COM-B Model Research Articles

Does higher demand for medicinal plants lead to more harvest? Evidence from the dual trade of Nardostachy jatamansi and Fritillaria cirrhosa and Tibetan people’s harvesting behavior

IntroductionAs the demand for herbal medicines is surging worldwide, regions of medicinal plants are vulnerable to large-scale and unsustainable exploitation for commercial trade and use. Yet, we still lack the understanding about the relationship between indigenous people harvesting and trade practices of medicinal plants and their influencing factors for possible intervention measures.MethodsHere, we combined qualitative and quantitative methods to survey traders (N = 20) and local harvesters (N = 923) from nine Tibetan townships in Hongyuan county, Sichuan Province, on the eastern Qinghai-Tibetan plateau in China. Specifically, we elucidated the local value chain of medicinal plants trade and harvest of Nardostachy jatamansi and Fritillaria cirrhosa, and explored the factors influencing harvester’s willingness to harvest these plants. Furthermore, we empirically tested the constructs of the COM-B model (Capability, Opportunity, Motivation -Behavior) in predicting the sustainable harvesting behavior of medicinal plants.Results and DiscussionOur results revealed that the trade characteristics of N. jatamansi and F. cirrhosa were contrasting, and the sustainability of the former species was largely dependent on the latter one. Importantly, the traders’ practices were affected by the supply, while the harvesters’ willingness to harvest were mainly influenced by harvest incomes, past harvesting experience, and grassland tenure. Finally, though motivation was not directly affecting harvesting behavior, the harvesters’ ecological worldview indirectly affected their harvesting behavior, particularly through the mediation of the level of compliance of village rules and customs. Overall, our results provided crucial insights for the conservation and sustainable management of the valuable wild medicinal plants.

Barriers and facilitators for safe sex behaviors in students from universidad de Santiago de Chile (USACH) through the COM-B model

BackgroundUnsafe sex is one of the main morbidity and mortality risk factors associated with sexually transmitted infections (STIs) in young people. Behavioral change interventions for promoting safe sex have lacked specificity and theoretical elements about behavior in their designs, which may have affected the outcomes for HIV/AIDS and STI prevention, as well as for safe sex promotion. This study offers an analysis of the barriers and facilitators that, according to the university students who participated in the focus groups, impede or promote the success of interventions promoting healthy sexuality from the perspective of the actions stakeholders should undertake. In turn, this study proposes intervention hypotheses based on the Behavior Change Wheel which appears as a useful strategy for the design of intervention campaigns.MethodsTwo focus groups were organized with students from Universidad de Santiago de Chile (USACH). The focus groups gathered information about the perceptions of students about sex education and health, risk behaviors in youth sexuality, and rating of HIV/AIDS and STI prevention campaigns. In the focus groups, participants were offered the possibility of presenting solutions for the main problems and limitations detected. After identifying the emerging categories related to each dimension, a COM-B analysis was performed, identifying both the barriers and facilitators of safe sex behaviors that may help orient future interventions.ResultsTwo focus groups were organized, which comprised 20 participants with different sexual orientations. After transcription of the dialogues, a qualitative analysis was performed based on three axes: perception about sex education, risk behaviors, and evaluation of HIV/AIDS and STI prevention campaigns. These axes were classified into two groups: barriers or facilitators for safe and healthy sexuality. Finally, based on the Behavior Change Wheel and specifically on its ‘intervention functions’, the barriers and facilitators were integrated into a series of actions to be taken by those responsible for promotion campaigns at Universidad de Santiago. The most prevalent intervention functions are: education (to increase the understanding and self-regulation of the behavior); persuasion (to influence emotional aspects to promote changes) and training (to facilitate the acquisition of skills). These functions indicate that specific actions are necessary for these dimensions to increase the success of promotional campaigns for healthy and safe sexuality.ConclusionsThe content analysis of the focus groups was based on the intervention functions of the Behavior Change Wheel. Specifically, the identification by students of barriers and facilitators for the design of strategies for promoting healthy sexuality is a useful tool, which when complemented with other analyses, may contribute improving the design and implementation of healthy sexuality campaigns among university students.

