Foster Behavior Change Research Articles

Healthy nutrition, in addition to medicines, is essential for the management of non-communicable diseases like heart disease and diabetes. Primary healthcare professionals (PHCPs), including pharmacists, are well positioned to provide nutrition advice to patients. However, they also report to be time poor and lack sufficient nutrition education and knowledge. Therefore, access to reliable, evidence-based nutrition educational resources is important for the ability of this essential workforce to deliver nutrition counseling to patients. This systematic search and review aimed to explore brief nutrition resources utilized by PHCPs for patient education, including resource design, content, and outcomes of resource use. A systematic search was conducted across the databases Scopus, Medline, Embase, and CINAHL of studies published in the past 20years. Of 1914 papers, 19 papers matched the inclusion criteria. Written, verbal, and digital nutrition resources were utilized in various formats, including pamphlets (n = 14), videos (n = 1), websites (n = 2), Apps (n = 2), booklets (n = 1), webinars (n = 1), and sheets to record information (n = 1). Three important resource characteristics were identified: (i) specific nutrient and food group advice, (ii) illustrations and population-specific language, and (iii) elements to foster behavior change. Most studies (n = 18) reported positive outcomes, including improved attitudes and patient knowledge about nutrition as well as better self-reported dietary habits and overall health. Brief nutrition resources utilized by pharmacists, doctors, nurses, and dentists were effective in delivering nutrition information, resulting in improved self-reported outcomes for patients. In addition, combining written resources with brief counseling increased patient understanding of nutrition information.

Background and objectivesThe use of antimicrobials in human and animal health care settings is considered a major driving force behind the emergence of antimicrobial resistance, encouraging a focus on evidence-based interventions aimed at promoting behaviours aligned with antimicrobial stewardship (AMS) ideals within both sectors. The Arwain complex intervention within Wales established peer networks of ‘Veterinary Prescribing Champions’ (VPCs) within and between Welsh veterinary practices to facilitate AMS training, support and activity. This study evaluates AMS goal setting and implementation within continuously engaged Arwain veterinary practices (n = 34) between 2020 and 2024.MethodsDescriptive quantitative analysis of Practice Action Plans (2020, 2024) and self-reported data on Action Plan implementation (2024), combined with qualitative analysis of participant interviews (2023) and participatory workshop feedback (2024) on challenges to implementing change, offer insight on the focus, achievements and implementation of AMS within the Arwain complex intervention.ResultsVPCs focused on behaviour-led (practice team/farm client) and structural (farm/practice-focused) changes. All practices reported at least one change goal initiated, with the majority (73%) reporting at least one fully implemented change. AMS implementation challenges included practical and cultural considerations of veterinary practices, the complexities of delivering AMS within inter-professional teams, the situated complexity of AMS on farm and the geographic, economic, regulatory, epidemiological and attitudinal factors implicit in the practice ‘outer setting’.ConclusionsThe Arwain complex intervention led to successful implementation of AMS changes across participating practices, with varying complexity, abstractness and completeness. Further research into the impact on antimicrobial use is needed to evaluate and inform future policy.

Cash transfer and a psychological intervention: Impact on alcohol outcomes and household welfare in India.

Child malnutrition remains a critical public health challenge in Sri Lanka and is exacerbated by socioeconomic disparities and gaps in community-based educational interventions. This mixed-methods study evaluated the effectiveness of a structured educational program delivered through mothers' support groups on maternal knowledge, attitudes, and practices related to child nutrition and well-being. This study was conducted across three districts (Nuwara Eliya, Trincomalee, and Puttalam), and the quasi-experimental design included pre- and postintervention surveys (n = 208) and focus group discussions with the mothers' support group members. A three-day interactive intervention covered nutrition-related topics, with knowledge, attitudes, and practices assessed via validated questionnaires and thematic analysis of qualitative data. The quantitative results revealed slight non-statistically significant improvements in knowledge (10.77 ± 2.18-11.04 ± 2.38, p = 0.064), attitudes (29.12 ± 4.06-29.70 ± 3.85, p = 0.095), and practices (19.59 ± 3.48-20.46 ± 3.09, p = 0.051). The qualitative findings were more promising, revealing enhanced awareness of balanced diets, strengthened peer networks, and improved childcare practices. Key barriers include financial constraints, logistical challenges, and initial resistance, which can be mitigated through community engagement and multisectoral collaboration. This study demonstrates the potential of mothers' support group-led interventions to foster incremental behavioral changes and social cohesion, despite its limited, statistically significant findings. Scaling such programs requires addressing structural barriers, integrating sustained reinforcement, and leveraging partnerships with local stakeholders. These findings advocate for future research on sustainable, equity-focused nutrition interventions on a much larger scale.

