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Wilkie, Stephanie, and Nicola Davinson. "The impact of nature-based interventions on public health: a review using pathways, mechanisms and behaviour change techniques from environmental social science and health behaviour change." Journal of the British Academy 9s7 (2021): 33–61. http://dx.doi.org/10.5871/jba/009s7.033.
Анотація:
The aim of this narrative review is to explore whether nature-based interventions improved individual public health outcomes and health behaviours, using a conceptual framework that included pathways and pathway domains, mechanisms, and behaviour change techniques derived from environmental social science theory and health behaviour change models. A two-stage scoping methodology was used to identified studies published between 2000 and 2021. Peer reviewed, English-language reports of nature-based interventions with adults (N = 9) were included if the study met the definition of a health�behaviour change intervention and reported at least one measured physical/mental health outcome. Interventions focused on the restoring or building capacities pathway domains as part of the nature contact/experience pathway; varied health behaviour change mechanisms and techniques were present but environmental social-science-derived mechanisms to influence health outcomes were used less. Practical recommendations for future interventions include explicit statement of the targeted level of causation, as well as utilisation of both environmental social science and health behaviour change theories and varied public health outcomes to allow simultaneously testing of theoretical predictions.
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Reme, S. E., D. Stahl, T. Kennedy, R. Jones, S. Darnley, and T. Chalder. "Mediators of change in cognitive behaviour therapy and mebeverine for irritable bowel syndrome." Psychological Medicine 41, no. 12 (April 11, 2011): 2669–79. http://dx.doi.org/10.1017/s0033291711000328.
Анотація:
BackgroundCognitive behaviour therapies (CBTs) have through several trials been demonstrated to reduce symptoms and disability in irritable bowel syndrome (IBS) patients, but the mechanisms responsible for the changes are still unknown. The aim of this study was to test a theoretical model of CBT and investigate if cognitions and/or behaviour mediated the changes seen in CBT for IBS.MethodTo assess for possible mediating effects, we applied path analysis to the dataset of 149 diagnosed participants randomized to mebeverine hydrochloride plus CBT or mebeverine hydrochloride alone. Primary outcome was symptom severity, while secondary outcomes were work and social adjustment and anxiety.ResultsThe path analyses supported mediational paths for all outcomes. Changes in behaviour and cognitions mediated all three outcomes, with models placing behaviour change ‘upstream’ of cognition change having best fit. The analyses of model fits revealed best fit for the anxiety model and hence provide increased confidence in the causal model of anxiety.ConclusionsChanges in behaviour and cognitions mediate the change in CBT given to IBS patients. The results strengthen the validity of a theoretical model of CBT by confirming the interaction of cognitive, emotional and behavioural factors in IBS.
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O'Cass, Aron, and Deborah Griffin. "Eliciting positive social change: marketing’s capacity to drive prosocial behaviours." Marketing Intelligence & Planning 33, no. 5 (August 3, 2015): 826–43. http://dx.doi.org/10.1108/mip-02-2014-0027.
Анотація:
Purpose – While social marketing has been utilised to bring about positive social change, ultimately, the decision to engage in prosocial behaviour resides with the individual. The purpose of this paper is to explore the determinants and outcomes of prosocial behaviours. Design/methodology/approach – A web-based self-administered survey was used to collect data from a convenience sample of largely university staff and students. Data obtained were analysed using SEM-based partial least squares methodology. Findings – The results show that individuals who are future oriented and issue involved are more likely to engage in prosocial behaviour. Also, these individuals are more likely to assess fewer negative consequences and experience more positive feelings as a result of their prosocial behaviour. Research limitations/implications – While the study focuses on two social issues, it does provide some explanation of self-reported behaviour, rather than intention to behave. However, future research could pay attention to a wider array of social issues and undertake post hoc testing to measure the characteristics of the chosen social issues. This may enhance findings, and provide greater support for the generalisability of the model. Also, future research could be directed towards the examining the role of perceived risk and feelings as an outcome of behaviour. Practical implications – A better understanding of the prosocial individual can assist in designing more effective social marketing campaigns. In particular, focusing on positive feelings as a result of engaging in prosocial behaviour has practical implications. Originality/value – Little attention has been given in the marketing and consumer behaviour literature to understanding the prosocial individual. To this end, this research empirically tests a model of prosocial behaviour for two social issues that integrates determinants (social responsibility, time orientation and issue involvement) and outcomes (assessment of negative consequences and feelings). Moreover, the results highlight that positive feelings are a significant outcome of prosocial behaviour.
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Muriithi, Francis G., Aduragbemi Banke-Thomas, Gillian Forbes, Ruth W. Gakuo, Eleanor Thomas, Ioannis D. Gallos, Adam Devall, Arri Coomarasamy, and Fabiana Lorencatto. "A systematic review of behaviour change interventions to improve maternal health outcomes in sub-Saharan Africa." PLOS Global Public Health 4, no. 2 (February 20, 2024): e0002950. http://dx.doi.org/10.1371/journal.pgph.0002950.
Анотація:
The rate of decline in the global burden of avoidable maternal deaths has stagnated and remains an issue of concern in many sub-Saharan Africa countries. As per the most recent evidence, an average maternal mortality ratio (MMR) of 223 deaths per 100,000 live births has been estimated globally, with sub-Saharan Africa’s average MMR at 536 per 100,000 live births—more than twice the global average. Despite the high MMR, there is variation in MMR between and within sub-Saharan Africa countries. Differences in the behaviour of those accessing and/or delivering maternal healthcare may explain variations in outcomes and provide a basis for quality improvement in health systems. There is a gap in describing the landscape of interventions aimed at modifying the behaviours of those accessing and delivering maternal healthcare for improving maternal health outcomes in sub-Saharan Africa. Our objective was to extract and synthesise the target behaviours, component behaviour change strategies and outcomes of behaviour change interventions for improving maternal health outcomes in sub-Saharan Africa. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Our protocol was published a priori on PROSPERO (registration number CRD42022315130). We searched ten electronic databases (PsycINFO, Cochrane Database of Systematic Reviews, International Bibliography of Social Sciences, EMBASE, MEDLINE, Scopus, CINAHL PLUS, African Index Medicus, African Journals Online, and Web of Science) and included randomised trials and quasi-experimental studies. We extracted target behaviours and specified the behavioural interventions using the Action, Actor, Context, Time, and Target (AACTT) framework. We categorised the behaviour change strategies using the intervention functions described in the Behaviour Change Wheel (BCW). We reviewed 52 articles (26 randomized trials and 26 quasi-experimental studies). They had a mixed risk of bias. Out of these, 41 studies (78.8%) targeted behaviour change of those accessing maternal healthcare services, while seven studies (13.5%) focused on those delivering maternal healthcare. Four studies (7.7%) targeted mixed stakeholder groups. The studies employed a range of behaviour change strategies, including education 37 (33.3%), persuasion 20 (18%), training 19 (17.1%), enablement 16 (14.4%), environmental restructuring 8 (7.2%), modelling 6 (5.4%) and incentivisation 5 (4.5%). No studies used restriction or coercion strategies. Education was the most common strategy for changing the behaviour of those accessing maternal healthcare, while training was the most common strategy in studies targeting the behaviour of those delivering maternal healthcare. Of the 52 studies, 40 reported effective interventions, 7 were ineffective, and 5 were equivocal. A meta-analysis was not feasible due to methodological and clinical heterogeneity across the studies. In conclusion, there is evidence of effective behaviour change interventions targeted at those accessing and/or delivering maternal healthcare in sub-Saharan Africa. However, more focus should be placed on behaviour change by those delivering maternal healthcare within the health facilities to fast-track the reduction of the huge burden of avoidable maternal deaths in sub-Saharan Africa.
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Hall, Patricia, Maggie Lawrence, Thilo Kroll, Catherine Blake, James Matthews, and Olive Lennon. "Reducing risk behaviours after stroke: An overview of reviews interrogating primary study data using the Theoretical Domains Framework." PLOS ONE 19, no. 4 (April 26, 2024): e0302364. http://dx.doi.org/10.1371/journal.pone.0302364.
Анотація:
Background Lifestyle changes, in addition to preventive medications, optimise stroke secondary prevention. Evidence from systematic reviews support behaviour-change interventions post-stroke to address lifestyle-related risk. However, understanding of the theory-driven mediators that affect behaviour-change post-stroke is lacking. Methods Electronic databases MEDLINE, Embase, Epistemonikos and Cochrane Library of Systematic Reviews were searched to March 2023 for systematic reviews addressing behaviour-change after stroke. Primary studies from identified systematic reviews were interrogated for evidence supporting theoretically-grounded interventions. Data were synthesized in new meta-analyses examining behaviour-change domains of the Theoretical Domains Framework (TDF) and secondary prevention outcomes. Results From 71 identified SRs, 246 primary studies were screened. Only 19 trials (N = 2530 participants) were identified that employed theoretically-grounded interventions and measured associated mediators for behaviour-change. Identified mediators mapped to 5 of 14 possible TDF domains. Trial follow-up ranged between 1–12 months and no studies addressed primary outcomes of recurrent stroke or cardiovascular mortality and/or morbidity. Lifestyle interventions targeting mediators mapped to the TDF Knowledge domain may improve the likelihood of medication adherence (OR 6.08 [2.79, 13.26], I2 = 0%); physical activity participation (OR 2.97 [1.73, 5.12], I2 = 0%) and smoking cessation (OR 10.37 [3.22, 33.39], I2 = 20%) post-stroke, supported by low certainty evidence; Lifestyle interventions targeting mediators mapping to both TDF domains of Knowledge and Beliefs about Consequences may improve medication adherence post-stroke (SMD 0.36 [0.07, 0.64], I2 = 13%, very low certainty evidence); Lifestyle interventions targeting mediators mapped to Beliefs about Capabilities and Emotions domains may modulate low mood post-stroke (SMD -0.70 [-1.28, -0.12], I2 = 81%, low certainty evidence). Conclusion Limited theory-based research and use of behaviour-change mediators exists within stroke secondary prevention trials. Knowledge, Beliefs about Consequences, and Emotions are the domains which positively influence risk-reducing behaviours post-stroke. Behaviour-change interventions should include these evidence-based constructs known to be effective. Future trials should address cardiovascular outcomes and ensure adequate follow-up time.
