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Simpson EEA, Doherty J, Timlin D. Menopause as a window of opportunity: the benefits of designing more effective theory-driven behaviour change interventions to promote healthier lifestyle choices at midlife. Proc Nutr Soc 2024; 83:120-129. [PMID: 37955168 DOI: 10.1017/s0029665123004810] [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] [Indexed: 11/14/2023]
Abstract
Menopause is a natural developmental phase that all women go through from their early forties to mid-fifties, marking the transition from the reproductive to the non-reproductive years. This is characterised as the permanent cessation of menses due to progressive ovarian failure. Each woman's experience of the menopause is unique. Biopsychosocial changes occur during this time with some symptoms affecting up to 80 % of women and lasting for 4-5 years from the peri- to post-menopause. Reduced oestrogen may predispose some women to health issues following menopause, such as heart disease, diabetes, stroke and cognitive decline. It is vital to understand how to promote health and well-being to reduce the risk of developing chronic conditions in later life. Increased symptoms and concerns about health during the menopausal transition can be cues to action for some women to actively maintain their health. Menopause represents a window of opportunity to promote health, and to support women to make healthier lifestyle choices, part of the National Institute for Clinical Excellence guidelines for menopause management. Identifying appropriate strategies to change behaviour is less clear. Theories of behaviour change can provide frameworks to gain more insight into the facilitators and barriers to behaviour and can inform the researcher on what needs to change. This information can be used to inform the design, content, implementation and evaluation of a lifestyle intervention. This review paper will explore the impact of menopause on health and well-being generally, and the benefits of designing more effective theory-driven behaviour change interventions for menopause.
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Affiliation(s)
- Ellen Elizabeth Anne Simpson
- Psychology Research Institute, Ulster University, Cromore Road, Coleraine, County Londonderry, Northern Ireland, UK
| | - Julie Doherty
- School of Nursing & Midwifery, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Deirdre Timlin
- Department of Psychology, Rockhampton Hospital, Queensland Health, Rockhampton, Australia
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Parés-Salomón I, Señé-Mir AM, Martín-Bozas F, Loef B, Coffey A, Dowd KP, Jabardo-Camprubí G, Proper KI, Puig-Ribera A, Bort-Roig J. Effectiveness of workplace interventions with digital elements to reduce sedentary behaviours in office employees: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2024; 21:41. [PMID: 38641816 PMCID: PMC11031993 DOI: 10.1186/s12966-024-01595-6] [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: 07/07/2023] [Accepted: 04/14/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Digital interventions are potential tools for reducing and limiting occupational sedentary behaviour (SB) in sedentary desk-based jobs. Given the harmful effects of sitting too much and sitting for too long while working, the aim of this systematic review and meta-analysis was to examine the effectiveness of workplace interventions, that incorporated digital elements, to reduce the time spent in SB in office workers. METHODS Randomised control trials that evaluated the implementation of workplace interventions that incorporated digital elements for breaking and limiting SB among desk-based jobs were identified by literature searches in six electronic databases (PubMed, Web of Science, Scopus, CINAHL, PsycINFO and PEDro) published up to 2023. Studies were included if total and/or occupational SB were assessed. Only studies that reported pre- and postintervention mean differences and standard deviations or standard errors for both intervention arms were used for the meta-analysis. The meta-analysis was conducted using Review Manager 5 (RevMan 5; Cochrane Collaboration, Oxford, UK). Risk of bias was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields QUALSYST tool. RESULTS Nineteen studies were included in the systematic review. The most employed digital elements were information delivery and mediated organisational support and social influences. Multicomponent, information, and counselling interventions measuring total and/or occupational/nonoccupational SB time by self-report or via device-based measures were reported. Multicomponent interventions were the most represented. Eleven studies were included in the meta-analysis, which presented a reduction of 29.9 (95% CI: -45.2, -14.5) min/8 h workday in SB (overall effect: Z = 3.81). CONCLUSIONS Multicomponent interventions, using a wide range of digital features, have demonstrated effectiveness in reducing time spent in SB at the workplace among desk-based employees. However, due to hybrid work (i.e., work in the office and home) being a customary mode of work for many employees, it is important for future studies to assess the feasibility and effectiveness of these interventions in the evolving work landscape. TRIAL REGISTRATION The review protocol was registered in the Prospero database (CRD42022377366).
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Affiliation(s)
- Iris Parés-Salomón
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Anna M Señé-Mir
- Sports and Physical Activity Research Group, Sport and Physical Activity Studies Centre, University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain.
| | | | - Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Alan Coffey
- SHE Research Group, Department of Sport and Health Sciences, Technological University of the Shannon, Athlone, Ireland
| | - Kieran P Dowd
- SHE Research Group, Department of Sport and Health Sciences, Technological University of the Shannon, Athlone, Ireland
| | - Guillem Jabardo-Camprubí
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and Faculty of Health Science at Manresa, University of Vic-Central University of Catalonia, Manresa, Spain
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Anna Puig-Ribera
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Judit Bort-Roig
- Sports and Physical Activity Research Group, Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (Iris-CC) and University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
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Collins KE, Myers LS, Goodwin BC, Taglieri-Sclocchi A, Ireland MJ. The implementation and mechanisms of advance notification for cancer screening: A scoping review. Psychooncology 2024; 33:e6340. [PMID: 38588033 DOI: 10.1002/pon.6340] [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: 01/15/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE To describe and synthesise information on the content and delivery of advance notifications (information about cancer screening delivered prior to invitation) used to increase cancer screening participation and to understand the mechanisms that may underlie their effectiveness. METHODS Searches related to advance notification and cancer screening were conducted in six electronic databases (APA PsycINFO, CINAHL, Cochrane Library, Embase, PubMed, Web of Science) and results were screened for eligibility. Study characteristics, features of the advance notifications (cancer type, format, delivery time, and content), and the effect of the notifications on cancer screening participation were extracted. Features were summarised and compared across effective versus ineffective notifications. RESULTS Thirty-two articles were included in this review, reporting on 33 unique advance notifications. Of these, 79% were sent via postal mail, 79% were distributed prior to bowel cancer screening, and most were sent 2 weeks before the screening offer. Twenty-two full versions of the advance notifications were obtained for content analysis. Notifications included information about cancer risk, the benefits of screening, barriers to participation, social endorsement of cancer screening, and what to expect throughout the screening process. Of the 19 notifications whose effect was tested statistically, 68% were found to increase screening (by 0.7%-16%). Effectiveness did not differ according to the format, delivery time, or content within the notification, although some differences in cancer type were observed. CONCLUSION Future research should explore the effectiveness of advance notification via alternative formats and for other screening contexts and disentangle the intervention- and person-level factors driving its effect on screening participation.
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Affiliation(s)
- Katelyn E Collins
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Larry S Myers
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| | - Belinda C Goodwin
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
| | | | - Michael J Ireland
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
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Williams PA, Rotunda W, Porterfield D, Skeete RA, Smith AD, Proia KK. Implementation of Session Zero as a Recruitment Strategy in the National Diabetes Prevention Program's Lifestyle Change Program. Sci Diabetes Self Manag Care 2024; 50:74-86. [PMID: 38158815 PMCID: PMC10995983 DOI: 10.1177/26350106231215767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
PURPOSE The purpose of the study was to understand the extent to which organizations offering the Centers for Disease Control and Prevention's (CDC) National Diabetes Prevention Program (National DPP) lifestyle change program implement session zero (a pre-enrollment session designed to recruit, engage, and enroll participants in programs), the stated purpose(s) for offering session zero, the content of session zero, and best practices for using session zero for recruitment. METHODS Researchers conducted a survey of all organizations offering the National DPP lifestyle change program that were registered with the CDC's Diabetes Prevention Recognition Program and their affiliated delivery locations. RESULTS Most (79.5%) delivery locations reported implementing session zero; of these, most used session zero as a recruitment strategy (81.1%) and orientation session (72.8%), whereas few (17.7%) used session zero solely to complete participant enrollment paperwork. Most (60.7%) delivery locations that implement session zero offer all their sessions at the same location, offer one session per upcoming participant cohort (66.7%), and use a consistent agenda (83.0%). Out of a list of activities informed by behavior change theory, the most common was offering an opportunity to enroll in the year-long lifestyle change program at the end of session zero (71.1%). CONCLUSIONS Most National DPP delivery locations implement session zero as a recruitment and orientation session. Most delivery locations reported including some activities informed by behavior change theory, but delivery locations could offer more theoretically informed activities during their session zero. The findings provide practice-based considerations for implementing session zero for recruitment into lifestyle change programs.
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Affiliation(s)
| | - Wendi Rotunda
- RTI International, Research Triangle Park, North Carolina
| | | | | | - Akimi D Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Krista K Proia
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Zhou T, Salman D, McGregor A. mHealth Apps for the Self-Management of Low Back Pain: Systematic Search in App Stores and Content Analysis. JMIR Mhealth Uhealth 2024; 12:e53262. [PMID: 38300700 PMCID: PMC10870204 DOI: 10.2196/53262] [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: 10/04/2023] [Revised: 12/06/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND With the rapid development of mobile health (mHealth) technology, many health apps have been introduced to the commercial market for people with back pain conditions. However, little is known about their content, quality, approaches to care for low back pain (LBP), and associated risks of use. OBJECTIVE The aims of this research were to (1) identify apps for the self-management of LBP currently on the market and (2) assess their quality, intervention content, theoretical approaches, and risk-related approaches. METHODS The UK iTunes and Google Play stores were initially searched for apps related to the self-management of LBP in May 2022. A repeat search in June 2023 was conducted to ensure that any relevant new apps developed in the last year were incorporated into the review. A total of 3 keywords recommended by the Cochrane Back and Neck Group were used to search apps "low back pain," "back pain," and "lumbago." The quality of the apps was assessed by using the 5-point Mobile App Rating Scale (MARS). RESULTS A total of 69 apps (25 iOS and 44 Android) met the inclusion criteria. These LBP self-management apps mainly provide recommendations on muscle stretching (n=51, 73.9%), muscle strengthening (n=42, 60.9%), core stability exercises (n=32, 46.4%), yoga (n=19, 27.5%), and information about LBP mechanisms (n=17, 24.6%). Most interventions (n=14, 78%) are consistent with the recommendations in the National Institute for Health and Care Excellence (NICE) guidelines. The mean (SD) MARS overall score of included apps was 2.4 (0.44) out of a possible 5 points. The functionality dimension was associated with the highest score (3.0), whereas the engagement and information dimension resulted in the lowest score (2.1). Regarding theoretical and risk-related approaches, 18 (26.1%) of the 69 apps reported the rate of intervention progression, 11 (15.9%) reported safety checks, only 1 (1.4%) reported personalization of care, and none reported the theoretical care model or the age group targeted. CONCLUSIONS mHealth apps are potentially promising alternatives to help people manage their LBP; however, most of the LBP self-management apps were of poor quality and did not report the theoretical approaches to care and their associated risks. Although nearly all apps reviewed included a component of care listed in the NICE guidelines, the model of care delivery or embracement of care principles such as the application of a biopsychosocial model was unclear.
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Affiliation(s)
- Tianyu Zhou
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - David Salman
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Alison McGregor
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Gibson R, D'Annibale M, Oliver N, McGowan B, Forbes G, Crayton E, Guess N, Lorencatto F. Exploration of the individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes working in UK healthcare-The Shift-Diabetes Study: A qualitative study using the theoretical domains framework. Diabet Med 2024; 41:e15179. [PMID: 37452826 DOI: 10.1111/dme.15179] [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: 03/17/2023] [Revised: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
AIM To identify factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings. METHODS Semi-structured qualitative interviews based on the theoretical domains framework (TDF) were conducted with a convenience sample (n = 15) of shift workers (32-59 years) diagnosed with T2D who worked night shifts as part of a mixed shift schedule. The TDF was applied to analyse transcripts using a combined deductive framework and inductive thematic analysis approach. Identified influences were mapped to the behaviour change technique taxonomy to identify potential strategies to change dietary behaviour in this context. RESULTS Key barriers to healthy dietary behaviours were access and cost of food available during night work (TDF domain: Environment Context and Resources). Factors identified as both enablers and barriers included: availability of staff facilities and time to take a break, (Environment Context and Resources), the physical impact of night work (Beliefs About Consequences), eating in response to stress or tiredness (Emotion), advance planning of meals/food and taking own food to work (Behavioural Regulation). Potential techniques to address these influences and improve dietary behaviour in this context include: meal planning templates, self-monitoring and biofeedback, and increasing accessibility and availability of healthier food choices during night shifts. CONCLUSIONS The dietary behaviour of shift workers with T2D is influenced by interacting individual, socio-cultural and environmental factors. Intervention should focus on environmental restructuring and strategies that enable monitoring and meal planning.
