Self-reported Behavior Change Research Articles

The Consequences of Anthropomorphic and Teleological Beliefs in a Global Pandemic.

To describe something in terms of its purpose or function is to describe its teleology. Previous studies have found that teleological beliefs are positively related to anthropomorphism, and that anthropomorphism decreases the perceived unpredictability of non-human agents. In the current study, we explore these relationships using the highly salient example of beliefs about the coronavirus pandemic. Results showed that both anthropomorphism and teleology were negatively associated with perceived uncertainty and threat, and positively associated with self-reported behavioural change in response to the pandemic. These findings suggest that highly anthropomorphic and teleological individuals may view coronavirus as agentive and goal-directed. While anthropomorphic and teleological beliefs may facilitate behavioural change in response to the pandemic, we also found that the associated reduction in uncertainty and threat may be detrimental to behavioural change. We discuss the implications of these findings for messaging about global events more broadly.

Evaluating Preconception Health and Behaviour Change in Australian Women Planning a Pregnancy: The OptimalMe Program, a Digital Healthy Lifestyle Intervention with Remotely Delivered Coaching.

OptimalMe is a digital healthy lifestyle intervention for women planning a pregnancy, with remotely delivered coaching. This follow-up study of Australian women, stratified by coaching delivery mode (phone vs. videoconferencing), assessed alignment to preconception care guidelines and self-reported behaviour change. Overall, 298 women enrolled with a mean (SD) age of 31.8 (4.3) years and mean BMI of 25.7 (6.1) kg/m2. Suboptimal preconception behaviours were reported at baseline, including alcohol consumption (57.2%), infrequent weighing (37.2%) and incomplete cervical cancer screening (15.8%) and prenatal supplementation (38.5). At follow-up (4.5 months) (n = 217), a statistically significant shift towards desired behaviours was reported for alcohol consumption (z = -2.6045, p = 0.00932), preconception supplementation (z = -2.7288, p = 0.00634) and frequent weight monitoring (z = -5.2911, p < 0.00001). An insignificant shift towards adherence to cervical cancer screening (z = -1.8679, p = 0.06148) was observed, with a positive trend towards adherence. Results indicate that women who are actively planning a pregnancy require support to optimise health and lifestyle in preparation for pregnancy and general health and lifestyle improvement. Women demonstrated improvement in lifestyle behaviours and self-monitoring, indicating the uptake of low-intensity, non-prescriptive information provision. Supporting the provision of knowledge-enhancing tools and general healthy lifestyle information combines with skilled health coaching as an effective method for behaviour change and self-management. OptimalMe also shows significant improvements in rates of healthcare engagement, which suggests coaching-based digital health interventions may decrease women's barriers for preconception care and improve engagement in clinical settings.

A Psychometric Evaluation of the Dutch Revised Mystical Experience Questionnaire

ABSTRACT In the Netherlands, scientific interest in psychedelics and their subjective effects has been increasing. The present study examined the reliability, construct and predictive validity of the Dutch 30-item Revised Mystical Experience Questionnaire (MEQ30), a self-report measure that has been used to assess subjective and mystical experiences occasioned by psychedelics. In an online survey, 322 Dutch-speaking adults retrospectively reported on profound experiences with psychedelics. Confirmatory factor analyses demonstrated that both a four-factor structure and the same model extended with the MEQ30-total score as a second-order latent variable fit the data. Factor scores showed good internal reliability (α = between .81 and .94) and were significantly higher in participants that beforehand endorsed having had a mystical experience compared to those that did not, providing evidence for the construct validity of the questionnaire as a measure for self-reported mystical experiences. Additionally, MEQ30 scores significantly predicted the meaningfulness and spiritual significance of the psychedelic experience, as well as self-reported positive changes in well-being, life satisfaction and behavior, providing preliminary evidence for the predictive validity of the Dutch MEQ30. Findings suggest the reliability and validity of the Dutch MEQ30 and support the use of the scale in future studies on the subjective effects of psychedelics.

