Sustainable Change Research Articles

"A cuff is not enough": A community-based participatory research approach to soliciting perspectives of African Americans with hypertension and their family members on self-management intervention features.

We aimed to solicit the perspectives of African Americans with hypertension and their family members on the desired features of a behavioral hypertension self-management intervention. Using a community-based participatory approach to intervention design, we conducted four dyadic focus groups, including African American community members with hypertension (n = 23) and their family members (n = 23), recruited from African American-serving Christian churches in a large, southern metropolitan area. We used open-ended questions to elicit participants' perspectives regarding program features they would recommend, intervention delivery, and barriers necessary to address. Our grounded theory analysis identified themes reflecting participants' recommendations for hypertension self-management interventions to enhance health literacy and provide communication training via an accessible, population-tailored, family-based approach, which they believed has the potential to create family-level impact on health across generations. Participants also recommended intervention researchers engage in advocacy (i.e., via physician education and policy change) as part of a broader impact on structural inequities driving worse hypertension and health outcomes for African Americans. The perceptions and recommendations of African Americans with a lived experience of hypertension, as well as their family members, aid in shaping acceptable and efficacious behavioral interventions aiming to promote hypertension self-management behavior while leveraging the unique power of family relationships to create sustained behavior change.

Socio-demographic and cross-country differences in attention to sustainable certifications and changes in food consumption

Food labeling can influence, sometimes facilitate, changes in consumer diets to support environmental sustainability and in response to climate change. However, a significant impediment to this dietary shift may arise from the consumers’ tendency to underestimate the environmental impact of their food choices and from their limited knowledge about sustainable certifications. These aspects are influenced by the characteristics and geographical affiliations of individuals. In such a context, the aim of this research has been to identify the main factors that drive the food purchasing frequency and the changes in food consumption associated with consumers’ concerns about climate change and interest in sustainable food certifications by comparing different food products and countries (Italy, France, Germany, Denmark, the USA, and China). A cross-country survey was conducted on 6500 consumers of various food products. The obtained mean scores were then compared, using generalized linear mixed-effect models, to evaluate the associations between the consumers’ food purchasing frequency, the importance of sustainable certifications, and changes in food consumption due to climate change concerns. Much of the variation in food consumption, purchasing behaviors, and interest in sustainable certifications was found to depend on such factors as age, gender, and country of origin. Indeed, Chinese consumers exhibited a heightened interest in sustainable food certifications, yet their consumption scores for all food products overall were higher. Conversely, adult and elderly Danish consumers demonstrated a decrease in the consumption of cheeses, meat, fruits, and vegetables, and their interest scores in all sustainable food certifications were lower. Despite the challenges posed by various consumers’ interests and minimal changes in food consumption patterns, our findings suggest that sustainable certifications present a promising avenue for straightforward interventions to promote the adoption of sustainable diets and to address climate change.

What Effect Do Goal Setting Interventions Have on Physical Activity and Psychological Outcomes in Insufficiently Active Adults? A Systematic Review and Meta-Analysis.

Goal setting is commonly used for promoting physical activity (PA) among insufficiently active individuals. Previous reviews have analyzed the effects of goal setting on PA, but the purpose of this systematic review was to examine the concurrent effects of goal setting on PA and psychological outcomes in insufficiently active individuals to support interventions aiming to produce sustained PA behavior change. In this review (PROSPERO: CRD42021243970), we identified 13 studies with 1208 insufficiently active adults that reported the effects of goal-setting interventions (range 3-24wk) on both PA and psychological outcomes (eg,self-efficacy, motivation, and affect). We used meta-analysis and narrative synthesis to analyze these effects. All goals used in the included studies were specific goals. Setting specific goals had a large, positive effect on PA (g [standard mean difference] = 1.11 [P < .001]; 95% confidence interval, 0.74-1.47), but only a small, positive effect on the combined psychological outcomes (g [standard mean difference] = 0.25 [P < .001]; 95% CI, 0.10-0.40). Moderator analyses revealed that interventions that did not reward participants had a significantly greater effect on PA than interventions that did provide rewards (g = 1.30 vs 0.60, respectively, P ≤ .003). No other significant moderators were found. Our review offers initial insight into the long-term effects of specific goals on PA and psychological outcomes in insufficiently active adults. Further research that examines the PA and psychological effects of goal-setting interventions and investigates a wider range of goal types could develop a stronger evidence base to inform intervention for insufficiently active individuals.

