Which psychological factors change when habitual water treatment practices alter?

Background: Maintaining improvements in health behaviours following an intervention is necessary for optimal long-term health outcomes. Extending contact with participants following an initial intervention has been shown to promote maintenance of behaviour change and thus weight loss. Mobile telephone text messaging may be an ideal delivery modality to provide such extended contact. The Living Well after Breast Cancer feasibility weight loss trial provided the opportunity to evaluate a novel text message-delivered extended contact intervention. Aims and objectives: The primary aim of this thesis was to evaluate the feasibility, acceptability, and efficacy of a text message-delivered extended contact intervention in promoting the maintenance of weight loss and physical activity and dietary behaviour change. Four studies comprised this thesis research. Study One was a systematic review of maintenance outcomes following physical activity and/or dietary behaviour change interventions in breast cancer survivors. Study Two was a text message-delivered pilot study that informed the development of Study Three, the Living Well after Breast Cancer extended contact intervention. Study Four explored the predictors associated with short- and long-term physical activity and dietary behaviour change during the intervention. Methods and Results: Study One: A systematic review of physical activity and/or dietary behaviour change interventions in breast cancer survivors was conducted to determine the frequency with which physical activity and dietary maintenance outcomes are reported, and the participant and intervention characteristics associated with successful maintenance outcomes. A structured search of a range of relevant databases yielded a total of 1,298 publications, of which 63 trials were included. Findings indicated few trials reported on post-intervention outcomes (16%), and of those, less than half reported successful maintenance (40%). Few intervention characteristics were identified due to the heterogeneity of studies. Attention needs to be directed towards reporting post-intervention outcomes to inform extended contact intervention development. Study Two: A pilot study was conducted to determine the acceptability and feasibility of sending text messages to breast cancer survivors. Eight participants (mean age = 49 years) received highly tailored text messages to support physical activity and dietary behaviour change for two weeks. Participants reported high satisfaction, and reported the messages were encouraging and helpful reminders for behaviour change. The intervention was feasible to deliver on a small scale. These pilot findings informed the development of the Living Well after Breast Cancer extended contact intervention. Study Three: The feasibility, acceptability, and efficacy of the Living Well after Breast Cancer extended contact intervention to promote the maintenance of weight loss and physical activity and dietary behaviour change was evaluated. Participants completed an initial six-month telephone-delivered weight loss intervention (baseline to 6-months), and a six-month text message-delivered extended contact intervention (6- to 12-months), which was followed by a six-month period of no-contact (12- to 18-months). Guided by Social Cognitive Theory, text messages targeted a range of constructs and strategies proposed to be important for maintenance of weight loss and behaviour change. Text messages were individually tailored to participant preferences for timing, content, and frequency. Participants at baseline (n = 29) had a mean (SD) age of 55 (8.8) years, BMI of 30.0 (4.2) kg/m2, and were recruited a mean of 16.6 (3.2) months post-diagnosis. From baseline to 18-months, participants showed statistically significantly lower mean (95% CI) weight (-4.2kg [-6.0kg, -2.4kg]; p<0.001) and higher physical activity levels (10.4mins/day [3.6mins/day, 17.2mins/day]; p = 0.003), but no significant differences in energy intake (p = 0.200). Participants elected to receive a mean of eight text messages per fortnight (range 2-11), and reported a high rate of satisfaction. Results suggested a text message-delivered extended contact intervention may support the attenuation of weight regain and promote the maintenance of physical activity. Study Four: This study evaluated the theoretical constructs and participant characteristics associated with short- and long-term physical activity and dietary behaviour change in participants who completed the Living Well after Breast Cancer extended contact intervention. Findings indicated the importance of comprehensively targeting individual, social, and environmental constructs to promote short- and long-term behaviour change. Specifically, self-efficacy was associated with short- and long-term physical activity change, outcome expectancy and perceived environmental opportunity were associated with long-term physical activity change, and social support was associated with short- and long-term dietary change. Participants who were not employed, did not receive endocrine treatment, and were more than 12-months post-treatment were most responsive to the intervention. These findings fill a current gap in the literature identifying underlying behaviour change mechanisms that drive maintenance of behaviour change. Conclusion: This thesis research makes an important contribution to the limited evidence on the development, delivery, and evaluation of interventions to promote maintenance of physical activity and dietary behaviour change. Randomised trials are needed to evaluate comparative-effectiveness and cost-effectiveness of extended contact intervention delivery modalities to promote long-term weight loss and behaviour change.

