Related Behavioral Changes Research Articles

752 Baking Bread and Other New Hobbies: Characterizing Burn Center Admissions During the COVID-19 Pandemic

IntroductionThe effects of the ongoing COVID19 pandemic are wide-reaching and still emerging. Fear of the virus, public health messaging, and government-instituted lockdowns have altered how Americans live, work, and use the healthcare system. There is minimal data that assesses how the COVID-19 pandemic and associated stay at home orders have influenced the etiology of burn injuries. With the majority of burns occurring in the home, it is possible lock down orders have significantly impacted etiology of major burn injuries. This project aims to characterize the demographics and injury characteristics of burn patients seen at a regional burn center during the COVID-19 pandemic.MethodsFollowing IRB approval, our institution queried it’s burn registry from March 2020-June 2021. Data on demographics, injury circumstance and details, interventions, COVID-19 status, and outcomes were collected. Descriptive statistics were obtained for the population.ResultsThere were 622 inpatient admissions during the study timeframe. Patients were primarily Black (44.4%) or Caucasian (32.6%) males (65.6%) identifying as Non-Hispanic (81.8%). The mean age was 46.73±18.6 years. Mean total TBSA burned was 6.7±10.7%, 2nd and 3rd degree percentages were 2.11±4.64 and 0.62±5.2 respectively with 47 total inhalation injuries. Top burn etiologies were 244 (39.2%) scald and 175 (28.1%) flame with 249 (40%) coded etiology associated with food prep or consumption.The majority of the burns occurred at home (93%). Time from injury to admission was 616.98±2199.42 minutes and time to first excision from admission was 4314.3 ± 5657.3 minutes. ICU and hospital length of stay were 12.7±18.3 and 8.73±13.3 days. In-hospital mortality was 31 (5%). Nineteen patients tested positive for COVID-19 during this time.ConclusionsNearly half of all burn center admissions were for cooking related etiologies during this time. Time to admission was over 10 hours in a population dense area. More information of site specific pre-pandemic etiology and treatment data are needed to fully understand these initial findings. Further sub-analyses may also elucidate the influence of pandemic related behavioral changes as public health mandates evolved over time.

Experience with Atorvastatin in Conservative Management of Chronic Subdural Hematoma with Brief Review of Literature

Chronic subdural hematoma (CSDH) is one of the most common neurosurgical procedure done in any neurosurgical unit worldwide. The majority of CSDH are operated upon and there are very few studies regarding its conservative management. Mannitol, Steroids, Tranexemic acid, middle meningeal artery embolization and Angiotensin Converting Enzyme inhibitors are some options to treat CSDH conservatively. Atorvastatin is one of the newer and novel drugs that has been used effectively to medically treat CSDH.
 This is a retrospective study of 20 cases of CSDH that were managed conservatively with atorvastatin between 2015 to 2021.
 A total of 20 (7.5%) cases were included in the study period (January 2015 – January 2021). Glasgow Coma Score (GCS)/ Markwalder score (MS), mode of injury if any, age, sex, symptoms and neurological findings, co-morbidities, anti-platelet use, radiological finding of midline shift at admission and outcome with Glasgow outcome score (GOS) at the end of two months after treatment recorded. Atorvastatin in dose of 20 mg daily was given for maximum of two months with repeat CT/MRI scans done at 2 months. Repeat scan was done at 2 weeks and at 2 months and all of them showed complete resolution of the CSDH radiologically. The Glasgow outcome score showed good improvement in all the cases although there was mild confusion in five of the elderly which can be attributed to age related behavior changes.
 We conclude that atorvastatin can be used safely in not only elderly but also in younger subjects.

Abstract 140: Significant reduction in HbA1c levels among participants with poorly controlled type 2 diabetes on diabefly® digital therapeutics program using multidisciplinary approach

Background: Long-term hyperglycemia is a potential risk factor for both macro and microvascular complications in Type 2 diabetes. Digital therapeutics platform can be a highly accessible and cost-effective way in helping these patients with dietary, behavior change and fitness advice aimed towards better glycemic control.Aims and Objectives: To evaluate the effectiveness of Diabefly® digital therapeutics program using multidisciplinary approach in participants with type 2 diabetes mellitus having HbA1c ≥9%.Results: De-identified data of 49 participants using Diabefly® platform was analysed. The mean age was 46.12 years and 57.14% were females. At the end of 90 days, a significant mean reduction in HbA1C, body weight and body mass index (BMI) by 3.34%, 2.41 kg and 0.82 kg/m2 (p<0.001 for all) was observed respectively. 26 participants with complete data on waist circumference (WC) showed significant mean reduction by 4.89 cm (p<0.001). Among 21 participants with dietary data a significant mean reduction in carbohydrate and total calorie intake was observed after completion of the program (p<0.001).Conclusion: This study highlighted that the participants had a significant reduction in their HbA1c, body weight, BMI, WC, and intake of carbohydrate and total calories at the completion of the 90 days Diabefly® program thus making Digital therapeutics an indispensable tool for implementing lifestyle related behaviour change.