Can the capabilities, opportunities and motivations model predict health behavior 1 year later?

The capabilities (C), opportunities (O) and motivations (M) model of behavior (B) change (COM-B) is designed to capture the key features of numerous models of behavior change, but little is known about its predictive validity. The present study tests the predictive validity of COM-B prospectively in the domain of attending hearing screening. 6,000 adults, representative of the U.K. population (e.g., 52.6% women) who one year earlier had reported COM with respect to attending hearing screening, were contacted again to complete an online survey with respect to their actual attendance. Data were analyzed descriptively, and with logistic regression to examine the influence of sociodemographic variables and COM on attendance at hearing screening. Respondents reported being highly capable of attending hearing screening (Ms > 7.98 on a 0-10 scale), but much lower levels of automatic (M = 4.21 on a 0-10 scale) and reflective (M = 5.21 on a 0-10 scale) motivations. Logistic regression analyses showed that men and older people were more likely to have their hearing checked but that hearing difficulty was the dominant determinant of attending hearing screening. Controlling for these sociodemographic and clinical variables, opportunities and motivations (but not capabilities) were also significantly associated with behavior. The COM-B model was predictive of attending hearing screening over a one-year period, which potentially makes it valuable for understanding health behavior change. Interventions for improving uptake in hearing screening that goes beyond increasing knowledge and skills (capabilities) are required to increase attendance at hearing screening. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Creative beyond TikToks: Investigating Adolescents' Social Privacy Management on TikTok

TikTok has been criticized for its low privacy standards, but little is known about how its adolescent users protect their privacy. Based on interviews with 54 adolescents in Switzerland, this study provides a comprehensive understanding of young TikTok users' privacy management practices related to the creation of videos. The data were explored using the COM-B model, an established behavioral analysis framework adapted for sociotechnical privacy research. Our overall findings are in line with previous research on other social networks: adolescents are aware of privacy related to their online social connections (social privacy) and perform conscious privacy management. However, we also identified new patterns related to the central role of algorithmic recommendations potentially relevant for other social networks. Adolescents are aware that TikTok's special algorithm, combined with the app's high prevalence among their peers, could easily put them in the spotlight. Some adolescents also reduce TikTok, which was originally conceived as a social network, to its extensive audio-visual capabilities and share TikToks via more private channels (e.g., Snapchat) to manage audiences and avoid identification by peers. Young users also find other creative ways to protect their privacy such as identifying stalkers or maintaining multiple user accounts with different privacy settings to establish granular audience management. Based on our findings, we propose various concrete measures to develop interventions that protect the privacy of adolescents on TikTok.

Experiences of older people, healthcare providers and caregivers on implementing person-centered care for community-dwelling older people: a systematic review and qualitative meta-synthesis

BackgroundPerson-centered care (PCC) is a critical approach to improving the quality of care for community-dwelling older people. Old-age care services could be provided according to older peoples’ choices, needs, and preferences. The purpose of this study was to synthesize research evidence on the experiences of older people, healthcare providers, and caregivers with PCC and to identify the enablers and barriers to implementing PCC for community-dwelling older people.MethodsA meta-synthesis of qualitative research design was adopted. Data searches were performed using CINAHL (EBSCOhost), PubMed (OvidSP), Embase (Ovid), Cochrane Database, and PsycINFO (Ovid) in published articles and were reviewed from the earliest date to February 2023. The Qualitative Method Appraisal Tool was used to conduct a quality appraisal on selected articles. Data were extracted based on the capacity, opportunity, and motivation-behavior model (COM-B model), and the findings were synthesized using the meta-aggregative approach.ResultsTwelve included articles were analyzed to identify 122 findings that were organized into 11 categories and combined into three synthesized findings—capacities of older people, healthcare providers, and caregivers; opportunities in the implementation of PCC; motivation in implementing PCC. Capacities consisted of a lack of person-centered knowledge and skills, negative attitudes toward shared decision-making, and a lack of formal training to enhance capabilities among HCPs. Opportunities included a lack of coordination in resource allocation, strengthening multidisciplinary teamwork, establishing a desirable environment, and time constraints. Motivation in implementing PCC included encouraging self-reflection and regulation, respecting the autonomy of older people, lack of clear reward and empowerment mechanisms, and being resilient and optimistic.ConclusionsThe findings of this research provide a reference for implementing successful PCC in the community. The researchers identified barriers and facilitators of implementing PCC, facilitating through stakeholder’s person-centered knowledge and skills being valued and respecting the autonomy of older people. Establishing a positive environment and strengthening multidisciplinary team members also promotes the implementation of PCC. However, additional studies are required to explore the influencing factors and address the barriers.

