Self-monitoring Behavior Research Articles

Do monthly coaching calls influence proximal participant adherence in a behavioral weight loss program?

Participants who receive continued coach contact following behavioral weight loss treatment are more successful in maintaining their weight loss long-term. The current study examines whether these contacts have dynamic effects, such that participants are most adherent to the prescribed weight loss behaviors in the days after the call, when motivation and goal salience may be heightened, than they are as time goes on. The current study examined the trajectory of calorie intake, physical activity, weight, and self-monitoring behavior in the fourteen days after a monthly coaching call among participants completing the maintenance phase of a behavioral weight loss trial. For physical activity outcomes, caloric intake, and weight, there were no changes across time. Participants did have the highest adherence and quality of dietary self-monitoring immediately after the call, which diminished over time. Coach contact may continually renew commitment to this burdensome but critical behavior. Likelihood of self-weighing showed an opposite trend, where participants were more likely to weigh themselves in the days more distal from the coach call. Results can inform the timing and content of future coach contact to promote weight control.

The 24-Hour Movement Paradigm: An integrated approach to the measurement and promotion of daily activity in cancer clinical trials

Increased physical activity (PA), improved sleep, and decreased sedentary behavior (SB) are essential components of supportive care for cancer survivors. However, researchers and health care professionals have achieved limited success in improving these behaviors among cancer survivors. One potential reasoning is that, over the past two decades, guidelines for promoting and measuring PA, sleep, and SB have been largely siloed. With greater understanding of these three behaviors, health behavior researchers have recently developed a new paradigm: the 24-Hour movement approach. This approach considers PA, SB, and sleep as movement behaviors along a continuum that represent low through vigorous intensity activity. Together these three behaviors form the sum of an individual's movement across a 24-hour day. While this paradigm has been studied in the general population, its usage is still limited in cancer populations. Here, we seek to highlight (a) the potential benefits of this new paradigm for clinical trial design in oncology; (b) how this approach can allow for greater integration of wearable technology as a means of assessing and monitoring patient health outside the clinical setting, improving patient autonomy through self-monitoring of movement behavior. Ultimately, implementation of the 24-Hour movement paradigm will allow health behavior research in oncology to better promote and assess critical health behaviors to support the long-term well-being for cancer patients and survivors.

How the Behavior Change Content of a Nationally Implemented Digital Diabetes Prevention Program Is Understood and Used by Participants: Qualitative Study of Fidelity of Receipt and Enactment.

The National Health Service Digital Diabetes Prevention Programme (NHS-DDPP) is a program for adults in England at risk of developing type 2 diabetes mellitus (T2DM). It is based on NHS England specifications that stipulate specific behavior change techniques (BCTs), that is, active ingredients to produce behavior change to target diet and physical activity. Now rolled out nationally, the NHS-DDPP is being delivered by 4 independent providers as a 9-month intervention via apps, educational material, and remote health coaching. To optimize effectiveness, participants need to be able to understand and use behavior change content (eg, goal setting and problem solving) of an intervention delivered to them digitally. Previous research has shown that people benefit from support to aid the understanding and use of BCTs. The objectives of this qualitative study were to evaluate how participants in the NHS-DDPP understand and use BCT content, investigate how participants describe the role of health coaches in supporting their behavior change, and examine how the understanding and use of behavior change content of the NHS-DDPP varies across providers. In total, 45 service users were interviewed twice by telephone at 2 to 4 months into, and at the end of, the program. Topics included participants' understanding and use of key BCTs to support self-regulation (eg, goal setting) and the support they received via the program. Transcripts were analyzed thematically, informed by the framework method. Participants described their understanding and use of some behavior change content of the program as straightforward: use of BCTs (eg, self-monitoring of behavior) delivered digitally via provider apps. Participants valued the role of health coaches in supporting their behavior change through the emotional support they offered and their direct role in delivery and application of some BCTs (eg, problem solving) to their specific circumstances. Participants expressed frustration over the lack of monitoring or feedback regarding their T2DM risk within the program. Variations in the understanding and use of behavior change content of the NHS-DDPP were present across provider programs. Health coaches' support in delivery of key components of the program seems to be pivotal. To improve the understanding and use of BCTs in digital interventions, it is important to consider routes of delivery that offer additional interactive human support. Understanding of some self-regulatory BCTs may benefit from this support more than others; thus, identifying the optimal mode of delivery for behavior change content is a priority for future research. The NHS-DDPP could be improved by explicitly setting out the need for health coaches to support understanding of some self-regulatory BCT content such as problem solving in the service specification and amending the discharge process so that knowledge of any change in T2DM risk is available to participants.

