The behaviour change wheel: A new method for characterising and designing behaviour change interventions

PubMed Central

2011-01-01

Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions. PMID:21513547

Eating the elephant whole or in slices: views of participants in a smoking cessation intervention trial on multiple behaviour changes as sequential or concurrent tasks

PubMed Central

2012-01-01

Background This paper explores smoking cessation participants’ perceptions of attempting weight management alongside smoking cessation within the context of a health improvement intervention implemented in Glasgow, Scotland. Methods One hundred and thirty-eight participants were recruited from smoking cessation classes in areas of multiple deprivation in Glasgow and randomised to intervention, receiving dietary advice, or to control groups. The primary outcome of the study was to determine the % change in body weight. Semi-structured interviews were conducted with a purposive sample of 15 intervention and 15 control participants at weeks 6 (during the intervention) and 24 (at the end of the intervention). The current paper, though predominantly qualitative, links perceptions of behaviour modification to % weight change and cessation rates at week 24 thereby enabling a better understanding of the mediators influencing multiple behaviour change. Results Our findings suggest that participants who perceive separate behaviour changes as part of a broader approach to a healthier lifestyle, and hence attempt behaviour changes concurrently, may be at comparative advantage in positively achieving dual outcomes. Conclusions These findings highlight the need to assess participants’ preference for attempting multiple behaviour changes sequentially or simultaneously in addition to assessing their readiness to change. Further testing of this hypothesis is warranted. Trial Registration ISRCTN94961361 PMID:22759785

Reducing the decline in physical activity during pregnancy: a systematic review of behaviour change interventions.

PubMed

Currie, Sinead; Sinclair, Marlene; Murphy, Marie H; Madden, Elaine; Dunwoody, Lynn; Liddle, Dianne

2013-01-01

Physical activity (PA) typically declines throughout pregnancy. Low levels of PA are associated with excessive weight gain and subsequently increase risk of pre-eclampsia, gestational diabetes mellitus, hypertension disorders, delivery by caesarean section and stillbirth. Systematic reviews on PA during pregnancy have not explored the efficacy of behaviour change techniques or related theory in altering PA behaviour. This systematic review evaluated the content of PA interventions to reduce the decline of PA in pregnant women with a specific emphasis on the behaviour change techniques employed to elicit this change. Literature searches were conducted in eight databases. Strict inclusion and exclusion criteria were employed. Two reviewers independently evaluated each intervention using the behaviour change techniques (BCT) taxonomy to identify the specific behaviour change techniques employed. Two reviewers independently assessed the risk of bias using the guidelines from the Cochrane Collaboration. Overall quality was determined using the GRADE approach. A total of 1140 potentially eligible papers were identified from which 14 studies were selected for inclusion. Interventions included counselling (n = 6), structured exercise (n = 6) and education (n = 2). Common behaviour change techniques employed in these studies were goal setting and planning, feedback, repetition and substitution, shaping knowledge and comparison of behaviours. Regular face-to-face meetings were also commonly employed. PA change over time in intervention groups ranged from increases of 28% to decreases of 25%. In 8 out of 10 studies, which provided adequate data, participants in the intervention group were more physically active post intervention than controls. Physical activity interventions incorporating behaviour change techniques help reduce the decline in PA throughout pregnancy. Range of behaviour change techniques can be implemented to reduce this decline including goals and planning, shaping knowledge and comparison of outcomes. A lack of high quality interventions hampers conclusions of intervention effectiveness.

Development of a behaviour change intervention: a case study on the practical application of theory

PubMed Central

2014-01-01

Background Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. Methods The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. Results The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised ‘context-bound communication skills training.’ Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. Conclusions A stepped approach to the development of a behaviour change intervention, with the utilisation of theoretical frameworks to identify determinants of change matched with behaviour change techniques, has enabled a systematic and theory-driven development of an intervention designed to enhance consultations by GPs for patients with OA. The success of the behaviour change intervention in practice will be evaluated in the context of the MOSAICS trial as a whole, and will inform understanding of practice level and patient outcomes in the trial. PMID:24708880

Changing Environmentally Relevant Behaviour.

ERIC Educational Resources Information Center

Gudgion, T. J.; Thomas, M. Pugh

1991-01-01

Considered is the role of psychology in helping to change those human behaviors which have deleterious environmental effects. The foremost conclusion is that behavioral psychology can offer practical techniques for such change, yet there are indications that enduring behaviors may be better realized through the intrinsic motivation maintained by…

Changing children's eating behaviour - A review of experimental research.

PubMed

DeCosta, Patricia; Møller, Per; Frøst, Michael Bom; Olsen, Annemarie

2017-06-01

The interest in children's eating behaviours and how to change them has been growing in recent years. This review examines the following questions: What strategies have been used to change children's eating behaviours? Have their effects been experimentally demonstrated? And, are the effects transient or enduring? Medline and Cab abstract (Ovid) and Web of Science (Thomson Reuters) were used to identify the experimental studies. A total of 120 experimental studies were identified and they are presented grouped within these 11 topics; parental control, reward, social facilitation, cooking programs, school gardens, sensory education, availability and accessibility, choice architecture and nudging, branding and food packaging, preparation and serving style, and offering a choice. In conclusion, controlling strategies for changing children's eating behaviour in a positive direction appear to be counterproductive. Hands-on approaches such as gardening and cooking programs may encourage greater vegetable consumption and may have a larger effect compared to nutrition education. Providing children with free, accessible fruits and vegetables have been experimentally shown to positively affect long-term eating behaviour. The authors recommend future research to examine how taste and palatability can positively affect children's attitudes and eating behaviour. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

What works in school-based energy balance behaviour interventions and what does not? A systematic review of mediating mechanisms

PubMed Central

van Stralen, M M; Yildirim, M; Velde, SJ te; Brug, J; van Mechelen, W; Chinapaw, M J M

2011-01-01

Objective: Obesity prevention requires effective interventions targeting the so-called energy balance-related behaviours (that is, physical activity, sedentary and dietary behaviours). To improve (cost-)effectiveness of these interventions, one needs to know the working mechanisms underlying behavioural change. Mediation analyses evaluates whether an intervention works via hypothesised working mechanisms. Identifying mediators can prompt intervention developers to strengthen effective intervention components and remove/adapt ineffective components. This systematic review aims to identify psychosocial and environmental mediators of energy balance-related behaviours interventions for youth. Method: Studies were identified by a systematic search of electronic databases (Pubmed, Embase, PsycINFO, ERIC and SPORTDiscus). Studies were included if they (1) were school-based randomised controlled or quasi-experimental studies; (2) targeted energy balance behaviours; (3) conducted among children and adolescents (4–18 years of age); (4) written in English; and (5) conducted mediation analyses. Results: A total of 24 studies were included. We found strong evidence for self-efficacy and moderate evidence for intention as mediators of physical activity interventions. Indications were found for attitude, knowledge and habit strength to be mediators of dietary behaviour interventions. The few sedentary behaviour interventions reporting on mediating effects prevented us from forming strong conclusions regarding mediators of sedentary behaviour interventions. The majority of interventions failed to significantly change hypothesised mediators because of ineffective intervention strategies, low power and/or use of insensitive measures. Conclusion: Despite its importance, few studies published results of mediation analysis, and more high-quality research into relevant mediators is necessary. On the basis of the limited number of published studies, self-efficacy and intention appear to be relevant mediators for physical activity interventions. Future intervention developers are advised to provide information on the theoretical base of their intervention including the strategies applied to provide insight into which strategies are effective in changing relevant mediators. In addition, future research is advised to focus on the development, validity, reliability and sensitivity of mediator measures. PMID:21487398

Adding 'epi-' to behaviour genetics: implications for animal domestication.

PubMed

Jensen, Per

2015-01-01

In this review, it is argued that greatly improved understanding of domestication may be gained from extending the field of behaviour genetics to also include epigenetics. Domestication offers an interesting framework of rapid evolutionary changes caused by well-defined selection pressures. Behaviour is an important phenotype in this context, as it represents the primary means of response to environmental challenges. An overview is provided of the evidence for genetic involvement in behavioural control and the presently used methods for finding so-called behaviour genes. This shows that evolutionary changes in behaviour are to a large extent correlated to changes in patterns of gene expression, which brings epigenetics into the focus. This area is concerned with the mechanisms controlling the timing and extent of gene expression, and a lot of focus has been placed on methylation of cytosine in promoter regions, usually associated with genetic downregulation. The review considers the available evidence that environmental input, for example stress, can modify methylation and other epigenetic marks and subsequently affect behaviour. Furthermore, several studies are reviewed, demonstrating that acquired epigenetic modifications can be inherited and cause trans-generational behaviour changes. In conclusion, epigenetics may signify a new paradigm in this respect, as it shows that genomic modifications can be caused by environmental signals, and random mutations in DNA sequence are therefore not the only sources of heritable genetic variation. © 2015. Published by The Company of Biologists Ltd.

Emergent Societal Effects of Crimino-Social Forces in an Animat Agent Model

NASA Astrophysics Data System (ADS)

Scogings, Chris J.; Hawick, Ken A.

Societal behaviour can be studied at a causal level by perturbing a stable multi-agent model with new microscopic behaviours and observing the statistical response over an ensemble of simulated model systems. We report on the effects of introducing criminal and law-enforcing behaviours into a large scale animat agent model and describe the complex spatial agent patterns and population changes that result. Our well-established predator-prey substrate model provides a background framework against which these new microscopic behaviours can be trialled and investigated. We describe some quantitative results and some surprising conclusions concerning the overall societal health when individually anti-social behaviour is introduced.

Factors Related to Continuation of Health Behaviours among Stroke Survivors

PubMed Central

Kudo, Makoto

2011-01-01

Abstract Purpose: This study investigated stroke survivors' perspectives of health behaviours after stroke. We aimed to explore the actual process by which stroke survivors changed their health behaviours. Method: Semi-structured interviews were conducted with 40 people in a 1-year prospective study in the regional city of Chiba, Japan. Interviews covered views of health behaviours in order to explore why patients change their risk factors. Data were analysed using the principles of modified grounded theory. Results: Six categories related to practising health behaviours were identified: cause of stroke, antithetic thinking, awareness of the body, fear of disease progression, view of health, and psychological meaning of practise. Stroke survivors constructed a meaning of practise for each health behaviour. The recognition of previous lifestyle as cause of stroke, hope for recovery, and fear of future progression influenced health behaviours. Conclusions: The key finding of this study is that when cognitive behavioural therapy principles are enforced, an important aspect is that stroke survivors recognize the possibility that previous lifestyle was a cause of stroke and appreciate the necessity of preventing a new stroke. PMID:25792892

Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding.

PubMed

Stead, Martine; Tagg, Stephen; MacKintosh, Anne Marie; Eadie, Douglas

2005-02-01

The Theory of Planned Behaviour (TPB) has been widely applied to the explanation of health and social behaviours. However, despite its potential to inform behaviour change efforts, there have been surprisingly few attempts to use the TPB to design actual interventions. In 1998, the Scottish Road Safety Campaign implemented a 3-year mass media campaign to reduce speeding on Scotland's roads which was explicitly shaped by the TPB's three main predictors: Attitude, Subjective Norms and Perceived Behavioural Control. A 4-year longitudinal cohort study examined the impact of the campaign on communications outcomes and on TPB constructs. Overall, empirical support was found for the decision to use TPB as the theoretical underpinning of the advertising. The advertising was effective in triggering desired communications outcomes, and was associated with significant changes in attitudes and affective beliefs about speeding. In conclusion, future directions for road safety advertising and for TPB research are discussed.

Evidence of behaviour change following a hygiene promotion programme in Burkina Faso.

PubMed Central

Curtis, V.; Kanki, B.; Cousens, S.; Diallo, I.; Kpozehouen, A.; Sangaré, M.; Nikiema, M.

2001-01-01

OBJECTIVES: To determine whether a large, 3-year hygiene promotion programme in Bobo-Dioulasso, Burkina Faso, was effective in changing behaviours associated with the spread of diarrhoeal diseases. The programme was tailored to local customs, targeted specific types of behaviour, built on existing motivation for hygiene, and used locally appropriate channels of communication. METHODS: Two population surveys recorded the coverage of the programme among target audiences (mothers of children aged 0-35 months). Four surveys were carried out: three prior to the programme and one in 1998 (after the programme had been running for 3 years), using structured observation of hygiene behaviours in the participants' homes to document changes in target behaviours. FINDINGS: After the programme had run for 3 years, three-quarters of the mothers targeted had had contact with programme activities. Half could cite the two main messages of the programme correctly. Although the safe disposal of children's stools changed little between 1995 and 1998 (80% pre-intervention, 84% post-intervention), hand-washing with soap after cleaning a child's bottom rose from 13% to 31%. The proportion of mothers who washed their hands with soap after using the latrine increased from 1% to 17%. CONCLUSION: Hygiene promotion programmes can change behaviour and are more likely to be effective if they are built on local research and use locally appropriate channels of communication repeatedly and for an extended time. PMID:11436473

Identifying mechanisms of change in a conversation therapy for aphasia using behaviour change theory and qualitative methods

PubMed Central

Best, Wendy; Beckley, Firle Christina; Maxim, Jane; Beeke, Suzanne

2016-01-01

Abstract Background Conversation therapy for aphasia is a complex intervention comprising multiple components and targeting multiple outcomes. UK Medical Research Council (MRC) guidelines published in 2008 recommend that in addition to measuring the outcomes of complex interventions, evaluation should seek to clarify how such outcomes are produced, including identifying the hypothesized mechanisms of change. Aims To identify mechanisms of change within a conversation therapy for people with aphasia and their partners. Using qualitative methods, the study draws on behaviour change theory to understand how and why participants make changes in conversation during and after therapy. Methods & Procedures Data were derived from 16 participants (eight people with aphasia; eight conversation partners) who were recruited to the Better Conversations with Aphasia research project and took part in an eight session conversation therapy programme. The dataset consists of in‐therapy discussions and post‐therapy interviews, which are analysed using Framework Analysis. Outcomes & Results Seven mechanisms of conversational behaviour change are identified and linked to theory. These show how therapy can activate changes to speakers’ skills and motivation for using specific behaviours, and to the conversational opportunities available for strategy use. Conclusions & Implications These clinically relevant findings offer guidance about the processes involved in producing behavioural change via conversation therapy. A distinction is made between the process involved in motivating change and that involved in embedding change. Differences are also noted between the process engaged in reducing unhelpful behaviour and that supporting new uses of compensatory strategies. Findings are expected to have benefits for those seeking to replicate therapy's core processes both in clinical practice and in future research. PMID:27882642

Behavioural social choice: a status report.

PubMed

Regenwetter, Michel; Grofman, Bernard; Popova, Anna; Messner, William; Davis-Stober, Clintin P; Cavagnaro, Daniel R

2009-03-27

Behavioural social choice has been proposed as a social choice parallel to seminal developments in other decision sciences, such as behavioural decision theory, behavioural economics, behavioural finance and behavioural game theory. Behavioural paradigms compare how rational actors should make certain types of decisions with how real decision makers behave empirically. We highlight that important theoretical predictions in social choice theory change dramatically under even minute violations of standard assumptions. Empirical data violate those critical assumptions. We argue that the nature of preference distributions in electorates is ultimately an empirical question, which social choice theory has often neglected. We also emphasize important insights for research on decision making by individuals. When researchers aggregate individual choice behaviour in laboratory experiments to report summary statistics, they are implicitly applying social choice rules. Thus, they should be aware of the potential for aggregation paradoxes. We hypothesize that such problems may substantially mar the conclusions of a number of (sometimes seminal) papers in behavioural decision research.

Rapid behavioural gregarization in the desert locust, Schistocerca gregaria entails synchronous changes in both activity and attraction to conspecifics

PubMed Central

Rogers, Stephen M.; Cullen, Darron A.; Anstey, Michael L.; Burrows, Malcolm; Despland, Emma; Dodgson, Tim; Matheson, Tom; Ott, Swidbert R.; Stettin, Katja; Sword, Gregory A.; Simpson, Stephen J.

2014-01-01

Desert Locusts can change reversibly between solitarious and gregarious phases, which differ considerably in behaviour, morphology and physiology. The two phases show many behavioural differences including both overall levels of activity and the degree to which they are attracted or repulsed by conspecifics. Solitarious locusts perform infrequent bouts of locomotion characterised by a slow walking pace, groom infrequently and actively avoid other locusts. Gregarious locusts are highly active with a rapid walking pace, groom frequently and are attracted to conspecifics forming cohesive migratory bands as nymphs and/or flying swarms as adults. The sole factor driving the onset of gregarization is the presence of conspecifics. In several previous studies concerned with the mechanism underlying this transformation we have used an aggregate measure of behavioural phase state, Pgreg, derived from logistic regression analysis, which combines and weights several behavioural variables to characterise solitarious and gregarious behaviour. Using this approach we have analysed the time course of behavioural change, the stimuli that induce gregarization and the key role of serotonin in mediating the transformation. Following a recent critique that suggested that using Pgreg may confound changes in general activity with genuine gregarization we have performed a meta-analysis examining the time course of change in the individual behaviours that we use to generate Pgreg. We show that the forced crowding of solitarious locusts, tactile stimulation of the hind femora, and the short-term application of serotonin each induce concerted changes in not only locomotion-related variables but also grooming frequency and attraction to other locusts towards those characteristic of long-term gregarious locusts. This extensive meta-analysis supports and extends our previous conclusions that solitarious locusts undergo a rapid behavioural gregarization upon receiving appropriate stimulation for a few hours that is mediated by serotonin, at the end of which their behaviour is largely indistinguishable from locusts that have been in the gregarious phase their entire lives. PMID:24768842

Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study

PubMed Central

2013-01-01

Background Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective. Method Serial qualitative interviews examined the influences of significant others on women’s feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards. Results The dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers. Conclusions Applying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is recommended away from the dominant approach of support and education of individual women towards a more holistic, family-centred narrative approach, whilst acknowledging that breastfeeding is a practical skill that women and babies have to learn. PMID:23679158

Is Seeing Believing? The Process of Change During Cognitive-behavioural Therapy for Distressing Visual Hallucinations.

PubMed

Wilson, Rea; Collerton, Daniel; Freeston, Mark; Christodoulides, Thomas; Dudley, Robert

2016-07-01

People with psychosis often report distressing visual hallucinations (VH). In contrast to auditory hallucinations, there is little empirical evidence on effective interventions. The effectiveness of a novel-focused cognitive-behavioural therapy (CBT) intervention for VH was explored using a multiple baseline single case design with four participants. Change to individual appraisals, emotional and behavioural responses to VH were measured with daily diaries kept throughout the baseline and intervention phase lasting up to 16 sessions. Maintenance of change was tracked during a follow-up period of one month. Changes in appraisals, distress and response in accordance with the theory was evident in two out of four of the cases. However, change occurred within the baseline phase that limited the conclusions that change could be attributed to CBT alone. There was some evidence of clinically significant change and reliable change for two out of four of the cases at follow-up on one of the standardized psychiatric assessments. The research reported here has theoretical and clinical implications for refinement of the model and interventions for distressing VH. Copyright © 2015 John Wiley & Sons, Ltd. Distressing visual hallucinations (VH) are a relatively common symptom of psychosis. Visual hallucinations seem to be associated with greater impairment and disability. We have no specific treatment for VH. The appraisal of the visual experience and the behavioural response is important in maintaining the distress. Cognitive-behavioural therapy for VH at present has limited value. Copyright © 2015 John Wiley & Sons, Ltd.

Effects of marital transitions on changes in dietary and other health behaviours in US male health professionals

PubMed Central

Eng, P. M.; Kawachi, I.; Fitzmaurice, G.; Rimm, E.

2005-01-01

Study objective: To examine the effect of change in marital status on health behaviours among men. Design: Longitudinal study of repeated measures of marital status and health behaviours collected at four year intervals (1986–90; 1990–94). Setting: US male health professionals. Participants: 38 865 men aged 40–75 in 1986. Main results: Relative to men who stayed married over four years, men who became widowed increased their alcohol consumption. Men who become divorced or widowed experienced decreases in body mass index. Compared with men who remained unmarried, men who remarried exhibited increases in body mass index along with decreased physical activity. Becoming divorced or widowed was associated with decreased vegetable intake while remarriage was linked to greater consumption. Conclusions: Marital termination may adversely affect health and dietary behaviours among men. PMID:15598728

Self-reported changes in clinical behaviour by undergraduate dental students after video-based teaching in paediatric dentistry.

PubMed

Kalwitzki, M

2005-08-01

Four cohorts of undergraduate students (n = 113) were filmed on video tapes whilst performing paediatric treatments. Selected parts of these tapes were shown the day after. Thus, within one term each student was able to view his performance on a videotape as well as those of fellow students. After completion of the clinical course in paediatric dentistry students were asked by means of a questionnaire about behavioural changes in their clinical work regarding different topics. Considerable changes in behaviour were reported for various topics. Most of the students emphasised the viable role of the video for changing their behaviour. This was especially true for aspects of verbal and non-verbal communication where mainly female students benefited. Moreover, video was thought to have been useful for improving capacities to deal with patients in fear or pain and for ergonomics. About two-thirds of the students (64.6%) thought that watching the video had made it easier for them to put theoretical knowledge into action. Video does not seem to play an important role for confirmation and maintenance of behaviour patterns. In conclusion however, it can be stated that video has a high impact on the modification of behaviour patterns of undergraduate students for many aspects of clinical work. The use of video can thus attribute to dental education in an effective way.

Do specialty registrars change their attitudes, intentions and behaviour towards reporting incidents following a patient safety course?

PubMed Central

2010-01-01

Background Reporting incidents can contribute to safer health care, as an awareness of the weaknesses of a system could be considered as a starting point for improvements. It is believed that patient safety education for specialty registrars could improve their attitudes, intentions and behaviour towards incident reporting. The objective of this study was to examine the effect of a two-day patient safety course on the attitudes, intentions and behaviour concerning the voluntary reporting of incidents by specialty registrars. Methods A patient safety course was designed to increase specialty registrars' knowledge, attitudes and skills in order to recognize and cope with unintended events and unsafe situations at an early stage. Data were collected through an 11-item questionnaire before, immediately after and six months after the course was given. Results The response rate at all three points in time assessed was 100% (n = 33). There were significant changes in incident reporting attitudes and intentions immediately after the course, as well as during follow-up. However, no significant changes were found in incident reporting behaviour. Conclusions It is shown that patient safety education can have long-term positive effects on attitudes towards reporting incidents and the intentions of registrars. However, further efforts need to be undertaken to induce a real change in behaviour. PMID:20416053

Making the links: do we connect climate change with health? A qualitative case study from Canada

PubMed Central

2013-01-01

Background Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an environmental to a health issue. This paper builds on calls for increased understanding of the public’s views of human health risks associated with climate change, focusing on facilitators and barriers to behaviour change. Methods Semi-structured in-depth interviews (n = 22) with residents of the Golden Horseshoe region of Southern Ontario were conducted between August 2010 and January 2011. Topics included individual and community health, climate change, and facilitators and barriers to behaviour change. Results Few participants recognized the role of the environment in the context of either individual and community health. When asked about health concerns specific to their community, however, environmental issues were mentioned frequently. Health effects as possible impacts of global environmental change were mentioned by 77% of participants when prompted, but this link was not described in great detail or within the context of impacting their communities or themselves. Participants were willing to act in environmentally friendly ways, and possible incentives to undertake behaviour change such as decreasing cost were described. Health co-benefits were not identified as incentives to engaging in mitigative or adaptive behaviours. Conclusions The results support recent calls for reframing the impact of climate change from an environmental to a public health issue in order to increase public engagement in adaptive and mitigative behaviour change. While previous research has touched on public awareness of the human health risks of climate change, we have further explored the attitude-action link through the examination of facilitators and barriers to behaviour change. PMID:23496814

A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS?

PubMed Central

Munro, Salla; Lewin, Simon; Swart, Tanya; Volmink, Jimmy

2007-01-01

Background Suboptimal treatment adherence remains a barrier to the control of many infectious diseases, including tuberculosis and HIV/AIDS, which contribute significantly to the global disease burden. However, few of the many interventions developed to address this issue explicitly draw on theories of health behaviour. Such theories could contribute to the design of more effective interventions to promote treatment adherence and to improving assessments of the transferability of these interventions across different health issues and settings. Methods This paper reviews behaviour change theories applicable to long-term treatment adherence; assesses the evidence for their effectiveness in predicting behaviour change; and examines the implications of these findings for developing strategies to improve TB and HIV/AIDS medication adherence. We searched a number of electronic databases for theories of behaviour change. Eleven theories were examined. Results Little empirical evidence was located on the effectiveness of these theories in promoting adherence. However, several models have the potential to both improve understanding of adherence behaviours and contribute to the design of more effective interventions to promote adherence to TB and HIV/AIDS medication. Conclusion Further research and analysis is needed urgently to determine which models might best improve adherence to long-term treatment regimens. PMID:17561997

Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study

PubMed Central

Marteau, Theresa M.; Kinmonth, Ann Louise; Cohn, Simon

2015-01-01

Background: Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Methods: Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300 000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Results: Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. Conclusions: The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. PMID:25983329

Going beyond audit and feedback: towards behaviour-based interventions to change physician laboratory test ordering behaviour.

PubMed

Meidani, Z; Mousavi, G A; Kheirkhah, D; Benar, N; Maleki, M R; Sharifi, M; Farrokhian, A

2017-12-01

Studies indicate there are a variety of contributing factors affecting physician test ordering behaviour. Identifying these behaviours allows development of behaviour-based interventions. Methods Through a pilot study, the list of contributing factors in laboratory tests ordering, and the most ordered tests, were identified, and given to 50 medical students, interns, residents and paediatricians in questionnaire form. The results showed routine tests and peer or supervisor pressure as the most influential factors affecting physician ordering behaviour. An audit and feedback mechanism was selected as an appropriate intervention to improve physician ordering behaviour. The intervention was carried out at two intervals over a three-month period. Findings There was a large reduction in the number of laboratory tests ordered; from 908 before intervention to 389 and 361 after first and second intervention, respectively. There was a significant relationship between audit and feedback and the meaningful reduction of 7 out of 15 laboratory tests including complete blood count (p = 0.002), erythrocyte sedimentation rate (p = 0.01), C-reactive protein (p = 0.01), venous blood gas (p = 0.016), urine analysis (p = 0.005), blood culture (p = 0.045) and stool examination (p = 0.001). Conclusion The audit and feedback intervention, even in short duration, affects physician ordering behaviour. It should be designed in terms of behaviour-based intervention and diagnosis of the contributing factors in physicians' behaviour. Further studies are required to substantiate the effectiveness of such behaviour-based intervention strategies in changing physician behaviour.

[Changes of the neuronal membrane excitability as cellular mechanisms of learning and memory].

PubMed

Gaĭnutdinov, Kh L; Andrianov, V V; Gaĭnutdinova, T Kh

2011-01-01

In the presented review given literature and results of own studies of dynamics of electrical characteristics of neurons, which change are included in processes both an elaboration of learning, and retention of the long-term memory. Literary datas and our results allow to conclusion, that long-term retention of behavioural reactions during learning is accompanied not only by changing efficiency of synaptic transmission, as well as increasing of excitability of command neurons of the defensive reflex. This means, that in the process of learning are involved long-term changes of the characteristics a membrane of certain elements of neuronal network, dependent from the metabolism of the cells. see text). Thou phenomena possible mark as cellular (electrophysiological) correlates of long-term plastic modifications of the behaviour. The analyses of having results demonstrates an important role of membrane characteristics of neurons (their excitability) and parameters an synaptic transmission not only in initial stage of learning, as well as in long-term modifications of the behaviour (long-term memory).

Rapid behavioural gregarization in the desert locust, Schistocerca gregaria entails synchronous changes in both activity and attraction to conspecifics.

PubMed

Rogers, Stephen M; Cullen, Darron A; Anstey, Michael L; Burrows, Malcolm; Despland, Emma; Dodgson, Tim; Matheson, Tom; Ott, Swidbert R; Stettin, Katja; Sword, Gregory A; Simpson, Stephen J

2014-06-01

Desert Locusts can change reversibly between solitarious and gregarious phases, which differ considerably in behaviour, morphology and physiology. The two phases show many behavioural differences including both overall levels of activity and the degree to which they are attracted or repulsed by conspecifics. Solitarious locusts perform infrequent bouts of locomotion characterised by a slow walking pace, groom infrequently and actively avoid other locusts. Gregarious locusts are highly active with a rapid walking pace, groom frequently and are attracted to conspecifics forming cohesive migratory bands as nymphs and/or flying swarms as adults. The sole factor driving the onset of gregarization is the presence of conspecifics. In several previous studies concerned with the mechanism underlying this transformation we have used an aggregate measure of behavioural phase state, Pgreg, derived from logistic regression analysis, which combines and weights several behavioural variables to characterise solitarious and gregarious behaviour. Using this approach we have analysed the time course of behavioural change, the stimuli that induce gregarization and the key role of serotonin in mediating the transformation. Following a recent critique that suggested that using Pgreg may confound changes in general activity with genuine gregarization we have performed a meta-analysis examining the time course of change in the individual behaviours that we use to generate Pgreg. We show that the forced crowding of solitarious locusts, tactile stimulation of the hind femora, and the short-term application of serotonin each induce concerted changes in not only locomotion-related variables but also grooming frequency and attraction to other locusts towards those characteristic of long-term gregarious locusts. This extensive meta-analysis supports and extends our previous conclusions that solitarious locusts undergo a rapid behavioural gregarization upon receiving appropriate stimulation for a few hours that is mediated by serotonin, at the end of which their behaviour is largely indistinguishable from locusts that have been in the gregarious phase their entire lives. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory?

PubMed

Horne, Justine; Madill, Janet; O'Connor, Colleen; Shelley, Jacob; Gilliland, Jason

2018-04-10

Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provided to participants while aiming to determine whether or not genetic testing facilitates changes in lifestyle habits. This review is timely in light of a recently published "call-to-action" paper, highlighting the need to incorporate the TPB into personalized healthcare behaviour change research. Three bibliographic databases, one key website, and article reference lists were searched for relevant primary research articles. The PRISMA Flow Diagram and PRISMA Checklist were used to guide the search strategy and manuscript preparation. Out of 32,783 titles retrieved, 26 studies met the inclusion criteria. Three quality assessments were conducted and included: (1) risk of bias, (2) quality of genetic interventions, and (3) consideration of theoretical underpinnings - primarily the TPB. Risk of bias in studies was overall rated to be "fair." Consideration of the TPB was "poor," with no study making reference to this validated theory. While some studies (n = 11; 42%) made reference to other behaviour change theories, these theories were generally mentioned briefly, and were not thoroughly incorporated into the study design or analyses. The genetic interventions provided to participants were overall of "poor" quality. However, a separate analysis of studies using controlled intervention research methods demonstrated the use of higher-quality genetic interventions (overall rated to be "fair"). The provision of actionable recommendations informed by genetic testing was more likely to facilitate behaviour change than the provision of genetic information without actionable lifestyle recommendations. Several studies of good quality demonstrated changes in lifestyle habits arising from the provision of genetic interventions. The most promising lifestyle changes were changes in nutrition. It is possible to facilitate behaviour change using genetic testing as the catalyst. Future research should ensure that high-quality genetic interventions are provided to participants, and should consider validated theories such as the TPB in their study design and analyses. Further recommendations for future research are provided. © 2018 S. Karger AG, Basel.

Influence of children's oral health promotion on parents' behaviours, attitudes and knowledge.

PubMed

Tolvanen, Mimmi; Anttonen, Vuokko; Mattila, Marja-Leena; Hausen, Hannu; Lahti, Satu

2016-07-01

Objective The aim was to compare the changes in parents' oral health-related behaviour, knowledge and attitudes in 2001-2003 and 2003-2005, during a 3.4-year-intervention in Pori and in the reference area Rauma, Finland. Materials and methods The study population consisted of parents of children who participated in the oral health promotion programme in Pori (all 5th and 6th graders who started the 2001-2002 school year in the town of Pori, n = 1691) and the parents of same-aged children in a reference town (n = 807). In 2001-2003, the promotion was targeted only to the children in Pori. In 2003-2005, the promotion was targeted also to parents, for example via local mass media. The statistical significances of the differences in parents' self-reported behaviour, knowledge and attitudes, and changes in these, were evaluated using Mann-Whitney U-tests and confidence intervals. Results In 2001-2003, the trend in changing behaviours was in favour of parents in Pori. Mothers in Pori also improved their knowledge and the attitude 'importance of brushing for health and appearance'. In 2003-2005, the trend in changing behaviours was rather similar in both towns, which may be due to diffusion of the oral health intervention to Rauma via the media. Conclusions The results suggest that health promotion targeted to children, which in previous studies has been shown to be successful in improving children's behaviours, also helped their parents in mending their habits.

The assessment of post-vasectomy pain in mice using behaviour and the Mouse Grimace Scale.

