Stages Of Behavior Change Research Articles

Adoption intentions of home-refill delivery service for fast-moving consumer goods

Plastic waste from fast-moving consumer goods packaging has become a global concern. One solution is home-refill delivery service (HRDS) that offer the distribution of consumable products, including to environmentally conscious customers. This research thus employs an extended Technology Acceptance Model (TAM) with environmental concerns, green perceived value, and trust to explore the factors involved in the adoption intentions of HRDS among Indonesian consumers. From hypotheses empirically evaluated using partial least square structural equation modelling and multi-group analysis, we show a strong relationship between attitudes and adoption intentions of HRDS. Environmental concern relates significantly to green perceived value, perceived ease of use, and trust in forming positive attitudes toward HRDS. We further identify heterogeneity in relationships across socio-demographic characteristics, levels of trust, and stages of behavioral change. The findings herein provide useful insights into zero waste delivery services for consumer goods and empirical support for the important roles of consumer trust and environmental concern when adopting such services.

Action status and willingness to change health-promoting behaviors during the COVID-19 pandemic among elementary school children: a study based on Prochaska’s stages of behavior change theory (TTM)

Background & aim:COVID-19 pandemic has significant effects on lifestyle and health-promoting behaviors and adolescence is a very critical period due to the importance of identity formation and individual behaviors. Therefore, the aim of this study was to determine the status of health- promoting behaviors in the sixth grade male students attending elementary schools in Ardabil city based on Prochaska ‘s stages of behavior change (TTM).Materials & methods:This analytical cross-sectional study was conducted on the 619 sixth grade male students attending elementary schools during 2021. The data were collected using two instruments (a researcher-made questionnaire and Health Promoting Lifestyle Profile-II (HPLP-II) questionnaire). The data were analyzed using SPSS version 22 and one-way analysis of variance.Results:The majority of students in physical activity and healthy eating behaviors were in the pre-contemplation stage, 29.6% (183 people) and 33.1% (205 people), respectively. All dimensions of health-promoting behaviors were observed to have a significant relationship with the stages of Prochaska’s theory behavior change in students, their decision-making balance and self-efficacy scores (P < 0.001).Conclusion:The health of students is under serious threat due to the poor state of health-promoting behaviors and the weak desire to change behavior. By planning in educating the students, significant changes can be made in changing their behavior and improving their health.

A self-liberation intervention using a pedometer to encourage physical activity among sedentary nursing staff: A randomized controlled trial.

Nurses make up the majority of the workforce in any healthcare system. Physical inactivity due to heavy workloads has been widely reported among nurses. This study aimed to examine whether a self-liberation intervention could help nurses increase their physical activity levels that would result in other health benefits. A two-armed randomized controlled trial was implemented among 40 nurses (20 per arm). The control arm received information about the benefits of physical activity, but with no intervention. The intervention arm received the same information and were given pedometers for 12 weeks to record their daily steps while also receiving weekly reminders. Measurements were taken for anthropometric data, self-reported physical activity, exercise stage-of-change, exercise self-efficacy, and pedometer steps (intervention arm only). All statistical analyses were two-sided, with p ⩽ 0.05. The respondents' mean age was 47.9 ± 7.02 years with 90% being female. After the intervention, the intervention arm achieved a higher self-efficacy score (4.60 ± 1.75 to 5.63 ± 2.48) while a decline was observed in the control arm (5.02 ± 2.08 to 4.50 ± 1.90). At baseline, 16.7% (n = 3) of the control arm and 27.8% (n = 5) of the intervention arm were classified as moderately physically active (McNemar's test = 1.20, p = 0.549). After 12 weeks, this proportion increased to 27.7% (n = 5) in the control arm and 50.0% (n = 9) in the intervention arm (McNemar's test = 5.00, p = 0.172). For the intervention arm, mean daily step counts rose from 8889 ± 579.84 at week 1 to 9930 ± 986.52 at week 12 and reached the level of statistical significance (p < 0.01). Waist circumference of the intervention arm decreased significantly more than that of the control group (p < 0.01). The self-liberation intervention using a pedometer had positive effects on assisting sedentary nursing staff to progress through the stages of health behavior change and on their exercise self-efficacy, which could further help increase their exercise adherence and overall physical and mental wellbeing.

The effect of neighborhood walkability on changes in physical activity and sedentary behavior during a 12-week pedometer-facilitated intervention.

