Understanding Of Behavior Change Research Articles

Development and psychometric evaluation of the catheter assessment, management and performance (CAMP) scale for nurses

AimTo develop and test the psychometric properties of a self-administered scale to assess the knowledge, skills, attitudes and behaviour of nurses to support the self-management of patients living with indwelling urinary catheters. BackgroundNurses are pivotal in supporting patients with urinary catheter self-management to prevent potentially avoidable hospital presentations. However, no validated scale is available to assess nurses’ attitudes and readiness for this task. DesignA quasi-experimental design was used to collect survey data both at baseline and after the completion of the intervention. A total of 128 participants were recruited from the Western Sydney region (New South Wales, Australia), who were working in community healthcare settings. Research Electronic Data Capture (REDCap™) database was used to manage the survey data collected for data analysis purposes. This study has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN126210 0 0683831) MethodsUsing a three-stage process of concept identification, item construction and pilot testing to develop the Catheter Assessment, Management and Performance (CAMP) scale, followed by factorial and discriminant validity and reliability testing. This 23-item CAMP scale is theoretically informed by the COM-B (Capability, Opportunity, Motivation-Behaviour) model, recognised for its effectiveness in understanding and influencing behaviour change. The scale was distributed to nurses working in three community health care settings to assess their knowledge, attitude and behaviour regarding catheter management and performance. ResultsFour factors were identified using scree plot, accounting for 63.36 % of total explained variance, which reflected the four dimensions of the COM-B model. Cronbach's alpha of the overall CAMP scale (0.93) and subscales (0.92, 0.87, 0.85 and 0.86) indicate good internal consistencies. The CAMP scale was able to detect changes in nurses’ self-reported behaviour change following educational intervention (85.53 versus 95.98, p < 0.001). ConclusionThe CAMP scale is valid and reliable scale, capable of assessing nurses’ capability, opportunity and motivation to support patients, through delivery of catheter self-management education that can potentially prevent catheter-related complications and avoid hospital presentations. Future research could explore using CAMP scale among non-specialist nurses and in various clinical settings to enhance its effectiveness and generalisability.

Taking the Big Leap | understanding, accessing and improving behavioural science interventions.

Applied behaviour science's focus on individual-level behaviours has led to overestimation of and reliance on biases and heuristics in understanding behaviour and behaviour change. Behaviour-change interventions experience difficulties such as effect sizes, validity, scale-up, and long-term sustainability. One such area where we need to re-examine underlying assumptions for behavioural interventions in Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) prevention, which seek population-level benefits and sustained, measurable impact. This requires taking a "Big Leap." In our view, taking the big leap refers to using a behavioural science-informed approach to overcome the chasms due to misaligned assumptions, tunnel focus, and overweighting immediate benefits, which can limit the effectiveness and efficiency of public health programmes and interventions. Crossing these chasms means that decision-makers should develop a system of interventions, promote end-user agency, build choice infrastructure, embrace heterogeneity, recognise social and temporal dynamics, and champion sustainability. Taking the big leap toward a more holistic approach means that policymakers, programme planners, and funding bodies should "Ask" pertinent questions to evaluate interventions to ensure they are well informed and designed.

Care partners experience of an oral health intervention for individuals with mild cognitive impairment and mild dementia using behavior change technique: A qualitative study

Oral health declines in older adults with cognitive impairment. We aimed to improve oral hygiene outcomes for individuals with mild cognitive impairment (MCI) or mild dementia (MD) by fostering behavior changes among carepartners assisting them. We used qualitative data of verbatim transcripts of coaching sessions with carepartners (n = 17 dyads:10 dyads for MCI, 7 dyads for MD). Directed and emergent coding were used to understand behavior change techniques (BCTs). BCTs were compared with carepartners of participants with MCI and MD. Most frequently used BCTs in both groups: prompts and cues, instruction on how to perform the behavior, review behavioral goal, and problem solving. Different BCTs emerged in study: social support-unspecified of the MCI group and credible source for MD group. Findings clarified active intervention components, common BCTs used by carepartners, and different BCT approaches for both participants. Findings help to elucidate the mechanisms of changes in individuals’ behaviors in these interventions.