To examine the effectiveness of Buddhist ideology in promoting long-term behavioural changes in school children through yoga and meditation. This study utilized the scientific review process as a Meta synthesis to determine the effectiveness of Buddhism Ideology in facilitating long-term learning behaviour changes through yoga and meditation among school-level children in Nepal, framed within a pragmatic research philosophy. Extensive archival analysis followed by a thorough review would be the strategies employed during the scientific review. Based on the nature of data availability, both qualitative and quantitative research approaches would prove effective. The review was systematically executed through the gathering of research articles alongside reports and data. Bhagavadgita, known as Yoga Sastra, is a seminal text on Yoga. Yoga has been a fundamental element of human efforts directed towards achieving higher spiritual achievements. The importance of meditation practice for students is emphasized, and it also recommends teaching all students meditation and yoga to improve academic performance. Programs centered around yoga for middle school students showed benefits in mental health, executive functioning, and physical, social, and academic aspects for learners. It is a method and asset that can be incorporated into the daily lives of students to improve academic performance and lower stress levels. Keywords: behaviour, changes, meditation, helath, students, school, youga

In uncertain environments in which resources fluctuate continuously, animals must permanently decide whether to stabilise learning and exploit what they currently believe to be their best option, or instead explore potential alternatives and learn fast from new observations. While such a trade-off has been extensively studied in pretrained animals facing non-stationary decision-making tasks, it is yet unknown how they progressively tune it while learning the task structure during pretraining. Here, we compared the ability of different computational models to account for long-term changes in the behaviour of 24 rats while they learned to choose a rewarded lever in a three-armed bandit task across 24 days of pretraining. We found that the day-by-day evolution of rat performance and win-shift tendency revealed a progressive stabilisation of the way they regulated reinforcement learning parameters. We successfully captured these behavioural adaptations using a meta-learning model in which either the learning rate or the inverse temperature was controlled by the average reward rate.

The Rhode Island Community Alcohol Abuse and Injury Prevention Project (CAAIPP), implemented from 1984 through 1989, employed the "community gatekeeper" approach to reduce alcohol-related injuries and deaths. Targeting alcohol servers rather than drinkers, community-wide interventions were designed and implemented to encourage responsible serving behaviors through the adoption of techniques of responsible service. The primary goal of the CAAIPP server intervention evaluation was to assess both short-term and long-term changes in behavior of alcohol beverage servers who were recipients of CAAIPP training. A 5-hour training curriculum on "Responsible Alcohol Service" was offered to all alcohol servers in a randomly selected study community. A prospective study design was used to evaluate long-term changes in the self-reported behavior of 321 trainees using three time-points over 5 years. A cross-sectional survey was conducted 4 years posttraining to compare rates of self-reported server behaviors in the intervention community (n = 106) with two comparison communities (nA = 56, nB = 49). Fifteen months after training, trainees reported significantly higher levels of desired serving behavior than nontrained servers. Though positive effects of server training diminished with time, responsible serving behavior 4 years posttraining remained higher than pretraining levels. The impact appeared greatest for servers with fewer years serving experience, wait-persons, younger servers and servers who worked in establishments without written policies regarding serving practices. The results with regard to modifying server behavior are positive and indicate that server interventions shown to be efficacious should be implemented. Training programs that target specific serving skills in repeat sessions may be most promising for improving server behavior, particularly among both young and new servers working in establishments without written policies regarding serving practices.

This study was designed to assess if there are consistent treatment, stage, severity, effort and demographic effects which predict long-term changes across the multiple behaviors of smoking, diet and sun exposure. A secondary data analysis integrated data from four studies on smoking cessation (N = 3927), three studies on diet (N = 4824) and four studies on sun exposure (N = 6465). Across all three behaviors, behavior change at 24 months was related to treatment, stage of change, problem severity and effort effects measured at baseline. There were no consistent demographic effects. Across multiple behaviors, long-term behavior changes are consistently related to four effects that are dynamic and open to change. Behavior changes were not consistently related to static demographic variables. Future intervention research can target the four effects to determine if breakthroughs can be produced in changing single and multiple behaviors.

