Successful Behavior Change Research Articles

Nutrition as therapy – the role of dietitian counseling: a best practice implementation project

ABSTRACT Objectives: The objective of this best practice implementation project was to improve dieticians’ professional practice and dietary care through the use of counseling strategies. Introduction: Improving the design and implementation of evidence-based practice depends on successful behavior change interventions. This requires an appropriate method for designing the interventions and then analyzing the targeted behavior. Behavior change techniques (BCTs) have been demonstrated to improve the patient–dietitian relationship and patient treatment outcomes. Methods: This evidence-based quality improvement project used the JBI Evidence Implementation Framework to identify gaps in clinical practice and barriers to changing practice. We recruited 20 dietitians and conducted a baseline audit to determine their level of knowledge of BCTs, the extent to which they applied BCTs in their practice, and barriers to using BCTs. To address the identified barriers, a 5-hour training session was conducted by a dietitian with psychological training. A follow-up audit was then conducted to measure improvements in compliance with best practice. Results: The baseline audit revealed that 80% of participants used some of the targeted counseling strategies. The most common barriers were lack of guidance on the use of BCTs or insufficient knowledge of BCTs. The follow-up audit revealed that 93% of participants used some counseling strategies, representing a 13% improvement from baseline. Conclusions: Applying BCTs is a challenge in dietary practice. The results indicate that education about these techniques is needed. As the next step, we suggest disseminating the relevant recommendations among dietitians in Poland and providing education about the use of these methods. Spanish abstract: http://links.lww.com/IJEBH/A289

Making Exercise as Medicine a Clinical Reality

Apply It! • Emphasize the Prevalence of Chronic Conditions: 52% of U.S. adults suffer from at least one chronic condition, underscoring the widespread need for exercise intervention in managing these diseases. • Advocate for Structured Exercise Programs: Stress the importance of structured exercise programs in managing chronic diseases, citing well-documented physical and mental health benefits associated with regular physical activity. • Educate on Exercise Thresholds: Educate clients on the exercise thresholds recommended by the World Health Organization, emphasizing the need for at least 150 to 300 minutes of moderate-intensity physical activity per week, complemented by resistance training and a reduction in sedentary behaviors. • Tailor Programs to Individual Readiness: Assess clients' readiness to change unhealthy lifestyle habits using models like the Transtheoretical Stages of Change Model, and tailor exercise prescriptions and counseling accordingly to increase the likelihood of successful behavior change.

E.5 Designing a paradigm for post endovascular therapy imaging

Background: There is no guideline for imaging post endovascular therapy (EVT). MRI is considered superior to noncontrast CT for assessment of final infarct volume and to distinguish contrast from hemorrhage. We sought to align the post EVT imaging practices with those after intravenous thrombolysis Methods: We reviewed the EMR records for all EVT patients from Jan 1, 2019 to Dec 31, 2021. We assessed quantity of CT within 24h of EVT, quantity of MRIs performed, and indications listed. We then undertook an educational program targeting stakeholders. The objective was to transition to MRI at 24h for imaging post EVT. Exceptions included neurologic change, need for antiplatelet infusion, or intraoperative complications. Results: Post intervention, a significant reduction in CT within 24h (-28%, P=0.01) and increase in MRIs (+42%, P<0.00). CT within 24h per patient dropped by 50% (1.12 pre vs 0.57 post). Radiation dose per patient dropped by 49%. Average imaging costs increased by 17%, and the number of transfers off unit for imaging increased by 11%. Good functional outcome dropped from 44% preintervention to 34% postintervention (P=0.06). Conclusions: This represents the first systematic evaluation of post EVT imaging in a single center. We demonstrate successful behavior changes for post EVT imaging.

Social Engineering for Reducing Hypertension Case in Indonesia: a Qualitative Study in a Rural Area

Consuming foods with a large amount of salt is an unhealthy lifestyle that raises blood pressure. People currently love salty foods in Indonesia. One of district in Indonesia called Jeneponto referred to hypertension as Nai’ Cera. The Jeneponto community consumes more significant salty food higher than the provincial average for South Sulawesi. An intervention study was carried out to change the habit of consuming high salt, smoking and drinking coffee. This study is qualitative with participatory action research approach. The in-depth interviews and focused group discussion were addressed to twenty-two informants which involved in an intervention program. Social engineering became the key-point to socialize the importance of the program. Well-trained local people recruited as an agent of change. They followed the social engineering intervention and focused on what people need to reduce hypertension. The program raised awareness on hypertension towards their lives by educating as well as discussing on their risky habits on over consumptions fatty, sugar, salt substances. The successful behavior changes in this program comprised several keys to consider such as: the intervention locations, the closest relationship towards the agent, the agent as frontliner, sustainability of the program, and commitment of all components of intervention.

