Predictors Of Behavior Change Research Articles

2' Life-changing minutes: impact evaluation of a novel health promotion format on cancer prevention.

Cancer is one of the most important societal challenges in the world, with over 23 million new cases/year and 10 million deaths/year, that will only be properly tackled with a stronger focus on prevention. This calls for an informed population, aware of risk factors and willing to adopt preventive behaviors and early cancer screenings. For that purpose, 2' Life-changing minutes was created, the first ever televised Entertainment-Education series on cancer prevention. This study aims to evaluate the impact of 2' Life-changing minutes, a novel E-E format for cancer prevention, on knowledge gains and behavior changes. Two complementary studies were performed involving a total of 1314 participants: a test-screening (TS) study targeting potential viewers of the series, and a natural-screening (NS) study targeting those that spontaneously watched the series on television. We found (i) very high levels of appreciation and narrative engagement, and also willingness to see more episodes; (ii) statistically significant knowledge gains, ranging from 17% to 44%, on all four topics tested; (iii) evidence of effective behavior change. Regression analysis showed that narrative engagement was the best predictor of behavior change [NS: odds ratio (OR) = 3.38, 95% confidence interval (CI) = 1.70-6.74, p = 0.001; TS: OR = 2.05, 95% CI = 1.13-0.371, p = 0.018]. This study demonstrates the series' real impact and serves as a proof-of-concept for a novel strategy of cancer prevention that is based around compelling health narratives, rather than information or data, to engage viewers, increase knowledge and induce behavior change.

Utilization of the multi-theory model (MTM) of health behavior change to explain health behaviors: A systematic review.

The utilization of a theoretical framework is vital in health promotion research, particularly when endeavoring to modify health behaviors. This systematic review aimed at evaluating and synthesizing evidence through studies conducted using the fourth-generation multi-theory model (MTM) of health behavior change for its effectiveness. A comprehensive article search was performed across MEDLINE, CINAHL, and Academic Search Premier. The search focused on studies utilizing MTM from 2016 to December 2023, following the PRISMA guidelines for systemic reviews. An initial pool of 7583 articles was narrowed down through screening of titles, abstracts, and full texts. A total of 69 articles met the inclusion criteria. These studies, encompassing a global range of diverse target groups and health behaviors, were categorized as qualitative, cross-sectional, or experimental. The six qualitative studies revealed MTM themes for diverse health behaviors. The fifty-six cross-sectional studies showed MTM constructs effectively predicting behavior change, albeit with varying statistical significance. The seven experiments demonstrated MTM's role in initiating and sustaining change. For the initiation model, operationalized by 49 studies, the mean adjusted R2 was 38.4% (SD=16.4%). For the sustenance model, operationalized by 45 studies, the mean adjusted R2 was 38.9% (SD=15.5%). This systematic review corroborates the MTM as a potent framework for understanding, predicting, and facilitating health behavior changes. Its universal applicability and effectiveness underscore the model's potential as a foundational tool in designing future health promotion strategies and interventions aimed at positive and enduring behavior modifications.

IJCM_201A: Understanding psychological stress in working women: A cross-sectional study in Mangalore

Background: Stress is defined by American Psychological Association is “Any uncomfortable emotional experience accompanied by predictable biochemical, physiological and behavioral changes.” It is a feeling of being overwhelmed, worried or run-down. Stress affects people of all ages, gender and circumstances and can lead to both physical and psychological health issues. Social contexts and family structures are particularly impacted by stress in women. This study aims to assess the levels of stress and associated factors of stress among working women in Mangalore. Methodology: This cross-sectional study was conducted among 298 working women, who were managerial staff/Clerical staff recruited from 2 Banks, 2 shopping malls, health care workers from 2 hospitals and doctors/ clerical staff from Medical College, Mangalore. Data was collected using a semi- structured questionnaire including sociodemographic characteristics and perceived stress scale and analyzed using SPSS version 24. Results were expressed in mean (standard deviation) and proportion. For comparison across the groups chi-square test was used. A ‘p’ value of less than 0.05 was considered statistically significant. Results: Out of 298 women surveyed, 3.4% were found to be highly stressed, 83.9% were moderately stressed. Significant stress determinants were found to be associated with age, education, occupation, years of work experience and marital status- where the association is statistically significant. Working women prefer to go for leisure activities like outing with friends and family to reduce stress while other activities like smoking and alcohol consumption were least popular among the study participants. Conclusion: The study emphasizes the critical elements—age, education, employment, job experience, and years since marriage—that significantly influence women’s stress levels. Furthermore, it highlights that for working women, entertainment is the main way to decompress, and employers need to take note of this to help staff members maintain a healthy work-life balance.

