Behavioral Intervention Strategies Research Articles

Examining variability in Naturalistic Developmental Behavioral Intervention strategy use in caregivers of children with autism spectrum disorders.

Naturalistic Developmental Behavioral Interventions (NDBIs) for young children with autism spectrum disorder commonly involve caregiver-mediated approaches. However, to date, there is limited research on how caregivers' skills change, and, in turn, impact child outcomes. We evaluated the NDBI strategy use of 191 caregivers prior to participation in NDBIs (or control groups) across multiple randomized controlled trials, using the Measure of NDBI Strategy Implementation, Caregiver Change (MONSI-CC). Clustering analyses were used to examine caregiver variability in NDBI strategy use at intervention entry. Generalized Linear Mixed Models were used to examine changes in caregiver strategy use over the course of intervention and its impact on changes in children's social communication. Using clustering analysis, we found that caregivers' baseline skills fit four profiles: limited, emerging, variable, and consistent/high, with few demographic factors distinguishing these groups. Caregivers starting with limited or emerging skills improved in their strategy use with intervention. Caregivers starting with more skills (consistent/high or variable) maintained higher skills over intervention. Children of caregivers in these groups who received target NDBIs improved in their social communication skills. Results suggested that caregiver skills improve through participation in NDBIs and may directly contribute to their children's outcomes, although more research on mediating factors is needed. Individualized approaches for caregivers and their children starting with differing skill profiles at intervention entry may be warranted.

Combining anchoring with financial incentives to increase physical activity: a randomized controlled trial among college students.

The purpose of this study was to: (1) compare the relative efficacy of different combinations of three behavioral intervention strategies (i.e., personalized reminders, financial incentives, and anchoring) for establishing physical activity habits using an mHealth app and (2) to examine the effects of these different combined interventions on intrinsic motivation for physical activity and daily walking habit strength. A four-arm randomized controlled trial was conducted in a sample of college students (N = 161) who had a self-reported personal wellness goal of increasing their physical activity. Receiving cue-contingent financial incentives (i.e., incentives conditional on performing physical activity within ± one hour of a prespecified physical activity cue) combined with anchoring resulted in the highest daily step counts and greatest odds of temporally consistent walking during both the four-week intervention and the full eight-week study period. Cue-contingent financial incentives were also more successful at increasing physical activity and maintaining these effects post-intervention than traditional non-cue-contingent incentives. There were no differences in intrinsic motivation or habit strength between study groups at any time point. Financial incentives, particularly cue-contingent incentives, can be effectively used to support the anchoring intervention strategy for establishing physical activity habits. Moreover, mHealth apps are a feasible method for delivering the combined intervention technique of financial incentives with anchoring.

The Latrobe Smoking Support Service: A quantitative study of participants in a regional area.

More than 70% of current smokers in Australia have a definite plan to stop smoking and around half of them try to quit every year. Latrobe Community Health Service (LCHS) was commissioned by Gippsland Primary Health Network to establish Latrobe Smoking Support Service (LSSS) to break down barriers to accessing services and increase support for smoking cessation. This research aims to assess the feasibility of an ongoing smoking cessation support service and determine the effect the LSSS has on client smoking behavior. Quantitative data were collected for the LSSS situated at LCHS during the period from September 2021 to March 2022. A new client survey, a returning client survey, and a 6-week follow-up survey were conducted by Clinic staff. The consent forms were obtained from the clients. A total of 117 clients attended the LSSS at least once, and a further 315 returning client sessions were conducted. The data analysis was undertaken by means of various descriptive and inferential statistical techniques, such as multiple linear regression analysis. The research findings demonstrate the strong positive effect of the LSSS in helping clients to change their smoking behavior. Results of multiple regression analysis highlight the significant role of behavioral intervention strategies in the LSSS's success. A combination of both nicotine replacement therapy (NRT) and counseling was a key contributor to the project's success. This research proposed and tested the model of a smoking cessation support service that combines a comprehensive mix of services for smokers including free NRT, free counseling, and ongoing support of counselors or/and nurse practitioners.

Examining the association between delay discounting, delay aversion and physical activity in Chinese adults with type-2 diabetes mellitus.

