Behavior Change Outcomes Research Articles

A review on efficacy of polygenic risk score information on behavioral change and clinical outcomes

Abstract Background Polygenic Risk Score (PRS) represents a promising advancement in personalized medicine, enabling the inherited risk assessment for disease outcomes based on the effect of various common genetic variants. The utilization of PRS information to promote the adoption of healthier behaviors has witnessed an increase interest in recent years, but its full potential still needs to be fully addressed. Methods This systematic review aims to assess the efficacy of disclosing PRS information on individuals’ engagement in risk-reducing interventions. CENTRAL database has been searched up to December 2023 to identify randomized controlled trials (RCTs) comparing the disclosure of PRS results, with scenarios where other or no information is provided. We performed a preliminary meta-analysis on the mean difference of clinical and psychological outcomes between the two arms. Results Out of 4419 results, we included 12 studies. Trials focused on primary (83%), secondary (8%) and tertiary (8%) preventive interventions. As for the possible diseases predicted by the PRS, cardiovascular diseases (33%) were the most common (n = 4), along with cancers (33%), diabetes (25%) and metabolic disease (8%). PRS result disclosure was compared to standard care (n = 7), no information provided (n = 4), and family risk (n = 1). By pooling data from four comparable studies, we report a reduction in the mean difference for LDL cholesterol in the intervention group of -6.39mg/dL (95%CI -10.09, -2.70, I²=0%, p < 0.001). No significant changes were observed for systolic and diastolic blood pressure, and weight, in 3 studies and 4 analyzed studies, respectively. An increase in anxiety levels was observed towards the PRS group in 4 studies (SMD 0.24, 95%CI 0.02, 0.46, I² = 66%, p = 0.03). Conclusions Preliminary analysis show small or no effects of PRS disclosure on intermediate health or psychological outcomes. Larger trials assessing the potentiality of PRS disclosure are still needed. Key messages • From the analysis of twelve preventive trials on the efficacy of PRS on behavior change, we report a positive effect on LDL cholesterol reduction. • Larger well conducted trials are needed to integrate PRS-based information into future preventive strategies.

Culturally safe community agency health promotion capacity for diverse equity-seeking women: a rapid theoretical review

ObjectivesImmigrant and sexually/gender-diverse women (henceforth, women) face inequities in access to and quality of care. As a result, many seek health information from community agencies perceived as culturally safe. We...

Assessing the implementation of a tertiary care comprehensive pediatric asthma education program using electronic medical records and decision support tools

Background Self-management education is integral for proper asthma management. However, there is an accessibility gap to self-management education following asthma hospitalizations. Most pediatric patients and their families receive suboptimal or no education. Objective To implement a comprehensive pediatric asthma education program and evaluate subsequent self-management knowledge in patients as well as behavior change outcomes reflected in the frequency of asthma related repeat emergency department visits and hospitalization. The program implementation was informed by the Knowledge to Translation Action Framework and the i-PARIHS model for quality improvement and involved several iterative stages. Methods We implemented a comprehensive asthma education program for the families of all children 0-18 years old who had been admitted for an asthma exacerbation to the Children’s Hospital of Eastern Ontario (CHEO), beginning on April 1, 2018. The program was adapted to the stages of the Knowledge Translation to Action Framework including undertaking an environmental scan, expert stakeholder feedback, reviews, addressing barriers, and tailoring the intervention, along with evaluating knowledge and health outcomes. Education was delivered over 1-2 h in personalized individual or small group settings, within 4 wk of hospital discharge. All education was provided by registered nurses or respiratory therapists who were also certified asthma educators. The EPIC electronic medical record was used to facilitate referral and scheduling of asthma education sessions, and to track subsequent acute asthma visits. We compared the frequency of a repeat asthma emergency department (ED) visit or hospitalization within 1-year following an initial asthma hospitalization for children who would have received comprehensive asthma education, to a historical cohort of children who were hospitalized between April 9, 2017 – Apr 8, 2018, and did not receive asthma education. Results The program had a high enrollment, capturing nearly 75% of the target population. Most families found the program to be acceptable and reported increased knowledge of how to manage asthma. We identified a crude overall 54% reduction in repeat hospitalizations among children 1 year after implementation of the asthma education program (i.e. 10.2% (23/225) repeat hospitalization rate pre- implementation versus 4.8% (11/227) post-implementation). In adjusted time-to event analysis, this reduction was prominent at 3 months among those who received comprehensive asthma education, relative to those who did not, but this improvement was not sustained by 1 year (HR =1.1, 95% CI =0.55- 2.05; p-value = 0.6). Discussion Although we did not find long-term improvements in ED visits, or hospitalizations, in children of caregivers who participated in comprehensive asthma education, the asthma education program holds potential given that most patients found it to be acceptable and that it increased asthma management knowledge. A future asthma education program should include multiple sessions to ensure that the knowledge and behavior change will be sustained, leading ultimately to long-term reductions in repeat ED visits and hospitalizations.

