Biomedical subjects

J Brug

Publications and source records attributed to J Brug.

At least 19 recordsLinked to original sources

PubMed2001

Predictors of organ donation registration among Dutch adolescents.

BACKGROUND: In 1998, a new organ donor registration scheme was implemented in the Netherlands in order to increase the number of potential donors and to facilitate decisions and procedures concerning organ donation. However, registration rate and registration choices failed to meet the expectations. METHODS: A cross-sectional survey among a random sample of 1,731 Dutch adolescents of 18 and 19 years was conducted to study potential determinants of organ donor registration choices. RESULTS: Almost one fifth of the adolescents indicated that they did not return their organ donation registration form. Among subjects who registered, 57% were willing to donate their organs or tissues posthumously. More positive social influences, fewer negative outcome beliefs, and a low level of organ donation anxiety were significant predictors of returning a completed registration form and registration as an organ donor. In addition, religion was a significant predictor of returning a completed registration form, and positive outcome beliefs contributed to the prediction of registration as an organ donor. CONCLUSIONS: The results give clear suggestions for tailoring organ donation registration interventions to specific characteristics, beliefs, and misconceptions of adolescents. The results also suggest that it is important to encourage adolescents to discuss issues related to organ donation with their parents and friends in order to increase donor registration.

Adolescent↗

PubMed2001

Determinants of the intention of Dutch adolescents to register as organ donors.

This article identifies relevant predictors of willingness among Dutch adolescents to register as posthumous organ and tissue donors. A cross-sectional survey was conducted among 1836 Dutch adolescents between 16 and 18 years of age who had not yet been approached for registration. Sixty-seven percent of the participants indicated that they were willing to register as organ donors. In order of greatest association, negative outcome beliefs, anxiety, social outcome expectations, involvement with organ donation issues, positive outcome beliefs, knowledge about organ donation registration, past behaviour, and sex were significant predictors of the willingness to register as organ donor. Religion and level of education had a significant bi-variate correlation with intention, but were not significant predictors after controlling for other variables. The results give clear suggestions for tailoring organ donation registration interventions to specific characteristics, beliefs and misconceptions of adolescents.

Adolescent↗

PubMed2001

A checklist to improve patient education in a cardiology outpatient setting.

A randomised controlled trial with process evaluation was conducted (n=103) to study the use and impact of a Frequently Asked Questions checklist as a means to prepare coronary outpatients for a regular visit to their cardiologist. It was hypothesised that use of the checklist would result in better patient-doctor communication, lower state anxiety and higher knowledge scores among patients, resulting in greater patient satisfaction. The patients in the experimental group (n=53) received the checklist, with written instructions in addition to a brochure from the Dutch Heart Foundation, at home to prepare for their visit. The control patients only received the brochure. State anxiety immediately before the visit was significantly lower among experimental patients. No significant differences in patient satisfaction or knowledge were found. Using the checklist did not result in longer patient-doctor consultations. Experimental patients regarded the checklist as a useful tool to prepare for their visits to the clinic. We conclude that the checklist may be a useful tool for cardiac patients to prepare for their visits to their cardiologist.

Analysis of Variance↗

PubMed2001

Stages of change, psychological factors and awareness of physical activity levels in The Netherlands.

The purpose of this study was to investigate physical activity levels, stages of change, awareness, and differences in psychological factors relating to physical activity in an adult Dutch population, in order to identify specific objectives for physical activity promotion. Physical activity levels, self-rated physical activity, stages of change, awareness, attitudes, social influences and self-efficacy relating to physical activity were assessed among a random sample of 2608 adults using structured questionnaires. Almost 60% of the respondents did not meet the recommended target for physical activity to promote health. Half of these respondents were in the pre-contemplation stage, and >60% were overestimating their physical activity level. Furthermore, respondents who were not aware of their inadequate physical activity level had a less positive intention to increase their level of physical activity than those who rated their own physical activity level as low. Respondents in the pre-contemplation and maintenance stages had a less positive attitude, perceived less social support and had lower self-efficacy expectations towards increasing physical activity than those in the contemplation, preparation and action stages. The results suggest that interventions aimed at increasing physical activity in the studied population should be aimed at increasing awareness of personal activity levels and should be stage-matched.

Adolescent↗

PubMed2001

Evoked fear and effects of appeals on attitudes to performing breast self-examination: an information-processing perspective.

The effect of fear arousal on attitude toward participating in early detection activities [i.e. breast self-examination (BSE)] was studied from an information-processing perspective. It was hypothesized that fear arousal motivates respondents to more argument-based processing of fear-relevant persuasive information. Respondents first read information about breast cancer in which fear was manipulated. After measuring fear arousal, respondents read a persuasive message about performing BSE. Analyses with reported fear, but not manipulated fear, found support for the hypothesis. Respondents who reported mild fear of breast cancer based their attitude toward BSE more on the arguments provided than respondents who reported low fear of breast cancer. This finding suggests that the use of fear arousal may be an efficient tool in health education practice. However, alternative interpretations are provided, in addition to the suggestion to be careful with using fear arousal in health education messages.

