Changes In Driving Behavior Research Articles

How does a Smoke-Free campus initiative generates changes in smoking? A theory-based evaluation

Abstract Background Smoke-free campuses (SFC) prohibit smoking and vaping on all university grounds and for all users. Despite their effectiveness in reducing smoking prevalence, passive smoking, and denormalizing tobacco use, the complex interplay between the programme activities and their impact on users and campus environments remain unclear. This study aims to improve our understanding of the transformation processes associated with SFC expected outcomes. Methods We conducted a retrospective qualitative study on the first SFC implemented in France by the EHESP School of Public Health. Guided by Mayne’s theory of change framework that includes ten dimensions of an impact pathway (e.g. activities, reach/reaction, capacity, behaviour changes, etc.), the research examined the chain of effects and hypotheses driving this SFC. Our dataset included internal documents (e.g. minutes of meetings, administrative documents) and semi-structured interviews with stakeholders (n = 16) involved in the development and implementation of the analysed SFC. Data is currently being analysed. Results Initial results suggest that the EHESP’s SFC activities included communication initiatives, student ambassadors, cessation support for smokers, installation of smoking shelters on campus periphery, etc. These activities were geared on capacity change (e.g. securing support and compliance among campus users, reduce smoking opportunities, promoting the use of cessation aids) and were intended to drive behaviour change (reducing smoking and facilitating cessation among students and staff). The goal of this SFC was not only to impact behaviors but also to educate future health service managers at EHESP to implement SFC policies and set an example for other institutions in France. Conclusions This study identifies some of the transformations that activities of the EHESP’s SFC can generate in students and staff in order to fulfil its outcomes. It also highlighted its expected impact on other institutions. Key messages • Understanding how a smoke-free campus generates its changes is essential in facilitating transferability of experiences to other universities. • Smoke-free campus policies can also generate a broader impact on other institutions.

The Impact of Social Media Campaigns on Reducing Plastic Waste in Thailand’s Coastal Areas

This paper examines the role of social media campaigns in reducing plastic waste in Thailand’s coastal areas, focusing on their impact on public behavior and attitudes. Through campaigns such as #BeatPlasticPollution, #NoMorePlastic, and #TrashHeroThailand, social media has become a powerful tool for mobilizing communities and promoting sustainable practices. These campaigns have significantly influenced the reduction of single-use plastics, increased recycling efforts, and broader participation in environmental clean-up activities. By engaging local stakeholders, including coastal communities, businesses, and government entities, these initiatives have fostered a collective movement toward sustainability. The analysis explores how social media has reshaped public perceptions of plastic pollution and its environmental consequences, comparing behavior and awareness before and after key social media campaigns. The findings underscore the critical role of digital platforms in environmental advocacy and their long-term potential to drive behavior change on a global scale.

Decoding heterogeneity in data-driven self-monitoring adherence trajectories in digital lifestyle interventions for weight loss: a qualitative study

BackgroundData-driven trajectory modeling approaches have been used to identify participant subgroups with differing responses to digital lifestyle interventions. Identifying contributing factors to different participant subgroups can inform tailored strategies to early “rescue” intervention non-responders. Self-monitoring (SM) is a central mechanism in lifestyle interventions for driving behavior change and can serve as an early indicator for later intervention response. This qualitative study aimed to compare SM experiences between intervention response subgroups and to identify contributing factors to intervention response subgroups in a 6-month digital lifestyle intervention for adults with overweight or obesity.ResultsParticipants were middle-aged (52.9 ± 10.2 years), mostly female (65%), and of Hispanic ethnicity (55%). Four major themes with emerged from the thematic analysis: Acceptance towards SM Technologies, Perceived SM Benefits, Perceived SM Barriers, and Responses When Facing SM Barriers. Participants across both subgroups perceived SM as positive feedback, aiding in diet and physical activity behavior changes. Both groups cited individual and technical barriers to SM, including forgetfulness, the burdensome SM process, and inaccuracy. The Responder Group displayed positive problem-solving skills that helped them overcome the SM barriers. In contrast, some in the Non-responder Group felt discouraged from SM. Both subgroups found diet SM particularly challenging, especially due to technical issues such as the inaccurate food database, the time-consuming food entry process in the Fitbit app.ConclusionsOur study indicates that qualitative analysis is valuable for translating data-driven findings to actionable intervention improvement strategies. Our findings may inform the development of practical SM improvement strategies in future digital lifestyle interventions for weight loss. Notably, building problem solving skills emerge as a key approach to prevent potential non-responders from intervention disengagement.