Behavior change is associated with important decrease of cognitive and physical capacities among elderly people. Therefore, a proactive detection of long-term behavior changes in early stages of their evolution is a keystone to improve elderly healthcare services. In fact, nowadays’ geriatric methods mainly rely on scales and questionnaires, and are inconvenient to investigate long-term changes on a daily basis. Therefore, our proposed approach for behavior change detection analyzes elderly people behavior over long periods via ambient technologies. In fact, employed technologies are unobtrusive, do not interfere with the natural behavior of elderly people and do not affect their privacy. Furthermore, our long-term behavior analysis is based on the identification of significant behavior change indicators (e.g., mobility, memory, nutrition and social life indicators significantly correlate with cognitive and physical diseases), and the application of efficient statistical techniques that differentiate long-term and short-term changes in analyzed behavior. In addition, our two-year deployment validates our objective technological observations through real correlations with medical observations of nursing-home team.

As the United States debates major health reform issues, reversing the obesity epidemic needs to be at the forefront of the discussion. The serious health and economic implications associated with obesity threaten our workforce and burden our health care system. An estimated $117 billion is spent each year to cover the medical and indirect costs of obesity, including lost productivity. The direct health care costs of childhood obesity alone are estimated at $14 billion annually. If we fail to change the policies and environments that contribute to this epidemic, our next generation can expect even higher rates of obesity, greater health care costs, and a health care system less capable of meeting its needs. In the United States, two-thirds of adults and nearly onethird of our youth are overweight or obese. And while the prevalence of obesity has increased in all segments of our population, rates are significantly higher among AfricanAmericans, Native Americans, and Latinos. Research shows that many lower-income, culturally diverse communities have limited access to safe places to walk, bike, and play and that residents have poorer health outcomes. Physical inactivity is a major contributor to the development of obesity, and there is a great need to promote physical activity and support other healthy choices among the populations who are at greatest risk. Thus, efforts to combat obesity must test and implement economically feasible solutions that address the specific needs of these most vulnerable populations. By sharing results about what’s working to promote healthy changes in these populations, we can more rapidly establish the best practices that can inform action in communities across the country. Over the past few decades, we have learned that interventions designed solely to promote positive attitudes and increase health knowledge are insufficient to achieve longterm or sustainable behavior change. The socio-ecological model for behavior change suggests that effective community interventions must include environmental and policy solutions as key components if children and families are going to adopt healthy lifestyles. We cannot expect adults or kids to get regular physical activity or maintain a nutritious diet if they do not have convenient access to safe places to be active and affordable healthy foods. This commentary and the commentary by Kumanyika and Yancey focus on two systematic reviews of physical activity interventions: one conducted in African-American populations by Whitt-Glover and Kumanyika and one conducted in Native American populations by Teufel-Shone et al. These papers were commissioned by the Robert Wood Johnson Foundation (RWJF) to address the lack of published information concerning effective interventions that focus on physical inactivity and obesity among these populations. The literature reviews also examine how physical activity interventions can best be adapted to the cultural needs and values of each population; explore the impact of such interventions on obesity; and offer recommendations for future research. Both reviews show that there have been relatively few highquality studies within each target population. Furthermore, of the interventions that were implemented in either AfricanAmerican or Native American populations, there appeared to be little evidence of systematically adapting the original intervention to the cultural needs, values, and resources of the population studied. Addressing the policy and environmental factors that support sustainable long-term behavior changes was a challenge for all of the interventions, regardless of the specific population that was targeted. Initial findings from the literature reviews were presented at a 2-day meeting, Equal Rights to Health—Moving Forward Together, which was sponsored by RWJF in December 2003. Dr David Satcher, former United States Surgeon General, chaired the meeting, where representatives from research, practice, and media shared ideas and developed recommendations for preventing childhood obesity in the most affected communities. More than 50 experts who had worked with African-American, Latino, Native American, and rural populations participated in discussions about community-based programs, the evidence base regarding culturally diverse interventions, and the role of the media and communications in preventing childhood obesity. During the meeting, discussions revealed that many interventions designed to address obesity had not been widely translated into ‘‘real-world’’ practice, and had not been rigorously applied to culturally diverse populations that are most at risk for obesity. In some cases, the research-based programs were moderately effective, but communities lacked the resources required to implement and sustain the interventions. Many community organizations were unaware Copyright E 2009 by American Journal of Health Promotion, Inc. 0890-1171/09/$5.00 + 0 Terry L. Bazzarre, PhD, recently retired from his position as senior program officer at the Robert Wood Johnson Foundation (RWJF). While at RWJF, he oversaw the Foundation’s support for the literature reviews and Equal Rights to Health meeting described in this commentary.

