Effective Behaviour Change Interventions Research Articles

Barriers of Appropriate Antibiotic Prescription at PHCC in Qatar: Perspective of Physicians and Pharmacists.

The Ministry of Public Health in Qatar developed the NAP (National Action Plan to combat Antimicrobial Resistance (AMR) in collaboration with WHO Regional Office for the Eastern Mediterranean (WHO/EMRO). Among the major factors shaping AMR is antimicrobial prescribing and use. Tailoring Antimicrobial Resistance Program is a behavior change methodology that is utilized to adapt behavior change in relation to antimicrobial use. This study explores barriers of appropriate antibiotic (AB) prescription from the physicians’ and pharmacists’ perspectives at primary healthcare centers in Qatar. Data were collected from 50 participants across two PHCCs: 30 physicians and 20 pharmacists. Two different interview guides were constructed: One for physicians and one for pharmacists. In-depth, face-to-face, five focus groups were conducted and transcribed verbatim. Inductive qualitative analysis, involving discovering the themes in the interviews, was followed. Data were analyzed using constant comparative techniques. The Major themes arose from the analysis revealed that patients, practitioners mainly physicians, and the organization itself, played a role in shaping these barriers in the two primary healthcare centers. The findings would help develop and pilot behavior change interventions among patients, physicians and pharmacists with the aim of optimizing appropriate antibiotic prescription and use, which would support the implementation of the antibiotic stewardship program. Effective behavior change interventions should consider multiple factors including individual and organizational factors to optimize appropriate antibiotic prescription.

Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology.

Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the BehaviourChange Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project. Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar withthe ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) and publishing online. Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational , Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it. Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.

Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology

Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the Behaviour Change Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project. Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar with the ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) and publishing online. Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational , Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it. Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.

Promoting physical activity in primary care: a systematic review and meta-analysis.

BackgroundPromoting physical activity is an important part of patient care in primary care and has been investigated in many studies with a wide range of intervention characteristics, often including external support. It is unclear, however, if promoting physical activity is effective.AimTo investigate the effectiveness of behaviour change interventions to promote physical activity in primary care.Design and settingThis is a systematic review and meta-analysis to evaluate physical activity promotion in a primary care setting.MethodEMBASE, MEDLINE, PsycInfo, and the Joanna Briggs Institute Database were searched for ‘physical activity’, ‘interview’, ‘motivation’, ‘primary care’, and equivalent words to identify randomised controlled trials with physical activity as the outcome at patient level.ResultsThe review identified 25 eligible studies. The quality appraisal showed that most studies reported insufficient details regarding randomisation, group allocation, blinding, and fidelity of intervention delivery. The included studies reported a wide range of interventions with varying numbers of follow-up visits or phone calls. The overall effect size for interventions with a 6-month follow-up interval was 0.04 (95% confidence interval [CI] = −0.06 to 0.14), and for interventions with a 12-month follow-up interval it was 0.19 (95% CI = 0.03 to 0.36). Only one intervention based on three motivational interviewing sessions achieved a moderate effect.ConclusionCounselling to promote physical activity in primary care has a limited effect on patients’ behaviour and it might not, on its own, be enough to change physical activity behaviour.

Prescriber behaviours that could be targeted for change: An analysis of behaviours demonstrated during prescription writing in children.

The prescribing process for children with cancer is complex, and errors can occur at any step. As a result, many interventions have been used to reduce errors. However, few of them have been designed based on an understanding of the prescriber behaviour that can lead to errors. In order to design effective behaviour change interventions, it is important first to understand the prescribing process and identify prescriber behaviours that could be targeted for change. To describe the prescribing process in a paediatric oncology ward and to identify prescriber behaviours during prescription writing that could be targeted to reduce errors. This study employed two sequential phases. First, the prescribing process was observed and then described using the hierarchical task analysis (HTA) method. Second, prescriber tasks identified from the HTA were analysed using the behaviour change wheel (BCW) approach to identify promising behaviours for change. These identified behaviours were prioritised based on information collected from four focus groups with prescribers and chart review of errors made in the ward. The prescribing process was complex and involved multiple tasks performed in varying orders. Applying the BCW identified thirty-two candidate behaviours for potentially reducing prescribing errors. However, after prioritization, only two emerged as promising candidate behaviours for intervention: writing drug indications at the time of prescribing and using a pre-written order when ordering medications through electronic prescribing. This research suggests that two behaviours could be promising in reducing errors. Having identified these behaviours, future work could explore what needs to change with respect to individuals and their work environments to achieve the desired change in these identified behaviours.