Abstract 16930: Patient Perceptions of Multilevel Nudges About Cardiovascular Medication Refills: A Qualitative Analysis

Introduction: Nudges are simple messages designed to elicit behavior change. In a multi-center pragmatic clinical trial, we embedded nudge messages into short message service texts (SMS) to encourage patients to refill medications to improve medication adherence. In this study, we assessed patient perceptions of the nudge messages. Methods: We conducted in-depth, open-ended interviews with a sample of English and Spanish speaking patients with cardiovascular disease and documented medication refill gaps enrolled in the clinical trial from a tertiary care academic center, UCHealth, and an urban safety-net hospital, Denver Health. We transcribed interviews and performed content analysis to identify themes. Patients were interviewed about their experiences over the phone using interview guides and perceptions of the nudge messages. Content analysis was done by a trained reviewer to identify themes. Results: Among 12 interviews (4 in Spanish), all appreciated the nudge messages, even though some had successful systems to remind them of medications already. All patients interviewed had no concerns about the messages because they were discreet and respected patient privacy. Some patients felt the health system was caring for them by sending messages. Suggestions for improvement included: 1) medications instructions, such as whether to take them with food; 2) dietary education; and 3) reminders for taking medication in the middle of the day, the doses that were more likely to be missed. Despite liking the messages, most self-reported no change in their medication taking behavior due to reminders they had set up themselves. They did, however, appreciate the nudge messages, and a few patients stated that the messages helped them ‘stay on track’ with refills. Conclusions: Patients appreciated the nudge messages that encouraged them to pick up medication, and generally felt supported by the healthcare system in receiving them. Most patients had no suggestions for improving the nudges. Self-reported behavior change in taking medications was low, though patients’ statements suggested the messages were still helpful with refills. True behavior change will be revealed in the final quantitative analysis of the trial.

Potential impact of health communications to raise awareness of the relative risk of age and cancer: a qualitative study

BackgroundThe Cancer Research UK Cancer Awareness Measure Survey (2022) found older age as a risk factor for cancer to be low (around 2–4% across UK nations). However, 89 in 100 cancers are in those aged 50 years and older, and the majority of health-communications are targeted to these higher risk groups. This research aimed to understand the potential impact on health behaviours of communicating messages on relative increased risk of cancer with older age on participant's capability, motivation, and opportunity (COM-B model) in relation to positive early diagnosis health behaviours (body vigilance, intention to take part in cancer screening, preventative measures). MethodsIn this qualitative study, we conducted 60 min semi-structured paired-depth interviews of people aged 25–74 years from across the UK (20 pairs; n=40; age: mean 58·5 years, range 25–74; 19 [47%] men and 21 [53%] women; 27 [67%] White and 13 [33%] from Black or Asian minority ethnic groups). Participants were recruited via a recruitment agency and provided with an incentive of £60 for their time. To assess potential longer-term impact, participants filled a survey 2 weeks later on their views on the messages tested, and on self-reported actions taken as a result of the messages tested. The three different messages tested were rotated. Data were analysed using rapid thematic techniques, two moderators reviewed the data, and a framework analysis style assessed themes against capability, opportunity, and motivation (COM-B model). FindingsMessage 2 was the most preferred, as it was clear and easy to understand. Results suggested that including this messaging in health campaigns could encourage some positive early diagnosis heath behaviours. The post survey identified self-reported behaviour changes in nine (23%) of the 40 participants and sustained intentions in 29 (73%). Results overlayed with COM-B, identified messaging could support behaviour change by increasing awareness (psychological capability), providing a social cue (social opportunity), and encouraging emotions related to not wanting to get cancer or that they should be doing specific behaviours (reflective motivation). InterpretationFindings suggest communicating this message might have a positive effect on help-seeking behaviours in older adults (age ≥50 years). However, considerations include ensuring that the message is clear and understandable and that it doesn’t induce fear. Although this study design allowed for more in-depth exploration, results are limited due to the small sample size. FundingCancer Research UK.

