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Lawrence M, Davis B, Clark NE, Booth J, Donald G, Dougall N, Grealy M, Jani B, MacDonald J, Mason H, Maxwell M, Parkinson B, Pieri M, Wang X, Mercer S. In-person and online mixed method non-randomised studies exploring feasibility and acceptability of HEADS: UP, an adapted Mindfulness-Based Stress Reduction programme for stroke survivors experiencing symptoms of anxiety and depression. Pilot Feasibility Stud 2024; 10:119. [PMID: 39267177 PMCID: PMC11391595 DOI: 10.1186/s40814-024-01545-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 08/30/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND Depression and anxiety are prevalent after stroke and associated with poor outcomes. We previously co-developed a stroke-specific self-management intervention, HEADS: UP (Helping Ease Anxiety and Depression after Stroke). The two studies reported here aimed to test the feasibility and acceptability of the HEADS: UP course and supporting materials, and research processes ahead of a definitive trial. METHODS We recruited community-dwelling stroke survivors (SS) ≥ 3 months post-stroke, with symptoms of mood disorder (Hospital Anxiety and Depression Scale ≥ 8). Participants could 'enrol' a family member/ 'other' to take part with them, if desired. Study 1 tested HEADS: UP delivered in-person, and informed optimisation of research processes and intervention delivery and materials. In a pragmatic response to Covid-related socialising restrictions, HEADS: UP was then adapted for online delivery, tested in Study 2. The primary outcome (both studies) was the feasibility (acceptability, fidelity) of the intervention and of research processes. Quantitative data (including patient-reported outcome measures (PROMs) assessing mood and quality of life) and qualitative data were collected pre-/post-intervention. Descriptive statistics were used to analyse quantitative data; a thematic framework approach was used to analyse qualitative data. Both studies received ethical approval prior to commencement. RESULTS Study 1 Feasibility: 13 (59.1%) of 22 potentially eligible stroke survivors consented; aged 66 (median, interquartile range (IQR) 14); male (n = 9; 69%); 28 (IQR 34) months post-stroke. Of these, n = 10 (76.9%) completed PROMS pre-intervention; n = 6 (46.2%) post-intervention. Acceptability: Nine (69.2%) of the 13 participants attended ≥ 4 core intervention sessions. Aspects of screening and data collection were found to be burdensome. Study 2 Feasibility: SS n = 9 (41%) of 22 potentially eligible stroke survivors consented; aged 58 years (median; IQR 12); male (n = 4; 44.4%); 23 (IQR 34) months post-stroke. Of these, n = 5 (55.6%) completed PROMS pre-intervention; n = 5 (55.6%) post-intervention. Acceptability: Five (55.6%) of the 9 participants attended ≥ 4 core sessions. They found online screening and data collection processes straightforward.
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Affiliation(s)
- Maggie Lawrence
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow, Scotland, G4 0BA, UK.
| | - Bridget Davis
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow, Scotland, G4 0BA, UK
| | - Naomi E Clark
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow, Scotland, G4 0BA, UK
| | - Jo Booth
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow, Scotland, G4 0BA, UK
| | - Graeme Donald
- School of Health and Society, University of Salford, Salford, M6 6PU, UK
| | - Nadine Dougall
- Health and Social Care Sciences, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - Madeleine Grealy
- Psychological Services and Health, University of Strathclyde, Glasgow, G1 1XQ, UK
| | - Bhautesh Jani
- General Practice and Primary Care, School of Health and Wellbeing, MVLS, University of Glasgow, Glasgow, G12 9LJ, UK
| | - Jennifer MacDonald
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow, Scotland, G4 0BA, UK
| | | | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Ben Parkinson
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow, Scotland, G4 0BA, UK
| | - Matilde Pieri
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow, Scotland, G4 0BA, UK
| | - Xu Wang
- School of Humanities and Social Sciences, Leeds Beckett University, PD405 Portland Building, City Campus, Leeds, LS1 3HE, UK
| | - Stewart Mercer
- Primary Care and Multimorbidity, Usher Institute, University of Edinburgh, Edinburgh, Scotland, EH8 9AG, UK
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Whitfield MM, Bleah P, Concepcion Bachynski J, Macdonald D, Klein T, Ross-White A, Mimirinis M, Wilson R. Capability as a concept in advanced practice nursing and education: a scoping review. JBI Evid Synth 2024; 22:1789-1849. [PMID: 39175378 DOI: 10.11124/jbies-23-00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
OBJECTIVE The objective of this review was to map the literature about the concept of capability in advanced practice nursing education and practice to achieve greater clarity on the concept and its application. INTRODUCTION Advanced practice nursing roles make up a growing segment of the global nursing workforce. Capability has been proposed as an overarching description of the attributes of advanced practice nursing roles within complex workplace environments. Capability includes knowing how to learn, and the ability to creatively integrate prior knowledge, skills, judgment, and experience in both new and familiar situations. INCLUSION CRITERIA This review looked at the literature about capability applied to advanced practice nursing in any setting globally. We were guided by the International Council of Nurses' definition of advanced practice nursing, which includes nurses with both graduate education and an expanded scope of practice. Drawing from an initial review of the literature, we used a working definition of capability, which was a combination of knowledge, skills, experience, and competencies that enables advanced practice nurses to provide appropriate care for patients in both known and unfamiliar clinical settings. We included literature about individual capability as a concept in any setting related to advanced practice nursing and education. METHODS We searched 18 electronic databases and included qualitative, quantitative, and mixed methods study design methodologies, reviews, and reports. The gray literature search included policy and practice documents from the World Health Organization, the International Council of Nurses, and websites of 48 nursing and health organizations. Two reviewers independently completed title and abstract screening prior to full-text review and data extraction. Conflicts were resolved via discussion or with a third reviewer. Extraction was completed by 2 reviewers using a piloted data extraction tool. Articles published in English from 1975 to the present were included. Sources in languages other than English were not included in the review due to the difficulties in accurately translating the concept of capability. RESULTS Thirty-five sources were included in the review with publication dates from 2000 to 2023. Most sources originated from Australia, the United Kingdom, and the United States. Sources included frameworks and clinical guidelines, peer-reviewed articles, and gray literature. Capability was discussed in a range of settings, including specialized clinical roles. Applications of capability in educational settings included the use of capability frameworks to guide nurse practitioner education, nursing practice doctorates, and postgraduate nurse practitioner training. Definitions of capability, where provided, were relatively consistent. Capability was proposed as a distinguishing characteristic of advanced practice nursing, as a descriptor of clinical proficiency that moved beyond competency, and as a framework that accounted for complexity in health care settings. CONCLUSION Capability was used as a concept and framework to describe advanced practice nursing within complex practice environments that necessitate flexible approaches. Capability frameworks were applied holistically and to specific areas of practice or education, including in pregraduate and postgraduate advanced practice nursing education. Strategies for teaching and learning capability focused on flexibility, student-directed learning, and development of flexible learning pathways. SUPPLEMENTAL DIGITAL CONTENT A Norwegian-language version of the abstract of this review is available: http://links.lww.com/SRX/A58.
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Affiliation(s)
- Martha M Whitfield
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Community Nursing Department, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, Dartmouth, MA, United States
| | - Paulina Bleah
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Danielle Macdonald
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- The Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Tracy Klein
- College of Nursing, Washington State University Vancouver, Vancouver, WA, United States
| | - Amanda Ross-White
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- The Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Mike Mimirinis
- School of Human and Social Sciences, University of West London, London, United Kingdom
- Faculty of Humanities and Social Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Rosemary Wilson
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- The Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
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Saoudi I, Maltagliati S, Chalabaev A, Sarrazin P, Cheval B. Sociodemographic precursors of explicit and implicit attitudes towards physical activity. Psychol Health 2024:1-23. [PMID: 38946132 DOI: 10.1080/08870446.2024.2371964] [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: 07/31/2023] [Accepted: 06/19/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE In high-income countries, people with low socio-economic status (SES) engage in less leisure-time physical activity (PA) than those with higher SES. Beyond a materialistic account of this difference, the role of motivational precursors-among which attitudes are emblematic-remains poorly understood, particularly when it comes to dissociating the automatic vs. deliberative components of attitudes. This pre-registered study aimed to examine the associations between SES (i.e. income and educational attainment) and motivational precursors of PA (i.e. explicit and implicit attitudes), and whether gender and age may moderate these relationships. METHOD We used data from 970 adults (64% of women; mean age = 33 ± 12 years) from the Attitudes, Identities, and Individual Differences (AIID) study. RESULTS Results of multiple linear regression analyses showed that participants with the highest level of income (>150,000$ per year) reported more positive explicit and implicit attitudes towards PA than those with lower income. Exploratory analysis further showed that women reported weaker explicit attitudes towards PA, while both explicit and implicit attitudes towards PA became weaker at age increases. In contrast, educational attainment was not significantly associated with those attitudes, and there was only mixed evidence for a moderating role of participants' gender on the pattern of associations. CONCLUSION Our findings suggest that both the explicit and implicit attitudes towards PA may be socially patterned. Future intervention studies should examine whether these attitudinal differences could be reduced, and whether such a reduction could help buffer the unequal participation in PA behaviors across social groups.
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Affiliation(s)
| | | | | | | | - Boris Cheval
- Department of Sport Sciences and Physical Education, Ecole Normale Supérieure Rennes, Bruz, France
- Laboratory VIPS, University of Rennes, Rennes, France
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Puukko S, Heino MTJ, Kostamo K, Saurio K, Sniehotta FF, Hankonen N. How do behavioral public policy experts see the role of complex systems perspectives? An expert interview study. Transl Behav Med 2024; 14:417-425. [PMID: 38777342 PMCID: PMC11208291 DOI: 10.1093/tbm/ibae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Amidst the global momentum of behavioral insights (BI), there has been a shift from mostly nudge-based BI applications to systemic approaches. This is particularly pressing in public health, where interacting issues regularly produce unanticipated consequences. Regardless, little is known about adopting complex systems approaches in behavioral public policy. This study aims to capture current practices of international BI experts on the definition, application, drivers, and hindering factors in adopting complex systems approaches in public policy. Semi-structured individual expert interviews (n = 12) of international BI experts with extensive experience in educating, cooperating with, and/or advising public servants were analyzed with inductive content analysis. While the working definition of BI aligned with published definitions, experts varied in their descriptions of complex systems approaches and its significance for public policy, including socioecological aspects, systematic BI use across policy stages, recognizing intertwined behavior, and lack of ready-made solutions. They emphasized the importance of systems approaches, identifying drivers (e.g. need for a broader focus) and hindrances (e.g. pressure for quick results). Embracing complex systems in behavioral public policy provides a holistic perspective, extending beyond simple nudges, sometimes presumed as universally applicable. While complexity perspectives would align with policymakers' worldview, applications require more work to tailor to local situations and to evaluate. Recognizing that, given their distinct expertise content, BI expertise can be quite different from complex systems expertise. The field would benefit from clear descriptions and specialized training for effective integration and advocacy for these approaches.
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Affiliation(s)
- Sarmite Puukko
- The Unit of Social Research, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Matti T J Heino
- The Unit of Social Research, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Katri Kostamo
- The Unit of Social Research, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kaisa Saurio
- The Unit of Social Research, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Falko F Sniehotta
- Centre of Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- NIHR Policy Research Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Nelli Hankonen
- The Unit of Social Research, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Perowne R, Gutman LM. Barriers and enablers to the moderation of self-harm content for a young person's online forum. J Ment Health 2024; 33:357-365. [PMID: 35574666 DOI: 10.1080/09638237.2022.2069721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/04/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Self-harm amongst young people in the United Kingdom is higher than in other European countries. Young people who self-harm are often reluctant to seek professional help, turning increasingly to the internet for support, including online forums. There are concerns about misinformation or harmful content being shared, potentially leading to self-harm contagion. Moderation of online forums can reduce risks, improving forum safety. Moderation of self-harm content, however, is an under-researched area. AIMS Using the Behaviour Change Wheel (BCW), this study examines the barriers and enablers to moderation of self-harm content and suggests behaviour change techniques (BCTs) to address barriers. METHOD Qualitative interviews with 8 moderators (of a total of 16) from the UK's leading young people's support service for under 25s, The Mix, were conducted. RESULTS Thematic analysis identified eleven enablers, four barriers and one both an enabler and a barrier. Barriers included emotional exhaustion, working with partial information, access to timely support, vagueness within the guidelines and influence of community users. BCTs selected included increasing social support through a moderation buddy. CONCLUSIONS Optimisation strategies focus on increasing the support and level of information available to moderators and could be considered by other organisations providing similar services.