Rescuing Unwanted Household Goods: Moving Towards a Circular Economy

The world’s current ‘linear economy’ business model diminishes finite resources and disregards ongoing detrimental effects being created on our planet. Society needs to do something different, and move to a circular economy for sustainability. Changing existing consumer behaviour to extend the life of currently unwanted household goods can play a beneficial role to increase circularity. Underpinned by the COM-B model of behaviour and associated Behaviour Change Wheel (BCW), this study explores householders’ existing behaviour and views regarding unwanted goods, and perspectives of local government employees/contractors involved in collection of unwanted household goods, to develop recommended interventions to increase circularity. The study offers theoretical contributions as one of the first studies to apply the COM-B model and BCW within the circular economy context and identifies prioritisation/co-ordination as key issues needed in the model. Additionally, practical contributions are provided including recommendations for increased education, incentivisation and enablement (including improved infrastructure); with cost, safety, technology and politics key barriers to increasing circularity of unwanted goods by households. A crucial finding is a need for responsibilisation whereby all stakeholders must accept the specific role each needs to play in a co-ordinated effort to address the challenge of sustainability. The study provides social contribution addressing SDG Goal 12 (responsible consumption) and identifies how various stakeholders can do something different to assist increasing household participation in a circular economy – for the future of humankind and the planet.

Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review.

Evidence that nutrition-specific and nutrition-sensitive interventions can improve maternal and child nutrition status in sub-Saharan Africa is inconclusive. Using behaviour change theory and techniques in intervention design may increase effectiveness and make outcomes more predictable. This systematic review aimed to determine whether interventions that included behaviour change functions were effective. Six databases were searched systematically, using MeSH and free-text terms, for articles describing nutrition-specific and nutrition-sensitive behaviour change interventions published in English until January 2022. Titles, abstracts and full-text papers were double-screened. Data extraction and quality assessments followed Centre for Reviews and Dissemination guidelines. Behaviour change functions of interventions were mapped onto the COM-B model and Behaviour Change Wheel. PROSPERO registered (135054). The search yielded 1193 articles: 79 articles met inclusion criteria, ranging from low (n = 30) to high (n = 11) risk of bias. Many that applied behaviour change theory, communication or counselling resulted in significant improvements in infant stunting and wasting, household dietary intake and maternal psychosocial measures. Interventions with >2 behaviour change functions (including persuasion, incentivisation, environmental restructuring) were the most effective. We recommend incorporating behaviour change functions in nutrition interventions to improve maternal and child outcomes, specifically drawing on the Behaviour Change Wheel, COM-B model (SORT B recommendation). To enhance the designs of these interventions, and ultimately improve the nutritional and psychosocial outcomes for mothers and infants in sub-Saharan Africa, collaborations are recommended between behaviour change and nutrition experts, intervention designers, policy makers and commissioners to fund and roll-out multicomponent behaviour change interventions.