PubMed

Leach, Matthew C; Klaus, Kristel; Miller, Amy L; Scotto di Perrotolo, Maud; Sotocinal, Susana G; Flecknell, Paul A

2012-01-01

Current behaviour-based pain assessments for laboratory rodents have significant limitations. Assessment of facial expression changes, as a novel means of pain scoring, may overcome some of these limitations. The Mouse Grimace Scale appears to offer a means of assessing post-operative pain in mice that is as effective as manual behavioural-based scoring, without the limitations of such schemes. Effective assessment of post-operative pain is not only critical for animal welfare, but also the validity of science using animal models. This study compared changes in behaviour assessed using both an automated system ("HomeCageScan") and using manual analysis with changes in facial expressions assessed using the Mouse Grimace Scale (MGS). Mice (n = 6/group) were assessed before and after surgery (scrotal approach vasectomy) and either received saline, meloxicam or bupivacaine. Both the MGS and manual scoring of pain behaviours identified clear differences between the pre and post surgery periods and between those animals receiving analgesia (20 mg/kg meloxicam or 5 mg/kg bupivacaine) or saline post-operatively. Both of these assessments were highly correlated with those showing high MGS scores also exhibiting high frequencies of pain behaviours. Automated behavioural analysis in contrast was only able to detect differences between the pre and post surgery periods. In conclusion, both the Mouse Grimace Scale and manual scoring of pain behaviours are assessing the presence of post-surgical pain, whereas automated behavioural analysis could be detecting surgical stress and/or post-surgical pain. This study suggests that the Mouse Grimace Scale could prove to be a quick and easy means of assessing post-surgical pain, and the efficacy of analgesic treatment in mice that overcomes some of the limitations of behaviour-based assessment schemes.

Augmentation of the behavioural effects of desipramine by repeated immobilization stress.

PubMed

Hadweh, Nicolás; Santibañez, Marcos; González, Marcela Paz; Forray, María Inés

2010-12-25

The present report provides evidence that repeated immobilization stress (RIS) induced a noradrenergic-dependent depressive-like behaviour and an augmented behavioural response to desipramine (DMI), a noradrenaline reuptake inhibitor (NRI), in the forced swimming test (FST). The present results show that RIS decreased the baseline of climbing behaviour in the FST. Whereas subchronic administration of DMI (10mg/kg, three times in a 24h period) induced a significantly higher increase in climbing behaviour on repeatedly stressed rats compared to controls. The results also show that the concomitant administration of the low dose of DMI (3mg/Kg) during the RIS fully prevented the decrease of climbing behaviour induced by RIS, without exerting behavioural effects in control rats, further supporting an augmented response to the DMI antidepressant effects in the repeatedly stressed rats. In conclusion, our data indicate that RIS not only changes the behavioural responses in the FST but also increases the antidepressant effects of DMI. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Validation of the theoretical domains framework for use in behaviour change and implementation research

PubMed Central

2012-01-01

Background An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework. Methods Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis. Results There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): ‘Knowledge’, ‘Skills’, ‘Social/Professional Role and Identity’, ‘Beliefs about Capabilities’, ‘Optimism’, ‘Beliefs about Consequences’, ‘Reinforcement’, ‘Intentions’, ‘Goals’, ‘Memory, Attention and Decision Processes’, ‘Environmental Context and Resources’, ‘Social Influences’, ‘Emotions’, and ‘Behavioural Regulation’. Conclusions The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development. PMID:22530986

Environmental determinants of celeration behaviour.

PubMed

af Wåhlberg, Anders E

2015-01-01

Celeration (speed change) behaviour of drivers has been posited to be the best predictor of their traffic accident involvement. The origins of this behaviour, however, have not been specified. A model is therefore introduced, where celeration is partly due to the individual disposition of the driver (i.e., driving style), and partly to the environment (road layout, rules and traffic density). Three measurement problems for celeration were studied; the effect of traffic density, of regular versus irregular routes, and weight of the vehicle (loaded/unloaded) on celeration behaviour. Two small samples of truck drivers in Sweden were measured for several months each. There was a strong effect of vehicle load, with behaviour being more cautious with increased weight. Driving on different roads also yielded differences in behaviour, although the design used did not permit conclusions about what caused these. Traffic volume was not found to have any reliable effect on celeration.

IV drug users: changes in risk behaviour according to HIV status in a national survey in Spain.

PubMed Central

Delgado-Rodríguez, M; dé lá Fuente, L; Bravo, M J; Lardelli, P; Barrio, G

1994-01-01

STUDY OBJECTIVE--To determine whether HIV positive intravenous drug users (IVDUs) who were receiving outpatient treatment for opiate and cocaine abuse or dependence used practices aimed at reducing the spread of HIV. DESIGN--Cross sectional study of behaviour and HIV serostatus in IVDUs. SETTING--A nationwide sample, from 83 health centres for outpatient treatment, stratified by autonomous regions. PARTICIPANTS--Altogether 1074 IVDUs were recruited. HIV serostatus could be verified in 738 (68.7%) of these. MEASUREMENTS AND MAIN RESULTS--Crude and adjusted odds ratios and their 95% confidence intervals were estimated to assess the association between HIV serostatus and behavioural changes. In their daily interactions with other members of the same household, seropositive subjects more frequently used preventive methods aimed at avoiding transmission than seronegative patients. Treatment for abuse or dependency before the current regimen had a greater impact in HIV positive than HIV negative subjects in terms of abstaining from risk behaviours. There was a significant trend toward lower drug consumption in HIV positive subjects, and the number of seropositive and seronegative IVDUs who stopped injecting their drugs was significantly higher among the former. Seropositive subjects were also more likely to stop sharing drug injecting equipment and to change their sexual habits; they reported an increased consistent use of condoms. CONCLUSIONS--HIV positive IVDUs were more likely to change their risk behaviours than their HIV negative counterparts. PMID:7964355

Functional neuroimaging and presenting psychiatric features in frontotemporal dementia

PubMed Central

Mendez, M F; McMurtray, A; Chen, A K; Shapira, J S; Mishkin, F; Miller, B L

2006-01-01

Background Frontotemporal dementia (FTD) is a behavioural syndrome caused by degeneration of the frontal and anterior temporal lobes. Behavioural disturbances include psychiatric features. Whether patients with FTD present with psychiatric features varies with the initial neuroanatomical variability of FTD. Objective To identify presenting psychiatric changes not part of diagnostic criteria of FTD and contrast them with the degree of hemispheric asymmetry and frontal and temporal hypoperfusion on single photon emission computed tomography (SPECT) imaging. Methods 74 patients who met consensus criteria for FTD were evaluated at a two year follow up. All had brain SPECT on initial presentation. Results of an FTD psychiatric checklist were contrasted with ratings of regional hypoperfusion. Results The regions of predominant hypoperfusion did not correlate with differences on FTD demographic variables but were associated with presenting psychiatric features. Dysthymia and anxiety were associated with right temporal hypoperfusion. “Moria” or frivolous behaviour also occurred with temporal lobe changes, especially on the right. The only significant frontal lobe feature was the presence of a peculiar physical bearing in association with right frontal hypoperfusion. Conclusions Patients with FTD may present with psychiatric changes distinct from the behavioural diagnostic criteria for this disorder. Early temporal involvement is associated with frivolous behaviour and right temporal involvement is associated with emotional disturbances. In contrast, those with right frontal disease may present with alterations in non‐verbal behaviour. PMID:16043457

Adolescents' protection motivation and smoking behaviour.

PubMed

Thrul, Johannes; Stemmler, Mark; Bühler, Anneke; Kuntsche, Emmanuel

2013-08-01

The protection motivation theory (PMT) is a well-known theory of behaviour change. This study tested the applicability of the sub-constructs of threat and coping appraisal in predicting adolescents' smoking-related behavioural intentions and smoking behaviour longitudinally. Adolescents (N = 494) aged 11-16 years and not currently smoking at baseline participated in the study. Predictive validity of PMT constructs was tested in a path analysis model. Self-efficacy significantly predicted behavioural intention at baseline, which significantly predicted behavioural intention at follow-up, which in turn predicted smoking behaviour at follow-up. The effect of self-efficacy on behavioural intention at follow-up was mediated by behavioural intention at baseline and the effect of self-efficacy on smoking behaviour was mediated by behavioural intention at baseline and follow-up. In conclusion, we found support for one part of the PMT, namely for the predictive validity of the coping appraisal construct self-efficacy in predicting adolescents' smoking-related behavioural intention and smoking behaviour. These results fail to support the appropriateness of the PMT's construct threat appraisal in longitudinally predicting adolescents' smoking as well as the applicability of communicating fear and negative information as preventive interventions for this target group.

Methods of Measurement in epidemiology: Sedentary Behaviour

PubMed Central

Atkin, Andrew J; Gorely, Trish; Clemes, Stacy A; Yates, Thomas; Edwardson, Charlotte; Brage, Soren; Salmon, Jo; Marshall, Simon J; Biddle, Stuart JH

2012-01-01

Background Research examining sedentary behaviour as a potentially independent risk factor for chronic disease morbidity and mortality has expanded rapidly in recent years. Methods We present a narrative overview of the sedentary behaviour measurement literature. Subjective and objective methods of measuring sedentary behaviour suitable for use in population-based research with children and adults are examined. The validity and reliability of each method is considered, gaps in the literature specific to each method identified and potential future directions discussed. Results To date, subjective approaches to sedentary behaviour measurement, e.g. questionnaires, have focused predominantly on TV viewing or other screen-based behaviours. Typically, such measures demonstrate moderate reliability but slight to moderate validity. Accelerometry is increasingly being used for sedentary behaviour assessments; this approach overcomes some of the limitations of subjective methods, but detection of specific postures and postural changes by this method is somewhat limited. Instruments developed specifically for the assessment of body posture have demonstrated good reliability and validity in the limited research conducted to date. Miniaturization of monitoring devices, interoperability between measurement and communication technologies and advanced analytical approaches are potential avenues for future developments in this field. Conclusions High-quality measurement is essential in all elements of sedentary behaviour epidemiology, from determining associations with health outcomes to the development and evaluation of behaviour change interventions. Sedentary behaviour measurement remains relatively under-developed, although new instruments, both objective and subjective, show considerable promise and warrant further testing. PMID:23045206

The effectiveness of multi-component goal setting interventions for changing physical activity behaviour: a systematic review and meta-analysis.

PubMed

McEwan, Desmond; Harden, Samantha M; Zumbo, Bruno D; Sylvester, Benjamin D; Kaulius, Megan; Ruissen, Geralyn R; Dowd, A Justine; Beauchamp, Mark R

2016-01-01

Drawing from goal setting theory (Latham & Locke, 1991; Locke & Latham, 2002; Locke et al., 1981), the purpose of this study was to conduct a systematic review and meta-analysis of multi-component goal setting interventions for changing physical activity (PA) behaviour. A literature search returned 41,038 potential articles. Included studies consisted of controlled experimental trials wherein participants in the intervention conditions set PA goals and their PA behaviour was compared to participants in a control group who did not set goals. A meta-analysis was ultimately carried out across 45 articles (comprising 52 interventions, 126 effect sizes, n = 5912) that met eligibility criteria using a random-effects model. Overall, a medium, positive effect (Cohen's d(SE) = .552(.06), 95% CI = .43-.67, Z = 9.03, p < .001) of goal setting interventions in relation to PA behaviour was found. Moderator analyses across 20 variables revealed several noteworthy results with regard to features of the study, sample characteristics, PA goal content, and additional goal-related behaviour change techniques. In conclusion, multi-component goal setting interventions represent an effective method of fostering PA across a diverse range of populations and settings. Implications for effective goal setting interventions are discussed.

Socio-demographic predictors of health and environmental co-benefit behaviours for climate change mitigation in urban China

PubMed Central

Wang, Susan Shuxin; Ho, Janice Ying-en; Huang, Zhe; Liu, Sida; Guo, Chunlan

2017-01-01

Objective This study aims to examine the patterns and socio-demographic predictors of health and environmental co-benefit behaviours that support climate change mitigation in a densely populated Asian metropolis—Hong Kong. Methods A population-based, stratified and cross-sectional random digit dialling telephone survey study was conducted between January and February 2016, among the Cantonese-speaking population aged 15 and above in Hong Kong. Socio-demographic data and the self-reported practice of 10 different co-benefit behaviours were solicited. Ethics approval and participant’s verbal consent were sought. Findings The study sample consisted of 1,017 respondents (response rate: 63.6%) were comparable to the age, gender and geographical distributions of the Hong Kong population found in the latest 2011 Hong Kong Population Census. Among the co-benefit behaviours, using less packaging and disposable shopping bags were practiced in the highest frequency (70.1%). However, four behaviours were found to have never been practiced by more than half of the respondents, including bringing personal eating utensils when dining in restaurants or small eateries, showering less than five minutes, having one vegetarian meal a week, and buying more organic food. Results of multivariable logistic regression showed that frequency of practicing co-benefit behaviours were consistently associated with gender and age. Conclusion Urban residents in Hong Kong do not engage in the practice of co-benefit behaviours in a uniform way. In general, females and older people are more likely to adopt co-benefit behaviours in their daily lives. Further research to assess the knowledge and attitudes of the population towards these co-benefit behaviours will provide support to relevant climate change mitigation policies and education programmes. PMID:29176879

I'm watching you. Awareness that food consumption is being monitored is a demand characteristic in eating-behaviour experiments.

PubMed

Robinson, Eric; Kersbergen, Inge; Brunstrom, Jeffrey M; Field, Matt

2014-12-01

Eating behaviour is often studied in the laboratory under controlled conditions. Yet people care about the impressions others form about them so may behave differently if they feel that their eating behaviour is being monitored. Here we examined whether participants are likely to change their eating behaviour if they feel that food intake is being monitored during a laboratory study. In Study 1 participants were provided with vignettes of typical eating behaviour experiments and were asked if, and how, they would behave differently if they felt their eating behaviour was being monitored during that experiment. Study 2 tested the effect of experimentally manipulating participants' beliefs about their eating behaviour being monitored on their food consumption in the lab. In Study 1, participants thought they would change their behaviour if they believed their eating was being monitored and, if monitored, that they would reduce their food consumption. In Study 2 participants ate significantly less food after being led to believe that their food consumption was being recorded. Together, these studies demonstrate that if participants believe that the amount of food they eat during a study is being monitored then they are likely to suppress their food intake. This may impact the conclusions that are drawn from food intake studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Conceptual model for dietary behaviour change at household level: a ‘best-fit’ qualitative study using primary data

PubMed Central

2014-01-01

Background Interventions having a strong theoretical basis are more efficacious, providing a strong argument for incorporating theory into intervention planning. The objective of this study was to develop a conceptual model to facilitate the planning of dietary intervention strategies at the household level in rural Kerala. Methods Three focus group discussions and 17 individual interviews were conducted among men and women, aged between 23 and 75 years. An interview guide facilitated the process to understand: 1) feasibility and acceptability of a proposed dietary behaviour change intervention; 2) beliefs about foods, particularly fruits and vegetables; 3) decision-making in households with reference to food choices and access; and 4) to gain insights into the kind of intervention strategies that may be practical at community and household level. The data were analysed using a modified form of qualitative framework analysis, which combined both deductive and inductive reasoning. A priori themes were identified from relevant behaviour change theories using construct definitions, and used to index the meaning units identified from the primary qualitative data. In addition, new themes emerging from the data were included. The associations between the themes were mapped into four main factors and its components, which contributed to construction of the conceptual model. Results Thirteen of the a priori themes from three behaviour change theories (Trans-theoretical model, Health Belief model and Theory of Planned Behaviour) were confirmed or slightly modified, while four new themes emerged from the data. The conceptual model had four main factors and its components: impact factors (decisional balance, risk perception, attitude); change processes (action-oriented, cognitive); background factors (personal modifiers, societal norms); and overarching factors (accessibility, perceived needs and preferences), built around a three-stage change spiral (pre-contemplation, intention, action). Decisional balance was the strongest in terms of impacting the process of behaviour change, while household efficacy and perceived household cooperation were identified as ‘markers’ for stages-of-change at the household level. Conclusions This type of framework analysis made it possible to develop a conceptual model that could facilitate the design of intervention strategies to aid a household-level dietary behaviour change process. PMID:24912496

First step in managing bulimia nervosa: controlled trial of therapeutic manual.

PubMed Central

Treasure, J.; Schmidt, U.; Troop, N.; Tiller, J.; Todd, G.; Keilen, M.; Dodge, E.

1994-01-01

OBJECTIVE--To test the short term efficacy of a self directed treatment manual for bulimia nervosa. DESIGN--Randomised controlled trial of the manual against cognitive behavioural therapy and a waiting list. SETTING--Tertiary referral centre. SUBJECTS--81 consecutive referrals presenting with bulimia nervosa or atypical bulimia nervosa. MAIN OUTCOME MEASURES--Frequency of binge eating, vomiting, and other behaviours to control weight as well as abstinence from these behaviours. RESULTS--Cognitive behavioural treatment produced a significant reduction in the frequency of binge eating, vomiting, and other behaviours to control weight. The manual significantly reduced frequency of binge eating and weight control behaviours other than vomiting, and there was no change in the group on the waiting list. Full remission was achieved in five (24%) of the group assigned to cognitive behavioural treatment, nine (22%) of the group who used the manual, and two (11%) of the group on the waiting list. CONCLUSIONS--A self directed treatment manual may be a useful first intervention in the treatment of bulimia nervosa. PMID:8142791

Does emotional reasoning change during cognitive behavioural therapy for anxiety?

PubMed

Berle, David; Moulds, Michelle L; Starcevic, Vladan; Milicevic, Denise; Hannan, Anthony; Dale, Erin; Viswasam, Kirupamani; Brakoulias, Vlasios

2016-01-01

Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world. It is a key interpretative bias in cognitive models of anxiety disorders and appears to be especially evident in individuals with anxiety disorders. However, the amenability of emotional reasoning to change during treatment has not yet been investigated. We sought to determine whether emotional reasoning tendencies change during a course of routine cognitive-behavioural therapy (CBT). Emotional reasoning tendencies were assessed in 36 individuals with a primary anxiety disorder who were seeking treatment at an outpatient clinic. Changes in anxiety and depressive symptoms as well as emotional reasoning tendencies after 12 sessions of CBT were examined in 25 individuals for whom there was complete data. Emotional reasoning tendencies were evident at pretreatment assessment. Although anxiety and depressive symptoms decreased during CBT, only one of six emotional reasoning interpretative styles (pertaining to conclusions that one is incompetent) changed significantly during the course of therapy. Attrition rates were high and there was not enough information regarding the extent to which therapy specifically focused on addressing emotional reasoning tendencies. Individuals seeking treatment for anxiety disorders appear to engage in emotional reasoning, however routine individual CBT does not appear to result in changes in emotional reasoning tendencies.

Variability in baseline travel behaviour as a predictor of changes in commuting by active travel, car and public transport: a natural experimental study

PubMed Central

Heinen, Eva; Ogilvie, David

2016-01-01

Purpose To strengthen our understanding of the impact of baseline variability in mode choice on the likelihood of travel behaviour change. Methods Quasi-experimental analyses in a cohort study of 450 commuters exposed to a new guided busway with a path for walking and cycling in Cambridge, UK. Exposure to the intervention was defined using the shortest network distance from each participant’s home to the busway. Variability in commuter travel behaviour at baseline was defined using the Herfindahl–Hirschman Index, the number of different modes of transport used over a week, and the proportion of trips made by the main (combination of) mode(s). The outcomes were changes in the share of commute trips (i) involving any active travel, (ii) involving any public transport, and (iii) made entirely by car. Variability and change data were derived from a self-reported seven-day record collected before (2009) and after (2012) the intervention. Separate multinomial regression models were estimated to assess the influence of baseline variability on behaviour change, both independently and as an interaction effect with exposure to the intervention. Results All three measures of variability predicted changes in mode share in most models. The effect size for the intervention was slightly strengthened after including variability. Commuters with higher baseline variability were more likely to increase their active mode share (e.g. for HHI: relative risk ratio [RRR] for interaction 3.34, 95% CI 1.41, 7.89) and decrease their car mode share in response to the intervention (e.g. for HHI: RRR 7.50, 95% CI 2.52, 22.34). Conclusions People reporting a higher level of variability in mode choice were more likely to change their travel behaviour following an intervention. Future research should consider such variability as a potential predictor and effect modifier of travel and physical activity behaviour change, and its significance for the design and targeting of interventions. PMID:27200265

Barriers and Recommended Interventions to Prevent Melioidosis in Northeast Thailand: A Focus Group Study Using the Behaviour Change Wheel

PubMed Central

Suntornsut, Pornpan; Wongsuwan, Nittayasee; Malasit, Mayura; Kitphati, Rungreung; Michie, Susan; Peacock, Sharon J.

2016-01-01

Background Melioidosis, an often fatal infectious disease in Northeast Thailand, is caused by skin inoculation, inhalation or ingestion of the environmental bacterium, Burkholderia pseudomallei. The major underlying risk factor for melioidosis is diabetes mellitus. Recommendations for melioidosis prevention include using protective gear such as rubber boots and gloves when in direct contact with soil and environmental water, and consuming bottled or boiled water. Only a small proportion of people follow such recommendations. Methods Nine focus group discussions were conducted to evaluate barriers to adopting recommended preventive behaviours. A total of 76 diabetic patients from northeast Thailand participated in focus group sessions. Barriers to adopting the recommended preventive behaviours and future intervention strategies were identified using two frameworks: the Theoretical Domains Framework and the Behaviour Change Wheel. Results Barriers were identified in the following five domains: (i) knowledge, (ii) beliefs about consequences, (iii) intention and goals, (iv) environmental context and resources, and (v) social influence. Of 76 participants, 72 (95%) had never heard of melioidosis. Most participants saw no harm in not adopting recommended preventive behaviours, and perceived rubber boots and gloves to be hot and uncomfortable while working in muddy rice fields. Participants reported that they normally followed the behaviour of friends, family and their community, the majority of whom did not wear boots while working in rice fields and did not boil water before drinking. Eight intervention functions were identified as relevant for the intervention: (i) education, (ii) persuasion, (iii) incentivisation, (iv) coercion, (v) modeling, (vi) environmental restructuring, (vii) training, and (viii) enablement. Participants noted that input from role models in the form of physicians, diabetic clinics, friends and families, and from the government via mass media would be required for them to change their behaviours. Conclusion There are numerous barriers to the adoption of behaviours recommended for melioidosis prevention. We recommend that a multifaceted intervention at community and government level is required to achieve the desired behaviour changes. PMID:27472421

The “Health Coaching” programme: a new patient-centred and visually supported approach for health behaviour change in primary care

PubMed Central

2013-01-01

Background Health related behaviour is an important determinant of chronic disease, with a high impact on public health. Motivating and assisting people to change their unfavourable health behaviour is thus a major challenge for health professionals. The objective of the study was to develop a structured programme of counselling in primary care practice, and to test its feasibility and acceptance among general practitioners (GPs) and their patients. Methods Our new concept integrates change of roles, shared responsibility, patient-centredness, and modern communication techniques—such as motivational interviewing. A new colour-coded visual communication tool is used for the purpose of leading through the 4-step counselling process. As doctors’ communication skills are crucial, communication training is a mandatory part of the programme. We tested the feasibility and acceptance of the “Health Coaching” programme with 20 GPs and 1045 patients, using questionnaires and semistructured interviewing techniques. The main outcomes were participation rates; the duration of counselling; patients’ self-rated behavioural change in their areas of choice; and ratings of motivational, conceptual, acceptance, and feasibility issues. Results In total, 37% (n=350) of the patients enrolled in step 1 completed the entire 4-Step counselling process, with each step taking 8–22 minutes. 50% of ratings (n=303) improved by one or two categories in the three-colour circle, and the proportion of favourable health behaviour ratings increased from 9% to 39%. The ratings for motivation, concept, acceptance, and feasibility of the “Health Coaching” programme were consistently high. Conclusions Our innovative, patient-centred counselling programme for health behaviour change was well accepted and feasible among patients and physicians in a primary care setting. Randomised controlled studies will have to establish cost-effectiveness and promote dissemination. PMID:23865509

Gamification for health promotion: systematic review of behaviour change techniques in smartphone apps

PubMed Central

Lumsden, J; Rivas, C; Steed, L; Thiyagarajan, A; Sohanpal, R; Caton, H; Griffiths, C J; Munafò, M R; Taylor, S; Walton, R T

2016-01-01

Objective Smartphone games that aim to alter health behaviours are common, but there is uncertainty about how to achieve this. We systematically reviewed health apps containing gaming elements analysing their embedded behaviour change techniques. Methods Two trained researchers independently coded apps for behaviour change techniques using a standard taxonomy. We explored associations with user ratings and price. Data sources We screened the National Health Service (NHS) Health Apps Library and all top-rated medical, health and wellness and health and fitness apps (defined by Apple and Google Play stores based on revenue and downloads). We included free and paid English language apps using ‘gamification’ (rewards, prizes, avatars, badges, leaderboards, competitions, levelling-up or health-related challenges). We excluded apps targeting health professionals. Results 64 of 1680 (4%) health apps included gamification and met inclusion criteria; only 3 of these were in the NHS Library. Behaviour change categories used were: feedback and monitoring (n=60, 94% of apps), reward and threat (n=52, 81%), and goals and planning (n=52, 81%). Individual techniques were: self-monitoring of behaviour (n=55, 86%), non-specific reward (n=49, 82%), social support unspecified (n=48, 75%), non-specific incentive (n=49, 82%) and focus on past success (n=47, 73%). Median number of techniques per app was 14 (range: 5–22). Common combinations were: goal setting, self-monitoring, non-specific reward and non-specific incentive (n=35, 55%); goal setting, self-monitoring and focus on past success (n=33, 52%). There was no correlation between number of techniques and user ratings (p=0.07; rs=0.23) or price (p=0.45; rs=0.10). Conclusions Few health apps currently employ gamification and there is a wide variation in the use of behaviour change techniques, which may limit potential to improve health outcomes. We found no correlation between user rating (a possible proxy for health benefits) and game content or price. Further research is required to evaluate effective behaviour change techniques and to assess clinical outcomes. Trial registration number CRD42015029841. PMID:27707829

The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings

PubMed Central

2013-01-01

Background Promotion and provision of low-cost technologies that enable improved water, sanitation, and hygiene (WASH) practices are seen as viable solutions for reducing high rates of morbidity and mortality due to enteric illnesses in low-income countries. A number of theoretical models, explanatory frameworks, and decision-making models have emerged which attempt to guide behaviour change interventions related to WASH. The design and evaluation of such interventions would benefit from a synthesis of this body of theory informing WASH behaviour change and maintenance. Methods We completed a systematic review of existing models and frameworks through a search of related articles available in PubMed and in the grey literature. Information on the organization of behavioural determinants was extracted from the references that fulfilled the selection criteria and synthesized. Results from this synthesis were combined with other relevant literature, and from feedback through concurrent formative and pilot research conducted in the context of two cluster-randomized trials on the efficacy of WASH behaviour change interventions to inform the development of a framework to guide the development and evaluation of WASH interventions: the Integrated Behavioural Model for Water, Sanitation, and Hygiene (IBM-WASH). Results We identified 15 WASH-specific theoretical models, behaviour change frameworks, or programmatic models, of which 9 addressed our review questions. Existing models under-represented the potential role of technology in influencing behavioural outcomes, focused on individual-level behavioural determinants, and had largely ignored the role of the physical and natural environment. IBM-WASH attempts to correct this by acknowledging three dimensions (Contextual Factors, Psychosocial Factors, and Technology Factors) that operate on five-levels (structural, community, household, individual, and habitual). Conclusions A number of WASH-specific models and frameworks exist, yet with some limitations. The IBM-WASH model aims to provide both a conceptual and practical tool for improving our understanding and evaluation of the multi-level multi-dimensional factors that influence water, sanitation, and hygiene practices in infrastructure-constrained settings. We outline future applications of our proposed model as well as future research priorities needed to advance our understanding of the sustained adoption of water, sanitation, and hygiene technologies and practices. PMID:24160869

Behavioural inventory of the giraffe (Giraffa camelopardalis)

PubMed Central

2012-01-01

Background Numerous factors like continuous habitat reduction or fragmentation for free-ranging giraffes (Giraffa camelopardalis) as well as e.g. suboptimal housing conditions for animals in captivity might lead to behavioural alterations as part of the overall adaptation process to the changing living conditions. In order to facilitate current and future studies on giraffe behaviour, a comprehensive ethogram was compiled based on existing literature, as well as observations on giraffes in the wild (Hwange National Park, Zimbabwe; Entabeni Game Reserve, South Africa), and in captivity (National Zoological Gardens of South Africa, Pretoria). Findings The resulting ethogram lists 65 different behavioural patterns, which were described and grouped into seven categories: General activities, Abnormal repetitive behaviours, General interactions, Bull-Cow behaviour, Bull-Bull behaviour, Cow-Bull behaviour, Maternal behaviours, and Interactions by calves. The behaviours were further described regarding a presumed purpose, particularly with respect to social interactions and sexual behaviour. Contradictory descriptions from previous studies were considered and discussed in comparison with our own observations. Conclusions This ethogram provides a basis for current and future studies by suggesting a terminology which can be used for harmonizing behavioural observations, thus helping to facilitate comparability of future results. Subsequently, a better understanding of the behavioural ecology of giraffes in the wild as well as in captivity could aid future conservation efforts. PMID:23173954

Microstructural White Matter Changes Underlying Cognitive and Behavioural Impairment in ALS – An In Vivo Study Using DTI

PubMed Central

Kasper, Elisabeth; Schuster, Christina; Machts, Judith; Kaufmann, Joern; Bittner, Daniel; Vielhaber, Stefan; Benecke, Reiner; Teipel, Stefan; Prudlo, Johannes

2014-01-01

Background A relevant fraction of patients with amyotrophic lateral sclerosis (ALS) exhibit a fronto-temporal pattern of cognitive and behavioural disturbances with pronounced deficits in executive functioning and cognitive control of behaviour. Structural imaging shows a decline in fronto-temporal brain areas, but most brain imaging studies did not evaluate cognitive status. We investigated microstructural white matter changes underlying cognitive impairment using diffusion tensor imaging (DTI) in a large cohort of ALS patients. Methods We assessed 72 non-demented ALS patients and 65 matched healthy control subjects using a comprehensive neuropsychological test battery and DTI. We compared DTI measures of fiber tract integrity using tract-based spatial statistics among ALS patients with and without cognitive impairment and healthy controls. Neuropsychological performance and behavioural measures were correlated with DTI measures. Results Patients without cognitive impairment demonstrated white matter changes predominantly in motor tracts, including the corticospinal tract and the body of corpus callosum. Those with impairments (ca. 30%) additionally presented significant white matter alterations in extra-motor regions, particularly the frontal lobe. Executive and memory performance and behavioural measures were correlated with fiber tract integrity in large association tracts. Conclusion In non-demented cognitively impaired ALS patients, white matter changes measured by DTI are related to disturbances of executive and memory functions, including prefrontal and temporal regions. In a group comparison, DTI is able to observe differences between cognitively unimpaired and impaired ALS patients. PMID:25501028

Young People with Intellectual Disability Transitioning to Adulthood: Do Behaviour Trajectories Differ in Those with and without Down Syndrome?