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Affiliation(s)
- Rachel Perowne
- Department of Clinical, Educational and Health Psychology, University College London, London, England
| | - Leslie Morrison Gutman
- Department of Clinical, Educational and Health Psychology, University College London, London, England
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Trần TB, Ambrens M, Nguyễn J, Coleman E, Gilanyi Y, Letton M, Pandit A, Lock L, Thom JM, Sen S, Lambert K, Arnold R. Preferences of people with chronic kidney disease regarding digital health interventions that promote healthy lifestyle: qualitative systematic review with meta-ethnography. BMJ Open 2024; 14:e082345. [PMID: 38802278 PMCID: PMC11131123 DOI: 10.1136/bmjopen-2023-082345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES Diet and physical activity are crucial for people with chronic kidney disease (CKD) to maintain good health. Digital health interventions can increase access to lifestyle services. However, consumers' perspectives are unclear, which may reduce the capacity to develop interventions that align with specific needs and preferences. Therefore, this review aims to synthesise the preferences of people with CKD regarding digital health interventions that promote healthy lifestyle. DESIGN Qualitative systematic review with meta-ethnography. DATA SOURCES Databases Scopus, CENTRAL, MEDLINE, CINAHL and SPORTDiscus were searched between 2000 and 2023. ELIGIBILITY CRITERIA Primary research papers that used qualitative exploration methods to explore the preferences of adults with CKD (≥18 years) regarding digital health interventions that promoted diet, physical activity or a combination of these health behaviours. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened title, abstract and full text. Discrepancies were resolved by a third reviewer. Consumers' quotes were extracted verbatim and synthesised into higher-order themes and subthemes. RESULTS Database search yielded 5761 records. One record was identified following communication with a primary author. 15 papers were included. These papers comprised 197 consumers (mean age 51.0±7.2), including 83 people with CKD 1-5; 61 kidney transplant recipients; 53 people on dialysis. Sex was reported in 182 people, including 53% male. Five themes were generated regarding consumers' preferences for digital lifestyle interventions. These included simple instruction and engaging design; individualised interventions; virtual communities of care; education and action plans; and timely reminders and automated behavioural monitoring. CONCLUSION Digital health interventions were considered an important mechanism to access lifestyle services. Consumers' preferences are important to ensure future interventions are tailored to specific needs and goals. Future research may consider applying the conceptual framework of consumers' preferences in this review to develop and evaluate the effect of a digital lifestyle intervention on health outcomes. PROSPERO REGISTRATION NUMBER CRD42023411511.
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Affiliation(s)
- Thái Bình Trần
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Meghan Ambrens
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Jennifer Nguyễn
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Eve Coleman
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Yannick Gilanyi
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Meg Letton
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Anurag Pandit
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Logan Lock
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Jeanette M Thom
- School of Health Sciences, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Shaundeep Sen
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Concord Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Ria Arnold
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
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Enticott G. 'Good farmers' and 'real vets': social identities, behaviour change and the future of bovine tuberculosis eradication. Ir Vet J 2023; 76:17. [PMID: 37501201 PMCID: PMC10375597 DOI: 10.1186/s13620-023-00245-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
This paper considers the role of social research and human behaviour in attempts to eradicate bTB. Future attempts to eradicate bTB are likely to involve an increasing range of sophisticated technologies. However, the acceptance and use of these technologies is likely to depend on a range of behavioural incentives. The use of appropriate behavioural nudges may facilitate bTB eradication, but the paper contends that of more value are socio-cultural approaches to understanding behaviour. Specifically, the concepts of the 'good farmer' and 'real vets' are discussed to show how bTB eradication is dependent on social identities. In conclusion, the paper outlines four key roles for social research in assisting with future bTB eradication policies.
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Affiliation(s)
- Gareth Enticott
- School of Geography and Planning, Cardiff University, Cardiff, CF10 3WA, Wales.
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Andrews ALMM, Youngman KL, Packer RMA, O’Neill DG, Kafarnik C. A Review of Clinical Outcomes, Owner Understanding and Satisfaction following Medial Canthoplasty in Brachycephalic Dogs in a UK Referral Setting (2016-2021). Animals (Basel) 2023; 13:2032. [PMID: 37370542 PMCID: PMC10295752 DOI: 10.3390/ani13122032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
Brachycephalic breeds have increased in popularity despite growing awareness of their predisposition to a wide range of conformation-related diseases. The extreme facial conformation of many popular brachycephalic breeds compromises their ocular surface health, increasing the risk of painful corneal ulceration. Medial canthoplasty (MC) is a surgical procedure to address ocular abnormalities in brachycephalic dogs, which are collectively referred to as brachycephalic ocular syndrome (BOS). This study retrospectively reviewed the records of dogs recommended MC at a referral hospital between 2016 and 2021. A questionnaire was designed to identify owners' perceptions pre- and post-operatively. From 271 brachycephalic dogs recommended MC, 43.5% (118/271) underwent surgery and 72.0% (85/118) were Pugs. The majority of dogs (73.7%, 87/118) that underwent surgery had current or historical corneal ulceration. Follow-up was available in 104 dogs, of which 5.7% (6/104) had corneal ulceration post-operatively. Sixty-four owners completed the questionnaire and reported post-operative corneal ulceration in 12.5% of dogs (8/64), reduced ocular discharge (70.8%, 34/48), reduced ocular irritation (67.7%, 21/31) and less periocular cleaning (52.5%, 32/61). Owners were satisfied with the clinical (85.9%, 55/64) and cosmetic (87.5%, 56/64) outcome. In conclusion, MC has high clinical relevance for the surgical management of BOS, restoring functional conformation and improving the quality of life of affected dogs.
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Affiliation(s)
- Amy L. M. M. Andrews
- Queen Mother Hospital for Animals, The Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK; (K.L.Y.); (C.K.)
| | - Katie L. Youngman
- Queen Mother Hospital for Animals, The Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK; (K.L.Y.); (C.K.)
| | - Rowena M. A. Packer
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK;
| | - Dan G. O’Neill
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK;
| | - Christiane Kafarnik
- Queen Mother Hospital for Animals, The Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK; (K.L.Y.); (C.K.)
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Ball L, Brickley B, Williams LT, Advocat J, Rieger E, Ng R, Gunatillaka N, Clark AM, Sturgiss E. Effectiveness, feasibility, and acceptability of behaviour change tools used by family doctors: a global systematic review. Br J Gen Pract 2023; 73:e451-e459. [PMID: 37126578 PMCID: PMC9926293 DOI: 10.3399/bjgp.2022.0328] [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: 06/23/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Priority patients in primary care include people from low-income, rural, or culturally and linguistically diverse communities, and First Nations people. AIM To describe the effectiveness, feasibility, and acceptability of behaviour change tools that have been tested by family doctors working with priority patients. DESIGN AND SETTING A global systematic review. METHOD Five databases were searched for studies published from 2000 to 2021, of any design, that tested the effectiveness or feasibility of tangible, publicly available behaviour change tools used by family doctors working with priority patients. The methodological quality of each study was appraised using the Mixed Methods Appraisal Tool. RESULTS Thirteen of 4931 studies screened met the eligibility criteria, and described 12 tools. The health-related behaviours targeted included smoking, diet and/or physical activity, alcohol and/or drug use, and suicidal ideation. Six tools had an online/web/app-based focus; the remaining six utilised only printed materials and/or in-person training. The effectiveness of the tools was assessed in 11 studies, which used diverse methods, with promising results for enabling behaviour change. The nine studies that assessed feasibility found that the tools were easy to use and enhanced the perceived quality of care. CONCLUSION Many of the identified behaviour change tools were demonstrated to be effective at facilitating change in a target behaviour and/or feasible for use in practice. The tools varied across factors, such as the mode of delivery and the way the tool was intended to influence behaviour. There is clear opportunity to build on existing tools to enable family doctors to assist priority patients towards achieving healthier lifestyles.
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Affiliation(s)
- Lauren Ball
- The University of Queensland, Saint Lucia, Australia
| | - Bryce Brickley
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Lauren T Williams
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Jenny Advocat
- School of Primary and Allied Health Care, Monash University, Victoria, Australia
| | | | - Raeann Ng
- School of Medicine, Monash University, Victoria, Australia
| | - Nilakshi Gunatillaka
- School of Primary and Allied Health Care, Monash University, Victoria, Australia
| | - Alexander M Clark
- Faculty of Health Disciplines, Athabasca University, Alberta, Canada
| | - Elizabeth Sturgiss
- School of Primary and Allied Health Care, Monash University, Victoria, Australia
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Leggett H, Vinall-Collier K, Csikar J, Veronica Ann Douglas G. Barriers to prevention in oral health care for english NHS dental patients: a qualitative study of views from key stakeholders. BMC Oral Health 2023; 23:332. [PMID: 37245009 DOI: 10.1186/s12903-023-03030-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/09/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Despite significant progress in the control of oral diseases since the discovery of fluoride in the 1940s, dental caries and periodontal diseases continue to affect a significant proportion of the population, particularly socially disadvantaged and lower socioeconomic groups. The National Health Service in England provides preventive advice and treatments as part of an oral health assessment, and evidence-based guidance recommends the use of fissure sealants and topical fluorides in addition to dietary and oral hygiene advice. Although oral health promotion and education have become expected parts of dental care, the need for restorative treatments remains relatively high. We aimed to explore how barriers to preventive advice and treatment for NHS patients may be hindering the provision of prevention in oral health to patients from the perspectives of multiple key stakeholders. METHODS Semi-structured interviews and focus groups were undertaken between March 2016-February 2017 with four groups of stakeholders: dentists, insurers, policy makers and patient participants. The interviews were analysed using deductive, reflexive thematic analysis. RESULTS Thirty-two stakeholders participated: 6 dentists, 5 insurers, 10 policy makers, and 11 patient participants. Four themes were developed: Perspectives on the clarity of oral health messaging and patient's knowledge, The variability of prioritising prevention, Influences of the dentist-patient relationship on effective communication and Motivation to enact positive oral health behaviours. CONCLUSIONS The findings from this research indicate that patients' knowledge of and priority placed on prevention is variable. Participants believed that more targeted education could be valuable in enhancing these. A patient's relationship with their dentist could also influence their level of knowledge through the information shared with them, their receptivity to the preventive messages and the value they place on it. However, even with knowledge, prioritising prevention and a good patient-dentist relationship, without motivation to engage in preventive behaviour the impact of these is reduced. Our findings are discussed in relation to the COM-B model of behaviour change.