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Stoyneva, Iva, Kisha Coa, Jillian Pugatch, Amy Sanders, Mary Schwarz, and Heather Cole-Lewis. "SmokefreeTXT Behaviour Change Technique Analysis." Journal of Smoking Cessation 12, no. 4 (December 20, 2016): 231–43. http://dx.doi.org/10.1017/jsc.2016.24.
Анотація:
Mobile text-messaging smoking cessation interventions have demonstrated their efficacy in increasing cessation rates. These interventions tend to be multifaceted and there is a need to specify their building blocks. The purpose of this study was to use the Behavioural Change Techniques Taxonomy V1 (BCTTv1) to systematically analyse the behaviour change techniques present in the SmokefreeTXT (SFTXT) adult programme. The entire SFTXT library was coded using the BCTTv1. Frequencies were calculated to assess the presence of BCT groups and unique BCTs in the entire programme. The mix of BCTs was also examined by programme week and during periods of high user dropout. Of the 16 groups of behavioural techniques, 14 were present in SFTXT. Of the 93 distinct BCTs, 41 were present in the full SFTXT message library. The most prevalent BCT groups were Feedback and Monitoring, Natural Consequences, Social Support, and Shaping Knowledge. There were differences in the mix of BCTs across the duration of the intervention. The results will enable us to test how changes in the use of specific BCTs and their frequency of use over time, impact (1) engagement with the programme (particularly during the days with high dropout rates), and (2) smoking cessation outcomes over time.
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Varman, Sumantla D., Rachel A. Jones, Bridget Kelly, Megan L. Hammersley, Anne-Maree Parrish, Rebecca Stanley, and Dylan P. Cliff. "The effect of experiential learning interventions on physical activity outcomes in children: A systematic review." PLOS ONE 18, no. 11 (November 30, 2023): e0294987. http://dx.doi.org/10.1371/journal.pone.0294987.
Анотація:
Background This systematic review examined the effectiveness of experiential learning interventions for improving children’s physical activity knowledge, attitudes, and behaviours. It also aimed to identify intervention characteristics that resulted in the greatest impact. Methods Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO were searched from database inception to January 2023. Eligible studies: (1) included children 0–12 years; (2) assessed the effect of physical activity outcomes on children’s physical activity knowledge, attitudes or behaviour and (3) were randomised controlled trials conducted in any setting. Study risk of bias was assessed by two independent reviewers using the Cochrane risk of bias tool. Intervention approaches were categorised, and effect sizes were compared across studies for each outcome. Results Twelve studies were included in the review: ten in school age and two in below five years. For behavioural outcomes, six of eight studies showed medium to large effects (effects size (ES) range: 0.3–0.9), two of the three studies that assessed attitudinal outcomes displayed medium effects (ES range: 0.4–0.5) and both studies that assessed knowledge outcomes displayed medium to large effects (ES range: 0.4–1.3). The two experiential learning interventions among children < 5 years demonstrated small to medium effects on behaviour change (ES range: 0.2–0.5). Effective interventions combined enjoyable practical activities (fitness activities, games and challenges), with behaviour change techniques (goal setting, and self-monitoring), were underpinned by a behaviour change theory, and were often of short duration (< 4 months) but intense (several sessions/week). Moderate to high statistical heterogeneity was observed for behaviour outcomes and risk of bias across studies was generally high. Conclusions This review provides some evidence supporting the effectiveness of experiential learning interventions in improving physical activity outcomes in school-aged children. Additional evidence is needed in children <5 years old. Future experiential learning interventions need to strengthen the evidence with rigorous methodological quality and clear reporting of the experiential learning components.
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Hayes, Ben, Sarah Hindle, and Paul Withington. "Strategies for Developing Positive Behaviour Management. Teacher Behaviour Outcomes and Attitudes to the Change Process." Educational Psychology in Practice 23, no. 2 (June 2007): 161–75. http://dx.doi.org/10.1080/02667360701320861.
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Watson, Daniella, Patience Mushamiri, Paula Beeri, Toussaint Rouamba, Sarah Jenner, Simone Proebstl, Sarah H. Kehoe, Kate A. Ward, Mary Barker, and Wendy Lawrence. "Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review." PLOS Global Public Health 3, no. 3 (March 30, 2023): e0000401. http://dx.doi.org/10.1371/journal.pgph.0000401.
Анотація:
Evidence that nutrition-specific and nutrition-sensitive interventions can improve maternal and child nutrition status in sub-Saharan Africa is inconclusive. Using behaviour change theory and techniques in intervention design may increase effectiveness and make outcomes more predictable. This systematic review aimed to determine whether interventions that included behaviour change functions were effective. Six databases were searched systematically, using MeSH and free-text terms, for articles describing nutrition-specific and nutrition-sensitive behaviour change interventions published in English until January 2022. Titles, abstracts and full-text papers were double-screened. Data extraction and quality assessments followed Centre for Reviews and Dissemination guidelines. Behaviour change functions of interventions were mapped onto the COM-B model and Behaviour Change Wheel. PROSPERO registered (135054). The search yielded 1193 articles: 79 articles met inclusion criteria, ranging from low (n = 30) to high (n = 11) risk of bias. Many that applied behaviour change theory, communication or counselling resulted in significant improvements in infant stunting and wasting, household dietary intake and maternal psychosocial measures. Interventions with >2 behaviour change functions (including persuasion, incentivisation, environmental restructuring) were the most effective. We recommend incorporating behaviour change functions in nutrition interventions to improve maternal and child outcomes, specifically drawing on the Behaviour Change Wheel, COM-B model (SORT B recommendation). To enhance the designs of these interventions, and ultimately improve the nutritional and psychosocial outcomes for mothers and infants in sub-Saharan Africa, collaborations are recommended between behaviour change and nutrition experts, intervention designers, policy makers and commissioners to fund and roll-out multicomponent behaviour change interventions.
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Beck, Alison K., Erin Forbes, Amanda L. Baker, Ben Britton, Christopher Oldmeadow, and Gregory Carter. "Adapted motivational interviewing for brief healthcare consultations: protocol for a systematic review and meta-analysis of treatment fidelity in real-world evaluations of behaviour change counselling." BMJ Open 9, no. 7 (July 2019): e028417. http://dx.doi.org/10.1136/bmjopen-2018-028417.
Анотація:
IntroductionTreatment fidelity is an important and often neglected component of complex behaviour change research. It is central to understanding treatment effects, especially for evaluations conducted outside of highly controlled research settings. Ensuring that promising interventions can be delivered adequately (ie, with fidelity) by real-world clinicians within real-world settings is an essential step in developing interventions that are both effective and ‘implementable’. Whether this is the case for behaviour change counselling, a complex intervention developed specifically for maximising the effectiveness of real-world consultations about health behaviour change, remains unclear. To improve our understanding of treatment effects, best practice guidelines recommend the use of strategies to enhance, monitor and evaluate what clinicians deliver during patient consultations. There has yet to be a systematic evaluation of whether and how these recommendations have been employed within evaluations of behaviour change counselling, nor the impact on patient health behaviour and/or outcome. We seek to address this gap.Methods and analysisMethods are informed by published guidelines. Ten electronic databases (Medline, PubMed, EMBASE, PsycINFO, CINAHL Complete, ScienceDirect, Taylor and Francis; Wiley, ProQuest and Open Grey) will be searched for published and unpublished articles that evaluate behaviour change counselling within real-world clinical settings (randomised and non-randomised). Eligible papers will be rated against the National Institute of Health fidelity framework. A synthesis, evaluation and critical overview of fidelity practices will be reported and linear regression used to explore change across time. Random-effect meta-regression is planned to explore whether fidelity (outcomes reported and methods used) is associated with the impact of behaviour change counselling. Standardised effect sizes will be calculated using Hedges’ g (continuous outcomes) and ORs (binary/dichotomous outcomes).Ethics and disseminationNo ethical issues are foreseen. Findings will be disseminated via journal publication and conference presentation(s).PROSPERO registration numberCRD42019131169
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James, Jennifer, Wendy Hardeman, Helen Eborall, Mark Goodall, and John Wilding. "PARIS: protocol for a prospective single arm, theory-based, group-based feasibility intervention study to increase Physical Activity and reduce sedentary behaviouR after barIatric Surgery." BMJ Open 11, no. 12 (December 2021): e051638. http://dx.doi.org/10.1136/bmjopen-2021-051638.
Анотація:
IntroductionIncreased physical activity and reduced sedentary behaviour can encourage favourable outcomes after bariatric surgery. However, there is a lack of evidence as to how to support patients with behaviour change. The aim of this study is to assess the feasibility of a physiotherapist led, online group-based behaviour change intervention to increase physical activity and reduce sedentary behaviour following bariatric surgery.Methods and analysisSingle arm feasibility study of a theory and evidence-based group behaviour change intervention based on the Behaviour Change Wheel and Theoretical Domains Framework using behaviour change techniques from the Behaviour Change Technique Taxonomy v1. The intervention has eight objectives and specifies behaviour change techniques that will be used to address each of these. Groups of up to eight participants who have had surgery within the previous 5 years will meet weekly over 6 weeks for up to 1½ hours. Groups will be held online led by a physiotherapist and supported by an intervention handbook. Feasibility study outcomes include: rate of recruitment, retention, intervention fidelity, participant engagement and acceptability. Secondary outcomes include: physical activity, sedentary behaviour, body composition, self-reported health status and will be analysed descriptively. Change in these outcomes will be used to calculate the sample size for a future evaluation study. Qualitative interviews will explore participants’ views of the intervention including its acceptability. Data will be analysed according to the constant comparative approach of grounded theory.Ethics and disseminationThis study has National Health Service Research Ethics Committee approval; Haydock 20/NW/0472. All participants will provide informed consent and can withdraw at any point. Findings will be disseminated through peer-reviewed journals, conference and clinical service presentations.Trial registration numberISRCTN31524689.
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Michie, Susan, James Thomas, Pol Mac Aonghusa, Robert West, Marie Johnston, Michael P. Kelly, John Shawe-Taylor, Janna Hastings, Francesca Bonin, and Alison O’Mara-Eves. "The Human Behaviour-Change Project: An artificial intelligence system to answer questions about changing behaviour." Wellcome Open Research 5 (June 10, 2020): 122. http://dx.doi.org/10.12688/wellcomeopenres.15900.1.
