cluster randomised trial 4.5 years after intervention. Setting: NHS records of women who had attended 25 secondary schools in east Scotland. Participants: 4196 women (99-5% of those eligible) Intervention: SHARE programme (intervention group) v existing sex education (controlgroup). Main outcome measure: NHS recorded conceptions and terminations for the achieved sample linked at age 20. Results: in an "intention to treat" analysis there were no significant differences between the groups in registered conceptions per 1000 pupils (300 SHARE v 274 control; difference 26,95% confidence interval -33 to 86) and terminations per 1000 pupils (127 v 112; difference 15, -13 to 42) between ages 16 and 20. Conclusions: This specially designed sex education programme did not reduce conceptions or terminations by age 20 compared with conventional provision. The lack of effect was not due to quality of delivery. Enhancing teacher led school sex education beyond conventional provision in eastern Scotland is unlikely to reduce terminations in teenagers.
Abstract.
Ferguson E, France CR, Abraham C, Ditto B, Sheeran P (2007). Improving blood donor recruitment and retention: Integrating theoretical advances from social and behavioral science research agendas.
Transfusion,
47(11), 1999-2010.
Abstract:
Improving blood donor recruitment and retention: Integrating theoretical advances from social and behavioral science research agendas
BACKGROUND: Increasing blood donor recruitment and retention is of key importance to transfusion services. Research within the social and behavioral science traditions has adopted separate but complementary approaches to addressing these issues. This article aims to review both of these types of literature, examine theoretical developments, identify commonalities, and offer a means to integrate these within a single intervention approach. STUDY DESIGN AND METHODS: the social and behavioral science literature on blood donor recruitment and retention focusing on theory, interventions, and integration is reviewed. RESULTS: the role of emotional regulation (anticipated anxiety and vasovagal reactions) is central to both the behavioral and the social science approaches to enhancing donor motivation, yet although intentions are the best predictor of donor behavior, interventions targeting enactment of intentions have not been used to increase donation. Implementation intentions (that is, if-then plans formed in advance of acting) provide a useful technique to integrate findings from social and behavioral sciences to increase donor recruitment and retention. CONCLUSION: After reviewing the literature, implementation intention formation is proposed as a technique to integrate the key findings and theories from the behavioral and social science literature on blood donor recruitment and retention. © 2007 American Association of Blood Banks.
Abstract.
Good A, Abraham C (2007). Measuring defensive responses to threatening messages: a meta-analysis of measures.
Health Psychology Review,
1(2), 208-229.
Abstract:
Measuring defensive responses to threatening messages: a meta-analysis of measures
© 2008 Taylor. &. Francis. A systematic review and meta-analysis was conducted to establish the nature and relative sensitivity of measures used to detect defensive responses to threatening messages. Databases were searched using a descendency approach to identify quasi-experimental or experimental studies which (i) exposed participants to information that could be personally threatening; (ii) included measures of defensiveness; and (iii) compared groups that differed in their expected defensiveness. Comparisons between three types of group were included: (a) those who naturally differed in the personal relevance of the threatening message; (b) those who had or had not received efficacy information; and (c) those who had or had not received self-affirmation. Thirty-five papers (reporting 43 studies) met these criteria. Twelve different types of defensiveness measures were identified. of these, only three generated consistently expected results in relation to anticipated group differences. Suggestions are made for the use of multiple, standardised measures of defensive processing in future research.
Abstract.
Luszczynska A, Sobczyk A, Abraham C (2007). Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women.
Health Psychol,
26(4), 507-512.
Abstract:
Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women.
OBJECTIVE: the trial investigates the effects of augmenting an established weight-reduction intervention with implementation intention prompts. DESIGN: Fifty-five overweight or obese women (ages 18 to 76 years; body mass index from 25.28 to 48.33) enrolled in a commercial weight reduction program were randomly assigned to either an implementation intention prompt or a control condition. Data were collected twice, with a time gap of 2 months. MAIN OUTCOME MEASURES: the primary outcome was participants' change in weight and body mass index from preintervention to follow-up. RESULTS: Repeated measures analysis of variance revealed a significant Time = Condition interaction: on average, implementation intention prompt participants lost 4.2 kg (95% confidence interval = 3.19, 5.07), whereas control participants lost 2.1 kg (95% confidence interval = 1.11, 3.09). The change in frequency of planning mediated the effects of the intervention on weight and body mass index change. CONCLUSION: Among obese or overweight women participating in a commercial weight loss program, those who learn to form implementation intentions can achieve greater weight reduction. Planning facilitation is a key mechanism explaining enhanced weight loss generated by implementation intention formation.
Abstract.
Author URL.
Murgaff V, Abraham C, McDermott M (2007). Reducing friday alcohol comsumption among moderate, women drinkers: Evaluation of a brief evidence-based intervention.
Alcohol and Alcoholism,
42(1), 37-41.
Abstract:
Reducing friday alcohol comsumption among moderate, women drinkers: Evaluation of a brief evidence-based intervention
Aims: a randomized controlled trial was used to evaluate a brief research-based intervention designed to promote drinking within recommended limits on Fridays and Saturdays among moderate drinkers. Methods: the two-page, leaflet-like intervention included persuasive communication targeting motivational and volitional antecedents of behaviour as specified by an extended theory of planned behaviour (TPB) and implementation intention theory. Participants were randomly allocated to a control group (TPB questionnaire only) or to a group receiving the TPB questionnaire plus leaflet-like intervention. Cognitions and drinking behaviour were measured immediately before the intervention and at 8-weeks follow-up. The pre-intervention questionnaire was distributed to 573 participants of whom 347 (61%) responded at follow-up. Results: Significantly greater reduction in risky drinking on Fridays was observed among women (but not men) in the intervention group at 8-weeks follow-up. No other post-intervention differences were found. Conclusions: a low-cost, readily-produced, written intervention focusing on recommended daily limits reduced risky drinking amongst women on Fridays. Further work on similar interventions is warranted. © 2007 Oxford University Press.
Abstract.
Maio GR, Verplanken B, Manstead ASR, Stroebe W, Abraham C, Sheeran P, Conner M (2007). Social Psychological Factors in Lifestyle Change and Their Relevance to Policy.
SOCIAL ISSUES AND POLICY REVIEW,
1(1), 99-137.
Author URL.
Gardner B, Abraham C (2007). What drives car use? a grounded theory analysis of commuters' reasons for driving.
Transportation Research Part F: Traffic Psychology and Behaviour,
10(3), 187-200.
Abstract:
What drives car use? a grounded theory analysis of commuters' reasons for driving
A grounded theory analysis of reasons for driving to work was undertaken following semi-structured interviews with 19 regular private car commuters in a small English city. Five core motives were identified: journey time concerns; journey-based affect; effort minimisation; personal space concerns; and monetary costs. An underlying desire for control underpinned many of these motives. The analysis revealed misconceptions regarding journey times and control in relation to car and public transport use, systematic underestimation of car-related monetary costs, and the importance of self- and identity-relevant consequences in relation to transport policy acceptance. Drivers' motives and misconceptions are discussed in light of transport demand management policies. © 2006 Elsevier Ltd. All rights reserved.
