Catalyst For Behaviour Change Research Articles

Motivational Interviewing Conversational Agent for Parents as Proxies for Their Children in Healthy Eating: Development and User Testing.

BackgroundIncreased adoption of off-the-shelf conversational agents (CAs) brings opportunities to integrate therapeutic interventions. Motivational Interviewing (MI) can then be integrated with CAs for cost-effective access to it. MI can be especially beneficial for parents who often have low motivation because of limited time and resources to eat healthy together with their children.ObjectiveWe developed a Motivational Interviewing Conversational Agent (MICA) to improve healthy eating in parents who serve as a proxy for health behavior change in their children. Proxy relationships involve a person serving as a catalyst for behavior change in another person. Parents, serving as proxies, can bring about behavior change in their children.MethodsWe conducted user test sessions of the MICA prototype to understand the perceived acceptability and usefulness of the MICA prototype by parents. A total of 24 parents of young children participated in 2 user test sessions with MICA, approximately 2 weeks apart. After parents’ interaction with the MICA prototype in each user test session, we used qualitative interviews to understand parents’ perceptions and suggestions for improvements in MICA.ResultsFindings showed participants’ perceived usefulness of MICAs for helping them self-reflect and motivating them to adopt healthier eating habits together with their children. Participants further suggested various ways in which MICA can help them safely manage their children’s eating behaviors and provide customized support for their proxy needs and goals.ConclusionsWe have discussed how the user experience of CAs can be improved to uniquely offer support to parents who serve as proxies in changing the behavior of their children. We have concluded with implications for a larger context of designing MI-based CAs for supporting proxy relationships for health behavior change.

Exploring the COVID-19 Pandemic as a Catalyst for Behavior Change Among Patient Health Record App Users in Taiwan: Development and Usability Study.

BackgroundDuring the COVID-19 pandemic, personal health records (PHRs) have enabled patients to monitor and manage their medical data without visiting hospitals and, consequently, minimize their infection risk. Taiwan’s National Health Insurance Administration (NHIA) launched the My Health Bank (MHB) service, a national PHR system through which insured individuals to access their cross-hospital medical data. Furthermore, in 2019, the NHIA released the MHB software development kit (SDK), which enables development of mobile apps with which insured individuals can retrieve their MHB data. However, the NHIA MHB service has its limitations, and the participation rate among insured individuals is low.ObjectiveWe aimed to integrate the MHB SDK with our developed blockchain-enabled PHR mobile app, which enables patients to access, store, and manage their cross-hospital PHR data. We also collected and analyzed the app’s log data to examine patients’ MHB use during the COVID-19 pandemic.MethodsWe integrated our existing blockchain-enabled mobile app with the MHB SDK to enable NHIA MHB data retrieval. The app utilizes blockchain technology to encrypt the downloaded NHIA MHB data. Existing and new indexes can be synchronized between the app and blockchain nodes, and high security can be achieved for PHR management. Finally, we analyzed the app’s access logs to compare patients’ activities during high and low COVID-19 infection periods.ResultsWe successfully integrated the MHB SDK into our mobile app, thereby enabling patients to retrieve their cross-hospital medical data, particularly those related to COVID-19 rapid and polymerase chain reaction testing and vaccination information and progress. We retrospectively collected the app’s log data for the period of July 2019 to June 2021. From January 2020, the preliminary results revealed a steady increase in the number of people who applied to create a blockchain account for access to their medical data and the number of app subscribers among patients who visited the outpatient department (OPD) and emergency department (ED). Notably, for patients who visited the OPD and ED, the peak proportions with respect to the use of the app for OPD and ED notes and laboratory test results also increased year by year. The highest proportions were 52.40% for ED notes in June 2021, 88.10% for ED laboratory test reports in May 2021, 34.61% for OPD notes in June 2021, and 41.87% for OPD laboratory test reports in June 2021. These peaks coincided with Taiwan’s local COVID-19 outbreak lasting from May to June 2021.ConclusionsThis study developed a blockchain-enabled mobile app, which can periodically retrieve and integrate PHRs from the NHIA MHB's cross-hospital data and the investigated hospital's self-pay medical data. Analysis of users’ access logs revealed that the COVID-19 pandemic substantially increased individuals’ use of PHRs and their health awareness with respect to COVID-19 prevention.

Accentuate the positive, eliminate the negative: Reducing ambivalence through instructed emotion regulation.

Ambivalence, the simultaneous experience of positivity and negativity, is a conflicting, uncomfortable, arousing state but is a necessary catalyst for behavior change. We sought to examine whether feelings of ambivalence can be reduced using instructed emotion regulation of positive and negative affect, the components of subjective ambivalence. Event-related brain potentials (ERPs) were collected while participants played 3 blocks of mixed gambles, in which each trial involved losing or winning the lesser or greater of 2 amounts. In the 1st block participants responded naturally, and in the 2nd and 3rd blocks they were instructed to focus on either the positive or negative aspects of the outcome. Disappointing wins (e.g., winning $5 instead of winning $12) and relieving losses (losing $5 instead of losing $12) reliably elicited ambivalence; focusing on either the negative or positive aspects of the outcome reduced ambivalence as well as the magnitude of the late positive potential (LPP), indicating successful regulation. Both self-reported affect and ERPs indicated that emotional responses to losses were more difficult to regulate than responses to wins, consistent with a negativity bias in affective processing. Results are interpreted in the framework of theories of affect, and implications for changing behavioral motivation to support healthy behaviors are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Motivational Interviewing: A Communication Tool to Promote Positive Behavior Change and Optimal Health Outcomes.

