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Derby L, Connell Bohlen L, Michie S, Johnston M, Birk JL, Rothman AJ, Cornelius T. Linking measures to mechanisms of action in behavior change: A qualitative analysis of expert views. Soc Sci Med 2024; 352:117023. [PMID: 38820694 DOI: 10.1016/j.socscimed.2024.117023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 05/18/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
RATIONALE Testing mechanisms of action (MoAs) hypothesized to underlie behavior change can enhance intervention effectiveness. Rigorous measurement of putative mechanisms is critical to this effort, but measures are rarely validated with respect to target MoAs. OBJECTIVE This study aimed to elucidate challenges of linking measures to putative MoAs and to identify priorities for future research. METHOD This study was a systematic exploration of written comments by experts in behavioral intervention research and theories of behavior change (N = 20) capturing their opinions about a task querying whether self-report measures from the Science Of Behavior Change (SOBC) Measures Repository were related to a set of MoAs identified by the Human Behaviour Change Project (HBCP). RESULTS Six themes were identified: 1) Study Value, 2) Measure Properties, 3) Mechanism Properties, 4) Miscellaneous Measure Concerns, 5) Conceptual Challenges, and 6) Approaches to Developing Measure-Mechanism Links. Experts noted challenges such as lack of measure validation, poor measure properties (e.g., double-barreled items), overly broad MoA definitions that limited their utility, lack of clarity around the term "related," and more. Nonetheless, experts expressed the importance of the exercise. Suggestions included developing and refining measures that are validate for assessing MoAs, clarifying and elaborating MoA definitions, and conducting further, more granular research. CONCLUSION This systematic examination of expert comments highlights issues that need further investigation to advance behavioral science, specifically pertaining to identifying valid measures of MoAs in behavioral and process research. This study highlights the challenges and opportunities for future research on linking measures and MoA in behavioral science and subsequently enhancing the efficacy of behavioral interventions.
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Affiliation(s)
- Lilly Derby
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Psychology, Rutgers University, New Brunswick, NJ, 08901, USA.
| | - Lauren Connell Bohlen
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Aberdeen Health Psychology Group, University of Aberdeen, Aberdeen, UK
| | - Jeffrey L Birk
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Talea Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, 10032, USA
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2
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Dague P, Muller L, Paulevé L, Irigoin-Guichandut M. Towards a qualitative theory of the interruption of eating behavior change. J Theor Biol 2024; 581:111731. [PMID: 38211891 DOI: 10.1016/j.jtbi.2024.111731] [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: 04/23/2023] [Revised: 12/18/2023] [Accepted: 01/06/2024] [Indexed: 01/13/2024]
Abstract
The poor maintenance of eating behavior change is one of the main obstacles to minimizing weight regain after weight loss during diets for non-surgical care of obese or overweight patients. We start with a known informal explanation of interruption in eating behavior change during severe restriction and formalize it as a causal network involving psychological variables, which we extend with energetic variables governed by principles of thermodynamics. The three core phenomena of dietary behavior change, i.e., non-initiation, initiation followed by discontinuation and initiation followed by non-discontinuation, are expressed in terms of the value of the key variable representing mood or psychological energy, the fluctuation of which is the result of three causal relationships. Based on our experimental knowledge of the time evolution profile of the three causal input variables, we then proceed to a qualitative analysis of the resulting theory, i.e., we consider an over-approximation of it which, after discretization, can be expressed in the form of a finite integer-based model. Using Answer Set Programming, we show that our formal model faithfully reproduces the three phenomena and, under a certain assumption, is minimal. We generalize this result by providing all the minimal models reproducing these phenomena when the possible causal relationships exerted on mood are extended to all the other variables (not just those assumed in the informal explanation), with arbitrary causality signs. Finally, by a direct analytical resolution of an under-approximation of our theory, obtained by assuming linear causalities, as a system of linear ODEs, we find exactly the same minimal models, proving that they are also equal to the actual minimal models of our theory since these are framed below and above by the models of the under-approximation and the over-approximation. We determine which parameters need to be person-specific and which can be considered invariant, i.e., we explain inter-individual variability. Our approach could pave the way for universally accepted theories in the field of behavior change and, more broadly, in other areas of psychology.
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Affiliation(s)
- Philippe Dague
- Université Paris-Saclay, CNRS, ENS Paris-Saclay, Laboratoire Méthodes Formelles, 4 avenue des Sciences, 91190, Gif-sur-Yvette, France.
| | - Laurent Muller
- Université de Lorraine, APEMAC, Ile du Saulcy, 57045, Metz, France.
| | - Loïc Paulevé
- Université de Bordeaux, CNRS, Bordeaux INP, LaBRI, 351 cours de la Libération, 33405, Talence, France.
| | - Marc Irigoin-Guichandut
- Assistance Publique Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 47-83 Bd de l'Hôpital, 75013, Paris, France.
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3
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Papies EK, Nielsen KS, Soares VA. Health psychology and climate change: time to address humanity's most existential crisis. Health Psychol Rev 2024:1-31. [PMID: 38320578 DOI: 10.1080/17437199.2024.2309242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024]
Abstract
Climate change is an ongoing and escalating health emergency. It threatens the health and wellbeing of billions of people, through extreme weather events, displacement, food insecurity, pathogenic diseases, societal destabilisation, and armed conflict. Climate change dwarfs all other challenges studied by health psychologists. The greenhouse gas emissions driving climate change disproportionately originate from the actions of wealthy populations in the Global North and are tied to excessive energy use and overconsumption driven by the pursuit of economic growth. Addressing this crisis requires significant societal transformations and individual behaviour change. Most of these changes will benefit not only the stability of the climate but will yield significant public health co-benefits. Because of their unique expertise and skills, health psychologists are urgently needed in crafting climate change mitigation responses. We propose specific ways in which health psychologists at all career stages can contribute, within the spheres of research, teaching, and policy making, and within organisations and as private citizens. As health psychologists, we cannot sit back and leave climate change to climate scientists. Climate change is a health emergency that results from human behaviour; hence it is in our power and responsibility to address it.
