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Biomedical subjects

Jane Wardle

Publications and source records attributed to Jane Wardle.

69 records · Page 4Linked to original sources
PubMed2003

Psychological impact of colorectal cancer screening.

This article examines the psychological impact of participating in sigmoidoscopy screening for colorectal cancer prevention. The 1st study examined psychological well-being at 3 months, in relation to screening outcome, in 4,153 individuals. The 2nd study used longitudinal data to examine changes in psychological functioning from before to after screening in relation both to screening outcome and baseline indicators of vulnerability. There were few psychological differences between those who had received negative results or had polyps detected. These findings were confirmed in the longitudinal study, which also found no evidence for vulnerability to adverse effects among those who were initially most anxious or who perceived their risk of cancer to be higher. The longitudinal data suggested that screening might produce transient positive effects.

Anxiety↗
PubMed2003

Increasing attendance at colorectal cancer screening: testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults.

This article describes a trial of a psychoeducational intervention designed to modify negative attitudes toward flexible sigmoidoscopy screening and thereby increase screening attendance. The intervention materials addressed the multiple barriers shown to be associated with participation in earlier studies. Adults ages 55-64 (N = 2,966), in a "harder-to-reach" group were randomized either to receive an intervention brochure or to a standard invitation group. Attitudes and expectations were assessed by questionnaire, and attendance at the clinic was recorded. Compared with controls, the intervention group had less negative attitudes, anticipated a more positive experience, and had a 3.6% higher level of attendance. These results indicate that psychoeducational interventions can provide an effective means of modifying attitudes and increasing rates of screening attendance.

Attitude to Health↗
PubMed2003

Stress and dietary practices in adolescents.

Baseline data from the Health and Behavior in Teenagers Study (HABITS) were used to investigate associations between stress and dietary practices in a socioeconomically and ethnically diverse sample of 4,320 schoolchildren (mean age = 11.83 years). Male (n = 2,578) and female (n = 1,742) pupils completed questionnaire measures of stress and 4 aspects of dietary practice (fatty food intake, fruit and vegetable intake, snacking, and breakfast consumption) and also provided demographic and anthropometric data. Multivariate analyses revealed that greater stress was associated with more fatty food intake, less fruit and vegetable intake, more snacking, and a reduced likelihood of daily breakfast consumption. These effects were independent of individual (gender, weight) and social (socioeconomic status, ethnicity) factors. Stress may contribute to long-term disease risk by steering the diet in a more unhealthy direction.

Adolescent↗
PubMed2002

Trends in smoking, diet, physical exercise, and attitudes toward health in European university students from 13 countries, 1990-2000.

BACKGROUND: Smoking, diet, and physical exercise are key determinants of health. This study assessed changes over 10 years and their relationship to changes in health beliefs and risk awareness. METHOD: A survey was carried out of university students from 13 European countries (Belgium, England, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, The Netherlands, Poland, Portugal, and Spain) in 1990 (4,701 men, 5,729 women) and repeated in 2000 (4,604 men, 5,732 women). We assessed smoking, exercise, fruit and fat intake, beliefs in the importance of behaviors for health, and awareness of the influence of behaviors on heart disease risk. RESULTS: Smoking prevalence increased and fruit consumption decreased between 1990 and 2000, while physical exercise and fat intake were more stable. There were large variations between country samples. Health beliefs weakened, with marked decreases in beliefs about smoking and diet. Across country samples, changes in beliefs correlated with changes in the prevalence of behaviors. Awareness of the effects of smoking and exercise was stable, but knowledge of the role of fat intake increased over the decade. CONCLUSIONS: The differences in health behaviors, beliefs, and risk awareness between the two surveys were disappointing in this educated sector of young adult Europeans. The association between changes in beliefs and prevalence of behavior emphasizes the importance of enhancing positive attitudes to healthier lifestyles.

Adult↗
PubMed2002

Seatbelt use, attitudes, and changes in legislation: an international study.

