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Allison AL, Frost R, Murtagh N. Promoting planting in front gardens: a systematic approach to intervention development. UCL OPEN. ENVIRONMENT 2024; 6:e3147. [PMID: 38841425 PMCID: PMC11152043 DOI: 10.14324/111.444/ucloe.3147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 04/26/2024] [Indexed: 06/07/2024]
Abstract
Planting in front gardens is associated with a range of human and environmental health benefits. Effective interventions aimed at cultivating this practice are, however, hampered by the paucity of theory- and evidence-based behavioural research in this context. This study aims to systematically determine a set of behaviour change interventions likely to be effective at promoting planting in front gardens amongst UK householders. The Behaviour Change Wheel framework was applied. Behavioural systems mapping was used to identify community actors relevant to front gardening. Potential behavioural influences on householders' front gardening were identified using the Capability, Opportunity, Motivation, Behaviour model. Using peer-reviewed scientific findings as evidence, behavioural influences were systematically linked to potential intervention strategies, behaviour change techniques and real-world implementation options. Finally, intervention recommendations were refined through expert evaluations and local councillor and public stakeholder feedback, evaluating them against the Acceptability, Practicability, Effectiveness, Affordability, Side effects and Equity criteria in a UK implementation context. This study formulated 12 intervention recommendations, implementable at a community level, to promote front gardening. Stakeholder feedback revealed a preference for educational and supportive (social and practical) strategies (e.g., community gardening workshops, front gardening 'starter kits') over persuasive and motivational approaches (e.g., social marketing, motivational letters from the council to householders). Householders' front gardening behaviour is complex and influenced by the behaviour of many other community actors. It also needs to be understood as a step in a continuum of other behaviours (e.g., clearing land, gardening, waste disposal). This study demonstrates the application of behavioural science to an understudied implementation context, that is, front gardening promotion, drawing on a rigorous development process promoting a transparent approach to intervention design. Stakeholder consultation allowed relevance, feasibility and practical issues to be considered. These improve the likely effectiveness of interventions in practice. The next steps include evaluating the proposed interventions in practice.
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Affiliation(s)
- Ayşe Lisa Allison
- UCL Centre for Behaviour Change, University College London (UCL), 1-19 Torrington Pl, London WC1E 7HB, UK
- UCL Plastic Waste Innovation Hub, University College London (UCL), 90 Tottenham Court Road, London W1T 4TJ, UK
| | - Rachael Frost
- Department of Primary Care and Public Health, University College London (UCL), UCL Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
| | - Niamh Murtagh
- The Bartlett School of Sustainable Construction, University College London (UCL), 1-19 Torrington Pl, London WC1E 7HB, UK
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Keetley R, Manning JC, Williams J, Bennett E, Westlake M, Radford K. Understanding barriers and facilitators to long-term participation needs in children and young people following acquired brain injuries: a qualitative multi-stakeholder study. BRAIN IMPAIR 2024; 25:IB23100. [PMID: 38566298 DOI: 10.1071/ib23100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/22/2024] [Indexed: 04/04/2024]
Abstract
Background This study focused on exploring the longer-term participation needs of children and young people with acquired brain injury (CYP-ABI) and their families in one region of the UK and identifying the barriers and facilitators of their participation and well-being to inform the development of a behavioural change intervention for clinical implementation. Methods Qualitative interviews were conducted with CYP-ABI and parents. Focus groups were created with health, education, care and charity stakeholders. The International Classification of Functioning, Disability and Health (ICF) and the Behaviour Change Wheel (BCW) were used to map needs, barriers and facilitators. Results A total of 10 CYP/parent dyads (n = 20) and 17 health, education, care and charity stakeholders were included in this study. Unmet participation needs were mapped to the ICF and barriers/facilitators to the BCW. Significant unmet needs impacting CYP-ABI participation and family well-being were found. Barriers spanned 'Capability', 'Opportunity' and 'Motivation', the greatest being knowledge, skills, social influences, environmental context and resources, social identity and emotion. Facilitators included increasing awareness and understanding, supporting parents, long-term access to specialist assessment and rehabilitation, peer support and integrated collaborative pathways. Conclusion The long-term impact of ABI on CYP and families' participation and well-being were significant, with barriers spanning every sector and level of society. Implementation of collaborative, cross-sector (education, health and social care) accessible and family-centred care pathways is needed to meet the long-term needs of CYP-ABI and their families, ensuring equity of access. Multi-modal, family-centred, needs-led, theory-based interventions should be co-developed with CYP, families and stakeholders to improve the health and well-being outcomes and the lives of CYP-ABI and their families.
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Affiliation(s)
- Rachel Keetley
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, NG7 2HA, UK; and Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Joseph C Manning
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK; and School of Healthcare, University of Leicester, Leicester, UK
| | - Jane Williams
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Emily Bennett
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Meri Westlake
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, NG7 2HA, UK
| | - Kathryn Radford
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, NG7 2HA, UK
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Goodwin MV, Hogervorst E, Maidment DW. A qualitative study assessing the barriers and facilitators to physical activity in adults with hearing loss. Br J Health Psychol 2024; 29:95-111. [PMID: 37658583 DOI: 10.1111/bjhp.12689] [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: 11/11/2022] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES Growing epidemiological evidence has shown hearing loss is associated with physical inactivity. Currently, there is a dearth in evidence investigating why this occurs. This study aimed to investigate the barriers and facilitators to physical activity in middle-aged and older adults with hearing loss. DESIGN Individual semi-structured qualitative interviews. METHODS A phenomenological approach was taken. Ten adults (≥40 years) were interviewed via videoconferencing. The interview schedule was underpinned by the capability, opportunity, motivation and behaviour (COM-B) model. Reflexive thematic analysis was used to generate themes, which were subsequently mapped onto the COM-B model and behaviour change wheel. RESULTS Nine hearing loss specific themes were generated, which included the following barriers to physical activity: mental fatigue, interaction with the environment (acoustically challenging environments, difficulties with hearing aids when physically active) and social interactions (perceived stigma). Environmental modifications (digital capabilities of hearing aids), social support (hearing loss-only groups) and hearing loss self-efficacy were reported to facilitate physical activity. CONCLUSIONS Middle-aged and older adults with hearing loss experience hearing-specific barriers to physical activity, which has a deleterious impact on their overall health and well-being. Interventions and public health programmes need to be tailored to account for these additional barriers. Further research is necessary to test potential behaviour change techniques.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Ma R, Wang Y, Wang XQ, Yu K, Zhang CC, Zhou YQ. Analysis of hindering and facilitating factors of help-seeking behavior in schizophrenia based on COM-B model: a descriptive qualitative study. BMC Psychiatry 2023; 23:770. [PMID: 37867190 PMCID: PMC10591348 DOI: 10.1186/s12888-023-05226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Timely and systematic professional treatment is crucial in schizophrenia prognosis, but the global rate of mental health service, now, use or help-seeking behavior is low. METHODS In-depth semi-structured interviews were conducted with 13 participants with the diagnosis of schizophrenia between October to December 2021. The participants were purposively sampled from a psychiatric hospital's. Interviews were recorded and transcribed verbatim into NVivo 12.0. RESULTS The findings were summarized under 3 themes and 12 subthemes: (1) capability (lack of knowledge due to insufficient mental health literacy or lack of insight, inability to access disease information due to a lack of mental health literacy, and symptoms-related barriers); (2) opportunity (lack of disease information sources, inability to balance work and study during prolonged hospitalization, accessibility and convenience of medical resources, and the acquisition and utilization of social support); and (3) motivation (awareness of the disease and professional treatment, negative experiences of disease episodes, past medical experience, confidence in tcuring the disease, and the fulfillment of daily life and self-worth). CONCLUSION The medical help-seeking behavior of people with the diagnosis of schizophrenia is the result of the interaction of many barriers and facilitators, and challenges persist today. Interventions can be implemented with the BCW framework and our results to precisely eliminate delays in the diagnosis and treatment of mental problems.