Анотація:
Changing behaviour is necessary to address many of the threats facing human populations. However, identifying behaviour change interventions likely to be effective in particular contexts as a basis for improving them presents a major challenge. The Human Behaviour-Change Project harnesses the power of artificial intelligence and behavioural science to organise global evidence about behaviour change to predict outcomes in common and unknown behaviour change scenarios.
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Rooney, Kathleen, Caroline Hunt, Leanne Humphreys, David Harding, Miriam Mullen, and John Kearney. "Prediction of Outcome for Veterans with Post-Traumatic Stress Disorder Using Constructs from the Transtheoretical Model of Behaviour Change." Australian & New Zealand Journal of Psychiatry 41, no. 7 (July 2007): 590–97. http://dx.doi.org/10.1080/00048670701392825.
Анотація:
Objective: Post-traumatic stress disorder (PTSD) is a disabling condition, sometimes unresponsive to treatment. The aim of the present study was to examine the predictive utility of constructs from the transtheoretical model of behaviour change (TTM) known to predict outcome for other disorders. Method: A sample of 50 veterans presenting for a PTSD treatment programme provided data for this longitudinal study. Variables were assessed at four time-points during the treatment programme. Multiple regression and mixed-effects regression were utilized to determine the predictive utility of variables from the TTM. Results: Allocated stage of change at the time of a 2 day introduction programme predicted follow-up symptom severity, but changes therein during treatment did not predict changes in symptom severity. However, changes in the continuous readiness-to-change variable and behavioural processes of change were predictive of such changes. Conclusions: Despite some difficulties in the application of the TTM to PTSD, the model does appear to predict treatment outcome. Veterans who have increased readiness to change and who make more use of behavioural processes of change are likely to have improved outcomes.
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Celis-Morales, Carlos, Jose Lara, and John C. Mathers. "Personalising nutritional guidance for more effective behaviour change." Proceedings of the Nutrition Society 74, no. 2 (December 12, 2014): 130–38. http://dx.doi.org/10.1017/s0029665114001633.
Анотація:
Improving diet and other lifestyle behaviours has considerable potential for reducing the global burden of non-communicable diseases, promoting better health across the life-course and increasing wellbeing. However, realising this potential will require the development, testing and implementation of much more effective behaviour change interventions than are used conventionally. Evidence-based, personalised (or stratified) interventions which incorporate effective behaviour change techniques (BCT) and which are delivered digitally are likely to be an important route to scalable and sustainable interventions. Progress in developing such interventions will depend on the outcomes of research on: (i) the best bases for personalisation of dietary advice; (ii) identification of BCT which are proven to enhance intervention efficacy; (iii) suitable platforms (digital-based tools) for collection of relevant participant characteristics (e.g. socioeconomic information, current diet and lifestyle and dietary preferences) linked with intelligent systems which use those characteristics to offer tailored feedback and advice in a cost-effective and acceptable manner. Future research should focus on such interventions aiming to reduce health inequalities and to improve overall public health.
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Stubbs, R. James, Cristiana Duarte, Ruairi O'Driscoll, Jake Turicchi, and Joanna Michalowska. "Developing evidence-based behavioural strategies to overcome physiological resistance to weight loss in the general population." Proceedings of the Nutrition Society 78, no. 4 (October 31, 2019): 576–89. http://dx.doi.org/10.1017/s0029665119001083.
Анотація:
Physiological and behavioural systems are tolerant of excess energy intake and responsive to energy deficits. Weight loss (WL) changes body structure, physiological function and energy balance (EB) behaviours, which resist further WL and promote subsequent weight regain. Measuring and understanding the response of EB systems to energy deficits is important for developing evidence-based behaviour change interventions for longer-term weight management. Currently, behaviour change approaches for longer-term WL show modest effect sizes. Self-regulation of EB behaviours (e.g. goal setting, action plans, self-monitoring, relapse prevention plans) and aspects of motivation are important for WL maintenance. Stress management, emotion regulation and food hedonics may also be important for relapse prevention, but the evidence is less concrete. Although much is known about the effects of WL on physiological and psychological function, little is known about the way these dynamic changes affect human EB behaviours. Key areas of future importance include (i) improved methods for detailed tracking of energy expenditure, balance and by subtraction intake, using digital technologies, (ii) how WL impacts body structure, function and subsequent EB behaviours, (iii) how behaviour change approaches can overcome physiological resistance to WL and (iv) who is likely to maintain WL or relapse. Modelling physiological and psychological moderators and mediators of EB-related behaviours is central to understanding and improving longer-term weight and health outcomes in the general population.
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Wasylyshyn, Karol M., Hal S. Shorey, and Jason S. Chaffin. "Patterns of leadership behaviour: Implications for successful executive coaching outcomes." Coaching Psychologist 8, no. 2 (December 2012): 74–85. http://dx.doi.org/10.53841/bpstcp.2012.8.2.74.
Анотація:
An analysis of 300 business executive coaching cases resulted in the identification of three leadership behaviour patterns. These patterns were conceptualised on a continuum of remarkable, perilous, and toxic behaviour. It is suggested that the ability to recognise where their clients are on this behavioural continuum may aid executive coaches in sustaining coaching traction and achieving successful outcomes. This article presents several factors in a coach/boss partnership approach that helped discern where these executives fell on this continuum, as well as preliminary psychometric data that indicate the empirical validity of these leadership behaviour patterns. Further, based on using this behaviour patterns information in hundreds of positive coaching outcomes, specific coaching guidance is also provided. This guidance is based on an insight-oriented coaching model focused on promoting behaviour change most often in the area of emotional intelligence (EQ). Helping remarkable executives to leverage their reciprocal engagement with others can accelerate coaching success with these leaders. Minimising executives’ deep-seated feelings of ‘unrequited work’ is key for the effective coaching of those with a perilous behaviour pattern. Leaders with predominately toxic behaviours warrant particular scrutiny at the needs assessment stage for they may or may not be viable coaching candidates.
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Briffa, Mark, Lynne U. Sneddon, and Alastair J. Wilson. "Animal personality as a cause and consequence of contest behaviour." Biology Letters 11, no. 3 (March 2015): 20141007. http://dx.doi.org/10.1098/rsbl.2014.1007.
Анотація:
We review the evidence for a link between consistent among-individual variation in behaviour (animal personality) and the ability to win contests over limited resources. Explorative and bold behaviours often covary with contest behaviour and outcome, although there is evidence that the structure of these ‘behavioural syndromes' can change across situations. Aggression itself is typically repeatable, but also subject to high within-individual variation as a consequence of plastic responses to previous fight outcomes and opponent traits. Common proximate mechanisms (gene expression, endocrine control and metabolic rates) may underpin variation in both contest behaviour and general personality traits. Given the theoretical links between the evolution of fighting and of personality, we suggest that longitudinal studies of contest behaviour, combining behavioural and physiological data, would be a useful context for the study of animal personalities.
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Ho, Chinh Q. "Can MaaS change users’ travel behaviour to deliver commercial and societal outcomes?" Transportation Research Part A: Policy and Practice 165 (November 2022): 76–97. http://dx.doi.org/10.1016/j.tra.2022.09.004.
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Cotterill, Sarah, Mei Yee Tang, Rachael Powell, Elizabeth Howarth, Laura McGowan, Jane Roberts, Benjamin Brown, and Sarah Rhodes. "Social norms interventions to change clinical behaviour in health workers: a systematic review and meta-analysis." Health Services and Delivery Research 8, no. 41 (October 2020): 1–138. http://dx.doi.org/10.3310/hsdr08410.
Анотація:
Background A social norms intervention seeks to change the clinical behaviour of a target health worker by exposing them to the values, beliefs, attitudes or behaviours of a reference group or person. These low-cost interventions can be used to encourage health workers to follow recommended professional practice. Objective To summarise evidence on whether or not social norms interventions are effective in encouraging health worker behaviour change, and to identify the most effective social norms interventions. Design A systematic review and meta-analysis of randomised controlled trials. Data sources The following databases were searched on 24 July 2018: Ovid MEDLINE (1946 to week 2 July 2018), EMBASE (1974 to 3 July 2018), Cumulative Index to Nursing and Allied Health Literature (1937 to July 2018), British Nursing Index (2008 to July 2018), ISI Web of Science (1900 to present), PsycINFO (1806 to week 3 July 2018) and Cochrane trials (up to July 2018). Participants Health workers took part in the study. Interventions Behaviour change interventions based on social norms. Outcome measures Health worker clinical behaviour, for example prescribing (primary outcome), and patient health outcomes, for example blood test results (secondary), converted into a standardised mean difference. Methods Titles and abstracts were reviewed against the inclusion criteria to exclude any that were clearly ineligible. Two reviewers independently screened the remaining full texts to identify relevant papers. Two reviewers extracted data independently, coded for behaviour change techniques and assessed quality using the Cochrane risk-of-bias tool. We performed a meta-analysis and presented forest plots, stratified by behaviour change technique. Sources of variation were explored using metaregression and network meta-analysis. Results A total of 4428 abstracts were screened, 477 full texts were screened and findings were based on 106 studies. Most studies were in primary care or hospitals, targeting prescribing, ordering of tests and communication with patients. The interventions included social comparison (in which information is given on how peers behave) and credible source (which refers to communication from a well-respected person in support of the behaviour). Combined data suggested that interventions that included social norms components were associated with an improvement in health worker behaviour of 0.08 standardised mean differences (95% confidence interval 0.07 to 0.10 standardised mean differences) (n = 100 comparisons), and an improvement in patient outcomes of 0.17 standardised mean differences (95% confidence interval 0.14 to 0.20) (n = 14), on average. Heterogeneity was high, with an overall I 2 of 85.4% (primary) and 91.5% (secondary). Network meta-analysis suggested that three types of social norms intervention were most effective, on average, compared with control: credible source (0.30 standardised mean differences, 95% confidence interval 0.13 to 0.47); social comparison combined with social reward (0.39 standardised mean differences, 95% confidence interval 0.15 to 0.64); and social comparison combined with prompts and cues (0.33 standardised mean differences, 95% confidence interval 0.22 to 0.44). Limitations The large number of studies prevented us from requesting additional information from authors. The trials varied in design, context and setting, and we combined different types of outcome to provide an overall summary of evidence, resulting in a very heterogeneous review. Conclusions Social norms interventions are an effective method of changing clinical behaviour in a variety of health service contexts. Although the overall result was modest and very variable, there is the potential for social norms interventions to be scaled up to target the behaviour of a large population of health workers and resulting patient outcomes. Future work Development of optimised credible source and social comparison behaviour change interventions, including qualitative research on acceptability and feasibility. Study registration This study is registered as PROSPERO CRD42016045718. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 41. See the NIHR Journals Library website for further project information.