PubMed Central

Foley, Kitty-Rose; Taffe, John; Bourke, Jenny; Einfeld, Stewart L.; Tonge, Bruce J.; Trollor, Julian; Leonard, Helen

2016-01-01

Background Young people with intellectual disability exhibit substantial and persistent problem behaviours compared with their non-disabled peers. The aim of this study was to compare changes in emotional and behavioural problems for young people with intellectual disability with and without Down syndrome as they transition into adulthood in two different Australian cohorts. Methods Emotional and behavioural problems were measured over three time points using the Developmental Behaviour Checklist (DBC) for those with Down syndrome (n = 323 at wave one) and compared to those with intellectual disability of another cause (n = 466 at wave one). Outcome scores were modelled using random effects regression as linear functions of age, Down syndrome status, ability to speak and gender. Results DBC scores of those with Down syndrome were lower than those of people without Down syndrome indicating fewer behavioural problems on all scales except communication disturbance. For both groups disruptive, communication disturbance, anxiety and self-absorbed DBC subscales all declined on average over time. There were two important differences between changes in behaviours for these two cohorts. Depressive symptoms did not significantly decline for those with Down syndrome compared to those without Down syndrome. The trajectory of the social relating behaviours subscale differed between these two cohorts, where those with Down syndrome remained relatively steady and, for those with intellectual disability from another cause, the behaviours increased over time. Conclusions These results have implications for needed supports and opportunities for engagement in society to buffer against these emotional and behavioural challenges. PMID:27391326

Temporal Dynamics of Religion as a Determinant of HIV Infection in East Zimbabwe: A Serial Cross-Sectional Analysis

PubMed Central

Manzou, Rumbidzai; Schumacher, Christina; Gregson, Simon

2014-01-01

Background Religion is an important underlying determinant of HIV spread in sub-Saharan Africa. However, little is known about how religion influences changes in HIV prevalence and associated sexual behaviours over time. Objectives To compare changes in HIV prevalence between major religious groups in eastern Zimbabwe during a period of substantial HIV risk reduction (1998–2005) and to investigate whether variations observed can be explained by differences in behaviour change. Methods We analysed serial cross-sectional data from two rounds of a longitudinal population survey in eastern Zimbabwe. Univariate and multivariate logistic regression models were developed to compare differences in sexual behaviour and HIV prevalence between religious groups and to investigate changes over time controlling for potential confounders. Results Christian churches were the most popular religious grouping. Over time, Spiritualist churches increased in popularity and, for men, Traditional religion and no religion became less and more common, respectively. At baseline (1998–2000), HIV prevalence was higher in Traditionalists and in those with no religion than in people in Christian churches (men 26.7% and 23.8% vs. 17.5%, women: 35.4% and 37.5% vs. 24.1%). These effects were explained by differences in socio-demographic characteristics (for Traditional and men with no religion) or sexual behaviour (women with no religion). Spiritualist men (but not women) had lower HIV prevalence than Christians, after adjusting for socio-demographic characteristics (14.4% vs. 17.5%, aOR = 0.8), due to safer behaviour. HIV prevalence had fallen in all religious groups at follow-up (2003–2005). Odds of infection in Christians reduced relative to those in other religious groups for both sexes, effects that were mediated largely by greater reductions in sexual-risk behaviour and, possibly, for women, by patterns of conversion between churches. Conclusion Variation in behavioural responses to HIV between the major church groupings has contributed to a change in the religious pattern of infection in eastern Zimbabwe. PMID:24465868

Individual influences on lifestyle change to reduce vascular risk: a qualitative literature review

PubMed Central

Murray, Jenni; Honey, Stephanie; Hill, Kate; Craigs, Cheryl; House, Allan

2012-01-01

Background Management of cardiovascular risk includes adoption of healthy lifestyles. Uptake and completion rates for lifestyle programmes are low and many barriers and facilitators to lifestyle behaviour change have been reported in the literature. Clarity on which barriers and facilitators to target during consultations in primary care may support a more systematic approach to lifestyle behaviour change in those at high risk of cardiovascular events. Aim To identify the main barriers and facilitators to lifestyle behaviour change in individuals at high risk of cardiovascular events. Design A content synthesis of the qualitative literature reporting patient-level influences on lifestyle change. Method Qualitative studies involving patients at high risk of cardiovascular events were identified through electronic searching and screening against predefined selection criteria. Factors (reported influences) were extracted and, using a clustering technique, organised into categories that were then linked to key themes through relationship mapping. Results A total of 348 factors were extracted from 33 studies. Factors were organised into 20 categories and from these categories five key themes were identified: emotions, beliefs, information and communication, friends and family support, and cost/transport. Conclusion It is possible to organise the large number of self-reported individual influences on lifestyle behaviours into a small number of themes. Further research is needed to clarify which of these patient-level barriers and facilitators are the best predictors of uptake and participation in programmes aimed at helping people to change lifestyle. PMID:22687232

Change in the family food environment is associated with positive dietary change in children

PubMed Central

2013-01-01

Background The family food environment is an important influence in the development of children’s dietary habits. Research suggests that influences of current dietary behaviour and behaviour change may differ. The aims of this paper were to: (1) investigate the association between the food environment at baseline and change in children’s saturated fat intake; and (2) to explore whether a change in the food environment was associated with a change in children’s saturated fat intake. Method Secondary analysis of a 12 week cluster randomised controlled trial in 133 4-13 year old children. Families were randomly allocated to parental education regarding changing to reduced-fat dairy foods or a comparison non-dietary behaviour. The interventions were family focused. Parents received education from a dietitian in 3x30minute sessions to facilitate behaviour change. Parents completed a comprehensive questionnaire capturing three domains of the food environment – Parent knowledge and attitudes; shaping practices; and behaviours and role modelling. Children’s dietary intake was assessed via multiple 24-hour recalls at baseline and week 12. Changes in the family food environment and primary outcome (saturated fat) were calculated. Hierarchical linear regression models were performed to explore the association between baseline and change in food environment constructs and change in saturated fat intake. Standardised Beta are presented (p<0.05). Results After adjustments for child and family demographics, higher levels of perceived food availability (β=-0.2) at baseline was associated with greater reduction in saturated fat intake, where as higher perceived responsibility (β=0.2), restriction (β=0.3) and pressure to eat (β=0.3) were associated with lesser change in saturated fat. An increase in nutrition knowledge (β=-0.2), perceived responsibility (β=-0.3) and restriction (β=-0.3) from baseline to week 12 were associated with greater reduction in saturated fat intake. Conclusions The present study was one of the first to quantify changes in the family food environment, and identify a number of factors which were associated with a positive dietary change. Because interventions focus on behaviour change, the findings may provide specific targets for intervention strategies in the future. Trial registration Australia New Zealand Clinical Trials Registry ACTRN12609000453280. PMID:23294481

Optimal stomatal behaviour around the world

DOE PAGES

Lin, Yan-Shih; Medlyn, Belinda E.; Duursma, Remko A.; ...

2015-03-02

Stomatal conductance (g s) is a key land-surface attribute as it links transpiration, the dominant component of global land evapotranspiration, and photosynthesis, the driving force of the global carbon cycle. Despite the pivotal role of g s in predictions of global water and carbon cycle changes, a global-scale database and an associated globally applicable model of g s that allow predictions of stomatal behaviour are lacking. Here, we present a database of globally distributed g s obtained in the field for a wide range of plant functional types (PFTs) and biomes. We find that stomatal behaviour differs among PFTs accordingmore » to their marginal carbon cost of water use, as predicted by the theory underpinning the optimal stomatal model 1 and the leaf and wood economics spectrum 2,3. We also demonstrate a global relationship with climate. In conclusion, these findings provide a robust theoretical framework for understanding and predicting the behaviour of g s across biomes and across PFTs that can be applied to regional, continental and global-scale modelling of ecosystem productivity, energy balance and ecohydrological processes in a future changing climate.« less

Sickness behaviour associated with non-lethal infections in wild primates

PubMed Central

Ghai, Ria R.; Fugère, Vincent; Chapman, Colin A.; Goldberg, Tony L.; Davies, T. Jonathan

2015-01-01

Non-lethal parasite infections are common in wildlife, but there is little information on their clinical consequences. Here, we pair infection data from a ubiquitous soil-transmitted helminth, the whipworm (genus Trichuris), with activity data from a habituated group of wild red colobus monkeys (Procolobus rufomitratus tephrosceles) in Kibale National Park, Uganda. We use mixed-effect models to examine the relationship between non-lethal parasitism and red colobus behaviour. Our results indicate that red colobus increased resting and decreased more energetically costly behaviours when shedding whipworm eggs in faeces. Temporal patterns of behaviour also changed, with individuals switching behaviour less frequently when whipworm-positive. Feeding frequency did not differ, but red colobus consumption of bark and two plant species from the genus Albizia, which are used locally in traditional medicines, significantly increased when animals were shedding whipworm eggs. These results suggest self-medicative plant use, although additional work is needed to verify this conclusion. Our results indicate sickness behaviours, which are considered an adaptive response by hosts during infection. Induction of sickness behaviour in turn suggests that these primates are clinically sensitive to non-lethal parasite infections. PMID:26311670

Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit

PubMed Central

2017-01-01

Background The audit-feedback cycle is a behaviour change intervention used to reduce evidence-practice gaps. In this study, repeat audits, feedback, education and training were used to change practice and increase compliance with Australian guideline recommendations for stroke rehabilitation. Objective To increase the proportion of patients with stroke receiving best practice screening, assessment and treatment. Methods A before-and-after study design was used. Data were collected from medical records (n=15 files per audit). Four audits were conducted between 2009 and 2013. Consecutive files of patients with stroke admitted to the stroke unit were selected and audited retrospectively. Staff behaviour change interventions included four cycles of audit feedback, and education to assist staff with change. The primary outcome measure was the proportion of eligible patients receiving best practice against target behaviours, based on audit data. Results Between the first and fourth audit (2009 and 2013), 20 of the 27 areas targeted (74%) met or exceeded the minimum target of 10% change. Practice areas that showed the most change included sensation screening (+75%) and rehabilitation (+100%); neglect screening (+92%) and assessment (100%). Some target behaviours showed a drop in compliance such as anxiety and depression screening (−27%) or little or no overall improvement such as patient education about stroke (6% change). Conclusions Audit feedback and education increased the proportion of inpatients with stroke receiving best practice rehabilitation in some, but not all practice areas. An ongoing process of quality improvement is needed to help sustain these improvements. PMID:29450304

Impact of faculty development programs for positive behavioural changes among teachers: a case study

PubMed Central

2018-01-01

Purpose Faculty development (FD) is essential to prepare faculty members to become effective teachers to meet the challenges in medical education. Despite the growth of FD programmes, most evaluations were often conducted using short questionnaires to assess participants’ satisfaction immediately after they attended a programme. Consequently, there were calls for more rigorous evaluations based on observed changes in participants’ behaviours. Hence, this study aims to explore how the FD workshops run by the Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore have impacted behavioural changes in the educators. Methods We followed up with the educators at least half a year after they have attended the workshops. With limited literature as reference, we initiated a small-scale case-study research design involving semi-structured interviews with six educators which was triangulated with three focus group discussions with their students. This allowed us to explore behavioural changes among the educators as well as evaluate the feasibility of this research methodology. Results We identified three emerging categories among the educators: ignorance to awareness, from intuition to confirmation and expansion, and from individualism to community of practice. Conclusion Although FD have placed much emphasis on teaching and learning approaches, we found that the teacher-student interaction or human character components (passionate, willing to sacrifice, are open to feedback) in becoming a good educator are lacking in our FD workshops. PMID:29510604

What works in school-based energy balance behaviour interventions and what does not? A systematic review of mediating mechanisms.

PubMed

van Stralen, M M; Yildirim, M; te Velde, S J; Brug, J; van Mechelen, W; Chinapaw, M J M

2011-10-01

Obesity prevention requires effective interventions targeting the so-called energy balance-related behaviours (that is, physical activity, sedentary and dietary behaviours). To improve (cost-)effectiveness of these interventions, one needs to know the working mechanisms underlying behavioural change. Mediation analyses evaluates whether an intervention works via hypothesised working mechanisms. Identifying mediators can prompt intervention developers to strengthen effective intervention components and remove/adapt ineffective components. This systematic review aims to identify psychosocial and environmental mediators of energy balance-related behaviours interventions for youth. Studies were identified by a systematic search of electronic databases (PubMed, Embase, PsycINFO, ERIC and SPORTDiscus). Studies were included if they (1) were school-based randomised controlled or quasi-experimental studies; (2) targeted energy balance behaviours; (3) conducted among children and adolescents (4-18 years of age); (4) written in English; and (5) conducted mediation analyses. A total of 24 studies were included. We found strong evidence for self-efficacy and moderate evidence for intention as mediators of physical activity interventions. Indications were found for attitude, knowledge and habit strength to be mediators of dietary behaviour interventions. The few sedentary behaviour interventions reporting on mediating effects prevented us from forming strong conclusions regarding mediators of sedentary behaviour interventions. The majority of interventions failed to significantly change hypothesised mediators because of ineffective intervention strategies, low power and/or use of insensitive measures. Despite its importance, few studies published results of mediation analysis, and more high-quality research into relevant mediators is necessary. On the basis of the limited number of published studies, self-efficacy and intention appear to be relevant mediators for physical activity interventions. Future intervention developers are advised to provide information on the theoretical base of their intervention including the strategies applied to provide insight into which strategies are effective in changing relevant mediators. In addition, future research is advised to focus on the development, validity, reliability and sensitivity of mediator measures.

Intervention planning for the REDUCE maintenance intervention: a digital intervention to reduce reulceration risk among patients with a history of diabetic foot ulcers

PubMed Central

Sivyer, Katy; Vedhara, Kavita; Yardley, Lucy; Game, Frances; Chalder, Trudie; Richards, Gayle; Drake, Nikki; Gray, Katie; Weinman, John; Bradbury, Katherine

2018-01-01

Objectives To develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk. Methods Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I of intervention planning, evidence was collated from a scoping review of the literature and qualitative interviews with patients who have had DFUs (n=20). This was used to identify the psychosocial needs and challenges of this population and barriers and facilitators to the intervention’s target behaviours: regular foot checking, rapid self-referral in the event of changes in foot health, graded and regular physical activity and emotional management. In phase II, this evidence was combined with expert consultation to develop the intervention plan. Brief ‘guiding principles’ for shaping intervention development were created. ‘Behavioural analysis’ and ‘logic modelling’ were used to map intervention content onto behaviour change theory to comprehensively describe the intervention and its hypothesised mechanisms. Results Key challenges to the intervention’s target behaviours included patients’ uncertainty regarding when to self-refer, physical limitations affecting foot checking and physical activity and, for some, difficulties managing negative emotions. Important considerations for the intervention design included a need to increase patients’ confidence in making a self-referral and in using the maintenance intervention and a need to acknowledge that some intervention content might be relevant to only some patients (emotional management, physical activity). The behavioural analysis identified the following processes hypothesised to facilitate long-term behaviour maintenance including increasing patients’ skills, self-efficacy, knowledge, positive outcome expectancies, sense of personal control, social support and physical opportunity. Conclusions This research provides a transparent description of the intervention planning for the REDUCE maintenance intervention. It provides insights into potential barriers and facilitators to the target behaviours and potentially useful behaviour change techniques to use in clinical practice. PMID:29779008

A systematic review of cognitive and/or behavioural therapies for methamphetamine dependence

PubMed Central

Lee, Nicole K; Rawson, Richard A.

2015-01-01

Introduction and aims The use of methamphetamine is widespread and poses significant challenges for treatment providers. Much of the treatment knowledge about this group has been extrapolated from studies of treatment for cocaine dependence. Medications have been shown to be of limited effectiveness for methamphetamine users, making psychological interventions the treatment of choice. Design and methods This paper describes a systematic review of cognitive-behavioural and behavioural interventions for methamphetamine users. A systematic search of published literature was undertaken focusing only on randomised trials. Results There were a relatively small number of intervention studies that compared cognitive-behavioural or behavioural interventions using randomised trial methodology. Most commonly, studies examined cognitive behaviour therapy (CBT) and/or contingency management (CM). Treatment with CBT appears to be associated with reductions in methamphetamine use and other positive changes ,even over very short periods of treatment (2 and 4 sessions). CM studies found a significant reduction of methamphetamine during application of the procedure, but it is not clear if these gains are sustained at post-treatment follow-up. Discussion and conclusion Further research into cognitive behavioural and behavioural treatments for methamphetamine users is required, with a focus on improving longevity of the effect of intervention. PMID:18368613

Public acceptability of government intervention to change health-related behaviours: a systematic review and narrative synthesis

PubMed Central

2013-01-01

Background Governments can intervene to change health-related behaviours using various measures but are sensitive to public attitudes towards such interventions. This review describes public attitudes towards a range of policy interventions aimed at changing tobacco and alcohol use, diet, and physical activity, and the extent to which these attitudes vary with characteristics of (a) the targeted behaviour (b) the intervention and (c) the respondents. Methods We searched electronic databases and conducted a narrative synthesis of empirical studies that reported public attitudes in Europe, North America, Australia and New Zealand towards interventions relating to tobacco, alcohol, diet and physical activity. Two hundred studies met the inclusion criteria. Results Over half the studies (105/200, 53%) were conducted in North America, with the most common interventions relating to tobacco control (110/200, 55%), followed by alcohol (42/200, 21%), diet-related interventions (18/200, 9%), interventions targeting both diet and physical activity (18/200, 9%), and physical activity alone (3/200, 2%). Most studies used survey-based methods (160/200, 80%), and only ten used experimental designs. Acceptability varied as a function of: (a) the targeted behaviour, with more support observed for smoking-related interventions; (b) the type of intervention, with less intrusive interventions, those already implemented, and those targeting children and young people attracting most support; and (c) the characteristics of respondents, with support being highest in those not engaging in the targeted behaviour, and with women and older respondents being more likely to endorse more restrictive measures. Conclusions Public acceptability of government interventions to change behaviour is greatest for the least intrusive interventions, which are often the least effective, and for interventions targeting the behaviour of others, rather than the respondent him or herself. Experimental studies are needed to assess how the presentation of the problem and the benefits of intervention might increase acceptability for those interventions which are more effective but currently less acceptable. PMID:23947336

Impact of adding hand-washing and water disinfection promotion to oral cholera vaccination on diarrhoea-associated hospitalization in Dhaka, Bangladesh: evidence from a cluster randomized control trial

PubMed Central

Najnin, Nusrat; Leder, Karin; Qadri, Firdausi; Forbes, Andrew; Unicomb, Leanne; Winch, Peter J; Ram, Pavani K; Leontsini, Elli; Nizame, Fosiul A; Arman, Shaila; Begum, Farzana; Biswas, Shwapon K; Clemens, John D; Ali, Mohammad; Cravioto, Alejandro; Luby, Stephen P

2017-01-01

Abstract Background Information on the impact of hygiene interventions on severe outcomes is limited. As a pre-specified secondary outcome of a cluster-randomized controlled trial among >400 000 low-income residents in Dhaka, Bangladesh, we examined the impact of cholera vaccination plus a behaviour change intervention on diarrhoea-associated hospitalization. Methods Ninety neighbourhood clusters were randomly allocated into three areas: cholera-vaccine-only; vaccine-plus-behaviour-change (promotion of hand-washing with soap plus drinking water chlorination); and control. Study follow-up continued for 2 years after intervention began. We calculated cluster-adjusted diarrhoea-associated hospitalization rates using data we collected from nearby hospitals, and 6-monthly census data of all trial households. Results A total of 429 995 people contributed 500 700 person-years of data (average follow-up 1.13 years). Vaccine coverage was 58% at the start of analysis but continued to drop due to population migration. In the vaccine-plus-behaviour-change area, water plus soap was present at 45% of hand-washing stations; 4% of households had detectable chlorine in stored drinking water. Hospitalization rates were similar across the study areas [events/1000 person-years, 95% confidence interval (CI), cholera-vaccine-only: 9.4 (95% CI: 8.3–10.6); vaccine-plus-behaviour-change: 9.6 (95% CI: 8.3–11.1); control: 9.7 (95% CI: 8.3–11.6)]. Cholera cases accounted for 7% of total number of diarrhoea-associated hospitalizations. Conclusions Neither cholera vaccination alone nor cholera vaccination combined with behaviour-change intervention efforts measurably reduced diarrhoea-associated hospitalization in this highly mobile population, during a time when cholera accounted for a small fraction of diarrhoea episodes. Affordable community-level interventions that prevent infection from multiple pathogens by reliably separating faeces from the environment, food and water, with minimal behavioural demands on impoverished communities, remain an important area for research. PMID:29025064

Effects of Divergent Selection for Fear of Humans on Behaviour in Red Junglefowl

PubMed Central

Agnvall, Beatrix; Jensen, Per

2016-01-01

Domestication has caused a range of similar phenotypic changes across taxa, relating to physiology, morphology and behaviour. It has been suggested that this recurring domesticated phenotype may be a result of correlated responses to a central trait, namely increased tameness. We selected Red Junglefowl, the ancestors of domesticated chickens, during five generations for reduced fear of humans. This caused a marked and significant response in tameness, and previous studies have found correlated effects on growth, metabolism, reproduction, and some behaviour not directly selected for. Here, we report the results from a series of behavioural tests carried out on the initial parental generation (P0) and the fifth selected generation (S5), focusing on behaviour not functionally related to tameness, in order to study any correlated effects. Birds were tested for fear of humans, social reinstatement tendency, open field behaviour at two different ages, foraging/exploration, response to a simulated aerial predator attack and tonic immobility. In S5, there were no effects of selection on foraging/exploration or tonic immobility, while in the social reinstatement and open field tests there were significant interactions between selection and sex. In the aerial predator test, there were significant main effects of selection, indicating that fear of humans may represent a general wariness towards predators. In conclusion, we found only small correlated effects on behaviours not related to the tameness trait selected for, in spite of them showing high genetic correlations to fear of humans in a previous study on the same population. This suggests that species-specific behaviour is generally resilient to changes during domestication. PMID:27851792

Effects of Divergent Selection for Fear of Humans on Behaviour in Red Junglefowl.

PubMed

Agnvall, Beatrix; Jensen, Per

2016-01-01

Domestication has caused a range of similar phenotypic changes across taxa, relating to physiology, morphology and behaviour. It has been suggested that this recurring domesticated phenotype may be a result of correlated responses to a central trait, namely increased tameness. We selected Red Junglefowl, the ancestors of domesticated chickens, during five generations for reduced fear of humans. This caused a marked and significant response in tameness, and previous studies have found correlated effects on growth, metabolism, reproduction, and some behaviour not directly selected for. Here, we report the results from a series of behavioural tests carried out on the initial parental generation (P0) and the fifth selected generation (S5), focusing on behaviour not functionally related to tameness, in order to study any correlated effects. Birds were tested for fear of humans, social reinstatement tendency, open field behaviour at two different ages, foraging/exploration, response to a simulated aerial predator attack and tonic immobility. In S5, there were no effects of selection on foraging/exploration or tonic immobility, while in the social reinstatement and open field tests there were significant interactions between selection and sex. In the aerial predator test, there were significant main effects of selection, indicating that fear of humans may represent a general wariness towards predators. In conclusion, we found only small correlated effects on behaviours not related to the tameness trait selected for, in spite of them showing high genetic correlations to fear of humans in a previous study on the same population. This suggests that species-specific behaviour is generally resilient to changes during domestication.

Engagement of stakeholders in the development of a Theory of Change for handwashing and sanitation behaviour change.

PubMed

De Buck, Emmy; Hannes, Karin; Cargo, Margaret; Van Remoortel, Hans; Vande Veegaete, Axel; Mosler, Hans-Joachim; Govender, Thashlin; Vandekerckhove, Philippe; Young, Taryn

2018-02-01

A Theory of Change (ToC) is an approach to map programmes aimed at inducing change in a specific context, with the goal of increasing their impact. We applied this approach to the specific case of handwashing and sanitation practices in low- and middle-income countries and developed a ToC as part of a systematic review exercise. Different existing sources of information were used to inform the initial draft of the ToC. In addition, stakeholder involvement occurred and peer review took place. Our stakeholders included methodological (ToC/quantitative and qualitative research) and content experts (WASH (Water, Sanitation, Hygiene)/behaviour change), as well as end-users/practitioners, policy-makers and donors. In conclusion, the development of a ToC, and the involvement of stakeholders in its development, was critical in terms of understanding the context in which the promotional programmes are being implemented. We recommend ToC developers to work with stakeholders to create a ToC relevant for practice.

Stroke-Related Knowledge, Beliefs, and Behaviours of Chinese and European Canadians: Implications for Physical Therapists

PubMed Central

Li, Zhenyi; Jongbloed, Lyn

2014-01-01

ABSTRACT Purpose: To improve cross-cultural health education on risk-reducing behaviour change by examining the stroke-related knowledge, beliefs, and behaviours of Chinese Canadians (CCs). Methods: Participants (103 first-generation CCs and 101 European Canadians [ECs] representing the dominant cultural group in Canada) completed a cross-sectional questionnaire about knowledge, health behaviours, and beliefs related to stroke. Results: Compared with ECs, CCs were less aware of risk factors, warning signs, and appropriate responses to stroke in others. Information sources about stroke included mass media, family, and friends. CCs were less likely to smoke and drink alcohol but were also less likely to be physically active or to participate in structured exercise, less likely to have a healthy diet, and more likely to report stress. Conclusions: Theoretical dimensions of culture may explain variations in stroke-related knowledge, behaviours, and beliefs between CCs and ECs. Awareness of cultural differences can help physical therapists evaluate clients and appropriately tailor lifestyle-related health education. PMID:24799757

Understanding discharge data uncertainty and its consequences for analyses of spatial and temporal change in hydrological response

NASA Astrophysics Data System (ADS)

Westerberg, Ida

2017-04-01

Understanding and quantifying how hydrological response behaviour varies across catchments, or how catchments change with time requires reliable discharge data. For reliable estimation of spatial and temporal change, the change in the response behaviour needs to be larger than the uncertainty in the response behaviour estimates that are compared. Understanding how discharge data uncertainty varies between catchments and over time, and how these uncertainties propagate to information derived from the data, is therefore key to drawing the right conclusions in comparative analyses. Uncertainty in discharge data is often highly place-specific and reliable estimation depends on detailed analyses of the rating curve model and stage-discharge measurements used to calculate discharge time series from stage (water level) at the gauging station. This underlying information is often not available when discharge data is provided by monitoring agencies. However, even without detailed analyses, the chance that the discharge data would be uncertain at particular flow ranges can be assessed based on information about the gauging station, the flow regime, and the catchment. This type of information is often available for most catchments even if the rating curve data are not. Such 'soft information' on discharge uncertainty may aid interpretation of results from regional and temporal change analyses. In particular, it can help reduce the risk of wrongly interpreting differences in response behaviour caused by discharge uncertainty as real changes. In this presentation I draw on several previous studies to discuss some of the factors that affect discharge data uncertainty and give examples from catchments worldwide. I aim to 1) illustrate the consequences of discharge data uncertainty on comparisons of different types of hydrological response behaviour across catchments and when analysing temporal change, and 2) give practical advice as to what factors may help identify catchments with potentially large discharge uncertainty.

The cost of changing physical activity behaviour: evidence from a "physical activity pathway" in the primary care setting

PubMed Central

2011-01-01

Background The 'Physical Activity Care Pathway' (a Pilot for the 'Let's Get Moving' policy) is a systematic approach to integrating physical activity promotion into the primary care setting. It combines several methods reported to support behavioural change, including brief interventions, motivational interviewing, goal setting, providing written resources, and follow-up support. This paper compares costs falling on the UK National Health Service (NHS) of implementing the care pathway using two different recruitment strategies and provides initial insights into the cost of changing physical activity behaviour. Methods A combination of a time driven variant of activity based costing, audit data through EMIS and a survey of practice managers provided patient-level cost data for 411 screened individuals. Self reported physical activity data of 70 people completing the care pathway at three month was compared with baseline using a regression based 'difference in differences' approach. Deterministic and probabilistic sensitivity analyses in combination with hypothesis testing were used to judge how robust findings are to key assumptions and to assess the uncertainty around estimates of the cost of changing physical activity behaviour. Results It cost £53 (SD 7.8) per patient completing the PACP in opportunistic centres and £191 (SD 39) at disease register sites. The completer rate was higher in disease register centres (27.3% vs. 16.2%) and the difference in differences in time spent on physical activity was 81.32 (SE 17.16) minutes/week in patients completing the PACP; so that the incremental cost of converting one sedentary adult to an 'active state' of 150 minutes of moderate intensity physical activity per week amounts to £ 886.50 in disease register practices, compared to opportunistic screening. Conclusions Disease register screening is more costly than opportunistic patient recruitment. However, additional costs come with a higher completion rate and better outcomes in terms of behavioural change in patients completing the care pathway. Further research is needed to rigorously evaluate intervention efficiency and to assess the link between behavioural change and changes in quality adjusted life years (QALYs). PMID:21605400

Chronic Mild Stress (CMS) in Mice: Of Anhedonia, ‘Anomalous Anxiolysis’ and Activity

PubMed Central

Schweizer, Martin C.; Henniger, Markus S. H.; Sillaber, Inge

2009-01-01

Background In a substantial proportion of depressed patients, stressful life events play a role in triggering the evolution of the illness. Exposure to stress has effects on different levels in laboratory animals as well and for the rat it has been shown that chronic mild stress (CMS) can cause antidepressant-reversible depressive-like effects. The adoption of the model to the mouse seems to be problematic, depending on the strain used and behavioural endpoint defined. Our aim was to evaluate the applicability of CMS to mice in order to induce behavioural alterations suggested to reflect depression-like symptoms. Methodology/Principal Findings A weekly CMS protocol was applied to male mice of different mouse strains (D2Ola, BL/6J and BL/6N) and its impact on stress-sensitive behavioural measures (anhedonia-, anxiety- and depression-related parameters) and body weight was assessed. Overnight illumination as commonly used stressor in CMS protocols was particularly investigated in terms of its effect on general activity and subsequently derived saccharin intake. CMS application yielded strain-dependent behavioural and physiological responses including ‘paradox’ anxiolytic-like effects. Overnight illumination was found to be sufficient to mimic anhedonic-like behaviour in BL/6J mice when being applied as sole stressor. Conclusions/Significance The CMS procedure induced some behavioural changes that are compatible with the common expectations, i.e. ‘anhedonic’ behaviour, but in parallel behavioural alterations were observed which would be described as ‘anomalous’ (e.g. decreased anxiety). The results suggest that a shift in the pattern of circadian activity has a particular high impact on the anhedonic profile. Changes in activity in response to novelty seem to drive the ‘anomalous’ behavioural alterations as well. PMID:19177164

Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala

PubMed Central

Arnold, Benjamin; Arana, Byron; Mäusezahl, Daniel; Hubbard, Alan; Colford, John M

2009-01-01

Background The promotion of household water treatment and handwashing with soap has led to large reductions in child diarrhoea in randomized efficacy trials. Currently, we know little about the health effectiveness of behaviour-based water and hygiene interventions after the conclusion of intervention activities. Methods We present an extension of previously published design (propensity score matching) and analysis (targeted maximum likelihood estimation) methods to evaluate the behavioural and health impacts of a pre-existing but non-randomized intervention (a 3-year, combined household water treatment and handwashing campaign in rural Guatemala). Six months after the intervention, we conducted a cross-sectional cohort study in 30 villages (15 intervention and 15 control) that included 600 households, and 929 children <5 years of age. Results The study design created a sample of intervention and control villages that were comparable across more than 30 potentially confounding characteristics. The intervention led to modest gains in confirmed water treatment behaviour [risk difference = 0.05, 95% confidence interval (CI) 0.02–0.09]. We found, however, no difference between the intervention and control villages in self-reported handwashing behaviour, spot-check hygiene conditions, or the prevalence of child diarrhoea, clinical acute lower respiratory infections or child growth. Conclusions To our knowledge this is the first post-intervention follow-up study of a combined household water treatment and handwashing behaviour change intervention, and the first post-intervention follow-up of either intervention type to include child health measurement. The lack of child health impacts is consistent with unsustained behaviour adoption. Our findings highlight the difficulty of implementing behaviour-based household water treatment and handwashing outside of intensive efficacy trials. PMID:19574492

An intervention modelling experiment to change GPs' intentions to implement evidence-based practice: using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #2

PubMed Central

Hrisos, Susan; Eccles, Martin; Johnston, Marie; Francis, Jill; Kaner, Eileen FS; Steen, Nick; Grimshaw, Jeremy

2008-01-01

Background Psychological theories of behaviour may provide a framework to guide the design of interventions to change professional behaviour. Behaviour change interventions, designed using psychological theory and targeting important motivational beliefs, were experimentally evaluated for effects on the behavioural intention and simulated behaviour of GPs in the management of uncomplicated upper respiratory tract infection (URTI). Methods The design was a 2 × 2 factorial randomised controlled trial. A postal questionnaire was developed based on three theories of human behaviour: Theory of Planned Behaviour; Social Cognitive Theory and Operant Learning Theory. The beliefs and attitudes of GPs regarding the management of URTI without antibiotics and rates of prescribing on eight patient scenarios were measured at baseline and post-intervention. Two theory-based interventions, a "graded task" with "action planning" and a "persuasive communication", were incorporated into the post-intervention questionnaire. Trial groups were compared using co-variate analyses. Results Post-intervention questionnaires were returned for 340/397 (86%) GPs who responded to the baseline survey. Each intervention had a significant effect on its targeted behavioural belief: compared to those not receiving the intervention GPs completing Intervention 1 reported stronger self-efficacy scores (Beta = 1.41, 95% CI: 0.64 to 2.25) and GPs completing Intervention 2 had more positive anticipated consequences scores (Beta = 0.98, 95% CI = 0.46 to 1.98). Intervention 2 had a significant effect on intention (Beta = 0.90, 95% CI = 0.41 to 1.38) and simulated behaviour (Beta = 0.47, 95% CI = 0.19 to 0.74). Conclusion GPs' intended management of URTI was significantly influenced by their confidence in their ability to manage URTI without antibiotics and the consequences they anticipated as a result of doing so. Two targeted behaviour change interventions differentially affected these beliefs. One intervention also significantly enhanced GPs' intentions not to prescribe antibiotics for URTI and resulted in lower rates of prescribing on patient scenarios compared to a control group. The theoretical frameworks utilised provide a scientific rationale for understanding how and why the interventions had these effects, improving the reproducibility and generalisability of these findings and offering a sound basis for an intervention in a "real world" trial. Trial registration Clinicaltrials.gov NCT00376142 PMID:18194526

Parasite manipulation of brain monoamines in California killifish (Fundulus parvipinnis) by the trematode Euhaplorchis californiensis

USGS Publications Warehouse

Shaw, J.C.; Korzan, W.J.; Carpenter, R.E.; Kuris, A.M.; Lafferty, K.D.; Summers, C.H.; Overli, O.

2009-01-01

California killifish (Fundulus parvipinnis) infected with the brain-encysting trematode Euhaplorchis californiensis display conspicuous swimming behaviours rendering them more susceptible to predation by avian final hosts. Heavily infected killifish grow and reproduce normally, despite having thousands of cysts inside their braincases. This suggests that E. californiensis affects only specific locomotory behaviours. We hypothesised that changes in the serotonin and dopamine metabolism, essential for controlling locomotion and arousal may underlie this behaviour modification. We employed micropunch dissection and HPLC to analyse monoamine and monoamine metabolite concentrations in the brain regions of uninfected and experimentally infected fish. The parasites exerted density-dependent changes in monoaminergic activity distinct from those exhibited by fish subjected to stress. Specifically, E. californiensis inhibited a normally occurring, stress-induced elevation of serotonergic metabolism in the raphae nuclei. This effect was particularly evident in the experimentally infected fish, whose low-density infections were concentrated on the brainstem. Furthermore, high E. californiensis density was associated with increased dopaminergic activity in the hypothalamus and decreased serotonergic activity in the hippocampus. In conclusion, the altered monoaminergic metabolism may explain behavioural differences leading to increased predation of the infected killifish by their final host predators. ?? 2008 The Royal Society.