Attentiveness in urban spaces: The rhythm of the street

Driver vigilance research focuses on the safety impacts of maintaining sustained attention in underload conditions when automatic responses are adequate to the task and responses are sparse. However, urban environments have frequent risks that appear chaotically and require high levels of engagement—a very different vigilance task. Although drivers perceive a wide range of task demands as manageable, their movement patterns hint at more active engagement as they approach overload. This condition we are calling “Attentiveness,” to distinguish it from the classic exploration of vigilance in underload conditions. To understand how the built environment impacts driving automaticity and vigilance, data from the SHRP2 Naturalistic Driving Study (NDS) was used to evaluate driving patterns within urban multimodal street sections. Data for acceleration, jerk, lane position, and speed were tabulated for ten, 5-second epochs at 200 multimodal locations and compared to the behavior for the entire length of the drive. The built environment variables that demonstrated a strong correlation and impact size for a change in driver behavior included doorway density, block length, Walkscore, corridor aspect ratio (height over width), and terminated vistas. The commonality for these variables is that each one impacts the rate that novel stimuli arrive as drivers progress sequentially along their path. Acceleration, jerk, and lane position appear to be related to the rhythm of interruptions that occur along the length of the roadway.

Effect of Monetary Penalty and Traffic Law Enforcement Agents on Drivers’ Behaviour in Ogun State, Nigeria

Fine or penalties are parts of measures in preventing accidents fatalities on Nigeria roads due to erratic driver behavior. This study thus examined the influence of monetary penalties on driver behavior in Lagos State. The study employed survey research design by purposively distributed four hundred (400) structure questionnaires to both private and commercial drivers. The results of the study showed that 76% of the respondents attested to the effectiveness of monetary penalty in changing driver behavior despite its 28% (R2= .276) statistical contribution. However, it was concluded that changing of driver attitude is not as effective when the focus is concentrated on monetary penalty only. Therefore, it was recommended that, implementation of alternative penalty measures, including fines, community service, driver’s license revocation or the utilization of combinations of two penalty options. Keywords: Penalty option, Fines, Traffic Law, Law enforcement agents

Assessing distracted driving crash severities at New York City urban roads: A temporal analysis using random parameters logit model

Distracted driving poses one of the most significant risks to road safety. The current study aims to provide a deeper understanding of the factors affecting the severity of distracted driving crashes in New York City and to explore the temporal stability in the effects of different variables on crash outcomes in 2016 to 2019 period by adopting a post-crash perspective. The police-reported data of single-vehicle distraction-related crashes of private cars on urban roads of New York City was used for this study. Three injury categories were considered: no injury, minor injury, and severe injury. To investigate crash severities and identify unobserved heterogeneities, a random parameters logit model was conducted. The results revealed that a wide variety of variables including driver traits, vehicle and temporal characteristics, and crash attributes were found to be significant in explaining distracted-related crash severities. Furthermore, a series of likelihood ratio tests were conducted to identify the temporal shifts of estimated variables during the period. The results of the temporal analysis showed that the estimated variables of the random parameters model were unstable during the 4-year period, which may be the result of shifting trends such as the development of in-vehicle technologies, and new sources of distraction. However, the complex nature of distracted-related crashes and changes in driver behavior should be considered for further interpretation. This research provides a set of policy implications for planners and policymakers, aiming at facing factors contributing to a higher level of injury severity in distracted driving crashes. This includes providing targeted information on distracted driving to high-risk groups, such as younger drivers, and also combining education, awareness programs, higher penalties, and intense patrolling. Engineering measures such as enhanced roadside illumination and audible edge lines can be effective, especially in reducing late-night distracted driving crashes.