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Young, Claire L., Karen Trapani, Samantha Dawson, Adrienne O’Neil, Frances Kay-Lambkin, Michael Berk, and Felice N. Jacka. "Efficacy of online lifestyle interventions targeting lifestyle behaviour change in depressed populations: A systematic review." Australian & New Zealand Journal of Psychiatry 52, no. 9 (July 27, 2018): 834–46. http://dx.doi.org/10.1177/0004867418788659.
Анотація:
Background: It is well established that depression and non-communicable diseases are highly co-morbid and bi-directional in nature. ‘Lifestyle medicine’ has recently gained traction in the field of psychiatry, aimed at improvement of both physical and mental health. Online interventions can be an effective and inexpensive alternative or supplement to therapy that is delivered using more traditional modes, overcoming barriers that may prohibit people from accessing treatment by promoting flexibility and accessibility. Methods: This systematic review evaluates the existing evidence for the efficacy or effectiveness of lifestyle interventions for (1) individuals with depressive symptoms, (2) clinically depressed populations or discussing the outcomes of depression within a subset of a larger cohort that are delivered online or via smart phone. Included studies were randomised controlled trials, with active comparator conditions, in adult populations and with reported lifestyle and depression-related outcomes. The analysis examined attrition, engagement, adherence and behaviour change techniques employed to achieve the target behaviours. Results: Seven studies were included in the review and targeted behaviour change in five domains: alcohol reduction, improved sleep quality/insomnia reduction, increased physical activity, reduced/cessation of substance abuse and smoking cessation. Four of the studies achieved significant improvements in the targeted behaviour; of these three also reported significant improvements in depressive symptoms. No studies reported significant improvements in depressive symptoms without a change in the target lifestyle behaviour. Conclusion: The results of this review highlight the potential of online lifestyle interventions as adjunctive treatments for depression, and the possibility of achieving significant improvements in depressive symptoms when targeting lifestyle behaviour change.
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Hurley, K., E. Fitzpatrick, L. MacEachern, and J. Curran. "LO39: Systematic review of emergency department practice change interventions for improving asthma outcomes." CJEM 21, S1 (May 2019): S21. http://dx.doi.org/10.1017/cem.2019.82.
Анотація:
Introduction: Emergency departments (ED) play a vital role in asthma care for patients of all ages. Our objective was to review and synthesize all practice change interventions in ED settings that focused on improving the health outcomes of adults and children with asthma. Methods: This study was a systematic review adhering to the methods outlined by the Effective Practice and Organization of Care (EPOC) Cochrane Review Group. We developed a search strategy with a library scientist for the following databases: AMED, CINAHL, Embase, ERIC, MEDLINE, HealthStar, CENTRAL, DARE and Cochrane's EPOC and Airways registers. We also hand searched the Journal of Asthma, Pediatrics and Chest. Two reviewers independently reviewed titles, abstracts and full text using predetermined criteria. Data were extracted by two independent reviewers who used a structured abstraction form and assessed risk of bias. All discrepancies were resolved by consensus. Results: Our search strategy yielded 8,878 titles and abstracts for review. A total of 214 studies underwent full text screening and we extracted data from 27 studies. Risk of bias was judged as low in 10 studies, moderate in 8 studies and high in 9 studies. A range of interventions were employed, with education (n = 14) and reminders (n = 8) being the most prevalent. In pediatric settings, most studies targeted changing the behaviour of parents (n = 11). Four studies targeted health care providers and four studies targeted both providers and parents. We identified a major deficit in the use of behaviour change theory to guide intervention design. The most common primary outcomes of interest were unscheduled return visits (n = 14), primary care follow-up (n = 9), quality of life (n = 5) and ED length of stay (n = 4). We were not able to perform a meta-analysis due to heterogeneity in interventions and outcomes. Conclusion: Although we found a range of interventions used to improve asthma care in EDs, there was significant variation in reported primary outcomes. Both unscheduled return visits and primary care follow-ups, the most common primary outcomes, varied in the timeframe and manner in which they were collected. Most interventions were educational and based on an assumption that education would change behaviour. Future research in this ares would benefit from standardized outcome measures and intervention designs based upon models of behaviour change model.
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McIntosh, Kam. "Does a patient’s personality style impact health outcomes?" Journal of Haemophilia Practice 3, no. 2 (July 1, 2016): 34–36. http://dx.doi.org/10.17225/jhp00079.
Анотація:
Abstract This case describes a young man with severe haemophilia B who uses the “avoiding” mode of behaviour, leading to isolation and reduced ambulation. Health care providers promoting health change behaviour were able to empower the patient to direct his care toward his desired outcomes. As his self-awareness increases, he begins to use another mode of behaviour: compromising. Thomas- Kilmann’s conflict management framework is a novel approach to bringing two sides together in a working partnership. This challenging case shows the balance between a patient’s self-care and symbiotic interaction with HCPs to achieve successful health outcomes.
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McNamara, Lynda, Karen Scott, Roslyn N. Boyd, Elizabeth Farmer, Annabel Webb, Margot Bosanquet, Kim Nguyen, and Iona Novak. "Can web-based implementation interventions improve physician early diagnosis of cerebral palsy? Protocol for a 3-arm parallel superiority randomised controlled trial and cost–consequence analysis comparing adaptive and non-adaptive virtual patient instructional designs with control to evaluate effectiveness on physician behaviour, diagnostic skills and patient outcomes." BMJ Open 12, no. 11 (November 2022): e063558. http://dx.doi.org/10.1136/bmjopen-2022-063558.
Анотація:
IntroductionCerebral palsy (CP) is the most common childhood physical disability. Accurate diagnosis before 6 months is possible using predictive tools and decision-making skills. Yet diagnosis is typically made at 12–24 months of age, hindering access to early interventions that improve functional outcomes. Change in practice is required for physicians in key diagnostic behaviours. This study aims to close the identified research–practice gap and increase accurate CP diagnosis before 6 months of age through tailored web-based implementation interventions. This trial will determine whether adaptive e-learning using virtual patients, targeting CP diagnostic behaviours and clinical decision-making skills, effectively changes physician behaviour and practice compared with non-adaptive e-learning instructional design or control.Methods and analysisThis study is a 3-arm parallel superiority randomised controlled trial of two tailored e-learning interventions developed to expedite physician CP diagnosis. The trial will compare adaptive (arm 1) and non-adaptive (arm 2) instructional designs with waitlist control (arm 3) to evaluate change in physician behaviour, skills and diagnostic practice. A sample size of 275 paediatric physicians enables detection of small magnitude effects (0.2) of primary outcomes between intervention comparators with 90% power (α=0.05), allowing for 30% attrition. Barrier analysis, Delphi survey, Behaviour Change Wheel and learning theory frameworks guided the intervention designs. Adaptive and non-adaptive video and navigation sequences utilising virtual patients and clinical practice guideline content were developed, integrating formative key features assessment targeting clinical decision-making skills relative to CP diagnosis.Physician outcomes will be evaluated based on postintervention key feature examination scores plus preintervention/postintervention behavioural intentions and practice measures. Associations with CP population registers will evaluate real-world diagnostic patient outcomes. Intervention costs will be reported in a cost–consequence analysis from funders’ and societal perspectives.Ethics and disseminationEthics approved from The University of Sydney (Project number 2021/386). Results will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberAustralian New Zealand Clinical Trials Registry: ACTRN 12622000184774.
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Curran, Fiona, Catherine Blake, Caitriona Cunningham, Carla Perrotta, Hidde van der Ploeg, James Matthews, and Grainne O’Donoghue. "Efficacy, characteristics, behavioural models and behaviour change strategies, of non-workplace interventions specifically targeting sedentary behaviour; a systematic review and meta-analysis of randomised control trials in healthy ambulatory adults." PLOS ONE 16, no. 9 (September 7, 2021): e0256828. http://dx.doi.org/10.1371/journal.pone.0256828.
Анотація:
Background Sedentary behaviour (SB) research has grown exponentially but efficacy for interventions to reduce sedentary behaviour is often contaminated by interventions primarily or co-targeting other behaviours and outcomes. The primary aim of this research therefore, was to systematically review the efficacy of interventions specifically targeting sedentary behaviour reduction, as a sole primary outcome, from randomised control trials in healthy ambulatory adults. This research also sought to identify the successful interventions characteristics, behaviour change techniques (BCT’s) and underlying theories, and their relation to intervention effectiveness. Methods We followed PRISMA reporting guidelines for this systematic review. Six electronic databases were searched and a grey literature review conducted. Only randomised or cluster randomised controlled trials, from 2000 to 2020, in adult populations with a sole primary outcome of change in sedentary behaviour were included. Data codebooks were developed, data were extracted, and a narrative synthesis and meta-analysis was conducted using mixed methods random effects models. Results Of 5589 studies identified, 7 studies met the inclusion criteria. Six studies reported activPAL3 measures of mean daily sitting time, and four reported mean daily standing time, stepping time and number of sedentary breaks. Pooled analysis of weighted mean differences revealed a reduction in mean daily sitting time of -32.4mins CI (-50.3, -14.4), an increase in mean daily standing time of 31.75mins CI (13.7, 49.8), and mean daily stepping time of 9.5mins CI (2.8, 16.3), and an increase in rate of sedentary breaks per day of 3.6 (CI 1.6, 5.6). BCTs used exclusively in two of the three most effective interventions are ‘feedback on behaviour’ and ‘goal setting behaviour’ whilst all three most effective interventions included ‘instruction on how to perform the behaviour’ and ‘adding objects to the environment’, BCTs which were also used in less effective interventions. Conclusions Although limited by small sample sizes and short follow up periods, this review suggests that interventions specifically designed to change sedentary behaviour, reduce overall daily sitting time by half an hour, with an equivalent increase in standing time, in the short to medium term. Effective characteristics and behaviour change strategies are identified for future development of high quality interventions targeting change in sedentary behaviour. Prospero registration PROSPERO 2020 CRD42020172457 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172457.
