Potential Behavioral Changes Research Articles

The Minimum Wage and Consumer Nutrition

The U.S. Department of Agriculture estimates that one in nine U.S. households is “food insecure”: unable to purchase sufficient, or healthy food. Public policy advocates and politicians have pointed to the prevailing federal minimum wage as a culprit, labeling it a “starvation wage.” This study examines whether and to what extent increases to the minimum wage have improved the quantity and nutritional quality of food purchased by minimum wage earners, and what implications these potential changes in consumer behavior have for marketers. The authors show that households likely to be earning the minimum wage increase their calories purchased in response to minimum wage increases, and that these gains are predominantly found among households purchasing the least amount of food prior to the minimum wage rising. Although the authors do not find evidence that the average household improves the nutritional content of calories purchased, they do find evidence that the least healthy households (as measured by past purchases) buy more healthy foods in response to rising minimum wages. Overall, the findings suggest that higher minimum wages may not only help households afford more calories but also encourage some households to purchase more healthy calories. In addition, the authors find an increased openness among minimum wage households to purchasing new grocery items. This openness to trying previously unpurchased products offers promotion and product line planning opportunities to manufacturers. It also offers retailers with a nutrition-friendly brand image an opportunity to nudge consumers toward purchasing more healthy foods.

Singing Fin Whale Swimming Behavior in the Central North Pacific

Male fin whales sing using 20 Hz pulses produced in regular patterns of inter-note intervals, but little is known about fin whale swimming behavior while they are singing. Even less is known about fin whales in Hawaiian waters because they have rarely been sighted during surveys and passive acoustic monitoring has been limited to sparse hydrophone systems that do not have localization capabilities. We hypothesized that fin whale kinematics may be related to their singing behavior, or external variables such as time and sea state. To investigate this hypothesis, we analyzed 115 tracks containing 50,034 unique notes generated from passive acoustic recordings on an array of 14 hydrophones from 2011 to 2017 at the U.S. Navy Pacific Missile Range Facility off Kauai, Hawaii. Fin whales swam at an average speed of 1.1 m/s over relatively direct paths. We incorporated the whales' speed and turning angle into hidden Markov models to identify different behavioral states based on the whales' movements. We found that fin whale kinematic behavioral state was related to the vocalization rate (also known as cue rate) and time of day. When cue rate was higher, fin whales were more likely to swim slower and turn more than when cue rate was lower. During the night, fin whales were also more likely to swim slower and turn more than during the day. In addition, we examined whether the presence of singing fin whales was related to time and sea state using generalized additive models. Fin whale track presence was affected by day of the year and song season, and possibly also wind speed and wave height. Although the track kinematics from the fin whale tracks presented here are limited to a subset of whales that are acoustically active, they provide some of the only detailed movements of fin whales in the region and can be compared against fin whale swim speeds in other regions. Understanding how fin whale swimming behavior varies based on their vocalization patterns, time, and environmental factors will help us to contextualize potential changes in whale behavior during Navy training and testing on the range.

Understanding behaviour change to promote regular dental attendance.

Regular dental attendance is a key oral health behaviour. Behaviour change interventions are increasingly being used to promote positive oral health behaviours. A systematic approach to understanding behaviour has led to the development of frameworks which aim to guide the process of designing behaviour change interventions. One such framework is the Behaviour Change Wheel (BCW). This article aims to explore and identify barriers to regular dental attendance which may be targeted using behaviour change interventions based on the Capability, Opportunity and Motivation Behaviour model (COM-B) and the BCW, and suggests potential behaviour change techniques which could be utilised into a behaviour change intervention with the aim to promote regular dental attendance.

Are There Any Cognitive and Behavioral Changes Potentially Related to Quarantine Due to the COVID-19 Pandemic in People with Mild Cognitive Impairment and AD Dementia? A Longitudinal Study.