Programa Dia-D: ensaio propositivo de intervenção educativa para autogerenciamento em diabetes tipo 2

Abstract Objective to present the Diabetes em Dia (Dia-D) Program: an educational intervention for self-management in type 2 diabetes, focused on promoting healthy eating, being active, and taking medication, among adults with type 2 diabetes. Method a propositional essay of complex intervention based on two behavioral models: The ADCES7 Self-Care Behaviors™ (Association of Diabetes Care and Education Specialists); and the Behavior Change Wheel (BCW). Results BCW’s conceptual framework “Capability, Opportunity, Motivation-Behaviour (COM-B)” made it possible to define the determinants of target behaviors. Based on these, interventions were proposed, such as training, enablement, education, environmental restructuring, persuasion, service provision, guidelines, and communication. Behavior change techniques (demonstration and self-monitoring of behavior, information on health consequences, among others) underpinned the intervention content. Final considerations and implications for practice the theoretical models enabled the structuring of an educational intervention with an emphasis on proposing strategies for behavior modification, a central component in caring for people with diabetes. The relevance of adopting behavioral models in health education planning and the complex nature of the intervention design stand out.

Adherence to the therapy of patients with Heart Failure and Diabetes Mellitus: A Systematic Review

A comorbidity like diabetes mellitus (DM) complicates heart failure (HF) self-care management and adherence to the therapy and results poorer clinical outcomes. This study aims to examine the various factors influencing adherence to the therapy of patients with HF and DM. A systematic literature search was established in the electronic data basis PubMed, Cochrane Library and Cumulative Index to Nursing and Allied Health Literature (CINAHL) using inclusion and exclusion criteria. The search yielded eight articles. The introduction of empowerment models in the management of patients with HF and DM made patients more involved in their self-care management and their self-monitoring behavior and adherence were increased. Patients with HF and DM during their hospitalization, were less likely to receive smoking cessation counseling and blood pressure control and experienced longer length of stay. Patients with HF preserved ejection fraction (HFpEF) and DM were less likely to receive an angiotensin convertive enzyme (ACE) inhibitor or angiotensin receptor or beta-blockers and had worse blood pressure (BP) control compared with patients with reduced ejection fraction (HFrEF) and DM. Effective self-care management of patients with HF and DM seems to depend on the type and the severity of comorbid conditions and the availability of effective therapies. Adequate support to patients with HF and DM from health professionals (HPs) is important, in order to establish self-management and adherence to the therapy.

Abstract C087: Neighborhood influences on chronic hepatitis B monitoring behaviors among Asian Americans residing in Philadelphia county