Does messaging matter? A registered report on appearance-versus health-based message framing in exercise appeals targeted towards women

ObjectiveProspect theory proposes that message framing differentially impacts the likelihood of engaging in health-related behaviors. Specifically, gain-framed messages that highlight the benefits of engaging in a behavior are more effective at promoting preventative behaviors than loss-framed messages highlighting the costs associated with a lack of engagement. Research suggests that gain-framed messages may more successfully reduce psychological reactance compared to loss-framed messages, which in turn, may promote behavioral change. However, reactance as a mechanism has been largely overlooked in the literature and support for this hypothesis is mixed. These conflicting results may be due to additional factors, such as outcomes of the targeted behavior (health vs. appearance) and goal orientation. Therefore, the present study examined whether message framing (gain- vs. loss-framing) and the fit between a health message’s outcomes of focus (i.e., health vs. appearance) and an individual’s goal orientation predict psychological reactance, and in turn, cognitive and behavioral outcomes related to exercise. DesignThis study employed a randomized trial with four experimental groups composed of insufficiently active women. Specifically, participants were randomized to view a loss- or gain-framed video emphasizing either health- or appearance-related outcomes. ResultsCounter to expectations, there were no between-group differences on exercise-related attitudes and intentions immediately post-intervention, or self-reported behavior at 1-week post intervention. However, when health outcomes were emphasized, loss-framed messages generally elicited more reactivity than gain-framed messages. This finding was not replicated for the appearance conditions. Appearance messages also generally elicited more reactance than health messages. Meanwhile, reactance did not predict changes in exercise-related attitudes, intentions, or self-reported behavior, and the relationship between messaging content and reactance was generally not moderated by goal orientation. ConclusionFor young inactive women, receiving messages geared towards appearance-related risks of inactivity (e.g., weight gain) tended to produce more reactivity than messages geared towards health-related risks of inactivity (e.g., weakened immune system). However, this did not change exercise-related attitudes, intentions, or self-reported behaviors. Health gain-framed education regarding exercise may be an important part of a comprehensive intervention toolkit, but is likely not enough in and of itself to support or hinder exercise engagement, regardless of framing or emphasized outcomes.

Food-related consumer behaviours in times of crisis: Changes in the wake of the Ukraine war, rising prices and the aftermath of the COVID-19 pandemic

When the COVID-19 pandemic subsided, the war in Ukraine led to further disruptions in consumers’ daily behaviours, with rising prices for food and energy. We conducted a survey study on self-reported changes in food-related consumer behaviour in ten European countries and compared the results to a similar study conducted two years ago. A latent class cluster analysis distinguished five clusters and showed that different types of consumers can be distinguished based on how they react to the crisis as regards their eating habits. 19% of survey participants reported no major changes, and 32% reported changes mostly in terms of more price sensitivity. Among those that reported changes beyond reacting to higher prices, there are indications of more mindful eating and more deliberate choices. The changes already found earlier in response to the COVID-19 pandemic therefore seem to have been strengthened and supplemented by reactions to price increases. The results present a challenge to the food industry in terms of supplying healthy and sustainable food at affordable prices.

677-P: Exploring the Impact of CGM on Perceived Control of Non-Intensive Insulin Treated Type 2 Diabetes—“I liked keeping my line with as few spikes as possible”