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Affiliation(s)
- Rachel Gibson
- Department of Nutritional Sciences, King's College, London, UK
| | | | - Nick Oliver
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Barbara McGowan
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Gillian Forbes
- Centre for Behaviour Change, University College London, London, UK
| | - Elise Crayton
- Centre for Behaviour Change, University College London, London, UK
| | - Nicola Guess
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Ribaut J, DeVito Dabbs A, Dobbels F, Teynor A, Mess EV, Hoffmann T, De Geest S. Developing a Comprehensive List of Criteria to Evaluate the Characteristics and Quality of eHealth Smartphone Apps: Systematic Review. JMIR Mhealth Uhealth 2024; 12:e48625. [PMID: 38224477 PMCID: PMC10825776 DOI: 10.2196/48625] [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: 05/01/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND The field of eHealth is growing rapidly and chaotically. Health care professionals need guidance on reviewing and assessing health-related smartphone apps to propose appropriate ones to their patients. However, to date, no framework or evaluation tool fulfills this purpose. OBJECTIVE Before developing a tool to help health care professionals assess and recommend apps to their patients, we aimed to create an overview of published criteria to describe and evaluate health apps. METHODS We conducted a systematic review to identify existing criteria for eHealth smartphone app evaluation. Relevant databases and trial registers were queried for articles. Articles were included that (1) described tools, guidelines, dimensions, or criteria to evaluate apps, (2) were available in full text, and (3) were written in English, French, German, Italian, Portuguese, or Spanish. We proposed a conceptual framework for app evaluation based on the dimensions reported in the selected articles. This was revised iteratively in discussion rounds with international stakeholders. The conceptual framework was used to synthesize the reported evaluation criteria. The list of criteria was discussed and refined by the research team. RESULTS Screening of 1258 articles yielded 128 (10.17%) that met the inclusion criteria. Of these 128 articles, 30 (23.4%) reported the use of self-developed criteria and described their development processes incompletely. Although 43 evaluation instruments were used only once, 6 were used in multiple studies. Most articles (83/128, 64.8%) did not report following theoretical guidelines; those that did noted 37 theoretical frameworks. On the basis of the selected articles, we proposed a conceptual framework to explore 6 app evaluation dimensions: context, stakeholder involvement, features and requirements, development processes, implementation, and evaluation. After standardizing the definitions, we identified 205 distinct criteria. Through consensus, the research team relabeled 12 of these and added 11 more-mainly related to ethical, legal, and social aspects-resulting in 216 evaluation criteria. No criteria had to be moved between dimensions. CONCLUSIONS This study provides a comprehensive overview of criteria currently used in clinical practice to describe and evaluate apps. This is necessary as no reviewed criteria sets were inclusive, and none included consistent definitions and terminology. Although the resulting overview is impractical for use in clinical practice in its current form, it confirms the need to craft it into a purpose-built, theory-driven tool. Therefore, in a subsequent step, based on our current criteria set, we plan to construct an app evaluation tool with 2 parts: a short section (including 1-3 questions/dimension) to quickly disqualify clearly unsuitable apps and a longer one to investigate more likely candidates in closer detail. We will use a Delphi consensus-building process and develop a user manual to prepare for this undertaking. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021227064; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021227064.
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Affiliation(s)
- Janette Ribaut
- Institute of Nursing Science, Department Public Health, University of Basel, Basel, Switzerland
- Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Annette DeVito Dabbs
- School of Nursing, Department of Acute & Tertiary Care, University of Pittsburgh, Pittsburgh, PA, United States
- Clinical Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Fabienne Dobbels
- Institute of Nursing Science, Department Public Health, University of Basel, Basel, Switzerland
- Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Alexandra Teynor
- Department of Computer Science, University of Applied Sciences, Augsburg, Germany
| | | | - Theresa Hoffmann
- Institute of Nursing Science, Department Public Health, University of Basel, Basel, Switzerland
- Department Pflege und Betreuung, Genossenschaft Alterszentrum Kreuzlingen, Kreuzlingen, Switzerland
| | - Sabina De Geest
- Institute of Nursing Science, Department Public Health, University of Basel, Basel, Switzerland
- Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Lock M, Post D, Dollman J, Parfitt G. The effects of a theory-informed intervention on physical activity behaviour, motivation and well-being of frontline aged care workers: A pilot study with 6-month follow-up. Health Promot J Austr 2024; 35:207-219. [PMID: 37158108 DOI: 10.1002/hpja.740] [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: 11/06/2022] [Revised: 04/13/2023] [Accepted: 04/23/2023] [Indexed: 05/10/2023] Open
Abstract
ISSUE ADDRESSED Due to the nature of their jobs, frontline aged care workers may be a population at risk of poor health and lifestyle habits. Support of their well-being through the workplace is likely to be complex. The objective of this study was to assess the effectiveness of a need-supportive program for changing physical activity and psychological well-being via the motivational processes of behavioural regulations and perceived need satisfaction. METHODS Frontline aged care workers (n = 25) participated in a single cohort, pre-post pilot trial. The program included a Motivational Interviewing style appointment, education on goal setting and self-management, the use of affect, exertion and self-pacing for regulating physical activity intensity and practical support activities. Outcomes (7-day accelerometery, 6-min walk, K10 and AQoL-8D), and motivational processes (BREQ-3 and PNSE) were measured at baseline, 3 and 9 months, and analysed using linear mixed models for repeated measures. RESULTS There were significant increases in perceived autonomy at 3 months (Δ .43 ± SE: .20; p = .03) and 6-min walk distance at 9 months (Δ 29.11 m ± SE: 13.75; p = .04), which appeared to be driven by the relative autonomy index (behavioural regulations in exercise questionnaire [BREQ-3]). Amotivation increased at 3 months (Δ .23 ± SE:.12; p = .05); which may have been due to low scores at baseline. No other changes were demonstrated at any timepoint. SO WHAT?: Participants demonstrated positive changes in motivational processes and physical function, however, due to the low levels of participation in the program, the program had a negligible impact at the organisational level. Future researchers and aged care organisations should aim to address factors impacting participation in well-being initiatives.
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Affiliation(s)
- Merilyn Lock
- Division of Exercise Science, Health and Epidemiology, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Dannielle Post
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - James Dollman
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Gaynor Parfitt
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
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Wan CS, Rawat P, Gulyani P, Elmi Y, Ng AH. Dietary management of type 2 diabetes mellitus among South Asian immigrants: A mixed-methods study. Nutr Diet 2023; 80:413-424. [PMID: 37271927 DOI: 10.1111/1747-0080.12820] [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: 12/14/2022] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023]
Abstract
AIMS There is a high prevalence of South Asian immigrants in Australia living with type 2 diabetes mellitus, with the dietary management of the condition presenting as a key challenge. However, their current dietary patterns and barriers to diabetes self-management are unclear. Therefore, this study aims to (i) investigate current dietary patterns and (ii) explore barriers and facilitators to dietary management in this population. METHODS A concurrent mixed-methods study comprising three 24-h dietary recalls and a semi-structured interview for each self-identified South Asian immigrant adult with diabetes recruited across Victorian primary care clinics and social media to address the aforementioned two aims. Dietary recall data were converted into food groups using Foodworks, and data analysed in SPSS. Qualitative data were thematically analysed using NVivo. RESULTS Among 18 participants recruited, 14, 16 and 17 participants had grain, fruit and dairy intake lower than daily Australian recommendations, respectively. These findings echoed qualitative data that participants viewed diabetes management as reducing carbohydrate intake. Participants reported difficulties incorporating diabetes-related dietary and lifestyle recommendations into their routine and a lack of knowledge about available organisational support. They mentioned challenges in receiving social support from families and friends and relied on support from health professionals. Facilitators included proficiency in nutrition information label reading and self-blood glucose monitoring skills. CONCLUSION Enhancing the accessibility to organisational support, facilitating the adaption of dietary recommendations into individuals' routines, and strengthening support from health professionals are essential components in intervention development to improve diabetes management for South Asians.
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Affiliation(s)
- Ching Shan Wan
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Victoria, Australia
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Victoria, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | | | - Purva Gulyani
- Diet Yumm, Craigieburn, Victoria, Australia
- Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Yusra Elmi
- Diet Yumm, Craigieburn, Victoria, Australia
| | - Ashley H Ng
- Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Melbourne, Victoria, Australia
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Buttazzoni A, Nelson Ferguson K, Gilliland J. Barriers to and facilitators of active travel from the youth perspective: A qualitative meta-synthesis. SSM Popul Health 2023; 22:101369. [PMID: 36909930 PMCID: PMC9996358 DOI: 10.1016/j.ssmph.2023.101369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/27/2023] Open
Affiliation(s)
- Adrian Buttazzoni
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada.,Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Kendra Nelson Ferguson
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada.,Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Jason Gilliland
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada.,Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Paediatrics, University of Western Ontario, London, Ontario, Canada.,Department of Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada.,School of Health Studies, University of Western Ontario, London, Ontario, Canada
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Bélanger-Gravel A, Janezic I, Desroches S, Paquette MC, Therrien F, Barnett T, Lavoie KL, Gauvin L. Examining public health practitioners' perceptions and use of behavioural sciences to design health promotion interventions. BMC Health Serv Res 2023; 23:493. [PMID: 37194044 DOI: 10.1186/s12913-023-09455-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Behavioural sciences have been shown to support the development of more effective interventions aimed at promoting healthy lifestyles. However, the operationalization of this knowledge seems to be sub-optimal in public health. Effective knowledge transfer strategies are thus needed to optimize the use of knowledge from behavioural sciences in this field. To this end, the present study examined public health practitioners' perceptions and use of theories and frameworks from behavioural sciences to design health promotion interventions. METHODS This study adopted an exploratory qualitative design. Semi-structured interviews were conducted among 27 public health practitioners from across Canada to explore current intervention development processes, the extent to which they integrate theory and framework from behavioural sciences, and their perceptions regarding the use of this knowledge to inform intervention design. Practitioners from the public sector or non-profit/private organizations who were involved in the development of interventions aimed at promoting physical activity, healthy eating, or other healthy lifestyle habits (e.g., not smoking) were eligible to participate. RESULTS Public health practitioners generally agreed that behaviour change is an important goal of public health interventions. On the other hand, behavioural science theories and frameworks did not appear to be fully integrated in the design of public health interventions. The main reasons were (1) a perceived lack of fit with current professional roles and tasks; (2) a greater reliance on experiential-produced knowledge rather than academic knowledge (mainly for tailoring interventions to local setting characteristics); (3) the presence of a fragmented knowledge base; (4) the belief that theories and frameworks require too much time and resources to be operationalized; and 4) the belief that using behavioural sciences might undermine partnership building. CONCLUSIONS This study provided valuable insights that may inform knowledge transfer strategies that could be optimally designed to support the integration of behavioural sciences theories and frameworks into public health practices.
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Affiliation(s)
- Ariane Bélanger-Gravel
- Departement of Information and Communication, Université Laval, 1055, Ave du Séminaire, Québec, G1V 0A6, Canada.
- NUTRISS-INAF research Center, Université Laval, Quebec City, Québec, Canada.
- Research Center of the Quebec Heart and Lung Institute, Quebec City, Québec, Canada.
| | - Isidora Janezic
- Departement of Information and Communication, Université Laval, 1055, Ave du Séminaire, Québec, G1V 0A6, Canada
| | - Sophie Desroches
- NUTRISS-INAF research Center, Université Laval, Quebec City, Québec, Canada
- School of Nutrition, Université Laval, Quebec City, Québec, Canada
| | | | | | - Tracie Barnett
- Departement of Family Medicine, McGill University, Montréal, Québec, Canada
- Research Center of Sainte-Justine, Montréal, Québec, Canada
| | - Kim L Lavoie
- Departement of Psychology, University of Quebec at Montreal, Montréal, Québec, Canada
- Montreal Behavioural Medicine Center, Montréal, Québec, Canada
| | - Lise Gauvin
- School of Public Health, University of Montreal, Montréal, Québec, Canada
- Research Center of the Centre hospitalier universitaire de l'Université de Montréal, Montréal, Québec, Canada
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12
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Raju S, Cowdell F, Dyson J. A Systematic Review of Women's Experiences of Interventions to Prevent Excessive Gestational Weight Gain. Nurs Womens Health 2023; 27:211-219. [PMID: 37080250 DOI: 10.1016/j.nwh.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/14/2022] [Accepted: 03/08/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To synthesize research on women's experiences of interventions to prevent excessive gestational weight gain. DATA SOURCES A systematic search of the following databases was conducted: CINAHL Complete, Maternity and Infant Care Database, American Psychological Association PsycArticles, American Psychological Association PsycInfo, and MEDLINE. STUDY SELECTION Studies were included if they involved primary research regarding the experiences of women who were pregnant or up to 1 year postpartum when reflecting on their involvement in interventions to prevent excessive weight gain during pregnancy. Nonempirical studies and those that examined experiences of women who were not pregnant or who were beyond 1 year postpartum were excluded. DATA EXTRACTION Information was extracted and captured in a summary table that included the study aim, participants, study design, intervention, findings, and summary score, with exceptions to quality. DATA SYNTHESIS Data were synthesized thematically into three themes: (a) Intervention Qualities Valued by Women, (b) Challenges Faced by Women, and (c) Perceived Benefits and Recommendations for Modifications. CONCLUSION Interventions intended to help women prevent excessive gestational weight gain should be tailored to individuals' unique needs to ensure that the interventions are acceptable and effective.