Goal Setting Moderates Behavior Change Outcomes in College Students After an Online Health Coaching Intervention

ABSTRACT Background Health coaching sessions that incorporate goal setting may help improve college students' health behaviors. Purpose This study examined whether specific goal-setting practices moderated changes in health behaviors during an online wellness intervention in college students. Methods Participants were 90 college students recruited from one US university. The intervention was a one-hour virtual one-on-one health coaching session where participants set two goals for either physical activity (Metabolic Equivalent Task (MET)-minutes or MET-minutes), nutrition, sleep, or stress management. Self-reported baseline behaviors were collected, and follow-up surveys were completed at 6- and 12-weeks. Mixed effects models examined behavior change outcomes across the follow-up timepoints while testing the moderating effect of goal setting using interactions. Results The Goal×Time interaction was significant for moderate MET-minutes at 1st follow-up (b = 443, p = .003), and for total MET-minutes at the 2nd follow-up (b = 717, p = .047). The Goal×Time interaction was also significant for stress management at 1st follow-up (Odds Ratio = 7.3, p = .042). Discussion Participants who set physical activity and stress management goals had significantly higher physical activity and utilized more stress management techniques. Translation to Health Education Practice The use of specific goal-setting strategies for physical activity and stress management is recommended during online health coaching sessions. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars.

Effectiveness of a postpartum vascular risk reduction clinic on behavioral change and long-term cardiovascular outcomes in women who had preeclampsia: a case-control study

Effectiveness of a postpartum vascular risk reduction clinic on behavioral change and long-term cardiovascular outcomes in women who had preeclampsia: a case-control study

The effects of diabetes self-management programs on clinical and patient reported outcomes in older adults: a systematic review and meta-analysis.

With diabetes self-management continuing to become more complex for older adults, self-management programs have been shown to support this population in meeting their multifaceted medical needs. Building on our previous systematic review and meta-analysis, we aimed to update the literature on the effectiveness of diabetes self-management programs and investigate the impact of specific self-management interventions on clinical and patient-reported outcomes. We updated our literature search in the following databases: Medline, EMBASE, PsychINFO, CINAHL and Cochrane Database of Randomized Controlled Trials from November 2013 to July 2023 for studies that may fit our inclusion criteria. Two independent reviewers screened and extracted data from the included group of studies. A total of 17 studies with 21 comparison arms met the inclusion criteria, totalling 5976 older adults (3510 individuals randomized to self-management programming and 2466 to usual care). The pooled effectiveness of diabetes self-management programs in older adults on glycemic control (hemoglobin A1C) was a reduction of -0.32 (95% CI -0.44, -0.19). Specifically, the most effective approach on glycemic control (A1C) was the use of feedback (-0.52%; 95% CI -0.68, -0.36). Overall, self-management programs improved behaviour change outcomes, with feedback interventions being most effective (standardized mean difference [SMD] 0.91; 95% CI 0.39, 1.43). The effect of self-management programs on body mass index, weight and lipids were statistically and clinically significant. The evidence for diabetes self-management programs for older adults demonstrates a small but clinically meaningful reduction in A1C, improvement in patient-reported outcomes (behaviour, self-efficacy, knowledge), and other clinical outcomes (BMI, weight and lipids). The specific strategy used in diabetes self-management programs for older adults should be considered to achieve optimal results on outcomes.