Abstract The incidence of liver and intrahepatic bile duct cancer for Asian Americans is almost 2 times greater in comparison to Non-Hispanic white women and men. A major factor that contributes to liver cancer is hepatitis b (HBV) infection, which disproportionally affects Asian Americans, who represent 7% of the total US population but makes up around 58% of HBV-linked hepatocellular carcinoma cases. The purpose of this study was to examine the relationship between the neighborhood environment, including neighborhood walkability, Asianicity, and neighborhood disadvantage on HBV monitoring related behavior such as doctors' visits and HBV blood testing among Asian HBV patients. A total of 160 study participants were recruited from March 2019 to March 2020 through combined recruitment approaches, including through medical record review by authorized staff from collaborating health clinics, pharmacies, or community health centers and community-based organizations including racial/ethnic based educational and community centers, religion-based organizations, and senior centers. Study measures included baseline assessment information including sociodemographics, HBV infection history, HBV monitoring behavior, and knowledge about HBV prevention, diagnosis and treatment. Neighborhood level measures included neighborhood disadvantage, Asianicity, and neighborhood walkability using census and online measures. Hierarchical generalized linear models (HGLM) were used to account for individual nested within neighborhoods for predicting factors associated with doctor’s visits and blood test. Greater neighborhood disadvantage (OR=0.97, 95% CI=0.95-0.99, p=0.0041) and Asianicity (OR=0.97, 95% CI=0.95-0.98, p=0.0003), and lower neighborhood walkability (OR=1.06, 95% CI=1.02-1.09, p=0.0039) were associated with a lower likelihood of doctor visits for CHB. Greater Asianicity (OR=0.97, 95% CI=0.96-0.99, p=0.0044) was associated with a lower likelihood of HBV blood testing in the past 6 months. Evident neighborhood environment effects suggest the need to incorporate these factors into interventions to enhance HBV self-monitoring behaviors and slow disease progression of chronic HBV. Citation Format: Aisha Bhimla, Wenyue Lu, Lin Zhu, Yin Tan, Di Zhu, Jade Truehart, Ming-Chin Yeh, Minhhuyen Nguyen, Grace X. Ma. Neighborhood influences on chronic hepatitis B monitoring behaviors among Asian Americans residing in Philadelphia county [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C087.

SELF-MONITORING OF LIFESTYLES FOR DISEASE MANAGEMENT IN OVERWEIGHT DIABETIC SENIORS WITH/WITHOUT KIDNEY DISEASE

Abstract Overweight/obesity, diabetes, and chronic kidney disease (CKD) are common multiple chronic conditions (MCCs) in seniors. Fitbit fitness trackers were used to track physical activity and food intake over 12-week in 15 overweight/obese diabetic seniors (age=70.5±4.8) with/without CKD. The associations of percentage of days with tracked steps (PDWTS), percentage of days with food logs (PDWFL) and 7-day mean step count with body mass index, fasting glucose, HbA1c and renal function were examined using Pearson Correlation analysis. Qualitative data assessing perceived factors related to self-monitoring and lifestyle behaviors was collected and analyzed using content analysis. At week 12, PDWTS and PDWFL was positively and negatively associated with renal function (P<0.05) and HbA1c (P<0.05), respectively. Motivation and perceived benefits of self-monitoring were frequently cited facilitators for self-monitoring. Self-monitoring might help seniors manage MCCs. Motivating self-monitoring and providing health education on the benefits of self-monitoring in lifestyle interventions to manage MCCs are warranted.

Evaluating the Acceptance and Usability of an App Promoting Weight Gain Prevention and Healthy Behaviors Among Young Women With a Family History of Breast Cancer: Protocol for an Observational Study.

Breast cancer is the most common form of cancer in women, and around 20% of cases are associated with factors such as adult weight gain, overweight and obesity, and potentially modifiable health behaviors including high alcohol intake, smoking, lack of physical activity, and breastfeeding. Significant weight gain occurs between the ages of 18 and 35 years; hence, this age group could benefit from weight gain prevention interventions. Population studies have reported that women at increased risk of breast cancer account for a disproportionate amount of cases. Thus, there is a particular need to target weight gain prevention and other health behavior interventions for women at increased risk. A literature review identified no evidence-based apps that cover all relevant health behaviors. With patient and participant involvement from the target population, we have developed a new app to promote healthy behaviors among young women at increased risk of breast cancer. Alongside the app, a Facebook group provides peer support, and a virtual welcome event provides an overview of the project and the opportunity to meet the research team and other study participants. The aim of the intervention is to prevent weight gain via changes to eating habits and physical activity levels, and improve other health behaviors associated with breast cancer. The app includes goal setting and self-monitoring of health behaviors and provides education about breast cancer. This study aims to assess the acceptability and usability of the app in young women at increased risk of breast cancer, and the feasibility of the study procedures for a future, larger efficacy study. Young women (n=35, age 18-35 years) at increased risk of breast cancer (>17% lifetime risk) will be recruited via 2 recruitment procedures: mailed invite from the local breast cancer family history, risk and prevention clinic, and advertisements on social media and websites. Participants will have access to the app and the private Facebook group for 2 months. They will complete questionnaires regarding their health behaviors and breast cancer risk belief at the start and end of the study, complete app rating scales in the middle and at the end of the study, and be invited to give feedback on the app during the study period. Approximately 20 participants will have a semistructured interview at the end of the study regarding their views on the app and trial procedures. The trial is ongoing, and the publication of results is anticipated in 2023. The trial will provide evidence regarding the acceptability and usability of the newly developed app for young women at increased risk of breast cancer. Feedback obtained will be used to improve the app. The trial will also assess the feasibility of the study procedures and how these can be refined for a future efficacy study. ClinicalTrials.gov NCT05460650; https://clinicaltrials.gov/ct2/show/NCT05460650. PRR1-10.2196/41246.

