Biomedical subjects

Jane Wardle

Publications and source records attributed to Jane Wardle.

At least 37 records · Page 2Linked to original sources

PubMed2006

Mothers' attitudes towards preventing cervical cancer through human papillomavirus vaccination: a qualitative study.

Prophylactic vaccines against human papillomavirus (HPV) types causing cervical cancer will soon be available. Success of the vaccine relies on parents' willingness to vaccinate their prepubescent daughters. We explored mothers' attitudes towards vaccination. Twenty-four mothers of girls ages 8 to 14 years took part in four focus groups. Discussions covered attitudes to vaccination in general, cancer vaccines, vaccines for sexually transmitted infections (STI), and the HPV vaccine. Discussions were recorded, transcribed, and analyzed thematically. Mothers were broadly provaccination. Some were excited about a cancer vaccine, although there were fears that it might lead to unhealthy behaviors (e.g., smoking). STI vaccines got a mixed reception. Enthusiasm was moderated by concerns about an increase in risky sexual behavior. When provided with information about the HPV vaccine, women were in favor of protecting their daughters from cervical cancer, abnormal Papanicolaou results and, potentially, from cervical screening. Some worried about an increase in promiscuity and risk of other STIs. There was disagreement about the age at which girls should be vaccinated. Although some women thought this question should be medically driven, others were concerned about discussing the vaccine with young girls and preferred to wait until they were older. In conclusion, mothers were broadly in favor of HPV vaccination but had reservations, particularly about vaccinating girls as young as 10. Larger-scale quantitative work is needed to assess acceptability at the population level. If the vaccine is introduced, information provision is likely to be key to ensuring parents understand the rationale for vaccinating at a young age.

Adolescent↗

PubMed2006

Marriage and cancer prevention: does marital status and inviting both spouses together influence colorectal cancer screening participation?

OBJECTIVES: This study examined the influence of marital status and inviting both partners together on participation in colorectal cancer screening. SETTING: Data were from a subset of participants from the UK Flexible Sigmoidoscopy Trial (1996-1999). METHODS: Marital status was self-reported, and co-invitation of partner was obtained from the trial database. Screening intentions were assessed in 16,527 adults aged 55-64 years. Attendance was recorded in the 4130 respondents who were subsequently invited. RESULTS: Multivariate analyses, controlling for age and educational level, indicate that married (or cohabiting) people have more positive intentions (odds ratio [OR] = 1.26; 95% confidence interval [CI] 1.14-1.38) and higher attendance rates at screening (OR = 1.23; 95% CI 1.04-1.45) than nonmarried people. After adjusting for the marriage effect, inviting partners together (co-invitation) significantly increased screening intentions among women (OR = 1.17; 95% CI 1.04-1.31) but not men (OR = 0.97; 95% CI 0.85-1.10). Co-invitation significantly increased attendance at screening in both genders (OR = 1.34; 95% CI 1.14-1.58). CONCLUSIONS: In this age group, married adults are more likely to participate in colorectal cancer screening than the non-married, and inviting both members of a couple together further increases screening uptake. The positive effect of marriage was as strong for women as men.

Aged↗

PubMed2006

Alcohol consumption and symptoms of depression in young adults from 20 countries.

OBJECTIVE: The objective of this study was to determine whether the nonlinear association between alcohol and depressive symptoms observed in middle-aged and older men and women is present in young adults and is independent of culture, socioeconomic position, and health status. METHOD: Data were from the International Health and Behaviour Survey, involving 6,932 male and 8,816 female university students ages 17-30 years from 20 countries. Alcohol consumption was assessed in terms of number of drinks per week and number of drinks per episode, and the Beck Depression Inventory (BDI) was administered. Analyses were adjusted for clustering by country. RESULTS: The proportion of respondents with elevated BDI scores was 19.3%, 16.3%, and 20.0% for nondrinkers, moderate drinkers, and heavy drinkers, respectively. The odds of elevated BDI scores for nondrinkers compared with moderate drinkers were 1.22 (95% confidence interval [CI]: 1.06-1.42) after adjusting for age, gender, living arrangements, socioeconomic status, and self-rated health. Analysis based on the number of alcoholic drinks consumed in the past 2 weeks indicated that, in comparison with those who consumed 5-13 drinks, the odds of elevated BDI scores for nondrinkers were 1.25 (CI: 1.02-1.53) after adjusting for the same covariates. Heavy drinkers also had higher BDI scores than moderate consumers. CONCLUSIONS: The results suggest that the "U"-shaped association between alcohol consumption and depressive symptoms previously identified in Western countries is present in young people from a variety of cultural backgrounds. The relationship is not secondary to variations in health status, socioeconomic background, age, and gender.