Drawing the past to envision the future: supporting the development of primary STEM teacher identity

ABSTRACT Growing interest in STEM education and imminent curricular reform places new demands on teachers, giving impetus to re-examining how we prepare primary teachers for more integrated approaches. In addition to the acquisition of knowledge and skills, sustainable change demands the development of teacher identity, in which teachers are seen by themselves and others as STEM teachers. This paper reports on the emerging STEM teacher identities of five preservice primary teachers. Using STEM story-lines as an innovative graphing exercise, participants were prompted to reflect on key events that shaped their journey and share future-oriented narratives through drawing and storytelling, as they negotiated becoming STEM teachers. Findings suggest that although their own school experiences were varied and influential, an integrated STEM intervention was the common turning point in their STEM identity development, whereby participants aligned critical components of STEM with personal experiences and values. The reflective tools used supported identity work, by triggering a rediscovery and reinterpretation of their experiences with the benefit of increased knowledge for teaching STEM and, in turn, provided a means to re-envisage the future.

The barriers and facilitators to the design and delivery of sustainable healthcare across NHS Scotland: A forcefield analysis

Healthcare systems around the world have set ambitious targets to design and deliver more environmentally sustainable healthcare. To achieve these targets, individuals, teams, organisations, and whole systems will have to change current attitudes, practices and processes. Change management theory advocates for early identification of the influencing forces to change, so that actions can be taken to overcome the barriers and strengthen the facilitators to increase the likelihood of success. This project undertook a forcefield analysis exercise to identify the barriers and facilitators to the design and delivery of sustainable healthcare in Scotland. The exercise identified 12 facilitators and 12 barriers to sustainable change and formulated ten recommendations to strengthen the former and overcome the latter. It is hoped that the results will raise awareness of the factors that influence the design and delivery of sustainable healthcare and will inform what actions can be taken to increase the likelihood of success.

Sustaining the benefits of structured education: Participants' experiences of receiving structured individual support during a programme (DAFNEplus) informed by behavioural science.

The DAFNEplus programme seeks to promote sustained improvements in glycaemic management by incorporating techniques from behavioural science. It includes five sessions of structured individual support delivered over 12 months following group education. As part of a broader evaluation, and to inform decision-making about roll-out in routine care, we explored participants' experiences of, and engagement with, that individual support. We interviewed DAFNEplus participants (n = 28) about their experiences of receiving individual support and the impact they perceived it as having on their self management practices. We analysed data thematically. Participants described several important ways individual support had helped strengthen their self management, including: consolidating and expanding their understandings of flexible intensive insulin therapy; promoting ongoing review and refinement of behaviour; encouraging continued and effective use of data; and facilitating access to help from healthcare professionals to pre-empt or resolve emergent difficulties. Participants characterised themselves as moving towards independence in self management over the time they received individual support, with their accounts suggesting three key stages in that journey: 'Working with healthcare professionals'; 'Growing sense of responsibility'; and, 'Taking control'. Whilst all portrayed themselves as changed, participants' progress through those stages varied; a few continued to depend heavily on DAFNEplus facilitators for advice and/or direction at 12 months. While all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer-term, tailored support. This has important implications for decision-making about roll-out of DAFNEplus post-trial and for the development of future programmes seeking to bring about sustainable changes in self management practices.

Multidisciplinary perspective on a Finnish general upper-secondary school’s educational change: strengthening and hindering factors

ABSTRACT Sustaining change beyond individual teachers is challenging and understanding factors making educational change effective is needed. We aimed to identify the factors that educators and construction specialists considered influential to educational change of a general upper-secondary school that was under construction and was to meet the pedagogical goals of the concurrently renewed national core curriculum and legislation. The analysis of multidisciplinary interviews (n = 22) conducted during the early phase of the construction process assisted in identifying the factors that the participants perceived as strengthening and hindering educational change. The strengthening factors related to leadership support, collaboration opportunities, and teachers’ professional training, engagement, and transformative agency. The hindrances were constraints that related, for instance, to issues in funding, large group sizes and those that lacked applicable cross-curricular examples. We postulate the need to assist schools and individual teachers in creating conditions for educational change at all levels of municipal education.