Distinguishing between Low- and High-Cost Pro-Environmental Behavior: Empirical Evidence from Two Complementary Studies

To reach sustainability goals, researchers and policymakers must focus on addressing changes toward more pro-environmental behavior (PEB). Therefore, this study shows evidence-based perceptions of low- and high-cost behaviors and deduces recommendations for PEB interventions. We applied a multi-step mixed-method approach: First, a representative online survey was conducted to collect a general quantitative overview and classify low- and high-cost behavior based on past behavior and behavioral intentions. Second, a gamification intervention that aimed to gain quantitative data about certain behaviors and perceived low- and high-costs was conducted with university students. The results of the two studies showed that PEB can easily be categorized into high-, rather-high-, rather-low-, and low-cost behavior. However, this classification is not based on emission sectors, e.g., mobility, but on the specific behavior. Interventions can be recommended according to subjective costs: For example, low-cost behavior does not need additional interventions in most cases but must be maintained as is. According to the empirical findings, high-cost behavior needs top-down interventions, while rather-high- and rather-low-cost behavior requires bottom-up interventions to achieve behavior changes. In summary, managing interventions using this classification and focusing on high-impact behavior can lead to successful behavior changes and emission reductions.

Dynamics of Perceived Barriers to Change Physical Activity and Eating Habits in Adults Before and During a Lifestyle Intervention in a Primary Care Setting: A Mixed Methods Approach.

There is scarcity of data exploring the dynamics of barriers to changing physical activity (PA) and eating habits during a lifestyle intervention in a primary care setting. The aim of the present study was to investigate barriers to lifestyle change before and during a primary care lifestyle intervention in adults with different sociodemographic backgrounds. Barriers to healthy eating and PA were assessed in 114 adults (age = 55 ± 9 years) using a questionnaire before inclusion in the intervention. During the lifestyle intervention, factors perceived as obstacles to reach goals for PA and healthy eating habits were collected using focus group interviews in a sub-sample of 25 adults and analyzed using thematic analysis. At least 1 barrier to changing eating and PA habits was reported in 65% and 67% of the population, respectively, without differences due to sex, place of birth, and educational level. Before entering the lifestyle intervention, intrapersonal factors including lack of willpower and lack of enjoyment were the dominant barriers to PA and healthy eating, irrespective of place of birth, sex, and education level. In contrast, environmental factors such as lack of support from family and work-related constraints emerged as important barriers to overcome during the action phase of the lifestyle intervention. The present study highlights the dynamics of barriers to changing PA and eating habits in a primary care lifestyle intervention, emphasizing the need for barrier assessment during the different phases of an intervention to tailor support activities for successful lifestyle behavioral change.

Evaluating the impact of an incentive scheme to encourage pregnant people to set a quit-smoking date

PurposeThis study aims to demonstrate the evaluation of an incentive scheme to encourage pregnant people to set a quit-smoking date.Design/methodology/approachThe paper outlines a collaborative approach, working with pregnant people, clinicians, tobacco dependency practitioners and academics to gain insights into their perspectives and experiences. Quantitative and qualitative data were analysed.FindingsThe incentive scheme and appropriate support from clinicians have been shown to encourage pregnant people to set a quit date. The tobacco dependency practitioners helped remove barriers, such as the perception of the stigmatisation of smoking when pregnant. The practitioners also helped pregnant people make informed decisions to support successful behaviour change. The impact of the scheme resulted in improved infant health indicators. The scheme’s evaluation also supported establishing stakeholder knowledge exchange and learning processes.Research limitations/implicationsThis is a single-site study among a relatively small group of people designed to achieve a specific evaluation objective. Caution in generalising to wider settings should be exercised.Practical implicationsThis study highlights the efficacy of an incentive scheme, complemented with support from clinicians, and the significance of knowledge exchange and collaboration between stakeholders in health care with significance in similar settings.Originality/valueThe paper details the incentive scheme input, actions, output, outcomes and impact involving a wider range of stakeholders, including the emotional consequences for participants, clinicians and academics.

