Soft Interventions Research Articles

Personalizing travel behaviour change interventions using the trans-theoretical model and multimodality data

IntroductionBehaviourally informed soft policies, such as nudges, have become popular in areas like health, environment, and energy use as cost-effective instruments to change behaviour and decision-making. However, the effectiveness of soft policies in the transport sector is modest at best. One reason for this relative ineffectiveness might be their one-size-fits-all nature, and personalizing soft interventions has been suggested to increase their effectiveness. The Trans-theoretical Model (TTM) suggests that people progress through five stages of behavioural change, from pre-contemplating a behaviour to maintaining the behaviour, and behavioural interventions could be designed for specific stages. However, it is not always feasible to conduct surveys to place people at different stages of the TTM.MethodsThis paper explores whether it is possible to use multimodality data taken from a travel diary to place people at different stages of the TTM. The analysis uses an existing dataset from 826 respondents that includes self-reported TTM stages regarding cycling and data on multimodality. In the analysis, the multimodality data are used to allocate respondents to categories and assign them to TTM stages. The performances of the stage assignment approaches are evaluated using the self-reported TTM data and confusion matrices.FindingsThe accuracy of the allocation of participants to TTM stages using multimodality data is approximately 75%. The accuracy is higher for early stages (pre-contemplation) and later stages (maintenance) of the TTM. A data-driven approach to dealing with multimodality data performs slightly better than an approach that relies on pre-defined categorization.ConclusionThe paper suggests that it will be possible in the future to personalise behavioural interventions according to the stages of the TTM even in the absence of self-reported survey data that classifies people to TTM stages if objective multimodality data are available.

Postoperative Benefits of Soft Tissue Wrist Arthroscopy: Retro- and Prospective Analyses of Outcome Measures.

Background: Elective soft-tissue-only wrist arthroscopy is a standard procedure in hand surgery for the diagnosis and treatment of wrist pain. A number of pathologies can be treated arthroscopically, with the aim of pain reduction and improved wrist mobility. A postinterventional evaluation of the treatment using objective and patient-reported outcome measures (PROMs) allows for an evidence-based statement about the benefits of soft-tissue-only wrist arthroscopy. Methods: A dual-center study combining retro- and prospective clinical analyses of patient outcomes after soft-tissue-only wrist arthroscopies was performed. The data were collected at two hospitals with departments specializing in hand surgery. The outcome was measured by assessing the range of motion of the wrist and its manual strength, as well as PROMs, including Disabilities of the Arm, Shoulder and Hand (DASH) scores. Results: A total of 154 soft interventions met the study criteria and could be included. Seven months after the elective soft-tissue-only wrist arthroscopies, mobility improved significantly for active extension and flexion, as well as the ulnar and radial abduction of the wrist. The grip strength also improved significantly, by an average of 6 kg, during this period. The DASH score improved significantly, from 35 points to 14 points. Additionally, wrist pain at rest was reduced significantly. Conclusions: After elective soft-tissue-only wrist arthroscopy, patients showed an overall functional improvement in their wrist, with a significant reduction in pain and improvement of mobility and grip strength. This study emphasizes the importance of wrist arthroscopy as a successful treatment option for soft tissue pathologies of the wrist.

