Stages Of Change Research Articles

Assessing Older Adults' Readiness for Adopting Fall Prevention Recommendations Using the Transtheoretical Stages of Change.

Objectives: Reducing fall risk requires older adults (age 65+) to adopt effective prevention strategies. This study has three aims: 1) understand Stage of Change (SOC) for three fall prevention strategies; 2) determine strategies older adults' use; and 3) understand which characteristics relate to readiness to take action. Methods: A survey of 1063 older adults assessed fall risk, SOC, and use of fall prevention strategies. Data analysis included descriptive statistics and regression analysis. Results: The most common SOC for older adults by strategy was action for overall fall prevention (61%), contemplation for medication management (45%), and preparation and action for strength/balance (29% each). Believing falls are preventable was most strongly related to being in a Change stage (e.g., action, maintenance) for overall fall prevention (Risk Ratio: 1.4, 95% CI: 1.1, 1.7). Discussion: Health promotion can focus on increasing knowledge of evidence-based fall prevention strategies to encourage older adults to take action.

Changes Take Place in Stages! A Gradational Perspective on the Influence of Homeowners Associations on the Adoption of Wildlife-Friendly Landscape Maintenance

Lack of demand for professional wildlife-friendly landscape maintenance (WFLM) is not well understood, and further complicated by institutional and non-institutional influences. Framed by the Transtheoretical Model of Change, this study evaluated behaviors and perceptions pertaining to WFLM. A cross-sectional research design with quota sampling gathered stage of change, perceived motivators and barriers, processes of change, and self-efficacy from 1,219 Florida residents who hired a professional for landscape maintenance services. Comparisons were conducted to disentangle the relationship between living in a homeowners association and requesting WFLM. More residents were in earlier pre-action stages than later behavioral stages. There were stronger perceptions of some external barriers and motivators among homeowners association residents with perceptions of neighbors’ expectations being the greater motivator and barrier among this audience segment. Findings reveal a need to support residents in earlier stages of behavior change and integrate social norms into behavior change programs, especially within homeowners associations.

Utilising resistance feedback for software implementation in healthcare

The COVID-19 pandemic has caused a rapid transformation in the healthcare industry. Telemedicine, mHealth, and artificial intelligence technologies have become integral components of healthcare delivery, enabling remote consultations, symptom tracking, medication reminders, diagnosis, and treatment. However, the adoption of these technologies in healthcare organisations is often met with resistance from shareholders. The most frequent reasons are fear of technology, uncertainty about the impact of technology solutions on patient care, ethical and regulatory concerns, skepticism about the effectiveness of remote medical consultations, concerns about data privacy and security, reluctance to change workflows, risk of job losses due to automation of certain processes, and possible conflicts of interest. This article explores the complex landscape of shareholder resistance during software implementation projects, the origins of this problem, its manifestations, advantages, disadvantages, and consequences. The article also examines this issue through the prism of the Lewin’s Change Model and the Transtheoretical Model of Change, and demonstrates it on the examples of Information Technology Company and Microsoft. The article offers strategic recommendations for healthcare organisations to effectively manage and mitigate these challenges, facilitating a successful transition to the healthcare technology landscape. Among the main problems, the article discusses the following things: creating open and transparent communication channels for shareholders; joint problem-solving sessions with all stakeholders; an iterative approach to implementing IT projects in healthcare facilities, which allows reviewing, adjusting, and agreeing on solutions at each iteration; involving shareholders in decision-making at the early stages of the software implementation process; comprehensive programs to improve shareholder competencies; targeting opinion leaders who are supporters of changes in the organisation; maintaining continuous feedback, etc.

What, How and Why of a Psychologically Informed Environment (PIE) Within Youth Refuge

Being homeless is broadly understood to be traumagenic. Thus, support services for individuals experiencing homelessness (such as youth refuge) are encouraged to use trauma-informed models of care. However, there is a dearth of research that (1) focuses on youth refuge specifically, despite refuges being the most common response for youth homelessness worldwide, and (2) explains trauma-informed care models in detail so that they may be evaluated in practice. This paper outlines a trauma-aware framework used for nearly a decade within a youth refuge located in Melbourne, Australia: a psychologically informed environment (PIE). The paper provides: (1) an overview of trauma-informed care before describing what a PIE entails; (2) the how of a PIE, including core principles, their theoretical underpinnings, and how these principles are practically applied; and (3) the why of a PIE, focusing on implications for practice. A PIE is underpinned by key theoretical approaches such as attachment theory, the core emotional needs model, psychodynamic theory and formulation, social cognitive theory, and the transtheoretical model of change. A PIE encompasses five core principles of (1) relationships, rules, responsiveness, and roles; (2) physical and social spaces; (3) learning and enquiry; (4) staff support and training; and (5) psychological awareness. Overall, PIEs have been found to increase consumer engagement and decrease evictions, instill confidence and improve empathy within the staff, and decrease the risk for organizations, as seen by low incident rates. It is hoped that by providing this detailed outline of a PIE, more research can be undertaken into youth refuge care models, and more psychologically informed frameworks that address the multi-directional relationship between trauma and homelessness can be employed.

