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Njuguna C, Mistri P, Long L, Chetty-Makkan C, Maughan-Brown B, Buttenheim A, Schmucker L, Pascoe S, Thirumurthy H, O'Connor C, Mutasa B, Rees K. Behaviourally-informed two-way text messaging to improve return to HIV care in South Africa: evidence from a randomised controlled trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.19.24312207. [PMID: 39228693 PMCID: PMC11370491 DOI: 10.1101/2024.08.19.24312207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Introduction One-way text messaging to re-engage people in HIV care has shown promise, but little is known about two-way messaging where the recipient is asked to respond. We evaluated a two-way text messaging intervention, informed by behavioural science, to increase re-engagement in care following missed antiretroviral therapy (ART) visits. Methods We conducted an individual-level randomised controlled trial between February and March 2023 in Capricorn District, South Africa. Adults aged ≥18 years who had missed an ART visit by >28 days were randomised to (1) a standard one-way text message, or (2) behaviourally informed two-way text messages. Two-way messages asked recipients to reply by selecting from a list of reasons for their missed visit. Those who responded received another text message tailored to their response and designed using behavioural economics principles (affect heuristic, availability heuristic, loss aversion, social norms, providing slack, expanding choice). The primary outcome was return to care within 45 days, analysed as 1) intention to treat, and 2) restricted to successful message delivery. Results 3,695 participants were randomised: 1,845 to the one-way message group and 1,850 to the two-way message group. 27.9% (515/1845) of participants sent a one-way message and 27.2% (503/1850) sent a two-way message returned for an ART visit within 45 days (proportion difference:-0.7%, p-value: 0.622). In an analysis restricted to participants whose text message was delivered, 28.3% (310/1094) in the one-way message group compared to 28.3% (304/1076) in the two-way message group returned to care (proportion difference:-0.09%, p-value: 0.966). 19.5% (210/1076) responded to the two-way message. The two most commonly reported reasons for missed appointments were being out of town (41.0%) and still having medication (31.0%.). Among those who responded, 27.1% (95%CI: 21.3-33.7) returned for an ART visit. Clients ≥50 years were less likely to respond to the two-way text message, (AOR 0.4; 95%CI: 0.2-0.9). Conclusions Behaviourally informed two-way text messages did not improve return to care over one-way messages. However, they elicited reasons for disengagement, which could inform future outreach for missed visits. Additional research is needed on the mode, content and timing of two-way messages intended to increase return to care. Clinical Trial Number PACTR202202748760768 & DOH-27-042022-6703.
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Ferreira CM, Vieites Y, Goldszmidt R, Barros LSG, Andrade EB. Short- and long-term effects of incentives on prosocial behavior: The case of ride vouchers to a blood collection agency. Soc Sci Med 2024; 352:117019. [PMID: 38810507 DOI: 10.1016/j.socscimed.2024.117019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
This study addresses the challenge of low blood donation rates in developing countries by examining the effectiveness of a barrier-removal incentive-a one-day transportation voucher-to promote blood donation. Utilizing a longitudinal dataset of 23,750 donors from a Brazilian blood collection agency (BCA) collected between March 2018 and May 2020, we examine the short and long-term effects of this campaign on donation rates. Our results show that the incentive had a large positive influence on both donation attempts and successful donations on the day of the campaign. However, the short-term success of the intervention had an unintended consequence: the significant increase in prospective donors' waiting time at the BCA during the intervention day, which may help explain the negative impact on return rates in the 24-month follow-up. Despite these opposing outcomes, the net effect of the one-day blood donation incentive was still positive, offering valuable insights for BCAs aiming to enhance donor recruitment and retention strategies and emphasizing the need to balance immediate benefits with potential long-term impacts.
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Affiliation(s)
- Claudio M Ferreira
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil.
| | - Yan Vieites
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil.
| | - Rafael Goldszmidt
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil.
| | - Lucia S G Barros
- FGV EAESP Business Administration School of São Paulo, Fundação Getulio Vargas, Av. 9 de julho, 2029, Bela Vista, São Paulo, SP, 01313-902, Brazil.
| | - Eduardo B Andrade
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil; Imperial College Business School, Imperial College London, South Kensington Campus, Exhibition Rd, London, SW7 2AZ, United Kingdom.