Abstract.
Abraham C, Southby L, Quandte S, Krahé B, Van Der Sluijs W (2007). What's in a leaflet? Identifying research-based persuasive messages in European alcohol-education leaflets.
Psychology and Health,
22(1), 31-60.
Abstract:
What's in a leaflet? Identifying research-based persuasive messages in European alcohol-education leaflets
Cognitive antecedents of alcohol consumption have been identified and psychologists have provided research-based recommendations regarding the content of persuasive communication designed to reduce health-endangering drinking. Yet, there has been little research into the correspondence between such recommendations and the content of publicly available health education leaflets. This study assessed the extent to which messages in leaflets designed to reduce alcohol consumption correspond to research-based recommendations. Comprehensive samples of widely available alcohol education leaflets were assembled in UK (N∈=∈31), Germany (N∈=∈30) and the Netherlands (N∈=∈21). A quantitative content analysis Content Analysis Approach to Theory-specified Persuasive Educational Communication, CAATSPEC was employed to categorise the leaflet text. Results indicated that most leaflets did not include a range of persuasive messages targeting the potentially modifiable cognitive antecedents, with 68% including no more than half of 29 research-derived message types. Data-based recommendations on the construction of health education leaflets are provided.
Abstract.
2006
Luszczynska A, Abraham C (2006). Forming plans about nutrition and exercise results in weight reduction.
PSYCHOLOGY & HEALTH,
21, 94-94.
Author URL.
Mann E, Abraham C (2006). The role of affect in UK commuters' travel mode choices: an interpretative phenomenological analysis.
Br J Psychol,
97(Pt 2), 155-176.
Abstract:
The role of affect in UK commuters' travel mode choices: an interpretative phenomenological analysis.
Previous research has suggested that the choice between public transport and private car use is not solely based on utility considerations, such as time and cost. However, affective considerations tend not to be targeted in policy interventions to reduce car use. This may be due, in part, to a lack of clarity about which affective responses to car use are important and how they may affect willingness to switch to public transport. This study sought to clarify the role of affective responses in transport mode choice. An interpretative phenomenological analysis (IPA) of car users' accounts was conducted to (i) explore affect associated with decisions to drive or use public transport to get to work; and (ii) describe the role of affect on such transport decisions, and its relationship to utility considerations. Semi-structured interviews were conducted with 18 car users employed at a medium-sized UK university. Four affect themes were identified: These were journey-based affect (JBA), personal space, autonomy and identity. Typical 'utility' factors such as time, cost and reliability had important affective effects, and these were considered alongside utility components (e.g. getting to work on time). However, these effects were not always additive, and the role of affect depended on participants' own assessment of their circumstances. Implications for interventions are discussed.
Abstract.
Author URL.
2005
Myers L, Abraham C (2005). Beyond 'doctor's orders'. Psychologist, 18(11), 680-683.
Krahé B, Abraham C, Scheinberger-Olwig R (2005). Can safer-sex promotion leaflets change cognitive antecedents of condom use? an experimental evaluation.
British Journal of Health Psychology,
10(2), 203-220.
Abstract:
Can safer-sex promotion leaflets change cognitive antecedents of condom use? an experimental evaluation
An experimental evaluation of a safer sex promotion leaflet was undertaken to assess its capacity to change antecedent cognitions of condom use. The leaflet was identified in a previous study as addressing research-based cognitive antecedents of condom use. A pre-post-test experimental study including three conditions was conducted: (a) presentation of the leaflet; (b) presentation of the leaflet plus incentive for systematic processing; (c) no-leaflet control. The leaflet was evaluated in terms of its capacity to change eight cognitive correlates of condom use identified in a recent meta-analysis. The sample consisted of 230 tenth-grade students. Following baseline assessments, leaflet-induced change was measured immediately following the intervention and at a follow up 4 weeks post-intervention. The target leaflet alone did not result in significant changes in the cognitive antecedents of condom use compared with the control condition. However, in combination with an incentive for systematic processing, the target leaflet had a greater impact on cognitive antecedents than the no-leaflet control condition. The findings are discussed with regard to the development and evaluation of research-based health-promotion materials. © 2005 the British Psychological Society.
Abstract.
Abraham C, Michie S (2005). Contributing to public health policy and practice. Psychologist, 18(11), 676-679.
Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A (2005). Making psychological theory useful for implementing evidence based practice: a consensus approach.
Quality and Safety in Health Care,
14(1), 26-33.
Abstract:
Making psychological theory useful for implementing evidence based practice: a consensus approach
Background: Evidence-based guidelines are often not implemented effectively with the result that best health outcomes are not achieved. This may be due to a lack of theoretical understanding of the processes involved in changing the behaviour of healthcare professionals. This paper reports the development of a consensus on a theoretical framework that could be used in implementation research. The objectives were to identify an agreed set of key theoretical constructs for use in (1) studying the implementation of evidence based practice and (2) developing strategies for effective implementation, and to communicate these constructs to an interdisciplinary audience. Methods: Six phases of work were conducted to develop a consensus: (1) identifying theoretical constructs; (2) simplifying into construct domains; (3) evaluating the importance of the construct domains; (4) interdisciplinary evaluation; (5) validating the domain list; and (6) piloting interview questions. The contributors were a "psychological theory" group (n = 18), a "health services research" group (n = 13), and a "health psychology" group (n = 30). Results: Twelve domains were identified to explain behaviour change: (1) knowledge, (2) skills, (3) social/ professional role and identity, (4) beliefs about capabilities, (5) beliefs about consequences, (6) motivation and goals, (7) memory, attention and decision processes, (8) environmental context and resources, (9) social influences, (10) emotion regulation, (11) behavioural regulation, and (12) nature of the behaviour. Conclusions: a set of behaviour change domains agreed by a consensus of experts is available for use in implementation research. Applications of this domain list will enhance understanding of the behaviour change processes inherent in implementation of evidence-based practice and will also test the validity of these proposed domains.
Abstract.
Krahé B, Abraham C, Felber J, Helbig MK (2005). Perceived discrimination of international visitors to universities in Germany and the UK.
British Journal of Psychology,
96(3), 263-281.
Abstract:
Perceived discrimination of international visitors to universities in Germany and the UK
The extent to which international students and academics feel discriminated against in the host country was explored in three samples from two countries: students in Germany (N = 161), students in the UK (N = 139), and academics in Germany (N = 79). Respondents completed a measure of perceived discrimination of increasing severity, comprising antilocution (verbal derogation), avoidance, behavioural discrimination, and physical assault. Physical discernibility as foreigner, quality of private contacts with host nationals, and language proficiency were explored as predictors of perceived discrimination. Across the three samples, respondents who were identifiable as foreigners by their appearance reported more discrimination. Positive contacts with host nationals were associated with lower levels of perceived discrimination. Language proficiency predicted perceived antilocution in the two German samples. All samples perceived their personal level of discrimination to be lower than that of their respective in-groups (international students/academics), but the tendency was moderated by visibility and contact quality. © 2005 the British Psychological Society.