A Transtheoretical Model-Based Online Intervention to Improve Medication Adherence for Chinese Adults Newly Diagnosed With Type 2 Diabetes: A Mixed-Method Study.

Type 2 diabetes mellitus (T2DM) is increasing in China, with medication non-adherence being a significant contributor to uncontrolled T2DM. The Transtheoretical Model (TTM) has shown effectiveness in chronic disease management, but few studies have applied it in online interventions for T2DM medication adherence. The study aimed to develop and investigate the effects of a TTM-based online health education program on promoting positive stage of change (SOC) movement, improving self-efficacy and medication adherence, as well as reducing HbA1c levels in newly diagnosed patients with T2DM. This sequential mixed-method study was conducted from April 2023 to March 2024. Using the TTM framework, the study initially explored 32 participants' experiences with hypoglycemic medications, health information acquisition, and perspectives on online programs. Then, a quasi-experimental study design was conducted. Two communities were randomly assigned as the intervention (n = 91) and comparison (n = 98) groups, with 189 newly diagnosed middle-aged T2DM patients from various SOC. The intervention group received short videos health education and participated in WeChat group discussions, compared with usual care in the comparison group. Data were collected at baseline, 3-month, and 6-month follow-ups. The intervention group was more likely to achieve positive SOC movement (P < .001, Adj OR = 13.69 95% CI = 6.76-27.71) compared to the comparison group. The intervention group also had significantly higher mean CDMSS-11 and MMAS-8 scores at 6 months (P = .03 and <.001, respectively) and more likely to achieve clinically significant glycated Hemoglobin (HbA1c) change at 3 months (P < .001, Adj OR = 3.91, 95% CI = 1.77-8.63) and at 6 months (P < .001, Adj OR = 5.62, 95% CI = 2.70-11.69) compared to the comparison group. These findings support that applying the TTM to develop an online program could promote behavior change, improve self-efficacy and medication adherence, and could lead to better glycemic control in newly diagnosed T2DM patients.

Development of transtheoretical model measures for assessing decisional balance and temptation to vape

Introduction: Vaping is common among young adults in the United States. The Transtheoretical Model (TTM) has demonstrated success in smoking cessation efforts; however, it has not been comprehensively applied to vaping cessation, and core TTM vaping measures have not been developed. Method: A cross-sectional survey including measures of stage of change (SOC), temptation to vape, and decisional balance (DCBL) was disseminated (n = 459). Items were adapted from TTM smoking scales. The sample was split for exploratory and confirmatory factor analyses (EFA/CFA). Analyses of variance assessed relationships between constructs and SOC. Results: EFA/CFA resulted in one Temptation scale (CFI = .95; α = .87) and two DCBL scales (CFI = .91; Pros α = .72; Cons α = .72). Temptation to vape and Pros of vaping decreased significantly across SOC, while Cons increased significantly. Conclusions: TTM vaping measures for two key TTM constructs were developed utilizing a college sample. Results suggest that the developed measures map well onto the TTM framework.

MAINTENANCE OF HEALTH BEHAVIOR CHANGE: RECOMMENDATIONS FOR FUTURE RESEARCH

Abstract Modifying poor health behaviors can enhance function, improve quality-of-life, and reduce morbidity and mortality among older adults. However, achieving and sustaining behavior change can be difficult. A growing body of research suggest that initiation and maintenance are unique constructs within health behavior change; each requiring unique skills and each associated with unique outcomes. Although some leading health behavior change models (e.g., Transtheoretical Model of Change) include maintenance as a construct, maintenance is often overlooked in the scientific literature. As part of a NIA Research Centers Collaborative Network (RCCN) pilot award, this project utilized a series of qualitative activities to explore the concept of maintenance and identify future recommendations for advancing the field. Three unique listening sessions were conducted with clinician-researchers (1 group) and community-based service organizations (2 groups). An interdisciplinary expert think tank was then convened to reflect on key findings. All sessions were conducted virtually; transcripts were reviewed using a priori themes with additional themes generated by an open coding approach. Major themes included the following: (1) To date, there is no consensus definition of maintenance nor is there agreement on maintenance across behaviors. (2) Few behavior change models consider how health behaviors must shift to accommodate for age-related changes in cognition and/or physical function. (3) Existing funding mechanisms and timelines may not allow sufficient follow-up periods to examine maintenance over time. (4) Although the terms maintenance and sustainment are used interchangeably, community leaders emphasized the importance of sustaining health promotion programs in order to enable maintenance to occur.

