Sustained Behavior Change Research Articles

EDUKASI BAHAYA BULLYING KALANGAN PELAJAR DI SMPN 3 PELALAWAN

This article discusses education about the dangers of bullying at SMPN 3 Pelalawan. The goal is to increase student awareness of the negative effects of bullying. Activities involve students and use interactive lecture methods. The main focus includes understanding the concepts, signs, and handling of bullying. The results showed an increase in students' understanding of the concept of bullying to 85%, and the ability to recognize signs from 60% to 80%. 75% of students are also able to mention steps to prevent and deal with bullying. This success creates a safer and more inclusive school environment. The article recommends approaches such as open and in-depth discussion to overcome resistance. In the Future suggests focusing on in-person interactions, such as group discussions and simulated bullying. Engaging teachers, parents and measuring long-term impact is important for sustainable behavior change. With a more adaptive approach, it is hoped that this activity will remain effective in overcoming bullying in the future

취침 전 스마트기기 사용 감소를 위한 디자인 개입 연구

Due to the rapid proliferation of various smart devices in recent times, the usage of smart devices has been increasing rapidly. Particularly, the time spent using smart devices before bedtime constitutes a significant portion of overall smart device usage. Excessive use of smart devices before bedtime has negative effects on physical, mental, and social aspects. Therefore, in this study, we propose methods for bringing a behavior change based on behavioral theory, going beyond technology-based physical interventions, with the aim of reducing the usage time of smart devices before sleep. To achieve this, we designed two types of design-led interventions based on the feedback and feedforward concepts of behavioral theory and conducted a three-week long experiment. These proposed interventions were provided to the participants in each experimental group at a specific time (before going to bed). Based on the differences between the two groups, the study discussed the effectiveness of design-led interventions for instigating sustainable behavior change. This study holds significance as it offers practical guidance essential for the development of models and applications that may effectively utilise this particular design strategy.

4 C's Approach to Meaningful and Lasting Positive Behavior Change.

Making intentional and sustainable positive behavior changes is difficult for most individuals. Knowledge and even expert coaching have shown meager results in guiding individuals towards a healthier diet and lifestyle. It is clear from the current research that additional approaches, which can help stem the tide of obesity and other chronic diseases, are needed. This article introduces a systematic process-based approach which focuses on the 4C's, Clarity, Commitment, Compassion, and Consistency. It is essential for individuals to have Clarity before they begin their health journey. Clarity must address, what do I want to change, why, and how am I going to make the change. Commitment highlights the importance of following a process-based approach that focuses on small incremental changes which over time can lead to remarkable results. Compassion is the necessary ingredient which allows individuals to continue the journey despite setbacks. By staying committed to the process, by practicing self-compassion, and by finding a healthy community, the individual is slowly able to achieve Consistency in achieving and then maintaining a healthier diet and lifestyle.

Food Is Medicine: A Presidential Advisory From the American Heart Association.

Unhealthy diets are a major impediment to achieving a healthier population in the United States. Although there is a relatively clear sense of what constitutes a healthy diet, most of the US population does not eat healthy food at rates consistent with the recommended clinical guidelines. An abundance of barriers, including food and nutrition insecurity, how food is marketed and advertised, access to and affordability of healthy foods, and behavioral challenges such as a focus on immediate versus delayed gratification, stand in the way of healthier dietary patterns for many Americans. Food Is Medicine may be defined as the provision of healthy food resources to prevent, manage, or treat specific clinical conditions in coordination with the health care sector. Although the field has promise, relatively few studies have been conducted with designs that provide strong evidence of associations between Food Is Medicine interventions and health outcomes or health costs. Much work needs to be done to create a stronger body of evidence that convincingly demonstrates the effectiveness and cost-effectiveness of different types of Food Is Medicine interventions. An estimated 90% of the $4.3 trillion annual cost of health care in the United States is spent on medical care for chronic disease. For many of these diseases, diet is a major risk factor, so even modest improvements in diet could have a significant impact. This presidential advisory offers an overview of the state of the field of Food Is Medicine and a road map for a new research initiative that strategically approaches the outstanding questions in the field while prioritizing a human-centered design approach to achieve high rates of patient engagement and sustained behavior change. This will ideally happen in the context of broader efforts to use a health equity-centered approach to enhance the ways in which our food system and related policies support improvements in health.