This study aims to examine the strategic role of the Cieurih Community Health Center in increasing public awareness of healthy lifestyles, particularly in the Cipaku Sub-district. Employing a qualitative descriptive approach, data were collected through observation, in-depth interviews with key stakeholders, and documentation of program activities. The collected data were analyzed using three stages: data reduction, data presentation, and drawing conclusions with verification to ensure validity. The analysis focuses on three main dimensions of the Health Center’s role: (1) Interpersonal Role, which involves direct interaction with the community to build trust, encourage participation, and foster behavioral change; (2) Informational Role, which encompasses the dissemination of accurate health information, educational campaigns, and correction of misinformation; and (3) Decisional Role, which relates to planning, implementing, and evaluating health programs in response to local needs.The findings reveal that the Cieurih Community Health Center has made significant contributions to raising awareness and promoting healthy living practices through these roles. Initiatives such as health counseling, mobile clinic services, and collaborative activities with community leaders have shown positive influence. However, the study also identifies persistent challenges, including low levels of community participation, insufficient financial and human resources, and the strong influence of traditional cultural practices and misinformation that hinder optimal outcomes. To address these obstacles, adaptive strategies are necessary. Recommendations include the development of personalized approaches tailored to the socio-cultural context, the use of innovative communication methods such as social media and visual storytelling, and the strengthening of cross-sectoral collaboration with educational institutions, religious leaders, and local government agencies. These measures are expected to enhance community engagement, improve the accuracy and reach of health information, and sustain the long-term impact of health promotion programs.

ObjectiveTo examine storytelling interventions as health promotion tools in underserved populations across disease states, including hypertension, diabetes, overall chronic disease, obstetric care, and preventative health to assess intervention design and cultural tailoring and analyze reported quantitative and qualitative health outcomes.Data SourceA comprehensive literature search was performed in PUBMED.Study Inclusion and Exclusion CriteriaStudies were included if they implemented a storytelling intervention to promote health knowledge, behavior change, or health-related outcomes. Excluded studies lacked an evaluated intervention or reported outcomes. Reviews, commentaries, editorials, protocols without outcome data, and duplicate publications without novel findings were excluded. Only English-language studies were included due to reviewer fluency.Data ExtractionTwenty-five studies were included and categorized based on disease focus.Data SynthesisA narrative synthesis and inductive content analysis was performed. Studies were grouped by disease state and analyzed for population demographics, intervention development and delivery, cultural tailoring, storytelling theory, and measured outcomes.ResultsStorytelling, in digital and oral formats, improved health knowledge, self-efficacy, and preventive behaviors. Several methods were employed to culturally tailor interventions. Interventions were based on multiple behavioral theories.ConclusionsWhen culturally tailored and rooted in theory, regardless of delivery format, storytelling can foster behavior change across diverse health conditions.

The intersection of financial literacy and educational technology (EdTech) presents a transformative opportunity to address the persistent global gaps in financial knowledge, behavior, and decision-making. With increasing digital access and rising financial complexity, conventional models of financial education often fall short in engagement, personalization, and long-term impact. This paper proposes a conceptual framework for adaptive learning platforms designed to enhance financial literacy through personalized, data-driven pedagogical strategies. Drawing on theories of financial capability, behavioral economics, and adaptive learning design, the model integrates learner profiling, algorithmic content delivery, gamification, and real-time feedback mechanisms. The framework highlights how EdTech can be leveraged to move beyond static content delivery to foster behavioral change, contextual relevance, and financial decision-making skills in diverse demographic groups. This paper contributes to the literature by offering a scalable, learner-centric approach to digital financial education and by setting an agenda for empirical validation across socioeconomic and cultural contexts. Implications for policymakers, educators, and EdTech innovators are discussed, with recommendations for ethical design and digital inclusion.