Background and Aims: Progression of type 2 diabetes (T2D) demands complex treatment modalities, which may impair patients’ confidence and psychological health. Technologies allowing improved understanding of the dynamic disease process may improve engagement with therapy. Methods: As part of a larger observational study, we previously reported findings highlighting the impact of using Dexcom G6 real-time CGM (rtCGM) with T2D adults (diverse therapies) and prediabetes over a 12-week period. We now explored qualitative data generated from a subsample of T2D participants (N=38) on non-intensive insulin therapy (Basal only=24%, No insulin=76%). Participants answered open-ended questions about their experiences using CGM including self-reported learnings and changes in behavior. Primary themes from qualitative data were derived using content analysis and confirmed with inter-coder reliability. Results: Overall, most participants (&amp;gt;90%) ended the study with high levels of perceived control (PC) of their diabetes. For further analysis, participants’ change in PC at study end were plotted based on low, medium, or high PC before CGM use. Interesting group differences emerged wherein fewer participants reporting medium PC at baseline reported high PC at study end (vs. others with low and high baseline PC). Qualitative themes around perceived illness severity, depressive symptoms, and self-efficacy along with differences in demographics and glycemic metrics helped translate these meaningful findings. Conclusions: rtCGM use provided valuable improvements in participants’ engagement and understanding of their diabetes with potential for long-term clinical benefits. Future studies exploring relationships between perceived control of diabetes and progression of T2D may indicate potential areas for improved engagement with diabetes technology. Disclosure M.A.Crawford: Employee; Dexcom, Inc. C.Hicks: Employee; Dexcom, Inc. P.Genge: Employee; Dexcom, Inc. K.Greenawald: Employee; Dexcom, Inc. M.Tressler: Employee; Dexcom, Inc. D.R.Cherñavvsky: None. H.Singh: Employee; Tandem Diabetes Care, Inc., Dexcom, Inc. Funding Dexcom, Inc.

Perceptions and Experiences of Supplemental Nutrition Assistance Program (SNAP) Participants Related to Receiving Food and Nutrition-Related Text Messages Sent Agency-Wide: Findings from Focus Groups in San Diego County, California.

We developed and sent a series of five monthly text messages promoting fruit and vegetable consumption to approximately 170,000 SNAP participants in San Diego County, California. The text messages, which were sent in English and Spanish, included links to a dedicated bilingual website offering additional information, including how to select, store, and prepare seasonal fruits and vegetables, health benefits of different fruits and vegetables, recipes, and tips to reduce food waste. To our knowledge, this represents the first instance of a SNAP agency providing nutrition information directly to SNAP participants. We conducted seven focus groups (four in English and three in Spanish) with a convenience sample of twenty-six text message recipients, to elicit their perceptions of this intervention, self-reported behavior changes, and recommendations for moving forward. Respondents reported overwhelmingly positive perceptions of this effort, including increased intake of fruits and vegetables, and trying new fruits and vegetables. Participants also reported improved perceptions of SNAP. Virtually all would like this effort to continue, and many would like to receive the messages more frequently than once a month. This effort represents a relatively low-cost approach that SNAP agencies can implement to provide SNAP participants with food and nutrition information that can help them to improve their diets, optimize their food dollars, and enhance their feelings of well-being related to participating in the program.

Daily Dose of Development: Feasibility of an App-Based Curriculum of Normal Child Development for Pediatric Residents