The role of physical activity in diabetes is critical, influencing this disease's development, man-agement, and overall outcomes. In China, 22.3% of adults do not meet the minimum level of physical activity recommended by the World Health Organization. Therefore, it is imperative to identify the factors that contributing to lack of physical activity must be identified. To investigate the relationship among delay discounting, delay aversion, glycated hemoglobin (HbA1c), and various levels of physical activity in Chinese adults diagnosed with type 2 diabetes mellitus (T2DM). In 2023, 400 adults with T2DM were recruited from the People's Hospital of Linxia Hui Autonomous Prefecture of Gansu Province. A face-to-face questionnaire was used to gather demographic data and details on physical activity, delay discounting, and delay aversion. In addition, HbA1c levels were measured in all 400 participants. The primary independent variables considered were delay discounting and delay aversion. The outcome variables included HbA1c levels and different intensity levels of physical activity, including walking, moderate physical activity, and vigorous physical activity. Multiple linear regression models were utilized to assess the relationship between delay discounting, delay aversion, and HbA1c levels, along with the intensity of different physical activity measured in met-hours per week. After controlling for the sample characteristics, delay discounting was negatively associated with moderate physical activity (β = -2.386, 95%CI: -4.370 to -0.401). Meanwhile, delay aversion was negatively associated with the level of moderate physical activity (β = -3.527, 95% CI: -5.578 to -1.476) in the multiple linear regression model, with statistically significant differences. Elevated delay discounting and increased delay aversion correlated with reduced levels of moderate physical activity. Result suggests that delay discounting and aversion may influence engagement in moderate physical activity. This study recommends that health administration and government consider delay discounting and delay aversion when formulating behavioral intervention strategies and treatment guidelines involving physical activity for patients with T2DM, which may increase participation in physical activity. This study contributes a novel perspective to the research on physical activity in adults with T2DM by examining the significance of future health considerations and the role of emotional responses to delays.

Promoting electricity conservation through behavior change: A study protocol for a web-based multiple-arm parallel randomized controlled trial.

As a part of the framework of the EU-funded Energy efficiency through Behavior CHANge Transition (ENCHANT) project, the present paper intends to provide a "Research Protocol" of a web-based trial to: (i) assess the effectiveness of behavioral intervention strategies--either single or in combination--on electricity saving, and (ii) unravel the psychological factors contributing to intervention effectiveness in households across Europe. Six distinct interventions (i.e., information provision, collective vs. individual message framing, social norms, consumption feedback, competitive elements, and commitment strategies) targeting electricity saving in households from six European countries (i.e., Austria, Germany, Italy, Norway, Romania, and Türkiye) are evaluated, with an initial expected samples of about 1500 households per country randomly assigned to 12 intervention groups and two control groups, and data is collected through an ad-hoc online platform. The primary outcome is the weekly electricity consumption normalized to the last seven days before measurement per person per household. Secondary outcomes are the peak consumption during the last day before measurement and the self-reported implementation of electricity saving behaviors (e.g., deicing the refrigerator). The underlying psychological factors expected to mediate and/or moderate the intervention effects on these outcomes are intentions to save electricity, perceived difficulty of saving energy, attitudes to electricity saving, electricity saving habit strength, social norms to save electricity, personal norms, collective efficacy, emotional reaction to electricity consumption, and national identity. The intervention effectiveness will be evaluated by comparing psychological factors and consumption variables before and after the intervention, leading to a 14 (groups including 2 control groups) × 6 (time) mixed factorial design, with one factor between (group) and one factor within subjects (time)-6 measurements of the psychological factors and 6 readings of the electricity meters, which gives then 5 weeks of electricity consumption. Data collection for the present RCT started in January 2023, and by October 2023 data collection will conclude. Upon establishing feasibility and effectiveness, the outcomes of this study will assist policymakers, municipalities, NGOs, and other communal entities in identifying impactful interventions tailored to their unique circumstances and available resources. Researchers will benefit from a flexible, structured tool that allows the design, implementation and monitoring of complex interventions protocols. Crucially, the intervention participants will benefit from electricity saving strategies, fostering immediate effectiveness of the interventions in real-life contexts. This trial was preregistered in the Open Science Framework: https://osf.io/9vtn4.

