Person-based Approaches Research Articles

Development of a digital mental health intervention for youth with ADHD: exploring youth perspectives on wants, needs, and barriers.

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder affecting five to eight percent of children and youth worldwide. Inattention, impulsivity, and hyperactivity are core symptoms, which often leads to comorbid disorders and impairments. Increased prevalence of ADHD among youth requires development of accessible and scalable interventions. Digital interventions for ADHD show promising results for adults, yet insight into youths perspectives and needs from digital ADHD interventions is lacking. This study is set in a person-based approach and explore what youths want and need from a therapist-guided digital intervention for ADHD. Exploratory individual interviews were conducted with youths aged 13-16 years diagnosed with ADHD (N = 16). Participants with an ADHD diagnosis were recruited primarily via social media. The interview guide was based on research, treatment guidelines, and clinical expertise. The study applied reflexive thematic analysis, within a Big Q framework. Codes and themes were generated in Nvivo. Four main themes and sub-themes were generated: (1) Tailoring the intervention to youths with ADHD (Push the right buttons; Stumbling blocks), (2) Managing ADHD (Planning and Focus; Regulation and Balance; Social interactions), (3) Me and my ADHD (Insight and Understanding; Accept and Normalization), and (4) Balance between support and independence. The findings suggest that youths with ADHD prefer stimulating and interactive treatment and are aversive to overwhelming, passive content. The intervention and therapist should encourage empowerment by supporting the youths autonomy in managing their ADHD. Future research is needed to investigate feasibility for person-based approaches to digital mental health treatments. Furthermore, parent perspectives on digital treatment for youths with ADHD should be investigated.

Co-designing a nature-based intervention to promote postnatal mental health for mothers and their infants: a complex intervention development study in England

ObjectivesThere is burgeoning evidence for the potential of nature-based interventions to improve wellbeing. However, the role of nature in enhancing maternal mental health, child development and early relationships remains relatively...

Learning not blaming: Investigating ten fatal road traffic collisions using STAMP-CAST

There have been strong calls in the research literature for the adoption of system-based approaches to further reduce road casualties. However, person-based approaches remain at the forefront of both national and local-level decision-making around road safety in the UK. Focusing on person-based approaches inhibits learning across the system. Practical examples are needed to support adoption of system-based approaches and ensure safety learning is maximised within the industry.This study builds on previous work (Staton et al., 2022) mapping the control structure for the municipal area of Cambridgeshire, UK. It utilizes a system-based accident investigation method: Causal Analysis based on System Theory (CAST) (Leveson, 2019). The method is based on Rasmussen’s Risk Management Framework and is used to identify weaknesses in the control structure across the entire sociotechnical system. This supports understanding why the collision occurred and prevention of similar future events, rather than apportioning blame. In the study, CAST is used to investigate a random sample of ten fatal collisions that occurred in Cambridgeshire between 2018 and 2020. The investigations were conducted retrospectively using police forensic collision investigation files that had already concluded crown or coroner’s court proceedings.Across all ten collisions investigated, 21 different types of actor were identified across all levels of the system, each of whom played some role in at least one of the collisions. As a result, 49 specific recommendations are made concerning these actor’s roles in preventing future road deaths and serious injuries. In addition, 11 system-wide recommendations are made relating to communication and coordination; the safety information system; safety culture; design of the safety management system; changes and dynamics over time; and economic factors in the system environment.This study demonstrates that the CAST method is a viable tool for learning in the road safety industry and provides a taxonomy of system hazards, alongside the system control structure from Staton et al. (2022), to support any future analysis using this method. The use of CAST identifies the importance of controls within the road transport system and that currently, despite having one of the best road safety records in the world, the existing controls in place in the UK are insufficient to prevent serious injury and death occurring daily and are in danger of being eroded further through a political agenda of deregulation.This study reinforces that road safety requires system-based approaches and the strength of the CAST method in identifying system-wide recommendations which can be used in support of a Safe System approach to provide recommendations across the Safe System pillars.