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Affiliation(s)
- Heather Leggett
- The School of Dentistry, The University of Leeds, Leeds, UK.
| | | | - Julia Csikar
- The School of Dentistry, The University of Leeds, Leeds, UK
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Coteur K, Van Nuland M, Schoenmakers B, Van den Broeck K, Anthierens S. "At the time I only wanted to relieve stress": Exploring motivation for behaviour change in long-term hypnotic users. Heliyon 2023; 9:e16215. [PMID: 37234622 PMCID: PMC10205632 DOI: 10.1016/j.heliyon.2023.e16215] [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: 03/03/2023] [Revised: 04/07/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Background Motivating patients to discontinue long-term benzodiazepine receptor agonist (BZRA) use for insomnia remains an important challenge in primary care because of the medication's unfavourable risk-benefit profile. Previous studies have shown that understanding the complexity of patients' motivation is crucial to the primary care physician for providing effective interventions efficiently. Theoretical frameworks about behaviour change show that motivation is a multi-layered concept that interacts with other concepts, which aligns with a holistic perspective or implementation of the biopsychosocial model. Aim Exploring primary care patients' views and ideas on what factors helped or hindered them in discontinuing long-term BZRA use, in relation to motivation as conceptualised in the Behaviour Change Wheel, and associated domains of the Theoretical Domains Framework. Design and setting A qualitative study with semi-structured interviews in primary care in Belgium between September 2020 and March 2021. Method Eighteen interviews with long-term hypnotic users were audio recorded, transcribed and thematically analyzed, using the Framework Method. Results The success of discontinuation interventions does not solely rely on patients' spontaneous sense of striving for improvement. Reinforcement and identity were found to be important domains for motivation. Beliefs about personal capabilities, and about consequences of both BZRA intake and discontinuation, differed between previous and current users. Conclusion Motivation is a multi-layered concept which is not fixed in time. Patient empowerment and goal setting could help long-term BZRA users to lower their intake. As well as public health interventions that might change social attitudes towards the use of hypnotic medication.
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Affiliation(s)
- Kristien Coteur
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Belgium
| | - Marc Van Nuland
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Belgium
| | - Birgitte Schoenmakers
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Belgium
| | - Kris Van den Broeck
- Department of Family Medicine and Population Health, University of Antwerp, Belgium
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerp, Belgium
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Chen S, Wang R, Xu N, Zhang J, Liu Y, Cong S, Sun X, Zhu Z, Zhou H, Gu P, Zhang A. Identification of factors influencing core competence promotion among professional nurses and midwives: A qualitative study using the COM-B model. Nurse Educ Pract 2023; 69:103619. [DOI: 10.1016/j.nepr.2023.103619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 02/27/2023] [Accepted: 03/11/2023] [Indexed: 04/08/2023]
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Macdonald C, MacGregor B, Hillman S, MacArthur C, Bick D, Taylor B. Qualitative systematic review of general practitioners' (GPs') views and experiences of providing postnatal care. BMJ Open 2023; 13:e070005. [PMID: 37045584 PMCID: PMC10106050 DOI: 10.1136/bmjopen-2022-070005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES Develop an understanding of the views and experiences of general practitioners (GPs) about their role in postnatal care, including barriers and facilitators to good care, and timing and content of planned postnatal checks. DESIGN Qualitative systematic review. DATA SOURCES Electronic database searches of MEDLINE, EMBASE, CINAHL, PubMed, Web of Science, PsychINFO from January 1990 to September 2021. Grey literature and guideline references from National Institute of Health and Care Excellence, WHO, International Federation of Gynecology and Obstetrics, Royal College of General Practitioners, Royal College of Obstetrics and Gynaecology. INCLUSION CRITERIA Papers reporting qualitative data on views and experiences of GPs about postnatal care, including discrete clinical conditions in the postnatal period. Papers were screened independently by two reviewers and disputes resolved by a third reviewer. QUALITY APPRAISAL The Critical Appraisal Skills Programme checklist was used to appraise studies. DATA EXTRACTION AND SYNTHESIS Thematic synthesis involving line-by-line coding, generation of descriptive then analytical themes was conducted by the review team. The Capability, Opportunity, Motivation-Behaviour (COM-B) model was used to develop analytical themes. RESULTS 20 reports from 18 studies met inclusion criteria. Studies were published from 2008 to 2021, reporting on 469 GPs. 13 were from UK or Australia. Some also reported views of non-GP participants. The clinical focus of studies varied, for example: perinatal mental health, postnatal contraception. Five themes were generated, four mapped to COM-B: psychological capability, physical opportunity, social opportunity and motivation. One theme was separate from the COM-B model: content and timing of postnatal checks. Strong influences were in physical and social opportunity, with time and organisation of services being heavily represented. These factors sometimes influenced findings in the motivation theme. CONCLUSIONS GPs perceived their role in postnatal care as a positive opportunity for relationship building and health promotion. Addressing organisational barriers could impact positively on GPs' motivation to provide the best care. PROSPERO REGISTRATION NUMBER 268982.
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Affiliation(s)
- Clare Macdonald
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Becky MacGregor
- Unit of Academic Primary Care, University of Warwick, Coventry, UK
| | - Sarah Hillman
- Unit of Academic Primary Care, University of Warwick, Coventry, UK
| | - Christine MacArthur
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Debra Bick
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Beck Taylor
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Searby A, Burr D, Blums C, Harrison J, Smyth D. Barriers and facilitators to becoming an alcohol and other drug nurse practitioner in Australia: A mixed methods study. Int J Ment Health Nurs 2023; 32:839-853. [PMID: 36744685 DOI: 10.1111/inm.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/07/2023]
Abstract
Alcohol and other drug (AOD) nurse practitioners have an advanced scope of practice that allows them to diagnose, prescribe pharmacological treatments for alcohol and other substance use disorders, and monitor physical and mental health. The Behaviour Change Wheel (BCW) is used to understand barriers and facilitators to implementation by applying three conditions of behaviour change (capability, opportunity, and motivation-the COM-B framework). The aim of this paper is to describe the current AOD nurse practitioner workforce, and to explore barriers and facilitators to AOD nurse practitioner uptake in Australia. A mixed method approach was used in this study: a survey to determine the current state of the AOD nurse practitioner workforce (n = 41) and qualitative interviews with 14 participants to determine barriers to endorsement and ongoing work as a nurse practitioner. Interview transcripts were analysed using thematic analysis and mapped to the COM-B framework. The AOD nurse practitioner is a highly specialized provider of holistic care to people who use alcohol and other drugs, with AOD nurse practitioners performing advanced roles such as prescribing and medication management. However, there are several barriers to the further uptake of AOD nurse practitioners in Australia, including varied organizational support, a lack of support for the higher study required to become a nurse practitioner and a lack of available positions. Arguably, nurse practitioners are key to addressing prescriber shortages inherent in AOD treatment settings. In addition, they are equipped to provide true holistic care. We recommend that barriers are addressed to expand the AOD nurse practitioner workforce in Australia.
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Affiliation(s)
- Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
| | - Dianna Burr
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Colleen Blums
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
| | - Jason Harrison
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
- Central Queensland Mental Health, Alcohol and Other Drug Service, Rockhampton, Queensland, Australia
| | - Darren Smyth
- Drug and Alcohol Nurses of Australasia (DANA), Brisbane, Queensland, Australia
- Queensland Injectors Health Network (QuINH), Gold Coast, Queensland, Australia
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McNeil DW. Behavioural and cognitive-behavioural theories in oral health research: Current state and future directions. Community Dent Oral Epidemiol 2023; 51:6-16. [PMID: 36779644 PMCID: PMC10516240 DOI: 10.1111/cdoe.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 02/14/2023]
Abstract
OBJECTIVES Behavioural and cognitive-behavioural theories, models and frameworks have been incorporated for decades in behavioural and social oral health sciences, oral health care, and education of dentists, hygienists, and other oral healthcare professionals. METHODS While a myriad of these conceptualizations have been incorporated in this work, there are six of them that have had the greatest impact in the oral health arena: (a) Health Belief Model; (b) Theory of Reasoned Action, Theory of Planned Behavior and Integrated Behavioral Model, which are considered in unison; (c) Social Learning Theory and Social Cognitive Theory which are considered together; (d) Transtheoretical Model/Stages of Change Model; (e) Salutogenesis Model/Theory and Sense of Coherence Framework; and the (f) Behavior Change Wheel, Capability-Opportunity-Motivation-Behavior Model and Theoretical Domains Framework, which are categorized together. RESULTS An analysis of nomenclature (i.e. theories, models, frameworks and conceptualizations) is provided in the context of a description of each of these theories and models, with discussion about their aspects that particularly relate to oral health. Additionally, a quantitative, longitudinal view is provided of the frequency of use of these theories and models in the oral health arena. Given the benefits of theory-based intervention development, dissemination and implementation, it is important to consider these theories and models in a collective context. CONCLUSIONS At a basic level, these theories and models help in identifying and acting on mechanisms, both of behaviour itself and behaviour change. Future directions are discussed in terms of need for theory evolution and development.
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Lawrence M, Davis B, De Amicis L, Booth J, Dickson S, Dougall N, Grealy M, Jani B, Maxwell M, Parkinson B, Pieri M, Mercer S. The HEADS: UP Development Study: Working with Key Stakeholders to Adapt a Mindfulness-Based Stress Reduction Course for People with Anxiety and Depression after Stroke. Healthcare (Basel) 2023; 11:healthcare11030355. [PMID: 36766930 PMCID: PMC9914141 DOI: 10.3390/healthcare11030355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Following stroke, rates of mood disorder are and remain high at five years (anxiety 34.4%; depression 23%). Structured mindfulness-based stress reduction (MBSR) courses are effective in a range of health conditions, but stroke survivors find adherence challenging. We aimed to adapt a standard MBSR course specifically for people affected by stroke. METHODS We recruited stroke survivors and family members with symptoms of anxiety and/or depression to take part in a co-development study comprising two rounds of MBSR 'taster' sessions, followed by focus groups in which views were sought on the practices sampled. Data were collected in October 2017 and May 2018 and were analysed using framework analysis, informed adaptations to mindfulness materials and delivery. RESULTS Twenty-eight stroke survivors and seven family members participated. Nineteen (76%) stroke survivors had anxiety; 15 (60%) had depression. Five (71.4%) family members reported anxiety; n = 4 (57.1%) depression. Thirty participants attended the first round of taster sessions and focus groups; twenty (66%) the second and three (10%) were unable to attend either round. Framework analysis informed adaptations to course delivery, practices, and materials, ultimately resulting in a stroke-specific MBSR course, HEADS: UP (Helping Ease Anxiety and Depression after Stroke). CONCLUSIONS HEADS: UP may provide a feasible, appropriate, and meaningful self-management intervention to help alleviate symptoms of mood disorder.
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Affiliation(s)
- Maggie Lawrence
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
- Correspondence: ; Tel.: +44-(0)141-331-8863
| | - Bridget Davis
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Leyla De Amicis
- School of Education, University of Glasgow, Glasgow G3 6NH, UK
| | - Jo Booth
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Sylvia Dickson
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Nadine Dougall
- Health and Social Care Sciences, Edinburgh Napier University, Edinburgh EH11 4BN, UK
| | - Madeleine Grealy
- Psychological Services and Health, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Bhautesh Jani
- General Practice and Primary Care, School of Health and Wellbeing, MVLS, University of Glasgow, Glasgow G12 9LJ, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP-RU), Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Ben Parkinson
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Matilde Pieri
- Research Centre for Health (ReaCH), Glasgow Caledonian University (GCU), Glasgow G4 0BA, UK
| | - Stewart Mercer
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
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Nyangau PN, Nzuma JM, Irungu P, Junglen S, Kassie M. Health education impact on knowledge and management of arboviral diseases in Kenya: Evidence from randomised control trials. Glob Public Health 2023; 18:2274436. [PMID: 37902054 DOI: 10.1080/17441692.2023.2274436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/18/2023] [Indexed: 10/31/2023]
Abstract
Communities' knowledge and management strategies are crucial for mitigating and controlling the threat of existing and emerging diseases. In this study, we conducted randomised control trials (RCT) to examine the impact of health education on households' knowledge and management of three Arboviral Diseases (ADs); Rift Valley fever, Chikungunya fever, and Dengue fever in Kenya. The study was based on a sample of 629 households drawn from the three of Kenya's AD hotspot counties; Baringo, Kwale, and Kilifi. Employing a difference-in-difference method, our findings indicate that health education intervention significantly improved households' understanding of ADs transmission modes, causes, and prevention strategies. However, this intervention did not sufficiently influence households' disease management behaviour. We recommend the implementation of community engagement and outreach initiatives which have the potential to drive behavioural changes at the household level, thus enhancing the management and control of ADs in Kenya.