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He S, Liu X, Wang J, Ge H, Long K, Huang H. Influence of conventional driving habits on takeover performance in joystick-controlled autonomous vehicles: A low-speed field experiment. Heliyon 2024; 10:e31975. [PMID: 38882282 PMCID: PMC11177126 DOI: 10.1016/j.heliyon.2024.e31975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/08/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024] Open
Abstract
Takeover is a critical factor in the safety of autonomous driving. Takeover refers to the action of a human driver assuming control of an autonomous vehicle from its automated driving system. This can occur when the vehicle encounters a situation it cannot handle, when the system requests the driver to take control, or when the driver chooses to intervene for safety or other reasons. This study explored how traditional steering-wheel driving habits affect takeover performance in joystick-controlled autonomous vehicles. We conducted an experiment using a joystick-controlled Dongfeng Sharing-VAN autonomous vehicle in a low-speed campus environment. The participants were divided into three groups based on their driving experience: the individuals who have no licence and no experience (NN Group), the drivers who have licence but not experienced (HN Group), and the drivers who have licence and have been experienced (HH Group), representing varying levels of driving habits. The experiment focused on two takeover tasks: passive takeover and active takeover. We evaluated takeover performance using takeover time and takeover quality as key metrics. The results from the passive takeover task indicated that traditional driving habits had a significant negative impact on takeover performance. The HH Group took 2.65 s longer to complete the task compared to the NN Group, while the HN Group took 3.78 s longer. When we analyzed takeover time in stages, the initial stage showed the most significant difference in takeover time among the three groups. In the active takeover task, driving habits did not significantly affect takeover braking in front of obstacles in a low-speed driving environment. These findings suggest that conventional driving habits can hinder passive takeover in joystick-controlled autonomous vehicles. This insight can be valuable for developing training programs and guidelines for drivers transitioning from conventional to autonomous driving.
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Affiliation(s)
- Shijian He
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Xinyi Liu
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Jie Wang
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Hongcheng Ge
- Key Laboratory of Road and Traffic Engineering of the Ministry of Education, Tongji University, Shanghai, China
| | - Kejun Long
- School of Traffic and Transportation Engineering, Changsha University of Science & Technology, Changsha 410114, China
| | - Helai Huang
- School of Traffic and Transportation Engineering, Central South University, Changsha 410018, China
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Buono FD, Polonsky M, Sprong ME, Aviles A, Cutter CJ. Feasibility of a remotely monitored blood alcohol concentration device to facilitate treatment motivation. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100202. [PMID: 38045492 PMCID: PMC10690544 DOI: 10.1016/j.dadr.2023.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023]
Abstract
Background Consistent monitoring of blood alcohol concentration through breathalyzers is critical for identifying reoccurrence. Little research has effectively utilized convenient wireless enabled breathalyzers that can measure blood alcohol concentration while enhancing treatment motivation for outpatient care. The current study attempted to understand the impact of wireless breathalyzers on treatment motivation and self-efficacy in remaining sober for individuals diagnosed with alcohol use disorder in an outpatient treatment facility. Methods Participants were assigned to one of two conditions: the experimental breathalyzer and the treatment as usual group. The groups were assessed by the University of Rhode Island Change Assessment (URICA), and on self-efficacy, measured by the Alcohol Abstinence Self-Efficacy Scale (AASE). The evaluation period took place over three months with a six-week follow-up evaluation. During the entirety of the evaluation period and post-study follow up, interviews occurred. Results As a secondary analysis, the URICA's motivational scores were higher for participants receiving the experimental intervention at a two-month evaluation and at the six-week follow-up. The AASE's temptation to reoccurrence scores significantly reduced over time for both groups. The confidence to resist temptation was not significant. Three major themes emerged from the interviews, including the benefit of the breathalyzer facilitating their treatment, ease of device use, and technical issues. Conclusions The insights gained from this study will be important to develop cost-effective ancillary interventions for comprehensive alcohol dependence treatment. On-going monitoring enabled by new technology allows treatment providers to take an individualized disease-management approach as well as facilitating timely interventions by the treatment provider.