Pediatric resident education in child development has historically not been taught in a formal manner despite it being identified as a priority for residency education.1 A significant proportion of children with developmental delays are not identified until they enter school, representing a lost opportunity for early intervention and underscoring the importance of targeted resident education in child development.The advent and acceleration of technology enhanced learning (TEL) led to the development of innovative educational curricula flexibly accessed by a learner. Prior TEL endeavors teaching child development relied on strategies employing passive review of videos or online material. Spaced education is a framework centered on presentation of concepts delivered longitudinally and repeated at varied intervals, improving retention of knowledge. Prior studies demonstrate improved knowledge recall, with few that examined impact on clinical care or optimal integration into clinical rotations.2Daily Dose of Development (3D) is a web or mobile application with a comprehensive database of clinical vignettes mapped to updated developmental milestones. Vignettes are presented through cycles of multimedia questions, allowing spaced interactive application of knowledge in realistic scenarios. Curriculum development was informed by 2 feasibility studies assessing different delivery mechanisms, a targeted needs assessment of resident learners, and qualitative interviews with child developmental experts.A randomized control study was performed to evaluate the feasibility, acceptability, and preliminary effectiveness of the 3D app. All pediatric residents (n=90) at a single training institution were invited to participate in the study, 30 of whom were randomized to either the app or control group. Baseline demographic data were collected prior to launch of the app curriculum, which cycled over 3 months. Control group residents participated in existing curricular opportunities in child development without access to the app until study conclusion. Feasibility was assessed using surveys at the beginning, midpoint, and end of the study period, examining comfort level in child development, app usability and impact on clinical care, and open-ended questions. App usage data from Google Analytics were also collected.Out of 30 residents, 17 were randomized to the app and 13 to the control group. Fifty-seven percent (17 of 30) of residents completed all surveys: 8 (47%) in the app and 9 (53%) in the control group. Baseline demographics were comparable between groups.All 17 residents accessed the app during the study period. Of those responding to all surveys, 63% (5 of 8) accessed daily. The mean number of responses per quiz was 8.9 (ranging from 2-16 responses). Identified features to enhance the app included ability to download content, zoom in on multimedia, reference article links, customize push notifications, and stack missed questions.At study conclusion, 100% of the app arm endorsed 3D as effective for learning child development. Statistically significant improvement in comfort with milestone recall (P=.007), development evaluation methods (P=.001), and identification of developmental delay (P=.046) were noted between groups. Fifty percent (4 of 8) of the app group reported improvement in patient developmental assessments, compared to 33% (3 of 9) in controls (P=.49). Feedback demonstrated desire for ongoing education in child development, enthusiasm, and desire for incorporation of the app into existing traditional curricula. Loss to follow-up and small sample size limited analysis.This study demonstrated feasibility, acceptability, and preliminary effectiveness of app-based spaced curriculum as an adjunct to clinical rotations. Self-reported behavior change in clinical care as a result of participation in the app curriculum is a novel area of impact for this type of curriculum and requires further study. Future iterations focused on optimal implementation strategies are needed to develop best practices of integrating TEL curricula with traditional clinical teaching.

A prospective study of the impact of COVID-19-related restrictions on activities and mobility upon physical activity, travel behaviour and attitudes

Background and aimsPublic health measures adopted to contain the spread of COVID-19 included restrictions on activities and mobility as people were asked to stay at home and schools moved to online learning. This may have increased risk of non-communicable disease by limiting recreational and transport-related physical activity. Building on an existing study, we assessed changes in self-reported and device-measured physical activity and travel behaviour before, during and after the peak of local COVID-19 outbreak and restrictions (March–July 2020). We examined beliefs in effectiveness of strategies to increase active and public transport after restrictions were reduced. MethodsA longitudinal study of adult infrequent bus users (average ≤ 2 trips per week; n = 70; 67% women) in Hobart, Australia. One-week assessment periods at four separate timepoints (before, during, 0–3 months after, and 3–6 months after the peak restrictions period) involved wearing an accelerometer, daily transport diaries, online surveys and tracking bus smartcard boardings. ResultsPhysical activity (especially among older participants), bus use and private motor vehicle use declined significantly during or 0–3 months after the peak restrictions period and returned to pre-restrictions levels by 3–6 months after the peak restrictions period, except bus use which remained significantly lower. Retrospective surveys overstated declines in bus use and active transport and self-reports understated declines in physical activity. Social distancing and improving service efficiency and frequency were seen as effective strategies for increasing bus use after restrictions but belief in effectiveness of distancing decreased over time. ConclusionsWhen restrictions on mobility are increased, supportive health promotion measures are needed to prevent declines in physical activity, particularly for older adults. Public transport systems need capacity to implement temporary distancing measures to prevent communicable disease transmission. Providing convenient, flexible, and efficient options for public transport may help to replenish public transport use after restrictions are reduced.

The Effects of COVID-19 Pandemic Lockdowns on Alcohol Consumption and Tobacco Smoking Behaviour in South Africa: A National Survey