A Bayesian Inference-based approach for extracting driving data with implicit intention

PurposeThe growing availability of naturalistic driving datasets (NDDs) presents a valuable opportunity to develop various models for autonomous driving. However, while current NDDs include data on vehicles with and without intended driving behavior changes, they do not explicitly demonstrate a type of data on vehicles that intend to change their driving behavior but do not execute the behaviors because of safety, efficiency, or other factors. This missing data is essential for autonomous driving decisions. This study aims to extract the driving data with implicit intentions to support the development of decision-making models.Design/methodology/approachAccording to Bayesian inference, drivers who have the same intended changes likely share similar influencing factors and states. Building on this principle, this study proposes an approach to extract data on vehicles that intended to execute specific behaviors but failed to do so. This is achieved by computing driving similarities between the candidate vehicles and benchmark vehicles with incorporation of the standard similarity metrics, which takes into account information on the surrounding vehicles' location topology and individual vehicle motion states. By doing so, the method enables a more comprehensive analysis of driving behavior and intention.FindingsThe proposed method is verified on the Next Generation SIMulation dataset (NGSim), which confirms its ability to reveal similarities between vehicles executing similar behaviors during the decision-making process in nature. The approach is also validated using simulated data, achieving an accuracy of 96.3 per cent in recognizing vehicles with specific driving behavior intentions that are not executed.Originality/valueThis study provides an innovative approach to extract driving data with implicit intentions and offers strong support to develop data-driven decision-making models for autonomous driving. With the support of this approach, the development of autonomous vehicles can capture more real driving experience from human drivers moving towards a safer and more efficient future.

Implications of Alternative Communications and Sensing Technologies for Implementing Variable Speed Limit Control through Connected Vehicles: Sag Curve as a Case Study

Connected vehicles (CVs) will enable various applications to improve traffic flow. This paper’s focus is to investigate how the potential implementation of variable speed limit (VSL) through different types of communication and sensing technologies on CVs makes it possible to mitigate congestion at a sag curve bottleneck. A VSL algorithm is developed and implemented in a simulation environment for controlling the inflow of vehicles to a sag curve to minimize delays and increase throughput. Both vehicle-to-vehicle (V2V) and infrastructure-to-vehicle (I2V) options for CVs are investigated when implementing the VSL control strategy in a simulation environment. Also, for measuring traffic density in real-time either a fixed sensor (e.g., inductive loop) or distance (i.e., space headway) measuring device on CVs is considered. Through a feedback control algorithm, the speeds of CVs are manipulated at upstream of the sag curve to avoid the formation of bottlenecks caused by the change in longitudinal driver behavior. Various market penetration rates for CVs are considered in the simulations for three alternative communications and sensing technologies. Critical rates of CVs under each alternative are found at which the control system improves the system performance. It is demonstrated that for higher Market Penetration Rates (MPRs) the performance is about the same for all three scenarios. The results demonstrate that not only the MPR of CVs but also how CVs are distributed in the traffic stream is critical for system performance.

A multimodal fusion positioning method with adaptive driving behavior for intelligent vehicles

Due to the difficulty of Global Navigation Satellite System (GNSS) in urban canyon environments, GNSS and inertial navigation system (INS) fusion positioning is widely used in the field of intelligent driving. In actual positioning, INS usually uses the vehicle physical model as a constraint to calculate inertial measurement unit (IMU) data to supplement the vehicle position and attitude as GNSS positioning information. However, the existing algorithms usually use a fixed physical model. When the vehicle’s driving behavior changes, such as lane-changing, acceleration, deceleration, etc., the fixed model cannot provide long-term constraints on cumulative errors, resulting in a decrease in fusion positioning accuracy and stability. Therefore, this paper proposes a multimodal fusion positioning method with adaptive driving behavior for intelligent vehicles. First, to adapt to multimodal driving behavior, a multimodal assisted positioning physical model with adaptive driving behavior (MAPM) is established, which expresses different physical models probabilistically based on driving behavior and historical data. Secondly, high-precision estimation of vehicle positioning parameters is achieved based on model probability and interactive multi-model (IMM). Finally, effective fusion of MAPM/GNSS/INS positioning information is achieved under the federated Kalman filtering framework. The simulation results show that compared to traditional GNSS/INS fusion positioning, the proposed method can effectively improve positioning accuracy and stability, especially in driving conditions with changes in driving behavior.

