Broadening discussions of "safe" in hepatitis C prevention: a close-up of swabbing in an analysis of video recordings of injecting practice.
National Centre in HIV Social Research, University of New South Wales, NSW 2052, Australia. c.treloar@unsw.edu.au
Blood awareness messages have been used for some years in hepatitis C prevention efforts. However, hepatitis C prevention education has achieved only limited success. Innovative means of reaching people who inject drugs (PWIDs) are required. This study involved video recording injecting episodes of 13 clients of the Sydney Medically Supervised Injecting Centre in Kings Cross. Participants were interviewed the following day and asked to review their video and comment on their injecting practice. Also, feedback was provided to the participants on injecting technique and hepatitis C prevention. A peer researcher was present and engaged the participant in discussion around safer practice and explored the participants' explanations of their practice. This analysis provides information about the common aspects of "safer" and "unsafer" injecting technique observed in the video recordings. Unsafer in this context was defined as any practice which could cause harm including blood borne virus transmission risks, vein damage and introduction of other pathogens to the blood stream. Analysis of the video data show that common "unsafer" practices which have implications for blood borne virus transmission include: not washing hands before injecting; using fingers to stop bleeding; wiping injection site with swab (instead of applying pressure) to stop bleeding after injecting; and using the same swab to wipe another site. Analysis of interview data provided participants' explanations of their practices. Analysis of the discussions between the interview team and the participant provides insight into the types of messages and communication strategies which had credibility with the participants. These data show that broadening of hepatitis C education discussions to include other aspects of "safer" injecting can be useful in engaging experienced PWIDs in prevention. Embedding blood borne virus prevention messages in discussions about vein care may provide innovative ways to reinvigorate hepatitis C prevention efforts and impart these messages in a context which acknowledges the skills and knowledge of experienced PWIDs.
Br J Health Psychol. 2009 May;14(Pt 2):275-302. Epub 2008 Oct 15.
Integrating the theory of planned behaviour and self-determination theory in health behaviour: a meta-analysis.
School of Psychology, University of Nottingham, Nottingham, UK. martin.hagger@nottingham.ac.uk
PURPOSE: A meta-analysis of studies integrating the theory of planned behaviour (TPB) and self-determination theory (SDT) in health contexts is presented. The analysis aimed to provide cumulative empirical support for a motivational sequence in which self-determined motivation from SDT predicts the proximal predictors of intentions and behaviour from the TPB. METHODS: A literature search identified 36 integrated studies providing 45 tests of effects between TPB and SDT variables. Hunter and Schmidt's (1994) methods of meta-analysis were used to correct the effect sizes across the studies for statistical artifacts. Age (old versus young), publication status (published versus unpublished), study design (correlational versus experimental/intervention), and behaviour type (physical activity versus other health-related behaviours) were evaluated as moderators of the effects. A path-analysis using the meta-analytically derived correlations was conducted to examine the proposed motivational sequence. RESULTS: Statistically significant corrected correlations were evident among the perceived autonomy support and self-determined motivation constructs from SDT and the attitude, subjective norms, perceived behavioural control, intention, and health-related behaviour constructs from the TPB. Only six of the 28 effect sizes were moderated by the proposed moderators. Path analysis revealed that the significant effects of self-determined motivation on intentions and behaviour were partially mediated by the proximal predictors from the TPB. CONCLUSIONS: Evidence from this synthesis supported the theoretical integration and proposed motivational sequence. Results are discussed with reference to the complementary aspects of the TPB and SDT and the need for integrated experimental or intervention studies on a broader range of health behaviours.
http://www.ncbi.nlm.nih.gov.gate2.inist.fr/pubmed/18926008