Digital encounters: Human interactions in mHealth behavior change interventions.

Digitalization and high mobile phone ownership globally have radically changed communication in all areas of society, including health care. Previous research has shown the effectiveness of behavior change interventions delivered by mobile phones and has highlighted advantages, such as that they require fewer resources than traditional face-to-face interventions and can be delivered at any time. One of the foremost questions pertaining to unsupported digital interventions is whether they can ever be comparable to in-person interventions. Little is known about the therapeutic alliance and the specific qualities of encounters in digital interactions for behavior change. Human interactions in digital interventions and their relationship with outcomes require further investigation. This paper aims to encourage critical reflection and further consideration of mHealth behavior change interventions in a digital age, when even the professional is excluded from the intervention. Questions are raised on the feelings associated with digital therapeutic relationships and how such interactions might affect user’s capacity for behavioral change. Some technological features and human-like considerations for enhancing digital encounters in mHealth interventions are given. Finally, suggestions for future research to facilitate the digital encounter in mHealth behavior change interventions is presented.

Challenges in the impact evaluation of behaviour change interventions: The case of sea turtle meat and eggs in São Tomé

AbstractRobust impact evaluations are needed for conservation to learn and grow as a field. Currently we lack a large body of evidence on the effects of behaviour change interventions in social‐ecological systems. By uncovering mechanistic relationships and establishing causality we can refine future programmes to enhance likelihood of effectiveness. Although a range of sophisticated methodological approaches to evaluation have been developed, conceptually linking project outcomes with conservation impacts remains difficult in complex systems.For example, sea turtles are one taxon in which unsustainable harvesting has been a particular problem. There have been a number of campaigns to reduce demand for sea turtle products, but we still have little evidence documenting their outcomes. We conducted the first formal impact evaluation of a conservation marketing campaign aimed at reducing the consumption of sea turtle meat and eggs. The campaign took place on the island of São Tomé, Central Africa, and included traditional mass media advertisements as well as community events. This is one of few demand reduction evaluations that has assessed both human behaviour and biological conservation outcomes. It benefited from an advantageous setting for evaluation, as nesting sea turtles are relatively easy to monitor and the island's small size and geographic isolation increased the detectability of potentially confounding factors. We found a decrease in self‐reported sea turtle egg consumption and a decrease in poaching of adult sea turtles.However, multiple unforeseen difficulties arose which complicated attempts at causal attribution. We were hampered by spatial spillovers, design effects from the sensitive questioning technique, concurring law enforcement and changes in biological monitoring effort. These challenges highlight the difficulties faced by practitioners seeking to apply impact evaluations in the field. We reflect on what this means for future impact evaluations of behaviour change interventions in conservation. Our recommendations include combining multiple outcome measures to triangulate hard‐to‐measure behaviours and theory‐based evaluation methods to explore causal impacts.A freePlain Language Summarycan be found within the Supporting Information of this article.

Motivation theory-based physical activity programme for older adults in residential care facility: A modified Delphi and single-group pretest-posttest study.

Physical inactivity exposes older adults living in long-term care institutions to a high risk of health deterioration. Developing effective behaviour change interventions based on a theoretical framework is a pressing concern. This study developed an 'Easy Walking' intervention programme based on the Wheel of Motivation and aimed to: (1) develop the intervention programme for promoting self-efficacy of older adults living in long-term care facilities; and (2) examine the perceived helpfulness of the intervention programme for encouraging walking behaviours. This study consisted of two stages. In the first stage, a three-round modified Delphi process was conducted with ten experts to rate the eight motivators in the Wheel of Motivation. The Easy Walking programme was designed accordingly. In the second stage, a single-group pretest-posttest study design was employed to evaluate the Easy Walking programme. Structured questionnaires were used to collect data on the changes in self-efficacy and on the perceived helpfulness regarding the programme. The Easy Walking intervention programme features eight factors that influence motivation. Thirty older adults participated in and evaluated the programme. The results showed a significant difference in self-efficacy (t=-7.02, p<.001) of the older adults. Regarding the perceived usefulness of the intervention, the mean scores for each item ranged from 3.73 to 4.93 points. 'Safe environment' was perceived to be the most helpful factor for encouraging walking behaviours. The Easy Walking programme enhanced the self-efficacy of institutionalised older adults and was perceived as helpful in physical activity engagement. Nursing professionals in long-term care institutions could implement the Easy Walking programme to be part of daily nursing activities.