This community service project aimed to promote environmental awareness and sustainable waste management practices among primary school students at SDN Kuin Cerucuk V Banjarmasin. The program targeted students aged 8–12, a critical developmental stage for instilling environmentally responsible behaviour. Using a participatory approach, the activities included educational sessions, practical waste sorting exercises, and the installation of visual learning aids. Pre- and post-intervention assessments were conducted through direct observation and questionnaires to evaluate knowledge acquisition and behavioural changes. The results indicated a substantial improvement in students’ understanding of waste types and segregation practices. Prior to the intervention, 71.4% of students demonstrated limited knowledge, which shifted significantly post-intervention, with 71.4% achieving the highest knowledge category. Observable behavioural changes included consistent use of segregated waste bins and increased attentiveness to school cleanliness. The active involvement of teachers and school management contributed to the program’s success. However, sustainability challenges remain, including limited time for long-term mentoring, resource constraints among staff, and the absence of community-level waste infrastructure. Despite these obstacles, the project demonstrates that early environmental education, supported by collaboration and practical engagement, can effectively foster long-term behavioural change and lay the foundation for an environmentally conscious.

Background Suboptimal adherence to oral anticancer agents (OAAs) reduces therapeutic benefits among patients with gastrointestinal tract cancer. Self-regulation is an important mechanism to foster behavioral change, but little is known about how to utilize this mechanism to enhance adherence. Objective The aim of this study was to evaluate the feasibility, acceptability, and preliminary outcomes of an education program to promote self-regulation in managing adherence to OAAs. Methods A 2-arm pilot randomized controlled trial was adopted. Twenty-four participants were randomized to the control or intervention group with a 1:1 ratio. The control group received usual care. The intervention group received usual care and 4 sessions of education to promote self-regulation. Feasibility, acceptability, and preliminary outcomes were evaluated using descriptive statistics and Cohen’s d. Results The consent and attrition rates were 64.86% and 8.33%, respectively. Most (83.33%) participants in the intervention group finished all education sessions. They were satisfied with the educational content and perceived the program as helpful. A favorable trend of better adherence (adherence rate: 90.91%), more self-management behaviors (Cohen’s d = 0.915), less negative illness perceptions (Cohen’s d = −0.714), higher medication self-efficacy (Cohen’s d = 0.431), and necessity beliefs (Cohen’s d = 0.451) was found in the intervention group. Conclusions The education program is considered feasible and acceptable. A full-scale randomized control trial is needed to explore its effectiveness in a larger sample. Implications for Practice This education program to promote self-regulation is promising to support adherence to OAAs, self-management behaviors, favorable illness perceptions, and medication self-efficacy.

Sustainable energy consumption has become an essential goal in addressing climate change and reducing environmental degradation. Despite increasing awareness, behavioural change toward sustainable energi use, especially among youth, remains limited. Existing studies often focus on either individual knowledge or social environments in isolation, leaving a gap in understanding how sustainability literacy and social support jointly influence sustainable energy consumption behaviour. This study aims to explore these relationships in an educational context, focusing on university students as future agents of sustainable transformation. This research employed a quantitative approach using Covariance-Based Structural Equation Modeling (CB-SEM). Data were collected from 337 undergraduate students enrolled in business and economics programs at three Indonesian universities. The analysis examined the direct effects of sustainability literacy and social support on sustainable energy consumption behaviour. The findings reveal that both sustainability literacy and social support significantly and positively impact students’ sustainable energy consumption behaviour. Sustainability literacy equips students with knowledge to make informed energy choices, while social support reinforces these choices through motivation and affirmation from peers and social networks. These results highlight the importance of combining educational interventions and social reinforcement to foster behavioural change. Universities play a strategic role in embedding sustainability knowledge and cultivating supportive communities that enable sustainable lifestyles.

Mentorship and Coaching.

This study examines the role of communication and digital technologies in school-based nutrition interventions, focusing on their effectiveness in promoting fruit and vegetable (F&V) consumption and reducing sugar-sweetened beverage (SSB) intake among children aged 8 to 12. A quasi-experimental design was applied, comparing a control group with two intervention groups—one using printed communication materials (posters and flyers) and another employing digital learning games. Outcome variables included nutrition knowledge, food label literacy, dietary behaviour, self-efficacy, barriers to change, and nutrition self-care. Findings indicate significant improvements in nutrition knowledge and food label literacy across all groups, highlighting the intervention’s effectiveness. Self-care improved significantly in the treatment groups, while the digital games group demonstrated the strongest effect on actual behaviour change, showing higher F&V consumption and reduced SSB intake. These results reinforce the potential of media communication technologies in health education, particularly digital games, which foster engagement and behaviour change. This study underscores the value of digital tools in cost-effective, scalable health interventions. Future research should explore ways to sustain these effects over time and extend digital strategies to broader public health initiatives.