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Affiliation(s)
- Paul Nyamweya Nyangau
- Department of Agricultural Economics, Faculty of Agriculture, University of Nairobi, Nairobi, Kenya
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, Kenya
| | - Jonathan Makau Nzuma
- Department of Agricultural Economics, Faculty of Agriculture, University of Nairobi, Nairobi, Kenya
| | - Patrick Irungu
- Department of Agricultural Economics, Faculty of Agriculture, University of Nairobi, Nairobi, Kenya
| | - Sandra Junglen
- Berlin Institute of Health, Institute of Virology, Charité - Universitätsmedizin Berlin, Corporate Member of Free University Berlin, Humboldt-University Berlin, Berlin, Germany
- German Centre for Infection Research (DZIF), Associated Partner Site Charité, Berlin, Germany
| | - Menale Kassie
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, Kenya
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Williams DM. A meta-theoretical framework for organizing and integrating theory and research on motivation for health-related behavior. Front Psychol 2023; 14:1130813. [PMID: 36910809 PMCID: PMC9995609 DOI: 10.3389/fpsyg.2023.1130813] [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: 12/23/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
The concept of motivation is broad and multi-faceted. In health psychology, motivation has been conceptualized as cravings, urges, or desires for unhealthy behaviors, such as consumption of alcohol, cigarettes, or calorie-dense foods; or as behavioral intentions or proximal goals for healthy behaviors, such as smoking cessation, physical activity, or condom use. Because of the differences in terminology and associated theoretical underpinnings, it is difficult to characterize the state of the science or integrate research findings on motivation for health-related behavior. The present paper introduces a meta-theoretical Automatic-Reflective Motivation Framework (ARM-F) with the goals of organizing and integrating theory and research on motivation for health-related behaviors. At the first and broadest level, the ARM-F defines general motivation as a wanting or desire to do something. At the second level, it distinguishes between automatic and reflective motivation types, consistent with emerging perspectives in health psychology, historical and contemporary philosophical views on desire, and dual-processing perspectives in psychology. At the third level, the ARM-F preserves the nuanced terminologies and conceptualizations within the automatic (e.g., craving, urge, desire) and reflective (e.g., behavioral intention) motivation categories. The ARM-F has potential utility for organizing and integrating theory and research on motivation for health-related behavior, with implications for future research.
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Affiliation(s)
- David M Williams
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, United States
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Jose KA, Sharman MJ, Stanesby O, Greaves S, Venn AJ, Blizzard L, Palmer A, Cooper K, Williams J, Cleland VJ. Incentivising public transport use for physical activity gain: process evaluation of the COVID-19 disrupted trips4health randomised controlled trial. Int J Behav Nutr Phys Act 2022; 19:157. [PMID: 36550500 PMCID: PMC9772596 DOI: 10.1186/s12966-022-01394-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Partnering with a public transport (PT) provider, state government, and local government, the single-blinded randomised controlled trial, trips4health, investigated the impact of PT use incentives on transport-related physical activity (PA) in Tasmania, Australia. The intervention involved 16-weeks of incentives (bus trip credits) for achieving weekly PT use targets, supported by weekly text messages. This study objective was to conduct a process evaluation of the COVID-19 disrupted trips4health study. METHODS The Medical Research Council UK's framework for complex public health interventions guided the process evaluation. Participant reach, acceptability, fidelity and feasibility were evaluated. Administrative and post-intervention survey data were analysed descriptively. Semi-structured interviews with intervention participants (n = 7) and PT provider staff (n = 4) were analysed thematically. RESULTS Due to COVID-19, trips4health was placed on hold (March 2020) then stopped (May 2020) as social restrictions impacted PT use. At study cessation, 116 participants (approximately one third of target sample) had completed baseline measures, 110 were randomised, and 64 (n = 29 in the intervention group; n = 35 in the control group) completed post-intervention measures. Participants were 18 - 80 years (average 44.5 years) with females (69%) and those with tertiary education (55%) over-represented. The intervention was delivered with high fidelity with 96% of bus trip credits and 99% of behavioural text messages sent as intended. Interviewed PT staff said implementation was highly feasible. Intervention participant acceptability was high with 90% reporting bus trip incentives were helpful and 59% reporting the incentives motivated them to use PT more. From a total of 666 possible bus trip targets, 56% were met with 38% of intervention participants agreeing and 41% disagreeing that 'Meeting the bus trip targets was easy'. Interviews and open-ended survey responses from intervention participants revealed incentives motivated bus use but social (e.g., household member commitments) and systemic (e.g., bus availability) factors made meeting bus trip targets challenging. CONCLUSIONS trips4health demonstrated good acceptability and strong fidelity and feasibility. Future intervention studies incentivising PT use will need to ensure a broader demographic is reached and include more supports to meet PT targets. TRIAL REGISTRATION ACTRN12619001136190 .
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Affiliation(s)
- K A Jose
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - M J Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - O Stanesby
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - S Greaves
- Institute of Transport and Logistic Studies, The University of Sydney, Butlin Avenue, Darlington, Camperdown, New South Wales, 2006, Australia
| | - A J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - L Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - A Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - K Cooper
- Metro Tasmania, 212 Main Road, Moonah, Hobart, Tasmania, 7009, Australia
| | - J Williams
- Public Health Services, Department of Health, Tasmanian Government, 2/25 Argyle Street, Hobart, 7001, Australia
| | - V J Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Kristensen CB, Ide M, Forbes A, Asimakopoulou K. Psychologically informed oral health interventions in pregnancy and type 2 diabetes: A scoping review. FRONTIERS IN ORAL HEALTH 2022; 3:1068905. [PMID: 36620123 PMCID: PMC9811123 DOI: 10.3389/froh.2022.1068905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Oral health is a critical aspect of gestational diabetes management. Gestational diabetes is high blood glucose levels during pregnancy and is managed like type 2 diabetes with diet and physical activity interventions. This scoping review sets out to discuss why oral health support should also become part of gestational diabetes management. Objectives The primary objective was to synthesise the existing psychologically informed oral health interventions for pregnant women and individuals with type 2 diabetes, and the extent to which these interventions map on to the COM-B Model. No literature exists on oral health interventions in gestational diabetes, why studies with type 2 diabetes populations were selected instead. The secondary objective was to identify the precise outcomes targeted in the interventions. Methodology The Joanna Briggs Institute's Methodology for Scoping Reviews was used to conduct this review. The populations of interest were pregnant women and individuals with type 2 diabetes, and eligible concepts were psychologically informed oral health interventions. Quasi-experimental and experimental designs were considered. The Ovid Interface including Embase, Medline, Global Health, APA PsychInfo, Health Management Information, Maternity, Infant Care Database, the Cochrane Library, and CINAHL was used as information sources. The study selection followed the PRISMA guidelines. The first search was conducted on the week commencing the 25th of July 2022, with a follow-up search conducted on the 10th of October 2022. Results 28 records were included for synthesis. The most frequently assessed psychological outcome was oral health knowledge and the most frequently assessed oral clinical outcome was Plaque Index. All studies used an educational intervention approach, while psychological capability in the COM-B Model was targeted in all interventions by increasing oral health knowledge among the participants. The Health Belief Model was the most frequently used theory in the interventions. Conclusion The results demonstrate that oral health is a recognised aspect of pregnancy and type 2 diabetes. The findings from this review and a qualitative interview study which is under development will inform the first oral health intervention for women with gestational diabetes in the United Kingdom.
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Affiliation(s)
- Camilla Böhme Kristensen
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Mark Ide
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Angus Forbes
- Care in Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Koula Asimakopoulou
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
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Zhang C, Sankaran S, Aarts H. A functional analysis of personal autonomy: How restricting ‘what’, ‘when’ and ‘how’ affects experienced agency and goal motivation. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2022. [DOI: 10.1002/ejsp.2923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Chao Zhang
- Department of Psychology Utrecht University Utrecht The Netherlands
| | - Supraja Sankaran
- Department of Industrial Design Eindhoven University of Technology Eindhoven The Netherlands
| | - Henk Aarts
- Department of Psychology Utrecht University Utrecht The Netherlands
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Furtado T, Perkins E, Pinchbeck G, McGowan C, Watkins F, Christley R. Exploring human behavior change in equine welfare: Insights from a COM-B analysis of the UK's equine obesity epidemic. Front Vet Sci 2022; 9:961537. [DOI: 10.3389/fvets.2022.961537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
While equine obesity is understood by equine professionals to be a serious and widespread welfare problem, thus far approaches to reducing the prevalence of obesity in the UK's leisure horses have mainly been limited to educating owners about the dangers of obesity in their horses. In human health, approaches to behavior change encourage holistic thinking around human behavior, recognizing the importance of the connection between the individuals' knowledge, attitudes, habits, and the social and physical environments. This study used qualitative data from interviews with horse owners and professionals, open-access discussion fora and focus groups in order to collate extensive information about the factors shaping the UK's equine obesity crisis. The data were initially analyzed using a grounded theory method to determine the common themes, and were then analyzed using the COM-B model of behavior change, in order to identify areas where human behavior change might be better supported. The analysis highlighted the importance of a holistic approach to behavior change, since all areas of the COM-B were important in limiting owners' recognition of, and response to, equine obesity. For example, environments and social norms limited the likelihood of owners proactively managing horse weight, and owners also found it difficult to identify overweight horses, and evaluate the risks of long-term health issues as a result of weight, with short-term negative impacts of weight management. While interventions often aim to educate owners into changing their behavior, this analysis highlights the importance of creative and holistic approaches which work alongside the owners' motivations, while shaping the social and physical environments.
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Furtado T, Rendle D. To improve welfare in the equine species should we place greater emphasis on understanding our own? Equine Vet J 2022; 54:1001-1004. [PMID: 36196749 DOI: 10.1111/evj.13869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Tamzin Furtado
- Department of Livestock and One Health, University of Liverpool, Neston, UK
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Powell-Wiley TM, Martinez MF, Tamura K, Neally SJ, O'Shea KJ, Curlin K, Albarracin Y, Vijayakumar NP, Morgan M, Ortiz-Chaparro E, Bartsch SM, Osei Baah F, Wedlock PT, Ortiz-Whittingham LR, Scannell S, Potharaju KA, Randall S, Solano Gonzales M, Domino M, Ranganath K, Hertenstein D, Syed R, Weatherwax C, Lee BY. The Impact of a Place-Tailored Digital Health App Promoting Exercise Classes on African American Women's Physical Activity and Obesity: Simulation Study. J Med Internet Res 2022; 24:e30581. [PMID: 35994313 PMCID: PMC9446149 DOI: 10.2196/30581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 12/17/2021] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The increasing prevalence of smartphone apps to help people find different services raises the question of whether apps to help people find physical activity (PA) locations would help better prevent and control having overweight or obesity. OBJECTIVE The aim of this paper is to determine and quantify the potential impact of a digital health intervention for African American women prior to allocating financial resources toward implementation. METHODS We developed our Virtual Population Obesity Prevention, agent-based model of Washington, DC, to simulate the impact of a place-tailored digital health app that provides information about free recreation center classes on PA, BMI, and overweight and obesity prevalence among African American women. RESULTS When the app is introduced at the beginning of the simulation, with app engagement at 25% (eg, 25% [41,839/167,356] of women aware of the app; 25% [10,460/41,839] of those aware downloading the app; and 25% [2615/10,460] of those who download it receiving regular push notifications), and a 25% (25/100) baseline probability to exercise (eg, without the app), there are no statistically significant increases in PA levels or decreases in BMI or obesity prevalence over 5 years across the population. When 50% (83,678/167,356) of women are aware of the app; 58.23% (48,725/83,678) of those who are aware download it; and 55% (26,799/48,725) of those who download it receive regular push notifications, in line with existing studies on app usage, introducing the app on average increases PA and decreases weight or obesity prevalence, though the changes are not statistically significant. When app engagement increased to 75% (125,517/167,356) of women who were aware, 75% (94,138/125,517) of those who were aware downloading it, and 75% (70,603/94,138) of those who downloaded it opting into the app's push notifications, there were statistically significant changes in PA participation, minutes of PA and obesity prevalence. CONCLUSIONS Our study shows that a digital health app that helps identify recreation center classes does not result in substantive population-wide health effects at lower levels of app engagement. For the app to result in statistically significant increases in PA and reductions in obesity prevalence over 5 years, there needs to be at least 75% (125,517/167,356) of women aware of the app, 75% (94,138/125,517) of those aware of the app download it, and 75% (70,603/94,138) of those who download it opt into push notifications. Nevertheless, the app cannot fully overcome lack of access to recreation centers; therefore, public health administrators as well as parks and recreation agencies might consider incorporating this type of technology into multilevel interventions that also target the built environment and other social determinants of health.
