Role In Behavioral Changes Research Articles

Successes and lessons learned from a mobile health behavior intervention to reduce pain and improve health in older adults with obesity and chronic pain: a qualitative study.

Chronic pain is a prevalent issue among older adults in the United States that impairs quality of life. Physical activity has emerged as a cost-effective and non-pharmacological treatment for chronic pain, offering benefits such as improved physical functioning, weight loss, and enhanced mood. However, promoting physical activity in older individuals with chronic pain is challenging, given the cyclical relationship between pain and sedentary behavior. The Mobile Intervention to Reduce Pain and Improve Health (MORPH) trial was designed as an innovative, mobile health (mHealth) supported intervention to address this issue by targeting daylong movement, weight loss, and mindfulness to manage pain in older adults with chronic multisite pain. The objective of this paper is to provide the result of a qualitative analysis conducted on post-intervention interviews with MORPH participants. At the conclusion of the MORPH study, 14 participants were interviewed regarding their experience with the program. All interviews were conducted by phone before being transcribed and verified. A codebook of significant takeaways was created based on these accounts. Summaries were further synthesized into themes using the principles of thematic analysis. Three key themes of the MORPH intervention emerged from the qualitative interviews: MORPH technology (smart scales, Fitbit, MORPH Companion App) facilitated program adherence and accountability; MORPH intervention components (food tracking and mindfulness activities) facilitated program adherence and awareness, respectively; and, group meetings provided motivational support and accountability. Mobile health technologies, including a dedicated MORPH app, facilitated self-monitoring strategies, helped to break the cycle of old habits, and provided participants with immediate feedback on successes; however, technical issues required timely support to maintain engagement. Food tracking contributed to adherence and accountability for weight loss. Mindfulness activities increased participants' awareness of anxiety provoking thoughts and pain triggers. Finally, social support via group meetings and connection, played a crucial role in behavior change, but participants noted consistency in the delivery medium was essential to fostering genuine connections. Overall, the study results highlight the key considerations related to program technology, intervention components, and the value of social support that can help to guide the development of future interventions similar to MORPH.

Neural correlates of drinking reduction during a clinical trial of cognitive behavioral therapy for alcohol use disorder.

Cognitive behavioral therapy (CBT) is an effective treatment for alcohol use disorder (AUD). We hypothesized that the dorsolateral prefrontal cortex (DLPFC), a region implicated in cognitive control and goal-directed behavior, plays a role in behavior change during CBT by facilitating the regulation of craving (ROC). Treatment-seeking participants with AUD (N = 22) underwent functional magnetic resonance imaging (fMRI) scanning both before and after a 12-week, single-arm trial of CBT, using an ROC task that was previously shown to engage the DLPFC. We found that both the percentage of heavy drinking days (PHDD) and the overall self-reported alcohol craving measured during the ROC task were significantly reduced from pre- to post-CBT. However, we did not find significant changes over time in either the ability to regulate craving or regulation-related activity in any brain region. We found a significant 3-way interaction between the effects of cue-induced craving, cue-induced brain activity and timepoint of assessment (pre- or post-CBT) on PHDD in the left DLPFC. Follow-up analysis showed that cue-induced craving was associated with cue-induced activity in the left DLPFC among participants who ceased heavy drinking during CBT, both at pre-CBT and post-CBT timepoints. No such associations were present at either timepoint among participants who continued to drink heavily. These results suggest that patients in whom DLPFC functioning is more strongly related to cue-induced craving may preferentially respond to CBT.

Health risk perceptions of household air pollution and perceived benefits of improved stoves among pregnant women in rural Ethiopia: a mixed method study

ObjectiveSince community perceptions of the risk of biomass smoke and the benefits of improved stoves play a critical role in behaviour change to the uptake and sustainable utilisation of improved...

Life after "no": barriers to behavior change for persons declined hernia repair due to high-risk features.