The Relationship between Self-monitoring of Blood Sugar and Self-management Behaviors in Children with Type 1 Diabetes

The Relationship between Self-monitoring of Blood Sugar and Self-management Behaviors in Children with Type 1 Diabetes

Effectiveness of a Brief Mindfulness-Based Intervention of “STOP touching your face” During the COVID-19 Pandemic: a Randomized Controlled Trial

ObjectivesAvoiding touching the eyes, nose, and mouth (T-zone) is a strategy to reduce the spread of COVID-19. This study evaluated the effectiveness of a brief mindfulness-based intervention (MBI) named “STOP (Stop, Take a Breath, Observe, Proceed) touching your face” for reducing face-touching behavior.MethodsIn this online-based, two-arm, wait-list, randomized controlled trial, eligible participants were randomly assigned to the intervention (n = 545) or control group (n = 545). The results of 60-min self-monitoring of face-touching behavior were reported before and after the intervention. Reduction of the percentage of T-zone touching was the primary outcome, and reduction of face-touching frequency was a key secondary outcome. Outcomes were analyzed on an intention-to-treat (ITT) basis with a complete case analysis (CCA).ResultsITT analysis revealed that the percentage of T-zone touching was significantly reduced by 8.1% in the intervention group (from 81.1 to 73.0%, RR = 0.901, OR = 0.631, RD = − 0.081, p = 0.002), and insignificantly reduced by 0.6% in the control group (from 80.0 to 79.4%, p = 0.821). Fewer participants performed T-zone touching in the intervention group than in the control group (73.0% vs. 79.4%, RR = 0.919, OR = 0.700, RD = − 0.064, p = 0.015) after the intervention, and there was a greater reduction of T-zone touching frequency in the intervention group than in the control group [mean ± SD: 1.7 ± 5.13 vs. 0.7 ± 3.98, mean difference (95% CI): 1.03 (0.48 to 1.58), p < 0.001, Cohen’s d = − 0.218]. The above results were further confirmed by CCA.ConclusionsThis brief mindfulness-based intervention was potentially effective at reducing the spread of COVID-19 and could be further investigated as an intervention for preventing other infectious diseases spread by hand-to-face touching.Trial RegistrationClinicalTrials.gov NCT04330352.

Abstract 13540: Characteristics of Home-Based Walking Exercise Interventions Associated With Greater Improvement in Walking Performance in Peripheral Artery Disease: A Post-Hoc Analysis of the HONOR Randomized Clinical Trial Results