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Affiliation(s)
- Rui Ma
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Yu Wang
- Department of Nursing, Fu Wai Central China Cardiovascular Hospital, Zhengzhou, 451460, Henan, China
| | - Xiao-Qing Wang
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Kai Yu
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Chen-Chen Zhang
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China.
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Xie C, Li L, Zhou L, Sun C, Zhang Y, Li Y. Mediating role of learned helplessness' components in the association between health literacy/social support and self-management among maintenance haemodialysis patients in Changsha, China: a cross-sectional study. BMJ Open 2023; 13:e068601. [PMID: 37640465 PMCID: PMC10462950 DOI: 10.1136/bmjopen-2022-068601] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES To explore the multiple mediating roles of the learned helplessness's core system in the relationship between health literacy/social support and self-management. DESIGN Cross-sectional survey design. SETTING Changsha, China. PARTICIPANTS 239 Chinese maintenance haemodialysis (MHD) patients. METHODS Two multiple mediator models were constructed based on the COM-B (Capacity, Opportunity, Motivation - Behaviour) model. A total of 239 Chinese MHD patients participated in a cross-sectional study, which included surveys on the Learned Helplessness Scale for MHD patients, Dialysis Knowledge Questionnaire, Social Support Scale and Self-Management Scale for Haemodialysis. The PROCESS macro in SPSS was used for mediated effects analysis. RESULTS Helplessness and internality partially mediated the relationship between health literacy/social support and self-management ((β=-0.212, p<0.01; β=0.240, p<0.01)/(β=-0.331, p<0.001; β=0.376, p<0.001)). The mediation effect size was 0.780 (95% CI (0.373 to 1.218)) in the health literacy model, accounting for 45.29% of the total effect, and 0.286 (95% CI (0.207 to 0.377)) in the social support model, accounting for 57.88% of the total effect. The differences in effect sizes for helplessness and internality in the two models were -0.080 (95% CI (-0.374 to 0.216)) and -0.041 (95% CI (-0.127 to 0.043)), respectively. CONCLUSION Health literacy/social support directly affects MHD patients' self-management and indirectly affects it by changing learned helplessness, such as increasing internality while reducing helplessness.
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Affiliation(s)
- Chunyan Xie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Li Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Urology, Xinjiang Medical University Affiliated First Hospital, Urumqi, China
| | - Lin Zhou
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Blood Purification Center, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Cuifang Sun
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Blood Purification Center, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yini Zhang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Blood Purification Center, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
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Moore R, Vernon T, Gregory M, Freeman EL. Facilitators and barriers to physical activity among English adolescents in secondary schools: a mixed method study. Front Public Health 2023; 11:1235086. [PMID: 37655286 PMCID: PMC10466797 DOI: 10.3389/fpubh.2023.1235086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023] Open
Abstract
Background It is evident that physical activity (PA) programmes implemented in schools were not effective in improving PA behaviours among adolescents. This study investigated students' perceptions of barriers to PA among inactive English adolescents in secondary schools based on the Capability, Opportunity, Motivation, and Behaviour (COM-B) model, the Behaviour Change Wheel (BCW), and Theoretical Domains Framework (TDF). The study compared barriers faced by inactive and active groups participating in sports and PA in secondary schools to identify sources of behaviour contributing to inactivity. Methods A pre-intervention online survey was distributed to affiliated schools by 233 Teaching Schools Alliances (TSAs) as part of the monitoring and evaluation of the Secondary Teacher Training study. Data were cross-tabulated to analyse activity levels and behavioural barriers for active and inactive groups, using the COM-B domains. The research team followed a seven-step process to categorise barriers based on their relevant domain in the TDF mapped to the COM-B. Results The findings were derived from one of the most extensive surveys of adolescents ever undertaken involving 200,623 active and 8,231 inactive respondents. The study identified 52 barriers and 68 behaviours that prevent adolescents from participating in PA. Psychological and social barriers were found to affect all activity levels, genders, and ethnic groups, with a lack of confidence and self-consciousness being the most prevalent. Certain demographic groups, such as those from minority ethnic groups and disabled individuals, were found to be overrepresented among inactive populations. The finding of the study indicated that there were common barriers that affected both inactive and active groups, with further similarity when examining barriers between active and inactive girls. The study also found that girls were more likely to experience the main barriers compared to boys, while inactive boys were more likely to encounter these barriers compared to active boys. The findings suggest that common barriers could be addressed across the population, while recognising some differences in demographics, and the need to provide personalised support. Targeted interventions are also suggested for all girls and inactive boys. Conclusion This study highlights the range of barriers that impact adolescents and provides insight into potential mechanisms for behaviour change, including intervention functions, policy categories, and evidence-based behaviour change tools. The study highlights the need for further research to address the barriers to PA among adolescents, particularly those who are inactive. Utilising the findings of this study, future research should investigate the effectiveness of novel digital exercise interventions and policies in increasing PA levels among children and adolescents. Complex digital exercise interventions, including conversational AI solutions, could provide personalised tools to identify and revolutionise support around the multitude of barriers that impact adolescents globally."For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission."