Integrating coordination of food purchasing into activity space-based food environment research: Toward a household perspective.

Despite the advances in person-based approaches to studying food environments, most studies using these approaches have relied on individual-centered activity space measures and largely ignored cohabiting household members who play crucial roles in shaping an individual's food access, food behaviors, and diet. This can be problematic for completely capturing food environments relevant to an individual and add uncertainties to explorations of how individuals' food environments relate to their food behaviors. This viewpoint discusses the need for, and implications of, considering household members when measuring food access and disentangling the behavioral pathways connecting the food environment to diet. Ultimately, a conceptual framework and potential questions are proposed to integrate household members into food environment research.

Environmental Factors for the Advancement of Teachers’ Self-Efficacy in Professional Development

There is a shifting paradigm in gifted education from person-based approaches (i.e., identifying giftedness) to process-based approaches (i.e., transacting giftedness). This new framework is centered on enriching educational opportunities that will make the process meaningful (i.e., gifted) to everyone in a setting. However, little is known about how this renewed perspective can be applied in teacher professional development. In line with the socio-ecological models, our study aims to identify the best appropriate model to describe teacher self-efficacy (i.e., the dependent variable in the study) as professional development from an ecological perspective and to propose an ecologically intelligent school (EIS) for the advancement of self-efficacy. Structural equation modeling (SEM) was performed to create a model using TALIS 2018 dataset. Afterward, indices of goodness-of-fit criteria were examined for each model. The results indicate that there is a complex ecological background, in that various factors affect the dependent variable. Model 3 was determined as the most suitable model that can be proposed as an ecologically intelligent school (EIS) for the advancement of self-efficacy. The factors within the three layers of the socio-ecological model-communication with teachers, communication with students, school climate, and feeling valued by the national level-altogether created an appropriate model explaining teacher professional development, regarding self-efficacy.

Digital interventions for hypertension and asthma to support patient self-management in primary care: the DIPSS research programme including two RCTs

Digital interventions for hypertension and asthma to support patient self-management in primary care: the DIPSS research programme including two RCTs

Eczema Care Online: development and qualitative optimisation of an online behavioural intervention to support self-management in young people with eczema

ObjectivesTo describe the development of Eczema Care Online (ECO), an online behaviour change intervention for young people with eczema (phase I); and explore and optimise the acceptability of ECO among...

Dietary Interventions to Prevent Childhood Obesity: A Literature Review.

Several dietary interventions have been conducted to prevent/reduce childhood obesity, but most of them are known to have failed in tackling the obesity epidemic. This study aimed to review the existing literature on dietary interventions for the prevention of childhood obesity and their effectiveness. A literature search was conducted using PubMed Central®. Only articles published between 2009 and 2021, written in English, conducted in humans, and including children and/or adolescents (<18 years old) were considered. The majority of studies were school-based interventions, with some addressing the whole community, and including some interventions in the food sector (e.g., taxation of high fat/sugar foods, front-of-pack labelling) and through mass media (e.g., restrictions on food advertising for children) that directly or indirectly could help to manage childhood obesity. Most of the programs/interventions conducted focus mainly on person-based educational approaches, such as nutrition/diet education sessions, allied to the promotion of physical activity and lifestyles to students, parents, and school staff, and less on environmental changes to offer healthier food choices. Only a few trials have focused on capacity building and macro-policy changes, such as the adaptation of the built environment of the school, serving smaller portion sizes, and increasing the availability and accessibility of healthy foods and water in schools, and restricting the access to vending machines, for example. Overall, most of the intervention studies showed no consistent effects on changing the body mass index of children; they have only reported small weight reductions, clinically irrelevant, or no effects at all. Little is known about the sustainability of interventions over time.