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Affiliation(s)
- Esther K Papies
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, United Kingdom
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4
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Wolitzky-Taylor K, Mooney LJ, Otto MW, Metts A, Parsons EM, Hanano M, Ram R. Augmenting the efficacy of benzodiazepine taper with telehealth-delivered cognitive behavioral therapy for anxiety disorders in patients using prescription opioids: A pilot randomized controlled trial. Contemp Clin Trials 2023; 133:107334. [PMID: 37730196 PMCID: PMC10960249 DOI: 10.1016/j.cct.2023.107334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/07/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023]
Abstract
The risks of concomitant benzodiazepine (BZ) and opioid use are significant. Despite the urgent need to reduce BZ use among patients taking opioids, no treatment intervention research to our knowledge has addressed treatment for this concurrent, high-risk use. The current study will evaluate the efficacy of augmenting BZ taper procedures with CBT for anxiety disorders that has been adapted specifically for patients with concomitant BZ and opioid use (either use as prescribed or misuse), a high-risk patient population. Research combining rapidly scalable behavioral interventions ancillary to pharmacological approaches delivered via telehealth in primary care settings is innovative and important given concerning trends in rising prevalence of BZ/opioid co-prescription, BZ-associated overdose deaths, and known barriers to implementation of behavioral health interventions in primary care. CBT delivery using telehealth has the potential to aid adherence and promote access and dissemination of procedures in primary care. Lastly, the current study will utilize an experimental therapeutics approach to preliminarily explore the mechanism of action for the proposed interventions. The overall aim of the present pilot randomized controlled trial is to examine the feasibility and preliminary efficacy of a BZ taper with CBT for anxiety disorders adapted for patients with concomitant BZ (BZT + CBT) and opioid use to a BZ taper with a control health education program (BZT + HE) in a sample of individuals (N = 54) who have been prescribed and are taking benzodiazepines and opioids for at least 3 months prior to baseline and experience anxious distress. Screening and outcome measures, methods, and implications are described. Trial Registration: ClinicalTrials.gov (NCT05573906).
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Affiliation(s)
| | - Larissa J Mooney
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, USA
| | - Michael W Otto
- Boston University, Department of Psychological and Brain Sciences, Boston, MA, USA
| | | | - E Marie Parsons
- Boston University, Department of Psychological and Brain Sciences, Boston, MA, USA
| | - Maria Hanano
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA
| | - Reuben Ram
- UCLA Toluca Lake Clinic, Los Angeles, CA, USA
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5
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Pelly M, Fatehi F, Liew D, Verdejo-Garcia A. Novel behaviour change frameworks for digital health interventions: A critical review. J Health Psychol 2023; 28:970-983. [PMID: 37051615 PMCID: PMC10466959 DOI: 10.1177/13591053231164499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Digital health interventions - interventions delivered over digital media to support the health of users - are becoming increasingly prevalent. Utilising an intervention development framework can increase the efficacy of digital interventions for health-related behaviours. This critical review aims to outline and review novel behaviour change frameworks that guide digital health intervention development. Our comprehensive search for preprints and publications used PubMed, PsycINFO, Scopus, Web of Science and the Open Science Framework repository. Articles were included if they: (1) were peer-reviewed; (2) proposed a behaviour change framework to guide digital health intervention development; (3) were written in English; (4) were published between 1/1/19 and 1/8/2021; and (5) were applicable to chronic diseases. Intervention development frameworks considered the user, intervention elements and theoretical foundations. However, the timing and policy of interventions are not consistently addressed across frameworks. Researchers should deeply consider the digital applicability of behaviour change frameworks to improve intervention success.
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Affiliation(s)
| | - Farhad Fatehi
- Monash University, Australia
- The University of Queensland, Australia
| | - Danny Liew
- Monash University, Australia
- The Alfred Hospital, Australia
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Cornelius T, Mendieta M, Cumella RM, Lopez Veneros D, Tincher IM, Agarwal S, Kronish I. Family-authored ICU diaries to reduce fear in patients experiencing a cardiac arrest (FAID fear): A pilot randomized controlled trial. PLoS One 2023; 18:e0288436. [PMID: 37498834 PMCID: PMC10373992 DOI: 10.1371/journal.pone.0288436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/22/2023] [Indexed: 07/29/2023] Open
Abstract
Survivors of cardiac arrest (CA) and their family members often experience significant fear-based distress (cardiac fear; i.e., fear about the CA survivor's heart). Fear-based distress after CA is associated with higher rates of cardiac event recurrence and mortality in CA survivors. As posited in Dyadic Disruption Theory (DDT), cardiac fear in family members may contribute to the development of distress in CA survivors via socially-based mechanisms. Thus, interventions to reduce family distress may improve CA survivors' outcomes. ICU diaries are easy to implement and scalable and show promise for reducing distress after CA but are primarily targeted towards survivors. The primary aim of the Family-Authored ICU Diaries to reduce Fear in Patients Experiencing a CA (FAID Fear) pilot randomized controlled trial was to test feasibility of an ICU diary intervention targeted towards family member distress alone. Family members of patients hospitalized after CA (N = 16) were randomized 2:1 to receive the FAID Fear intervention or usual care. Intervention participants were provided brief instructions and were asked to write in the diary twice per week until the end of hospital care. Assessments occurred at baseline enrollment, end of hospital care, and 30 days later. Participants' mean age was 50.73 years (SD = 13.41; 80% cis-gender female; 60% White). Recruitment (16/25 referred; 64.0%), retention (14/16 enrolled; 87.5%), and intervention adherence (7/10 completed; 70%) were promising. Most agreed that the ICU diary intervention was appropriate (7/10 completed; 70.0%), feasible (9/10 completed; 90.0%]), and acceptable (8/10 completed; 80.0%). Fear was nonsignificantly lower in intervention participants (v. control) at end of hospital care and 30 days later. FAID Fear represents a first step in building theory-based dyadic interventions that can be implemented to support family members of CA survivors in the ICU, with potential to improve outcomes in CA survivors.
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Affiliation(s)
- Talea Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Miguel Mendieta
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Robin M. Cumella
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, United States of America
| | - David Lopez Veneros
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, United States of America
- School of Nursing, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Isabella M. Tincher
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Sachin Agarwal
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Ian Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, United States of America
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Shaw KR, Salloum RG, Snyder PA. A translational model for early childhood intervention: developing, implementing, and scaling-up effective practices. Front Public Health 2023; 11:1198206. [PMID: 37483917 PMCID: PMC10361727 DOI: 10.3389/fpubh.2023.1198206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Early intervention (EI) researchers (i.e., those focused on children birth to age 3 and their families who experience early vulnerabilities) often engage in translational research and implementation science at the intersection of public health, pediatrics, and EI. There is currently a significant research-to-practice gap in EI despite ongoing efforts to close it. Translational research and implementation science are promising approaches to promote transdisciplinary collaborations among researchers and to move EI research into practice, thus supporting positive outcomes for young children and families. This commentary proposes a contemporary alignment of translational research phases for EI. Two literature reviews served to inform development of this alignment: (1) a narrative literature review identified existing applications of translational phases to EI; and (2) a rapid review identified examples of existing behavior-focused translational models across disciplines. Several case examples of current translational research being conducted in EI are discussed and classified according to their respective translational phase. The proposed alignment and case examples provide a basis for transdisciplinary conversations among those working across the various fields and disciplines relevant to EI research. A shift in EI research to reflect a translational and implementation focus will help bridge the research-to-practice gap and, most importantly, speed the movement of scientific evidence into real-world contexts to positively impact young children and families.