Delaying an elective operation to mitigate risk factors improves patient outcomes. Elective ventral hernia repair is one such example. To address this issue, we developed a pre-operative optimization clinic to support high-risk patients seeking elective ventral hernia repair. Unfortunately, few patients progressed to surgery. Within this context, we sought to understand the barriers to behavior change among these patients with the goal of improving care for patients undergoing elective surgery. We performed semi-structured, qualitative interviews with 20 patients who were declined ventral hernia repair due to either active tobacco use or obesity. Patients were recruited from a pre-operative optimization clinic at an academic hospital. Interviews sought to characterize patients' perceived barriers to behavior change. Interviews were concluded once thematic saturation was reached. We used an inductive thematic analysis to analyze the data. All data analysis was performed using MAXQDA software. Among 20 patients (mean age 50, 65% female, 65% White), none had yet undergone ventral hernia repair. While most patients had a positive experience in the clinic, among those who did not, we found three dominant themes around behavior change: (1) Patient's role in behavior change: how the patient perceived their role in making behavior changes optimize their health for surgery; (2) Obtainability of offered resources: the need for more support for patients to access the recommended healthcare; and (3) Patient-provider concordance: the extent to which patients and providers agree on the relative importance of different attributes of their care. Behavior change prior to elective surgery is complex and multifaceted. While improving access to tobacco cessation resources and obesity management may improve outcomes for some, patients may benefit from increased on-site facilitation to promote access to resources as well as the use of patient-facing decision support tools to promote patient-provider concordance.

The effect of chronic experimental toxoplasmosis on some brain neurotransmitters level and behavior changes

Toxoplasma is capable of causing long-lasting brain cysts in its hosts, which can lead to physiological disturbances in brain neurotransmitters and result in changes in the host's behavior. This study aimed to investigate these changes using an experimental model.Twenty-five female Wistar rats, weighing 220-220 g and six weeks old, were selected for the study. The rats were divided into two control and experimental groups. The experimental group was injected with 5 × 105 tachyzoites of Toxoplasma gondii (virulent RH strain) intra-peritoneally. Four months after the injection, the rats were subjected to behavioral tests, including learning, memory, depression, and locomotor activity tests. The rats were then euthanized, and their brain and serum samples were analyzed for dopamine and serotonin levels. To ensure the presence of cysts in the brain tissue, a PCR test and preparation of pathological slides from the brain tissue were performed.The results showed that the amount of dopamine in the brain of the infected group was significantly higher than that of the control group, while the level of serotonin in brain of the infected group was significantly lower than that of the control group (P < 0.05). However, no significant difference was observed in the amount of these neurotransmitters in the blood of the two groups (P > 0.05). Behavioral changes were evaluated, and it was found that the learning and memory levels of the infected rats were significantly lower than those of the control group (P < 0.05), but no difference was observed in locomotor activity between the two groups (P > 0.05). This experimental infection model indicated that changes in neurotransmitter levels lead to behavior changes. ConclusionThe presence of parasite cysts in the brain can affect some of the host's behaviors through changes in neurotransmitter levels. Therefore, there is a possibility that there is a relationship between the presence of Toxoplasma cysts in the brain and neurological disorders. The results of this study suggest that chronic toxoplasmosis may play a role in behavior changes in psychotic diseases.

How Do Abnormalities in the Cerebrospinal Fluid Impact Neuropsychology with Progressing Age?

The behavior of an individual changes from neonate to elderly due to the development of the central nervous system (CNS). One of the important components of the CNS is the cerebrospinal fluid (CSF), which bathes the brain and spinal cord. CSF has changing properties throughout life, including composition and volume imbalance. However, a specific age group that shows prevailing abnormality- corresponding behavior remains unclear. The objective of this article is to explore how such changes reflect on one's psychological as well as physical processing. Production of CSF could be affected by many factors, including its flow, absorption, volume, and composition. Prenatally, congenital malformations and infections hold the greatest risk of impacting the child's physical and mental growth. In adolescents, transmission of external substances like alcohol or drugs in the cerebrospinal fluid is known to impact severe mood changes that potentially result in suicide and depression. In the adult working population, the influence of stress levels on CSF composition causes anxiety and sleep disorders. Finally, the reduced production of CSF was found to be associated with memory deficits and Alzheimer's disease in the aging group. From the collected evidence, it can be observed that CSF played an important role in behavioral changes and may be associated with neurodegenerations. By linking the CSF abnormalities to the clinical symptoms at different stages of life, it may provide additional information in the diagnosis of diseases that are associated with neuropsychological changes.