Cancer survivors' experiences of a physical activity program in primary care: a qualitative study.

This study aimed to gain insight into the experiences of, and reasons for, cancer survivors participating in a primary care PA program. We interviewed 17 patients from 11 Dutch GP practices. Patients were selected by purposive sampling based on their general practice, gender, educational level, motivation for PA, and change in PA. Interviews were audio recorded, transcribed verbatim, and pseudonymized for inductive thematic analysis. Three domains were identified with five themes: institutional domain: GP practice; program-specific domain: content sessions and PA, and activity tracker and goal setting; individual domain: experienced benefits, and personalized care needs. Participants valued the PA program because it was offered close to home, without additional costs, and by a trusted practice nurse familiar with the patients' medical background. Activity tracker use and goal setting motivated many participants but also led to demotivation and feelings of failure in others. Reported benefits included behavior change and favorable health outcomes. Many patients expressed the need to personalize psychological support and the program's timing. Access to a PA program in a primary care setting is valued for its accessibility and experienced health benefits, but also seems to meet an unmet need for support in picking up life during cancer recovery. Primary care is important for continued care of cancer survivors. An accessible PA program in this setting may fulfil a need for not only lifestyle support but also continuing life after cancer treatment.

A Web-Based Physical Activity Promotion Intervention for Inactive Parent-Child Dyads: Protocol for a Randomized Controlled Trial.

Low levels of physical activity are associated with numerous adverse health outcomes, yet sedentary lifestyles are common among both children and adults. Physical activity levels tend to decline steeply among children aged between 8 and 12 years, even though children's behavioral patterns are largely governed by familial structures. Similarly, parents' activity levels have been generally reported as lower than those of nonparents of comparable age. For this reason, family-based physical activity promotion interventions are a potentially valuable and relatively underresearched method for mitigating physical activity declines as children develop into adolescents and for increasing physical activity in parents. This study aims to assess the efficacy, feasibility, and acceptability of a novel theory-based web-based physical activity promotion intervention among parent-child dyads in Finland who do not meet physical activity recommendations at baseline. Participants (target N=254) will be recruited from the general population using a panel company and advertisements on social media and randomly assigned to either an immediate intervention group or a waitlist control group. The intervention consists of 4 web-based group workshops over the course of 10 weeks, web-based tasks and resources, and a social support chat group. Data on physical activity behavior and constructs from the integrated behavior change model will be collected through self-report surveys assessing physical activity, autonomy support, autonomous motivation, attitude, subjective norm, perceived behavioral control, intention, self-monitoring, habit, and accelerometer measurements at baseline, post intervention, and 3 months post intervention. Exit interviews with participants will assess the feasibility and acceptability of the intervention procedures. This study will reveal whether the intervention changes leisure-time physical activity among intervention participants relative to the control group and will examine the intervention's effects on important theoretical predictors of physical activity. It will also yield data that can be used to refine intervention materials and inform further implementation. Trial recruitment commenced in September 2023, and data collection should be completed by December 2024. The planned intervention has potential implications for both theory and practice. Practically, the use of an entirely web-based intervention may have scalable future uses for improving physical activity in 2 key populations, while also potentially informing on the value of dyadic, family-based strategies for encouraging an active lifestyle as an alternative to strategies that target either parents or children independently. Further, by assessing change in psychological constructs alongside potential change in behavior, the intervention also allows for important tests of theory regarding which constructs are most linked to favorable behavior change outcomes. ClinicalTrials.gov NCT06070038; https://clinicaltrials.gov/study/NCT06070038. DERR1-10.2196/55960.