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13
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Flood SM, Thompson B, Faulkner G, Vanderloo LM, Blackett B, Dolf M, Latimer-Cheung AE, Duggan M, Di Sebastiano KM, Lane KN, Brouwers MC, McKenna J, Chulak-Bozzer T, Fuller D, Ruissen GR, Sturrock SL, Tomasone JR. Development of a ParticipACTION App-Based Intervention for Improving Postsecondary Students' 24-Hour Movement Guideline Behaviors: Protocol for the Application of Intervention Mapping. JMIR Res Protoc 2023; 12:e39977. [PMID: 36917173 PMCID: PMC10131646 DOI: 10.2196/39977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Canadian 24-Hour Movement Guidelines for adults provide specific recommendations for levels of physical activity, sedentary behavior, and sleep (ie, the movement behaviors) required for optimal health. Performance of the movement behaviors is associated with improved mental well-being. However, most postsecondary students do not meet the movement behavior recommendations within the Canadian 24-Hour Movement Guidelines and experience increased stress and declining well-being, suggesting the need for an intervention targeting students' movement behaviors. OBJECTIVE We aimed to develop and implement a theory-informed intervention intended to improve the movement behaviors and mental well-being of first-year postsecondary students. METHODS The Intervention Mapping protocol was applied in the development and implementation of the intervention. Intervention Mapping entailed performing a needs assessment, determining the intervention outcomes, selecting theory- and evidence-based change methods and applications, preparing and producing intervention plans and materials, developing the implementation plan, and finally developing an evaluation plan. The Theoretical Domains Framework and the Behavior Change Wheel were also used in conjunction with the Intervention Mapping protocol to ensure a solid theoretical basis for the intervention. This protocol led to the development and implementation of a 6-week, theory-informed ParticipACTION app-based intervention aimed at helping first-year postsecondary students improve their movement behaviors and mental well-being. The developed app content provided students with information on each of the movement behaviors and behavioral strategies (ie, goal setting, action planning, monitoring, and coping planning). The use of Intervention Mapping allowed for the continuous involvement of various multidisciplinary partners and end users, ensuring that the intervention design and implementation was appropriate for the target audience. The feasibility, acceptability, and potential impact of the intervention will be examined in a subsequent proof-of-concept study at 2 Canadian university campuses. RESULTS Participant recruitment occurred during September 2021, and the intervention was conducted from October to December 2021. The deadline for completion of the postintervention questionnaire by participants was mid-December 2021. The analysis of data examining the feasibility, acceptability, and potential impact of the intervention began in January 2022, with the publication of the proof-of-concept evaluation expected in 2023. CONCLUSIONS Intervention Mapping with the Theoretical Domains Framework and Behavior Change Wheel was a useful approach to combine evidence and theoretical concepts to guide the design and implementation of a ParticipACTION app-based intervention targeting postsecondary students' movement behaviors and mental well-being. This process may serve as an example for other researchers developing multiple behavior change app-based interventions. Should the forthcoming evaluation demonstrate the intervention's acceptability, feasibility, and potential impact, the intervention may provide a scalable method of improving postsecondary students' movement behaviors and mental well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/39977.
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Affiliation(s)
- Stephanie M Flood
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Brooke Thompson
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Leigh M Vanderloo
- Department of Science and Evaluation, ParticipACTION, Toronto, ON, Canada
| | - Beth Blackett
- Student Wellness Services, Queen's University, Kingston, ON, Canada
| | - Matt Dolf
- Office of Wellbeing Strategy, University of British Columbia, Vancouver, BC, Canada
| | - Amy E Latimer-Cheung
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Mary Duggan
- Canadian Society for Exercise Physiology, Ottawa, ON, Canada
| | - Katie M Di Sebastiano
- Department of Sport and Exercise Sciences, Durham University, Durham, United Kingdom
| | - Kirstin N Lane
- Canadian Society for Exercise Physiology, Ottawa, ON, Canada.,School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Melissa C Brouwers
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Julia McKenna
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Tala Chulak-Bozzer
- Department of Science and Evaluation, ParticipACTION, Toronto, ON, Canada
| | - Daniel Fuller
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Geralyn R Ruissen
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Shelby L Sturrock
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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14
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Mavragani A, Ji L, Wang Q, Yang G, Xiu S, Cui T, Shi N, Zhu L, Xu X, Jin H, Zhen S. Understanding Drivers of Vaccine Hesitancy During the COVID-19 Pandemic Among Older Adults in Jiangsu Province, China: Cross-sectional Survey. JMIR Form Res 2023; 7:e39994. [PMID: 36693149 PMCID: PMC9907572 DOI: 10.2196/39994] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/17/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Older adults are particularly at risk from infectious diseases, including serve complications, hospitalization, and death. OBJECTIVE This study aimed to explore the drivers of vaccine hesitancy among older adults based on the "3Cs" (confidence, complacency, and convenience) framework, where socioeconomic status and vaccination history played the role of moderators. METHODS A cross-sectional questionnaire survey was conducted in Jiangsu Province, China, between June 1 and July 20, 2021. Older adults (aged ≥60 years) were recruited using a stratified sampling method. Vaccine hesitancy was influenced by the 3Cs in the model. Socioeconomic status and vaccination history processed through the item parceling method were used to moderate associations between the 3Cs and hesitancy. Hierarchical regression analyses and structural equation modeling were used to test the validity of the new framework. We performed 5000 trials of bootstrapping to calculate the 95% CI of the pathway's coefficients. RESULTS A total of 1341 older adults participated. The mean age was 71.3 (SD 5.4) years, and 44.7% (599/1341) of participants were men. Confidence (b=0.967; 95% CI 0.759-1.201; P=.002), convenience (b=0.458; 95% CI 0.333-0.590; P=.002), and less complacency (b=0.301; 95% CI 0.187-0.408; P=.002) were positively associated with less vaccine hesitancy. Socioeconomic status weakened the positive effect of low complacency (b=-0.065; P=.03) on low vaccine hesitancy. COVID-19 vaccination history negatively moderated the positive association between confidence (b=-0.071; P=.02) and lower vaccine hesitancy. CONCLUSIONS Our study identified that confidence was the more influential dimension in reducing vaccine hesitancy among older adults. COVID-19 vaccination history, as well as confidence, had a positive association with less vaccine hesitancy and could weaken the role of confidence in vaccine hesitancy. Socioeconomic status had a substitution relationship with less complacency, which suggested a competitive positive association between them on less vaccine hesitancy.
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Affiliation(s)
| | - Lili Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Guoping Yang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Shixin Xiu
- Department of Immunization Planning, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Lin Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xuepeng Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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15
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Akksilp K, Koh JJE, Tan V, Tong EH, Budtarad N, Xueying G, Dieterich AV, Tai BC, Müller AM, Isaranuwatchai W, Rouyard T, Nakamura R, Müller-Riemenschneider F, Teerawattananon Y, Chen C. The physical activity at work (PAW) study: a cluster randomised trial of a multicomponent short-break intervention to reduce sitting time and increase physical activity among office workers in Thailand. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 8:100086. [PMID: 37384135 PMCID: PMC10305858 DOI: 10.1016/j.lansea.2022.100086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Background Sedentary behaviour increases the risks of non-communicable diseases. The objective of this trial was to evaluate the effect of the Physical Activity at Work multicomponent intervention to reduce sedentary behaviour in Thai office workers. Methods Offices under the Ministry of Public Health Thailand, were randomly allocated to the intervention and control group in a 1:1 ratio, stratified by office size. The intervention included individual (pedometer and lottery-based financial incentives), social (group movement breaks), environmental (posters), and organisational (leader encouragement) components. At baseline and 6-month follow-up, participants wore ActiGraphTM on the waist for ten days. The primary outcome was the between-group difference in sedentary time at 6-month, analysed using a linear mixed-effects model. Other outcomes were physical activity, biomarkers, productivity, and musculoskeletal health. Trial registration: The PAW study was registered at the Thai Clinical Trials Registry (ID TCTR20200604007) on 02 June 2020. Findings 282 office workers were recruited and randomly allocated to the control group (142 participants, nine offices) and the intervention group (140 participants, nine offices). The mean age was 38.6 years (SD = 10.4), and 81% were women. There was no evidence of intervention effects on sedentary time during waking hours (-26.8; 95% CI = -69.2 to 15.7 min), physical activity levels, or biomarkers between groups at 6-month. In the adjusted analysis, increases in time spent in moderate-to-vigorous physical activity (5.45; 95% CI = -0.15 to 11.1 min) and step count (718; 95% CI = -45 to 1481 steps) during waking hours were observed, although there was no evidence of a difference between groups. Interpretation The intervention did not significantly reduce sedentary time in Thai office workers. Suboptimal intervention uptake due to Covid-19 pandemic restrictions and loss of statistical power associated with recruitment constraints may explain this result. Further investigations are needed to evaluate the processes of the trial. Funding The Thai Health Promotion Foundation and the International Decision Support Initiative (iDSI).
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Affiliation(s)
- Katika Akksilp
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Health Intervention and Technology Assessment Programme (HITAP), Ministry of Public Health, Thailand
| | - Jemima Jia En Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Vanessa Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Eunice Huiying Tong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Nuttakarn Budtarad
- Health Intervention and Technology Assessment Programme (HITAP), Ministry of Public Health, Thailand
| | - Guo Xueying
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Anna Valeria Dieterich
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Programme (HITAP), Ministry of Public Health, Thailand
| | - Thomas Rouyard
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yot Teerawattananon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Health Intervention and Technology Assessment Programme (HITAP), Ministry of Public Health, Thailand
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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16
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Orr CA, Gordon R. Using Health Behavior Theory to Address COVID-19 Vaccine Hesitancy: A Scoping Review of Communication and Messaging Interventions. THE AMERICAN BEHAVIORAL SCIENTIST 2022:00027642221138274. [PMCID: PMC9703017 DOI: 10.1177/00027642221138274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Vaccine hesitancy has been among the most vexing challenges during the COVID-19 pandemic, ultimately leading to maladaptive health behaviors such as vaccine delay and refusal. A variety of approaches have been employed to address this problem, including communication and messaging interventions targeting the underlying determinants of vaccine hesitancy. However, there exists no published evidence synthesis examining how such interventions are using health behavior theory to address COVID-19 vaccine hesitancy. The purpose of this study was to conduct a scoping review of health communication and messaging interventions aimed at addressing COVID-19 vaccine hesitancy, and to systematically evaluate the use of health behavior theory in the design of these interventions. The review followed a five-step iterative framework proposed by Levac and colleagues. Comprehensive searches using an exhaustive list of keyword combinations were used across three online databases to identify articles to screen for inclusion. A structured, validated coding scheme was then applied to assess the use of health behavior theory. Additional study data were extracted using a separate structured form. A total of 36 articles published between January 2020 and February 2022 met inclusion criteria and were included in the review. Ten studies (27.7%) did not mention or use health behavior theory at all. Most studies (n = 26) at least mentioned theory or theory-relevant constructs, with 26 different theories and 52 different theoretical constructs represented in the sample. Although theory and theoretical determinants of vaccination behavior were often mentioned, few studies used theory to specify and target causal pathways of behavior change, and only one study targeted misinformation as a determinant of vaccine hesitancy. The findings from this review provide critical insight into the state of theory-based intervention design and point to significant gaps in the literature to prioritize in future research.