Introduction: During the first phase of the coronavirus (COVID-19) pandemic lockdowns in South Africa (SA), both alcohol and tobacco were considered non-essential goods and their sales were initially prohibited and further restricted to certain days and timeframes. This study investigates self-reported changes in alcohol consumption and tobacco smoking behaviour in the general population during the COVID-19 pandemic lockdowns in SA. Methods: A cross-sectional national survey was conducted in October 2021 (before the Omicron wave 4 and while SA was in low-level lockdown) among 3,402 nationally representative respondents (weighted to 39,640,674) aged 18 years and older. Alcohol consumption and tobacco use were assessed from the beginning of the lockdown towards the end of March 2020 until October 2021 using the WHO-AUDIT and the US Centre for Disease Control (CDC) Global Adult Tobacco Survey questionnaires, respectively. Results: Among those that drank alcohol (33.2%), 31.4% were classified as having a drinking problem that could be hazardous or harmful and 18.9% had severe alcohol use disorder during the COVID-19 lockdowns. Twenty-two per cent (22.0%) of those that reported alcohol consumption reported that the COVID-19 pandemic lockdowns changed their alcohol consumption habits, with 38.1% reporting a decreased intake or quitting altogether. Among the one in five respondents (19.2%) who had ever smoked, most reported smoking at the time of the survey (82.6%) with many classified as light smokers (87.8%; ≤10 cigarettes/day). Almost a third (27.2%) of those smoking reported that the COVID-19 pandemic lockdowns had changed their use of tobacco products or vaping, with 60.0% reporting a reduction/quitting tobacco use. Given that sales were restricted this indicates that people could still get hold of tobacco products. Heavy smoking was associated with older age (p = 0.02), those classified as wealthy (p < 0.001), those who started or increased tobacco smoking during the pandemic lockdowns (p = 0.01) and residential provinces (p = 0.04). Conclusion: Given restrictions on the sale of alcohol and tobacco in SA between 27 March and August 17, 2020, during the pandemic, respondents reported an overall decline in alcohol consumption and tobacco use which might suggest that the regulatory restrictive strategies on sales had some effect but may be inadequate, especially during times where individuals are likely to experience high-stress levels. These changes in alcohol consumption and tobacco use were different from what was reported in several European countries, possibly due to differences in the restrictions imposed in SA when compared to these European countries.

Tackling Health Inequities: A Unique, Asynchronous Course Designed Through Peer-to-Peer Methods.

This study investigates the efficacy and feasibility of an asynchronous, peer-to-peer health disparities enrichment course on postbaccalaureate prehealth students' knowledge, behaviors, and reaction to course materials. Growing awareness of social inequities has prompted educators of prehealth and medical students to explore student education by addressing systemic healthcare issues. This cross-sectional study assessed reactions, learning, and self-reported behavior changes in students after taking the course "Social Determinants, Disparities, and Preparing for the Future of Healthcare" (SDDH). The curriculum was designed by prehealth postbaccalaureate students for their peers. Course goals were to educate participants on social determinants of health and to build cultural and structural competence in their roles as future healthcare professionals. SDDH is an asynchronous, noncredit-bearing, 5-h online course with 10 modules covering various topics. The Kirkpatrick Model was used to assess the effectiveness of the curriculum, alongside qualitative and quantitative analyses of student performance. Out of the 102 active students in the prehealth program that accepted the invitation to join, 29 students successfully completed the course (rate of completion = 28%). On average, students expressed positive reactions and attitudes toward the course and experienced an observable increase in knowledge assessment scores upon curriculum completion (P-value = .0002). Students' self-reported observations demonstrated sustained behavioral change 3 months after course completion. It is critical to educate prehealth students on health disparities, structural, and cultural competence. A course such as SDDH may help prehealth students build effective communication skills for advocacy and develop an empathetic, patient-centered approach earlier on in their career pursuit. Some barriers to students completing the entire course include its length, uncredited status, and voluntary self-enrollment.

The role of different characters on story-consistent attitudes and self-reported mental health-related behavior change among viewers of 13 Reasons Why.

The role of different characters on story-consistent attitudes and self-reported mental health-related behavior change among viewers of 13 Reasons Why.