Abstract.
Kellar I, Abraham C (2005). Randomized controlled trial of a brief research-based intervention promoting fruit and vegetable consumption.
British Journal of Health Psychology,
10(4), 543-558.
Abstract:
Randomized controlled trial of a brief research-based intervention promoting fruit and vegetable consumption
Objective. The present study sought to test the efficacy of a brief research-based, leaflet-like intervention to promote eating the recommended daily intake of fruit and vegetables (RDIFV). Design. A controlled, pre- post-test experimental study with random allocation and a I week self-report behavioural follow-up was conducted. Method. The intervention employed persuasive communication targeting self-efficacy and intention, and invited participants to form implementation intentions in relation to acquiring and preparing fruit and vegetables for consumption. Results. Intervention participants had stronger post-intervention intentions to consume the RDIFV, and higher anticipated regret in relation to failing to do so, compared with controls, controlling for pre-intervention scores. At follow-up, the intervention group was found to have eaten more fruit and vegetables and to have consumed the RDIFV more frequently. Discussion. It is concluded that this study supports the previously reported power of implementation intentions to prompt enactment of intentions, and that a brief research-based leaflet-like intervention could result in immediate enhancement of intentions and anticipated regret, and promote greater fruit and vegetable consumption. © 2005 the British Psychological Society.
Abstract.
Abraham C (2005). Sequencing and prioritising of intentions in planned behaviour.
PSYCHOLOGY & HEALTH,
20, 9-10.
Author URL.
Abraham C, Dudley J (2005). Simple explanations increase comprehension of terms used in oncology consultations.
PSYCHOLOGY & HEALTH,
20, 10-10.
Author URL.
Lemmens KPH, Abraham C, Hoekstra T, Ruiter RAC, De Kort WLAM, Brug J, Schaalma HP (2005). Why don't young people volunteer to give blood? an investigation of the correlates of donation intentions among young nondonors.
TRANSFUSION,
45(6), 945-955.
Author URL.
2004
Abraham C, Henderson M, Der G (2004). Cognitive impact of a research-based school sex education programme.
Psychology and Health,
19(6), 689-703.
Abstract:
Cognitive impact of a research-based school sex education programme
The cognitive impact of a research-based, teacher-delivered sex education programme for 13-15-year olds (SHARE) was evaluated in 25 Scottish schools. The relationship between cognitions targeted by SHARE and the sexual behaviour of teenagers who had first sexual intercourse after receiving sex education was assessed. The belief that there are alternatives to sexual intercourse in romantic/sexual relationships and the intention to resist unwanted sexual activities were significantly correlated with delayed sexual intercourse. An extended theory of planned behaviour, including descriptive norm and anticipated regret, provided a good model of the cognitive correlates of consistent condom use, explaining 25.9% of the variance. The impact of the SHARE programme on targeted cognitions was compared to that of conventional sex education by means of a randomised controlled trial, taking account of school effects. Those receiving SHARE had significantly higher scores on the belief that there are alternatives to sexual intercourse in romantic/sexual relationships, intentions to resist unwanted sexual activities and intentions to discuss condoms with sexual partners. SHARE recipients were also less likely to agree that condom use would interrupt sexual fun and reduce sexual enjoyment. However, mean differences between trial arms were small and no significant differences were found for the strongest cognitive correlates of consistent condom use, including the intention to always use a condom.
Abstract.
Wilkinson D, Abraham C (2004). Constructing an integrated model of the antecedents of adolescent smoking.
Br J Health Psychol,
9(Pt 3), 315-333.
Abstract:
Constructing an integrated model of the antecedents of adolescent smoking.
OBJECTIVE: Reviews have called for integrative, theoretically informed models of the 'hundreds of associations' (Miller & Slap, 1989, p. 131) between psychosocial measures and adolescent smoking (e. g. Tyas & Pederson, 1998). Such a model was tested. METHOD: a prospective, classroom-based survey measuring previously identified correlates of smoking allowed comparison of the strength of relationships between antecedents and smoking status six months later. The prospective sample included 225 13 to 14-year-olds. Measures of behaviour-specific cognitions derived from the Theory of Planned Behaviour (TPB)-as well as personality, self-esteem, parental support and parental control, sociodemographic factors, and descriptive norms-were included. Relationships between antecedents were explored using path analyses. RESULTS: High initial rates of smoking were observed. of the variance in smoking six months later, 56% was explained by seven direct predictors: intention, perceived ease of smoking, estimated number of friends smoking, percentage of older brothers smoking, self-esteem, extraversion and car access. DISCUSSION: Results emphasize the importance of behaviour-specific cognitions specified by the TPB but suggest that other factors, including extraversion and self-esteem, need to be included in models of the antecedents of smoking. The findings also imply that some antecedents, such as parental support, may indirectly influence adolescent smoking through their effect on other variables.
Abstract.
Author URL.
Abraham C, Sheeran P (2004). Deciding to exercise: the role of anticipated regret.
Br J Health Psychol,
9(Pt 2), 269-278.
Abstract:
Deciding to exercise: the role of anticipated regret.
OBJECTIVES: Two studies tested (a) whether anticipated regret (AR) qualifies as an additional predictor of intentions to engage in a health-enhancing behaviour (exercise) after variables from the Theory of Planned Behaviour (TPB) and past behaviour have been controlled, and (b) whether a manipulation that induces participants to focus on AR causes stronger intentions to exercise. DESIGN: Study 1 employed a cross-sectional questionnaire design; Study 2 employed a between-participants experimental design (AR focus vs. no AR focus). METHOD: Participants (N = 385) completed standard, multi-item, reliable measures of TPB constructs and AR and also reported their past behaviour (Study 1). Participants in Study 2 (N = 70) completed measures of AR and intention; salience of AR was manipulated by means of item order. RESULTS: Study 1 showed that even though TPB variables and past behaviour were reliable predictors of intention, and explained 51% of the variance, AR contributed a substantial increment in the variance (5%) even after these predictors had been taken into account. Study 2 showed that participants who were induced to focus on AR prior to intention formation had significantly stronger intentions to exercise compared to controls. CONCLUSION: the findings indicate that AR predicts a health-enhancing behaviour (as well as the health-risk behaviours examined in previous research) and that effects of AR are independent of TPB variables and past behaviour. The findings also indicate that a simple and inexpensive manipulation of the salience of AR can be used to promote exercise intentions.
Abstract.
Author URL.
Michie S, Abraham C (2004). Interventions to change health ehaviours: Evidence-based or vidence-inspired?.