Pedometer-facilitated interventions encourage physical activity via the accumulation of steps. Mixed evidence suggests that neighborhood walkability might influence the effectiveness of physical activity interventions, including pedometer-facilitated interventions. Our study investigated the moderating effect of neighborhood walkability on immediate (4-week) and short-term (12-week) changes in self-reported neighborhood-specific leisure and transportation walking, leisure-based moderate and vigorous-intensity physical activity, and leisure-based screen time during a pedometer-facilitated intervention (UWALK). This quasi-experiment undertaken in Calgary (Canada) compared behavior changes during the 12-week intervention between two neighborhood groups classified as 'walkable' or 'car dependent' based on Walk Score®. Of the 573 volunteers (adults in the contemplation and preparation stages of physical activity behavior change), 466 participated in UWALK. Surveys captured sociodemographic characteristics, perceived neighborhood walkability, neighborhood preferences, motivation, physical activity and screen-based leisure. Covariate-adjusted linear mixed models estimated the differences in physical activity and leisure screen time between the neighborhood walkability groups at baseline, 4-weeks, and 12-weeks. UWALK participants included mostly females (83%) and had an average age of 49.2 years. Weekly minutes of walking for transport inside the neighborhood was higher (p < .001) among participants from walkable versus car dependent neighborhoods at baseline (42.5 vs. 21.1), 4-weeks (81.2 vs. 48.2), and 12-weeks (87.2 vs. 48.0). Regardless of neighborhood walkability, all physical activity outcomes were higher and leisure screen time lower at 4-weeks and 12-weeks compared with baseline. We found no significant neighborhood group by time interactions. Pedometer-facilitated interventions may be effective for supporting short-term changes in physical activity and sedentary behavior even among adults residing in low walkable neighborhoods.

Nutrition Quotient and Dietary Self-efficacy according to the Transtheoretical Model in Adolescent Athletes

PURPOSE: This study aimed to explore the direction of nutrition management and education for adolescent athletes based on the transtheoretical model (TTM).METHODS: This cross-sectional study was conducted on 205 male adolescent athletes using questionnaires in Seoul and Gyeonggi provinces. Differences in nutritional indices, dietary behaviors, and dietary self-efficacies were compared according to the stage of dietary behavior change, and significance was verified using analysis of variance and chi-square tests.RESULTS: According to the stage of change in dietary behavior, a significant difference was observed in the grade and score of the nutrition quotient (NQ), and the nutritional status and quality of meals were extremely poor in the precontemplation and contemplation groups. Dietary self-efficacy differed significantly according to the stage of change in dietary behavior. Compared to the pre-contemplation and contemplation stage groups, the action and maintenance stage groups had a higher willingness to practice desirable dietary behaviors and overcome barriers.CONCLUSIONS: In this study, we demonstrated that individualized nutritional intervention based on TTM was an effective strategy for healthy dietary behavior and had a positive impact on adolescent athletes’ sports performance. Furthermore, nutrition education should include content that enhances students’ dietary self-efficacy.

Cervical cancer screening in a population of black South African women with high HIV prevalence: A cross-sectional study.

Cervical cancer is largely preventable through early detection, but screening uptake remains low among black women in South Africa. The purpose of this study was to determine the prevalence and factors associated with cervical cancer screening in the past 10 years among black African women in primary health care (PHC) clinics, in Gauteng Province, South Africa. This was a cross-sectional study involving 672 consecutively recruited black women at cervical cancer screening programs in PHC clinics between 2017 and 2020. An interviewer-administered questionnaire covered socio-demographics, HIV status, sexual history, cervical cancer risk factors knowledge, and screening behaviours in the past 10 years. The mean age of participants was 38 years. More than half (63%) were aged 30-49 years. Most completed high school education (75%), were unemployed (61%), single (60%), and HIV positive (48%). Only 285 (42.4%) of participants reported screening for cervical cancer in the past 10 years. Of participants that reported receiving information on screening, 27.6% (n = 176) and 13.97% (n = 89) did so from healthcare facilities and community platforms respectively. Participants aged 30 years or more were more likely to report for cervical cancer screening as compared to other categories in the past 10 years. The study found low cervical cancer screening prevalence. This calls for health education campaigns and prevention strategies that would target individual patients' contexts and stages of behavioral change. Such strategies must also consider socio-demographic and clinical correlates of cervical cancer screening and promote better integration into PHC services in South Africa.