Introduction: Benefits of home-based exercise (HBE) interventions in lower extremity peripheral artery disease (PAD) are variable. This post-hoc analysis of the HONOR randomized trial studied characteristics of a home-based exercise intervention associated with greater 6-minute walk improvement in PAD. Methods: HONOR was a multi-centered randomized trial. PAD participants were randomized to either a HBE intervention or usual care for 9 months. The intervention consisted of four weekly in-person visits with an exercise coach followed by 16 telephone coaching calls over the next eight months. Participants were asked to walk for exercise five days/week, wear a Fitbit to monitor activity, upload their Fitbit on the study website, and visit the website at least weekly to view their exercise goals and monitor their progress toward exercise goals. The primary outcome was change in 6-minute walk distance at 9-month follow-up. Results: Of 200 people randomized (age 70 yrs. ±10.4, 52.5% female, 50% Black), 182 (91%) completed nine-month follow-up. Overall, the exercise intervention did not improve 6-minute walk compared to usual care [+5.5 vs. +14.4 m respectively (Mean diff: –8.9 m, 95% CI, –26.0, +8.2 m, P = .31)]. Among the 99 people randomized to HBE, change in 6-minute walk ranged from -239.2-233.7. See table for characteristics associated with greater six-minute walk improvement. Conclusion: In a home-based exercise intervention for PAD, more frequent use of the intervention website and greater exercise sessions/week, but not more time wearing a Fitbit, were associated with greater 6-minute walk improvement. Future home-based exercise interventions for PAD should help patients self-monitor exercise behavior and increase exercise sessions per week.

Telephone Health and Wellness Coaching for Weight Loss in the Occupational Health Setting: A Mixed Methods Single-Case Study

Occupational health nurse practitioners need to support self-determined health decisions and behavior change for weight loss. This article describes a telephone-based health and wellness coaching intervention. A mixed methods single-case study approach was used. Nine coaching conversations were analyzed using the self-determination theory as an underpinning theoretical framework. Health-related quality of life improved, and there was a 4.46% reduction in body weight. Three main themes emerged from the coaching conversations: owning goals (desired outcomes and motivation to change, setting SMART [Specific, Measurable, Achievable, Relevant, and Time-Bound] goals, and behavior strategies), accountability (self-monitoring behavior and outcomes), and support (realizing perceived barriers and enablers).

Screen Time and Productivity: An Extension of Goal- setting Theory to Explain Optimum Smartphone Use

Over the past several years, much research has examined the negative consequences that can arise from smartphone use. To help reduce these consequences, companies have developed smartphone applications and features to enable self-monitoring behaviors. However, the mechanisms that have caused smartphone-enabled self-monitoring behaviors to emerge and the positive outcomes that might result from such behaviors have received limited scholarly attention. In this study, we ameliorate this gap by proposing a framework that highlights key antecedents and outcomes of screen- time self-monitoring success based on a smartphone-based self-monitoring intervention. Informed by a short-term longitudinal study, our results show how smartphone-based self-monitoring can enhance awareness of smartphone use and, consequently, lead to positive outcomes for users. Our findings reveal that how users perceive smartphone self- monitoring affordances, their outcome expectations, and their smartphone self-monitoring efficacy positively relate to the extent they engage in smartphone-based self-monitoring behavior. In turn, self-monitoring enhances user productivity and leads to an overall sense of contentment with achievement. Nevertheless, our findings suggest that self-monitoring fatigue negatively moderates these relationships. This study offers novel theoretical and practical insights to encourage users to use smartphones in a more regulated manner. More generally, this study contributes to the literature on self-monitoring and self-regulation in digitally enabled environments.

Analysis Psychosocial Factors Affecting Behaviour of Self-Monitoring Blood Glucose in People with Type 2 Diabetes Mellitus

Introduction: Compliance with monitoring blood glucose levels is crucial to diabetes management. Self-monitoring behaviour of blood glucose levels can be influenced by psychosocial factors in people with T2DM, such as knowledge, coping, diabetes distress, family support, and nurse support. Objective: The study aimed to analyze psychosocial factors that influence the behaviour of self-monitoring of blood glucose levels in people with T2DM. Methods: The study was a descriptive-analytic study with a cross-sectional design. The sample was T2DM patients in the Jember Regency with a sample size of 138 respondents, taken using multistage random sampling. Data were collected using a questionnaire (SKILLDS, Coping Scale, DDS, HDFSS, Nurse's role perception, and the SMBG questionnaire) and analyzed using a multiple linear regression test. Results The modelling results show that psychosocial factors (knowledge, coping, diabetes distress, family support, and nurse support) have a simultaneous and significant influence on the behaviour of monitoring blood glucose levels (F = 9.292; p = 0.001 &lt; α = 0.05) with adjusted R2 = 0.232. It showed that psychosocial factors could explain the variance of behaviour monitoring blood glucose levels by 23.2%. Partially, there are three influential variables, namely coping, perception of family support, and perception of nurse support (p= 0.039; p= 0.016; and p= 0.020 &lt; α =0.05). Better coping, family support, and nurse support could improve blood glucose monitoring. Conclusion: Psychosocial factors can affect monitoring blood glucose levels in people with T2DM. The nurse can make efforts to improve the behaviour by monitoring blood glucose levels by considering the psychosocial aspects of people with T2DM through preventive promotion efforts to improve coping, family support, and nurse support to improve self-management and quality of life of people with T2DM.