Education of Patients With Atrial Fibrillation and Evaluation of the Efficacy of a Mobile Virtual Patient Environment: Protocol for a Multicenter Pseudorandomized Controlled Trial.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a leading cause of mortality and morbidity. Patient knowledge about AF and its management is paramount but often limited. Patients need to be appropriately informed about treatment options, medicinal adherence, and potential consequences of nonadherence, while also understanding treatment goals and expectations from it. Mobile health apps have experienced an explosion both in their availability and acceptance as "soft interventions" for patient engagement and education; however, the prolific nature of such solutions revealed a gap in the evidence base regarding their efficacy and impact. Virtual patients (VPs), interactive computer simulations, have been used as learning activities in modern health care education. VPs demonstrably improved cognitive and behavioral skills; hence, they have been effectively implemented across undergraduate and postgraduate curricula. However, their application in patient education has been rather limited so far. This work aims to implement and evaluate the efficacy of a mobile-deployed VP regimen for the education and engagement of patients with AF on crucial topics regarding their condition. A mobile VP app is being developed with the goal of each VP being a simple scenario with a set goal and very specific messages and will be subsequently attempted and evaluated. A mobile VP player app is being developed so as to be used for the design of 3 educational scenarios for AF management. A pseudorandomized controlled trial for the efficacy of VPs is planned to be executed at 3 sites in Greece, Ukraine, and Kazakhstan for patients with AF. The Welch t test will be used to demonstrate the performance of patients' evaluation of the VP experience. Our study is at the development stage. A preliminary study regarding the system's development and feasibility was initiated in December 2022. The results of our study are expected to be available in 2024 or when the needed sample size is achieved. This study aims to evaluate and demonstrate the first significant evidence for the value of VP resources in outreach and training endeavors for empowering and patients with AF and fostering healthy habits among them. PRR1-10.2196/45946.

Causality-Based Fair Multiple Decision by Response Functions

A recent trend of fair machine learning is to build a decision model subjected to causality-based fairness requirements, which concern with the causality between sensitive attributes and decisions. Almost all (if not all) solutions focus on a single fair decision model and assume no hidden confounder to model causal effects in a too simplified way. However, multiple interdependent decision models are actually used and discrimination may transmit among them. The hidden confounder is another inescapable fact and causal effects cannot be computed from observational data in the unidentifiable situation. To address these problems, we propose a method called CMFL (Causality-based Multiple Fairness Learning). CMFL parameterizes the causal model by response-function variables, whose distributions capture the randomness of causal models. CMFL treats each classifier as a soft intervention to infer the post-intervention distribution, and combines the fairness constraints with the classification loss to train multiple decision classifiers. In this way, all classifiers can make approximately fair decisions. Experiments on synthetic and benchmark datasets confirm its effectiveness, the response-function variables can deal with the unidentifiable issue and hidden confounders.

The quizzical failure of a nudge on academic integrity education: a randomized controlled trial

BackgroundStudies on academic integrity reveal high rates of plagiarism and cheating among students. We have developed an online teaching tool, Integrity Games (https://integgame.eu/), that uses serious games to teach academic integrity. In this paper, we test the impact of a soft intervention – a short quiz – that was added to the Integrity Games website to increase users’ interest in learning about integrity. Based on general principles of behavioral science, our quiz highlighted the intricacy of integrity issues, generated social comparisons, and produced personalized advice. We expected that these interventions would create a need for knowledge and encourage participants to spend more time on the website.MethodsIn a randomized controlled trial involving N = 405 students from Switzerland and France, half of the users had to take a short quiz before playing the serious games, while the other half could directly play the games. We measured how much time they spent playing the games, and, in a post-experimental survey, we measured their desire to learn about integrity issues and their understanding of integrity issues.ResultsContrary to our expectations, the quiz had a negative impact on time spent playing the serious games. Moreover, the quiz did not increase participants' desire to learn about integrity issues or their overall understanding of the topic.ConclusionsOur quiz did not have any measurable impact on curiosity or understanding of integrity issues, and may have had a negative impact on time spent on the Integrity games website. Our results highlight the difficulty of implementing behavioral insights in a real-world setting.Trial registrationThe study was preregistered at https://osf.io/73xty.

GEO spacecraft maneuver detection based on causal inference

Geosynchronous (GEO) spacecraft maneuver detection is deemed crucial for space domain awareness (SDA) as it helps to maintain catalogs of high value resident space objects (RSOs). However, several difficulties in resolving maneuver time and requirements for historical data quality still exist for the current research. This paper proposes a method based on causal inference for accurate and timely detection of the maneuver using real-time observational data from optical sensors. Firstly, the residual information of time series observations is obtained through counterfactual reasoning. Secondly, according to the Gaussianity of the optical sensor observation noise, a structural causal equation (SCE) of the residuals of time series observations is derived. Lastly, the maneuver is abstracted as a soft intervention, and the minimum average treatment effect (MATE) is proposed to estimate the effect of the maneuver and used as a feature parameter to identify the GEO spacecraft maneuver. After experimental analysis, the detection rate and detection timeliness of the proposed method reach more than 90%, a significant improvement compared with the conventional χ2, skewness, and kurtosis test methods.