Applying an extended theoretical approach to identifying Canadian dental students’ acceptance of teledentistry: A cross-sectional study

Objective Teledentistry is a promising innovation for improving service quality and patient outcomes. While studies have shown the relevance of theoretical frameworks in understanding behaviour change predictors for telehealth implementation efforts, their application in dentistry is limited. This study aimed to test different theoretical approaches to identify the factors affecting dental students’ behavioural intention to use teledentistry. Methods This cross-sectional study involved students in their final two years of undergraduate dental programmes, from three Canadian provinces (Quebec, Nova Scotia, and Saskatchewan) using an electronic self-reported questionnaire. Following descriptive analyses, we tested three theoretical models (the technology acceptance model, psychosocial model, and integrated model) using path analysis and multiple linear regression analysis. We analyzed the modifying effect of sociodemographic characteristics and prior use of teledentistry. Results Out of the 46 students who participated, the majority were female (53.5%) and aged over 25 years (62.8%). The three models successfully explained a substantial portion of the variance in behavioural intention to use teledentistry, ranging from 58.0% to 76.6%. Social role beliefs ( p &lt; 0.001) and control beliefs ( p &lt; 0.001) were the most significant predictors of behavioural intention to use. Prior use of teledentistry modified the association between control beliefs and behavioural intention to use teledentistry. Conclusions The original technology acceptance model was a good predictive model of behavioural intention to use teledentistry with perceived use as the strongest predictor. However, the integrated model performed the best in highlighting the relevance of training and education to foster teledentistry implementation in dental schools. The generalizability of the findings is constrained by the modest sample size, warranting larger studies for validation.

Peningkatan Hasil Belajar IPA Siswa Kelas V Materi Perpindahan Kalor Melalui Model Cooperative Learning Type STAD di SDN Cinere 1 Depok

Based on the learning results of class V students in Negeri Cinere 1 Depok, this research concluded that the science learning outcomes about heat transfer were mostly below the 75 KKM threshold. Only six out of 34 female students were able to reach the KKM. Therefore, it is necessary to improve science lessons on Heat and its Transfer using the STAD cooperative learning method. The aim of this research is to improve student learning and achieve the expected results. To improve student learning outcomes in understanding behavior changes, the STAD cooperative learning method is provided. For this reason, this research method uses a system consisting of observation, execution, discussion and reflection. Research findings show that using this method leads to increased student learning comprehension each semester. In practice, only 6 of 34 students (17.6%) met the requirements for the course in KKM 75. In the first sample, there were 18 people (52.94%). In contrast, the number of people in cycle 2 increased to 31 (91.18%). The results of this research can improve learning outcomes. The findings of this research indicate that the STAD collaborative learning method can improve student learning outcomes in class V at SDN Cinere 1 in Depok when it comes to the topic of science material and its transfer.

Beyond mediators: A critical review and methodological path forward for studying mechanisms in alcohol use treatment research.