Development of an IEC resource (brochure) on suicide prevention for college students: A qualitative study in the Indian context.

Information Education Communication (IEC) materials play a vital role in behavior change by raising awareness about health issues. In India, suicide is the leading cause of death in the age group of 15-39 years, exemplifying the pressing need for raising awareness about suicide prevention. This study aimed to develop a brochure on suicide prevention for young adults with the help of scientific methodology. A cross-sectional qualitative research design was used in the study, and purposive sampling was used to collect the data. The study analyzed the awareness level and existing knowledge gap about suicide prevention among college students with the help of focus group discussions (FGDs) conducted independently among mental health experts, college teachers, and college students. Based on the findings from the FGDs, a comprehensive brochure was developed. The qualitative data collected by FGDs were analyzed using direct content analysis. The findings of the FGDs helped identify the knowledge gaps with regard to young adult suicide prevention, and a brochure was prepared to address the same. The development of young adult suicide prevention IEC resources pertinent to Indian settings is crucial. To bridge the knowledge gap on suicide prevention among college students and raise awareness, a brochure was developed based on scientific findings of the FGDs.

Transcription Factors as Important Regulators of Changes in Behavior through Domestication of Gray Rats: Quantitative Data from RNA Sequencing.

Studies on hereditary fixation of the tame-behavior phenotype during animal domestication remain relevant and important because they are of both basic research and applied significance. In model animals, gray rats Rattus norvegicus bred for either an enhancement or reduction in defensive response to humans, for the first time, we used high-throughput RNA sequencing to investigate differential expression of genes in tissue samples from the tegmental region of the midbrain in 2-month-old rats showing either tame or aggressive behavior. A total of 42 differentially expressed genes (DEGs; adjusted p-value < 0.01 and fold-change > 2) were identified, with 20 upregulated and 22 downregulated genes in the tissue samples from tame rats compared with aggressive rats. Among them, three genes encoding transcription factors (TFs) were detected: Ascl3 was upregulated, whereas Fos and Fosb were downregulated in tissue samples from the brains of tame rats brain. Other DEGs were annotated as associated with extracellular matrix components, transporter proteins, the neurotransmitter system, signaling molecules, and immune system proteins. We believe that these DEGs encode proteins that constitute a multifactorial system determining the behavior for which the rats have been artificially selected. We demonstrated that several structural subtypes of E-box motifs—known as binding sites for many developmental TFs of the bHLH class, including the ASCL subfamily of TFs—are enriched in the set of promoters of the DEGs downregulated in the tissue samples of tame rats’. Because ASCL3 may act as a repressor on target genes of other developmental TFs of the bHLH class, we hypothesize that the expression of TF gene Ascl3 in tame rats indicates longer neurogenesis (as compared to aggressive rats), which is a sign of neoteny and domestication. Thus, our domestication model shows a new function of TF ASCL3: it may play the most important role in behavioral changes in animals.

Promoting Health and Behavior Change through Evidence-Based Landscape Interventions in Rural Communities: A Pilot Protocol.

Rural communities in the United States have many public health issues, including a high prevalence of physical inactivity, obesity, and higher risks for major non-communicable diseases. A lack of safe and convenient places to exercise could intensify healthy lifestyle disparities. Individually adapted physical activity prescriptions at the primary level of healthcare could play a role in behavior change for rural residents. Healthcare professionals and designers created the rural wellness hub concept, which integrates walking trails and therapeutic landscape features on the clinic site, to support patient physician-prescribed activities and treatments. This research protocol reports the design and implementation of the rural wellness hub at a clinic in Clay County, West Virginia. Following a participatory, evidence-based landscape intervention (EBLI) protocol, 58 user representatives (patient = 49; clinic employee = 9) participated in the four-phase protocol: (1) pre-design survey, (2) design and development, (3) post-design interview, and (4) post-occupancy evaluation. Survey and interview data from all phases were collected and analyzed. The preliminary results indicate that the redesigned clinic campus could promote several health programs among local communities, with the benefits of walking trails, in particular, highlighted. The rigorous EBLI protocol could serve as a template for rural communities that seek to develop similar healthcare intervention programs.