Addressing behavior in pollinator conservation policies to combat the implementation gap.

Solutions for conserving biodiversity lie in changing people's behavior. Ambitious international and national conservation policies frequently fail to effectively mitigate biodiversity loss because they rarely apply behavior-change theories. We conducted a gap analysis of conservation behavior-change interventions advocated in national conservation strategies with the Behavior Change Wheel (BCW), a comprehensive framework for systematically characterizing and designing behavior-change interventions. Using pollinator conservation as a case study, we classified the conservation actions listed in national pollinator initiatives in relation to intervention functions and policy categories of the BCW. We included all national-level policy documents from the European Union available in March 2019 that focused on conservation of pollinators (n = 8). A total of 610 pollinator conservation actions were coded using in-depth directed content analysis, resulting in the identification of 787 intervention function and 766 policy category codes. Overall, these initiatives did not employ the entire breadth of behavioral interventions. Intervention functions most frequently identified were education (23%) and environmental restructuring (19%). Least frequently identified intervention functions were incentivization (3%), and restriction (2%) and coercion were completely absent (0%). Importantly, 41% of all pollinator conservation actions failed to identify whose behavior was to be changed. Building on these analyses, we suggest that reasons for the serious implementation gap in national and international conservation policies is founded in insufficient understanding of which behavioral interventions to employ for most beneficial impacts on biodiversity and how to clearly specify the intervention targets. We recommend that policy advisors engage with behavior-change theory to design effective behavior-change interventions that underpin successful conservation policies.

How are body mass and body attitude impacted by a behaviour change intervention in primary care? A pragmatic randomised controlled trial.

Aims:This study evaluated the effect of behaviour change interventions at Norwegian Healthy Life Centres on change in body mass index (BMI) and body attitude, and explored the predictors for change after 6 months. Methods: We randomised 118 participants to either an intervention or a control group. Eligible participants: ⩾18 years and able to take part in group-based interventions. Body attitude, weight, and height were assessed at inclusion and after 6 months. We analysed the data using simple and multiple regression. Results: Eighty-six participants completed 6-month follow-up. The study found no intervention effect on BMI or body attitude across the two groups. However, an interaction effect indicated that the leaner participants in the intervention group reduced their weight significantly (b 0.94, p < 0.001). BMI reduction was predicted by self-efficacy for physical activity and autonomous motivation for change. Weight loss was associated with impaired body attitude, body shape concern, impaired weight-related self-esteem, weight cycling, and controlled motivation for change. Improvement in body attitude was positively impacted by self-rated health, the experience of childhood respect, life satisfaction, and self-efficacy for physical activity. Impaired body attitude was predicted by body shape concern, impaired weight-related self-esteem, and controlled motivation. Conclusions: The interventions did not affect body mass on average, but promoted weight loss among the leaner participants. Because weight reduction was associated body shape concern and impaired body attitude, the study supports the claim that interventions should be weight neutral and aim to improve body image and psychological well-being rather than weight reduction.