PurposeStrategies to promote more sustainable consumer choices have been gaining interest among tourism and hospitality scholars. In particular, behavioral economic theories of decision-making have gained popularity in the past decade, led by behavioral interventions (BIs) such as the nudge movement. This paper aims to present a critical reflection on this recent trend, with a specific focus on whether these BI approaches are an adequate tool to contribute to long-term behavioral changes, one crucial aim of the promotion of sustainable consumption.Design/methodology/approachBased on a critical review of recent significant academic works in the field, this paper reflects on how nudge principles are applied in the hospitality and tourism sectors, as well as the usual justifications given for their use. This paper then discusses the potential limitations, both theoretical and practical, of using these short-term focused approaches to decisions that intend to have long-term outcomes and aims.FindingsBIs in hospitality and tourism have the potential to create long-term sustainable changes through a more comprehensive view of behavioral factors influencing decisions; however, such approaches would need to be strongly embedded in theoretical arguments that question “how” and “why” behavior change could be sustainable in the long term. This paper proposes a conceptual framework to address these concerns for future research.Research limitations/implicationsThis critical reflection proposes a comprehensive framework that will help guide stronger theoretically motivated identification, design and empirical testing of BIs and nudges. Industry can eventually benefit from theoretically stronger interventions that provide a balance between the short-term and long-term influence of BIs to attain customer loyalty and eventually greater value for business stakeholders.Originality/valueThis reflection paper critically reviews the basis of BIs and recommends a framework to strengthen their theoretical arguments. This reflection focuses on the theoretical critique of BIs and nudges to ensure long-term behavior changes are sustainable. The paper also proposes a comprehensive framework that incorporates well-founded theoretical models to enhance BIs and nudge literature.

