Individual Behavior Change Research Articles

EcoSanté Lifestyle Intervention: Encourage Reflections on the Connections between Health and Environment

EcoSanté is a mobile lifestyle intervention that encourages individual behavior change while also helping participants understand the deep connections between daily lifestyle choices and our collective impact on the planet. Informed by research on “small” intervention approaches, we sent participants daily behavioral challenges that demonstrated connections between personal health and environmental impact at large. Through a 20-day mobile intervention study, 139 participants uploaded 1,920 submissions documenting their attempts to engage in these challenges. We found that participants’ self-reported healthy eating behavior and general self-efficacy improved significantly immediately after the intervention. Moreover, 30 days after the intervention, participants’ self-reported eating, exercise, and general self-efficacy all significantly improved compared to the beginning of the study. Participants had a more negative reaction when being asked to come up with their own challenges. Based on quantitative and qualitative findings, we provide implications for future researcher on mobile behavior intervention research.

The thing that made me think

Abstract Given the threatening consequences of anthropogenic climate change, it is vital to modify energy-intensive daily routines to minimize individual energy consumption. However, changing daily routines is challenging due to their abstract, future-oriented nature and the comfort they provide. Interactive technologies can play a crucial role in facilitating this process. Instead of relying on rhetorical persuasion through information and appeals, we propose two design approaches within the research agenda of the MOVEN research group: (1) employing friction to disrupt routines, and (2) advocating for the interests of natural entities using counterpart technologies. Regarding the disruption of routines, we explore the use of humor as a design element to dampen the resulting resistance (i.e., psychological reactance). Moreover, we reflect on the opportunities of counterpart technologies as a new interaction paradigm in the context of sustainability. Finally, we discuss the potentials and limitations of individual behavior change for a holistic, sustainable transformation.

Examining Pathways from Food Insecurity to Safer Sex Efficacy Among Northern and Indigenous Adolescents in the Northwest Territories, Canada.

Food insecurity is a social determinant of health linked with elevated HIV exposure. Safer sex efficacy (SSE), the ability to navigate sexual decision-making and condom use, is an important marker of sexual wellbeing. Pathways from food insecurity to SSE are understudied, particularly among adolescents in Arctic regions who are at the nexus of food insecurity and sexual health disparities. We examined pathways from food insecurity to SSE among adolescents in the Northwest Territories (NWT), Canada. We implemented cross-sectional surveys with adolescents aged 13-18 recruited through venue-based sampling in 17 NWT communities. We conducted multivariable logistic regression to assess socio-demographic factors associated with food insecurity. We then conducted structural equation modeling (SEM) using maximum likelihood estimation to assess direct effects of food insecurity on SSE and indirect effects via resilience, depression, and relationship power inequity. We assessed both condom use SSE (e.g., confidence in using condoms) and situational SSE (e.g., SSE under partner pressure). Most participants (n = 410) identified as Indigenous (79%) and 45% reported experiencing food insecurity. In SEM, we did not find a significant direct effect from food insecurity to SSE; however, we found indirect effects from food insecurity to condom use SSE through resilience and depression and from food insecurity to situational SSE through resilience. Findings call for structural interventions to address food insecurity, alongside resilience-focused strategies that address the intersection of sexual and mental health. Sexual health strategies focused on individual behavior change are insufficient to address larger contexts of poverty among Northern youth.