Taking a more nuanced look at behavior change for demand reduction in the illegal wildlife trade

AbstractThe illegal wildlife trade threatens the future of many species, and undermines economies and livelihoods. Conservationists have largely responded with supply‐side interventions, such as antipoaching patrols, but these often fail to stem the tide of wildlife trafficking. There is now increasing interest in demand‐side interventions, which seek to lower poaching pressure on sought‐after species by reducing consumer's desire for, and purchase of, specific wildlife products. Individual behavior change approaches, from environmental education to social marketing, have been widely advocated by academics, practitioners, and policy makers. However, this is an emerging field and we lack the breadth of evidence needed to understand and predict the potential outcomes of demand reduction interventions. To help us gain broader insights, we examine the literature from public health and international development on the effectiveness of behavior change interventions, and critique the current conceptualization of strategies for reducing consumer demand in the illegal wildlife trade. We show that behavior change is difficult to achieve and interventions may have unintended and undesirable consequences because of unaddressed systemic, cultural and environmental drivers, and limited resourcing. We conclude that some sections of the conservation community are advocating a shift from one reductionist approach based on limiting supply, to another based on limiting demand, and argue that conservationists should learn from the public health and international development projects that have integrated systems thinking. By accounting for the multiple interactions and synergies between different factors in the wildlife trade, we can develop more strategic approaches to protecting endangered species.

Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology

Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the Behaviour Change Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project. Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar with the ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) language and publishing online. Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational, Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it. Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.

An international, Delphi consensus study to identify priorities for methodological research in behavioral trials in health research

BackgroundNon-communicable chronic diseases are linked to behavioral risk factors (including smoking, poor diet and physical inactivity), so effective behavior change interventions are needed to improve population health. However, uptake and impact of these interventions is limited by methodological challenges. We aimed to identify and achieve consensus on priorities for methodological research in behavioral trials in health research among an international behavioral science community.MethodsAn international, Delphi consensus study was conducted. Fifteen core members of the International Behavioral Trials Network (IBTN) were invited to generate methodological items that they consider important. From these, the research team agreed a “long-list” of unique items. Two online surveys were administered to IBTN members (N = 306). Respondents rated the importance of items on a 9-point scale, and ranked their “top-five” priorities. In the second survey, respondents received feedback on others’ responses, before rerating items and re-selecting their top five.ResultsNine experts generated 144 items, which were condensed to a long-list of 33 items. The four most highly endorsed items, in both surveys 1 (n = 77) and 2 (n = 57), came from two thematic categories:“Intervention development” (“Specifying intervention components” and “Tailoring interventions to specific populations and contexts”) and “Implementation” (“How to disseminate behavioral trial research findings to increase implementation” and “Methods for ensuring that behavioral interventions are implementable into practice and policy”). “Development of novel research designs to test behavioral interventions” also emerged as a highly ranked research priority.ConclusionsFrom a wide array of identified methodological issues, intervention development, implementation and novel research designs are key themes to drive the future behavioral trials’ research agenda. Funding bodies should prioritize these issues in resource allocation.

Preferences and the Effectiveness of Behavior-Change Interventions: Evidence from Adoption of Improved Cookstoves in India

AbstractPreference heterogeneity can influence behavior in economically significant ways, thereby influencing the effectiveness of environmental policies or interventions. We test this hypothesis i...

Understanding Electric Bikers’ Red-Light Running Behavior: Predictive Utility of Theory of Planned Behavior vs Prototype Willingness Model

To date, electric bikers’ (e-bikers’) red-light running (RLR) behavior is often viewed as one of the main contributors to e-bike-related accidents, especially for traffic scenarios with high e-bike ridership. In this paper, we aim to understand e-bikers’ RLR behavior based on structural equation modeling. Specifically, the predictive utility of the theory of planned behavior (TPB), prototype willingness model (PWM), and their combined form, TPB-PWM model, is used to analyze e-bikers’ RLR behavior, and a comparison analysis is made. The analyses of the three modeling approaches are based on the survey data collected from two online questionnaires, where more than 1,035 participant-completed questionnaires are received. The main findings in this paper are as follows: (i) Both PWM and TPB-PWM models could work better in characterizing e-bikers’ RLR behavior than the TPB model. The former two models explain more than 80% (81.3% and 81.4%, respectively) of the variance in e-bikers’ RLR behavior, which is remarkably higher than that of the TPB model (only 74.3%). (ii) It is also revealed that RLR willingness contributes more on influencing the RLR behavior than RLR intention, which implies that such behavior is dominated by social reactive decision-making rather than the reasoned one. (iii) Among the examined psychological factors, attitude, perceived behavioral control, past behavior, prototype perceptions (favorability and similarity), RLR intention, and RLR willingness were the crucial predictors of e-bikers’ RLR behavior. Our findings also support designing of more effective behavior-change interventions to better target e-bikers’ RLR behavior by considering the influence of the identified psychological factors.