Understanding how treatments for alcohol use disorder (AUD) facilitate behavior change has long been recognized as an important area of research for advancing clinical care. However, despite decades of research, the specific mechanisms of change for most AUD treatments remain largely unknown because most prior work in the field has focused only on statistical mediation. Statistical mediation is a necessary but not sufficient condition to establish evidence for a mechanism of change. Mediators are intermediate variables that account statistically for the relationship between independent and dependent variables, whereas mechanisms provide more detailed explanations of how an intervention leads to a desired outcome. Thus, mediators and mechanisms are not equivalent. To advance mechanisms of behavior change research, in this critical review we provide an overview of methodological shortfalls of existing AUD treatment mechanism research and introduce an etiologically informed precision medicine approach that facilitates the testing of mechanisms of behavior change rather than treatment mediators. We propose a framework for studying mechanisms in alcohol treatment research that promises to facilitate our understanding of behavior change and precision medicine (i.e., for whom a given mechanism of behavior change operates and under what conditions). The framework presented in this review has several overarching goals, one of which is to provide a methodological roadmap for testing AUD recovery mechanisms. We provide two examples of our framework, one pharmacological and one behavioral, to facilitate future efforts to implement this methodological approach to mechanism research. The framework proposed in this critical review facilitates the alignment of AUD treatment mechanism research with current theories of etiologic mechanisms, precision medicine efforts, and cross-disciplinary approaches to testing mechanisms. Although no framework can address all the challenges related to mechanisms research, our goal is to help facilitate a shift toward more rigorous and falsifiable behavior change research.

Reducing Risk of ADRDs: Innovative Framework to Inform Behavior Change

AbstractBackgroundIn the United States alone, more than six million individuals are living with Alzheimer’s disease and related dementias (ADRDs), with minority groups disproportionately impacted. An estimated one‐third of ADRD cases is associated with eight modifiable risk factors: physical inactivity, smoking, depression, low education, diabetes, midlife obesity, midlife hypertension, and hearing loss. With the ADRD pandemic fast approaching, there is greater urgency to identify and adopt risk reduction behavior changes. Lifestyle interventions have shown efficacy in reducing risk for ADRDs and delaying the onset of symptoms. These interventions are often grounded in traditional theories of health behavior change; however, few intervention frameworks exist that combine constructs from multiple discrete theories, or incorporate concept of stigma, a powerful influence in setting the foundation of risk reduction behavior change.MethodsA review of the literature identified health behavior models from which risk reduction interventions are developed. Insights from these studies informed the development of a new framework to inform ADRD risk reduction interventions. This new framework seeks to leverage constructs from the Social Ecological Model (SEM), Health Belief Model (HBM), Transtheoretical Model (TTM), and the Health Stigma and Discrimination Framework (HSDF) to better inform and understand the factors that influence ADRD risk reduction behaviors.ResultThis framework contains several concepts that predict why individuals will take action to reduce risk of ADRDs: individual factors, social‐environmental factors, self and public stigma, and perceptions. Our model also includes stages of change to integrate processes and principles of change, offering a temporal dimension for understanding behavior change. This novel framework can be utilized to inform both individual and community‐level interventions.ConclusionThis new framework provides an innovative and alternative foundation for new ADRD risk reduction interventions. Applicable across a range of risk reduction behaviors, the model highlights the domains and pathways common across ADRD research and intervention implementation. This crosscutting approach will support a more efficient and effective response to addressing preventable risk factors for ADRDs, with the goal of application and realization. Further research is needed to assess the strengths and limitations of this framework in real‐world settings.

Unraveling the role of adapting risk perception during the COVID-19 pandemic in Europe

During the COVID-19 pandemic, the behavioral response to reported case numbers changed drastically over time. While a few dozen cases were enough to trigger government-induced and voluntary contact reduction in early 2020, less than a year later much higher case numbers were required to induce behavioral change. Little attention has been paid to understand and mathematically model this effect of decreasing risk perception over longer time-scales. Here, first we show that weighing the number of cases with a time-varying factor of the form ta,a<0 explains real-world mobility patterns from several European countries during 2020 when introduced into a very simple behavior model. Subsequently, we couple our behavior model with an SIR epidemic model. Remarkably, decreasing risk perception can produce complex dynamics, including multiple waves of infection. We find two regimes for the total number of infected individuals that are explained by the interplay of initial attention and the rate of attention decrease. Our results show that including adaption into non-equilibrium models is necessary to understand behavior change over long time scales and the emergence of non-trivial infection dynamics.