A Causal Model of Health Literacy among Thai Older Adults with Uncontrolled Diabetes

Uncontrolled diabetes among older adults leads to acute and chronic complications that threaten health and life. Health literacy is crucial to managing health and making successful behavior changes for optimal diabetes outcomes. However, a clear understanding of multiple factors and their mechanisms to influence health literacy is lacking. This descriptive cross-sectional study aimed to test a Model of Health Literacy among Thai Older Adults with Uncontrolled Diabetes and examined the influencing pathways of cognitive function, diabetes knowledge, provider-patient communication, empowerment perception, social support, Internet use, and social engagement regarding health literacy. The sample consisted of 259 older Thai adults with uncontrolled diabetes. Data were collected using a demographic data form, the European Health Literacy Survey Questionnaire, the Diabetes Knowledge Scale, the Diabetes Empowerment Process Scale, the Provider-patient Communication Scale, the Social Support Questionnaire, the Montreal Cognitive Assessment-Basic Test, the Internet Use Questionnaire, and the Being Actively Engaged with Society Subscale of the Active Ageing Scale for Thai People. Data were analyzed using descriptive statistics and structural equation modeling with AMOS. The results showed that the model explained 76% of the quality of life variance. Diabetes knowledge and cognitive function directly affected health literacy. Health literacy was indirectly affected by provider-patient communication and empowerment perception through diabetes knowledge, social engagement through cognitive function, and Internet use through cognitive function and diabetes knowledge. Nurses can develop strategies by integrating Internet use and social engagement in empowerment communication programs to improve diabetes knowledge and cognitive function toward higher health literacy in this population.

Physicians' Words, Patients' Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study.

Background: Preventive cardiology aims to educate patients about risk factors and the importance of mitigating them through lifestyle adjustments and medications. However, long-term adherence to recommended interventions remains a significant challenge. This study explores how physician counselling contributes to successful behavior changes in various aspects of lifestyle. Methods: A cross-sectional study conducted in Greece in 2022-2023 included 1988 participants. Validated questionnaires assessed patients' characteristics, dietary habits, and lifestyle choices. Results: The findings revealed that patients who received lifestyle advice from physicians demonstrated increased compliance with the Mediterranean diet and a higher involvement in physical activity. Notably, they were also less likely to be non-smokers. Importantly, physicians' recommendations had a more pronounced association with adherence level to the Mediterranean diet compared to other lifestyle behaviors. Additionally, specific dietary components like cereal, legume, and red meat consumption were significantly associated with physicians' guidance. Conclusions: This study highlights the complex relationship between patients' cardiometabolic health, lifestyle decisions, and healthcare professionals' guidance. The substantial influence of physicians on Mediterranean diet adherence underscores the necessity for a multidisciplinary healthcare approach. Collaborative efforts involving physicians, dietitians, and fitness experts can offer comprehensive support to patients in navigating the intricate landscape of cardiometabolic health.

The Design andApplication ofa Health Behavioral Change (HBC) Roadmap.

To assist in addressing medical readiness challenges, the DOD has established various Centers of Excellence to focus efforts to protect, treat, train, and educate service members concerning risks and potential injuries. Using the hearing health domain as a pilot, this effort used DOD methods to evaluate all facets of successful health behavior change (HBC) practices within a military environment and developed a framework and pathway for HBC. The DOD uses the Joint Capabilities Integration and Development System (JCIDS) to ensure new DOD capabilities are identified and fielded in a manner that is interoperable, resilient, and supportables. The study sponsor for the Health Behavioral Change Framework study is the Defense Health Agency Deputy Assistant Director for Research and Engineering (R&E). The main objective of this group was to ensure that final products would both meet the requirements as defined by the JCIDS process, as well as be used by the operational force in addressing HBCs that improve readiness of the joint force. The Health Behavior Change Guidebook applies to all organizations across the DOD and military health system that may participate in or support specific tasks related to the design, conduct, and assessment of the HBC campaign. The advantage of the process is the ability to define gaps and solutions at an enterprise level. The HBC framework can be applied to a variety of health domains to include behavioral health. Use of the "Guidebook for Design, Conduct and Assessment of Health Behavior Change Campaign Within the DOD" and DOTMLPF-P analysis will move Defense Health Agency toward more disciplined use of the JCIDS. The HBC framework allowed the Hearing Center of Excellence to lead the hearing health community to create a capability-based assessment for hearing HBC.

