Transtheoretical Model Of Behavior Change Research Articles

Using the Transtheoretical Model of Behavior Change to Explore Forest Landowner Perspectives on Water Quality

Family forest owners (FFOs) are critical stakeholders in ensuring many conservation outcomes, including improved water quality. In the highly forested Lake Champlain basin of Vermont, FFOs likely play a particularly important role in addressing water quality impairment. This study focused on FFOs’ thinking and decision-making around management practices on their land. Based on a dataset of 28 interviews collected using a semi-structured interview approach, the interviews were qualitatively coded and analyzed using the Transtheoretical Model of behavior change (TTM) framework. Our findings suggest that interviewed landowners were concerned about basin water quality but generally not aware of the connection between watershed health and actions taken on their particular forest parcel. We further describe how three TTM Processes of Change (helping relationships, consciousness raising, and environmental re-evaluation) may influence landowners’ decisions to manage their forests with water quality in mind. Our results suggest pathways for the design and targeting of behavioral change interventions based on the TTM that should inform landowner outreach as well as further research.

Predictor of smoking cessation among school-going adolescents in Indonesia: a secondary analysis based on the transtheoretical model of behavioral change.

This study elucidates the complex journey of adolescents toward smoking cessation, investigating the association of relevant demographic factors, advertising, promotion, anti-cigarette messages, and individual knowledge and attitudes with being in different smoking cessation stages. Utilizing data from the 2019 Indonesia Global Youth Tobacco Survey, this secondary analysis included adolescents who reported ever smoking. The Transtheoretical Model (TTM) guided the categorization of the outcome variable into three smoking cessation stages based on the responses to two questions related to the intention and timing of the smoking cessation. This included contemplation, action, and maintenance stages. Multinomial logistic regression analyzed the associations between each independent variable and being in each stage of smoking cessation. The study comprised 3596 Indonesian adolescents from grades 7-12, of which 2484 responded to two questions related to intention and timing of smoking cessation and were included in regression analysis. Findings indicate that males and those aged ≥16 were predominantly in contemplation phase. Early smoking initiation, usage of other tobacco products, and exposure to various forms of smoke increased the likelihood of being in contemplation and action phases. Parental smoking, school smoking exposure, and second-hand smoke were significant contemplation phase predictors. Exposure to tobacco advertising was linked to an increased likelihood of being in contemplation and action phases, whereas anti-cigarette messages showed no significant impact. Awareness of cigarette and second-hand smoke harms reduced the odds of being in the contemplation phase, while enjoying smoking and willingness to accept cigarettes from friends increased the odds of being in contemplation and action phases rather than in maintenance phase. Addressing age, gender, cultural influences, environmental factors, and attitudes towards smoking through tailored interventions is vital for aiding smoking cessation in Indonesian adolescents. Strengthened tobacco control in schools and public places is recommended to bolster these efforts. Longitudinal studies are required to explore the evolving patterns of smoking cessation behaviors over time, enhancing our understanding of the factors influencing sustained cessation.

Body image perception and physical activity behavior among adult population: Application of trans-theoretical model of behavior change.

The human body changes during life, but research on how sociodemographic characteristics and physical activity (PA) related to all aspects of body image are still unclear and there is conflict in the relevant results. This study aims to examine gender-specific body image perception and physical activity in relation to BMI and sociodemographic characteristics among health employees who worked in health and medical care centers. The study was a population-based cross-sectional survey of 170 health employees (55 men and 115 women) in Binaloud, Iran. Participants completed a self-administered questionnaire, which consisted of a self-administered Multidimensional Body-Self Image Questionnaire (MBSRQ) and stages of change scales. The full version of Marcus-TTM based on the stages of physical activity changes was used based on 5 items related to regular physical activity behavior and intentions. There were no significant differences between men and women in total body image score, body area satisfaction, and attitude. Disease orientation (p = 0.02) and health orientation (p = 0.05) were the only significant differences between men and women. The number of children, level of education, BMI, and PA had a stronger influence on body image concerns and body dissatisfaction. PA and 7 of the 10 subclasses of MBSRQ (appearance evaluation, fitness evaluation, fitness orientation, health evaluation, health orientation, and illness orientation) showed a significant difference (P<0.05) between participants in the five TTM stages. The ideal body image and body satisfaction may differ by the number of children, level of education, gender, BMI, and PA. Evidence from this study supports that participants' stages of change affect their physical activity and body image perception. This result suggests a need for conducting work/home place intervention to promote adults' body image perception and body area satisfaction based on the usage-specific stage under consideration.