Developing public transport messaging to provide crowding information during COVID-19: Application of the COM-B model and behaviour change wheel

The COVID-19 outbreak meant that using public transport was potentially unsafe for risk of catching and transmitting the virus. UK anxiety is high with lockdowns preventing a normal way of life for over a year. A lack of ability to travel freely causes numerous declines in quality of life including social isolation and poor physical and mental health. People need crowding information to choose safer travel options and subdue coronavirus. To provide effective guidance, it is essential to empirically formulate messaging to create clarity and trust which can be acted upon in confidence. Behaviour Change Techniques incorporating the Behaviour Change Wheel and COM-B model have been utilised in vast areas of public health intervention development and messaging. There is consensus that public transport information needs to be clearer and more accessible but BCTs have not been utilised in the development of public transport advice. This paper outlines the development of crowding messaging for public transport on a platform available to UK travellers. Barriers and facilitators were explored; related behaviours, intervention functions and behaviour change techniques were mapped. Specific message phrasing was developed utilising the mapped functions and advice from the literature. With the COVID-19 outbreak, having accessible and effective messaging for safely using public transport is a continuation of the work recently conducted examining the best ways to present public health information. It is important to be transparent when developing messaging and interventions accessible to the public and this work forms a basis for continued exploration and development in this area.

Impact of the COVID-19 pandemic on student' sleep patterns, sexual activity, screen use, and food intake: A global survey.

BackgroundThe education sector experienced substantial impacts during the COVID-19 pandemic resulting from worldwide restrictions.PurposeTo examine differences in the sleep patterns, sexual activity, screen use, and food intake of students and non-students during the COVID-19 pandemic.MethodsThis was a global cross-sectional study conducted in the second half of 2020 using multiple social media platforms to recruit study participants globally. A close-ended questionnaire was administered anonymously in English, French, Spanish, Portuguese, and Arabic to adults ages 18 and older. The outcome variables considered in analyses were changes in sleep pattern, sexual activity, screen use, and food intake. The explanatory variable was student status categorized as students vs. non-student. T-test, chi-square, and Mann Whitney U tests were used to assess differences between student and non-student populations. One logistic regression model was built for each outcome variable. Country of residence and country income level were included in the adjusted models.ResultsThere were 17,008 participants of which 3,793 (22.3%) were students. Of the total sample, 4,889 (28.7%) reported changes in sleep, 4,642 (31.8%) reported increases in sexual activity, 10,278 (70.7%) reported increases in screen use, and 5,662 (40.2%) reported increases in food intake during the pandemic. Compared to non-students, students had significantly higher odds of reporting changes in sleep (AOR = 1.52), increases in sexual activity (AOR = 1.79), and increases in screen use (AOR = 1.36) but lower odds of reporting increase in food intake (AOR = 0.87).ConclusionStudents displayed higher risk of experiencing changes in sleep, sexual behavior, and screen use during the COVID-19 pandemic. This has the potential to lead to broader adverse effects on students’ overall wellbeing. The findings and implications raise further obligations on the education sector to put extra-curricular support systems in place that address COVID-19 related behavior changes that have the potential to adversely impact students’ wellbeing.

Depression among caregivers of patients with dementia: Associative factors and management approaches.

As elderly people increasingly come to represent a higher proportion of the world’s population, various forms of dementia are becoming a significant chronic disease burden. The World Health Organization emphasizes dementia care as a public health priority and calls for more support for family caregivers who commonly play a significant, central role in dementia care. Taking care of someone with dementia is a long-term responsibility that can be stressful and may lead to depression among family caregivers. Depression and related behavioral and cognitive changes among caregivers could in turn affect the status and prognosis of the dementia patient. This review article explores depression in dementia caregivers and summarizes proposed mechanisms, associated factors, management and research findings, and proposes future research directions.