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Affiliation(s)
- Richard Moore
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Tim Vernon
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Maxine Gregory
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Elizabeth Louise Freeman
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, United Kingdom
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Mai DL, Howell T, Benton P, Bennett PC. Application of an Adapted Behaviour Change Wheel to Assistance Dog Puppy Raising: A Proposed Raiser-Centred Support Program. Animals (Basel) 2023; 13:ani13020307. [PMID: 36670852 PMCID: PMC9855162 DOI: 10.3390/ani13020307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/01/2023] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
Puppy raising (PR) programs recruit volunteer community members (raisers) to raise assistance dog (AD) candidates from puppyhood until the dogs are ready for advanced training. Once qualified, ADs assist human handlers with a disability to live more independently. Unfortunately, about 50% of all puppies do not meet the behavioural standards required for further training after completing a PR program. This increases costs and lengthens the time taken for a handler to obtain an AD. Research has identified several factors that influence raisers' experiences. It has also shown that raisers' socialisation and training practices affect perceived puppy behaviour. Drawing on the argument that puppy raiser practices are central to improving overall puppy raising program outcomes, this paper interprets recent findings within the framework provided by the behaviour change wheel-an established behaviour change framework-to suggest a coordinated approach to supporting puppy raisers. The recommendations will allow future research to employ more objective measures and more rigorous experimental designs as the field attempts to corroborate existing findings and develop evidence-based models of practice.
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Affiliation(s)
- Dac L. Mai
- Anthrozoology Research Group, Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Flora Hill, VIC 3552, Australia
- Correspondence: ; Tel.: +61-03-5444-7203
| | - Tiffani Howell
- Anthrozoology Research Group, Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Flora Hill, VIC 3552, Australia
| | - Pree Benton
- Anthrozoology Research Group, Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Flora Hill, VIC 3552, Australia
- Centre for Service and Therapy Dogs Australia, Melbourne, VIC 3162, Australia
| | - Pauleen C. Bennett
- Anthrozoology Research Group, Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Flora Hill, VIC 3552, Australia
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McVicar J, Nourse R, Keske MA, Maddison R. Development of a behavioural support intervention for e-bike use in Australia. BMC Public Health 2022; 22:2399. [PMID: 36544125 PMCID: PMC9768958 DOI: 10.1186/s12889-022-14693-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Insufficient physical activity (PA) is a risk factor for the development of many non-communicable diseases. Electric bicycles (e-bikes) offer considerable potential to support people to be physically active, however, no previous e-bike intervention studies have supported e-bike use with behavioural support. The aim of this study was to co-develop theory-based intervention components which can be used to increase physical activity through e-cycling among people who are overweight or obese and physically inactive. METHODS We conducted a mixed-methods study using an online survey and virtual co-design workshops. We utilised the Behaviour Change Wheel (BCW) to inform the development of the behavioural support intervention to facilitate day-to-day e-cycling. RESULTS One hundred participants completed an online survey and seven participated in the online co-design workshops. The development of the intervention identified five intervention functions (enablement, training, environmental restructuring, education, and persuasion) and 16 behaviour change techniques (BCTs) from 11 BCT groups (goals and planning, feedback and monitoring, social support, shaping knowledge, natural consequences, comparison of behaviour, associations, repetition and substitution, comparison of outcomes, antecedents, and self-belief). CONCLUSION To our knowledge, this is the first study to combine co-design and the BCW to develop a comprehensive behavioural support intervention for e-bike use. Theory based intervention options should be considered when providing e-bikes to individuals to help them increase their habitual PA levels.
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Affiliation(s)
- Jenna McVicar
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia ,grid.1021.20000 0001 0526 7079School of Exercise and Nutrition Sciences, Deakin University, Gheringhap Street, Geelong, VIC 3220 Australia
| | - Rebecca Nourse
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Michelle A. Keske
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Ralph Maddison
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
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Niven A, Baker G, Almeida EC, Fawkner SG, Jepson R, Manner J, Morton S, Nightingale G, Sivaramakrishnan D, Fitzsimons C. "Are We Working (Too) Comfortably?": Understanding the Nature of and Factors Associated with Sedentary Behaviour When Working in the Home Environment. OCCUPATIONAL HEALTH SCIENCE 2022; 7:71-88. [PMID: 36465155 PMCID: PMC9708134 DOI: 10.1007/s41542-022-00128-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 12/03/2022]
Abstract
Home working has increased due to COVID-19, but little is known about how this change has impacted the health risk behaviour of elevated sedentary time. The aim of this cross-sectional exploratory study was to assess occupational sitting behaviour when working at home, and use the Capability Opportunity Motivation-Behaviour (COM-B) model to identify influences on this behaviour. University staff (n = 267; 69% female; 92% white) who were predominantly working from home completed a questionnaire to assess sitting time, sitting breaks, demographic and occupational characteristics, and a 7-item COM-B questionnaire and open-ended questions to assess influences on time spent sitting whilst working from home. Data were analysed descriptively, a repeated measures ANOVA was used to determine differences in the COM-B items, and binary logistic regression was used to examine predictors of sitting time. Staff spent on average 89.5% (SD = 17.1) of their time sitting whilst working at home, and took an average of 1.36 (1.38) sitting breaks per hour. There were significant and meaningful differences in the influence of the COM factors on ability and willingness to reduce sitting behaviour (p < .0001; ηp 2 = .38), and the open-ended responses added further context. The included variables accounted for 20.7% of variance in sitting behaviour, with age, sitting breaks, motivation-automatic, and opportunity-physical contributing significantly. Working from home leads to elevated levels of sitting, and the COM-B provides a useful model to identify key influences on ability and willingness to reduce sitting. Strategies incorporating regular breaks, habit formation/reversal, and restructuring the physical environment may be beneficial.