Use of participatory mapping approaches for activity space studies: a brief overview of pros and cons

Participatory mapping approaches have raised increasing interest in a variety of fields of research and practice during the past two decades. However, their use in modeling and studying individual mobility and activity spaces is rather recent and limited. This paper focuses on the use of public participation GIS (PPGIS) data in activity space modeling and analysis and aims to draw more scholarly attention to the existing research potentials in this area. While reviewing the pros of using PPGIS for activity space studies, this paper also discusses the existing limitations and outlines how they can be addressed in future research. PPGIS effectively enables collecting data from larger samples, making it possible to conduct more comprehensive geospatial and statistical analyses on the data. Additionally, the strong link between individuals and places in PPGIS data facilitates more person-based approaches in investigating person-environment relationships. However, use of PPGIS for activity space studies comes with analytical and data quality challenges that need to be thoroughly taken into consideration. Particularly, future research needs to seek new ways of including the temporal dimension in PPGIS and find new methods of using the data for activity space modeling and analysis.

Safety Culture: Identifying a Healthcare Organization’s Approach to Safety Event Review and Response Through the Analysis of Event Recommendations

A nonpunitive approach to safety event reporting and analysis is an important dimension of healthcare organization safety culture. A system-based safety event review process, one focused on understanding and improving the conditions in which individuals do their work, generally leads to more effective and sustainable safety solutions. On the contrary, the more typical person-based approach, that blames individuals for errors, often results in unsustainable and ineffective safety solutions, but these solutions can be faster and less resource intensive to implement. We sought to determine the frequency of system-based and person-based approaches to adverse event reviews through analysis of the recommendation text provided by a healthcare organization in response to an event report. Human factors and clinical safety science experts developed a taxonomy to describe the content of the recommendation text, reviewed 8,546 event report recommendations, and assigned one or more taxonomy category labels to each recommendation. The taxonomy categories aligned with a system-based approach, aligned with a person-based approach, did not provide an indicator of the approach, or indicated the review/analysis was pending. A total of 9,848 category labels were assigned to the 8,546 event report recommendations. The most frequently used category labels did not provide an indicator of the approach to event review (4,145 of 9,848 category labels, 42.1%), followed by a person-based approach (2,327, 23.6%), review/analysis pending (1,862 ,18.9%), and a system-based approach (1,514, 15.4%). Analyzing the data at the level of each recommendation, 23.2% (1,979 of 8,546) had at least one person-based and no system-based category, 13.3% (1,133) had at least one system-based and no person-based category, and 3% (254) had at least one person-based and one system-based category. There was variability in the event review approach based on the general event type assigned to the safety event (e.g., medication, transfusion, etc.) as well as harm severity. Results suggest improvements in applying system-based approaches are needed, especially for certain general event type categories. Recommendations for improving safety event reviews are provided.

Intervention Planning for the Tinnitus E-Programme 2.0, an Internet-Based Cognitive Behavioral Intervention for Tinnitus.

Purpose The purpose of this study is to comprehensively describe the intervention planning process for the Tinnitus E-Programme 2.0, an Internet-based cognitive behavioral intervention for tinnitus. Method Theory-, evidence-, and person-based approaches to intervention development were used. In Phase 1, quantitative systematic reviews were used to identify potentially effective intervention techniques and design features. Primary mixed-methods research involving adults with tinnitus explored the acceptability of the first version of the intervention. In Phase 2, person-based guiding principles highlighted key intervention design objectives and features to address needs of the intervention's target group (identified in Phase 1) to maximize its acceptability, feasibility of delivery, and effectiveness. Theory-based "behavioral analysis" and "logic modeling" comprehensively described intervention content and potential mechanisms of action. From this planning work, a prototype intervention was developed. Results The intervention design objectives outlined in the guiding principles were to (a) normalize tinnitus, (b) support users to maintain a regular relaxation practice, (c) minimize the worsening of users' tinnitus sensation, and (d) ensure the intervention is accessible to those with hearing loss. Behavioral analysis and logic modeling identified intervention processes (e.g., illness perceptions, beliefs about consequences, skills, goals) and purported mediators (acceptance of tinnitus, negative thinking, use of the cognitive skills tools for managing negative thoughts, and practicing regular relaxation) hypothesized to facilitate reductions in tinnitus symptom severity. Conclusions The guiding principles highlight key design objectives and features to consider when developing interventions for tinnitus. The logic model offers hypothesized mechanisms of action that can be tested in future process analyses.

