Positive Behavior Change Research Articles

Education and Awareness on Antimicrobial Resistance in the WHO African Region: A Systematic Review.

This review documents the status of AMR education and awareness in the WHO African region, as well as specific initiatives by its member states in implementing education and awareness interventions, as a strategic objective of the Global Action Plan on AMR, i.e., improve knowledge and understanding on AMR through effective communication, education, and training. A systematic search was conducted in Google Scholar, PubMed, and African Journals Online Library according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, for articles published in English. Retrieval and screening of articles was performed using a structured search protocol following a pre-set inclusion/exclusion criterion. Eighty-five published articles reporting 92 different studies from 19 Member States met inclusion criteria and were included in the final qualitative synthesis. Nigeria (21) and Ethiopia (16) had most of the studies, while the rest were distributed across the remaining 17 Member States. The majority of the articles were on knowledge, attitude, and practices with regard to AMR and antimicrobial use and most of them documented a general lack and suboptimal knowledge, poor attitude and practices, and widespread self-medication. This review shows low levels of knowledge of AMR coupled with extensive misuse of antimicrobial medicines by different target audiences. These findings underscore the urgent need for enhanced and context-specific educational and positive behavioural change interventions.

Randomised control trial of a novel digital system to provide contextualised data feedback to augment physical activity behaviour change in a free-living environment as part of cardiac rehabilitation

Abstract Background Physical activity (PA) is a core component of cardiac rehabilitation (CR) and is crucial for enhancing cardiovascular (CV) fitness[1]. In the UK, CR programmes involve 1-2 hours of face-to-face contact per week over 6-8 weeks, implying that 98-99% of the intervention period is currently unmonitored and not optimised for potential positive lifestyle interventions. Consequently, CR staff are blind to PA that occurs outside of the clinical setting, which could be of too low or high intensity and/or duration, according to the Association of Certified Physiotherapists in Cardiac Rehabilitation (ACPICR) guidelines[2]. A previous pilot study showed a novel digital system to be feasible, acceptable and effective for CR patients[3], making it a promising intervention to assess in a randomised control trial (RCT). Purpose To conduct a RCT to examine whether contextualised data feedback delivered using a novel digital service, in conjunction with usual care (UC) promotes positive PA behavioural change, with direct comparison to UC alone. Methods This prospective, parallel group, open-label, RCT enrolled 130 patients eligible for CR and consisted of an 8-week intervention period with follow-up at 8-weeks. The intervention group received the novel digital CR service plus UC, with the control group receiving UC alone. The primary outcome was changes in PA to achieve the ACPICR guidelines. Both groups wore a PA monitor to collect minute-level energy expenditure data that underwent processing using a patented method to extract the specific PA metrics required for analysis. The secondary outcome was changes in CV fitness between pre and post assessments, measured using Incremental Shuttle Walk Test (ISWT). Results Patient characteristics are shown in Table 1. Adherence to data collection was good, with an average of 37 complete days (≥768 minutes per day) of PA data per person. Fifty-six intervention group patients and 49 control group patients were analysed for the primary outcome. A significant difference (p<0.025) in the probability of achieving the ACPICR ‘Daily Activity’ guideline was found between groups, with the intervention group more likely to achieve the guideline at week-8 versus control. Despite Covid-19 challenges, pre and post ISWT measurements were obtained for 33 intervention group patients and 37 control group patients. No significant differences between groups were found. However, the average improvement seen in the intervention group, +89 metres (m), exceeded the minimum clinically important difference for the ISWT (+70 m), and was more than double that seen in the control group, +44 m. Conclusion This RCT builds on previous evidence supporting the use of the novel digital service in CR[3]. Engagement with, and completion of, the digital CR service was excellent. Participation was associated with statistically significant improved PA in relation to ACPICR guidelines and clinically important increases in CV fitness versus UC alone.Table 1

Knowledge and Behaviors of Foot Care in Muslims With Diabetes Mellitus: Does Islamic Ritual Ablution Make a Difference?