Chronic cocaine but not chronic amphetamine use is associated with perseverative responding in humans

PubMed Central

Roiser, Jonathan P.; Robbins, Trevor W.; Sahakian, Barbara J.

2013-01-01

Rationale Chronic drug use has been associated with increased impulsivity and maladaptive behaviour, but the underlying mechanisms of this impairment remain unclear. We investigated the ability to adapt behaviour according to changes in reward contingencies, using a probabilistic reversal-learning task, in chronic drug users and controls. Materials and methods Five groups were compared: chronic amphetamine users (n = 30); chronic cocaine users (n = 27); chronic opiate users (n = 42); former drug users of psychostimulants and opiates (n = 26); and healthy non-drug-taking control volunteers (n = 25). Participants had to make a forced choice between two alternative stimuli on each trial to acquire a stimulus–reward association on the basis of degraded feedback and subsequently to reverse their responses when the reward contingencies changed. Results Chronic cocaine users demonstrated little behavioural change in response to the change in reward contingencies, as reflected by perseverative responding to the previously rewarded stimulus. Perseverative responding was observed in cocaine users regardless of whether they completed the reversal stage successfully. Task performance in chronic users of amphetamines and opiates, as well as in former drug users, was not measurably impaired. Conclusion Our findings provide convincing evidence for response perseveration in cocaine users during probabilistic reversal-learning. Pharmacological differences between amphetamine and cocaine, in particular their respective effects on the 5-HT system, may account for the divergent task performance between the two psychostimulant user groups. The inability to reverse responses according to changes in reinforcement contingencies may underlie the maladaptive behaviour patterns observed in chronic cocaine users but not in chronic users of amphetamines or opiates. PMID:18214445

Lack of vasopressin does not prevent the behavioural and endocrine changes induced by chronic unpredictable stress.

PubMed

Varga, János; Domokos, Agnes; Barna, István; Jankord, Ryan; Bagdy, György; Zelena, Dóra

2011-01-15

Vasopressin (VP) plays an important role in hypothalamo-pituitary-adrenal (HPA) axis regulation and in stress-related disorders. Our previous studies confirmed the role of VP in acute situations, where VP-deficient Brattleboro rats had less depression-like behaviour compared to animals that express VP. In this study, we test the hypothesis that VP-deficient rats are more resistant to the development of chronic HPA axis hyperactivity and depression-like symptoms after chronic unpredictable stress (CUS). Male VP-deficient Brattleboro rats were compared to their heterozygous littermates (controls). CUS consisted of different mild stimuli for 5 weeks. Elevated plus maze and forced swim test were used for behavioural characterization, while organs and blood for HPA axis parameters were collected at the end of the experiment. In controls, CUS resulted in the development of chronic stress state characterized by typical somatic (body weight reduction, thymus involution) and endocrine changes (resting plasma ACTH and corticosterone elevation and POMC mRNA elevation in anterior lobe of the pituitary). Floating time in the forced swim test was enhanced together with reduced open arm entries on elevated plus maze and a reduction in daily food intake. Unexpectedly, the lack of VP did not alter the effect of CUS on the somatic and behavioural measures, but only prevented CUS-induced corticosterone changes. In conclusion, lifelong VP-deficiency has a positive effect on corticosterone elevation following CUS but does not affect the behavioural consequences of CUS. It is likely that the interplay of several related factors, rather than an alteration in a single neuropeptide, modulates behaviour and disease pathogenesis. Copyright © 2010 Elsevier Inc. All rights reserved.

Evaluation of Stepping Stones as a tool for changing knowledge, attitudes and behaviours associated with gender, relationships and HIV risk in Karnataka, India

PubMed Central

2011-01-01

Background Stepping Stones training aims to help individuals explore sexual relationships and recognize gender inequalities, the structural drivers of the HIV epidemic, in order to understand risk behaviours and to seek solutions to factors that increase HIV vulnerability. Despite earlier studies suggesting the success of Stepping Stones, little data exist to show diffusion to trainees' social networks or the wider community. Methods A mixed-methods evaluation of this approach was undertaken using in-depth interviews of trainees and friends, and polling booth surveys in 20 villages where Stepping Stones training took place and in another 20 villages with no Stepping Stones intervention. Results The interview respondents and their friends reported significant changes in their relationships after training, and benefit from discussion of gender, sexuality, condom use and HIV vulnerability issues. However, though diffusion of this knowledge at the level of personal contacts was strong, the evaluation revealed that diffusion to the community level was limited. Conclusions The qualitative part of this study reflects other studies in different settings, in that SS participants gained immensely from the training. Wider behaviour change is a challenging goal that many programmes fail to attain, with most interventions too limited in scope and intensity to produce larger community effects. This may have contributed to the fact that we observed few differences between interventions and non-intervention villages in this study. However, it is also possible that we had excessive expectations of individual change at the community level, and that it might have been more appropriate to have had broader community level rather than individual behavioural change indicators. We suggest that SS could be enhanced by efforts to better engage existing community opinion leaders, to empower and train participants as community change agents, and to support the development of village-level action plans that combat sexual stereotyping and risky behaviours that lead to unhealthy sexual relationships. PMID:21702965

Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews

PubMed Central

Johnson, Mark J; May, Carl R

2015-01-01

Objectives Translating research evidence into routine clinical practice is notoriously difficult. Behavioural interventions are often used to change practice, although their success is variable and the characteristics of more successful interventions are unclear. We aimed to establish the characteristics of successful behaviour change interventions in healthcare. Design We carried out a systematic overview of systematic reviews on the effectiveness of behaviour change interventions with a theory-led analysis using the constructs of normalisation process theory (NPT). MEDLINE, CINAHL, PsychINFO and the Cochrane Library were searched electronically from inception to July 2015. Setting Primary and secondary care. Participants Participants were any patients and healthcare professionals in systematic reviews who met the inclusion criteria of having examined the effectiveness of professional interventions in improving professional practice and/or patient outcomes. Interventions Professional interventions as defined by the Cochrane Effective Practice and Organisation of Care Review Group. Primary and secondary outcome measures Success of each intervention in changing practice or patient outcomes, and their mechanisms of action. Reviews were coded as to the interventions included, how successful they had been and which NPT constructs its component interventions covered. Results Searches identified 4724 articles, 67 of which met the inclusion criteria. Interventions fell into three main categories: persuasive; educational and informational; and action and monitoring. Interventions focusing on action or education (eg, Audit and Feedback, Reminders, Educational Outreach) acted on the NPT constructs of Collective Action and Reflexive Monitoring, and reviews using them tended to report more positive outcomes. Conclusions This theory-led analysis suggests that interventions which contribute to normative restructuring of practice, modifying peer group norms and expectations (eg, educational outreach) and relational restructuring, reinforcing modified peer group norms by emphasising the expectations of an external reference group (eg, Reminders, Audit and Feedback), offer the best chances of success. Combining such interventions is most likely to change behaviour. PMID:26423853

Hepatitis B vaccination and changes in sexual risk behaviour among men who have sex with men in Amsterdam.

PubMed

Xiridou, M; Wallinga, J; Dukers-Muijers, N; Coutinho, R

2009-04-01

The impact of hepatitis B vaccination in men having sex with men in Amsterdam has been marginal until now, possibly because of increases in sexual risk behaviour counterbalancing the effect of vaccination. A mathematical model is used to describe the hepatitis B epidemic. The model shows that, with the current vaccination coverage, the decrease in incidence is small in the beginning. However, the number of infections prevented per vaccine administered rises over time. Nevertheless, increased risk behaviour reduces the benefit of vaccination. Targeting high-risk men is more successful in reducing and containing the epidemic than targeting low-risk men. In conclusion, the vaccination campaign is effective and should be intensified. High-risk men should be targeted for vaccination and for risk reduction.

Partial lesion of the serotonergic system by a single dose of MDMA results in behavioural disinhibition and enhances acute MDMA-induced social behaviour on the social interaction test.

PubMed

Ando, Romeo D; Benko, Anita; Ferrington, Linda; Kirilly, Eszter; Kelly, Paul A T; Bagdy, Gyorgy

2006-06-01

The acute effects of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) on anxiety-related behaviours were studied using indices of social interaction in Dark Agouti (DA) both drug naive rats and those pretreated with MDMA (15 mg/kg i.p.) 3 weeks earlier. The functional neuroanatomy of these MDMA effects was visualised using 2-deoxyglucose imaging of local cerebral glucose use (LCMRglu), whilst MDMA-induced serotonergic neurotoxicity was measured by radioligand binding with [3H]paroxetine. Acute MDMA alone markedly decreased most typical elements of social interaction but increased adjacent lying, a behaviour that also contains social elements. In animals pre-exposed to MDMA, decreased [3H]paroxetine binding indicated serotonergic terminal depletion, and in these animals significant increases in locomotor activity, exploratory behaviour and aggressive behaviour were found. Both behavioural effects and also the metabolic activation induced by acute MDMA were potentiated in rats previously exposed to the drug. In conclusion, a single dose of MDMA caused marked changes in social behaviour acutely that might be interpreted either as a decrease or increase in anxiety. Three weeks after MDMA a behavioural disinhibition similar to psychomotor agitation, a symptom connected to depression or mania, and a sensitization to the acute effects of MDMA are apparent in both the behavioural and brain metabolic effects of the drug.

Characteristics of Interventions Targeting Multiple Lifestyle Risk Behaviours in Adult Populations: A Systematic Scoping Review

PubMed Central

King, Kristel; Meader, Nick; Wright, Kath; Graham, Hilary; Power, Christine; Petticrew, Mark; White, Martin; Sowden, Amanda J.

2015-01-01

Background Modifiable lifestyle risk behaviours such as smoking, unhealthy diet, physical inactivity and alcohol misuse are the leading causes of major, non-communicable diseases worldwide. It is increasingly being recognised that interventions which target more than one risk behaviour may be an effective and efficient way of improving people’s lifestyles. To date, there has been no attempt to summarise the global evidence base for interventions targeting multiple risk behaviours. Objective To identify and map the characteristics of studies evaluating multiple risk behaviour change interventions targeted at adult populations in any country. Methods Seven bibliographic databases were searched between January, 1990, and January/ May, 2013. Authors of protocols, conference abstracts, and other relevant articles were contacted. Study characteristics were extracted and inputted into Eppi-Reviewer 4. Results In total, 220 studies were included in the scoping review. Most were randomised controlled trials (62%) conducted in the United States (49%), and targeted diet and physical activity (56%) in people from general populations (14%) or subgroups of general populations (45%). Very few studies had been conducted in the Middle East (2%), Africa (0.5%), or South America (0.5%). There was also a scarcity of studies conducted among young adults (1%), or racial and minority ethnic populations (4%) worldwide. Conclusions Research is required to investigate the interrelationships of lifestyle risk behaviours in varying cultural contexts around the world. Cross-cultural development and evaluation of multiple risk behaviour change interventions is also needed, particularly in populations of young adults and racial and minority ethnic populations. PMID:25617783

Can research assessments themselves cause bias in behaviour change trials? A systematic review of evidence from solomon 4-group studies.

PubMed

McCambridge, Jim; Butor-Bhavsar, Kaanan; Witton, John; Elbourne, Diana

2011-01-01

The possible effects of research assessments on participant behaviour have attracted research interest, especially in studies with behavioural interventions and/or outcomes. Assessments may introduce bias in randomised controlled trials by altering receptivity to intervention in experimental groups and differentially impacting on the behaviour of control groups. In a Solomon 4-group design, participants are randomly allocated to one of four arms: (1) assessed experimental group; (2) unassessed experimental group (3) assessed control group; or (4) unassessed control group. This design provides a test of the internal validity of effect sizes obtained in conventional two-group trials by controlling for the effects of baseline assessment, and assessing interactions between the intervention and baseline assessment. The aim of this systematic review is to evaluate evidence from Solomon 4-group studies with behavioural outcomes that baseline research assessments themselves can introduce bias into trials. Electronic databases were searched, supplemented by citation searching. Studies were eligible if they reported appropriately analysed results in peer-reviewed journals and used Solomon 4-group designs in non-laboratory settings with behavioural outcome measures and sample sizes of 20 per group or greater. Ten studies from a range of applied areas were included. There was inconsistent evidence of main effects of assessment, sparse evidence of interactions with behavioural interventions, and a lack of convincing data in relation to the research question for this review. There were too few high quality completed studies to infer conclusively that biases stemming from baseline research assessments do or do not exist. There is, therefore a need for new rigorous Solomon 4-group studies that are purposively designed to evaluate the potential for research assessments to cause bias in behaviour change trials.

Mediators of longitudinal associations between television viewing and eating behaviours in adolescents

PubMed Central

2011-01-01

Background Television viewing has been associated with poor eating behaviours in adolescents. Changing unhealthy eating behaviours is most likely to be achieved by identifying and targeting factors shown to mediate the association between these behaviours. However, little is known about the mediators of the associations between television viewing and eating behaviours. The aim of this study was to examine mediators of the longitudinal associations between television viewing (TV) and eating behaviours among Australian adolescents. Method Eating behaviours were assessed using a web-based survey completed by a community-based sample of 1729 adolescents from years 7 and 9 of secondary schools in Victoria, Australia, at baseline (2004-2005) and two years later. TV viewing and the potential mediators (snacking while watching TV and perceived value of TV viewing) were assessed via the web-based survey at baseline. Results Adolescents who watched more than two hours of TV/day had higher intakes of energy-dense snacks and beverages, and lower intakes of fruit two years later. Furthermore, the associations between TV viewing and consumption of energy-dense snacks, energy-dense drinks and fruit were mediated by snacking while watching TV. Perceived value of TV viewing mediated the association between TV viewing and consumption of energy-dense snacks, beverages and fruit. Conclusion Snacking while watching TV and perceived value of TV viewing mediated the longitudinal association between TV viewing and eating behaviours among adolescents. The efficacy of methods to reduce TV viewing, change snacking habits while watching TV, and address the values that adolescents place on TV viewing should be examined in an effort to promote healthy eating among adolescents. PMID:21450065

Theorising and testing environmental pathways to behaviour change: natural experimental study of the perception and use of new infrastructure to promote walking and cycling in local communities

PubMed Central

Panter, Jenna; Ogilvie, David

2015-01-01

Objective Some studies have assessed the effectiveness of environmental interventions to promote physical activity, but few have examined how such interventions work. We investigated the environmental mechanisms linking an infrastructural intervention with behaviour change. Design Natural experimental study. Setting Three UK municipalities (Southampton, Cardiff and Kenilworth). Participants Adults living within 5 km of new walking and cycling infrastructure. Intervention Construction or improvement of walking and cycling routes. Exposure to the intervention was defined in terms of residential proximity. Outcome measures Questionnaires at baseline and 2-year follow-up assessed perceptions of the supportiveness of the environment, use of the new infrastructure, and walking and cycling behaviours. Analysis proceeded via factor analysis of perceptions of the physical environment (step 1) and regression analysis to identify plausible pathways involving physical and social environmental mediators and refine the intervention theory (step 2) to a final path analysis to test the model (step 3). Results Participants who lived near and used the new routes reported improvements in their perceptions of provision and safety. However, path analysis (step 3, n=967) showed that the effects of the intervention on changes in time spent walking and cycling were largely (90%) explained by a simple causal pathway involving use of the new routes, and other pathways involving changes in environmental cognitions explained only a small proportion of the effect. Conclusions Physical improvement of the environment itself was the key to the effectiveness of the intervention, and seeking to change people's perceptions may be of limited value. Studies of how interventions lead to population behaviour change should complement those concerned with estimating their effects in supporting valid causal inference. PMID:26338837

Smokers’ self-reported responses to the introduction of reduced ignition propensity (RIP) cigarettes

PubMed Central

Seidenberg, Andrew B; Rees, Vaughan W; Alpert, Hillel R; O'Connor, Richard J; Giovino, Gary A; Hyland, Andrew; Connolly, Gregory N

2015-01-01

Background Changes in cigarette design to meet mandated fire safety standards may have unintended effects on smoker responses by diminishing the consumer's perceptions of product acceptability, smoking and increasing fire-risk behaviours. To address these concerns, population-level data are needed from a jurisdiction where reduced ignition propensity (RIP) cigarettes have been introduced. Methods A cohort of adult smokers was recruited in Massachusetts, USA using a random-digit-dialled telephone survey. The cohort was contacted prior to, and 8 months following, the state-mandated introduction of RIP cigarettes on 1 January 2008. Changes in self-reported subjective cigarette characteristics, smoking topography, fire-risk behaviours, fire events and quitting intentions were assessed. Results A total of 620 Massachusetts smokers completed the baseline survey conducted prior to implementation of the law, and 353 (57%) completed the follow-up survey conducted after implementation. No significant changes were found in self-reported fire-risk behaviour or quitting intentions. In addition, smokers were less likely to report smoking greater than 20 cigarettes per day and inhaling deeply into the chest after the law. Conclusions The introduction of RIP cigarettes in Massachusetts yielded little change, and no adverse effect, on self-reported smoker response, among a sample of mostly Caucasian smokers. PMID:21752794

Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories.

PubMed

Kwasnicka, Dominika; Dombrowski, Stephan U; White, Martin; Sniehotta, Falko

2016-09-01

Behaviour change interventions are effective in supporting individuals in achieving temporary behaviour change. Behaviour change maintenance, however, is rarely attained. The aim of this review was to identify and synthesise current theoretical explanations for behaviour change maintenance to inform future research and practice. Potentially relevant theories were identified through systematic searches of electronic databases (Ovid MEDLINE, Embase, PsycINFO). In addition, an existing database of 80 theories was searched, and 25 theory experts were consulted. Theories were included if they formulated hypotheses about behaviour change maintenance. Included theories were synthesised thematically to ascertain overarching explanations for behaviour change maintenance. Initial theoretical themes were cross-validated. One hundred and seventeen behaviour theories were identified, of which 100 met the inclusion criteria. Five overarching, interconnected themes representing theoretical explanations for behaviour change maintenance emerged. Theoretical explanations of behaviour change maintenance focus on the differential nature and role of motives, self-regulation, resources (psychological and physical), habits, and environmental and social influences from initiation to maintenance. There are distinct patterns of theoretical explanations for behaviour change and for behaviour change maintenance. The findings from this review can guide the development and evaluation of interventions promoting maintenance of health behaviours and help in the development of an integrated theory of behaviour change maintenance.

Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories

PubMed Central

Kwasnicka, Dominika; Dombrowski, Stephan U; White, Martin; Sniehotta, Falko

2016-01-01

ABSTRACT Background: Behaviour change interventions are effective in supporting individuals in achieving temporary behaviour change. Behaviour change maintenance, however, is rarely attained. The aim of this review was to identify and synthesise current theoretical explanations for behaviour change maintenance to inform future research and practice. Methods: Potentially relevant theories were identified through systematic searches of electronic databases (Ovid MEDLINE, Embase, PsycINFO). In addition, an existing database of 80 theories was searched, and 25 theory experts were consulted. Theories were included if they formulated hypotheses about behaviour change maintenance. Included theories were synthesised thematically to ascertain overarching explanations for behaviour change maintenance. Initial theoretical themes were cross-validated. Findings: One hundred and seventeen behaviour theories were identified, of which 100 met the inclusion criteria. Five overarching, interconnected themes representing theoretical explanations for behaviour change maintenance emerged. Theoretical explanations of behaviour change maintenance focus on the differential nature and role of motives, self-regulation, resources (psychological and physical), habits, and environmental and social influences from initiation to maintenance. Discussion: There are distinct patterns of theoretical explanations for behaviour change and for behaviour change maintenance. The findings from this review can guide the development and evaluation of interventions promoting maintenance of health behaviours and help in the development of an integrated theory of behaviour change maintenance. PMID:26854092

Economic Instruments for Population Diet and Physical Activity Behaviour Change: A Systematic Scoping Review

PubMed Central

Shemilt, Ian; Hollands, Gareth J.; Marteau, Theresa M.; Nakamura, Ryota; Jebb, Susan A.; Kelly, Michael P.; Suhrcke, Marc; Ogilvie, David

2013-01-01

Background Unhealthy diet and low levels of physical activity are common behavioural factors in the aetiology of many non-communicable diseases. Recent years have witnessed an upsurge of policy and research interest in the use of taxes and other economic instruments to improve population health. Objective To assemble, configure and analyse empirical research studies available to inform the public health case for using economic instruments to promote dietary and physical activity behaviour change. Methods We conducted a systematic scoping review of evidence for the effects of specific interventions to change, or general exposure to variations in, prices or income on dietary and physical activity behaviours and corollary outcomes. Systematic electronic searches and parallel snowball searches retrieved >1 million study records. Text mining technologies were used to prioritise title-abstract records for screening. Eligible studies were selected, classified and analysed in terms of key characteristics and principal findings, using a narrative, configuring synthesis focused on implications for policy and further research. Results We identified 880 eligible studies, including 192 intervention studies and 768 studies that incorporated evidence for prices or income as correlates or determinants of target outcomes. Current evidence for the effects of economic instruments and exposures on diet and physical activity is limited in quality and equivocal in terms of its policy implications. Direct evidence for the effects of economic instruments is heavily skewed towards impacts on diet, with a relative lack of evidence for impacts on physical activity. Conclusions The evidence-based case for using economic instruments to promote dietary and physical activity behaviour change may be less compelling than some proponents have claimed. Future research should include measurement of people’s actual behavioural responses using study designs capable of generating reliable causal inferences regarding intervention effects. Policy implementation needs to be carefully aligned with evaluation planning and design. PMID:24086440

Factors related to reduction in the consumption of fast food: application of the theory-based approaches

PubMed Central

Zeinab, Jalambadani; Gholamreza, Garmaroudi; Mehdi, Yaseri; Mahmood, Tavousi; Korush, Jafarian

2017-01-01

Background The Trans-Theoretical model (TTM) and Theory of Planned Behaviour (TPB) may be promising models for understanding and predicting reduction in the consumption of fast food. The aim of this study was to examine the applicability of the Trans-Theoretical model (TTM) and the additional predictive role of the subjective norms and perceived behavioural control in predicting reduction consumption of fast food in obese Iranian adolescent girls. Materials and Methods. A cross sectional study design was conducted among twelve randomly selected schools in Sabzevar, Iran from 2015 to 2017. Four hundred eighty five randomly selected students consented to participate in the study. Hierarchical regression models used to predict the role of important variables that can influence the reduction in the consumption of fast food among students. using SPSS version 22. Results Variables Perceived behavioural control (r=0.58, P<0.001), Subjective norms (r=0.51, P<0.001), self-efficacy (r=0.49, P<0.001), decisional balance (pros) (r=0.29, P<0.001), decisional balance (cons) (r=0.25, P<0.001), stage of change (r=0.38, P<0.001), were significantly and positively correlated while experiential processes of change (r=0.08, P=0.135) and behavioural processes of change (r=0.09, P=0.145), were not significant. Conclusions The study demonstrated that the TTM (except the experiential and behavioural processes of change) focusing on the perceived behavioural control and subjective norms are useful models for reduction in the consumption of fast food. Significance for public health The Ministries of Education and Public Health should cooperate in supporting the below-mentioned formal and non-formal school, family and community nutritional education and activities. Lastly, the Ministry of Public Health should conduct programmes with restaurant owners on healthy Iranian food and its hygienic presentation and promotion, to enhance their ability to compete with fast-food restaurants. PMID:29071252

Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a qualitative process evaluation

PubMed Central

Finning, Katie; Moore, Lucy; Ekers, David; McMillan, Dean; Farrand, Paul A; O’Mahen, Heather A; Watkins, Edward R; Wright, Kim A; Fletcher, Emily; Rhodes, Shelley; Woodhouse, Rebecca; Wray, Faye

2017-01-01

Objective To explore participant views on acceptability, mechanisms of change and impact of behavioural activation (BA) delivered by junior mental health workers (MHWs) versus cognitive behavioural therapy (CBT) delivered by professional psychotherapists. Design Semistructured qualitative interviews analysed using a framework approach. Participants 36 participants with major depressive disorder purposively sampled from a randomised controlled trial of BA versus CBT (the COBRA trial). Setting Primary care psychological therapies services in Devon, Durham and Leeds, UK. Results Elements of therapy considered to be beneficial included its length and regularity, the opportunity to learn and not dwelling on the past. Homework was an important, although challenging aspect of treatment. Therapists were perceived as experts who played an important role in treatment. For some participants the most important element of therapy was having someone to talk to, but for others the specific factors associated with BA and CBT were crucial, with behavioural change considered important for participants in both treatments, and cognitive change unsurprisingly discussed more by those receiving CBT. Both therapies were considered to have a positive impact on symptoms of depression and other areas of life including feelings about themselves, self-care, work and relationships. Barriers to therapy included work, family life and emotional challenges. A subset (n=2) of BA participants commented that therapy felt too simple, and MHWs could be perceived as inexperienced. Many participants saw therapy as a learning experience, providing them with tools to take away, with work on relapse prevention essential. Conclusions Despite barriers for some participants, BA and CBT were perceived to have many benefits, to have brought about cognitive and behavioural change and to produce improvements in many domains of participants’ lives. To optimise the delivery of BA, inexperienced junior MHWs should be supported through good quality training and ongoing supervision. Trial registration number ISRCTN27473954, 09/12/2011 PMID:28408544

Changing micronutrient intake through (voluntary) behaviour change. The case of folate.

PubMed

Jensen, Birger B; Lähteenmäki, Liisa; Grunert, Klaus G; Brown, Kerry A; Timotijevic, Lada; Barnett, Julie; Shepherd, Richard; Raats, Monique M

2012-06-01

The objective of this study was to relate behaviour change mechanisms to nutritionally relevant behaviour and demonstrate how the different mechanisms can affect attempts to change these behaviours. Folate was used as an example to illuminate the possibilities and challenges in inducing behaviour change. The behaviours affecting folate intake were recognised and categorised. Behaviour change mechanisms from "rational model of man", behavioural economics, health psychology and social psychology were identified and aligned against folate-related behaviours. The folate example demonstrated the complexity of mechanisms influencing possible behavioural changes, even though this only targets the intake of a single micronutrient. When considering possible options to promote folate intake, the feasibility of producing the desired outcome should be related to the mechanisms of required changes in behaviour and the possible alternatives that require no or only minor changes in behaviour. Dissecting the theories provides new approaches to food-related behaviour that will aid the development of batteries of policy options when targeting nutritional problems. Copyright © 2012 Elsevier Ltd. All rights reserved.

Descriptive epidemiology of changes in weight and weight-related behaviours of Australian children aged 5 years: two population-based cross-sectional studies in 2010 and 2015

PubMed Central

Baur, Louise A; Garnett, Sarah P

2018-01-01

Objective Over the past 10–15 years there has been substantial investment in New South Wales (NSW), Australia, to reduce child obesity through interventions in children aged 0–5 years. We report changes in weight and weight-related behaviours of 5-year-old children. Design Cross-sectional surveys conducted in 2010 and 2015. Setting NSW schools (2010 n=44; 2015 n=41) Participants Australian children in kindergarten (2010 n=1141 and 2015 n=1150). Outcome measures Change in anthropometry and indicators of diet, screen time, school travel and awareness of health recommendations. Additionally, we examined 2015 differences in weight-related behaviours by sociodemographic characteristics. Results Prevalence of overweight/obesity was 2.1% lower (adjusted OR (AOR) 0.83, 95% CI 0.67 to 1.04) and abdominal obesity 1.7% higher (AOR 1.35, 95% CI 0.93 to 1.98) in 2015 than 2010. Significant improvements in multiple weight-related behaviours were observed among children in the highest tertile of junk food consumption (AOR 0.63, 95% CI 0.50 to 0.80), rewarded for good behaviour with sweets (AOR 0.59, 95% CI 0.47 to 0.74) and had a TV in their bedroom (AOR 0.65, 95% CI 0.43 to 0.96). In 2015, children from low socioeconomic neighbourhoods and non-English-speaking backgrounds were generally less likely to engage in healthy weight-related behaviours than children from high socioeconomic status neighbourhoods and from English-speaking backgrounds. Children in these demographic groups were less likely to eat breakfast daily, have high junk food intake and eat fast food regularly. Children from rural areas tended to have healthier weight-related behaviours than children from urban areas. Conclusions There were significant positive changes in 5-year-old children’s weight-related behaviours but children from low socioeconomic neighbourhoods and from non-English-speaking backgrounds were more likely to engage in unhealthy weight-related behaviours than children from high socioeconomic neighbourhoods and English-speaking backgrounds. The findings indicate that there is a need to enhance population-level efforts and ensure community programmes are targeted and tailored to meet different subpopulation needs. PMID:29627808

The contribution of lifestyle coaching of overweight patients in primary care to more autonomous motivation for physical activity and healthy dietary behaviour: results of a longitudinal study

PubMed Central

2014-01-01

Background Combined lifestyle interventions (CLIs) have been advocated as an effective instrument in efforts to reduce overweight and obesity. The odds of maintaining higher levels of physical activity (PA) and healthier dietary behaviour improve when people are more intrinsically motivated to change their behaviour. To promote the shift towards more autonomous types of motivation, facilitator led CLIs have been developed including lifestyle coaching as key element. The present study examined the shift in types of motivation to increase PA and healthy dieting among participants of a primary care CLI, and the contribution of lifestyle coaching to potential changes in motivational quality. Methods This prospective cohort study included participants of 29 general practices in the Netherlands that implemented a CLI named ‘BeweegKuur’. Questionnaires including items on demographics, lifestyle coaching and motivation were sent at baseline and after 4 months. Aspects of motivation were assessed with the Behavioural Regulation and Exercise Questionnaire (BREQ-2) and the Regulation of Eating Behaviour Questionnaire (REBS). We performed a drop out analysis to identify selective drop-out. Changes in motivation were analysed with t-tests and effect size interpretations (Cohen’s d), and multivariate regression analysis was used to identify predictors of motivational change. Results For physical activity, changes in motivational regulation were fully in line with the tenets of Self Determination Theory and Motivational Interviewing: participants made a shift towards a more autonomous type of motivation (i.e. controlled types of motivation decreased and autonomous types increased). Moreover, an autonomy supportive coaching style was generally found to predict a larger shift in autonomous types of motivation. For healthy dietary behaviour, however, except for a small decrease in external motivation, no favourable changes in different types of motivation were observed. The relation between coaching and motivation appeared to be influenced by the presence of physical activity guidance in the programme. Conclusions Motivation of participants of a real life primary care CLI had changed towards a more autonomous motivation after 4 months of intervention. Autonomy-supportive lifestyle coaching contributed to this change with respect to physical activity. Lifestyle coaching for healthy diet requires thorough knowledge about the problem of unhealthy dieting and solid coaching skills. PMID:25027848

Cognitive and Emotion Regulation Change Processes in Cognitive Behavioural Therapy for Social Anxiety Disorder.

PubMed

O'Toole, Mia S; Mennin, Douglas S; Hougaard, Esben; Zachariae, Robert; Rosenberg, Nicole K

2015-01-01

The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT. Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies. Copyright © 2014 John Wiley & Sons, Ltd.

The impact of two workplace-based health risk appraisal interventions on employee lifestyle parameters, mental health and work ability: results of a randomized controlled trial.

PubMed

Addley, K; Boyd, S; Kerr, R; McQuillan, P; Houdmont, J; McCrory, M

2014-04-01

Health risk appraisals (HRA) are a common type of workplace health promotion programme offered by American employers. In the United Kingdom, evidence of their effectiveness for promoting health behaviour change remains inconclusive. This randomized controlled trial examined the effects of two HRA interventions on lifestyle parameters, mental health and work ability in a UK context. A total of 180 employees were randomized into one of three groups: Group A (HRA augmented with health promotion and education activities), Group B (HRA only) and Group C (control, no intervention). After 12 months, changes in mean scoring in 10 lifestyle, mental health and work ability indices were compared, Groups A and B demonstrated non-significant improvements in 70% and 80%, respectively, compared with controls (40%). Odds ratios revealed that, compared with the control group, Group A was 29.2 (95% CI: 9.22-92.27) times more likely to report a perceived change in lifestyle behaviour; Group B 4.4 times (95% CI: 1.65-11.44). In conclusion, participation in the HRA was associated with a higher likelihood of perceived lifestyle behaviour change which was further increased in the augmented HRA group, thereby providing preliminary evidence that HRA and augmented HRA in particular may help UK employees make positive healthy lifestyle changes.

Behaviour Centred Design: towards an applied science of behaviour change.

PubMed

Aunger, Robert; Curtis, Valerie

2016-12-01

Behaviour change has become a hot topic. We describe a new approach, Behaviour Centred Design (BCD), which encompasses a theory of change, a suite of behavioural determinants and a programme design process. The theory of change is generic, assuming that successful interventions must create a cascade of effects via environments, through brains, to behaviour and hence to the desired impact, such as improved health. Changes in behaviour are viewed as the consequence of a reinforcement learning process involving the targeting of evolved motives and changes to behaviour settings, and are produced by three types of behavioural control mechanism (automatic, motivated and executive). The implications are that interventions must create surprise, revalue behaviour and disrupt performance in target behaviour settings. We then describe a sequence of five steps required to design an intervention to change specific behaviours: Assess, Build, Create, Deliver and Evaluate. The BCD approach has been shown to change hygiene, nutrition and exercise-related behaviours and has the advantages of being applicable to product, service or institutional design, as well as being able to incorporate future developments in behaviour science. We therefore argue that BCD can become the foundation for an applied science of behaviour change.