Examining capabilities, opportunities, and motivations for healthy eating behaviors in Latin American restaurants: a quantitative application of the COM-B model to inform future interventions

BackgroundEating foods away from home has been associated with poor diet quality and adverse health outcomes. Research is needed to examine barriers and facilitators to making healthier eating choices in restaurant settings. We operationalized the Capability, Opportunity, and Motivation for Behavior Model (COM-B Model) to conduct a behavioral diagnosis for healthy eating behaviors at Latin American restaurants (LARs), an understudied yet increasingly important food environment with the potential to positively influence diets.MethodsWe conducted an online survey with adults in the United States that reported eating food from LARs at least once a month (n = 509) recruited via an online market research panel to examine capabilities – physical (e.g., skills) and psychological (e.g., knowledge), opportunities – social (e.g., norms) and physical (e.g., environmental), and motivations – reflective (e.g., self-conscious intentions) and automatic (e.g., emotions) associated with healthier choices at LARs. In a survey focused on LAR-associated behaviors, each COM-B domain was scored between 1–5, with scores ≥ 4 denoted as having high capability, opportunity, and motivation to eat healthfully at LARs (potential range of total score = 6–35). Regression analysis was used to examine the association between COM-B scores (total and by domain) and select demographic characteristics (age, gender, race, Latin heritage, income, education, marital status, and Latin majority state of residency).ResultsMore than half of the participants (57.1%) were classified as having high physical capability, followed by psychological capability (43.9%) in the LAR environment. The proportions of participants with either high motivation or high opportunity were low, ranging from 37.3% (reflective motivation) to physical opportunity (15.6%). The overall mean COM-B total score was 19.8 ± 3.0. Higher total COM-B scores were associated with younger age, self-identifying as white, having Latin heritage, and having higher income (p < 0.05).ConclusionsThis study expands the application of the COM-B framework using quantitative inquiry to evaluate levels of capability, motivation, and opportunity for healthy eating in LAR settings and initial demographic associations with determinants for healthy eating in these settings. This work can aid in tailoring interventions and developing evaluation tools for LAR-related healthy eating interventions.

Going through changes: A longitudinal study of meat reduction over time in the UK

There are increasing moral, environmental and public health imperatives to curb meat consumption. While research on meat reduction has proliferated in recent years, the majority of empirical work has taken cross-sectional and/or experimental approaches. Therefore, this study sought to understand the process of dietary change through an observational longitudinal survey of 1,529 UK residents over the course of one year. An online questionnaire was used to take measures of diet, exposure to animal advocacy, exposure to animals and animal-lovers, the transtheoretical model of change, the COM-B model (capability, opportunity, motivation → behaviour), and demographics at 0, 6, and 12 months. While no support was found for predictions made on the COM-B model, some support was found for hypotheses made on the transtheoretical model - in particular, there was some evidence that those at later stages who still ate meat were more likely to give it up, and those at earlier stages who had given up meat were more likely to start eating it again. There were also generally stronger measures of decisional balance (i.e. conviction in the decision to give up meat) and self-efficacy for those at more advanced stages. Analyses also indicate that increases in consumption of animal product alternatives were significantly correlated with decreases in animal products in the same category. Ordinal regression models yielded low predictive ability, meaning that information on the interventions which may influence animal product consumption was limited. Findings are discussed in the context of previous literature and recommendations for future research.

Perceptions, attitudes, and practices of a Belgian teaching hospital's physicians, pharmacists, and nurses regarding antibiotic use and resistance: survey towards targeted actions for Antimicrobial Stewardship