Sociodemographic and treatment-related determinants of recent substance use among adults with comorbid substance misuse and psychotic disorders discharged from substance use treatment

IntroductionRates of alcohol and illicit substance use are higher among persons with psychotic disorders relative to the general population. The adverse health and psychological effects of substance use behaviors disproportionately impact persons with psychotic disorders. Prior research has shown that persons with psychotic disorders experience increased difficulty in reducing substance use behaviors, and interventions targeting substance use behavior change among this population have demonstrated limited effectiveness. One reason for this is that little is known about the factors that influence substance use and behavior change among this population. To address these disparities, the present study investigated sociodemographic and treatment-related factors of substance use recurrence among persons with psychotic disorders who received substance use treatment services. MethodsData came from the 2015–2018 Treatment Episode Dataset-Discharges (TEDS-D). TEDS-D collects annual data on adolescent and adult discharges from state-certified substance use treatment centers in the United States. The study conducted all analyses with a subsample of 1956 adult discharges with a psychotic disorder who received services from an outpatient substance use treatment center for at least one month. χ2 tests of independence and multivariable logistic regression analyses were used to examine associations of sociodemographic and treatment-related characteristics with substance use recurrence while in treatment (α < 0.05 analyses). The study presents results from multivariable logistic regression models as adjusted odds ratios (AORs) with 95 % confidence intervals (CI). ResultsThose who were age 50 or older, were referred to treatment by the criminal justice system, and attended substance use self-help groups had lower odds of substance use recurrence while in treatment. Sex, educational attainment, employment status, living situation, type of substance use, and treatment history were not significantly associated with substance use recurrence. ConclusionsIn designing treatment services, providers should consider whether focusing on sociodemographic, including cultural, factors can affect more positive substance use behavior change and other desired treatment outcomes among those with psychotic disorders and comorbid substance misuse. Further study is needed to identify these factors among specific subpopulations of those with psychotic disorders and substance misuse.

A systematic review of behaviour change interventions to improve maternal health outcomes in sub-Saharan Africa.

The rate of decline in the global burden of avoidable maternal deaths has stagnated and remains an issue of concern in many sub-Saharan Africa countries. As per the most recent evidence, an average maternal mortality ratio (MMR) of 223 deaths per 100,000 live births has been estimated globally, with sub-Saharan Africa's average MMR at 536 per 100,000 live births-more than twice the global average. Despite the high MMR, there is variation in MMR between and within sub-Saharan Africa countries. Differences in the behaviour of those accessing and/or delivering maternal healthcare may explain variations in outcomes and provide a basis for quality improvement in health systems. There is a gap in describing the landscape of interventions aimed at modifying the behaviours of those accessing and delivering maternal healthcare for improving maternal health outcomes in sub-Saharan Africa. Our objective was to extract and synthesise the target behaviours, component behaviour change strategies and outcomes of behaviour change interventions for improving maternal health outcomes in sub-Saharan Africa. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Our protocol was published a priori on PROSPERO (registration number CRD42022315130). We searched ten electronic databases (PsycINFO, Cochrane Database of Systematic Reviews, International Bibliography of Social Sciences, EMBASE, MEDLINE, Scopus, CINAHL PLUS, African Index Medicus, African Journals Online, and Web of Science) and included randomised trials and quasi-experimental studies. We extracted target behaviours and specified the behavioural interventions using the Action, Actor, Context, Time, and Target (AACTT) framework. We categorised the behaviour change strategies using the intervention functions described in the Behaviour Change Wheel (BCW). We reviewed 52 articles (26 randomized trials and 26 quasi-experimental studies). They had a mixed risk of bias. Out of these, 41 studies (78.8%) targeted behaviour change of those accessing maternal healthcare services, while seven studies (13.5%) focused on those delivering maternal healthcare. Four studies (7.7%) targeted mixed stakeholder groups. The studies employed a range of behaviour change strategies, including education 37 (33.3%), persuasion 20 (18%), training 19 (17.1%), enablement 16 (14.4%), environmental restructuring 8 (7.2%), modelling 6 (5.4%) and incentivisation 5 (4.5%). No studies used restriction or coercion strategies. Education was the most common strategy for changing the behaviour of those accessing maternal healthcare, while training was the most common strategy in studies targeting the behaviour of those delivering maternal healthcare. Of the 52 studies, 40 reported effective interventions, 7 were ineffective, and 5 were equivocal. A meta-analysis was not feasible due to methodological and clinical heterogeneity across the studies. In conclusion, there is evidence of effective behaviour change interventions targeted at those accessing and/or delivering maternal healthcare in sub-Saharan Africa. However, more focus should be placed on behaviour change by those delivering maternal healthcare within the health facilities to fast-track the reduction of the huge burden of avoidable maternal deaths in sub-Saharan Africa.