Self-adaptive hybrid urban morphologies community (HUMC): Its shared environment and soft intervention for sustainable urban governance

Cities have entered a transitional stage from incremental development to intension existent development. Beyond demolition and reconstruction, revitalising existing functioning neighbourhoods to make them more liveable and resilient while balancing their inter-relationships is an important topic in sustainable urban planning and governance. This paper puts forward a conceptual model for a “hybrid urban morphologies community” (HUMC) and explores its collective environmental performances. Taking the Hubei HUMC as a case study site, the paper examines its diverse temporal-spatial environmental performances by adopting on-site observation and measurement, focusing on local micro-scale climate, thermal comfort, and pedestrian ventilation capacity. Results reveal that none of the eight examined morphological patterns in Hubei HUMC consistently exhibited satisfactory environmental performance across all time periods in a typical summer day. Each morphological pattern presented varied merits and drawbacks during specific time periods. These morphological patterns together create an environmental complementary and form a synergetic socio-ecological system under the shared environment mechanism, which enables residents to have continuous outdoor habitation. Correlation and regression analyses illustrated that SVF, TSF, GCR, and GSA were the most critical of the “adaptable” urban morphological indicators (UMIs) that influenced urban outdoor environmental performances. Ultimately, soft intervention is advocated through temporarily rather than permanently adjusting these “adaptable” UMIs to ameliorate spaces with unsatisfactory environmental performances during the specific time periods. The proposed HUMC provides a reference model for urban management zoning and establishment of resilient self-adaptive urban communities.

Examining transportation mode changes during COVID-19 in Toyama, Japan

ABSTRACT Although the coronavirus disease of 2019 arguably changed citizens’ transportation mode choices, how these choices changed and what factors influenced them, especially during the soft intervention period, remains ambiguous. To clarify this phenomenon, this study examined how citizens’ socio-demographic and psychological factors contributed to their transportation mode changes (public transportation, active transportation: walking and cycling, and cars) between 2019 and 2020. We employed the extended theory of the norm activation model and the value–attitude–behaviour hierarchy, surveyed 973 citizens in Toyama City, Japan, and applied a confirmatory factor analysis and a multinomial logistic regression model. Regarding psychological characteristics, the findings showed that those with positive attitudes toward public transportation tended to shift to public transportation; those with high personal norms for car use tended to shift to public transportation; those with perceived behavioural control over car use tended not to change to public transportation; and those with positive attitudes toward car use tended not to shift to active transportation. Socio-demographically, respondents who were female, highly educated and/or whose income decreased from the previous year tended to shift to active transportation. Age was not significantly associated with transportation mode changes. No significant variable was found between respondents’ shift to cars and socio-demographic and psychological factors. Our study provides implications, suggesting that policymakers focus on adopting measures to retain female or highly educated individuals in the active transportation mode use even beyond the pandemic period, while raising awareness among men, informing them of the health benefits of the active transportation mode and establishing active transportation mode-friendly infrastructure.