The aim of the study was to examine potential cognitive, mood (depression and anxiety) and behavioral changes that may be related to the quarantine and the lockdown applied during the COVID-19 pandemic in Greek older adults with mild cognitive impairment (MCI), and AD dementia in mild and moderate stages. Method: 407 older adults, diagnosed either with MCI or AD dementia (ADD), were recruited from the Day Centers of the Greek Association of Alzheimer Disease and Related Disorders (GAADRD). Neuropsychological assessment was performed at baseline (at the time of diagnosis) between May and July of 2018, as well as for two consecutive follow-up assessments, identical in period, in 2019 and 2020. The majority of participants had participated in non-pharmacological interventions during 2018 as well as 2019, whereas all of them continued their participation online in 2020. Results: Mixed measures analysis of variance showed that participants’ ‘deterioration difference—D’ by means of their performance difference in neuropsychological assessments between 2018–2019 (D1) and 2019–2020 (D2) did not change, except for the FUCAS, RAVLT, and phonemic fluency tests, since both groups resulted in a larger deterioration difference (D2) in these tests. Additionally, three path models examining the direct relationships between performance in tests measuring mood, as well as everyday functioning and cognitive measures, showed that participants’ worsened performance in the 2019 and 2020 assessments was strongly affected by NPI performance, in sharp contrast to the 2018 assessment. Discussion: During the lockdown period, MCI and ADD patients’ neuropsychological performance did not change, except from the tests measuring verbal memory, learning, and phonemic fluency, as well as everyday functioning. However, the natural progression of the MCI as well as ADD condition is the main reason for participants’ deterioration. Mood performance became increasingly closely related to cognition and everyday functioning. Hence, the role of quarantine and AD progression are discussed as potential factors associated with impairments.

Impact Of Activity Monitoring On Physical Activity, Sedentary Behavior, And Weight During The Covid-19 Pandemic

Emerging evidence has reported decreases in individuals’ physical activity and increases in sedentary behavior and bodyweight during the COVID-19 pandemic. The present study sought to assess the ability of physical activity monitoring to mitigate these negative outcomes. Such devices may promote physical activity and discourage sedentary behavior by providing feedback to the users. Therefore, individuals who do not use physical activity monitoring may report greater pandemic-related reductions in physical activity and greater increases in sedentary behavior and bodyweight relative to individuals who use monitors. PURPOSE: To assess the ability of physical activity monitoring to moderate potential changes in physical activity, sedentary behavior, and bodyweight due to the COVID-19 pandemic. METHODS: A sample of adults from a public, American university (N = 404, 40.3 ± 15.3 years old) completed an online survey consisting of validated questionnaires assessing self-reported mild, moderate, and strenuous physical activity (Godin), sedentary behavior (IPAQ), and bodyweight. Participants reported these variables for two separate time points: prior to the closure of campus due to the pandemic in March of 2020 and again at the time of the survey administration (May-June 2020). Participants also reported whether they did (n = 172) or did not (n = 232) regularly use physical activity monitoring devices. RESULTS: Two group (monitors, no monitors) by two time point (pre-, post-campus closure) ANOVAs revealed significant (p < 0.001) main effects of time for sitting and bodyweight but not for any measure of physical activity (p ≥ 0.15). On average, participants increased sitting by 67.8 ± 156.6 min/day and gained 1.4 ± 7.6 lbs. from pre- to post-campus closure. There were also significant (p ≤ 0.02) main effects of group as participants who used monitors reported 58% greater strenuous physical activity, 11% lower mild physical activity and 10% less sitting than those that did not use monitors. However, there were no significant (p ≥ 0.15) group by time interactions for any variable. CONCLUSIONS: While physical activity was not affected, participants reported significant increases in sedentary behavior and bodyweight during the COVID-19 pandemic. The use of a physical activity monitor did not moderate these effects.