ObjectivesThis study aimed to identify barriers to the proper use of antibiotics by healthcare professionals and to help the hospital Antimicrobial Stewardship develop suitable actions for the staff.MethodsIn a Belgian teaching hospital, a survey was conducted among physicians, pharmacists, and nurses involved in antibiotherapy. Questions from the 2019 European Center for Disease Prevention and Control (ECDC) survey were analyzed based on components of the COM-B model (capabilities, opportunities, and motivations). First, collected data were reviewed with the Ethnos software to analyze the different COM-B model components. For statistical analyses, responses were grouped into three clear-cut answers in a Fisher’s exact test.ResultsOverall, 400 staff members were included. We found that our professions, combined, have a good perception of antibiotic resistance (97.8%). For capabilities, however, only 77.2% state that they have sufficient knowledge, with 91.3%, 71.5%, and 63.0% for physicians, nurses, and pharmacists, respectively. For opportunities (access to resources, information, and training), it is observed that 72.2% report having easy access to the guidelines they need to manage infections. In comparison, for 64.2% of the respondents, this information changed their opinion on the useless or inappropriate prescription, administration, and delivery of antibiotics. For 55.0%, this information has enabled them to change their practices. Finally, for motivations, 92.8% of respondents state that they know about the link between their practices and the emergence and spread of antibiotic resistance. However, only 65.0% of participants say they have a role in managing antibiotic resistance. We found that 5 out of 8 questions are significantly dependent on the profession: 2 inquiries related to capability, 1 to opportunity, and 2 to motivation.ConclusionWe found that responses to the ECDC questionnaire are related to the profession. While some topics are universal/cross-functional, others must be explicitly tailored to each professional category. Information is useless if not accessible. Communication and provision of documents are thus paramount.

Barriers and facilitators to implementing a new regulation restricting antimicrobial use in dairy production in Québec, Canada: A qualitative study.

With the emergence of antimicrobial resistance (AMR), many countries are implementing restrictive regulations to reduce antimicrobial use (AMU) in animal production. Although these measures are effective at the national level, their implementation may generate challenges for producers and veterinarians. The objective of this study was to explore the barriers and facilitators of implementing a new regulation restricting the use of antimicrobials of very high importance for human health in the dairy production sector in the province of Québec, Canada. Individual interviews were conducted with fifteen veterinarians and twenty-seven dairy producers. Thematic analysis was performed based on the COM-B model of behavior change (capability-opportunity-motivation-behavior). Our results indicated that the lack of availability of alternative treatments, the long delays related to diagnostic tests and the fear of economic consequences were major barriers to the implementation of the regulation. A small number of producers also perceived that the regulation negatively impacted the health and wellbeing of their animals. Additionally, participants acknowledged the importance of early education and training to better understand the purpose of the regulation and increase its acceptability. Lastly, most participants reported that they had not only reduced their use of antimicrobials of very high importance for human health following the regulation, but they had also increased preventive practices on their farm. This study reveals that the implementation of restrictive regulations to reduce AMU in animal production can lead to multiple challenges in practice. Our results highlight the need for better communication and training of producers and veterinarians before and during the implementation of similar regulations in the future and underline the importance of measuring the direct and indirect impacts of those regulations on productivity and on animal health and wellbeing.

Perceived Barriers and Facilitators to a Healthy Diet among Cancer Survivors: A Qualitative Exploration Using the TDF and COM-B

Cancer survivors consider nutrition to be highly important and are motivated to seek information about lifestyle changes, including nutrition, to improve their long-term health. Despite this, suboptimal dietary intake is still reported. Understanding cancer-specific barriers and facilitators to healthy eating among this population could help develop targeted interventions for this group. This study explored the barriers and facilitators to following a healthy diet among cancer survivors using the Theoretical Domains Framework (TDF) and COM-B model. Semi-structured focus groups with 20 cancer survivors were conducted between February and August 2021, which were transcribed verbatim. Seven key TDF domains accounted for 87% of all coded responses. These were (a) environmental context and resources; (b) knowledge; (c) behavioural regulation; (d) social/professional role and identity; (e) belief about consequences; (f) social influences; and (g) skills. Key barriers were lack of knowledge, non-specific or irrelevant information, environmental aspects, and family. Facilitators were awareness of the importance of nutrition, the health benefits of a plant-based diet, confidence in cooking skills, organisation, balance, family, time, and viewing themselves as someone who eats healthily and access to fresh produce. Enablement was the most prominently linked intervention function. This work can inform future interventions in this area and ensure they are end-user-centred.

Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis.