The Necessity and Feasibility of Usage-Based Insurance for New Energy Vehicles in China

Aims: With the continuous development and growth of China's new energy automobile market, new automobile owners desire exclusive auto insurance. However, most insurance companies use traditional automobile commercial auto insurance to cover them. Under this pricing model, there is little overall difference in premiums, regardless of whether the driver's driving behavior is good or not. This paper wants to implement usage-based insurance (UBI) in China because it can add more auxiliary pricing factors, adjust according to the driver's driving behavior changes, and make auto insurance pricing more scientific and fair.
 Study Design: This paper employs the literature review and market research methods to analyze the current product supply and consumer demand in the Chinese auto insurance market. Firstly, introduce the current situation of the development of the new energy automobile insurance market in China and its problems. Then, discuss the necessity and feasibility of developing UBI auto insurance for new energy vehicles in China. Finally, based on the reality of China's new energy vehicle UBI auto insurance gives some programs.
 Conclusion: This paper finds that from the perspective of insurance companies, consumers, and the social level, UBI auto insurance for new energy automobiles is necessary, and it is also the direction of future auto insurance reform and development. Subsequently, combined with China's current relevant policies and technologies, it is concluded that the development of UBI auto insurance for new energy vehicles in China is feasible.

Operasional Bank Sampah dalam Pembentukan Gaya Hidup Berkelanjutan

The waste bank is one of the important solutions in overcoming the waste problem and forming a sustainable lifestyle. In the waste bank system, waste is collected, processed and recycled to create products of economic value. This abstract discusses the results and discussion of waste bank operations in the context of establishing a sustainable lifestyle. The operational results of the waste bank include reducing waste in landfills (TPA), increasing recycling, creating valuable products, and environmental education. By managing waste efficiently, waste banks reduce negative impacts on the environment and help reduce the use of natural resources. In addition, waste banks also play an important role in shaping a sustainable lifestyle through several discussions. First, the waste bank increases environmental awareness among the public, changes the mindset towards waste, and inspires changes in behavior towards a cleaner and more sustainable environment. Second, active community participation in the waste bank strengthens community involvement in waste management and creates a participatory climate in environmental decision-making. Third, the waste bank opens local economic opportunities by creating products from waste, helping to empower the local community's economy, and reducing social inequality. Furthermore, the waste bank reduces the use of new natural resources by processing used goods into useful products, helping to reduce pressure on the environment. Finally, the operation of the waste bank makes the public aware of the problem of waste and the importance of collective action in dealing with this problem. Overall, waste banks play an important role in shaping sustainable lifestyles by creating positive outcomes and driving behavior change and environmental awareness. The waste bank is an important first step in changing the perspective of waste and forming a more environmentally responsible society.

The Importance of Persuasion Strategies in Doctors’ Social Media Messages

This study investigates how doctors employ persuasion strategies (Ethos, logos, and pathos) on Instagram to influence the health behaviors of their followers during the COVID-19 pandemic. Analyzing three influential doctors on social media (DSMIs), the research applies Aristotle's persuasive strategies to understand how these doctors craft messages that drive behavior change and enhance COVID-19 awareness among their 581 followers. Employing a mixed methods approach within the pragmatism paradigm, the study utilizes interviews, literature reviews, content analysis, and surveys for comprehensive data collection. The study reveals that approximately 41% of followers demonstrated a firm intention, with an additional 43% showing a solid intention to change their attitudes and behaviors. About 84% expressed a strong commitment to adopting a healthier lifestyle. The research also identified followers who initially had doubts or confusion about COVID-19 due to misinformation. However, it became convinced of its existence after following the DSMIs' posts, mainly through engaging video content. Engagement is more significant for video content than photos, with pathos, Ethos, and logos effectively fostering engagement. Around 52,438 (314,000) DSMI followers shifted from initial skepticism to meaningful positive attitude transformations, driven by successful engagement through pathos, Ethos, and logos. The study underscores the significance of delivering persuasive and appealing messages to influence behaviors positively. It suggests active social media participation can extend beyond the pandemic, fostering ongoing health awareness.