Technology-Enabled Interventions for Sustaining Behaviour Change in Adolescents: A Scoping Review for Research Gaps

Long-term behaviour change for adolescents plays an important role in improving the adolescent's future health. However, long-term behaviour changes are rarely sustained. This study aims to inform human-computer interaction researchers of the current state of research regarding the designing of technology-enabled interventions for sustaining behaviour change for adolescents, as well as provide recommendations for future research directions. Through a scoping review, 22 interventions were identified and analysed to report the behaviour change strategies, characteristics, levels of influence, and formats of technology used, as well as the frameworks used to develop these interventions. Based on the review's findings, three research gaps were identified: (1) the exploration of approaches to restructuring the environment; (2) the exploration of the effects of varying levels of social interactivity between people; and (3) the development of frameworks for building interventions.

When sustainability aligns with adolescent motives: development and validation of the Sustainability Motive-Alignment Scale (SMAS)

The sustainability motive-alignment hypothesis posits that adolescents will be motivated to act sustainably when they view sustainable behavior as aligned with their motives for autonomy and peer status. Based on this hypothesis, we developed the Sustainability Motive-Alignment Scale (SMAS), a brief self-report scale of individual differences in sustainability motive-alignment. In four studies across two relatively individualistic (U.S., Netherlands) and two relatively collectivistic countries (China, Colombia), the SMAS was reliable and valid as a single-factor scale; measurement invariant in terms of age and genders but measurement noninvariant in terms of culture, suggesting cultural differences in adolescents’ construals of sustainability motive-alignment; and positively associated with measures of sustainable attitudes, norms, self-efficacy, behavior, and climate change knowledge. Thus, sustainability motive-alignment can be assessed as a conceptually distinct psychological dimension underlying adolescents’ sustainable tendencies. We hope that our brief, psychometrically sound instrument will spark developmentally informed research on the psychological underpinnings of adolescent sustainability.

Time Perspective, Dietary Behavior, and Glycemic Control in Patients With Type 2 Diabetes.

Dietary behavior is a key component in the self-management of patients with Type 2 diabetes (T2DM), as it is essential for glycemic control and preventing diabetic complications. However, it is challenging for patients with diabetes to make sustainable dietary behavior changes and achieve long-term optimal glycemic control. Dietary behavior changes involve present efforts to achieve future benefits. The primary aim of this study was to investigate the relationships among time perspective, dietary behaviors, and health outcomes in patients with T2DM. Based on the temporal self-regulation theory and previous research, the secondary aim of the study was to explore how time perspective influences dietary behaviors. Following convenient sampling ( N = 329), a cross-sectional study was conducted in patients with T2DM between November 2021 and October 2022. Data were collected using self-reported questionnaires and the retrieval of clinical information from medical records. Hierarchical regression and path analysis were used to explore the relationships among study variables. Our analyses showed that a future-oriented time perspective was associated with better dietary behavior but was not significantly related to hemoglobin A1c. Hierarchical regression analysis also demonstrated that having a more future-oriented time perspective was associated with healthier dietary behavior after controlling covariates. Based on the theory and path analysis, there was an indirect effect of future time perspective on dietary behavior through self-control capacity and intention. The study reveals that a future-oriented time perspective can promote healthier dietary behavior when providing care for patients with T2DM. As a theoretical framework, the temporal self-regulation theory offers references for researchers and clinicians to take into consideration patients' time perspectives and their intentions and self-control capacity when developing interventional programs to improve dietary behaviors.

Opening the Black Box of an mHealth Patient-Reported Outcome Tool for Diabetes Self-Management: Interview Study Among Patients With Type 2 Diabetes.