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Affiliation(s)
- Ailsa Niven
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, Scotland
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, Scotland
| | - Eva Coral Almeida
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, Scotland
| | - Samantha G Fawkner
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, Scotland
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research & Policy, University of Edinburgh, Edinburgh, Scotland
| | - Jillian Manner
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, Scotland
- Scottish Collaboration for Public Health Research & Policy, University of Edinburgh, Edinburgh, Scotland
| | - Sarah Morton
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, Scotland
| | - Glenna Nightingale
- Scottish Collaboration for Public Health Research & Policy, University of Edinburgh, Edinburgh, Scotland
| | - Divya Sivaramakrishnan
- Scottish Collaboration for Public Health Research & Policy, University of Edinburgh, Edinburgh, Scotland
| | - Claire Fitzsimons
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, Scotland
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Moffat A, Cook EJ, Chater AM. Examining the influences on the use of behavioural science within UK local authority public health: Qualitative thematic analysis and deductive mapping to the COM-B model and Theoretical Domains Framework. Front Public Health 2022; 10:1016076. [PMID: 36339139 PMCID: PMC9632167 DOI: 10.3389/fpubh.2022.1016076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/22/2022] [Indexed: 01/28/2023] Open
Abstract
Background Behavioural science and its contribution towards improving public health is receiving increased recognition. Yet, the translation of these insights into public health practice is under-researched. This study explored the factors influencing the use of behavioural science within public health at a local authority level. Methods Fourteen local authority staff (n = 13 female) in the south of England participated in semi-structured interviews, which were analysed inductively to identify key themes. These were later mapped deductively to the COM-B model and Theoretical Domains Framework. Findings Nine themes were identified as factors that influence the use of behavioural science in local authority public health: (1) "Limited past experience," (2) "Narrow understanding," (3) "Perceived value of behavioural science," (4) "Translational gap from theory-to-practice," (5) "No protected time," (6) "Old ways of working," (7) "Political influence and organisational culture," (8) "Relationships with key stakeholders," (9) "Access to behavioural science resources". Deductive mapping of these themes revealed that five of the COM constructs (excluding Physical Capability) and eleven of the TDF domains influenced behavioural science use, with "Social influences" and "Knowledge" being the most prominent. Discussion Use of behavioural science within local authority public health practice is limited and inconsistent. For it to be successfully implemented, there must be an understanding of its role and value, alongside strategies to overcome a translational gap from theory to practice. Public health teams would benefit from protected time to enable application and strategies to break old habits of using a common-sense approach. System-wide buy-in, particularly related to senior leadership and system partners is needed, which would benefit from organisational and political culture change. Training opportunities, practical resources and expert in-house support should be considered a priority across public health teams.
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Affiliation(s)
- Abby Moffat
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom,*Correspondence: Abby Moffat
| | - Erica Jane Cook
- School of Psychology, University of Bedfordshire, Luton, United Kingdom
| | - Angel Marie Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom,Centre for Behaviour Change, University College London, London, United Kingdom
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Grimshaw SL, Taylor NF, Conyers R, Shields N. Promoting positive physical activity behaviors for children and adolescents undergoing acute cancer treatment: Development of the CanMOVE intervention using the Behavior Change Wheel. Front Pediatr 2022; 10:980890. [PMID: 36313891 PMCID: PMC9607881 DOI: 10.3389/fped.2022.980890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Increasing participation in physical activity has the potential to improve outcomes for children and adolescents with cancer during treatment and into survivorship. The aim of this study is to outline the theoretical process behind development of CanMOVE, a behavior change intervention designed to increase physical activity for children and adolescents with cancer. Study design This study followed a theoretical design process consistent with the Behavior Change Wheel to inform the design of a complex intervention. Materials and methods The three stages of the Behavior Change Wheel intervention design process include: (1) understanding physical activity behavior within the pediatric cancer setting, (2) identifying potential intervention functions, and (3) identifying appropriate behavior change and implementation strategies. Qualitative and behavior change literature relevant to the pediatric cancer treatment setting were used to inform each stage. Results An individualized and flexible approach to physical activity promotion that considers intrinsic factors specific to the child/adolescent and their environment is required. Fifteen behavioral change strategies were identified to form the intervention components of CanMOVE. Implementation strategies were identified to build motivation, opportunity and capacity toward increasing physical activity behaviors. Key intervention components of CanMOVE include standardized assessment and monitoring (physical activity, physical function, and health-related quality of life), provision of an activity monitor to both child/adolescent and parent, and one-on-one capacity building sessions with a healthcare professional. Capacity building sessions include education, goal setting, an active supervised physical activity session, barrier identification and problem solving, and action planning. Conclusion CanMOVE is a novel approach to physical activity promotion in the pediatric cancer treatment setting. The use of a theoretical intervention design process will aid evaluation and replication of CanMOVE when it is assessed for feasibility in a clinical setting. The design process utilized here can be used as a guide for future intervention development.
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Affiliation(s)
- Sarah L. Grimshaw
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Nicholas F. Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Rachel Conyers
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
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12
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Yin S, Kasraian D, van Wesemael P. Children and Urban Green Infrastructure in the Digital Age: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105906. [PMID: 35627443 PMCID: PMC9141241 DOI: 10.3390/ijerph19105906] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/10/2022]
Abstract
In the digital age, time spent outdoor in green areas is significantly decreasing for children living in cities. With the advent of digital technology, a series of digital tools are gradually integrated into children’s lives and act as a double-edged sword: on the one hand, an increasing number of children tend to stay at home and play digital games instead of interacting with nature; on the other hand, new digital technology is increasingly being used to engage children with outdoor activities. A host of studies have investigated children’s behaviour in the natural environment. However, a systematic literature review of children’s interaction with the urban green infrastructure (UGI) and the respective role of digital environment, based on a theoretical framework that explicitly takes the multi-level determinants and individual-level mechanism of behaviour change into account does not exist yet. This work provides a conceptual framework that covers various determinants, such as motivation, capability, and opportunity related factors of children’s behaviour in terms of their UGI interaction at the city and neighbourhood levels, while taking into account the individual-level mechanism of behavioural change and the role of the digital environment. The framework is used to systematically review recent international empirical evidence on the determinants of children–UGI interaction. The results are useful for laying the theoretical foundation for future empirical research on children–UGI interaction, specifically in the presence of digital interventions. They also provide urban/digital intervention designers and policymakers with theory-based design and policy guidelines for the creation of child-friendly UGI.