Stroke affects more than 30 million people every year, but only two-thirds of patients comply with prescribed medication, leading to high stroke recurrence rates. Digital technologies can facilitate interventions to support treatment adherence. This study evaluates the effectiveness of remote interventions and their mechanisms of action in supporting medication adherence after stroke. PubMed, MEDLINE via Ovid, Cochrane CENTRAL, the Web of Science, SCOPUS, and PsycINFO were searched, and meta-analysis was performed using the Review Manager Tool. Intervention content analysis was conducted based on the COM-B model. Ten eligible studies were included in the review and meta-analysis. The evidence suggested that patients who received remote interventions had significantly better medication adherence (SMD 0.49, 95% CI [0.04, 0.93], and p = 0.03) compared to those who received the usual care. The adherence ratio also indicated the interventions' effectiveness (odds ratio 1.30, 95% CI [0.55, 3.10], and p = 0.55). The systolic and diastolic blood pressure (MD -3.73 and 95% CI [-5.35, -2.10])/(MD -2.16 and 95% CI [-3.09, -1.22]) and cholesterol levels (MD -0.36 and 95% CI [-0.52, -0.20]) were significantly improved in the intervention group compared to the control. Further behavioural analysis demonstrated that enhancing the capability within the COM-B model had the largest impact in supporting improvements in adherence behaviour and relevant clinical outcomes. Patients' satisfaction and the interventions' usability were both high, suggesting the interventions' acceptability. Telemedicine and mHealth interventions are effective in improving medication adherence and clinical indicators in stroke patients. Future studies could usefully investigate the effectiveness and cost-effectiveness of theory-based and remotely delivered interventions as an adjunct to stroke rehabilitation programmers.

An Application of the Distributed-Order Time- and Space-Fractional Diffusion-Wave Equation for Studying Anomalous Transport in Comb Structures

A comb structure consists of a one-dimensional backbone with lateral branches. These structures have widespread application in medicine and biology. Such a structure promotes an anomalous diffusion process along the backbone (x-direction), along with classical diffusion along the branches (y-direction). In this work, we propose a distributed-order time- and space-fractional diffusion-wave equation to model a comb structure in the more general setting. The distributed-order time- and space-fractional diffusion-wave equation is firstly formulated to study the anomalous diffusion in the comb model subject to an irregular convex domain with the motivation that the time-fractional derivative considers the memory characteristic and the space one with the variable diffusion coefficient possesses the nonlocal characteristic. The finite element method is applied to obtain the numerical solution. The stability and convergence of the numerical discretization scheme are derived and analyzed. Two numerical examples of relevance to the comb model are given to verify the correctness of the numerical method. Moreover, the influence of the involved parameters on the three-dimensional and axial projection drawing particle distribution subject to an elliptical domain are analyzed, and the physical meanings are interpreted in detail.

Informing a collaborative-care model for delivering medication assisted treatment for opioid dependence (MATOD): An analysis of pharmacist, prescriber and patient perceptions.

Demand for medication assisted treatment for opioid dependence (MATOD) in Australia exceeds capacity, particularly in rural and regional areas. There is increasing recognition that community pharmacists are well-positioned to take on expanded roles in MATOD delivery, however there has been limited Australian research exploring attitudes of pharmacists, prescribers, and patients to collaborative models of care. This study aimed to better understand enablers and barriers to a collaborative model for MATOD, to inform implementation in regions where increases in treatment capacity are urgently needed. Semi-structured telephone interviews were conducted with pharmacists (n=11), prescribers (n=6), and patients (n=8) recruited from the Frankston-Mornington Peninsula region in Victoria, Australia, where transport and access to services have impacts on health care utilisation. The COM-B model was used to explore perceptions of pharmacists' capability, opportunity, and motivations for delivering collaborative care. There was strong motivation among healthcare professionals to participate in a collaborative model of care, with the main perceived benefits including improvements in accessibility, convenience, and continuity of care, and leverage of pharmacists' high level of patient engagement. Key barriers identified by both pharmacists and prescribers included a perceived lack of pharmacist skills in some areas (capability) and resources (opportunity) to deliver collaborative care in a community pharmacy setting. Established relationships between all stakeholders (social opportunity) and communication between pharmacists and prescribers were identified as facilitators. Barriers and facilitators aligned with seven key areas: skills, confidence, relationships, patient selection, protocols, communication and resources. Findings informed the development of a collaborative model that was individualised, protocol based, and supported by training and clear processes. This study identifies specific barriers and facilitators to a pharmacist-prescriber collaborative model of care for MATOD. The resulting model will be tested in a hybrid implementation-effectiveness trial in the Frankston-Mornington Peninsula region.