Mobile health (mHealth) tools are used to collect data on patient-reported outcomes (PROs) and facilitate the assessment of patients' self-management behaviors outside the clinic environment. Despite the high availability of mHealth diabetes tools, there is a lack of understanding regarding the underlying reasons why these mHealth PRO tools succeed or fail in terms of changing patients' self-management behaviors. This study aims to identify the factors that drive engagement with an mHealth PRO tool and facilitate patients' adoption of self-management behaviors, as well as elicit suggestions for improvement. This qualitative study was conducted within the context of a randomized controlled trial designed to evaluate the efficacy of an mHealth PRO tool (known as i-Matter) versus usual care regarding reduction in glycated hemoglobin (HbA1c) levels and adherence to self-management behaviors at 12 months among patients with uncontrolled type 2 diabetes. Patients randomized to i-Matter participated in semistructured interviews about their experiences at the 3-, 6-, 9-, and 12-month study visits. A qualitative analysis of the interviews was conducted by 2 experienced qualitative researchers using conventional qualitative content analysis. The sample comprised 71 patients, of whom 67 (94%) completed at least one interview (n=48, 72% female patients; n=25, 37% identified as African American or Black; mean age 56.65 [SD 9.79] years). We identified 4 overarching themes and 6 subthemes. Theme 1 showed that the patients' reasons for engagement with i-Matter were multifactorial. Patients were driven by internal motivating factors that bolstered their engagement and helped them feel accountable for their diabetes (subtheme 1) and external motivating factors that helped to serve as reminders to be consistent with their self-management behaviors (subtheme 2). Theme 2 revealed that the use of i-Matter changed patients' attitudes toward their disease and their health behaviors in 2 ways: patients developed more positive attitudes about their condition and their ability to effectively self-manage it (subtheme 3), and they also developed a better awareness of their current behaviors, which motivated them to adopt healthier lifestyle behaviors (subtheme 4). Theme 3 showed that patients felt more committed to their health as a result of using i-Matter. Theme 4 highlighted the limitations of i-Matter, which included its technical design (subtheme 5) and the need for more resources to support the PRO data collected and shared through the tool (subtheme 6). This study isolated internal and external factors that prompted patients to change their views about their diabetes, become more engaged with the intervention and their health, and adopt healthy behaviors. These behavioral mechanisms provide important insights to drive future development of mHealth interventions that could lead to sustained behavior change.

Optimistic narrative future visions: a communication tool for promoting sustainable (plastic) behavior.

Plastic pollution is a pressing global issue, necessitating a focus on consumer behavior to curb this problem at its source. To effectively promote sustainable practices, communication strategies that employ future visions have gained attention. This study examines the effects of a narrative video intervention depicting an optimistic future vision concerning single-use plastic bag consumption in South Africa, compared to a representation of the prevailing status quo. Using a preregistered within-subject design, we assess the psychological and emotional responses to two scenarios of which one is illustrating adaptive behaviors toward reduced plastic bag usage, and the other showcasing current consumption patterns. Parametric analyses revealed a shift in emotional states, characterized by a greater experience of positive emotions and a reduced experience of negative emotions following the exposure to the optimistic future scenario video, as compared to the status quo video. Moreover, engagement with the optimistic future scenario was associated with higher levels of perceived behavioral control and behavioral intentions. No significant changes were found regarding sense of responsibility. These findings point to the potential of optimistic future visions to influence individuals at psychological and emotional levels. This renders optimistic future vision communication as an effective tool for sustainable behavior change, particularly in relation to the sustainable use of plastic shopping bags.

O.5.2-9 Development of an active lifestyle intervention to promote physical activity sustainably in stroke patients: study design

Abstract Purpose Physical inactivity is a major public health concern and a growing problem among stroke patients. Despite existing interventions, current approaches are not successful in promoting physical activity sustainably in stroke patients, particularly when transitioning from clinical care to the home environment. In co-creation with patients and healthcare professionals, this study develops an active lifestyle intervention, tailored to patients' personal, social, and environmental determinants, to promote an active lifestyle in their own living environment. Methods A co-creative design-based approach will be used for the development of an active lifestyle intervention. The design process involved collaboration with stroke patients, physiatrists, physiotherapists, lifestyle coaches and health behavior professionals. A classic design thinking process will be used to structure the research activities in five phases: empathize, define, ideate, prototype, and test phases. To gather the needs and requirements for the intervention, interviews (n = 15) and focus group sessions (n = 15) will be held. An iterative process of prototyping will lead to a final version of the active lifestyle intervention. Results At the conference, our team will be able to present the design of the study, focusing in particular on the aspect of engaging patients to co-create the design-based intervention so that patients’ personal, social and environmental determinants for sustained behavior change in the home environment can be adhered to. Conclusion Designing an active lifestyle intervention together with patients and professionals, using the co-creative design-based approach, will help to gain deeper insights in the specific needs and requirements of stroke patients transitioning from clinical care to the home environment.