Identifying trusted local sources and predicting behavior change pathways according to COVID-19 vaccination status: Results of a 2022 statewide survey of Alaskan adults

BackgroundLow rates of COVID-19 vaccination remain a substantial public health challenge. Despite early successes, vaccinations of Alaskans trail the US average, drawing attention to the need for better-designed and targeted vaccine confidence interventions. Our objective was to assess levels of community trust and theory-driven predictors of vaccination status to inform the design of future programs. MethodsWe conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status. FindingsAmong those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated, a sense of professional responsibility, and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated, perceived risks from non-vaccination and whether vaccination is a healthy choice. ConclusionsThese findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted.

Effects of N-acetylcysteine and acetyl-L-carnitine on acute PTZ-induced seizures in larval and adult zebrafish.

Epilepsy is a prevalent neurological disease, affecting approximately 1-2% of the global population. The hallmark of epilepsy is the occurrence of epileptic seizures, which are characterized by predictable behavioral changes reflecting the underlying neural mechanisms of the disease. Unfortunately, around 30% of patients do not respond to current pharmacological treatments. Consequently, exploring alternative therapeutic options for managing this condition is crucial. Two potential candidates for attenuating seizures are N-acetylcysteine (NAC) and Acetyl-L-carnitine (ALC), as they have shown promising neuroprotective effects through the modulation of glutamatergic neurotransmission. This study aimed to assess the effects of varying concentrations (0.1, 1.0, and 10mg/L) of NAC and ALC on acute PTZ-induced seizures in zebrafish in both adult and larval stages. The evaluation of behavioral parameters such as seizure intensity and latency to the crisis can provide insights into the efficacy of these substances. Our results indicate that both drugs at any of the tested concentrations were not able to reduce PTZ-induced epileptic seizures. On the other hand, the administration of diazepam demonstrated a notable reduction in seizure intensity and increased latencies to higher scores of epileptic seizures. Consequently, we conclude that, under the conditions employed in this study, NAC and ALC do not exhibit any significant effects on acute seizures in zebrafish.

Barriers and Enablers to Implementing Teledentistry From the Perspective of Dental Health Care Professionals: Protocol for a Systematic Quantitative, Qualitative, and Mixed Studies Review.

There is growing literature on the potential of digital technologies for improving access to, ensuring continuity and quality of health care, and to strengthen health systems. Some studies have reported the cost-effectiveness of teledentistry, its reliability for remote dental screening, diagnosis, consultation, and treatment planning. Nonetheless, current evidence suggests that teledentistry implementation faces many challenges and is not yet adopted by dental health care providers (DHCPs). Developing strategies to improve teledentistry adoption requires an understanding of the factors that promote or hinder its successful implementation. This systematic review aims to identify and synthetize barriers and enablers to implementing teledentistry as perceived by DHCPs in their clinical practices, using the Theoretical Domains Framework (TDF) and the Capacity, Opportunity, and Motivation Behavior (COM-B) model. This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Protocols) checklist. Literature will be searched in the following databases: PubMed, Cochrane Library, Web of Science, CINAHL, Embase, and PsycINFO. We will perform additional searches on Google, Google Scholar, and ProQuest Dissertations & Theses Global, screen the references of the included studies to capture additional relevant studies, and contact the authors of studies if we need more details. We will consider studies using qualitative, quantitative, and mixed methods. There will be no restrictions on the publication date and dental setting. We will include studies published in French, English, and Portuguese. Two independent reviewers will select the study, extract data, and assess methodological quality using the Mixed Methods Appraisal Tool's checklist. Data analysis will include a descriptive and a thematic content analysis. We will synthetize and categorize the barriers and enablers using the TDF and COM-B model and present a narrative synthesis of our results using tables, figures, and quotes. By March 2023, the literature search has retrieved 7355 publications. We will identify the range of barriers and enablers to implementing teledentistry through DHCPs' perspectives. Considering the critical need for theory-based implementation interventions to improve the use of evidence-informed practices, we will synthesize the factors influencing the adoption of teledentistry based on the TDF domains and the 3 essential conditions predicting behavior change in accordance with the COM-B model. As needed, we will include additional determinants if not included in the TDF. We will conduct some subgroups analyses if studies are sufficient. We expect to complete the review by July 2024. This review will provide some insights on the determinants of teledentistry implementation as perceived by DHCPs in dental settings. These findings will cater to patients, families, DHCPs, researchers, academic and professional decision-makers, and policy makers. The results of the systematic review could be used to develop theory-led interventions in improving teledentistry implementation. PROSPERO CRD42021293376; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=293376. PRR1-10.2196/44218.

