Behavioral Model Research Articles

The Effectiveness of an Intervention Based on the Information, Motivation, and Behavioral Skills Model on Treatment Adherence and Self-Efficacy in Patients with Coronary Artery Diseases: An Explanatory Mixed Method Study

Background: Promoting adherence to treatment and self-efficacy in patients with coronary artery diseases helps to improve patient outcomes. The present study was conducted to explain the effectiveness of interventions based on information, motivation, and behavioral skills model on treatment adherence and self-efficacy in patients with coronary artery diseases. Methods: This explanatory-sequential study was conducted on patients with coronary artery diseases in Shiraz, Iran. First, a quasi-experimental study was conducted on 112 patients who were randomly assigned to two intervention and control groups. The intervention consisted of ten motivational training sessions that were designed based on Information, Motivation, and Behavioral Skills (IMBS) model and continued with six months of telephone follow-up and counseling. Data were collected before, three months, and six months after the end of the intervention. Then, in the second phase, a qualitative study including 20 in-depth interviews with 18 participants from the intervention group was conducted. The data were analyzed by deductive and inductive qualitative content analysis. Finally, quantitative findings were explained with the help of qualitative findings. Results: The findings showed that the mean score of treatment adherence, medication adherence, and self-efficacy in the intervention group was significantly higher than the control group 3 and 6 months after the intervention (p<0.001). The results of the qualitative phase of the study also showed that the four main categories include receiving targeted information, encouragement to care, gained self-efficacy/doubt in care, and improvement/non-improvement of treatment adherence behaviors can explain quantitative phase results. Conclusion: The results showed that receiving training with effective methods, strengthening the support system, self-confidence and positive attitudes about care, and promoting self-management and proper management of emotional distress contributed to the effectiveness of the interventions. However, receiving conflicting information, limited financial resources, and the inability to face challenges were among the obstacles to strengthening self-efficacy and adherence to treatment.

Investigating what promotes and deters Scottish cybercrime reporting

Cybercrime is under-reported in Scotland, with the reasons for this being poorly understood. To investigate underreporting, we commenced with a search of the related research and then carried out a review of actual cases. Next, to uncover Scottish-specific factors, we qualitatively interviewed 10 Scottish cybercrime victims. It emerged that victims blamed themselves for falling prey to cybercrime and were reluctant to report the incident. This is arguably a direct consequence of the UK government’s cybersecurity responsibilization strategy. Informed by our findings, we articulated a national strategy for promoting cybercrime reporting using the MINDSPACE behavioral influence model. Subsequently, we verified this model with a survey of 380 Scottish respondents, a representative sample of the general population in terms of age and gender. We report on and discuss our findings. Finally, we recommend two interventions to inform a national strategy for improving cybercrime reporting in Scotland.

Behavioral Economics Concepts and the Q.E. Method

In Behavioral Economics, the notion of perfect rationality is replaced by a more nuanced understanding that recognizes the limits of human decision-making, such as bounded rationality, willpower, self-interest, and attention. Instead of expecting individuals to always act in perfectly rational ways, models in Behavioral Economics are judged by the accuracy of their predictions rather than the realism of their assumptions. This perspective aligns well with the Quantification of Quality Data (Q.E.) method, which also prioritizes the accuracy and integrity of the model's outcomes over the simplicity of its assumptions. The Q.E. method begins with a solid theoretical framework, where a hypothesis is carefully crafted to define the scope and objectives of the analysis. This initial step is crucial because it sets the foundation for the mathematical determination that follows, ensuring that the analysis is rooted in a clear theoretical context rather than being driven solely by empirical data. By generating values for independent variables within a defined range through randomization, the Q.E. method allows for a comprehensive exploration of how these variables influence the model. This process typically involves the use of multiple mathematical equations to fully capture the complex behavior of the model. A key feature of the Q.E. method is its feedback loop, which plays a critical role in maintaining consistency between the mathematical model and the underlying theoretical principles. Through iterative hypothesis testing, model adjustment, and continuous feedback, the Q.E. method ensures that the mathematical model not only aligns with the theory but also accurately reflects the behavioral nuances that are central to Behavioral Economics. This rigorous approach allows for the refinement of the initial hypothesis and the confirmation of the model’s predictive accuracy, ensuring that the quantification of quality data is both theoretically sound and empirically valid. In this way, the Q.E. method supports the development of Behavioral Economic models that are robust, reliable, and reflective of real-world decision-making processes.