Training of Health Care personnel on Obstetric Violence: An Experience in Togo using the Forum Theatre Technique

Obstetrical Violence (OV) refers to all the disrespectful treatments and mistreatments inflicted on women during pregnancy and childbirth by health professionals. It can be physical, psychological or discriminatory, related to a lack of consent or respect, an abandonment of care or detention in the health structure in case of unpaid fees [1]. In Togo, OV is multifactorial and contributes to maintaining high maternal mortality by reducing attendance at health facilities [2]. We set up a training program for OV using a participatory technique called forum theater [3], with the nursing staff of maternity hospitals in the Maritime and Plateaux regions. Our study evaluated the potential of forum theater to raise awareness of OV among health care personnel and promote sustainable behavior change. We conducted 15 workshops with 391 professionals (55% of midwives and 25% of birth attendants). Participants completed a questionnaire before and after the intervention, assessing theoretical knowledge about OV and the frequency of violence that could be seen in the services. Participants reported a 33% increase of OV observed in their daily lives (p<0.05), including twice as physical violence and discrimination. This before-and-after difference was even more pronounced for the midwives, with an 80% increase (p<0.05). All concluded that they would change their behavior towards patients. Forum theater thus shows promise for improving providers’ ability to recognize and respond to VO. It is an effective tool to improve the attendance figures at health facilities and reduce maternal mortality in Togo.

Psychometric validity of the Thai version of the Motivation for Healthy Eating Scale in patients with acute coronary syndrome.

Motivation plays a crucial role in lifestyle modifications for disease control and preventing recurrent cardiac events. Higher motivation levels are associated with improved health outcomes, including adherence to a healthy diet and sustained behavior change. However, there is a lack of evaluation of instruments for assessing motivation to adhere to diet recommendations, specifically among patients in Thailand. This study aimed to assess the psychometric validity of the Thai version of the Motivation for Healthy Eating Scale (MHES) in patients with acute coronary syndrome in Thailand. The study was conducted between May and August 2022, involving 200 patients with acute coronary syndrome selected through multistage random sampling from tertiary care institutions in Bangkok, Thailand. The scale was translated from English to Thai using the back-translation method. Principal Component Analysis (PCA) and Cronbach's alpha were employed to evaluate the validity and reliability of the scale. The Thai version of the MHES demonstrated satisfactory reliability with a Cronbach's alpha coefficient of 0.73. The analysis revealed four factors consisting of 16 items: 1) 'integrated and integrated regulation' with seven items, 2) 'intrinsic and external regulation' with three items, 3) 'introjected regulation' with three items, and 4) 'amotivation' with three items. These factors collectively explained 66.78% of the total variance. The findings indicate that the Thai version of the MHES is a reliable and valid instrument for assessing motivation related to dietary behavior among Thai patients with acute coronary syndrome. Nurses and healthcare professionals can use this scale to evaluate the motivation of dietary behavior among this population, thereby facilitating targeted interventions and promoting positive health outcomes.

Sustainable Marketing and its Impact on Society: A Study of Marketing Strategies and Opportunities Promoting Eco-Friendly Lifestyle

In the face of growing environmental concerns and the need for more sustainable practices, businesses increasingly recognize the importance of incorporating sustainability into their marketing strategies. This research paper aims to explore the concept of sustainable marketing and its impact on society, specifically focusing on marketing strategies that promote eco-friendly lifestyles. Through an in-depth analysis of existing literature, case studies, and empirical evidence, this paper investigates how sustainable marketing initiatives shape consumer behavior and foster positive societal changes. The study also examines the various opportunities and challenges businesses encounter while implementing eco-friendly marketing strategies, shedding light on the potential benefits for both the environment and business performance.

Play-able: using play to realise the intent of social design

Design - by its relational nature of connecting people, places and things - is an intrinsically social practice. However, the marked shift from prioritising commercial design objectives to creating constructive opportunities for collective engagement and social change has resulted in the emergence of social design. Viewed as a discursive moment and not a discipline, social design embraces different design approaches and participatory processes; as such, it is not defined by a pre-determined design process or outcome, but rather by its intent of engendering responsibility and social behaviour change. Within this context then, the aim of the paper is to reflect on the way in which play enables designers to realise the intent of their social design practice. To address the aim, the paper first contextualises social design and presents a conceptual framework of play. Secondly, the paper presents South African vignettes of the city and the higher-education design classroom to highlight the practical value play affords design to aid the understanding of social problems in general and advancing agency and ownership for sustained social behaviour change, in particular.