Handoff Education Interventions: A Scoping Review Focused on Sustaining Improvements.

Handoffs involve the transfer of patient information and responsibility for care between health care professionals. The purpose of the current scoping review was (1) to describe handoff studies with education as part of the intervention and (2) to explore the role of handoff educational interventions in sustaining handoff improvements. This scoping review utilized previously published systematic reviews and a structured, systematic search of 5 databases (January 2006-June 2020). Articles were identified, and data were extracted by pairs of trained, independent reviewers. The search identified 74 relevant articles, most published after 2015 (70%) and conducted in the United States (76%). Almost all of the studies (99%) utilized instruction, 66% utilized skills practice, 89% utilized a memory aid, and 43% utilized reinforcement. However, few studies reported using education theory or followed accepted tenets of curriculum development. There has been a substantial increase over time in reporting actual handoff behavior change (17%-68%) and a smaller but important increase in reporting patient outcomes (11%-18%). Thirty-five percent of studies (26/74) had follow-up for 6 months or more. Twelve studies met the criteria for sustained change, which were follow-up for 6 months or more and achieving statistically significant improvements in either handoff skills/processes or patient outcomes at the conclusion of the study. All 12 studies with sustained change used multi-modal educational interventions, and reinforcement was more likely to be used in these studies than all others (75%, 9/12) versus (37%, 23/62), P = 0.015. Future handoff intervention efforts that include education should use education theory to guide development and include needs assessment and goals and measurable objectives. Educational interventions should be multi-modal and include reinforcement. Future research studies should measure actual handoff behavior change (skills/process) and patient outcomes, include follow-up for more than 6 months, and use education reporting guidelines.

Evaluation of a digital patient education programme for Chinese immigrants after a heart attack.

To evaluate a self-administered digital education resource for patients after a heart attack (adapted simplified Chinese version of Cardiac College™) on secondary prevention knowledge and health behaviour change outcomes. Chinese immigrants recovering from a heart attack were recruited from cardiac rehabilitation programmes at four metropolitan tertiary hospitals. Participants provided access to Cardiac College™ (adapted simplified Chinese version), a self-learning secondary prevention virtual education resource over 4 weeks. The web-based resources include 9 booklets and 10 pre-recorded video education sessions. Assessments included health literacy, secondary prevention knowledge, self-management behaviours, self-reported physical activity, and a heart-healthy diet. Satisfaction, acceptability, and engagement were also assessed.From 81 patients screened, 67 were recruited, and 64 (95.5%) completed the study. The participants' mean age was 67.2 ± 8.1 years old, 81.2% were males, and the majority had no English proficiency (65.6%). Following the intervention, significant improvements were observed for secondary prevention knowledge overall and in all subdomains, with the most improvement occurring in medical, exercise, and psychological domains (P < 0.001). Dietary and self-management behaviours also improved significantly (P < 0.05). According to participants, the educational materials were engaging (100%), and the content was adequate (68.8%); however, 26.6% found the information overwhelming. Overall, 46.9% were highly satisfied with the resources. A self-learning virtual patient-education package improved secondary prevention knowledge and self-care behaviour in Chinese immigrants after a heart attack. The culturally adapted version of Cardiac College™ offers an alternative education model where bilingual staff or translated resources are limited.

Personal goal setting eHealth component associated with improved weight loss at 6 months: A mixed methods secondary analysis.