Masticatory Behavior Change with a Wearable Chewing Counter: A Randomized Controlled Trial

Because a relationship has been reported between masticatory behavior, obesity, and postprandial blood glucose, it is recommended to chew well and take a longer time to eat. The purpose of this study was to examine the possibility of changing masticatory behavior using a small ear-hung wearable chewing counter, which can monitor masticatory behavior without disturbing daily meals. In total, 235 healthy volunteers participated in a 4-wk randomized controlled trial and were divided into 3 groups. All participants were instructed about the importance of mastication at the first visit. During the intervention, group B used the chewing counter without an algorithm during each meal (notification of the number of chews after meal), and group C used the chewing counter with a masticatory behavior change algorithm (setting a target value and displaying the number of chews in real time). Group A was set as the control group. The number of chews and the meal time when consuming 1 rice ball (100 g) were measured before and after the intervention using the chewing counter, and the rate of change in these values was evaluated. Participants also provided a subjective evaluation of their changes in masticatory behavior. The number of chews and the meal time of 1 rice ball increased significantly in groups B and C compared with before the intervention, and the rate of change was significantly higher in group C than in group A and group B. In addition, the subjective evaluation of the change in the number of chews was highest in group C. Self-monitoring of masticatory behavior by providing a target value and the degree of achievement for the number of chews using a wearable chewing counter with a behavioral change algorithm could promote effective change in masticatory behavior and lead to an increased number of chews. (Trial ID: UMIN000034476)

Refining a Multicomponent Intervention to Increase Perceived HIV Risk and PrEP Initiation: Focus Group Study Among Black Sexual Minority Men.

BackgroundIncreased preexposure prophylaxis (PrEP) initiation is needed to substantially decrease HIV incidence among Black sexual minority men (BSMM). However, BSMM perceive others as PrEP candidates instead of themselves and are less likely than other groups to use PrEP if prescribed. Peers and smartphone apps are popular HIV prevention intervention tools typically used independently. However, they could be useful together in a multicomponent strategy to improve perceived HIV risk and PrEP initiation for this group. Information regarding attitudes and preferences toward this multicomponent strategy is limited.ObjectiveThe goal of this study is to obtain attitudes and perspectives regarding the design of a multicomponent intervention that uses a smartphone app and a peer change agent (PCA) to increase perceived HIV risk and PrEP initiation. The intervention will be refined based on thematic findings for a culturally responsive approach.MethodsData were obtained guided by life course theory and the health belief model using 12 focus groups and 1 in-depth interview among HIV-negative BSMM from Baltimore, MD, between October 2019 and May 2020 (n=39). Groups were stratified by the following ages: 18 to 24 years, 25 to 34 years, and 35 years and older. Participants were provided details regarding an existing mobile app diary to self-monitor sexual behaviors and a hypothetical PCA with whom to review the app. Facilitators posed questions regarding perceived HIV risk, attitudes toward the app, working with a PCA, and preferences for PCA characteristics and approaches.ResultsMost participants identified as homosexual, gay, or same gender-loving (26/38, 68%), were employed (26/38, 69%), single (25/38, 66%), and interested in self-monitoring sexual behaviors (28/38, 68%). However, themes suggested that participants had low perceived HIV risk, that self-monitoring sexual behaviors using a mobile app diary was feasible but could trigger internalized stigma, and that an acceptable PCA should be a possible self for BSMM to aspire to but they still wanted clinicians to “do their job.”ConclusionsHIV-negative BSMM have dissonant attitudes regarding perceived HIV risk and the utility of a mobile app and PCA to increase perceived HIV risk and PrEP initiation. Future research will explore the feasibility, acceptability, and preliminary impact of implementing the multicomponent intervention on perceived HIV risk and PrEP initiation among BSMM in a pilot study.

