Motivate Behavior Change Research Articles

A prosocial fake news intervention with durable effects

The present online intervention promoted family-based prosocial values—in terms of helping family members—among young adults to build resistance against fake news. This preregistered randomized controlled trial study is among the first psychological fake news interventions in Eastern Europe, where the free press is weak and state-sponsored misinformation runs riot in mainstream media. In this intervention, participants were endowed with an expert role and requested to write a letter to their digitally less competent relatives explaining six strategies that help fake news recognition. Compared to the active control group there was an immediate effect (d = 0.32) that persisted until the follow-up four weeks later (d = 0.22) on fake news accuracy ratings of the young, advice-giving participants. The intervention also reduced the bullshit receptivity of participants both immediately after the intervention and in the long run. The present work demonstrates the power of using relevant social bonds for motivating behavior change among Eastern European participants. Our prosocial approach with its robust grounding in human psychology might complement prior interventions in the fight against misinformation.

Knowledge, Attitudes and Practices toward Dengue Fever, Vector Control, and Vaccine Acceptance Among the General Population in Countries from Latin America and Asia Pacific: A Cross-Sectional Study (GEMKAP)

Dengue represents a major public health concern. With effective vaccines in development, it is important to identify motivational factors to maximize dengue vaccine uptake. A cross-sectional, quantitative, electronic survey was administered to a nationally representative adult population (n = 3800) in Argentina, Brazil, Colombia, Mexico, Indonesia, Malaysia, and Singapore. Willingness to vaccinate against dengue, and Knowledge, Attitudes, and Practices (KAP) toward dengue, vector control, prevention, and vaccination were determined. The Capability, Opportunity, Motivation for Behavior change (COM-B) framework was used to identify factors correlated with dengue vaccine(s) uptake. KAP scores (standardized, 0-100% scale) resulted in a low global score for Knowledge (48%) and Practice (44%), and a moderate score for Attitude (66%); scores were comparable across countries. Of all respondents, 53% had a high willingness (Score: 8-10/10) to vaccinate against dengue, which was higher (59%) in Latin America (Argentina, Brazil, Colombia, Mexico) than in Asia Pacific (40%) (Indonesia, Malaysia, Singapore). Key factors significantly (p < 0.05) associated with increased willingness to vaccinate included accessibility to the public (subsidies and incentives) and trust in the healthcare system and government. A common approach to dengue prevention across endemic countries--with some country-specific customization, including education, vaccination, and vector control (multi-pronged)--may reduce dengue burden and improve outcomes.

Increasing intention to reduce fossil fuel use: a protection motivation theory-based experimental study

Reducing individual fossil fuel use is an important component of climate change mitigation, but motivating behaviour change to achieve this is difficult. Protection motivation theory (PMT) is a psychological framework that outlines the conditions under which people are more likely to be persuaded to take a specific response or action. This experimental study investigated the impact six different protection motivation theory-based messages had on intention to reduce fossil fuel use in a sample 3803 US adults recruited via Amazon Mechanical (MTurk). Only messages targeting self-efficacy and response efficacy increased intention to reduce fossil fuel use relative to the control message. However, only the self-efficacy message had an impact on its target construct (i.e. self-efficacy). As such, the mechanism for action for the response efficacy message is unclear. Furthermore, while the current study demonstrates that many of the PMT-related messages did not achieve changes in intention, this it is still possible that messages targeting these constructs could still lead to changes in intention in other modalities and when other message content is used. Given the urgency of responding to climate change, the potential for additive benefits of combining effective PMT-based messages should be considered irrespective of their mechanism as should research focused on how to effectively target other key PMT constructs.

Design of a RCT evaluating a lifestyle intervention in patients with type 2 diabetes and a critical appraisal of the recruitment process