Goal setting is a behavior change technique associated with improved change in outcomes. Digital (eHealth, mHealth) behavior change interventions often prescribe all goals with no opportunity for participants to create and track their own; thus, little is known about the types of goals participants create for themselves and their impacts on behavioral outcomes. This analysis describes the goals created by participants using an optional personal goal-setting component and evaluates the association between participant goal creation and weight loss in an eHealth adult weight loss intervention. This represents a mixed methods QUANT-qual design to understand the types of goals users create for themselves and their impacts on behavior change outcomes. Qualitative codes were applied for the topic, behavior/outcome focus, adherence to SMART criteria, and repetition with count summaries. Quantitative analyses applied regression modeling to determine if the number of goals set was associated with the 6-month weight change, controlling for covariates. Participants (n = 363) set an average of 23.4 goals (SD = 22.7) over 6 months. Those who reached at least 5% weight loss set significantly more goals than those who lost between 1% and 4.99% or who lost <1% or gained weight (p's < 0.0001). Setting more personal goals was associated with significant weight loss reduction at 6 months, controlling for covariates (p's < 0.05). Greater use of a personal goal-setting feature was associated with improved weight loss outcomes among active users. This can be a low-investment addition to digital behavior change interventions to contribute to improved outcomes.

Social support via Internet communication technology for diabetes self-management: a scoping review.

The global prevalence of diabetes has been increasing over the past 30 years, leading to a rise in complications; diabetes is the leading cause of amputations, blindness, and kidney failure in developed countries. Diabetes self-management is challenging due to the complex lifestyle changes required. Social support from family and friends plays a crucial role in overcoming barriers to healthy behavior choices. Integrating Internet and communication technologies with social support interventions has the potential to improve diabetes self-management. A scoping review was conducted by searching PubMed, Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Association for Computing Machinery (ACM) Digital Library databases for studies combining diabetes, Internet and communication technologies, and social support interventions. Inclusion criteria focused on adult patients with diabetes and primarily Internet and communication technologies-based strategies to initiate and enhance social support. Data abstraction included study population, design, outcomes, social support domains emphasized, support relationship intervention strategy, and Internet and communication technologies modality. The review identified 39 articles and 33 unique studies representing 27 unique interventions utilizing peer web forums, interactive voice recordings, messaging-based interventions (including Short Message Service and instant messaging), and email as Internet and communication technologies modalities. Various outcomes were reported, including improvements in perception of social support, psychosocial well-being, behavior changes, and clinical outcomes. Existing support relationships may be more effective in promoting behavior change and clinical outcomes compared to developing new relationships. Studies that explicitly measured patients' perception of support consistently showed improvements in psycho-social, behavioral, and clinical outcomes. This scoping review highlights the pivotal role of social support in diabetes self-management. By integrating Internet and communication technologies into interventions, diverse modalities such as web forums and text messaging have shown promise in enhancing patients' perception of support and improving psychosocial well-being, behavior changes, and clinical outcomes. The emphasis on leveraging existing support relationships, rather than establishing new ones, underscores the effectiveness of personalized, patient-centered approaches. These findings provide essential insights for healthcare strategies, emphasizing the need to harness technology and existing social networks to empower individuals in managing diabetes effectively.

Digital empathy in behaviour change interventions: A survey study on health coach responses to patient cues.

Digital health coaching interventions for behaviour change (BC) are effective in addressing various health conditions. Implementing these requires accurate descriptions of components and health coaches (HC) delivery methods, alongside understanding patients' perceptions of these interactions. The HC-patient relationship significantly influences BC outcomes. Here, empathy is an important driver that enables HCs to offer tailored advice that resonates with patients' needs, fostering motivation. Yet, defining and measuring empathy remains a challenge. In this study, we draw on various BC frameworks and Pounds' empathy appraisal approach to categorise HCs responses to patient cues and explore the interplay between empathy and BC. Using a two-round survey, we collected responses from 11 HCs to 10 patient messages from the Bump2Baby and Me trial in a simulated interaction. We analysed 88 messages to identify empathic responses and behaviour change techniques. Patients' implicit empathy opportunities showed higher response rates than explicit ones. HCs prioritised positive reinforcement and employed various strategies to achieve similar objectives. The most common empathic response was 'Acceptance' for patients' implicit positive expressions of self-judgement. HCs emphasised relatedness-support and competence-promoting techniques for implicit negative feelings and judgements, such as 'Show unconditional regard' and 'Review behaviour goals', and 'Action planning and Problem-solving' techniques to address explicit negative appreciations and feelings. The use of different techniques with the same objective highlights the complexity of BC interactions. Further research is needed to explore the impact of this variability on patient outcomes and programme fidelity.