This study aimed to determine the relationship between ablution ritual and foot knowledge, self-care behaviors, and the presence of diabetic foot ulcers in Muslims with type 2 diabetes mellitus (T2DM). A descriptive, comparative method was utilized to identify ablution ritual and foot knowledge, self-care behaviors, and the presence of diabetic foot ulcers. There were 228 persons with T2DM, with 162 participants (71.1%) in the ablution group and 66 participants (28.9%) in the no-ablution group, with 19.7% having diabetic foot ulcers. Diabetic foot knowledge and foot self-care behaviors of persons with T2DM were below a medium level, and there was a significant difference between ablution behavior and the presence of diabetic foot ulcers (x2 =6.646, p<.05). Culturally congruent interventions that acknowledge and understand the cultural practices and beliefs of Muslims with T2DM may be recommended to enhance their knowledge levels and promote positive behavior changes.

Green Marketing and Its Influence on Consumer Purchasing Behaviour

As global environmental concerns continue to mount, businesses have increasingly turned to green marketing strategies to align with consumer demand for eco-friendly products and services. This study examines the intricate relationship between green marketing and consumer purchasing behavior, shedding light on the factors influencing environmentally-conscious consumer choices.&#x0D; The research explores the multifaceted dynamics of green marketing, considering various elements such as environmental messaging, sustainability labels, product design, and corporate social responsibility. It investigates how these factors impact consumer perceptions, attitudes, and behaviors toward green products, while also addressing the prevalence of green washing in the marketplace.&#x0D; Through a comprehensive review of existing literature and empirical studies, this research delves into the complexities of consumer decision-making processes in the context of green marketing. It examines the role of personal values, social influences, cultural factors, and trust in shaping consumer responses to sustainability-oriented marketing efforts.&#x0D; The study also highlights the long-term implications of green marketing, focusing on consumer loyalty to green brands and sustained environmentally responsible purchasing behavior. It emphasizes the potential for green marketing to drive lasting positive changes in consumer behavior and contribute to the broader sustainability agenda.&#x0D; Furthermore, the research considers the ethical and policy dimensions of green marketing, emphasizing the importance of transparent and responsible marketing practices. It discusses the role of government regulations and educational initiatives in fostering a marketplace where green marketing aligns with genuine environmental commitments.&#x0D; In an era marked by increasing environmental awareness and calls for sustainability, understanding how green marketing influences consumer choices is not only of academic interest but also holds significant practical implications for businesses, policymakers, and consumers themselves. This study provides valuable insights into the evolving landscape of green marketing and its transformative potential in promoting sustainable consumption patterns.

Pengaruh Edukasi Terintegrasi Terhadap Gangguan Mineral Dan Tulang Pada Penyakit Ginjal Kronik Di Rumah Sakit Dr. Soedjono Magelang

This study aims to evaluate the positive influence of Integrated Education on body mineral balance and bone health in sufferers of Chronic Kidney Disease (CKD). An experimental research design with a control group was used. The research subjects involved sufferers of stage 3-4 CKD, who were divided into an intervention group (receiving Integrated Education) and a control group (no intervention). Research parameters include levels of calcium, phosphorus, parathormone, bone mineral density, as well as patient knowledge and behavior. Findings: Increased Knowledge: The intervention group experienced a significant increase in knowledge related to CKD management compared to the control group, Positive Behavioral Changes: Patients who took part in the integrated education program showed more positive behavioral changes, including medication adherence, a healthy diet, and a healthy lifestyle, Improvement in Mineral and Bone Disorder Parameters: The intervention group showed significant improvement in calcium, phosphorus and parathormone levels. Bone mineral density also increased significantly. Clinical Implications: The results of the study suggest that Integrated Education can be an effective approach in improving CKD management, with a positive impact on the body's mineral balance and bone health. Conclusion: Integrated education has a significant influence on knowledge, behavior and mineral and bone balance parameters in CKD sufferers. Implementation of this program can improve CKD management and prevent complications related to mineral and bone disorders. Recommendation: Further research could explore the long-term effects of Integrated Education, consider variations in individual responses, and involve a wider sample group.