Repeated restraint stress induced neurobehavioral and sexual hormone disorders in male rats.

Several studies have demonstrated that depression include disruptions not only for mental human disorders but also their healthy living. Rodent-based behavioral tests and models are widely used to understand the mechanisms by which stress triggers anxiety-related behaviors.This present study examined the evidence of a chronic restraint stress (CRS) paradigm in male Wistar rats for the progressive nature of depression alongside with related changes in behavior and functions. The body weight was determined, and the behavior tests, including sucrose preference and the open field test were performed. Theses parameters confirme the presence of anxiety-like and depression-like behaviors beside that we will focus on the response of ACTH and testosterone concentrations in rats.The results obtained during the experiment show that CRS led to decrease the time spent in the field center, a decrease of total distance travelled, in the stressed group compared with the control group. A significant increased of ACTH levels and decreased in testosterone hormone levels in the CRS. According to these results the CRS rodent model has value to validating the development for depression.

A Comprehensive User Modeling Framework and a Recommender System for Personalizing Well-Being Related Behavior Change Interventions: Development and Evaluation

Health recommender systems (HRSs) have the potential to effectively personalize well-being related behavior change interventions to the needs of individuals. However, personalization is often considered from a narrow perspective, and the underlying user features are inconsistent across HRSs. Particularly, theory-based determinants of behavior and the variety of lifestyle domains influencing well-being are poorly addressed. We propose a comprehensive, theory-based framework of user features, a virtual individual (VI) model, to support the extensive personalization of digital well-being interventions. We introduce a prototype HRS (With-Me HRS), which uses knowledge-based filtering and recommends behavior change objectives and activities from several lifestyle domains. With-Me HRS realizes a minimum set of important VI model features related to well-being, lifestyle, and behavioral intention. We report the preliminary validity and usefulness of the HRS, evaluated in a real-life health-coaching program with 50 participants. The recommendations were used in decision-making for half of the participants and hidden for others. For 73% of the participants (85% with visible vs. 62% with hidden recommendations), at least one of the recommended activities was included into their coaching plans. The HRS reduced coaches’ perceived effort in identifying appropriate coaching tasks for the participants (effect size: Vargha-Delaney Â=0.71, 95% CI 0.59-0.84) but not in identifying behavior change objectives. From the participants’ perspective, the quality of coaching improved (effect size for one of three quality metrics: Â=0.71, 95% CI 0.57-0.83). These results provide a baseline for testing the influence of additional user model features on the validity of recommendations generated by knowledge-based multi-domain HRSs.

Greater COVID‐19 impact for underrepresented racial and ethnic minority groups: A survey study on the Wisconsin Alzheimer’s Disease Research Center participants

BackgroundThe COVID‐19 pandemic has posed substantial impact on people’s life and wellbeing, especially for the aging population who are at greater risk. This study compared the difference in the impact between older adults from underrepresented racial/ethnic groups (URGs) versus non‐URGs.MethodThe National Alzheimer’s Coordinating Center COVID‐19 Impact Survey was self‐reported by 221 participants aged 49‐99 years from the Wisconsin Alzheimer’s Disease Research Center clinical core between August and December, 2020. 43 participants who reported “Black or African American” or “American Indian or Alaska Native” in primary or secondary race or reported “Yes” to Hispanic” ethnicity were classified as URGs. The remaining 178 participants who reported only “White” or “Asian” in the primary and secondary races and “No” to “Hispanic” ethnicity were classified as non‐URGs. The survey inquired on (1) COVID‐19 symptoms, testing, diagnosis, and hospitalization; (2) worrying, social isolation, and disruption on everyday life associated with the pandemic; (3) related cognitive, psychiatric, and behavioral changes; and (4) change of willingness in research participation. Group differences on survey responses were tested using Fisher’s exact test, non‐parametric Kruskal‐Wallis test, and binary or ordinal logistic regressions.ResultNo significant group difference was found in sex, age, and clinical diagnosis. However, URG participants had lower education and higher Clinical Dementia Rating (CDR) scores (Table 1). URGs were approximately doubled non‐URGs in the percentages of experiencing COVID‐19 symptoms, having a positive diagnosis, and reporting “very much” or “extremely” worrying about getting COVID‐19 and changing willingness to participate in clinical research. Controlling for sex, age, education, and CDR score, URGs were more likely to be tested for COVID‐19 (Odds Ratio = 2.37), have significantly reduced income (OR=4.74), experience change in memory or thinking (OR=2.97), and report a greater total number of psychiatric or behavioral changes (OR=2.04). However, URGs felt less isolated from family or friends (OR=0.55).ConclusionURGs had greater medical, psychological, and economical consequences than non‐URGs, which implied racial/ethnic disparities associated with the pandemic. Future research is needed to identify inequities in the social determinants and understand their association with disparities, which would help inform policies and strategies to achieve health equity.