Introduction&#x0D; Changing lifestyle can delay the progression of type 2 diabetes (T2D). Although there are evidence-based recommendations on diet and physical activity (PA; Colberg et al., 2016; Evert et al., 2019), T2D patients have difficulties implementing them (Booth, et al., 2013). Therefore, we have developed an intervention to promote PA and a healthy diet. While providing a supportive lifestyle change program for T2D patients, the recruitment entails difficulties.&#x0D; Objective&#x0D; The objective is to describe the design of the study and the intervention. As the study is still ongoing, the screening and recruitment process is to be analysed in more detail.&#x0D; Methods&#x0D; The intervention is investigated in a two-arm randomised controlled trial with N = 90 participants. Participants of the intervention group receive a one-year personal health coaching via telephone and access to an application. The intervention adapts the lifestyle recommendations to the individual needs based on achievable goals. The motivation and volition concept and behavior change techniques are used to empower participants to implement a healthy lifestyle. The control group receives access to the application. Primary outcomes are objectively measured PA and HbA1c. All outcomes are measured at baseline, at 27 weeks after inclusion and at 54 weeks after inclusion. Since May 2021, patients with T2D have been screened in two hospitals according to the study criteria (Hohberg et al., 2022). Due to a small number of eligible and interested patients, the criteria were adjusted in the course of the study and recruitment strategies were evaluated and adapted.&#x0D; Results&#x0D; Before the amendment of the inclusion criteria, 6.4% (113/1776; 05/2021-01/2022), and after the amendment, 22% (274/1243; 02/2022-10/2022) of T2D patients were eligible for the study. Finally, 1.8% (54/3019) of screened and 14% (54/387) of patients eligible for the study could be included. Reasons leading to a decline in participation are still being reviewed up to the conference. Exemplary reasons are e.g. no motivation, no time or too much stress, the program is not suitable for them or they are no longer contactable.&#x0D; Conclusion&#x0D; A strict definition of inclusion criteria as it is common in clinical trials with T2D patients results in only a very small part of the patients treated in the hospital being eligible for the study. Of these patients, only a few have interest or capacity to participate in the study. Researchers planning lifestyle interventions for T2D patients need to critically reflect on inclusion criteria and the recruitment process in order to obtain study results which are finally applicable to the real-world clinical population.&#x0D; References&#x0D; Booth, A. O., Lowis, C., Dean, M., Hunter, S. J., &amp; McKinley, M. C. (2013). Diet and physical activity in the self-management of type 2 diabetes: barriers and facilitators identified by patients and health professionals. Primary Health Care Research &amp; Development, 14(3), 293-306. https://doi.org/10.1017/S1463423612000412&#x0D; Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., &amp; Tate, D. F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079.&#x0D; https://doi.org/10.2337/dc16-1728&#x0D; Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H. K., MacLeod, J., Mitri, J., Pereira, R. F., Rawlings, K., Robinson, S., Saslow, L., Uelmen, S., Urbanski, W. S., &amp; Yancy Jr., W. S. (2019). Nutrition therapy for adults with diabetes or prediabetes: A consensus report. Diabetes Care, 42(5), 731-754.&#x0D; https://doi.org/10.2337/dci19-0014&#x0D; Hohberg, V., Kreppke, J.-N., Kohl, J., Seelig, E., Zahner, L., Streckmann, F., Gerber, M., König, D., &amp; Faude, O. (2022). Effectiveness of a personal health coaching intervention (diabetescoach) in patients with type 2 diabetes: Protocol for an open-label, pragmatic randomised controlled trial. BMJ Open, 12(6), Article e057948. https://doi.org/10.1136/bmjopen-2021-057948

The efficacy of genotype-based dietary or physical activity advice in changing behavior to reduce the risk of cardiovascular disease, type II diabetes mellitus or obesity: a systematic review and meta-analysis.

Despite clear evidence that adherence to dietary and physical activity advice can reduce the risk of cardiometabolic disease, a significant proportion of the population do not follow recommendations. Personalized advice based on genetic variation has been proposed for motivating behavior change, although research on its benefits to date has been contradictory. To evaluate the efficacy of genotype-based dietary or physical activity advice in changing behavior in the general population and in individuals who are at risk of cardiovascular disease (CVD) or type II diabetes mellitus (T2DM). MEDLINE, EMBASE, PsycInfo, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to January 7, 2022. Randomized controlled trials of a genotype-based dietary and/or physical activity advice intervention that aimed to change dietary and/or physical activity behavior were included. Abstracts of 7899 records were screened, and 14 reports from 11 studies met the inclusion criteria. Genotype-based dietary or physical activity advice was found to have no effect on dietary behavior in any of the studies (standardized mean difference [SMD] .00 [-.11 to .11], P = .98), even when analyzed by subgroup: "at risk" (SMD .00 [-.16 to .16, P = .99]; general population (SMD .01 [-.14 to .16], P = .87). The physical activity behavior findings were similar for all studies (SMD -.01 [-.10 to .08], P = .88), even when analyzed by subgroup: "at risk" (SMD .07 [-.18 to .31], P = .59); general population (SMD -.02 [-.13 to .10], P = .77). The quality of the evidence for the dietary behavior outcome was low; for the physical activity behavior outcome it was moderate. Genotype-based advice does not affect dietary or physical activity behavior more than general advice or advice based on lifestyle or phenotypic measures. This was consistent in studies that recruited participants from the general population as well as in studies that had recruited participants from populations at risk of CVD or T2DM. PROSPERO registration no. CRD42021231147.