Be prepared to act as a ‘first responder’ for rising rates of student stress

About 80% of post‐pandemic college students in 2022 remained stressed, often exhibiting related health problems, according to the American Psychological Association. Along with anxiety and depression, stress remains among the top three mental health issues. A succinct definition of stress by researcher Andrew Baum states that stress is an “emotional experience accompanied by predictable biochemical, physiological and behavioral changes.”

Be prepared to act as a “first responder” for rising rates of student stress

According to the American Psychological Association, in 2022, about 80% of post‐pandemic college students remained stressed, often exhibiting related health problems. Along with anxiety and depression, stress remains among the top three mental health issues. A succinct definition of stress by researcher Andrew Baum states that stress is an “emotional experience accompanied by predictable biochemical, physiological and behavioral changes.”

The Impact of Social Media Interventions on Weight Reduction and Physical Activity Improvement Among Healthy Adults: Systematic Review.

A sedentary lifestyle and being overweight or obese are well-established cardiovascular risk factors and contribute substantially to the global burden of disease. Changing such behavior is complex and requires support. Social media interventions show promise in supporting health behavior change, but their impact is unclear. Moreover, previous reviews have reported contradictory evidence regarding the relationship between engagement with social media interventions and the efficacy of these interventions. This review aimed to critically synthesize available evidence regarding the impact of social media interventions on physical activity and weight among healthy adults. In addition, this review examined the effect of engagement with social media interventions on their efficacy. CINAHL and MEDLINE were searched for relevant randomized trials that were conducted to investigate the impact of social media interventions on weight and physical activity and were published between 2011 and 2021 in the English language. Studies were included if the intervention used social media tools that provided explicit interactions between the participants. Studies were excluded if the intervention was passively delivered through an app website or if the participants had a known chronic disease. Eligible studies were appraised for quality and synthesized using narrative synthesis. A total of 17 papers reporting 16 studies from 4 countries, with 7372 participants, were identified. Overall, 56% (9/16) of studies explored the effect of social media interventions on physical activity; 38% (6/16) of studies investigated weight reduction; and 6% (1/16) of studies assessed the effect on both physical activity and weight reduction. Evidence of the effects of social media interventions on physical activity and weight loss was mixed across the included studies. There were no standard metrics for measuring engagement with social media, and the relationship between participant engagement with the intervention and subsequent behavior change was also mixed. Although 35% (6/16) of studies reported that engagement was not a predictor of behavior change, engagement with social media interventions was found to be related to behavior change in 29% (5/16) of studies. Despite the promise of social media interventions, evidence regarding their effectiveness is mixed. Further robust studies are needed to elucidate the components of social media interventions that lead to successful behavior change. Furthermore, the effect of engagement with social media interventions on behavior change needs to be clearly understood. PROSPERO International Prospective Register of Systematic Reviews CRD42022311430; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=311430.

Computational Simulation Model to Predict Behavior Changes in Inflammatory Bowel Disease Patients during the COVID-19 Pandemic: Analysis of Two Regional Japanese Populations.