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Affiliation(s)
- Kallen R. Shaw
- School of Special Education, School Psychology, and Early Childhood Studies, College of Education, Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, Gainesville, FL, United States
| | - Ramzi G. Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Patricia A. Snyder
- School of Special Education, School Psychology, and Early Childhood Studies, College of Education, Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, Gainesville, FL, United States
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8
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Stoeckel LE, Hunter C, Onken L, Green P, Nielsen L, Aklin WM, Simmons JM. The NIH Science of Behavior Change Program: Looking Toward the Future. Behav Ther 2023; 54:714-718. [PMID: 37330260 PMCID: PMC10331559 DOI: 10.1016/j.beth.2023.03.006] [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] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
The National Institutes of Health established the Science of Behavior Change (SOBC) program to promote basic research on the initiation, personalization, and maintenance of health behavior change. The SOBC Resource and Coordinating Center now leads and supports activities to maximize the creativity, productivity, scientific rigor, and dissemination of the experimental medicine approach and experimental design resources. Here, we highlight those resources, including the Checklist for Investigating Mechanisms in Behavior-change Research (CLIMBR) guidelines introduced in this special section. We describe the ways in which SOBC can be applied across a range of domains and contexts, and end by considering ways to extend SOBC's perspective and reach, so as to best promote behavior change linked with health, quality of life, and well-being.
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Affiliation(s)
| | - Christine Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health
| | - Lisa Onken
- National Institute on Aging, National Institutes of Health
| | - Paige Green
- National Cancer Institute, National Institutes of Health
| | | | - Will M Aklin
- National Institute on Drug Abuse, National Institutes of Health
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9
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Cornelius T, Derby L, Connell Bohlen L, Birk JL, Rothman AJ, Johnston M, Michie S. Linking measures to mechanisms of action: An expert opinion study. Br J Health Psychol 2023; 28:98-115. [PMID: 35781731 PMCID: PMC9807686 DOI: 10.1111/bjhp.12614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study sought to integrate the NIH Science of Behaviour Change (SOBC) measures repository comprising measures of putative mechanisms with mechanisms of action (MoA) identified by the Human Behaviour-Change Project (HBCP). DESIGN Participants were 30 international experts recruited from professional networks and societies. In three anonymous virtual rounds, experts established consensus on hypothesized links between 26 MoAs and 44 self-report measures. METHODS In Round 1, experts completed a survey rating agreement with 84 pre-identified measure-MoA links and suggested new links. In Round 2, experts discussed 10 links in an online forum, including pre-identified links with <50% agreement and new links suggested by 20-50% of experts. In Round 3, experts completed a survey rating all links eligible for discussion in Round 2. RESULTS Twenty-seven experts completed Round 1, 23 completed Round 2 and 18 completed Round 3. In Round 1, 82 of 84 pre-identified links reached >50% agreement and 14 new links were suggested by >50% of experts. In Round 2, experts discussed measure-MoA links and measurement quality. In Round 3, 71 of 96 links reached ≥50% agreement. A total of 167 links reached >50% expert agreement, 33 of which reached ≥90% agreement. CONCLUSION By identifying putative mechanisms (HBCP) for the 44 self-report measures (SOBC), this study advances the cumulation of scientific results and interoperability of resources to facilitate process research.
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Affiliation(s)
- Talea Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Lilly Derby
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Lauren Connell Bohlen
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Jeffrey L Birk
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marie Johnston
- Aberdeen Health Psychology Group, University of Aberdeen, Aberdeen, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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10
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Farquharson B, Johnston M, Williams B, Smith K, Dombrowski S, Jones C, Treweek S, Dougall N, Grindle M, Savinc J, Abyhankar P. Reducing patient delay in acute coronary syndrome: Randomized controlled trial testing effect of behaviour change intervention on intentions to seek help. Br J Health Psychol 2023; 28:188-207. [PMID: 35942523 PMCID: PMC10086951 DOI: 10.1111/bjhp.12619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the efficacy of a behaviour change intervention to reduce patient delay with symptoms of acute coronary syndrome. DESIGN A 3-arm web-based, parallel randomized controlled trial. METHODS The intervention comprised 12 behaviour change techniques (BCTs) embedded in a text-only or text+visual narrative (the techniques were systematically identified through systematic review and a consensus exercise). Between February and November 2017, n = 145 people who had recently experienced acute coronary syndrome were randomly allocated to intervention ('text+visual' or 'text-only') or control. Intentions to phone an ambulance immediately for acute coronary syndrome symptoms were assessed before and after the intervention using symptom scenarios, and the change in intention was compared across the three groups. RESULTS Significant increases in intention to phone an ambulance immediately for ACS symptoms were seen following the 'text+visual' intervention but not following 'text-only' or control. However, the study was underpowered to detect any significant changes in intention between the 3 groups. There were no unintended effects on intentions for non-urgent symptoms. CONCLUSIONS A 'text+visual' BCT-based intervention may significantly increase intention to phone an ambulance with symptoms of ACS. Further testing of the effect of the intervention on actual behaviour is required.
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Magness CS, Stern K, Burnside A, Masterson D, Finkelstein S, Kramer A, Smith PK, Foster CJE. Changes in Gatekeeper Beliefs Following ASIST and Relation to Subsequent Gatekeeper Suicide Prevention Behaviors. Community Ment Health J 2023; 59:1013-1020. [PMID: 36607521 DOI: 10.1007/s10597-022-01084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/22/2022] [Indexed: 01/07/2023]
Abstract
This study examines relations between suicide prevention gatekeeper beliefs and actual helping behaviors following participation in Applied Suicide Intervention Skills Training (ASIST). Participants (n = 434) completed measures examining suicide-related beliefs and behaviors using a naturalistic pre-post design. All beliefs demonstrated significant change from pre- to posttest. Regression analyses indicate that beliefs about perceived barriers to action and the controllability of suicide predicted identification of high-risk youth; perceived barriers to action were also negatively related to helping responses and referrals 6-9 months post training. Self-efficacy was not related to suicide prevention behaviors at follow-up. The importance of anchoring training curriculums and measurement to health behavior change theories is discussed.