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Affiliation(s)
- Frank D. Buono
- Yale School of Medicine, 300 George Street, New Haven, CT 06517, United States
| | | | | | - Allison Aviles
- Yale School of Medicine, 300 George Street, New Haven, CT 06517, United States
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Liefgreen A, Weinstein N, Wachter S, Mittelstadt B. Beyond ideals: why the (medical) AI industry needs to motivate behavioural change in line with fairness and transparency values, and how it can do it. AI & SOCIETY 2023; 39:2183-2199. [PMID: 39309255 PMCID: PMC11415467 DOI: 10.1007/s00146-023-01684-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 04/21/2023] [Indexed: 09/25/2024]
Abstract
Artificial intelligence (AI) is increasingly relied upon by clinicians for making diagnostic and treatment decisions, playing an important role in imaging, diagnosis, risk analysis, lifestyle monitoring, and health information management. While research has identified biases in healthcare AI systems and proposed technical solutions to address these, we argue that effective solutions require human engagement. Furthermore, there is a lack of research on how to motivate the adoption of these solutions and promote investment in designing AI systems that align with values such as transparency and fairness from the outset. Drawing on insights from psychological theories, we assert the need to understand the values that underlie decisions made by individuals involved in creating and deploying AI systems. We describe how this understanding can be leveraged to increase engagement with de-biasing and fairness-enhancing practices within the AI healthcare industry, ultimately leading to sustained behavioral change via autonomy-supportive communication strategies rooted in motivational and social psychology theories. In developing these pathways to engagement, we consider the norms and needs that govern the AI healthcare domain, and we evaluate incentives for maintaining the status quo against economic, legal, and social incentives for behavior change in line with transparency and fairness values.
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Affiliation(s)
- Alice Liefgreen
- Hillary Rodham Clinton School of Law, University of Swansea, Swansea, SA2 8PP UK
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights Road, Reading, RG6 6AL UK
| | - Netta Weinstein
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights Road, Reading, RG6 6AL UK
| | - Sandra Wachter
- Oxford Internet Institute, University of Oxford, 1 St. Giles, Oxford, OX1 3JS UK
| | - Brent Mittelstadt
- Oxford Internet Institute, University of Oxford, 1 St. Giles, Oxford, OX1 3JS UK
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Gardner B, Arden MA, Brown D, Eves FF, Green J, Hamilton K, Hankonen N, Inauen J, Keller J, Kwasnicka D, Labudek S, Marien H, Masaryk R, McCleary N, Mullan BA, Neter E, Orbell S, Potthoff S, Lally P. Developing habit-based health behaviour change interventions: twenty-one questions to guide future research. Psychol Health 2023; 38:518-540. [PMID: 34779335 DOI: 10.1080/08870446.2021.2003362] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Habitual behaviours are triggered automatically, with little conscious forethought. Theory suggests that making healthy behaviours habitual, and breaking the habits that underpin many ingrained unhealthy behaviours, promotes long-term behaviour change. This has prompted interest in incorporating habit formation and disruption strategies into behaviour change interventions. Yet, notable research gaps limit understanding of how to harness habit to change real-world behaviours. METHODS Discussions among health psychology researchers and practitioners, at the 2019 European Health Psychology Society 'Synergy Expert Meeting', generated pertinent questions to guide further research into habit and health behaviour. RESULTS In line with the four topics discussed at the meeting, 21 questions were identified, concerning: how habit manifests in health behaviour (3 questions); how to form healthy habits (5 questions); how to break unhealthy habits (4 questions); and how to develop and evaluate habit-based behaviour change interventions (9 questions). CONCLUSIONS While our questions transcend research contexts, accumulating knowledge across studies of specific health behaviours, settings, and populations will build a broader understanding of habit change principles and how they may be embedded into interventions. We encourage researchers and practitioners to prioritise these questions, to further theory and evidence around how to create long-lasting health behaviour change.