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Affiliation(s)
- Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Marie F Martinez
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
- Center for Advanced Technology and Communication in Health, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Kosuke Tamura
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Sciences Branch, Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Sam J Neally
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Kelly J O'Shea
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
- Center for Advanced Technology and Communication in Health, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Kaveri Curlin
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Yardley Albarracin
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Nithya P Vijayakumar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Matthew Morgan
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Erika Ortiz-Chaparro
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Sarah M Bartsch
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
- Center for Advanced Technology and Communication in Health, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Foster Osei Baah
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Patrick T Wedlock
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
- Center for Advanced Technology and Communication in Health, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Lola R Ortiz-Whittingham
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Sheryl Scannell
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
- Center for Advanced Technology and Communication in Health, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Kameswari A Potharaju
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Samuel Randall
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Mario Solano Gonzales
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Molly Domino
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Kushi Ranganath
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Daniel Hertenstein
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Rafay Syed
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Colleen Weatherwax
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
- Center for Advanced Technology and Communication in Health, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Bruce Y Lee
- Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
- Center for Advanced Technology and Communication in Health, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
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Zhang C, Adriaanse MA, Potgieter R, Tummers L, de Wit J, Broersen J, de Bruin M, Aarts H. Habit formation of preventive behaviours during the COVID-19 pandemic: a longitudinal study of physical distancing and hand washing. BMC Public Health 2022; 22:1588. [PMID: 35987602 PMCID: PMC9392502 DOI: 10.1186/s12889-022-13977-1] [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: 01/19/2022] [Accepted: 07/25/2022] [Indexed: 11/02/2022] Open
Abstract
Abstract
Background
Since the outbreak of the COVID-19 pandemic, physical distancing and hand washing have been used as effective means to reduce virus transmission in the Netherlands. However, these measures pose a societal challenge as they require people to change their customary behaviours in various contexts. The science of habit formation is potentially useful for informing policy-making in public health, but the current literature largely overlooked the role of habit in predicting and explaining these preventive behaviours. Our research aimed to describe habit formation processes of physical distancing and hand washing and to estimate the influences of habit strength and intention on behavioural adherence.
Methods
A longitudinal survey was conducted between July and November 2020 on a representative Dutch sample (n = 800). Respondents reported their intentions, habit strengths, and adherence regarding six context-specific preventive behaviours on a weekly basis. Temporal developments of the measured variables were visualized, quantified, and mapped onto five distinct phases of the pandemic. Regression models were used to test the effects of intention, habit strength, and their interaction on behavioural adherence.
Results
Dutch respondents generally had strong intentions to adhere to all preventive measures and their adherence rates were between 70% and 90%. They also self-reported to experience their behaviours as more automatic over time, and this increasing trend in habit strength was more evident for physical-distancing than for hand washing behaviours. For all six behaviours, both intention and habit strength predicted subsequent adherence (all ps < 2e-16). In addition, the predictive power of intention decreased over time and was weaker for respondents with strong habits for physical distancing when visiting supermarkets (B = -0.63, p <.0001) and having guests at home (B = -0.54, p <.0001) in the later phases of the study, but not for hand washing.
Conclusions
People’s adaptations to physical-distancing and hand washing measures involve both intentional and habitual processes. For public health management, our findings highlight the importance of using contextual cues to promote habit formation, especially for maintaining physical-distancing practices. For habit theories, our study provides a unique dataset that covers multiple health behaviours in a critical real-world setting.
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Sabbagh HJ, Abdelaziz W, Quritum M, AlKhateeb NA, Abourdan J, Qureshi N, Qureshi S, Hamoud AHN, Mahmoud N, Odeh R, Al-Khanati NM, Jaber R, Balkhoyor AL, Shabi M, Folayan MO, Alade O, Gomaa N, Alnahdi R, Mahmoud NA, El Wazziki H, Alnaas M, Samodien B, Mahmoud RA, Abu Assab N, Saad S, Alhachim SG, El Tantawi M. Cigarettes' use and capabilities-opportunities-motivation-for-behavior model: a multi-country survey of adolescents and young adults. Front Public Health 2022; 10:875801. [PMID: 35937229 PMCID: PMC9353685 DOI: 10.3389/fpubh.2022.875801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/27/2022] [Indexed: 01/08/2023] Open
Abstract
The use of cigarettes among adolescents and young adults (AYA) is an important issue. This study assessed the association between regular and electronic-cigarettes use among AYA and factors of the Capability-Motivation-Opportunity-for-Behavior-change (COM-B) model. A multi-country survey was conducted between August-2020 and January-2021, Data was collected using the Global-Youth-Tobacco-Survey and Generalized-Anxiety-Disorder-7-item-scale. Multi-level logistic-regression-models were used. Use of regular and electronic-cigarettes were dependent variables. The explanatory variables were capability-factors (COVID-19 status, general anxiety), motivation-factors (attitude score) and opportunity-factors (country-level affordability scores, tobacco promotion-bans, and smoke free-zones) controlling for age and sex. Responses of 6,989-participants from 25-countries were used. Those who reported that they were infected with COVID-19 had significantly higher odds of electronic-cigarettes use (AOR = 1.81, P = 0.02). Normal or mild levels of general anxiety and negative attitudes toward smoking were associated with significantly lower odds of using regular-cigarettes (AOR = 0.34, 0.52, and 0.75, P < 0.001) and electronic-cigarettes (AOR = 0.28, 0.45, and 0.78, P < 0.001). Higher affordability-score was associated with lower odds of using electronic-cigarettes (AOR = 0.90, P = 0.004). Country-level-smoking-control policies and regulations need to focus on reducing cigarette affordability. Capability, motivation and opportunity factors of the COM-B model were associated with using regular or electronic cigarettes.
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Affiliation(s)
- Heba Jafar Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- *Correspondence: Heba Jafar Sabbagh
| | - Wafaa Abdelaziz
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Joud Abourdan
- Medical Faculty, Istanbul Medipol University, Istanbul, Turkey
| | - Nafeesa Qureshi
- City Quay Dental Practice and Implant Centre, Dundee, Scotland
| | - Shabnum Qureshi
- Department of Education, University of Kashmir, Srinagar, India
| | | | - Nada Mahmoud
- Faculty of Dentistry, National Ribat University, Khartoum, Sudan
| | - Ruba Odeh
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Nuraldeen Maher Al-Khanati
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Rawiah Jaber
- General Courses, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mohammed Shabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Omolola Alade
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Noha Gomaa
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Raqiya Alnahdi
- Department of Dental Surgery, Oman Dental College, Muscat, Oman
| | | | - Hanane El Wazziki
- Laboratory of Cereal Plant Pathology, National Institute for Argonomic Research, Settat, Morocco
| | - Manal Alnaas
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, Scotland
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, South Africa
| | | | | | | | | | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Li R, Zheng L, Yuan L. TMT's decision-making on adoption of management innovation. JOURNAL OF ORGANIZATIONAL CHANGE MANAGEMENT 2022. [DOI: 10.1108/jocm-10-2021-0311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeExternal environment drives established enterprises to employ management innovation. Drawing on dual-process theories, this paper purports to investigate TMT's intuitive and rational decision-making styles as mediating roles between perceived environmental turbulences and management innovation, and explain how organizational slack play an critical moderating role.Design/methodology/approachSPSS 25 is used to test 120 established enterprises' top management team (TMT) samples in China, and the moderated mediation model is empirically tested by using hierarchical regression analysis and conditional process analysis.FindingsPerceived environmental turbulences promotes management innovation. Organizational slack as contextual variable influences the relationship between technology turbulence and TMT's decision-making styles. Interestingly, only perceived technology turbulence indirectly affects management innovation through TMT's intuitive decision-making when moderated by organizational slack. However, the indirect effect from perceived market turbulence to management innovation through TMT's rational decision-making is not significant when moderated by organizational slack.Originality/valueBased on management innovation's human agency perspective, TMT's decision-making styles have not been discussed in research on management innovation. This paper sheds light on TMT's decision-making styles as mediating role.
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Aljafari A, ElKarmi R, Nasser O, Atef A, Hosey MT. A Video-Game-Based Oral Health Intervention in Primary Schools—A Randomised Controlled Trial. Dent J (Basel) 2022; 10:dj10050090. [PMID: 35621543 PMCID: PMC9139898 DOI: 10.3390/dj10050090] [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: 04/07/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Poor oral health practices and high levels of dental caries have been reported among children in the developing world. Video games have been successful in promoting oral health in children. The aim of this study was to assess the impact of an oral-health-education video game on children’s dietary knowledge and dietary and toothbrushing practices; Methods: Two Schools in Amman, Jordan were randomly selected and assigned to either intervention or control. Six- to eight-year old children took part. The intervention group played the oral-health-education video game; the control group received no intervention. The groups were compared in terms of changes in: child dietary knowledge, dietary and toothbrushing practices, plaque scores, and parental familiarity with preventive treatments. Data were submitted to statistical analysis with the significance level set at p ≤ 0.05. Results: Two hundred and seventy-eight children took part. Most (92%) had carious teeth. At baseline, children reported having more than one sugary snack a day and only 33% were brushing twice a day. Most parents were unaware of fluoride varnish (66%) or fissure sealants (81%). At follow-up, children in the intervention group had significantly better dietary knowledge, and parents in both groups became more familiar with fluoride varnish. There were no significant changes in children’s plaque scores, toothbrushing and dietary practices, or parental familiarity with fissure sealants in either group. Conclusions: Using an oral-health-education video game improved children’s dietary knowledge. However, future efforts should target children together with parents, and need to be supplemented by wider oral-health-promotion.
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Affiliation(s)
- Ahmad Aljafari
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman 11942, Jordan;
- Correspondence:
| | - Rawan ElKarmi
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman 11942, Jordan;
| | - Osama Nasser
- Department of Dentistry, Jordan University Hospital, Amman 11942, Jordan; (O.N.); (A.A.)
| | - Ala’a Atef
- Department of Dentistry, Jordan University Hospital, Amman 11942, Jordan; (O.N.); (A.A.)
| | - Marie Therese Hosey
- Centre of Oral, Clinical and Translational Science, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London WC2R 2LS, UK;
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Andersen RM, Skou ST, Clausen MB, Jäger M, Zangger G, Grøntved A, Brønd JC, Soja AMB, Tang LH. Maintenance of physical activity after cardiac rehabilitation (FAIR): study protocol for a feasibility trial. BMJ Open 2022; 12:e060157. [PMID: 35383088 PMCID: PMC8984013 DOI: 10.1136/bmjopen-2021-060157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION To enhance health and prevent secondary consequences for patients with cardiovascular disease (CVD), maintenance of an active lifestyle following participation in cardiac rehabilitation (CR) is important. However, levels of physical activity often decrease after completion of a structured CR programme. Models that support long-term behaviour change with a sustained level of physical activity are imperative. The aim of this study is to evaluate the feasibility of a mobile health intervention based on the Health Action Process Approach theoretical model of behaviour change in patients with CVD for 3 months after completion of a CR programme. METHODS AND ANALYSIS In a feasibility trial design, we will recruit 40 participants from CR programmes at Slagelse Hospital, the City of Slagelse (municipality), or Holbæk Hospital. After completing the standard structured CR programme, each participant will create an action plan for physical activity together with a physiotherapist. Following that, participants are sent 2 weekly text messages for 3 months. The first text message prompts physical activity, and the second will check if the action plan has been followed. If requested by participants, a coordinator will call and guide the physical activities behaviour. The feasibility of this maintenance intervention is evaluated based on predefined progression criteria. Physical activity is measured with accelerometers at baseline and at 3 months follow-up. ETHICS AND DISSEMINATION Study approval was waived (EMN-2021-00020) by the Research Ethics Committee of Region Zealand, Denmark. Study results will be made public and findings disseminated to patients, health professionals, decision-makers, researchers and the public. TRIAL REGISTRATION NUMBER NCT05011994.