Conventional and living guideline for schizophrenia: barriers and facilitating factors in guideline implementation

This study aims to investigate the barriers and facilitators to guideline adherence for the print format of the German schizophrenia guideline as well as for the concept of a digital living guideline for the first time. For this purpose, the schizophrenia guideline was transferred to a digital guideline format within the web-based tool MAGICapp. An online survey was performed under participation of mental healthcare professionals (medical doctors, psychologists/psychotherapists, psychosocial therapists, caregivers) in 17 hospitals for psychiatry in Southern Germany and a professional association for German neurologists and psychiatrists. 524 participants opened the survey, 439 completed the demographic questions and commenced the content-related survey and 309 provided complete data sets. Results indicate a higher occurrence of knowledge-related barriers for the living guideline. The print version is associated with more attitude-related and external barriers. Older professionals reported more attitude-related barriers to a living guideline compared to younger professionals. Differences between professions regarding barriers were found for both formats. Various barriers exist for both guideline formats and a need for facilitators was expressed across professions. Many of the mentioned obstacles and facilitators can be more easily addressed with living guidelines. However, also living guidelines face barriers. Thus, the introduction of these new formats alone cannot lead to sustainable behavior change regarding guideline adherence. Yet, living guidelines seem to be a cornerstone to improved and tailored guideline implementation as they facilitate to keep recommendations up to date and to address the need of individual professional groups.

Sosialisasi Filtrasi Air Sederhana Sebagai Upaya Meningkatkan Sadar Sanitasi di SDN Lemahkembar

Providing access to clean water and proper sanitation is important in ensuring good health and well-being for individuals and communities. SDN Weakkembar is an elementary school located in an area that does not yet have adequate access to clean water sources. Therefore, socialization about simple water filtration is an important step to increase sanitation awareness in this school. This socialization aims to explain the importance of clean water and good sanitation, as well as to introduce and socialize simple water filtration methods to students at SDN Lemahkembar. This simple water filtration method involves using inexpensive and readily available materials, such as sand, gravel, cotton wool, tissues, used bottles, and dacron to rid the water of impurities and contaminants. The socialization was carried out through a series of educational activities, including presentations, group discussions, and practical demonstrations on how to make and use a simple water filtration device. Apart from that, sanitation awareness campaigns were also carried out, which involved putting up posters, distributing brochures about the importance of personal and environmental hygiene. The results of this activity show that the socialization of simple water filtration has succeeded in increasing sanitation awareness at SDN Weakkembar. School students become more aware of the importance of using clean water and good sanitation to maintain their health. They are also skilled in building and using simple water filtration devices, which can help them gain access to safer, clean water. With this socialization, it is hoped that sanitation awareness at SDN Lemahkembar will continue to increase and become a habit that is maintained. This can have a positive impact on the health of students and school girls and encourage sustainable behavior changes related to sanitation in the surrounding community.

Health action process approach: promoting physical activity, and fruit and vegetable intake among Australian adults.

Based on the health action process approach (HAPA) this study examined whether changes in social cognition constructs could predict change in physical activity and fruit and vegetable intake for adult participants in My health for life, an Australian health promotion behaviour change program. Variance-based structural equation modelling was used to analyse data obtained from Australian adult program participants (n = 167) at baseline (T1), week 14 (T2), week 26 (T2), and 6-month post-program (T4). Change scores were calculated for the social cognition constructs and behaviour. Changes in action self-efficacy and outcome expectancies positively predicted changes in intentions. Action self-efficacy changes also predicted changes in maintenance self-efficacy which, in turn, mediated the effect of action self-efficacy on recovery self-efficacy and planning. Planning was predicted by changes in intentions and maintenance self-efficacy. Findings support the use of the HAPA model in designing complex health behaviour change interventions to achieve sustained behaviour change.

Studying Movement-Related Behavioral Maintenance and Adoption in Real Time: Protocol for an Intensive Ecological Momentary Assessment Study Among Older Adults.