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Affiliation(s)
- Caroline A. Orr
- Applied Research Laboratory for Intelligence and Security (ARLIS), University of Maryland, College Park, MD, USA
| | - Ruthanna Gordon
- Applied Research Laboratory for Intelligence and Security (ARLIS), University of Maryland, College Park, MD, USA
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17
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van der Feltz S, van der Molen HF, Lelie L, Hulshof CTJ, van der Beek AJ, Proper KI. Changes in Fruit and Vegetable Consumption and Leisure Time Physical Exercise after a Citizen Science-Based Worksite Health Promotion Program for Blue-Collar Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13652. [PMID: 36294231 PMCID: PMC9603698 DOI: 10.3390/ijerph192013652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Blue-collar workers have, on average, poorer health than white-collar workers. Existing worksite health promotion programs (WHPPs) are often not successful among blue-collar workers. This study evaluates the effect of the Citizen Science-based WHPP on the targeted lifestyle behaviors among construction workers. The data of 114 participants were retrieved from questionnaires before (T0) and after (T1) the WHPP. Outcome measures were mean and categorical changes in daily fruit and vegetable intake and weekly leisure time physical exercise. Changes were tested using Wilcoxon signed rank tests and McNemar tests. No statistically significant changes were found between T0 and T1. In total, 73.7% of the participants felt involved in the WHPP. Changes in the outcome measures were not significantly different between subgroups based on age, nor in subgroups based on feelings of involvedness. The low intensity of the developed program could be an explanation for this lack of significant change. Future studies using the Citizen Science approach in an occupational setting should aim at developing a more intensified program and should test its effectiveness by comparing changes in a (randomized) controlled trial.
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Affiliation(s)
- Sophie van der Feltz
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Henk F. van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Lisa Lelie
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Carel T. J. Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Karin I. Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands
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18
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Perez A, Green JL, Ball GDC, Amin M, Compton SM, Patterson S. Behavioural change as a theme that integrates behavioural sciences in dental education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:453-458. [PMID: 34553458 DOI: 10.1111/eje.12720] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/13/2021] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
The behavioural sciences curriculum in dental education is often fragmented and its clinical relevance is not always apparent to learners. Curriculum integration is vital to understand behavioural subjects that are interrelated but frequently delivered as separate issues in dental programmes. In this commentary, we discuss behavioural change as a curricular theme that can integrate behavioural sciences in dental programmes. Specifically, we discuss behavioural change in the context of dental education guidelines and describe four general phases of behavioural change (defining the target behaviour, identifying the behavioural determinants, applying appropriate behavioural change techniques and evaluating the behavioural intervention) to make the case for content that can be covered within this curricular theme, including its sequencing. This commentary is part of ongoing efforts to improve the behavioural sciences curriculum in dental education in order to ensure that dental students develop the behavioural competencies required for entry-level general dentists.
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Affiliation(s)
- Arnaldo Perez
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jacqueline L Green
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Maryam Amin
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Sharon M Compton
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Steven Patterson
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
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St Quinton T, Trafimow D. The unappreciated relevance of auxiliary assumptions for evaluating theory-based interventions in health psychology. THEORY & PSYCHOLOGY 2022. [DOI: 10.1177/09593543221113263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of theory in health behavior change interventions has been recently questioned with mixed results found for theory-based intervention effectiveness. But theory testing in intervention depends on not only theoretical assumptions, but on auxiliary assumptions too. Specifically, auxiliary assumptions are required to traverse the distance from nonobservational terms in theories and observational terms at the level of the empirical hypotheses in interventions. We believe intervention failures are often due to flaws in auxiliary assumptions rather than assumptions at the theoretical level. We use the theory of planned behavior to illustrate how the consideration of these auxiliary assumptions is important to appraise the effectiveness of interventions informed by theory. We hope that bringing attention to the importance of auxiliary assumptions provides a more nuanced and accurate appraisal of theory utility.
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Cummins KM. Explanations for the Cloudy Evidence That Theory Benefits Health Promotion. Front Psychol 2022; 13:910041. [PMID: 35846677 PMCID: PMC9285721 DOI: 10.3389/fpsyg.2022.910041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
Persuasive arguments for using theory have been influential in health behavior and health promotion research. The use of theory is expected to improve intervention outcomes and facilitate scientific advancement. However, current empirical evaluations of the benefits of theory have not consistently demonstrated strong effects. A lack of resolution on this matter can be attributed to several features of the current body of evidence. First, the use of theory may be confounded with other features that impact health-related outcomes. Second, measurement of theory use has not been reliable. Third, the field conflates models and theories. Lastly, the evidentiary status and applicability of theories are not considered. Addressing these challenges during the execution of meta-analyses and designing original research specifically to estimate the benefits of theory could improve research and practice.
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21
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Otto AK, Wollesen B. Multicomponent exercises to prevent and reduce back pain in elderly care nurses: a randomized controlled trial. BMC Sports Sci Med Rehabil 2022; 14:114. [PMID: 35729667 PMCID: PMC9210633 DOI: 10.1186/s13102-022-00508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/15/2022] [Indexed: 12/03/2022]
Abstract
Background Sports science is making an important contribution to health services research and supports the development of tailored interventions, e.g., in nursing settings. Working in elderly care is associated with a high prevalence of low back pain (LBP). Due to the diverse requirements and high strains, multicomponent programs are essential to address all relevant factors. This randomized controlled trial investigated the effects of a tailored ten-week ergonomics and twelve-week strength training on lifting behavior, strength endurance, LBP, functional impairment and adherence. Methods n = 42 nurses were randomly assigned to the intervention (IG; n = 20) or control group (CG; n = 22). They were eligible for participation if they were active in residential care and if they provided written informed consent. Other employees were excluded. The data were collected at baseline, at ten weeks (after ergonomics training), at 22 weeks (after strength training), and at 34 weeks (follow-up). The analysis combined physical tests with questionnaires (Progressive Isoinertial Lifting Evaluation, PILE-Test; Biering-Sørensen-Test; Visual Analog Scale Pain, VAS; Oswestry Disability Index, ODI; self-developed questionnaire for adherence). Group differences were analyzed by Chi2-Tests, ANOVA, and Linear Mixed Models. Results The IG showed an improved lifting performance (PILE-Test; 95% CI 1.378–7.810, p = .006) and a reduced LBP compared to the CG (VAS; 95% CI − 1.987 to 0.034, p = .043) after ergonomics training (PILE-Test, F(1,34) = 21.070, p < .001; VAS, F(1,34) = 5.021, p = .032). The results showed no differences concerning the Biering-Sørensen-Test and the ODI. Positive adherence rates were observed. Conclusions This approach and the positive results are essential to derive specific recommendations for effective prevention. The study results can be completed in future research with additional strategies to reduce nurses’ burden further. Trial registration The trial was registered at DRKS.de (DRKS00015249, registration date: 05/09/2018).
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Affiliation(s)
- Ann-Kathrin Otto
- Department of Human Movement Science, University of Hamburg, Turmweg 2, 20148, Hamburg, Germany. .,Department of Biopsychology and Neuroergonomics, Technical University of Berlin, Fasanenstraße 1, 10623, Berlin, Germany.
| | - Bettina Wollesen
- Department of Human Movement Science, University of Hamburg, Turmweg 2, 20148, Hamburg, Germany
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22
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Yang L, Ji L, Wang Q, Xu Y, Yang G, Cui T, Shi N, Zhu L, Xiu S, Jin H, Zhen S. Vaccination Intention and Behavior of the General Public in China: Cross-sectional Survey and Moderated Mediation Model Analysis. JMIR Public Health Surveill 2022; 8:e34666. [PMID: 35723904 PMCID: PMC9253970 DOI: 10.2196/34666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/03/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Promoting vaccination and eliminating vaccine hesitancy are key measures for controlling vaccine-preventable diseases. OBJECTIVE We aimed to understand the beliefs surrounding and drivers of vaccination behavior, and their relationships with and influence on vaccination intention and practices. METHODS We conducted a web-based survey in 31 provinces in mainland China from May 24, 2021 to June 15, 2021, with questions pertaining to vaccination in 5 dimensions: attitude, subjective norms, perceived behavioral control, intention, and behavior. We performed hierarchical regression analysis and structural equation modeling based on the theory of planned behavior-in which, the variables attitude, subjective norms, and intention each affect the variable intention; the variable intention mediates the relationships of attitude and subjective norms with behavior, and the variable perceived behavioral control moderates the strength of this mediation-to test the validity of the theoretical framework. RESULTS A total of 9924 participants, aged 18 to 59 years, were included in this study. Vaccination intention mediated the relationships of attitude and subjective norms with vaccination behavior. The indirect effect of attitude on vaccination behavior was 0.164 and that of subjective norms was 0.255, and the difference was statistically significant (P<.001). The moderated mediation analysis further indicated that perceived behavioral control would affect the mediation when used as moderator, and the interaction terms for attitude (β=-0.052, P<.001) and subjective norms (β=-0.028, P=.006) with perceived behavioral control were significant. CONCLUSIONS Subjective norms have stronger positive influences on vaccination practices than attitudes. Perceived behavioral control, as a moderator, has a substitution relationship with attitudes and subjective norms and weakens their positive effects on vaccination behavior.
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Affiliation(s)
- Liuqing Yang
- Department of Epidemiology and Health Statistic, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Lili Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Qiang Wang
- Department of Epidemiology and Health Statistic, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yan Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Guoping Yang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Tingting Cui
- Department of Epidemiology and Health Statistic, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistic, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Lin Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Shixin Xiu
- Department of Immunization Planning, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Hui Jin
- Department of Epidemiology and Health Statistic, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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23
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Smith D, Cartwright M, Dyson J, Hartin J, Aitken LM. Selecting intervention content to target barriers and enablers of recognition and response to deteriorating patients: an online nominal group study. BMC Health Serv Res 2022; 22:766. [PMID: 35689227 PMCID: PMC9186287 DOI: 10.1186/s12913-022-08128-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Patients who deteriorate in hospital wards without appropriate recognition and/or response are at risk of increased morbidity and mortality. Track-and-trigger tools have been implemented internationally prompting healthcare practitioners (typically nursing staff) to recognise physiological changes (e.g. changes in blood pressure, heart rate) consistent with patient deterioration, and then to contact a practitioner with expertise in management of acute/critical illness. Despite some evidence these tools improve patient outcomes, their translation into clinical practice is inconsistent internationally. To drive greater guideline adherence in the use of the National Early Warning Score tool (a track-and-trigger tool used widely in the United Kingdom and parts of Europe), a theoretically informed implementation intervention was developed (targeting nursing staff) using the Theoretical Domains Framework (TDF) version 2 and a taxonomy of Behaviour Change Techniques (BCTs). Methods A three-stage process was followed: 1. TDF domains representing important barriers and enablers to target behaviours derived from earlier published empirical work were mapped to appropriate BCTs; 2. BCTs were shortlisted using consensus approaches within the research team; 3. shortlisted BCTs were presented to relevant stakeholders in two online group discussions where nominal group techniques were applied. Nominal group participants were healthcare leaders, senior clinicians, and ward-based nursing staff. Stakeholders individually generated concrete strategies for operationalising shortlisted BCTs (‘applications’) and privately ranked them according to acceptability and feasibility. Ranking data were used to drive decision-making about intervention content. Results Fifty BCTs (mapped in stage 1) were shortlisted to 14 (stage 2) and presented to stakeholders in nominal groups (stage 3) alongside example applications. Informed by ranking data from nominal groups, the intervention was populated with 12 BCTs that will be delivered face-to-face, to individuals and groups of nursing staff, through 18 applications. Conclusions A description of a theory-based behaviour change intervention is reported, populated with BCTs and applications generated and/or prioritised by stakeholders using replicable consensus methods. The feasibility of the proposed intervention should be tested in a clinical setting and the content of the intervention elaborated further to permit replication and evaluation. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08128-6.