근거이론에 기반한 팬데믹시대 잠재관광자의 관광행동 변화 경험 연구

The tourism industry faced a turning point due to the COVID-19 pandemic. This study examined potential tourists' behavior change during the pandemic. In-depth interviews with 14 potential tourists who planned to travel abroad in 2020 but delayed their plans were conducted. The collected data was analyzed using NVivo 12. Coding of the interview data resulted in 143 concepts and 31 sub-categories divided into nine categories. To be specific, the causal condition was the “outbreak of the pandemic.” The contextual conditions included “social distancing” and “travel alert.” The phenomenon was “limited tourist activity.” The intervening conditions were “tourism nostalgia”, “need for tourism”, and “perceived risk.” The actions/interactions included “tourism response behavior in the pandemic.” The consequence was “changes in tourism behavior.” In the selective coding stage, the core category was found to be “change in tourism behavior according to tourist responses in the pandemic.” The results provide a theoretical framework for understanding the psychological mechanisms and behaviors of potential tourists in the pandemic. Moreover, new factors related to changes in the tourism behavior of potential tourists. The study confirms recent research findings that the psychological mechanisms of tourists are an even greater influence than the pandemic itself. This study contributes in-depth understanding of the perceptions, attitudes, behaviors, and reactions of potential tourists in the pandemic situation, which was previously insufficiently explored.

Optimum Iron Provision Potentiate the Cognitive Functions in Children-A Review Article

Micronutrient deficiencies, especially those related to iodine and iron, are linked to different cognitive impairments, as well as to potential long-term behavioral changes. Among the cognitive impairments caused by iron deficiency, those referring to attention span, intelligence, and sensory perception functions are mainly cited, as well as those associated with emotions and behavior, often directly related to the presence of iron deficiency anemia. In addition, iron deficiency without anemia may cause cognitive disturbances. At present, the prevalence of iron deficiency and iron deficiency anemia is 2%–6% among European children. Given the importance of iron deficiency relative to proper cognitive development and the alterations that can persist through adulthood as a result of this deficiency, the objective of this study was to review the current state of knowledge about this health problem. The relevance of iron deficiency and iron-deficiency anemia, the distinction between the cognitive consequences of iron deficiency and those affecting specifically cognitive development, and the debate about the utility of iron supplements are the most relevant and controversial topics. Despite there being methodological differences among studies, there is some evidence that iron supplementation improves cognitive functions. Nevertheless, this must be confirmed through adequate follow-up studies among different groups.&#x0D; TAJ 2021; 34: No-1: 115-122

Sensor and Video: Two Complementary Approaches for Evaluation of Dairy Cow Behavior after Calving Sensor Attachment.

Simple SummaryWe analyzed whether attaching sensors to the tail of cows for the early detection of calving leads to behavioral changes. In this study, we combined conventional video analysis with data from digital sensor technologies. To detect the potential agitation of cows after calving sensor attachment, we analyzed cow activity behavior. Based on the combined results of video and sensor analysis, there was no clear evidence that attaching sensors to the tail generally altered the ethological pattern of all cows analyzed. However, the investigation of individual cows showed an increase in the frequency of tail raising and rubbing the tail after calving sensor attachment. These changes would be worth analyzing in more detail on a larger scale.Studies evaluating calving sensors provided evidence that attaching the sensor to the tail may lead to changes in the cows’ behavior. Two different calving sensors were attached to 18 cows, all of which were equipped with a rumen bolus to record their activity. Two methodological approaches were applied to detect potential behavioral changes: analysis of homogeneity of variance in cow activity (5 days pre-sensor and 24 h post-sensor) and analysis of video-recorded behavior (12 h pre- and post-sensor, respectively) in a subgroup. The average results across the sample showed no significant changes in the variability of activity and no statistically significant mean differences in most visually analyzed behaviors, namely walking, eating, drinking, social interaction, tail raising, rubbing the tail, and the number of standing and lying bouts after calving sensor attachment. In addition to considering mean values across all cows, individual cow investigations revealed an increased number of time slots showing a significant increase in the variability of activity and an increased frequency of tail raising and rubbing the tail on objects after calving sensor attachment in some cows, which should be investigated in more detail on a larger scale.

Effects of Power Training on Physical Activity, Sitting Time, Disability, and Quality of Life in Older Patients With Type 2 Diabetes During the COVID-19 Confinement.