A Data Mining-Based Method to Disclose Usage Behavior Patterns of Fresh Air Systems in Beijing Dwellings during the Heating Season

As the popularity of fresh air systems (FAS) in residential buildings increases, exploring the behavioral characteristics of their use can help to provide a comprehensive understanding of the potential for demand flexibility in residential buildings. However, few studies in the past have focused on the personalized usage behavior of FAS. To fill this gap, this study proposes a method based on data mining techniques to reveal the behavioral patterns of FAS usage and the motivations behind them, including motivational patterns, operation duration patterns, and human–machine interaction patterns, for 13 households in Beijing. The simultaneously obtained behavioral patterns, in turn, form the basis of association rules, which can classify FAS usage behavior into two typical residential user profiles containing user behavioral characteristics. This study can not only provide more accurate assumptions and inputs for behavioral stochastic models but also provide data support for the development and optimization of demand response strategies.

Influence of Household Socio-Economic, Demographic, And Cultural Factors on Women's Access to Maternal Healthcare in Malindi Sub County, Kilifi County, Kenya

Globally, maternal healthcare access remains a critical concern due to significant disparities, particularly in developing countries where access rates are notably lower. The Sustainable Development Goals underscore the importance of prioritizing maternal health, urging nations to improve access to maternal healthcare services. However, various factors hinder full access to such services. This study investigated the influence of social and economic factors on household access to maternal healthcare in Malindi Sub County, Kilifi County. Specifically, it examined the impact of income levels, literacy rates, parental age, and religious beliefs. The study, grounded in the Behavioral Model of Healthcare Service Utilization, Maternal Morbidity Measurement (MMM), and the Three Delay Theory, employed a descriptive survey design approach. A sample size of 382 respondents was determined using the Krejcie and Morgan’s (1970) formula from a population of 73,547 households. Stratified sampling was employed to divide the sub-county into five strata based on wards, selecting households with mothers accessing maternal health services using purposive sampling. Additionally, twenty respondents were purposively chosen for key informant interviews. Because the dependent variable in the questionnaire was binary (access to maternal healthcare was either yes or no), the study used binomial logistic regression modeling to ascertain the influence of income levels, literacy levels, parental age and religious beliefs on the access to maternal healthcare. Income levels, with a coefficient of 2.236 (p-value = 0.007), literacy levels, with a coefficient of 1.981 (p-value = 0.002), and religious beliefs, with a coefficient of 1.004 (p-value = 0.037), were identified as significant factors positively influencing access to maternal healthcare. Conversely, parental age demonstrated a significant negative impact on access, with a coefficient of -1.262 (p-value = 0.004). The study concludes that socioeconomic status, education, and religious beliefs significantly influence maternal healthcare access, with a particular concern regarding diminished access as parental age increases. Consequently, this research emphasizes the critical need for targeted interventions to alleviate these disparities, recommending economic empowerment for women with lower income levels, health literacy education initiatives for vulnerable populations, and a multimodal approach to address cultural barriers and support both younger and older mothers in accessing healthcare services.

