Champion's HBMS was originally developed to predict participation in mammography or breast cancer screenings. There were a total of 41 items in the HBMS across six different subscales.
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The total score ranges for each subscale vary because they depend on the number of statements within each subscale. Scores are interpreted as falling within either the positive, neutral, or negative range. Table 1 shows the number of statements within each subscale. Responses were totaled for each subscale for analyses. Questionnaires regarding the TPB are constructed using the procedures outlined by Ajzen.
The breakdown of numbers of statements within each subscale is in Table 1. The total score ranges for each subscale vary depending on the number of statements within each subscale. To ensure that all aspects related to attitudes, perceived behavioral control, perceived subjective norms, and intention to participate in an ERIPP were assessed, nine open-ended salient beliefs questions were added to the initial scale Table 2.
Individuals were given space to type in their response to each salient belief question. The responses were then coded by three researchers who were athletic trainers with previous experience performing qualitative analysis. One of the coders was involved in the initial scale development but the other two were not. Initially, 10 randomly selected responses were assigned to each coder and the coders created a code book independently. Then the coders met to confirm the code book and the remaining responses were randomly assigned to the coders. Frequency counts of each code book response were calculated.
In some cases, the statement was the same as an existing scale item and a new item was not added. The DPA is a generic patient-reported outcome measure assessing quality of life in respect to physical activity. Participants respond to each statement with a descriptor ranging from no problem 0 to severe 4. The responses for each component are added to create a physical summary component score and mental summary component score. The scores for the physical summary component range from 0 to Higher scores are associated with increased functional impairments associated with participation in physical activity.
The scores for the mental summary component range from 0 to 16, with higher scores being associated with increased mental impairments associated with participating in a physical activity. The mDPA has excellent internal consistencies within the two subscales, ranging from 0.
The HADS is used to measure anxiety and depression related to health. The two components of this scale are anxiety and depression. The participant responds according to a scale provided, which ranges from 0 to 3. The total score for each subscale is derived from adding the responses for each statement within the subscale.
A score ranging from 0 to 7 is defined as normal, 8 to 10 is borderline abnormal, and 11 to 21 is abnormal. The psychometric properties of the HADS have been established previously. The ESES was used to measure an individual's beliefs about his or her ability to participate in physical activity. Participants rate their confidence in participating in physical activity by responding to statements on a scale ranging from not true at all 1 to exactly true 4.
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Responses for each item are added to create a total score for the scale. Total scores range from 10 to Higher scores are associated with having a greater confidence in participating in physical activity, whereas lower scores are associated with decreased confidence in participating in physical activity. The internal consistencies were excellent and ranged from 0. If the internal consistency Cronbach's alpha improved by more than 0. Spearman correlations were used for all correlation analyses. Alpha was set at a P value of. The means and standard deviations for total scores of all subscales are listed in Table 3.
The original and final internal consistencies of each subscale can be found in Table 1. All other internal consistencies of the items within the subscales did not improve when an item was removed; therefore all other statements were retained.
The final internal consistencies ranged from 0. Two items were identified during the coding process due to the high frequency of responses from the salient beliefs questions to be added to the future TPBS. All other subscales were correlated with at least one other subscale. Additionally, participants identified two areas within the salient beliefs questions including a perceived benefit of improving knowledge and a perceived barrier of the location of the ERIPP that were added to the final instrument.
The internal consistency of the subscales these statements were added to be investigated further. It is possible that expanding the number of participants and the breadth of response range via broader samples of active individuals within the study will improve the internal consistencies. The internal consistency of the subscales is important because the measure ensures that the statements of the subscale are assessing the construct they are associated with.
Additionally, these results may indicate that the population in this study requires further education regarding this aspect. This indicates that there is some explained variance across subscales; however, the strength of these correlations does not suggest there is excessive redundancy. Therefore, an individual with a history of a lower extremity injury who is still experiencing some physical limitations may have different behavioral determinants of ERIPP participation than an individual without any physical limitations. There is a possibility that intervention strategies may need to be tailored to individuals with different levels of physical limitations.