Psychometric evaluation of the Protection Motivation Theory scale in assessing fall protection motivation among older adults to reduce fall risk

BackgroundProtection Motivation Theory could be another potential and good framework that addresses essential elements in a behavioural change leading to positive fall protective behaviours. The positive behavioural change could reduce the risk of falls and improve the quality of life of the older community. The study aims to evaluate the reliability and validity of the culturally adapted Protection Motivation Theory scale for older adults' fall protection motivation or protective behaviours to reduce fall risk.MethodsA cross-sectional study was conducted to establish a psychometric instrument validation. A total of 389 participants aged 55 years and above were included. The study was conducted in Sarawak, Malaysia, from November 2021 to January 2022 in two phases, translation of the PMT Scale, cross-cultural adaptation, face validation and pre-testing of the PMT Scale. The participants were selected using multistage random sampling in a primary healthcare clinic. Data entry and statistical analysis were performed using IBM SPSS version 26 for exploratory factor analysis and SmartPLS version 3.3.7 for confirmatory factor analysis using partial least square structural equation modelling.ResultsThe Kaiser–Meyer–Olkin value was 0.760, Bartlett's sphericity test was significant and the total variance explained was 61%. It identified 31 items within eight dimensions of the Protection Motivation Theory scale. The Higher Order Constructs' measurement model indicates that the convergent and discriminant validity were established (Cronbach's alpha and composite reliability: ≥ 0.740; average variance extracted: 0.619 to 0.935 and Henseler's Heterotrait-Monotrait criterion for all constructs' discriminant validity: < 0.9). Test–retest for the intraclass correlation coefficient was 0.745. The model's coefficient of determination demonstrated R2 = 0.375.ConclusionOverall, the Protection Motivation Theory Scale has established its reliability and validity for assisting older adults in the community. The Protection Motivation Theory Scale could be used in fall prevention interventions by promoting fall protective behaviours to reduce fall risk among community-dwelling older adults. The scale could assist healthcare providers in assessing the intention of older adults to use fall protective behaviours to reduce fall risk and serve as an alternative reference in developing fall prevention education in a fall prevention strategy.

Increasing Understanding About the Wise Use of Social Media for Depok Communities

The use of social media has become inevitable in modern life. Although it has many benefits, using social media can also bring risks and negative impacts, especially when not used wisely. This community service aims to increase the Depok community's understanding of using social media wisely. The method used in the implementation of community service is by conducting community service activities face to face with the people of Depok City , which is located in the Rangkap Jaya Sub-District, Pancoran Mas District - Depok City. The results of this program show a significant increase in understanding among the people of Depok. Community service program participants reported being better able to spot fake news, maintain online privacy, and interact ethically on social media. In addition, participants were also more aware of potential dangers such as online bullying and the spread of false information. This community service program has succeeded in creating positive changes in the social media usage behavior of the people of Depok. This proves the effectiveness of a community-based approach in increasing digital literacy. These findings can serve as a reference for similar efforts in other communities, promoting wiser and more responsible use of social media throughout society.

Infodemic Management for Social and Behavior Change: Youth Mobilization for Combating Disinformation During COVID-19

This study discusses an undergraduate elective university course as a notable case for youth mobilization in combatting misinformation during COVID-19 with positive social and behavior change outcomes of an indicative nature. Remote modality of the civic engagement course entailed students’ voluntary work at partnering with society organizations specialized in new media technologies. Students’ engagement with the civil society organizations’ three different research and implementation projects as a form of voluntary work enabled them to mobilize in accordance with a vital dimension of infodemic management, namely engagement of communities to take positive action. Results derived from a mixed model research present that individual change observed on the students’ knowledge, attitudes and practices as well as social change objectives of partnering institutions and the course are modestly positive, suggesting replication of adapted course design and implementation in relevant contexts.

Effectiveness of Therapeutic Community Rehabilitation Program for Drug Abuse in Social Institutions

This research conducts an evaluation of the Therapeutic Community (TC) Program implemented for residents grappling with drug abuse within social institutions. The study aims to assess the program's effectiveness, the impact on participants, and its implications for social institutions and the broader field of substance abuse treatment. Through a mixed-methods approach, the research scrutinizes quantitative data to measure changes in substance abuse levels, mental health, and readiness for reintegration, coupled with qualitative insights from participant experiences. The outcomes reveal significant reductions in substance abuse levels, improvements in mental health indicators, and positive behavioral changes among participants. The study highlights the pivotal role of peer support and community integration in residents' recovery journeys. The implications of the findings encompass enhanced recovery pathways for individuals, reinforcing the value of community support, while calling for sustained support mechanisms and comprehensive approaches within social institutions. This evaluation underscores the dynamic nature of substance abuse interventions and underscores the importance of continuous assessment, innovation, and adaptive strategies for improved rehabilitation initiatives.