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Baker, John, Kathryn Berzins, Krysia Canvin, Sarah Kendal, Stella Branthonne-Foster, Judy Wright, Tim McDougall, Barry Goldson, Ian Kellar, and Joy Duxbury. "Components of interventions to reduce restrictive practices with children and young people in institutional settings: the Contrast systematic mapping review." Health and Social Care Delivery Research 10, no. 8 (May 2022): 1–180. http://dx.doi.org/10.3310/yvkt5692.
Анотація:
Background Incidents in which children or young people experience severe distress or harm or cause distress or harm to others occur frequently in children and young people’s institutional settings. These incidents are often managed using restrictive practices, such as restraint, seclusion, sedation or constant observation; however, these also present significant risks of physical and psychological harm to children and young people as well as staff. Numerous interventions aim to reduce the use of restrictive techniques, but research is hampered by limited attention to specific intervention components. The behavior change technique taxonomy may improve reporting by providing a common language for specifying the content and mechanisms of behaviour change. This study aimed to identify, standardise and report the effectiveness of components of interventions to reduce restrictive practices in children and young people’s institutional settings. Objectives To map interventions aimed at reducing restrictive practices in children and young people’s institutional settings internationally, to conduct behaviour change technique analysis of intervention components, to identify process elements, and to explore effectiveness evidence to identify promising behaviour change techniques and compare the results with those found in adult psychiatric inpatient settings in a companion review. Design Systematic mapping review with programme content coding using the behavior change technique taxonomy. Review methods Eleven relevant English-language health and social care research databases 1989–2019 [including Applied Social Sciences Index (ASSIA), Criminal Justice Abstracts, Educational Resources Information Center (ERIC), MEDLINE and PsycInfo®], grey literature and social media were searched during 2019 (updated January 2020). Data extraction, guided by Workgroup for Intervention Development and Evaluation Research (WIDER), Cochrane Library and theory coding scheme recommendations, included intervention characteristics and study design and reporting. Screening and quality appraisal used the Mixed Methods Appraisal Tool. The behavior change technique taxonomy was applied systematically, and interventions were coded for behaviour change technique components. Outcomes data were then related back to these components. Results There were 121 records, including 76 evaluations. Eighty-two interventions, mostly multicomponent, were identified. Evaluation approaches commonly used a non-randomised design. There were no randomised controlled trials. Behaviour change techniques from 14 out of a possible 16 clusters were detected. Four clusters (i.e. goals and planning, antecedents, shaping knowledge, and feedback and monitoring) contained the majority of identified behaviour change techniques and were detected in over half of all interventions. Two clusters (i.e. self-belief and covert learning) contained no identified behaviour change techniques. The most common setting in which behaviour change techniques were found was ‘mental health’. The most common procedure focused on staff training. The two most common behaviour change techniques were instruction on how to perform the behaviour and restructuring the social environment. Promising behaviour change techniques included instruction on how to perform the behaviour, restructuring the social environment, feedback on outcomes of behaviour and problem-solving. Compared with the companion review, service user perspectives were more sparse and there was more interest in trauma-informed approaches. Effectiveness evidence, range of interventions and reporting were broadly similar. Limitations Poor reporting may have prevented detection of some behaviour change techniques. The finding that the evidence was weak restricted the feasibility of examining behaviour change technique effectiveness. Literature searches were restricted to English-language sources. Conclusions This study generated, to our knowledge, the first review of evidence on the content and effectiveness of interventions to reduce restrictive practices in children and young people’s institutional settings. Interventions tend to be complex, reporting is inconsistent and robust evaluation data are limited, but some behaviour change techniques seem promising. Future work Promising behaviour change techniques could be further explored. Better evidence could help address the urgent need for effective strategies. Study registration This study is registered as PROSPERO CRD42019124730. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 8. See the NIHR Journals Library website for further project information.
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Faisal, Mehreen Riaz, Masuma Pervin Mishu, Faisal Jahangir, Sabahat Younes, Omara Dogar, Kamran Siddiqi, and David J. Torgerson. "The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children’s oral health: A systematic review and meta-analysis." PLOS ONE 17, no. 1 (January 11, 2022): e0262118. http://dx.doi.org/10.1371/journal.pone.0262118.
Анотація:
Objectives Dental caries is the most common preventable childhood condition. Non-dental professionals and health workers are often well placed to support parents in adopting positive oral health behaviours for their children. The aim of this study was to determine the effectiveness of behaviour change interventions and their individual component behaviour change techniques (BCTs), that were delivered by non-dental professionals and health workers. Methods A systematic search of Ovid MEDLINE, PubMed, CINAHL, Cochrane Library, Web of Science, TRoPHI and PROQUEST from inception until March 2021 was conducted. Randomised controlled trials and quasi-experimental studies for improving oral health outcomes in children were included. Quality assessment was carried out using Cochrane Risk of Bias tool and ROBINS-I tool. Publication bias was assessed using funnel plots and Egger’s regression intercept. Effect sizes were estimated as standardised mean difference (SMD) and odds ratio/risk ratio for proportions. Meta-analyses were performed for studies reporting mean decayed, missing, filled surfaces (dmfs) and mean decayed, missing, filled, teeth (dmft) indices. Behaviour change technique coding was performed using behaviour change technique taxonomy v1 (BCTTv1). Results Out of the 9,101 records retrieved, 36 studies were included with 28 showing a significant effect either in clinical and/or behavioural/knowledge outcomes. Most studies (n = 21) were of poor methodological quality. The pooled SMD for caries experience showed statistically significant result for caries prevention at surface level -0.15 (95% CI -0.25, -0.04) and at the tooth level -0.24 (95% CI -0.42, -0.07). In 28 effective interventions, 27 individual BCTs were identified and the most frequently used were: “Instructions on how to perform the behaviour” and “Information about health consequences”. Conclusion There is low quality of evidence suggesting non-dental professionals and health workers may help improve oral health outcomes for children. To confirm these findings, further high-quality studies incorporating a variety of BCTs in their interventions for adoption of good oral health behaviours are needed.
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Merriel, Abi, Amie Wilson, Emily Decker, Julia Hussein, Michael Larkin, Katie Barnard, Millie O’Dair, Anthony Costello, Address Malata, and Arri Coomarasamy. "Systematic review and narrative synthesis of the impact of Appreciative Inquiry in healthcare." BMJ Open Quality 11, no. 2 (June 2022): e001911. http://dx.doi.org/10.1136/bmjoq-2022-001911.
Анотація:
BackgroundAppreciative Inquiry is a motivational, organisational change intervention, which can be used to improve the quality and safety of healthcare. It encourages organisations to focus on the positive and investigate the best of ‘what is’ before thinking of ‘what might be’, deciding ‘what should be’ and experiencing ‘what can be’. Its effects in healthcare are poorly understood. This review seeks to evaluate whether Appreciative Inquiry can improve healthcare.MethodsMajor electronic databases and grey literature were searched. Two authors identified reports of Appreciative Inquiry in clinical settings by screening study titles, abstracts and full texts. Data extraction, in duplicate, grouped outcomes into an adapted Kirkpatrick model: participant reaction, attitudes, knowledge/skills, behaviour change, organisational change and patient outcomes.ResultsWe included 33 studies. One randomised controlled trial, 9 controlled observational studies, 4 qualitative studies and 19 non-controlled observational reports. Study quality was generally poor, with most having significant risk of bias. Studies report that Appreciative Inquiry impacts outcomes at all Kirkpatrick levels. Participant reaction was positive in the 16 studies reporting it. Attitudes changed in the seventeen studies that reported them. Knowledge/skills changed in the 14 studies that reported it, although in one it was not universal. Behaviour change occurred in 12 of the 13 studies reporting it. Organisational change occurred in all 23 studies that reported it. Patient outcomes were reported in eight studies, six of which reported positive changes and two of which showed no change.ConclusionThere is minimal empirical evidence to support the effectiveness of Appreciative Inquiry in improving healthcare. However, the qualitative and observational evidence suggests that Appreciative Inquiry may have a positive impact on clinical care, leading to improved patient and organisational outcomes. It is, therefore, worthy of consideration when trying to deliver improvements in care. However, high-quality studies are needed to prove its effects.PROSPERO registration numberCRD42015014485.
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McCrea, Rod, Zoe Leviston, Iain Walker, and Tung-Kai Shyy. "Climate Change Beliefs Count: Relationships With Voting Outcomes at the 2010 Australian Federal Election." Journal of Social and Political Psychology 3, no. 1 (May 5, 2015): 124–41. http://dx.doi.org/10.5964/jspp.v3i1.376.
Анотація:
Climate change is a political as well as an environmental issue. Climate change beliefs are commonly associated with voting behaviour, but are they associated withswingsin voting behaviour? The latter are arguably more important for election outcomes. This paper investigates the predictive power of these beliefs on voting swings at the 2010 Australian federal election after controlling for a range of other related factors (demographic characteristics of voters, different worldviews about nature and the role of government, and the perceived opportunity cost of addressing climate change). Drawing on data from two nationally representative surveys of voters and data from the Australian Electoral Commission, this paper investigates relationships between climate change beliefs and voting swings at both the individual and electorate levels. At an individual level, a hypothetical 10% change in climate change beliefs was associated with a 2.6% swing from a conservative Coalition and a 2.0% swing toward Labor and 1.7% toward the Greens party, both left on the political spectrum. At the electorate level, this equates to a shift of 21 seats between the two main political parties (the Coalition and Labor) in Australia’s 150 seat parliament, after allocating Green preferences. Given many seats are marginal, even modest shifts in climate change beliefs can be associated with changes in electoral outcomes. Thus, climate change is expected to remain a politically contested issue in countries like Australia where political parties seek to distinguish themselves, in part, by their responses to climate change.