Family relationships and DSM-5 personality domains in adolescence: A person- and variable-based approach

The present study aimed to examine the role of family relationships (i.e., interparental conflict, mother-adolescent and father-adolescent attachment) on adolescents' dysfunctional personality domains at the person- and variable-based level. Adolescents from five middle schools in mainland China were recruited in this sample (N = 644, Range age = 13–17, 40.7% male). Four family relationship profiles, labeled as disengaged, moderate, cohesive, and conflictual families, were reliably identified utilizing multiple dimensions of interparental conflict and parent-adolescent attachment. These profiles simultaneously showed evidence of spillover and compensatory patterns within family relationships. Meanwhile, multiple regression analyses found that the multiple mediating effects of adolescents' appraisals of interparental conflict and father-adolescent attachment were significant. In addition, there was a significant serial mediating role of mother-adolescent attachment and father-adolescent attachment between the associations of interparental conflict properties and adolescents' dysfunctional personality domains. Our findings underscore that both person-based and variable-based approaches for studying family relational dynamics are useful to illuminate spillover and compensatory patterns of family influence in adolescents' dysfunctional personality development.

Principles of moral accounting: How our intuitive moral sense balances rights and wrongs

We are all saints and sinners: Some of our actions benefit others, while other actions lead to harm. How do people balance moral rights against moral wrongs when evaluating others' actions? Across 9 studies, we contrast the predictions of three conceptions of intuitive morality—outcome-based (utilitarian), act-based (deontologist), and person-based (virtue ethics) approaches. These experiments establish four principles: Partial offsetting (good acts can partly offset bad acts), diminishing sensitivity (the extent of the good act has minimal impact on its offsetting power), temporal asymmetry (good acts are more praiseworthy when they come after harms), and act congruency (good acts are more praiseworthy to the extent they offset a similar harm). These principles are difficult to square with utilitarian or deontological approaches, but sit well within person-based approaches to moral psychology. Inferences about personal character mediated many of these effects (Studies 1–4), explained differences across items and across individuals (Studies 5–6), and could be manipulated to produce downstream consequences on blame (Studies 7–9); however, there was some evidence for more modest roles of utilitarian and deontological processing too. These findings contribute to conversations about moral psychology and person perception, and may have policy and marketing implications.

Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice and subsequently change antibiotic use

ObjectivesTo develop a behavioural intervention package to support clinicians and patients to amend incorrect penicillin allergy records in general practice. The intervention aimed to: (1) support clinicians to refer patients...

Staying at the Edge of Privacy: Edge Computing and Impersonal Extraction

From self-driving cars to smart city sensors, billions of devices will be connected to networks in the next few years. These devices will collect vast amounts of data which needs to be processed in real-time, overwhelming centralized cloud architectures. To address this need, the industry seeks to process data closer to the source, driving a major shift from the cloud to the ‘edge.’ This article critically investigates the privacy implications of edge computing. It outlines the abilities introduced by the edge by drawing on two recently published scenarios, an automated license plate reader and an ethnic facial detection model. Based on these affordances, three key questions arise: what kind of data will be collected, how will this data be processed at the edge, and how will this data be ‘completed’ in the cloud? As a site of intermediation between user and cloud, the edge allows data to be extracted from individuals, acted on in real-time, and then abstracted or sterilized, removing identifying information before being stored in conventional data centers. The article thus argues that edge affordances establish a fundamental new ‘privacy condition’ while sidestepping the safeguards associated with the ‘privacy proper’ of personal data use. Responding effectively to these challenges will mean rethinking person-based approaches to privacy at both regulatory and citizen-led levels.