To evaluate the effectiveness of a multicomponent supervised and unsupervised training program focused on muscle power to counteract the potential changes in sedentary behavior, disability, physical activity (PA), and health-related quality of life (HRQoL) caused by the COVID-19 pandemic domiciliary confinement in prefrail older adults with type 2 diabetes mellitus. Thirty-five older adults with type 2 diabetes mellitus were assigned to 2 groups according to their frailty status: exercise training group (prefrail or frail; n = 21; 74.7 [4.5]y; 33.3% male) and control group (robust; n = 14; 73.1 [3.9]y; 42.9% male). The exercise training group followed a multicomponent training program focusing on muscle power: supervised (5wk) and unsupervised (6wk). The primary outcomes, including PA and sitting time, perceived disability, and HRQoL, were assessed at the baseline and after 11weeks. At the end of confinement, there were significant decreases in PA in both groups (P < .05). Thus, sitting time increased more in the control group than in the exercise training group (P < .05). The HRQoL measures remained unchanged. Muscle power training before and during mandatory COVID-19 self-isolation in type 2 diabetes mellitus older adults (1)attenuates the COVID-19 domiciliary confinement-related increase in sitting time and (2)slightly decreases the self-reported levels of disability and maintains HRQoL.

A recreation ecology perspective on the COVID-19 (SARS-CoV-2) pandemic: Potential parks and protected area impacts relating to visitor spatial use, terrestrial flora and fauna, and management

Measures to limit the spread of COVID-19 require changes in the ways that people travel, gather, and recreate in outdoor spaces. In 2020, to limit human-to-human transmission of COVID-19, US park and protected area managers at all levels of governance implemented closures and restrictions on the types of activities and facilities available for public use. At the same time, the US Centers for Disease Control and Prevention outlined suggestions for social distancing, wearing face masks, and limiting travel and group sizes for social gatherings. This thought piece explores potential shifts in park accessibility and human behaviors that may lead to cascading impacts on visitor spatial use, terrestrial flora and fauna, and park management. We discuss potential changes in visitor spatial behavior and possible subsequent ecological impacts on terrestrial flora and fauna. Additionally, we connect these topics with management implications and emphasize adaptive management and continued monitoring to address current and future pandemic-related issues. We provide park managers, researchers, and other professionals with expected social and ecological implications resulting from managerial and behavioral shifts in response to the COVID-19 pandemic. Furthermore, we suggest management approaches to address and monitor these impacts. This information can help shape how park managers respond to the ongoing pandemic and future human health issues that impact park visitors and flora and fauna. Finally, we offer suggestions for where prospective researchers can direct their focus, especially in areas where recreation ecology and human disease management intersect.

Creating Health Information for Individuals with Hearing Loss

&#x0D; &#x0D; &#x0D; Creating accessible health information (HI) decreases inequities, empowers individuals to make informed health decisions, and promote cues to action for potential health behavior changes. However, HI may not be created with accommodations to allow engagement in HI for some populations, such as indi- viduals with hearing loss. Therefore, developing HI based on specific guidelines such as Universal Design for Learning (UDL) can lend itself useful in HI development. The purpose of this article is to explain UDL guidelines of representation and how they can be incorporated into HI so that it is accessible to a wide audience, including with hearing loss.&#x0D; &#x0D; &#x0D;

Building Community in the HIV Online Intervention Space: Lessons From the HealthMPowerment Intervention.