Probing the Practicality of Ethical School Leadership Amid Socio-Political and Economic Turmoil

This study aims to probe the practicality of ethical school leadership amid socio-political and economic turmoil. This was necessitated by the collapse of the Zimbabwean economy in 2000 up until 2009 when they abandoned their currency due to hyperinflation. The downturn of the economy has not been abated to date, and education, together with other social services has been affected tremendously. The objective of this study is to find out the practicality of school leadership amid social, political, and economic turmoil, such as the one prevailing in Zimbabwe. Based on the findings, the study aims to suggest ways of dealing with ethical school leadership in such an environment. A qualitative study was conducted involving two primary and two secondary schools, where four school heads and sixteen teachers constituted the sample. Semi-structured interviews and focus group interviews were conducted. The findings indicated that school heads and teachers are finding it very difficult to practice ethical school leadership in the environment prevailing in Zimbabwe. This paper proposes that ethical leadership be promoted in these schools through engaging the 'reusable past' from their African Indigenous Knowledge and additionally applying a multi-dimensional and multi-sectoral intervention strategy to bring sustainable and practical change.

Beyond carbon-centric estimates: revisiting the interplay between hydroclimatic conditions and dryland forestation

In the global pursuit of climate mitigation, extensive tree planting initiatives have targeted the vast drylands. However, the carbon sequestration potential of forestation in these regions remains uncertain, primarily due to the oversight of crucial factors like vegetation-climate interactions. By revisiting the benefits of dryland forestation using comprehensive Earth System Modeling, we underscore the vital role of hydroclimatic factors in shaping the effectiveness of nature-based solutions, urging a reassessment of criteria for accurate carbon-centric estimates and sustainable global climate change mitigation strategies.

The COVID-19 pandemic and dynamics of livelihood assets in the Kwahu South District of Ghana: determinants and policy implications

ABSTRACT The debate on the changes in livelihood assets as a function of health shocks remains inconclusive, thus spurring attention from scientists and development practitioners across the globe. This paper analyses COVID-19-induced changes in the livelihood assets of rural households in Ghana. While content analysis was employed in qualitative data analysis, the quantitative data set was analysed using a binary logistic regression model. The analyses led to the following conclusions: The COVID-19 pandemic led to a more significant decline in financial assets than social assets. Although several socio-economic factors determine changes in the livelihood assets of households, the assets base of migrants was disproportionately affected by the pandemic. Further, women were disproportionately affected since market access restrictions significantly affected their income and savings and, consequently, their ability to buy farm necessities. These results suggest the need to emphasise the resilience of financial assets in times of pandemics, especially for migrants. This study provides new insights to inform the sustainable livelihoods framework, emphasising pandemics and changing livelihood strategies. Studies to uncover the coping strategies of migrants in the context of health shocks are required to complement this position.

Mapping sustainability: A comparative analysis proposal across EU countries and regions

This paper addresses the need to understand the structure of sustainability change in the face of the unpredictability of modern civilization. The aim of the paper is to examine the structure of sustainability change in relation to smaller spatial units such as the regions of the European Union and to compare these results with those achieved at the country level. For this purpose, the sustainable development indicators available in the Eurostat database were analyzed. Studies published to date have tended to focus on the performance of national economies or selected regions. In this article, the available data on regions are also analyzed. The study aims to compare the level of sustainable development achieved at the level of EU countries and regions located within them. Methodologically, the study uses advanced methods of comparative analysis, and the synthesis of the data enables the construction of a synthetic measure using taxonomic methods, facilitating the classification of EU countries and regions into clusters. The results highlight significant divergences in sustainability achievements between EU countries and regions. The study reveals the importance of studying sustainable development in smaller geographical cross-sections. The results highlight the need to expand access to data at the regional level (sustainability indicators) to facilitate more comprehensive analyses and inform targeted policy interventions. Looking to the future, the study recommends further research into the inter-linkages between sustainability and other critical areas in EU regions, such as innovation and competitiveness.