Does the joint implementation of hard and soft transportation policies lead to travel behavior change? An experimental analysis

Over the last few decades, there has been a growing interest in a variety of travel demand management strategies, both hard and soft, aimed at persuading people to reduce their car use. However, only few studies employed predictive models to assess the effectiveness of soft interventions and understand the impact of both objective and socio-psychological variables on changes in travel behavior. Additionally, though a combination of hard and soft measures is recognized as achieving the best results in reducing car use, few studies differentiate between the effects of the two types. The aim of this work is to quantify the effect of a combination of hard (introduction of a new light railway line) and soft measures (Personalized Travel Plan program) among a group of car drivers in the metropolitan area of Cagliari (Sardinia, Italy). We used data collected before and after the implementation of a Personalized Travel Plan program, where a control group was identified to disentangle the effect of the hard from the soft measure. We specified and estimated an Integrated Choice and Laten Variable (ICLV) model to assess the effect of both objective characteristics and some socio-psychological variables on the choice to use a new light railway service or not. Model results point out that people who lived along the light rail corridor and received and read their Personalized Travel Plan were more likely to switch from car to the light rail. Furthermore, we found that the parameters associated with the psycho-social variables Attachment to the car and Dislike of public transport have a negative influence on the probability to use the new travel alternative. At the same time, our findings on the effect of the soft measure need to be interpreted with some caution as its impact on choice probability was mitigated by travel distance and psycho-social variables.

Soft Economic Incentives and Soft Behavioral Interventions on the Public's Green Purchasing Behaviour - The Evidence from China.

PurposeTo explore the effects of “soft” behavioral intervention policies (eg, green emotions, social norms) and “soft” economic incentive policies (eg, high-intensity subsidies, low-intensity subsidies) and their combinations on the public’s green product purchasing behavior.Participants and MethodsAn online questionnaire experiment was conducted on Chinese users using Credamo online questionnaire platform to explore the effects of different “soft” intervention policies on consumers’ green purchasing behavior, and the sample data were examined using multiple regression. In Study 1, a total of 460 valid samples were collected to explore the differences in the effects of single intervention policies; in Study 2, a total of 556 valid samples were collected to explore the effects of a combination of soft policies.ResultsIn the area of green product purchasing, both behavioral interventions and economic incentives alone can promote green consumption behavior; economic incentives have a more positive impact on guiding consumers to green consumption; the combination of “soft” behavioral interventions and “soft” economic incentives has a positive impact on green consumption. The combination of “soft” behavioral intervention policies and “soft” economic incentive policies is more effective than the individual policies.ConclusionThe experimental results of Study 1 show that the policy effects of both behavioral intervention policies and economic incentive intervention policies are evident for goods with different value attributes. Meanwhile, comparing the two types of soft intervention policies, we find that the effect of economic incentive intervention policies is stronger than that of soft behavioral intervention policies. In Study 2, the empirical analysis of the policy mix shows that the policy mix is more effective. The combination of “soft” economic incentive policies and “soft” behavioral intervention policies can effectively increase the salience of policy instruments, and the effect of policy combinations is greater than that of single policies.

Achieving Long-Term Fairness in Sequential Decision Making

In this paper, we propose a framework for achieving long-term fair sequential decision making. By conducting both the hard and soft interventions, we propose to take path-specific effects on the time-lagged causal graph as a quantitative tool for measuring long-term fairness. The problem of fair sequential decision making is then formulated as a constrained optimization problem with the utility as the objective and the long-term and short-term fairness as constraints. We show that such an optimization problem can be converted to a performative risk optimization. Finally, repeated risk minimization (RRM) is used for model training, and the convergence of RRM is theoretically analyzed. The empirical evaluation shows the effectiveness of the proposed algorithm on synthetic and semi-synthetic temporal datasets.

Achieving Counterfactual Fairness for Causal Bandit

In online recommendation, customers arrive in a sequential and stochastic manner from an underlying distribution and the online decision model recommends a chosen item for each arriving individual based on some strategy. We study how to recommend an item at each step to maximize the expected reward while achieving user-side fairness for customers, i.e., customers who share similar profiles will receive a similar reward regardless of their sensitive attributes and items being recommended. By incorporating causal inference into bandits and adopting soft intervention to model the arm selection strategy, we first propose the d-separation based UCB algorithm (D-UCB) to explore the utilization of the d-separation set in reducing the amount of exploration needed to achieve low cumulative regret. Based on that, we then propose the fair causal bandit (F-UCB) for achieving the counterfactual individual fairness. Both theoretical analysis and empirical evaluation demonstrate effectiveness of our algorithms.

