2017-06-28, Radtke, Theda, Ostergaard, Mathias, Cooke, Richard, Scholz, Urte

Background:
Web-based alcohol interventions are a promising way to reduce alcohol consumption because of their anonymity and the possibility of reaching a high numbers of individuals including heavy drinkers. However, Web-based interventions are often characterized by high rates of attrition. To date, very few studies have investigated whether individuals with higher alcohol consumption show higher attrition rates in Web-based alcohol interventions as compared with individuals with lower alcohol consumption.

Objectives:
The aim of this study was to examine the attrition rate and predictors of attrition in a Web-based intervention study on alcohol consumption.

Methods:
The analysis of the predictors of attrition rate was performed on data collected in a Web-based randomized control trial. Data collection took place at the University of Konstanz, Germany. A total of 898 people, which consisted of 46.8% males (420/898) and 53.2% females (478/898) with a mean age of 23.57 years (SD 5.19), initially volunteered to participate in a Web-based intervention study to reduce alcohol consumption. Out of the sample, 86.9% (781/898) were students. Participants were classified as non-completers (439/898, 48.9%) if they did not complete the Web-based intervention. Potential predictors of attrition were self-reported: alcohol consumption in the last seven days, per week, from Monday to Thursday, on weekends, excessive drinking behavior measured with the Alcohol Use Disorder Identification Test (AUDIT), and drinking motives measured by the Drinking Motive Questionnaire (DMQ-R SF).

Results:
Significant differences between completers and non-completers emerged regarding alcohol consumption in the last seven days (B=−.02, P=.05, 95% CI [0.97-1.00]), on weekends (B=−.05, P=.003, 95% CI [0.92-0.98]), the AUDIT (B=−.06, P=.007, 95% CI [0.90-0.98], and the status as a student (B=.72, P=.001, 95% CI [1.35-3.11]). Most importantly, non-completers had a significantly higher alcohol consumption compared with completers.

Conclusions:
Hazardous alcohol consumption appears to be a key factor of the dropout rate in a Web-based alcohol intervention study. Thus, it is important to develop strategies to keep participants who are at high risk in Web-based interventions.

2014, Radtke, Theda, Inauen, Jennifer, Rennie, Laura, Orbell, Sheina, Scholz, Urte

Compensatory health beliefs (CHBs)–beliefs that an unhealthy behavior can be compensated for by a healthy behavior–can be distinguished into trait and state beliefs. Trait CHBs are stable individual differences, whereas state CHBs are activated in a tempting situation–for example, when faced with an attractive snack. The aim of this study was to test whether diet-specific trait or state CHBs are predictive for an unhealthy behavior–namely, high-calorie snack consumption. A scenario was created in which 66 women aged 16 to 50 were faced with a high-calorie snack. Diet-specific trait and state CHBs correlated moderately with each other. Regression analyses revealed that diet-specific trait CHBs with exercise as the compensatory behavior were significantly predictive for high-calorie snack consumption, over and above control variables such as age, whereas state CHBs were only marginally significant. Diet-specific trait and state CHBs with reduced intake (eat less later) as the compensatory behavior were not related to high-calorie snack consumption. Results showed that trait CHBs are relevant for the prediction of high-calorie snack consumption. Future studies might want to further refine the measurement of CHBs, especially state CHBs.

2012, Radtke, Theda, Scholz, Urte

2014-05, Radtke, Theda, Kaklamanou, Daphne, Scholz, Urte, Hornung, Rainer, Armitage, Christopher J.

Compensatory Health Beliefs (CHBs) – beliefs that an unhealthy behaviour can be compensated for by healthy behaviour – are hypothesised to be activated automatically to help people resolve conflicts between their desires (e.g. eat chocolate) and their long-term goals (e.g. dieting). The aim of the present research was to investigate diet-specific CHBs within the context of a theoretical framework, the Health Action Process Approach (HAPA), to examine the extent to which diet-specific CHBs contribute to dieting intentions and dietary intake. Seventy-five dieting women were recruited in Switzerland and England and were asked to complete measures of diet-specific CHBs, risk perception, outcome expectancies, self-efficacy, intention, and behaviour. Path modelling showed that, overall, diet-specific CHBs were not related to dieting intentions (β = .10) or behaviour (β = .06) over and above variables specified in the HAPA. However, risk perception moderated the relationship between diet-specific CHBs and intention (β = .26). Diet-specific CHBs positively predicted intention in women with high risk perception, but not in women with low risk perception. This positive relationship might be explained by the assumption that CHBs play different roles at different stages of the health-behaviour change process. Future studies should further examine moderators and stage-specific differences of the associations between CHBs, intention and health-behaviour change.

2013, Radtke, Theda, Scholz, Urte, Keller, Roger, Perren, Sonja, Hornung, Rainer

This study constitutes the first psychometric examination of the German-language version of the Compensatory Health Belief (CHB) scale to assess the belief that unhealthy behavior can be compensated for by engaging in healthy behavior. Data from four different Swiss samples of 1,571 adolescents/students (age range 15 – 55 years), collected between 2007 and 2009, were used. Confirmatory factor analysis did not support either the hypothesized 4-factor structure or a second-order factor structure with a latent overall variable for the German-language CHB scale. These results support the inconsistent patterns of CHBs found across European cultures. Thus, the development of behavior-specific scales might be of advantage. Further recommendations for an improvement of the measurement of compensatory health beliefs are discussed.