Can applying behaviour change principles make public health policies more impactful and sustainable?

Abstract Issue/problem The incorporation of evidence-based recommendations into policy documents and health guidance often does not lead to measurable changes in public health outcomes. Description of the problem All the preventative measures of COVID-19 were behavioural in nature, e.g., getting vaccinated, wearing masks, physically and socially distancing, getting tested, etc. However, most government policies did not consider behavioural science or behaviour change frameworks when crafting them. This led to a significant reduction in trust in governments and a resistance to the evolving policies. Results Through the international iCARE study (www.icarestudy.com), we captured data throughout the pandemic on people's capabilities, opportunities, and motivation to engage in COVID-19 prevention behaviours, as well as their actual behaviours. This data has led to key insights into how policies could have been crafted to actively engage individuals in the varying measures that they needed to undertake to reduce the impact of COVID-19. Lessons learned The incorporation of behaviour change principles in the development and implementation of policies has the potential to engage more shareholders and drive behaviour change. However, more evidence is needed to determine the optimal way to do so, and to assess the effectiveness of these efforts in improving public health outcomes. To achieve this, a rigorous monitoring plan is necessary to evaluate the impact of policy changes and health guidance on public health outcomes.

Using Neuromarketing to Create More Effective Messages in Sustainability Advertising Campaigns

Sustainability has become a hot topic in recent years, and it is essential for businesses to integrate sustainability into their marketing strategies. However, it is not enough to simply communicate messages related to sustainability in advertising. The challenge is to create campaigns that inspire consumers to act in ways that are better for the environment. Currently, many brands are trying to communicate topics related to sustainability in advertising, but not all campaigns will make people want to treat the environment better. It is knowledge from neuromarketing that allows us to better understand consumer motivations and behaviour. Thanks to this, brands can communicate their sustainability messages more effectively. In the article, we focused on a review of existing research that deals with the topics of sustainability in the context of advertising and consumer behaviour. We describe findings that help in the creation of advertising messages in campaigns that aim to motivate the consumer to be environmentally responsible. Neuromarketing research provides valuable insights into the emotional drivers of consumer behaviour, empowering brands to design effective sustainability campaigns. Companies can drive behaviour change and build a more sustainable future. Ultimately, the effective communication of sustainability topics in advertising not only benefits the environment but also helps companies build a stronger relationship with their customers, creating a beneficial scenario for all stakeholders. Our goal is to offer companies recommendations for a better understanding of their consumers and to be able to communicate sustainability topics more effectively so that they have a real impact.

Hard-to-reach energy users: An ex-post cross-country assessment of behavioural-oriented interventions

Hard-to-reach (HTR) energy users encompass individuals who are physically difficult to reach, underserved, or challenging to engage and motivate in demand-side energy programmes. Given a mix of societal challenges (e.g. inequity, energy poverty, decarbonisation, the COVID-19 pandemic), HTR energy users are receiving increasing attention. However, there is a lack of knowledge on the performance of interventions that target (explicitly or implicitly) HTR energy users, particularly from a behaviour change perspective. Our study addresses this knowledge gap, and aims to provide a systematic ex-post comparative cross-country assessment of nineteen case studies, implemented in eight countries. From a methodological point of view, our study explores and tests the usefulness of applying the ‘Building Blocks of Behaviour Change’ (BBBC) in assessing the extent to which interventions employ design and implementation practices that are known to drive behaviour change. Our findings reveal that interventions perform well with respect to the Audience, Behaviour, and Delivery building blocks, but show room for improvement in the Content and Evaluate blocks. Assessing the BBBC framework reveals promising results in terms of credibility, confirmability, transferability, and reliability; however, limitations and uncertainties are also present. Considering the exploratory methodological nature of our study, the results highlight numerous context-specific factors that frame our findings and the suitability of the research approach. We underscore that greater attention must be paid to both the integration of behavioural science methods into HTR interventions, and the systematic analysis of heterogeneity in future HTR-related energy research.