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Paxling, Björn, Susanne Lundgren, Anita Norman, Jonas Almlöv, Per Carlbring, Pim Cuijpers, and Gerhard Andersson. "Therapist Behaviours in Internet-Delivered Cognitive Behaviour Therapy: Analyses of E-Mail Correspondence in the Treatment of Generalized Anxiety Disorder." Behavioural and Cognitive Psychotherapy 41, no. 3 (May 1, 2012): 280–89. http://dx.doi.org/10.1017/s1352465812000240.
Анотація:
Background: Internet-delivered cognitive behaviour therapy (iCBT) has been found to be an effective way to disseminate psychological treatment, and support given by a therapist seems to be important in order to achieve good outcomes. Little is known about what the therapists actually do when they provide support in iCBT and whether their behaviour influences treatment outcome. Aims: This study addressed the content of therapist e-mails in guided iCBT for generalized anxiety disorder. Method: We examined 490 e-mails from three therapists providing support to 44 patients who participated in a controlled trial on iCBT for generalized anxiety disorder. Results: Through content analysis of the written correspondence, eight distinguishable therapist behaviours were derived: deadline flexibility, task reinforcement, alliance bolstering, task prompting, psychoeducation, self-disclosure, self-efficacy shaping, and empathetic utterances. We found that task reinforcement, task prompting, self-efficacy shaping and empathetic utterances correlated with module completion. Deadline flexibility was negatively associated with outcome and task reinforcement positively correlated with changes on the Penn State Worry Questionnaire. Conclusions: Different types of therapist behaviours can be identified in iCBT, and though many of these behaviours are correlated to each other, different behaviours have an impact on change in symptoms and module completion.
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Curtis, Kristina, and Eleni Karasouli. "An assessment of the potential of health promotion apps to support health behaviour change." Health Psychology Update 23, no. 2 (2014): 43–49. http://dx.doi.org/10.53841/bpshpu.2014.23.2.43.
Анотація:
With thousands of health promotion apps available to consumers claiming to support healthier lifestyles and reduce risk behaviours, there is now a real need for rigorous research to evaluate their potential for improving public health. This article provides an overview of the research on existing health promotion apps and discusses the potential for smartphones to deliver behaviour change techniques and impact on surrogate and real health outcomes using initial data from pilot studies of weight loss apps.
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Curtis, Val. "Explaining the outcomes of the 'Clean India' campaign: institutional behaviour and sanitation transformation in India." BMJ Global Health 4, no. 5 (September 2019): e001892. http://dx.doi.org/10.1136/bmjgh-2019-001892.
Анотація:
IntroductionMany less developed countries are struggling to provide universal access to safe sanitation, but in the past 5 years India has almost reached its target of eliminating open defaecation.ObjectiveTo understand how the Indian government effected this sanitation transformation.MethodsThe study employed interviews with 17 actors in the government’s ‘Clean India’ programme across the national capital and four states, which were analysed using a theory of change grounded in Behaviour Centred Design.ResultsThe Swachh Bharat Mission (Gramin) claims to have improved the coverage of toilets in rural India from 39% to over 95% of households between 2014 and mid-2019. From interviews with relevant actors we constructed a theory of change for the programme, in which high-level political support and disruptive leadership changed environments in districts, which led to psychological changes in district officials. This, in turn, led to changed behaviour for sanitation programming. The prime minister set an ambitious goal of eliminating open defaecation by the 150th birthday of Mahatma Gandhi (October 2019). This galvanised government bureaucracy, while early success in 100 flagship districts reduced the scepticism of government employees, a cadre of 500 young professionals placed in districts imparted new ideas and energy, social and mass media were used to inform and motivate the public, and new norms of ethical behaviour were demonstrated by leaders. As a result, district officials became emotionally involved in the programme and felt pride at their achievement in ridding villages of open defaecation.ConclusionsThough many challenges remain, governments seeking to achieve the sustainable development goal of universal access to safe sanitation can emulate the success of India’s Swachh Bharat Mission.
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Graves, Catherine, and Katy Roelich. "Psychological Barriers to Pro-Environmental Behaviour Change: A Review of Meat Consumption Behaviours." Sustainability 13, no. 21 (October 20, 2021): 11582. http://dx.doi.org/10.3390/su132111582.
Анотація:
Meat consumption behaviours contribute significantly to global greenhouse gas emissions. Interventions to enable meat consumption reductions need to consider the psychological barriers preventing behavioural changes. Our aims were twofold; (1) to explore the psychological barriers to reducing meat consumption and how they can be overcome through a Rapid Evidence Review; and (2) to explore the usefulness of integrating the Kollmuss and Agyeman (K&A) model of pro-environmental behaviour and psychological distance, which provides the analytical framework. This review utilised three databases, focussing on empirical studies since 2010, which returned 277 results with seven eligible studies. We found that habit is the most significant psychological barrier to change, however, values and attitudes could act as moderating variables. We found gaps in the behavioural mechanism, indicating the presence of direct and indirect psychological barriers. We identified several actionable policy recommendations, such as utilising co-benefits, the importance of values in messaging, and targeting repeated behaviours. We found that study outcomes did not always translate into policy recommendations, and they were limited by existing policy paradigms. Psychological distance provides additional explanatory power, when combined with the K&A model, therefore, integrating psychological distance across pro-environmental behavioural research and policy could improve the effectiveness of interventions.
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Limpens, Marlou M., Rita J. G. Van den Berg, Iris Den Uijl, Madoka Sunamura, Trudy Voortman, Eric Boersma, and Nienke Ter Hoeve. "Physical activity and sedentary behaviour changes during and after cardiac rehabilitation: Can patients be clustered?" Journal of Rehabilitation Medicine 55 (July 12, 2023): jrm4343. http://dx.doi.org/10.2340/jrm.v55.4343.
Анотація:
Objective: To identify clusters of patients according to changes in their physical behaviour during and after cardiac rehabilitation, and to predict cluster membership.Methods: The study included 533 patients (mean age 57.9 years; 18.2% females) with a recent acute coronary syndrome who participated in a 12-week multi-disciplinary cardiac rehabilitation programme, within a cohort study design. Physical behaviour (light physical activity, moderate-to vigorous physical activity, step count, and sedentary behaviour) was measured using accelerometry at 4 timepoints. To identify clusters of patients according to changes in physical behaviour during and after cardiac rehabilitation, latent class trajectory modelling was applied. Baseline factors to predict cluster membership were assessed using multinomial logistic regression.Results: During and after cardiac rehabilitation, 3 separate clusters were identified for all 4 physical behaviour outcomes: patients with steady levels (comprising 68–83% of the patients), and improving (6–21%) or deteriorating (4–23%) levels. Main predictor for membership to a specific cluster was baseline physical behaviour. Patients with higher starting physical behaviour were more likely to be a member of clusters with deteriorating levels.Conclusion: Separate clusters of physical behaviour changes during and after cardiac rehabilitation could be identified. Clusters were mainly distinguished by baseline physical behaviour level. LAY ABSTRACTPhysical behaviour is a construct including both physical activity and sedentary behaviour. Healthy levels of physical behaviour are important for cardiac patients. Cardiac rehabilitation programs are designed to promote a heart-healthy lifestyle for this group. Nevertheless, not all patients perform sufficient physical activity after cardiac rehabilitation. It is important to identify patients at risk for disappointing physical behaviour outcomes at an early stage to provide additional care. Outcomes of the current study show that cardiac patients can be clustered according to their change in physical behavior during and after cardiac rehabilitation. The majority showed steady levels and no improvements, but we could also identify groups of patients with improving and deteriorating levels. Patients with higher starting physical activity levels or low sedentary behaviour levels were more likely to be a member of clusters with deteriorating levels. These patients could benefit of additional interventions.
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Russell, Naomi, and Jennifer Taylor. "Attitude and behaviour change – it takes a generation." Journal of Mental Health Training, Education and Practice 9, no. 4 (December 2, 2014): 207–14. http://dx.doi.org/10.1108/jmhtep-09-2014-0026.
Анотація:
Purpose – The purpose of this paper is to describe the work of the Children and Young People's Programme of Time to Change, which is England's biggest campaign to end the stigma and discrimination that surrounds mental health. Design/methodology/approach – The paper draws upon research into the nature and effects of mental health stigma and discrimination on young people and also outlines the strategy of the Time to Change campaign and its initial outcomes. Findings – The paper includes testimonies from young people with lived experience of mental health problems about the stigma and discrimination they have faced. It also outlines the aims, objectives and stages of implementation of the Time to Change Children and Young People's Programme. The paper particularly focuses on the campaign work undertaken in secondary schools, the social leadership programme for young people with lived experience of mental health problems and the process of designing effective campaign messaging for social media. Originality/value – Time to Change is England's biggest campaign to end the stigma and discrimination that surrounds mental health. This paper provides a unique insight into the process of developing and rolling out an anti-stigma campaign for young people.
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Incledon, E., M. Wake, and L. Brennan. "Mood and behaviour outcomes of BMI change in overweight children: Longitudinal community study." Obesity Research & Clinical Practice 5 (October 2011): 35. http://dx.doi.org/10.1016/j.orcp.2011.08.122.
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Buchan, Kelly, and Heather M. Morgan. "Using the Onitor® Track for weight loss: A mixed methods study among overweight and obese women." Health Informatics Journal 26, no. 3 (December 17, 2019): 1841–65. http://dx.doi.org/10.1177/1460458219890790.
Анотація:
Non-communicable disease rates associated with being overweight or obese are rising. Technologies warrant consideration as weight loss interventions. Cloudtag’s® Onitor® Track, a dual-position wearable plus smartphone application, monitors energy expenditure and provides tailored exercise programmes. This research aimed to undertake an experimental study of 20 overweight and obese women using the technology; explore its feasibility and acceptability through interviews; and investigate its behaviour change techniques. The primary outcome was decreased body weight (kg) at 4 weeks. Secondary outcomes were body mass index (kg/m2) and waist circumference (cm) changes. 15 overweight and obese women took part. Results indicated weight loss (median 2.7 kg, p < 0.05) and waist circumference decrease (median 4 cm, p < 0.05), but attrition was high (60%). Users reported dietary changes but few activity adjustments. They valued feedback. 27 behaviour change techniques were identified. The Onitor® Track shows potential for weight loss in overweight and obese women, but further work is needed.