Near-Peer Facilitation of a Soft Skills Program for Young Adults With Autism.

Young adults with autism spectrum disorder (ASD) experience poor employment outcomes. Teaching soft skills and using peer-based interventions improve outcomes for people with ASD. To evaluate the preliminary efficacy of a soft skills intervention and the feasibility of delivery to a group of young adults with ASD by near-peer occupational therapy master's-level students. Pretest-posttest single-group design. College campus. Convenience sample of 14 young adults (M age = 21.57 yr) with ASD. The Assistive Soft Skills and Employment Training (ASSET) program is a 12-session, manualized, soft skills group intervention previously validated with the ASD population. Topics include communication, attitude and enthusiasm, teamwork, networking, professionalism, and stress management. Social functioning, self-efficacy, and adaptive behavior were measured preintervention and immediately postintervention using standardized self-report rating scales. Participant satisfaction and experience were assessed using program-specific measures. Participants made statistically significant improvements, with medium to large effect sizes in social functioning, self-efficacy, and adaptive behavior. They reported high levels of satisfaction and a positive experience with the program content and delivery. This study provides evidence of participant satisfaction and perceived soft skills improvement and confidence, in addition to the preliminary efficacy of master's-level students as near-peer facilitators of the ASSET program with an ASD population. What This Article Adds: The results suggest that trained and supervised master's-level students can effectively deliver a manualized intervention as near-peer facilitators, elicit positive feedback and high levels of participant satisfaction, and replicate and extend previously reported participant gains.

The impact of conservative soft orthotic intervention with strapping on thoracic kyphotic posture and spinal mobility in children with cerebral palsy: a randomized control trial

BackgroundThis study mainly aimed to evaluate the influences of Thera Togs orthotic undergarment with its strapping system on dorsal kyphotic posture and spinal mobility in children with spastic diplegic cerebral palsy. The study also investigated the impact of the modulation of thoracic kyphosis on balance and risk of falls in these children.Study designThis study was a randomized control trial.ParticipantsForty children with diplegic cerebral palsy, aged from 8 to 10 years were met the inclusion criteria and participated in this study. Only 38 children completed the study.MethodsThe children in the control group received 2 h of conventional exercise protocol aiming for modulating thoracic kyphotic posture. The treatment program was conducted 3 times/week, for 12 successive weeks. Children in the study group wore TheraTogs orthoses with the strapping system for 8 h every day in combination with the conventional exercise program.Outcome measuresFor both groups, the primary outcome measures (thoracic kyphotic angle, and thoracic flexion and extension range of motion), and the secondary outcomes (the overall stability index of fall risk test, and the pediatric balance scale score) were recorded at baseline and after completion of the treatment. T test was used to compare the changes within-and between-groups in all measured variables, at baseline and immediately after 12 weeks of treatment.ResultsChildren in the study group showed significant improvements in the scores of all primary and secondary measures post-treatment compared to the control group (P < 0.05).ConclusionConservative treatment composed of TheraTogs orthotic system with conventional exercise treatment is effective in modulating thoracic kyphosis and improving dorsal range of motion in children with spastic diplegic cerebral palsy. This improvement has a positive influence on postural balance performance and reduces the risk of fall in these children.Trial registrationThe ClinicalTrial.gov PRS (NCT05063175). 30 September 2021—retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05063175

Sensitization of Online Users for Social Resilience: A Case-based Analysis of Learning Outcomes

The article is based on the learning outcomes of a sensitization session held with students enrolled in eleven universities of the twin cities under a project titled Sensitization of Youth for Socially Resilient Communities in the Digitalizing World. The objectives were to sensitize youth for safe digital behaviour, spread the message of respecting human values, personal space, and privacy in digital communication, communicate the harassment policy concerns, and promote the emerging normative order for respecting cultural diversity and harmony for self-actualization behavioural change. Around 500 students directly participated in online and in-person sessions. The findings are based on the post-session assessment results recorded from 374 responses. The project outcome reflects a better understanding of the notion of privacy, personal space, cyber-bullying, cyber-crimes, online sexual assaults, types &amp; legislation against harassment through a US-Pakistan diplomatic soft intervention and initiative for Pakistani youth.