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Affiliation(s)
- Duncan Smith
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK. .,Patient Emergency Response & Resuscitation Team (PERRT), University College London Hospitals NHS Foundation Trust, Euston Road, London, NW1 2BU, UK.
| | - Martin Cartwright
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Judith Dyson
- Reader in Implementation Science, Birmingham City University, Westbourne Road, Edgbaston, Birmingham, B15 3TN, UK
| | - Jillian Hartin
- Patient Emergency Response & Resuscitation Team (PERRT), University College London Hospitals NHS Foundation Trust, Euston Road, London, NW1 2BU, UK
| | - Leanne M Aitken
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK.,School of Nursing and Midwifery, Griffith University, Nathan, QLD, 4111, Australia
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24
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Bravington A, Chen H, Dyson J, Jones L, Dalgliesh C, Bryan A, Patnick J, Macleod U. Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design: a worked example from a study of cervical screening attendance in older women. BMC Health Serv Res 2022; 22:610. [PMID: 35524217 PMCID: PMC9074234 DOI: 10.1186/s12913-022-07926-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous screening interventions have demonstrated a series of features related to social determinants which have increased uptake in targeted populations, including the assessment of health beliefs and barriers to screening attendance as part of intervention development. Many studies cite the use of theory to identify methods of behaviour change, but fail to describe in detail how theoretical constructs are transformed into intervention content. The aim of this study was to use data from a qualitative exploration of cervical screening in women over 50 in the UK as the basis of intervention co-design with stakeholders using behavioural change frameworks. We describe the identification of behavioural mechanisms from qualitative data, and how these were used to develop content for a service-user leaflet and a video animation for practitioner training. The interventions aimed to encourage sustained commitment to cervical screening among women over 50, and to increase sensitivity to age-related problems in screening among primary care practitioners. METHODS Secondary coding of a qualitative data set to extract barriers and facilitators of cervical screening attendance. Barrier and facilitator statements were categorised using the Theoretical Domains Framework (TDF) to identify relevant behaviour change techniques (BCTs). Key TDF domains and associated BCTs were presented in stakeholder focus groups to guide the design of intervention content and mode of delivery. RESULTS Behavioural determinants relating to attendance clustered under three domains: beliefs about consequences, emotion and social influences, which mapped to three BCTs respectively: (1) persuasive communication/information provision; (2) stress management; (3) role modelling and encouragement. Service-user stakeholders translated these into three pragmatic intervention components: (i) addressing unanswered questions, (ii) problem-solving practitioner challenges and (iii) peer group communication. Based on (ii), practitioner stakeholders developed a call to action in three areas - clinical networking, history-taking, and flexibility in screening processes. APEASE informed modes of delivery (a service-user leaflet and a cartoon animation for practitioners). CONCLUSION The application of the TDF to qualitative data can provide an auditable protocol for the translation of qualitative data into intervention content.
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Affiliation(s)
- Alison Bravington
- Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK.
| | - Hong Chen
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Judith Dyson
- Centre for Social Care, Health and Related Research, Birmingham City University, Birmingham, UK
| | - Lesley Jones
- Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | | | | | - Julietta Patnick
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Una Macleod
- Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
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25
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Taylor L, Ranaldi H, Amirova A, Zhang L, Ahmed AA, Dibb B. Using virtual representations in mHealth application interventions for health-related behaviour change: A systematic review. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2069906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Lauren Taylor
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Hannah Ranaldi
- Department of Psychology, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Aliya Amirova
- Health Services Research and Management, School of Health Sciences, City, University of London, London, United Kingdom
| | - Louisa Zhang
- Department of Psychology, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Ayan A Ahmed
- Department of Psychology, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Bridget Dibb
- Department of Psychology, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
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26
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Ramezani M, Tayefi B, Zandian E, SoleimanvandiAzar N, Khalili N, Hoveidamanesh S, Massahikhaleghi P, Rampisheh Z. Workplace interventions for increasing physical activity in employees: A systematic review. J Occup Health 2022; 64:e12358. [PMID: 36085590 PMCID: PMC9463462 DOI: 10.1002/1348-9585.12358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 07/30/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background There is scattered evidence of the impact of workplace interventions in improving employees' physical activity. This systematic review was performed to evaluate the strategies of workplace interventions and their effectiveness, as reported in primary studies. Method Primary experimental trials, both randomized controlled trials (RCTs) and non‐RCTs, which examined interventions to increase healthy adult employees' physical activity were included in this review. Studies in English or Persian published between 2009 and 2019 with access to full text of resources were considered. Google Scholar, PubMed, Web of Science, Scopus and Cochrane Library, ProQuest (Thesis) and World Health Organization Clinical Trial Registration Databases and Persian databases such as SID, Magiran, IranMedex, Irandoc were searched. All the stages of review were conducted based on PRISMA. RoB and ROBINS‐I were used to assess the risk of bias of the primary studies. Results Thirty‐nine studies, with a total of 18 494 participants, met the inclusion criteria. Of these, 22 were RCTs, 17 were non‐RCTs. Effective interventions were reported in 15 RCTs and 14 non‐RCTs. Four main strategies of interventions were identified, consisting of motivation and support; monitoring and feedback; information and education; and activity. Thirteen different behavior change techniques (BCT) were identified with self‐determination theory (SDT) being the most frequent behavior change theory used. Conclusion It seems that a multi‐strategy intervention that one of the strategies of which is physical activity in the workplace (Activity), the use of behavioral change theories, especially SDT, may be indicative of a more effective intervention. It is recommended that BCTs be considered when designing physical activity interventions.
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Affiliation(s)
- Mozhdeh Ramezani
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Batool Tayefi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Zandian
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Neda SoleimanvandiAzar
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Khalili
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Parissa Massahikhaleghi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Rampisheh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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27
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Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake. Vaccines (Basel) 2021; 10:vaccines10010007. [PMID: 35062668 PMCID: PMC8777721 DOI: 10.3390/vaccines10010007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a return to pre-pandemic ways of living. However, vaccine development, distribution and promotion have not been sufficient to ensure maximum vaccine uptake. Vaccination is an individual choice and requires acceptance of the need to be vaccinated in light of any risks. This paper presents a behavioural sciences framework to promote vaccine acceptance by addressing the complex and ever evolving landscape of COVID-19. Effective promotion of vaccine uptake requires understanding the context-specific barriers to acceptance. We present the AACTT framework (Action, Actor, Context, Target, Time) to identify the action needed to be taken, the person needed to act, the context for the action, as well as the target of the action within a timeframe. Once identified a model for identifying and overcoming barriers, called COM-B (Capability, Opportunity and Motivation lead to Behaviour), is presented. This analysis identifies issues associated with capability, opportunity and motivation to act. These frameworks can be used to facilitate action that is fluid and involves policy makers, organisational leaders as well as citizens and families.
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28
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Popoola M, Dingle M, MacLaren J, Dyson J. What are the barriers to nurses mobilising adult patients in intensive care units? An integrative review. Aust Crit Care 2021; 35:595-603. [PMID: 34756801 DOI: 10.1016/j.aucc.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/08/2021] [Accepted: 09/05/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES There is a need for early mobilisation of patients in intensive care units to prevent acquired weaknesses which can have a long-term impact on health and quality of life. This need is not always fulfilled. We therefore sought to conduct an integrative review of international evidence to answer the question: What are the barriers to nurses mobilising adult patients in intensive care units? REVIEW METHOD USED We conducted a systematic search and thematic analysis. We were able to present a descriptive quantitative synthesis of the survey articles included. DATA SOURCES We searched CINAHL, MEDLINE, and PsycINFO databases between and including 2010 and 2020 using search terms synonymous with "intensive care unit" and "nurse" and "early mobilisation" and "barrier using Boolean operators" and "truncation". We completed backwards and forwards citation searches on included studies. RESULTS We included seven articles which we synthesised into three themes and 13 subthemes as follows: (i) organisational barriers (subthemes were staffing levels, time and workload, resources, and care coordination), (ii) individual barriers (subthemes were self and team safety, knowledge and training, beliefs about the consequences of early mobilisation, stress, and other barriers), and (iii) patient-related barriers (subthemes were medical instability/physical status, patient safety, neurological deficits and sedation, and nonconcordance of patients). CONCLUSION Nurses' barriers were wide ranging, and interventions to improve concordance with early mobilisation need to be tailored to address this group's specific barriers.
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Affiliation(s)
| | - Maria Dingle
- City, University of London, Northampton Square, London, EC1V 0HB, UK.
| | - Julie MacLaren
- City, University of London, Northampton Square, London, EC1V 0HB, UK.
| | - Judith Dyson
- Birmingham City University, Westbourne Road, Edgbaston, Birmingham, B15 3TN, UK.
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29
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Zaslavsky O, Su Y, Kim B, Roopsawang I, Wu KC, Renn BN. Behavior change factors and retention in dietary interventions for older adults: scoping review. THE GERONTOLOGIST 2021; 62:e534-e554. [PMID: 34477843 DOI: 10.1093/geront/gnab133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although poor diet is a major driver of morbidity and mortality in people 60 and older, few dietary interventions are widely implemented for this population. We mapped behavior change theories, agents, and techniques in dietary interventions for adults 60+ and explored relationships between these factors and ability to retain at least 80% of the study participants. RESEARCH DESIGN AND METHODS We conducted a scoping review using MEDLINE, CINAHL, and Web of Science through April 2021 for dietary interventions in adults 60 and older. We collated, summarized, and calculated frequency distributions of behavior change theories, behavior change agents, and behavior change techniques (BCTs) using BCTv1 taxonomy with regard to participant retention across 43 studies. RESULTS Only 49% and 30% of the studies reported behavior theory and change agents respectively. Of the studies reporting on theory and agents, the most common were social cognitive theory and the related mechanism of self-efficacy. The most common BCTv1 were "shaping knowledge" and "goals and planning." Several BCTv1 such as "antecedents" and "reward and threat" and evidence for concordance between BCTs and change agents were more common in interventions with higher retention rates. DISCUSSION AND IMPLICATIONS Mechanistically concordant studies with BCTs that involve resource allocation and positive reinforcement through rewards may be advantageous for retention in dietary intervention for older adults. Future studies should continue developing theory and mechanism-oriented research. Furthermore, future studies should consider diversifying the portfolio of currently deployed BCTs and strengthening a concordance between BCTs and mechanisms of change.
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Affiliation(s)
- Oleg Zaslavsky
- Biobehavioral Nursing and Health Informatics Department, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Yan Su
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Boeun Kim
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Inthira Roopsawang
- Ramathibodi School of Nursing, Faculty of Medicine Ramthibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kuan-Ching Wu
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Brenna N Renn
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA.,Department of Psychiatry and Behavior Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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30
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Pirotta S, Joham AE, Moran LJ, Skouteris H, Lim SS. Informing a PCOS Lifestyle Program: Mapping Behavior Change Techniques to Barriers and Enablers to Behavior Change Using the Theoretical Domains Framework. Semin Reprod Med 2021; 39:143-152. [PMID: 34433214 DOI: 10.1055/s-0041-1735456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article aimed to identify the behavior change techniques (BCTs) based on facilitators and barriers to lifestyle management in women with polycystic ovary syndrome (PCOS) according to the behavior change wheel (BCW). This qualitative study design using inductive thematic analysis following semistructured interviews (n = 20) identified barriers and enablers to lifestyle management. These were then mapped to Capability, Opportunity, Motivation-Behavioral Model (COM-B) constructs and the corresponding Theoretical Domains Framework (TDF) domains. This study included women with PCOS residing in Australia. Main outcome measures include intervention functions, policy categories, and BCTs described in the BCW. Twenty-three BCTs were recognized to influence behavior change in women with PCOS. Factors were categorized into the subcomponents of the COM-B: psychological capability (e.g., lack of credible information), physical capability (e.g., managing multiple health conditions), physical opportunity (e.g., limited access to resources), social opportunity (e.g., adequate social support), reflective motivation (e.g., positive health expectancies following behavior change), and automatic motivation (e.g., emotional eating). Future research should use this work to guide PCOS lifestyle intervention development and then test intervention effectiveness through an experimental phase to provide empirical evidence for wider use and implementation of tailored, theory-informed PCOS lifestyle programs as part of evidence-based PCOS management.
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Affiliation(s)
- Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - A E Joham
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Diabetes, Monash Health, Clayton, Victoria, Australia
| | - L J Moran
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - H Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Warwick Business School, Warwick University, Coventry, United Kingdom
| | - S S Lim
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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31
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Dyson J, Cowdell F. How is the Theoretical Domains Framework applied in designing interventions to support healthcare practitioner behaviour change? A systematic review. Int J Qual Health Care 2021; 33:6324052. [PMID: 34279637 DOI: 10.1093/intqhc/mzab106] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/21/2021] [Accepted: 07/19/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The use of theory is recommended to support interventions to promote implementation of evidence-based practices. However, there are multiple models of behaviour change which can be complex and lack comprehensiveness and are therefore difficult to understand and operationalize. The Theoretical Domains Framework sought to address these problems by synthesizing 33 models of behaviour or behaviour change. Given that it is 15 years since the first publication of the Theoretical Domains Framework (TDF), it is timely to reflect on how the framework has been applied in practice. OBJECTIVE The objective of this review is to identify and narratively synthesize papers in which the TDF, (including frameworks that incorporate the TDF) have been used have been used to develop implementation interventions. METHODS We searched MEDLINE, PsychINFO, CINAHL and the Cochrane databases using the terms: 'theoretical domains framework*' or TDF or Capability, Opportunity, Motivation to Behaviour (COM-B) or 'behav* change wheel' or 'BCW' AND implement* or improv* or quality or guideline* or intervention* or practice* or EBP or 'evidence based practice' and conducted citation and key author searches. The included papers were those that used any version of the TDF published from 2005 onwards. The included papers were subject to narrative synthesis. RESULTS A total of 3540 papers were identified and 60 were included. Thirty-two papers reported intervention design only and 28 reported intervention design and testing. Despite over 3000 citations there has been limited application to the point of designing interventions to support the best practice. In particular use of the framework has not been tried or tested in non-western countries and barely used in non-primary or acute care settings. Authors have applied the framework to assess barriers and facilitators successfully but reporting of the process of selection of behaviour change techniques and intervention design thereafter was variable. CONCLUSION Despite over three thousand citations of the framework there has been limited application to the point of designing interventions to support best practice. The framework is barely used in non-western countries or beyond primary or acute care settings. A stated purpose of the framework was to make psychological theory accessible to researchers and practitioners alike; if this is to be fully achieved, further guidance is needed on the application of the framework beyond the point of assessment of barriers and facilitators.