Preschool Teachers’ Perceptions and Use of Naturalistic Developmental Behavioral Intervention Strategies: An Explanatory Sequential Mixed Methods Investigation

Preschool classrooms serve children of varying abilities, including those who may benefit from social communication intervention. Research supports the use of naturalistic developmental behavioral interventions (NDBI) to effectively increase the social communication skills of young children. Yet, little is known about preschool teachers’ perspectives on and use of NDBI strategies. The purpose of this explanatory sequential mixed methods study was to integrate data from classroom observation, teacher self-report, and qualitative interviews to understand training and support needs for increasing implementation of NDBIs in a preschool classroom context. Eight preschool teachers provided a recording of an intervention session, self-reported their use of NDBI strategies, and participated in an interview to discuss their experiences. Results indicate preschool teacher participants perceive NDBI strategies favorably although they may need targeted support understanding and using NDBI strategies. We discuss implications for practice that may support increased use of NDBIs by preschool teachers.

Self-Concept Clarity and Loneliness among College Students: The Chain-Mediating Effect of Fear of Negative Evaluation and Self-Disclosure.

Self-concept clarity is considered a crucial indicator of mental health. Although several studies have examined the correlation between self-concept clarity and loneliness, few studies have investigated the underlying mechanism. Based on the evolutionary theory of loneliness and social penetration theory, this cross-sectional study focused on cognitive and behavioral factors in interpersonal communication situations, aiming to explore the relationship between self-concept clarity and loneliness as well as its internal mechanism. An online questionnaire survey comprised 1145 college students in China to assess their self-concept clarity, fear of negative evaluation, self-disclosure, and loneliness. After controlling for demographic variables, the results showed that self-concept clarity was not only able to directly and negatively predict loneliness but also indirectly predict loneliness through the independent mediating effects of fear of negative evaluation and self-disclosure, as well as the chain-mediating effect of fear of negative evaluation to self-disclosure. This study provides important implications for cognitive and behavioral intervention strategies to alleviate people's loneliness and improve their mental health.

The regulation of social factors on anxiety and microglial activity in nucleus accumbens of adolescent male mice: Influence of social interaction strategy

BackgroundAdolescence is a period characterized by a high vulnerability to emotional disorders, which are modulated by biological, psychological, and social factors. However, the underlying mechanisms remain poorly understood. MethodsCombining physical or emotional social defeat stress (PS and ES) and pair or isolation rearing conditions, we investigated the effects of stress type and social support on emotional behavior and central immune molecules in adolescent mice, including anxiety, social fear, and social interaction strategies, as well as changes in microglia-specific molecules (ionized calcium-binding adaptor molecule 1 (Iba1) and a cluster of differentiation molecule 11b (CD11b)) in the medial prefrontal cortex (mPFC), hippocampus (HIP), amygdala (AMY), and nucleus accumbens (NAc). ResultsMice exposed to both physical stress and isolated rearing condition exhibited the highest levels of anxiety, social fear, and microglial CD11b expression in the NAc. In terms of social support, pair-housing with siblings ameliorated social fear and NAc molecular changes in ES mice, but not in PS mice. The reason for the differential benefit from social support was attributed to the fact that ES mice exhibited more active and less passive social strategies in social environment compared to PS mice. Further, the levels of stress-induced social fear were positively associated with the expression of microglial CD11b in the NAc. ConclusionThese findings offer extensive evidence regarding the intricate effects of multiple social factors on social anxiety and immune alteration in the NAc of adolescent mice. Additionally, they suggest potential behavioral and immune intervention strategies for anxiety-related disorders in adolescents.

Looking out for You and Me: College students’ Strategies for Preventing Sexual Assault in Drinking Contexts

Background : Sexual assault and heavy alcohol use are prevalent and interrelated public health concerns on university campuses. Surprisingly, however, few alcohol harm reduction interventions address this intersection to help students reduce both personal and community risks for sexual assault in college drinking contexts. Objectives : In the current study, students (ages 18–24) shared strategies they use to protect themselves and others from sexual assault in college drinking contexts, as well as challenges to implementing these strategies. A series of six focus groups were conducted across two universities in the U.S. (N = 35). Participants responded to open-ended questions focused on drinking and sexual assault (e.g., What are some of the things students might do to avoid or address situations where they feel pressured of coerced to hook up or have sex when they do not want to?). Results : Thematic analyses demonstrated students’ awareness of protective behavioral and bystander intervention strategies that could help reduce vulnerability to experience sexual assault for themselves or others in drinking contexts. Perceived barriers to using bystander intervention strategies included student’s own and friends’ heavy drinking (decreased inhibitions, loss of autonomy), ambiguity in deciphering risk (lack of familiarity, minimization, diffusion of responsibility), and gender (gender norms, power imbalances). Conclusions : This study informs the development of interventions that help students identify strategies and overcome barriers to reduce risks for sexual assault in college drinking contexts.