Implications of E-Learning of the Ministry of Religion on Student Learning Motivation in Islamic Religious Education Subjects at Madrasah Aliyah Daruttaqwa Gresik

Focus in terms of research researchers analyzes the Implications of the Ministry of Religion's E-Learning on Students' Learning Motivation In Islamic Religious Education Subjects. This type of research is qualitative research with a descriptive approach and also a search with a case study approach. Because of online learning Teachers are required to think creatively and innovative so that students do not feel bored with studying e-learning. Besides that, there is also an impact with studying e-learning which results in changes in student motivational behavior in studying during the e-learning. The aims of this research are: 1) to analyze and describe the implementation of the Ministry of Religion's e-learning study Daruttaqwa Senior High School Gresik. 2) to analyze and describe studying implications of Minister try of Religion's e-learning on student learning motivation in Islamic religious education subjects at Daruttaqwa Senior High School Gresik. The results of the research at Daruttaqwa Senior High Schoolresik are 1) the learning process using the e-learning application of the Ministry of Religion which before starting learning the teacher councils must develop a method and creative and innovative learning media. Sometimes all teacher’s council also uses WhatsApp groups, google classroom, and youtube videos. 2) From the data obtained, it shows students learning motivation decreased because the teacher could not directly control when students learn, students feel bored during online learning, students often ignore assignments when submitting assignments.

Evaluation criteria for health apps supporting medication adherence in early-stage technology development - a scoping review.

Health apps offer an approach to improve the patients' management of their medication. Although the Digital Healthcare Act (DVG) has created a claim in the statutory health insurance (SHI), the large number of health apps available and their varying quality make it difficult for service providers and especially for medical laypersons to select an adequate high-quality medication app. Manufacturers need guidance for the development of high-quality apps right from the start. Various general evaluation concepts for health apps have been available to date. However, the requirements that should be met by healthcare depend largely on the field of application and the type of apps. This article aims to provide an overview of the international evidence on specific criteria for the evaluation of medication apps. Within the framework of a scoping review, a systematic search was conducted in PubMed and EMBASE on January 29, 2020. The search was limited to publications from 2007 onwards as well as to English and German articles. Additionally, a semi-systematic research of reference lists of the previously included articles as well as a structured search of websites of relevant stakeholders were conducted. Inclusion criteria were the following: the publication deals with health apps that can be used on smartphones and focus on supporting medication intake; the publication does not refer to evaluation criteria for a single app exclusively. The included publications were examined in a qualitative content analysis searching for evaluation criteria and categorizing them according to the framework criteria of the DVG and the Digital Health Applications Ordinance (DiGAV). 2,542 articles were identified in the systematic search (999 in PubMed, 1,543 in EMBASE, 560 duplicates). A total of 16 studies met the inclusion criteria. The semi-systematic research and the structured search identified one further study. A catalog of criteria was developed based on the included 17 studies. This catalog covers the general topics "patient orientation" (data protection and security, consumer protection, user friendliness) and "quality/core functions of medication apps" (reminder, self-monitoring, (drug) information, motivation to change behavior, drug/patient safety, robustness) as well as "interoperability/cooperation". Due to its specific importance for medication apps, the subcategory "motivation for behavioral change" stands out beneath the general topic "quality/core functions of medication apps". This category aims to evaluate the design of individual functions with regard to their potential to actually change the behavior of app users. The criteria for the evaluation of health apps mentioned in the DiGAV intersected with the criteria identified in the literature research. However, the area of positive health care effects was hardly covered by the included studies. In the development of the criteria catalog, it was not possible to weight the identified criteria. Therefore, the catalog should be understood as a supporting checklist for service providers, manufacturers, and/or users. A large variety of possible evaluation criteria for medication apps could be shown. Future research should focus on the possibilities of weighting these diverse evaluation criteria, using not only clinical studies but also methods to identify preferences.