Exploring cognitive behavioral mechanisms related to dissociation among patients suffering from schizophrenia: A pilot study

IntroductionDissociation is a challenging syndrome present in multiple psychiatric disorders for which no gold standard treatment exists. Recently, some authors have developed a Cognitive Behavioral Model of dissociation, offering new insights for psychotherapy. However, this model has primarily been assessed in patients suffering from PostTraumatic Stress Disorder (PTSD). Therefore, the aim of this study is to explore the relevance of this conceptualization in patients suffering from schizophrenia. MethodWe recruited 20 patients (15 men) suffering from schizophrenia. After providing consent, they completed self-reported questionnaires assessing dissociation, PTSD, beliefs about emotion, beliefs about dissociation, mindfulness abilities, and emotion regulation. Then, they responded to three open-ended questions exploring the triggers of dissociation and strategies used to counteract it. ResultsWe found a low prevalence of the different cognitive-behavioral mechanisms related to dissociation in our sample. However, we found significant relationships between these mechanisms and dissociative symptoms. This relationship was also identified in the qualitative analysis. ConclusionThe present results offer primary data supporting the relevance of the cognitive-behavioral conceptualization of dissociation in patients suffering from schizophrenia. Further studies should be conducted with larger samples and include additional variables to enhance the understanding of dissociation in this population.

Barriers and enablers that influence the uptake of HIV testing among heterosexual migrants in the Netherlands.

Heterosexual migrant men and women in the Netherlands often face barriers to accessing health services, including HIV testing, that may lead to late-stage HIV diagnoses. This study explored factors of influence in the usage of HIV testing among heterosexual migrants. Qualitative evaluation with semi-structured interviews at the Amsterdam-based AIDS Healthcare Foundation (AHF) Checkpoint and one focus group discussion (FGD) conducted during June-July 2023 with 19 participants: interviews with 12 heterosexual migrants from low- or middle-income countries (LMICs) and FGD (n = 5) and interviews (n = 2) with 7 key informants from the (public) health sector. Recorded interviews were transcribed and thematically analyzed, using the framework of Andersen's Expanded Behavioral Model of Health Services Use. In total, 55 themes emerged from the interviews and the FGD. Examples include insufficient availability of information on HIV and testing services, and difficulty in accessing these services (e.g. the barrier of the online appointment system of the Centre for Sexual Health (CSH)). HIV test participants expressed free, rapid testing, no appointment required, and a positive experience during their HIV test as enablers to test in the future. Results from key informants showed that poor health literacy and lack of clarity on the healthcare system's guidelines were barriers for heterosexual migrants in accessing information on HIV and testing services. It also revealed past initiatives and interventions that were successful in reaching at-risk groups such as the integration of HIV testing into sexually transmitted infection (STI) testing, but that were subsequently discontinued due to financial constraints. Factors contributing to a low HIV test uptake were participants' perception of limited accessibility of CSH facilities, insufficient available information on HIV (testing) services, and low perception of HIV risk. Unclear policies on accessing HIV/STI testing services at CSHs, and potential missed opportunities for HIV testing at general practitioners were contributing factors identified by key informants.

Predisposing, enabling, and need factors influencing health-related quality of life among people with metabolic syndrome

BackgroundMetabolic syndrome (MetS) continues to impact the health-related quality of life (HRQoL) of patients despite various available therapeutic interventions. There is a dearth of information on how patient-centered factors holistically predict HRQoL to provide more insights on addressing MetS. ObjectiveTo predict the HRQoL of patients with MetS in the Southern states, using the predisposing, enabling, and need factors. MethodsThe study adopted a cross-sectional approach in collecting 706 complete surveys on HRQoL assessment using the EQ-5D-5L survey and demographic characteristics based on the predisposing, enabling, and need factors of Andersen’s Behavioral model. The study focused on people with MetS in the southern states of the United States. Multinomial logistic regression was conducted to investigate the relationship between the number of comorbidities and each HRQoL dimension. Ordinal regression was used to explore factors predicting HRQoL. Sensitivity analysis was conducted using bootstrapping analysis to evaluate the regression’s robustness. ResultsOver 70% were females and 30% had at least a bachelor's degree, while 47% were married. Most respondents (71.1%) had no problem with self-care. However, 20.0% had severe problems with pain, while the highest proportion (8.6%) was observed for extreme problems with anxiety or depression. A unit increase in comorbidities resulted in higher odds of having extreme problems with mobility (odds ratio [OR] = 1.95), usual activities (OR = 1.73), and pain (OR = 1.70). Only 40.8% of the respondents had good HRQoL, compared to 26.2% with poor HRQoL. Age, race, geographical area, marital status, household income, number of prescription drugs, comorbidities, and body mass index were predictors of HRQoL. ConclusionAn increase in comorbidities significantly increased the odds of having challenges with the HRQoL dimensions. Demographic, socioeconomic, and health-related factors significantly predicted HRQoL. Therefore, health care providers must consider these factors as a component of patient-centered care to address health disparities and promote optimal health outcomes among people with MetS.