Psychological and psychosocial determinants of COVID Health Related Behaviours (COHeRe): An evidence and gap map.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. Common recommended measures to limit risk of infection include frequent handwashing, reducing the frequency of social interactions and the use of face coverings. It is important to identify those factors that can predict the uptake and maintenance of these protective behaviours. We aimed to identify and map the existing evidence (published and unpublished) on psychological and psychosocial factors that determine uptake and adherence to behaviours aimed at reducing the risk of infection or transmission of COVID-19. Our extensive search included electronic databases (n = 12), web searches, conference proceedings, government reports, other repositories including both published peer reviewed, pre-prints and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID-19), (2) behaviours of interest and (3) terms related to psychological and psychosocial determinants of COVID Health-Related Behaviours and adherence or compliance with recommended behaviours, to capture both malleable and non-malleable determinants (i.e. determinants that could be changed and those that could not). This Evidence and Gap Map (EGM) includes all types of studies examining determinants of common recommended behaviours aimed at mitigating human-to-human spread of COVID-19. All potential malleable and non-malleable determinants of one or more behaviours are included in the map. As part of the mapping process, categories are used to group determinants. The mapping categories were based on a previous rapid review by Hanratty 2021. These include: 'behaviour', 'cognition', 'demographics', 'disease', 'emotions', 'health status', 'information', 'intervention', and 'knowledge'. Those not suitable for categorisation in any of these groups are included in the map as 'other' determinants. Results were imported to a bibliographic reference manager where duplications of identical studies gathered from multiple sources were removed. Data extraction procedures were managed in EPPI-Reviewer software. Information on study type, population, behaviours measured and determinants measured were extracted. We appraised the methodological quality of systematic reviews with AMSTAR-2. We did not appraise the quality of primary studies in this map. As of 1 June 2022 the EGM includes 1034 records reporting on 860 cross-sectional, 68 longitudinal, 78 qualitative, 25 reviews, 62 interventional, and 39 other studies (e.g., mixed-methods approaches). The map includes studies that measured social distancing (n = 487), masks and face coverings (n = 382), handwashing (n = 308), physical distancing (n = 177), isolation/quarantine (n = 157), respiratory hygiene/etiquette (n = 75), cleaning surfaces (n = 59), and avoiding touching the T-zone (n = 48). There were 333 studies that assessed composite measures of two or more behaviours. The largest cluster of determinants was 'demographics' (n = 730 studies), followed by 'cognition' (n = 496 studies) and determinants categorised as 'other' (n = 447). These included factors such as 'beliefs', 'culture' and 'access to resources'. Less evidence is available for some determinants such as 'interventions' (n = 99 studies), 'information' (n = 101 studies), and 'behaviour' (149 studies). This EGM provides a valuable resource for researchers, policy-makers and the public to access the available evidence on the determinants of various COVID-19 health-related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID-19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.

Issues, Problems and Challenges of Enhancing Social Functioning among Children with Cognitive Disabilities in Tanzania: A Theoretical Review

The paper attempts to provide a theoretical and empirical perspective related to the issues, problems and challenges of enhancing social functioning among children with cognitive disability in Tanzania. Specifically, the study reviews three theories, namely empowerment, inclusive and ecological with a view of finding the challenges associated with the enhancement of children with cognitive disability. The study is a literature review based on survey from books, scholarly articles and other relevant sources seeking explanations on the enhancement of social functioning among children with cognitive disability. The reviewed literature were summarized, analysed, and synthesized. The findings reveal that, the theories used in social work practice have diverse and different foci of analysis and intervention. This is largely because addressing a social problem there are many variables and uncertainties in social work practice. Because of that, there is no one single objective “reality” in social theory and practice. Secondly, whereas theories such as the ecological describes the influence of different subsystems in the changing individual behaviour, other behaviours such as discrimination and social exclusion among people with disabilities do not seem to change. The study further reveals that the assumptions of the inclusive theory of developing positive social relationships (e.g. friendships and acquisition of social skills) have not been successful because of existence negative attitudes among societal members which are influenced by false beliefs about people with cognitive disability. The study concludes that, whereas the theories help social workers to understand complex human behaviour and social environment which influence their clients’ lives and the nature of social problems, there are no theories which help in understanding African realities. The study observes that, negative social environment and attitudinal change have a negative impact in facilitating positive behavioural change in as far as enhancing social functioning among children with cognitive disability. The study recommends that more research be conducted to address the existing prohibiting factors. It is further recommended that concerted be made among different actors including policy interventions to raise awareness of local communities.