Walk With Me: reducing harm and confronting the toxic drug poisoning crisis in small British Columbia cities through community engaged research

In an era of escalating and intersectional crises, the toxic drug poisoning crisis stands out as a devastating and persistent phenomenon. Where we write from in British Columbia (BC), Canada, over 13,000 deaths have occurred in the eight years since the toxic drug poisoning crisis was declared a provincial health emergency. While many of these deaths have occurred in large urban centres, smaller rural communities in British Columbia are also grappling with the profound impacts of the toxic drug poisoning crisis and are struggling to provide adequate support for their vulnerable populations. In response to these challenges, the Walk With Me research project has emerged in the Comox Valley of Vancouver Island, BC, employing community-engaged methodologies grounded in pluralist knowledge production. Walk With Me seeks to understand the unique manifestations of the toxic drug poisoning crisis in small communities, identifying local harm reduction interventions that can foster community resilience, and aiming to catalyze sustainable change by amplifying the voices of those directly affected by the crisis to advocate for policy changes. This paper outlines the conceptual and methodological underpinnings of the Walk With Me project as a harm reduction initiative, which holds community partnerships and diverse ways of knowing at its heart. It presents the community-engaged research framework used by the project to address overlapping health and social crises, offering practical examples of its application in various research projects across sites and organizations. The paper concludes with a reflection on the impacts of Walk With Me to date, highlighting the lessons learned, challenges encountered, and opportunities for future research and action. Overall, this article captures the urgent need for community-engaged approaches to address the toxic drug poisoning crisis and other multidimensional crises facing society, particularly in smaller and rural communities, underscoring the potential for meaningful change through collaborative, grassroots efforts.

Cross sectional survey of attitudes on sustainability and climate change among baccalaureate nursing faculty and students

BackgroundNurse educators are critical to ensuring future nurses are prepared to meet healthcare needs due to climate change. AimThe purpose of this research was to assess the attitudes of nursing students and faculty on sustainability and climate change in nursing and nursing education. DesignThis study used a descriptive, cross-sectional online survey of nursing students and faculty recruited online and at national conferences. SettingsOnline survey. ParticipantsA convenience sample of students and faculty were recruited from a national student nursing convention and a national meeting of community health nursing educators along with the principal investigator's university. Additional faculty were recruited from national nursing education organization email listservs. Eligibility criteria included adults 18 years or older who are enrolled students or faculty in an undergraduate nursing program. MethodsParticipants completed the Sustainability Attitudes in Nursing Survey (SANS_2) survey online. Survey responses were downloaded and analyzed using IBM SPSS. ResultsIndependent sample Mann-Whitney U tests of responses from faculty and students was significantly different, p = 0.047, for the question “Issues about climate change should be included in the nursing curriculum”. Comparison of SANS_2 overall means from first-year nursing students in other countries showed lower mean scores among first-year U.S. students that climate and sustainability are important issues of nursing and nursing education. Comparison of faculty overall SANS_2 means found greater support for including climate change and sustainability among U.S. nursing faculty when compared with faculty from South Carolina. ConclusionsThe results of the survey found differences in support among baccalaureate faculty and students for including climate change and sustainability in nursing education. Additional research into the effectiveness of learning activities needs to be done by nurse educators and researchers as part of on-going efforts to ensure future nursing students understand the impact of climate change on health.

Long-term impact of unhealthy food tax on consumption and the drivers behind: A longitudinal study in Hungary

Several countries have introduced public health product taxes with the objective of reducing the absolute amount of consumption of unhealthy food and tackling obesity. This study aims to estimate the long-term impact of the Hungarian public health product tax introduced in 2011.To achieve this, a unique consumer purchase dataset was analysed to examine daily fast-moving consumer goods purchases from a representative sample of 2,000 households from 2010 to 2018. The results indicate that the tax has been fully reflected in consumer prices. A decline in consumption was observed initially, consistent with previous experiences in Hungary and other countries. However, over time, the data suggests a recovery and even an increase in line with the growth of disposable income. The proportion of taxed products in total fast-moving consumer goods purchases increased from 5.9 % (95 % CI: 5.7 % to 6.0 %) in 2010 to 7.4 % (95 % CI: 7.3 % to 7.6 %) in 2018. Furthermore, the tax has contributed to increased inequality as low-income households spend a higher proportion of their total expenditure on it.Although taxes on unhealthy foods have proven effective in the short-term, they may not be adequate for reducing overall consumption in the long-term, particularly as disposable income increases. In conclusion, implementing complex interventions is necessary to achieve sustainable positive changes in dietary habits.