Perceived stress as a predictor of eating behavior during the 3-year PREVIEW lifestyle intervention

BackgroundTo better support participants to achieve long-lasting results within interventions aiming for weight loss and maintenance, more information is needed about the maintenance of behavioral changes. Therefore, we examined whether perceived stress predicts the maintenance of changes in eating behavior (flexible and rigid restraint of eating, disinhibition, and hunger).MethodsThe present study was a secondary analysis of the PREVIEW intervention including participants with overweight (BMI ≥ 25 kg/m2) at baseline and high risk of type 2 diabetes (n = 1311). Intervention included a 2-month low-energy diet phase and a 34-month subsequent weight maintenance phase. The first 6 months were considered an active behavior change stage and the remaining 2.5 years were considered a behavior maintenance stage. Eating behavior was measured using the Three Factor Eating Questionnaire and stress using the Perceived Stress Scale. The associations between stress and eating behavior were analyzed using linear mixed effects models for repeated measurements.ResultsPerceived stress measured after the active behavior change stage (at 6 months) did not predict changes in eating behavior during the behavior maintenance stage. However, frequent high stress during this period was associated with greater lapse of improved flexible restraint (p = 0.026). The mean (SD) change in flexible restraint from 6 to 36 months was −1.1 (2.1) in participants with frequent stress and −0.7 (1.8) in participants without frequent stress (Cohen’s ds (95% CI) = 0.24 (0.04–0.43)). Higher perceived stress at 6 months was associated with less flexible restraint and more disinhibition and hunger throughout the behavior maintenance stage (all p < 0.001).ConclusionsPerceived stress was associated with features of eating behavior that may impair successful weight loss maintenance. Future interventions should investigate, whether incorporating stress reduction techniques results in more effective treatment, particularly for participants experiencing a high stress level.

Mixed-methods study to assess an intervention for healthier lifestyles in primary healthcare

Abstract Background Smoking, physical inactivity, low fruit and vegetable consumption, and obesity are common in Kosovo. The Accessible Quality Healthcare project is implementing a primary healthcare intervention that entails nurse-guided motivational counselling to facilitate lifestyle behaviour change. This study assesses the uptake of counselling and the impact on health behaviours and participants’ stages of health behaviour change as well as describes experiences and perceived benefits of motivational counselling. Methods Study participants (n = 907) were recruited from 12 municipalities participating in the Kosovo Non-Communicable Disease Cohort study. For the quantitative study, data on lifestyle behaviours, use of counselling, and stages for behavioural change were used. For the qualitative study, in-depth interviews were conducted with 26 cohort participants who had undergone motivational counselling. Results Motivational counselling was received by only 22% of the eligible participants in the intervention municipalities. Unhealthy behaviours remain high even in persons who underwent counselling (of whom 13% are smokers; 86% are physically inactive; 93% with inadequate fruit and vegetable consumption; 61% are obese). According to the qualitative study results, the participants that received counselling were very satisfied with the services but requested additional services such as group physical activity sessions and specialized services for smoking cessation. Conclusions More tailored and additional primary healthcare approaches in accordance with patients’ views need to be considered for the motivational counselling intervention to reach patients and efficiently facilitate lifestyle behaviour change. Key messages • The following tailored approaches are suggested: a) strengthened referral mechanism b) specialized services for smoking cessation; c) delivery of group physical activity sessions. • More tailored and additional primary health care approaches in accordance with patients’ views need to be considered for the motivational counselling intervention.

Self-assessed achievement of eating balanced meals – is it reliable for tailoring interventions?