2011-09, Radtke, Theda, Scholz, Urte, Keller, Roger, Knäuper, Bärbel, Hornung, Rainer

Objective: Compensatory health beliefs (CHBs) are defined as beliefs that negative consequences of unhealthy behaviours can be compensated for by engaging in other health behaviours. CHBs have not yet been investigated in detail regarding smoking. Smoking might cause cognitive dissonance in smokers, if they are aware that smoking is unhealthy and simultaneously hold the general goal of staying healthy. Hence, CHBs are proposed as one strategy for smokers to resolve such cognitive dissonance. The aim of the present study was to develop a scale to measure smoking-specific CHBs among adolescents and to test whether CHBs are related to a lower readiness to stop smoking. Design: For the main analyses, cross-sectional data were used. In order to investigate the retest-reliability follow-up data, 4 months later were included in the analysis. Method: A newly developed scale for smoking-specific CHBs in adolescents was tested for its validity and reliability as well as its predictive value for the readiness to stop smoking in a sample of 244 smokers (15–21 years) drawn from different schools. Multilevel modelling was applied.
Results: Evidence was found for the reliability and validity of the smoking-specific CHB scale. Smoking-specific CHBs were significantly negatively related to an individual's readiness to stop smoking, even after controlling for other predictors such as self-efficacy or conscientiousness. Conclusions: CHBs may provide one possible explanation for why adolescents fail to stop smoking.

2014, Berli, Corina, Loretini, Philipp, Radtke, Theda, Hornung, Rainer, Scholz, Urte

Objective: Compensatory health beliefs (CHBs), defined as beliefs that healthy behaviours can compensate for unhealthy behaviours, may be one possible factor hindering people in adopting a healthier lifestyle. This study examined the contribution of CHBs to the prediction of adolescents’ physical activity within the theoretical framework of the Health Action Process Approach (HAPA).

Design: The study followed a prospective survey design with assessments at baseline (T1) and two weeks later (T2).

Method: Questionnaire data on physical activity, HAPA variables and CHBs were obtained twice from 430 adolescents of four different Swiss schools. Multilevel modelling was applied.

Results: CHBs added significantly to the prediction of intentions and change in intentions, in that higher CHBs were associated with lower intentions to be physically active at T2 and a reduction in intentions from T1 to T2. No effect of CHBs emerged for the prediction of self-reported levels of physical activity at T2 and change in physical activity from T1 to T2.

Conclusion: Findings emphasise the relevance of examining CHBs in the context of an established health behaviour change model and suggest that CHBs are of particular importance in the process of intention formation.

2012-10, Radtke, Theda, Scholz, Urte, Keller, Roger, Hornung, Rainer

Compensatory Health Beliefs (CHBs) are defined as beliefs that the negative consequences of unhealthy behaviours can be compensated for by engaging in healthy behaviours. CHBs have not yet been investigated within a framework of a behaviour change model, nor have they been investigated in detail regarding smoking. Thus, the aim of this study was to investigate on a theoretical basis whether smoking-specific CHBs, as a cognitive construct, add especially to the prediction of intention formation but also to changes in smoking behaviour over and above predictors specified by the Health Action Process Approach (HAPA). The sample comprised 385 adolescent smokers (mean age: 17.80). All HAPA-specific variables and a smoking-specific CHB scale were assessed twice, 4 months apart. Data were analysed using structural equation modelling. Smoking-specific CHBs were significantly negatively related to the intention to stop smoking over and above HAPA-specific predictors. Overall, 39% of variance in the intention to quit smoking was explained. For the prediction of smoking, CHBs were not able to explain variance over and above planning and self-efficacy. Thus, smoking-specific CHBs seem mainly important in predicting intentions but not behaviour. Overall, the findings contribute to the understanding of the role of smoking-specific CHBs within a health-behaviour change model.

2011, Radtke, Theda, Keller, Roger, Bütikofer, Andrea, Hornung, Rainer

Aim
The purpose of the study is to present adolescents' perceptions of smokers and non-smokers among 1015 Swiss adolescents.

Method
The analyses are based on data from Tobacco Monitoring Switzerland, which is a survey of tobacco consumption in Switzerland. To measure the perceptions of smokers and non-smokers, respondents were asked to attribute a series of adjectives to each group. It was also recorded when respondents mentioned that "there is no difference between smokers and non-smokers."

Results
Results show that regardless of whether the adolescents smoked or did not smoke – with the exception of more sociable – the image of smokers was more negative than the image of non-smokers. Findings also indicated that regular smokers in particular often stated that there are no differences between both groups.

Conclusions
Overall, the image of smokers is more negative than the image of non-smokers, with the exception of the attribute more sociable. This perception of smokers could be important for prevention measures in new contexts (e. g., school transitions), where smoking could be a means of establishing new social ties.