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Affiliation(s)
- Rune Martens Andersen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Søren Thorgaard Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mikkel Bek Clausen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Madalina Jäger
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Graziella Zangger
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jan Christian Brønd
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Lars H Tang
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Santos S, Smania-Marques R, Albino VA, Fernandes ID, Mangueira FFA, Altafim RAP, Olinda R, Smith M, Traxler J. Prevention and control of mosquito-borne arboviral diseases: lessons learned from a school-based intervention in Brazil (Zikamob). BMC Public Health 2022; 22:255. [PMID: 35135522 PMCID: PMC8822808 DOI: 10.1186/s12889-022-12554-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Since the 1980s, when dengue was reintroduced in Brazil, outbreaks and epidemics caused by different arbovirus strains transmitted by vector mosquitoes such as Aedes aegypti have been an annual occurrence. The aim of this study was to evaluate the behavioural change of high school students and teachers who participated in an educational intervention for the prevention and vector control of arboviral diseases. Methods In this school-based intervention, a self-reported questionnaire was used in a pre-post intervention methodology to assess environmental risk factors, sociodemographic variables and to measure attitudes and behaviours. In all, 883 high school students and teachers from the city of Campina Grande, in the state of Paraíba, northeastern Brazil, participated. The e-health intervention consisted of a competition between schools to comply with preventive actions via content production for social networks, and the monitoring was performed over a period of three months through the ZikaMob software developed by the researchers. Results Out of the 883 survey participants, 690 were students ranging in age from 14 to 41 years, with an average of 17 ± 2 years; and 193 were teachers from 22 to 64 years old, averaging 38 ± 9 years. The analysis of the data shows that significant differences in most of the target behaviours were apparent after the intervention, with an increase of about 10% in the performance of inspection actions; a 7% greater separation of recyclables and a 40% increase in the screening of windows among students. Students showed lower fear of, and a lower self-perception of the risk of, acquiring arboviruses than teachers on average. Conclusions ZikaMob is an innovative strategy with the potential to be replicated in any location that has an internet network and can involve an unlimited number of participants. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12554-w.
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Affiliation(s)
- Silvana Santos
- Public Health Programme, Universidade Estadual da Paraíba - Campus I - Bodocongó, Rua das Baraúnas, s/n - Prédio da Integração Acadêmica - sala 329, Campina Grande, 58490-500, Brazil.
| | | | - Victor Alves Albino
- Public Health Programme, Universidade Estadual da Paraíba - Campus I - Bodocongó, Rua das Baraúnas, s/n - Prédio da Integração Acadêmica - sala 329, Campina Grande, 58490-500, Brazil
| | - Izabelly Dutra Fernandes
- Public Health Programme, Universidade Estadual da Paraíba - Campus I - Bodocongó, Rua das Baraúnas, s/n - Prédio da Integração Acadêmica - sala 329, Campina Grande, 58490-500, Brazil.,Department of Biology, Universidade Estadual da Paraíba, Campina Grande, Brazil.,Secretary of Education, Science and Technology, State of Paraíba, João Pessoa, Brazil
| | - Francisco Fernandes Abel Mangueira
- Public Health Programme, Universidade Estadual da Paraíba - Campus I - Bodocongó, Rua das Baraúnas, s/n - Prédio da Integração Acadêmica - sala 329, Campina Grande, 58490-500, Brazil
| | | | - Ricardo Olinda
- Department of Statistics, Universidade Estadual da Paraíba, Campina Grande, Brazil
| | - Matt Smith
- Education Observatory, University of Wolverhampton, Wolverhampton, UK
| | - John Traxler
- Education Observatory, University of Wolverhampton, Wolverhampton, UK
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Schmidtke KA, Aujla N, Marshall T, Hussain A, Hodgkinson GP, Arheart KL, Birnbach DJ, Kudrna L, Vlaev I. A Crossover Randomized Controlled Trial of Priming Interventions to Increase Hand Hygiene at Ward Entrances. Front Public Health 2022; 9:781359. [PMID: 35111716 PMCID: PMC8801705 DOI: 10.3389/fpubh.2021.781359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundResearch conducted in the United States suggests that two primes (citrus smells and pictures of a person's eyes) can increase hand gel dispenser use on the day they are introduced in hospital. The current study, conducted at a hospital in the United Kingdom, evaluated the effectiveness of these primes, both in isolation and in combination, at the entry way to four separate wards, over a longer duration than the previous work.MethodsA crossover randomized controlled trial was conducted. Four wards were allocated for 6 weeks of observation to each of four conditions, including “control,” “olfactory,” “visual,” or “both” (i.e., “olfactory” and “visual” combined). It was hypothesized that hand hygiene compliance would be greater in all priming conditions relative to the control condition. The primary outcome was whether people used the gel dispenser when they entered the wards. After the trial, a follow up survey of staff at the same hospital assessed the barriers to, and facilitators of, hand hygiene compliance. The trial data were analyzed using regression techniques and the survey data were analyzed using descriptive statistics.ResultsThe total number of individuals observed in the trial was 9,811 (female = 61%), with similar numbers across conditions, including “control” N = 2,582, “olfactory” N = 2,700, “visual” N = 2,488, and “both” N = 2,141. None of the priming conditions consistently increased hand hygiene. The lowest percentage compliance was observed in the “both” condition (7.8%), and the highest was observed in the “visual” condition (12.7%). The survey was completed by 97 staff (female = 81%). “Environmental resources” and “social influences” were the greatest barriers to staff cleaning their hands.ConclusionsTaken together, the current findings suggest that the olfactory and visual priming interventions investigated do not influence hand hygiene consistently. To increase the likelihood of such interventions succeeding, future research should focus on prospectively determined mechanisms of action.
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Affiliation(s)
| | - Navneet Aujla
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Tom Marshall
- Primary Care Clinical Sciences Institute of Applied Health Research College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Abid Hussain
- Public Health England, Public Health Laboratory, Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - Gerard P. Hodgkinson
- Manchester Institute of Innovation Research, Alliance Manchester Business School, The University of Manchester, Manchester, United Kingdom
| | - Kristopher L. Arheart
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States
| | - David J. Birnbach
- Department of Anesthesiology, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Laura Kudrna
- Institute of Applied Health, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Laura Kudrna
| | - Ivo Vlaev
- Behavioral Science Group, Warwick Business School, The University of Warwick, Coventry, United Kingdom
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McBride E, Mase H, Kerrison RS, Marlow LAV, Waller J. Improving postal survey response using behavioural science: a nested randomised control trial. BMC Med Res Methodol 2021; 21:280. [PMID: 34922447 PMCID: PMC8684081 DOI: 10.1186/s12874-021-01476-7] [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: 07/29/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022] Open
Abstract
Background Systematic reviews have identified effective strategies for increasing postal response rates to questionnaires; however, most studies have isolated single techniques, testing the effect of each one individually. Despite providing insight into explanatory mechanisms, this approach lacks ecological validity, given that multiple techniques are often combined in routine practice. Methods We used a two-armed parallel randomised controlled trial (n = 2702), nested within a cross-sectional health survey study, to evaluate whether using a pragmatic combination of behavioural science and evidenced-based techniques (e.g., personalisation, social norms messaging) in a study invitation letter increased response to the survey, when compared with a standard invitation letter. Participants and outcome assessors were blinded to group assignment. We tested this in a sample of women testing positive for human papillomavirus (HPV) at cervical cancer screening in England. Results Overall, 646 participants responded to the survey (response rate [RR] = 23.9%). Logistic regression revealed higher odds of response in the intervention arm (n = 357/1353, RR = 26.4%) compared with the control arm (n = 289/1349, RR = 21.4%), while adjusting for age, deprivation, clinical site, and clinical test result (aOR = 1.30, 95% CI: 1.09–1.55). Conclusion Applying easy-to-implement behavioural science and evidence-based methods to routine invitation letters improved postal response to a health-related survey, whilst adjusting for demographic characteristics. Our findings provide support for the pragmatic adoption of combined techniques in routine research to increase response to postal surveys. Trial registration ISRCTN, ISRCTN15113095. Registered 7 May 2019 – retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01476-7.
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Affiliation(s)
- Emily McBride
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London (UCL), London, UK.
| | - Hiromi Mase
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London (UCL), London, UK
| | - Robert S Kerrison
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London (UCL), London, UK.,School of Health Sciences, University of Surrey, Surrey, UK
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
| | - Jo Waller
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
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Furtado T, Rendle D. Creating environments for change: are there new ways to approach horse keeper behaviour in equine parasite control? Vet Rec 2021; 189:197-199. [PMID: 34505681 DOI: 10.1002/vetr.906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Tamzin Furtado
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, UK
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Buchanan H, Newton JT, Baker SR, Asimakopoulou K. Adopting the COM-B model and TDF framework in oral and dental research: A narrative review. Community Dent Oral Epidemiol 2021; 49:385-393. [PMID: 34270110 PMCID: PMC9290067 DOI: 10.1111/cdoe.12677] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Abstract
Background Recent advances in the psychological understanding of health‐related behaviour have focused on producing a comprehensive framework to model such behaviour. The Capability‐Opportunity‐Motivation‐Behaviour (COM‐B) and its associated Theoretical Domains Framework (TDF) allow researchers to classify psychological and behavioural constructs in a consistent and transferable manner across studies. Aim To identify oral and dental health‐related studies that have used the TDF and/or COM‐B as frameworks to guide research and examine the ways in which these concepts have been practically used in such research. Method Narrative review of published literature. To be included, the paper had to (1) state that the TDF or COM‐B had been used and to have targeted at least one construct identified in either framework, (2) include primary empirical data, (3) focus on a behaviour directly related to oral or dental‐related health (eg brushing, applying fluoride varnish, flossing) and/or attitudes, intentions and beliefs related to the behaviour. Studies could include any research design, and participants of any age or gender and include patients, parents or dental health professionals. Findings Nine studies were identified that had drawn on the COM‐B and/or TDF as the framework for their research. Seven of the studies were based on the TDF only, with one employing both the COM‐B and Health Belief Model, and one using the TDF with COM‐B. The nine studies covered a broad range of oral health‐related behaviours including child tooth brushing, fluoride varnish application and non‐ or micro‐invasive management of proximal caries lesions. The populations in the studies included dentists, dental teams and parents of children. All studies adopted only a subset of the constructs within the TDF, often without justification. Conclusions It is encouraging that oral health researchers are adopting standardized psychological frameworks to develop their research and oral health interventions. Future work should build on the small number of studies identified in this review and consider using standardized tools to do so.