Gamification towards and alongside equity, diversity and inclusion: Looking back to move forward

Given the urgent need for environments that enable everyone in fulfilling their fullest potential, many new media innovations have focused on equity, diversity and inclusion (EDI) actions. Gamification is one of these innovations, becoming a promising avenue to engage people towards effective social change. Yet, the intersection between EDI and gamification is incipient and fragmented, preventing a comprehensive understanding of current findings and future advancements in this field. This literature review systematically investigates the meanings, methods and effects of gamification in EDI actions (i.e. gamification towards EDI), and the design of equitable, diverse and inclusive gamification (i.e. gamification alongside EDI). Results elucidate how gamification improves performance, enriches experiences and fosters change, while analysing its design through gender, age and disability lenses. Future work calls for broader and deeper gamified EDI interventions informed by social sciences, diverse people-oriented design and empirical demonstration of sustainable social change.

Preparing Vulnerable Communities: Disaster Mitigation Strategies for Economically Depressed Areas in Oklahoma

When disasters strike, vulnerable areas that are economically disadvantaged are adversely affected economically, culturally, and healthily, as the lack of resources and vulnerabilities amplify their problems. This research focuses on the population specifics of disaster vulnerabilities and targeted policies for economically depressed neighborhoods in Oklahoma. Relative to less susceptible entities, poor people are likelier to take damage from tornados, winter storms, wildland fires, and flooding because they lack the resources required for preparation, response, and recovery. Through an equity-focused lens, the study examines four key factors amplifying disaster risk: those due to aging critical infrastructure, lack of insurance and savings, health disparities, or the failure to plan adequately. Collapsed stormwater drainage systems, roads, bridges, and water pipes in financially deprived communities experience cracks in a hurry during duresses. With little or no funds, families earning every paycheck cannot afford to purchase rescue insurance or, in the case of names, save money to build an emergency fund, including money to cover repair costs, temporary housing, and other costs. This is, of course, made even worse by any previously existing medical, disability, or mental health issues as well, with poorer health outcomes than might usually be expected since access to healthcare services, treatments, and medications is also disrupted. Lastly, language and education barriers lead to the lower development of disaster plans; the delays include access to early warning systems and a need for more awareness of risks among vulnerable groups. Given these weaknesses, the study offers policymakers, funders, and resilience practitioner’s implementable policy, investment, and community-oriented intervention recommendations. The hazards can be lessened by prioritizing infrastructure upgrades, insurance reduction, and commitment to spread-out shelters and relief supplies. Long-term recovery programs financed specifically by equal aid promote program equity of rebuilding. Regarding inclusive messaging on public preparation and early warnings, local trusted institutions should be appropriated to reach a diverse population. Collaborative networks among government agencies, relief organizations, businesses, and grassroots associations can bolster response capacity. Their unified efforts on localized resilience initiatives advance strategic plans for the state's most economically fragile neighborhoods. Implementation should focus on those with the highest vulnerability markers and the least ability to prepare, respond, and recover independently— metrics assessing community functionality, equity factors, and recovering spending offer evidence-based progress milestones. With climate change projected to increase disaster severity in Oklahoma, research-driven and equitable resilience policies for marginalized communities can reduce prolonged suffering. Tailored preparation, outreach, critical system backups, and financial support lessen acute shocks and accelerate recovery. However, sustainable policy change relies on addressing root socioeconomic inequalities through systemic interventions beyond immediate disaster management.