Unraveling green personal care: Exploring the shift in consumer values and stages of change toward green consumption

AbstractThe personal care market has seen a significant increase in environmentally‐conscious or “green” products, driven by a heightened sensitivity to environmental issues. In this study, we broaden the scope of the Theory of Planned Behavior (TPB) by including constructs related to health consciousness (HC), concern with personal appearance (CPA), and environmental product value (EPV). Our research explores the complex relationship between purchase intention (PI) and the various stages of change (SOC) associated with the consumption of products in the green category. The investigation examines the unique factors that combine attitudes and intentions while simultaneously analyzing the socio‐demographic influences on the progressive stages of behavioral change. By employing techniques such as structural equation modeling and variance analysis on an extensive dataset collected from 679 participants, our findings reveal a positive correlation between PI and the SOC. Notably, aspects of HC, CPA, and the EPV significantly influence attitudes toward green personal care products (GPCPs). The conclusions drawn from this study resonate with deep theoretical implications and simultaneously provide a substantial and practical framework for commercial enterprises.

Transtheoretical Model for Exercise: Measure Redevelopment and Assessing the Role of Barriers in a Diverse Population.

To redevelop and improve Transtheoretical Model (TTM) exercise measures for Black and Hispanic/Latinx adults. The redeveloped scales will address barriers to exercise potentially relevant to populations of color in the United States (US). Cross-sectional, split-half measure development. Online survey in the US. 450 Black and/or Hispanic/Latinx adults. Demographics, exercise engagement (IPAQ-SF), stage of change (SOC), decisional balance (DCBL), self-efficacy (SE), and barriers to exercise. Split-half exploratory (EFA) and confirmatory factor analyses (CFA) were executed to establish measurement structure and fit, followed by multivariate analyses to assess constructs by SOC. EFA/CFA for DCBL revealed three factors (α = .85, .70, .75) which represented Pros of exercise, Cons of exercise related to time and safety, and Cons of exercise related to physical or emotional discomfort. Model fit was adequate (CFI = .89). For SE, two factors (α = .85, .77) resulted with good model fit (CFI = .91). These factors reflected self-efficacy to exercise when confronted with generally challenging situations, and self-efficacy to exercise when specifically experiencing affective difficulties, such as depression or anxiety. Lastly, a novel Barriers measure resulted in three factors (α = .82, .77, .76), representing barriers encountered due to family responsibilities, work obligations, and health challenges, with good model fit (CFI = .95). Shifts in the core TTM constructs by SOC largely mapped onto the theoretical trends expected under the TTM. This study produced systematically developed TTM exercise measures for Black and Hispanic/Latinx adults in the US that address and incorporate important barriers to exercise. This research represents an important step forward in broadening the inclusion of diverse populations to TTM measure development processes and may lead to a better understanding of relevant factors impeding exercise engagement in the US.

Development and Validation of Forman Readiness to Change Scale for Drug Addiction

Purpose: The present study aimed to develop an indigenous valid and reliable scale to measure the readiness to change in patients with drug addiction.&#x0D; Design/Methodology/Approach: approach in which theories behind the transtheoretical model of change and drug addiction were examined along with semi-structured interviews and Focus Group Discussions. Phase one of the present study was scale construction, for this purpose initial items pool was generated from literature, focus groups of ward boys and nurses, interviews of psychologists, and in-depth interviews of diagnosed patients of drug abuse. Major themes were extracted by using Interpretive Phenomenological Analysis and transformed into statements. For content validity, three experts were requested to rate items on a Likert-type scale and items were included or excluded by 1/3 ratio. For construct validity scale was administered on 100 diagnosed patients with drug addiction.&#x0D; Findings: Exploratory Factor Analysis (EFA) with the Varimax rotation method and Kaisar Normalization extracted three factors. The factors were named after stages of readiness for change including pre contemplation, contemplation and action stage.&#x0D; Implications/Originality/Value: This study contributed to psychometric research through the development of an indigenous scale to assess readiness to change on the transtheoretical model of behavior change in Pakistan. No such tool was found available presently to measure this and readiness was being measured on an international scale.