A mixed-methods approach to understanding barriers and facilitators to healthy eating and exercise from five European countries: highlighting the roles of enjoyment, emotion and social engagement

Healthy adults are consistently falling below national and international recommendations for physical activity and dietary intake across Europe. This study took a co-creative approach with adult samples from five European countries to qualitatively and quantitatively establish motivators, barriers and sustaining factors for positive health behaviour change. Stage 1 delivered a newly-designed online programme, creating a community who identified challenges, motivators and solutions to sustaining positive healthy eating and physical activity behaviours. Stage 2 administered an online survey (developed from Stage 1 findings) to a larger sample to quantify the relative importance of these motivators and barriers. Results from both stages indicated enjoyment, positive emotions, and reward as key motivators for both behaviours across all five countries. Barriers included habit-breaking difficulties, temptation and negative affective states. Those with a high BMI placed more importance on social pressure than those with healthy BMI. Participants’ reports of motivators and barriers reflected relevant approaches from consumer science, behavioural economics, and psychology. Interventions supporting adults who are not chronically ill but would benefit from improved diet and/or physical activity should not focus exclusively on health as a motivating factor. Emphasis on enjoyable behaviours, social engagement and reward will likely improve engagement and sustained behaviour change.

Social media and health promotion: evaluation of effectiveness in promoting hypertension self-care in urban contexts of social iniquities

This paper explores the role of social media in promoting self-care for Systemic Arterial Hypertension (SAH) and addressing health inequities, emphasizing its significance in the context of the COVID-19 pandemic. It calls for a focus on social determinants of health and highlights the global impact of Chronic Non-Communicable Diseases (NCDs), with a particular focus on Brazil's healthcare system. The research, a collaboration between the University of Brasília and the research initiative Escola de Pacientes DF (EP-DF), employs Participatory Community Based Research (CBPR) to evaluate the impact of social media on SAH self-care in urban areas with social inequities. The study includes a scoping review of relevant articles, document analysis of SAH patient testimonials, and knowledge translation for community understanding. Results from the scoping review show positive changes in self-care behaviors due to social media interventions, while acknowledging challenges such as low Functional Health Literacy (FHL), age, education, and internet access. In conclusion, the paper highlights social media's potential in improving healthcare accessibility and equity for SAH and NCDs in vulnerable communities.

Elevated parent and child hair cortisol moderated the efficacy of a mindful eating intervention.

To explore whether elevated baseline hair cortisol moderated effects of a mindful eating intervention on anthropometrics, blood pressure (BP), household food insecurity, eating behaviour, and various psychosocial outcomes. The 14-week intervention included a parent Facebook-based programme, 3 parent meetings, preschooler letters connecting school learning to home practices, and a preschool-based mindful eating programme. Among 107 parent-preschooler dyads, mean age was 47.32months for preschoolers and 30.12years for parents. Among preschoolers, 54.2% were female, 8.4% were Hispanic, and 19.6% were Black. Among parents, 95.3% were female, 6.5% were Hispanic, 15.0% were Black, 39.4% were single, and 43.4% were unemployed. Preschoolers' elevated hair cortisol was related to a smaller reduction in preschoolers' % body fat (r=.31) and smaller increases in parents' perceived responsibility for child feeding (r=-.37). Parents' elevated hair cortisol was associated with smaller decreases in preschoolers' emotional eating (r=.39) and household food insecurity (r=.44). Relationships between baseline hair cortisol and post-intervention outcomes (BP, emotional eating, fruit/vegetable intake, food insecurity, and coping) varied by baseline values of outcome variables. Given that stress may attenuate intervention effects, a stress management component may be necessary to foster positive behavioural changes. Moreover, interventions should be tailored according to participants' characteristics to achieve optimal effects.

Dissecting Pashto Radio Dramas: An Examination of their Structural Fabric

The aims of this paper are twofold: firstly, to explore the unique characteristics and structural elements of radio drama as a distinct form of storytelling; and secondly, to examine the significance and enduring impact of radio drama as an art form. By delving into the intricacies of plot, character, dialogue, and setting within the context of radio drama, the paper seeks to illuminate how these elements interact to create immersive narratives that captivate audiences. Furthermore, by analyzing the role of voice acting, sound effects, and music in enhancing the storytelling experience, the paper aims to underscore the artistic and emotional resonance of radio drama. Through these discussions, the paper ultimately aims to provide insight into the historical, cultural, and artistic significance of radio drama, highlighting its continued relevance and influence in the modern era.