Overcoming Patient Pain Together: Breast Cancer Patients and Caregivers’ Pretreatment Psychosocial Distress Linked to Patients’ Pain Interference During the First Year of Treatment

Breast cancer patients experience treatment-related pain from surgery, radiation, chemotherapy, and long-term hormonal treatment, which can lead to poorer outcomes. Patient and family caregivers' psychosocial distress exacerbates patient pain interference, but this has not been directly examined among breast cancer patients in dyadic models longitudinally. Guided by a biopsychosocial framework, the Biobehavioral Family Model, we explore how multiple reports of patient pain interference across the first year of treatment are linked to the patient (N = 55) and caregiver (N = 55) pretreatment psychosocial distress (eg, depression, anxiety, marital satisfaction, family relationship quality). Specifically, we find that breast cancer patients’ pain interference increases and then decreases over the first year of treatment. Additionally, caregivers' pretreatment anxiety was associated with increased patient pain interference over time (B = .19, SE = .07, P = .008), while patients’ pretreatment psychosocial distress was not associated with a change in their pain interference. Yet, looking at clinically specific times during the first year of treatment, we find that caregiver-reported higher marital satisfaction is associated with lower patient-reported pain interference later in treatment (6 months: B = −.58, SE = .24, P = .017; 12 months: B = −.82, SE = .23, P < .001). We conclude that, per the Biobehavioral Family Model, pretreatment patient and caregiver psychosocial distress is linked to patient pain interference during the first year of breast cancer treatment. Thus, caregivers’ psychosocial distress (ie, anxiety and marital satisfaction) may be a particularly important target in future dyadic behavioral intervention strategies to reduce breast cancer patient pain. PerspectiveThis article presents the link between breast cancer patients and family caregiver pretreatment psychosocial distress (anxiety, depression, marital satisfaction, and family quality) on patient pain interference during 1 year of breast cancer treatment. Findings suggest that caregiver anxiety and marital satisfaction may be important targets for future dyadic behavioral pain interventions.

HIV status affects PTSD symptom severity, psychophysiology, and heart rate variability in women with low but not high exposure to childhood maltreatment

Objective People living with HIV (PLWH) experience high rates of childhood maltreatment, which increases risk for posttraumatic stress disorder (PTSD). Thus, it is important to understand how HIV status interacts with childhood maltreatment to influence PTSD symptom severity and underlying psychophysiology. Methods The current study assessed whether HIV status interacts with childhood maltreatment to influence PTSD symptom severity and heart rate variability during a dark-enhanced startle (DES) task in 88 Black women with (n=30) and without HIV (n=58). Results HIV was associated with greater PTSD symptom severity only in women with low levels of childhood maltreatment (p=.024). Startle potentiation during DES was highest in women living without HIV and with high childhood maltreatment (p=.018). In women who had experienced low levels of childhood maltreatment, respiratory sinus arrhythmia (RSA) was lower during the dark phase of DES in women living without HIV than women living with HIV (WLWH), (p=.046). RSA during the light phase of DES was lower in WLWH than in women living without HIV (p=.042). Conclusion In the current sample of Black women, HIV status was associated with PTSD symptom severity in a manner dependent on level of childhood maltreatment, suggesting that HIV status may be an important factor to consider for behavioral and pharmacological treatment strategies for PTSD. Additionally, HIV status is associated with lower percent potentiation to darkness and lower RSA during the light phase of DES, suggesting physiological mechanisms by which HIV may contribute to PTSD symptoms in individuals exposed to low levels of childhood maltreatment.

Tailoring parenting styles and family-based interventions cross-culturally as an effective prevention strategy for youth substance use: a scoping review.