The influence of middle-aged male driver profile on driving performance and the effects of three perceptual countermeasures: A simulator study

The human-environment-vehicle triad and how it relates to crashes has long been a topic of discussion, in which the human factor is consistently seen as the leading cause. Recently, more sophisticated approaches to Road Safety have advocated for a road-driver interaction view, in which human characteristics influence road perception and road environment affects driver behavior. This study focuses on road-driver interaction by using a driving simulator. The objective is to investigate how the driver profile influences driving performance and the effects of three countermeasures (peripheral transverse lines before and after the beginning of the curves and roadside poles in the curves). Fifty-six middle-aged male participants drove a non-challenging rural highway simulated scenario based on a real road where many single-vehicle crashes occurred. The drivers' profiles were assessed through their behavioral history measured by a validated version of the Driver Behavior Questionnaire (DBQ) comprising three dimensions: Errors (E), Ordinary Violations (OV), and Aggressive Violations (AV). The relationship between speed and trajectory measures and drivers' profiles was investigated using random-parameter models with heterogeneity in the means. The models' results showed that the DBQ subscale scores in OV explained a considerable part of the heterogeneity found in drivers' performance. Furthermore, the heterogeneity in the means caused by the DBQ subscale scores in OV and E in the presence of peripheral transverse lines indicates a difference in how drivers react to the countermeasures. The peripheral lines were more efficient than roadside poles to moderate speed but did not positively influence all drivers' trajectories. Although the peripheral lines could be seen as an alternative to change driver behavior in a non-challenging or monotonous road environment, the design used in this study should be reviewed.

On-site communication measures as a tool in outdoor recreation management: a systematic map

BackgroundCommunication is a central tool used to manage the balance between outdoor recreation and environmental protection in natural areas. Several studies have evaluated different communication measures in case studies, but rarely are these measures compared across contexts. We review the literature guided by the question: what is the scope of evidence of on-site communication to change human behavior towards a more sustainable direction in outdoor recreation? Taking natural areas as our starting point, we map research-based distribution and abundance of communication measures, with emphasis on their outcomes and study design.MethodsThe target population for our mapping review are outdoor recreationists and nature-based tourists who visit natural or near-natural settings. We examined studies that have crafted written, oral and visual intervention measures to change behavior by using persuasion, education and information rather than legal restrictions or bans. Examples of challenges addressed with communication measures include proper waste disposal, using designated trails, minimizing wear and tear at campsites, avoid disturbing wildlife, and encouraging appropriate and safe behavior. We did not restrict our search geographically. We searched publication databases for peer-reviewed published articles (WoS, Scopus) and forward and backward citation chasing. To identify grey literature we used the database IRMA and internet searches in Google Scholar supplemented with specialist searches. Inclusion criteria and related search terms were based on PICO and included population (P: people participating in outdoor recreation in natural settings), terms that denoted intervention (I: on-site communication measures in situ vs. C: no communication measures) and terms that denoted outcome (O: changed behavior). We screened first by title and abstract and finally full text. For each article selected for full-text screening, metadata was extracted on key variables of interest such as behavior category, context, targeted population, study design and outcomes.Review findingsOverall, we identified 54 studies that were assessed in the review. Our review documents growing academic interest looking at actual behavior change in outdoor recreation. Theory is often subsidiary to attempted behavioral change via communication and different situational aspects, such as targeted visitor populations and environmental context, as well as psychological factors remain underexplored in the literature. The primary communication medium in the reviewed papers is passive use of signs. Awareness raising is the dominant communication mode, but other modes such as emotions, identity, and social norms are common. The geographic distribution of the studies is highly skewed to the United States.ConclusionsThe amassed studies have an uneven focus on different settings and mediums used to change behavior. Research could benefit from investigating different contexts and the state of the natural environment before and after interventions. We advocate for casting a wider disciplinary net and interest in qualitative investigations to produce data-rich studies of where and how sustainable behavior is encouraged and eventually achieved. Collectively, different disciplinary perspectives are required to understand the aspects that contribute to sustainable, and sustained, behavior change. It is important to distinguish what aspects of behavior change could be generalized across settings, and which purely contextual aspects drive behavior change.