AB038. Neighbourhood health niche and well-being related behaviour change after coronavirus disease (COVID-19) pandemic

AB038. Neighbourhood health niche and well-being related behaviour change after coronavirus disease (COVID-19) pandemic

Culinary medicine and culinary nutrition education for individuals with the capacity to influence health related behaviour change: A scoping review.

Culinary medicine (CM) or culinary nutrition (CN) education provided to professionals with the capacity to influence behaviour change is an emerging strategy to promote diet quality and reduce the burden of diet related chronic disease in adults. The purpose of this scoping review was to synthesise current research describing CM/CN education provided to or by health, education and culinary professionals, or students of these disciplines. Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was used. Eleven electronic databases were searched in March 2019. Included studies were: (i) nutrition, health or lifestyle programs with a CM/CN component; (ii) study participants or programs facilitated by people working or training in health, community and/or adult education, or culinary roles where facilitator training was described; (iii) reported in the English language; and (iv) published from 2003. In total, 33 studies were included. Nineteen studies delivered programs to general population groups and were facilitated by health professionals and/or health university students. Fourteen studies delivered CM/CN training to health professionals or students. Studies reported changes in participants' culinary skill and nutrition knowledge (n = 18), changes in dietary intake (n = 13), attitudes and behaviour change in healthy eating and cooking (n = 4), and competency in nutrition counselling and knowledge (n = 7). Further research examining the effectiveness of CM/CN programs, and that describes optimal content, format and timing of the programs, is needed. Research evaluating the impact of training in CM/CN to education and culinary professionals on healthy cooking behaviours of their patients/clients is warranted.

Differences in COVID-19 Preventive Behavior and Food Insecurity by HIV Status in Nigeria.

The aim of the study was to assess if there were significant differences in the adoption of COVID-19 risk preventive behaviors and experience of food insecurity by people living with and without HIV in Nigeria. This was a cross-sectional study that recruited a convenience sample of 4471 (20.5% HIV positive) adults in Nigeria. Binary logistic regression analysis was conducted to test the associations between the explanatory variable (HIV positive and non-positive status) and the outcome variables—COVID-19 related behavior changes (physical distancing, isolation/quarantine, working remotely) and food insecurity (hungry but did not eat, cut the size of meals/skip meals) controlling for age, sex at birth, COVID-19 status, and medical status of respondents. Significantly fewer people living with HIV (PLWH) reported a positive COVID-19 test result; and had lower odds of practicing COVID-19 risk preventive behaviors. In comparison with those living without HIV, PLWH had higher odds of cutting meal sizes as a food security measure (AOR: 3.18; 95% CI 2.60–3.88) and lower odds of being hungry and not eating (AOR: 0.24; 95% CI 0.20–0.30). In conclusion, associations between HIV status, COVID-19 preventive behaviors and food security are highly complex and warrant further in-depth to unravel the incongruities identified.

What Drives Us to Walk: Understanding Components and Processes of Behaviour Change Towards Active Mobility

Walking is widely promoted as a healthy and sustainable way to get around. Still, although the benefits of walking are undisputed, it is equally known that most people walk much less than they could and should do. This article explores this discrepancy from the angle of human behaviour change processes and applies a theoretically grounded systematics for identifying the most important barriers against walking. This is followed by a description of behaviour types and related behaviour change motives to inspire strategies and arguments to address different types of target groups. The proposed framework can support the selection of measures and strategies to increase walking in different environments and addressing specific social groups.

Recognizing and responding to Traumatized Youth: preliminary results and implications for police trainings

ABSTRACT This research study analyzed 944 pre-training and 871 post-training survey responses from a youth-specific in-service police training. Before training, police largely had negative views on youth, but are interested in improving their knowledge and interaction skills with youth. Post-training, police demonstrated significant improvement in their self-skill ratings and acknowledged various behavior-related changes they planned to make when interacting with youth. Patterns in responses also emerged based on officer characteristics. Training appears helpful in changing youth-related knowledge, beliefs, and skills in officers and to match the expectations or desires of officers receiving the training. The results from these training surveys highlight unique opportunities for future investigation and practice, such modifications to training content and delivery, and for policy initiatives, including consistently integrating youth training into police education.