The lock pickers, the gatekeepers, and the non-grievables: a case study of youth workers’ roles in preventing violent extremism

ABSTRACT In the prevention of violent extremism (PVE), various so-called soft interventions have been introduced, suggesting that teachers, social workers, and youth workers play key roles in detecting and responding to early signs of radicalization leading to violent extremism. Research has been conducted on how these interventions are being implemented and whether or not they may contribute to the securitization of welfare work. In this case study, eleven youth workers and their three managers were interviewed about their experiences of engaging in PVE work. They all worked in a neighbourhood in Gothenburg, Sweden, which was one of the earliest and most affected areas in Europe for recruitment to what was to become the so-called Islamic State (IS). The study focuses on their recollection of how they were informed about the on-going radicalization to violent extremism at the time, what actions they took, and how they were prepared for conducting PVE work. Some of the youth workers noticed signs of radicalization to violent extremism early in 2013, but they worked on short-term contracts and were not in a position to pass on the information to higher authorities. A better organized Gothenburg city could have started its PVE work two years earlier, rather than in 2015.

COVID-19, policy interventions and credit: The Brazilian experience

The COVID-19 pandemic caused a global health and economic crisis to which governments responded with massive policy interventions. Using Brazil as a testing ground, we investigate the influence of the pandemic and ensuing policy interventions on local credit markets. First, we find that the pandemic has a significantly negative impact on local credit. Second, using a novel manually collected database on the staggered municipal government policy interventions, we show heterogenous effects of interventions: positive effects of soft interventions (e.g., social distancing and mass gathering restrictions) and late reopening, and negative effects of hard interventions (e.g., closure of non-essential services) and early reopening. Third, we find that state-owned banks grant more local credit than privately owned banks during the COVID-19 crisis but this difference is less pronounced than it was in the 2008 Financial Crisis. We confirm our results using pre-pandemic local political preference as instrument for policy interventions and orthogonalized policy intervention indicators, and in placebo tests.

Entrepreneurial motivational factors and operational performance of small-scale industries in Yanya

To address the growing labour unemployment rate in Nigeria, several hard and soft intervention policies have been put in place by the Nigerian government and supporting partners. Based on the assumption that unemployment, government interventions, and personal ambition can motivate individuals into entrepreneurship, this study examined the effect of entrepreneurial motivational factors on the operational performance of Small Scale Industries (SSIs) located in Yanya, Abuja. Relying on a cross-sectional survey research design, 337 practicing entrepreneurs, random sampling technique and multiple regression analysis, the study found that facilitating and compelling motivational factors are the significant predictors of SSIs’ performance, while ambitious motivational factor is negatively but significantly impactful on SSIs’ performance. It, therefore, suffices to recommend that the Nigerian government and organized private sector should collaborate to increase the stock of hard and soft infrastructure, especially in the industrial estates and business clusters, to enhance entrepreneurship participation and inclusiveness

Greening the Chinese Leviathan: China’s renewable energy governance as a source of soft power

This article examines China’s rapid and large-scale renewable energy expansion and the challenge it presents to orthodox approaches to sustainable energy diffusion that emphasise soft interventions and stakeholder participation. We show that China eschewed participatory modes of energy governance and pursued a centrally steered, hard interventionist strategy adapted to its non-democratic regime. We observe that China’s approach provides an alternative blueprint for development that is potentially attractive to some audiences. Drawing on recent soft power debates, we argue that China’s hard interventionist mode of governance in the renewables sector has the potential to enhance Chinese soft power both domestically and abroad.