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McQuinn S, Belton S, Staines A, Sweeney MR. Co-design of a school-based physical activity intervention for adolescent females in a disadvantaged community: insights from the Girls Active Project (GAP). BMC Public Health 2022; 22:615. [PMID: 35351045 PMCID: PMC8966245 DOI: 10.1186/s12889-022-12635-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Globally, adolescents' physical activity (PA) participation rates are low, particularly among lower socioeconomic groups, with females consistently the least active. The aim of this study was to co-design, with adolescent females, a school-based PA intervention in a single-sex, females-only designated disadvantaged post-primary school in Ireland. This involved using the Behaviour Change Wheel (BCW) and Public and Patient Involvement (PPI). This paper outlines the novel methodological approach taken. METHODS The three stages 1) understand the behaviour, 2) identify intervention options, and 3) identify content and implementation options of the BCW guide is described. A student PPI Youth Advisory Group (YAG) (n = 8, aged 15-17) was established. Mixed-methods were used with students (n = 287, aged 12-18) and teachers (n = 7) to capture current self-reported PA levels and to identify factors influencing adolescent females' PA behaviour in their school setting. The intervention options, content and implementation options were identified through discussion groups with the YAG. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention. RESULTS Just 1.4% of the students in this sample reported meeting the recommended PA guidelines. Students identified having more 'time' as the strongest predictor to becoming more active in school (Mean = 4.01, 95% CI 3.91 to 4.12). Social influences, environmental context and resources, behavioural regulation, beliefs about capabilities, goals, and reinforcement emerged from the qualitative data as factors influencing PA behaviour at school. The BCW co-design process resulted in the identification of seven intervention functions, four policy categories and 21 Behaviour Change Techniques. The Girls Active Project (GAP) intervention, a peer-led, after-school PA programme was proposed. CONCLUSIONS This paper describes how the BCW, a comprehensive, evidence-based, theory-driven framework was used in combination with PPI to co-design a school-based intervention aimed to increase adolescent females' PA levels. This approach could be replicated in other settings to develop targeted behavioural interventions in populations with specific demographic characteristics.
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Affiliation(s)
- Sara McQuinn
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin, 9, Ireland.
| | - Sarahjane Belton
- School of Health and Human Performance, Faculty of Science and Health, Dublin City University, Glasnevin, Dublin, 9, Ireland
| | - Anthony Staines
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin, 9, Ireland
| | - Mary Rose Sweeney
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin, 9, Ireland
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Creaser AV, Hall J, Costa S, Bingham DD, Clemes SA. Exploring Families' Acceptance of Wearable Activity Trackers: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063472. [PMID: 35329166 PMCID: PMC8950917 DOI: 10.3390/ijerph19063472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/02/2022] [Accepted: 03/12/2022] [Indexed: 12/30/2022]
Abstract
Background: The family environment plays a crucial role in child physical activity (PA). Wearable activity trackers (wearables) show potential for increasing children’s PA; however, few studies have explored families’ acceptance of wearables. This study investigated the acceptability of using wearables in a family setting, aligning experiences with components of the Technology Acceptance Model and Theoretical Domains Framework. Methods: Twenty-four families, with children aged 5–9 years, took part in a 5-week study, where all members were provided with a Fitbit Alta HR for 4 weeks. Acceptability was measured using weekly surveys and pre-post-questionnaires. Nineteen families participated in a focus group. Quantitative and qualitative data were integrated using the Pillar Integration Process technique. Results: Pillars reflected (1) external variables impacting wearable use and PA and (2) wearable use, (3) ease of use, (4) usefulness for increasing PA and other health outcomes, (5) attitudes, and (6) intention to use a wearable, including future intervention suggestions. Conclusions: Families found the Fitbit easy to use and acceptable, but use varied, and perceived impact on PA were mixed, with external variables contributing towards this. This study provides insights into how wearables may be integrated into family-based PA interventions and highlights barriers and facilitators of family wearable use.
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Affiliation(s)
- Amy V. Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Silvia Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Stacy A. Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester LE5 4PW, UK
- Correspondence:
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McDermott G, Brick NE, Shannon S, Fitzpatrick B, Taggart L. Barriers and facilitators of physical activity in adolescents with intellectual disabilities: An analysis informed by the COM-B model. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:800-825. [PMID: 35229409 PMCID: PMC9305883 DOI: 10.1111/jar.12985] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/13/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Abstract
Background Adolescents with intellectual disabilities are insufficiently physically active. Where interventions have been developed and delivered, these have had limited effectiveness, and often lack a theoretical underpinning. Aim Through application of the COM‐B model, our aim is to explore the factors influencing adolescent physical activity within schools. Methods A qualitative methodology, using focus groups with students who have mild/moderate intellectual disabilities, their parents'/carers' and teachers'. The COM‐B model provided the lens through which the data were collected and analysed. Results We identified of a range of individual, interpersonal, and environmental factors influencing physical activity, across all six COM‐B constructs, within the context of the ‘school‐system’. Conclusion This is the first study to use the COM‐B model to explore school‐based physical activity behaviour, for adolescents with intellectual disabilities. Identification of such physical activity behavioural determinants can support the development of effective and sustainable interventions.
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Affiliation(s)
- Gary McDermott
- School of Sport, Ulster University, Magee Campus, Derry, UK
| | - Noel E Brick
- School of Psychology, Ulster University, Coleraine Campus, Coleraine, UK
| | - Stephen Shannon
- School of Sport, Ulster University, Magee Campus, Derry, UK.,Bamford Centre for Mental Health and Well-being Ulster University, Magee Campus, Derry, UK
| | | | - Laurence Taggart
- School of Nursing, Ulster University, Jordanstown Campus, Jordanstown, UK
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16
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Coupe N, Cotterill S, Peters S. Enhancing community weight loss groups in a low socioeconomic status area: Application of the COM-B model and Behaviour Change Wheel. Health Expect 2021; 25:2043-2055. [PMID: 34350682 PMCID: PMC9615060 DOI: 10.1111/hex.13325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/03/2021] [Accepted: 07/14/2021] [Indexed: 12/18/2022] Open
Abstract
Background Obesity rates are higher among people of lower socioeconomic status. While numerous health behaviour interventions targeting obesity exist, they are more successful at engaging higher socioeconomic status populations, leaving those in less affluent circumstances with poorer outcomes. This highlights a need for more tailored interventions. The aim of this study was to enhance an existing weight loss course for adults living in low socioeconomic communities. Methods The Behaviour Change Wheel approach was followed to design an add‐on intervention to an existing local authority‐run weight loss group, informed by mixed‐methods research and stakeholder engagement. Results The COM‐B analysis of qualitative data revealed that changes were required to psychological capability, physical and social opportunity and reflective motivation to enable dietary goal‐setting behaviours. The resulting SMART‐C booklet included 6 weeks of dietary goal setting, with weekly behavioural contract and review. Conclusion This paper details the development of the theory‐ and evidence‐informed SMART‐C intervention. This is the first report of the Behaviour Change Wheel being used to design an add‐on tool to enhance existing weight loss services. The process benefitted from a further checking stage with stakeholders.