The Impact of the COVID-19 Public Health Crisis on Communication and Quality of Life: Insights From a Community of Stroke and Brain Trauma Survivors.

Purpose The COVID-19 pandemic has led to stay-at-home orders and social distancing guidelines that have the potential to greatly impact individuals' behavior and social engagement. Adults recovering from stroke or other brain trauma, who often have communication difficulties and other long-term challenges, are a population already at risk of isolation and lower quality of life. We investigated the impact of public health guidelines and related behavioral changes on self-perceptions of communication abilities and psychosocial factors in this population. Method The Stroke Comeback Center, a community-based center for stroke and other brain trauma survivors with communication impairments, disseminated an online survey to current members to investigate changes in communication, social engagement, and quality of life. Results Participants (N = 50) reported a number of changes in their day-to-day activities that reflect the current social distancing guidelines, such as reduced outings into the community and fewer in-person conversations with those living outside one's home. Overall, feelings of connectedness to others and overall quality of life were reported to be decreased when compared to before the COVID-19 pandemic, whereas receptive language abilities and technology skills were reported to have improved. Perhaps most interestingly, certain behavioral changes (including healthy movement activities and participation in virtual programs) had specific relationships with perceived communication abilities and social engagement. Conclusions Changes in daily life resulting from the COVID-19 pandemic have had a tangible impact on self-perceived psychosocial elements (e.g., quality of life) and communication abilities among stroke and other brain trauma survivors. Clinicians and researchers may consider these perceived changes when engaging with this population as the effects of the pandemic continue and in the period of community re-entry that may follow. Supplemental Material https://doi.org/10.23641/asha.14830881.

How Alcohol Influences Mechanisms of Sexual Risk Behavior Change: Contributions of Alcohol Challenge Research to the Development of HIV Prevention Interventions.

This paper examines the contributions of laboratory-based alcohol challenge research (ACR) to the development of HIV prevention interventions. Following a brief overview of HIV prevention interventions and related health behavior change models, we discuss how alcohol may influence mechanisms of behavior change. The paper highlights the value of ACR for: (1) elucidating mechanisms of action through which alcohol affects sexual risk behavior, (2) testing how alcohol may influence mechanisms thought to underlie HIV prevention interventions, (3) clarifying moderators of the causal influences of alcohol, (4) identifying novel intervention targets, and (5) developing strategies to reduce sexual risk among those who consume alcohol. We conclude with a discussion of the importance of using experimental research to identify mechanisms of behavior change that are specific to populations at high risk for HIV and outline some key implications for developing HIV prevention interventions that integrate the role of alcohol.

Role of mass media in disseminating knowledge about Tuberculosis among the attendants accompanying patients of a tertiary care hospital of Bangladesh

Background : Tuberculosis (TB) is a major public health problem in Bangladesh. The use of mass media is one of the important strategies in communicating behavioural change in relation to TB prevention and the treatment. However, most of the mass media public health interventions do not sufficiently engage the people. Due to this, truly little is known about the effects of locally instigated mass media promotion.&#x0D; Objective : To explore role of mass media on knowledge generation about Tuberculosis transmission in Bangladesh.&#x0D; Methods : This cross-sectional study was conducted among 180 adult persons(attendants of patients) of different socio-economic backgrounds attending the outpatient’s departments(OPD) of a tertiary care hospital. Purposive sampling was the process of selecting the subjects. Data were collected using one pretested semi-structured questionnaire through face-to-face interview.&#x0D; Results : A total180 respondents were interviewed. Mean age of the respondents was 28.75 ± 8.55 years. Majority of the respondents were graduate (29.0%).A total of 20.2% respondents had adequate knowledge about TB transmission without any misconceptions. Similarly, regarding the misconceptions on modes of TB transmission, 40.5% replied that TB transmits through utensils,57.6% respondents replied that TB transmits through sharing clothes/bed sheets/towel. About 28.3% respondents had the perception that the cost of TB treatment is high. Among the respondents30.5% had the false perception that it was necessary to go to big hospitals for TB treatment. Highest 140 (77.8%) respondents said television as the source of information in TB prevention. Friends/ relatives/ teachers, newspaper, radio, billboard etc. were the other sources. Twenty did not hear of TB prevention program.&#x0D; Conclusion : The mass media can be effective in getting messages about TB across to the community in developing countries. In this study we found that television, newspapers, and billboards were particularly useful tools for reaching out to them with specific campaigns regarding TB control.&#x0D; Northern International Medical College Journal Vol.11 (2) Jan 2020: 463-467