Résultats d’une intervention pluridisciplinaire en thérapie comportementale, psycho-nutrition et activité physique sur les troubles alimentaires d’adultes en surpoids entre 2016 et 2018

ObjectivesThere is a growing need to build healthcare program addressed to overweighed and obese people suffering from eating disorders. The program named “Surpoids Objectif Forme Training” (SOFT) is dedicated to eating disorders care in overweighed people. In this study we wanted to assess severity of eating disorder before, and after the intervention with measuring Three Factors Eating Questionnaire (TFEQ) score in all patients who attended the program between years 2016 and 2018. Materials and methodsSOFT is a multidisciplinary intervention organised for outpatients in Hospital La Casamance located in Aubagne, France. For each SOFT intervention lasting 10 weeks, patients were attending 40 sessions: 10 sessions in cognitive therapy in order to understand compulsive eating and to increase emotions skills (to recognize and to face emotions) and alternative behaviours; 10 sessions in psycho-nutrition with working on cognitive flexibility, connection to present and to senses (mindful eating) and recognizing sensations of hunger and satiating; 10 sessions of physiotherapy to get aware of body needs with hypopressive gymnastics and proprioceptive training; 10 sessions in adapted physical activity to encourage daily moderate physical activity and to introduce changes in patients way of living. This study was a prospective cohort study, in which we included all overweighed adults patients suffering from compulsive eating disorder including binge eating disorder and night eating syndrome. We wanted to assess TFEQ score before and after the program. We also measured Body Mass Index (BMI), bioelectrical impedance (muscle and fat mass), waist and hip circumferences, waist-hip ratio, endurance with 6minutes walking test and muscle strength. ResultsTwo hundred and one patients were included and 168 followed the entire program. The average BMI in our group was 35kg/m2. Less than 25% of patients were suffering of binge eating disorder but most of patients had compulsive eating (65%). More than 50% of them had a TFEQ score higher than 25 before entering the program (average TFEQ was 25.2). After the program average TFEQ score had decreased from 25.2 to 20.0 (P<10−4), with only 17.9% of patients with a TFEQ score above 25. These results showed improvement of severity of eating disorders with our multidisciplinary intervention. The cognitive restraint factor (F1) was not significantly decreased after intervention (P=0.884), but disinhibition factor (F2) and hunger factor (F3) were significantly decreased (P<10−4 for both) showing less compulsive behaviours and better hunger perception. BMI was also decreased after the intervention from 35.8 to 35.5 (P=0.003). Waist hip ratio decreased from 0.86 to 0.85 (P=0.002) but muscle and fat mass were not significantly changed. Physical activity parameters were also improved, with 586 meters distance in 6minutes walking test instead of 499 meters (P<10−4) and 30 repetitions instead of 25 (P<10−4) in one minute sit-to-stand test. ConclusionsMost of patients were female, usually more frequent in eating disorders patients. More than 65% of patients had compulsive disorders without BED, which shows probably numerous atypical forms. Severity of eating troubles was decreased after intervention in disinhibition and perception of hunger, but cognitive restriction was increased in some patients, probably because they were trying to lose weight during SOFT program. In the same way, despite of a significant loss of weight, there was no change in muscle and fat mass proportions after intervention. By the way reducing restriction was sometimes inducing increase of intakes in some patients, and as a result no change observed in average body fat mass and muscle mass. After intervention we also noticed that waist circumference, hip circumference and waist-hip ratio were significantly decreased, probably thanks to physical activity targeting posture and improving global physical condition. We observed also best performances in muscle strength (sit to stand test) and in endurance (6minutes walking test). Main limitations in this study were: a non-randomized non controlled study design; lack of long term assessment (which is very important for maintaining weight and avoid medical complications of overweighting) and no assessment of patient's quality of life after intervention as we think this is a great part of motivation to maintain long term changes of way of life. Despite these limitations, we hope that this program could be extended to all patients suffering from obesity and eating disorders with efficiency on eating behaviour. Changes in eating behaviour and in physical activity seem to be the first step to maintain weight at a long term perspective.