Attractor landscapes: a unifying conceptual model for understanding behaviour change across scales of observation

ABSTRACT Models and theories in behaviour change science are not in short supply, but they almost exclusively pertain to a particular facet of behaviour, such as automaticity or reasoned action, or to a single scale of observation such as individuals or communities. We present a highly generalisable conceptual model which is widely used in complex systems research from biology to physics, in an accessible form to behavioural scientists. The proposed model of attractor landscapes can be used to understand human behaviour change on different levels, from individuals to dyads, groups and societies. We use the model as a tool to present neglected ideas in contemporary behaviour change science, such as hysteresis and nonlinearity. The model of attractor landscapes can deepen understanding of well-known features of behaviour change (research), including short-livedness of intervention effects, problematicity of focusing on behavioural initiation while neglecting behavioural maintenance, continuum and stage models of behaviour change understood within a single accommodating framework, and the concept of resilience. We also demonstrate potential methods of analysis and outline avenues for future research.

Exploring Temporal Changes In Exercise Behavior, Perceived Fitness, And Identity In Former High School Athletes

While exercise promotion is recommended to preserve athletes’ post-sport transition quality, specific understanding of behavioral changes after retirement is unknown and necessary for program development. PURPOSE: Document temporal changes to exercise behavior, perceived fitness, and identity in former high school athletes (FHSAs) entering college, understand their exercise experiences, and explain why observed changes occurred using mixed methods. METHODS: Over their freshman year, FHSAs completed 8 online surveys assessing bodyweight, perceived fitness (Likert scale 1-5), self-reported exercise, perceived barriers (Likert scale 1-5), and identity (Likert scale 1-7). Responses were analyzed using hierarchical mixed modeling procedures, idiographic visual analysis, and intraclass correlation coefficients (ICC). A subsample completed semi-structured interviews incorporating their survey data, which underwent thematic analysis. RESULTS: As a group, FHSAs (N=35, 7 men, 18±0 years) exhibited no statistically significant changes in any primary outcomes, but idiographic analyses revealed substantial intra-individual variation. Most variables demonstrated “poor”-“fair” consistency (ICC .271-.654); only bodyweight (ICC=.987), athlete identity (ICC=.788), and exercise identity (ICC=.898) exhibited “good”-“excellent” consistency. Interviews (n=14) yielded 5 themes: adapting to transition, from “athlete” to “athletic exerciser”, motivational determinants to exercise, within-person pre-condition, and environment. CONCLUSION: FHSAs maintained relatively high levels of exercise, identity, and ‘good’ fitness perceptions as a group. However, noted variability from participants’ time devoted to schoolwork, exercise-specific social supports, and COVID-19 restrictions suggests individual responses were not represented by average values. FHSAs’ sports backgrounds provided exercise-related competence and self-regulatory abilities, but made balancing fitness expectations and losses difficult. Future directions should explore other former athlete populations’ behavior, ways of nurturing FHSA’s exercise-related competence and self-regulation, and the cyclical relationship conceptualized from interviews between participants’ exercise and identity.

Implementation of Healthy Conversation Skills to support behaviour change in the Bukhali trial in Soweto, South Africa: A process evaluation

BackgroundTo address the need for preconception health interventions in low- and middle-income countries, the Healthy Life Trajectories Initiative (HeLTI) was launched in Soweto, South Africa to optimise young women's physical and mental health to establish healthier trajectories for themselves and, where relevant, the next generation. As part of HeLTI trial, the Bukhali intervention utilises the Healthy Conversation Skills (HCS) approach to promote behaviour change with 18–28-year-old women. The aim of this article is to report on the process evaluation of implementing HCS, to identify implementation challenges, and make recommendations for HCS adaptations. MethodsData were collected from intervention session records (participants’ response to setting behaviour change goals, community health workers (CHWs) impression of their HCS use; n ​= ​7418), individual in-depth interviews with participants (n ​= ​35), focus groups (3) and debrief sessions (13) with CHWs who deliver the intervention. ResultsThe findings indicated that the HCS approach was not implemented as originally intended. Challenges were reported regarding participants' willingness to set behaviour change goals, and prioritise health and health behaviour change, as well as participants’ exposure to trauma, influencing their ability to prioritise health behaviour change. While CHWs were able to identify strengths of the HCS approach, there were challenges with contextual adaptation, especially using HCS in a multilingual setting such as Soweto. Recommendations for contextual adaptations of the HCS approach in Soweto, South Africa include simplification of certain HCS tools, language adaptions for a multilingual setting, adapting training to fit in with time constraints of a trial, and adopting a trauma-informed perspective to health behaviour change. ConclusionsThis article extends our understanding of challenges to health behaviour change for young women in a low-income setting, highlighting the role of trauma, and the need for a trauma-informed perspective to understand behaviour change in this context.(PACTR201903750173871, Registered March 27, 2019).