Unsafe drinking water, insufficient sanitation and hygiene behaviour and indoor air pollution are some of the most important environmental risks, which are harmful to health. They cause diarrhoea, pneumonia and sepsis, and are with 65% the leading cause of death in children under 5 years of age. Lack of safe water perpetuates the cycle whereby poor populations become further disadvantaged and poverty entrenched. &#13;\nPoint-of-use household water treatment and safe storage systems (POU-HWT) represent one of the most promising strategies to block major transmission pathways associated with contracting diarrhoea, especially in low income countries. Home-based solar water disinfection (SODIS) is one of those POU-HWT systems being promoted worldwide. The SODIS-method consists of exposing water-filled, transparent PET bottles to sunlight for at least 6 hours. The evidence base of the health effectiveness of SODIS from population-based scientific evaluations is limited and experiences from large-scale roll outs of SODIS interventions are equally scarce. The community-randomised trial described in this thesis investigates the health effectiveness and the factors that lead to the uptake of the intervention.&#13;\nThe main goal of this thesis was to assess the effectiveness of a Latin American community-level SODIS dissemination programme in reducing child diarrhoea and the determination of factors related to the adoption of SODIS among the population. From 2004 to 2006, a community-randomised controlled trial was thus, conducted in 22 community-clusters situated in Bolivia. SODIS was implemented in the intervention communities by a local NGO over 15 months. The promotion of SODIS consisted of interactive, repeated, and standardised events held on community and household level. In order to comprehensively describe both, application and uptake, and the health effect of SODIS, a health surveillance system with community-based staff measuring compliance with SODIS as well as the occurrence of diarrhoea in children under 5 was established. Since no standards to classify households according to their SODIS-use exist, different indicators for use were measured by evaluators independent from the implementing NGO. Further, surveys assessed household determinants as well as SODIS promotion and -campaign factors, which were associated with the SODIS adoption.&#13;\nDespite the extensive SODIS promotion campaign a possible health impact in this typical rural Bolivian setting was too low to be assessed by this study. The intention-to-treat analysis of the 1-year health monitoring of 725 children &lt;5 (425 households) detected no significant difference in diarrhoea morbidity between the intervention and the control communities. This finding is neither in line with the results of former trials assessing the health impact of SODIS, nor with the results of trials testing a variety of different other POU-HWT technologies. This inconclusive finding might be explained by the moderate compliance or the fact that most of the endemic diarrhoeal disease is not exclusively transmitted through the consumption of contaminated drinking water only, but rather transmitted from person to person by hands, food and other fomites due to poor hygiene practices. Those risk factors could potentially have disguised the health effect of SODIS. Supposedly a more ‘holistic’ approach including community water improvements, sanitation and hygiene may produce better health outcomes than SODIS as a POU-HWT alone.&#13;\nDuring the project and before the cessation of the SODIS promotional activities we measured an overall compliance with the intervention of 32% at any given day during the study. In contrast, around 80% of households reported using SODIS regularly after the first phase and again at the end of the implementation. The SODIS-implementing NGO observed an average SODIS-usage rate of 75%. The remarkable discrepancies of compliance with SODIS registered in our study when assessed by different staff raise questions of how to interpret the compliance rates of other published SODIS-effectiveness studies. The occurrence of bias due to self-reporting and courtesy of villagers resulting potentially in an over-estimation of SODIS-use could be prevented in future SODIS evaluations if assessed by independent agencies.&#13;\nThe continuous monitoring by our community-based staff of adoption, application, rejection and discontinuation of the SODIS intervention allowed the identification of household determinants and SODIS-campaign factors leading to adoption or rejection of the method among different SODIS-user groups. The analysis revealed that households that were more likely to use SODIS were those that participated more frequently in SODIS promotional events, included women, owned latrines, and had severely wasted children living in the home. Those household-level factors are easily assessable indicators that SODIS-programme managers could use to identify early adopters in SODIS promotion campaigns.&#13;\nIn summary, this thesis demonstrates that the SODIS-method promoted in a typical rural Bolivian setting was not effective in reducing diarrhoeal disease in children under 5 years, despite a comprehensive SODIS-dissemination of a local non-governmental organisation. Unless the overall adoption and acceptance of POU-HWT methods, especially across broad levels of the population most in need will be considerably increased, the public health benefit will be modest. This research suggests that additional work is needed to better understand how the well-established laboratory efficacy of this POU-HWT method translates into field effectiveness under various cultural settings and intervention intensities.&#13;\n

Procedures are common in pediatric emergency departments and frequently cause distress from pain and/or anxiety. The objective of this study was to describe the incidence, types, and magnitude of long-term behavior changes after procedures in the emergency setting. This is a descriptive pilot study to determine if children display negative behavioral changes after a minor emergency department procedure (abscess drainage or laceration repair). Behavior change was measured at 1 week by telephone follow-up using the 27-item Post Hospitalization Behavior Questionnaire, a well-validated instrument that measures behavior changes across 6 categories: general anxiety, separation anxiety, anxiety about sleep, eating disturbances, aggression toward authority, and apathy/withdrawal. Significant behavior change was defined as 5 or more negative behavior changes on the 27-item questionnaire. Twenty percent of children who underwent abscess drainage (n = 30) and 20% who underwent laceration repair (n = 30) displayed significant negative behavior change at 1 week. Children who displayed significant negative behavior change tended to be younger (3.6 vs 5.9 years) and trended toward being more likely to have received anxiolysis or sedation (16.7% vs 8.3%). Separation anxiety, sleep difficulties, and aggression toward authority were the most common behavior changes. In this pilot study, a significant percentage of children undergoing common emergency procedures exhibited an appreciable burden of negative behavior change at 1 week; these results demonstrate the need for further rigorous investigation of predictors of these changes and interventions, which can ameliorate these changes.

Heart disease, diabetes mellitus (DM) type 2, and obesity are three of the most prevalent diseases in the USA. Some obesity-related comorbidities are disproportionately higher within African-American and Hispanic communities. While governmental and local health programs offer educational opportunities encouraging long-term health behavior changes, the most accessible programs have been through faith-based communities. This narrative review investigates the outcomes of faith-based wellness programs on Latino and African-American populations with respect to general health and wellness, obesity management, DM type 2, and hypertension. Perceived authority of faith community nurses, faith leaders, and accountability and encouragement provided by faith communities are critical. Long-term behavior change is positively affected by elements faith-based organizations can provide: cultural appropriateness, community support, and self-efficacy.