Spillover Effects Between the Stock Market and the Real Economy in a Mixed-Frequency Agent-Based Macrofinancial Model

Abstract This paper illustrates a behavioral mixed frequency macro-finance model where both real and financial variables are generated on a daily basis. Further, while financial sector data is collected at the same frequency as it is generated (i.e. daily), real data can only be collected on a quarterly basis. Under these circumstances, output and inflation, upon which data is available with a significant delay, become unsuitable as the sole information guide for monetary policy. We suggest that policy makers can deal with this information problem by reacting to the variable on which data is collected on high frequency basis: the stock price.

A multi-pathogen behavioral exposure model for young children playing in public spaces in developing communities.

Diarrheal disease is the second leading cause of death among children under five in developing communities, despite active interventions to improve access to water, sanitation, and hygiene resources. Even interventions with high fidelity and compliance saw minimal improvements in health outcomes, necessitating a need for looking beyond traditionally targeted exposure pathways. This study focuses on the pathogen exposure a young child may receive while playing in the public spaces of informal settlements, where animal feces, human feces, and garbage are frequently observed. The study utilized 79 soil samples previously collected across ten cluster sites in Corail, Haiti and processed using DelAgua cultural assays and quantitative Polymerase Chain Reaction methods. Molecular assays screened for Aeromonas, Vibrio cholera, and several pathogenic Escherichia coli species. Behavioral observations of young children (<5 years old) were also conducted in overlapping areas with the environmental sampling to quantify frequency of risky and mitigating behaviors. Environmental and behavioral data were combined to obtain the posterior distribution of children's pathogen exposure from playing in a public space for one hour. The model estimated that children have a likelihood of approximately 70% of being exposed to a pathogen during one hour of play and a greater than 30% chance of being exposed to multiple pathogens in the same period. While children and toddlers practice fewer risky behaviors compared to infants, they were shown to have higher likelihood of exposure and slightly higher pathogen dose per exposure. As anticipated, a high correlation between genes from the same E. coli species was observed in the model output. These findings demonstrate the need to consider public spaces as an important exposure pathway for young children for both future research and interventions.

Spatial variations in health service utilization among migrant population: a perspective on health equity.

As health equity becomes a prioritized goal in global health policy, extensive research has revealed that socio-economic and geographical factors jointly exacerbate barriers to medical service access for both internal and international migrant populations, further accelerating existing health disparities. This study explores healthcare service utilization disparities among internal migrants in China, a population profoundly affected by the country's economic reforms and urbanization since the late 1970s. These transformations have led to significant migratory movements and subsequent healthcare challenges for these populations. Leveraging data from the 2017 China Migrant Dynamic Survey, comprising 169,989 samples across 28 provinces, we introduce a novel metric-the "No Treatment ratio" (NT-ratio). This ratio quantifies the proportion of migrants who, after falling ill, choose not to seek treatment relative to the total migrant population in a given province or region, serving as a critical measure of health risk. Building upon Anderson's Behavioral Model of Health Services Use, we adapted the model to better reflect the unique circumstances of migrant populations. The study employs spatial autocorrelation, hotspot analysis, and geodetector techniques to dissect the multifaceted factors influencing healthcare disparities. Our Findings reveal that the NT-ratio is significantly higher in eastern and northeastern China. Key factors influencing the NT-ratio include age, left-behind experiences, health education, and per capita medical resources. In response to these disparities, we recommend optimizing the distribution of medical resource, strengthening tiered diagnosis and treatment systems, and integrating health, education, and social security resources. These measures aim to improve healthcare utilization among migrant populations and reduce health inequities, aligning with global health objectives.