Regulatory Frameworks and Governance in Islamic Banking: A Bibliometric Review of Compliance Standards

Over the past few decades, the global discourse on environmental sustainability and climate change has catalyzed a profound transformation in economic paradigms, giving rise to the concept of the green economy. This paradigm emphasizes the integration of environmental considerations into economic activities to foster sustainable development and mitigate environmental degradation. In the context of Islamic banking, which operates under the principles of Sharia, there is a growing recognition of the importance of aligning financial practices with ethical and social values, including environmental stewardship. This bibliometric review explores the regulatory frameworks and governance structures in Islamic banking with a focus on compliance standards related to environmental sustainability. Through a systematic analysis of scholarly literature, this study aims to shed light on current trends, key areas of focus, and potential areas for improvement in ensuring environmental sustainability within Islamic banking operations.

Successful dietary changes correlate with weight-loss outcomes in a new dietary weight-loss program.

Currently available behavioral and dietary weight-loss programs lack magnitude and sustainability compared with bariatric surgery. A novel dietary weight-loss program was developed to assist participants in achieving sustainable diet changes by building knowledge and skills in food self-selection. Although the approach worked, a large variation was observed in outcome among participants. Determine factors affecting weight-loss outcomes among participants to further improve the efficacy of the program. Participants attended 19 dietary educational sessions during a 1-year intervention which included prescribed homework. Changes in weight, diet, and body composition were assessed. Participants (n=22) achieved mean body weight loss of -6.49(8.37%, p<0.001) from baseline at 12months. Nine participants (41%) achieved weight loss >5% of initial bodyweight; two reached a Body Mass Index 25kg/m2. A large divergence in weight loss among participants was observed; successful (n=9) achieved -12.9(9.6)% while unsuccessful achieved -2.03(2.78)%. Dietary protein and fiber density by 24-h records showed a significant and inverse correlation with weight loss (%) throughout the program. Weight loss at 3months and 12months showed a strong correlation (r=0.84). Participants with self-reported depression lost significantly less weight than those without depression at 12months (p<0.03). Divergence in weight-loss outcomes among the participants is likely due to a difference in successful dietary implementation. Intra-cohort analysis indicates early weight-loss success and early dietary implementation was predictive of long-term success.

From multilevel to trans-level interventions: A critical next step for creating sustainable social change to improve mental health.

Eliminating mental health disparities requires simultaneously addressing numerous determinants of health, including social inequities. Although emphasis on multilevel change is growing, interventions typically involve separate efforts or people focusing on each level. We propose a trans-level conceptual model for mental health intervention that simultaneously facilitates change across multiple intersecting levels with four guiding principles: (1) emphasis on structural change; (2) involvement of people experiencing health and social inequities in achieving structural change by addressing the necessary preconditions of access to resources for basic needs, community membership and belonging, and knowledge or information to participate in social change efforts; (3) valuing and building on the expertise and strengths of individuals, families, and communities experiencing health inequities; and (4) dismantling unequal power dynamics of helping relationships through a focus on mutual learning and support and cocreation of change. Tracing the trajectory of a 23-year community-based mental health intervention partnership (the Refugee and Immigrant Well-Being Project), we illustrate the trans-level intervention model and describe its impact on individual mental health and sustainable change at multiple levels. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Towards greener futures: SVR-based CO2 prediction model boosted by SCMSSA algorithm

This research presents the utilization of an enhanced Sine cosine perturbation with Chaotic perturbation and Mirror imaging strategy-based Salp Swarm Algorithm (SCMSSA), which incorporates three improvement mechanisms, to enhance the convergence accuracy and speed of the optimization algorithm. The study assesses the SCMSSA algorithm's performance against other optimization algorithms using six test functions to show the efficacy of the enhancement strategies. Furthermore, its efficacy in improving Support Vector Regression (SVR) models for CO2 prediction is assessed. The results reveal that the SVR-SCMSSA hybrid model surpasses other hybrid models and standard SVR in terms of training and prediction accuracy by obtaining 95 % accuracy. Its swift convergence, precision, and resistance to local optima position make it an excellent choice for addressing complex problems such as CO2 prediction, with critical implications for sustainability efforts. Moreover, feature importance analysis by SVR-SCMSSA offers valuable insights into the key contributors to CO2 prediction in the dataset, emphasizing the significance and impact of factors such as fossil fuel, Biomass, and Wood as major contributors to CO2 emission. The research suggests the adoption of the SVR-SCMSSA hybrid model for more accurate and reliable CO2 prediction to researchers and policymakers, which is essential for environmental sustainability and climate change mitigation.