The need for smart healthcare tools and techniques has increased due to the availability of low-cost IoT sensors and devices and the growing aging population in the world. Early detection of health conditions such as dementia and Parkinsons are important for treatment and medication. Out of the many symptoms of such health conditions, one critical behavior is sleep activity changes. In this paper, we evaluate and apply an unsupervised machine learning: K-Means, to detect changes in long-term sleep behavior in the bedroom using smart-home motion sensors installed in 6 real-life single resident elderly homes for approximately three years. Our method analyses the transformation of clusters for a participant over three years, 2019, 2020, and 2021. This is done using three features: duration of stay, the hour of the day, and duration frequency. Data clustering is used to group durations of being in the bedroom at different hours of the day. This is done to see if there is a shift in these clusters for elderly persons with healthy aging and those developing health conditions like dementia and Parkinsons. We foresee that such methods to detect long-term behavior changes can support caregivers in carrying out their assessment for discovering the early onset of health conditions, thereby preventing further progression and providing timely treatment.

&lt;p&gt;Given the proliferating aging population, increasing moderate-to-vigorous physical activity (MVPA) and exercise is critical because it enhances overall well-being and reduces the rates of many adverse age-related health conditions. However, intervention efforts to establish sustained changes in MVPA have yielded limited success due their sole focus on conscious factors (e.g., changing goals and intentions). Thus, older adults continue to represent the highest proportion of sedentary adults, despite their knowledge of the widespread health benefits associated with PA and exercise or even their intentions to engage in such behaviors. Consequently, the benefits of PA and exercise are not being fully realized and health problems perpetuate. Developing evidence-based interventions that establish sustained changes in MVPA and exercise behaviors in older adults is a major public health priority, but this requires going beyond social-cognitive constructs. The broad goal of my dissertation is to advance scientific understanding about the neural systems associated with changes in MVPA behaviors among sedentary older adults.&lt;/p&gt;&lt;p&gt;Emerging evidence indicates that nonconscious processes also regulate exercise behaviors, stemming from accumulated affective responses from past exercise experiences (e.g., pleasant vs unpleasant). Grounded by current understanding about affect's role on decision-making, the present study hypothesized that physiological changes induced by single bouts of PA serve as somatic markers in the brain that guide future PA-related behaviors. Specifically, my dissertation extended previous research by testing whether acute exercise responses in affect-related brain systems predict PA behavior change following a 3-month exercise intervention. This hypothesis is supported by prior research indicating that self-reported changes in affect (i.e., pleasant/unpleasant feelings) during moderate-intensity exercise reliably predicts future MVPA behavior. The results of my dissertation advances previous findings by investigating how these affective responses to exercise are represented in the brain and how they relate to PA behavior change. I tested my central hypothesis through the following two specific aims:&lt;/p&gt;&lt;p&gt;In Specific Aim 1, I investigated whether the acute physiological and neural responses to exercise were related to the subjective experience of exercise in older adults. Healthy, low-active, older participants (N = 34, Age = 67.2 years, 21 females) completed an acute exercise procedure consisting of two within-subjects exercise conditions occurring on separate counter-balanced sessions. During the active condition, participants cycled at a moderate intensity (65% of maximum heart rate), and during the passive condition, their legs were moved by motorized pedals on the same machine and at the same pedal rate as in the active condition. To investigate exercise-related changes in brain function, functional MRI scans were acquired before and after the acute exercise. Additionally, salivary samples were collected throughout the experiment to provide objective biomarkers that have been linked with psychological changes. Finally, participants provided self-reported changes in affect. I found that acute exercise was associated with increases in salivary markers of sympathetic activity and decreases in salivary cortisol levels with no significant differences between conditions. Acute exercise also resulted in observable increases in positive affect with no differences between conditions. Finally, no observable acute exercise-related changes in functional connectivity occurred.&lt;/p&gt;&lt;p&gt;In Specific Aim 2, I identified predictors of exercise behavior change from objectively-measured biomarkers and neural systems that are acutely responsive to exercise. After completing the acute exercise sessions, participants began a 3-month supervised exercise intervention. To assess intervention-related changes in unsupervised PA behavior, participants wore a PA monitoring device for 7 days before and immediately after the intervention. Individuals who exhibited a stronger acute functional connectivity response between nucleus accumbens (NAcc) and medial prefrontal cortex (mPFC) before the intervention were more likely to increase their unsupervised levels of MVPA after the intervention. Given the role of NAcc-mPFC circuitry in affect-based decision making and self-referential processing, the present findings suggest that enhanced cognitive appraisal and awareness of affective changes are related to more sustained changes in long term behavior. This study is the first to demonstrate neurobiological evidence supporting the relationship between positive affective responses to acute exercise and long-term changes in exercise behavior. This research advocates the utility of affect-based measures in tailoring exercise interventions for sedentary older adults.&lt;/p&gt;