Managing inflammatory bowel disease (IBD) is a major challenge for physicians and patients during the COVID-19 pandemic. To understand the impact of the pandemic on patient behaviors and disruptions in medical care, we used a combination of population-based modeling, system dynamics simulation, and linear optimization. Synthetic IBD populations in Tokyo and Hokkaido were created by localizing an existing US-based synthetic IBD population using data from the Ministry of Health, Labor, and Welfare in Japan. A clinical pathway of IBD-specific disease progression was constructed and calibrated using longitudinal claims data from JMDC Inc for patients with IBD before and during the COVID-19 pandemic. Key points considered for disruptions in patient behavior (demand) and medical care (supply) were diagnosis of new patients, clinic visits for new patients seeking care and diagnosed patients receiving continuous care, number of procedures, and the interval between procedures or biologic prescriptions. COVID-19 had a large initial impact and subsequent smaller impacts on demand and supply despite higher infection rates. Our population model (Behavior Predictor) and patient treatment simulation model (Demand Simulator) represent the dynamics of clinical care demand among patients with IBD in Japan, both in recapitulating historical demand curves and simulating future demand during disruption scenarios, such as pandemic, earthquake, and economic crisis.

Waitlist mortality in pediatric liver transplantation: The goal is zero.

Waitlist mortality in pediatric liver transplantation: The goal is zero.

Predicting Behavior Change in Students With Special Education Needs Using Multimodal Learning Analytics

Predicting Behavior Change in Students With Special Education Needs Using Multimodal Learning Analytics

“I am fatigued of being stigmatized”: On the need to investigate stigma-related barriers to physical activity

Understanding what predicts behavior change is a hot topic in health psychology, especially with regard to physical activity. While existing research has revealed key factors of physical activity (e.g., reasoned cognitions, automatic processes), it fails to accurately identify those that are specific to the most inactive populations (e.g., older adults, obese individuals, women, people living with chronic disease). In this commentary, we propose to articulate current approaches of health behavior change with the social psychology of stereotypes, based on the observation that inactive groups are often targeted by negative stereotypes. This articulation may allow to better identify the barriers to physical activity that are specific to individuals from the most inactive groups. More particularly, we propose that low self-control resources, indexed by perceived fatigue, and negative self-perceptions may be key factors of physical inactivity in these individuals. This proposition could in turn help to explain why some behavioral change techniques that are efficient in healthy or young adults are inefficient in other individuals.

MindingMe: A Feasibility Study on Conducting Neuroimaging Research Among Diverse Groups.

Neuroimaging tools, such as functional magnetic resonance imaging, are useful in understanding differences in brain activity that predict behavior change. Designing interventions based on brain activity and response may enhance current self-management regimens. Yet, diverse groups, such as Black women with chronic illness, have historically been left out of neuroimaging research. The aims of this study were to assess (a) the feasibility of conducting neuroimaging research among Black women with hypertension and (b) the predictors of willingness to participate in future studies. A survey designed to assess interest in participating in neuroimaging research was distributed through a Facebook campaign targeting Metro-Detroit Blacks with hypertension. A 10-minute, 44-item survey queried the women regarding their perspectives related to participation in neuroimaging studies. Logistic regression analyses were conducted to predict willingness to participate in a future study; they included a range of predictors: demographic indicators, history of blood pressure diagnosis, systolic and diastolic blood pressure, and availability of a support person who could accompany the participant to a future study session. Two hundred fifty-seven Black women completed the survey. On average, the women were 59 years old, had been diagnosed with hypertension for 14 years, and had a systolic blood pressure of 141 mmHg. Participants were willing to travel 40 miles to participate, and many preferred to drive a personal vehicle. Some women were claustrophobic (20%) or had metal in their bodies (13%) and, therefore, would likely be ineligible to participate in neuroimaging studies. Some were nervous about the "small space" of a scanner, but others stated they would "enjoy participating" and wanted to "help future people…get well." Women who had a support person to attend their appointment with them were almost 4 times more likely to state they would participate in future studies. Those who had been diagnosed with hypertension for more than 11 years (the median) were almost 3 times more likely to report interest in participating in a future study than those participants who had been diagnosed with hypertension for 11 years or less. Black women with hypertension were interested and eligible to participate in neuroimaging research. Despite some of the facilitators and barriers we identified, the women in our sample were interested in participating in future studies. The presence of a support person and length of time with a hypertension diagnosis are important predictors of willingness to participate in a future study.