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Affiliation(s)
- Christina S Magness
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA.
| | - Karlin Stern
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Amanda Burnside
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Devyn Masterson
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Seth Finkelstein
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Anne Kramer
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
| | - Patricia K Smith
- Injury & Violence Prevention Section, Michigan Department of Health and Human Services, PO Box 30195, Lansing, MI, 48909, USA
| | - Cynthia J Ewell Foster
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48105, USA
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Scherer EA, Metcalf SA, Whicker CL, Bartels SM, Grabinski M, Kim SJ, Sweeney MA, Lemley SM, Lavoie H, Xie H, Bissett PG, Dallery J, Kiernan M, Lowe MR, Onken L, Prochaska JJ, Stoeckel LE, Poldrack RA, MacKinnon DP, Marsch LA. Momentary Influences on Self-Regulation in Two Populations With Health Risk Behaviors: Adults Who Smoke and Adults Who Are Overweight and Have Binge-Eating Disorder. Front Digit Health 2022; 4:798895. [PMID: 35373179 PMCID: PMC8971561 DOI: 10.3389/fdgth.2022.798895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/22/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Self-regulation has been implicated in health risk behaviors and is a target of many health behavior interventions. Despite most prior research focusing on self-regulation as an individual-level trait, we hypothesize that self-regulation is a time-varying mechanism of health and risk behavior that may be influenced by momentary contexts to a substantial degree. Because most health behaviors (e.g., eating, drinking, smoking) occur in the context of everyday activities, digital technologies may help us better understand and influence these behaviors in real time. Using a momentary self-regulation measure, the current study (which was part of a larger multi-year research project on the science of behavior change) used ecological momentary assessment (EMA) to assess if self-regulation can be engaged and manipulated on a momentary basis in naturalistic, non-laboratory settings. Methods This one-arm, open-label exploratory study prospectively collected momentary data for 14 days from 104 participants who smoked regularly and 81 participants who were overweight and had binge-eating disorder. Four times per day, participants were queried about momentary self-regulation, emotional state, and social and environmental context; recent smoking and exposure to smoking cues (smoking sample only); and recent eating, binge eating, and exposure to binge-eating cues (binge-eating sample only). This study used a novel, momentary self-regulation measure comprised of four subscales: momentary perseverance, momentary sensation seeking, momentary self-judgment, and momentary mindfulness. Participants were also instructed to engage with Laddr, a mobile application that provides evidence-based health behavior change tools via an integrated platform. The association between momentary context and momentary self-regulation was explored via mixed-effects models. Exploratory assessments of whether recent Laddr use (defined as use within 12 h of momentary responses) modified the association between momentary context and momentary self-regulation were performed via mixed-effects models. Results Participants (mean age 35.2; 78% female) in the smoking and binge-eating samples contributed a total of 3,233 and 3,481 momentary questionnaires, respectively. Momentary self-regulation subscales were associated with several momentary contexts, in the combined as well as smoking and binge-eating samples. For example, in the combined sample momentary perseverance was associated with location, positively associated with positive affect, and negatively associated with negative affect, stress, and tiredness. In the smoking sample, momentary perseverance was positively associated with momentary difficulty in accessing cigarettes, caffeine intake, and momentary restraint in smoking, and negatively associated with temptation and urge to smoke. In the binge-eating sample, momentary perseverance was positively associated with difficulty in accessing food and restraint in eating, and negatively associated with urge to binge eat. While recent Laddr use was not associated directly with momentary self-regulation subscales, it did modify several of the contextual associations, including challenging contexts. Conclusions Overall, this study provides preliminary evidence that momentary self-regulation may vary in response to differing momentary contexts in samples from two exemplar populations with risk behaviors. In addition, the Laddr application may modify some of these relationships. These findings demonstrate the possibility of measuring momentary self-regulation in a trans-diagnostic way and assessing the effects of momentary, mobile interventions in context. Health behavior change interventions may consider measuring and targeting momentary self-regulation in addition to trait-level self-regulation to better understand and improve health risk behaviors. This work will be used to inform a later stage of research focused on assessing the transdiagnostic mediating effect of momentary self-regulation on medical regimen adherence and health outcomes. Clinical Trial Registration ClinicalTrials.gov, Identifier: NCT03352713.
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Affiliation(s)
- Emily A Scherer
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Stephen A Metcalf
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States.,Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Cady L Whicker
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Sophia M Bartels
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Michael Grabinski
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Sunny Jung Kim
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.,Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Mary Ann Sweeney
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Shea M Lemley
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Hannah Lavoie
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States.,Department of Health Education and Behavior, University of Florida, Gainesville, FL, United States
| | - Haiyi Xie
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
| | - Patrick G Bissett
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Jesse Dallery
- Department of Psychology, University of Florida, Gainesville, FL, United States
| | - Michaela Kiernan
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Michael R Lowe
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Lisa Onken
- National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Luke E Stoeckel
- National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Russell A Poldrack
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - David P MacKinnon
- Department of Psychology, Arizona State University, Tempe, AZ, United States
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, United States
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Cullen L, Hanrahan K, Edmonds SW, Reisinger HS, Wagner M. Iowa Implementation for Sustainability Framework. Implement Sci 2022; 17:1. [PMID: 34983585 PMCID: PMC8725573 DOI: 10.1186/s13012-021-01157-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background An application-oriented implementation framework designed for clinicians and based on the Diffusion of Innovations theory included 81 implementation strategies with suggested timing for use within four implementation phases. The purpose of this research was to evaluate and strengthen the framework for clinician use and propose its usefulness in implementation research. Methods A multi-step, iterative approach guided framework revisions. Individuals requesting the use of the framework over the previous 7 years were sent an electronic questionnaire. Evaluation captured framework usability, generalizability, accuracy, and implementation phases for each strategy. Next, nurse leaders who use the framework pile sorted strategies for cultural domain analysis. Last, a panel of five EBP/implementation experts used these data and built consensus to strengthen the framework. Results Participants (n = 127/1578; 8% response) were predominately nurses (94%), highly educated (94% Master’s or higher), and from across healthcare (52% hospital/system, 31% academia, and 7% community) in the USA (84%). Most (96%) reported at least some experience using the framework and 88% would use the framework again. A 4-point scale (1 = not/disagree to 4 = very/agree) was used. The framework was deemed useful (92%, rating 3–4), easy to use (72%), intuitive (67%), generalizable (100%), flexible and adaptive (100%), with accurate phases (96%), and accurate targets (100%). Participants (n = 51) identified implementation strategy timing within four phases (Cochran’s Q); 54 of 81 strategies (66.7%, p < 0.05) were significantly linked to a specific phase; of these, 30 (55.6%) matched the original framework. Next, nurse leaders (n = 23) completed a pile sorting activity. Anthropac software was used to analyze the data and visualize it as a domain map and hierarchical clusters with 10 domains. Lastly, experts used these data and implementation science to refine and specify each of the 75 strategies, identifying phase, domain, actors, and function. Strategy usability, timing, and groupings were used to refine the framework. Conclusion The Iowa Implementation for Sustainability Framework offers a typology to guide implementation for evidence-based healthcare. This study specifies 75 implementation strategies within four phases and 10 domains and begins to validate the framework. Standard use of strategy names is foundational to compare and understand when implementation strategies are effective, in what dose, for which topics, by whom, and in what context. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-021-01157-5.