Abstract Background Recording the self-assessed achievement of eating balanced meals offers the possibility to tailor nutritional interventions to the stage of behaviour change. Beforehand of an intervention, the self-assessed achievement of eating balanced meals was recorded and verified against the actual consumption. Methods Self-assessed achievement of eating balanced meals was operationalised using the behavioral stages of the Health Action Process Approach (HAPA). The actual consumption was assessed by a validated 3-day dietary record and the Healthy Eating Index of the National Nutrition Survey (HEI-NVS) was calculated. A score of 100 points represents one hundred percent compliance with the recommendations of the German Nutrition Society. Ten additional points could be scored if vegetables and fruit were consumed above the recommendation. An HEI-NVS score of ≥ 80.0 points was considered a cut-off for ‘eating balanced meals'. Results In a sample of 130 participants (86.9 % female, 29.0 ± 11.3 years), 9.2 % rated themselves as Non-Intenders, 17.7 % as Intenders, and 73,1 % as Actors. Their HEI-NVS was 69.6 ± 10.6 points, 79.2 ± 9.5 points, and 79.7 ± 9,0 points, respectively (ANOVA, p &amp;lt; 0.01). In the post-hoc-Test (Scheffé) Non-Inteders differed from the other groups (p &amp;lt; 0.05), Intenders and Actors were not different (n.s.). The proportion of participants with an HEI-NVS score ≥ 80.0 points was 16.7% for Non-Intenders, 60.9% for Intenders, and 51.6% for Actors (Chi2-Test, p &amp;lt; 0.05). Conclusions Self-assessed achievement of eating balanced meals is characterised by self-underestimation (predominatly Intenders) and self-overestimation (predominatly Actors). Tailored interventions should take this into account. Key messages • Self-assessed achievement of eating balanced meals is characterised by self-overestimation. • Self-assessed achievement of eating balanced meals is also characterised by self-underestimation.

Comparative effectiveness of two behavioral change intervention packages for tobacco cessation initiated in the tertiary care setting of North India—protocol for a two-arm randomized controlled trial

BackgroundTo reduce the global burden of tobacco use, clinical guidelines support behavioral therapy and pharmacotherapy as preferred interventions for tobacco cessation. The evidence-based behavioral interventions has consistently shown to be impactful in community settings; however, its efficacy has not been established in hospital settings. The current study aims to investigate impact of trans-theoretical-based behavioral intervention package on tobacco users suffering from non-communicable diseases attending tertiary care settings of North India.Methods/designA two-arm randomized controlled trial (RCT) in a tertiary healthcare hospital will be performed. A total of 360 tobacco users attending NCD clinics in four departments, cardiology, neurology, pulmonary medicine, and ENT (otolaryngology), will be recruited over a period of 3 months. After ascertaining the eligibility criteria, they will be followed up to 6 months (1, 3, 6) for their tobacco use status, readiness to quit, nicotine dependence, stage of behavior change, and self-reported and biochemical validation (urine cotinine) for tobacco abstinence. Assignment of intervention including allocation concealment, sequence generation, and blinding will be done as per SPIRIT guidelines for RCT protocols.DiscussionAs no strong evidence exists about the effectiveness of tobacco cessation intervention in tertiary settings, the current study will build evidence about the similar interventions in such settings.Trial registrationCTRI/2019/09/021406.

Modified brief counseling-5A, motivational SMS on medication-taking behavior and compliance among diabetic patients

Knowledge of diabetes mellitus (DM) management can improve adherence in medication-taking behavior. Counseling by pharmacists is believed to contribute to its better acquisition. Nevertheless, many counseling and reminder media are still currently developed. This study aimed to identify the effects of brief counseling-5A modification and a motivational reminder through short message services (SMS), designed with a religious approach, on medication-taking behavior and adherence among DM outpatients at Jetis 1 Community Health Center, Bantul, Yogyakarta, Indonesia. This quasi-experimental study employed a pretest-posttest control group design. Data were collected prospectively from May to August, 2018. There were 72 patients who met the inclusion criteria divided evenly into two groups, the treatment group and the control group. The data collected by interviews using questionnaires on medication-taking behavior and the medication adherence rating scale (MARS) and were statistically assessed using the Wilcoxon test. The results showed that brief counseling-5A, combined with religious motivational SMS, raised the stage of behavior change in DM patients. There were increases (Δ) in medication-taking behavior by 2.76±1.59 and patient compliance by 3.44±3.45. In conclusion, brief counseling-5A by pharmacists and motivational text reminders can improve the medication-taking behavior and compliance of DM patients with the therapy.

Views of men with Parkinson's disease regarding physical activity health messaging