Psychology and Health,
19(1), 29-49.
Abstract:
Interventions to change health ehaviours: Evidence-based or vidence-inspired?
This critical review assesses whether evaluation studies can answer three key questions about behaviour change interventions: 'Do they work? How well do they work? How do they work?' Reviews of intervention evaluations are examined, particularly those addressing decreasing unprotected sexual intercourse and smoking. Selection of outcome measures and calculation of effect sizes are discussed. The article also considers the extent to which evaluation reports specify (i) discrete intervention techniques and (ii) psychological mechanisms that account for observed behavioural change. It is concluded that intervention descriptions are often not specific about the techniques employed and that there is no clear correspondence between theoretical inspiration and adoption of particular change techniques. The review calls for experimental testing of specific theory-based techniques, separately and in combination.
Abstract.
Kelley K, Abraham C (2004). RCT of a theory-based intervention promoting healthy eating and physical activity amongst out-patients older than 65 years.
Soc Sci Med,
59(4), 787-797.
Abstract:
RCT of a theory-based intervention promoting healthy eating and physical activity amongst out-patients older than 65 years.
A randomised controlled trial was used to evaluate a theory-based health promotion intervention. The intervention, a healthy living booklet, was designed to promote healthy eating and physical activity amongst people aged over 65 years attending hospital out-patient clinics. The booklet employed persuasive arguments targeting the most proximal cognitive antecedents of behaviour specified by the theory of planned behaviour, as well as goal setting prompts. Participants (N = 252, average age=82) were randomly allocated to a control (patient satisfaction questionnaire) or intervention (healthy living booklet) group. Cognitions and behaviour were measured pre-intervention and at a two week follow up. The intervention group made significantly higher gains in perceived behavioural control, intention and behaviour for both target behaviours, suggesting that the intervention was successful. Sixty three of those invited to set goals to eat more healthily (e.g. "to eat five portions of fruit and vegetables a day") did so, and 67% of those who set such goals reported 100% success in acting on them. By contrast, only 34% of intervention participants set an activity goal (e.g. "a five minute walk everyday"), and only 51% reported 100% success in enacting these goals. Results suggest that the observed behavioural effects of the healthy eating booklet could be attributed to goal setting as well as changes in perceived behavioural control and intention.
Abstract.
Author URL.
Schaalma HP, Abraham C, Gillmore MR, Kok G (2004). Sex education as health promotion: What does it take?.
Abstract:
Sex education as health promotion: What does it take?
Abstract.
2003
Abraham C, Sheeran P (2003). Acting on intentions: the role of anticipated regret.
Br J Soc Psychol,
42(Pt 4), 495-511.
Abstract:
Acting on intentions: the role of anticipated regret.
Three studies tested the hypothesis that anticipated regret (AR) increases consistency between exercise intentions and behaviour. Study 1 employed a longitudinal survey design (N = 384). Measures specified by the theory of planned behaviour, past behaviour, and AR were used to predict self-reported exercise behaviour 2 weeks later. AR moderated the intention-behaviour relationship such that participants were most likely to exercise if they both intended to exercise and anticipated regret if they failed to exercise. Study 2 used an experimental design to examine the effect of focusing on AR prior to reporting intentions (N = 229). Exercise was measured 2 weeks later and the AR-focus manipulation was found to moderate the intention-behaviour relationship in a similar manner to that observed in Study 1. In Study 3 (N = 97), moderation was replicated and was shown to be mediated by the temporal stability of intention.
Abstract.
Author URL.
Abraham C, Sheeran P (2003). Implications of goal theories for the theories of reasoned action and planned behaviour.
Current Psychology,
22(3), 264-280.
Abstract:
Implications of goal theories for the theories of reasoned action and planned behaviour
This paper argues that the predictive validity of the theories of reasoned action and planned behaviour could be enhanced by considering key ideas from goal theories. In particular, goal theories highlight the importance of: (a) construing action as a process of behavioural selection designed to achieve actors' goals, (b) assessing the extent to which people have planned how to perform action sequences implied by their goals (c) investigating goal conflict in order to understand intention-behaviour discrepancies (d) examining contextual variations in goal salience to account for the dynamics of choice, (e) using intention stability to index the prioritization of goals, and (f) analyzing the content of the goals underlying attitudes and intentions. Suggestions are made about self-report measures and computations that would permit greater use of these ideas in future research.
Abstract.
Chapman K, Abraham C, Jenkins V, Fallowfield L (2003). Lay understanding of terms used in cancer consultations.
Psychooncology,
12(6), 557-566.
Abstract:
Lay understanding of terms used in cancer consultations.
The study assessed lay understanding of terms used by doctors during cancer consultations. Terms and phrases were selected from 50-videotaped consultations and included in a survey of 105 randomly selected people in a seaside resort. The questionnaire included scenarios containing potentially ambiguous diagnostic/prognostic terms, multiple-choice, comprehension questions and figures on which to locate body organs that could be affected by cancer. Respondents also rated how confident they were about their answers. About half the sample understood euphemisms for the metastatic spread of cancer e.g. 'seedlings' and 'spots in the liver' (44 and 55% respectively). Sixty-three per cent were aware that the term 'metastasis' meant that the cancer was spreading but only 52% understood that the phrase 'the tumour is progressing' was not good news. Yet respondents were fairly confident that they understood these terms. Knowledge of organ location varied. For example, 94% correctly identified the lungs but only 46% located the liver. The findings suggest that a substantial proportion of the lay public do not understand phrases often used in cancer consultations and that knowledge of basic anatomy cannot be assumed. Yet high confidence ratings indicate that asking if patients understand is likely to overestimate comprehension. Awareness of the unfamiliarity of the lay population with cancer-related terms could prompt further explanation in cancer-related consultations.
Abstract.
Author URL.
Sheeran P, Abraham C (2003). Mediator of moderators: Temporal stability of intention and the intention-behavior relation.
Personality and Social Psychology Bulletin,
29(2), 205-215.
Abstract:
Mediator of moderators: Temporal stability of intention and the intention-behavior relation
Intention certainty, past behavior, self-schema, anticipated regret, and attitudinal versus normative control all have been found to moderate intention-behavior relations. It is argued that moderation occurs because these variables produce "strong" intentions. Stability of intention over time is a key index of intention strength. Consequently, it was hypothesized that temporal stability of intention would mediate moderation by these other moderators. Participants (N = 185) completed questionnaire measures of theory of planned behavior constructs and moderator variables at two time points and subsequently reported their exercise behavior. Findings showed that all of the moderators, including temporal stability, were associated with significant improvements in consistency between intention and behavior. Temporal stability also mediated the effects of the other moderators, supporting the study hypothesis. © 2003 by the Society for Personality and Social Psychology, Inc.
Abstract.
Phillips P, Abraham C, Bond R (2003). Personality, Cognition, and University Students' Examination Performance.