Intention to Transfer and Transfer Following eLearning in Spain

Understanding vocational learning and transfer is vital to European citizens. We need to understand how transfer works, which factors influence it, and how these factors affect employee behaviour. Research in online training specific to Southern Europe is needed to move the field forward. The Unified Model of Motivation for Training Transfer (MTT) was proposed to understand behaviour change after training. It conceives three phases: (1) forming transfer intentions, (2) actualizing implementation intentions for transfer, and (3) strengthening transfer commitment. We analysed initial transfer intention and transfer following online training in three Spanish organisations. We used an ex post facto prospective design with one group (n = 204). We applied the online version of the Initial Transfer Intention questionnaire (ITI) three days before the training, and the Transfer Questionnaire (TrQ) three to four months after the training. Training consisted of 22 online courses offered by the three participating organisations. A cluster analysis and post hoc analysis were performed. We identified three groups (k = 3), indicating that there were significant differences in the means between employees with low and high intention to transfer. Results showed a greater difference in the factor profile between participants with LowPT and HighPT. We identified common characteristics among people with low levels of transfer; this information can help understand what type of employee will transfer less and provide cues on how to prevent this from happening in future training activities. Limitations and recommendations for research and practice are discussed.

Adolescents' Long-Term Experiences of Manageability, Comprehensibility, and Meaningfulness of a Group-Based Exercise Intervention for Depression.

Physical exercise is a potentially effective treatment for adolescents with mild to moderate depression. However, there is a lack of long-term follow-ups to reveal adolescents’ experiences of exercise as a treatment for depression. The salutogenic concept of sense of coherence (SOC), comprising the domains manageability, comprehensibility, and meaningfulness is important to understand behaviour change. This study aimed to describe adolescents’ long-term experiences of manageability, comprehensibility, and meaningfulness of a group-based exercise intervention for depression. Fourteen adolescents with persistent depression were recruited from a psychiatric outpatient clinic and interviewed one year after participating in a 14-week moderate to vigorous exercise intervention for depression. An abductive qualitative content analysis was conducted, based on the three SOC domains manageability, comprehensibility, and meaningfulness. The results revealed that participation in the intervention was made manageable by a supportive environment, including: the intervention design, togetherness with peer group, and encouragement from adults. The comprehensibility of the intervention emerged through the insights regarding health benefits of exercise and the aim of the intervention. Meaningfulness was achieved through improved health behaviour, well-being and self-esteem, along with strengthened belief in the future and increased commitment to everyday life. The group-based exercise intervention was experienced as manageable, comprehensible, and meaningful.

Understanding Behaviour Change in Theory-Based Evaluation of Market Systems Development Programmes

Market systems development (MSD) programmes aim to influence private actor behaviour to promote markets that work better for the poor. This article aims to inform theory-based evaluation (TBE) of such programmes, arguing that a stronger analysis of market actor behaviour change is needed. It proposes a ‘behaviour change framework’ (BCF), building on recent advances in the TBE literature. These focus attention on behaviour change as contingent on the alignment of actor capability, motivation, and opportunity, influenced by the meso and macro contexts. The article applies the BCF to three theory-based MSD evaluations to illustrate its applicability and draw lessons on its use. The BCF can be used to identify evidence gaps and support more compelling explanations of what worked and under what conditions. Such evidence can inform future MSD programmes, and enable them to better stimulate systemic change in line with poverty reduction.