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Affiliation(s)
- Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Madelynne A Arden
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology & Politics, Sheffield Hallam University, Sheffield, UK
| | - Daniel Brown
- Department of Applied Psychology, Griffith University, Brisbane, Australia
| | - Frank F Eves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - James Green
- School of Allied Health and Physical Activity for Health Research Cluster (Health Research Institute), University of Limerick, Limerick, Ireland
| | - Kyra Hamilton
- Griffith University and Menzies Health Institute Queensland, Mt Gravatt, Qld, Australia
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Jennifer Inauen
- Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jan Keller
- Division Health Psychology, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wrocław, Poland.,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Sarah Labudek
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Hans Marien
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Radomír Masaryk
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University Bratislava, Bratislava, Slovakia
| | - Nicola McCleary
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Barbara A Mullan
- Behavioural Science and Health Research Group, Curtin University, Perth, Australia
| | - Efrat Neter
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Sheina Orbell
- Department of Psychology, University of Essex, Essex, UK
| | - Sebastian Potthoff
- Department of Social Work, Education, and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Phillippa Lally
- Research Department of Behavioural Science and Health, University College London, London, UK
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Watson S, McCrum LA, McGuinness B, Cardwell C, Clarke M, Woodside JV, McKenna G, McGowan L. Establishing Healthy Eating 'Habits': A Pilot Randomised Controlled Trial of a Habit-Based Dietary Intervention following Oral Rehabilitation for Older Adults. Nutrients 2023; 15:nu15030731. [PMID: 36771437 PMCID: PMC9919723 DOI: 10.3390/nu15030731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
An ageing population presents significant nutritional challenges, particularly for partially dentate adults. This two-armed pilot randomised controlled trial (RCT) compared habit formation (automaticity) for healthy eating behaviours between control and intervention groups after participation in a habit-based dietary intervention for older adults, following oral rehabilitation in the United Kingdom (UK). n = 54 participants were randomised to receive a habit-based dietary intervention (intervention group n = 27, IG) or standard dietary advice in a leaflet (control group n = 27, CG). The IG attended three sessions over six weeks, which focused on habit formation for three healthy eating behaviours (increasing fruit and vegetables, wholegrains, and healthy proteins). Participants were assessed for habit strength (using the Self-Report Behavioural Automaticity Index (SRBAI)) alongside health and nutrition outcomes at six weeks, four months and eight months. Forty-nine participants completed all follow-up visits. The IG compared to the CG had significant increases in automaticity at six weeks, four months (primary outcome) and eight months for eating ≥3 portions of fruit and vegetables; choosing wholegrain sources over white alternatives, and choosing healthy protein sources over red/processed meat. The mean change in the Mini Nutritional Assessment total score was greater in the IG compared with the CG at six weeks only (p = 0.03). A habit-based dietary intervention following oral rehabilitation increased automaticity for healthy dietary behaviours, which could translate into clinically meaningful benefits in this cohort of older adults.
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Affiliation(s)
- Sinead Watson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Leigh-Ann McCrum
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Bernadette McGuinness
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Christopher Cardwell
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Mike Clarke
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Jayne V. Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Gerry McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Laura McGowan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT12 6BA, UK
- Correspondence: ; Tel.: +44-2890-976401
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Gardner B, Rebar AL, Lally P. How does habit form? Guidelines for tracking real-world habit formation. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2041277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Amanda L. Rebar
- Physical Activity Research Group, Appleton Institute, School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Phillippa Lally
- Research Department of Behavioural Science and Health, University College London, London, UK
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Petherick A, Goldszmidt R, Andrade EB, Furst R, Hale T, Pott A, Wood A. A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue. Nat Hum Behav 2021; 5:1145-1160. [PMID: 34345009 DOI: 10.2139/ssrn.3774252] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/08/2021] [Indexed: 05/28/2023]
Abstract
As the COVID-19 pandemic lingers, the possibility of 'pandemic fatigue' has raised worldwide concerns. Here, we examine whether there was a gradual reduction in adherence to protective behaviours against COVID-19 from March through December 2020, as hypothesized in expectations of fatigue. We considered self-report behaviours from representative samples of the populations of 14 countries (N = 238,797), as well as mobility and policy data for 124 countries. Our results show that changes in adherence were empirically meaningful and geographically widespread. While a low-cost and habituating behaviour (mask wearing) exhibited a linear rise in adherence, high-cost and sensitizing behaviours (physical distancing) declined, but this decline decelerated over time, with small rebounds seen in later months. Reductions in adherence to physical distancing showed little difference across societal groups, but were less intense in countries with high interpersonal trust. Alternative underlying mechanisms and policy implications are discussed.