A collaborative approach to developing sustainable behaviour change interventions for childhood obesity prevention: Development of the Choosing Healthy Eating for Infant Health (CHErIsH) intervention and implementation strategy.

There is growing recognition of the need for effective behaviour change interventions to prevent chronic diseases that are feasible and sustainable and can be implemented within routine health care systems. Focusing on implementation from the outset of intervention development, and incorporating multiple stakeholder perspectives to achieve this, is therefore essential. This study explores the development of the Choosing Healthy Eating for Infant Health (CHErIsH) childhood obesity prevention intervention and implementation strategy to improve infant feeding behaviours. Five qualitative and quantitative evidence syntheses, two primary qualitative studies, and formal/informal consultations were conducted with practice, policy, research, and parent stakeholders. The Behaviour Change Wheel was used to guide the integration of findings. The CHErIsH intervention targets parent-level behaviour change and comprises (1) brief verbal messages and (2) trustworthy resources, to be delivered by health care professionals (HCPs) during routine infant vaccination visits. The implementation strategy targets HCP-level behaviour change and comprises (1) a local opinion leader, (2) incentivized training, (3) HCP resources and educational materials, (4) electronic delivery prompts, (5) awareness-raising across all primary care HCPs, and (6) local technical support. This study provides a rigorous example of the development of an evidence-based intervention aimed at improving parental infant feeding behaviours, alongside an evidence-based behaviour change strategy to facilitate implementation and sustainability in primary care. This approach demonstrates how to systematically incorporate multiple stakeholder perspectives with existing literature and move from multiple evidence sources to clearly specified intervention components for both the intervention and implementation strategy. Statement of Contribution What is already known? Incorporating insights from practice, policy, and public/patient stakeholders plays a key role in developing behaviour change interventions that are feasible and sustainable and can be implemented within routine health care systems. However, there are limited examples that provide in-depth guidance of how to do this using a systematic approach. What this study adds? This study describes an innovative use of the Behaviour Change Wheel to integrate multiple sources of evidence collected from practice, policy, research, and parent stakeholders to concurrently develop an evidence-based intervention to improve parental infant feeding behaviours and an implementation strategy to facilitate sustainable delivery by health care professionals in routine primary care.

“Nudge” and Statistics

Abstract Mark Pilling highlights the role of statistics and study design in helping policy-makers and business leaders to determine the effectiveness of behaviour change interventions

Biopsychosocial correlates of physical activity and sedentary time in adults with severe obesity.

Adults with severe obesity have poorer health, are less active and spend more time sedentary compared to people with a lower body mass index (BMI). There is a pressing need to understand the factors associated with low physical activity (PA) and excessive sedentary time to develop more effective behaviour change interventions for this population. The purpose of this study was to identify biopsychosocial correlates of PA and sedentary time in adults living with severe obesity. Forty-four adults living with severe obesity (age = 50.5 ± 13.3 years; BMI = 44.3 ± 7.8 kg/m2 ) completed a survey including questions on sociodemographic characteristics, comorbidities, psychosocial factors (eg, social physique anxiety [SPA], social support for PA, PA level self-perception), quality of life, daily pain and self-reported moderate-to-vigorous intensity PA (MVPA). Participants also completed the 6-minute walk test (6MWT) to assess physical fitness and wore an accelerometer to assess objective PA and sedentary time. In stepwise linear multivariate analyses, higher objective MVPA was associated with higher 6MWT distance, being single and lower SPA (R2 = 0.46, P < .001), whereas higher self-reported MVPA was associated with greater PA level self-perceptions (R2 = 0.47, P < .001). Greater objective light intensity PA was associated with greater quality of life and self-efficacy for PA (R2 = 0.26, P = .001). Greater sedentary time was associated with having more comorbidities (R2 = 0.25, P < .001). This study shows that adults living with severe obesity who have more comorbidities, poorer quality of life and/or lower self-efficacy perception for PA are more likely to be sedentary and to practice less light intensity PA. Additionally, those who were in a relationship, had higher SPA and/or had lower physical fitness practiced less MVPA. Future research is needed to determine causal effects.