The effect of environmental regulation on population migration: Evidence from China's new ambient air quality standards

Environmental regulations may lead to changes in individual behaviors. This paper investigates the effect of environmental regulations on population migration. Using the new ambient air quality standard (NAAQS) as an event study, the difference-in-differences (DID) strategy is constructed for estimation. We find that, on average, over 18.76 thousand in the net inflow of the permanent population decreases after implementing the NAAQS. The reduction primarily occurs in cities that implement the new standard in the first stage. The mechanism analysis shows the NAAQS both increases the population inflow by improving air quality and reduces it through polluting industry transfer and industrial upgrading. The heterogeneous analyses show that the NAAQS has significantly negative effects on population migration in cities that monitor air quality more strictly, cities located southeast of the Hu Huanyong Line, and cities with higher economic development levels. Conversely, the NAAQS has no significant impact on cities in the northwest of the Hu Huanyong Line and cities with low economic development.

A Content Analysis of Behavior Change Techniques Employed in North American Vaping Prevention Interventions

Vaping among North American youth has surfaced as a concerning public health epidemic. Increasing evidence of harms associated with E-cigarette use, especially among the young, has prompted urgency in addressing vaping. Although a number of individual behavior change campaigns have arisen as a result, little is known about which behavior change techniques are being employed to influence youth vaping behavior. In this study, we aimed to code all North American vaping prevention campaigns using the behavior change technique taxonomy (Version 1) to determine which behavior change techniques are being used. We identified the sample of campaigns through systematic searches using Google. After applying the exclusion criteria, the campaigns were reviewed and coded for behavior change techniques. In total, 46 unique vaping prevention campaigns were identified, including 2 federal (1 from Canada, 1 from the U.S.), 43 U.S. state-level, and 1 Canadian provincial-level campaign(s). The number of behavior change technique categories and behavior change techniques in a campaign ranged from 0 to 5 (mean=1.56) and 0 to 6 (mean=2.13), respectively. Of the 16 possible behavior change technique categories, 4 were utilized across the campaigns, which included 5. Natural consequences (89%), 6. Comparison of behavior (22%), 13. Identity (20%), and 3. Social support (11%). Only a small number of behavior change techniques were used in North American vaping prevention campaigns, with a heavy and often sole reliance on communicating the health consequences of use. Incorporating other promising behavior change techniques into future campaigns is likely a productive way forward to tackling the complex and multifaceted issue of youth vaping.

Assessment of behavioural effects of three water-soluble polymers in zebrafish embryos

The water-soluble polymers (WSPs) are widely used in many industrial applications and are present in several commonly used products due to their physical-chemical characteristics: as their name indicates, despite being synthetic polymers, they are able to solubilize in water. Because of this peculiar property, both the qualitative-quantitative evaluation in aquatic ecosystems and their potential (eco)toxicological effects have been neglected until now. The aim of this study was to evaluate the possible effects of three of the most widely used WSPs as polyacrylic acid (PAA), polyethylene glycol (PEG) and polyvinyl pyrrolidone (PVP) on the swimming behaviour of zebrafish (Danio rerio) embryos after the exposure to different concentrations (0.001, 0.5, 1 mg/L). The exposure lasted from the eggs' collection up to 120 h post fertilization (hpf) also using three different light intensity (300 lx, 2200 lx, 4400 lx) to better evaluate any effects related to different gradients of light/dark transitions. In order to analyze individual behavioural changes in embryos, their swimming movements were tracked and a number of parameters for locomotion and directionality were quantified. The main results showed that all three WSPs resulted in significant (p ≤ 0.05) variations in different movement parameters, suggesting a possible toxicity scale: PVP > PEG ≫ PAA.