Behaviour Centred Design: towards an applied science of behaviour change

PubMed Central

Aunger, Robert; Curtis, Valerie

2016-01-01

ABSTRACT Behaviour change has become a hot topic. We describe a new approach, Behaviour Centred Design (BCD), which encompasses a theory of change, a suite of behavioural determinants and a programme design process. The theory of change is generic, assuming that successful interventions must create a cascade of effects via environments, through brains, to behaviour and hence to the desired impact, such as improved health. Changes in behaviour are viewed as the consequence of a reinforcement learning process involving the targeting of evolved motives and changes to behaviour settings, and are produced by three types of behavioural control mechanism (automatic, motivated and executive). The implications are that interventions must create surprise, revalue behaviour and disrupt performance in target behaviour settings. We then describe a sequence of five steps required to design an intervention to change specific behaviours: Assess, Build, Create, Deliver and Evaluate. The BCD approach has been shown to change hygiene, nutrition and exercise-related behaviours and has the advantages of being applicable to product, service or institutional design, as well as being able to incorporate future developments in behaviour science. We therefore argue that BCD can become the foundation for an applied science of behaviour change. PMID:27535821

Influence of Fines Content on Consolidation and Compressibility Characteristics of Granular Materials

NASA Astrophysics Data System (ADS)

Lipiński, Mirosław J.; Wdowska, Małgorzata K.; Jaroń, Łukasz

2017-10-01

Various behaviour of soil under loading results to large extent from kind of soil considered. There is a lot of literature concerning pure sand or plastic clays, while little is known about materials, which are from classification point of view, between those soils. These materials can be considered as cohesionless soils with various fines content. The paper present results of tests carried out in large consolidometer on three kinds of soil, containing 10, 36 and 97% of fines content. Consolidation, permeability and compressibility characteristics were determined. Analysis of the test results allowed to formulate conclusion concerning change in soil behaviour resulting from fines content.

Thinking styles and doctors' knowledge and behaviours relating to acute coronary syndromes guidelines

PubMed Central

Sladek, Ruth M; Bond, Malcolm J; Huynh, Luan T; Chew, Derek PB; Phillips, Paddy A

2008-01-01

Background How humans think and make decisions is important in understanding behaviour. Hence an understanding of cognitive processes among physicians may inform our understanding of behaviour in relation to evidence implementation strategies. A personality theory, Cognitive-Experiential Self Theory (CEST) proposes a relationship between different ways of thinking and behaviour, and articulates pathways for behaviour change. However prior to the empirical testing of interventions based on CEST, it is first necessary to demonstrate its suitability among a sample of healthcare workers. Objectives To investigate the relationship between thinking styles and the knowledge and clinical practices of doctors directly involved in the management of acute coronary syndromes. Methods Self-reported doctors' thinking styles (N = 74) were correlated with results from a survey investigating knowledge, attitudes, and clinical practice, and evaluated against recently published acute coronary syndrome clinical guidelines. Results Guideline-discordant practice was associated with an experiential style of thinking. Conversely, guideline-concordant practice was associated with a higher preference for a rational style of reasoning. Conclusion Findings support that while guidelines might be necessary to communicate evidence, other strategies may be necessary to target discordant behaviours. Further research designed to examine the relationships found in the current study is required. PMID:18439250

Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study

PubMed Central

2013-01-01

Introduction Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. Methods IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. Results HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother’s diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. Conclusion We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial. PMID:24373301

Using health psychology to help patients: theories of behaviour change.

PubMed

Barley, Elizabeth; Lawson, Victoria

2016-09-08

Behaviour change theories and related research evidence highlight the complexity of making and sticking to health-related behaviour changes. These theories make explicit factors that influence behaviour change, such as health beliefs, past behaviour, intention, social influences, perceived control and the context of the behaviour. Nurses can use this information to understand why a particular patient may find making recommended health behaviour changes difficult and to determine factors that may help them. This article outlines five well-established theories of behaviour change: the health belief model, the theory of planned behaviour, the stages of change model, self-determination theory, and temporal self-regulation theory. The evidence for interventions that are informed by these theories is then explored and appraised. The extent and quality of evidence varies depending on the type of behaviour and patients targeted, but evidence from randomised controlled trials indicates that interventions informed by theory can result in behaviour change.

Evidence, theory and context - using intervention mapping to develop a school-based intervention to prevent obesity in children

PubMed Central

2011-01-01

Background Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. Methods This paper describes the development of the Healthy Lifestyles Programme (HeLP), a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM). The intervention focuses on the following health behaviours, i) reduction of the consumption of sweetened fizzy drinks, ii) increase in the proportion of healthy snacks consumed and iii) reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Results Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives - establish motivation, take action and stay motivated - in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. Conclusion The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their eating and activity behaviours. Although the process was time consuming, this systematic approach ensures that the behaviour change techniques and delivery methods link directly to the Programme's performance objectives and their associated determinants. This in turn provides a clear framework for process analysis and increases the potential of the intervention to realise the desired outcome of preventing and reducing obesity in children. PMID:21752261

The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children’s Centres: results from a complex public health intervention

PubMed Central

Baird, Janis; Jarman, Megan; Lawrence, Wendy; Black, Christina; Davies, Jenny; Tinati, Tannaze; Begum, Rufia; Mortimore, Andrew; Robinson, Sian; Margetts, Barrie; Cooper, Cyrus; Barker, Mary; Inskip, Hazel

2014-01-01

Objectives The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds. Design Non-randomised controlled evaluation of a complex public health intervention. Participants 527 women attending Sure Start Children's Centres (SSCC) in Southampton (intervention) and 495 women attending SSCCs in Gosport and Havant (control). Intervention Training SSCC staff in behaviour change skills that would empower women to change their health behaviours. Outcomes Main outcomes dietary quality and physical activity. Intermediate outcomes self-efficacy and sense of control. Results 1-year post-training, intervention staff used skills to support behaviour change significantly more than control staff. There were statistically significant reductions of 0.1 SD in the dietary quality of all women between baseline and follow-up and reductions in self-efficacy and sense of control. The decline in self-efficacy and control was significantly smaller in women in the intervention group than in women in the control group (adjusted differences in self-efficacy and control, respectively, 0.26 (95% CI 0.001 to 0.50) and 0.35 (0.05 to 0.65)). A lower decline in control was associated with higher levels of exposure in women in the intervention group. There was a statistically significant improvement in physical activity in the intervention group, with 22.9% of women reporting the highest level of physical activity compared with 12.4% at baseline, and a smaller improvement in the control group. The difference in change in physical activity level between the groups was not statistically significant (adjusted difference 1.02 (0.74 to 1.41)). Conclusions While the intervention did not improve women's diets and physical activity levels, it had a protective effect on intermediate factors—control and self-efficacy—suggesting that a more prolonged exposure to the intervention might improve health behaviour. Further evaluation in a more controlled setting is justified. PMID:25031194

The educational potential of alcohol-related flushing among Chinese young people

PubMed Central

Shell, Duane F.; Huang, Zhaoqing; Qian, Ling

2015-01-01

Aim: This paper describes Chinese university students' understanding of the meaning of the alcohol-related flushing response and how they reacted to their own and someone else's flushing in a group drinking situation. Method: The researcher surveyed 530 Chinese university students about their understanding of flushing and their perception of how people respond to a person who visibly flushes while drinking alcohol. Findings: Most students did not know about the physiological cause of flushing. There were significant gender differences in both reactions to and perception of responses to a person who flushes. There was no direct relationship between flushing and drinking behaviour. Conclusions: This description of flushing behaviour and responses to a flushing person is discussed in terms of educational opportunities to change behaviours that could reduce the cancer related risks of this visibly at-risk group. PMID:25983401

Development of Interlocking Masonry Bricks and its’ Structural Behaviour: A Review Paper

NASA Astrophysics Data System (ADS)

Al-Fakih, Amin; Mohammed, Bashar S.; Nuruddin, Fadhil; Nikbakht, Ehsan

2018-04-01

Conventional bricks are the most elementary building materials for houses construction. However, the rapid growth in today’s construction industry has obliged the civil engineers in searching for a new building technique that may result in even greater economy, more efficient and durable as an alternative for the conventional brick. Moreover, the high demands for having a speedy and less labour and cost building systems is one of the factor that cause the changes of the masonry conventional systems. These changes have led to improved constructability, performance, and cost as well. Several interlocking bricks has been developed and implemented in building constructions and a number of researches had studied the manufacturing of interlocking brick and its structural behaviour as load bearing and non-load bearing element. This technical paper aims to review the development of interlocking brick and its structural behaviour. In conclusion, the concept of interlocking system has been widely used as a replacement of the conventional system where it has been utilized either as load bearing or non-load bearing masonry system.

A situational analysis of training for behaviour change counselling for primary care providers, South Africa

PubMed Central

Mash, Bob; Everett-Murphy, Katherine

2015-01-01

Abstract Background Non-communicable diseases and associated risk factors (smoking, alcohol abuse, physical inactivity and unhealthy diet) are a major contributor to primary care morbidity and the burden of disease. The need for healthcare-provider training in evidence-based lifestyle interventions has been acknowledged by the National Department of Health. However, local studies suggest that counselling on lifestyle modification from healthcare providers is inadequate and this may, in part, be attributable to a lack of training. Aim This study aimed to assess the current training courses for primary healthcare providers in the Western Cape. Setting Stellenbosch University and University of Cape Town. Methods Qualitative interviews were conducted with six key informants (trainers of primary care nurses and registrars in family medicine) and two focus groups (nine nurses and eight doctors) from both Stellenbosch University and the University of Cape Town. Results Trainers lack confidence in the effectiveness of behaviour change counselling and in current approaches to training. Current training is limited by time constraints and is not integrated throughout the curriculum – there is a focus on theory rather than modelling and practice, as well as a lack of both formative and summative assessment. Implementation of training is limited by a lack of patient education materials, poor continuity of care and record keeping, conflicting lifestyle messages and an unsupportive organisational culture. Conclusion Revising the approach to current training is necessary in order to improve primary care providers’ behaviour change counselling skills. Primary care facilities need to create a more conducive environment that is supportive of behaviour change counselling. PMID:26245589

A systematic review of educational interventions to change behaviour of prescribers in hospital settings, with a particular emphasis on new prescribers

PubMed Central

Brennan, Nicola; Mattick, Karen

2013-01-01

Aims Prescribing is a complex task and a high risk area of clinical practice. Poor prescribing occurs across staff grades and settings but new prescribers are attributed much of the blame. New prescribers may not be confident or even competent to prescribe and probably have different support and development needs than their more experienced colleagues. Unfortunately, little is known about what interventions are effective in this group. Previous systematic reviews have not distinguished between different grades of staff, have been narrow in scope and are now out of date. Therefore, to inform the design of educational interventions to change prescribing behaviour, particularly that of new prescibers, we conducted a systematic review of existing hospital-based interventions. Methods Embase, Medline, SIGLE, Cinahl and PsychINFO were searched for relevant studies published 1994–2010. Studies describing interventions to change the behaviour of prescribers in hospital settings were included, with an emphasis on new prescibers. The bibliographies of included papers were also searched for relevant studies. Interventions and effectiveness were classified using existing frameworks and the quality of studies was assessed using a validated instrument. Results Sixty-four studies were included in the review. Only 13% of interventions specifically targeted new prescribers. Most interventions (72%) were deemed effective in changing behaviour but no particular type stood out as most effective. Conclusion Very few studies have tailored educational interventions to meet needs of new prescribers, or distinguished between new and experienced prescribers. Educational development and research will be required to improve this important aspect of early clinical practice. PMID:22831632

Post-intervention effects on screen behaviours and mediating effect of parental regulation: the HEalth In Adolescents study – a multi-component school-based randomized controlled trial

PubMed Central

2014-01-01

Background To improve effectiveness of future screen behaviour interventions, one needs to know whether an intervention works via the proposed mediating mechanisms and whether the intervention is equally effective among subgroups. Parental regulation is identified as a consistent correlate of screen behaviours, but prospective evidence as well as the mediation role of parental regulation is largely lacking. This study investigated post-intervention main effects on screen behaviours in the HEIA-intervention – a Norwegian school-based multiple-behaviour study, as well as mediation effects of parental regulation by adolescents’ and parents’ report. In addition, moderating effects of gender and weight status on the intervention and mediating effects were explored. Methods Participating schools were randomized to control (n = 25) or intervention (n = 12) condition. Adolescents (n = 908 Control; 510 Intervention) self-reported their weekday and weekend TV-viewing and computer/game-use. Change in adolescents’ behaviours was targeted through school and parents. Adolescents, mothers (n = 591 Control; 244 Interventions) and fathers (n = 469 Control; 199 Intervention) reported parental regulation of the screen behaviours post-intervention (at 20 month). The product-of-coefficient test using linear regression analysis was conducted to examine main and mediating effects. Results There was no intervention effect on the screen behaviours in the total sample. Gender moderated effect on weekend computer/game-use, while weight status moderated the effect on weekday TV-viewing and computer/game-use. Stratified analyses showed a small favourable intervention effect on weekday TV-viewing among the normal weight. Parental regulation did not mediate change in the screen behaviours. However, stronger parental regulation was associated with less TV-viewing and computer/game-use with effects being conditional on adolescents’ versus parental reports. Parental regulation of the screen behaviours, primarily by the parental report, was associated with change in the respective behaviours. Conclusion Multiple behaviour intervention may not affect all equally well, and the effect may differ by weight status and gender. In future interventions parents should be encouraged to regulate their adolescents’ TV-viewing and computer/game-use on both weekdays and weekends as parental regulation was identified as a determinant of these screen behaviours. However, future intervention studies may need to search for more effective intervention strategies targeting parental regulation. Trial registration Current Controlled Trials ISRCTN98552879 PMID:24568125

Tools assessing nurse manager behaviours and RN job satisfaction: a review of the literature.

PubMed

Feather, Rebecca

2015-09-01

To determine the state of the science in relation to registered nurse (RN) perceptions of nurse manager behaviours that influence registered nurse job satisfaction. Nurse managers have been related by research to the job satisfaction of their staff. However, little is known about how nurses perceive the behaviours of nurse managers as influencing their job satisfaction. A literature search was conducted to identify journal articles that included studies involving instruments of nurse manager behaviours and staff nurse job satisfaction levels. The literature shows a lack of consistency in the definitions of job satisfaction, instrumentation for measurement and conclusions that identify specific management behaviours effective for high levels of job satisfaction of RNs related to staff nurse perceptions. Studies include important aspects of what shapes a healthy work environment for nurses, but no single study identified specific nurse manager behaviours based solely on the perceptions of staff nurses and their job satisfaction. The perceptions of staff nurses are important for hospital administrators and nurse managers in order to know how to improve satisfaction and reduce turnover. Instruments developed based on manager beliefs may not provide data needed to influence a change in management behaviours that results in improved job satisfaction. © 2014 John Wiley & Sons Ltd.

Determinants of Three-Year Change in Children’s Objectively Measured Sedentary Time

PubMed Central

Foley, Louise; Corder, Kirsten; Ekelund, Ulf; van Sluijs, Esther M. F.

2016-01-01

Background Sedentary behaviours (SB) are highly prevalent in young people and may be adversely associated with physical and mental health. Understanding of the modifiable determinants of SB is necessary to inform the design of behaviour change interventions but much of the existing research is cross-sectional and focussed upon screen-based behaviours. Purpose To examine the social, psychological and environmental determinants of change in children’s objectively measured sedentary time from age 11 to 14 years. Methods Data are from the second (2008) and third (2011) waves of assessment in the Sport, Physical Activity, and Eating Behaviour: Environmental Determinants in Young People (SPEEDY) study, conducted in the county of Norfolk, United Kingdom. Longitudinal data on accelerometer assessed sedentary time were available for 316 (53.5% female, 11.2±0.3 years at baseline) and 264 children after-school and at the weekend respectively. Information on 14 candidate determinants, including school travel mode and electronic media ownership, was self-reported. Change in the proportion of registered time spent sedentary was used as the outcome variable in cross-classified linear regression models, adjusted for age, sex, body mass index and baseline sedentary time. Simple and multiple models were run and interactions with sex explored. Results Daily sedentary time increased by 30–40 minutes after-school and at the weekend from baseline to follow-up. Participants who travelled to school by cycle exhibited smaller increases in after-school sedentary time (beta; 95%CI for change in % time spent sedentary: -3.3;-6.7,-0.07). No significant determinants of change in weekend sedentary time were identified. Conclusions Time spent sedentary increased during the three-year duration of follow-up but few of the variables examined were significantly associated with changes in sedentary time. Children’s mode of school travel may influence changes in their sedentary time over this period and should be examined further, alongside broader efforts to identify modifiable determinants of SB during childhood. PMID:27942036

Low pasture allowance until late gestation in ewes: behavioural and physiological changes in ewes and lambs from lambing to weaning.

PubMed

Freitas-de-Melo, A; Ungerfeld, R; Hötzel, M J; Orihuela, A; Pérez-Clariget, R

2017-02-01

Low pasture allowance during gestation affects ewes' BW at parturition, the bond with their lamb, lamb development, and thus also may affect their responses to weaning. The objectives were to determine if native pasture allowance from before conception until late pregnancy affects ewe-lamb behaviours at lambing, ewes' milk yield, lambs' BW, and the behavioural and physiological changes of ewes and lambs at weaning. From 23 days before conception until 122 days of pregnancy, 24 ewes grazed on two different native pasture allowances: high (10 to 12 kg of dry matter (DM)/100 kg of BW per day; HPA treatment; n=12) or low (5 to 8 kg of DM/100 kg of BW per day; LPA treatment; n=12). Thereafter, all ewes grazed on Festuca arundinacea and received rice bran and crude glycerine. Ewes' body condition score (BCS) and BW were recorded during pregnancy and postpartum periods. Milk yield was determined on days 32, 41 and 54 after lambing. Lambs' BW was recorded from birth until 72 days after lambing. Latency from parturition until the ewe licked her lamb, maternal behaviour score (a test that evaluates maternal attachment to the lamb) and latency for lamb to stand up and suckle were determined. The behaviour of the lambs and ewes was recorded before and after weaning (at 65 days). The ewes' serum total protein, albumin and globulin concentrations were measured before and after weaning. The HPA ewes presented greater BW (P<0.005) and BCS (P<0.005) than the LPA ewes during pregnancy and postpartum (P<0.04), and had a greater milk yield than the LPA ewes (P<0.03). Treatments did not influence any behaviour at lambing, lambs' BW, neither the ewes' behavioural and physiological changes at weaning. HPA lambs paced and vocalized more than LPA lambs (P<0.0001). The variation of albumin concentration before and after weaning was greater in the HPA lambs than in the LPA lambs (P<0.0001). In conclusion, although ewes' BW, BCS and milk production were affected by pasture allowance until late pregnancy, this did not affect the behaviours that lead to the establishment of the mother-young bond, nor the ewes' behavioural responses at weaning. Lambs reared by ewes that grazed on low pasture allowance during pregnancy presented fewer behavioural changes and a lower decrease of albumin concentration after weaning. Lambs' BW was not affected by the feeding received by their mothers.

Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review.

PubMed

Hallward, Laura; Patel, Nisha; Duncan, Lindsay R

2018-02-01

Physical activity interventions can improve prostate cancer survivors' health. Determining the behaviour change techniques used in physical activity interventions can help elucidate the mechanisms by which an intervention successfully changes behaviour. The purpose of this systematic review was to identify and evaluate behaviour change techniques in physical activity interventions for prostate cancer survivors. A total of 7 databases were searched and 15 studies were retained. The studies included a mean 6.87 behaviour change techniques (range = 3-10), and similar behaviour change techniques were implemented in all studies. Consideration of how behaviour change techniques are implemented may help identify how behaviour change techniques enhance physical activity interventions for prostate cancer survivors.

Dietary magnesium deficiency alters gut microbiota and leads to depressive-like behaviour.

PubMed

Winther, Gudrun; Pyndt Jørgensen, Betina M; Elfving, Betina; Nielsen, Denis Sandris; Kihl, Pernille; Lund, Sten; Sørensen, Dorte Bratbo; Wegener, Gregers

2015-06-01

Gut microbiota (GM) has previously been associated with alterations in rodent behaviour, and since the GM is affected by the diet, the composition of the diet may be an important factor contributing to behavioural changes. Interestingly, a magnesium restricted diet has been shown to induce anxiety and depressive-like behaviour in humans and rodents, and it could be suggested that magnesium deficiency may mediate the effects through an altered GM. The present study therefore fed C57BL/6 mice with a standard diet or a magnesium deficient diet (MgD) for 6 weeks, followed by behavioural testing in the forced swim test (FST) to evaluate depressive-like behaviour. An intraperitoneal glucose tolerance test (GTT) was performed 2 day after the FST to assess metabolic alterations. Neuroinflammatory markers were analysed from hippocampus. GM composition was analysed and correlated to the behaviour and hippocampal markers. It was found that mice exposed to MgD for 6 weeks were more immobile than control mice in the FST, suggesting an increased depressive-like behaviour. No significant difference was detected in the GTT. GM composition correlated positively with the behaviour of undisturbed C57BL/6 mice, feeding MgD diet altered the microbial composition. The altered GM correlated positively to the hippocampal interleukin-6. In conclusion, we hypothesise that imbalances of the microbiota-gut-brain axis induced by consuming a MgD diet, contributes to the development of depressive-like behaviour.

Exposure to a maternal cafeteria diet changes open-field behaviour in the developing offspring.

PubMed

Speight, Abigail; Davey, William G; McKenna, Emily; Voigt, Jörg-Peter W

2017-04-01

The early postnatal period is a sensitive period in rodents as behavioural systems are developing and maturing during this time. However, little is currently known about the behavioural effects of feeding a hyper-energetic cafeteria diet (CD) during the lactational period when offspring behaviour is tested during early adolescence. To this end, 23days old offspring from dams (Wistar) fed on CD during lactation were tested in either the open-field or the elevated plus-maze for exploration and anxiety-related behaviour. On postnatal day 9, maternal behaviour and non-maternal behaviour of the dam was assessed. It was hypothesized that lactational CD feeding would reduce anxiety in the offspring. CD-fed dams had a higher energy intake, due to an overconsumption of sugars and fats. When offspring from these dams were exposed to the open field after weaning, their locomotor activity was increased. They entered the more aversive inner zone of the open-field after a shorter latency, made more entries into and spent more time in the inner zone. Anxiety-related behaviour was not affected upon exposure to the elevated plus maze, suggesting anxiolysis in the open-field only. Increased maternal licking/grooming behaviour could possibly contribute to the anxiolytic phenotype as observed in the offspring from the CD group. In conclusion, we demonstrate that lactational overfeeding impacts on the development of behaviour in the early adolescent rat. Copyright © 2016 ISDN. Published by Elsevier Ltd. All rights reserved.

Behavioural phenotypes over the lifetime of a holometabolous insect

PubMed Central

2015-01-01

Introduction: Behavioural traits can differ considerably between individuals, and such differences were found to be consistent over the lifetime of an organism in several species. Whether behavioural traits of holometabolous insects, which undergo a metamorphosis, are consistent across ontogeny is virtually unexplored. We investigated several behavioural parameters at five different time points in the lifetime of the holometabolous mustard leaf beetle Phaedon cochleariae (Coleoptera: Chrysomelidae), two times in the larval (second and third larval stage) and three times in the adult stage. We investigated 1) the stability of the behavioural phenotype (population level), 2) whether individuals rank consistently across behavioural traits and over their lifetime (individual level), and 3) in how far behavioural traits are correlated with the developmental time of the individuals. Results: We identified two behavioural dimensions in every life stage of P. cochleariae, activity and boldness (population level). Larvae and young adults ranked consistently across the investigated behavioural traits, whereas consistency over time was only found in adults but not between larvae and adults (individual level). Compared to adult beetles, larvae were less active. Moreover, younger larvae were bolder than all subsequent life stages. Over the adult lifetime of the beetles, males were less active than females. Furthermore, the activity of second instar larvae was significantly negatively correlated with the development time. Conclusions: Our study highlights that, although there is no individual consistency over the larval and the adult life stage, the behavioural clustering shows similar patterns at all tested life stages of a holometabolous insect. Nevertheless, age- and sex-specific differences in behavioural traits occur which may be explained by different challenges an individual faces at each life stage. These differences are presumably related to the tremendous changes in life-history traits from larvae to adults and/or to a niche shift after metamorphosis as well as to different needs of both sexes, respectively. A faster development of more active compared to less active second instar larvae is in line with the pace-of-life syndrome. Overall, this study demonstrates a pronounced individuality in behavioural phenotypes and presumably adaptive changes related to life stage and sex. PMID:26816525

What interventions are used to improve exercise adherence in older people and what behavioural techniques are they based on? A systematic review

PubMed Central

Hannink, Erin; Dawes, Helen; Barker, Karen

2017-01-01

Objectives To conduct a systematic review of interventions used to improve exercise adherence in older people, to assess the effectiveness of these interventions and to evaluate the behavioural change techniques underpinning them using the Behaviour Change Technique Taxonomy (BCTT). Design Systematic review. Methods A search was conducted on AMED, BNI, CINAHL, EMBASE, MEDLINE and PsychINFO databases. Randomised controlled trials that used an intervention to aid exercise adherence and an exercise adherence outcome for older people were included. Data were extracted with the use of a preprepared standardised form. Risk of bias was assessed with the Cochrane Collaboration’s tool for assessing risk of bias. Interventions were classified according to the BCTT. Results Eleven studies were included in the review. Risk of bias was moderate to high. Interventions were classified into the following categories: comparison of behaviour, feedback and monitoring, social support, natural consequences, identity and goals and planning. Four studies reported a positive adherence outcome following their intervention. Three of these interventions were categorised in the feedback and monitoring category. Four studies used behavioural approaches within their study. These were social learning theory, socioemotional selectivity theory, cognitive behavioural therapy and self-efficacy. Seven studies did not report a behavioural approach. Conclusions Interventions in the feedback and monitoring category showed positive outcomes, although there is insufficient evidence to recommend their use currently. There is need for better reporting, use and the development of theoretically derived interventions in the field of exercise adherence for older people. Robust measures of adherence, in order to adequately test these interventions would also be of use. PROSPERO registration number CRD42015020884. PMID:29247111

Developing the content of two behavioural interventions: Using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #1

PubMed Central

Hrisos, Susan; Eccles, Martin; Johnston, Marie; Francis, Jill; Kaner, Eileen FS; Steen, Nick; Grimshaw, Jeremy

2008-01-01

Background Evidence shows that antibiotics have limited effectiveness in the management of upper respiratory tract infection (URTI) yet GPs continue to prescribe antibiotics. Implementation research does not currently provide a strong evidence base to guide the choice of interventions to promote the uptake of such evidence-based practice by health professionals. While systematic reviews demonstrate that interventions to change clinical practice can be effective, heterogeneity between studies hinders generalisation to routine practice. Psychological models of behaviour change that have been used successfully to predict variation in behaviour in the general population can also predict the clinical behaviour of healthcare professionals. The purpose of this study was to design two theoretically-based interventions to promote the management of upper respiratory tract infection (URTI) without prescribing antibiotics. Method Interventions were developed using a systematic, empirically informed approach in which we: selected theoretical frameworks; identified modifiable behavioural antecedents that predicted GPs intended and actual management of URTI; mapped these target antecedents on to evidence-based behaviour change techniques; and operationalised intervention components in a format suitable for delivery by postal questionnaire. Results We identified two psychological constructs that predicted GP management of URTI: "Self-efficacy," representing belief in one's capabilities, and "Anticipated consequences," representing beliefs about the consequences of one's actions. Behavioural techniques known to be effective in changing these beliefs were used in the design of two paper-based, interactive interventions. Intervention 1 targeted self-efficacy and required GPs to consider progressively more difficult situations in a "graded task" and to develop an "action plan" of what to do when next presented with one of these situations. Intervention 2 targeted anticipated consequences and required GPs to respond to a "persuasive communication" containing a series of pictures representing the consequences of managing URTI with and without antibiotics. Conclusion It is feasible to systematically develop theoretically-based interventions to change professional practice. Two interventions were designed that differentially target generalisable constructs predictive of GP management of URTI. Our detailed and scientific rationale for the choice and design of our interventions will provide a basis for understanding any effects identified in their evaluation. Trial registration Clinicaltrials.gov NCT00376142 PMID:18194527

Discussing patient's lifestyle choices in the consulting room: analysis of GP-patient consultations between 1975 and 2008

PubMed Central

2010-01-01

Background The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room. This study aims to examine whether or not healthy and unhealthy lifestyle choices of patients are currently being discussed more often in primary care consultations than in former decades. Furthermore, we are interested in GPs' approach to lifestyle behaviour during consultations. Lastly, we examine whether lifestyle behaviour is discussed more with certain patients during consultations, depending on gender, age and educational background. Method We analysed video-recordings of medical consultations, collected between 1975 and 2008 in Dutch GP practices. Data were analysed using logistic regression. Results This study shows that discussion of smoking behaviour and physical activity has increased somewhat over time. A change in discussion of nutrition and alcohol is, however, less clear. Overall, alcohol use is the least discussed and physical activity the most discussed during consultations. GPs mainly refer to lifestyle when it is relevant to the patient's complaints (symptom approach). GPs' approach to lifestyle behaviour did not change over time. In general, lifestyle behaviour is discussed more with older, male patients (except for nutrition). GPs talk about lifestyle behaviour with patients from different educational backgrounds equally (except for physical activity). Conclusion In recent years there is greater awareness of a healthy lifestyle, which is reflected to a limited extent in this study. Still, lifestyle behaviour is discussed in only a minority of consultations. GPs do not refer to lifestyle behaviour as a routine procedure, i.e. do not include it in primary prevention. This highlights the importance of the introduction of prevention consultations, where GPs can discuss lifestyle issues with patients who do not (yet) have risk symptoms. PMID:21062427

Relationships between the intention to use guidelines, behaviour of insurance physicians and their determinants

PubMed Central

2013-01-01

Background We studied the intention of a group of insurance physicians to use the guidelines for depression, and their behaviour in disability assessments. We considered attitude, social norm and self-efficacy, knowledge/skills and stimuli, based on the Attitude - Social norm - self-Efficacy model (ASE model) as possible determinants of both intention and behaviour. The aim of this study was to understand the determinants of insurance physicians’ behaviour when they are expected to use guidelines in daily practice. Method A representative sample of 42 insurance physicians participated in this study. Cross-sectional data were collected by means of a questionnaire based on the ASE model. We developed the questionnaire on the basis of literature and ascertained the content validity of it. Behaviour was made to comprise both “use of the guidelines” and “change in disability assessment behaviour” by the insurance physicians. Reliability analyses were performed to form additive scales of the ASE constructs. These scales were analysed with structural equations modelling (LISREL), by modifying a start model into a final model with a good fit, within theoretical constraints. In these analyses special attention was paid to the fact that the sample size was small. Results The most important determinants of the intention and the self-reported use of the guidelines, were: the influence of colleagues, the self-efficacy of the insurance physicians in their use of the guidelines, and the way the guidelines were implemented. The intention to use the guidelines for depression was not associated with the self-reported use of these guidelines, but there proved to be a faint, positive association with the self-reported change in assessment behaviour. Conclusions Almost all the insurance physicians in this study intended to use at least elements of the guidelines. Their intention, self reported use of the guidelines and self-reported change in assessment behaviour were explored with help of the ASE model. The model suggested relationships between intention, self reported use of the guidelines and self-reported change in assessment behaviour on the on the one hand and various determinants on the other hand. Be that as it may, we see opportunities to improve insurance physicians’ guideline adherence by offering them a multifaceted training in which they learn to apply the guidelines for depression. PMID:24103198

The effectiveness of strategies such as health warning labels to reduce alcohol-related harms - an Australian perspective.

PubMed

Stockley, C S.

2001-07-01

The efficacy of health warning labels for products such as alcoholic beverages continue to be debated internationally and now in Australia as a means of mitigating the misuse of alcohol within community groups. This paper discusses evidence emanating primarily from the USA that has adopted a health warning label for both alcohol and tobacco, and from Australia that has adopted a health warning label for tobacco, on the effectiveness of such a strategy in changing consumer behaviour. The conclusion drawn is that such labelling is generally ineffective in changing consumer behaviour and hence such a strategy is inappropriate for reducing alcohol-related harms. The paper also discusses briefly what advertising and messages influence consumers, positively and negatively, and what specific strategies have been shown to better educate consumers and change their consumption from excessive to light to moderate as defined by the (Australian) National Health and Medical Research Council, which is the present premise of harm minimisation in Australia.

Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review.

PubMed

Larkin, Louise; Gallagher, Stephen; Cramp, Fiona; Brand, Charles; Fraser, Alexander; Kennedy, Norelee

2015-10-01

Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.