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Affiliation(s)
- Laura Cullen
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
| | - Kirsten Hanrahan
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, 200 Hawkins Dr., Iowa City, IA, 52242, USA
| | - Stephanie W Edmonds
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, 200 Hawkins Dr., Iowa City, IA, 52242, USA
| | - Heather Schacht Reisinger
- Department of Internal Medicine, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.,Institute for Clinical and Translational Science, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA
| | - Michele Wagner
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, 200 Hawkins Dr., Iowa City, IA, 52242, USA
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El Ouazzani H, Fortin S, Venisse N, Dupuis A, Rouillon S, Cambien G, Gourgues AS, Pierre-Eugène P, Rabouan S, Migeot V, Albouy-Llaty M. Perinatal Environmental Health Education Intervention to Reduce Exposure to Endocrine Disruptors: The PREVED Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010070. [PMID: 35010328 PMCID: PMC8750995 DOI: 10.3390/ijerph19010070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 05/21/2023]
Abstract
Environmental health promotion interventions may reduce endocrine disruptor (ED) exposure. The PREVED (PREgnancy, preVention, Endocrine Disruptors) project was developed to improve knowledge, to enhance risk perception, and to change exposure behavior. Our objective was to present the phases of the PREVED project using the RE-AIM method. PREVED intervention consisted of three workshops during pregnancy. Reach, adoption, and implementation phases were assessed with qualitative studies. Efficacy study consisted of a three-arm randomized controlled trial (RCT) on 268 pregnant women: (i) control group (leaflet), (ii) intervention group in neutral location, (iii) intervention group in contextualized location. The main outcome was the percentage evolution of participants who reported consuming canned food. Secondary outcomes were evolution of psycho-social scores, evolution of ED presence in urine, and ED presence in colostrum. The intervention adoption was centered on upper-privileged women, but implementation assessment showed that key features (highly practical intervention) seemed to be carried out and had initiated some behavior changes. A total of 268 pregnant women participated in the intervention and 230 in a randomized controlled trial (control group: 86 and intervention groups: 172). We found no significant differences in consumption of canned food and in percentage of women having a decrease of bisphenol A or parabens in urine, but we found a significant increase in the evolution of risk perception score and overall psychosocial score in intervention groups (respectively: +15.73 control versus +21.03 intervention, p = 0.003 and +12.39 versus +16.20, p = 0.02). We found a significant difference in percentage of women with butylparaben detection between control group and intervention groups (13% versus 3%, p = 0.03). PREVED intervention is the first intervention research dedicated to perinatal environmental health education in France. By sharing know-how/experience in a positive non-alarmist approach, it improved risk perception, which is key to behavior change, aiming to reduce perinatal ED exposure. Including women in precarious situations remains a major issue.
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Affiliation(s)
- Houria El Ouazzani
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- Faculty of Medicine and Pharmacy, University of Poitiers, 6 Rue de la Milétrie, 86031 Poitiers, France
- BioSPharm Pole, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France;
| | - Simon Fortin
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
| | - Nicolas Venisse
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- BioSPharm Pole, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France;
- Ecology and Biology of Interaction, CNRS UMR 7267, 86073 Poitiers, France
| | - Antoine Dupuis
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- Faculty of Medicine and Pharmacy, University of Poitiers, 6 Rue de la Milétrie, 86031 Poitiers, France
- BioSPharm Pole, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France;
- Ecology and Biology of Interaction, CNRS UMR 7267, 86073 Poitiers, France
| | - Steeve Rouillon
- APHP Laboratory of Pharmacology, GH Henri Mondor, 94010 Creteil, France;
| | - Guillaume Cambien
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- Faculty of Medicine and Pharmacy, University of Poitiers, 6 Rue de la Milétrie, 86031 Poitiers, France
- Ecology and Biology of Interaction, CNRS UMR 7267, 86073 Poitiers, France
| | - Anne-Sophie Gourgues
- BioSPharm Pole, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France;
| | - Pascale Pierre-Eugène
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- Faculty of Medicine and Pharmacy, University of Poitiers, 6 Rue de la Milétrie, 86031 Poitiers, France
- Ecology and Biology of Interaction, CNRS UMR 7267, 86073 Poitiers, France
| | - Sylvie Rabouan
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- Faculty of Medicine and Pharmacy, University of Poitiers, 6 Rue de la Milétrie, 86031 Poitiers, France
- Ecology and Biology of Interaction, CNRS UMR 7267, 86073 Poitiers, France
| | - Virginie Migeot
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- Faculty of Medicine and Pharmacy, University of Poitiers, 6 Rue de la Milétrie, 86031 Poitiers, France
- BioSPharm Pole, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France;
| | - Marion Albouy-Llaty
- Center of Clinical Investigation Inserm 1402, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France; (H.E.O.); (S.F.); (N.V.); (A.D.); (G.C.); (P.P.-E.); (S.R.); (V.M.)