TO ESTABLISH PEER SUPPORT STRATEGIES FOR DECREASING OUT-OF-SEAT BEHAVIOUR FOR LEARNERS WITH AUTISM SPECTRUM DISORDERS IN SPECIAL SCHOOLS, EMBU COUNTY, KENYA

The study sought to establish peer-support strategies used in decreasing out-of-seat behaviour for learners with Autism Spectrum Disorders in special schools, in Embu County, Kenya. The study used Abraham Maslow's hierarchy of needs. This theory states that the motivation of human needs is acquired at different levels. The study adopted a survey research design. The study target population were 25 headteachers, 48 teachers, 65 parents and 5 EARCS from 2 special schools and 23 special units in Embu County. Purposive sampling was employed. The sample size constituted 20% of 25 schools, 5 head teachers, 32 teachers, 10 parents, and 5 EARCs translating to 62 respondents. Questionnaires were used to collect data from the headteachers and teachers, an interview schedule was conducted on parents/guardians and an observation checklist was used to observe learners with Autism Spectrum Disorders in class. Piloting was done at St. Monica School for Intellectual Disabled to enhance the validity and reliability of the research instruments. Data were analysed using Statistical Package for Social Sciences (SPSS) computer presented program and findings were presented in form of frequency distribution tables, bar graphs and pie charts. Findings of the study revealed that most teachers have existing self-management techniques aimed at reducing out-of-seat behavior. The pupils were generally happy with the techniques the teachers had set together. Similarly, the teachers were happy to carry out the existing peer support techniques to reduce out-of-seat behavior. Most teachers strongly agreed that by observing what peers do, children develop self-efficiency. The study concluded that the use of peer support strategies play a significant role in behaviour change among children with ASD because the strategy enables them to come together, share experience and decide on solutions to a common challenge. The study recommended that the Ministry of Education should put in place measures to compel schools through monitoring and capacity building such as training to ensure that SNE learners’ are appropriately placed. The government should allocate extra funds to public primary special schools to help them procure materials for SNE learners to prepare the schools for the implementation of SNE curriculum. Further research should be carried out in all counties in Kenya on peer-support strategies for decreasing out-of-seat behaviour in learners with Autism Spectrum Disorders. Similarly, other areas regarding learners with Autism Spectrum Disorders should be explored.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0569/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

The motivational roots of sustainable diets: Analysis of food choice motives associated to health, environmental and socio-cultural aspects of diet sustainability in a sample of French adults

Achieving sustainable healthy diets for all will require substantial changes in individuals' food choices. Motivation plays a central role in behaviour change, yet little is known about the relationship between food choice motives and sustainability of the overall diet. The present study explored the relationship between food choice motives and different facets of diet sustainability in order to emphasize individuals' motivational supports and barriers regarding diet sustainability. We analysed food choice motives and dietary data collected through online questionnaires in 938 French adults (79% female, mean age ​= ​39y (SD ​= ​12)). The importance of nine food choice motives was assessed and three overarching motivational dimensions were derived from a principal component analysis on food choice motives: ‘health and sustainability, ‘ease and accessibility’ and ‘pleasure’. Food intakes were recorded using a food frequency questionnaire and six indicators of diet sustainability were calculated: nutritional quality, environmental impact, adherence to the EAT-Lancet diet, organic food consumption, local food consumption and ready-to-eat meals consumption. ‘Health and sustainability’ motives were consistently positively associated with diet sustainability indicators. On the contrary, ‘ease and accessibility’ motives were consistently negatively associated with diet sustainability. Associations between ‘pleasure’ motives and diet sustainability were mixed. Based on these results, it seems equally important to promote individuals' awareness of health and environmental impacts of food as to increase the accessibility of convenient sustainable healthy food products to support individuals' food choices towards sustainable diets. • Motivation plays a central role in food choice decision. • ‘Health and sustainability’ motives are associated with more sustainable diets. • ‘Ease and accessibility’ motives are associated with less sustainable diets. • Changing motivations may help to initiate a shift towards more sustainable diets. • Reshaping the food environment may help to make sustainable food choices easier.