Co-producing a physical activity intervention in two forensic psychiatry settings in the UK: The IMPACT study

IntroductionIn the UK there are 3500 individuals detained in medium secure forensic psychiatry units. Service users in such settings have complex and serious mental illness (SMI), often with co-morbid physical health problems and a life expectancy of at least 10 years shorter than the general population. They often have low levels of physical activity. There is little evidence about physical activity interventions for medium secure service users in the United Kingdom.ObjectivesOur objective is to co-produce, with medium secure service users, the content and delivery of an intervention to increase physical activity. We shall assess feasibility, acceptability and pilot data collection methods for outcomes relevant for a future randomised controlled trial.MethodsThis is a 24-month mixed-methods project that will follow the Medical Research Council (MRC) framework Developing and Evaluating Complex Interventions. The study has 4 phases.- Phases 1-2 will gather information required to co-develop an evidence based intervention in Phase 3.- Phase 4 will assess the intervention in a feasibility study, evaluating and testing the intervention for a future pilot study.Study settings: Two NHS Medium Secure In-Patient Psychiatric Hospitals in the UK.ResultsThis paper presents the findings from the Phase 1 questionnaire and focus groups with service users and hospital staff that identified the barriers and facilitators to physical activity in such settings. The results are then discussed in relation to the Phase 2 qualitative results that explored stakeholders’ and service users’ opinions into how to increase physical activity among medium secure service users by identifying potential elements for inclusion in a physical activity intervention, to gain insight into how we can establish engagement of this group with the intervention, maintain commitment, avoid drop-out and develop the intervention design. All findings are presented using the Capability, Opportunity, and Motivation Model of Behaviour (COM-B model), which is widely used to identify what needs to change for a behaviour change intervention to be effective.ConclusionsThe findings of Phases 1-2 are allowing the team to move forward with Phase 3 that is currently developing an intervention to increase physical activity for adult inpatient service users in the medium secure units. This phase will be guided by the MRC framework and the COM-B model to define the target behaviours and select the most suitable intervention components (functions and techniques) and implementation approach.Disclosure of InterestNone Declared

Is China ready for change? Consumer behaviour towards buying plant-based meat alternatives: applying the COM-B model

PurposeMany consumers express interest in plant-based meat alternatives (PBMA); however, they are reluctant to change their meat consumption behaviour. To support the transition to a “meat-free” diet, it is necessary to understand the influencing factors to purchase PBMA. This study responds to a gap in the literature and aims to explore the factors influencing Chinese consumers' willingness to purchase PBMA in terms of “Capability, Motivation and Opportunity”.Design/methodology/approachCross-sectional data were collected through an online survey in China (n = 591). Correlation testing and multiple linear regression were used to identify factors that may influence consumers' willingness to purchase PBMA by applying the COM-B model; which refers to Capability (C), opportunity (O), and motivation (M) as three key factors capable of changing behaviour (B).FindingsThe results show that consumers with better income and education are more likely to consume PBMA. Familiarity with purchasing channels and cooking knowledge were “capability” catalyst for purchase intentions; support from people around and who also consume PBMA provided opportunities; animal welfare, food safety, sustainability and emotional benefits were motivating factors for facilitation. With capabilities and opportunities, consumers are more likely to be motivated to purchase PBMA. It was also clear, environmental support and appropriate purchasing conditions overweigh knowledge and previous experience in motivating PBMA purchase. Additionally, the study found that familiarity, past experience, high status symbols of meat and health concerns were positively associated with but did not affect purchase intentions (p > 0.05).Social implicationsThe current study did not find a substitution effect for PBMA, as participants tended to consider PBMA as a type of meat and did not substitute it for their daily meat consumption unless motivated.Originality/valueThis study provides a theoretical framework and insights for future research, and production companies can develop marketing initiatives based on the contributing factors using the COM-B model.