Effectiveness of interventions to reduce ordering of thyroid function tests: a systematic review

PubMed Central

Abbott, Rebecca; Rogers, Morwenna; Fleming, Simon; Patterson, Anthea; Hamilton, William Trevor; Heaton, Janet; Vaidya, Bijay; Hyde, Christopher

2016-01-01

Objectives To evaluate the effectiveness of behaviour changing interventions targeting ordering of thyroid function tests. Design Systematic review. Data sources MEDLINE, EMBASE and the Cochrane Database up to May 2015. Eligibility criteria for selecting studies We included studies evaluating the effectiveness of behaviour change interventions aiming to reduce ordering of thyroid function tests. Randomised controlled trials (RCTs), non-randomised controlled studies and before and after studies were included. There were no language restrictions. Study appraisal and synthesis methods 2 reviewers independently screened all records identified by the electronic searches and reviewed the full text of any deemed potentially relevant. Study details were extracted from the included papers and their methodological quality assessed independently using a validated tool. Disagreements were resolved through discussion and arbitration by a third reviewer. Meta-analysis was not used. Results 27 studies (28 papers) were included. They evaluated a range of interventions including guidelines/protocols, changes to funding policy, education, decision aids, reminders and audit/feedback; often intervention types were combined. The most common outcome measured was the rate of test ordering, but the effect on appropriateness, test ordering patterns and cost were also measured. 4 studies were RCTs. The majority of the studies were of poor or moderate methodological quality. The interventions were variable and poorly reported. Only 4 studies reported unsuccessful interventions but there was no clear pattern to link effect and intervention type or other characteristics. Conclusions The results suggest that behaviour change interventions are effective particularly in reducing the volume of thyroid function tests. However, due to the poor methodological quality and reporting of the studies, the likely presence of publication bias and the questionable relevance of some interventions to current day practice, we are unable to draw strong conclusions or recommend the implementation of specific intervention types. Further research is thus justified. Trial registration number CRD42014006192. PMID:27259523

The usefulness of GPS bicycle tracking data for evaluating the impact of infrastructure change on cycling behaviour.

PubMed

Heesch, Kristiann C; Langdon, Michael

2016-02-01

Issue addressed A key strategy to increase active travel is the construction of bicycle infrastructure. Tools to evaluate this strategy are limited. This study assessed the usefulness of a smartphone GPS tracking system for evaluating the impact of this strategy on cycling behaviour. Methods Cycling usage data were collected from Queenslanders who used a GPS tracking app on their smartphone from 2013-2014. 'Heat' and volume maps of the data were reviewed, and GPS bicycle counts were compared with surveillance data and bicycle counts from automatic traffic-monitoring devices. Results Heat maps broadly indicated that changes in cycling occurred near infrastructure improvements. Volume maps provided changes in counts of cyclists due to these improvements although errors were noted in geographic information system (GIS) geo-coding of some GPS data. Large variations were evident in the number of cyclists using the app in different locations. These variations limited the usefulness of GPS data for assessing differences in cycling across locations. Conclusion Smartphone GPS data are useful in evaluating the impact of improved bicycle infrastructure in one location. Using GPS data to evaluate differential changes in cycling across multiple locations is problematic when there is insufficient traffic-monitoring devices available to triangulate GPS data with bicycle traffic count data. So what? The use of smartphone GPS data with other data sources is recommended for assessing how infrastructure improvements influence cycling behaviour.

Using Action Research and Peer Perspectives to Develop Technology That Facilitates Behavioral Change and Self-Management in COPD

PubMed Central

McCabe, Catherine; Dinsmore, John; Brady, Anne Marie; Mckee, Gabrielle; O'Donnell, Sharon; Prendergast, David

2014-01-01

Background. Behavioural change and self-management in patients with chronic illness may help to control symptoms, avoid rehospitalization, enhance quality of life, and decrease mortality and morbidity. Objective. Guided by action research principles and using mixed methods, the aim of this project was to develop peer based educational, motivational, and health-promoting peer based videos, using behavioural change principles, to support self-management in patients with COPD. Methods. Individuals (n = 32) living with COPD at home and involved in two community based COPD support groups were invited to participate in this project. Focus group/individual interviews and a demographic questionnaire were used to collect data. Results. Analysis revealed 6 categories relevant to behavioural change which included self-management, support, symptoms, knowledge, rehabilitation, and technology. Participants commented that content needed to be specific, and videos needed to be shorter, to be tailored to severity of condition, to demonstrate “normal” activities, to be positive, and to ensure that content is culturally relevant. Conclusions. This study demonstrated that detailed analysis of patient perspectives and needs for self-management is essential and should underpin the development of any framework, materials, and technology. The action research design principles provided an effective framework for eliciting the data and applying it to technology and testing its relevance to the user. PMID:24959177

Behavioural Responses to Thermal Conditions Affect Seasonal Mass Change in a Heat-Sensitive Northern Ungulate

PubMed Central

van Beest, Floris M.; Milner, Jos M.

2013-01-01

Background Empirical tests that link temperature-mediated changes in behaviour (activity and resource selection) to individual fitness or condition are currently lacking for endotherms yet may be critical to understanding the effect of climate change on population dynamics. Moose (Alces alces) are thought to suffer from heat stress in all seasons so provide a good biological model to test whether exposure to non-optimal ambient temperatures influence seasonal changes in body mass. Seasonal mass change is an important fitness correlate of large herbivores and affects reproductive success of female moose. Methodology/Principal Findings Using GPS-collared adult female moose from two populations in southern Norway we quantified individual differences in seasonal activity budget and resource selection patterns as a function of seasonal temperatures thought to induce heat stress in moose. Individual body mass was recorded in early and late winter, and autumn to calculate seasonal mass changes (n = 52 over winter, n = 47 over summer). We found large individual differences in temperature-dependent resource selection patterns as well as within and between season variability in thermoregulatory strategies. As expected, individuals using an optimal strategy, selecting young successional forest (foraging habitat) at low ambient temperatures and mature coniferous forest (thermal shelter) during thermally stressful conditions, lost less mass in winter and gained more mass in summer. Conclusions/Significance This study provides evidence that behavioural responses to temperature have important consequences for seasonal mass change in moose living in the south of their distribution in Norway, and may be a contributing factor to recently observed declines in moose demographic performance. Although the mechanisms that underlie the observed temperature mediated habitat-fitness relationship remain to be tested, physiological state and individual variation in thermal tolerance are likely contributory factors. Climate-related effects on animal behaviour, and subsequently fitness, are expected to intensify as global warming continues. PMID:23776584

Patients' and practitioners' views on health behaviour change: a qualitative study.

PubMed

Elwell, Laura; Povey, Rachel; Grogan, Sarah; Allen, Candia; Prestwich, Andrew

2013-01-01

This study was designed to examine patients' and health professionals' perspectives on lifestyle behaviour change and to inform the development of a lifestyle behaviour change intervention to be used in primary care. Focus groups were conducted with seven patients and 13 health professionals where they were asked to discuss lifestyle behaviour change in relation to the design and development phase of a tailored lifestyle behaviour change intervention package. An inductive thematic analysis of transcripts suggested a range of issues that are relevant to the development and implementation of lifestyle change interventions such as time, lack of resources and starting interventions too late, as well as personal circumstances and the continuous effort that behaviour change requires. They were interpreted as two superordinate themes of 'internal and external influences on behaviour change' and 'behaviour change initiation and maintenance'. The results are discussed in relation to the implications they may have for researchers and health service commissioners designing interventions and practitioners implementing lifestyle change interventions in primary care. Many factors are involved in patients' and health care professionals' understanding of interventions and lifestyle behaviour change. These should be taken into consideration when designing interventions based on behaviour change theories.

Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials

PubMed Central

Nyman, Samuel R.; Goodwin, Kelly; Kwasnicka, Dominika; Callaway, Andrew

2016-01-01

Objective: Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals. Design: Eight adults aged 60–87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions. Main outcome measures: Walking was objectively measured using pedometers. Results: Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time. Conclusion: We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people’s physical activity. PMID:26387689

Neonatal finasteride administration alters hippocampal α4 and δ GABAAR subunits expression and behavioural responses to progesterone in adult rats.

PubMed

Modol, Laura; Casas, Caty; Navarro, Xavier; Llidó, Anna; Vallée, Monique; Pallarès, Marc; Darbra, Sònia

2014-02-01

Allopregnanolone is a neurosteroid that has been reported to fluctuate during early developmental stages. Previous experiments reported the importance of neonatal endogenous allopregnanolone levels for the maturation of the central nervous system and particularly for the hippocampus. Changes in neonatal allopregnanolone levels have been related to altered adult behaviour and with psychopathological susceptibility, including anxiety disorders, schizophrenia and drug abuse. However, the mechanism underlying these changes remains to be elucidated. In the present study we assessed changes in hippocampal expression of α4 and δ GABAA receptor (GABAAR) subunits as a consequence of neonatal finasteride (a 5-α reductase inhibitor) administration during early development (PD6 to PD15) in male rats. We observed that the treatment altered the temporal window of the natural peak in the expression of these subunits during development. Additionally, the level of these subunits were higher than in non-handled and control animals in the adult hippocampus. We observed that in adulthood, neonatal finasteride-treated animals presented an anxiogenic-like profile in response to progesterone administration which was absent in the rest of the groups. In conclusion, these results corroborate the relevance of neonatal maintenance of neurosteroid levels for behavioural anxiety responses in the adult, and point to some of the mechanisms involved in this alterations.

Theory of planned behaviour variables and objective walking behaviour do not show seasonal variation in a randomised controlled trial

PubMed Central

2014-01-01

Background Longitudinal studies have shown that objectively measured walking behaviour is subject to seasonal variation, with people walking more in summer compared to winter. Seasonality therefore may have the potential to bias the results of randomised controlled trials if there are not adequate statistical or design controls. Despite this there are no studies that assess the impact of seasonality on walking behaviour in a randomised controlled trial, to quantify the extent of such bias. Further there have been no studies assessing how season impacts on the psychological predictors of walking behaviour to date. The aim of the present study was to assess seasonal differences in a) objective walking behaviour and b) Theory of Planned Behaviour (TPB) variables during a randomised controlled trial of an intervention to promote walking. Methods 315 patients were recruited to a two-arm cluster randomised controlled trial of an intervention to promote walking in primary care. A series of repeated measures ANCOVAs were conducted to examine the effect of season on pedometer measures of walking behaviour and TPB measures, assessed immediately post-intervention and six months later. Hierarchical regression analyses were conducted to assess whether season moderated the prediction of intention and behaviour by TPB measures. Results There were no significant differences in time spent walking in spring/summer compared to autumn/winter. There was no significant seasonal variation in most TPB variables, although the belief that there will be good weather was significantly higher in spring/summer (F = 19.46, p < .001). Season did not significantly predict intention or objective walking behaviour, or moderate the effects of TPB variables on intention or behaviour. Conclusion Seasonality does not influence objectively measured walking behaviour or psychological variables during a randomised controlled trial. Consequently physical activity behaviour outcomes in trials will not be biased by the season in which they are measured. Previous studies may have overestimated the extent of seasonality effects by selecting the most extreme summer and winter months to assess PA. In addition, participants recruited to behaviour change interventions might have higher levels of motivation to change and are less affected by seasonal barriers. Trial registration Current Controlled Trials ISRCTN95932902 PMID:24499405

The contribution of behavioural science to primary care research: development and evaluation of behaviour change interventions.

PubMed

Sutton, Stephen

2011-10-01

Behavioural science is concerned with predicting, explaining and changing behaviour. Taking a personal perspective, this article aims to show how behavioural science can contribute to primary care research, specifically in relation to the development and evaluation of interventions to change behaviour. After discussing the definition and measurement of behaviour, the principle of compatibility and theories of behaviour change, the article outlines two examples of behaviour change trials (one on medication adherence and the other on physical activity), which were part of a research programme on prevention of chronic disease and its consequences. The examples demonstrate how, in a multidisciplinary context, behavioural science can contribute to primary care research in several important ways, including posing relevant research questions, defining the target behaviour, understanding the psychological determinants of behaviour, developing behaviour change interventions and selection or development of measures. The article concludes with a number of recommendations: (i) whether the aim is prediction, explanation or change, defining the target behaviour is a crucial first step; (ii) interventions should be explicitly based on theories that specify the factors that need to be changed in order to produce the desired change in behaviour; (iii) intervention developers need to be aware of the differences between different theories and select a theory only after careful consideration of the alternatives assessed against relevant criteria; and (iv) developers need to be aware that interventions can never be entirely theory based.

Social Change and Increasing of Bipolar Disorders: An Evolutionary Model

PubMed Central

Carta, Mauro Giovanni

2013-01-01

Introduction: The objective of this paper is to see if behaviours defined as pathological and maladjusted in certain contexts may produce adaptive effects in other contexts, especially if they occur in attenuated form. Interactions between environment and behaviour are studied from an evolutionary standpoint in an attempt to understand how new attitudes emerge in an evolving context. Methodology: Narrative review. Following an historical examination of how the description of depression in Western society has changed, we examine a series of studies performed in areas where great changes have taken place as well as research on emigration from Sardinia in the 1960s and 70s and immigration to Sardinia in the 1990s. Results and conclusions: If we postulate that mood disorders are on the increase and that the epidemic began in the 17th century with the "English malady", we must suppose that at least the "light" forms have an adaptive advantage, otherwise the expansion of the disorder would have been self-limiting. "Compulsive hyper-responsabilization”, as well as explorative behaviours, may represent a base for adaptation in certain conditions of social change. The social emphasis in individualism and responsibility may have changed not only the frequency, but also the phenomenology of mood disorders particularly the increases in bipolar disorders. From the sociobiological standpoint the conditions that may favour "subthreshold" bipolar or depressive features are to be considered in relation to the contextual role of gender and the different risks of the two disorders in males and females. PMID:23878615

Economic rationalisation of health behaviours: the dangers of attempting policy discussions in a vacuum.

PubMed

Reilly, Rachel; Rowley, Kevin; Luke, Joanne; Doyle, Joyce; Ritte, Rebecca; O'Shea, Rebekah; Brown, Alex

2014-08-01

When analysing the health behaviours of any group of people, understanding the constraints and possibilities for individual agency as shaped by the broader societal context is critical. In recent decades, our understanding of the ways in which physical and social environments influence health and health behaviours has expanded greatly. The authors of a recent analysis of Australian Aboriginal health data using an economic 'rational choice model,' published in this journal, claim to make a useful contribution to policy discussions relating to Aboriginal health, but neglect context. By doing so, they neglect the very factors that determine the success or failure of policy change. Notwithstanding the technical sophistication of the analyses, by ignoring most relevant determinants of health, the conclusions misrepresent the lives of Aboriginal and Torres Strait Islander people and therefore risk perpetuating harm, rather than improving health. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Early detection of health and welfare compromises through automated detection of behavioural changes in pigs.

PubMed

Matthews, Stephen G; Miller, Amy L; Clapp, James; Plötz, Thomas; Kyriazakis, Ilias

2016-11-01

Early detection of health and welfare compromises in commercial piggeries is essential for timely intervention to enhance treatment success, reduce impact on welfare, and promote sustainable pig production. Behavioural changes that precede or accompany subclinical and clinical signs may have diagnostic value. Often referred to as sickness behaviour, this encompasses changes in feeding, drinking, and elimination behaviours, social behaviours, and locomotion and posture. Such subtle changes in behaviour are not easy to quantify and require lengthy observation input by staff, which is impractical on a commercial scale. Automated early-warning systems may provide an alternative by objectively measuring behaviour with sensors to automatically monitor and detect behavioural changes. This paper aims to: (1) review the quantifiable changes in behaviours with potential diagnostic value; (2) subsequently identify available sensors for measuring behaviours; and (3) describe the progress towards automating monitoring and detection, which may allow such behavioural changes to be captured, measured, and interpreted and thus lead to automation in commercial, housed piggeries. Multiple sensor modalities are available for automatic measurement and monitoring of behaviour, which require humans to actively identify behavioural changes. This has been demonstrated for the detection of small deviations in diurnal drinking, deviations in feeding behaviour, monitoring coughs and vocalisation, and monitoring thermal comfort, but not social behaviour. However, current progress is in the early stages of developing fully automated detection systems that do not require humans to identify behavioural changes; e.g., through automated alerts sent to mobile phones. Challenges for achieving automation are multifaceted and trade-offs are considered between health, welfare, and costs, between analysis of individuals and groups, and between generic and compromise-specific behaviours. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Anticipated health behaviour changes and perceived control in response to disclosure of genetic risk of breast and ovarian cancer: a quantitative survey study among women in the UK

PubMed Central

Meisel, Susanne F; Side, Lucy; Gessler, Sue; Hann, Katie E J; Wardle, Jane; Lanceley, Anne

2017-01-01

Background Genetic risk assessment for breast cancer and ovarian cancer (BCOC) is expected to make major inroads into mainstream clinical practice. It is important to evaluate the potential impact on women ahead of its implementation in order to maximise health benefits, as predictive genetic testing without adequate support could lead to adverse psychological and behavioural responses to risk disclosure. Objective To examine anticipated health behaviour changes and perceived control to disclosure of genetic risk for BCOC and establish demographic and person-specific correlates of adverse anticipated responses in a population-based sample of women. Design Cross-sectional quantitative survey study carried out by the UK Office for National Statistics in January and March 2014. Setting Face-to-face computer-assisted interviews conducted by trained researchers in participants’ homes. Participants 837 women randomly chosen from households across the UK identified from the Royal Mail’s Postcode Address File. Outcome measures Anticipated health behaviour change and perceived control to disclosure of BCOC risk. Results In response to a genetic test result, most women (72%) indicated ‘I would try harder to have a healthy lifestyle’, and over half (55%) felt ‘it would give me more control over my life’. These associations were independent of demographic factors or perceived risk of BCOC in Bonferroni-corrected multivariate analyses. However, a minority of women (14%) felt ‘it isn’t worth making lifestyle changes’ and that ‘I would feel less free to make choices in my life’ (16%) in response to BCOC risk disclosure. The former belief was more likely to be held by women who were educated below university degree level (P<0.001) after adjusting for other demographic and person-specific correlates. Conclusion These findings indicate that women in the UK largely anticipate that they would engage in positive health behaviour changes in response to BCOC risk disclosure. PMID:29275340

Management of behavioural change in patients presenting with a diagnosis of dementia: a video vignette study with Australian general practitioners

PubMed Central

Jiwa, Moyez; Nichols, Pam; Magin, Parker; Pagey, Georgina; Meng, Xingqiong; Parsons, Richard; Pillai, Vinita

2014-01-01

Objective To test the impact of feedback on the proposed management of standardised patients presenting with behavioural change with a diagnosis of dementia in Australian primary care. Materials and methods A video vignette study was performed with Australian general practitioners (GPs) in 2013. Participants viewed six pairs of matched videos depicting people presenting changed behaviour in the context of a dementia diagnosis in two phases. In both phases GPs indicated their diagnosis and management. After phase 1, GPs were offered feedback on management strategies for the patients depicted. Analyses focused on identification of change in management between the two phases of the study. Factors impacting on the intention to coordinate care for such patients were tested in a questionnaire based on the Theory of Planned Behaviour. Results Forty-five GPs completed the study. There was significant improvement in the proposed management of three of the six scenarios after the intervention. Older GPs were more likely to refer appropriately (OR=1.11 (1.01 to 1.23), p=0.04.). Overall referral to support agencies was more likely after the intervention (OR=2.52 (1.53 to 4.14), p<0.001). Older GPs were less likely to intend to coordinate care for such patients (OR=0.89 (0.81 to 0.98) p=0.02). Participants who felt confident about their ability to coordinate care were more likely to do so (OR=3.79 (1.08 to 13.32) p=0.04). Conclusions The intervention described in this study promoted multidisciplinary management of patients with behavioural problems with a diagnosis of dementia. Increasing practitioner confidence in their ability to coordinate care may increase the proportion of GPs who will respond to patients and carers in this context. Older GPs may benefit in particular. PMID:25256189

The association between individual counselling and health behaviour change: the See Kidney Disease (SeeKD) targeted screening programme for chronic kidney disease.

PubMed

Galbraith, Lauren; Hemmelgarn, Brenda; Manns, Braden; Samuel, Susan; Kappel, Joanne; Valk, Nadine; Ronksley, Paul

2016-01-01

Health behaviour change is an important component of management for patients with chronic kidney disease (CKD); however, the optimal method to promote health behaviour change for self-management of CKD is unknown. The See Kidney Disease (SeeKD) targeted screening programme screened Canadians at risk for CKD and promoted health behaviour change through individual counselling and goal setting. The objectives of this study are to determine the effectiveness of individual counselling sessions for eliciting behaviour change and to describe participant characteristics associated with behaviour change. This is a cross-sectional, descriptive study. The study setting is the National SeeKD targeted screening programme. The participants are all 'at risk' patients who were screened for CKD and returned a follow-up health behaviour survey (n = 1129). Health behaviour change was defined as a self-reported change in lifestyle, including dietary changes or medication adherence. An individual counselling session was provided to participants by allied healthcare professionals to promote health behaviour change. A survey was mailed to all participants at risk of CKD within 2-4 weeks following the screening event to determine if behaviour changes had been initiated. Descriptive statistics were used to describe respondent characteristics and self-reported behaviour change following screening events. Results were stratified by estimated glomerular filtration rate (eGFR) (< 60 and ≥ 60 mL/min/1.73 m(2)). Log binomial regression analysis was used to determine the predictors of behaviour change. Of the 1129 respondents, the majority (89.8 %) reported making a health behaviour change after the screening event. Respondents who were overweight (body mass index [BMI] 25-29.9 kg/m(2)) or obese (BMI ≥ 30.0 kg/m(2)) were more likely to report a behaviour change (prevalence rate ratio (PRR) 0.66, 95 % confidence interval (CI) 0.44-0.99 and PRR 0.49, 95 % CI 0.30-0.80, respectively). Further, participants with a prior intent to change their behaviour were more likely to make a behaviour change (PRR 0.58, 95 % CI 0.35-0.96). Results did not vary by eGFR category. We are unable to determine the effectiveness of the behaviour change intervention given the lack of a control group. Potential response bias and social desirability bias must also be considered when interpreting the study findings. Individual counselling and goal setting provided at screening events may stimulate behaviour change amongst individuals at risk for CKD. However, further research is required to determine if this behaviour change is sustained and the impact on CKD progression and outcomes.

The impact of an employee wellness programme in clothing/textile manufacturing companies: a randomised controlled trial

PubMed Central

2013-01-01

Background The prevalence of health risk behaviours is growing amongst South African employees. Health risk behaviours have been identified as a major contributor to reduced health related quality of life (HRQoL) and the increased prevalence of non-communicable diseases. Worksite wellness programmes promise to promote behaviour changes amongst employees and to improve their HRQoL. The aim of this study was to evaluate the short-term effects of an employee wellness programme on HRQoL, health behaviour change, body mass index (BMI) and absenteeism amongst clothing and textile manufacturing employees. Methods The study used a randomised control trial design. The sample consisted of 80 subjects from three clothing manufacturing companies in Cape Town, South Africa. The experimental group was subjected to a wellness programme based on the principles of cognitive behaviour therapy (CBT) as well as weekly supervised exercise classes over six weeks. The control group received a once-off health promotion talk and various educational pamphlets, with no further intervention. Measurements were recorded at baseline and at six weeks post-intervention. Outcome measures included the EQ-5D, Stanford Exercise Behaviours Scale, body mass index and absenteeism. Data was analysed with the Statistica-8 software program. Non-parametric tests were used to evaluate the differences in the medians between the two groups and to determine the level of significance. The Sign test was used to determine the within group changes. The Mann–Whitney U test was used to determine the difference between the two groups. Results At six weeks post intervention the experimental group (39 subjects) demonstrated improvement in almost every parameter. In contrast, apart from an overall decrease in time off work and a reduction in BMI for all study participants, there was no significant change noted in the behaviour of the control group (41 subjects). Seventy percent of the experimental group had improved HRQoL EQ-5D VAS scores post intervention, indicating improved perceived HRQoL. In comparison, only 58% of the control group had improved HRQoL EQ-5D VAS scores post intervention. There was no significant difference between the two groups at baseline or at six weeks post intervention. Conclusion An employee wellness programme based on the principles of CBT combined with weekly aerobic exercise class was beneficial in improving the perceived HRQoL and changing health-related behaviours of clothing manufacturing employees. However, it cannot be concluded that the EWP was more effective than the once off health promotion talk as no significant changes were noted between the two groups at 6-weeks post intervention.This trial has been registered with ClinicalTrials.gov (trial registration number NCT01625039). PMID:23311458

Evaluating mobile phone applications for health behaviour change: A systematic review.

PubMed

McKay, Fiona H; Cheng, Christina; Wright, Annemarie; Shill, Jane; Stephens, Hugh; Uccellini, Mary

2018-01-01

Introduction Increasing smartphones access has allowed for increasing development and use of smart phone applications (apps). Mobile health interventions have previously relied on voice or text-based short message services (SMS), however, the increasing availability and ease of use of apps has allowed for significant growth of smartphone apps that can be used for health behaviour change. This review considers the current body of knowledge relating to the evaluation of apps for health behaviour change. The aim of this review is to investigate approaches to the evaluation of health apps to identify any current best practice approaches. Method A systematic review was conducted. Data were collected and analysed in September 2016. Thirty-eight articles were identified and have been included in this review. Results Articles were published between 2011- 2016, and 36 were reviews or evaluations of apps related to one or more health conditions, the remaining two reported on an investigation of the usability of health apps. Studies investigated apps relating to the following areas: alcohol, asthma, breastfeeding, cancer, depression, diabetes, general health and fitness, headaches, heart disease, HIV, hypertension, iron deficiency/anaemia, low vision, mindfulness, obesity, pain, physical activity, smoking, weight management and women's health. Conclusion In order to harness the potential of mobile health apps for behaviour change and health, we need better ways to assess the quality and effectiveness of apps. This review is unable to suggest a single best practice approach to evaluate mobile health apps. Few measures identified in this review included sufficient information or evaluation, leading to potentially incomplete and inaccurate information for consumers seeking the best app for their situation. This is further complicated by a lack of regulation in health promotion generally.

Healthy Behaviour Change and Cardiovascular Outcomes in Newly Diagnosed Type 2 Diabetes Patients - ADDITION-Cambridge Cohort Study

PubMed Central

Long, Gráinne H; Cooper, Andrew J M; Wareham, Nicholas J; Griffin, Simon J; Simmons, Rebecca K

2014-01-01

OBJECTIVE To examine whether improvements in health behaviours are associated with reduced risk of cardiovascular disease (CVD) in individuals with newly-diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS Population-based prospective cohort study of 867 newly diagnosed diabetes patients aged between 40 and 69 years from the treatment phase of the ADDITION-Cambridge study. As the results for all analyses were similar by trial arm, data were pooled and results presented for the whole cohort. Participants were identified via population-based stepwise screening between 2002 and 2006 and underwent assessment of physical activity (EPAQ questionnaire), diet (plasma vitamin C and self-report), and alcohol consumption (self-report) at baseline and one year. A composite primary CVD outcome was examined, comprised of cardiovascular mortality, non-fatal myocardial infarction, nonfatal stroke and revascularisation. RESULTS After a mean (SD) follow-up of 5.1 (1.1) years, 6% of the cohort experienced a CVD event (12.2/1000-person years; 95% CI 9.3 to 15.9). CVD risk was inversely related to the number of positive health behaviours changed in the year following diabetes diagnosis. The relative risk (95% CI) for primary CVD event in individuals who did not change any health behavior compared to those who adopted three/four healthy behaviors was 4.17 (1.02 to 17.09), adjusting for age, sex, study group, social class occupation and prescription of cardio-protective medication (ptrend = 0.005). CONCLUSIONS Cardiovascular disease risk was inversely associated with the number of healthy behaviour changes adopted in the year following diagnosis of diabetes. Interventions that promote early achievement of these goals in newly diagnosed patients could help reduce the burden of diabetes-related morbidity and mortality. PMID:24658389

Rodent motor and neuropsychological behaviour measured in home cages using the integrated modular platform SmartCage™

PubMed Central

Khroyan, Taline V; Zhang, Jingxi; Yang, Liya; Zou, Bende; Xie, James; Pascual, Conrado; Malik, Adam; Xie, Julian; Zaveri, Nurulain T; Vazquez, Jacqueline; Polgar, Willma; Toll, Lawrence; Fang, Jidong; Xie, Xinmin

2017-01-01

SUMMARY To facilitate investigation of diverse rodent behaviours in rodents’ home cages, we have developed an integrated modular platform, the SmartCage™ system (AfaSci, Inc. Burlingame, CA, USA), which enables automated neurobehavioural phenotypic analysis and in vivo drug screening in a relatively higher-throughput and more objective manner.The individual platform consists of an infrared array, a vibration floor sensor and a variety of modular devices. One computer can simultaneously operate up to 16 platforms via USB cables.The SmartCage™ detects drug-induced increases and decreases in activity levels, as well as changes in movement patterns. Wake and sleep states of mice can be detected using the vibration floor sensor. The arousal state classification achieved up to 98% accuracy compared with results obtained by electroencephalography and electromyography. More complex behaviours, including motor coordination, anxiety-related behaviours and social approach behaviour, can be assessed using appropriate modular devices and the results obtained are comparable with results obtained using conventional methods.In conclusion, the SmartCage™ system provides an automated and accurate tool to quantify various rodent behaviours in a ‘stress-free’ environment. This system, combined with the validated testing protocols, offers powerful a tool kit for transgenic phenotyping and in vivo drug screening. PMID:22540540

Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review

PubMed Central

Feast, Alexandra; Orrell, Martin; Charlesworth, Georgina; Melunsky, Nina; Poland, Fiona; Moniz-Cook, Esme

2016-01-01

Background Tailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes. Aims To understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered. Method A systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012. Results We identified 25 high-quality studies and two main reasons for behaviours being reported as challenging by family carers: changes in communication and relationships, resulting in ‘feeling bereft’; and perceptions of transgressions against social norms associated with ‘misunderstandings about behaviour’ in the relative with dementia. The underlying belief that their relative had lost, or would inevitably lose, their identity to dementia was a fundamental reason why family carers experienced behaviour as challenging. Conclusions Family carers' perceptions of BPSD as challenging are associated with a sense of a declining relationship, transgressions against social norms and underlying beliefs that people with dementia inevitably lose their ‘personhood’. Interventions for the management of challenging behaviour in family settings should acknowledge unmet psychological need in family carers. PMID:26989095

An evaluation of the behaviour-change techniques used on Canadian cancer centre Web sites to support physical activity behaviour for breast cancer survivors.

PubMed

Sylvester, B D; Zammit, K; Fong, A J; Sabiston, C M

2017-12-01

Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. All Canadian cancer centre Web sites ( n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London-Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity.

Risk Estimation and Sexual Behaviour: A Longitudinal Study of 16- 21-year olds.

PubMed

Breakwell, G M; Breakwell, G M

1996-01-01

The relationships among risk estimation, impulsivity and patterns of sexual risk-taking in 16-21-year-olds are examined. A sample of 236 males and 340 females completed a postal questionnaire on three occasions at annual intervals. They reported their assessment of their own risk of HIV infection, the risk of HIV infection associated with six types of sexual activity, their likelihood of engaging in each of these activities, and whether they had participated in these activities between the first and second data collections. Impulsivity was indexed using a standard test. The data support the conclusion that strong social representations of sexual risks exist which do not markedly change during late adolescence. These risk estimates predict behavioural expectations, primarily for the riskiest behaviours, and for females (actual participation in vaginal sex); but for males, risk estimates fail to predict behaviour. Evidence here for a rational model of individual decision- making in relation to sexual risk- taking is sparse. Impulsivity was not a good predictor of expected or actual patterns of sexual behaviour, though higher impulsivity was associated with having more sexual partners and, in females, with starting to have sex younger.

Goats display audience-dependent human-directed gazing behaviour in a problem-solving task.

PubMed

Nawroth, Christian; Brett, Jemma M; McElligott, Alan G

2016-07-01

Domestication is an important factor driving changes in animal cognition and behaviour. In particular, the capacity of dogs to communicate in a referential and intentional way with humans is considered a key outcome of how domestication as a companion animal shaped the canid brain. However, the lack of comparison with other domestic animals makes general conclusions about how domestication has affected these important cognitive features difficult. We investigated human-directed behaviour in an 'unsolvable problem' task in a domestic, but non-companion species: goats. During the test, goats experienced a forward-facing or an away-facing person. They gazed towards the forward-facing person earlier and for longer and showed more gaze alternations and a lower latency until the first gaze alternation when the person was forward-facing. Our results provide strong evidence for audience-dependent human-directed visual orienting behaviour in a species that was domesticated primarily for production, and show similarities with the referential and intentional communicative behaviour exhibited by domestic companion animals such as dogs and horses. This indicates that domestication has a much broader impact on heterospecific communication than previously believed. © 2016 The Author(s).