Self-reported changes in sleep patterns and behavior in children and adolescents during COVID-19

The COVID-19 pandemic and lockdowns worldwide forced children and adolescents to change and adapt their lives to an unprecedented situation. Using an online survey, we investigated whether they showed changes in sleep quality and other related factors due to this event. Between February 21st, 2021 and April 19th, 2021, a total of 2,290 Austrian children and adolescents (6–18 years) reported their sleep habits and quality of sleep as well as physical activity, daylight exposure and usage of media devices during and, retrospectively, before the pandemic. Results showed an overall delay of sleep and wake times. Almost twice as many respondents reported having sleeping problems during the pandemic as compared to before, with insomnia, nightmares and daytime sleepiness being the most prevalent problems. Furthermore, sleeping problems and poor quality of sleep correlated positively with COVID-19 related anxiety. Lastly, results showed a change from regular to irregular bedtimes during COVID-19, higher napping rates, a strong to very strong decrease in physical activity and daylight exposure, as well as a high to very high increase in media consumption. We conclude that the increase in sleeping problems in children and adolescent during COVID-19 is concerning. Thus, health promoting measures and programs should be implemented and enforced.

Music festival drug checking: evaluation of an Australian pilot program

BackgroundThis paper explores the feasibility of delivering a music festival-based drug checking service in Australia, evaluating service design and stakeholder acceptability.MethodsQuestionnaire and interview data were collected from adult service users and key stakeholders. A mixed methods approach was used to analyse the data on implementation, impact and acceptability.ResultsThe trial service tested 170 substances with more than 230 patrons (including individuals who attended in groups). Adult service users had an average age of 21 years. Voluntary participation in the evaluation resulted in 158 participants completing the pre-service questionnaire, most of whom also completed the post-service (147 participants). Eleven in-depth qualitative interviews were conducted with patrons in the weeks following the drug checking. Concordance between what the patron expected the drug to be and drug checking results occurred in 88 per cent (n = 139) of the sample. Evaluation results show that the experience of testing and the accompanying harm reduction brief interventions positively impacted on patrons’ self-reported drug harm reduction knowledge, trust of health providers and stated drug use intentions. The service was received positively by service users.ConclusionThis is the first independent evaluation of a pilot drug checking service in Australia. Consideration of operational feasibility and self-reported behavioural change suggests that the program was successful, although communication about the interpretation of drug checking results could be improved. Future studies should develop strategies for follow-up and consider the applicability of behavioural change theory.

The Impact of Household Context on Self-Perceived Changes in Solo and Partnered Sexual Behaviors During the COVID-19 Pandemic: Findings from a U.S. Probability Survey.

To understand how household context factors impacted self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the COVID- 19 pandemic, we conducted an online, nationally representative, cross-sectional survey of U.S. adults (N = 1010; aged 18-94years; 62% response rate) from April 10-20, 2020. We used weighted descriptive statistics with Wilcoxon rank sign tests to understand the population prevalence and significance of self-reported changes (five-point scale: much less to much more) in 10 solo and partnered sexual behaviors. Ordinal regression was used to assess the impact of household predictor variables-including number of children at home, number of adults in home, partnership status (unpartnered, partnered and not living together, partnered and living together) and employment status (not working, employed not as essential worker, employed as essential worker). All models were adjusted for gender, age, sexual orientation, race/ethnicity, and residence location (urban, suburban, rural).All solo and partnered sexual behaviors showed some amount of significant change-increased activity for some and decreased for others-for U.S. adults during the pandemic. Not living with a partner was broadly associated with decreased affectionate partnered sexual behaviors; unpartnered adults reported increased sexting. Individuals not employed reported increased oral sex and increased consumption of sexually explicit materials as compared to non-essential workers. Number of children at home and household size were not significantly linked to self-reported behavior change. Ongoing sexual health-focused research should continue to focus on understanding how adults manage opportunities and constraints to their sexual lives in the context of a still-going pandemic. While many aspects of social life look more "normal" (e.g., many people have returned to their in-person offices and children are largely back in school), new and more-infectious strains of COVID-19 have proven that the pandemic may still yet impact daily living. Lessons learned from COVID need to include sexual health planning both for any future strains of COVID, as well as for future public health emergencies.