Behaviour change techniques that constitute effective planning interventions to improve physical activity and diet behaviour for people with chronic conditions: a systematic review

ObjectivesAction planning is a brief and effective behaviour change technique (BCT) to improve physical activity (PA) and diet behaviour (DB). This study aimed to identify critical BCTs and mechanisms of...

The Association Between Smartphone App-Based Self-monitoring of Hypertension-Related Behaviors and Reductions in High Blood Pressure: Systematic Review and Meta-analysis.

BackgroundSelf-monitoring of behavior can support lifestyle modifications; however, we do not know whether such interventions are effective in supporting positive changes in hypertension-related health behaviors and thus in reducing blood pressure in patients treated for hypertension.ObjectiveThis systematic literature review evaluates the extent to which smartphone app–based self-monitoring of health behavior supports reductions in blood pressure and changes in hypertension-related behaviors. It also explores the behavioral components that might explain intervention effectiveness.MethodsA systematic search of 7 databases was conducted in August 2021. Article screening, study and intervention coding, and data extraction were completed independently by reviewers. The search strategy was developed using keywords from previous reviews and relevant literature. Trials involving adults, published after the year 2000, and in the English language were considered for inclusion. The random-effects meta-analysis method was used to account for the distribution of the effect across the studies.ResultsWe identified 4638 articles, of which 227 were included for full-text screening. A total of 15 randomized controlled trials were included in the review. In total, 7415 patients with hypertension were included in the meta-analysis. The results indicate that app-based behavioral self-monitoring interventions had a small but significant effect in reducing systolic blood pressure (SBP), on average, by 1.64 mmHg (95% CI 2.73-0.55, n=7301; odds ratio [OR] 1.60, 95% CI 0.74-3.42, n=114) and in improving changes in medication adherence behavior (standardized mean difference [SMD] 0.78, 95% CI 0.22-1.34) compared to usual care or minimal intervention. The review found the intervention had a small effect on supporting improvements in healthy diet by changing habits related to high sodium food (SMD –0.44, 95% CI –0.79 to –0.08) and a trend, although insignificant, toward supporting smoking cessation, low alcohol consumption, and better physical activity behaviors. A subgroup analysis found that behavioral self-monitoring interventions combined with tailored advice resulted in higher and significant changes in both SBP and diastolic blood pressure (DBP) in comparison to those not providing tailored advice (SBP: –2.92 mmHg, 95% CI –3.94 to –1.90, n=3102 vs –0.72 mmHg, 95% CI –1.67 to 0.23, n=4199, χ2=9.65, P=.002; DBP: –2.05 mmHg, 95% CI –3.10 to –1.01, n=968 vs 1.54 mmHg, 95% CI –0.53 to 3.61, n=400, χ2=9.19, P=.002).ConclusionsSelf-monitoring of hypertension-related behaviors via smartphone apps combined with tailored advice has a modest but potentially clinically significant effect on blood pressure reduction. Future studies could use rigorous methods to explore its effects on supporting changes in both blood pressure and hypertension-related health behaviors to inform recommendations for policy making and service provision.Trial RegistrationPROSPERO CRD42019136158; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=136158