Transit-based job accessibility and urban spatial structure

Job accessibility is a measure of people, opportunities, and transportation system that are fundamental elements of urban spatial structure. Therefore, job accessibility can be used as a tool to understand urban spatial structure. Studying transit-based job accessibility can provide more insight into inner cities. To study transit-based job accessibility, a person-based approach is needed in order to take full consideration of the elements. However, person-based approaches are substantially restricted by the availability of individual trip data. This paper takes a simulation approach to study transit-based job accessibility. First, transit-dependent worker agents are generated using a population synthesis. Then the agents are enabled with job search and commuting capabilities. Once the agents are deployed in a commuting simulation, individual commuting trips are recorded. An individual job accessibility index is developed based on simulated commuting trips. The index is normalized with an expected value of 1.0 and a measurable uncertainty level, which makes it easy to interpret and suitable for cross-regional studies. A case study is conducted in Tucson, Arizona, where about 10,000 transit-dependent worker agents produce more than 600,000 individual commuting trips during morning and afternoon peak hours. Census block, group-level job accessibility shows a random spatial pattern that coincides with a dispersed urban spatial structure of the case study area.

Feasibility trial of a digital self-management intervention ‘My Breathing Matters’ to improve asthma-related quality of life for UK primary care patients with asthma

ObjectiveTo assess the feasibility of a randomised controlled trial (RCT) and acceptability of an asthma self-management digital intervention to improve asthma-specific quality of life in comparison with usual care.Design and...

Dynamic cities: Location-based accessibility modelling as a function of time

The concept of accessibility – the potential of opportunities for interaction – binds together the key physical components of urban structure: people, transport and social activity locations. Most often these components are dynamic in nature and hence the accessibility landscape changes in space and time based on people's mobilities and the temporality of the transport network and activity locations (e.g. services). Person-based accessibility approaches have been successful in incorporating time and space in the analyses and models. Still, the more broadly applied location-based accessibility modelling approaches have, on the other hand, often been static/atemporal in their nature. Here, we present a conceptual framework of dynamic location-based accessibility modelling that captures the dynamic temporality of all three accessibility components. Furthermore, we empirically test the proposed framework using novel data sources and tools. We demonstrate the impact of temporal aspects in accessibility modelling with two examples: by investigating food accessibility and its spatial equity. Our case study demonstrates how the conventional static location-based accessibility models tend to overestimate the access of people to potential opportunities. The proposed framework is universally applicable beyond the urban context, from local to global scale and on different temporal scales and multimodal transport systems. It also bridges the gap between location-based accessibility and person-based accessibility research.

Intervention planning for the REDUCE maintenance intervention: a digital intervention to reduce reulceration risk among patients with a history of diabetic foot ulcers

ObjectivesTo develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk.MethodsTheory-based, evidence-based and...

Parsing profiles of temperamental reactivity and differential routes to delay of gratification: A person-based approach.

Informed by a developmental psychopathology perspective, the present study applied a person-based approach to examine whether associations between early sociocontextual experiences (e.g., socioeconomic factors and maternal discipline practices) and preschool-age children's delay of gratification vary across profiles of children's temperamental reactivity. In addition, the study examined the direct and mediating role of children's set shifting in associations with delay of gratification within each profile. The sample consisted of 160 socioeconomically and ethnically diverse mothers and their 5-year-old children drawn from a longitudinal study of mother-child relationships. Latent profile analyses identified three profiles of temperamental reactivity distinguished by sensitivity to reward and punishment and negative affectivity. Multigroup analysis revealed maternal sensitive discipline (observed during a parent-child compliance task) at age 3.5 predicted longer delay of gratification at age 5 in the punishment reactivity/negative affectivity group. Maternal inductive reasoning discipline at age 3.5 predicted longer delay in the low temperamental reactivity group. For children with the reward reactivity/negative affectivity profile, higher family income at age 3.5 predicted longer delay of gratification at age 5, which was mediated by children's set shifting. Findings underscore the utility of person-based approaches for delineating differential developmental routes toward children's delay of gratification.