Longitudinal Patterns of Sexually Transmitted Infection Risk Based on Psychological Characteristics and Sexual Behavior in Heterosexual Sexually Transmitted Infection Clinic Visitors.

Great heterogeneity in sexually transmitted infections (STI) risk exists, and investigating individual-level characteristics related to changes in STI risk over time might facilitate the development and implementation of effective evidence-based behavior change interventions. The aim of this study was to identify longitudinal patterns of STI risk based on psychological and behavioral characteristics. A longitudinal study was conducted among heterosexual STI clinic visitors aged 18 to 24 years. Latent classes based on behavioral and psychological characteristics at baseline, and transitions from 1 latent class to another at 3-week, 6-month, and 1-year follow-up, were identified using latent transition analysis. Four latent classes were identified that could be differentiated by psychological and behavioral characteristics and STI risk: overall low-risk (10%), insecure high-risk (21%), condom-users (38%), and confident high-risk (31%). Although the majority of the total study population did not move to another latent class over time, the size of the overall low-risk group increased from 10% at baseline to 30% after 1 year. This was mainly due to transitions from the insecure high-risk, condom-users, and confident high-risk class at 3-week follow-up to the overall low-risk class at 6-month follow-up. Distinct subgroups among heterosexual STI clinic visitors can be differentiated from each other by multiple psychological and behavioral characteristics, and these characteristics reflecting the risk of acquiring STI are consistent over the course of 1 year in most individuals. An integral approach, adapting behavioral interventions to match multiple psychological and behavioral characteristics of high-risk subgroups, might be more effective in controlling STI transmission.

Workshop: Behaviour change and knowledge translation: The unlocked potential to improve people’s health

Abstract Background Despite the complexities of modern healthcare it remains the case that human behaviour plays a critical role in health outcomes and in the efficacy of most treatments. We know that people get sick because of unhealthy behaviours. We know that the success of most healthcare interventions is highly dependent on patients’ willingness to adhere to self-care activities such as taking medications or performing self-examinations. Over the last decades well-validated, cost-effective behavioural medicine interventions have been developed. The field has contributed to strategies in health education, with techniques for modifying behaviour, and enhancing motivation and learning for health. More recently, multilevel intervention models, including environmental and policy variables, are being increasingly proposed and tested. Yet, for several reasons, only few such interventions have been translated into policy recommendations or implemented successfully in clinical practice. Through highlighting critical gaps in knowledge translation that can be addressed by integrating modern theoretical and methodological approaches across disciplines we hope to contribute to the development of effective and implementable behaviour change interventions for optimal population and individual health and well-being. Aim The aim of this workshop is to broaden our understanding of measures that have originated from behavioural sciences and have a lot to offer to public health. This workshop also seeks to contribute to capacity building in knowledge translation and evidence-informed decision-making in public health. Workshop structure The workshop will consist of five presentations providing an overview of topical issues in the field of behaviour change and knowledge translation, followed by an interactive audience discussion. The first presentations will introduce the most recent challenges in knowledge translation from the WHO/Europe perspective. The second presentation will discuss the possibilities of using behaviour change principles in the development and adoption of health policies showcasing the Canada’s newly adopted Food Guide. The third presentation will highlight the challenges in tackling physician’s ability to effectively conduct behaviour change counselling with their patients in the context of chronic disease prevention. The fourth presentation will make the link between the knowledge translation theory and practice, using the Behaviour Change Wheel theory. The fifth presentation will introduce the free academic meta-search engine - Motrial, which has a great potential in evaluating the randomized controlled trials and fuelling meta-analyses and systematic reviews in return of better quality. Further to the reflexion on the current knowledge base, an audience discussion will give attendees the opportunity to share their opinions regarding challenges and opportunities in knowledge translation to improve people’s health and well-being. Key messages Policy development and adoption can be considered as a behaviour change process. The application of behaviour change principles to the policy process may lead to greater stakeholder engagement and faster policy implementation.