Chatbot-Delivered Online Intervention to Promote Seasonal Influenza Vaccination During the COVID-19 Pandemic

Receiving seasonal influenza vaccination (SIV) is important for adults during the COVID-19 pandemic. There are few robust evaluations of tailored interventions for improving SIV uptake among adults 65 years or older. To evaluate the relative efficacy of a stages of change (SOC)-tailored online intervention compared with a standard, non-SOC-tailored online intervention in increasing SIV uptake among Hong Kong residents 65 years or older. This nonblinded parallel-group randomized clinical trial was conducted between December 1, 2021, and July 31, 2022, in Hong Kong, China. Eligible participants were 65 years or older, had Cantonese- and/or Mandarin-speaking skills, were community-dwelling, had Hong Kong residency, were smartphone users, and had not received SIV for the 2021 to 2022 influenza season. Participants were recruited through random telephone calls, and those who completed the baseline telephone survey were randomized to either the intervention or control group. Both complete case and intention-to-treat (ITT) analyses were performed. In the intervention group, a simplified rule-based chatbot first assessed participants' SOC related to SIV uptake and then automatically selected and sent participants SOC-tailored online health promotion messages (videos) through a messaging application (WhatsApp; Meta) once every 2 weeks for 4 sessions. In the control group, the chatbot sent a link to access through the messaging application a standard online health promotion message (video) covering general SIV information every 2 weeks for 4 sessions. The primary outcome was self-reported SIV uptake at month 6, which was validated by the research team. The secondary outcome was SOC measured at both baseline and month 6 by validated questions. A total of 396 participants (mean [SD] age of 70.2 [4.3] years; 249 females [62.9%]) were randomized to the intervention (n = 198) or control (n = 198) group. The ITT analysis showed that the validated SIV uptake rate was higher in the intervention group than the control group at month 6 (50.5% vs 35.3%; P = .002). The mean (SD) SOC score was higher in the intervention group than the control group (2.8 [1.4] vs 2.4 [1.4]; P = .02). More participants in the intervention group completed at least 1 episode of intervention than in the control group (77.3% vs 62.6%; P < .001). Results of this trial indicate that the SOC-tailored online intervention was more effective than the non-SOC-tailored intervention and may be a sustainable new method in increasing SIV uptake among adults 65 years or older. ClinicalTrials.gov Identifier: NCT05155241.

Development of a transdiagnostic digital interactive application for eating disorders: psychometric properties, satisfaction, and perceptions on implementation in clinical practice

BackgroundGiven limited availability of informed treatments for people affected by eating disorders (EDs), there has been increasing interest in developing self-administered, technology-based ED interventions. However, many available interventions are limited to a specific ED diagnosis or assume that participants are ready to change. We developed a digital self-help application (called ASTrA) that was explicitly designed to be transdiagnostic and to help increase motivation for change. The aim of the present study was to describe the development and examine the psychometric properties, user satisfaction and rated potentials for practical use of our application.MethodsThe content of our application was based on concepts derived from self-determination theory, the transtheoretical model of change, and cognitive theory. The application was developed by a multidisciplinary team of clinicians, researchers, staff members and individuals with lived ED experience, each being involved in all steps of the application’s development. We tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of 15 patients with an ED and 13 clinicians specialized in ED treatment. Psychometric properties were evaluated using descriptive statistics, correlations, content validity indices and intraclass coefficients. Differences in satisfaction ratings and perceived potential for clinical implementation of the application between clinicians and patients were examined using Mann–Whitney U tests.ResultsThe digital application showed excellent validity (mean i-CVI: .93, range: .86–.96) and internal reliability (all Cronbach alpha’s > .88). Patients and clinicians both considered the application acceptable, appropriate, and feasible for use in clinical practice.ConclusionsFindings suggest that our transdiagnostic interactive application has excellent psychometric properties. Furthermore, patients and clinicians alike were positive about the possible use of the application in clinical practice. The next step will be to investigate the application's effectiveness as an intervention to promote autonomous motivation and to facilitate remission in people on the waitlist for specialized ED treatment.

Motivational Interviewing and Chronic Care Management Using the Transtheoretical Model of Change.