Adolescent↗

PubMed2005

Positive affect and biological function in everyday life.

There is accumulating evidence that positive affect may protect against ill-health and risk of disease. Here, we summarize results from our research program into the biological correlates of positive affect. Data have been collected from middle-aged men and women, with positive affect assessed through repeated ratings of happiness over a working day. The results indicate that greater happiness is associated with lower salivary cortisol both on working and nonworking days, reduced fibrinogen stress responses, and lower ambulatory heart rate in men. These effects are independent of age, socioeconomic status, smoking, body mass and psychological distress. A 3 year follow-up has confirmed these biological associations with happiness. In addition, we found that happiness was inversely related to ambulatory systolic blood pressure on follow-up, again independently of potential confounders including negative affect. These results suggest that positive affective states are linked to favorable health outcomes through their influence on health-related biology, and may be particularly relevant in old age, when the accumulation of risk factors leads to increased risk of chronic disease.

Activities of Daily Living↗

PubMed2005

Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes.

Negative affective states such as depression are associated with premature mortality and increased risk of coronary heart disease, type 2 diabetes, and disability. It has been suggested that positive affective states are protective, but the pathways through which such effects might be mediated are poorly understood. Here we show that positive affect in middle-aged men and women is associated with reduced neuroendocrine, inflammatory, and cardiovascular activity. Positive affect was assessed by aggregating momentary experience samples of happiness over a working day and was inversely related to cortisol output over the day, independently of age, gender, socioeconomic position, body mass, and smoking. Similar patterns were observed on a leisure day. Happiness was also inversely related to heart rate assessed by using ambulatory monitoring methods over the day. Participants underwent mental stress testing in the laboratory, where plasma fibrinogen stress responses were smaller in happier individuals. These effects were independent of psychological distress, supporting the notion that positive well-being is directly related to health-relevant biological processes.

Affect↗

PubMed2005

The impact of obesity on psychological well-being.

Children and adolescents with obesity face stigmatization and discrimination in many areas of their lives, and it has been assumed that their psychological well-being will be compromised as a result. This chapter examines the most recent empirical evidence on the relationship between childhood obesity and body dissatisfaction, self-esteem and depression. Studies of clinical samples typically report poorer psychological well-being in treatment seekers when compared with population-based obese and normal weight controls. However, research in community samples suggests that despite moderate levels of body dissatisfaction, few obese children are depressed or have low self-esteem. A number of important moderators and mediators of the association between obesity and well-being have emerged, with females, Caucasians and adolescents being particularly at risk. Implications for treatment and future research priorities are suggested.

Adolescent↗

PubMed2005

Parental control over feeding and children's fruit and vegetable intake: how are they related?

OBJECTIVES: To replicate the finding of a negative association between parental control and fruit and vegetable consumption in girls. To extend the investigation to boys and examine sex differences. To test the hypothesis that children's food neophobia explains this association. DESIGN: Cross-sectional questionnaire survey. MEASURES: The questionnaire included items assessing parents' and children's fruit and vegetable intake, the Parental Control Index, and the Child Food Neophobia Scale. SUBJECTS: Parents of 564 2- to 6-year-old children, recruited from 22 London nursery schools. STATISTICAL ANALYSIS: Relationships between continuous variables were examined with Pearson product moment correlation coefficients. Sex differences were tested using independent sample t tests, and sex differences in correlations were assessed from their 95% confidence intervals. Parental control and children's food neophobia were entered into a hierarchical multiple regression to test the hypothesis that neophobia explains the association between parental control and children's fruit and vegetable intake. RESULTS: We replicated the finding that parental control was correlated with children's fruit and vegetable consumption and found no significant sex differences. Parental fruit and vegetable consumption and children's food neophobia were also strong predictors of children's fruit and vegetable consumption, and both were associated with parental control, suggesting that they might explain the association between control and intake. Controlling for children's food neophobia and parental intake reduced the association of parental control with children's fruit and vegetable intake to nonsignificance. CONCLUSIONS: These findings emphasize the importance of systematic research about associations between parental feeding styles and children's dietary habits so that dietetics professionals can give parents sound advice.