Towards Use of Capability, Opportunity and Motivation Model in Predicting Ugandan Citizens’ Behavior towards Engagement in Policy Formulation through E-participation

Abstract Though the government of Uganda has put in place a fully-fledged ministry of ICT and allowed citizens to electronically participate in policy formulation following article 37 of the constitution of Uganda, most citizens are still reluctant. This reluctance has led to limited participation and formulation of unrepresentative policies, loss of citizens’ trust in government, and defiance of formulated policies. This study’s focus was to apply the capability, opportunity, and motivation (COM-B) model to understand how citizens’ engagement behaviors toward policy formulation could be improved. The following hypotheses were tested: There is a significant influence of motivation and opportunity on capability; Capability mediates the relationship between motivation, opportunity, and engagement; and there is a significant influence of capability, opportunity, and motivation on engagement. A survey was used to collect data from 361 respondents in four regions in Uganda using a multistage and simple random sampling method. Collected data were analysed using SPSS and SEM. Study findings found a significant influence of Motivation and Opportunity on Capability; a significant direct influence of Opportunity and Capability on engagement; and a significant indirect influence of motivation on engagement through capability. Implying that Capability partially mediates the relationship between Opportunity and engagement but fully mediates the relationship between Motivation and engagement. However, Opportunity had the strongest influence on capability and engagement behaviors. This study’s contribution was in testing the applicability of the COM-B model in policy formulation in Uganda. The recommendation to policymakers is to increase opportunity since it has a stronger influence on both Capability and engagement behaviors.

Changing Hearts and Minds in the Equestrian World One Behaviour at a Time.

Equestrianism is currently facing a range of pressing challenges. These challenges, which are largely based on evolving attitudes to ethics and equine wellbeing, have consequences for the sport's social licence to operate. The factors that may have contributed to the current situation include overarching societal trends, specific aspects of the equestrian sector, and factors rooted in human nature. If equestrianism is to flourish, it is evident that much needs to change, not the least, human behaviour. To this end, using established behaviour change frameworks that have been scientifically validated and are rooted in practice-most notably, Michie et al.'s COM-B model and Behaviour Change Wheel-could be of practical value for developing and implementing equine welfare strategies. This review summarises the theoretical underpinnings of some behaviour change frameworks and provides a practical, step-by-step approach to designing an effective behaviour change intervention. A real-world example is provided through the retrospective analysis of an intervention strategy that aimed to increase the use of learning theory in (educational) veterinary practice. We contend that the incorporation of effective behaviour change interventions into any equine welfare improvement strategy may help to safeguard the future of equestrianism.

Design principles of interactive play systems for children’s outdoor play: A designers’ perspective

In recent years, designers around the world have developed a number of interactive play systems to stimulate children’s outdoor play. This paper provides a framework for the design principles used by designers of interactive play systems. In addition, the mechanisms by which these design principles could potentially contribute to stimulating children’s outdoor play are discussed based on the COM-B model of behaviour change. The COM-B model is adopted to elaborate the design principles and their mechanisms of action. This model provides a basis for designing healthy behaviour change interventions. It defines behaviour as the result of an interaction between three components that generate behaviour: Capability, Opportunity, and Motivation. The contribution of this paper is to identify the design principles and link them to the underlying factors of children’s outdoor play in terms of the components of the COM-B model. Clarifying this link elaborates the mechanisms of action of design principles to stimulate children’s outdoor play. An in-depth interview approach is used to explore the designers’ perspectives. The findings of this research contribute to the theory of behaviour change and are beneficial for practitioners, and in particular, interactive designers who develop systems that stimulate children’s outdoor play.