Predictors of Adolescents' Transition Through the Stages of Change for Quitting E-Cigarettes: Findings From the Population Assessment of Tobacco and Health Study.

To identify predictive factors associated with US adolescents' transition through the stages of change for potentially quitting e-cigarettes using the Trans-theoretical model of behavior change. Prospective cohort study. United States. We utilized data from adolescents (12-17 years) in Wave 3 of the Population Assessment of Tobacco and Health study who used e-cigarettes exclusively over the past 30 days (n = 177) and were followed up with in Wave 4. Outcome variables were 3 transition categories: those who remained stagnant, those who progressed, and those who regressed in their stage of quitting e-cigarettes. Predictor variables were socio-demographics, e-cigarette harm perception, e-cigarette use at home or by important people, social norms, e-cigarette and anti-tobacco advertisements, and e-cigarette health warnings. Weighted-adjusted multinomial regression analysis was performed to determine the association between predictor and outcome variables. From Wave 3 to Wave 4, 19% of adolescents remained stagnant; 73.3% progressed; and 7.7% regressed. Adolescents were less likely to progress in their stage of change if they perceived nicotine in e-cigarettes to be "not at all/slightly harmful" (AOR = .26 [95% CI: .25, .27], P < .001); reported important people's use of e-cigarettes (AOR = .18 [95% CI: .05, .65, P = .009); and "rarely" noticed e-cigarette health warnings (AOR = .28 [95% CI: .08, .98, P = .054). Intervention efforts must target specific predictive factors that may help adolescents quit e-cigarettes.

Engaging internal and external audiences to develop and promote zoo-based conservation efforts.

As place-based conservation organizations, zoos are in a central position to support individuals in making small changes in their lives that will support the protection of wildlife and their habitats. This paper describes the secondary analysis of data collected from multi-phase front-end, exploratory evaluation that informed the development of a conservation action campaign in association with a non-profit, urban zoo. In phase one, internal organization staff were invited to attend workshops during which they brainstormed potential conservation actions that they felt were important for the zoo to promote. They identified and ranked 164 unique actions. In phase two, the ranking was used to narrow down the 164 actions to 20 actions which were used to develop a survey administered to visitors who opted in to receiving online surveys from the zoo. The survey asked participants to state their interest in each of the 20 conservation actions. The Transtheoretical Model of Behavior Change informed the analysis of responses. Through this approach we identified actions that people were already doing, interested in doing, and not interested in doing. The responses from this survey were used to narrow down the list further to 10 actions used in a survey in phase three. This second survey administered to zoo visitors on grounds asked participants which of the 10 actions they would be most interested in doing, and the perceived barriers and benefits of doing them. This process allowed us to use evidence-based decision making to choose which conservation actions would resonate most with the community for our conservation action campaign. We also were able to identify values visitors held that might influence environmentally friendly behaviors. Visitors who responded to this survey tended to respond in ways that aligned with self-transcendent values. The research suggests that the campaign should focus on habitat restoration and remediation and purchasing wildlife friendly coffee and other products.

P102: Supporting Informal Carers to Undertake Regular Physical Activity from Home: a Co-design and Prototype Development Study of a novel app, “CareFit”