Adult↗

PubMed2000

Differences in use and impact of computer-tailored dietary fat-feedback according to stage of change and education.

Computer-tailored written nutrition education has been found to be more effective in motivating people to reduce their consumption of fat than traditional written information. The present study aimed to test whether this innovative nutrition education intervention is also suitable for people with low motivation to change and low education among a self-selected sample of 699 adults. Computer-tailored feedback proved to be more effective in motivating precontemplators to proceed towards fat reduction than general information. Higher appreciation and use of the computer-tailored fat-feedback was found among respondents in contemplation than in other stages. No difference in impact of computer-tailored fat-feedback on fat intake was found between educational groups. Respondents with low education were more positive about how interesting and how personally relevant the tailored letters were. It was concluded that printed computer-tailored fat-feedback can be applied successfully to motivate precontemplators and people with low education to (consider to) reduce their fat intake.

Adult↗

PubMed2000

Tailoring dietary feedback to reduce fat intake: an intervention at the family level.

In this study, we wished to investigate whether the use of tailored nutrition education letters addressed to each family member simultaneously at home could serve as a valuable strategy for nutrition education. Family quartets (both parents and two adolescents, all healthy individuals) were chosen to be the units of intervention. The first aim of our study was to investigate the impact of tailored versus standardized nutrition education on fat intake and on psychosocial determinants of fat intake in families, using a randomized dietary feedback study. Our second aim was to study the differential effect of the tailored nutrition education on different family members. Analyses were conducted among 18 experimental families (n = 72) and 17 control families (n = 68). The tailored intervention was more effective than the nontailored intervention in reducing total and saturated fat intake when all the family members were included (F = 4.0, P < 0.05 and F = 5.9, P < 0.05). However, follow-up analyses revealed that only mothers benefit from the tailored intervention (F = 6.4, P < 0.05 and F = 10.2, P < 0.005). For fathers and adolescents, both interventions resulted in a significant decrease in fat scores. Furthermore, tailored feedback resulted in stronger awareness of personal fat intake and awareness of fat intake of family members. Tailored advice has the potential to communicate the personal need to change. As differences in fat reduction between family members receiving general or tailored nutrition education letters were smaller than expected, future research will have to prove that family-based tailored interventions are more effective than standardized interventions and interventions focusing on a single person. It also needs to be clarified why mothers in particular benefit from tailored feedback.

Adolescent↗

PubMed1999

Computer-tailored interventions motivating people to adopt health promoting behaviours: introduction to a new approach.

This issue of Patient Education and Counseling discusses the development, application and effectiveness of computer-tailored interventions. Computer-tailored interventions are a relatively new health education approach. The interventions are characterised by the fact that the content of the materials is adapted, with the aid of computers, to the specific characteristics of a particular person. The use of computers also facilitates addressing large segments of the population, who can now receive materials that are not general but highly individualized. This thematic issue features papers dealing with a wide range of topics. These articles describe the application of behavioural change theories to this new approach, the advantages of computer-tailored interventions over more general mass media approaches, their effectiveness and future directions for research on computer-tailored interventions. This editorial paper introduces computerised tailoring and provides a brief overview of its elements and applications as well as of the papers in this issue, and summarises the main conclusions and suggestions for future research on computer-tailored interventions.

Attitude to Health↗

PubMed1999

The application and impact of computer-generated personalized nutrition education: a review of the literature.

Computer-tailored nutrition education may be more effective than general nutrition education because messages are tailored to individual behavior, needs and beliefs of subjects. Therefore, the messages are likely to be of more personal relevance and may have stronger motivational effects. Computer-generated nutrition education has been studied for different dietary behaviors, in different target populations, and in different settings. In recent years, eight studies have been published that assessed the impact of comprehensive computer-generated nutrition interventions that were based on behavior change theory. In this article, the process of providing people with computer-tailored nutrition education is described and the studies on the impact of computer-tailored nutrition education are reviewed. The results point to the conclusion that computer-tailored nutrition education is more likely to be read, remembered, and experienced as personally relevant compared to standard materials. Furthermore, computer-tailored nutrition education also appears to have a greater impact in motivating people to change their diet, their fat intake in particular, although at present no definite conclusions can be drawn.

Attitude to Health↗

PubMed1999

Dutch research into the development and impact of computer-tailored nutrition education.