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Affiliation(s)
- Anna Petherick
- Blavatnik School of Government, University of Oxford, Oxford, UK.
| | - Rafael Goldszmidt
- Brazilian School of Public and Business Administration (EBAPE), Getulio Vargas Foundation (FGV), Rio de Janeiro, Brazil
| | - Eduardo B Andrade
- Brazilian School of Public and Business Administration (EBAPE), Getulio Vargas Foundation (FGV), Rio de Janeiro, Brazil
| | - Rodrigo Furst
- Brazilian School of Public and Business Administration (EBAPE), Getulio Vargas Foundation (FGV), Rio de Janeiro, Brazil
| | - Thomas Hale
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Annalena Pott
- Department of Zoology, University of Oxford, Oxford, UK
| | - Andrew Wood
- Department of Zoology, University of Oxford, Oxford, UK
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10
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A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue. Nat Hum Behav 2021; 5:1145-1160. [PMID: 34345009 DOI: 10.1038/s41562-021-01181-x] [Citation(s) in RCA: 189] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/08/2021] [Indexed: 01/31/2023]
Abstract
As the COVID-19 pandemic lingers, the possibility of 'pandemic fatigue' has raised worldwide concerns. Here, we examine whether there was a gradual reduction in adherence to protective behaviours against COVID-19 from March through December 2020, as hypothesized in expectations of fatigue. We considered self-report behaviours from representative samples of the populations of 14 countries (N = 238,797), as well as mobility and policy data for 124 countries. Our results show that changes in adherence were empirically meaningful and geographically widespread. While a low-cost and habituating behaviour (mask wearing) exhibited a linear rise in adherence, high-cost and sensitizing behaviours (physical distancing) declined, but this decline decelerated over time, with small rebounds seen in later months. Reductions in adherence to physical distancing showed little difference across societal groups, but were less intense in countries with high interpersonal trust. Alternative underlying mechanisms and policy implications are discussed.
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Werner A, Risius A. Motives, mentalities and dietary change: An exploration of the factors that drive and sustain alternative dietary lifestyles. Appetite 2021; 165:105425. [PMID: 34051276 DOI: 10.1016/j.appet.2021.105425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/19/2022]
Abstract
Any transition to a sustainable food system will require long-term changes in consumer behaviour, including a major reduction in the proportion of animal-based foods in people's diets. Such long-term dietary changes have widely been found difficult to achieve, however, since eating behaviors are interlinked with habits and lifestyles. In order to attain a better understanding of the driving forces that guide and support changes in eating patterns, this study identifies some of the key factors that lead people not only to adopt alternative dietary lifestyles but also to sustain these lifestyles over the long term. A generic qualitative methodology was used to gather and analyse qualitative data on the food-related motivations and identities of 17 long-term 'alternative dieters'. Our content analysis of this data revealed the following three factors to be particularly relevant in motivations for dietary change: (1) the experience of a 'key moment'; (2) the accumulation of knowledge; and (3) health concerns. While our findings show that the experience of key moments tends to catalyse immediate behavioral responses, changes due to knowledge and health concerns appear to lead to more gradual and organized processes of change. Regarding the mentalities that seem to reinforce and help sustain the transition to long-lasting alternative diets, our study identified three further characteristics: (1) self-reflectiveness; (2) responsibility; and (3) interconnectedness. Overall, our findings provide valuable insights into the key drivers that initiate processes of long-lasting dietary change as well as the mentalities that serve to underpin and sustain such changes. Follow-up research with a largersample of participants is recommended to confirm and further explore these characteristics as a means of informing policies aiming at achieving a transition to more sustainable food systems.
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Affiliation(s)
- Aspasia Werner
- University of Göttingen, Platz der Göttinger Sieben 5, 37073, Göttingen, Germany; Thünen Institute of Biodiversity, Bundesallee 65, 38116, Braunschweig, Germany.
| | - Antje Risius
- University of Göttingen, Platz der Göttinger Sieben 5, 37073, Göttingen, Germany
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