Background:Informal carers (unpaid family members and friends), are critical to millions worldwide for the ongoing delivery of health and well-being needs. However, the physical and mental wellbeing of caregivers is often poor including low levels of physical activity, frequently owed to contributing factors such as lack of time, lack of support and motivation. Thus, accessible evidence-based tools to facilitate physical activity for carers are urgently needed.Objective:The aim of this study was to co-design and develop a novel mobile app to educate and support carers in the undertaking of regular physical activity. This is achieved via integration of the transtheoretical model of behaviour change and UK physical activity guidelines across 8 weeks of use.Methods:We co-designed a mobile app, “CareFit,” by directly involving caregivers, health care professionals, and social care professionals in the requirements, capturing, and evaluation phases across a number of Agile Scrum development sprints. Requirements for CareFit were grounded in a combination of behavioural change science and UK government physical activity guidelines.Results:Participants identified different barriers and enablers to physical activity, such as a lack of time, recognition of existing activities, and concerns regarding safely undertaking physical activity. Requirements analysis highlighted the importance of simplicity in design and a need to anchor development around the everyday needs of caregivers (eg, easy-to-use video instructions, reducing text). Our final prototype app integrated guidance for undertaking physical activity at home through educational, physical activity, and communication components.Conclusions:Integrating government guidelines with models of behavioural change into a mobile app to support the physical activity of carers is novel and holds future promise. Integrating core physical activity guidelines into a co-designed smartphone app with functionality such as a weekly planner and educational material for users is feasible acceptable and usable. Here we will document the latest developments on the project including an ongoing national study currently taking place in Scotland to test the prototype with 50 carers.

Consumer engagement with sustainable wine: An application of the Transtheoretical Model

Sustainable wine is an important emergent wine category for which there is limited research on levels of consumer engagement and the multifaceted drivers of that engagement. Here, I extend prior research largely limited to organic wine, and apply the Transtheoretical Model of Behavioural Change (TTM) for the first time to determine consumer engagement around eight sustainable wine behaviours, and the role of purchase motivators, wine involvement and demographic factors in predicting those behaviours. The online survey of 727 Canadian wine consumers determined the action stage for each sustainable wine behaviour (precontemplation, contemplation, preparation, or action), and multinomial logistic regressions assessed the drivers of both action and inaction (precontemplation). Results show that most consumers are in a change stage with respect to sustainable wine behaviours (i.e., contemplation or preparation), suggesting the need for both education and sustainable certification initiatives. Generally, neither gender, income, province of residence, education nor the importance of price in wine purchase decisions associated with action stage for behaviours. In contrast, wine involvement and the importance of sustainability cues in wine purchase were the strongest and most consistent predictors of both action and inaction, while age and the importance of both taste expectation and perceived quality were predictive for some behaviours. I conclude that TTM is a very useful construct for assessing the nuances of consumer behaviour toward sustainable products, and the findings provide guidance for stakeholders interested in promoting greater sustainability in the wine industry through influencing consumer choice behaviour.

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

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

Usability and feasibility of a tablet-based e-coach for older adults in rehabilitation units to improve nutrition and physical activity: a prospective pilot study

BackgroundFor older adults (≥ 70 years), it is often challenging to maintain new nutrition and physical activity behaviours learned in rehabilitation. To minimize the risk of negative health consequences when returning home, an e-coach can be helpful. Aligning the program with an established concept such as the Transtheoretical Model of Behaviour Change (TTM) and guidance from healthcare professionals can optimize behaviour change.ObjectiveThis prospective single-arm pilot study aimed to assess the usability and feasibility of a nutrition and mobility e-coach for older adults during and after rehabilitation for a period of 9 weeks. In addition, we examined the change in the TTM phase as an indicator of the participant’s readiness to change or the changes made.MethodsOlder adults (≥ 70 years) with nutrition deficits and/ or mobility limitations were recruited in a rehabilitation centre. Participants’ phases of behaviour change in the TTM were identified by comparing current nutrition and physical activity habits via self-report with age-specific nutrition and physical activity recommendations. They received a tablet with the e-coach containing educational and interactive elements on the topics of nutrition and physical activity in older age. Participants used the e-coach and received support from healthcare professionals. The TTM phases were assessed at five times; the e-coach content was adjusted accordingly. Usability was assessed using the System Usability Scale (SUS, Score range: 0-100). Timestamps were used to evaluate how frequently participants used the e-coach: high (≥ 67% of the days), medium (66 − 33% of the days), and low (< 33% of the days).ResultsApproximately 140 patients were approached and n = 30 recruited. Complete data sets of n = 21 persons were analysed (38% female, mean age 79.0 ± 6.0 years). The SUS was 78.6 points, 11 participants (42%) were classified as high users, 6 (39%) as medium users and 4 (19%) as low users. After nine weeks, 15 participants (71%) achieved the physical activity recommendations (baseline: 33%, n = 7). Nutrition recommendations were achieved by 14 participants (66%) after nine weeks (baseline: 24%, n = 5).ConclusionThe e-coach seems to be usable and feasible for older adults. We identified some optimization potentials for our application that can be transferred to the development of comparable e-health interventions for vulnerable older adults.