Older adults struggle to maintain newly initiated levels of physical activity (PA) or sedentary behavior (SB) and often regress to baseline levels over time. This is partly because health behavior theories that inform interventions rarely address how the changing contexts of daily life influence the processes regulating PA and SB or how those processes differ across the behavior change continuum. Few studies have focused on motivational processes that regulate the dynamic nature of PA and SB adoption and maintenance on microtimescales (ie, across minutes, hours, or days). The overarching goal of Project Studying Maintenance and Adoption in Real Time (SMART) is to determine the motivational processes that regulate behavioral adoption versus maintenance over microtimescales, using a dual process framework combined with ecological momentary assessment and sensor-based monitoring of behavior. This paper describes the recruitment, enrollment, data collection, and analytics protocols for Project SMART. In Project SMART, older adults engaging in at least 30 minutes of moderate-to-vigorous intensity PA per week complete 3 data collection periods over 1 year, with each data collection period lasting 14 days. Across each data collection period, participants wear an ActiGraph GT3X accelerometer (ActiGraph, LLC) on their nondominant waist and an ActivPAL micro4 accelerometer (PAL Technologies, Ltd) on their anterior thigh to measure PA and SB, respectively. Ecological momentary assessment questionnaires are randomly delivered via smartphone 10 times per day on 4 selected days in each data collection period and assess reflective processes (eg, evaluating one's efficacy and exerting self-control) and reactive processes (eg, contextual cues) within the dual process framework. At the beginning and end of each data collection period, participants complete a computer-based questionnaire to learn more about their typical motivation for PA and SB, physical and mental health, and life events over the course of the study. Recruitment and enrollment began in January 2021; enrollment in the first data collection period was completed by February 2022; and all participants completed their second and third data collection by July 2022 and December 2022, respectively. Data were collected from 202 older adults during the first data collection period, with approximate retention rates of 90.1% (n=182) during the second data collection period and 88.1% (n=178) during the third data collection period. Multilevel models and mixed-effects location scale modeling will be used to evaluate the study aims. Project SMART seeks to predict and model the adoption and maintenance of optimal levels of PA and SB among older adults. In turn, this will inform the future delivery of personalized intervention content under conditions where the content will be most effective to promote sustained behavior change among older adults. DERR1-10.2196/47320.

Perceptions of university students on nutrition as a useful tool to manage anxiety and depression levels

Objective: Mental health problems among university students are an emergent public health issue and prevention is crucial. Dietary interventions are currently being investigated as additional treatment options for mental illness. This work aimed (i) to measure and correlate the general status of physical-mental health and diet habits of undergraduate students (n=164, 96 females and 68 males) from different universities, in England and Türkiye; (ii) to develop a specific questionnaire to measure their knowledge on nutrition for mental health (as only general nutrition knowledge questionnaires were available), and (iii) to identify barriers for healthier food choices and sustainable behavioural changes. Materials and methods: The study was based on a cross-sectional survey. Undergraduate students were invited by email and their participation was voluntary and anonymous. Values were expressed as means and standard deviation. A significance level of 0.05 was set. Discussion and conclusion: The results showed that more than 1/3 presented a medium to a high level of somatization symptoms while more than 1/4 presented a moderate to severe level of anxiety and depression. Moreover, results showed a significant negative correlation between nutritional knowledge with physical status, anxiety and depression level and a significant positive correlation with adherence to the Mediterranean diet. Cost, time, convenience and no healthy options on campus canteens/restaurants were the main reported barriers against a healthier diet. Most of the students showed poor nutritional knowledge on how nutrition may impact mental health, but a high interest in learning about nutrition to improve their physical and mental health. Nutrition education and the support of a nutritional team may be alternative tools at the universities to help students manage their anxiety/depression, general health status and academic performance.

Barriers and confidence among colorectal and prostate cancer survivors participating in two behavioral intervention studies.

Exercise and healthy diet are key components of cancer survivorship. We sought to explore perceived barriers to engaging in healthy diet and exercise, and whether these barriers change throughout remote-based behavioral interventions. Smart Pace (SP) and Prostate 8 (P8) were two 12-week pilot randomized controlled trials (RCTs) among 42 colorectal cancer (CRC) survivors and 76 prostate cancer (PC) survivors, respectively, that encouraged participants to implement exercise (both) and healthy diet (P8 only) through text messaging and wearable fitness monitors; P8 also included web materials. Participants completed surveys on perceived barriers and confidence in their ability to implement healthy behaviors at enrollment and 12 weeks; P8 also included a 52-week assessment. At enrollment, CRC survivors commonly reported a lack of discipline/willpower (36%), time (33%), and energy (31%); PC survivors often reported a lack of knowledge about healthy dietary behaviors (26%). Not having anyone with whom to exercise with was a common barrier among both groups (21% in CRC, 20% in PC). Among the intervention groups in both studies, various enrollment barriers (overall, functional/psychological disability, aversiveness, excuses, and inconveniences) were associated with change in behavior over time. Among CRC and PC survivors, there are multiple potential barriers related to motivation, time, social support, and lack of knowledge, that can be addressed and overcome to improve healthy behaviors. Tailoring lifestyle interventions to participants' individual barriers and confidence is needed to promote and sustain behavior change long-term.