STEM STUDENTS’ ENGLISH LANGUAGE LEARNING STRATEGIES AND UNDERLYING FACTORS PERTAINING TO OPEN DISTANCE LEARNING

Background and Purpose: The COVID19 pandemic challenges on learning necessitate the understanding of students’ Language Learning Strategies (LLS). Studies on science, technology, engineering, and mathematics (STEM) students’ English LLS is scarce. The objectives of the study are to examine the LLS employed by STEM students learning English as a second language (ESL) in a public university (PU) in Malaysia and to investigate the LLS underlying factors pertaining to the open distance learning (ODL).&#x0D; &#x0D; Methodology: This study was designed as survey research, employing the quantitative approach to gather data. The Strategy Inventory of Language Learning (SILL) questionnaire was administered to 250 engineering undergraduates as respondents, who were chosen using a purposive sampling method. Data were analyzed descriptively using the Statistical Package for Social Sciences (SPSS) version 21.0. The Principal Component Analysis (PCA) with varimax rotation was conducted to determine the construct validity. PCA appropriateness was suggested by the inter-item correlation.&#x0D; &#x0D; Findings: The compensation, metacognitive and cognitive learning strategies were the most frequently used strategies while the memory and affective strategies were the least. The PCA added vital information like the memory strategy corresponds to the metacognitive strategy. The cognitive strategy concept of ‘practice,’ may demand a revisit to some traditional grammar learning methods. There are also demands for social-emotional factors to be considered. ODL has imposed bigger demands too.&#x0D; &#x0D; Contributions: The findings may assist ESL educators to boost STEM students’ self-monitoring behavior, to plan and coordinate their own learning process. PCA’s ‘Self-Awareness’ concept revealed that policy makers need to conduct more training to ensure executions run smoothly.&#x0D; &#x0D; Keywords: English, Language Learning Strategies (LLS), Open Distance Learning (ODL), Science Technology, Engineering, and Mathematics (STEM).&#x0D; &#x0D; Cite as: Nurul Jannah, A. G., Tengku Intan Suzila, T. S., &amp; Zainurin, A. R. (2022). STEM students’ English learning strategies and underlying factors in relation to issues in open distance learning. Journal of Nusantara Studies, 7(2), 81-102. http://dx.doi.org/10.24200/jonus.vol7iss2pp81-102

Behaviour change interventions to promote health and well-being among older migrants: A systematic review.

BackgroundWhether behaviour change interventions are effective for the maintenance of older migrants’ health and well-being is uncertain. A systematic review was conducted to assess evidence for the capacity of behaviour change techniques (BCTs) to promote the health and well-being of older migrants.MethodsElectronic databases (Cochrane CENTRAL, Embase, Ovid MEDLINE and Web of Science) were searched systematically to identify relevant randomised controlled trials, pre–post studies and quasi-experimental studies published before March 2021. Additional articles were identified through citation tracking. Studies examining BCTs used to promote the health and/or well-being of older migrants were eligible. Two independent reviewers used the Behaviour Change Technique Taxonomy version 1 to extract data on BCTs. Data on intervention functions (IFs) and cultural adaption strategies were also extracted. Intervention contents (BCTs, IFs, culture adaption strategies) were compared across effective and ineffective interventions according to health and well-being outcome clusters (anthropometrics, health behaviour, physical functioning, mental health and cognitive functioning, social functioning and generic health and well-being).ResultsForty-three studies (23 randomised controlled trials, 13 pre–post studies and 7 quasi-experimental studies) reporting on 39 interventions met the inclusion criteria. Thirteen BCTs were identified as promising for at least one outcome cluster: goal-setting (behaviour), problem-solving, behavioural contract, self-monitoring of behaviour, social support (unspecified), instruction on how to perform the behaviour, information about health consequences, information about social and environmental consequences, demonstration of the behaviour, social comparison, behavioural practice/rehearsal, generalisation of a target behaviour and addition of objects to the environment. Three BCTs (instruction on how to perform the behaviour, demonstration of the behaviour, and social comparison) and two IFs (modelling and training) were identified as promising for all outcome clusters.ConclusionsThirteen distinct BCTs are promising for use in future interventions to optimise health and well-being among older migrants. Future research should focus on the effectiveness of these BCTs (combinations) in various contexts and among different subgroups of older migrants, as well as the mechanisms through which they act. Given the scarcity of interventions in which cultural adaption has been taken into account, future behavioural change interventions should consider cultural appropriateness for various older migrant (sub)groups.Trial registrationPROSPERO CRD42018112859.