Factors associated with early sexual onset and delaying sex in rural middle school youth.

Early sexual onset contributes to poor health outcomes through the life course. We use the social behavioral model to examine the behaviors and attitudes associated with early sexual onset and the intention to delay sex in middle school youth. Youth in rural communities with high rates of hepatitis C and HIV filled out a survey prior to implementation of an evidence-based sex education program. Participants were asked if they had ever had sex and whether they planned to abstain from sex until the end of high school. We collected demographics, attitudes about abstinence, agency for sexual refusal, parent communication, sexual health knowledge, and history of system involvement. Logistic regression was utilized to examine factors associated with each outcome. Our sample included 6,799 students, 12.7 years old ± 0.9 and 50.3% female. 5.1% had ever had sex and 73.9% planned to abstain until the end of high school. Early sexual onset was associated with older age, negative attitudes toward abstinence, lower agency for sexual refusal, more frequent parent communication about sex, history of child welfare, and history of juvenile involvement. Planning to abstain until the end of high school was associated with being younger, female, positive attitudes toward abstinence, higher agency for sexual refusal, less communication with parents about sex, more communication with parents about relationships, not having a history of foster involvement, and not having a history of juvenile involvement. Age, agency, and parent communication were all associated with both outcomes. Our findings highlight the importance of early comprehensive, trauma-informed sex education.

Variables associated with higher community integration among permanent supportive housing residents

ABSTRACT Few studies have used a framework for exploring a broad range of resident characteristics, housing, and service use features that might increase community integration among permanent supportive housing (PSH) residents who have lived in scattered-site or single-site PSH for 6 months to 5+ years. This study is original in identifying predisposing, enabling, and need factors associated with higher community integration among PSH residents. PSH residents from Quebec (Canada) were recruited through 25 housing organizations between January 2020 and April 2022. Structured interviews using numerous standardized scales were conducted, each lasting about 90 minutes. Based on the Gelberg-Andersen Behavioral Model, independent variables, measured mostly within 12 months of the interview, were categorized into predisposing, need, and enabling factors. Multivariate linear regression analysis was produced on community integration. Those experiencing moderate to severe psychological distress and having more unmet needs had lower community integration scores. Conversely, residents in single-site PSH located in neighborhoods with good physical conditions and high collective effectiveness, and those who received more outpatient services showed better community integration. Enhancing intergovernmental collaboration to develop high-quality PSH in well-maintained neighborhoods, focusing on socialization and community participation, especially for scattered-site PSH residents, may contribute to improved community integration.

Perceptions and decision-making of dental professionals to adopting sustainable waste management behaviour: a Theory of Planned Behaviour analysis.

Background High carbon emissions associated with clinical waste disposal in dentistry pose an environmental and public health concern. Current NHS guidelines do not mandate sustainable waste management resulting in recyclable dental waste being incinerated. In the absence of such policies, decision to implement sustainable waste management practices falls upon dental professionals who rely on their own knowledge and beliefs about the environmental impact of dentistry. Literature exploring barriers to sustainable waste management by dental professionals require further insight on dental professionals' decision-making processes. Therefore, this study uses a behavioural decision-making model - the Theory of Planned Behaviour (TPB) - to explore sustainable waste segregation behaviour of dental professionals based on their attitudes and beliefs about sustainable dentistry and climate change.Methods Fifteen semi-structured interviews were conducted with dental professionals between October and November 2022 in dental practices in Fife, Scotland. Interviews were analysed using Braun and Clarke's reflexive thematic data analysis.Findings Following thematic analysis, eight themes were identified around the participants' attitudes, perceived subjective norms and perceived behavioural control, pointing at the way knowledge gaps and lack of awareness were often linked with attitudes which are associated with low intention to execute sustainable waste management.Conclusions TPB offers a useful framework to understand waste segregation behaviour of dental professionals. Further studies are required to further establish sustainable waste management behaviour.