Ketamine alleviates fear memory and spatial cognition deficits in a PTSD rat model via the BDNF signaling pathway of the hippocampus and amygdala

BackgroundPost-traumatic stress disorder (PTSD) is associated with traumatic stress experiences. This condition can be accompanied by learning and cognitive deficits. Studies have demonstrated that ketamine can rapidly and significantly alleviate symptoms in patients with chronic PTSD. Nonetheless, the effects of ketamine on neurocognitive impairment and its mechanism of action in PTSD remain unclear. MethodsIn this study, different concentrations of ketamine (5, 10, 15, and 20 mg/kg, i.p.) were evaluated in rat models of single prolonged stress and electrophonic shock (SPS&S). Expression levels of brain-derived neurotrophic factor (BDNF) and post-synaptic density-95 (PSD-95) in the hippocampus (HIP) and amygdala (AMG) were determined by Western blot analysis and immunohistochemistry. ResultsThe data showed that rats subjected to SPS&S exhibited significant PTSD-like cognitive impairment. The effect of ketamine on SPS&S-induced neurocognitive function showed a U-shaped dose effect in rats. A single administration of ketamine at a dosage of 10–15 mg/kg resulted in significant changes in behavioral outcomes. These manifestations of improvement in cognitive function and molecular changes were reversed at high doses (15–20 mg/kg). ConclusionOverall, ketamine reversed SPS&S-induced fear and spatial memory impairment and the down-regulation of BDNF and BDNF-related PSD-95 signaling in the HIP and AMG. A dose equal to 15 mg/kg rapidly reversed the behavioral and molecular changes and promoted the amelioration of cognitive dysfunction. The enhanced association of BDNF signaling with PSD-95 effects could be involved in the therapeutic efficiency of ketamine for PTSD.

Sex and individual differences in the effect of chronic low-dose ethanol on behavioral strategy selection.

The development of an alcohol use disorder (AUD) involves impaired behavioral control and flexibility. Behavioral inflexibility includes an inability to shift behavior in response to changes in behavioral outcomes. Low levels of ethanol drinking may promote the formation of inflexible, habitual reward seeking, but this may depend on the timing of ethanol exposure in relation to learning. The goal of this study was to determine whether a history of low-dose ethanol exposure promoted contingency-insensitive sucrose seeking and altered behavioral strategy selection. Male and female C57BL/6J mice were trained to perform a response (lever press) for sucrose on two different reinforcement schedules: one that is thought to promote inflexible responding (random interval) and one that maintains flexible responding (variable ratio [VR]). Following instrumental training each day, mice were exposed to saline or low-dose ethanol (0.5 g/kg; i.p.) either proximal (1 h after) or distal (4 h after) to learning. Mice were then tested for sensitivity to changes in contingency in a contingency degradation test. A history of low-dose ethanol exposure shifted behavioral strategy selection, as measured by reward tracking behavior, but this depended on sex and reinforcement schedule history. Both male and female mice used different strategies depending on the reinforcement schedule, but only males exhibited ethanol-induced shifts in strategy selection. A history of low-dose ethanol exposure did not impact contingency sensitivity in males but promoted insensitivity in females specifically on the VR lever. Female mice show distinct behavioral effects of repeated, low-dose ethanol exposure as compared to males, with sex differences in the use of reward tracking strategies to guide behavior. Future studies should investigate sex differences in the neural consequences of chronic low-dose ethanol exposure that may underlie behavioral changes.