Understanding motivation for Australian adolescents and young adults with cystic fibrosis: Modifiable factors to support self-management.

Cystic fibrosis (CF) is Australia's most common life limiting genetic condition, characterised by declining health and quality of life (QoL) over time. Despite improvements in treatment, there remains no cure. Adolescents and young adults (AYAs) with CF experience broad impacts to psychosocial functioning and QoL, as well as major transitions in care, all at a time of significant developmental change. The importance of developmentally tailored approaches to youth health care and self-management for young people with CF are well understood. However, to date, models of youth specific self-management have been lacking and motivation for young people with CF has not been well explored. This qualitative study, based on a social constructionist epistemological framework, addresses this gap. A total of 21 AYAs aged 15-30years were recruited through one paediatric and one adult Australian CF centre. Demographic, clinical and distress data were captured to describe health complexity. Semi-structured interviews were audio-recorded, transcribed and analysed using thematic analysis. Participants were representative of Australian AYAs with CF by demography and clinical status. Alarmingly, over a third reported clinically significant distress. Two themes emerged. The first Identified impacts to motivation and self-management resulting from the challenges of managing CF, life and care. These included time and competing priorities, changing health statis, mental health, social factors, unmet needs and health system complexity. The second identified factors that support motivation including: achievement, meaning and purpose; consequence avoidance; and accountability. These results illustrate the importance of AYA specific, theoretically founded, holistic self-management models which extend beyond current theoretical approaches that aim to understand behaviour change or address barriers, in isolation from motivation. Improved approaches to care based on these findings are essential to foster positive behavioural change, support self-management and foster the best health outcomes for young people living with CF.

Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models

ABSTRACT Objectives Theoretical models have informed the understanding of pregnancy as a ‘teachable moment’ for health behaviour change. However, these models have not been developed specifically for, nor widely tested, in this population. Currently, no pregnancy-specific model of behaviour change exists, which is important given it is a unique yet common health event. This study aimed to assess the extent to which factors influencing antenatal behaviour change are accounted for by the COM-B model and Teachable Moments (TM) model and to identify which model is best used to understand behaviour change during pregnancy. Design Theoretical mapping exercise. Methods A deductive approach was adopted; nine sub-themes identified in a previous thematic synthesis of 92 studies were mapped to the constructs of the TM and COM-B models. The sub-themes reflected factors influencing antenatal health behaviour. Findings All sub-themes mapped to the COM-B model constructs, whereas the TM model failed to incorporate three sub-themes. Missed factors were non-psychological, including practical and environmental factors, social influences, and physical pregnancy symptoms. In contrast to the COM-B model, the TM model provided an enhanced conceptual understanding of pregnancy as a teachable moment for behaviour change, however, neither model accounted for the changeable salience of influencing factors throughout the pregnancy experience. Conclusions The TM and COM-B models are both limited when applied within the context of pregnancy. Nevertheless, both models offer valuable insight that should be drawn upon when developing a pregnancy-specific model of behaviour change.

Understanding behaviour change to promote regular dental attendance.

Regular dental attendance is a key oral health behaviour. Behaviour change interventions are increasingly being used to promote positive oral health behaviours. A systematic approach to understanding behaviour has led to the development of frameworks which aim to guide the process of designing behaviour change interventions. One such framework is the Behaviour Change Wheel (BCW). This article aims to explore and identify barriers to regular dental attendance which may be targeted using behaviour change interventions based on the Capability, Opportunity and Motivation Behaviour model (COM-B) and the BCW, and suggests potential behaviour change techniques which could be utilised into a behaviour change intervention with the aim to promote regular dental attendance.