Perubahan Perilaku Masyarakat Buang Air Besar Sembarangan (BABS) Menuju Hidup Bersih dan Sehat

Open defecation is still carried out in several locations in Jakarta, especially in slum settlements as a result of uncontrolled migration flows that are not accompanied by the readiness and availability of adequate housing. Basically, this behavior is a way of fulfilling the biological need to defecate. Individual ways to fulfill it are influenced by external factors and individual internal factors, which can shape behavior in a positive or negative direction. These ways are strongly influenced by the determinants of behavior. This study aims to raise facts on the ground which show that there are differences in reactions to interventions carried out in an effort to change open defecation behavior that occurs in marginalized Jakarta communities towards clean and healthy living behavior (PHBS). In addition, to find the driving factors that influence the success of behavior change. This research took place in two residential locations, namely RT.15/RW.07 and RT.01/RW.03, North Tanjung Duren Village, Grogol Petamburan District, West Jakarta Administrative City. The research method is descriptive qualitative. Research factors are reinforcing, predisposing, and enabling factors. The results of this study identified differences in the factors driving behavior change in the two research locations. At the location of RT.01/RW.03, there are external stimuli and agents of change (reinforcing factor), cohesiveness in society (predisposing factor), empowerment/independence (enabling factor). In the location of RT.15/RW.07, there are external stimuli and agents of change, while the other two factors are not owned and instead become quite basic differentiators when compared to the first location and there are obstacles in the form of a culture of poverty among the residents of RT.15/RW. 07, which relies more on government assistance, has also colored the contrast in people's awareness of clean and healthy living behavior.

The Role of Positive Psychology in Lifestyle Medicine.

Lifestyle medicine leverages six pillars-a predominantly plant-based diet, physical activity, sleep, avoiding risky substance, stress management, and social connection. Facilitating behavior change represents the crux of success with each of these pillars. Positive emotions and positive psychology constructs are shown to drive behavior change in the upward spiral theory of lifestyle change. Moreover, positive psychology interventions serve as additional, independent protective health factors. This paper offers a brief review of the empirical evidence for these roles of positive psychology and makes the case for explicitly adding positive psychology to the foundational lifestyle medicine pillars.

Lifelong Fitness in Ambulatory Children and Adolescents with Cerebral Palsy II: Influencing the Trajectory.

Physical activity of at least moderate intensity in all children contributes to higher levels of physical and psychological health. While essential, children with cerebral palsy (CP) often lack the physical capacity, resources, and knowledge to engage in physical activity at a sufficient intensity to optimize health and well-being. Low levels of physical activity place them at risk for declining fitness and health, contributing to a sedentary lifestyle. From this perspective, we describe a framework to foster a lifelong trajectory of fitness in ambulatory children with CP (GMFCS I-III) as they progress into adolescence and adulthood, implemented in conjunction with a training program to augment bone and muscle health. First, we recommend that altering the fitness trajectory of children with CP will require the use of methods to drive behavioral change prior to adolescence. Second, to promote behavior change, we suggest embedding lifestyle intervention into fitness programming while including meaningful activities and peer socialization to foster self-directed habit formation. If the inclusion of lifestyle intervention to drive behavior change is embedded into fitness programs and found to be effective, it may guide the delivery of targeted programming and community implementation. Participation in comprehensive programming could alter the long-term trajectory of musculoskeletal health while fostering strong self-efficacy in persons with CP.