It is possible that participating in exercise and being confident in that ability influences the different cues that remind an individual to participate in an ERIPP. Participating in physical activity on a regular basis may in itself be a cue to remind an individual that preventing injuries and participating in an ERIPP are important. Individuals who are confident in their ability to participate in physical activity may have better attitudes regarding participation in ERIPPs when compared to those who are not confident in participating in physical activity.
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Although there was a correlation between confidence in participating in physical activity and two of the subscales, there was no correlation with intention to participate. Additionally, these results indicate that depression, anxiety, and exercise related to self-efficacy may not influence an individual's intention to participate in an ERIPP. Previous literature has investigated the behavioral determinants of ERIPP participation within physically active individuals.
Using theory to inform the development of the scales used to assess behavioral determinants of ERIPP participation may give clinicians a more robust depiction of how to maximize compliance by understanding their perceptions of this health behavior, especially if future interventions are also based on these theories. A previous study investigated the use of a homogenous educational interventions to improve both attitudes toward ERIPP participation and compliance with the programs.
It is possible that using the HBMS and TPBS developed in this study to first assess the behavioral determinants of ERIPP participation and then inform the development of educational interventions could lead to improved adoption and compliance. The subscales that were correlated the most to intention to participate could be targeted using an intervention.
To increase compliance, the scales must be used to inform implementation strategies. For example, Martinez et al. Clinicians could use this information to develop an educational intervention including the benefits of the ERIPP and specifically highlight the potential to reduce the risk for lower extremity musculoskeletal injuries.
The educational information could be delivered to the users prior to participating in the ERIPP to facilitate adoption of and compliance with the program. Several informational reminders could be distributed periodically over time to gain continued compliance. The implementation strategies that can be used to leverage ERIPP adoption and compliance will likely differ for various groups of users based on their perceptions and attitudes toward ERIPPs. Therefore, creating scales to assess the behavioral determinants of ERIPP participation is vitally important to developing an implementation strategy.
As a result of the preliminary nature of this research, there were several limitations associated with this study that will be addressed through further development of the HBMS and TPBS prior to integration into clinical practice.
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First, the number of participants included in this study was limited, which allowed us to perform preliminary scale development but did not allow for the evaluation of factor structure. Further research should evaluate the use of the scales within a larger population and the scales should be subjected to more advanced statistical procedures to confirm factor structure and identify clinically meaningful cut-scores. The number of participants within each physical activity group in this study did not permit a comparison across subgroups of physically active adults.
Future studies should compare behavioral determinants of ERIPP participation across different levels of physical activity participation. If behavioral determinants of ERIPP participation differ among groups, there is a possibility that interventions may need to be tailored for individuals within different physical activity groups. Therefore, several aspects of the psychometric properties and the use of these instruments require additional investigation. The preliminary information gained from these scales may provide more insight into adoption and compliance challenges for implementing ERIPPs in clinical settings.
Additionally, the information gained from the scales may be used to inform interventions to improve compliance of ERIPPs. These scales may aid clinicians in gaining a better picture of the attitudes and perceptions of the intended user of an ERIPP and developing effective interventions based on the information gained. List the individuals or groups who would approve or think you should participate in an injury prevention program. List the individuals who would disapprove or think you should not participate in an injury prevention program. The typical examples of immediate causes and contributing factors for human failures are given below:.
It is concluded that the performance of human is being strongly influenced by organizational, regulatory, cultural and environmental factors affecting the workplace.
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For example, organizational processes constitute the breeding grounds for many predictable human errors, including inadequate communication facilities, ambiguous procedures, unsatisfactory scheduling, insufficient resources, and unrealistic budgeting in fact, all processes that the organization can control. Following figure summarizes some of the factors contributing to human errors and to accidents.
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