BackgroundRates of noncommunicable diseases continue to rise worldwide. Many of these diseases are a result of engaging in risk behaviors. Without lifestyle and behavioral intervention, noncommunicable diseases can worsen and develop into more debilitating diseases. Behavioral interventions are an effective strategy to reduce the burden of disease. Behavior change techniques can be described as the “active ingredients” in behavior change and address the components that need to be altered in order for the target behavior to change. Health professionals, such as pharmacists and nurses, can engage in opportunistic behavior change with their patients, to encourage positive health behaviors.ObjectiveWe aimed to develop, implement, and evaluate a behavior change workshop targeted at health professionals in Australia, with the goal of increasing knowledge of behavior change techniques and psychological variables.MethodsA prospective study design was used to develop and evaluate a 2-hour behavior change workshop targeted at health professionals. The workshop was developed based on the Capability, Opportunity, Motivation, and Behavior Model and had five core objectives: (1) to detail the role of health professionals in delivering optimal care, (2) to demonstrate opportunities to change behavior, (3) to describe principles of behavior change, (4) to explain behavior change techniques, and (5) to determine the most appropriate behavior change techniques to use and when to use them. A total of 10 workshops were conducted. To evaluate the workshops and identify any potential long-term changes in behavior, we collected pre- and postworkshop data on knowledge and psychological constructs from the attendees.ResultsA final sample of 41 health professionals comprising general practitioners, nurses, and pharmacists completed the pre- and postworkshop surveys. Following the workshops, there were significant improvements in knowledge of behavior change techniques (t40=–5.27, P<.001), subjective norms (t40=–3.49, P=.001), descriptive norms (t40=–3.65, P<.001), perceived behavioral control (t40=–3.30, P=.002), and intention (t36=–3.32, P=.002); each had a large effect size. There was no significant difference in postworkshop attitude (t40=0.78, P=.44). The participants also found the workshops to be highly acceptable.ConclusionsA 2-hour, theoretically informed workshop designed to facilitate the use of behavior change techniques by health professionals was shown to be largely effective. The workshops resulted in increases in knowledge, descriptive and subjective norms, perceived behavioral control, and intention, but not in attitude. The intervention was also shown to be highly acceptable, with the large majority of participants deeming the intervention to be needed, useful, appropriate, and applicable, as well as interesting and worth their time. Future research should examine the lasting impacts of the workshop on health professionals’ practices.

Reducing rates of partner change and increasing condom usage among gay men are obvious targets for potentially reducing syphilis transmission among gay men. We developed an agent-based stochastic model to examine syphilis transmission among a population of gay men, representative of gay men in Australia. This model was used to explore the potential impact of changes in sexual behavior over 1 month, 3 month, and indefinite time frames on syphilis epidemics. Simulations of interventions showed that short-term reductions in rates of partner change and increased condom use would have negligible impact on the long-term trends of syphilis epidemics. If no interventions are introduced, then the model forecasts that the syphilis prevalence in the population could continue to rise, with an increase of 80% in the number of men infected with syphilis during the next decade. However, if changes in sexual behavior are maintained in the long-term, then syphilis epidemics can be mitigated. If condom use is sustained at 80% in partnerships that are HIV discordant or of unknown status, then the prevalence of syphilis is estimated to decrease by 9% over 10 years. Similarly, if partner acquisition rates decrease by 25%, then there will be a 22% reduction in syphilis prevalence. Interventions promoting partner reduction or increased condom use would be ineffective in the short-term, and would have limited prospects for success in the long-term unless very large changes in behavior are sustained. Complementary social research indicates that such long-term changes in behavior are unlikely to be adopted, and therefore other intervention strategies need to be developed to reduce syphilis among gay men.