Adult↗

PubMed2005

Dietary restraint, body dissatisfaction, and psychological distress: a prospective analysis.

This study uses prospective data from a survey of 1,177 adolescent girls to examine whether emotional eating, binge eating, abnormal attitudes to eating and weight, low self-esteem, stress, and depression are associated with dietary restraint or body dissatisfaction. In analyses that included both restraint and body dissatisfaction as independent predictors, restraint was associated only with more negative attitudes to eating, whereas body dissatisfaction was significantly associated with all the adverse outcomes. These results cast doubt on the proposition that restrained eating is a primary cause of bulimic symptoms, emotional eating, and psychological distress seen in individuals who are trying to control their weight, and rather suggest that body dissatisfaction is the key factor.

Adolescent↗

PubMed2005

Age and gender differences in children's food preferences.

The present study was conducted to examine the developmental patterning of food preferences in a large sample of British schoolchildren and to investigate possible gender differences. Using a cross-sectional survey design, the study was carried out in three primary and three secondary schools in West London, UK. A total of 1291 children aged from 4 to 16 years completed a 115-item food preference questionnaire in class time, supervised by class teachers and assistants. Children indicated whether they had ever tried each item and, if so, how much they liked it. We observed age-related increases in the number of foods tried (P<0.001), liked (P<0.005) and disliked (P<0.05). Controlling for the number of foods tried rendered the increase in dislikes non-significant and reversed the age effect on the number liked. Girls liked fruit (P<0.05) and vegetables (P<0.001) more than boys did; boys liked fatty and sugary foods (P<0.005), meat (P<0.001), processed meat products (P<0.001) and eggs (P<0.05) more than girls did. Some age differences were apparent in liking for categories of food, although the effects were not linear. Across ages and genders, children rated fatty and sugary foods most highly, although ratings for fruit were also high. Children's food preferences overall are not consistent with a healthy diet. Interventions should focus on increasing the familiarity, availability and accessibility of healthy foods and should be mindful of the need to target messages appropriately for boys who have less healthful food preferences than girls at all ages.

Adolescent↗

PubMed2005

Understanding the aetiology of childhood obesity: implications for treatment.

Childhood obesity poses one of the greatest challenges to paediatric health in the 21st century. Developing effective strategies for treatment and prevention is therefore a priority for clinical medicine and public health. This process is taking place at a time of unprecedented change in the understanding of the role of genetic factors in human health and disease, and genetic research into obesity has challenged assumptions about causal processes. In the spirit of the conference theme, the present paper will discuss the implications of the understanding of genetic and environmental influences on obesity for the development of effective behavioural treatments.

Child↗

PubMed2005

The effects of a genetic information leaflet on public attitudes towards genetic testing.

Genetics opinion surveys often include information to ensure that respondents have sufficient understanding to give informed responses. The information is assumed to be neutral but may skew responses. We assessed the impact of a seemingly "neutral" information leaflet on attitudes towards genetic testing among 1,024 survey respondents, half of whom received the leaflet. The leaflet group reported higher levels of subjective understanding of genetic testing (68 percent vs. 53 percent), were mre interested in genetic testing (81 percent vs. 77 percent), and held more positive attitudes towards genetics than people who did not receive the leaflet. Information leaflets may have the intended effect of increasing understanding, but may also unintentionally influence reported views of genetics. In the light of the weight given to public consultation in today's governance and regulation of human genetics, increased awareness of how even seemingly neutral information can influence public attitudes is recommended.

Adult↗

PubMed2005

Will genetic testing for complex diseases increase motivation to quit smoking? Anticipated reactions in a survey of smokers.

The aim of this study was to improve understanding of smokers' potential reactions to genetic testing for smoking-related diseases. One thousand twenty-four respondents completed a postal survey; 186 were smokers. Questions addressed anticipated psychological and behavioral reactions to genetic test results using hypothetical scenarios. Of smokers, 65% anticipated being motivated to quit smoking upon receiving a positive genetic test result; 39% anticipated being demotivated by a negative result. More smokers anticipated being depressed in response to receiving a positive result for cancer than for heart disease (40% vs. 24%). Anticipated motivation was associated with higher desire to quit and lower nicotine addiction, anticipated depression with poorer understanding of genetic testing, and anticipated demotivation with lower education. Smokers who have a high desire to quit may use genetic testing as a motivational tool. Understanding of genetics may be important in determining how individuals respond to genetic tests for complex diseases.