BackgroundMany men with Parkinson's Disease (PD) do not meet the recommended levels of physical activity (PA) for health benefits. Tailored, meaningful, and culturally sensitive PA health messages may be a catalyst to shape men's motivations toward participation. ObjectiveWe explored the views of New Zealand (NZ) men with PD about existing PA health messages, and how these could be adapted to be more effective. MethodsThis qualitative study recruited six community dwelling, regularly physically active, NZ European men with PD (aged 54–69 years, 2–18 years post-diagnosis) from a community exercise class in Canterbury, NZ. Participants engaged in semi-structured interviews which were audio-recorded, transcribed verbatim, and analyzed inductively for themes. ResultsParticipants expressed that effective PA health messages should reflect men's motivations for PA which included physical and mental well-being and social connection. Inclusive, positive, and relatable language and imagery were considered crucial PA message communication strategies. Participants viewed health professionals' PA advice as superficial and unhelpful; however, celebrities with PD were considered inspirational messengers. Messages endorsed by trustworthy sources, such as the Parkinson's Society, were perceived to enhance the credibility. ConclusionsEffective PA messages should be gain framed and tailored to the target audience. We recommend health professionals provide comprehensive PA advice or consider onward referral. Future research which uses a co-design participatory methodology to collaborate with men with PD from culturally diverse backgrounds and represent all stages of PA behaviour change is recommended to provide comprehensive insights for meaningful, effective, and culturally sensitive PA health messaging.

Analyzing Factors Associated with the Behavior-Change Stage of Colorectal Cancer Screening.

This study attempted to identify the stages of colorectal cancer screening (CRCS) behavior change by applying the precaution adoption process model (PAPM) and to examine the factors affecting each stage. A quantitative, descriptive, cross-sectional design was used. A total of 305 workers at one of the largest industrial complexes in South Korea were allocated using convenience sampling. Data were analyzed using independent t-test, one way ANOVA and multi-nominal logistic regression using SPSS 25.0 (SPSS Inc., Chicago, IL, USA). Most of the subjects were in the undecided-to-act stage. The factors affecting each stage were gender, marital status, family history, private insurance subscription, perceived barrier, and self-efficacy. It is critical to select a target group considering the behavioral change stage to establish a strategy for improving the CRCS rate. Developing and implementing a CRCS education program in consideration of the behavioral change stage will be a strategy to increase the examination of effectiveness of CRCS.

The Transtheoretical Model based psychoeducation's effect on healthy lifestyle behaviours in schizophrenia: A randomized controlled trial

ObjectiveThe study was conducted with the pretest-posttest randomized controlled trial design to detect the psychoeducation's effect, based on the Transtheoretical Model, on the healthy lifestyle behaviours of individuals with schizophrenia. MethodsThe data were collected from 82 participants, as 41 intervention and 41 control. The data were collected via personal information form, behavioural change stage diagnosis form and healthy lifestyle scale II. 6-week psychoeducation, consisting of 6 modules, based on the Transtheoretical Model, was applied to the intervention group. No interventions were applied to the control group. Pretests and posttests were applied to both groups. ResultsWhen the healthy lifestyle scale II of intervention and control groups and final test results arranged according to ANCOVA analysis are compared, average final test results were meaningfully positive for the intervention group with taking control of the pretest and other covariants. When the pretest-posttest results in terms of behavioural change of the intervention group are evaluated; a meaningful difference among nutrition, physical exercises, spiritual self-improvement and stress management, which all are the stages of behavioural change, was detected. ConclusionIt was determined that psychoeducation on a healthy lifestyle, based on the Transtheoretical Model in an individual with schizophrenia affected physical exercises, spiritual self-improvement and interpersonal relationships sub-dimension in medium level, and had a drastic influence on health responsibility, nutrition, stress management sub-dimensions and all healthy lifestyle behaviours. Progress in behavioural change stages was detected. Clinical trials IDNCT05259748.

Understanding the Role of Clinical Champions and Their Impact on Clinician Behavior Change: The Need for Causal Pathway Mechanisms.

The clinical champion approach is a highly utilized implementation strategy used to mitigate barriers and improve outcomes of implementation efforts. Clinical champions are particularly effective at addressing provider-level barriers and promoting provider-behavior change. Yet, the specific causal pathways that explain how clinical champions impact provider behavior change have not been well-explicated. The current paper applies behavior change models to develop potential causal pathway mechanisms. The proposed mechanisms are informed by previous literature involving clinical champions and empirically supported behavior change models. These models are applied to link specific attributes to different stages of behavior change and barriers for providers. Two unique pathway mechanisms were developed, one that explicates how providers develop intention to use EBPs, while the other explicates how providers transition to EBP use and sustainment. Clinical champions may promote intention development through behavioral modeling and peer buy-in. In contrast, champions promote behavioral enactment through skill building and peer mentorship. Clinical champions likely play a critical role in reducing provider implementation barriers for providers across various phases of behavior change. The proposed pathways provide potential explanations for how clinical champions promote provider behavior change. Future research should prioritize empirically testing causal pathway mechanisms.