European Journal of Personality,
17(6), 435-448.
Abstract:
Personality, Cognition, and University Students' Examination Performance
A prospective study explored the relationship between personality traits (as defined by the five factor model), type of motivation (as defined by self-determination theory), and goal-specific cognitions (including those specified by the theory of planned behaviour) as antecedents of degree performance amongst undergraduate students. A sample of 125 students completed a questionnaire two to three months before their final examinations. Structural equation modelling was used to explore relationships. Intention and perceived behavioural control explained 32% of the variance in final degree marks, with intention being the strongest predictor. Controlling for theory of planned behaviour variables, anticipated regret, good-student identity, controlled extrinsic motivation, Conscientiousness, and Openness had direct significant effects on intention. In total, 65% of the variance in intention was explained. The resultant model illustrates how personality traits may affect examination performance by means of mediators such as intention, anticipated regret, student identity, and autonomous intrinsic motivation. Copyright © 2003 John Wiley. &. Sons, Ltd.
Abstract.
2002
Abraham C, Krahé B, Dominic R, Fritsche I (2002). Do health promotion messages target cognitive and behavioural correlates of condom use? a content analysis of safer sex promotion leaflets in two countries.
Br J Health Psychol,
7(Pt 2), 227-246.
Abstract:
Do health promotion messages target cognitive and behavioural correlates of condom use? a content analysis of safer sex promotion leaflets in two countries.
OBJECTIVE: to categorize and quantify the content of publicly available safer sex promotion leaflets in the UK and Germany and to assess the extent to which this content corresponds to the cognitive and behavioural correlates of condom use identified by theory-based research. METHODS: a content analysis using a 45 category coding manual was undertaken. The manual included 20 'correlate-representative' categories identifying text promoting the strongest cognitive and behavioural correlates of condom use. RESULTS: Overall inter-coder reliability was high. Few content differences were observed between the German and UK samples. Leaflets from both countries highlighted information on how people become infected with HIV and advice to contact health care professionals. Few mentioned delaying or abstaining from sexual intercourse. Only 25% of leaflets included text that referred to more than 10 of the 20 correlate-representative categories. Moreover, using one standard deviation above the mean as an indication of frequent inclusion, two-thirds of leafets failed to target frequently more than two of the 20 correlate-representative categories. CONCLUSIONS: Some safer sex promotion leaflets frequently promote the strongest cognitive and behavioural correlates of condom use. In general, however, the recommendations of researchers investigating psychological correlates of condom use have not shaped the content of safer sex promotion leaflets.
Abstract.
Author URL.
Wight D, Raab GM, Henderson M, Abraham C, Buston K, Hart G, Scott S (2002). Limits of teacher delivered sex education: Interim behavioural outcomes from randomised trial.
British Medical Journal,
324(7351), 1430-1433.
Abstract:
Limits of teacher delivered sex education: Interim behavioural outcomes from randomised trial
Objective: to determine whether a theoretically based sex education programme for adolescents (SHARE) delivered by teachers reduced unsafe sexual intercourse compared with current practice. Design: Cluster randomised trial with follow up two years after baseline (six months after intervention). A process evaluation investigated the delivery of sex education and broader features of each school. Setting: Twenty five secondary schools in east Scotland. Participants: 8430 pupils aged 13-15 years; 7616 completed the baseline questionnaire and 5854 completed the two year follow up questionnaire. Intervention: SHARE programme (intervention group) versus existing sex education (control programme). Main outcome measures: Self reported exposure to sexually transmitted disease, use of condoms and contraceptives at first and most recent sexual intercourse, and unwanted pregnancies. Results: When the intervention group was compared with the conventional sex education group in an intention to treat analysis there were no differences in sexual activity or sexual risk taking by the age of 16 years. However, those in the intervention group reported less regret of first sexual intercourse with most recent partner (young men 9.9% difference, 95% confidence interval -18.7 to -1.0; young women 7.7% difference, -16.6 to 1.2). Pupils evaluated the intervention programme more positively, and their knowledge of sexual health improved. Lack of behavioural effect could not be linked to differential quality of delivery of intervention. Conclusions: Compared with conventional sex education this specially designed intervention did not reduce sexual risk taking in adolescents.
Abstract.
Abraham C, Gregory N, Wolf L, Pemberton R (2002). Self-esteem, Stigma and Community Participation Amongst People with Learning Difficulties Living in the Community.
Journal of Community and Applied Social Psychology,
12(6), 430-443.
Abstract:
Self-esteem, Stigma and Community Participation Amongst People with Learning Difficulties Living in the Community
A cross-sectional study examined the relationship between self-esteem, community participation, age, perceived stigma and social support amongst a sample of 50 people with mild to moderate learning difficulties attending two day centres. Respondent-paced, structured interviews following ethical and assessment guidelines were used to gather data. Retest interviews were conducted with 20% of the sample 3 months subsequently and only those measures with good test-retest reliability were used to test hypotheses. The results showed fairly high levels of community participation and self-esteem. Self-esteem was negatively correlated with stigma and a sub-group with high concerns regarding meeting strangers was identified. In accordance with studies of non-disabled samples, self-esteem was positively associated with age. Social support was comparable to, or higher than, that observed in non-disabled samples. High social support was observed for staff going out with respondents and for practical help from liked persons and friends. Community participation appeared to be related to higher self-esteem in older participants but lower self-esteem in younger participants. Implications for future research and practice are discussed. Copyright © 2002 John Wiley. &. Sons, Ltd.
Abstract.
2001
Conner M, Abraham C (2001). Conscientiousness and the theory of planned behavior: Toward a more complete model of the antecedents of intentions and behavior.
PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN,
27(11), 1547-1561.
Author URL.
Kelley K, Bond R, Abraham C (2001). Effective approaches to persuading pregnant women to quit smoking: a meta-analysis of intervention evaluation studies.
Br J Health Psychol,
6(Pt 3), 207-228.
Abstract:
Effective approaches to persuading pregnant women to quit smoking: a meta-analysis of intervention evaluation studies.
OBJECTIVES: the study aimed to: (1) assess the effectiveness of prenatal smoking cessation interventions, (2) clarify whether the psychological changes targeted by interventions are related to their effectiveness, (3) identify specific intervention components associated with greater effectiveness, and (4) establish whether aspects of evaluation methodology are associated with a greater effectiveness. DESIGN: Differences in proportions of women quitting and odds ratios were calculated for the intervention and control groups. Interventions were categorized in relation to the main intervention target (i.e. cognitive preparation versus increased threat perception), use of follow-up contact, use of individual cessation counselling and other characteristics. Methodological approaches to evaluation were also categorized. METHODS: a systematic literature review generated 36 controlled evaluations, including one unpublished study. A meta-analysis was used to relate study classifications to effectiveness. This involved univariate analyses and a multivariate model of the relationship between observed univariate effects. RESULTS: a weighted mean odds ratio of 1.93 indicated a good overall effectiveness. Cognitive preparation interventions achieved higher quit rates (6.5%) compared to interventions focusing on threat perception (2.2%). However, this effect was not maintained in the multivariate analysis. CONCLUSION: Interventions should employ follow-up, but further research is required to assess the impact of one-to-one counselling. Clarification of the psychological change processes underlying the observed effectiveness of these interventions is required. Future research should seek to identify the active ingredients and cognitive mediators of successful interventions.