Association between COVID-19 preventive behavioral changes and anxiety in Karachi, Pakistan: A cross-sectional pilot study

BackgroundCOVID-19 has turned into emergent psychological impacts across cohorts with devastating consequences related to preventive measures. Health organizations recommended some preventive measures (e.g., wearing masks, frequent handwashing, etc.) to overcome the COVID-19 pandemic. However, performing these behaviors may increase anxiety among populations. Thus, the present study aimed to investigate the role of behavioral changes to prevent COVID-19 infection and anxiety during the COVID-19 pandemic in Pakistan. Subjects and methodsThe present cross-sectional study was conducted for 10 days during July 2020 among the general public of Karachi after the imposition of lockdown amid the COVID-19 pandemic, with a sample size of 331 participants. The questionnaire consisted of three parts i.e., (i) socio-demographics, (ii) perception and preventive behaviors towards COVID-19, and (iii) anxiety-related questions using the Urdu Generalized Anxiety Disorder (GAD-7). The data was analyzed using logistic regression to investigate the association between behavior change and anxiety. ResultsAlmost half of the participants (i.e., 48.9%) reported being anxious. Although most of the participants were compliant with preventive behavioral changes in their daily lives but no associations between preventive behaviors and anxiety were found. There were significant associations between anxiety and some of the socio-demographic variables (i.e., gender: females were more anxious; age group and marital status single participants were more anxious). ConclusionBased on the present findings, it is clearly evident that Pakistani people are suffering psychiatric problems during the COVID-19 pandemic. Hence, appropriate initiatives should be adopted as soon as possible. Besides, COVID-19 related preventive behavioral measures are highly recommended to practice without putting anything back for psychological fears.

Examination of influence of social media education through mobile phones on the change in physical activity and sedentary behavior in pregnant women: a randomized controlled trial

BackgroundNowadays because of some necessities and demands for virtual and remote education, a new model of health approach through mobile-phones is widely used to deal with improving physical activity and its beneficial effect on pregnancy. There are a small number of studies for showing this importance and the efficacy of such methods, so this study was aimed to determine the influence of social networking through mobile phones on changing the physical activity behavior in pregnant women.MethodsThis randomized controlled trial was conducted with parallel groups on 90 pregnant women referring to Urmia health centers in 2018–2019. The participants from various social and economic backgrounds were included. The participants were randomly assigned to a control and a treatment group. Demographic and Pregnancy Physical Activity Questionnaire (PPAQ) questionnaires were filled. In addition to routine cares, the treatment group received educational intervention through social network within 16 training sessions related to physical activity and nutrition in 8 weeks.ResultsThe mean weight in both control and treatment groups changed significantly during the study, but in different trends (P < 0.001, Mean Difference (MD) = 4.43). At the beginning of the study, control and treatment groups were not different in terms of daily physical activity level (P = 0.17, MD = 0.62), meanwhile, there was a statistically significant difference at the end of intervention in the level of daily physical activity (P < 0.001, MD = 0.69). Comparison of both groups, based on different categories of activity level at the end of the treatment, showed a non-significant difference in sedentary activities (P = 0.89, MD = 0.46), but the intervention led to a significant difference based on the other level of activities; light (P < 0.001, MD = 51.94), moderate (P < 0.001, MD = 46.87), and sever (P = 0.05, MD = 1.07).ConclusionEducational intervention based on social networks through mobile phones had an effective role in behavior change in physical activity during pregnancy.Trial registrationIRCT20151004024340N15, Registration date05/06/2020.