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Affiliation(s)
- Nia Coupe
- Faculty of Health and Medicine, Lancaster Medical School, Lancaster University, Lancaster, UK.,Faculty of Social Science, School of Psychology, University of Chester, Chester, UK
| | - Sarah Cotterill
- Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, School of Health Sciences, Centre for Biostatistics, The University of Manchester, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, Manchester Centre for Health Psychology, The University of Manchester, Manchester, UK
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17
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Beal J, Farrent S, Farndale L, Bell L. Reliability and Validity of a Carbohydrate-Counting Knowledge Questionnaire for Young Australians With Type 1 Diabetes. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:614-618. [PMID: 33582035 DOI: 10.1016/j.jneb.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To test the reliability and validity of a carbohydrate-counting knowledge questionnaire in young Australians with type 1 diabetes mellitus (T1DM). METHODS Children or young adults (<20 years) with T1DM, or their parents, completed the 72-item Australian PedCarbQuiz (AusPCQ), adapted from the American PedCarbQuiz, and an expert assessment of carbohydrate-counting knowledge. Responses were scored and summed (0-72, higher scores = greater knowledge). Internal reliability was assessed using Cronbach α, and relative validity using Spearman correlations (with HbA1c) and Bland-Altman analysis (with the expert assessment). RESULTS Australian PedCarbQuiz reliability (n = 44, mean score = 59.7 ± 5.6) was acceptable (α = 0.83). There was a lack of agreement (mean bias = 10.7, P = 0.008) and significant proportional bias between AusPCQ scores and expert assessments (β = -0.73 [95% confidence interval, -1.82 to -0.79]; P < 0.001). CONCLUSIONS AND IMPLICATIONS The AusPCQ was shown to be reliable but not valid in a small sample. Testing in a larger sample is warranted.
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Affiliation(s)
- Jacqueline Beal
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Shelley Farrent
- Department of Dietetics and Nutrition, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Lavinia Farndale
- Department of Dietetics and Nutrition, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Lucinda Bell
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
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Woods CB, Crowley E, Powell C, O'Brien W, Murphy MH, Belton S, Saunders J, Connolly S, Farmer O, Ng K. Socio-ecological correlates of physical activity in a nationally representative sample of adolescents across Ireland and Northern Ireland. Prev Med Rep 2021; 23:101472. [PMID: 34258178 PMCID: PMC8259398 DOI: 10.1016/j.pmedr.2021.101472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 05/18/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022] Open
Abstract
Adolescent physical activity (PA) can be categorized into different levels. Categories include inactive, somewhat active, active, or daily active. Demographic, intrapersonal and interpersonal factors varied by PA category. Depending on PA category, school- and community-related factors also varied. As Every Move Counts, future correlate analyses may benefit from PA categorization.
Physical activity (PA) is associated with a range of health benefits for adolescents. Few adolescents meet one hour daily of moderate-to-vigorous physical activity (MVPA). The World Health Organisation (WHO) now recommends an ‘on average’ accumulation. In light of these updates, comparing correlates associated with meeting versus not meeting the PA guidelines provides limited understanding of adolescent behavioural choices. The aim of this study was to fractionate PA behaviour and investigate influential socio-ecological correlates across a diverse range of PA categories. A nationally representative sample (N = 6,563; age = 13.5 ± 1.9 years; male = 46.2%) completed a researcher supervised self-report survey. Empirically established instruments assessing the socio-ecological correlates of PA were included. Levels of MPVA were categorised into daily active (60mins.MVPA.daily), active (60mins.MVPA.5–6 days), somewhat active (60mins.MVPA.3–4 days) or inactive (60mins.MVPA.0–2 days). Descriptive statistics, chi-square analyses and multivariate blockwise binary logistic regression models were run separately for each PA category. Few were daily active (12.7%), 33.6% active, 36.5% somewhat active and 17.2% were inactive. Results showed that correlates differed in terms of direction and strength, depending on individual activity status. Increasing age was positively associated with being somewhat active, but not with being active or daily active. Attending an ‘all-girls school’ was negatively associated with daily active. High interpersonal support from family, friends or teachers was negatively associated with inactive or somewhat active, reducing the likelihood of adolescents remaining in these unhealthy PA categories. This novel information is useful for exploring previously established inconsistent relationships with PA. More sensitive categorisation and intervention tailoring to diverse PA categories is required.