Utilization of anal cytology screening among sexual and gender minority populations in Pennsylvania.

Despite the risk of anal cancer in sexual and gender minority populations (SGM), anal cancer screening remains infrequent and inconsistent in these populations. The objective of this analysis was to identify factors associated with anal cancer screenings among sexual and gender minority populations (SGM) using the Andersen's Behavioral Model of Health Services Use. Secondary analyses of two cross-sectional surveys from the 2020 (N=1125) and 2022 (N=630) "Pennsylvania LGBTQ Health Needs Assessment." Multiple logistic regression analyses were used to identify correlates of anal cytology screening. Average age was 37.7 (SD=13.3) and 39.7 (SD=13.6) in 2020 and 2022, respectively. Approximately 16-18% reported living with HIV. A minority of respondents reported past year screening (14.0% 2020 and 13.6% 2022). Enabling and need-based factors consistently associated with screening included STI treatment, living with HIV, PrEP use, and multiple sex partners. Robust factors associated with ever being screened were age and living with HIV. Anal cytology screening is being done in Pennsylvania at a small but not insignificant rate. In accordance with existing guidelines, SGM living with HIV were most likely to be screened, but still at a low rate. Predictive factors associated with screening in this study can inform future interventions to implement guideline-specific anal cancer prevention. Factors that reflect consistent connection to healthcare are associated with increased rates of screening via anal cytology testing, indicating there are opportunities to implement anal cancer screening as part of a larger, more comprehensive SGM-focused care pathway.

"Such pushing and shoving… and the smell! Why ever would they allow these people in to the Academy” sociability and body language of Madrid's museums visitors (19th century)

In 1828 preparations were being made for the opening of the first public museum in Spain: the Royal Prado Museum. Along with the placement of the works of art and the control of their security, visitors were an essential part of the organisation of the establishment. Although the valued role of museums as democratisers of culture has been emphasised, more recent studies have observed that the first visitors to European museums were not from all social strata. This article aims to analyse the public museum as an arena of sociability and to investigate the involvement of social elites in both the control of access and the imposition of behavioural models within these "temples of the arts.” For this reason, this paper approaches the debate around the concept of citizenship. On the one hand, it explores the gradual opening of museums to all social classes and the social debates surrounding it. On the other hand, it analyses the use of the museum as a space of symbolic battle for the appropriation of these scenarios and the creation of exclusion dynamics to limit interactions between social classes. Therefore, the text analyses, among other sources of analysis, the body language of visitors. An object of study that has been understudied but which can offer us interesting answers.

A Conceptual Framework of the Retirement Savings Behavior among Civil Servants in Malaysia

The feasibility of maintaining a comfortable standard of living for civil servants in Malaysia is frequently questioned due to their reliance on pensions as the primary source of retirement funds, which may not suffice to cover the rising retirement costs. To address this issue, civil servants could consider accumulating savings during their working years instead of solely depending on pension disbursements. This academic discourse examines the effect of the independent variables of attitudes towards retirement savings (financial risk tolerance, past behaviours, and subjective norms as psychological elements) and financial considerations (tax incentives) on retirement savings behaviour. Additionally, the research also explores the moderating role of perceived government policy and perceived behavioural control with its antecedents, namely financial literacy, self-control between the independent variables, and retirement savings behaviour among civil servants in Malaysia. Drawing from the extended interactive theory of planned behaviour, amalgamated theories comprising the interactive theory of planned behaviour, rationale choice theory, and the behavioural economic model and existing literature, this article introduces a conceptual framework detailing the determinants influencing the RSB of civil servants in Malaysia. The proposed framework has the potential to benefit various stakeholders, particularly civil servants seeking to prepare adequately for their retirement years.

D-MHGCN: An End-to-End Individual Behavioral Prediction Model Using Dual Multi-Hop Graph Convolutional Network.