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Hawkins, Andrew, Jasper Odgers, Amanda Reeves, and Alicia McCoy. "Evaluating telephone and online psychological support and referral." Evaluation Journal of Australasia 20, no. 3 (June 29, 2020): 157–75. http://dx.doi.org/10.1177/1035719x20927146.
Анотація:
Mental health counselling and support over the telephone or internet is increasingly common. Evaluating effectiveness requires outcome measures and understanding factors driving behaviour. This article describes a theory-driven evaluation of the one-month outcomes of a short-term solution-focused support session for anxiety or depression with a counsellor. The primary aim of the evaluation was to measure the outcomes of this session on service users’ help-seeking behaviour. It also sought to understand reasons for behaviour based on behaviour change theory. A secondary aim was to measure changes in feelings of stress and coping before and after the session, and collect evidence of the value of the service in terms of ‘consumer-defined recovery’. The evaluation found the service was effective, with the overwhelming majority taking some action, being more engaged with a health professional, having reduced feelings of distress, increased confidence to cope and less hopelessness. Improvements for service users included ‘reality testing’ the advice given and building commitment or intent to follow the advice, and ‘rehearsing’ so service users can demonstrate to themselves they have the skills required and can overcome any obstacles to following the advice.
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McLaughlin, Lyndsey, and Allan Skelly. "Does Positive Behaviour Support provided by a community team improve outcomes for adults with intellectual disabilities?" FPID Bulletin: The Bulletin of the Faculty for People with Intellectual Disabilities 16, no. 1 (April 2018): 35–43. http://dx.doi.org/10.53841/bpsfpid.2018.16.1.35.
Анотація:
Positive Behaviour Support (PBS) is proposed as the model of care for adults with intellectual disabilities (ID) whose behaviour challenges others. In this study we considered how much change was observed in 16 clients presenting to a community learning disabilities team with challenging behaviour, and receiving PBS, as measured on the HoNOS-LD, a generic outcome measure. Clear improvements in behavioural and emotional functioning were identified for all clients. Quality of life and communicative abilities showed an interaction of length of involvement, with greater change in clients receiving PBS for more than one year. The pre-post effect size (Cohen’s d) for change in Total HoNOS-LD Score was 0.86 (large). We discuss the potential implications and limitations of this study.
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Okumah, Murat, Julia Martin-Ortega, Paula Novo, and Pippa J. Chapman. "Revisiting the Determinants of Pro-Environmental Behaviour to Inform Land Management Policy: A Meta-Analytic Structural Equation Model Application." Land 9, no. 5 (April 30, 2020): 135. http://dx.doi.org/10.3390/land9050135.
Анотація:
Environmental policies in the realm of land management are increasingly focussing on inducing behavioural change to improve environmental management outcomes. This is based, implicitly or explicitly, on theories that suggest that pro-environmental behaviour can be understood, predicted and altered based on certain factors (referred to as determinants of pro-environmental behaviour). However, studies examining the determinants of pro-environmental behaviour have found mixed evidence. It is therefore important that we revisit these theories to assess if the evidence supports their postulations so that a more robust knowledge base can be established to inform land management policies. In this study, we do this using meta-analytic structural equation modelling (MASEM) to explore whether the evidence on determinants of pro-environmental behaviour supports the postulations of some predominantly applied theories of behaviour and/or behaviour change. The study analyses research in four environmental policy areas to identify implications for land management. Evidence from these related environmental areas is expected to provide insights relevant to the land management literature and to allow us to identify the extent to which lessons on pro-environmental behaviour from these other areas can be transferred to the land management context. Our findings suggest a strong evidence base for the Theories of Planned Behaviour and Reasoned Action, Attitude-Behaviour-Context Model, and the Persuasion Theory, but a weak evidence base for the Value-Belief-Norm Theory and the Norm Activation Model. We also found that type of environmental policy area moderates the relationship between different variables. This has key policy implications since, while lessons can be learnt from other environmental policy areas, land management policies aimed at influencing behaviours will need to be tailored to the specific context rather than simply ‘imported’ from other fields. Such context-specific policies may encourage pro-environmental behaviours, and potentially contribute towards improving environmental management outcomes.
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Hillier, Bradley, Lucy Wright, Andre Strydom, and Angela Hassiotis. "Use of the HoNOS–LD in identifying domains of change." Psychiatrist 34, no. 8 (August 2010): 322–26. http://dx.doi.org/10.1192/pb.bp.108.024323.
Анотація:
Aims and methodTo analyse clinical outcome indicator data from the Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) in adults with intellectual disability admitted to mental health wards during a 19-month period; and to identify clinically relevant domains of change associated with in-patient admission.ResultsSignificant improvements were found in mental state, behaviour and social functioning. Improvements were also found in cognition and activities of daily living.Clinical implicationsThe HoNOS-LD is a useful tool for measuring clinical outcomes in several relevant domains and guiding in-patient treatment in learning disability psychiatry. It may also provide a currency for payment-by-results and influence the commissioning of learning disability services.
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Evangelidis, Nicole, Jonathan Craig, Adrian Bauman, Karine Manera, Valeria Saglimbene, and Allison Tong. "Lifestyle behaviour change for preventing the progression of chronic kidney disease: a systematic review." BMJ Open 9, no. 10 (October 2019): e031625. http://dx.doi.org/10.1136/bmjopen-2019-031625.
Анотація:
ObjectivesModifying lifestyle can prevent the progression of chronic kidney disease (CKD) but the specific elements which lead to favourable behaviour change are not well understood. We aimed to identify and evaluate behaviour change techniques and functions in lifestyle interventions for preventing the progression of CKD.DesignSystematic review.Data sourcesMEDLINE, EMBASE, CINAHL and PsycINFO.Eligibility criteriaTrials of lifestyle behaviour change interventions (including diet, physical activity, smoking and/or alcohol) published to September 2018 in adults with CKD stages 1–5.Data extraction and synthesisTrial characteristics including population, sample size, study setting, intervention, comparator, outcomes and study duration, were extracted. Study quality was independently assessed by two reviewers using the Cochrane risk of bias tool. The Behaviour Change Technique Taxonomy v1 was used to identify behaviour change techniques (eg, goal setting) and the Health Behaviour Change Wheel was used to identify intervention functions (eg, education). Both were independently assessed by three reviewers.ResultsIn total, 26 studies involving 4263 participants were included. Risk of bias was high or unclear in most studies. Interventions involved diet (11), physical activity (8) or general lifestyle (7). Education was the most frequently used function (21 interventions), followed by enablement (18), training (12), persuasion (4), environmental restructuring (4), modelling (2) and incentivisation (2). The most common behaviour change techniques were behavioural instruction (23 interventions), social support (16), behavioural demonstration (13), feedback on behaviour (12) and behavioural practice/rehearsal (12). Eighteen studies (69%) showed a significant improvement in at least one primary outcome, all of which included education, persuasion, modelling and incentivisation.ConclusionLifestyle behaviour change interventions for CKD patients frequently used education, goal setting, feedback, monitoring and social support. The most promising interventions included education and used a variety of intervention functions (persuasion, modelling and incentivisation).PROSPERO registration numberCRD42019106053.
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Matvienko-Sikar, Karen, Molly Byrne, Mike Clarke, Jamie Kirkham, Jan Kottner, Katie Mellor, Fiona Quirke, et al. "Using behavioural science to enhance use of core outcome sets in trials: protocol." HRB Open Research 5 (November 20, 2023): 23. http://dx.doi.org/10.12688/hrbopenres.13510.2.
Анотація:
Background Core outcome sets (COS) represent agreed-upon sets of outcomes, which are the minimum that should be measured and reported in all trials in specific health areas. Use of COS can reduce outcome heterogeneity, selective outcome reporting, and research waste, and can facilitate evidence syntheses. Despite benefits of using COS, current use of COS in trials is low. COS use can be understood as a behaviour, in that it is something trialists do, or not do, adequately. The aim of this study is to identify strategies, informed by behaviour change theory, to increase COS use in trials. Methods The project will be conducted in two stages, informed by the behaviour change wheel (BCW). The BCW is a theoretically based framework that can be used to classify, identify, and develop behaviour change strategies. In Stage 1, barriers and enablers to COS use will be extracted from published studies that examined trialist’s use of COS. Barriers and facilitators will be mapped to the components of COM-B model (capability, opportunity, and motivation), which forms part of the BCW framework. Stage 2 will build on Stage 1 findings to identify and select intervention functions and behaviour change techniques to enhance COS use in trials. Discussion The findings of this study will provide an understanding of the behavioural factors that influence COS use in trials and what strategies might be used to target these factors to increase COS use in trials.
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Soltani, H., M. A. Arden, A. M. S. Duxbury, and F. J. Fair. "An Analysis of Behaviour Change Techniques Used in a Sample of Gestational Weight Management Trials." Journal of Pregnancy 2016 (2016): 1–15. http://dx.doi.org/10.1155/2016/1085916.
Анотація:
Introduction. Maternal obesity and excessive gestational weight gain are associated with multiple adverse outcomes. There is a lack of clarity on the specific components of effective interventions to support pregnant women with gestational weight management.Method. All 44 studies within a preexisting review of lifestyle interventions, with a potential to impact on maternal weight outcomes, were considered for content analysis. Interventions were classified using Behaviour Change Technique (BCT) taxonomy clusters to explore which categories of BCT were used in interventions and their effectiveness in managing gestational weight gain.Results. The most commonly used BCTs were within the categories of “feedback and monitoring,” “shaping knowledge,” “goals and planning,” “repetition and substitution,” “antecedents,” and “comparison of behaviours.” For diet and mixed interventions “feedback and monitoring,” “shaping knowledge,” and “goals and planning” appeared the most successful BCT categories.Conclusions. Poor reporting within studies in defining the BCTs used, in clarifying the differences in processes between intervention and control groups, and in differentiating between the intervention and research processes made BCT classification difficult. Future studies should elaborate more clearly on the behaviour change techniques used and report them accurately to allow a better understanding of the effective ingredients for lifestyle interventions during pregnancy.
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Dale, Hannah, Linsay Brassington, and Kristel King. "The impact of healthy lifestyle interventions on mental health and wellbeing: a systematic review." Mental Health Review Journal 19, no. 1 (March 5, 2014): 1–26. http://dx.doi.org/10.1108/mhrj-05-2013-0016.