Adolescent↗

PubMed2005

Sociodemographic, developmental, environmental, and psychological correlates of physical activity and sedentary behavior at age 11 to 12.

BACKGROUND: Low levels of physical activity and high levels of sedentary behavior during adolescence are a cause for concern. Sociodemographic, developmental, environmental, and psychological factors may be relevant, but the correlates of these behaviors may differ. PURPOSE: To investigate the multidimensional correlates of physical activity and sedentary behavior in a large sample of 11- to 12-year-old boys and girls. METHODS: Cross-sectional survey of 2,578 boys and 1,742 girls from 36 schools stratified by socioeconomic background and gender mix of students (84% response rate). Questionnaire assessments and objective measurements of height and weight were obtained. RESULTS: Days of vigorous physical activity and hours of sedentary behaviors over the past week were uncorrelated. Ethnicity, socioeconomic factors, developmental stage, environmental factors, and psychological variables were associated with physical activity and sedentary behavior in univariate analyses. In multiple regression, sedentary behavior was greater in ethnic minority groups, in students from more deprived backgrounds, and in those with conduct problems. Girls who were more advanced developmentally and who reported emotional symptoms also engaged in more sedentary behaviors. Vigorous physical activity was associated with good self-rated health, prosocial psychological characteristics, and (in boys) with low emotional symptoms. CONCLUSIONS: A multidimensional approach to understanding the context of physical activity in early adolescence is needed because factors in several domains are relevant. The correlates of physical activity and sedentary behaviors are distinct in this age group, and there are also important gender differences.

Child↗

PubMed2004

A perspective from countries using organized screening programs.

Cancer screening may be offered to a population opportunistically, as part of an organized program, or as some combination of the preceding two options. Organized screening is distinguished from opportunistic screening primarily on the basis of how invitations to screening are extended. In organized screening, invitations are issued from centralized population registers. In opportunistic screening, however, due to the lack of central registers, invitations to screening depend on the individual's decision or on encounters with health care providers. The current article outlines key differences between organized and opportunistic screening. In the current study, literature searches were performed using PubMed and MEDLINE. Additional data were assembled from interviews with health officials in the five countries investigated and from the authors' personal files. Opportunistic screening was found to be distinguishable from organized screening on the basis of whether screening invitations were issued from centralized population registers. Organized screening programs also assumed centralized responsibility for other key elements of screening, such as eligibility requirements, quality assurance, follow-up, and evaluation. Organized programs focused on reducing mortality and morbidity at the level of the population rather than at the level of the individual. Thus, programs did not necessarily offer the most sensitive screening test for a particular cancer, and tests sometimes were offered at suboptimal intervals with respect to individual-level protection. Nonetheless, organized systems paid greater attention to the quality of screening, as measured by factors such as cancer detection rates, tumor characteristics, and false-positive biopsy rates. As a result, participants in organized screening programs received greater protection from the harmful effects associated with screening. In addition, organized programs worked more systematically toward providing value for money in an inevitably resource-limited environment. Although organized and opportunistic models of screening can yield similar uptake rates, organized programs exhibited greater potential ability to reduce cancer incidence and mortality, because of the higher levels of population coverage and centralized commitment to quality and monitoring; were more likely to be cost-effective; and offered greater protection against the harmful effects associated with poor quality or overly frequent screening.

Cost-Benefit Analysis↗

PubMed2004

Sociocultural influences on attitudes to weight and eating: results of a natural experiment.