The challenge of substance use among youth continues to be a highly concerning public health issue across the globe. The notion that parenting lifestyles and family-based intervention can help in the prevention of adolescent substance use have received robust attention from policy makers, researchers' clinicians and general public, nonetheless, there is scarcity of high quality evidence to support these concepts. To review available literature which assessed the effects of parenting styles and family-based interventions on the prevention of adolescent substance use. A scoping review of literature to identify studies published in English between 2012 and 2022 was conducted searching Scopus, MEDLINE, PsychInfo, and CINAHL databases focused on effects of parenting styles and family-based interventions in the prevention of adolescent substance use.Keywords of family-based intervention strategies and possible outcomes of parenting styles on youth substance use were coded from the results, discussion, or conclusion. Strategies were inductively categorized into themes according to the focus of the strategy. A total of 47 studies, published between 2012 and 2022 in English language included. Narrative synthesis illustrated that parental involvement, restriction of mature-rated content, parental monitoring, authoritative parenting styles, and parental support and knowledge can help in the prevention of adolescent substance use. On the contrary, poor parent-child bonding, overprotection, permissive parenting, parental frustrations, authoritarian and harsh parenting styles promoted adolescent substance use disorders. Proximal risk factors like peer influence, previous use of other substances, and risky behaviours had more effect than just parenting styles. Culturally tailored family-based intervention strategies such as "Preventive Parenting", "Parent Training", and "Parent Involvement", with focus on "Technology Assisted Intervention", particularly "SMART "(Substance Misuse among Adolescents in Residential Treatment) are found as effective family-based intervention strategies to mitigate substance use in youth. Culturally tailored family-based behavioural strategies psychosocial intervention strategies can be considered of the most effective strategies to prevent substance use disorders in youth.

Academic Strategies and Behavioral Management Interventions for Children with Attention Deficit Hyperactive Disorder (ADHD). A Survey of Literature.

Globally ADHD affects between 5 to 12 % of school going children (APA, 2013), with 9 to 80% of those children having learning difficulties in school (Ghahramani et al., 2016, Birrah et al.,2018). Yet it is recommended that behavioral therapy is the first line of treatment for children with ADHD (APA 2013, CHAD 2021). From this perspective, strategies for academic and behavioral management interventions are very critical especially to the teacher and parent/caregiver. The major purpose of this review article was to identify, explore and review studies that came up and implemented strategies for academic and behavioral management interventions to address challenges of children with ADHD.A literature search was conducted to identify studies on the topic of ADHD interventions and particularly those with findings on academic and behavioral management intervention strategies, conducted in the period between 2000 to 2022 and written in English were considered, a total of 40 studies met the criterion for inclusion and only (16) sixteen of those were reviewed. The findings of the review implicated that the interventions strategies that targeted both the teacher and the parent such as task modifications, get organized and physical classroom accommodation strategies (peer tutoring, physical structure adjustments) all had a significant impact on the behaviors of children with ADHD both at school and home. However, most of those children studied were taking medication for ADHD and these studies were done on smaller samples for shorter duration, therefore it is imperative that, the ADHD interventions strategies should be implemented for a longer period also on a larger sample.

A04: A Pilot Study on the Persistence of Children's Online Sports Games

Purpose: In the post-epidemic era, children's physical activity has decreased sharply, and smart sports at home have gradually emerged, making online sports games an important path for children's sports participation. This pilot study was to explore the persistence of children's online sports game participation through exercise frequency recording and provided guidance for online sports game intervention programs. Methods: A total of 29 primary school children were enrolled, including 24 boys and 5 girls. Participants exercise autonomously through motion software. In this study, the movement of each participant was recorded through the background of the software system and exported to Excel. Two-week period was used as one stage and a total of six stages were analyzed. After preliminary collation of the data, one-way ANOVA using SPSS23.0 was performed. Results: By analyzing the motion records of the 12 weeks of online exercise, overall trend of the first five stages is linear decreasing, and the trend of the fifth and sixth stages is flat; There was no significant difference between the first stage and the fourth stage (p &gt; 0.05). The first and fifth and sixth stages showed that the differences (p &lt; 0.01). The difference between the second and sixth stages was significant (p &lt; 0.05), and the difference between the second and fifth phases was very significant (p &lt; 0.01). Conclusions: Online sports games have a certain attraction to children, ensuring the frequency of children's early sports participation, but this attraction is difficult to last for a long time. Children's interest in sports will decline to varying degrees with time. It is recommended to further improve and stabilize the persistence of children's participation by formulating external behavioral intervention strategies and adjusting internal intervention programs.