Infodemic Management for Social and Behavior Change: Youth Mobilization for Combating Disinformation During COVID-19

This study discusses an undergraduate elective university course as a notable case for youth mobilization in combatting misinformation during COVID-19 with positive social and behavior change outcomes of an indicative nature. Remote modality of the civic engagement course entailed students’ voluntary work at partnering with society organizations specialized in new media technologies. Students’ engagement with the civil society organizations’ three different research and implementation projects as a form of voluntary work enabled them to mobilize in accordance with a vital dimension of infodemic management, namely engagement of communities to take positive action. Results derived from a mixed model research present that individual change observed on the students’ knowledge, attitudes and practices as well as social change objectives of partnering institutions and the course are modestly positive, suggesting replication of adapted course design and implementation in relevant contexts.

Promoting men's health through sports clubs: a rapid realist review

Abstract Background Traditional health promotion interventions have failed to engage men. Sports clubs offer male-friendly health promotion settings for men, but little is known about implementable intervention strategies and subsequent effects. This rapid realist review (RRR) aims to identify context, mechanisms and effects of health promotion interventions targeting men by or in collaboration with sports clubs. Methods The RRR methodology was developed in collaboration with a panel of Danish practice and policy representatives and international academics. A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE, Embase, and SportDiscus databases and through grey literature sources. Included studies: 1) targeted men aged 18+ years, 2) reported health promotion outcomes, and 3) were delivered primarily by or in collaboration with sports clubs. Results Fifty-two studies were included. Preliminary analyses indicate that interventions delivered through sports clubs show promise for engaging men with high cardiometabolic risk and producing favorable health outcomes. Preliminary findings from the realist synthesis show that if men felt a strong attachment to the sports club (context), it resonated with their feelings of social identity which outweighed a former reluctance to attend health programs (mechanism), and thus increased the men's likelihood for program engagement and health behavior change (outcome). Conclusions Our study indicates that men's health promotion through sports clubs is emergent. While great strides have been made to increase men's involvement in health promoting activities by delivering interventions through sports clubs, research has predominantly focused on select behaviours (e.g., physical activity), sub-groups (e.g., sports fans) and predominantly Caucasian, overweight, middle-aged men.

O.4.4-8 Promoting men’s health through sports clubs: a rapid realist review

Abstract Purpose Traditional health promotion interventions have failed to engage men. Sports clubs offer male-friendly environments that have been identified as an attractive setting for men’s health promotion, but little is known about implementable intervention strategies and subsequent effects. This rapid realist review (RRR) aims to close this gap by assessing context, mechanisms and effects of health promotion interventions targeting men by or in collaboration with sports clubs. Methods The RRR methodology was developed in collaboration with a panel of Danish practice and policy representatives and international academics. A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE, Embase, and SportDiscus databases. Included studies: 1) targeted men aged 18+ years, 2) reported health promotion outcomes, and 3) were delivered primarily by or in collaboration with sports clubs. A grey literature search of National Sports Associations and Federations and non-government men’s health organizations was also performed. Dalkin’s conceptualization of mechanisms in realist methodology was used to identify context- mechanism-outcome configurations (CMOc) and develop a program theory. The study follows Cochrane’s guidance for rapid reviews and is registered in Research Registry (ID: reviewregistry1556). Results We identified 2.720 studies after duplicates removal. Preliminary analyses indicate that interventions delivered through sports clubs show promise for engaging men and producing favorable health outcomes (e.g., weight loss, increased physical activity and improved social support). The realist synthesis suggests that health interventions delivered through sports clubs (resource mechanism) targeted at men who have high attachment to the sport or club (context), may align with their interests and identities (mechanism), to increase the potential for engagement and health behavior change (outcome). The analysis will be finalised by August. Conclusions Our study indicates that men’s health promotion through sports clubs is emergent. While great strides have been made to increase men’s involvement in health promoting activities by delivering interventions through sports clubs, research has predominantly focused on select behaviours (e.g., physical activity) and sub-groups (e.g., sports fans). Support/Funding Source This work was funded by the five Steno Diabetes Centers in Denmark, which are partly funded by the Novo Nordisk Foundation.