Sungai Pisang Village is confronted with several public health issues, particularly a high incidence of diseases attributable to inadequate sanitation facilities and unhealthy lifestyle practices. This community-based intervention aimed to improve clean and healthy living behaviors through a combination of educational strategies and practical disease prevention activities. The intervention consisted of structured health education sessions, hands-on demonstrations of hygiene practices, and subsequent evaluations to measure behavioral outcomes and program effectiveness. Active engagement from community members and institutional support from the local health center facilitated program implementation. Findings revealed a significant increase in public awareness and the adoption of clean and healthy living behaviors practices, especially in terms of environmental hygiene, healthy dietary behavior, and preventive health measures. The results suggest that such integrative health promotion efforts can effectively foster sustainable behavioral changes, provided that continuous support from stakeholders is maintained.

Aim. This study examined how effectively managing website information media can enhance the active involvement of physical education (PE) teacher alumni as education and physical activity ambassadors in rural communities, using a systematic literature review approach. Materials and methods. Data were gathered through a comprehensive search of Google Scholar, focusing on journals indexed in the Scopus database and published between 2019 and 2024. A total of 18,000 articles were initially identified. Through multiple phases of rigorous screening—including title and abstract screening, eligibility assessment, and relevance validation—only 19 studies met the inclusion criteria. The selected studies were further evaluated based on research design quality, relevance to rural PE engagement, and technological application effectiveness. Results. The findings indicate that proficient management of online information platforms plays a critical role in mobilizing alumni to support physical education, community health, and injury prevention programs in underserved regions. Identified mechanisms include knowledge dissemination, promotion of functional training, online coaching, and rehabilitation support. Alumni use web-based media to deliver educational content, organize sports initiatives, and foster behavioral change related to health and physical activity. Compared to traditional outreach methods, such as direct programming or community campaigns, web platforms offer greater scalability and sustainability, especially in geographically isolated settings. Additionally, these platforms support physiotherapy engagement, enabling digital consultations, injury recovery guidance, and biomechanical education. This positions alumni as hybrid agents of education, public health, and grassroots sport development. Conclusions. Effective website management not only strengthens alumni roles in rural education and wellness but also contributes to long-term strategies for improving community resilience, reducing health disparities, and promoting inclusive physical activity practices.

Unmanaged waste accumulation in urban areas poses significant environmental and social challenges, especially in rapidly urbanizing regions of Southeast Asia. This study evaluates the effectiveness of a community-based landscape intervention to restore an informal waste site in Pekanbaru, Indonesia, using a culturally adapted telajakan-inspired ecological design. The central research question addresses whether participatory restoration can foster behavioral change and sustain ecological function in low-resource urban settings. The intervention was implemented on a 50 m² site that had been used for illegal dumping for over a year. Involving 105 residents, the program combined awareness-raising workshops, waste removal, soil enhancement, and the planting of native and ornamental species-including Cymbopogon nardus, Manihot esculenta, and Rosa chinensis. Data were collected through pre- and post-surveys, photographic documentation, and field observations over a three-month period. Statistical analysis (paired t-test and Chi-square test) showed significant improvements in residents' environmental knowledge and participation (p < 0.001). During the observation period, all planted species survived and the site remained clean, with continued community-led maintenance through monthly clean-up events. The findings demonstrate that integrating traditional landscape practices with community-based interventions can lead to meaningful behavioral change and short-term ecological success. This case provides a replicable, culturally grounded framework for informal waste site restoration in under-resourced urban areas, with implications for participatory sustainability and environmental justice in the Global South.

Protocol for a wait list randomised controlled trial: Using social media for health promotion, communication and advocacy - A massive open online course.