Professional Development Increases Child Care Providers’ NDBI Implementation and Children’s Language Outcomes

A majority of children’s language learning experiences occur in inclusive early child care and education settings. Few evidence-based professional development (PD) programs exist to empower early childhood education providers to use language instruction practices with children in inclusive classrooms. There is little research on providers’ implementation of naturalistic developmental behavioral intervention (NDBI) strategies to improve children’s language outcomes in whole-group inclusive instruction. We conducted a pilot cluster randomized controlled trial to test the hypothesis that providers in the Early Achievements for Child Care Providers (EA-CP) PD program would show greater gains in NDBI implementation fidelity during shared book reading relative to business-as-usual (BAU) providers. This hypothesis was confirmed. Compared to BAU providers, EA-CP providers exhibited significantly greater fidelity gains from pre-training to mid-training, post-training, and 12-week maintenance assessments. A secondary hypothesis was that toddlers with and without developmental delays in the EA-CP condition would exhibit greater vocabulary and communication gains than toddlers in the BAU condition. Analyses of children with and without delays showed significantly greater expressive vocabulary and story-related engagement and communication in the EA-CP group. For children with delays, positive effects favoring the EA-CP group but not statistically significant were found. Implications for research, practice, and policy are discussed.

Implementation of Naturalistic Developmental Behavioral Intervention Strategies: An Examination of Preschool Teachers’ Perceptions

Naturalistic developmental behavioral intervention (NDBI) strategies appear to be well-suited for implementation by preschool teachers of young children ages 3 through 5, yet research exploring NDBI implementation within this specific context is extremely limited. We applied an implementation science framework to examine reported knowledge, frequency of use, and social validity perceptions of NDBI to support implementation within preschool classrooms. We surveyed 152 preschool teachers and compared ratings of general and special educators to understand their knowledge and use of NDBI strategies. We also compared ratings of preschool teachers with and without higher education training in applied behavior analysis. Findings indicate that NDBI strategies are a usable innovation for preschool teachers, yet targeted preservice and inservice training is warranted along with improved organizational factors to support NDBI uptake. Furthermore, open-ended survey responses provided a deeper understanding of social validity ratings and suggestions for NDBI-focused professional development.

E-cigarette cessation interest and quit attempts among young adults reporting exclusive e-cigarette use or dual use with other tobacco products: How can we reach them?

There is limited evidence to inform e-cigarette quitting interventions. This mixed-methods study examined: 1) e-cigarette and other tobacco product perceptions and cessation-related factors; and 2) potential behavioral intervention strategies among young adults reporting exclusive e-cigarette use or dual use with other tobacco products. We analyzed Fall 2020 survey data from 726 participants reporting past 6-month e-cigarette use (mean age=24.15 years, 51.1% female, 38.5% racial/ethnic minority) from 6 US metropolitan areas and Spring 2021 qualitative interview data from a subset (n=40), comparing tobacco-related perceptions and cessation-related factors among those reporting exclusive use versus dual use. Among survey participants (35.5% exclusive e-cigarette use, 64.5% dual use), those reporting dual use indicated greater importance of quitting all tobacco or nicotine products (mean=5.28, SD=3.44 vs mean=4.65, SD=3.75, p=0.033), whereas those reporting exclusive use expressed greater confidence in quitting e-cigarettes (mean=7.59, SD=3.06 vs mean=7.08, SD=3.01, p=0.029) and all tobacco and nicotine products (mean=7.00, SD=3.16 vs mean=6.31, SD=3.13, p=0.008), as well as less favorable perceptions (i.e. more harmful to health and addictive, less socially acceptable) of cigarettes, cigars, and smokeless tobacco (p<0.05). Interview participants (50.0% exclusive e-cigarette use; 50.0% dual use) attributed previous failed e-cigarette quit attempts to their inability to cope with social influences, stress, and withdrawal symptoms. Although most expressed disinterest in quitting due to belief of eventually outgrowing e-cigarettes (among those reporting exclusive use) or unreadiness to abstain from nicotine (among those reporting dual use), many acknowledged the need for quitting interventions. Young adult e-cigarette cessation interventions should target risk perceptions, cessation barriers, and social influences/support.

Product repair in a circular economy: Exploring public repair behavior from a systems perspective

AbstractRepair practices are driven not only by consumers’ internal motivation, but also by external infrastructural, social including cultural, financial, and political factors. We explore these factors with the goal of understanding the public repair of electrical and electronic products (e‐products) from a systems perspective to help devise appropriate change interventions. We document (a) behavioral aspects, (b) techno‐economic factors, and (c) intervention strategies aimed at promoting repair practices. To gauge this, a survey was administered among 922 volunteers across 14 countries with experience in repairing e‐products at public repair events. Findings suggest that while behavioral constructs including personal values, beliefs, and attitudes toward product repair are the main proximal drivers of intention to repair, the ability to repair plays an important role. Further, these individual factors are influenced by the techno‐economic settings such as access to repair services, economic benefits, and the ease of product repair stands out as the key enablers for product lifetime extension. As per intervention strategies, the results highlight economic incentives, regulatory requirements, and public awareness as the key drivers. However, influencing repair behavior directly may not always be the most effective strategy. New initiatives to improve involvement should focus on more repairable products, exploiting the innovative potentials of commercial as well as non‐profit repair initiatives, education, and supporting the development of skills among volunteer repairers.

