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Recreational prescription opioid misuse among college students in the USA: An application of the theory of planned behavior

Robert E. Davis, Martha A. Bass, Mary A. Ford, John P. Bentley, KoFan Lee, Nicole A. Doyle


Published Online: July 15, 2019


Introduction: Young adults aged 18-25 are at elevated risk for prescription drug misuse compared to other age groups. The purpose of the current study was to utilize the Theory of Planned Behavior (TPB) to predict the intention to engage in recreational prescription opioid misuse (RPOM) among college students while identifying specific salient beliefs that underlie this behavior.
Methods: A random sample of college students in the USA completed an electronic survey measuring TPB constructs, salient beliefs, RPOM, and demographic items. Salient beliefs regarding RPOM were identified through a qualitative elicitation process using a subsample (n = 17) of the target population. Content analysis identified specific beliefs that would form questionnaire items to be assessed among the larger sample.
Results: Among the entire sample (n = 776), 20.7% reported lifetime RPOM with 11.9% reporting past 6-month RPOM. Ten behavioral, two normative, and eight control beliefs identified in the subsample significantly and positively correlated with intention for RPOM when measured among the entire sample. A staged hierarchical logistic regression model examined the relationship between TPB constructs and intention. With the exception of perceived behavioral control, all constructs were significantly related to intention to engage in RPOM in the next six months. Descriptive norms had the strongest relationship to intention (OR = 1.37, 95% CI 1.23 to 1.54, P < .001), followed by subjective norms (OR = 1.33, 95% CI 1.20 to 1.48, P < .001), and finally attitude (OR = 1.13, 95% CI 1.09 to 1.17, P <.001). Further, attitude significantly moderated the descriptive norm-intention relationship.
Conclusion: The beliefs identified by this study may benefit interventions aimed at preventing prescription opioid misuse among this population. Further, targeting global perceptions of peer behavior, as well as, attitudes toward recreational use of prescription opioids may be particularly efficacious.

Investigating the effectiveness of theory-based interventions for improving treatment adherence of patients with type 2 Diabetes Mellitus: A systematic review of Randomised Controlled Clinical Trials

Despoina Menti, Caroline Limbert, Georgios Lyrakos


Published Online: May 30, 2019


Introduction: Theory can enhance the effectiveness of interventions designed to change health-related behaviours, however, there is a significant lack of such interventions to improve treatment adherence of Type 2 Diabetes Mellitus (T2DM) patients. This systematic review aims at examining the effectiveness of theory-based interventions on improving adherence of T2DM patients, also examining their methodological quality.
Methods: An electronic search was conducted, including only Randomised Controlled Trials published in English and Greek from 2004 to 2016. Databases searched included PubMed/Medline, Science Direct, Wiley Online Library, Oxford Journals and PsychInfo. The review protocol was designed and performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results: The review included reports of 11 interventions, using the Health Belief Model (n = 3), Social Cognitive Theory (SCT) (n = 2), Theory of Planned Behaviour (n = 2), Transtheoretical Model (n = 2), Information-Motivation-Behavioural skills model (n = 1) and Motivational Interviewing (n = 1). Nine interventions improved adherence of T2DM patients; the mean quality of the studies was 6.6, out of 10.
Discussion and Conclusion: Most theory-based interventions were effective in improving adherence of T2DM patients, especially SCT, which successfully improved all three aspects of treatment (i.e., medication taking, diet and physical exercise). Self-efficacy  is included in most of the theories and was the most effective element, especially when combined with goal setting practices, another common, effective element across interventions. However, the wide heterogeneity in the methodology of the studies impeded comparison and synthesis of findings. Common limitations were the use of self-reports, short follow-up periods and insufficient information on how theoretical constructs were used to design the intervention.

The Public Health Surveillance Well-Being Scale: Reliability and validity study of the Turkish version

Selma Infal Kesim, Faith Kara


Published Online: April 30, 2019


Introduction: The Public Health Surveillance Well-Being Scale (PHS-WB) is a measuring tool developed by Bann and colleagues (2012) for determining the well-being status of a community, expressed in terms of physical, mental, and social well-being. This study aimed to adapt, translate and validate the PHS-WB from English into the Turkish language.
Methods: A questionnaire ad hoc for collecting socio-demographic characteristics of participants, the Public Health Surveillance Well-Being Scale (PHS-WS) and the Perceived Wellness Scale (PWS) were used in our study. For the validity of the PHS-WS language, the original language of the scale was first translated from English into Turkish, whereas the back translation of the final draft was carried out from Turkish to English by a different language expert. The Content Validity Index was calculated. For the scale (criterion) validity, the coincidental scale validation method was used. The structural validity was assessed by using the exploratory factor analysis (EFA).
Results: The scale showed a high internal consistency, as the Cronbach’s alpha coefficient was 0.83 for the total score and 0.66, 0.76, and 0.69 for the physical, social and mental subscales, respectively. There was a total of 12 items in the final Turkish form of the PHS-WB, having the same factor structure as the original as result of the validity and safety studies performed.
Discussion and Conclusions: The validity and reliability of the Public Health Surveillance Well-being Scale was ensured. This questionnaire could be used by researchers for further investigation in different regions of Turkey, on larger sample groups and for evaluation of special groups, such as individuals with chronic illness and disability, or individuals employed in specific occupation (e.g., healthcare and social care professionals, unemployed, and students).