Abstract B017: A home-based vegetable gardening intervention to address health behaviors and well-being among chronic disease survivors in the Deep South

Abstract Purpose: To assess changes over time in health behaviors (fruit &amp; vegetable [F&amp;V] consumption and physical activity [PA]), physical performance (PP), and anthropometrics among chronic disease survivors (CDS) of cancer, diabetes, and heart disease participating in a home-based vegetable gardening intervention in the Deep South. Methods: A community-based partnership was developed between the O’Neal Comprehensive Cancer Center, the Alabama Cooperative Extension System, and the Mississippi State Cooperative Extension System to implement an evidence-based gardening intervention (Harvest for Health). CDS were recruited from nine counties in Alabama and six in Mississippi. All participants were provided gardening supplies and paired with a Master Gardener (MG) from the Cooperative Extension. MGs mentored participants in planning, planting, and maintaining a summer/fall garden over a 3-month period. Senior Physical Performance Battery (SPPB) and anthropometrics (weight, height, and waist circumference [WC]) were collected by trained study personnel during community-based assessments (baseline and post-intervention). Self-reported data on health behaviors (NCI's Eating at America's Table Study and modified Godin leisure-time exercise questionnaire) were collected electronically via REDCap (baseline, post-intervention, 6-month follow-up). Results: One hundred and twenty CDS enrolled in the study (66% diabetes; 34% cancer; 29% heart disease). Participants (93% African American; 81% female; Mage=65) tended to be retired/disabled (62%), have overweight or obesity (92%), and reported a family income of less than $40,000 (68%). Overall, CDS engaged in gardening for 15-45 minutes (70%), several times a week (79%). Increases were seen in PA minutes/week at post-intervention (Moderate PA +10, p=0.34; Vigorous PA +30; p=0.05) and 6-month follow-up (Moderate PA +26, p&amp;lt;0.01; Vigorous PA +22; p&amp;lt;0.01). A trend in increased F&amp;V consumption was seen, with nearly a one serving/day increase at 6-month follow-up (3.7 vs 3.0; p=0.07). When asked to rate, on a scale of 1-10 (1=not at all to 10=very much), the influence of gardening on motivating behavior change, CDS reported that gardening motivated them to… “eat a healthier diet” (M=7.9; SD=2.1), “eat more vegetables” (M=8.2; SD=2.1), and “be more physically active” (M=7.6; SD=2.4). Improvements in anthropometrics were seen post-intervention (weight: -2 lbs.; BMI: -0.37 kg/m2; WC: -0.81 cm). Improvements in the SPPB were demonstrated in 5-of-8 measures (2-minute step test +4 steps; 30-second chair stand +0.6 rises; arm curl +1.7 curls, p&amp;lt;0.01; right hand grip strength +5 kg, p&amp;lt;0.01; right hand grip strength +5.7 kg, p&amp;lt;0.01). Discussions/Conclusions: The vegetable gardening intervention led to several improvements in lifestyle behaviors and outcomes among CDS in the Deep South and may offer an innovative approach to improving health among populations in need. Citation Format: Jennifer R. Bail, Meghan Tipre, Oluseun Akinyele, Bolanle Bolaji, Tara Bowman, Claudia Hardy, Wendy Demark-Wahnefried, Monica L Baskin. A home-based vegetable gardening intervention to address health behaviors and well-being among chronic disease survivors in the Deep South [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B017.

Sustainable mobility persuasion via smartphone apps: Lessons from a Swiss case study on how to design point-based rewarding systems

In the effort to counteract problems associated with the current carbon intensive transport system, app-based tools persuading mobility behaviour change have emerged worldwide. Most of such apps adopt a gamified approach and motivate behaviour change through external extrinsic motivational factors such as real-life prizes, that are attributed based on the distance travelled by non-car transport modes. Despite this approach might be effective in promoting additional leisure trips by sustainable mobility, it might keep car-based commuting habits unaltered, or even stimulate unfair app behaviour to gain points. In this paper, we focus on the Bellidea persuasive app, that was co-designed with interested citizens in a Swiss-based living lab experiment, and present how we addressed the shortcomings of prize-based rewarding systems, while also dealing with the constraints imposed by current levels of accuracy in automatic transport mode detection. We illustrate and discuss our design choices and the related algorithmic solutions by referring to the following dilemmas: “single transport modes versus modal split”, “trust versus control”, “dynamism versus rigidity”, and “global versus local”. We conclude by analysing real-life mobility data-sets collected by the Bellidea app and discussing our design solutions against their capacity to attract its target user group, namely car driver individuals.