ABSTRACT This paper analyses micro-dynamics at play during group activities aimed at preventing gender-based violence (GBV) in the Democratic Republic of Congo. Gender-transformative interventions seek to reduce GBV by shifting gender norms towards more equitable practices, but there is limited research on how change occurs in group discussions. Based on ethnographic observations, the paper explores how new knowledge, reflection, and experiential learning foster attitude and behaviour change. The analysis is grounded in Paulo Freire’s emancipatory pedagogy, and his theory that critical consciousness forms the basis of collective action for change. Using the concepts of “repetition” and “rupture”, it makes visible practices of normative disruption at play during the sessions. The findings suggest that the introduction of new knowledge alone is not sufficient for change to take place. Rather, it is the collective recognition of the socially constructed nature of norms, the active creation of a counter-discourse, and the rehearsing of new behaviours that drive transformation.

Among rural communities in South Kalimantan, rivers are still the primary source of activities, such as in Muara Bangkal Village in Banjarmasin. Rivers are used for bathing, washing, defecating, and urinating or MCK (mandi-cuci-kakus). These activities pose significant health risk due to water pollution. This study applied the Health Belief Model (HBM) in Focus Group Discussions (FGD) to evaluate its effectiveness for improving health perceptions. The HBM framework emphasized perceived susceptibility, severity, benefits, and barriers related to river usage, aiming to foster behavioral change through targeted education.The community service program involved 25 participants who completed pre- and post-intervention questionnaires to assess perception changes. There was an improvement in scores from 34.76 to 39.24 after participants filled out questionnaires regarding river usage as a means of toilet and bath. All participants (100%) also said they used the river for bathing and washing. This community service education was published on the online mass media, the website, and on the YouTube channel. Participants' perceptions regarding river usage improve, which can be a stimulus in helping to alter the behavior of communities in utilizing the river for MCK.

ABSTRACT Purpose Farm advisors are professionals who support farmers to enhance their knowledge, develop skills and solve problems, to facilitate the adoption of beneficial behaviours. However, there is a dearth of literature, exploring how advisors deliver this support to farmers; or more specifically, the ‘behaviour change techniques’ (BCTs) they use. Accordingly, using the Behaviour Change Technique Taxonomy v01 (BCTTv01), the current study will explore the support advisors perceive they deliver to farmers, to foster on-farm behaviour change, and the factors which influence its effective delivery. Design/Methodology/Approach Eight semi-structured interviews were conducted with farm advisors. Interview transcripts underwent inductive/deductive hybrid thematic analysis, to identify the specific BCTs advisors delivered when working with farmers and the factors which influenced their effective delivery. Findings Twenty-one BCTs were identified, including goal setting and social support. Relational factors including building trust, fostering collaboration, displaying compassion and supporting autonomy, facilitated a supportive environment for the delivery of these techniques. Practical implication To assist advisors in their role, behaviour change training focused on understanding the change process and building motivation, is needed. Theoretical implication The findings advance the theoretical understanding of how advisors support behaviour change on-farm, through the application of the BCTTv01. Originality This study takes a novel approach to further the understanding of how advisors support on-farm behaviour change, by utilising the BCTTv01.

PurposeThis study examines the influence of environmental beliefs and personal norms on green purchase behavior among academic staff in Ugandan universities.Design/methodology/approachA cross-sectional survey design with a quantitative, deductive reasoning approach was employed, involving 331 academic staff from universities in Uganda’s Central Region. Data were analyzed using SPSS version 21.FindingsThe results indicate a strong and positive relationship between environmental beliefs and green purchasing behavior. Personal norms significantly correlate with environmental beliefs but do not directly influence green purchasing behavior. However, environmental beliefs serve as a crucial mediator, bridging the relationship between personal norms and green purchasing behavior, emphasizing their pivotal role in shaping sustainable consumption.Research limitations/implicationsThe study is limited by its cross-sectional design, which restricts the ability to capture the evolution of environmental beliefs and personal norms over time. Future studies should employ longitudinal approaches to track these changes and explore their long-term impact on sustainable consumption behaviors.Practical implicationsThe findings suggest that policymakers and university administrators should prioritize educational initiatives, institutional policies and community engagement to foster belief-driven behavioral change. Integrating sustainability into curricula, implementing campus-wide sustainability programs and improving access to green products are recommended strategies for promoting sustainable purchasing practices.Originality/valueThis study is among the first to examine the relationship between environmental beliefs, personal norms and green purchasing behavior among university staff in a least-developed country. The findings highlight environmental beliefs as the most influential factor driving green purchasing behavior in Ugandan universities, offering valuable insights for sustainability efforts in developing nations.