The transtheoretical model of behavior change: Implications for social work practice

ABSTRACT The transtheoretical model of behavior change (TTM) can be used to help people to stop smoking and engage in other addictive behaviors. It has also been used on cancer prevention, HIV risk reduction, dietary change, exercise, occupational safety, and organizational change initiatives. TTM can be used with other therapies to assess an individual’s stage of change. This literature review examines the origins, actors, principles, applications, and evidence relevant to the development of TTM and the ways that it is being applied by members of the social work profession.

Understanding German farmers’ intention to adopt drought insurance

Climate risks, particularly droughts and heat waves, negatively affect agricultural incomes worldwide. Drought insurance is promising to mitigate resulting income losses at the farm level. As the proportion of German farmers insured against drought is low, policymakers and insurers aim to increase the appeal of drought insurance to farmers. However, to accelerate their efforts in this regard, more information regarding farmers' intention to adopt drought insurance beyond current adoption is needed. To obtain initial insights, we surveyed 127 German farmers in a risk management context and applied a modified transtheoretical model of behavioral change. This revealed detailed information on the gradual adoption of drought insurance. Given a heterogenous distribution among the gradual stages of adoption, a binomial logit model was estimated instead of an ordered logit to investigate farmers' current intention to adopt drought insurance. Furthermore, the machine learning technique of least absolute shrinkage and selection operator (LASSO) was applied to select the most relevant features to be used as explanatory variables in the estimation. The results show that farmers' gender and risk attitude, land tenure, how severely they were affected previously by weather risks, and the level of trust in index insurance products have a statistically significant effect on farmers' intention to adopt drought insurance. Additionally, this study provides insights into farmers' reasons against drought insurance. As such, the results are important to policymakers considering policy intervention, insurers interested in farmers' intention to insure and to researchers focusing on farmers’ adaptation to climate change.

Shared experiences among successful hearing aid users with high hearing aid self-efficacy

Objective While targeted rehabilitation can enhance hearing aid self-efficacy (HASE), little research has been done to determine the factors contributing to its predictive value. By investigating the experiences of individuals who successfully use HAs and have high levels of HASE, we hoped to illuminate specific strategies and/or sources of support these individuals share that might explain why high HASE is often linked to successful outcomes. Design and study sample This qualitative study explored the experiences of five older adults who were successful HA users and reported having high HASE. Semi-structured interview guides were developed using the transtheoretical model of behavioral change as a framework. Interviews were analyzed thematically and holistically. Results Participants attributed their HA success to: intrinsic motivation to improve their hearing, confident self-reliance when making health decisions, willingness to act on advice from trusted others, pro-social personal attributes, positive expectations about HA outcomes, and actively pursuing an optimal HA outcome. Conclusions For these participants, internal factors related to emotional state and source of motivation, and, to a lesser extent, verbal persuasion played a crucial role in their long-term success. This suggests that external influencers might be less impactful in facilitating success for those with high HASE.

Eco-score labels on meat products: Consumer perceptions and attitudes towards sustainable choices

Non-profit organisations have developed labelling strategies to communicate the environmental impact of food products, helping consumers make more informed purchase decisions. The evidence on whether environmental food labelling can change behaviours toward environmental meat choices is unclear, due to context factors within shopping environments and differences in attitudes towards meat and the environment. This study investigates attitudes towards an eco-score label on meat products by measuring the influence of meat and environmental attitudes and identifying drivers and barriers through a mixed-methods design. An online questionnaire (N = 255) posed questions concerning meat consumption, label perceptions, and use intentions. Recruitment was via convenience sampling under the criteria of UK dweller, omnivorous diet and over 18 years of age. Nine semi-structured interviews explored the drivers and barriers for intended use through thematic analysis. Perceptions Scores (PS) and Purchase Intention (PI) scores of the label were positive. Results showed an individual’s Meat attachment (affinity) score (MAAS) negligibly influenced PS but provided a moderately negative relationship with PI. Environmental label use and attitudes positively influenced PS and PI. The qualitative data identified label design and concept perceptions as drivers for use, whereas habitual shopping behaviours and perceived price were barriers. The research contributes to the transtheoretical model of behavioural change, identifying that 58% of participants contemplate label use but require more information. Explanations found for the gap between positive perceptions and low behavioural intentions support this, as poor label awareness and knowledge of the environmental impact of meat production were highlighted.