Public's Knowledge of Hypertension and its Associated Factors: A Cross-Sectional Study

Background:Hypertension is a significant challenge for healthcare systems globally. It is estimated to cause 7.5 million deaths worldwide annually. Knowledge of hypertension plays a crucial role in behavioral changes required to prevent and manage the condition. This study aimed to assess the public's knowledge of hypertension’s risk factors, symptoms, complications, and treatment.Methods:This cross-sectional, descriptive, and exploratory study included a convenience sample of 723 Jordanian adults. The Hypertension Knowledge Test was used to measure the participants' knowledge of hypertension’s risk factors, symptoms, complications, and treatment.Results:The participants' mean score of total hypertension knowledge was 11.5 ±3.82 (52.2%), with 85.9% (n=621) having inadequate knowledge. Their mean scores for hypertension’s risk factors, symptoms, complications, and treatment were 7.45 ±2.35 (62.1%), 2.29 ±1.21 (45.8%), 1.38 ± 0.943 (46%), and 0.391 ± 0.603 (19.6%), respectively. Four factors were found to be significant predictors of participants' knowledge, such as age (p=0.002), education level (p&lt;0.001), family history (p&lt;0.001), and receiving hypertension-related information (p&lt;0.001).Conclusion:The participants had inadequate knowledge regarding hypertension’s complications, risk factors, symptoms, and treatment. Public health education programs that focus on hypertension knowledge are required. Nurses and other healthcare providers should take the initiative in hypertension education. Strategic planning and designing of hypertension programs are required to fit the needs of the Jordanian public to enhance their knowledge of hypertension and related preventive and control measures.

Attitudes and views on healthy lifestyle interventions for the prevention of dementia and cardiovascular disease among older people with low socioeconomic status: a qualitative study in the Netherlands

ObjectivesIndividuals with a low socioeconomic status (SES) have an increased risk of cardiovascular disease (CVD) and dementia, partly due to the high prevalence of unhealthy behaviours in this population. Interventions...

Mechanisms of change in drinking following an alcohol-related injury: A qualitative examination of the sentinel event effect

Background: Sentinel events are negative health-related events that trigger change in risky health behaviors. Despite its presumed major role in behavior change, the sentinel event effect has received little empirical attention. Through analysis of qualitative interviews, we explored how sentinel events trigger behavior change. Methods: Thematic analysis and concept mapping were used to develop a preliminary model of the sentinel event effect among a sample of 24 adult heavy drinking Mexican-origin men previously admitted to a hospital due to injury. The model was checked against cases that did versus did not report change in alcohol use following an alcohol-related negative event. Results: Findings suggest that sentinel events may arouse negative emotional reactions, encourage reflection on the negative consequences of drinking, and cause reevaluation of the severity and significance of drinking. These processes may increase motivation to change. Conclusions: Findings support the concept of the sentinel event as a natural intervention, and identifies potential social-cognitive and motivational mechanisms through which it influences change. Findings stand to inform research on mechanisms underlying brief intervention effects, and research that seeks to identify treatment targets.

Behavior Guidance during the Covid-19 Pandemic: Health Literacy as a Weapon against the Virus

ABSTRACT Portugal was hit by COVID-19 on the 2nd of March 2020. For almost two months, the country was confined due to the declaration of the emergency state. The confinement was always conveyed by the media, who clearly guided citizens toward preventive behaviors and so became a means of fighting this pandemic by helping the country stay home. Several authors recognize the importance of health communication and health literacy in fighting COVID-19. In a public health crisis like this, media are important actors in the promotion of health and prevention of disease, and they can have a central role in behavior change. To further understand how the media guided citizens toward preventive behaviors we applied a questionnaire survey to Portuguese journalists. More than 90% assumed citizens’ behavior guidance. Journalists’ perceptions about their work reflect a true concern with the promotion of health literacy, and their assumption of a public service mission was crucial in people’s adherence to confinement. Health literacy achieved its maximum during this confinement period, not only because these were extraordinary times but also because Portuguese journalists had an exemplar behavior.

Developing a Culturally Responsive Lifestyle Intervention for Overweight/Obese U.S. Mexicans.