BACKGROUND: The use of seat belts is among the most effective methods of reducing injury in motor vehicle crashes. We examined trends in seat belt use by university students from 13 European countries between 1990 and 2000, in relation to changes in legislation, attitudes, and hazardous driver behaviors. METHODS: Data were collected via an anonymous standardized questionnaire from university students in Belgium, England, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, the Netherlands, Poland, Portugal, and Spain. There were 10,576 respondents in 1990, and 10,294 in 2000. Data were also collected from 1672 students in the United States in 2000. Analyses were performed in early 2002. RESULTS: Reported seat belt use increased from 63% to 73% in male students, and from 66% to 77% in female students over the decade. There were marked increases in seat belt use in countries with changes in legislation or enforcement from 1990 to 2000, with 24% to 64% more respondents reporting seat belt use in 2000. The prevalence of use and noted changes during this period correlated with findings from national surveys (r= 0.91). Attitudes to seat belt use were associated with behavior both within and between countries. Nonuse of seat belts was positively related to alcohol-impaired driving and failure to obey speed limits. CONCLUSIONS: Legislation has a substantial impact on the use of vehicle seat belts, but additional gains require efforts to change attitudes within the university student population.

Accidents, Traffic↗
PubMed2002

Parental feeding style and the inter-generational transmission of obesity risk.

OBJECTIVE: This study was designed to determine whether a community sample of obese mothers with young children used different feeding styles compared with a matched sample of normal-weight mothers. Four aspects of feeding style were assessed: emotional feeding, instrumental feeding (using food as a reward), prompting/encouragement to eat, and control over eating. RESEARCH METHODS AND PROCEDURES: Participants were from 214 families with same-sex twins; 100 families in which both parents were overweight or obese and 114 in which both parents were normal weight or lean. RESULTS: We found that obese mothers were no more likely than normal-weight mothers to offer food to deal with emotional distress, use food as a form of reward, or encourage the child to eat more than was wanted. The obese and normal-weight mothers did differ on "control"; obese mothers reported significantly less control over their children's intake, and this was seen for both first-born and second-born twins. Twin analyses showed that these differences were not in response to children's genetic propensities, because monozygotic correlations were no greater than dizygotic correlations for maternal feeding style. DISCUSSION: These results suggest that the stereotype of the obese mother, who uses food in nonnutritive ways so that her child also becomes obese, is more likely to be myth than fact. However, the results raise the possibility that lack of control of food intake might contribute to the emergence of differences in weight.

Adult↗
PubMed2002

An international comparison of tobacco smoking, beliefs and risk awareness in university students from 23 countries.

AIMS: To assess the prevalence of current tobacco smoking, associations with beliefs about the health benefits of not smoking and awareness of risks for lung cancer and heart disease in university students sampled from 23 countries, and to explore the utility of the World Health Organization (WHO) model of the world-wide tobacco epidemic in understanding differences between countries. DESIGN: Anonymous questionnaire survey. PARTICIPANTS: A total of 19 298 university students (8482 men, 10 816 women) aged 17-30 years from 23 countries, studying courses unrelated to health. MEASUREMENTS: Standardized measures of smoking, wish to stop smoking, ratings of beliefs in the importance of not smoking for health and awareness of the influence of smoking on lung cancer and heart disease. FINDINGS: Prevalence varied widely, being highest in samples from South European countries and lowest in developing countries (Thailand, South Africa). The pattern of tobacco use and differences between men and women conformed largely to the WHO model. Health beliefs were associated strongly with smoking behaviour both within and between countries. Awareness of specific health risks of smoking was very variable, with particularly low levels in Asian, South American and developing country samples. Risk awareness was inconsistently related to behaviour. CONCLUSIONS: The pattern of tobacco smoking in well-educated young adults appears to conform with wider international patterns of tobacco use. Awareness of specific health risks is poor, and modifying attitudes must be a central element in modifying tobacco use world-wide.

Adolescent↗
PubMed2002

Sex differences in the association of socioeconomic status with obesity.

OBJECTIVES: This study investigated socioeconomic predictors of obesity in men and women. METHODS: Data from the 1996 Health Survey for England were used to compare odds ratios for obesity by education, occupation, and 2 economic markers after control for age, marital status, and ethnicity. RESULTS: Obesity risk was greater among men and women with fewer years of education and poorer economic circumstances and among women, but not men, of lower occupational status. CONCLUSIONS: Higher educational attainment and higher socioeconomic status were associated with a lower risk of obesity in both men and women, whereas higher occupational status was associated with a lower risk only for women. The implications of these findings for understanding causes and prevention of obesity are discussed.

Adolescent↗
PubMed2002

Increasing fruit and vegetable intake among adults attending colorectal cancer screening: the efficacy of a brief tailored intervention.