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Affiliation(s)
- Judith Dyson
- Healthcare Research and Implementation Science, Faculty of Health, Education and Life Sciences, Birmingham City University, Westbourne Road, Edgbaston, Birmingham B15 3TN, UK
| | - Fiona Cowdell
- Faculty of Health, Education and Life Sciences, Nursing and Healthcare Research, Birmingham City University, Westbourne Road, Birmingham B15 3TN, UK
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32
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Mbous YP, Patel J, Kelly KM. A systematic review and meta-analysis of physical activity interventions among colorectal cancer survivors. Transl Behav Med 2021; 10:1134-1143. [PMID: 33044539 DOI: 10.1093/tbm/ibz176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
With the growing number of colorectal cancer survivors (CRCS), theory-based, high-quality physical activity (PA) interventions are needed to promote quality and quantity of life. This systematic review and meta-analysis synthesized theory-based PA interventions among CRCS. Using PubMed, PsyINFO, CINAHL, MEDLINE, SportDiscus, and Cochrane databases, studies including CRCS participants, a PA outcome, a behavioral theory/model or behavior change techniques (BCTs), and randomized research design were identified. Two reviewers coded BCT, intervention reproducibility (Template for Intervention Description and Replication-TIDier), risk of bias, and quality of evidence. From an initial screen of 1,328 articles, 10 RCTs met our inclusion criteria. The Transtheoretical Model (n = 3), Social Cognitive Theory (n = 3), and Theory of Planned Behavior (n = 2) were the most used theories. "Goal setting (behavior)" (n = 10), "goal setting (outcome)" (n = 10), "action planning" (n = 9), and "problem solving" (n = 9) were the most commonly used BCTs. Intervention modalities were primarily print material based (n = 4) and telephone counseling (n = 4). Findings demonstrated that theory-based PA interventions are successful at increasing PA among CRCS as meta-analysis evidenced a small effect size of 0.26. TDier items 3, 9, and 12 hindered intervention replicability. Lack of blinding and bias in the measurement of outcomes by assessors resulted in serious bias. In-depth theoretical applications are needed for PA interventions that minimize bias and improve outcomes measurement. Intervention adherence and fidelity, as well as theoretical construct measurement pre- and post-intervention, will enhance the behavioral research enterprise. PROSPERO registration: CRD42019142816.
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Affiliation(s)
- Yves Paul Mbous
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, School of Pharmacy
| | - Jayeshkumar Patel
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, School of Pharmacy
| | - Kimberly M Kelly
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, School of Pharmacy
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Consumer awareness and perceptions of arsenic exposure from rice and their willingness to change behavior. Food Control 2021. [DOI: 10.1016/j.foodcont.2021.107875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Dieberger AM, van Poppel MNM, Watson ED. Baby Steps: Using Intervention Mapping to Develop a Sustainable Perinatal Physical Activity Healthcare Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5869. [PMID: 34070723 PMCID: PMC8198094 DOI: 10.3390/ijerph18115869] [Citation(s) in RCA: 3] [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: 04/16/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022]
Abstract
While the benefits of physical activity (PA) during and after pregnancy have been established, many women do not reach the recommended PA levels during this time. A major barrier found in the literature is a lack of counselling by healthcare providers (HCPs), which is partly caused by the limited knowledge on the topic. The aim of this study was to develop an intervention to improve the promotion of PA by HCPs. We used Intervention Mapping (IM), a theory-based framework to develop an intervention, called "Baby steps", in a high-income (Austria) and a low-to-middle-income country (South Africa). We applied the following IM steps: (1) A needs assessment to determine the barriers and enablers of PA promotion by HCPs, including a scoping literature review and community needs assessments (qualitative interviews, questionnaires, and focus groups with midwives, obstetricians, and community health workers) to determine the desired outcomes of the intervention. (2) Performance and change objectives were formulated, describing the behaviors that need to change for the intervention to succeed. (3) Based on these objectives, theory-based behavior change techniques were selected, and practical applications were developed. (4) The applications were combined into two evidence-based interventions tailored to each country's needs. Step (5) and (6) consist of an implementation and evaluation plan, respectively. The intervention is aimed at HCPs, such as midwives and community health workers, consisting of a two-day training course, including practical resources. Combining didactic and interactive education, it addresses both PA knowledge and the skills needed to transfer knowledge and facilitate behavior change. In the future, the intervention's effect on women's activity levels during and after pregnancy needs to be studied.
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Affiliation(s)
- Anna M. Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - Mireille N. M. van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Mozartgasse 14, 8010 Graz, Austria;
| | - Estelle D. Watson
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 27 St. Andrews Road, Parktown, Johannesburg 2193, South Africa;
- Department of Exercise Sciences, Faculty of Science, The University of Auckland, Building 907, Suiter Street, Newmarket, Auckland 1142, New Zealand
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Zhang C, Lakens D, IJsselsteijn WA. Theory Integration for Lifestyle Behavior Change in the Digital Age: An Adaptive Decision-Making Framework. J Med Internet Res 2021; 23:e17127. [PMID: 33835036 PMCID: PMC8065564 DOI: 10.2196/17127] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 09/26/2020] [Accepted: 02/17/2021] [Indexed: 01/19/2023] Open
Abstract
Despite the growing popularity of digital health interventions, limitations of traditional behavior change theories and a lack of theory integration hinder theory-driven behavior change applications. In this paper, we aim to review theories relevant to lifestyle behavior change from the broader psychology literature and then integrate these theories into a new theoretical framework called adaptive decision-making to address two specific problems. First, our framework represents lifestyle behaviors at two levels-one of individual daily decisions (action level) and one of larger behavioral episodes (reflection level)-to more closely match the temporal characteristics of lifestyle behaviors and their associated digital data. Second, the framework connects decision-making theories and learning theories to explain how behaviors and cognitive constructs dynamically influence each other, making it a suitable scaffold for building computational models. We map common digital intervention techniques onto the behavioral and cognitive processes in the framework and discuss possible contributions of the framework to both theory development and digital intervention design.
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Affiliation(s)
- Chao Zhang
- Human-Technology Interaction Group, Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Daniël Lakens
- Human-Technology Interaction Group, Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Wijnand A IJsselsteijn
- Human-Technology Interaction Group, Department of Industrial Engineering & Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
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Smith D, Cartwright M, Dyson J, Hartin J, Aitken LM. Barriers and enablers of recognition and response to deteriorating patients in the acute hospital setting: A theory-driven interview study using the Theoretical Domains Framework. J Adv Nurs 2021; 77:2831-2844. [PMID: 33739478 DOI: 10.1111/jan.14830] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/02/2021] [Accepted: 03/05/2021] [Indexed: 12/01/2022]
Abstract
AIM To explore barriers and enablers of recognition and response to signs of patient deterioration by nursing staff in an acute hospital. DESIGN A theory-driven interview study underpinned by the Theoretical Domains Framework of behaviour change. METHODS Between 07/01/2019 and 18/12/2019 a purposive sample of registered nurses and healthcare assistants was recruited to participate in a semi-structured (audio-recorded) interview, to explore the determinants of seven specified behaviours of the afferent limb. Anonymised transcripts were deductively coded (using the 14 Theoretical Domains Framework domains as coding categories) and then extracts within each domain were inductively analysed to synthesise belief statements and themes. Prioritisation criteria from published literature were applied. RESULTS Thirty-two semi-structured interviews were conducted. From 1,888 quotes, 184 belief statements and 66 themes were synthesised. One hundred and forty-six belief statements, represented by 58 themes, met prioritisation criteria. Nine domains of the Theoretical Domains Framework were of high importance: Knowledge; Social, Professional Role and Identity; Beliefs about Consequences; Reinforcement; Intentions; Goals; Memory, Attention and Decision Processes; Environment, Context and Resources and Social Influences. CONCLUSIONS Barriers and enablers most likely to impact on nursing staff afferent limb behaviour were identified in nine domains of the Theoretical Domains Framework.
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Affiliation(s)
- Duncan Smith
- School of Health Sciences, City University of London, London, UK.,Patient Emergency Response & Resuscitation Team (PERRT), University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Judith Dyson
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Jillian Hartin
- Patient Emergency Response & Resuscitation Team (PERRT), University College London Hospitals NHS Foundation Trust, London, UK
| | - Leanne M Aitken
- School of Health Sciences, City University of London, London, UK.,School of Nursing and Midwifery, Griffith University, Nathan, Qld., Australia
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Ahmed S, Pinnock H, Steed E. Developing theory-based asthma self-management interventions for South Asians and African Americans: A systematic review. Br J Health Psychol 2021; 26:1040-1068. [PMID: 33724618 DOI: 10.1111/bjhp.12518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Intervention development guidelines suggest that behavioural interventions benefit from being theory-based. Minority populations typically benefit less from asthma self-management interventions, and the extent to which appropriate theory has been used for culturally tailored interventions has not been addressed. We aimed to determine theory use and theoretical domains targeted in asthma self-management interventions for South Asian and Black populations. METHODS We systematically searched electronic databases, research registers, manually searched relevant journals and reference lists of reviews for randomised controlled trials of asthma self-management for South Asian and Black populations, and extracted data using the Theory Coding Scheme to inform if/how theory was used and explore its associations with asthma outcomes, and the Theoretical Domains Framework was used to identify targeted theoretical domains and its relationship to effectiveness of asthma outcomes. RESULTS 20 papers (19 trials) were identified; theory was not extensively used in interventions. It was unclear whether theory use or theoretical domains targeted in interventions improved asthma outcomes. South Asian interventions included 'behavioural regulation', while 'reinforcement' was mostly used in African American interventions. 'Knowledge' was central for all populations, though there were differences related to 'environmental context and resources' e.g., language adaptations for South Asians; asthma resources provided for African Americans. Author descriptions of interventions targeting providers were limited. CONCLUSIONS There was little evidence of theory-based approaches used in cultural interventions for asthma self-management. Demystifying theoretical concepts (and cultural interpretations of constructs) may provide clarity for 'non-experts', enabling mainstream use of theory-driven approaches in intervention development.
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Affiliation(s)
- Salina Ahmed
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Barts and the London, School of Medicine and Dentistry, Queen Mary, University of London, UK
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, UK
| | - Elizabeth Steed
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Barts and the London, School of Medicine and Dentistry, Queen Mary, University of London, UK
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Willmott T, Rundle-Thiele S. Are we speaking the same language? Call for action to improve theory application and reporting in behaviour change research. BMC Public Health 2021; 21:479. [PMID: 33691658 PMCID: PMC7944470 DOI: 10.1186/s12889-021-10541-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/03/2021] [Indexed: 12/14/2022] Open
Abstract
Inconsistencies are evident in definitions and interpretations of theory, application of theory, and reporting of theory use within the behaviour change field impeding cumulative knowledge advancement. Standardised frameworks and methods are needed to support the definition, application, and reporting of theory, and to assist researchers in understanding how theory should be applied to build cumulative knowledge over time. Progress is being made with the development of ontologies, taxonomies, methods for mapping interventions, and coding schemes; however, consolidation is needed to improve levels and quality of theory use, and to facilitate the translation of theory-driven research in practice. This paper discusses the importance of rigorous theory application and reporting in health-related behaviour change research and outlines the need for a standardised framework that supports both researchers and practitioners in designing, implementing, and evaluating theory-driven interventions in a concrete and consistent manner. To this end, several recommendations are provided to facilitate the development of a standardised framework that supports theory application and reporting in the behaviour change field. Concrete and consistent theory application and reporting will permit critical appraisal within and across studies, thereby advancing cumulative knowledge of behaviour change over time.