A BERTweet-based design for monitoring behaviour change based on five doors theory on coral bleaching campaign

Coral reefs are very important ecosystem which are the foundation of all life on this earth, but now they are under threat. Coral bleaching are happening now at a serious rate and the ultimate goal of conservation effort toward this issue is behaviour change. One of the most important parts of conservation effort is monitoring. However, monitoring the success of the coral bleaching campaign on behaviour change requires extensive data collection so traditional methods are not effective because they require resources that may not be met. The goal of this study is to build fast and vast automation in analyzing the stage of behaviour change. Social media data has prospect to become good alternative to be used because social media usage is currently increasing every year, including Twitter. Therefore, an automatic classification model was designed which can identify the stages of behaviour change based on the Five Doors Theory on Twitter. Five Doors Theory define 5 stages of behavior change: Desirability, Enabling Context, Can Do, Buzz, and Invitation. The data was fetched through a trusted repository, Mendeley Data, with title "An Annotated Dataset for Identifying Behaviour Change Based on Five Doors Theory Under Coral Bleaching Phenomenon on Twitter". There are 1,222 tweets with keywords related to coral bleaching that have been annotated according to the behaviour change stages. There are two proposed designs: embedding extraction which utilizes the output of each encoder layer in BERTweet and stacking ensemble which uses several BERTweet models with different hyperparameters that are ensembled using a logistic regression model. The best accuracy of 0.7796 with an f1-score of 0.7945 was obtained in the stacking ensemble design scenario. The classification model created can identify each class at the stage of behaviour change well, even though the dataset is unbalanced in its distribution. The proposed design has a performance that exceeds all baseline models and the standalone BERTweet. In conclusion, the automatic classification model create the process of monitoring the stages of behavior change run effectively and efficiently so that the success of the coral bleaching campaign can be monitored and achieved.

Beyond one size fits all? An experimental study of the effects of stage‐specific interventions to promote ecological online food shopping

AbstractEncouraging people to consume sustainably is more important than ever to tackle climate change. In the area of nutrition, we focused on understanding how social norm inspired treatments can effectively be applied to promote sustainable purchasing without restricting choice. Many intervention studies in this area have applied ‘one size fits all’‐measures, ignoring the target group's context and psycho‐social preconditions. To examine the effectiveness of tailored interventions, we tested the impact on purchasing decisions of four treatments. The treatments were developed based on the four stages of behavioural change that conceptualise behavioural change as a transition through a sequence of stages: predecision, preaction, action, and postaction. In an online experiment (N = 855), these treatments (shopping assistant, success story, commitment, and feedback) were integrated into a true‐to‐the‐original online food shop and socio‐psychological constructs were collected using a downstream questionnaire. The results of a regression analysis showed that there are differences in the effectiveness of the treatments on participants' purchasing decisions. The feedback treatment turned out to be a particularly effective measure for encouraging large numbers of people at different stages of behavioural change to select greener products. In line with theory, the impact of several socio‐psychological variables designed to encourage more eco‐friendly purchases increased from stage to stage. The results may motivate online food shop providers to create customer experiences that promote eco‐friendly consumption. At the same time, it should also encourage other researchers working in this field to develop effective measures that support the achievement of sustainability goals.

Non-communicable disease prevention in Kosovo: quantitative and qualitative assessment of uptake and barriers of an intervention for healthier lifestyles in primary healthcare

BackgroundSmoking, physical inactivity, low fruit and vegetable consumption, and obesity are common in Kosovo. Their prevention is a priority to relieve the health system of from costly non-communicable disease treatments. The Accessible Quality Healthcare project is implementing a primary healthcare intervention that entails nurse-guided motivational counselling to facilitate change in the domains of smoking, diet, alcohol consumption and physical inactivity for at-risk patients. This study quantitatively assesses the uptake of motivational counselling and the distribution of health behaviours and stages of health behaviour change of the participants according to the intervention, as well as qualitatively describes experiences and perceived benefits of motivational counselling.MethodsStudy participants (n = 907) were recruited consecutively in 2019 from patients visiting the Main Family Medical Centres in 12 municipalities participating in the Kosovo Non-Communicable Disease Cohort study as part of the Accessible Quality Healthcare project. For the quantitative study, we used baseline and first follow-up data on smoking status, physical inactivity, obesity, fruit and vegetable as well as alcohol consumption, uptake of counselling, and stages for behavioural change. For the qualitative study, in-depth interviews were conducted with a subset of 26 cohort participants who had undergone motivational counselling.ResultsMotivational counselling was obtained by only 22% of the eligible participants in the intervention municipalities. Unhealthy behaviours are high even in persons who underwent counselling (of whom 13% are smokers; 86% physically inactive; 93% with inadequate fruit and vegetable consumption; and 61% are obese); only the rate of smoking was lower in those who obtained counselling. Among smokers, over 80% were still in the pre-contemplation phase of behaviour change. More advanced stages of behaviour change were observed among the highly prevalent group of inactive persons and participants with poor dietary habits, among the 5 intervention municipalities. According to the qualitative study results, the participants who obtained motivational counselling were very satisfied with the services but requested additional services such as group physical activity sessions and specialized services for smoking cessation.ConclusionsMore tailored and additional primary health care approaches in accordance with patients’ views need to be considered for the motivational counselling intervention to reach patients and efficiently facilitate lifestyle behaviour change.