The Impact of First UK-Wide Lockdown (March–June 2020) on Sexual Behaviors in Men and Gender Diverse People Who Have Sex with Men During the COVID-19 Pandemic: A Cross-Sectional Survey

The global COVID-19 pandemic resulted in strict social distancing measures restricting close physical contact. Men (cis and trans) and other gender diverse people who have sex with men (MGDSM) are at higher risk of sexually transmitted infections (STIs) and may have experienced changes in sexual behavior during government restrictions on social and sexual contact. We aimed to examine self-reported sexual behavior of MGDSM during the first UK-wide lockdown to identify the characteristics of the individuals who might most require sexual health promotion and clinical support. In April–May 2020, we conducted an online survey of MGDSM, promoted on social media and Grindr. Our exploratory approach used descriptive analysis to identify self-reported changes in sexual behavior and performed regression analyses to identify correlates of casual sex during the lockdown. A total of 1429 respondents completed the survey: mean age 36 years, 84% White, 97% male or trans male, 98% assigned male sex at birth, 2% female or non-binary, 65% degree educated or higher. During the lockdown, 76% reported not having any casual sex partners. While the majority reported reduced casual sex, 3% reported an increase in casual sex with one person and 2% with three or more people (group sex). About 12% of the sample engaged in casual sex with only one person and 5% with four or more sexual partners during the lockdown. Reporting casual sex during lockdown was associated with: lower level of education OR = 2.37 [95% CI 1.40–4.01]; identifying as a member of an ethnic minority OR = 2.27[1.40–3.53]; daily usage of sexual networking apps OR = 2.24[1.54–3.25]; being less anxious about contracting SARS-CoV-2 through sex OR = 1.66[1.12–2.44]; using PrEP before lockdown OR = 1.75[1.20–2.56]; continuing to use PrEP OR = 2.79[1.76–4.57]; and testing for STIs during lockdown OR = 2.65[1.76–3.99]. A quarter of respondents remained sexually active with casual partners, indicating a need to provide STI screening services and health promotion targeted to groups most likely to have need over this period. Future research is required to better understand how to support sexual and gender minorities to manage sexual risk in the context of pandemic public health initiatives.

Isidingo as entertainment-education

In developing countries, the popular media can be used effectively to address socialproblems (Vaughan, Rogers, Singhal &amp; Swalehe, 2000:82). In recent decades, variousdevelopmental, educational and other socially useful messages have often been includedin the content of soap operas (Mody, 1991).The producers of South African soap opera Isidingo are acutely aware of their socialresponsibility and therefore attempt to make a contribution towards social change andnation building. As such, Isidingo employs positive role models to transmit pro-socialmessages to its viewers. This paper will report on a study that explored the applicationof the entertainment-education (E-E) strategy in the local soap opera Isidingo byinvestigating the perceptions of female viewers in respect of self-reported knowledgeacquisition, attitudes and behavioural changes due to watching this programme.

Swap Up Your Meal: A Mass Media Nutrition Education Campaign for Oklahoma Teens.

To address a statewide need for obesity prevention, the Oklahoma Tobacco Settlement Endowment Trust launched Swap Up in 2021, a mass media nutrition education effort for teens, ages 13–18. Swap Up utilizes the SAVI messaging approach, an audience-centric message development framework that recognizes barriers to healthy living and offers realistic solutions. Five months into the campaign, an online survey was conducted (n = 200) to assess short-term program goals related to campaign delivery, engagement, and relevance. A secondary, long-term goal related to documenting and understanding self-reported changes in past month nutrition-related behaviors was also explored. A majority of participants (72%) reported aided awareness of the campaign brand logo/advertisements, and awareness (83%) of at least one main message. Nearly half (44%) of the participants reported at least one engagement with digital media. Main message recognition, perceived relevance, and self-reported nutritional behaviors were consistently highest among those reporting both campaign awareness and digital engagement. Ultimately, Swap Up reached and delivered nutrition education messages to Oklahoma teens within the first year of launch, as intended, and was associated with self-reported changes in recent behavior. This study provides evidence that SAVI offers a promising approach for nutrition education, and underscores why digital and social media engagement strategies are critical for mass media teen behavior change campaigns. Campaign implementation and evaluation are ongoing.