Mobile health platforms can facilitate social support and address HIV (human immunodeficiency virus) stigma but pose challenges for intervention design and participant engagement. Giddens's structuration theory, that individuals are shaped by-and shape-their communities through rules and resources that give them power to operate within these environments, provides a useful analytic framework for exploring these dynamic intervention spaces. Data were drawn from an online randomized controlled trial intervention (HealthMpowerment) for young Black men who have sex with men to reduce condomless anal intercourse. We applied a conversational analysis informed by structuration theory to 65 user-generated conversations that included stigma content. We aimed to understand how the interdependent relationship between the intervention space and participants' contributions might contribute to behavior change. Thirty five intervention participants contributed to the analyzed conversations. Our analysis identified three types of conversational processes that may underlie behavior change: (1) Through intervention engagement, participants established norms and expectations that shaped their discussions; (2) participants used anecdotes and anonymity to reinforce norms; and (3) intervention staff members sought to improve engagement and build knowledge by initiating discussions and correcting misinformation, thus playing an integral role in the online community. The lens of structuration theory usefully reveals potential behavior change mechanisms within the social interactions of an online intervention. Future design of these interventions to address HIV stigma should explicitly characterize the context in which individuals (study staff and participants) engage with one another in order to assess whether these processes are associated with improved intervention outcomes.

Preparing for Puberty in Girls With Special Needs: A Cohort Study of Caregiver Concerns and Patient Outcomes.

To characterize the patient population with cognitive or physical impairments that presents for anticipatory guidance of puberty, evaluate caregiver concerns with respect to puberty, and describe chosen management strategies and outcomes following menarche. Retrospective cohort study SETTING: Academic tertiary care women and children's hospital PARTICIPANTS: Eligible female patients with special needs up to age 26 years presenting for anticipatory guidance from 2009 to 2018 MAIN OUTCOME MEASURES: Primary outcomes included characterization of patients presenting for anticipatory guidance and their reasons for menstrual management. Secondary outcomes were satisfaction with menstrual management and bleeding patterns. A total of 61 patients presented for anticipatory guidance of puberty, on average 13.5 months prior to menarche. Compared to the overall adolescent population with special needs who presented for gynecologic care, patients who had autism spectrum disorder (ASD), were nonverbal, or had attention-deficit/hyperactivity disorder (ADD/ADHD) were more likely to present for a pre-menarchal visit to discuss anticipated pubertal development (P < .001, P = .009, and P = .04, respectively). More than half of families described potential behavioral changes as their main concern. The majority of post-menarchal patients (80%) desired hormonal management of menses, including 30% of patients who had placement of a levonorgestrel intrauterine device. In all, 96% of patients were satisfied with their final menstrual bleeding pattern; 50% achieved amenorrhea or light spotting. This study describes the important role of pre-menarchal reproductive counseling for girls with disabilities. Anticipation of puberty causes great anxiety in families and patients, especially those with ASD, ADD/ADHD, and non-verbal status. Providers should consider initiating these conversations early in pubertal development.

DON'T SPEED UP, SPEED KILLS: MAMMAL ROADKILLS ON HIGHWAY SECTIONS OF PR-445 IN THE SOUTH OF BRAZIL

Animal-vehicle collisions are the main negative impact of roads on wildlife, where they cause population declines, shifts in community structure, and potential changes in species behavior. Here, we determined mammal roadkill rates and the hotspots with higher rates for medium- and large-bodied mammals on the Highway PR-445 in the state of Paraná, Brazil. We have also evaluated possible differences in the frequency of roadkills concerning species activity patterns and their feeding habits. In doing so, we monitored the PR-445 twice a week between the kilometers 1 and 76, from March 2018 to March 2019, totaling 7296 km after 96 trips. We have recorded 93 mammal roadkills belonging to 17 species, representing a rate of 0.013 individual/km/day. The Carnivora, Didelphimorphia, and Cingulata orders showed to be the most common representatives among the roadkills. Omnivores were more prone to get hit by vehicles than herbivores and carnivores. The type of mammal activity pattern was not determinant in explaining the differences in roadkill rates. Highways in Paraná are among the roads that register the highest number of vehicle collisions with vertebrates in the country. This issue, together with extensive habitat loss and fragmentation, increases the threats to the relictual fauna. Our results indicate that the regions with the highest incidence of mammal roadkills on PR-445 are those close to stretches over rivers and with remnants of native vegetation. Thus, we emphasize that more comprehensive measures (e.g., wildlife passages and speed reducers) are essential to mitigate the impact of roads on wildlife.

