Supportive Environment Seen as a Reason Some Young Hemophiliacs Engage in Risky Sports

Positive mental attitudes and encouragement from family and friends are key reasons young hemophiliacs participate in sports that could increase their risk of bleeding, a study says.

The research showed that psychosocial factors play a larger role in their taking part in discouraged physical activity than in their accepting other health-related recommendations.

The study, “Understanding adherence to treatment and physical activity in children with hemophilia: The role of psychosocial factors,” was published in the journal Pediatric Hematology and Oncology.

Researchers at the Université de Montréal in Canada noted that few studies of hemophiliacs’ acceptance of treatment and physical-activity recommendations are based on theoretical models of behavior. The research team argued that this has led to fewer options for changing hemophiliacs’ behavior in beneficial ways.

The theory of planned behavior is often used to understand the motivation behind a behavior. Its core premise is that the “intention to adopt a behavior is a central predictor of future behavior.”

The theory says three factors shape intention.

The first is attitudes, which are based on a person’s cost/benefit analysis of a behavior.

The second is the subjective norm that people have applied to their social environment. It is a combination of what they believe others think about their behavior, and their motivation to accept these opinions.

The third factor is perceived behavioral control. It involves people’s confidence about the skills and knowledge they have to engage in a behavior.

The research team recruited 24 patients, aged 6–18, with severe hemophilia A or B. All were on preventive treatment and able to get on-demand treatment when necessary. The mean age of the recruits was 11.8 years.

The study found that the group was inclined to accept recommendations for recommended physical activity, preventive treatment, and on-demand treatment. It was much less inclined to accept recommendations to avoid certain sports.

In terms of the attitudes factor in the theory of planned behavior, the group was less inclined to avoid risky sports than to follow other recommendations because it apparently saw the benefits of engaging in the sports as outweighing the costs.

Also in terms of the theory, the group’s level of perceived behavioral control with risky sports was lower than it was with the other recommendations.

In addition, a person’s propensity to avoid risky sports was linked to how much of that activity he or she had done in the past. This indicated that earlier behaviors influenced later thinking.

Parents’ and friends’ belief that taking part in non-recommended sports was worth the risk increased the chance that a hemophiliac would participate.

Conversely, if parents and friends believed that avoiding non-recommended sports was a good way to prevent bleeding episodes, the youngsters were more inclined to avoid the sports.