Beyond average: A method for measuring the tightness, looseness, and polarization of social norms

Social norms are ubiquitous and understanding what shape they take is a central element of successful behavior change interventions. Existing methods focus on measuring norms in the form of what the average or most frequent behavior/opinion is in a given context. The complementary method presented here offers the ability to measure the distribution of norm-related beliefs at the individual level in an incentive-compatible way, thus offering a helpful tool for informed policymaking and behavior change interventions. This approach intuitively captures the tightness and looseness of norms, addressing scenarios where mean or modal outcomes may conceal underlying variations. This paper is accompanied by ready-made Qualtrics software to enhance the practical application of this method.

Capability, Opportunity, and Motivation Model for Behavior Change in People With Asthma: Protocol for a Cross-Sectional Study.

Asthma is a common lung condition that cannot be cured, but it can usually be effectively managed using available treatments. Despite this, it is widely acknowledged that 70% of patients do not adhere to their asthma treatment. Personalizing treatment by providing the most appropriate interventions based on the patient's psychological or behavioral needs produces successful behavior change. However, health care providers have limited available resources to deliver a patient-centered approach for their psychological or behavioral needs, resulting in a current one-size-fits-all strategy due to the nonfeasible nature of existing surveys. The solution would be to provide health care professionals with a clinically feasible questionnaire that identifies the patient's personal psychological and behavioral factors related to adherence. We aim to apply the capability, opportunity, and motivation model of behavior change (COM-B) questionnaire to detect a patient's perceived psychological and behavioral barriers to adherence. Additionally, we aim to explore the key psychological and behavioral barriers indicated by the COM-B questionnaire and adherence to treatment in patients with confirmed asthma with heterogeneous severity. Exploratory objectives will include a focus on the associations between the COM-B questionnaire responses and asthma phenotype, including clinical, biological, psychosocial, and behavioral components. In a single visit, participants visiting Portsmouth Hospital's asthma clinic with a diagnosis of asthma will be asked to complete a 20-minute questionnaire on an iPad about their psychological and behavioral barriers following the theoretical domains framework and capability, opportunity, and motivation model. Participants' data are routinely collected, including demographics, asthma characteristics, asthma control, asthma quality of life, and medication regime, which will be recorded on an electronic data capture form. The study is already underway, and it is anticipated that the results will be available by early 2023. The COM-B asthma study will investigate an easily accessible theory-based tool (a questionnaire) for identifying psychological and behavioral barriers in patients with asthma who are not adhering to their treatment. This will provide useful information on the behavioral barriers to asthma adherence and whether or not a questionnaire can be used to identify these needs. The highlighted barriers will improve health care professionals' knowledge of this important subject, and participants will benefit from the study by removing their barriers. Overall, this will enable health care professionals to use effective individualized interventions to support improved medication adherence while also recognizing and meeting the psychological needs of patients with asthma. ClinicalTrials.gov NCT05643924; https://clinicaltrials.gov/ct2/show/NCT05643924. DERR1-10.2196/44710.

Locally relevant food-based recommendations could increase iron and calcium intake for adolescent girls in Vietnam.

Unhealthy eating habits are common among adolescents in Vietnam, where transitioning food environments increasingly offer energy-dense micronutrient-poor foods. Successful behavior change approaches must be feasible and acceptable, promoting local foods that are available, accessible, and preferred. Yet, few studies have investigated the potential of food-based approaches for adolescents. We used linear programming to identify problem nutrients, local nutrient sources, and realistic food-based recommendations (FBRs) to improve nutrient intake among girls 16-22 years in Thai Nguyen, Vietnam. We then identified a reduced set of FBRs to prioritize the most critical micronutrient gaps. Calcium and iron targets could not be met in any realistic diet modeling scenario. The best set of FBRs included seven recommendations which could meet intake targets for 9 of 11 modeled micronutrients. The best reduced set of three FBRs targeting iron and calcium only-although more feasible for behavior change-was less effective at improving intake of these nutrients since fewer foods were recommended. Given the difficulty of meeting calcium and iron targets using local foods within acceptable dietary patterns, additional interventions, such as supplementation, staple food fortification, or increasing the availability of affordable calcium- and iron-rich foods, may be necessary to promote dietary adequacy for adolescent girls.

Predicting Disengagement to Better Support Outcomes in a Web-Based Weight Loss Program Using Machine Learning Models: Cross-Sectional Study.