Abstract.
Author URL.
Jones F, Abraham C, Harris P, Schulz J, Chrispin C (2001). From knowledge to action regulation: Modeling the cognitive prerequisites of sun screen use in Australian and UK samples.
Psychology and Health,
16(2), 191-206.
Abstract:
From knowledge to action regulation: Modeling the cognitive prerequisites of sun screen use in Australian and UK samples
Sun protective cognition and behaviour was studied on beaches in Australia (n = 113) and in the UK (n = 376). Cognition measures based on social psychological models, including the Theory of Planned Behaviour, were used to construct a model of sunscreen use. Path analysis showed that knowledge, norms, perceived threat, self-efficacy and perceived importance of short-term negative consequences of sun exposure accounted for 44% of the variance in intentions to use sunscreen. A measure of prior planning contributed as much to the prediction of behaviour as did intentions and there was support for both a moderating and a mediating influence of planning on intention. The results support theoretical proposals that post-decisional cognitions should be added to current theoretical models and have implications for intervention design.
Abstract.
Abraham C (2001). Predicting health behaviour: Research and practice with social cognition models.
PSYCHOLOGIST,
14(5), 260-260.
Author URL.
Ruiter RAC, Abraham C, Kok G (2001). Scary warnings and rational precautions: a review of the psychology of fear appeals.
Psychology and Health,
16(6), 613-630.
Abstract:
Scary warnings and rational precautions: a review of the psychology of fear appeals
Research into the effects of fear-arousal on precautionary motivation and action is reviewed. Current models do not adequately distinguish between emotional (i.e. fear arousal) and cognitive (i.e. threat perception) responses to fear appeals and, in general, are not well supported. Evidence suggesting that (i) coping appraisals are more powerful predictors of precautionary action than threat perception and that (ii) fear control processes may interfere with precautionary motivation, recommends cautious and limited use of fear appeals in health promotion. It seems likely that fear arousal is less important in motivating precautionary action than perceptions of action effectiveness and self-efficacy. Moreover, perceived personal relevance may be critical to the emotional and cognitive impact of threat information. Available findings are summarised in the form of a process model that highlights the potential complexity of fear arousal effects. Sequential measurement of fear arousal, other than by self-report, is recommended in studies seeking to clarify these effects.
Abstract.
2000
Wight D, Henderson M, Raab G, Abraham C, Buston K, Scott S, Hart G (2000). Extent of regretted sexual intercourse among young teenagers in Scotland: a cross sectional survey.
British Medical Journal,
320(7244), 1243-1244.
Abstract:
Extent of regretted sexual intercourse among young teenagers in Scotland: a cross sectional survey
This cross sectional survey determined the extent of regretted sexual intercourse among young teenagers in Scotland. Using a questionnaire, data were obtained from 7395 third-year pupils (3365 boys and 3730 girls) aged 13 years and 6 months to 14 years and 9 months in 24 nondenominational state secondary schools. Regretted sexual intercourse, measured on a three-point scale, was analyzed by ordinal logistic regression. The data revealed that 18% (661) of boys and 15.4% (576) of girls had experienced sexual intercourse, of which 74.8% occurred since their 13th birthday. Boys, compared with girls, reported higher levels of regret. For boys, higher levels of regret were significantly associated with having exerted pressure to have sex. On multivariate analysis, reports of being pressured, exerting pressure, not having planned sexual intercourse with partner, and high levels of parental monitoring were significantly related to girls' regret. For women, regret seemed to be related to lack of control. Sex education should focus on assisting young people to develop relationship and negotiation skills. In addition, making teenagers aware of potential emotional and relationship consequences of early sexual intercourse may delay first intercourse.
Abstract.
Wight D, Abraham C (2000). From psycho-social theory to sustainable classroom practice: developing a research-based teacher-delivered sex education programme.
Health Educ Res,
15(1), 25-38.
Abstract:
From psycho-social theory to sustainable classroom practice: developing a research-based teacher-delivered sex education programme.
This paper describes the development of a theoretically based sex education programme currently undergoing a randomized controlled trial in the UK. It considers some of the practical difficulties involved in translating research-based conclusions into acceptable, replicable and potentially effective classroom lessons. The discussion acknowledges that the implications of social psychological research and the requirements of rigorous evaluation may conflict with accepted principles inherent in current sex education practice. It also emphasizes that theoretical ideas must be carefully embedded in lessons which are informed by an awareness of classroom culture, and the needs and skills of teachers. For example, the use of same-sex student groups to reflect on the gendered construction of sexuality may be problematic. Materials must be tailored to recipients' circumstances, which may require substituting for limited experience with the use of detailed scripts and scenarios. Furthermore, role-play techniques for sexual negotiation that work elsewhere may not be effective in the UK. The use of trigger video sessions and other techniques are recommended. Finally, the problems involved in promoting condom-related skills are discussed. The paper concludes that, if an intervention is to be sustainable beyond the research stage, it must be designed to overcome such problems while remaining theoretically informed.
Abstract.
Author URL.
1999
Abraham C, Costa-Pereira A, Florey CD, Ogston S (1999). Cognitions associated with initial medical consultations concerning recurrent breathing difficulties: a community-based study.
PSYCHOLOGY & HEALTH,
14(5), 913-925.
Author URL.
Abraham C, Clift S, Grabowski P (1999). Cognitive predictors of adherence to malaria prophylaxis regimens on return from a malarious region: a prospective study.
Soc Sci Med,
48(11), 1641-1654.
Abstract:
Cognitive predictors of adherence to malaria prophylaxis regimens on return from a malarious region: a prospective study.
Cases of 'imported malaria' into countries where malaria is not endemic are increasing and evidence suggests that non-use of malaria prophylaxis and lack of adherence are contributing to this increase. Non-adherence may be especially likely because chemoprophylaxis regimens require travellers to continue to take medication for 4 weeks after their return from a malarious region. This study investigated the extent to which cognition measures specified by the theory of planned behaviour and the health belief model could distinguish between those who reported greater or lesser adherence after their return. Cognitions were measured using a brief questionnaire on the day of departure from the malarious region and reports of adherence were collected between 5 and 7 weeks later. Data from two longitudinal samples of UK tourists returning from the Gambia were analysed; 106 mefloquine users and 61 chloroquine and proguanil users. Results suggested that malaria prophylaxis adherence could be improved. 22.5% of mefloquine users and 31% of chloroquine and proguanil users reported adherence for 3 weeks or less. A model based on the theory of planned behaviour explained approximately 50% of the variance in reported adherence amongst mefloquine users and 40% amongst chloroquine and proguanil users, comparing favorably with other published applications of the theory. Findings suggest that targeting key cognitions could enhance adherence on return from malarious regions. Enhancing perceived control over adherence may be important as well as emphasising susceptibility to malaria infection. Reassuring mefloquine users concerning potential side effects of the drug may also encourage adherence on return. Implications for future research are discussed.