Digital Engagement of Older Adults: Scoping Review

Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults' experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time. Our objectives were to identify the extent and breadth of existing literature on older adults' perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement. We used the Arksey and O'Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults' digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability). The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults' digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults' digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults' knowledge and skills to cope with digital technology development. RR2-10.2196/25616.

Values engagement as a predictor of eating disorder severity in a residential sample of female adolescents with eating disorders

ABSTRACT Values are freely chosen life directions and/or qualities of being that can motivate behavior change. There is nascent support for the utility of values work as a part of the therapeutic process across treatments, particularly in third wave therapy approaches (e.g., acceptance and commitment therapy). However, therapeutic values work is underresearched in clinical samples of youth. The aim of the present study is to examine the role of the two distinct values processes (engagement and obstruction), body image inflexibility, alongside other common comorbid symptoms of eating disorders (anxiety, depression) in a sample of female adolescents with eating disorders attending a residential eating disorder treatment program. Participants (N = 75) were patients at a residential eating disorder treatment facility and completed a battery of measures at time of admission. Correlational analyses and multiple regression were performed. Results found correlations between eating disorder severity, values engagement, values obstruction, body image flexibility, anxiety, and depression in the expected directions. Regression results found body image inflexibility, progression towards values, and anxiety as significant predictors of eating disorder severity (adjusted R2 = .54). This study points to the importance of emphasizing values engagement in youth with eating disorders, highlighting a potential treatment target for future research.

Implementing the language comprehension test C-BiLLT: a qualitative description study using the COM-B model of behaviour change

BackgroundIt is challenging to reliably assess the language comprehension of children with severe motor and speech impairments using traditional assessment tools. The Computer Based instrument for Low motor Language Testing (C-BiLLT) aims to reduce barriers to evidence-based assessment for this population by allowing children to access the test using non-traditional methods such as eye gaze so they can independently respond to test items. The purpose of this study is to develop a contextualized understanding of the factors that influenced clinicians’ implementation of the C-BILLT in practice in the Netherlands and Norway.Materials and methodsA qualitative approach including semi-structured individual interviews with 15 clinicians (speech-language pathologists, neuropsychologists, and one teacher, counsellor, and vision specialist) was used. Data analysis was conducted in two rounds. First, a deductive approach including a codebook was used to code data within the COM-B components describing clinicians’ capability, opportunity, and motivation for behaviour change. Then, an abductive approach applying thematic analysis was used to identify meaningful patterns within the COM-B components.ResultsSeveral meaningful barriers and facilitators were identified across the data. Clinicians used the C-BiLLT with two distinct groups of clients: (1) the population it was originally developed for, and (2) clients that could have also been assessed using a traditional language test. Clinicians working with the first group experienced more, and more complex barriers across all COM-B components, to successful C-BiLLT use than the latter.ConclusionThis study provides timely insights into the capability, opportunity, and motivation factors important for creating and sustaining assessment behaviour change in clinicians who used or attempted to use the C-BiLLT. Potential tailored intervention strategies aimed at improving implementation of novel assessment tools are discussed and may be helpful for others working to improve service delivery for children with complex needs.

Investigating Psychological Impact after Receiving Genetic Risk Results-A Survey of Participants in a Population Genomic Screening Program.

Genomic screening programs have potential to benefit individuals who may not be clinically ascertained, but little is known about the psychological impact of receiving genetic results in this setting. The current study sought to further the understanding of individuals' psychological response to receiving an actionable genetic test result from genomic screening. Telephone surveys were conducted with patient-participants at 6 weeks and 6 months post genetic result disclosure between September 2019 and May 2021 and assessed emotional response to receiving results via the FACToR, PANAS, and decision regret scales. Overall, 354 (29.4%) study participants completed both surveys. Participants reported moderate positive emotions and low levels of negative emotions, uncertainty, privacy concern, and decision regret over time. There were significant decreases in negative emotions (p = 0.0004) and uncertainty (p = 0.0126) between time points on the FACToR scale. "Interested" was the highest scoring discrete emotion (T1 3.6, T2 3.3, scale 0-5) but was significantly lower at 6 months (&lt;0.0001). Coupled with other benefits of genomic screening, these results of modest psychological impact waning over time adds support to clinical utility of population genomic screening programs. However, questions remain regarding how to elicit an emotional response that motivates behavior change without causing psychological harm.