Engagement is key to interventions that achieve successful behavior change and improvements in health. There is limited literature on the application of predictive machine learning (ML) models to data from commercially available weight loss programs to predict disengagement. Such data could help participants achieve their goals. This study aimed to use explainable ML to predict the risk of member disengagement week by week over 12 weeks on a commercially available web-based weight loss program. Data were available from 59,686 adults who participated in the weight loss program between October 2014 and September 2019. Data included year of birth, sex, height, weight, motivation to join the program, use statistics (eg, weight entries, entries into the food diary, views of the menu, and program content), program type, and weight loss. Random forest, extreme gradient boosting, and logistic regression with L1 regularization models were developed and validated using a 10-fold cross-validation approach. In addition, temporal validation was performed on a test cohort of 16,947 members who participated in the program between April 2018 and September 2019, and the remaining data were used for model development. Shapley values were used to identify globally relevant features and explain individual predictions. The average age of the participants was 49.60 (SD 12.54) years, the average starting BMI was 32.43 (SD 6.19), and 81.46% (39,594/48,604) of the participants were female. The class distributions (active and inactive members) changed from 39,369 and 9235 in week 2 to 31,602 and 17,002 in week 12, respectively. With 10-fold-cross-validation, extreme gradient boosting models had the best predictive performance, which ranged from 0.85 (95% CI 0.84-0.85) to 0.93 (95% CI 0.93-0.93) for area under the receiver operating characteristic curve and from 0.57 (95% CI 0.56-0.58) to 0.95 (95% CI 0.95-0.96) for area under the precision-recall curve (across 12 weeks of the program). They also presented a good calibration. Results obtained with temporal validation ranged from 0.51 to 0.95 for area under a precision-recall curve and 0.84 to 0.93 for area under the receiver operating characteristic curve across the 12 weeks. There was a considerable improvement in area under a precision-recall curve of 20% in week 3 of the program. On the basis of the computed Shapley values, the most important features for predicting disengagement in the following week were those related to the total activity on the platform and entering a weight in the previous weeks. This study showed the potential of applying ML predictive algorithms to help predict and understand participants' disengagement with a web-based weight loss program. Given the association between engagement and health outcomes, these findings can prove valuable in providing better support to individuals to enhance their engagement and potentially achieve greater weight loss.

Essential Service Products as Channels for COVID-19 Awareness and Behavior Change: A Narrative Review

Coronavirus disease 2019 (COVID-19) is here to stay. Nonpharmacological interventions such as hand hygiene, social distancing, and respiratory hygiene have remained the mainstay to curb the spread of the virus, and these are sustainable. To understand the information, education, and communication (IEC) efforts undertaken during previous pandemics and successful behavior change strategies that may be applicable to ongoing COVID-19 pandemic, we conducted a narrative review of articles using PubMed search on September 11, 2022. The results highlighted that reinforced IEC is the need of the hour in efforts against COVID-19 pandemic. The communication strategy during a pandemic should be of three stages aligned to the objectives of building a basic understanding and knowledge in the target population: building an awareness of the threat; personal actions to minimize the impact; and reinforcing the need for appropriate actions to minimize disease transmission, in that order. An innovative strategy of displaying IEC on the daily essential products can result in a sustainable solution that might result in a “felt need” in the community to follow COVID-19 appropriate behavior. A broad base of stakeholders' engagement with civil bodies, nongovernmental organizations, private sectors with well-defined responsibilities and accountability would offer an enabling environment for these efforts in ultimately curbing the COVID-19 pandemic.

The Psychologically Informed Practice Consultation Roadmap: A Clinical Implementation Strategy.

Psychologically informed practice (PiP) includes a special focus on psychosocial obstacles to recovery, but research trials have revealed significant difficulties in implementing PiP outside of research environments. Qualitative studies have identified problems of both competence and confidence in tackling the psychosocial aspects of care, with a tendency to prefer dealing with the more mechanical aspects of care. In PiP, the distinction between assessment and management is not clear-cut. Analysis of the problem is part of the intervention, and guided self-management begins with the initial detective work by the patient, who is encouraged to develop successful and relevant behavior change. This requires a different style and focus of communication that some clinicians find difficult to enact. In this Perspective, the PiP Consultation Roadmap is offered as a guide for clinical implementation to establish a therapeutic relationship, develop patient-centered communication, and guide effective pain self-management. These strategies are illustrated through the metaphor of the patient learning to drive, with the therapist as a driving instructor and the patient as a student driver. For convenience, the Roadmap is depicted in 7 stages. Each stage represents aspects of the clinical consultation in a recommended order, although the Roadmap should be viewed as a general guide with a degree of flexibility to accommodate individual differences and optimize PiP interventions. It is anticipated that the experienced PiP clinician will find it progressively easier to implement the Roadmap as the building blocks and style of consultation become more familiar.