- Faculty of Medicine and Pharmacy, University of Poitiers, 6 Rue de la Milétrie, 86031 Poitiers, France
- BioSPharm Pole, University Hospital of Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, France;
- Ecology and Biology of Interaction, CNRS UMR 7267, 86073 Poitiers, France
- Correspondence:
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Fitzgerald HE, Hoyt DL, Kredlow MA, Smits JAJ, Schmidt NB, Edmondson D, Otto MW. Anxiety Sensitivity as a Malleable Mechanistic Target for Prevention Interventions: A Meta-Analysis of the Efficacy of Brief Treatment Interventions. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2021; 28:323-337. [PMID: 35300171 PMCID: PMC8923531 DOI: 10.1037/cps0000038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Anxiety sensitivity (AS) is a transdiagnostic risk factor and potential treatment target for prevention of associated psychopathology and negative health behaviors. We conducted a meta-analysis evaluating the efficacy of brief interventions in at-risk samples for reducing AS and associated clinical/behavioral outcomes (e.g., depression, alcohol use) across 28 studies (1,998 participants). AS targeted interventions, compared to control conditions, evidenced a significant moderate effect size for alleviating AS from pre- to post-treatment (d = 0.54) and approached a large effect size from pre-treatment to short-term follow-up (d = 0.78). The effect size for long-term follow-up did not reach significance (d = 0.29). For clinical/behavioral outcomes, AS interventions demonstrated significant small-to-moderate effect sizes for the three timepoints examined (d's = 0.20-0.41). Our findings help validate AS as a modifiable mechanistic target for prevention efforts.
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Affiliation(s)
- Hayley E Fitzgerald
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
| | - Danielle L Hoyt
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
| | - M Alexandra Kredlow
- Department of Psychology, Harvard University, 52 Oxford Street, Cambridge, MA 02140
| | - Jasper A J Smits
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, 305 E. 23 St., Austin, TX 78712
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306
| | | | - Michael W Otto
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
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16
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Marteau TM, Fletcher PC, Munafò MR, Hollands GJ. Beyond choice architecture: advancing the science of changing behaviour at scale. BMC Public Health 2021; 21:1531. [PMID: 34376159 PMCID: PMC8356415 DOI: 10.1186/s12889-021-11382-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 06/25/2021] [Indexed: 11/10/2022] Open
Abstract
Addressing the global threats to population and planetary health requires changing many behaviours at scale. This demands consideration not only of the effect size of an intervention but also its reach - the proportion of the population exposed to the intervention.We propose that a relatively under-researched and generally poorly specified set of interventions involving changes to physical micro-environments - often referred to as Choice Architecture - has the potential to make a significant contribution to meeting this urgent challenge.Realising the potential of Choice Architecture interventions requires integration of basic - i.e. laboratory-based - and applied - i.e. field-based - research, generating interventions that can be delivered at scale alongside advancing theory. We illustrate this with examples to highlight the complementarity of laboratory and field studies informed by and in turn updating the results of evidence synthesis. The examples comprise two sets of interventions - changing the relative availability of products and changing their size - to reduce consumption of meat, energy from food and alcohol across populations.
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Affiliation(s)
- Theresa M Marteau
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marcus R Munafò
- University of Bristol, School of Psychological Science, Bristol, UK
| | - Gareth J Hollands
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Murray DM, Ganoza LF, Vargas AJ, Ellis EM, Oyedele NK, Schully SD, Liggins CA. New NIH Primary and Secondary Prevention Research During 2012-2019. Am J Prev Med 2021; 60:e261-e268. [PMID: 33745818 DOI: 10.1016/j.amepre.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This manuscript characterizes primary and secondary prevention research in humans and related methods research funded by NIH in 2012‒2019. METHODS The NIH Office of Disease Prevention updated its prevention research taxonomy in 2019‒2020 and applied it to a sample of 14,523 new extramural projects awarded in 2012-2019. All projects were coded manually for rationale, exposures, outcomes, population focus, study design, and type of prevention research. All results are based on that manual coding. RESULTS Taxonomy updates resulted in a slight increase, from an average of 16.7% to 17.6%, in the proportion of prevention research awards for 2012‒2017; there was a further increase to 20.7% in 2019. Most of the leading risk factors for death and disability in the U.S. were observed as an exposure or outcome in <5% of prevention research projects in 2019 (e.g., diet, 3.7%; tobacco, 3.9%; blood pressure, 2.8%; obesity, 4.4%). Analysis of existing data became more common (from 36% to 46.5%), whereas randomized interventions became less common (from 20.5% to 12.3%). Randomized interventions addressing a leading risk factor in a minority health or health disparities population were uncommon. CONCLUSIONS The number of new NIH awards classified as prevention research increased to 20.7% in 2019. New projects continued to focus on observational studies and secondary data analysis in 2018 and 2019. Additional research is needed to develop and test new interventions or develop methods for the dissemination of existing interventions, which address the leading risk factors, particularly in minority health and health disparities populations.
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Affiliation(s)
- David M Murray
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland.
| | - Luis F Ganoza
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Ashley J Vargas
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Erin M Ellis
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Natasha K Oyedele
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Sheri D Schully
- All of Us Research Program, Office of the Director, NIH, Bethesda, Maryland
| | - Charlene A Liggins
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
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Norris E, Hastings J, Marques MM, Mutlu ANF, Zink S, Michie S. Why and how to engage expert stakeholders in ontology development: insights from social and behavioural sciences. J Biomed Semantics 2021; 12:4. [PMID: 33757593 PMCID: PMC7985588 DOI: 10.1186/s13326-021-00240-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Incorporating the feedback of expert stakeholders in ontology development is important to ensure content is appropriate, comprehensive, meets community needs and is interoperable with other ontologies and classification systems. However, domain experts are often not formally engaged in ontology development, and there is little available guidance on how this involvement should best be conducted and managed. Social and behavioural science studies often involve expert feedback in the development of tools and classification systems but have had little engagement with ontology development. This paper aims to (i) demonstrate how expert feedback can enhance ontology development, and (ii) provide practical recommendations on how to conduct expert feedback in ontology development using methodologies from the social and behavioural sciences. MAIN BODY Considerations for selecting methods for engaging stakeholders are presented. Mailing lists and issue trackers as existing methods used frequently in ontology development are discussed. Advisory boards and working groups, feedback tasks, consensus exercises, discussions and workshops are presented as potential methods from social and behavioural sciences to incorporate in ontology development. CONCLUSIONS A variety of methods from the social and behavioural sciences exist to enable feedback from expert stakeholders in ontology development. Engaging domain experts in ontology development enables depth and clarity in ontology development, whilst also establishing advocates for an ontology upon its completion.
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Affiliation(s)
- Emma Norris
- Health Behaviour Change Research Group, Department of Health Sciences, Brunel University, Uxbridge, UK.