OBJECTIVE: The aim of the present paper is to describe the essential elements of computer-tailored nutrition education and to study the impact of written computer-tailored nutrition education in comparison to general written nutrition advice. DESIGN: The impact of computer-tailored nutrition education was studied in three randomised trials as compared to general nutrition education. The data of the three studies were taken together and re-analysed. SUBJECTS: Random samples of employees at two work sites and a self-selected sample of the Dutch adult population. The total number of subjects was 1309. Response rates were between 45% in one of the work sites and 88% in the self-selected sample. INTERVENTIONS: Subjects in the experimental condition received computer-tailored nutrition education. With computer-tailoring, expert individualised nutrition education can be realised through an automated process for relatively large target groups with relatively low costs per person. MAIN OUTCOME MEASURES: The impact on changes in fat intake were studied. The use and appreciation of the intervention was also assessed. RESULTS: Subjects who received computer-tailored advice had a lower mean fat score at post-test, adjusted for baseline intake levels. Subjects who received tailored advice were more likely to have read and discussed the nutrition advice. CONCLUSION: The results point to the conclusion that printed computer-tailored nutrition education is superior to general written nutrition education.

Adult↗

PubMed1999

Computer-tailored nutrition education: differences between two interventions.

The impact of two computer-tailored nutrition education interventions was assessed and compared in a randomized trial among 315 subjects with a pre-test-post-test comparison group design. Respondents in both the experimental and the comparison group received feedback tailored to their consumption of fat, fruit and vegetables. Respondents in the experimental group received additional psychosocial feedback tailored to their attitudes, perceived social support and self-efficacy expectations towards reducing their fat consumption and increasing their consumption of fruit and vegetables. A significant reduction in fat consumption and increase in the consumption of fruit and vegetables were found in both the experimental and the comparison group between pre-test and post-test. Respondents in the experimental group more often indicated that the feedback they received was interesting and easy to understand. Respondents in the comparison group more often reported having reduced their fat consumption because of the feedback they received. No significant differences in consumption of fat, fruit and vegetables were found at post-test between the experimental group and the comparison group. These results do not support the hypothesis that additional psychosocial information is an essential component of effective tailored feedback. The results indicate that tailored feedback might be effective in inducing dietary changes.

Adult↗

PubMed1998

Nationwide implementation of guided supermarket tours in The Netherlands: a dissemination study.

The purpose of this study was to assess adoption, implementation and maintenance of a guided supermarket tour program of nutrition education by Dutch Public Health Services (PHSs), and the factors associated with program dissemination. A first questionnaire was sent to all 60 PHSs, and measured program adoption, perceived program attributes, and characteristics of the adopting organization and person. A second questionnaire was only sent to adopting PHSs, and measured extent and success of implementation, intentions to continue the program, and characteristics of the main implementing person. Of the 59 PHSs who responded, 30 adopted the program and 17 implemented it sufficiently. Perceived program complexity, social influence within the PHS toward program participation and existence of a separate health education department were predictors of adoption. Perceived program complexity was also a predictor of extent of implementation. The number of health educators within each PHS was a predictor of sufficient implementation. It was concluded that adoption and implementation of the program was reasonable, considering the limited dissemination strategy. Dissemination might have been more successful if the program had been less complex and required less effort, if positive social influence had been generated, and if specific attention had been given to PHSs without a separate health education department.

Attitude of Health Personnel↗

PubMed1998

Fat Watch: a nationwide campaign in The Netherlands to reduce fat intake--process evaluations.

Fat Watch was a four-year campaign carried out in cooperation with retailers and industry, aiming at a reduction of fat consumption by 10% among the Dutch population. Mass media and supermarkets were the main conveyers of the message. Supermarkets participated well in the first (53%) and in the third year (51%), but to a lesser extent in the second year (36%). Campaign awareness in the target group (household shoppers for food) was relatively high in the first year (60%), but dropped in the next two years (40% and 32%, respectively). Combined with prominent mass media messages and with promotional activities of food products by suppliers, supermarkets seem a good channel for dissemination of nutrition information. Fat Watch has proved that cooperation of governmental, industrial and retail organizations for several years with respect to nutrition education activities is possible in the Netherlands.

Diet Surveys↗

PubMed1998

Fat Watch: a nationwide campaign in The Netherlands to reduce fat intake--effect evaluation.

In the Netherlands, the nationwide Fat Watch campaign aiming at a reduction in fat consumption was organized from 1991 onwards. This study describes the effects of the first three consecutive campaign years on attention to fat, diet and health, attitudes, self-efficacy expectations and intentions related to dietary fat reduction, and self-rated fat intake. Data were collected each year according to the Solomon design, by telephone interviews among about 1200 consumers responsible for household purchases. Campaign awareness was high in each campaign year, but a decrease in campaign awareness was found after the first campaign in 1991. The 1991 campaign was primarily aimed at getting the attention of the Dutch public for the fat-reduction message and indeed resulted in increased attention. The second campaign year resulted in small but statistically significant positive changes in attitudes, which was the specific target of the 1992 campaign. Intention to buy low-fat food products was also significantly increased. The 1993 campaign failed to realize the targeted increases in self-efficacy among the study population, but a significant campaign effect on intentions was found. The evaluation of all three campaigns indicated that the Dutch underestimate their personal fat intake and this has been identified as an important barrier to a further reduction in fat consumption. Making subjects aware of their personal fat consumption will be given priority in future campaigns.