The Impact of Social Media Interventions on Weight Reduction and Physical Activity Improvement Among Healthy Adults: Systematic Review.

A sedentary lifestyle and being overweight or obese are well-established cardiovascular risk factors and contribute substantially to the global burden of disease. Changing such behavior is complex and requires support. Social media interventions show promise in supporting health behavior change, but their impact is unclear. Moreover, previous reviews have reported contradictory evidence regarding the relationship between engagement with social media interventions and the efficacy of these interventions. This review aimed to critically synthesize available evidence regarding the impact of social media interventions on physical activity and weight among healthy adults. In addition, this review examined the effect of engagement with social media interventions on their efficacy. CINAHL and MEDLINE were searched for relevant randomized trials that were conducted to investigate the impact of social media interventions on weight and physical activity and were published between 2011 and 2021 in the English language. Studies were included if the intervention used social media tools that provided explicit interactions between the participants. Studies were excluded if the intervention was passively delivered through an app website or if the participants had a known chronic disease. Eligible studies were appraised for quality and synthesized using narrative synthesis. A total of 17 papers reporting 16 studies from 4 countries, with 7372 participants, were identified. Overall, 56% (9/16) of studies explored the effect of social media interventions on physical activity; 38% (6/16) of studies investigated weight reduction; and 6% (1/16) of studies assessed the effect on both physical activity and weight reduction. Evidence of the effects of social media interventions on physical activity and weight loss was mixed across the included studies. There were no standard metrics for measuring engagement with social media, and the relationship between participant engagement with the intervention and subsequent behavior change was also mixed. Although 35% (6/16) of studies reported that engagement was not a predictor of behavior change, engagement with social media interventions was found to be related to behavior change in 29% (5/16) of studies. Despite the promise of social media interventions, evidence regarding their effectiveness is mixed. Further robust studies are needed to elucidate the components of social media interventions that lead to successful behavior change. Furthermore, the effect of engagement with social media interventions on behavior change needs to be clearly understood. PROSPERO International Prospective Register of Systematic Reviews CRD42022311430; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=311430.

Let’s Ask the Teachers: A Qualitative Analysis of Health Education in Schools and Its Effectiveness

There is a need for action in health promotion for children and adolescents. Schools are assumed to be an appropriate place to enable students to behave healthily. Numerous interventions have been piloted in schools, but sustained implementation appears challenging. An alternative approach might be to ask teachers how they conduct health education and what they see as effective. Accordingly, we conducted an explorative study using semi-structured interviews with eleven teachers from secondary schools in Germany in 2019. The interviews focused on different aspects of health education: goals, methods and strategies, effectiveness, possible barriers, and ways to reduce them. We inductively identified six dimensions of effectiveness that teachers believe are relevant for effective health teaching in schools. Regarding methods and strategies, many were mentioned, but only a part was explicitly named as effective. Most of these strategies focus on improving students’ knowledge and skills, followed by strengthening health-promoting attitudes, but rarely promote long-term behavior change. Moreover, it became apparent that some aspects, such as goalsetting and developing action plans, received little attention in lessons, even though they are considered important for successful behavior change.

Engaging Young People in Climate Change Action: A Scoping Review of Sustainability Programs

Young people are stepping forward and engaging in or leading programs promoting climate action and sustainability. To optimize program outcomes, it is important to understand the nature of these programs, as well as their successes and enablers. Consequently, a scoping review was conducted across six databases, Taylor and Francis, Medline, Web of Science, Scopus, Sage and Wiley, to examine existing programs that promote climate change action amongst young people aged 12 to 25 years. The review sought to determine what is known about these programs and their outcomes by documenting what elements contribute to successful behavior changes in young people. Forty-eight articles were included in the review, with almost half of the studies from the United States. Eight elements recurred throughout the reviewed journal articles including intersecting external and internal factors contributing to reported behavior change. External factors included the social environment, place, knowledge, leadership and goal setting development that fostered internal factors that included, self-efficacy, identity, agency and action competence, and systems thinking. Learning from these programs to improve design and ensure sustainable outcomes is key to improving the capabilities of young people to continue responding to the climate challenge.

Self-report and device-based physical activity measures and adherence to physical activity recommendations: a cross-sectional survey among people with inflammatory joint disease in four European countries

ObjectivesSelf-monitoring of physical activity (PA) has the potential to contribute to successful behaviour change in PA interventions in different populations, including people with inflammatory joint diseases (IJDs). The objectives of...