Novel Lifestyle Medicine Virtual Referral Clinic: A Quality Improvement Initiative to Increase Value-Based Care

Lifestyle education is a key component of healthcare, particularly primary care. Multiple studies have shown that dedicated patient education on lifestyle topics, in addition to medication management, creates the most positive outcomes. Improving knowledge on health topics is critical for eliciting positive change in health behaviors. However, education takes time, and access to focused education outside of the office visit can be a challenge. We discuss here a quality improvement initiative to increase value-based care by utilizing telehealth to improve access to Lifestyle Medicine education during the COVID-19 pandemic. We focused on 4 primary objectives including creating a Lifestyle Medicine Virtual Referral Clinic (LMVRC) embedded within our Family Medicine Residency, determining payor mix of referred patients, utilizing a telehealth platform to provide lifestyle medicine education, and finally determining the influence of our services on patient’s perceived health. There were many key findings in the development, implementation, and evaluation of the LMVRC that could serve to assist others and our clinic in further development of lifestyle medicine education in the primary care setting. In our experience, a LMVRC embedded in a primary care setting proved to be an effective approach to provide access for patients and advancing value-based care.

Review of Serious Energy Games: Objectives, Approaches, Applications, Data Integration, and Performance Assessment

In recent years, serious energy games (SEGs) garnered increasing attention as an innovative and effective approach to tackling energy-related challenges. This review delves into the multifaceted landscape of SEG, specifically focusing on their wide-ranging applications in various contexts. The study investigates potential enhancements in user engagement achieved through integrating social connections, personalization, and data integration. Among the main challenges identified, previous studies overlooked the full potential of serious games in addressing emerging needs in energy systems, opting for oversimplified approaches. Further, these studies exhibit limited scalability and constrained generalizability, which poses challenges in applying their findings to larger energy systems and diverse scenarios. By incorporating lessons learned from prior experiences, this review aims to propel the development of SEG toward more innovative and impactful directions. It is firmly believed that positive behavior changes among individuals can be effectively encouraged by using SEG.

Research trends and content analysis of ocean literacy studies between 2017 and 2021

Ocean literacy (OL) refers to the ability of citizens to understand and explain the concepts and phenomena related to the oceans, and leads them to positive behavioral change for the protection and sustainability of the oceans. The study presents a bibliometric analysis of ocean literacy-based studies published between 2017 and 2021, in order to provide more meaningful information about (a) the academic journals that mostly publish ocean literacy studies, (b) the content analysis of the articles, (c) country rankings over the years (d) the keywords mostly used and (e) the funding source. The Web of Science (WoS) and Scopus databases were used to find ocean literacy-based articles. Seventy-nine articles from forty ocean literacy academic journals covered by WoS and Scopus were carefully selected using predefined criteria. The results revealed that most of ocean literacy-based articles were published in the Frontiers in Marine Science journal (n=23). The countries that published the most ocean literacy-based articles were UK, Italy, Canada, USA, and Portugal. Most of the studies were supported by governmental budgets (n=44). The most popular concepts in ocean literacy-based studies included “Global OL Perspectives’’, “Sustainability”, “Citizen Science”, “Students’ OL Improvement”, “Measuring and Evaluating Students and Teachers’ OL”, “Stakeholders’ Effects on OL”, “OL Based Books-iBooks-Textbooks” and “Individuals’ Affective Domain on OL”. By considering the large number of ocean literacy-based articles published in academic journals indexed in WoS and Scopus, this article can contribute significantly to ocean literacy studies and informed and responsible research, as well as to citizen input to policy development on ocean literacy.