Community pharmacists’ readiness to take action to improve working conditions

ObjectiveThe objective of this study was to assess pharmacists’ readiness to take actions resulting in change at the individual level or systemic level. Design/Setting and Participants/Outcome measuresAn online survey was distributed via pharmacy-related social media pages and several state pharmacy association newsletters and e-mail listservs. Fifteen items assessed participants’ readiness to pursue change using a 5-point scale based on the transtheoretical model of behavior change (1 = Do not plan on doing, 2 = Plan to take in the next 6 months, 3 = Plan to take in the next month, 4 = Took in the past 6 months, 5 = Took more than 6 months ago). Categorical principal components analysis (CATPCA) was used as a data reduction technique to identify underlying components of the 15 items assessing readiness to improve working conditions. Component scores for each component were calculated and used as dependent variables in multivariable linear regression models to test associations between the components and sociodemographic and work-related predictors. ResultsCATPCA revealed a 12-item scale with 2 components accounting for 39.97% of the total variance. Pharmacists working in independent pharmacies had a significantly higher willingness than chain pharmacists to pursue actions with potential to result in systemic-level changes, such as contacting or joining an organization to attempt to improve their current working conditions (regression coefficient = 0.623, P < 0.001). Pharmacists working in independent pharmacies had a significantly lower willingness than chain pharmacists to pursue actions resulting in individual-level changes, such as changing their current job or quitting (regression coefficient = −0.485, P < 0.001). ConclusionPharmacists working in national chains may be less willing than independent pharmacists to pursue systemic-level changes owing to fear of discipline from employers. Future research should examine the effect of interventions intended to increase pharmacists’ motivation and readiness to pursue changes to improve working conditions.

Use of human behaviour change models to investigate horse owner intention to adopt emergency colic recommendations.

Behavioural models are widely used within human medicine to understand beliefs and intention associated with major health interventions. To investigate horse-owner beliefs and practices associated with emergency colic planning. Cross-sectional study. An online survey incorporating the Trans-Theoretical Model of behaviour change and the Theory of Planned Behaviour was developed to assess owner intention to adopt three areas of emergency colic planning: (1) prevention/recognition, (2) involvement of others and (3) personal preparation. Participants were recruited using a snowball sampling strategy; multivariable logistic regression of data was performed. There were 701 horse-owners who completed the survey. Respondents fell into one of two categories: no intention to adopt or already implementing emergency planning recommendations. Most agreed that emergency colic plans would improve their horse's welfare (68%) and aid in decision making (78%). Most disagreed that colic was inevitable (66%) and that treatment options were not within their control (69%). Multivariable analysis showed that those who believed emergency plans were worth creating were more likely to adopt preventive (OR: 2.33, 95% CI: 1.27-4.30, p = 0.007) and personal preparation (OR: 1.61, 95% CI: 1.31-1.97, p < 0.001) recommendations. Preventive recommendations were also associated with 'REACT' campaign awareness (OR 2.36, 95% CI: 1.40-3.97, p = 0.001). Favourable behavioural beliefs, such as the acknowledgement of welfare and decision-making benefits, were linked to the involvement of others in planning (OR: 2.93, 95% CI: 1.78-4.81, p < 0.001). Potential response bias and small sample size. The majority of owners were either unwilling to adopt suggested recommendations or believed that their approach was currently sufficient. Most owners perceived veterinary professionals as most influential on their decision to plan for a colic emergency, highlighting their importance in any educational campaign.

Individualized diet conversation in primary care: A pilot intervention.