Predicting individual behavior is a crucial area of research in neuroscience. Graph Neural Networks (GNNs), as powerful tools for extracting graph-structured features, are increasingly being utilized in various functional connectivity (FC) based behavioral prediction tasks. However, current predictive models primarily focus on enhancing GNNs' ability to extract features from FC networks while neglecting the importance of upstream individual network construction quality. This oversight results in constructed functional networks that fail to adequately represent individual behavioral capacity, thereby affecting the subsequent prediction accuracy. To address this issue, we proposed a new GNN-based behavioral prediction framework, named Dual Multi-Hop Graph Convolutional Network (D-MHGCN). Through the joint training of two GCNs, this framework integrates individual functional network construction and behavioral prediction into a unified optimization model. It allows the model to dynamically adjust the individual functional cortical parcellation according to the downstream tasks, thus creating task-aware, individual-specific FCNs that largely enhance its ability to predict behavior scores. Additionally, we employed multi-hop graph convolution layers instead of traditional single-hop methods in GCN to capture complex hierarchical connectivity patterns in brain networks. Our experimental evaluations, conducted on the large, public Human Connectome Project dataset, demonstrate that our proposed method outperforms existing methods in various behavioral prediction tasks. Moreover, it produces more functionally homogeneous cortical parcellation, showcasing its practical utility and effectiveness. Our work not only enhances the accuracy of individual behavioral prediction but also provides deeper insights into the neural mechanisms underlying individual differences in behavior.

The Dynamic Adaptation of the Journey of Hope: A School-Based Intervention to Support Pandemic and Disaster-Affected Children and Youth.

The Journey of Hope (JoH) is an evidence-based behavioral health prevention intervention model designed for disaster-affected children and youth. While the in-person JoH model has been extensively delivered and studied, the virtual implementation of this intervention, specifically tailored for the unique needs of children and youth during the COVID-19 pandemic, has not been previously explored. In this context, authors of this article adapted the JoH to a virtual delivery model, aiming to provide access to behavioral health preventive services for children and youth during the COVID-19 pandemic when in-person services were not feasible. This adaptation, utilizing the dynamic adaptation process (DAP) and community-based participatory research (CBPR) principles, was carefully designed to meet pandemic-related challenges while maintaining the core components of the original intervention. The primary objectives of this article are twofold: (1) to provide an overview of the theoretical and conceptual underpinnings of the JoH-C19, including the framework that guided the adaptation, and (2) to describe the virtually adapted curriculum and initial pilot of the JoH-C19. This adaptation represents a crucial step in ensuring the accessibility of virtual behavioral health interventions for young populations facing various collective traumas and challenges in a rapidly evolving world.

5A's Behavior Change Model Improves Nutrition Knowledge and Intake Among Adolescent Athletes.

This study compared the effects of 12 weeks of intensive nutrition education (IE) using the 5A's behavioral change model and basic nutrition education (BE) on nutritional knowledge and nutrient intake among Korean adolescent athletes. This study included elite adolescent athletes (IE group: n = 65, BE group: n = 65) at a physical education high school in Seoul. In this prospective, randomized, controlled trial, the athletes' body composition, nutritional knowledge, nutrient intake, and self-management practices were evaluated at the beginning and end of the intervention. Both groups had increased levels of nutrition knowledge between pre- and post-test, but the change in total score for nutrition knowledge was significantly higher in the IE group than in the BE group (p < 0.001). Energy intake post-test increased significantly in the IE group (from 2,185 to 2,651 kcal/day, p < 0.001) but not in the BE group. The intake of carbohydrates, protein, and fat also increased significantly in the IE group (carbohydrates: from 298 to 352 g/day, protein: from 86 to 106 g/day, fat: from 71 to 88 g/day, all p < 0.001), but the change in the BE group was not significant. Additionally, the IE group showed a significant overall increase in vitamins and minerals compared to the BE group at post-test. Adolescent athletes in the IE group showed improved nutritional knowledge and intake compared to those in the BE group 12 weeks after the intervention.