Stages of Behavioral Change for Fruit and Vegetable Intake in Adolescents: A School-Based Cross-Sectional Study in Japan

OBJECTIVE: The purpose of this study was to understand why adolescents choose to eat fewer fruits and vegetables by examining the stages of behavioral change and perceived barriers to fruits and vegetable intake in a school-based study in Japan.&#x0D; &#x0D; METHODS: A cross-sectional survey was performed at junior and senior high schools from 2018 to 2020, and 933 students aged 12&amp;ndash;18 agreed to participate. A questionnaire obtained information on demographic characteristics, daily fruit and vegetable intake, and to assess the stage of change regarding eating more fruits and vegetables and barriers faced by the participants. &#x0D; &#x0D; RESULTS: The daily average amount of fruit and vegetable intake was 89.3 g and 178 g, respectively. In response to whether they were &amp;ldquo;Eating 350 g or more vegetables and 200 g or more fruits a day most day,&amp;rdquo; 52.6% answered &amp;ldquo;not thinking about doing it&amp;rdquo; (precontemplation stage); the ratio was particularly high among males (61.1%). Moreover, as the stage of change increased from precontemplation to action/maintenance, the daily intake of fruits and vegetables increased and the perceived barriers decreased. We also found that environment when dining out, personal habits, and family and self-preference were perceived as the most important factors related to barriers to eating more fruits and vegetables. &#x0D; &#x0D; CONCLUSION: This study suggests that stage-tailored interventions need to target the above-mentioned barriers, particularly for students in the precontemplation and contemplation stages, and to enhance knowledge on the health benefits of fruits and vegetables, as well as consider a gender-specific approach.

Influence of Nursing Intervention Based on Risk Assessment Model on Self-Efficacy and Postoperative Rehabilitation of Surgical Patients.

The study aims to explore the effect of nursing intervention based on risk assessment model on self-efficacy and postoperative rehabilitation of surgical patients. The study applied a risk assessment model to the behavioral intervention of rehabilitation exercise in patients after percutaneous coronary intervention (PCI). A total of 157 patients were selected from a certain hospital, with 52 cases in the experimental group and 55 cases in the control group. A comprehensive cardiac rehabilitation intervention strategy based on TTM is given by researchers trained with professional knowledge, including dividing the stages of behavior change, developing a rehabilitation exercise plan through exercise teaching and exercise training, diet and lifestyle guidance, and urging patients to take regular medication and regular follow-up. The stage of rehabilitation movement behavior change improved. The preexperiment health status was (35.39 ± 14.31), and the overall health of the control group was (32.59 ± 15.41). Overall health status and QOL scores were relatively low in both the groups. The intervention group scored higher than the control group. After coronary stent implantation, the heart restores its original pumping function, various organs and tissues receive effective blood perfusion, and the symptoms of myocardial infarction such as profuse sweating, dizziness, fatigue, and precordial discomfort are effectively relieved. The physical discomfort can gradually improve or even recover to the functional state before the onset of the disease. Before the intervention, the self-efficacy score of the intervention group was (23.68 ± 4.49). After the intervention, the self-efficacy score of the intervention group was (26.21 ± 4.09), while the self-efficacy score of the control group before the intervention was (22.21 ± 4.1). After the intervention, the self-efficacy score of the control group was (25.23 ± 4.41). Although the self-efficacy score of the control group was improved, the difference was small, and the intervention effect was not obvious. It indicates that risk assessment intervention can improve patients' self-efficacy level and quality of life of postoperative rehabilitation patients.