Global Hopf bifurcation of a two-delay epidemic model with media coverage and asymptomatic infection

The influence of media coverage on disease transmission has attracted more and more attention, but the impact mechanism of media coverage with asymptomatic infection needs to be studied urgently. Therefore, a SIsIaS−M model with two delays and asymptomatic infection is considered. The two kinds of delays are respectively caused by the lag time of media reports about the number of patients and the lag time of audience feedback after media coverage. By using the geometric approach based on the third compound matrix, the existence of a threshold for the average duration of media coverage ensures that the endemic equilibrium in delay-free differential system is globally asymptotically stable. In the delay system the uniqueness, positivity and boundedness of solutions are investigated, and the system is persistent when R0>1. Through stability analysis, we find that the disease can be eliminated when the proportion of symptomatic patients in total patients is above a threshold. By choosing the sum of two delays as a bifurcation parameter, we analyze the stability switches of the endemic equilibrium, and discuss the onset and termination of Hopf bifurcations of periodic solutions. The properties of local Hopf bifurcation are also obtained. Furthermore, the global Hopf bifurcations are unbounded and a sufficient condition for the system to have multiple periodic solutions is obtained. Three parameters related to media coverage are found in numerical simulations to have thresholds that guarantee the stability of the endemic equilibrium. In numerical simulations, if media coverage is highly responsive to the number of patients or it has a strong influence on individual behavioural changes, this can lead to periodic oscillations. Conversely, although this makes the disease stable, the number of patients who reach steady state is higher. This is the same result as for the dissipation rate of media coverage, and again there is a threshold that makes the endemic equilibrium stable.

Travel Pattern Analysis on Switching Behavior in Response to the COVID-19 Pandemic

The COVID-19 pandemic has significantly affected people’s daily life across the globe. This paper aims to understand the change of individual travel behavior during the pandemic. We administer a survey to record people’s travel habits before, during and after the stay-at-home order in New York City. Respondents’ information, including travel mode, travel frequency, trip purpose and demographics, is gathered to study switching behavior regarding travel patterns during the pandemic. Results show that among all travel mode choices, public transits are the most affected by the pandemic while bikes and automobiles are the least affected by the pandemic.

Implementation of a frailty intervention in the transition from hospital to home: a realist process evaluation protocol for the FORTRESS trial

IntroductionFrailty in Older people: Rehabilitation, Treatment, Research Examining Separate Settings (the FORTRESS study) is a multisite, hybrid type II, stepped wedge, cluster, randomised trial examining the uptake and outcomes of...

Mitigating Weight Stigma in Long-Term Care With Trauma-Informed Principles

Mitigating Weight Stigma in Long-Term Care With Trauma-Informed Principles

Killer, Thief or Companion? A Corpus-Based Study of Dementia Metaphors in UK Tabloids

ABSTRACT This article examines the metaphors that are used to represent dementia in British tabloid newspapers over a ten-year period (2010–2019). The analysis takes a corpus-based approach to metaphor identification and analysis, utilizing in particular the corpus linguistic technique of collocation analysis. Metaphors are considered in terms of the ‘targets’ they frame, which include the following aspects of dementia: (i.) prevalence; (ii.) causes; (iii.) symptoms and prognosis; (iv.) lived experience; and (v.) responses. A range of metaphors are identified, with the tabloids exhibiting a particular preference for metaphors which construct dementia as an agentive and violent entity and people with dementia as passive victims, and which foreground preventative responses to dementia such as pharmacological intervention and individual behavior change. It is argued that such metaphors have the potential to contribute to dementia stigma and place focus on preventing or eliminating dementia while backgrounding responses which may help people to “live well” with the syndrome in the here-and-now. Metaphors which frame dementia as a companion or which the experience of dementia as a journey are put forward as potentially less stigmatizing alternatives which might better reflect the particularities of this complex public health issue.