Анотація:
Purpose – There is growing evidence that health behaviour change interventions are associated with mental health and wellbeing improvements. This paper aims to examine the effect of healthy lifestyle interventions on mental wellbeing. Design/methodology/approach – Six databases (Medline, Evidence Based Medicine Cochrane Registered Controlled Trials, Evidence Based Medicine Full Text Reviews, British Nursing Index, Embase, PsycINFO) were searched from database commencement up to April 2013. A broad focus on lifestyle interventions and mental health and wellbeing outcomes was chosen. Papers were systematically extracted by title then abstract according to predefined inclusion and exclusion criteria. Inclusion criteria: any individual population (non-couple/family); any health behaviour change interventions; mental health and wellbeing outcomes; and a one-two level of evidence. Interventions aimed at workers were excluded, as were articles assessing cognitive functioning rather than mental health or wellbeing, or those using medications in interventions. Findings – Two authors reviewed 95 full papers. In total, 29 papers met inclusion criteria, representing a range of interventions spanning physical activity, diet, alcohol intake, drug use and smoking. A range of measures were used. The majority (n=25) of studies demonstrated improvements on at least one indicator of mental health and wellbeing. Limitations include the broad range of outcome measures used, varied follow-up times and the lack of detail in reporting interventions. Originality/value – Health behaviour change interventions targeting physical outcomes appear to have benefits to mental health and wellbeing spanning healthy populations and those with physical or mental health problems. Evidence is strongest for interventions targeting exercise and diet, particularly in combination and the actual lifestyle changes made and adherence appear to be important. However, it is not clear from this review which specific components are necessary or essential for improvements in mental health and wellbeing.
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Abdullah, Noor Syafiqah, and Kamisah Osman. "The effects of gender on knowledge, attitude and behaviour of science teachers towards climate change." International Journal of Asian Social Science 14, no. 1 (February 7, 2024): 50–59. http://dx.doi.org/10.55493/5007.v14i1.4975.
Анотація:
This article presents the defense for the education area as an undiscovered chance to battle environmental change, through the execution of climate change education across the curriculum. Hence, the work to distinguish the variables that decide the knowledge, attitude, and behavior of educators towards climate change is significant, since educators are significant partners in making powerful climate change education an outcome in schools. Nonetheless, not much consideration has been given to endeavors to evaluate the knowledge, attitude, and behavior of science educators related to climate change. Along these lines, this study was directed to distinguish distinctions in gender in science educators' knowledge, attitude, and behavior related to climate change. Using a stratified cluster random sampling method, a survey of 632 national secondary school science teachers in six states—Kedah, Johor, Terengganu, Selangor, Sabah, and Sarawak—was used to take a quantitative approach. The information gathered through the survey was then examined utilizing a descriptive and inferential technique. Discoveries show that the degree of knowledge, attitude, and behavior of teachers about climate change is high. The outcomes obtained from this study likewise uncover that socio-demographic factors, for example, gender can influence teachers' knowledge, attitude, and behavior about climate change. The aftereffects of this study can help policymakers to conclude the proper moves that can be made in dealing with the impacts of climate change through further developing climate change education across the curriculum, and further reassuring mitigative activities to shield the environment from the antagonistic impacts of climate change.
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Blamey, Avril, Jacki Gordon, Kim Newstead, and Jacqueline McDowell. "Strengthening adult community-based cooking skills interventions using realist principles." British Food Journal 119, no. 5 (May 2, 2017): 1130–46. http://dx.doi.org/10.1108/bfj-09-2016-0432.
Анотація:
Purpose The purpose of this paper is to present learning on the strategies used by cooking skills practitioners and the programme theories, behaviour change mechanisms/contexts and intended outcomes associated with these in varied contexts. Design/methodology/approach Grey literature from Scottish cooking skills courses were reviewed using realist principles. Intervention implementation variables were identified and iteratively coded to uncover intended intervention strategies and programme theories. The lack of robust evaluation processes and outcome data in the grey literature prevented the testing of intended programme theories against outcomes. Alternatively, implementation strategies were aligned against behavioural-theory constructs contained in national guidance. Prioritised theories were further clarified/refined using practitioner and participant focus group data. Learning was used to inform future practice/evaluation. Findings Courses targeted and reached vulnerable individuals. Practitioners articulated multiple theories and assumptions about how strategies may work. Numerous strategies and behaviour constructs were used to target, tailor and reinforce cooking/food and wider social outcomes. Mechanisms were assumed to be triggered by different contexts and lead to varied outcomes. Strategies used were consistent with evidenced behaviour change constructs and guidelines. Interventions aimed to achieve non-cooking/social outcomes as well as cooking ones – including potential mediators of cooking behaviour, e.g. self-confidence. Contexts facilitated/limited the use of certain strategies. Limitations in course design, reporting and self-evaluation need to be addressed. Practical implications Recommendations for improving intervention commissioning, design and evaluation using realist principles are provided. Originality/value Learning addresses gaps in knowledge about the implementation of cooking skills interventions identified from systematic reviews and can improve course design and evaluation.
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Jones, Daniel A., Krishnaraj S. Rathod, Sudheer Koganti, Pitt Lim, Sam Firoozi, Richard Bogle, Ajay K. Jain, et al. "The association between the public reporting of individual operator outcomes with patient profiles, procedural management, and mortality after percutaneous coronary intervention: an observational study from the Pan-London PCI (BCIS) Registry using an interrupted time series analysis." European Heart Journal 40, no. 31 (April 10, 2019): 2620–29. http://dx.doi.org/10.1093/eurheartj/ehz152.
Анотація:
AbstractAimsThe public reporting of healthcare outcomes has a number of potential benefits; however, unintended consequences may limit its effectiveness as a quality improvement process. We aimed to assess whether the introduction of individual operator specific outcome reporting after percutaneous coronary intervention (PCI) in the UK was associated with a change in patient risk factor profiles, procedural management, or 30-day mortality outcomes in a large cohort of consecutive patients.Methods and resultsThis was an observational cohort study of 123 780 consecutive PCI procedures from the Pan-London (UK) PCI registry, from January 2005 to December 2015. Outcomes were compared pre- (2005–11) and post- (2011–15) public reporting including the use of an interrupted time series analysis. Patients treated after public reporting was introduced were older and had more complex medical problems. Despite this, reported in-hospital major adverse cardiovascular and cerebrovascular events rates were significantly lower after the introduction of public reporting (2.3 vs. 2.7%, P < 0.0001). Interrupted time series analysis demonstrated evidence of a reduction in 30-day mortality rates after the introduction of public reporting, which was over and above the existing trend in mortality before the introduction of public outcome reporting (35% decrease relative risk 0.64, 95% confidence interval 0.55–0.77; P < 0.0001).ConclusionThe introduction of public reporting has been associated with an improvement in outcomes after PCI in this data set, without evidence of risk-averse behaviour. However, the lower reported complication rates might suggest a change in operator behaviour and decision-making confirming the need for continued surveillance of the impact of public reporting on outcomes and operator behaviour.
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Friesen, Phoebe. "Personal responsibility within health policy: unethical and ineffective." Journal of Medical Ethics 44, no. 1 (September 22, 2016): 53–58. http://dx.doi.org/10.1136/medethics-2016-103478.
Анотація:
This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of taking personal responsibility into account within health policy to either expand the debate to also include socially accepted behaviours or to provide an alternative explanation of the narrowly focused discussion. Second, a critical response is offered to arguments that claim that policies based on personal responsibility would lead to several positive outcomes including healthy behaviour change, better health outcomes and decreases in healthcare spending. It is argued that using individual responsibility as a basis for resource allocation in healthcare is unlikely to motivate positive behaviour changes, and is likely to increase inequality which may lead to worse health outcomes overall. Finally, the case of West Virginia's Medicaid reform is examined, which raises a worry that policies focused on personal responsibility have the potential to lead to increases in medical spending overall.
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Sremanakova, Jana, Anne Marie Sowerbutts, Chris Todd, Richard Cooke, and Sorrel Burden. "Systematic Review of Behaviour Change Theories Implementation in Dietary Interventions for People Who Have Survived Cancer." Nutrients 13, no. 2 (February 13, 2021): 612. http://dx.doi.org/10.3390/nu13020612.
Анотація:
Background: An increasing number of dietary interventions for cancer survivors have been based on the behaviour change theory framework. The purpose of this study is to review the use and implementation of behaviour change theories in dietary interventions for people after cancer and assess their effects on the reported outcomes. Methods: The search strategy from a Cochrane review on dietary interventions for cancer survivors was expanded to incorporate an additional criterion on the use of behaviour change theory and updated to September 2020. Randomised controlled trials (RCT) testing a dietary intervention compared to the control were included. Standard Cochrane methodological procedures were used. Results: Nineteen RCTs, with 6261 participants (age range 44.6 to 73.1 years), were included in the review. The Social Cognitive Theory was the most frequently used theory (15 studies, 79%). Studies included between 4 to 17 behaviour change techniques. Due to limited information on the mediators of intervention and large heterogeneity between studies, no meta-analyses was conducted to assess which theoretical components of the interventions are effective. Conclusions: Whilst researchers have incorporated behaviour change theories into dietary interventions for cancer survivors, due to inconsistencies in design, evaluation and reporting, the effect of theories on survivors’ outcomes remains unclear.
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Patel, Rabia Ruby, and Tanya Monique Graham. "Critical health response in the time of COVID-19: lessons from the past." South African Journal of Psychology 51, no. 2 (June 2021): 336–45. http://dx.doi.org/10.1177/00812463211015047.
Анотація:
This article examines the South African government’s response to COVID-19 by exploring the strong emphasis that has been placed on South Africans taking personal responsibility for good health outcomes. This emphasis is based on the principles of the traditional Health Belief Model which is a commonly used model in global health systems. More recently, there has been a drive towards other health behaviour change models, like the COM-B model and Behaviour Change Wheel (BCW); nonetheless, these remain entrenched within the principles of individual health responsibility. However, the South African experience with the HIV epidemic serves as a backdrop to demonstrate that holding people personally accountable for health behaviour changes has major pitfalls; health risk is never objective and does not take place outside of subjective experience. This article makes the argument that risk-taking health behaviour change in the South African context has to consider community empowerment and capacity building.