Research priorities for child and adolescent physical activity and sedentary behaviours: an international perspective using a twin-panel Delphi procedure

PubMed Central

2013-01-01

Background The quantity and quality of studies in child and adolescent physical activity and sedentary behaviour have rapidly increased, but research directions are often pursued in a reactive and uncoordinated manner. Aim To arrive at an international consensus on research priorities in the area of child and adolescent physical activity and sedentary behaviour. Methods Two independent panels, each consisting of 12 experts, undertook three rounds of a Delphi methodology. The Delphi methodology required experts to anonymously answer questions put forward by the researchers with feedback provided between each round. Results The primary outcome of the study was a ranked set of 29 research priorities that aimed to be applicable for the next 10 years. The top three ranked priorities were: developing effective and sustainable interventions to increase children’s physical activity long-term; policy and/or environmental change and their influence on children’s physical activity and sedentary behaviour; and prospective, longitudinal studies of the independent effects of physical activity and sedentary behaviour on health. Conclusions These research priorities can help to guide decisions on future research directions. PMID:24228891

Managing Acute Behavioural Disturbances in the Emergency Department Using the Environment, Policies and Practices: A Systematic Review.

PubMed

Weiland, Tracey J; Ivory, Sean; Hutton, Jennie

2017-06-01

Effective strategies for managing acute behavioural disturbances (ABDs) within emergency departments (EDs) are needed given their rising occurrence and negative impact on safety, psychological wellbeing, and staff turnover. Non-pharmacological interventions for ABD management generally fall into four categories: environmental modifications; policies; practice changes; and education. Our objective was to systematically review the efficacy of strategies for ABD management within EDs that involved changes to environment, architecture, policy and practice. We performed systematic searches of CINAHL Plus with Full Text, PsycINFO, MEDLINE, and EMBASE, as well as reference lists of relevant review articles to identify relevant studies published between January 1985 - April 2016. We included studies written in English, which reported management of behavioural disturbances in adults associated with the ED through the use of environmental modifiers (including seclusion, restraint, specialised rooms, architectural changes), policy, and practice-based interventions excepting education-only interventions. Efficacy outcomes of interest included incidence, severity, and duration of ABD, incidence of injuries, staff absenteeism, restraint use, restraint duration, and staff and patient perceptions. Two reviewers independently screened titles and abstracts, and assessed the relevancy and eligibility of studies based on full-text articles. Two authors independently appraised included studies. A narrative synthesis of findings was undertaken. Studies reporting interventions for managing ABDs within the ED are limited in number and quality. The level of evidence for efficacy is low, requiring caution in conclusions. While there is preliminary evidence for environmental change in the form of specialised behavioural rooms, security upgrades and ED modifications, these are not supported by evidence from controlled studies. Many of these "common sense" environmental changes recommended in many guidelines have been widely implemented in EDs. There is an unambiguous gap in the literature regarding the efficacy of interventions for ABD management in EDs involving environmental, policy or practice-based changes. With growing demand on EDs, and with increasing numbers of ABDs, identification of robust evidence-based interventions for safe and effective ABD management is vital.

A systematic review of acculturation, obesity and health behaviours among migrants to high-income countries.

PubMed

Alidu, L; Grunfeld, E A

2018-06-01

Objective There is extensive evidence for weight gain among people migrating from low/middle-income to high-income countries, which may be due, in part, to acculturation factors. This review aimed to identify associations between acculturation and body weight among immigrants to high-income countries and identify if studies accounted for the role played by health behaviours. Methods A systematic literature search using keywords was performed with three databases (Medline, PsychINFO and EMBASE). The 35 studies were included that utilised quantitative methodology and presented empirical findings focused on acculturation and body weight among adult immigrants. Findings There was evidence presented across multiple studies for an association between acculturation (measured with standard measures or as duration of stay) and obesity. Most studies were cross sectional, which did not allow the exploration of drivers of change in health behaviours and weight gain. Conclusion This is the first review to examine associations between acculturation and body weight among migrants utilising both acculturation scales and proxy measures of acculturation and to examine the role of health behaviours. Evidence from this review suggests that health interventions should target first generation migrants to promote retention of their original healthy behaviours. Recent migrant groups report healthier behaviours than comparative host country populations, and therefore interventions should be promoted at the initial stages following migration to avoid uptake of unhealthy behaviours.

Effective techniques for changing physical activity and healthy eating intentions and behaviour: A systematic review and meta-analysis.

PubMed

McDermott, Máirtín S; Oliver, Madalyn; Iverson, Don; Sharma, Rajeev

2016-11-01

The primary aim of this study was to review the evidence on the impact of a change in intention on behaviour and to identify (1) behaviour change techniques (BCTs) associated with changes in intention and (2) whether the same BCTs are also associated with changes in behaviour. A systematic review was conducted to identify interventions that produced a significant change in intention and assessed the impact of this change on behaviour at a subsequent time point. Each intervention was coded using a taxonomy of BCTs targeting healthy eating and physical activity. A series of meta-regression analyses were conducted to identify effective BCTs. In total, 25 reports were included. Interventions had a medium-to-large effect on intentions (d +  = 0.64) and a small-to-medium effect (d +  = 0.41) on behaviour. One BCT, 'provide information on the consequences of behaviour in general', was significantly associated with a positive change in intention. One BCT, 'relapse prevention/coping planning', was associated with a negative change in intention. No BCTs were found to have significant positive effects on behaviour. However, one BCT, 'provide feedback on performance', was found to have a significant negative effect. BCTs aligned with social cognitive theory were found to have significantly greater positive effects on intention (d +  = 0.83 vs. 0.56, p < .05), but not behaviour (d +  = 0.35 vs. 0.23, ns), than those aligned with the theory of planned behaviour. Although the included studies support the notion that a change in intention is associated with a change in behaviour, this review failed to produce evidence on how to facilitate behaviour change through a change in intention. Larger meta-analyses incorporating interventions targeting a broader range of behaviours may be warranted. Statement of contribution What is already known on this subject? Prior research on the causal relationship between intention and behaviour has produced mixed findings. Further experimental research to determine the precise nature of these variables is clearly warranted. However, precise guidance on how to change intention is still lacking. What does this study add? This study aimed to identify behaviour change techniques associated with changes in intention and behaviour. Techniques with positive effects on intention were identified; however, these did not have an impact on behaviour. Larger meta-analyses incorporating interventions targeting a broader range of behaviours may be warranted. © 2016 The British Psychological Society.

Interventions for treating obesity in children.

PubMed

Summerbell, C D; Ashton, V; Campbell, K J; Edmunds, L; Kelly, S; Waters, E

2003-01-01

The prevalence of overweight and obesity is increasing in child populations throughout the world. Obesity in children has significant short and long term health consequences. To assess the effects of a range of lifestyle interventions designed to treat obesity in childhood. We searched CCTR, MEDLINE, EMBASE, CINAHL, PsychLIT, Science Citation Index, Social Science Citation Index. Each database was searched from 1985 to July 2001. We also contacted experts in child obesity treatment. We selected randomised controlled trials of lifestyle interventions for treating obesity in children with a minimum of six months duration. Examples of lifestyle interventions include dietary, physical activity and/or behavioural therapy interventions, with or without the support of associated family members. Interventions from any setting and delivered by any professional were considered. However, interventions that specifically dealt with the treatment of eating disorders were excluded. Two of our research team independently assessed trial quality and extracted data. Authors of the included studies were contacted for additional information where this was appropriate. We included 18 randomised controlled trials with 975 participants. Many studies were run from a specialist obesity clinic within a hospital setting. Five studies (n=245 participants) investigated changes in physical activity and sedentary behaviour. Two studies (n=107 participants) compared problem-solving with usual care or behavioural therapy. Nine studies (n=399 participants) compared behavioural therapy at varying degrees of family involvement with no treatment or usual care or mastery criteria and contingent reinforcement. Two studies (n=224 participants) compared cognitive behavioural therapy with relaxation.Most of the studies included in this review were too small to have the power to detect the effects of the treatment. We did not conduct a meta-analysis since so few of the trials included the same comparisons and outcomes. Therefore, we synthesised the results in a narrative format. Although 18 research studies were found, most of these were very small studies drawn from homogenous, motivated groups in hospital settings and so generalisable evidence from them is limited. In conclusion, there is a limited amount of quality data on the components of programs to treat childhood obesity that favour one program over another. Further research that considers psychosocial determinants for behaviour change, strategies to improve clinician-family interaction, and cost-effective programs for primary and community care is required. We conclude that no direct conclusions can be drawn from this review with confidence.

Physiotherapists use a small number of behaviour change techniques when promoting physical activity: A systematic review comparing experimental and observational studies.

PubMed

Kunstler, Breanne E; Cook, Jill L; Freene, Nicole; Finch, Caroline F; Kemp, Joanne L; O'Halloran, Paul D; Gaida, James E

2018-06-01

Physiotherapists promote physical activity as part of their practice. This study reviewed the behaviour change techniques physiotherapists use when promoting physical activity in experimental and observational studies. Systematic review of experimental and observational studies. Twelve databases were searched using terms related to physiotherapy and physical activity. We included experimental studies evaluating the efficacy of physiotherapist-led physical activity interventions delivered to adults in clinic-based private practice and outpatient settings to individuals with, or at risk of, non-communicable diseases. Observational studies reporting the techniques physiotherapists use when promoting physical activity were also included. The behaviour change techniques used in all studies were identified using the Behaviour Change Technique Taxonomy. The behaviour change techniques appearing in efficacious and inefficacious experimental interventions were compared using a narrative approach. Twelve studies (nine experimental and three observational) were retained from the initial search yield of 4141. Risk of bias ranged from low to high. Physiotherapists used seven behaviour change techniques in the observational studies, compared to 30 behaviour change techniques in the experimental studies. Social support (unspecified) was the most frequently identified behaviour change technique across both settings. Efficacious experimental interventions used more behaviour change techniques (n=29) and functioned in more ways (n=6) than did inefficacious experimental interventions (behaviour change techniques=10 and functions=1). Physiotherapists use a small number of behaviour change techniques. Less behaviour change techniques were identified in observational studies compared to experimental studies, suggesting physiotherapists use less BCTs clinically than experimentally. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Why is changing health-related behaviour so difficult?

PubMed

Kelly, Michael P; Barker, Mary

2016-07-01

To demonstrate that six common errors made in attempts to change behaviour have prevented the implementation of the scientific evidence base derived from psychology and sociology; to suggest a new approach which incorporates recent developments in the behavioural sciences. The role of health behaviours in the origin of the current epidemic of non-communicable disease is observed to have driven attempts to change behaviour. It is noted that most efforts to change health behaviours have had limited success. This paper suggests that in policy-making, discussions about behaviour change are subject to six common errors and that these errors have made the business of health-related behaviour change much more difficult than it needs to be. Overview of policy and practice attempts to change health-related behaviour. The reasons why knowledge and learning about behaviour have made so little progress in alcohol, dietary and physical inactivity-related disease prevention are considered, and an alternative way of thinking about the behaviours involved is suggested. This model harnesses recent developments in the behavioural sciences. It is important to understand the conditions preceding behaviour psychologically and sociologically and to combine psychological ideas about the automatic and reflective systems with sociological ideas about social practice. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

PubMed

Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

2017-12-01

Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation produced perceptions of patient safety improvement. TDF use enabled behaviour change analysis due to implementation, for example, staff adoption of behaviours to ensure general practitioners receive good quality discharge information.

Global measures of outcome in a controlled comparison of pharmacological and psychological treatment of panic disorder and agoraphobia in primary care.

PubMed Central

Sharp, D M; Power, K G; Simpson, R J; Swanson, V; Anstee, J A

1997-01-01

BACKGROUND: Panic disorder, with and without agoraphobia, is a prevalent condition which presents primarily in general practice. Previous clinical outcome studies have been conducted mainly in specialist university departments or hospital settings, and have tended to employ complex rating scales that are not well suited for use as outcome measures in primary care. AIM: To evaluate the outcome, in a primary care setting, of fluvoxamine versus cognitive behaviour therapy, each used alone and in combination in a double-blind placebo-controlled framework, balanced for therapist contact. METHOD: A total of 149 patients satisfying DSMIII-R criteria for panic disorder were randomly allocated to receive one of the following: fluvoxamine, placebo, fluvoxamine plus cognitive behaviour therapy, placebo plus cognitive behaviour therapy, and cognitive behaviour therapy alone. These five treatment groups represent the minimum number acceptable for such a comparison to be made. All patients received an identical schedule of contact over 13 weeks. Measures of symptom severity, general health and social disruption were taken at entry point and end point; measures of change in symptoms were taken at end point only. Outcome was reported in terms of brief global ratings of severity of illness and change in symptoms, and of ratings of general health and social disruption that are suitable for use in general practice. RESULTS: All active treatment groups showed statistically significant advantages over placebo over a range of outcome ratings. The groups employing cognitive behaviour therapy showed the most robust and consistent response. CONCLUSION: The brief global measures reported here proved adequate to the task of assessing treatment outcome. Results indicate that treatments including cognitive behaviour therapy can be effective in the treatment of panic disorder and agoraphobia in primary care. PMID:9167318

Efficacy of Structured Yoga Intervention for Sleep, Gastrointestinal and Behaviour Problems of ASD Children: An Exploratory Study

PubMed Central

Pradhan, Balaram; Navaneetham, Janardhana

2017-01-01

Introduction Autism Spectrum Disorder (ASD) is a neuro developmental disorder which appears at early childhood age between 18 and 36 months. Apart from behaviour problems ASD children also suffer from sleep and Gastrointestinal (GI) problems. Major behaviour problems of ASD children are lack of social communication and interaction, less attention span, repetitive and restrictive behaviour, lack of eye to eye contact, aggressive and self-injurious behaviours, sensory integration problems, motor problems, deficiency in academic activities, anxiety and depression etc. Our hypothesis is that structured yoga intervention will brings significant changes in the problems of ASD children. Aim The aim of this study was to find out efficacy of structured yoga intervention for sleep problems, gastrointestinal problems and behaviour problems of ASD children. Materials and Methods It was an exploratory study with pre-test and post-test control design. Three sets of questionnaires having 61 questions developed by researchers were used to collect data pre and post yoga intervention. Questionnaires were based on three problematic areas of ASD children as mentioned above and were administered to parents by teachers under the supervision of researcher and clinical psychologists. Experimental group was given yoga intervention for a period of 90 days and control group continued with school curriculum. Results Both children and parents participated in this intervention. Significant changes were seen post yoga intervention in three areas of problems as mentioned above. Statistical analysis also showed significance value of 0.001 in the result. Conclusion Structured yoga intervention can be conducted for a large group of ASD children with parent’s involvement. Yoga can be used as alternative therapy to reduce the severity of symptoms of ASD children. PMID:28511484

The contribution of hypothalamic neuroendocrine, neuroplastic and neuroinflammatory processes to lipopolysaccharide-induced depressive-like behaviour in female and male rats: Involvement of glucocorticoid receptor and C/EBP-β.

PubMed

Adzic, Miroslav; Djordjevic, Jelena; Mitic, Milos; Brkic, Zeljka; Lukic, Iva; Radojcic, Marija

2015-09-15

Peripheral inflammation induced by lipopolysaccharide (LPS) causes behavioural changes indicative for depression. The possible mechanisms involve the interference with neuroinflammatory, neuroendocrine, and neurotrophic processes. Apart from heterogeneity in the molecular background, sexual context may be another factor relevant to the manifestation of mood disturbances upon an immune challenge. We investigated sex-dependent effects of a 7-day LPS treatment of adult Wistar rats on depressive-like behaviour and their relation with hypothalamic neuroendocrine factor, corticotrophin-releasing hormone (CRH), proplastic brain-derived neurotropic factor (BDNF), pro-inflammatory cyclooxygenase-2 (COX-2) and nuclear factor kappa beta (NFkB). Also, their regulators, the glucocorticoid receptor (GR) and CCAAT enhancer-binding protein (C/EBP) β were followed. LPS induced depressive-like behaviour in females was associated with the increased hypothalamic CRH and decreased BDNF, but not with COX-2. These changes were paralleled by an increase in nuclear GR, NFkB and 20 kDa C/EBPβ. LPS also altered behaviour in males and increased CRH expression, but in contrast to females, this was accompanied with the elevated COX-2, accumulation of cytosolic GR and elevated nuclear 38 kDa C/EBPβ and NFkB. In conclusion, depressive-like phenotype induced by LPS in both sexes emerges from similar HPA axis activation and sex-specific alterations of hypothalamic molecular signalling: in males it is related to compromised control of neuroinflamation connected with cytoplasmic GR retention, while in females it is related to diminished proplastic capacity of BDNF. Sex-dependent mechanisms by which inflammation alters hypothalamic processes and cause pathological behaviour in animals, could be operative in the treatment of depression-related brain inflammation. Copyright © 2015 Elsevier B.V. All rights reserved.

A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes)

PubMed Central

Biddle, Stuart J. H.; Edwardson, Charlotte L.; Wilmot, Emma G.; Yates, Thomas; Gorely, Trish; Bodicoat, Danielle H.; Ashra, Nuzhat; Khunti, Kamlesh; Nimmo, Myra A.; Davies, Melanie J.

2015-01-01

Aims Type 2 diabetes mellitus (T2DM), a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT) design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time. Methods Adults aged 18–40 years who were either overweight (with an additional risk factor for T2DM) or obese were recruited for the Sedentary Time ANd Diabetes (STAND) RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL) and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables. Results 187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m2) were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT) and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures. Conclusions A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change. Moreover, some participants reported a focus on physical activity rather than reductions in sitting per se. The habitual nature of sedentary behaviour means that behaviour change is challenging. Trial Registration Controlled-Trials.com ISRCTN08434554 PMID:26623654

Effectiveness of alcohol prevention interventions based on the principles of social marketing: a systematic review

PubMed Central

2013-01-01

Background Alcohol education aims to increase knowledge on the harm related to alcohol, and to change attitudes and drinking behaviour. However, little (lasting) evidence has been found for alcohol education, in changing alcohol-related attitudes and behaviour. Social marketing uses marketing techniques to achieve a social or healthy goal, and can be used in alcohol education. Social marketing consists of eight principles: customer orientation, insight, segmentation, behavioural goals, exchange, competition, methods mix, and is theory based. This review investigates the application of social marketing in alcohol prevention interventions, and whether application of social marketing influences alcohol-related attitudes or behaviour. Method A literature search was conducted in PubMed, PsychInfo, Cochrane and Scopus. Inclusion criteria were that original papers had to describe the effects of an alcohol prevention intervention developed according to one or more principles of social marketing. No limits were set on the age of the participants or on the kind of alcohol prevention intervention. The abstracts of the 274 retrieved studies were reviewed and the full texts of potentially relevant studies were screened. Results Six studies met the inclusion criteria and were included in this review. These six studies showed associations for the application of social marketing techniques on alcohol-related attitudes or behaviour; one study relates to participation in a drinking event, four to alcohol drinking behaviour, two to driving a car while under the influence of alcohol, two to recognition of campaign messages or campaign logo, and one to awareness of the campaign. However, no associations were also found. In addition, the studies had several limitations related to a control group, response rate and study methodology. Conclusion Based on this review, the effect of applying the principles of social marketing in alcohol prevention in changing alcohol-related attitudes or behaviour could not be assessed. More research, with a good quality methodology, like using a randomized control trial and measuring short, medium, and long-term effects, is required on this topic. Policy implications are discussed. PMID:23725406

Contextual Mediators influencing the Effectiveness of Behavioural Change Interventions: A Case of HIV/AIDS Prevention Behaviours

PubMed Central

Musiimenta, Angella

2012-01-01

Background: Although Uganda had recorded declines in HIV infection rates around 1990’s, it is argued that HIV/AIDS risk sexual behaviour, especially among the youth, started increasing again from early 2000. School-based computer-assisted HIV interventions can provide interactive ways of improving the youth’s HIV knowledge, attitudes and skills. However, these interventions have long been reported to have limited success in improving the youth’s sexual behaviours, which is always the major aim of implementing such interventions. This could be because the commonly used health promotion theories employed by these interventions have limited application in HIV prevention. These theories tend to lack sufficient attention to contextual mediators that influence ones sexual behaviours. Moreover, literature increasingly expresses dissatisfaction with the dominant prevailing descriptive survey-type HIV/AIDS-related research. Objective and Methods: The objective of this research was to identify contextual mediators that influence the youth’s decision to adopt and maintain the HIV/AIDS preventive behaviour advocated by a computer-assisted intervention. To achieve this objective, this research employed qualitative method, which provided in-depth understanding of how different contexts interact to influence the effectiveness of HIV/AIDS interventions. The research question was: What contextual mediators are influencing the youth’s decision to adopt and maintain the HIV/AIDS preventive behaviour advocated by a computer-assisted intervention? To answer this research question, 20 youth who had previously completed the WSWM intervention when they were still in secondary schools were telephone interviewed between Sept.08 and Dec.08. The collected data was then analysed, based on grounded theory’s coding scheme. Results: Findings demonstrate that although often ignored by HIV interventionists and researchers, variety of contextual mediators influence individual uptake of HIV preventives. These include relationship characteristics, familial mediators, peer influence, gender-based social norms, economic factors and religious beliefs. Conclusion: To generate concomitant mutual efforts, rather than exclusively focusing on individual level mediators, there is an urgent need to shift to integrative approaches, which combine individual level change strategies with contextual level change approaches in the design and implementation of interventional strategies to fight against HIV/AIDS. PMID:23569636

Behavioural disinhibition in the general population during the antiretroviral therapy roll-out in Sub-Saharan Africa: systematic review and meta-analysis.

PubMed

Legemate, Eva M; Hontelez, Jan A C; Looman, Caspar W N; de Vlas, Sake J

2017-07-01

Improved life expectancy and reduced transmission probabilities due to ART may result in behavioural disinhibition - that is an increase in sexual risk behaviour in response to a perceived lower risk of HIV. We examined trends in sexual risk behaviour in the general population of sub-Saharan African countries 1999-2015. We systematically reviewed scientific literature of sexual behaviour and reviewed trends in Demographic and Health Surveys. A meta-analysis on four indicators of sexual risk behaviour was performed: unprotected sex, multiple sexual partners, commercial sex and prevalence of sexually transmitted infections. Only two peer-reviewed studies met our inclusion criteria, while our review of DHS data spanned 18 countries and 16 years (1999-2015). We found conflicting trends in sexual risk behaviour. Reported unprotected sex decreased consistently across the 18 countries, for both sexes. In contrast, reporting multiple partners was decreasing over the period 1999 to the mid-2000s, yet has been consistently increasing thereafter. Similar trends were found for reported sexually transmitted infections and commercial sex (men only). In conclusion, we found no clear evidence of behavioural disinhibition due to expanded access to ART in sub-Saharan Africa. Substantial increases in condom use coincided with increases in reported multiple partners, commercial sex and sexually transmitted infections, especially during the period of ART scale-up. Further research is needed into how these changes might affect HIV transmission. © 2017 John Wiley & Sons Ltd.

Effects Total Solar Eclipse to Nasty Behaviour of the Several Legume Plants as a Result Student Research

NASA Astrophysics Data System (ADS)

Anggraeni, S.; Diana, S.; Supriatno, B.

2017-09-01

Some group students of plant Physiology course have given task to do free inquiry. They investigated of the nasty behaviour of several legume plants in response to changes in light during the partial solar eclipse that occurred at March 9, 2016. The investigation carried out in UPI Bandung, West Java, Indonesia, which is in the penumbra region of a total solar eclipse with the location coordinates of latitude: -6.86105, longitude: 07.59071, S 6057’ 37.53553 “and E 107035’ 24.29141”. They were measuring the movement of opening leaves every ten minutes at the beginning of the start until the end of the eclipse compared with the behaviour without eclipsing. Influence is expressed by comparing the leaf opening movement (measured in the form of leaf angular) at the time of the eclipse with a normal day. Each group was observed for one plant of the legume, there are: Mimosa pudica, Bauhinia purpurea, Caesalpinia pulcherrima, and Arachis pintoi. The results showed that the changes in leaf angular in plants Mimosa pudica, Caesalpinia pulcherrima, and Arachis pintoi differently significant, except for Bauhinia purpurea. In conclusion, the total solar eclipse in the penumbra area affects the movement of some nasty legume plants. It is recommended to conduct a study of the nasty behaviour of legume plants in the area umbra in the path of a total solar eclipse.

Homo-psychologicus: Reactionary behavioural aspects of epidemics.

PubMed

Cherif, Alhaji; Barley, Kamal; Hurtado, Marcel

2016-03-01

We formulate an in silico model of pathogen avoidance mechanism and investigate its impact on defensive behavioural measures (e.g., spontaneous social exclusions and distancing, crowd avoidance and voluntary vaccination adaptation). In particular, we use SIR(B)S (e.g., susceptible-infected-recovered with additional behavioural component) model to investigate the impact of homo-psychologicus aspects of epidemics. We focus on reactionary behavioural changes, which apply to both social distancing and voluntary vaccination participations. Our analyses reveal complex relationships between spontaneous and uncoordinated behavioural changes, the emergence of its contagion properties, and mitigation of infectious diseases. We find that the presence of effective behavioural changes can impede the persistence of disease. Furthermore, it was found that under perfect effective behavioural change, there are three regions in the response factor (e.g., imitation and/or reactionary) and behavioural scale factor (e.g., global/local) factors ρ-α behavioural space. Mainly, (1) disease is always endemic even in the presence of behavioural change, (2) behavioural-prevalence plasticity is observed and disease can sometimes be eradication, and (3) elimination of endemic disease under permanence of permanent behavioural change is achieved. These results suggest that preventive behavioural changes (e.g., non-pharmaceutical prophylactic measures, social distancing and exclusion, crowd avoidance) are influenced by individual differences in perception of risks and are a salient feature of epidemics. Additionally, these findings indicates that care needs to be taken when considering the effect of adaptive behavioural change in predicting the course of epidemics, and as well as the interpretation and development of the public health measures that account for spontaneous behavioural changes. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Clustering of diet, physical activity and smoking and a general willingness to change.

PubMed

de Vries, Hein; Kremers, Stef; Smeets, Tamara; Reubsaet, Astrid

2008-01-01

Addressing multiple health behaviours are important in preventing disease and mortality. The present study investigated the clustering of health behaviours, cognitive determinants and stages of change in 2827 adults for the lifestyle factors of physical activity, fruit, vegetable and fat consumption and smoking. The results showed that only 3% of the total population met recommended guidelines for all of the five behaviours. Behaviours were found to be weakly associated. Behaviour-specific cognitions and stages of change for the behaviours clustered more strongly, however. With respect to diet and physical activity, respondents in the preparation stage for one behaviour were likely also to be preparing to change another behaviour. Possible mechanisms for the apparent general willingness to change multiple behaviours are discussed, as well as potential implications for health promotion practice.

Early responses to H7N9 in southern Mainland China

PubMed Central

2014-01-01

Background H7N9 posed potentially serious health challenges for Chinese society. The previous SARS outbreak in this country was accompanied by contradictory information, while worries about wide-spread influenza led to discrimination worldwide. Early understanding of public threat perceptions is therefore important for effective public health communication and intervention. Methods We interviewed 1011 respondents by phone two weeks after the first case. Questions examined risk awareness and media use, beliefs about the emergence of the threat and those most at risk, anxiety about infection and preventive and avoidant behaviours. Results Results demonstrate moderate levels of anxiety but relatively high levels of trust towards government officials. Threat emergence was associated with hygiene levels, temperature change, floating pigs in the Huangpu River and migration to the city. Anxiety predicted both recommended and non-recommended behavioural changes. Conclusions Comparatively high levels of trust in Chinese government advice about H7N9 contrast positively with previous pandemic communications in China. Anxiety helped drive both recommended and non-recommended behaviours, with potentially important economic and social implications. This included evidence of 'othering’ of those associated with the threat (e.g. migrants). Findings emphasise the need to manage public communications early during new influenza outbreaks. PMID:24397830

Evaluation of the disruptive behaviors among treatment teams and its reflection on the therapy process of patients in the operating room: The impact of personal conflicts

PubMed Central

Maddineshat, Maryam; Hashemi, Mitra; Tabatabaeichehr, Mahbubeh

2017-01-01

INTRODUCTION: Understanding the development and distribution of disruptive behaviour among members of a health-care team is critical to the safety and quality of patient care in high-risk environments such as operating rooms. The present study identified disruptive behaviour and its effect on the treatment of patients in the operating room environment. SUBJECTS AND METHODS: This cross-sectional study used the convenience sampling method to select 144 operating room physicians and nurses (91 women and 53 men). The study was conducted in the operating rooms of four academic hospitals with different specialties in North Khorasan province in Iran from December 2013 to September 2014. The data were collected using a translated, modified, and validated questionnaire to investigate the prevalence and consequences of disruptive behaviour, the response of the health care system to the behaviour, factors affecting the creation of conflict and the spread of disruptive behaviour. Statistical analysis of the data was performed using SPSS 18. RESULTS: Disruptive behaviour was reported by 82.95% physicians and nurses. On average, 39% of physicians and 21% of operating room nurses exhibited disruptive behaviour. Disruptive behaviour is associated with psychological and clinical consequences. Factors such as fear of retaliation (8%), lack of change (43.8%), lack of security (18.1%) and attitude of the organization (14.6%) are significant reasons for the failure to report these behaviours. CONCLUSIONS: The findings suggest that disruptive behaviour occurs and affects treatment and workflow of treatment teams in the operating room. Interpersonal conflict contributes to the growth of such behaviour; thus, more research should focus on this subject in the future. PMID:28852659

The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

PubMed Central

2012-01-01

Background Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief), economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change. PMID:22978613

Do Decapod Crustaceans Have Nociceptors for Extreme pH?

PubMed Central

Puri, Sakshi; Faulkes, Zen

2010-01-01

Background Nociception is the physiological detection of noxious stimuli. Because of its obvious importance, nociception is expected to be widespread across animal taxa and to trigger robust behaviours reliably. Nociception in invertebrates, such as crustaceans, is poorly studied. Methodology/Principal Findings Three decapod crustacean species were tested for nociceptive behaviour: Louisiana red swamp crayfish (Procambarus clarkii), white shrimp (Litopenaeus setiferus), and grass shrimp (Palaemonetes sp.). Applying sodium hydroxide, hydrochloric acid, or benzocaine to the antennae caused no change in behaviour in the three species compared to controls. Animals did not groom the stimulated antenna, and there was no difference in movement of treated individuals and controls. Extracellular recordings of antennal nerves in P. clarkii revealed continual spontaneous activity, but no neurons that were reliably excited by the application of concentrated sodium hydroxide or hydrochloric acid. Conclusions/Significance Previously reported responses to extreme pH are either not consistently evoked across species or were mischaracterized as nociception. There was no behavioural or physiological evidence that the antennae contained specialized nociceptors that responded to pH. PMID:20422026

Noise characteristics of the Escherichia coli rotary motor

PubMed Central

2011-01-01

Background The chemotaxis pathway in the bacterium Escherichia coli allows cells to detect changes in external ligand concentration (e.g. nutrients). The pathway regulates the flagellated rotary motors and hence the cells' swimming behaviour, steering them towards more favourable environments. While the molecular components are well characterised, the motor behaviour measured by tethered cell experiments has been difficult to interpret. Results We study the effects of sensing and signalling noise on the motor behaviour. Specifically, we consider fluctuations stemming from ligand concentration, receptor switching between their signalling states, adaptation, modification of proteins by phosphorylation, and motor switching between its two rotational states. We develop a model which includes all signalling steps in the pathway, and discuss a simplified version, which captures the essential features of the full model. We find that the noise characteristics of the motor contain signatures from all these processes, albeit with varying magnitudes. Conclusions Our analysis allows us to address how cell-to-cell variation affects motor behaviour and the question of optimal pathway design. A similar comprehensive analysis can be applied to other two-component signalling pathways. PMID:21951560

[Health behaviour and changes in health behaviour - are education and social status relevant?].

PubMed

Altenhöner, T; Philippi, M; Böcken, J

2014-01-01

Individual health behaviour counts as an important factor for health status. A healthier lifestyle substantially contributes to better health. People burdened with lower health and with lower socio-economic status could benefit notably. So far it is not known exhaustively to what extent education and social status contribute to changes in health behaviour and which motifs play a decisive role. Based on cross-sectional data from the seventh wave of the "Gesundheitsmonitor", Bertelsmann Foundation, (n=1 436), the influence of social status and education on health behaviour and changes in behaviour was analysed. Specific health behaviour correlates with level of education and socio-economic status. In contrast, regarding health behaviour changes in the last 12 months prior to survey, no social class- or education-specific effect was found. Age, health status as well as fears and wishes in relation to health seem to be important causalities for changes of health-related behaviour. Interventions to foster healthy lifestyles should include class differences in specific health-related behaviour and personal reasons for behavioural changes. © Georg Thieme Verlag KG Stuttgart · New York.

Incorrect likelihood methods were used to infer scaling laws of marine predator search behaviour.