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Affiliation(s)
- Catherine B Woods
- Physical Activity for Health, Health Research Institute, Ireland.,Department of Physical Education and Sport Sciences, University of Limerick, Ireland
| | - Emmet Crowley
- Physical Activity for Health, Health Research Institute, Ireland.,Department of Physical Education and Sport Sciences, University of Limerick, Ireland
| | - Cormac Powell
- Physical Activity for Health, Health Research Institute, Ireland.,High Performance Unit, Sport Ireland National Campus, Dublin, Ireland
| | - Wesley O'Brien
- School of Education, Sports Studies and Physical Education Programme, University College Cork, Ireland
| | - Marie H Murphy
- Sport and Exercise Sciences Research Institute, Ulster University, United Kingdom
| | - Sarahjane Belton
- School of Health and Human Performance, Dublin City University, Ireland
| | - Jean Saunders
- Claddagh Statistical Consultancy Services, Shannon & CSTAR@UL, University of Limerick, Ireland
| | - Sinead Connolly
- Sport and Exercise Sciences Research Institute, Ulster University, United Kingdom
| | - Orlagh Farmer
- School of Education, Sports Studies and Physical Education Programme, University College Cork, Ireland
| | - Kwok Ng
- Physical Activity for Health, Health Research Institute, Ireland.,Department of Physical Education and Sport Sciences, University of Limerick, Ireland.,School of Educational Sciences and Psychology, University of Eastern Finland, Finland
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Wang H, Blake H, Chattopadhyay K. Development of a School-Based Intervention to Increase Physical Activity Levels Among Chinese Children: A Systematic Iterative Process Based on Behavior Change Wheel and Theoretical Domains Framework. Front Public Health 2021; 9:610245. [PMID: 33987160 PMCID: PMC8110714 DOI: 10.3389/fpubh.2021.610245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/16/2021] [Indexed: 12/29/2022] Open
Abstract
Regular physical activity has a range of benefits for children's health, academic achievement, and behavioral development, yet they face barriers to participation. The aim of the study was to systematically develop an intervention for improving Chinese children's physical activity participation, using the Behavior Change Wheel (BCW) and Theoretical Domains Framework (TDF). The BCW and TDF were used to (i) understand the behavior (through literature review), (ii) identify intervention options (through the TDF-intervention function mapping table), (iii) select content and implementation options [through behavior change technique (BCT) taxonomy and literature review], and (iv) finalize the intervention content (through expert consultation, patient and public involvement and engagement, and piloting). A systematic iterative process was followed to design the intervention by following the steps recommended by the BCW. This systematic process identified 10 relevant TDF domains to encourage engagement in physical activity among Chinese children: knowledge, memory, attention and decision processes, social influences, environmental context and resources, beliefs about capabilities, beliefs about consequences, social/professional role and identity, emotions, and physical skills. It resulted in the selection of seven intervention functions (education, persuasion, environmental restricting, modeling, enablement, training, and incentivization) and 21 BCTs in the program, delivered over a period of 16 weeks. The BCW and TDF allowed an in-depth consideration of the physical activity behavior among Chinese children and provided a systematic framework for developing the intervention. A feasibility study is now being undertaken to determine its acceptability and utility.
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Affiliation(s)
- Haiquan Wang
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A Joanna Briggs Institute Centre of Excellence, Nottingham, United Kingdom
| | - Holly Blake
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A Joanna Briggs Institute Centre of Excellence, Nottingham, United Kingdom
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20
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Corr M, McMullen J, Morgan PJ, Barnes A, Murtagh EM. Supporting Our Lifelong Engagement: Mothers and Teens Exercising ( SOLE MATES); a feasibility trial. Women Health 2019; 60:618-635. [PMID: 31709910 DOI: 10.1080/03630242.2019.1688446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to examine the feasibility of the Supporting Our Lifelong Engagement; Mothers and Teens Exercising (SOLE MATES) program. SOLE MATES, a single-arm six-week feasibility trial, comprised six face-to-face sessions. Participants were mothers (n = 27) with daughters (n = 31) aged 12-16 years. Data were collected in Ireland between January 2018 and March 2018. Feasibility benchmarks examined recruitment, data collection, acceptability, resources and participant responses. The primary outcome was daughters' step counts, measured via sealed pedometer for seven consecutive days at baseline and six weeks. Secondary outcomes included mothers' step counts, measures of communication, co-participation in activity, health-related quality of life and parenting practices. Feasibility benchmarks were reached or exceeded, except for retention. Eligibility rates were 93.4%, and baseline activity levels were low. Program content, measures and facilitators were acceptable, demonstrated through a mean score of 4.14 (SD 0.3) on a 5-point Likert Scale. Daily steps increased in mothers (2,875 increase, p = .009) and daughters (1,393 increase, p = .007). Positive feasibility metrics demonstrated the program's appeal. Participant responses for outcome measures also indicated program success. However, the relatively homogenous sample and relatively poor initial participation rate were study limitations. The intervention should be evaluated in a randomized controlled trial.
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Affiliation(s)
- Méabh Corr
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick , Limerick, Ireland
| | - Jaimie McMullen
- School of Sport and Exercise Science, University of Northern Colorado , Greeley, Colorado, USA
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle , Newcastle, Australia
| | - Alyce Barnes
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle , Newcastle, Australia
| | - Elaine M Murtagh
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick , Limerick, Ireland
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Croot L, O’Cathain A, Sworn K, Yardley L, Turner K, Duncan E, Hoddinott P. Developing interventions to improve health: a systematic mapping review of international practice between 2015 and 2016. Pilot Feasibility Stud 2019; 5:127. [PMID: 31720005 PMCID: PMC6839208 DOI: 10.1186/s40814-019-0512-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/15/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Researchers publish the processes they use to develop interventions to improve health. Reflecting on this endeavour may help future developers to improve their practice. METHODS Our aim was to collate, describe, and analyse the actions developers take when developing complex interventions to improve health. We carried out a systematic mapping review of empirical research studies that report the development of complex interventions to improve health. A search was undertaken of five databases over 2015-2016 using the term 'intervention dev*'. Eighty-seven journal articles reporting the process of intervention development were identified. A purposive subset of 30 articles, using a range of published approaches to developing interventions, was selected for in-depth analysis using principles of realist synthesis to identify the actions of intervention development and rationales underpinning those actions. RESULTS The 87 articles were from the USA (39/87), the UK (32/87), continental Europe (6/87), and the rest of the world (10/87). These mainly took a pragmatic self-selected approach (n = 43); a theory- and evidence-based approach, e.g. Intervention Mapping, Behaviour Change Wheel (n = 22); or a partnership approach, e.g. community-based participatory research, co-design (n = 10). Ten actions of intervention development were identified from the subset of 30 articles, including identifying a need for an intervention, selecting the intervention development approach to follow, considering the needs of the target population, reviewing published evidence, involving stakeholders, drawing or generating theory, and designing and refining the intervention. Rationales for these actions were that they would produce more engaging, acceptable, feasible, and effective interventions. CONCLUSIONS Developers take a variety of approaches to the international endeavour of complex intervention development. We have identified and described a set of actions taken within this endeavour regardless of whether developers follow a published approach or not. Future developers can use these actions and the rationales that underpin them to help them make decisions about the process of intervention development. TRIAL REGISTRATION PROSPERO, CRD42017080545.