PENDIDIKAN ANEMIA GIZI MELALUI GAMES ULAR TANGGA MENINGKATKAN ASUPAN GIZI PADA REMAJA PUTRI

One of the nutritional problems that often occurs among adolescents is iron deficiency anemia, especially for adolescent girls who have a higher risk of anemia than young men. Based on the prevalence in the world in adolescent girls reached 32.8%, meaning that there are still anemia problems that have not been resolved. The study aimed to determine the effect of nutritional anemia education through snakes and ladders games on nutritional intake in adolescent girls. The design used quasi-experiment with pre test-post test method with control group on 48 class X students at SMK Negeri 1 Banyudono. Nutrition education through snakes and ladders games was conducted once a week for 4 weeks, containing anemia definition material and food intake selection. Food intake data was obtained through the interview method using a 3x24 hour food recall questionnaire. The results showed that there was an effect of snakes and ladders games on iron (p=0.017) and protein (p&lt;0.001) intake. Snakes and ladders games had no effect on folic acid (p=0.753) and vitamin C (p=0.886). There was an effect of lecture method on folic acid (p&lt;0.001). There was no effect of lecture method on iron (p=0.081), protein (p=0.295) and vitamin C (p=0.230) intake. The conclusion shows that snakes and ladders games significantly affect iron and protein intake, while the lecture method significantly affects folic acid intake. Therefore, the application of nutrition education materials is carried out gradually and continuously to achieve positive behavioral changes and prevent health problems in daily life.

The development of social capital in a peer-led mHealth cognitive behavioral antiretroviral therapy adherence intervention for HIV + adolescents and young adults

ABSTRACT Adherence Connection for Counseling, Education, and Support (ACCESS)-I is a peer-led mHealth antiretroviral therapy adherence intervention for adolescents and young adults living with HIV who are in treatment but have detectable viral loads. Participants received five online sessions with peer health coaches who followed a structured intervention manual. Peers maintained intervention fidelity but also engaged in casual discussion that was not directly related to ART adherence or HIV. We conducted a qualitative analysis of the casual interactions that occurred during the ACCESS I intervention. Sessions were transcribed and coded, and these casual interactions were then coded into 10 subcodes to document their content, and also coded for three types of social capital – emotional, informational, and instrumental. Emotional and Informational social capital codes were the most common, while instrumental codes were rare. Activities was the most common topic overall, while encouragement was more common in emotional social capital narratives and personal experience was more common in informational social capital narratives. These casual interactions may strengthen peer-participant relationships, building social capital that could then be used to encourage positive behavior change. Although social capital was not directly measured, these analyses illustrate the value of attending to seemingly casual interactions in peer-led interventions.

4 C's Approach to Meaningful and Lasting Positive Behavior Change.

Making intentional and sustainable positive behavior changes is difficult for most individuals. Knowledge and even expert coaching have shown meager results in guiding individuals towards a healthier diet and lifestyle. It is clear from the current research that additional approaches, which can help stem the tide of obesity and other chronic diseases, are needed. This article introduces a systematic process-based approach which focuses on the 4C's, Clarity, Commitment, Compassion, and Consistency. It is essential for individuals to have Clarity before they begin their health journey. Clarity must address, what do I want to change, why, and how am I going to make the change. Commitment highlights the importance of following a process-based approach that focuses on small incremental changes which over time can lead to remarkable results. Compassion is the necessary ingredient which allows individuals to continue the journey despite setbacks. By staying committed to the process, by practicing self-compassion, and by finding a healthy community, the individual is slowly able to achieve Consistency in achieving and then maintaining a healthier diet and lifestyle.

The need for game-based learning methods to address cyber threats

Cyber security threats are increasingly a serious concern to organisations, with an annual worldwide cost of a trillion dollars in 2021. Potentially the most significant contributor to cyber security threats is the human element, yet this has typically been insufficiently addressed in proposed solutions. Significant resources have been allocated to software, training and other solutions designed to tackle this threat, yet existing methods to improve cyber security have failed to deliver the desired results. Commonly cited issues include the lack of engagement in training, leading to disinterest and a ‘one size fits all’ approach, meaning some groups benefit from training more than others. This study will examine the need for game-based training methods in addressing cyber security threats caused by human error. Game-based training methods have previously been proposed to improve engagement in training and this study will discuss other potential benefits of game-based training. The aim of this work is to justify the use of game-based training methods in cyber security and begin to determine which aspects of games may be most effective at causing long-term positive behaviour change. Following an extensive literature review, a pilot study was run in which a survey was presented to 37 individuals who have taken cyber security training in the past, to query opinions and perceptions regarding cyber security training participants had previously taken, and how they feel they would behave when faced with certain cyber security threats. Upon analysis in SPSS, the results of this work indicate that factors such as training frequency and exposure to cyber security attacks have a significant impact on cyber security behaviour. A correlation between engaging training and impact of training on behaviour also serves to justify the development of such training methods. When combined with previous results on cyber security training this highlights the need for training to be engaging, regular, and relevant, and shows that the realistic simulation of cyber security threats (such as in game-based training) is of significant benefit. These results will help inform future development of effective game-based training methods and encourage their use more widely.