Parents' Perceptions of and Responses to School-Based Body Mass Index Screening Programs-A Systematic Review.

Evidence for the effectiveness of state-mandated body mass index (BMI) screening programs in the United States has been inconclusive, and potential unintended consequences of the programs have been debated. The present review aims to understand parents' perceptions of and responses to school-based BMI screening, and to highlight racial/ethnic differences. We systematically identified studies published January 2003-May 2019 examining parent and/or youth perceptions of and/or responses to US school-based BMI screening. A total of 16 studies were included in the review. Studies suggested that while parents largely found BMI screening helpful, they held concerns regarding stigma, lack of privacy, and unhealthy behaviors and attitudes resulting from school-based screening. Furthermore, parents did not frequently follow-up with health care providers, although they reported some healthy behavior changes. Our review highlights existing parent perceptions of school-based BMI screening including the potential for healthy behavior change and important concerns regarding weight-stigma and disturbed eating attitudes/behaviors. Additionally, racial/ethnic differences in screening preferences and experiences were found. Limitations of existing literature included a need to understand youths' experiences and a lack of standardized, reliable outcomes research. Implications for future research and the role of parents, schools, and providers are discussed.

A vehicle-by-vehicle approach to assess the impact of variable message signs on driving behavior

Variable Message Signs (VMS) provide real-time information on traffic conditions, making it possible to guide drivers through electronic signs along the road. Relevant literature has proved VMS to be effective, especially for diverting traffic during incidents in the highway or inducing a speed reduction. Previous efforts, however, usually involve off-highway experiences, including the use of simulators or stated preference surveys, or the measurement of aggregate values of traffic through technologies that are prone to a higher failure rate, such as loop detectors. For bridging this gap, in this research, we propose a novel vehicle-by-vehicle approach (VBV), that differentiate by vehicle type, to assess the impact of VMS on drivers’ road behavior patterns along a section of a Chilean urban highway during risky situations. In addition to the messaging information, we use full traffic data obtained from free-flow gates equipped with automatic vehicle identification (AVI) technology. We conduct statistical analyses to study two potential messaging-induced behavioral changes, namely speed reduction and lane changes. For the speed reduction behavior, in 87.50% of the studied messages, the results indicate that the messages failed to induce the desired change in behavior. This value decreases to 71.85% for lane changes. The results indicate that heavy vehicle drivers and low-mileage drivers are more likely to follow lane change messages.

Increasing Older Adult Involvement in Geriatric Assessment: A Mixed-Methods Process Evaluation.

Objectives: Goal setting and motivational interviewing (MI) may increase well-being by promoting healthy behavior. Since we failed to show improved well-being in a proactive assessment service for community-dwelling older adults applying these techniques, we studied whether implementation processes could explain this. Methods: Goals set during the comprehensive geriatric assessment were evaluated on their potential for behavior change. MI and goal setting adherence wasassessed by reviewing audiotaped interactions and interviewing care professionals. Results: Among the 280 goals set with 230 frail older adults (mean age 77 ± 6.9 years, 59% women), more than 90% had a low potential for behavior change. Quality thresholds for MI were reached in only one of the 11 interactions. Application was hindered by the context and the limited proficiency of care professionals. Discussion: Implementation was suboptimal for goal setting and MI. This decreased the potential for improved well-being in the participating older adults.