Designing audit and feedback dashboards for dentists to monitor their opioid prescribing

Background and objectivePrescription drug abuse is a major factor leading to drug overdose deaths in the US and dentists are one of the leading prescribers of opioid pain medication. Knowing that Audit & Feedback (A&F) dashboards are an effective tool and are used as quality improvement interventions, we aimed to develop such dashboards personalized for dental providers which could allow them to monitor their own opioid prescribing performance. MethodsIn this paper we report on the process for designing the A&F dashboards for dentists which were developed by using an iterative human-centered design process. The results obtained from each iteration were used to enrich the information needs analyses, provide function testing, and guide the design decisions of the next iteration. ResultsEngaging dentists in the development and refinement of the dashboards while using the think-aloud protocol for user-testing, provided rapid feedback and identified areas that were confusing and needed either a redesign or additional explanatory content. The final version of dashboards consisted of displaying necessary information through easy to interpret visualizations and interactive features. These included providing access to current national and organizational prescribing guidelines, displaying changes in individual prescribing behavior over time, comparing individual prescribing rate to peer group rate and target rate, displaying procedure specific prescribing, integrating patient reported post-operative dental pain experience and providing navigation and interpretation tips for users. The dashboards were easy to learn and understand for the dentists and were deemed as worth using often in dental practice. ConclusionOur research was able to demonstrate the creation of useful and usable A&F dashboards using data from electronic dental records and patient surveys, for dentists to effectively monitor their opioid prescribing behavior. Efficacy of the dashboards will be tested in future work.

Being an Emotionally Intelligent Leader through the Nine-Layer Model of Emotional Intelligence—The Supporting Role of New Technologies

Several years ago, a characteristic of leadership was the intelligence index, but in recent years this has changed, and emotional intelligence is considered an important parameter for a leader. A leader who shows a high index of emotional intelligence can activate his/her human potential and subsequently others. There is a large body of literature on “what” great leaders should do, but more emphasis needs to be placed on “how” to develop such leaders by focusing on detailed individual behavior change and self-development. The current article aims to investigate the concept of emotional intelligence and describe the levels of the emotional intelligence pyramid model and how these are reflected in the role of leadership. The theoretical model is complemented by a set of metacognitive and metaemotional strategies while emphasizing the role of technologies to provide fertile ground for the implementation of emotional intelligence skills in leadership. The strategies framework provides a training paradigm for implementation in education and working environments. The results of this article provide a new theoretical framework of the emotional skills a leader must possess, and they also provide a useful framework for cultivating them, which will promote long-term human capital development and help everyone achieve educational and professional success. The pyramid model of emotional intelligence and its strategies can have practical applications in any form of leadership, as research has shown a positive correlation between these two concepts.

Creating a shared vision by uniting local stakeholders to tackle plastic bag consumption

Single-use plastic bags contribute significantly to the plastic pollution in South Africa posing a serious environmental challenge. Hence, there is a need for comprehensive strategies to reduce plastic bag consumption. We report the results of an online workshop aimed to create a positive, shared future vision. The workshop was attended by 12 invited participants from diverse backgrounds and disciplines and utilized a collaborative approach to propose a framework for reducing plastic bag usage during grocery shopping in South Africa. The findings suggest that a combination of economic, structural and behavioral interventions is necessary to promote lasting behavior change, including financial incentives, a broad introduction of more environmentally friendly alternatives, and promoting bag reuse. Additionally, the vision underscored the importance of using social channels such as education and social norms. The invited stakeholders did not endorse conventional approaches such as increasing an already existing levy or implementing a complete ban on plastic bags. They also questioned the introduction of fully recycled plastic bags. Instead, the proposed vision encourages an integrated approach to reducing plastic bag usage involving individual behavior change and community engagement. The development of a creative product such as a video to showcase a future vision offers a powerful tool for communication with further stakeholders and political authorities, to engage with the community and broader population and for inspiring collective action. Overall, the findings have implications for policymakers, business leaders, environmental educators, and individuals committed to reducing plastic pollution and promoting sustainable practices in South Africa.