Enhancing Mental Health and Medication Adherence Among Men Who Have Sex With Men Recently Diagnosed With HIV With a Dialectical Behavior Therapy-Informed Intervention Incorporating mHealth, Online Skills Training, and Phone Coaching: Development Study Using Human-Centered Design Approach.

Mental health problems are common among men who have sex with men (MSM) living with HIV and may negatively affect medication adherence. Psychosocial interventions designed to address these urgent needs are scarce in China. Incorporating behavioral health theories into intervention development strengthens the effectiveness of these interventions. The absence of a robust theoretical basis for interventions may also present challenges to identify active intervention ingredients. This study aims to systematically describe the development of a mobile health-based intervention for MSM recently diagnosed with HIV in China, including the theoretical basis for the content and the considerations for its technological delivery. We used intervention mapping (IM) to guide overall intervention development, a behavioral intervention technology model for technological delivery design, and a human-centered design and cultural adaptation model for intervention tailoring throughout all steps of IM. The dialectical behavior therapy (DBT)-informed intervention, Turning to Sunshine, comprised 3 components: app-based individual skills learning, group-based skills training, and on-demand phone coaching. The theoretical basis for the intervention content is based on the DBT model of emotions, which fits our conceptualization of the intervention user's mental health needs. The intervention aims to help MSM recently diagnosed with HIV (1) survive moments of high emotional intensity and strong action urges, (2) change emotional expression to regulate emotions, and (3) reduce emotional vulnerability, as well as (4) augment community resources for mental health services. Technological delivery considerations included rationale of the medium, complexity, and esthetics of information delivery; data logs; data visualization; notifications; and passive data collection. This study laid out the steps for the development of a DBT-informed mobile health intervention that integrated app-based individual learning, group-based skills training, and phone coaching. This intervention, Turning to Sunshine, aims to improve mental health outcomes for MSM newly diagnosed with HIV in China. The IM framework informed by human-centered design principles and cultural adaptation considerations offered a systematic approach to develop the current intervention and tailor it to the target intervention users. The behavioral intervention technology model facilitated the translation of behavioral intervention strategies into technological delivery components. The systematic development and reporting of the current intervention can serve as a guide for similar intervention studies. The content of the current intervention could be adapted for a broader population with similar emotional struggles to improve their mental health outcomes.

Associations among risk perception, health efficacy, and health behaviors for cardiovascular disease: an application of risk perception attitude framework.

There is currently a pervasive prevalence of cardiovascular disease (CVD) risk worldwide and an inadequate amount of action is being taken to promote healthy lifestyle habits. The risk perception attitude (RPA) framework, which classifies individuals based on their risk perception and efficacy belief, enables us to predict their preventive behaviors. We applied the RPA framework to analyze CVD prevention behaviors among Chinese adults and extended its application to CVD objective risk. A cross-sectional survey was performed in two sites in Zhejiang Province, from March to August 2022, which contained self-reported CVD risk perception, objective CVD risk, efficacy belief, physical activity, healthy diet, and covariates. We used the RPA framework to categorize participants into four groups, then analysis was conducted to estimate inter-group differences in healthy behaviors. We further conducted a hierarchical logistic regression analysis with individuals' health behaviors as the dependent variable, using three blocks of independent variables. Among 739 participants, healthy physical activity and healthy diet had significant differences among four RPA groups, post hoc tests clarified that the proportion of respondents with healthy PA in the responsive group (61.6%) was significantly higher than that in the other three groups. Risk perception and efficacy belief significantly predicted health behavior against CVD; the relationship between absolute CVD risk and health behavior was moderated by efficacy belief. Early CVD risk screening is crucial, but tailored support and a proper understanding of personal risk are essential to promote healthy behaviors. Developing communication and behavioral counseling intervention strategies on the basis of the RPA framework has the potential to promote healthy behaviors for CVD prevention.