Knowledge, attitude and Behavior of the Moroccan Population During Covid-19

Background: Since December 2019 the world has experienced a significant spread of the Covid-19pandemic. The purpose of this study is to investigate the impact of the coronavirus disease (COVID-19) onthe mental health of the population.Method: This cross-sectional study was conducted in Morocco and was administered to a sample of702 respondents. The subject was assessed using a questionnaire containing the following information:Personal demographic characteristics, knowledge and awareness of COVID-19 outbreak, Attitude towardsCOVID-19 outbreak, Behavioral change in relation to COVID-19 outbreak, Patient Health Questionnaire(PHQ-4) screening questions for anxiety and depression, and finally a questionnaire related to people at riskof psychological harm from social isolation during the COVID-19 pandemic, data collection began threeweeks after confinement began and lasted for five weeks, from April 10 to 08 Mai.Results: 702 participants responded to the survey. The descriptive analysis of the database showed thatthe majority of respondents were male (69.3%), aged 20 to 30 years (46.15%), with university diploma(61.25%) and employed (63.53%).Knowledge differed considerablyby level of education; however, Attitudediffered significantly according to gender and educational level. Correlations between the knowledge,attitude, behavioral behavioural, PHQ-4 and the psychological harm score shows that the variables “attitude,behavioural and Psychological harm” are significantly correlated with the PHQ-4 score, the higher the latterare the greater the last is high.In addition, the “Knowledge” variable is also significantly correlated. Thegreater the knowledge, the smaller the PHQ-4 score.Conclusion: The covid-19 pandemic is a public health problem

Snapshot observations demonstrate within- and across-year weather related changes in butterfly behavior

Climate change impacts animal abundances, distributions, and behaviors, frequently at the detriment to individuals. However, for many animals, including butterflies, current research focuses primarily on estimating abundance and distribution without observing behavior. Because behaviors often respond to climate change before other metrics, understanding behavioral change is critical for future climate change research and projections. Therefore, we investigated weather related changes in adult butterfly behavior using snapshot behavioral observations taken as part of a four year study of butterfly abundance throughout North Dakota, USA. Across 1,107 site-visits, we categorized adult butterfly behavior using 146,610 observations while also recording local weather variables with each site visit. We found patterns in butterfly behavior within years, including more flying and less resting at sites that were warmer during that site visit. We also observed differences across years, including more flying overall and a weaker behavioral response to temperature in a year that was particularly cool and wet. Further incorporating such behavioral observations into abundance surveys can help lead to better insights about weather-related variation in behavioral patterns and their consequences for animals facing climate change.

Barriers of Appropriate Antibiotic Prescription at PHCC in Qatar: Perspective of Physicians and Pharmacists.

The Ministry of Public Health in Qatar developed the NAP (National Action Plan to combat Antimicrobial Resistance (AMR) in collaboration with WHO Regional Office for the Eastern Mediterranean (WHO/EMRO). Among the major factors shaping AMR is antimicrobial prescribing and use. Tailoring Antimicrobial Resistance Program is a behavior change methodology that is utilized to adapt behavior change in relation to antimicrobial use. This study explores barriers of appropriate antibiotic (AB) prescription from the physicians’ and pharmacists’ perspectives at primary healthcare centers in Qatar. Data were collected from 50 participants across two PHCCs: 30 physicians and 20 pharmacists. Two different interview guides were constructed: One for physicians and one for pharmacists. In-depth, face-to-face, five focus groups were conducted and transcribed verbatim. Inductive qualitative analysis, involving discovering the themes in the interviews, was followed. Data were analyzed using constant comparative techniques. The Major themes arose from the analysis revealed that patients, practitioners mainly physicians, and the organization itself, played a role in shaping these barriers in the two primary healthcare centers. The findings would help develop and pilot behavior change interventions among patients, physicians and pharmacists with the aim of optimizing appropriate antibiotic prescription and use, which would support the implementation of the antibiotic stewardship program. Effective behavior change interventions should consider multiple factors including individual and organizational factors to optimize appropriate antibiotic prescription.