Abstract.
Author URL.
Sheeran P, Abraham C, Orbell S (1999). Psychosocial Correlates of Heterosexual Condom Use: a Meta-Analysis.
Psychological Bulletin,
125(1), 90-132.
Abstract:
Psychosocial Correlates of Heterosexual Condom Use: a Meta-Analysis
Despite increasing incidence of HIV/AIDS, there has been no systematic review of correlates of condom use among heterosexual samples. To rectify this, the present study used meta-analysis to quantify the relationship between psychosocial variables and self-reported condom use. Six hundred sixty correlations distributed across 44 variables were derived from 121 empirical studies. Variables were organized in terms of the labeling, commitment, and enactment stages of the AIDS Risk Reduction Model (Catania, Kegeles. &. Coates, 1990). Findings showed that demographic, personality, and labeling stage variables had small average correlations with condom use. Commitment and enactment stage variables fared better, with attitudes toward condoms, behavioral intentions, and communication about condoms being the most important predictors. Overall, findings support a social psychological model of condom use highlighting the importance of behavior-specific cognitions, social interaction, and preparatory behaviors rather than knowledge and beliefs about the threat of infection.
Abstract.
Abraham C, Sheeran P, Norman P, Conner M, De Vries N, Otten W (1999). When good intentions are not enough: Modeling postdecisional cognitive correlates of condom use.
Journal of Applied Social Psychology,
29(12), 2591-2612.
Abstract:
When good intentions are not enough: Modeling postdecisional cognitive correlates of condom use
Measures of intention usually leave substantial proportions of the variance in behavior unexplained. It has been suggested that improved behavioral prediction could be achieved by identifying postdecisional cognitive processes capable of distinguishing between intenders who do act and those do not act. Condom-related self-report measures of postdecisional cognitive processes were developed and tested in a cross-sectional questionnaire study involving 447 heterosexual students. A discriminant function composed of postdecisional measures was found to significantly distinguish between intenders who reported use and non-use and to correctly classify 80% of intenders. The results indicate that measures of the relative importance of competing intentions, prior planning of specific preparatory actions, and action-specific self-efficacy may enhance the prediction of condom use among intenders.
Abstract.
1998
Abraham C, Sheeran P, Orbell S (1998). Can social cognitive models contribute to the effectiveness of HIV-preventive behavioural interventions? a brief review of the literature and a reply to Joffe (1996; 1997) and Fife-Schaw (1997).
Br J Med Psychol,
71 ( Pt 3), 297-310.
Abstract:
Can social cognitive models contribute to the effectiveness of HIV-preventive behavioural interventions? a brief review of the literature and a reply to Joffe (1996; 1997) and Fife-Schaw (1997)
A recent debate in the British Journal of Medical Psychology has considered the role of social cognitive models, such as the theory of reasoned action and the theory of planned behaviour, in understanding HIV-preventive behaviour. In this paper we clarify some of the assumptions involved in applications of social cognitive models. We briefly review available evidence on the capacity of such models to predict HIV-preventive sexual behaviour and outline a number of criteria for judging their predictive success. The importance of behavioural prediction for the development of effective HIV-preventive behavioural interventions is discussed and recent evaluations of interventions based on these models are reviewed. We conclude that the models are effective in predicting HIV-preventive behaviours and provide empirically supported theoretical guidance on psychological changes likely to result in HIV-preventive behaviour change. In addition we argue that, to date, evaluations of theoretically specified interventions are encouraging. Further development and rigorous testing of HIV/AIDS interventions based on social cognitive models is recommended.
Abstract.
Author URL.
Abraham C, Sheeran P, Orbell S (1998). Can social cognitive models contribute to the effectiveness of HIV-preventive behavioural interventions? a brief review of the literature and a reply to Joffe (1996; 1997) and Fife-Schaw (1997).
British Journal of Medical Psychology,
71(3), 297-310.
Abstract:
Can social cognitive models contribute to the effectiveness of HIV-preventive behavioural interventions? a brief review of the literature and a reply to Joffe (1996; 1997) and Fife-Schaw (1997)
A recent debate in the British Journal of Medical Psychology has considered the role of social cognitive models, such as the theory of reasoned action and the theory of planned behaviour, in understanding HIV-preventive behaviour. In this paper we clarify some of the assumptions involved in applications of social cognitive models. We briefly review available evidence on the capacity of such models to predict HIV-preventive sexual behaviour and outline a number of criteria for judging their predictive success. The importance of behavioural prediction for the development of effective HIV-preventive behavioural interventions is discussed and recent evaluations of interventions based on these models are reviewed. We conclude that the models are effective in predicting HIV-preventive behaviours and provide empirically supported theoretical guidance on psychological changes likely to result in HIV-preventive behaviour change. In addition we argue that, to date, evaluations of theoretically specified interventions are encouraging. Further development and rigorous testing of HIV/AIDS interventions based on social cognitive models is recommended.
Abstract.
Abraham C, Sheeran P, Wight D (1998). Designing research-based materials to promote safer sex amongst young people.
Psychology, Health and Medicine,
3(1), 127-131.
Abstract:
Designing research-based materials to promote safer sex amongst young people
Studies of relationships, sexual behaviour, condom use, termination rates and the spread of sexually transmitted diseases suggest that many young people require greater preparation if they are to minimise distress and health threats in their romantic and sexual relationships. Yet most safer sex promotion programmes have been found to be ineffective. Social cognitive theories have been found to reliably distinguish between those who do an do not report subsequent condom use. These theories provide a framework for designing and evaluating safer sex promotion materials and have informed the development of a new school-based sex education programme - the SHARE programme.
Abstract.
Abraham C, Sheeran P, Johnston M (1998). From health beliefs to self-regulation: Theoretical advances in the psychology of action control.
Psychology and Health,
13(4), 569-591.
Abstract:
From health beliefs to self-regulation: Theoretical advances in the psychology of action control
The paper reviews the theoretical concepts included in a range of social cognitive models which have identified psychological antecedents of individual motivation and behaviour. Areas of correspondence are noted and core constructs (derived primarily from the theory of planned behaviour and social cognitive theory) are identified. The role of intention formation, self-efficacy beliefs, attitudes, normative beliefs and self-representations are highlighted and it is argued that these constructs provide a useful framework for modelling the psychological prerequisites of health behaviour. Acknowledging that intentions do not translate into action automatically, recent advances in our understanding of the ways in which prior planning and rehearsal can enhance individual control of action and facilitate the routinisation of behaviour are considered. The importance of engaging in preparatory behaviours for the achievement of many health goals is discussed and the processes by which goals are prioritised, including their links to self-representations, are explored. The implications of social cognitive and self-regulatory theories for the cognitive assessment of individual readiness for action and for intervention design in health-related settings are highlighted.