A qualitative study of active travel amongst commuters and older adults living in market towns

BackgroundBeing physically active is associated with better health, but rates of physical inactivity are high amongst adults in England. Active travel, defined as making routine journeys in physically active ways, has been identified as a potential solution. There is a lack of research into how modal shift towards active travel can be encouraged in market towns. The aims of the current study are to understand how new cycling and walking infrastructure and community activation projects might support modal shift to active travel amongst commuters and older adults in market towns.MethodsThis was a qualitative study using focus groups, ‘go-along’ interviews, and in-depth interviews as the main methods of data collection. Thirty-three participants (12 commuters and 21 older adults) took part across six focus groups. Eight of these also completed a go-along interview (4 walking, 4 cycling). Data were analysed using the Framework method of thematic analysis.ResultsMarket towns have existing advantages for active travel, being relatively compact with most routine destinations within easy reach. The barriers to active travel faced by older adults and commuters in market towns are similar to those in cities; poor infrastructure remains the key barrier. Poorly maintained paths are hazardous for older pedestrians, and low-or-no lighting and lack of well-connected, delineated cycle routes deter both commuters and older adults. One factor which does appear qualitatively different to cities is participants’ perception that the social norms of cycling differ in market towns.ConclusionsPolicies to promote active travel in market towns are most likely to be effective when they include measures targeted at both individual behaviour change and population level measures like large-scale infrastructure improvements. Initiatives to change the social norms around cycling may be required to increase active travel rates.

Preventable cancers: Is it enough to change our behaviour?

In France, part of 40 % of preventable cancers can be attributed to lifestyle habits. Epidemiological data show that occupational exposures are a major cause of these cancers. However, despite this evidence, the prevention actions promoted by public authorities are focused on changing individual behaviors. In this article, we seek to understand the reasons of the erasure of the role of socio-environmental factors in cancer prevention discourse.

Behavioral Science and Education for Sustainable Development: Towards Metacognitive Competency

Behavioral science is increasingly considered foundational for addressing various sustainable development challenges. Behavioral change and action competence have also become important goals in Education for Sustainable Development (ESD), complementing and interacting with other educational goals such as the development of sustainability-relevant knowledge, skills, values, and attitudes. We argue that these interconnected learning goals of ESD can be advanced by integrating interdisciplinary behavioral science concepts, methods, and insights into the design of curricula, learning environments, and processes for participatory whole-school approaches. Specifically, we highlight the role of metacognitive competency in self-directed individual and collective behavior change and we present our educational design concept for teaching human behavior as an interdisciplinary theme in ESD.

Value of implementation science and hybrid implementation research designs for nursing education research: A discussion paper

IntroductionNursing education research is complex and contextualized. The evaluation and impact of educational innovations on students, educators, and educational outcomes are influenced by the complexity of environments. Most interventional research in nursing is designed and implemented without considering the behavioral and contextual issues affecting educational innovations, uptake and change processes, and outcomes. Implementation science has emerged as a valuable methodology for designing and conducting interventional research that has the potential to translate evidence and innovations quickly into practice. PurposeThis paper aims to explore the value of implementation science theories, models, and frameworks and hybrid designs for interventional nursing education research and illustrate how these can be used in nursing education research. MethodsA brief overview of implementation science, the various types of theories, models and frameworks and Hybrid designs are provided. Illustrative examples demonstrating the incorporation of these methodologies in interventional nursing education research are provided. ResultsA brief overview of implementation and its key concepts namely context, implementation strategies, fidelity, outcomes, adaptation, and sustainability is provided. Three types of hybrid designs are discussed with examples in nursing education research. DiscussionThe implications of implementation science for nursing education research are: a) Accelerating uptake of innovations to improve educational outcomes, b) targeting systematic change in individual and organizational behaviour and c) ensuring the sustainability of teaching and learning innovations. ConclusionIncorporating implementation science in nursing education research can optimize the uptake of educational innovations in practice in a sustainable manner. Nurse educators should equip themselves with implementation science skills and develop competencies to enhance the delivery of effective and quality nursing education.