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Affiliation(s)
- Taylor Willmott
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD 4111 Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD 4111 Australia
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Ly A, Zemek R, Wright B, Zwicker J, Schneider K, Mikrogianakis A, Conradi A, Johnson D, Clark B, Barlow K, Burey J, Kolstad A, Yeates KO. "What is the actual goal of the pathway?": examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework. BMC Health Serv Res 2021; 21:119. [PMID: 33546684 PMCID: PMC7863464 DOI: 10.1186/s12913-021-06110-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 01/21/2021] [Indexed: 01/17/2023] Open
Abstract
Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.
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Affiliation(s)
- Anh Ly
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
| | - Roger Zemek
- Department of Pediatrics, University of Ottawa, 75 Laurier Avenue East, Ottawa, Ontario, K1N 6N5, Canada
| | - Bruce Wright
- Department of Pediatrics, University of Alberta, 3-513 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 2R7, Canada
| | - Jennifer Zwicker
- University of Calgary, School of Public Policy, 906 8th Avenue SW, Calgary, Alberta, T2P 1H9, Canada
| | - Kathryn Schneider
- University of Calgary, Faculty of Kinesiology, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Angelo Mikrogianakis
- Department of Pediatrics, McMaster University, 1280 Main Street, Hamilton, Ontario, L8S 4K1, Canada
| | - Alf Conradi
- Department of Pediatrics, University of Alberta, 4-539 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 2R7, Canada
| | - David Johnson
- Department of Pediatrics, University of Calgary, 28 Oki Drive NW, Calgary, T3B 6A8, Canada
| | - Brenda Clark
- Department of Pediatrics, University of Alberta, 10230 111 Avenue, Edmonton, Alberta, T5G 0B7, Canada
| | - Karen Barlow
- University of Queensland, Child Health Research Centre, Brisbane, QLD, 4072, Australia
| | - Joseph Burey
- Department of Psychology, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4, Canada
| | - Ash Kolstad
- University of Calgary, Faculty of Kinesiology, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
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Younie S, Mitchell C, Bisson MJ, Crosby S, Kukona A, Laird K. Improving young children's handwashing behaviour and understanding of germs: The impact of A Germ's Journey educational resources in schools and public spaces. PLoS One 2020; 15:e0242134. [PMID: 33227004 PMCID: PMC7682880 DOI: 10.1371/journal.pone.0242134] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/28/2020] [Indexed: 01/17/2023] Open
Abstract
CONTEXT Effective handwashing can prevent the spread of germs, including Covid-19. However, young children can lack a fundamental understanding of germ transfer. A Germ's Journey educational resources were designed to support young children in learning about germs and handwashing. These resources include a book, website, song, online games and glo-gel activities that are informed by a behaviour change model. RESEARCH GAP Prior research has not evaluated the impacts of these resources on behavioural outcomes. PURPOSE OF THE STUDY Two intervention studies evaluated the impacts of these resources on both knowledge and behavioural outcomes. METHOD In Study 1, children (n = 225) were recruited from four schools and randomly assigned by classrooms to participate in a multicomponent intervention (vs. control). In Study 2, children (n = 104) were recruited from a museum and randomly assigned to participate in a song intervention (vs. control). Trained observers recorded participants' engagement in six handwashing behaviours and their understanding of germs. These behavioural and knowledge outcomes were analysed using regression and related analyses. RESULTS In Study 1, significant improvements were observed between baseline and follow up in the intervention group for both behavioural scores (Est = 0.48, SE = 0.14, t = 3.30, p = 0.001) and knowledge scores (Est = 2.14, SE = 0.52, z = 4.11, p < 0.001), whereas these improvements were not observed in the control group (ts < 1). In Study 2, the intervention group had significantly higher behavioural scores compared to the control group (Est. = -0.71, SE = 0.34, t = -2.07, p = 0.04). CONCLUSION This research demonstrates that specifically designed hand hygiene educational resources can improve handwashing practice and understanding in young children, and could lead to the reduction of the transmission of disease within this group.
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Affiliation(s)
- Sarah Younie
- Institute for Research in Criminology, Community, Education and Social Justice, De Montfort University, Leicester, United Kingdom
| | - Chloe Mitchell
- Institute for Psychological Science, De Montfort University, Leicester, United Kingdom
- * E-mail:
| | - Marie-Josee Bisson
- Institute for Psychological Science, De Montfort University, Leicester, United Kingdom
| | - Sapphire Crosby
- Institute for Research in Criminology, Community, Education and Social Justice, De Montfort University, Leicester, United Kingdom
| | - Anuenue Kukona
- Institute for Psychological Science, De Montfort University, Leicester, United Kingdom
| | - Katie Laird
- Infectious Disease Research Group, Leicester Institute for Pharmaceutical Innovation, De Montfort University, Leicester, United Kingdom
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Plotnikoff R, Morgan PJ, Lubans DR, Rhodes R, Costigan SA. The Intersect of Theory, Methods, and Translation in Guiding Interventions for the Promotion of Physical Activity: A Case Example of a Research Programme. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ronald Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education & Arts, University of Newcastle,
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education & Arts, University of Newcastle,
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education & Arts, University of Newcastle,
| | - Ryan Rhodes
- Behavioral Medicine Laboratory, University of Victoria,
| | - Sarah A Costigan
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education & Arts, University of Newcastle,
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Lock M, Post D, Dollman J, Parfitt G. Feasibility and Process Evaluation of a Need-Supportive Physical Activity Program in Aged Care Workers: The Activity for Well-Being Project. Front Psychol 2020; 11:518413. [PMID: 33101113 PMCID: PMC7554301 DOI: 10.3389/fpsyg.2020.518413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 08/18/2020] [Indexed: 11/25/2022] Open
Abstract
The need to undertake pilot testing and evaluation of novel health promotion programs has become increasingly apparent for the purpose of understanding the true effects of complex interventions and for testing and refining behavioral theories that these interventions are informed by. A mixed-methods process evaluation and feasibility study was undertaken for a need-supportive physical activity program that was piloted in a single-group pre–post study. The piloted program was designed to support participant needs of autonomy, competence, and relatedness through evidence-based and theory-informed behavior change strategies including a motivational interviewing style appointment, education on self-management tools (i.e., pedometers, goal setting, action and coping planning, a customized website for goal setting and self-monitoring), and self-determined methods of regulating physical activity intensity [affect, rating of perceived exertion (RPE), and self-pacing]. The program aimed to positively impact physical activity behavior, psychological well-being, and associated motivational processes. Reach, adoption, fidelity, context, change and performance objectives, and feasibility of the program were evaluated using information from survey respondents from the target population (n = 118) and implementing staff (n = 6); questionnaires from pilot study participants (n = 21); and individual semi-structured interviews with a combination of pilot study participants, non-participants, and implementing staff (n = 19). Process evaluation of the Activity for Well-Being program found that the reach of the program was moderate but adoption was low. The use of self-management tools and self-determined methods of regulating physical activity intensity appeared to be feasible. The website had mixed responses and low engagement. The element of having a support person elicited a strong positive response in the program participant interviews. Involving local implementing staff more directly into the delivery of the intervention could have potentially improved reach, adoption, and feasibility of the program.
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Affiliation(s)
- Merilyn Lock
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Dannielle Post
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - James Dollman
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Gaynor Parfitt
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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Otto AK, Pietschmann J, Appelles LM, Bebenek M, Bischoff LL, Hildebrand C, Johnen B, Jöllenbeck T, Kemmler W, Klotzbier T, Korbus H, Rudisch J, Schott N, Schoene D, Voelcker-Rehage C, Vogel O, Vogt L, Weigelt M, Wilke J, Zwingmann K, Wollesen B. Physical activity and health promotion for nursing staff in elderly care: a study protocol for a randomised controlled trial. BMJ Open 2020; 10:e038202. [PMID: 33028557 PMCID: PMC7539591 DOI: 10.1136/bmjopen-2020-038202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Nursing staff is burdened by high workload and stress. Furthermore, heavy lifting, as well as transferring nursing home residents, cause lumbar tissue damage and back pain. Exercise intervention studies to reduce work-related problems are rare and the evidence for efficacy of studies among nurses is limited. Studies including targeted analysis of requirements are necessary to generate effective recommendations and tailored interventions for health promotion programmes. The purpose of this multicentred intervention study is to identify work-related problems, to implement health promotion programmes and to evaluate their effectiveness. METHODS AND ANALYSIS A randomised controlled trial will be conducted, including a total of 48 nursing home facilities in eight regions of Germany with an estimated sample size of 700 nurses. Standardised ergonomics and posture training (10 weeks, once a week for 20-30 min) and subsequently, back-fitness training (12 weeks, once a week for 45-60 min) will be administered. Following the implementation of standardised health promotion programmes, further demand-oriented interventions can be implemented. The perceived exposure to work-related demands, work-related pain in different parts of the body, health-related quality of life, perceived stress, work-related patterns of behaviour and experience, presentism behaviour, work environment as well as general needs and barriers to health promotion, will be assessed at baseline (pre-test), at 10 weeks (post-test, after ergonomics training), at 22 weeks (post-test, after back-fitness training) and at 34 weeks of the programme (follow-up). ETHICS AND DISSEMINATION The study was reviewed and approved by the local ethics committee of the University of Hamburg (AZ: 2018_168). The results of the study will be published in open-access and international journals. Furthermore, the results will be presented in the participating nursing homes and at national and international conferences. TRIAL REGISTRATION NUMBER DRKS.de (DRKS00015241).
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Affiliation(s)
- Ann-Kathrin Otto
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | | | - Luisa-Marie Appelles
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Michael Bebenek
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Laura L Bischoff
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Claudia Hildebrand
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Bettina Johnen
- Department of Sports and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Thomas Jöllenbeck
- Department of Sport and Health, University of Paderborn, Paderborn, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Klotzbier
- Department of Sports and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Heide Korbus
- Department of Sports and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Julian Rudisch
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Nadja Schott
- Department of Sports and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | | | - Oliver Vogel
- Institute of Sports Sciences, Goethe University of Frankfurt, Frankfurt, Germany
| | - Lutz Vogt
- Institute of Sports Sciences, Goethe University of Frankfurt, Frankfurt, Germany
| | - Matthias Weigelt
- Department of Sport and Health, University of Paderborn, Paderborn, Germany
| | - Jan Wilke
- Institute of Sports Sciences, Goethe University of Frankfurt, Frankfurt, Germany
| | - Katharina Zwingmann
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Bettina Wollesen
- Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
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Coenen P, Robroek SJW, van der Beek AJ, Boot CRL, van Lenthe FJ, Burdorf A, Oude Hengel KM. Socioeconomic inequalities in effectiveness of and compliance to workplace health promotion programs: an individual participant data (IPD) meta-analysis. Int J Behav Nutr Phys Act 2020; 17:112. [PMID: 32887617 PMCID: PMC7650284 DOI: 10.1186/s12966-020-01002-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This individual patient data (IPD) meta-analysis aimed to investigate socioeconomic inequalities in effectiveness on healthy behavior of, and compliance to, workplace health promotion programs. METHODS Dutch (randomized) controlled trials were identified and original IPD were retrieved and harmonized. A two-stage meta-analysis was conducted where linear mixed models were performed per study (stage 1), after which individual study effects were pooled (stage 2). All models were adjusted for baseline values of the outcomes, age and gender. Intervention effects were assessed on physical activity, diet, alcohol use, and smoking. Also, we assessed whether effects differed between participants with low and high program compliance and. All analyses were stratified by socioeconomic position. RESULTS Data from 15 studies (n = 8709) were harmonized. Except for fruit intake (beta: 0·12 [95% CI 0·08 0·15]), no effects were found on health behaviors, nor did these effects differ across socioeconomic groups. Only participants with high compliance showed significant improvements in vigorous and moderate-to-vigorous physical activity, and in more fruit and less snack intake. There were no differences in compliance across socioeconomic groups. CONCLUSIONS Workplace health promotion programs were in general not effective. Neither effectiveness nor compliance differed across socioeconomic groups (operationalized by educational level). Even though stronger effects on health behavior were found for participations with high compliance, effects remained small. The results of the current study emphasize the need for new directions in health promotion programs to improve healthy behavior among workers, in particular for those in lower socioeconomic position.
