Predicting intention to participate in self-management behaviors in patients with Familial Hypercholesterolemia: A cross-national study

Hagger MS 1 , Hamilton K 2 , Hardcastle SJ 3 , Hu M 4 , Kwok S 5 , Lin J 6 Show all authors , Nawawi HM 7 , Pang J 8 , Santos RD 9 , Soran H 10 , Su TC 11 , Tomlinson B 4 , Watts GF 12

Affiliations 

  • 1 Psychological Sciences, University of California, Merced, USA; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; School of Applied Psychology, Griffith University, Brisbane, Australia. Electronic address: mhagger@ucmerced.edu
  • 2 School of Applied Psychology, Griffith University, Brisbane, Australia
  • 3 School of Health and Human Performance, Dublin City University, Ireland; Institute for Health Research, University of Notre Dame, Fremantle, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
  • 4 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong,Special Administrative Region
  • 5 Cardiovascular Trials Unit, Manchester University NHS Foundation Trust, Manchester, UK; Lipoprotein Research Group, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
  • 6 Department of Atherosclerosis, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  • 7 Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM) and Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
  • 8 School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
  • 9 Lipid Clinic Heart Institute (InCor), University of São Paulo Medical School Hospital, and Preventive Medicine Centre and Cardiology Program Hospital Israelita Albert Einstein, São Paulo, Brazil
  • 10 Cardiovascular Trials Unit, Manchester University NHS Foundation Trust, Manchester, UK
  • 11 Department of Internal Medicine and Cardiovascular Centre and College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 12 School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia; Lipid Disorders Clinic, Cardiometabolic Service, Department of Cardiology, Royal Perth Hospital, Perth, Australia
Soc Sci Med, 2019 12;242:112591.
PMID: 31630009 DOI: 10.1016/j.socscimed.2019.112591

Abstract

RATIONALE: Familial Hypercholesterolemia (FH) is a genetic condition that predisposes patients to substantially increased risk of early-onset atherosclerotic cardiovascular disease. FH risks can be minimized through regular participation in three self-management. BEHAVIORS: physical activity, healthy eating, and taking cholesterol lowering medication.

OBJECTIVE: The present study tested the effectiveness of an integrated social cognition model in predicting intention to participate in the self-management behaviors in FH patients from seven countries.

METHOD: Consecutive patients in FH clinics from Australia, Hong Kong, Brazil, Malaysia, Taiwan, China, and UK (total N = 726) completed measures of social cognitive beliefs about illness from the common sense model of self-regulation, beliefs about behaviors from the theory of planned behavior, and past behavior for the three self-management behaviors.

RESULTS: Structural equation models indicated that beliefs about behaviors from the theory of planned behavior, namely, attitudes, subjective norms, and perceived behavioral control, were consistent predictors of intention across samples and behaviors. By comparison, effects of beliefs about illness from the common sense model were smaller and trivial in size. Beliefs partially mediated past behavior effects on intention, although indirect effects of past behavior on intention were larger for physical activity relative to taking medication and healthy eating. Model constructs did not fully account for past behavior effects on intentions. Variability in the strength of the beliefs about behaviors was observed across samples and behaviors.

CONCLUSION: Current findings outline the importance of beliefs about behaviors as predictors of FH self-management behaviors. Variability in the relative contribution of the beliefs across samples and behaviors highlights the imperative of identifying sample- and behavior-specific correlates of FH self-management behaviors.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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