OBJECTIVE: Exposure to teenage culture is widely believed to contribute to concerns about weight in children and adolescents. The current study tested the hypothesis that greater exposure to older girls at school would be associated with thinner size ideals, increased concern about weight, and more dieting. METHOD: Participants (n = 200) were 9 and 11-year-old girls. The age of the oldest pupils in the school defined the exposure variable. Nine-year-olds in junior schools (oldest pupils = 11) and 11-year-olds in middle schools (oldest pupils = 13) were defined as nonexposed. Nine-year-olds in middle schools (oldest pupils = 13) and 11-year-olds in secondary schools (oldest pupils = 18) were defined as exposed. Girls were weighed and measured and completed measures of ideal size, perceived weight, body esteem, eating attitudes, dieting, and self-esteem. RESULTS: Being at a school with older pupils was associated with having a thinner ideal, feeling more overweight, having more friends who had dieted, scoring higher on the Child Eating Attitudes Test, and having lower self-esteem. Effects were strongest among the 9-year-olds. DISCUSSION: Exposure to older girls in school may accelerate the development of negative attitudes to weight and eating.

Affect↗

PubMed2004

Socioeconomic differences in cancer screening participation: comparing cognitive and psychosocial explanations.

This paper compares psychosocial and cognitive models of socioeconomic variation in participation in screening for colorectal cancer. The psychosocial model suggests that factors such as higher stress and lower social support explain, in part, why people from lower socioeconomic status (SES) environments are less likely to participate in screening. The cognitive model suggests that beliefs about cancer risk and screening will play an important part in differential participation. In practice both sets of factors may contribute to explaining socioeconomic differentials. The data for these analyses are drawn from a randomised controlled trial of colorectal cancer screening (the UK Flexible Sigmoidoscopy Trial). The participants are from the Scottish centre, where recruitment was stratified to generate a socioeconomically diverse sample. The dependent variable was interest in attending screening. A questionnaire covering demographic status, psychosocial and cognitive factors as well as interest in screening was sent to 10,650 adults. The results showed the predicted SES gradient in interest. There were also SES differences in both psychosocial and cognitive variables. A series of logistic regression models were used to test potential mediators of the association between SES and interest in attending screening by successively including psychosocial factors, cognitive factors, and then both, in the equation. Only the inclusion of the cognitive variables significantly reduced the variation associated with SES, providing better support for the cognitive than the psychosocial model.

Colorectal Neoplasms↗

PubMed2004

Beliefs about the risk factors for cervical cancer in a British population sample.

BACKGROUND: The introduction of human papillomavirus (HPV) testing into cervical screening has the potential to alter public perceptions of cervical cancer by making explicit the role of a sexually transmitted virus in its etiology. HPV knowledge has been found to be poor, although there is evidence of public awareness of a link between sexual activity and cervical cancer risk. We explored beliefs about the risk factors for cervical cancer in a large population sample. METHODS: Face-to-face interviews were carried out with a representative sample of the British population. All participants were asked what they thought increased a women's chances of developing cervical cancer. RESULTS: The response rate was 71% (n = 1940). The most common single response was 'don't know' (38%). Forty-one percent of respondents mentioned factors relating to sex, but only 14% were aware of a link with sexual transmission and fewer than 1% named HPV. Women and more educated people had better knowledge of the established risk factors. The patterning of risk factor awareness by age varied across risk factors. CONCLUSIONS: Awareness of the role of a sexually transmitted virus in the etiology of cervical cancer is very low in Britain. Provision of information associated with the introduction of HPV testing could change public perceptions of cervical cancer.

Adolescent↗

PubMed2004

Leisure-time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development.

BACKGROUND: Physical inactivity has been linked with chronic disease and obesity in most western populations. However, prevalence of inactivity, health beliefs, and knowledge of the risks of inactivity have rarely been assessed across a wide range of developed and developing countries. METHODS: A cross-sectional survey was carried out with 19,298 university students from 23 countries varying in culture and level of economic development. Data concerning leisure-time physical activity, health beliefs, and health knowledge were collected. RESULTS: The prevalence of inactivity in leisure time varied with cultural and economic developmental factors, averaging 23% (North-Western Europe and the United States), 30% (Central and Eastern Europe), 39% (Mediterranean), 42% (Pacific Asian), and 44% (developing countries). The likelihood of leisure-time physical activity was positively associated with the strength of beliefs in the health benefits of activity and with national economic development (per capita gross domestic product). Knowledge about activity and health was disappointing, with only 40-60% being aware that physical activity was relevant to risk of heart disease. CONCLUSIONS: Leisure-time physical activity is below recommended levels in a substantial proportion of students, and is related to cultural factors and stage of national economic development. The relationship between health beliefs and behavior is robust across cultures, but health knowledge remains deficient.

Adult↗