Do older adults make more risky decisions in the Hungry Donkey Task or in the Iowa Gambling Task?

ABSTRACT The Iowa Gambling Task (IGT) and the Hungry Donkey Task (HDT) are well-known tasks employed to assess decisions under ambiguity. Although the two tasks are equal in terms of wins and losses, they differ in terms of the recipient: while in the IGT participants make decisions for themselves, in the HDT decisions are made to help a hungry donkey. Decisions for themselves versus another one in a situation of ambiguity are particularly important in the field of aging because of older adults’ changes in motivational and other-oriented behavior. The present study aimed to test whether older adults make different decisions under ambiguity for themselves than for another one (i.e., the hungry donkey) as compared to younger adults. Forty-five young adults (M = 23.31; SD = 1.58) and 45 older adults (M = 72.47; SD = 5.49) performed the IGT and the HDT. In addition, participants performed tasks on working memory, set-shifting, and inhibition. Results showed age-related differences in the HDT but not in the IGT. Older adults, compared to younger adults, made disadvantageous decisions to help the hungry donkey as compared to themselves. Interestingly, this pattern of results is not explained by the age-related decline in cognitive functioning. The findings seem to suggest that older adults’ decisions made under the condition of ambiguity are affected by motivational and emotional changes associated with aging.

Web-based physical activity promotion in young people with CF: a randomised controlled trial

BackgroundPhysical activity levels are known to decline following hospitalisation for people with cystic fibrosis (pwCF). However, optimal physical activity promotion strategies are unclear. This study investigated the effect of a...

Youth-Reported School Connection and Experiences of a Middle School–Based Screening, Brief Intervention, and Referral to Treatment Initiative: Preliminary Results From a Program Evaluation

PurposeThis study aimed (1) to evaluate the feasibility of a school-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) program that expands on traditional SBIRT to support the mental health and well-being of middle school students and (2) to assess its effects on students’ connection with adults at school. MethodsFocus group discussions were conducted with 26 students in grades 6–8 to understand student perspectives about an innovative school-based SBIRT program. A subset of middle school students from the SBIRT program who received a brief intervention (BI) after screening (n = 116) were asked to rate their experience meeting with the interventionist in terms of feeling comfortable, feeling listened to, and talking about their goals. Additionally, these students’ ratings of connection to adults at school was compared from the time of screening (baseline) to following BI using two-sided paired t-tests. ResultsStudents who participated in focus groups expressed favorable opinions about universal screening and this school-based SBIRT model and noted that relationship building with adults at school was an important factor for open communication and motivating behavior change for students. Nearly all students who completed the post-BI survey rated their experiences with interventionists during BI as “Excellent,” “Very Good,” or “Good” in all categories (98%). Students’ reported mean school connection scores significantly higher after participation in school-based SBIRT than at baseline (5.9/8 vs. 7.0/8, p < .001). DiscussionMiddle school students were satisfied with the school-based SBIRT model and participation in the program resulted in increased student connection with adults at school. These findings improve our understanding of the experience of SBIRT intervention with middle school students and on school connection in particular.

Behavioral intervention grounded in motivational interviewing and behavioral economics shows promise with Black and English-speaking Latino persons living with HIV with unsuppressed HIV viral load in New York City: A mixed methods pilot study.

IntroductionSustained HIV viral suppression is the ultimate goal of HIV treatment. African American/Black and Latino persons with HIV (PWH) in the United States are less likely than their White peers to achieve and sustain viral suppression. To address these disparities, we developed a “low-touch” behavioral intervention drawing on motivational interviewing and behavioral economics. The intervention had three main components: (1) a motivational interviewing counseling session, (2) 16 weeks of automated text messages and quiz questions about HIV management, where participants earned points by answering quiz questions, and 3) a lottery prize, based on viral suppression status, number of points earned, and chance (max. $275).Materials and methodsThe intervention was tested in a pre-test/post-test design. The present pilot study used mixed methods to explore the intervention's feasibility, acceptability, impact, and ways it could be improved. Participants engaged in a baseline assessment, qualitative interview, and two structured follow-up assessments over an 8-month period, and provided laboratory reports to document HIV viral load. We carried out descriptive quantitative analyses. Qualitative data were analyzed using a directed content analysis approach. Data integration was carried out using the joint display method.FindingsParticipants (N = 40) were 50 years old, on average (SD = 11), and approximately half (58%) were male. Close to two-thirds (68%) were African American/Black and 32% were Latino. Participants were diagnosed with HIV 22 years ago on average (SD = 8). The intervention was feasible (e.g., mean number of quiz questions answered = 13/16) and highly acceptable. While not powered to assess efficacy, the proportion with suppressed HIV viral load increased from baseline to follow-up (46% participants at the first, 52% participants at the second follow-up evidenced HIV viral suppression). In qualitative analyses, perspectives included that overall, the intervention was acceptable and useful, it was distinct from other programs, lottery prizes were interesting and appreciated but not sufficient to motivate behavior change, and the structure of lottery prizes was not sufficiently clear. Regarding data integration, qualitative data shed light on and extended quantitative results, and added richness and context.ConclusionThis low-touch intervention approach is sufficiently promising to warrant refinement and study in future research.