The number of Americans living with chronic health conditions has steadily increased. Chronic diseases are the leading causes of death and disability in the United States and cost the healthcare system an estimated $4.1 trillion dollars a year. The role of social workers in assisting patients in the management of their chronic diseases is vital. The behavioral health changes often required of chronic care management (CCM) patients require support and intervention by professionals to help the patient improve self-management of their chronic health conditions. Motivational interviewing (MI) is an evidence-based practice that helps people change by paying attention to the language patients use as they discuss their change goals and behaviors. Applying the principles and strategies of MI within the stages of change model (transtheoretical model of change) can help social workers better understand and assist patients receiving CCM. This article outlines specific strategies the social worker can use to address motivation at different stages of change.

Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model.

In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination. Cross-sectional measurement development. Online survey. 528 US adults ages 18-75. Demographics, stage of change (SOC), DCBL, SE, myths, and barriers. The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs. For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) (n1 = 8, α = .97; n2 = 5, α = .93; n3 = 4, α = .84). For SE, two correlated factors were revealed (n1 = 12, α = .96; n2 = 3, α = .89). Single-factor solutions for Myths (n = 13, α = .94) and Barriers (n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers. This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.

An Investigation Into Voluntary Occupational Turnover of Sport Employees Using the Transtheoretical Model of Change

Voluntary occupational turnover is rampant within the economy and, thus, a timely line of inquiry within sport management. However, sport management literature has primarily explored turnover intentions rather than the realized experience of voluntary occupational turnover. Thus, the purpose of this study was to understand sport management employees’ experiences of voluntary occupational turnover using the Transtheoretical Model of Change as a guiding theoretical framework. Interpretative qualitative inquiry guided the research design with 12 former Division I swimming coaches. Findings illustrated themes aligning with the Transtheoretical Model of Change. However, an additional theme was identified: the tipping point, occurring between contemplation and preparation when a discernible event occurred which prompted the participant to move from contemplation to preparation. This study further extends the Transtheoretical Model of Change and its applicability within sport while providing implications regarding the retention of sport management employees.

Differences and Associations of Physical Activeness, Quality of Life, Motivational Factors, and Stages of Change Between Young and Mid Adults

The current study aimed to examine differences and associations of physical activity (PA) levels, quality of life (QoL), motives for PA, and stages of change (SOC) between young and mid adults. A total of 208 participants in Malaysia completed an online survey which comprised of questionnaires about PA, motivational factors, QoL, and SOC in PA. Independent t-tests revealed that young adults engaged in more PA in general, as well as light PA. However, mid adults in general scored higher levels of QoL and its four domains (i.e., physical, psychological, social, and environmental). Moreover, young adults were significantly more motivated by appearance for PA. Pearson correlations revealed higher levels of vigorous PA linked to, higher social domain of QoL in both age groups, and, physical and psychological domain of QoL in mid adults. Vigorous PA also showed the strongest positive links with motivations in competence in both young and mid adults. Cross tabulations showed that both young and mid adults have highest frequency counts in contemplation stage for moderate and light PA and highest frequency counts in the maintenance stage for vigorous PA. This study is the first to show how young and mid adults differed in PA levels, QoL, motives behind PA engagements, and how they correlate differently. However, both age groups showed similar SOC patterns, indicating the likelihood of moderate and light PA engagements when they see the possibility of change but still lack commitment, whilst those engaged in vigorous PA are more likely to actively maintaining the change.

Does Empowering Victim to Earn a Living Reduces the Risk of Domestic Violence Severity? A Narrative Review and A Pilot Study

Defined as the act of causing or attempting to cause physical, psychological or sexual harm to a person by another person who is either a spouse, former spouse, adult child, parent or any other family members, domestic violence is a global public health issue including in Malaysia. One way to mitigate the risk of domestic violence is through the ability of a domestic violence victim to earn her own income. Unfortunately, although some studies have shown that the higher the income level of victim, the lesser the risk of domestic violence severity, other studies did not demonstrate this relationship. Additionally, different past studies have used different indicators in analyzing the impact of income level on domestic violence severity. Some studies used household income levels, whilst other studies used the victims’ individual income levels. This paper will discuss on the impact of economic empowerment to mitigate the severity of domestic violence including some conflicting findings in recent literature. Using the Transtheoretical Model of Change and Walker’s cycle of abuse, this paper will also highlight the importance of creating awareness that domestic violence is not acceptable, adopting a non-judgmental attitude to minimize stigmatization and secondary traumatization as well as rendering social support in helping victims toward a journey of sustained change.