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Affiliation(s)
- Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Work, Health and Technology, Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 79-86, 2316, Leiden, The Netherlands
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Black N, Eisma MC, Viechtbauer W, Johnston M, West R, Hartmann‐Boyce J, Michie S, de Bruin M. Variability and effectiveness of comparator group interventions in smoking cessation trials: a systematic review and meta-analysis. Addiction 2020; 115:1607-1617. [PMID: 32043675 PMCID: PMC7496125 DOI: 10.1111/add.14969] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 01/10/2020] [Indexed: 12/22/2022]
Abstract
AIMS To examine variability and effectiveness of interventions provided to comparator (control) groups in smoking cessation trials. METHODS Systematic review with meta-analysis of randomized controlled trials (RCTs) of behavioral interventions for smoking cessation, with or without stop-smoking medication. We searched the Cochrane Tobacco Addiction Group Specialized Register for RCTs with objective outcomes measured at ≥ 6 months. Study authors were contacted to obtain comprehensive descriptions of their comparator interventions. Meta-regression analyses examined the relationships of smoking cessation rates with stop-smoking medication and behavior change techniques. RESULTS One hundred and four of 142 eligible comparator groups (n = 23 706) had complete data and were included in analyses. There was considerable variability in the number of behavior change techniques delivered [mean = 15.97, standard deviation (SD) = 13.54, range = 0-45] and the provision of smoking cessation medication (43% of groups received medication) throughout and within categories of comparator groups (e.g. usual care, brief advice). Higher smoking cessation rates were predicted by provision of medication [B = 0.334, 95% confidence interval (CI) = 0.030-0.638, P = 0.031] and number of behavior change techniques included (B = 0.020, 95% CI = 0.008-0.032, P < 0.001). Modelled cessation rates in comparator groups that received the most intensive support were 15 percentage points higher than those that received the least (23 versus 8%). CONCLUSIONS Interventions delivered to comparator groups in smoking cessation randomized controlled trials vary considerably in content, and cessation rates are strongly predicted by stop-smoking medication and number of behavior change techniques delivered.
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Affiliation(s)
- Nicola Black
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Health Sciences Building, ForesterhillAberdeenUK
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Maarten C. Eisma
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Health Sciences Building, ForesterhillAberdeenUK
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenthe Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Marie Johnston
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Health Sciences Building, ForesterhillAberdeenUK
| | - Robert West
- Department of Behavioral Science and HealthUniversity College LondonLondonUK
| | | | - Susan Michie
- Centre for behavior ChangeUniversity College LondonGower StreetLondonWC1E 6BTUK
| | - Marijn de Bruin
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Health Sciences Building, ForesterhillAberdeenUK
- Radboud University Medical CenterRadboud Institute for Health Sciences, IQ HealthcareNijmegenthe Netherlands
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46
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Brennan MC, Brown JA, Ntoumanis N, Leslie GD. Barriers and facilitators of physical activity participation in adults living with type 1 diabetes: a systematic scoping review. Appl Physiol Nutr Metab 2020; 46:95-107. [PMID: 32835497 DOI: 10.1139/apnm-2020-0461] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To identify and map barriers and facilitators of physical activity (PA) in adults living with type 1 diabetes (T1D) in any care setting or environment. A scoping review was conducted in accordance with the PRISMA-ScR guidelines to address the aim of this review. Exclusion/inclusion criteria were determined a priori. Articles captured in the search were subject to title and abstract screening before full-text articles were assessed for eligibility against the exclusion/inclusion criteria. Included articles underwent critical appraisal before being charted, mapped, and discussed. Forty-six articles were included in the final synthesis. Most commonly, articles reported cross-sectional survey studies (46%), then qualitative designs (17%), and opinion or text (17%). Experimental studies accounted for 13% of included articles. Hypoglycaemia/fear of hypoglycaemia was the most commonly reported barrier and patient education the most commonly discussed facilitator. Quality appraisal revealed methodological issues among included articles. Higher quality research with theoretically sound behaviour-change interventions combined with targeted patient education is needed to address hypoglycaemia/fear of hypoglycaemia as a barrier to PA. Novelty: Hypoglycaemia and fear of hypoglycaemia were the most commonly reported barriers to PA in adults with T1D. Powered randomised controlled trials are required to establish efficacy of behaviour change interventions targeting these barriers to PA.
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Affiliation(s)
- Marian C Brennan
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Health Services, Diabetes WA, Subiaco, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Janie A Brown
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,St John of God Midland Public and Private Hospital, Midland, WA 6056, Australia
| | - Nikos Ntoumanis
- School of Psychology/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Gavin D Leslie
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
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Masud J, Islam Bhuyian MS, Kumar Biswas S, Zohura F, Perin J, Papri N, Dil Farzana F, Parvin T, Monira S, Alam M, George CM. Diarrhoeal disease knowledge among diarrhoea patient housholds: findings from the randomised controlled trial of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) mobile health program. Trop Med Int Health 2020; 25:996-1007. [PMID: 32406989 DOI: 10.1111/tmi.13415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the impact of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) handwashing with soap and water treatment mobile health (mHealth) program on diarrhoeal disease knowledge among diarrhoea patients and their household members in urban Dhaka, Bangladesh. METHODS A cluster-randomised controlled trial of the CHoBI7 mHealth program was conducted among diarrhoea patient households in Dhaka, Bangladesh. Patients were randomised to three arms: standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (weekly voice and text messages) (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. An open-ended questionnaire was administered to 1468 participants 12 years of age or older on diarrhoeal disease transmission and prevention. These items were combined to form a diarrhoeal disease knowledge score measured at baseline and at a 1 week, 6 month and 12 month follow-up. RESULTS At baseline, when participants were asked to report three ways diarrhoeal diseases were spread 37% (546/1468) of participants reported by water, 13% (187/1468) by lack of handwashing and 4% (53/1468) by food not being covered properly. At baseline when asked to name three ways diarrhoeal diseases could be prevented, 35% (515/1468) of participants reported safe water, and 16% (228/1468) reported handwashing with soap. At the 12-month follow-up, the overall diarrhoeal disease knowledge score was significantly higher in the mHealth with no home visits arm (score coefficient: 0.69, 95% Confidence Interval: 0.36, 1.01, P < 0.0001) and the mHealth with two home visits arm (score coefficient: 1.18, 95% CI: 0.87, 1.49, P < 0.0001) compared with the standard recommendation arm. CONCLUSION The CHoBI7 mHealth program significantly increased knowledge of diarrhoeal disease transmission and prevention among diarrhoea patients and their household members 12 months after in-person visits for program delivery were conducted.
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Affiliation(s)
- Jahed Masud
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Shwapon Kumar Biswas
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fatema Zohura
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jamie Perin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nowshin Papri
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fahmida Dil Farzana
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmina Parvin
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shirajum Monira
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Munirul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Christine Marie George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Bourhill J, Lee JJ, Frie K, Aveyard P, Albury C. What Makes Opportunistic GP Interventions Effective? An Analysis of Behavior Change Techniques Used in 237 GP-Delivered Brief Interventions for Weight Loss. Ann Behav Med 2020; 55:228-241. [PMID: 32686819 DOI: 10.1093/abm/kaaa046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Evidence shows that clinician-delivered brief opportunistic interventions are effective in obesity, and guidelines promote their use. However, there is no evidence on how clinicians should do this, and guidelines are not based on clinical evidence. PURPOSE A trial (Brief Interventions for Weight Loss [BWeL]) showed that brief opportunistic interventions on obesity that endorsed, offered, and facilitated referral to community weight management service (CWMS) led to 77% agreeing to attend, and 40% attending CWMS, as well as significantly greater weight loss than control at 12 months. We assessed which behavior change techniques (BCTs) doctors used that were associated with CWMS attendance. METHODS We coded 237 recorded BWeL interventions using the behavioral change techniques version one taxonomy. We also coded the BWeL training video to examine delivery of recommended BCTs. Mixed effects logistic regression assessed the association between each BCT, the total number of BCTs, and delivery of recommended BCTs, with patient's agreement to attend and actual CWMS attendance. RESULTS Of 237 patients, 133 (56%) agreed to attend and 109 (46%) attended. Thirteen BCTs were used more than eight times but none of the 13 were associated with increased attendance. One, "practical social support," was significantly associated with increased patient agreement (odds ratio [OR] = 4.80, 95% confidence interval [CI] = 1.15, 20.13). Delivery of recommended BCTs and the total number of BCTs used were both associated with increased agreement (OR = 1.56, 95% CI = 1.09, 2.23 and OR = 1.34, 95% CI = 1.03, 1.75, respectively), but not attendance at CWMS (OR = 1.20, 95% CI = 0.98-1.47 and OR = 1.08, 95% CI = 0.94-1.24, respectively). CONCLUSIONS There is no evidence that particular BCT can increase the effectiveness of brief opportunistic interventions for obesity in adults. However, using more BCTs and delivery of recommended BCTs may increase agreement to attend community weight management services.
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Affiliation(s)
- Jana Bourhill
- University of Oxford Medical School, Osler House, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK.,Brasenose College, University of Oxford, Oxford, UK
| | - Joseph J Lee
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kerstin Frie
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Paul Aveyard
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Charlotte Albury
- Medical Sciences Division, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Nathan N, Murawski B, Hope K, Young S, Sutherland R, Hodder R, Booth D, Toomey E, Yoong SL, Reilly K, Tzelepis F, Taylor N, Wolfenden L. The Efficacy of Workplace Interventions on Improving the Dietary, Physical Activity and Sleep Behaviours of School and Childcare Staff: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144998. [PMID: 32664554 PMCID: PMC7400238 DOI: 10.3390/ijerph17144998] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 01/07/2023]
Abstract
There is a need for effective interventions that improve the health and wellbeing of school and childcare staff. This review examined the efficacy of workplace interventions to improve the dietary, physical activity and/or sleep behaviours of school and childcare staff. A secondary aim of the review was to assess changes in staff physical/mental health, productivity, and students’ health behaviours. Nine databases were searched for controlled trials including randomised and non-randomised controlled trials and quasi-experimental trials published in English up to October 2019. PRISMA guidelines informed screening and study selection procedures. Data were not suitable for quantitative pooling. Of 12,396 records screened, seven articles (based on six studies) were included. Most studies used multi-component interventions including educational resources, work-based wellness committees and planned group practice (e.g., walking groups). Multiple outcomes were assessed, findings were mixed and on average, there was moderate risk of bias. Between-group differences in dietary and physical activity behaviours (i.e., fruit/vegetable intake, leisure-time physical activity) favoured intervention groups, but were statistically non-significant for most outcomes. Some of the studies also showed differences favouring controls (i.e., nutrient intake, fatty food consumption). Additional robust studies testing the efficacy of workplace interventions to improve the health of educational staff are needed.
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Affiliation(s)
- Nicole Nathan
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
- Correspondence:
| | - Beatrice Murawski
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Kirsty Hope
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Sarah Young
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Rebecca Hodder
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Debbie Booth
- University Library, Academic Division, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;
| | - Elaine Toomey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, University Road, Galway H91 TK33, Ireland;
| | - Sze Lin Yoong
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Kathryn Reilly
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Flora Tzelepis
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Natalie Taylor
- Cancer Research Division, Cancer Council New South Wales, 153 Dowling St, Woolloomooloo, NSW 2011, Australia;
- School of Health Sciences, University of Sydney, Camperdown, NSW 2006, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Area Health Service, Longworth Avenue, Wallsend, NSW 2287, Australia; (S.Y.); (R.S.); (R.H.); (S.L.Y.); (K.R.); (F.T.); (L.W.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (B.M.); (K.H.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
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Ruiter RAC, Crutzen R. Core Processes: How to Use Evidence, Theories, and Research in Planning Behavior Change Interventions. Front Public Health 2020; 8:247. [PMID: 32671010 PMCID: PMC7326771 DOI: 10.3389/fpubh.2020.00247] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 05/20/2020] [Indexed: 11/24/2022] Open
Abstract
Psychology is not only a basic behavioral science but also an applied discipline that is used to solve societal problems. In a problem-driven context, the search for existing literature, the correct application of appropriate theories, and the collection of additional research data are basic tools essential for the systematic development of any theory- and evidence-based behavior change intervention. The processes of brainstorming, literature review, theory selection and application, and data collection are “Core Processes” that can be used in different phases/steps of intervention planning—from needs assessment to intervention design to program implementation and evaluation—and within different planning frameworks. In this paper, we illustrate how the use of these “Core Processes” provides expert, empirical and theoretical guidance to planners from problem definition to problem solution. Specific emphasis is put on finding theories that are potentially useful in providing answers to planning questions using a combination of approaches to access and select theories (i.e., the topic, concept, and general theories approaches). Furthermore, emphasis is put on the logic of answering planning questions in a specific order by first brainstorming before consulting the literature, then applying theories, and finally collecting additional data.
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Affiliation(s)
- Robert A C Ruiter
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
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