Hispanics are the largest minority group in the United States, constituting 18 % of the population. Mexicans are the largest Hispanic subgroup and are at disproportionate risk for overweight/obesity. Lifestyle interventions targeting dietary change and physical activity have resulted in significant weight loss in several large randomized clinical trials in the general population, but few studies have tailored interventions to Mexican Americans. We conducted a community needs assessment from 2018 to 2020 in accordance with Domenech-Rodriguez and Wieling's Cultural Adaptation Process (CAP) model to inform the development of SANOS (SAlud y Nutrición para todOS) (Health and Nutrition for All), a culturally-tailored, community-based diet and lifestyle education and counseling program that addresses overweight/obesity among U.S. Mexicans. Five Spanish-language focus groups were conducted until thematic saturation with 31 overweight/obese Mexicans in New York City about their knowledge, priorities, and preferences regarding diet, exercise, and evidence-based strategies for behavioral change. A grounded theory approach was used to analyze the data. Five themes were identified: (1) A strong desire for tangible information related to diet and health, (2) Family as a primary motivator for behavior change, (3) Desire for group-based motivation and accountability to sustain intervention participation, (4) Belief in short-term goal setting to prevent loss of motivation, and (5) Time and workplace-related barriers to intervention adoption. Ecological factors such as the effect of acculturation on diet, family members' role in behavior change, and socioenvironmental barriers to healthy dietary practices and physical activity should be considered when adapting evidence-based treatments for Mexican Americans.

Self-regulation as a Mediator of Mindfulness and Physical Activity: A Narrative Review

Mindfulness is gaining increased attention as a means of increasing physical activity (PA) participation. Given that only 15.4% of adult Canadians currently meet the Canadian Physical Activity Guidelines (Colley et al., 2011), it is imperative to find ways to increase PA among adults. One way to do this is to promote self-regulation skills as self-regulation is among the top predictors of PA participation (Teixeira et al., 2015). The purpose of this narrative review was to further understand the role of self-regulation as a potential mechanism by which mindfulness may be related to PA participation. Initially, 160 papers were identified by title for this review. After reading abstracts, 37 papers were identified as possibly relating to the topic of interest. Following full readings, 26 papers were included in the final review. Likely due to the novelty of this topic, there is limited research on the mechanisms by which mindfulness may be related to physical activity. Review of the literature suggests that self-regulation appears to be a promising mechanism by which mindfulness could improve physical activity participation (Shapiro et al., 2006; Samdal et al., 2017), as self-regulation has been shown to play an important role in behaviour change, however, other alternative mechanisms include improved self-efficacy, as well as improved satisfaction (Neace et al., 2020; Tsafou et al., 2016). The authors conclude that more research on the mechanisms of mindfulness on PA, specifically self-regulation as a mechanism, could foster more knowledgeable intervention practices, and consequently improve mindfulness-based interventions efficacy.

The association between media exposure and enrollment in health insurance in Nepal: Implications for health policy

AbstractExposure to mass media plays a crucial role in behavior change or decision‐making. The study used a cross‐sectional survey design. A total of 810 households were randomly selected for data collection by using a validated interview schedule. The study examined exposure to radio, television (TV), hoarding boards (billboards), newspapers, and brochures, pamphlets, and posters as media platform “independent variables” and enrollment in health insurance (HI) as the “dependent variable.” Data showed that 60% of the respondents had exposure to HI information with electronic (radio and TV) media and 33% had exposure via printed or displayed media. All these media were significantly associated with enrollment in HI. But exposure to HI‐related information from radio (adjusted odds ratio [aOR] = 1.91, 95% confidence interval [CI] = 1.39–2.61, p &lt; 0.001), TV (aOR = 1.72, 95% CI = 1.25–2.38, p &lt; 0.01), and hoarding board (billboard) (aOR = 1.87, 95% CI = 1.25–2.81, p &lt; 0.01) were the significant predictor for enrollment in HI. The study findings suggest that it would be best to consider the use of these predictor communication channels when making strategic communication plans to promote HI enrollment in Nepal.