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Affiliation(s)
- Heather Buchanan
- Division of Rehabilitation, Ageing & Wellbeing, Medical School, University of Nottingham, Nottingham, UK
| | - Jonathon Timothy Newton
- Faculty of Dentistry, Oral and Craniofacial Sciences, King' College London, Guy's Hospital, London, UK
| | - Sarah R Baker
- Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Koula Asimakopoulou
- Faculty of Dentistry, Oral and Craniofacial Sciences, King' College London, Guy's Hospital, London, UK
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Beard E, Lorencatto F, Gardner B, Michie S, Owen L, Shahab L. Behavioral Intervention Components Associated With Cost-effectiveness: A Comparison of Six Domains. Ann Behav Med 2021; 56:176-192. [PMID: 34114597 PMCID: PMC8832109 DOI: 10.1093/abm/kaab036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background To help implement behavior change interventions (BCIs) it is important to be able to characterize their key components and determine their effectiveness. Purpose This study assessed and compared the components of BCIs in terms of intervention functions identified using the Behaviour Change Wheel Framework (BCW) and in terms of their specific behavior change techniques (BCTs) identified using the BCT TaxonomyV1, across six behavioral domains and the association of these with cost-effectiveness. Methods BCIs in 251 studies targeting smoking, diet, exercise, sexual health, alcohol and multiple health behaviors, were specified in terms of their intervention functions and their BCTs, grouped into 16 categories. Associations with cost-effectiveness measured in terms of incremental cost-effectiveness ratio (ICER) upper and lower estimates were determined using regression analysis. Results The most prevalent functions were increasing knowledge through education (72.1%) and imparting skills through training (74.9%). The most prevalent BCT groupings were shaping knowledge (86.5%), changing behavioral antecedents (53.0%), supporting self-regulation (47.7%), and providing social support (44.6%). Intervention functions associated with better cost-effectiveness were those based on training (βlow = −15044.3; p = .002), persuasion (βlow = −19384.9; p = .001; βupp = −25947.6; p < .001) and restriction (βupp = −32286.1; p = .019), and with lower cost-effectiveness were those based on environmental restructuring (β = 15023.9low; p = .033). BCT groupings associated with better cost-effectiveness were goals and planning (βlow = −8537.3; p = .019 and βupp = −12416.9; p = .037) and comparison of behavior (βlow = −13561.9, p = .047 and βupp = −30650.2; p = .006). Those associated with lower cost-effectiveness were natural consequences (βlow = 7729.4; p = .033) and reward and threat (βlow = 20106.7; p = .004). Conclusions BCIs that focused on training, persuasion and restriction may be more cost-effective, as may those that encourage goal setting and comparison of behaviors with others.
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Affiliation(s)
- E Beard
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - F Lorencatto
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, London, UK
| | - B Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Michie
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, London, UK
| | - L Owen
- National Institute for Health and Care Excellence, NICE, UK
| | - L Shahab
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
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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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Marselle MR, Turbe A, Shwartz A, Bonn A, Colléony A. Addressing behavior in pollinator conservation policies to combat the implementation gap. CONSERVATION BIOLOGY : THE JOURNAL OF THE SOCIETY FOR CONSERVATION BIOLOGY 2021; 35:610-622. [PMID: 32602624 DOI: 10.1111/cobi.13581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 06/18/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Solutions for conserving biodiversity lie in changing people's behavior. Ambitious international and national conservation policies frequently fail to effectively mitigate biodiversity loss because they rarely apply behavior-change theories. We conducted a gap analysis of conservation behavior-change interventions advocated in national conservation strategies with the Behavior Change Wheel (BCW), a comprehensive framework for systematically characterizing and designing behavior-change interventions. Using pollinator conservation as a case study, we classified the conservation actions listed in national pollinator initiatives in relation to intervention functions and policy categories of the BCW. We included all national-level policy documents from the European Union available in March 2019 that focused on conservation of pollinators (n = 8). A total of 610 pollinator conservation actions were coded using in-depth directed content analysis, resulting in the identification of 787 intervention function and 766 policy category codes. Overall, these initiatives did not employ the entire breadth of behavioral interventions. Intervention functions most frequently identified were education (23%) and environmental restructuring (19%). Least frequently identified intervention functions were incentivization (3%), and restriction (2%) and coercion were completely absent (0%). Importantly, 41% of all pollinator conservation actions failed to identify whose behavior was to be changed. Building on these analyses, we suggest that reasons for the serious implementation gap in national and international conservation policies is founded in insufficient understanding of which behavioral interventions to employ for most beneficial impacts on biodiversity and how to clearly specify the intervention targets. We recommend that policy advisors engage with behavior-change theory to design effective behavior-change interventions that underpin successful conservation policies.
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Affiliation(s)
- Melissa R Marselle
- Department Ecosystem Services, Helmholtz Centre for Environmental Research - UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Biodiversity, Friedrich Schiller University Jena, Dornburger St. 159, Jena, 07743, Germany
| | | | - Assaf Shwartz
- Human and Biodiversity Research Lab, Faculty of Architecture and Town Planning, Technion - Israel Institute of Technology, Haifa, 32000, Israel
| | - Aletta Bonn
- Department Ecosystem Services, Helmholtz Centre for Environmental Research - UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Biodiversity, Friedrich Schiller University Jena, Dornburger St. 159, Jena, 07743, Germany
| | - Agathe Colléony
- Human and Biodiversity Research Lab, Faculty of Architecture and Town Planning, Technion - Israel Institute of Technology, Haifa, 32000, Israel
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Husted M, Dalton R. 'Don't show that you're scared': resilience in providing healthcare in a UK low-to-medium secure hospital. Health Psychol Behav Med 2021; 9:84-103. [PMID: 34104551 PMCID: PMC8158232 DOI: 10.1080/21642850.2021.1874956] [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] [Indexed: 11/06/2022] Open
Abstract
Background: Healthcare provision within specialist hospitals is associated with heightened levels of stress and burnout, risking negative implications for employees, organisations, and patients. Minimal research has focused on lower-skilled worker experiences. This study explores frontline care workers’ experience and perceptions of providing care within a low-to-medium secure hospital within the UK. Method: Eight semi-structured interviews were conducted with healthcare assistants and mental health nurses (18–65 years) at a low-to-medium secure hospital. Thematic analysis (Braun & Clarke, 2006) was used to analyse the data. Results: Three main themes are proposed: ‘Resilience to threat’ capturing the daily occurrence and normalisation of threat; ‘Need for support’ shows peer to peer talk as the primary coping mechanism but importantly, a possible disconnect between perceptions, and provision, of organisational support; finally, ‘Unique environment’ highlights the dual aspect of providing care and correction whilst coping with common challenges e.g. staff shortages. Conclusions: Results provide insight into the pressures experienced by frontline healthcare workers alongside staff motivation to ‘make a difference’. Findings highlight some unique challenges of working in low-to-medium secure hospitals which contributes to negative outcomes for worker engagement, performance, and individuals’ mental and physical health. Implications for organisations and future practice are discussed.
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Affiliation(s)
- Margaret Husted
- Psychology Department, University of Winchester, Winchester, UK
| | - Rheyanne Dalton
- Psychology Department, University of Winchester, Winchester, UK
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Gillespie D, Hatchard J, Squires H, Gilmore A, Brennan A. Conceptualising changes to tobacco and alcohol policy as affecting a single interlinked system. BMC Public Health 2021; 21:17. [PMID: 33397324 PMCID: PMC7783976 DOI: 10.1186/s12889-020-10000-3] [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: 02/17/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To support a move towards a coordinated non-communicable disease approach in public health policy, it is important to conceptualise changes to policy on tobacco and alcohol as affecting a single interlinked system. For health economic models to effectively inform policy, the first step in their development should be to develop a conceptual understanding of the system complexity that is likely to affect the outcomes of policy change. Our aim in this study was to support the development and interpretation of health economic models of the effects of changes to tobacco and alcohol policies by developing a conceptual understanding of the main components and mechanisms in the system that links policy change to outcomes. METHODS Our study was based on a workshop from which we captured data on participant discussions on the joint tobacco-alcohol policy system. To inform these discussions, we prepared with a literature review and a survey of participants. Participants were academics and policy professionals who work in the United Kingdom. Data were analysed thematically to produce a description of the main components and mechanisms within the system. RESULTS Of the people invited, 24 completed the survey (18 academic, 6 policy); 21 attended the workshop (16 academic, 5 policy). Our analysis identified eleven mechanisms through which individuals might modify the effects of a policy change, which include mechanisms that might lead to linked effects of policy change on tobacco and alcohol consumption. We identified ten mechanisms by which the tobacco and alcohol industries might modify the effects of policy changes, grouped into two categories: Reducing policy effectiveness; Enacting counter-measures. Finally, we identified eighteen research questions that indicate potential avenues for further work to understand the potential outcomes of policy change. CONCLUSIONS Model development should carefully consider the ways in which individuals and the tobacco and alcohol industries might modify the effects of policy change, and the extent to which this results in an unequal societal distribution of outcomes. Modelled evidence should then be interpreted in the light of the conceptual understanding of the system that the modelling necessarily simplifies in order to predict the outcomes of policy change.
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Affiliation(s)
- Duncan Gillespie
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK.
- SPECTRUM Consortium, Edinburgh, UK.
| | - Jenny Hatchard
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Hazel Squires
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
| | - Anna Gilmore
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
- SPECTRUM Consortium, Edinburgh, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Alan Brennan
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
- UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
- SPECTRUM Consortium, Edinburgh, UK
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General dental practitioners' approach to caries prevention in high-caries-risk children. Eur Arch Paediatr Dent 2020; 22:187-193. [PMID: 32572857 DOI: 10.1007/s40368-020-00548-4] [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] [Received: 11/19/2019] [Accepted: 06/12/2020] [Indexed: 10/24/2022]
Abstract
AIMS To evaluate the advice and preventive care provided by General Dental Practitioners (GDPs) to high-caries-risk children in Jordan. METHODS A cross-sectional study using an open-ended questionnaire. GDPs were presented with a high-caries-risk child scenario and asked regarding: (1) oral hygiene and dietary advice they would give; (2) preventive-care they would offer; (3) barriers they face in prevention delivery. Answers were compared to an evidence-based guideline. Data were input into SPSS-20 and analysed using descriptive statistics and frequencies. Chi-square test was used to compare results by age, gender, practice location and type. RESULTS One-hundred and sixty GDPs were approached and 128 agreed to participate (80%), of whom 87 (69%) were female. The average age was 31 years [range 22-50]. Sixty-nine percent practiced in the capital, Amman. Sixty-five percent gave advice on tooth-brushing frequency, but only 23% suggested brushing at bed-time and 24% recommended parental supervision. None provided advice on toothpaste fluoride content. Seventy-one percent advised reducing sugary-food amounts, but only 21% focused on frequency and 2% suggested using diet diaries. Most knew about fissure-sealants (77%) and fluoride-varnish (80%). Forty-two percent reported barriers to delivering preventive-care, including parental attitudes (36%), child cooperation (30%), financial reward (19%), and training (6%). Participants practicing outside of the capital were less likely to use fluoride-varnish [P = 0.002] and more likely to report barriers [P = 0.001]. CONCLUSIONS Advice delivered by GDPs to high-caries-risk children in Jordan does not meet the standards of an evidence-based guideline. Future initiatives for oral-health-promotion should aim to address the barriers reported, especially outside the capital.
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Antwi-Agyei P, Dwumfour-Asare B, Amaning Adjei K, Kweyu R, Simiyu S. Understanding the Barriers and Opportunities for Effective Management of Shared Sanitation in Low-Income Settlements-The Case of Kumasi, Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4528. [PMID: 32586062 PMCID: PMC7345014 DOI: 10.3390/ijerph17124528] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 11/30/2022]
Abstract
Improved sanitation for all is a daunting task for low-income countries, and shared toilets often provide an alternative to private household sanitation for most urban residents. This study sought to provide better understanding of the existing barriers and opportunities for improved management of shared sanitation. The study used focus group discussions and in-depth interviews with 70 users (landlords and tenants) of shared sanitation in Kumasi, Ghana to assess barriers and opportunities of "high-quality" shared sanitation. The commonly used toilet facilities were dry toilets-Kumasi Ventilated Improved Pit latrine and Ventilated Improved Pit latrines; and flush systems-water closet and pour flush connected to septic tanks. Between 2 and 21 households, or 4 and 84 people, shared one facility. Participants' description of "high-quality" (Ideal) shared sanitation was centred on cleanliness, user behaviour, smell, and user crowding. They also identified challenges of shared sanitation as overcrowded users, poor user behaviours, conflicts among users, and high cost associated with frequent desludging. However, opportunities for improvement included users' preference for shared toilets due to enjoyed benefits, existing facility management practices, and mutual understanding among users (tenants and landlords). Interventions and policy guidelines to influence behaviour change of shared sanitation users are proposed and are intended to be delivered by local government and users.