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Affiliation(s)
- Liz Croot
- Medical Care Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Alicia O’Cathain
- Medical Care Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Katie Sworn
- Medical Care Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Lucy Yardley
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Katrina Turner
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Edward Duncan
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | - Pat Hoddinott
- NMAHP Research Unit, University of Stirling, Stirling, UK
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Graça J, Godinho CA, Truninger M. Reducing meat consumption and following plant-based diets: Current evidence and future directions to inform integrated transitions. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.07.046] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Ellis K, Pears S, Sutton S. Behavioural analysis of postnatal physical activity in the UK according to the COM-B model: a multi-methods study. BMJ Open 2019; 9:e028682. [PMID: 31377705 PMCID: PMC6686995 DOI: 10.1136/bmjopen-2018-028682] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Develop a behavioural analysis of factors influencing postnatal physical activity (PA) according to the 'capability, opportunity, motivation and behaviour' (COM-B) model of behaviour to inform intervention development using the Behaviour Change Wheel (BCW). DESIGN Cross-sectional, multi-method study using semi-structured interviews and a quantitative questionnaire. SETTING Children's centres and mother and baby groups in Hertfordshire and Cambridgeshire, UK. PARTICIPANTS Convenience samples of postnatal women were interviewed (n=16) and completed the questionnaire (n=158). METHODS Semi-structured interviews followed a preprepared topic guide exploring the COM-B model components and analysed using framework analysis. The questionnaire, based on the self-evaluation of behaviour questionnaire, was adapted using patient and public involvement and findings from the interviews. Questionnaire participants rated their agreement with 22 predefined statements related to COM-B model components. Mean, SD and 95% CI were calculated and each item categorised according to importance. Demographic data were collected. RESULTS The questionnaire identified that new mothers would be more active if they had more time, felt less tired, had accessible childcare, were part of a group, advised by a healthcare professional, able to develop a habit and had more motivation. Additional themes emerging from qualitative data were engaging in PA groups with other new mothers, limited physical stamina following complicated births, social interaction, enjoyment and parental beliefs as motivation, provision of child-friendly PA facilities and environments and babies' unpredictable routines. CONCLUSION The behavioural analysis presented in this paper identifies and adds detail on the range of factors influencing the target behaviour. Some are unique to the target population, requiring targeted interventions for postnatal women, whereas some are individualised, suggesting the need for individually tailored interventions. We will use the behavioural analysis presented to design an intervention using the subsequent steps in the BCW.
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Affiliation(s)
- Kate Ellis
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Sally Pears
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Sutton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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How do mobile health applications support behaviour changes? A scoping review of mobile health applications relating to physical activity and eating behaviours. Public Health 2019; 175:8-18. [PMID: 31374453 DOI: 10.1016/j.puhe.2019.06.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/03/2019] [Accepted: 06/19/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this review was to analyse how researchers conducting studies about mobile health applications (MHApps) effectiveness assess the conditions of this effectiveness. STUDY DESIGN A scoping review according to PRIMSA-ScR checklist. METHODS We conducted a scoping review of efficacy/effectiveness conditions in high internal validity studies assessing the efficacy of MHApps in changing physical activity behaviours and eating habits. We used the PubMed, Web of Science, SPORTDiscus and PsycINFO databases and processed the review according to the O'Malley and PRISMA-ScR recommendations. We selected studies with high internal validity methodologies (randomised controlled trials, quasi-experimental studies, systematic reviews and meta-analyses), dealing with dietary and/or physical activity behaviours; covering primary, secondary or tertiary prevention and dealing with behaviour change (uptake, maintenance). We excluded articles on MHApps relating to high-level sport and telemedicine. The process for selecting studies followed a set protocol with two authors who independently appraised the studies. RESULTS Twenty-two articles were finally selected and analysed. We noted that the mechanisms and techniques to support behaviour changes were poorly reported and studied. There was no explanation of how these MHApps work and how they could be transferred or not. Indeed, the main efficacy conditions reported by authors refer to practical aspects of the tools. Moreover, the issue of social inequalities was essentially reduced to access to the technology (the shrinking access divide), and literacy was poorly studied, even though it is an important consideration in digital prevention. All in all, even when they dealt with behaviours, the evaluations were tool-focused rather than intervention-focused and did not allow a comprehensive assessment of MHApps. CONCLUSION To understand the added value of MHApps in supporting behaviour changes, it seems important to draw on the paradigms relating to health technology assessment considering the characteristics of the technologies and on the evaluation of complex interventions considering the characteristics of prevention. This combined approach may help to clarify how these patient-focused MHApps work and is a condition for improved assessment of MHApps in terms of effectiveness, transferability and scalability.
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McDonald JL, Farnworth MJ, Clements J. Integrating Trap-Neuter-Return Campaigns Into a Social Framework: Developing Long-Term Positive Behavior Change Toward Unowned Cats in Urban Areas. Front Vet Sci 2018; 5:258. [PMID: 30406118 PMCID: PMC6207997 DOI: 10.3389/fvets.2018.00258] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/28/2018] [Indexed: 11/16/2022] Open
Abstract
Cat management is often discussed in terms of population reduction, with trap-neuter-return (TNR) campaigns commonly organized to manage unowned urban cat populations. However, long-term effectiveness is only possible if positive neutering practices are continued by local residents. Here we discuss how implementing TNR within a wider framework of social engagement has the potential to tackle cat overpopulation and instill long-term positive behavior change toward them. We demonstrate how community engagement pre-TNR can help establish a baseline of the attitudes, knowledge and behavior concerning cats. Using a case study, we explore whether this information can be linked with positive intended behavior based on intentions to arrange for neutering of unowned cats. Structural equation modeling indicated that negative attitudes toward cats and reduced knowledge around neutering reduced the likelihood of positive intended behavior. This result was underpinned by the indirect effects of perceptions of unowned cats and reduced understanding of their needs. Utilizing these results alongside an understanding of the values and motivation of the community allows for tailored and targeted education and intervention. In turn, this addresses the underlying knowledge gaps and perceptions regarding cat welfare. This framework can help address the challenge of cat management because it: (1) takes an integrative approach to identifying the motivations of communities to take responsibility for unowned cats; (2) changes the structure of the social environment, encouraging positive neutering practices for unowned cats. In turn this improves the impact and longevity of TNR campaigns whilst promoting positive welfare change for unowned and owned cats; and (3) appreciates that opinions are likely to vary hugely between areas, therefore providing an adaptable community level approach.
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Affiliation(s)
- Jennifer L McDonald
- Cats Protection, National Cat Centre, Haywards Heath, United Kingdom.,Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | - Mark J Farnworth
- Animal, Rural and Environmental Sciences, Nottingham Trent University, Southwell, United Kingdom
| | - Jane Clements
- Cats Protection, National Cat Centre, Haywards Heath, United Kingdom
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