Most primary care providers do not routinely discuss nutrition and diet with their patients, largely due to lack of time, inadequate resources, and perceived complexity of the topic. This article describes development and implementation of a brief protocol for systematically assessing and discussing diet during routine primary care visits to increase the frequency of these conversations and improve patient health outcomes. The authors developed a protocol for assessing both nutrition and stage of change as well as a guide for engaging in patient-led conversations about nutrition. The protocol was modeled after Screening, Brief Intervention, and Referral to Treatment and informed by the Dietary Guidelines for Americans, the Transtheoretical Model of Behavior Change, and principles of motivational interviewing. It was implemented over three months at a rural health clinic staffed by one NP. The protocol and conversation guide were easy to use with minimal training and seamlessly incorporated into clinic workflow. The likelihood of making diet changes increased significantly following the diet conversation, with persons who initially scored lower in readiness to change ultimately reporting significantly greater increases. A protocol for assessing diet and engaging patients in a stage of change-appropriate diet conversation can be efficiently integrated into a single primary care visit and increase patients' intent to change their diet. Further investigation is needed to evaluate the protocol more completely and in multiple clinics.

Transtheoretical model of behavior change and motivational profiles among University of Baguio students using fitness applications

Introduction: This study aims to determine how the motivational profile affects the behavior change of fitness application users in terms of adopting regular physical activity. Methods: The study utilized a descriptive correlation method design to determine the variations of the motivational regulations of fitness application users. A total of 204 college students were respondents, wherein 57 were male, and 147 were female. Respondents were of legal age, undergraduates, and have used or are using physical fitness applications. Respondents answered the questionnaire online in their free time. Data collected were subjected to tabulation, averaging, and Fisher’s Exact Test. Results: The study found no noticeable difference between genders in terms of the motivational regulations comprising their motivational profile and the distribution of users along the stages of the Transtheoretical Model of Behavior Change. Intrinsic and identified regulations were found to be high amongst the respondents (Intrinsic = 5.62; Identified = 5.31), while their external regulation was low (External = 2.51). Data suggest that the motivational profile of fitness application users is found to be autonomous. Moreover, there is a highly significant relationship between identified regulation and exercise behavior change along the preparation or action stages (p = 0.001). A significant relationship between intrinsic regulation and the preparation or action stage of exercise behavior change is also established (Fisher’s Exact Test, p = 0.016). Discussion: The motivational profiles of fitness application users are favorable in adopting regular physical activity. Promotion and encouragement of the established autonomous motivational profile can help people seriously consider starting exercise as it increases one’s likelihood of sustaining interest and motivation to achieve and maintain higher stages of exercise behavior.

Impact of Community Based Nutrition Intervention in the Prevention and Control of Anaemia Among Reproductive Aged Women of India.

Maternal and child under-nutrition is particularly widespread in low and middle-income nations, increasing the overall disease burden due to poor nutritional status. The aim of this study was to develop nutrition intervention for the prevention and control of anaemia among women of reproductive age. Community-based intervention study was conducted among 443 women of reproductive age group (15-49 years) to determine the effectiveness of a 6-month nutrition intervention package. The nutrition intervention was developed by using Precede-Proceed model and the trans-theoretical model of behavior change. Multi-channel communication approach was adopted and nutrition intervention package was provided. Assessment of haemoglobin, red blood cells, platelet, ferritin, folate, vitamin B12, haematocrit test, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width and total leucocyte count was compared at the baseline and endline after the intervention among the participants. The chi-square test of independence and t-test were performed. The only mean ferritin level shows significant improvement (p < 0.001). A significant decrease (~ 15%, p = 0.027) in anaemia was observed after the intervention. Improvement in anaemic status of women was observed. National schemes and programs require a more robust strategical implementation like food fortification/bio fortification and behaviour change communication at village level to enhance the availability and accessibility of fortified food.

Principles, tools and techniques for brief behaviour change interventions.

Nurses are well placed to deliver brief opportunistic health promotion interventions during routine encounters with patients. Brief interventions have been shown to be effective in prompting behaviour change among people who engage in harmful drinking or substance misuse. Nurses can use their communication, relationship-building and partnership-working skills to support people to consider behaviour change. This article explains the concepts that underlie brief behaviour change interventions, which include motivational interviewing and the transtheoretical model of behaviour change. The article also describes practical tools and techniques that nurses can use to deliver such interventions.

Investigating pro-environmental behaviour among students: towards an integrated framework based on the transtheoretical model of behaviour change

Investigating pro-environmental behaviour among students: towards an integrated framework based on the transtheoretical model of behaviour change