Changes in Sheep Behavior before Lambing

The aim of this study was to assess the duration and frequency of behavioral observations of pregnant ewes as they approached lambing. An understanding of behavioral changes before birth may provide opportunities for enhanced visual monitoring at this critical stage in the animal’s life. Behavioral observations for 17 ewes in late pregnancy were recorded during two separate time periods, which were 4 to 6 weeks before lambing and before giving birth. It was normal farm procedure for the sheep to come indoors for 6 weeks of close monitoring before lambing. The behaviors of standing, lying, walking, shuffling and contraction behaviors were recorded for each animal during both time periods. Over both time periods, the ewes spent a large proportion of their time either lying (0.40) or standing (0.42), with a higher frequency of standing (0.40) and shuffling (0.28) bouts than other behaviors. In the time period before giving birth, the frequency of lying and contraction bouts increased and the standing and walking bouts decreased, with a higher frequency of walking bouts in ewes that had an assisted lambing. The monitoring of behavioral patterns, such as lying and contractions, could be used as an alert to the progress of parturition.

Assessing the Impact of a Global Health Fellowship on Pharmacists' Leadership Skills and Consideration of Benefits to the National Health Service (NHS) in the United Kingdom.

Antimicrobial resistance (AMR) poses a global, public health concern that affects humans, animals and the environment. The UK Fleming Fund’s Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) scheme aimed to support antimicrobial stewardship initiatives to tackle AMR through a health partnership model that utilises volunteers. There is evidence to indicate that NHS staff participating in international health projects develop leadership skills. Running in parallel with the CwPAMS scheme was the first Chief Pharmaceutical Officer’s Global Health (CPhOGH) Fellowship for pharmacists in the UK. In this manuscript, we evaluate the impact, if any, of participation in the CwPAMS scheme and the CPhOGH Fellowship, particularly in relation to leadership skills, and consider if there are demonstrable benefits for the NHS. The 16 CPhOGH Fellows were invited to complete anonymised baseline and post-Fellowship self-assessment. This considered the impact of the Fellowship on personal, professional and leadership development. Senior colleagues were invited to provide insights into how the Fellows had performed over the course of the Fellowship. All Fellows responded to both the pre- and post-Fellowship questionnaires with a return of 100% (16/16) response rate. There was a significant improvement in Fellows’ perception of their confidence, teaching abilities, understanding of behaviour change, management and communication skills. However, there was no change in the Fellows’ attitude to work. Feedback was received from 26 senior colleagues for 14 of the CPhOGH Fellows. Overall, senior colleagues considered CPhOGH Fellows to progress from proficient/established competencies to strong/excellent when using the national pharmacy Peer Assessment Tool and NHS Healthcare Leadership Model. The majority (88%) of senior colleagues would recommend the Fellowship to other pharmacists. The analysis of the data provided suggests that this CPhOGH Fellowship led to the upskilling of more confident, motivated pharmacist leaders with a passion for global health. This supports the NHS’s long-term plan “to strengthen and support good compassionate and diverse leadership at all levels”. Constructive feedback was received for improvements to the Fellowship. Job satisfaction and motivation improved, with seven CPhOGH Fellows reporting a change in job role and five receiving a promotion.

Applying theory to overcome internal barriers for healthy behavior change in adults with intellectual disabilities.

Adults with disabilities are 57% less physically active than individuals without disabilities and two times as likely to be obese. With obesity, adults with disabilities also face increased risk of comorbid disabilities stemming from obesity. The purpose of this theoretical case study was to identify key behavioral change theories which may be utilized to increase physical activity levels in adults with intellectual disabilities. The Self-Efficacy Theory and Self-Determination Theory both present constructs for understanding behavior change, and many of these constructs are interrelated which strongly suggests many behavioral change theories identify internal barriers for change. With theoretical case studies, these theories are examined within the context of adapted physical activity to depict how the Self-Efficacy Theory and Self-Determination Theory could be utilized to increase physical activity in individuals with intellectual disabilities.