A citywide experiment testing the impact of geographically targeted, high-pay-off vaccine lotteries.

Lotteries have been shown to motivate behaviour change in many settings, but their value as a policy tool is relatively untested. We implemented a pre-registered, citywide experiment to test the effects of three high-pay-off, geographically targeted lotteries designed to motivate adult Philadelphians to get their COVID-19 vaccine. In each drawing, the residents of a randomly selected 'treatment' zip code received half the lottery prizes, boosting their chances of winning to 50×-100× those of other Philadelphians. The first treated zip code, which drew considerable media attention, may have experienced a small bump in vaccinations compared with the control zip codes: average weekly vaccinations rose by an estimated 61 per 100,000 people per week (+11%). After pooling the results from all three zip codes treated during our six-week experiment, however, we do not detect evidence of any overall benefits. Furthermore, our 95% confidence interval provides a 9% upper bound on the net benefits of treatment in our study.

Persuasive strategy implementation choices and their effectiveness: towards personalised persuasive systems

ABSTRACT Persuasive systems motivate behaviour change using persuasive strategies (PS) which are often implemented in various ways. However, whether or not the effectiveness of PS varies depending on implementation choices is yet to be investigated via an empirical study. We conduct a large-scale study of 568 participants to investigate if and how individuals at different Stages of Change (SoC) respond to different implementations of each strategy in the same system. We also explore why the implementations motivate behaviour change using ARCS motivation model. Our results show that people’s SoC plays a significant role in the perceived effectiveness of different implementations of the same strategy and that the implementations motivate for different reasons. For instance, people at the precontemplation stage are motivated by reward strategy implemented as badges because it increases their Confidence, while people in the preparation stage prefer reward implemented as points to build their Confidence. Our work links SoC theory with motivation theory and Persuasive Systems Design (PSD) model to offer practical guidelines for tailoring PS implementations to individuals to motivate behaviour change.

A behavior change model to address caregiver hesitancy around COVID-19 vaccination in pediatrics

IntroductionMany families express hesitancy around immunizing their children against COVID-19. We sought to better understand the perspectives of vaccine hesitant caregivers, and develop targeted recommendations for health care workers and policymakers to engage in more effective vaccine discussions. MethodsWe conducted semi-structured telephone interviews with 23 caregivers recruited from a pediatric infectious diseases clinic, including a subset of patients referred to discuss vaccine hesitancy. Thematic analysis of the interviews identified themes that were mapped using behavior change models to identify perceived barriers and facilitators towards COVID-19 immunization. ResultsBarriers and facilitators were mapped to the WHO (World Health Organization) 3C’s (confidence, complacency, convenience) model of vaccine hesitancy as well as the COM-B (capability, opportunity, motivation) behavior change model. Barriers included mistrust in authorities, misperception of the risk of COVID-19 in children, and perceived health contraindications and negative previous vaccine experiences. Facilitators included positive relationships with healthcare workers, the promise of a “return to normal”, and societal pressures to immunize. ConclusionsEfforts to increase vaccine uptake in the pediatric population must target specific barriers and facilitators to immunization expressed by caregivers. To address these concerns, we suggest: 1. Educating hesitant caregivers by highlighting the long-term pandemic effects on children and the threat of COVID-19 to children’s health, 2. Building on the trust caregivers have in healthcare workers by involving frontline workers in public health policy, and 3. Harnessing the power of peer pressure by mobilization of societal pressures and establishing COVID-19 vaccination as the norm in children.