Application of a sensory evaluation methodology for recipes utilized in federal nutrition education programs

Federal nutrition education programs utilize recipe demonstrations to engage with low-income participants and promote healthy eating behaviors; however, recipes created for these programs are developed in state extension offices or in collaboration with local cooks/chefs, and the fit of the recipes within their educational programming is subjective. Thus, a sensory evaluation methodology was developed to support recipe and curricula development. It is intended for use with a unique population of low-income participants of federal nutrition education programs in central locations. The inclusion of sensory evaluation methods allows state extension staff to make sensory attribute-specific improvements to their recipes prior to implementing them in their curricula. This article will detail the methodology that has been used for two successful studies in the community and briefly explain the researchers' “lessons learned,” suggested statistical analyses and relationships to analyze, and the future implications of this methodology. Practical Applications To encourage behavior change and promote healthy eating, nutrition education programs can utilize this sensory evaluation methodology to guide their recipe development and curricula decisions. The inclusion of sensory evaluation may present with an upfront higher recipe testing cost and increased time required by stakeholders to provide feedback, but it offers a deeper understanding of the target audiences' likes and dislikes. This information can be used to determine gaps in information on specific foods or nutrients within nutrition education lessons, to improve upon the recipe offerings in direct education, and to inform recipe development as new recipes are introduced to the target audience. Finally, the addition of questions related to preparation or purchase intent may allow content developers of these programs to infer the practicality of the recipes and predict behavior change.

COVID-19-Related Perceived Threat Following a Second Dose Vaccination in Adults with Chronic Illness: A Mixed-Method Study.

BackgroundIn patients with comorbidities such as chronic illness, the severity and mortality risk of the disease (COVID-19) are high. Even if they are fully vaccinated, they should follow all precautions for unvaccinated people because the vaccine may not provide them complete protection. As a result, understanding their response to a threat is essential because knowing their threat level can be a good predictor of behavioral changes and health-protective behaviors.MethodsAn institution-based cross-sectional mixed-method study design was used at the University of Gondar specialized hospital from May 1 to June 30, 2021. An interviewer-administered questionnaire was used for the quantitative, and tape recorders, field notes, and memos were properly taken during the in-depth interviews for the qualitative data. Multivariable logistic regression with consideration of adjusted odds ratio of 95% confidence interval and p-value of 0.05% was used for statistical significance.ResultsThe study enrolled 239 people, with a 96% response rate, ranging from 24 to 67 years, with the majority (57.9%) male. Even after receiving the second dose of AstraZeneca, nearly half (46.5%) of participants with a chronic illness perceived a threat to COVID-19. The participant’s age ranges from 24 to 34 years [3.24 (AOR= 3.24 (95% CI: 1.08, 9.68))], patients who are student [2.38 (AOR= 2.38 (95% CI: 1.12, 5.06))], participants applying the recommended behavioral response [2.36 (AOR=2.36 (95% CI: 1.16, 4.81))] and duration of illness ranged from four to six-year [3.17 (AOR=3.17 (95% CI (1.05, 9.58))] were statistically associated with perceived threat.ConclusionMost people with chronic illnesses do not see the disease as a threat. Particular emphasis should be placed on creating awareness programs and disseminating information through media on prevention, and ongoing health education is strongly advisable.

Intention to change multiple health risk behaviors and predictors of behavior change in vocational education students

Objective: No studies have examined vocational education students’ intention to change multiple health risk behaviors and whether baseline characteristics predict behavior change. Participants: Paticipants were vocational education students in New South Wales, Australia. Methods: Students in the no-intervention control arm of a cluster randomized controlled trial completed an online survey at baseline and 6 months later. Results: Of 450 participants (83.3%) who reported multiple health risk behaviors at baseline, one-third (33.1%) intended to change at least two risk behaviors within 6 months. Participants experiencing symptoms of anxiety [OR = 7.43, 95% CIs 1.26–43.87; p = 0.03] and who intended to change three to four risk behaviors [OR = 23.30, 95% CIs 4.01–135.40; p = 0.001] rather than one behavior had significantly greater odds of changing at least one behavior in 6 months. Conclusions: Interventions could support vocational education students to change behaviors they wish to as well as motivate them to address other risk behaviors.