Readiness to Refrain from Carbonated Drinks among High School Female Students: The Transtheoretical Model of Change as a Theoretical Framework

Objective: This study is a part of randomized controlled trial. This study aims to identify high school female students’ readiness to refrain from carbonated drinks. Method: The study included a simple random sample of 144 high school female students who were recruited from Al-Russafa High School for females in Baghdad City. The study instrument consists of participants’ sociodemographic characteristics of age, living arrangement, and family’s socioeconomic status, Stages of Change for Carbonated Drinks Consumption Behavior Scale (Short Form), Stages of Change for Carbonated Drinks Consumption Behavior Scale (Continuous Measure), The Processes of Change for Carbonated Drinks Consumption Behavior Scale, The Self-Efficacy for Carbonated Drinks Consumption Behavior Scale which includes 18 Decisional Balance Scale for Carbonated Drinks Consumption Behavior. Data were analyzed using the statistical package for social science (SPSS) for Windows, version 26. Results: More than half are in the Precontemplation Stage of Change (n = 84; 58.3%), followed by those who are in the Preparation Stage of Change (n = 30; 20.8%), those who are in the Contemplation Stage of Change (n = 28; 19.5%), and those who are in the Maintenance Stage of Change (n = 2; 1.4%).The regression model displays that the family’s socioeconomic status, Self-Liberation, and students’ age positively predicted the Stages of Change to refrain from carbonated drinks (p-value = .004, .009, 035) respectively. Conclusion: The regression model displayed that Self-Liberation and students’ age positively predicted the Stages of Change to refrain from carbonated drinks. This finding implies that .The regression model displayed that students’ age positively predicted the Stages of Change to refrain from carbonated drinks. Keywords: Carbonated Drinks; Readiness to Refrain; High School Female Students.

Linking social and built environmental factors to leisure-time physical activity in rural cancer survivors.

This study explored associations between social and built environmental factors and leisure-time physical activity (LTPA) in rural cancer survivors (RCS) and whether these associations differed by exercise stage of change (SOC). RCS (n = 219) completed questionnaires assessing LTPA, SOC, and social (social status, connectedness, support) and environmental (home environment, neighborhood environment) factors. Linear regression models examined associations between social and built environmental factors and LTPA and tested for moderation by SOC. Half (50.7%) of RCS were physically active, and 49.3% were not active. Social factors positively associated with LTPA included subjective social status in the community (B = 89.0, P = .014) and in the United States (B = 181.3, P < .001), social connectedness (B = 122.3, P = .024), and social support for physical activity from family (B = 41.9, P < .001) and friends (B = 44.3, P < .001). Environmental factors positively associated with LTPA included the home environment (B = 111.2, P < .001), perceived environmental support for PA (B = 355.4, P = .004), and neighborhood attributes, including bicycling infrastructure (B = 191.3, P = .003), proximity to recreation facilities (B = 140.1, P = .021), traffic safety (B = 184.5, P = .025), and aesthetics (B = 342.6, P < .001). SOC statistically significantly moderated the association between social status in the United States and LTPA (B = 160.3, P = .031). Social and built environmental factors were consistently linked with LTPA and provide context for multilevel interventions promoting LTPA in RCS.

Going through changes: A longitudinal study of meat reduction over time in the UK

There are increasing moral, environmental and public health imperatives to curb meat consumption. While research on meat reduction has proliferated in recent years, the majority of empirical work has taken cross-sectional and/or experimental approaches. Therefore, this study sought to understand the process of dietary change through an observational longitudinal survey of 1,529 UK residents over the course of one year. An online questionnaire was used to take measures of diet, exposure to animal advocacy, exposure to animals and animal-lovers, the transtheoretical model of change, the COM-B model (capability, opportunity, motivation → behaviour), and demographics at 0, 6, and 12 months. While no support was found for predictions made on the COM-B model, some support was found for hypotheses made on the transtheoretical model - in particular, there was some evidence that those at later stages who still ate meat were more likely to give it up, and those at earlier stages who had given up meat were more likely to start eating it again. There were also generally stronger measures of decisional balance (i.e. conviction in the decision to give up meat) and self-efficacy for those at more advanced stages. Analyses also indicate that increases in consumption of animal product alternatives were significantly correlated with decreases in animal products in the same category. Ordinal regression models yielded low predictive ability, meaning that information on the interventions which may influence animal product consumption was limited. Findings are discussed in the context of previous literature and recommendations for future research.