Motivational interviewing (MI) is a collaborative communication style that can be integrated into everyday practice to improve conversations and serve as a catalyst for behavior change. This article reviews the fundamental principles and basic skills of MI. It discusses how MI has evolved from a therapeutic modality to a conversational style, applicable in the school setting and specifically for school nurses. The article provides an overview of how MI can be used by school nurses, challenges they may face, and resources to support implementation.

A DEMONSTRATION BUILDING PROJECT: PROMOTING SUSTAINABILITY VALUES

ABSTRACT This article explores the relevance of the demonstration project as a strategy for inspiring contemporary building practice in a process towards sustainable building and as a tool for influencing environmental values in the community. The Log Cabin Project in Napier, New Zealand, is a demonstration facility for displaying sustainable building and living practices situated on the campus of the Eastern Institute of Technology (EIT). The project is the refurbishment of an existing structure designed to showcase the sustainable use of material resources, energy and water conservation, and waste-water management. The aim was to investigate the effect visiting a demonstration sustainable building might have on people’s knowledge of and attitude towards sustainability issues, and more specifically whether the methods for making a building more sustainable displayed in the building affected how people thought about their own living environments. In February 2016, five visitor groups, three of EIT students not previously connected with the project, one of EIT staff, and a local environment group were invited to view the project and surveys were conducted both before and after the visit with 126 participants completing both pre- and post-surveys. The research found improved scores after the visit in six of the seven survey measures of environmental knowledge, motives, and intentions, especially in the case of student visitor groups. The results also indicated promising increases in environmental values and concerns for environmental quality after the visit. Correlation between gender and sustainable action was not significant, however there was significant correlation between age and actions intended in the future where engagement was higher among young participant groups. Moreover, although many visitors had previously engaged with at least one pro-environmental activity before visiting the project (90%), 42% made at least one change as a result of the visit. These findings suggest the project was a catalyst for behaviour change. Discussions are centred on the usefulness of demonstration sustainable buildings as tools for fostering environmental protection practices.

Editorial Commentary: Hepatitis C Virus Testing and Drug Use in North America; Is There More Than Meets the Eye?

Editorial Commentary: Hepatitis C Virus Testing and Drug Use in North America; Is There More Than Meets the Eye?

Acceptability of screening for early detection of liver disease in hazardous/harmful drinkers in primary care

It is estimated that one-quarter of adults in the UK drink at harmful/hazardous levels leading to increased mortality and alcohol liver disease (ALD). The Alcohol Liver Disease Detection Study (ALDDeS) aimed to test out in primary care the feasibility of alcohol misuse screening in adults, using the AUDIT questionnaire, and to assess screening harmful/hazardous alcohol users for ALD using newer non-invasive serum markers of fibrosis. To explore patients' experiences of taking part in ALDDeS and understanding of the delivery and process of screening for ALD using self-report questionnaires and feedback of liver fibrosis risk using levels of non-invasive serum markers. A nested qualitative study based in five primary care practices in the UK. From a sample of patients who were identified as drinking at harmful/hazardous levels, 30 participants were identified by maximum variation sampling for qualitative in-depth interviews. Using the principles of constant comparison the transcribed interviews were thematically analysed. Receiving a postal AUDIT questionnaire was viewed as acceptable by participants. For some completing the AUDIT increased awareness of their hazardous alcohol use and a positive blood test indicating liver fibrosis was a catalyst for behaviour change. For others, a negative blood test result provided a licence to continue drinking at hazardous levels. A limited understanding of safe drinking and of ALD was common. Educational and training needs of primary care professionals must be taken into account, so that patients with marker levels indicating low risk of fibrosis are correctly informed about the likely risks of continuing to drink at the same levels.

The use of building energy certificates to reduce energy consumption in European public buildings

This paper presents evidence for the role of building energy certificates as a behaviour change tool that drives improvements in the energy performance of public buildings. Findings are presented from an evaluation of a large-scale voluntary building labelling campaign, CYBER Display®. Energy-Cities, the European association of local authorities, launched its Display® Campaign in 2001 aimed at encouraging authorities to publicly display the energy and environmental performances of their buildings. Over 500 local and regional authorities in Europe participated in producing over 22,000 certificates. The database contains over 10,000 buildings and provides an excellent opportunity to produce an overview of the broad energy performance trends of buildings in Europe. Common technical factors are identified that lead to improved energy performance. Evidence from a comprehensive survey also reveals a further set of common factors in terms of communication activities that appear to lead to improved energy performance. The paper concludes that whilst building energy certificates are no panacea for the problem of increased emissions from public buildings, producing and displaying building energy certificates such as the Display® Poster can act as a catalyst for behaviour change.

2012 Olympics: A catalyst for behaviour change?

Aiming to make the most of the Olympic legacy, Sarah Prest and Rachel Partridge, from NHS Dorset, explain how one county is encouraging lifestyle change

The Utah House: An effective educational tool and catalyst for behavior change?

The Utah House in Kaysville, UT is a demonstration facility built and operated by Utah State University Cooperative Extension. It is designed to showcase alternative building techniques, with a focus on sustainable use of resources, energy and water conservation, healthy indoor air, and universal design. A survey was sent to visitors of the Utah House in January 2008. Questions were asked about knowledge of key topics, and engagement in selected pro-environmental behaviors, to determine if their visit to the house influenced their level of knowledge or more importantly, their behavior. Significant increases in self-reported knowledge were found for all five topic areas, indicating that the house was an effective educational tool. Differences in self-reported knowledge before the visit were found for gender and educational level, but mean ratings for all groups were essentially the same after the visit. Although many visitors had already engaged in at least one pro-environmental behavior before coming to the house (83%), a large percentage (63%) made at least one change as a result of their visit, indicating that the house was a catalyst for behavior change. Although several interesting correlations were found between knowledge, feelings and behavior, no strong predictor of behavior emerged.