- Centre for Behaviour Change, University College London, London, UK.
| | - Janna Hastings
- Centre for Behaviour Change, University College London, London, UK
| | - Marta M Marques
- Centre for Behaviour Change, University College London, London, UK
- ADAPT SFI Research Centre & Trinity Centre for Practice and Healthcare Innovation, Trinity College, Dublin, Ireland
| | | | - Silje Zink
- Centre for Behaviour Change, University College London, London, UK
- Norwegian National Advisory Unit on Rehabiliation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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Efficacy of Nalbuphine as an Adjuvant to Ropivacaine in Ultrasound-guided Supraclavicular Brachial Block. Clin J Pain 2020; 37:158-159. [DOI: 10.1097/ajp.0000000000000899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Scioli ER, Smith BN, Whitworth JW, Spiro A, Esterman M, Dutra S, Bogdan KM, Eld A, Rasmusson AM. Moderated mediation for exercise maintenance in pain and posttraumatic stress disorder: A randomized trial. Health Psychol 2020; 39:826-840. [PMID: 32833484 PMCID: PMC8559731 DOI: 10.1037/hea0000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study utilizes the Science of Behavior Change (SOBC) experimental medicine approach to evaluate the effects of a 3-month, individually prescribed progressive exercise training program on neurobiological, cognitive and motivational mechanisms by which our exercise-training paradigm may foster exercise maintenance. We will investigate hypothesized relationships between exercise-training associated augmentation of neuropeptide Y (NPY) system function and improvements in self-regulation and reward sensitivity-cognitive control and motivational processes posited to promote self-efficacy and intrinsic motivation, which have been shown to predict exercise maintenance. This study will recruit Veterans with chronic low back pain and posttraumatic stress disorder (PTSD). Procedures include a baseline, acute cardiopulmonary exercise challenge assessment that will inform the exercise prescription for a 12-week progressive exercise training program comprised of three 45-minute aerobic exercise sessions per week-all of which will be supervised by an exercise physiologist. Additionally, a week-7 and week-14 exercise challenge assessment will track changes in NPY system function and the variables of interest. We hypothesize that increases in the capacity to release NPY in response to acute exercise testing will be associated with improvements in self-regulation and reward sensitivity, which will in turn be associated with self-efficacy and intrinsic motivation to maintain regular exercise. Ninety participants will be randomized either to the "active exercise training condition" or to the "wait list symptom monitoring condition". The study aims to demonstrate the feasibility of procedures and elucidate mechanisms relevant to developing individually prescribed, motivationally based exercise regimens to reduce negative consequences of PTSD and low back pain over the long-term. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Erica R Scioli
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | - Brian N Smith
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | | | - Avron Spiro
- Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC) VA Boston Healthcare System
| | | | - Sunny Dutra
- Clinical Psychology Department, William James College
| | - Kristina M Bogdan
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | - Alex Eld
- Affiliate of Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | - Ann M Rasmusson
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
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21
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Davidson KW, Scholz U. Understanding and predicting health behaviour change: a contemporary view through the lenses of meta-reviews. Health Psychol Rev 2020; 14:1-5. [PMID: 31957549 PMCID: PMC7068962 DOI: 10.1080/17437199.2020.1719368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/18/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Karina W Davidson
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, USA
| | - Urte Scholz
- Applied Social and Health Psychology, University of Zurich, Zurich, Switzerland
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22
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Hunter RF, Montes F, Murray JM, Sanchez-Franco SC, Montgomery SC, Jaramillo J, Tate C, Kumar R, Dunne L, Ramalingam A, Kimbrough EO, Krupka E, Zhou H, Moore L, Bauld L, Llorente B, Sarmiento OL, Kee F. MECHANISMS Study: Using Game Theory to Assess the Effects of Social Norms and Social Networks on Adolescent Smoking in Schools-Study Protocol. Front Public Health 2020; 8:377. [PMID: 32850598 PMCID: PMC7417659 DOI: 10.3389/fpubh.2020.00377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022] Open
Abstract
This proof of concept study harnesses novel transdisciplinary insights to contrast two school-based smoking prevention interventions among adolescents in the UK and Colombia. We compare schools in these locations because smoking rates and norms are different, in order to better understand social norms based mechanisms of action related to smoking. We aim to: (1) improve the measurement of social norms for smoking behaviors in adolescents and reveal how they spread in schools; (2) to better characterize the mechanisms of action of smoking prevention interventions in schools, learning lessons for future intervention research. The A Stop Smoking in Schools Trial (ASSIST) intervention harnesses peer influence, while the Dead Cool intervention uses classroom pedagogy. Both interventions were originally developed in the UK but culturally adapted for a Colombian setting. In a before and after design, we will obtain psychosocial, friendship, and behavioral data (e.g., attitudes and intentions toward smoking and vaping) from ~300 students in three schools for each intervention in the UK and the same number in Colombia (i.e., ~1,200 participants in total). Pre-intervention, participants take part in a Rule Following task, and in Coordination Games that allow us to assess their judgments about the social appropriateness of a range of smoking-related and unrelated behaviors, and elicit individual sensitivity to social norms. After the interventions, these behavioral economic experiments are repeated, so we can assess how social norms related to smoking have changed, how sensitivity to classroom and school year group norms have changed and how individual changes are related to changes among friends. This Game Theoretic approach allows us to estimate proxies for norms and norm sensitivity parameters and to test for the influence of individual student attributes and their social networks within a Markov Chain Monte Carlo modeling framework. We identify hypothesized mechanisms by triangulating results with qualitative data from participants. The MECHANISMS study is innovative in the interplay of Game Theory and longitudinal social network analytical approaches, and in its transdisciplinary research approach. This study will help us to better understand the mechanisms of smoking prevention interventions in high and middle income settings.