Fruits and vegetables appear to confer protection against several cancers, but most adults in the United Kingdom eat substantially less than the recommended amounts. Cancer screening services could provide a valuable context in which to provide advice on increasing fruit and vegetable intake. This study examined the efficacy of a brief, tailored, psycho-educational intervention for increasing fruit and vegetable intake, carried out in a cancer screening clinic. The study was a randomized, controlled trial. 742 participants, 55-64 years of age, recruited from three cancer screening clinics, completed a baseline questionnaire. They were assigned either to the tailored intervention group or to an untreated control group. The primary outcome measure was self-reported consumption of fruit and vegetables. At 6 week follow-up there were significant increases in daily servings of fruit and vegetables in the tailored intervention group (CI, 0.87-1.25) compared with the untreated group (CI, 0.08-0.43). These results support the efficacy of a simple, written message, which is tailored to the intake and knowledge levels of the individual, for modifying cancer-protective dietary behaviors, at least in the short term. They also suggest that cancer screening clinics may be a good context for providing this service.

Adult↗
PubMedDate not supplied

Age of onset and body dissatisfaction in obesity.

This study investigated variation in body dissatisfaction among obese women in relation to age of onset of obesity, and evaluated the contribution of teasing about weight and self-esteem as possible causes of higher body dissatisfaction in the early-onset group. One hundred and five obese women (body mass index [BMI] > or =30), recruited from clinical settings in England, completed a mailed questionnaire. The early-onset group (by age 16) had a higher BMI, greater body dissatisfaction, and lower self-esteem. Predictably, they also reported more childhood teasing. Path analyses confirmed our expectation that early onset of obesity has an adverse effect on body image, which is independent of current BMI. Regression analyses failed to support the hypothesized mediating role of either childhood teasing or lower self-esteem. The possible direction of causal effects between body dissatisfaction and self-esteem is discussed, with the suggestion that early onset of obesity increases the risk of body dissatisfaction, which in turn impairs self-esteem.

Adult↗
PubMedDate not supplied

Socioeconomic status differences in coping with a stressful medical procedure.

OBJECTIVE: The objective of this study was to test the hypothesis that socioeconomic disadvantage results in adverse emotional reactions to a novel, stressful, medical examination. METHODS: Sigmoidoscopy screening for colorectal cancer was identified as a potential stressor. A subset of participants (N = 3535) from the U.K. Flexible Sigmoidoscopy Trial completed pre- and postscreening questionnaires regarding psychologic well-being. All trial participants were sent a postscreening questionnaire after 3 months (post-flexible sigmoidoscopy [FS] sample, N = 29,804), including measures of distress (the General Health Questionnaire), anxiety (State-Trait Anxiety Inventory), a single-item measure of bowel cancer worry, and a 6-item measure of positive consequences of screening. Socioeconomic status (SES) was coded from postcodes with the Townsend Index. SES differences in changes in emotional well-being over the course of screening were evaluated in the longitudinal sample. SES differences in postscreening well-being in relation to screening outcome were evaluated in the post-FS sample. RESULTS: Bowel cancer worry and anxiety were higher in lower SES groups before screening. Both reduced after screening, but there were no SES differences in the change. In the post-FS sample, there was an SES gradient in anxiety but not in distress. Lower SES groups indicated more positive reactions. There were no interactions between SES and screening outcome for any indicator of well-being. CONCLUSIONS: Lower SES was associated with worse psychologic well-being before and after screening, but lower SES participants did not show any differentially greater adverse reactions compared with higher SES participants. Moderately stressful experiences in everyday life do not necessarily more unfavorably affect those with fewer educational and economic resources.

Adaptation, Psychological↗
PubMedDate not supplied

International study of heavy drinking: attitudes and sociodemographic factors in university students.

The authors studied the prevalence of heavy drinking among students in 21 developed and developing countries using an anonymous survey of 7,846 male and 9,892 female students aged 17 to 30 years. There were wide variations in the prevalence of drinking among countries, and the highest rates of heavy drinking (defined as 5 or more drinks for men and 4 or more drinks for women on at least 1 occasion over the past 2 weeks) were reported in Belgium, Colombia, Ireland, and Poland (men), and Ireland and England (women). Heavy drinking was associated with living away from home, having a wealthier family background, and having well-educated parents. Beliefs about the dangers to health of excessive consumption were negatively related to heavy drinking. Heavy drinking is a concern among students in several countries and is associated with greater affluence. Challenging beliefs concerning health risks is a crucial aspect of prevention in this population.

Adolescent↗