Bias↗

PubMed1998

The impact of computer-tailored feedback and iterative feedback on fat, fruit, and vegetable intake.

A randomized trial was conducted to study the impact of individualized computer-generated nutrition information and additional effects of iterative feedback on changes in intake of fat, fruits, and vegetables. Respondents in the experimental group received computer-generated feedback letters tailored to their dietary intake, intentions, attitudes, self-efficacy expectations, and self-rated behavior. After the first feedback letter, half of the experimental group received additional iterative feedback tailored to changes in behavior and intentions. The control group received a single general nutrition information letter in a format similar to the tailored letters. Computer-tailored feedback had a significantly greater impact on fat reduction and fruit and vegetable intake than did general information. Iterative computer-tailored feedback had an additional impact on fat intake. The results confirm that computer-generated individualized feedback can be effective in inducing recommended dietary changes and that iterative feedback can increase the longer term impact of computer-tailored nutrition education on fat reduction.

Adult↗

PubMed1997

Consumption of fruit and vegetables: how to motivate the population to change their behavior.

This study reports the discrepancy between two methods to assess fruit and vegetable consumption in a Dutch adult population (N = 367). The consumption of fruit and vegetables was assessed by using a food frequency method (the number of grams of fruit and vegetables subjects ate every day) and by assessing subjects' own estimates of their fruit and vegetable intake. Besides the behavior, intention and determinants were measured using a theoretical model including attitude, self-efficacy and social influence to eat fruit and vegetables. Results showed that there were large differences between the self-rated and estimated objective consumption of fruit and vegetables. Subjects rated their own intake as much higher than their estimated actual intake. Furthermore, multiple regression analyses showed that the determinants predicted the self-rated consumption much better than the estimated consumption.

Adult↗

PubMed1997

Are awareness of dietary fat intake and actual fat consumption associated?--a Dutch-American comparison.

OBJECTIVES: To compare dietary fat intake, the accuracy of individuals' awareness about their fat intake, and sociodemographic and psychosocial correlates of awareness, in Dutch and American samples of employed adults. A discrepancy between objective dietary intake data and subjective self-evaluation of dietary fat consumption has been recognized in the past and might undermine healthy diet promotion interventions, and this is important because people who believe that their diets are healthful are less likely to be interested in making changes. Further, international comparisons have not been examined to date. DESIGN: Data collected for the baseline surveys of the 'Healthy Bergeijk' study in the Netherlands and the 'Working Well Trial' in the United States were compared. SUBJECTS: Working adults from a Dutch community health intervention study (n = 768) and an American worksite health promotion trial (n = 15,440). MAIN OUTCOME MEASURES: Objectively assessed dietary fat intake, measured by food frequency questionnaires, and subjective ratings of fat intake (self-rated fat intake). RESULTS: Findings show that the Dutch respondents had higher objectively assessed fat intake and lower subjective ratings of fat intake (P < 0.001). American respondents perceived their diets as higher in fat, more often stated their intentions to reduce fat intake, and were slightly more likely to make realistic estimates of their dietary fat. Dutch subjects were significantly more likely to underestimate their fat intakes. In both samples, women were most likely to underestimate their fat consumption and the most educated persons were most likely to be realistic. CONCLUSIONS: A substantial proportion of adults, both in the United States and the Netherlands, lack accurate awareness about how much fat they consume, though errors tend to be in opposite directions in the two countries. This study is an important first step toward broadening our international understanding of human dietary behavior for disease prevention.

Adult↗

PubMed1997

Validity and reliability of self-reported exposure to environmental tobacco smoke in work offices.

Environmental tobacco smoke (ETS) is an occupational carcinogen. Large companies often examine ETS exposure by employee surveys. However, reliable and valid self-report measures have been lacking. This study compared validity and reliability of various self-report measures. One hundred and seven nonsmokers from 11 Dutch worksites were interviewed. Three self-report measures were correlated with nicotine concentrations collected with area monitors in nonsmokers' offices. Nicotine concentrations averaged 12.7 micrograms/m. The item "How much tobacco smoke, on average, is there during a day in your work office?" correlated highest with nicotine concentrations (r = 0.65; P < 0.001) and produced the lowest standard error of measurement. It was concluded that this simple self-report item may be a valid measure to assess the reach and effectiveness of worksite smoking policies.

Adult↗