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Affiliation(s)
- Ruth F. Hunter
- Centre for Public Health, Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
- *Correspondence: Ruth F. Hunter
| | - Felipe Montes
- Department of Industrial Engineering, Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
| | - Jennifer M. Murray
- Centre for Public Health, Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | | | - Shannon C. Montgomery
- Centre for Public Health, Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Joaquín Jaramillo
- Department of Public Health, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Christopher Tate
- Centre for Public Health, Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Rajnish Kumar
- Queen's Management School, Queen's University Belfast, Belfast, United Kingdom
| | - Laura Dunne
- Centre for Evidence and Social Innovation, School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, United Kingdom
| | - Abhijit Ramalingam
- Department of Economics, Appalachian State University, Boone, NC, United States
| | - Erik O. Kimbrough
- The George L. Argyros School of Business and Economics, Smith Institute for Political Economy and Philosophy, Chapman University, Orange, CA, United States
| | - Erin Krupka
- Behavioral and Experimental Economics Laboratory, School of Information, University of Michigan, Ann Abhor, MI, United States
| | - Huiyu Zhou
- School of Informatics, University of Leicester, Leicester, United Kingdom
| | - Laurence Moore
- MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Linda Bauld
- The Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Olga L. Sarmiento
- Department of Public Health, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Frank Kee
- Centre for Public Health, Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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Hollands GJ, Naughton F, Farley A, Lindson N, Aveyard P. Interventions to increase adherence to medications for tobacco dependence. Cochrane Database Syst Rev 2019; 8:CD009164. [PMID: 31425618 PMCID: PMC6699660 DOI: 10.1002/14651858.cd009164.pub3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Pharmacological treatments for tobacco dependence, such as nicotine replacement therapy (NRT), have been shown to be safe and effective interventions for smoking cessation. Higher levels of adherence to these medications increase the likelihood of sustained smoking cessation, but many smokers use them at a lower dose and for less time than is optimal. It is important to determine the effectiveness of interventions designed specifically to increase medication adherence. Such interventions may address motivation to use medication, such as influencing beliefs about the value of taking medications, or provide support to overcome problems with maintaining adherence. OBJECTIVES To assess the effectiveness of interventions aiming to increase adherence to medications for smoking cessation on medication adherence and smoking abstinence compared with a control group typically receiving standard care. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register, and clinical trial registries (ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform) to the 3 September 2018. We also conducted forward and backward citation searches. SELECTION CRITERIA Randomised, cluster-randomised or quasi-randomised studies in which adults using active pharmacological treatment for smoking cessation were allocated to an intervention arm where there was a principal focus on increasing adherence to medications for tobacco dependence, or a control arm providing standard care. Dependent on setting, standard care may have comprised minimal support or varying degrees of behavioural support. Included studies used a measure that allowed assessment of the degree of medication adherence. DATA COLLECTION AND ANALYSIS Two authors independently screened studies for eligibility, extracted data for included studies and assessed risk of bias. For continuous outcome measures, we calculated effect sizes as standardised mean differences (SMDs). For dichotomous outcome measures, we calculated effect sizes as risk ratios (RRs). In meta-analyses for adherence outcomes, we combined dichotomous and continuous data using the generic inverse variance method and reported pooled effect sizes as SMDs; for abstinence outcomes, we reported and pooled dichotomous outcomes. We obtained pooled effect sizes with 95% confidence intervals (CIs) using random-effects models. We conducted subgroup analyses to assess whether the primary focus of the adherence treatment ('practicalities' versus 'perceptions' versus both), the delivery approach (participant versus clinician-centred) or the medication type were associated with effectiveness. MAIN RESULTS We identified two new studies, giving a total of 10 studies, involving 3655 participants. The medication adherence interventions studied were all provided in addition to standard behavioural support.They typically provided further information on the rationale for, and emphasised the importance of, adherence to medication or supported the development of strategies to overcome problems with maintaining adherence (or both). Seven studies targeted adherence to NRT, two to bupropion and one to varenicline. Most studies were judged to be at high or unclear risk of bias, with four of these studies judged at high risk of attrition or detection bias. Only one study was judged to be at low risk of bias.Meta-analysis of all 10 included studies (12 comparisons) provided moderate-certainty evidence that adherence interventions led to small improvements in adherence (i.e. the mean amount of medication consumed; SMD 0.10, 95% CI 0.03 to 0.18; I² = 6%; n = 3655), limited by risk of bias. Subgroup analyses for the primary outcome identified no significant subgroup effects, with effect sizes for subgroups imprecisely estimated. However, there was a very weak indication that interventions focused on the 'practicalities' of adhering to treatment (i.e. capabilities, resources, levels of support or skills) may be effective (SMD 0.21, 95% CI 0.03 to 0.38; I² = 39%; n = 1752), whereas interventions focused on treatment 'perceptions' (i.e. beliefs, cognitions, concerns and preferences; SMD 0.10, 95% CI -0.03 to 0.24; I² = 0%; n = 839) or on both (SMD 0.04, 95% CI -0.08 to 0.16; I² = 0%; n = 1064), may not be effective. Participant-centred interventions may be effective (SMD 0.12, 95% CI 0.02 to 0.23; I² = 20%; n = 2791), whereas those that are clinician-centred may not (SMD 0.09, 95% CI -0.05 to 0.23; I² = 0%; n = 864).Five studies assessed short-term smoking abstinence (five comparisons), while an overlapping set of five studies (seven comparisons) assessed long-term smoking abstinence of six months or more. Meta-analyses resulted in low-certainty evidence that adherence interventions may slightly increase short-term smoking cessation rates (RR 1.08, 95% CI 0.96 to 1.21; I² = 0%; n = 1795) and long-term smoking cessation rates (RR 1.16, 95% CI 0.96 to 1.40; I² = 48%; n = 3593). In both cases, the evidence was limited by risk of bias and imprecision, with CIs encompassing minimal harm as well as moderate benefit, and a high likelihood that further evidence will change the estimate of the effect. There was no evidence that interventions to increase adherence to medication led to any adverse events. Studies did not report on factors plausibly associated with increases in adherence, such as self-efficacy, understanding of and attitudes toward treatment, and motivation and intentions to quit. AUTHORS' CONCLUSIONS In people who are stopping smoking and receiving behavioural support, there is moderate-certainty evidence that enhanced behavioural support focusing on adherence to smoking cessation medications can modestly improve adherence. There is only low-certainty evidence that this may slightly improve the likelihood of cessation in the shorter or longer-term. Interventions to increase adherence can aim to address the practicalities of taking medication, change perceptions about medication, such as reasons to take it or concerns about doing so, or both. However, there is currently insufficient evidence to confirm which approach is more effective. There is no evidence on whether such interventions are effective for people who are stopping smoking without standard behavioural support.
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Affiliation(s)
- Gareth J Hollands
- University of CambridgeBehaviour and Health Research UnitForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Felix Naughton
- University of East AngliaSchool of Health SciencesNorwichUK
| | - Amanda Farley
- University of BirminghamPublic Health, Epidemiology and BiostatisticsEdgbastonBirminghamWest MidlandsUKB15 2TT
| | - Nicola Lindson
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
| | - Paul Aveyard
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
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