Abstract.
Wight D, Abraham C, Scott S (1998). Towards a psycho-social theoretical framework for sexual health promotion.
Health Education Research,
13(3), 317-330.
Abstract:
Towards a psycho-social theoretical framework for sexual health promotion
Numerous interventions have been designed to promote safer sexual behaviour amongst young people. However, relatively few have proved effective, which is, at least partially, due to the lack of development of theoretically based programmes. An understanding of the origins and control of sexual behaviour can be derived from basic social science research. Unless this is applied to the design of behaviour-change programmes they are unlikely to target the most important determinants of young people's sexual behaviour and are, therefore, unlikely to be effective. This paper outlines some of the key theoretical insights which have been drawn upon in the development of a new sex education programme currently being tested in Scottish schools. The theoretical basis is intentionally eclectic, combining social psychological cognitive models with sociological interpretations, since we are not concerned to advance any particular theory but to find which are most useful in promoting sexual health. First, the social influences on sexual behaviour are considered, and then the way in which these translate into individual perceptions and beliefs. Finally, the paper attempts to develop a theoretical understanding of sexual interaction and the social contexts of sexual behaviour.
Abstract.
1997
Abraham C (1997). The psychology of preventive health - Pitts,M.
SOCIAL SCIENCE & MEDICINE,
45(10), 1603-1603.
Author URL.
1996
Abraham C, Hampson SE (1996). A social cognition approach to health psychology: Philosophical and methodological issues.
Psychology and Health,
11(2), 223-241.
Abstract:
A social cognition approach to health psychology: Philosophical and methodological issues
Health psychologists working within a "social cognition" framework routinely regard verbal reports as indices of cognitive/mental representations and behavioural dispositions. Social cognition developed within social psychology but the philosophy of science, theoretical assumptions and methodological practices which constitute it are not universally accepted by social psychologists. This paper explores the implications of debates about the validity of a social cognitive perspective for research practice in health psychology. The realist foundations of social cognition are contrasted with the social constructionist perspective underpinning many discourse analysis studies. It is argued that a realist view of potentially accurate verbal reports and an individual cognitive focus are essential to health psychology research. However, it is emphasized that culture-bound self-presentational processes operating in data-collection contexts necessitate methodologies capable of monitoring and controlling the impact of those contexts on the content of collected verbal reports. Various methodological approaches are discussed and illustrative studies are used to demonstrate how cognitive categorizations of verbal reports can be used to predict health outcomes.
Abstract.
Abraham C, Wight D (1996). Developing HIV-preventive behavioural interventions for young people in Scotland.
Int J STD AIDS,
7 Suppl 2, 39-42.
Author URL.
Abraham CS, Sheeran P, Abrams D, Spears R (1996). Health beliefs and teenage condom use: a prospective study.
Psychology and Health,
11(5), 641-655.
Abstract:
Health beliefs and teenage condom use: a prospective study
Results from a longitudinal survey of sexual behaviour and HIV-relevant cognitions amongst 258 sexually-active adolescents are reported. Demographic characteristics, previous sexual experience, prior condom use, beliefs specified by the health belief model (HBM), peer norms regarding condom use and condom use intentions were measured using a confidential postal questionnaire. Measures of sexual behaviour and condom use consistency were included in a follow-up questionnaire one year later. A discriminant analysis revealed that demographic and HBM measures did not predict reported sexual activity over the study year. Path analysis revealed that intentions and HBM measures did not account for significant proportions of variance in consistency of condom use or mediate the effects of prior sexual experience or demographic measures. Those reporting more frequent sexual intercourse were less likely to use condoms consistently while those who had used condoms previously reported more consistent use. Gender differences suggested that young women's good intentions were less likely to be tra nslated into subsequent, consistent condom use. Theoretical and applied implications are considered.
Abstract.
Moir J, Abraham C (1996). Why I want to be a psychiatric nurse: Constructing an identity through contrasts with general nursing.
Journal of Advanced Nursing,
23(2), 295-298.
Abstract:
Why I want to be a psychiatric nurse: Constructing an identity through contrasts with general nursing
The justification of psychiatric specialization among undergraduate nursing students is examined. The data highlight how students are able to produce a positive view of their initial entry into nursing and then later create a positive and distinctive specialist occupational identity through negative comparisons with general nursing. Their experience in both psychiatric and general settings is drawn upon to add credibility to their claims. Contrasts based on the work schedules, patient focus, professional autonomy, opportunity for professional development, and required skills are considered.
Abstract.
1995
SPEARS R, ABRAHAM C, SHEERAN P, ABRAMS D (1995). STUDENTS JUDGMENTS OF THE RISKS OF HIV-INFECTION AS a FUNCTION OF SEXUAL PRACTICE, SEX OF TARGET AND PARTNER, AND AGE AND SEX OF STUDENT.
JOURNAL OF COLLEGE STUDENT DEVELOPMENT,
36(2), 103-111.
Author URL.
1994
Sheeran P, Abraham C (1994). Measurement of condom use in 72 studies of HIV-preventive behaviour: a critical review.
Patient Education and Counseling,
24(3), 199-216.
Abstract:
Measurement of condom use in 72 studies of HIV-preventive behaviour: a critical review
Ninety-four distinct measures of condom use were identified in a review of 72 psychosocial studies of HIV-prevention. A coding scheme was developed which characterised each measure in terms of: (1) type of measure (e.g. frequency of use, use at last intercourse), (2) response alternatives (e.g. Likert scale), (3) recall period (e.g. lifetime, last month), (4) partner specification (e.g. 'new' partner), and (5) activity specification (e.g. vaginal or anal intercourse). Results show a great deal of inconsistency in measurements of condom use across studies. Single-item frequency or consistency measures were most common. Several diff iculties with measures employed to date were identified. These included indeterminate reliability and validity of measures, lack of attention to the epidemiological significance of different types of use and terminological and self-presentational problems with items assessing use. Implications of extant measurement approaches for the accumulated knowledge base on predictors of 'safer' sex and suggestions for future research in this area are outlined. © 1994.
Abstract.
1987
BROTHERTON CJ, LEATHER PJ, LLEWELYN SP, BANNISTER P, BETNEY G, CHMIEL N, HOLMES DA, JEFFERSON J, LEWIS S, LOMAX C, et al (1987). LINKS BETWEEN PSYCHOLOGY IN BRITAIN AND SOUTH-AFRICA.
BULLETIN OF THE BRITISH PSYCHOLOGICAL SOCIETY,
40, 27-28.
Author URL.