Youth Level of Service/Case Management Inventory Assessments as Predictors of Behavioral Change in Multisystemic Therapy and Functional Family Therapy in Norway

Background: Multisystemic Therapy (MST) and Functional Family Therapy (FFT) are evidence-based Blueprint programs shown to be effective towards youth problem behaviors. Purpose: The present study aimed to investigate treatment outcomes following MST and FFT among Norwegian youths with serious behavior problems. Research design: Routine Outcome Monitoring (ROM) data of the Youth Level of Service/Case Management Inventory at intake and post-test was used along with measures of five national treatment goals. Study sample: The study is based on two samples of youths assigned to MST ( n = 2018) and FFT ( n = 453). Analysis: Data were analyzed separately for MST and FFT, to explore changes during treatment and accomplishment of the treatment goals. Results: At intake youths in MST showed a significant higher level of risk factors compared to those referred to FFT. Significant reductions in risk factors and behavioral problems were evident for both interventions. Follow-up results demonstrated sustained reductions of problem behaviors. Conclusion: Both treatments decrease risk factors and increase the completion of outcome goals. Implications of the results are discussed.

The International Assessment of COVID-19-related Attitudes, Concerns, Responses and Impacts in Relation to Public Health Policies (iCARE) study

Abstract Issue/problem COVID-19 global pandemic has had significant health, social and financial impacts on global communities. Many of the national mitigation strategies to curb the virus spread have been targeting human behaviours. Insights from behavioural sciences are crucial for effective community engagement and positive behaviour change on a population-level. Description of the study The iCARE Study (which is co-funded by CIHR and the Quebec government) is a multi-wave, international observational study of public awareness, attitudes, concerns and behavioural responses to public health policies implemented to reduce the spread of COVID-19 (www.icarestudy.com). Survey data is being continuously collected in 6 week rounds (since March 2020) using representative sampling (in Canada, Italy, Israel, France, Ireland, Australia, Colombia etc.) and convenience sampling methodology (globally). The survey was constructed around the: (1) The COM-B (Capability, Opportunity, Motivation-Behaviour) model; and the (2) The Health Beliefs Model, which provide a framework for understanding factors that predict behaviour change on a population level. Results The iCARE study leverages an existing online assessment platform, and has received over 90,000 survey responses to date. This research initiative provides real-time evidence to support COVID-19 policy strategy and communication around the world, through a global multi-stakeholder engagement that gathers expertise from almost 200 collaborators in 40 countries. Of note, the study has received a range of local, national and international media coverage and directly inputted into several government policies. Lessons iCARE study is an example of a successful intersectorial, collaborative research and policy initiative that leverages multiple stakeholders to bring behavioural perspective at the forefront of the development and delivery of public health policies globally.

Role of theories in school-based diabetes care interventions: A critical review.

BACKGROUNDDiabetes is one of the most common chronic diseases of childhood. School plays an essential role in the management of student diabetes, which reduces the risk of short- and long-term diabetes complications and ensures that students are well-positioned for optimal academic performance and growth.AIMThe aim of this review was to systematically identify and synthesize the literature concerning theory-based diabetes care interventions in K-12 schools in the United States. It critically assessed the specific role of theories and associated essential constructs in intervention design, implementation, outcome measurement, and evaluation.METHODSRelevant literature was identified by keyword searches of the Cochrane Library, PubMed, and Web of Science.RESULTSFour interventions met the eligibility criteria and were included in the review. Of those, two evaluated online diabetes education programs for school personnel and the other two assessed in-person interventions. Three studies adopted a one-group pre-post study design, and the remaining one adopted a one-shot case-study design. Three of the interventions adopted social cognitive theory, and the remaining one was guided by the diffusion of innovations theory. Three studies identified core constructs of a theory as predictors of behavioral change. Two used theory to select or develop intervention techniques. Two studies used theory to customize participant intervention techniques. Two studies discussed their findings in the context of theory. No study used theory to select potential intervention participants.CONCLUSIONIn conclusion, despite the value of theory in intervention design and evaluation, theory-based diabetes interventions at school remain scarce. Future research may seek ways to better integrate theory and empirical research.