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Affiliation(s)
- Prince Antwi-Agyei
- Department of Civil and Environmental Engineering, University of Energy and Natural Resources (UENR), Regional Centre of Energy and Environmental Sustainability (RCEES), P.O. Box 214, Sunyani BS0061, Ghana
| | - Bismark Dwumfour-Asare
- Department of Environmental Health & Sanitation Education, University of Education Winneba, Asante-Mampong Campus, P.O. Box 40, Asante-Mampong AM0013, Ghana;
| | - Kwaku Amaning Adjei
- Department of Civil Engineering, Regional Water and Environmental Sanitation Centre (RWESCK), Kwame Nkrumah University of Science and Technology (KNUST), PMB, University Post Office, Kumasi AK448, Ghana;
| | - Raphael Kweyu
- Department of Geography, Kenyatta University, P.O. Box 43844, Nairobi 00100, Kenya;
| | - Sheillah Simiyu
- Urbanisation and Well-being Unit, African Population & Health Research Center, P.O. Box 10787, Nairobi 00100, Kenya;
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Lau Y, Chee DGH, Chow XP, Cheng LJ, Wong SN. Personalised eHealth interventions in adults with overweight and obesity: A systematic review and meta-analysis of randomised controlled trials. Prev Med 2020; 132:106001. [PMID: 31991155 DOI: 10.1016/j.ypmed.2020.106001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/26/2019] [Accepted: 01/24/2020] [Indexed: 01/04/2023]
Abstract
Given that many existing electronic health (eHealth) interventions with a general approach have limited effects, a personalised approach is necessary. We aimed to evaluate the effectiveness of personalised eHealth interventions in reducing body weight and identify the effective key features of such interventions. We searched seven databases for randomised controlled trials (RCTs) from inception until September 6, 2018. Of the 26,733 records identified, 15 RCTs were included. Meta-analysis revealed a significant reduction (-2.77 kg, 95% confidence interval - 3.54 to -2.00 kg) in the personalised eHealth intervention group compared with that in the control group (Z = -7.04, p < .001). The duration of the interventions ranged from 14 weeks and three trials had follow-up assessments at 6 and 12 months. Our subgroup analyses highlighted several crucial design elements of future personalised eHealth interventions by utilising a combination of tailored content and customised feedback with human feedback, usage of theoretical basis, short message service, device, reminder, self-monitoring, goal setting and synchronous communication for 12 to 14 weeks. Egger's regression asymmetry test suggested no evidence of publication bias (p = .458). Using meta-regression we found evidence that a statistically significant impact of age and year of publication on the effectiveness of intervention. The overall evidence grade of outcomes ranged from very low to low, hence future trials should use well-designed RCTs.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Xue Ping Chow
- Nursing Division, Singapore General Hospital, SingHealth, Singapore.
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Suei Nee Wong
- National University of Singapore Libraries, National University of Singapore, Singapore.
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Hagger MS, Moyers S, McAnally K, McKinley LE. Known knowns and known unknowns on behavior change interventions and mechanisms of action. Health Psychol Rev 2020; 14:199-212. [DOI: 10.1080/17437199.2020.1719184] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Martin S. Hagger
- Psychological Sciences, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Susette Moyers
- Psychological Sciences, University of California, Merced, CA, USA
| | - Kaylyn McAnally
- Psychological Sciences, University of California, Merced, CA, USA
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Olsson A, Erlandsson LK, Håkansson C. The occupation-based intervention REDO™-10: Long-term impact on work ability for women at risk for or on sick leave. Scand J Occup Ther 2020; 27:47-55. [PMID: 31099284 DOI: 10.1080/11038128.2019.1614215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/14/2019] [Accepted: 04/27/2019] [Indexed: 10/26/2022]
Abstract
Background: Stress-related disorders are increasing in western societies and are the main reason for sick-leave in Sweden. Previous research justifies occupation-based interventions to increase health and work ability.Aim: To investigate if the occupation-based intervention ReDO™-10 predicts work ability for women at risk for or on sick-leave.Material and Methods: A longitudinal cohort study design including the REDOTM-10. The participants answered a questionnaire about their perceptions of health, work ability, occupational balance, occupational values and mastery at baseline, after intervention and at 12 months follow-up. Differences before and after the intervention as well as at 12 months follow-up and possible predictors of work ability were analyzed.Results: Eighty-six women (response rate 70%) answered the questionnaire at follow-up. Perceived health, occupational balance, occupational value, mastery and work ability were improved after intervention. Perceived health, mastery and socio-symbolic value predicted work ability.Conclusion: The intervention increased perceived health and perceived health predicted work ability. However, the occupational aspects in the intervention did not predict work ability. For the intervention to predict work ability, the work placement might be necessary.Significance: The results of the present study add to earlier evidence that a work focus is of importance both in prevention of sick leave and in return to work interventions.
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Affiliation(s)
- Anna Olsson
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Lena-Karin Erlandsson
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Health and Well fare, Halmstad University, Halmstad, Sweden
| | - Carita Håkansson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
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Garip G, Seneviratne SR, Iacovou S. Learners’ perceptions and experiences of studying psychology online. JOURNAL OF COMPUTERS IN EDUCATION 2020; 7:553-573. [PMCID: PMC7293431 DOI: 10.1007/s40692-020-00167-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 05/22/2023]
Abstract
This study aimed to explore the lived experiences of six international and mature online learners studying on an undergraduate psychology course to identify barriers and facilitators to studying online. A secondary aim was to deductively explore the applicability of the Capability, Opportunity, Motivation, and Behaviour model to participants' narratives related to self-regulated online learning. Online interviews with six demographically diverse participants were conducted and analysed using Interpretative Phenomenological Analysis. The overarching theme was 'the balancing act of online learners', which consisted of three major themes (and respective subthemes): (1) 'identity as an online learner' ('in today's world, we're all very busy'), (2) 'access to resources' ('importance of location' and 'comparing online to on-campus teaching and learning'), and (3) 'changing nature of social interactions' ('tutors as a crutch' and 'peer-to-peer interactions'). A number of facilitators and barriers related to these themes were identified, which are applicable to the COM-B model. The COM-B model offers a novel approach in designing and delivering learning materials and activities that may instil or help maintain self-regulated learning in online psychology students.
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Affiliation(s)
- Gulcan Garip
- University of Derby Online Learning, University of Derby, Kedleston Road, Derby, DE22 1GB UK
| | | | - Susan Iacovou
- University of Roehampton (Laureate Education B.V.), Erasmus House, Roehampton Lane, London, SW15 5PU UK
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Interdependent Factors of Demand-Side Rationale for Chemical, Biological, Radiological, and Nuclear Medical Countermeasures. Disaster Med Public Health Prep 2019; 14:739-755. [PMID: 31735188 DOI: 10.1017/dmp.2019.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The deliberate use of chemical, biological, radiological, and nuclear (CBRN) materials in war or terrorist attacks is perceived as a great threat globally. In the event of a release of CBRN agents, protection by means of medical countermeasures (MedCMs) could reduce health vulnerability. Nonetheless, for some diseases caused by these agents, innovative MedCMs do not exist and many of those that do might not be readily available. Inappropriate research and development funding and government procurement efforts can result in adverse economic consequences (eg, lost income, cost per loss of life, medical expenses) far exceeding the costs of strong and comprehensive preparedness initiatives. By illustrating factors of demand-side rationale for CBRN MedCMs, this article aims to strengthen integrity of policy-making associated with current demand requirements. Namely, an approach to inspire broader assessment is outlined by compiling and adapting existing economic models and concepts to characterize both soft and hard factors that influence demand-side rationale. First, the soft factor context is set by describing the impact of behavioral and political economics. Then, lessons learned from past public health funding models and associated collaborative access infrastructure are depicted to represent hard factors that can enhance the viability of MedCM preparedness evaluations.
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Marchant G, Nicaise V, Chastin S, Boiché J. [Reducing the amount of time spent sitting in a professional setting: the “Sedentariness at Work” (SAW) survey]. SANTE PUBLIQUE 2019; Vol. 31:377-385. [PMID: 31640325 DOI: 10.3917/spub.193.0377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this research was to evaluate the effects of an intervention on reducing sitting time in a professional setting. METHODS The intervention consisted of a group presentation on sedentary behavior at work and active work breaks, followed by an individual planning phase. Participants were then invited to use alert software for four weeks. The intervention lasted six weeks; 38 people aged 29 to 59 years participated (80% women). Before and after the intervention, participants wore accelerometers to assess behaviors (sedentary and physical activity at work) and responded to a questionnaire measuring the degree of automaticity for sitting at work and taking active breaks. RESULTS After the intervention, the time spent in a sitting position during a working day decreased significantly. Specifically, sitting time decreased more among those aged 29 to 43 years; who had decided to take breaks of at least 5 minutes; and had more extended sitting time before the intervention. CONCLUSIONS This study demonstrated that combining an informational strategy with computer- or mobile-generated alerts reduces sitting time spent in the workplace. This intervention was inexpensive for employees and companies. An interesting perspective could be to compare these effects with those of interventions based on a change in the physical work environment (such as the installation of adjustable desks).
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Marien H, Custers R, Aarts H. Studying Human Habits in Societal Context: Examining Support for a Basic Stimulus–Response Mechanism. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2019. [DOI: 10.1177/0963721419868211] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human habits are considered to be an important root of societal problems. The significance of habits has been demonstrated for a variety of behaviors in different domains, such as work, transportation, health, and ecology, suggesting that habits have a pervasive impact on human life. Studying and changing habits in societal context requires a broad view of behavior, which poses a challenge for applying basic models to complex human habits. We address the conceptualization and operationalization of habits in the current literature and note that claims about the role of habits in societal context rarely agree with the basic definition of habits as goal-independent behavior. We consider future directions that are important for making progress in the study of habit change in societal context.
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Affiliation(s)
- Hans Marien
- Department of Psychology, Utrecht University
| | | | - Henk Aarts
- Department of Psychology, Utrecht University
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Interventions to improve healthcare workers' hand hygiene compliance: A systematic review of systematic reviews. Infect Control Hosp Epidemiol 2019; 39:1449-1456. [PMID: 30526716 DOI: 10.1017/ice.2018.262] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC). METHODS PRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed. RESULTS Overall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness. CONCLUSIONS This is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes.
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Improving the Welfare of Companion Dogs-Is Owner Education the Solution? Animals (Basel) 2019; 9:ani9090662. [PMID: 31500203 PMCID: PMC6770859 DOI: 10.3390/ani9090662] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 11/22/2022] Open
Abstract
Simple Summary The welfare of most dogs living in homes is largely unknown. However, national surveys carried out by animal welfare charities and findings by animal welfare researchers have shown significant deterioration in some key aspects of dog welfare. For example, more dogs presenting to vets with behavioural problems, obesity, and ill-health due to poor breeding practices. This means that some dogs are suffering due to their owners’ behaviours or ownership practices. Educating dog owners as to how best to look after their dogs is, and has been seen by many, as key to improving the welfare of dogs living in homes. However, the concept of education, the context in which it occurs, and the lack of systematic evaluation of the effectiveness of education interventions means that nobody really knows if this approach works. This paper explores these concepts and draws together a wide range of sources of information to highlight some of the complexities of improving dog welfare by educating owners. Abstract Vets, animal welfare charities, and researchers have frequently cited educating owners as a necessity for improving the welfare of companion dogs. The assumption that improving an owner’s knowledge through an education intervention subsequently results in improvements in the welfare of the dog appears reasonable. However, the complexity of dog welfare and dog ownership and the context in which these relationships occur is rapidly changing. Psychology has demonstrated that humans are complex, with values, attitudes, and beliefs influencing our behaviours as much as knowledge and understanding. Equally, the context in which we individuals and our dogs live is rapidly changing and responding to evolving societal and cultural norms. Therefore, we seek to understand education’s effectiveness as an approach to improving welfare through exploring and understanding these complexities, in conjunction with the relevant research from the disciplines of science education and communication. We argue that well designed and rigorously evaluated education interventions can play a part in the challenge of improving welfare, but that these may have limited scope, and welfare scientists could further consider extending cross-disciplinary, cross-boundary working, and research in order to improve the welfare of companion dogs.
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