Impact of unilateral ureteral obstruction on cognition and neurodegeneration

IntroductionCognitive impairment is a common complication in chronic kidney disease (CKD) patients. Currently, limited types of animal models are available for studying cognitive impairment in CKD. We used unilateral ureteral obstruction (UUO) in mice as an animal model to study the cognitive changes and related pathology under prolonged renal impairment MethodsUUO was performed in 8-week-old male C57BL/6 N mice with double-ligation of their left ureter. A sham group was subjected to the same experimental procedure without ureteral obstruction. Cognitive and behavioral tests were performed to examine potential changes in cognition and behavior at 2, 4 and 12 weeks after surgery. Sera were collected, and kidneys and brains were harvested for the detection of systemic inflammation markers and neurodegenerative changes. ResultsThese mice displayed weak performance in the novel object recognition test, Y-maze test, and puzzle box test compared to the sham group. Reductions in synaptic proteins such as synapsin-1, synaptophysin, synaptotagmin, PSD95, NMDAR2B and AMPAR were confirmed by western blot analysis. Histological examination revealed elevated levels of Nrf2 and 8-hydroxyguanosine, and hyperphosphorylation of tau in the hippocampus. UUO mice also had increased levels of C-reactive protein (CRP) and TNF-α. ConclusionsWe characterized the cognitive and neuropathological changes in UUO mice. The results show that this mouse model can be used to further study cognitive changes related to chronic renal impairment.

Facilitated Stories for Change: Digital Storytelling as a Tool for Engagement in Facilitated Discussion for Reduction of Diabetes-Related Health Disparities Among Rural Latino Patients With Diabetes.

Latino populations, particularly those living in rural areas, experience a disproportionately high prevalence and poorer outcomes of type 2 diabetes mellitus (T2DM). The purpose of this study was to test the acceptability and perceived effectiveness of a group-based, facilitated digital storytelling intervention for T2DM self-management among rural Latino patients. Twenty Latino adults with T2DM participated in facilitated storytelling discussions at two primary clinics. Participants viewed a 12-minute T2DM self-management digital storytelling intervention, followed by a facilitated group discussion. Surveys, observations, and focus groups were used to assess for acceptability and perceived effectiveness of the intervention through descriptive and qualitative analysis, informed by narrative and social cognitive theory. All participants found the intervention interesting and useful and reported improvement in confidence, motivation, and behavioral intentions for T2DM self-management. Themes mapped closely with narrative theory models, further suggestive of the behavior change potential. Facilitated discussions may add value to viewing of digital stories and represent a scalable approach to provide culturally congruent health care for Latino patients with diabetes in rural settings. Within the paradigm of group-based diabetes educational programs, this lends itself well to critical transcultural nursing care.

Intention to Engage in Winter Sport in Climate Change Affected Environments.

Exercise, including winter sport activities, shows positive effects on physical and mental health, with additional benefits when participating in natural environments. Winter sport activities are particularly vulnerable to climate change, since global warming will decrease the duration and amount of snow. In the context of climate change in alpine environments, little is known on the determinants of winter sport behavior. Thus, the following study primarily aimed at comparing the effect of being exposed to a climate change affected scenario (CCA) or to a climate change unaffected scenario (CCU) on the intention to engage in recreational winter sport activities. Secondly, we aimed to analyze the role of anticipated affective responses during exercising based on the Theory of Planned Behavior (TPB). An experimental cross-sectional web-based study design was used. Participants were randomly allocated to pictures of either CCA or CCU. TPB variables and affective responses with regard to the displayed scenarios were assessed. Statistical analyses included Mann-Whitney-U Tests, linear regression, and mediation analyses. Significant group differences were seen in all TPB variables, p < 0.038; −0.13 < r < −0.30, as well as in affective responses, p < 0.001; −0.24 < r < −0.85. Lower intention to engage in winter sport activities and lower anticipated affective valence during exercising was found in CCA compared to CCU. Attitude toward winter sport was significantly positively associated with intention to engage in winter sport, beta = 0.66, p < 0.001. The effect of group allocation on attitude was mediated by anticipated affective valence, indirect effect = 0.37, p < 0.001. Intention to engage in recreational winter sport activities was lower in participants exposed to the climate change affected winter sport scenario. Since affective valence seems to influence attitude and consequently intention to exercise, the role of non-cognitive variables with regard to climate change related exposure should be considered in future studies. Therefore, winter sport resorts may consider altered winter sport behaviors due to the consequences of climate change as well as the importance of providing an optimal framework to enhance affective valence of their guests in order to mitigate potential changes in winter sports behavior.