PubMed

Edwards, Andrew M; Freeman, Mervyn P; Breed, Greg A; Jonsen, Ian D

2012-01-01

Ecologists are collecting extensive data concerning movements of animals in marine ecosystems. Such data need to be analysed with valid statistical methods to yield meaningful conclusions. We demonstrate methodological issues in two recent studies that reached similar conclusions concerning movements of marine animals (Nature 451:1098; Science 332:1551). The first study analysed vertical movement data to conclude that diverse marine predators (Atlantic cod, basking sharks, bigeye tuna, leatherback turtles and Magellanic penguins) exhibited "Lévy-walk-like behaviour", close to a hypothesised optimal foraging strategy. By reproducing the original results for the bigeye tuna data, we show that the likelihood of tested models was calculated from residuals of regression fits (an incorrect method), rather than from the likelihood equations of the actual probability distributions being tested. This resulted in erroneous Akaike Information Criteria, and the testing of models that do not correspond to valid probability distributions. We demonstrate how this led to overwhelming support for a model that has no biological justification and that is statistically spurious because its probability density function goes negative. Re-analysis of the bigeye tuna data, using standard likelihood methods, overturns the original result and conclusion for that data set. The second study observed Lévy walk movement patterns by mussels. We demonstrate several issues concerning the likelihood calculations (including the aforementioned residuals issue). Re-analysis of the data rejects the original Lévy walk conclusion. We consequently question the claimed existence of scaling laws of the search behaviour of marine predators and mussels, since such conclusions were reached using incorrect methods. We discourage the suggested potential use of "Lévy-like walks" when modelling consequences of fishing and climate change, and caution that any resulting advice to managers of marine ecosystems would be problematic. For reproducibility and future work we provide R source code for all calculations.

Sense of community-belonging and health-behaviour change in Canada.

PubMed

Hystad, Perry; Carpiano, Richard M

2012-03-01

Research indicates that primary prevention targeting individual behaviours should incorporate contextual factors. The objectives of this study are to examine the role of community-belonging and contextual factors on health-behaviour change in Canada, and whether the influence of community-belonging on behaviour change varies by specific types of behaviours and contextual factors. Data on individual-level community-belonging, socio-demographics and self-rated health were obtained for 119 693 respondents from the 2007/2008 Canadian Community Health Survey located within 100 health regions across Canada. Contextual factors were based on health-region groupings of socio-economic determinants of health. Multilevel models were used to estimate the influence of community-belonging and health-region contextual factors on general, and specific, health-behaviour changes in the past year. After controlling for individual and contextual factors, community-belonging showed a positive dose-response relationship with health-behaviour change. Health-region contextual factors were only slightly associated with behaviour change; however, the influence of community-belonging on behaviour change showed significant variability based on health-region contextual factors. The influence of community-belonging also varied by specific health-behaviour changes, but for most prominent health behaviours (exercise, weight loss and improved diet) the effect was consistent. Community-belonging was strongly related to health-behaviour change in Canada and may be an important component of population health prevention strategies. Efforts to increase community-belonging, however, need to be considered along with contextual factors.

Beyond the 'teachable moment' - A conceptual analysis of women's perinatal behaviour change.

PubMed

Olander, Ellinor K; Darwin, Zoe J; Atkinson, Lou; Smith, Debbie M; Gardner, Benjamin

2016-06-01

Midwives are increasingly expected to promote healthy behaviour to women and pregnancy is often regarded as a 'teachable moment' for health behaviour change. This view focuses on motivational aspects, when a richer analysis of behaviour change may be achieved by viewing the perinatal period through the lens of the Capability-Opportunity-Motivation Behaviour framework. This framework proposes that behaviour has three necessary determinants: capability, opportunity, and motivation. To outline a broader analysis of perinatal behaviour change than is afforded by the existing conceptualisation of the 'teachable moment' by using the Capability-Opportunity-Motivation Behaviour framework. Research suggests that the perinatal period can be viewed as a time in which capability, opportunity or motivation naturally change such that unhealthy behaviours are disrupted, and healthy behaviours may be adopted. Moving away from a sole focus on motivation, an analysis utilising the Capability-Opportunity-Motivation Behaviour framework suggests that changes in capability and opportunity may also offer opportune points for intervention, and that lack of capability or opportunity may act as barriers to behaviour change that might be expected based solely on changes in motivation. Moreover, the period spanning pregnancy and the postpartum could be seen as a series of opportune intervention moments, that is, personally meaningful episodes initiated by changes in capability, opportunity or motivation. This analysis offers new avenues for research and practice, including identifying discrete events that may trigger shifts in capability, opportunity or motivation, and whether and how interventions might promote initiation and maintenance of perinatal health behaviours. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

A Method for Co-Designing Theory-Based Behaviour Change Systems for Health Promotion.

PubMed

Janols, Rebecka; Lindgren, Helena

2017-01-01

A methodology was defined and developed for designing theory-based behaviour change systems for health promotion that can be tailored to the individual. Theories from two research fields were combined with a participatory action research methodology. Two case studies applying the methodology were conducted. During and between group sessions the participants created material and designs following the behaviour change strategy themes, which were discussed, analysed and transformed into a design of a behaviour change system. Theories in behavioural change and persuasive technology guided the data collection, data analyses, and the design of a behaviour change system. The methodology has strong emphasis on the target group's participation in the design process. The different aspects brought forward related to behaviour change strategies defined in literature on persuasive technology, and the dynamics of these are associated to needs and motivation defined in literature on behaviour change. It was concluded that the methodology aids the integration of theories into a participatory action research design process, and aids the analyses and motivations of design choices.

How behavioural science can contribute to health partnerships: the case of The Change Exchange.

PubMed

Byrne-Davis, Lucie M T; Bull, Eleanor R; Burton, Amy; Dharni, Nimarta; Gillison, Fiona; Maltinsky, Wendy; Mason, Corina; Sharma, Nisha; Armitage, Christopher J; Johnston, Marie; Byrne, Ged J; Hart, Jo K

2017-06-12

Health partnerships often use health professional training to change practice with the aim of improving quality of care. Interventions to change practice can learn from behavioural science and focus not only on improving the competence and capability of health professionals but also their opportunity and motivation to make changes in practice. We describe a project that used behavioural scientist volunteers to enable health partnerships to understand and use the theories, techniques and assessments of behavioural science. This paper outlines how The Change Exchange, a collective of volunteer behavioural scientists, worked with health partnerships to strengthen their projects by translating behavioural science in situ. We describe three case studies in which behavioural scientists, embedded in health partnerships in Uganda, Sierra Leone and Mozambique, explored the behaviour change techniques used by educators, supported knowledge and skill development in behaviour change, monitored the impact of projects on psychological determinants of behaviour and made recommendations for future project developments. Challenges in the work included having time and space for behavioural science in already very busy health partnership schedules and the difficulties in using certain methods in other cultures. Future work could explore other modes of translation and further develop methods to make them more culturally applicable. Behavioural scientists could translate behavioural science which was understood and used by the health partnerships to strengthen their project work.

Applying theories of health behaviour and change to hearing health research: Time for a new approach.

PubMed

Coulson, Neil S; Ferguson, Melanie A; Henshaw, Helen; Heffernan, Eithne

2016-07-01

In recent years, there has been an increase in the application of behavioural models, such as social cognition models, to the promotion of hearing health. Despite this, there exists a well-developed body of literature that suggests such models may fail to consistently explain reliable amounts of variability in human behaviours. This paper provides a summary of this research across selected models of health-related behaviour, outlining the current state of the evidence. Recent work in the field of behaviour change is presented together with commentary on the design and reporting of behaviour change interventions. We propose that attempts to use unreliable models to explain and predict hearing health behaviours should now be replaced by work which integrates the latest in behaviour change science, such as the Behaviour Change Wheel and Theoretical Domains Framework.

Patterns of cognitive dissonance-reducing beliefs among smokers: a longitudinal analysis from the International Tobacco Control (ITC) Four Country Survey

PubMed Central

Fotuhi, Omid; Fong, Geoffrey T; Zanna, Mark P; Borland, Ron; Yong, Hua-Hie; Cummings, K Michael

2013-01-01

Objective The purpose of this paper is to assess whether smokers adjust their beliefs in a pattern that is consistent with Cognitive Dissonance Theory. This is accomplished by examining the longitudinal pattern of belief change among smokers as their smoking behaviours change. Methods A telephone survey was conducted of nationally representative samples of adult smokers from Canada, the USA, the UK and Australia from the International Tobacco Control Four Country Survey. Smokers were followed across three waves (October 2002 to December 2004), during which they were asked to report on their smoking-related beliefs and their quitting behaviour. Findings Smokers with no history of quitting across the three waves exhibited the highest levels of rationalisations for smoking. When smokers quit smoking, they reported having fewer rationalisations for smoking compared with when they had previously been smoking. However, among those who attempted to quit but then relapsed, there was once again a renewed tendency to rationalise their smoking. This rebound in the use of rationalisations was higher for functional beliefs than for risk-minimising beliefs, as predicted by social psychological theory. Conclusions Smokers are motivated to rationalise their behaviour through the endorsement of more positive beliefs about smoking, and these beliefs change systematically with changes in smoking status. More work is needed to determine if this cognitive dissonance-reducing function has an inhibiting effect on any subsequent intentions to quit. PMID:22218426

Continuity and discontinuity of attachment patterns: a short-term longitudinal pilot study using a sample of late-adopted children and their adoptive mothers.

PubMed

Pace, C S; Zavattini, G C; D'Alessio, M

2012-01-01

This study analysed the attachment patterns of 28 late-adopted children (placed when they were between four and seven years of age) and their adoptive mothers. The change in the children's internal working models (IWMs) within seven to eight months of their placement was evaluated. In addition, we wanted to observe the influence of a secure-autonomous maternal state of mind in facilitating the change in the children's IWMs and the possible associations between the maternal IWMs and the children's IWMs in the adoptive dyads. The separation-reunion procedure (SRP) was used for the late-adopted children in order to assess their attachment behavioural patterns, and the Manchester Child Attachment Story Task (MCAST) was used to evaluate their attachment narrative patterns. The adoptive mothers completed the Adult Attachment Interview (AAI) in order to classify their state of mind with regard to attachment. The results showed a significant change in the attachment behavioural patterns of late-adopted children, from insecure to secure (p = .002). Furthermore, the children who presented this change were predominantly placed with secure-autonomous adoptive mothers (p = .047), although the link between the adoptive mothers' representations of their attachment history and their adopted children's completed narratives was not significant. In conclusion, it seems possible to revise the attachment behaviour of late-adopted children but, for about one-third of children, the adverse history will persist at a narrative/representational level.

A Fibre-Reinforced Poroviscoelastic Model Accurately Describes the Biomechanical Behaviour of the Rat Achilles Tendon

PubMed Central

Heuijerjans, Ashley; Matikainen, Marko K.; Julkunen, Petro; Eliasson, Pernilla; Aspenberg, Per; Isaksson, Hanna

2015-01-01

Background Computational models of Achilles tendons can help understanding how healthy tendons are affected by repetitive loading and how the different tissue constituents contribute to the tendon’s biomechanical response. However, available models of Achilles tendon are limited in their description of the hierarchical multi-structural composition of the tissue. This study hypothesised that a poroviscoelastic fibre-reinforced model, previously successful in capturing cartilage biomechanical behaviour, can depict the biomechanical behaviour of the rat Achilles tendon found experimentally. Materials and Methods We developed a new material model of the Achilles tendon, which considers the tendon’s main constituents namely: water, proteoglycan matrix and collagen fibres. A hyperelastic formulation of the proteoglycan matrix enabled computations of large deformations of the tendon, and collagen fibres were modelled as viscoelastic. Specimen-specific finite element models were created of 9 rat Achilles tendons from an animal experiment and simulations were carried out following a repetitive tensile loading protocol. The material model parameters were calibrated against data from the rats by minimising the root mean squared error (RMS) between experimental force data and model output. Results and Conclusions All specimen models were successfully fitted to experimental data with high accuracy (RMS 0.42-1.02). Additional simulations predicted more compliant and soft tendon behaviour at reduced strain-rates compared to higher strain-rates that produce a stiff and brittle tendon response. Stress-relaxation simulations exhibited strain-dependent stress-relaxation behaviour where larger strains produced slower relaxation rates compared to smaller strain levels. Our simulations showed that the collagen fibres in the Achilles tendon are the main load-bearing component during tensile loading, where the orientation of the collagen fibres plays an important role for the tendon’s viscoelastic response. In conclusion, this model can capture the repetitive loading and unloading behaviour of intact and healthy Achilles tendons, which is a critical first step towards understanding tendon homeostasis and function as this biomechanical response changes in diseased tendons. PMID:26030436

Adverse life events and emotional and behavioural problems in adolescence: the role of coping and emotion regulation.

PubMed

Flouri, Eirini; Mavroveli, Stella

2013-12-01

We tested whether emotion regulation (cognitive reappraisal and expressive suppression) and coping (distraction, avoidance, support seeking and active coping) mediate or moderate the association between change in life stress (change in number of adverse life events) and change in adolescent problem behaviour. We used prospective and retrospective longitudinal data from a community sample. We measured change in problem behaviour as emotional and behavioural problems at Time 2 controlling for emotional and behavioural problems at Time 1, a year earlier. We measured change in life stress as life stress between Times 1 and 2, controlling for total previous life stress (before Time 1). Neither coping nor emotion regulation mediated the association between change in life stress and change in problem behaviour. Avoidance and expressive suppression were related to an increase in problem behaviour. Only cognitive reappraisal moderated the effect of increase in life stress on worsening of problem behaviour, suggesting that, as expected, cognitive reappraisal was a protective factor. In adolescents who reported they habitually reappraise, the association between change in life stress and change in emotional and behavioural problems was non-significant. Copyright © 2012 John Wiley & Sons, Ltd.

Behaviour change opportunities at mother and baby checks in primary care: a qualitative investigation of the experiences of GPs.

PubMed

Talbot, Hannah; Strong, Emily; Peters, Sarah; Smith, Debbie M

2018-04-01

Pregnancy is widely recognised as a 'teachable moment' for healthy behaviour change and the postnatal period has been identified as the opportune time to initiate this change. In the UK, all women are offered a routine health check at 6-8 weeks postpartum with their GP. This provides a potential opportunity to facilitate long-term behaviour change discussions. To explore GPs' views and experiences of using the postnatal check as a health-related behaviour change opportunity. A qualitative, inductive study in general practice. Semi-structured telephone interviews were conducted with 18 GPs. Audiorecorded interviews were transcribed verbatim and analysed using thematic analysis. One theme emerged from the data: the postnatal check is an unrealised opportunity to facilitate health-related behaviour change. This theme was organised into three subthemes: opportunity for health-related behaviour change; role responsibility; and patient-led versus GP-led behaviour change. Although GPs recognise the postnatal check as a potential opportunity for health-related behaviour change, it is underutilised as they do not perceive this to be the purpose of the check and are uncertain as to their role in facilitating lifestyle changes. To enable this long-term lifestyle behaviour change opportunity to be utilised more fully, further research is needed to understand women's expectations of the postnatal checks and the scope for further recommendations, guidance, and communication training around behaviour change. © British Journal of General Practice 2018.

Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review

PubMed Central

Rushforth, Bruno; McCrorie, Carolyn; Glidewell, Liz; Midgley, Eleanor; Foy, Robbie

2016-01-01

Background Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. Aim To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians’ and nurses’ perceived influences on care. Design and setting Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Method Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians’ or nurses’ perceived influences on treatment goals for type 2 diabetes. Results A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Conclusion Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than ‘one size fits all’ approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians’ skills and emotions around treatment intensification and facilitation of patient behaviour change. PMID:26823263

Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial.

PubMed

Butler, Christopher C; Simpson, Sharon A; Hood, Kerenza; Cohen, David; Pickles, Tim; Spanou, Clio; McCambridge, Jim; Moore, Laurence; Randell, Elizabeth; Alam, M Fasihul; Kinnersley, Paul; Edwards, Adrian; Smith, Christine; Rollnick, Stephen

2013-03-19

To evaluate the effect of training primary care health professionals in behaviour change counselling on the proportion of patients self reporting change in four risk behaviours (smoking, alcohol use, exercise, and healthy eating). Cluster randomised trial with general practices as the unit of randomisation. General practices in Wales. 53 general practitioners and practice nurses from 27 general practices (one each at all but one practice) recruited 1827 patients who screened positive for at least one risky behaviour. Behaviour change counselling was developed from motivational interviewing to enable clinicians to enhance patients' motivation to change health related behaviour. Clinicians were trained using a blended learning programme called Talking Lifestyles. Proportion of patients who reported making beneficial changes in at least one of the four risky behaviours at three months. 1308 patients from 13 intervention and 1496 from 14 control practices were approached: 76% and 72% respectively agreed to participate, with 831 (84%) and 996 (92%) respectively screening eligible for an intervention. There was no effect on the primary outcome (beneficial change in behaviour) at three months (362 (44%) v 404 (41%), odds ratio 1.12 (95% CI 0.90 to 1.39)) or on biochemical or biometric measures at 12 months. More patients who had consulted with trained clinicians recalled consultation discussion about a health behaviour (724/795 (91%) v 531/966 (55%), odds ratio 12.44 (5.85 to 26.46)) and intended to change (599/831 (72%) v 491/996 (49%), odds ratio 2.88 (2.05 to 4.05)). More intervention practice patients reported making an attempt to change (328 (39%) v 317 (32%), odds ratio 1.40 (1.15 to 1.70)), a sustained behaviour change at three months (288 (35%) v 280 (28%), odds ratio 1.36 (1.11 to 1.65)), and reported slightly greater improvements in healthy eating at three and 12 months, plus improved activity at 12 months. Training cost £1597 per practice. Training primary care clinicians in behaviour change counselling using a brief blended learning programme did not increase patients reported beneficial behaviour change at three months or improve biometric and a biochemical measure at 12 months, but it did increase patients' recollection of discussing behaviour change with their clinicians, intentions to change, attempts to change, and perceptions of having made a lasting change at three months. Enduring behaviour change and improvements in biometric measures are unlikely after a single routine consultation with a clinician trained in behaviour change counselling without additional intervention. ISRCTN 22495456.

Improving medication management in multimorbidity: development of the MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) intervention using the Behaviour Change Wheel.

PubMed

Sinnott, Carol; Mercer, Stewart W; Payne, Rupert A; Duerden, Martin; Bradley, Colin P; Byrne, Molly

2015-09-24

Multimorbidity, the presence of two or more chronic conditions, affects over 60 % of patients in primary care. Due to its association with polypharmacy, the development of interventions to optimise medication management in patients with multimorbidity is a priority. The Behaviour Change Wheel is a new approach for applying behavioural theory to intervention development. Here, we describe how we have used results from a review of previous research, original research of our own and the Behaviour Change Wheel to develop an intervention to improve medication management in multimorbidity by general practitioners (GPs), within the overarching UK Medical Research Council guidance on complex interventions. Following the steps of the Behaviour Change Wheel, we sought behaviours associated with medication management in multimorbidity by conducting a systematic review and qualitative study with GPs. From the modifiable GP behaviours identified, we selected one and conducted a focused behavioural analysis to explain why GPs were or were not engaging in this behaviour. We used the behavioural analysis to determine the intervention functions, behavioural change techniques and implementation plan most likely to effect behavioural change. We identified numerous modifiable GP behaviours in the systematic review and qualitative study, from which active medication review (rather than passive maintaining the status quo) was chosen as the target behaviour. Behavioural analysis revealed GPs' capabilities, opportunities and motivations relating to active medication review. We combined the three intervention functions deemed most likely to effect behavioural change (enablement, environmental restructuring and incentivisation) to form the MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) intervention. MY COMRADE primarily involves the technique of social support: two GPs review the medications prescribed to a complex multimorbid patient together. Four other behavioural change techniques are incorporated: restructuring the social environment, prompts/cues, action planning and self-incentives. This study is the first to use the Behaviour Change Wheel to develop an intervention targeting multimorbidity and confirms the usability and usefulness of the approach in a complex area of clinical care. The systematic development of the MY COMRADE intervention will facilitate a thorough evaluation of its effectiveness in the next phase of this work.

Evaluating the relative effectiveness of high-intensity and low-intensity models of behaviour change communication interventions for abortion care-seeking in Bihar and Jharkhand, India: a cross-sectional study

PubMed Central

Banerjee, Sushanta K; Andersen, Kathryn; Pearson, Erin; Warvadekar, Janardan; Khan, Danish U; Batra, Sangeeta

2017-01-01

Background This study aimed to compare the effectiveness of a high-intensity model (HIM) and a low-intensity model (LIM) of behaviour change communication interventions in Bihar and Jharkhand states of India designed to improve women's knowledge and usage of safe abortion services, as well as the dose effect of intervention exposure. Methods We conducted two cross-sectional household surveys among married women aged 15–49 years in intervention and comparison districts. Difference-in-difference models were used to assess the efficacy of the intervention, adjusting for sociodemographic characteristics. Results Although both intervention types improved abortion knowledge, the HIM intervention was more effective in improving comprehensive knowledge about abortion. In particular, there were improvements in knowledge on legality of abortion (AOR=2.2; 95% CI 1.6 to 2.9) and nearby sources of safe abortion care (AOR=1.7; 95% CI 1.2 to 1.3). Conclusions Higher level of exposure to abortion-related messages was related to more accurate knowledge about abortion within both intervention groups. Evidence was mixed on changes in abortion care-seeking behaviour. More work is needed to ensure that women seek safe abortion services in lieu of informal services that may be more likely to lead to postabortion complications. PMID:28237953

Preventive Role of Indian Black Pepper in Animal Models of Alzheimer’s Disease

PubMed Central

Suresh, RN; MK, Jayanthi; HL, Kalabharathi; AM, Satish; VH, Pushpa

2015-01-01

Introduction: Dementia is the clinical symptom of alzheimer’s disease. Brain cholinesterase levels and behavioural changes are the markers for Alzheimer’s disease and aluminium chloride is one causative agent for polymerization of tau protein and amyloid plaque formation in Alzheimer’s disease. Effect of piper nigrum and its role in prevention of alzhimer’s disease and symptoms are well linked in this study. Aim: To study the effect of piper nigrum for the prevention of alzheimer’s associated histopathological, biochemical and behaviour changes in rat model. Materials and Methods: Twenty four rats were taken in this study. Their baseline behavioural parameters were noted and group was separated randomly in four. Rats were pretreated with piper nigrum and Alzheimer’s disease was induced. Biochemical and histopathological changes were noted at the end of experiment. Results: There was marked decrease in cholinesterase level, amyloidal plaque formation in rats brain who were pretreated with piper nigrum. At the same time there was decrease in escape latency time (ELT) and increase in memory in piper treated rats. Conclusion: Piper nigrum prove to be effective for prevention of Alzheimer’s disease. This finding has to be confirmed with studies including larger population. Further research on cholinesterase inhibitors, role of flavonoids on prevention of neurodegeneration in Alzheimer’s disease can be encouraged. PMID:26023568

No phenotypic plasticity in nest-site selection in response to extreme flooding events.

PubMed

Bailey, Liam D; Ens, Bruno J; Both, Christiaan; Heg, Dik; Oosterbeek, Kees; van de Pol, Martijn

2017-06-19

Phenotypic plasticity is a crucial mechanism for responding to changes in climatic means, yet we know little about its role in responding to extreme climatic events (ECEs). ECEs may lack the reliable cues necessary for phenotypic plasticity to evolve; however, this has not been empirically tested. We investigated whether behavioural plasticity in nest-site selection allows a long-lived shorebird ( Haematopus ostralegus ) to respond to flooding. We collected longitudinal nest elevation data on individuals over two decades, during which time flooding events have become increasingly frequent. We found no evidence that individuals learn from flooding experiences, showing nest elevation change consistent with random nest-site selection. There was also no evidence of phenotypic plasticity in response to potential environmental cues (lunar nodal cycle and water height). A small number of individuals, those nesting near an artificial sea wall, did show an increase in nest elevation over time; however, there is no conclusive evidence this occurred in response to ECEs. Our study population showed no behavioural plasticity in response to changing ECE patterns. More research is needed to determine whether this pattern is consistent across species and types of ECEs. If so, ECEs may pose a major challenge to the resilience of wild populations.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'. © 2017 The Author(s).

A meta-analysis of the effects of measuring theory of planned behaviour constructs on behaviour within prospective studies.

PubMed

Mankarious, Evon; Kothe, Emily

2015-01-01

Measurement reactivity effects, such as the mere measurement effect, have been proposed as a reason for behavioural changes in a number of theory of planned behaviour intervention studies. However, it is unclear whether such changes are the result of the mere measurement effect or of other artefacts of intervention study design. The aim of this study is to determine the size and direction of changes in health behaviours from baseline to follow-up in prospective studies using the theory of planned behaviour. Electronic databases were searched for the theory of planned behaviour studies which measured health behaviours at two or more time points. Change in behaviour was calculated for all studies. Sixty-six studies were included. Mean effect sizes across all studies were small and negative (d = -.03). Effect size was moderated by behaviour, behaviour type and follow-up length. Subgroup analyses showed significant decreases in socially undesirable behaviour (d = -.28), binge drinking (d = -.17), risk driving (d = -.20), sugar snack consumption (d = -.43) and sun-protective behaviour (d = -.18). Measurement of intention at baseline resulted in significant decreases in undesirable behaviour. Changes in undesirable behaviours reported in other studies may be the result of the mere measurement effect.

Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework

PubMed Central

2012-01-01

Background There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a Series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research. Methods The intervention was developed considering three main components: theory, evidence, and practical issues. We used a four-step approach, consisting of guiding questions, to direct the choice of the most appropriate components of an implementation intervention: Who needs to do what, differently? Using a theoretical framework, which barriers and enablers need to be addressed? Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? And how can behaviour change be measured and understood? Results A complex implementation intervention was designed that aimed to improve acute low back pain management in primary care. We used the TDF to identify the barriers and enablers to the uptake of evidence into practice and to guide the choice of intervention components. These components were then combined into a cohesive intervention. The intervention was delivered via two facilitated interactive small group workshops. We also produced a DVD to distribute to all participants in the intervention group. We chose outcome measures in order to assess the mediating mechanisms of behaviour change. Conclusions We have illustrated a four-step systematic method for developing an intervention designed to change clinical practice based on a theoretical framework. The method of development provides a systematic framework that could be used by others developing complex implementation interventions. While this framework should be iteratively adjusted and refined to suit other contexts and settings, we believe that the four-step process should be maintained as the primary framework to guide researchers through a comprehensive intervention development process. PMID:22531013

Longitudinal changes in objectively measured sedentary behaviour and their relationship with adiposity in children and adolescents: systematic review and evidence appraisal.

PubMed

Tanaka, C; Reilly, J J; Huang, W Y

2014-10-01

This review aimed to determine longitudinal changes in objectively measured overall sedentary behaviour, and to examine their associations with adiposity in children and adolescents. A search for longitudinal studies was performed using several electronic databases. Of 161 potentially eligible papers, 10 for change in sedentary behaviour and 3 for longitudinal associations with change in adiposity were included. Weighted mean increase in daily sedentary behaviour per year was 5.7% for boys and 5.8% for girls. Only one paper included preschool children, and it showed a decrease in sedentary behaviour. Nine studies were from Western countries. Null associations were reported between sedentary behaviour and adiposity in two studies, the other found that increases in sedentary behaviour were associated with increases in adiposity, but only in those with body mass index above the 50th percentile. There was consistent evidence that sedentary behaviour increases with age in school-age children and adolescents, by approximately 30 min extra daily sedentary behaviour per year. There was little evidence on the influence of changes in sedentary behaviour on changes in adiposity. There is a need for more longitudinal research, for more evidence from outside the Western world, and for more studies that examine 'dose-response' associations between changes in sedentary behaviour and changes in adiposity. © 2014 The Author(s). obesity reviews © 2014 World Obesity.

Analysis of health behaviour change interventions for preventing dental caries delivered in primary schools.

PubMed

Adair, P M; Burnside, G; Pine, C M

2013-01-01

To improve oral health in children, the key behaviours (tooth brushing and sugar control) responsible for development of dental caries need to be better understood, as well as how to promote these behaviours effectively so they become habitual; and, the specific, optimal techniques to use in interventions. The aim of this paper is to describe and analyse the behaviour change techniques that have been used in primary school-based interventions to prevent dental caries (utilizing a Cochrane systematic review that we have undertaken) and to identify opportunities for improving future interventions by incorporating a comprehensive range of behaviour change techniques. Papers of five interventions were reviewed and data were independently extracted. Results indicate that behaviour change techniques were limited to information-behaviour links, information on consequences, instruction and demonstration of behaviours. None of the interventions were based on behaviour change theory. We conclude that behaviour change techniques used in school interventions to reduce dental caries were limited and focused around providing information about how behaviour impacts on health and the consequences of not developing the correct health behaviours as well as providing oral hygiene instruction. Establishing which techniques are effective is difficult due to poor reporting of interventions in studies. Future design of oral health promotion interventions using behaviour change theory for development and evaluation (and reporting results in academic journals) could strengthen the potential for efficacy and provide a framework to use a much wider range of behaviour change techniques. Future studies should include development and publication of intervention manuals which is becoming standard practice in other health promoting programmes. © 2013 S. Karger AG, Basel.

Behaviour change interventions to influence antimicrobial prescribing: a cross-sectional analysis of reports from UK state-of-the-art scientific conferences.

PubMed

Rawson, T M; Moore, L S P; Tivey, A M; Tsao, A; Gilchrist, M; Charani, E; Holmes, A H

2017-01-01

To improve the quality of antimicrobial stewardship (AMS) interventions the application of behavioural sciences supported by multidisciplinary collaboration has been recommended. We analysed major UK scientific research conferences to investigate AMS behaviour change intervention reporting. Leading UK 2015 scientific conference abstracts for 30 clinical specialties were identified and interrogated. All AMS and/or antimicrobial resistance(AMR) abstracts were identified using validated search criteria. Abstracts were independently reviewed by four researchers with reported behavioural interventions classified using a behaviour change taxonomy. Conferences ran for 110 days with >57,000 delegates. 311/12,313(2.5%) AMS-AMR abstracts (oral and poster) were identified. 118/311(40%) were presented at the UK's infectious diseases/microbiology conference. 56/311(18%) AMS-AMR abstracts described behaviour change interventions. These were identified across 12/30(40%) conferences. The commonest abstract reporting behaviour change interventions were quality improvement projects [44/56 (79%)]. In total 71 unique behaviour change functions were identified. Policy categories; "guidelines" (16/71) and "service provision" (11/71) were the most frequently reported. Intervention functions; "education" (6/71), "persuasion" (7/71), and "enablement" (9/71) were also common. Only infection and primary care conferences reported studies that contained multiple behaviour change interventions. The remaining 10 specialties tended to report a narrow range of interventions focusing on "guidelines" and "enablement". Despite the benefits of behaviour change interventions on antimicrobial prescribing, very few AMS-AMR studies reported implementing them in 2015. AMS interventions must focus on promoting behaviour change towards antimicrobial prescribing. Greater focus must be placed on non-infection specialties to engage with the issue of behaviour change towards antimicrobial use.

Measuring healthy behaviours using the stages of change model: an investigation into the physical activity and nutrition behaviours of Australian miners.

PubMed

Lacey, Sarah J; Street, Tamara D

2017-01-01

Obesity is one of the fastest growing modern day epidemics affecting preventable disease and premature deaths. Healthy lifestyle behaviours, such as physical activity and nutritional consumption, have been shown to reduce the likelihood of obesity and obesity related health risks. Originally designed for measurement of unhealthy behaviours, the Stages of Change model, describes 'precontemplators' as individuals who engage in the unhealthy behaviour, are unaware that their behaviour is problematic, and are resistant to change. The aim of this study was to refine and assess the measures of the Stages of Change model in order to achieve a concise and reliable classification of precontemplators, in the context of healthy behaviours. Eight hundred and ninety-seven employees participated in a health survey measuring current health behaviours and stage of change. This study compared a traditional precontemplation measure to a modified version in the assessment of two healthy behaviours: physical activity and fruit and vegetable consumption. The modified measure was more accurate and captured fewer individuals currently meeting the guideline for both physical activity and nutrition, compared to the traditional measure of stages of change. However, across all stages of change, the measure incorrectly classified some employees with regards to meeting health guidelines. When applied to healthy behaviours, the stages of change measure for precontemplation should be further refined to reflect knowledge that the behaviour is unhealthy, and apathy to change. Additionally, measures should define health guidelines to increase reliable classification across all stages of change. The findings can be applied to inform the design and implementation of health promotion strategies targeting obesity related lifestyle behaviours in the general population.

Behavioural change, indoor air pollution and child respiratory health in developing countries: a review.

PubMed

Barnes, Brendon R

2014-04-25

Indoor air pollution caused by the indoor burning of solid biomass fuels has been associated with Acute Respiratory Infections such as pneumonia amongst children of less than five years of age. Behavioural change interventions have been identified as a potential strategy to reduce child indoor air pollution exposure, yet very little is known about the impact of behavioural change interventions to reduce indoor air pollution. Even less is known about how behaviour change theory has been incorporated into indoor air pollution behaviour change interventions. A review of published studies spanning 1983-2013 suggests that behavioural change strategies have the potential to reduce indoor air pollution exposure by 20%-98% in laboratory settings and 31%-94% in field settings. However, the evidence is: (1) based on studies that are methodologically weak; and (2) have little or no underlying theory. The paper concludes with a call for more rigorous studies to evaluate the role of behavioural change strategies (with or without improved technologies) to reduce indoor air pollution exposure in developing countries as well as interventions that draw more strongly on existing behavioural change theory and practice.

Development of a behaviour change intervention: a case study on the practical application of theory.

PubMed

Porcheret, Mark; Main, Chris; Croft, Peter; McKinley, Robert; Hassell, Andrew; Dziedzic, Krysia

2014-04-03

Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised 'context-bound communication skills training.' Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. A stepped approach to the development of a behaviour change intervention, with the utilisation of theoretical frameworks to identify determinants of change matched with behaviour change techniques, has enabled a systematic and theory-driven development of an intervention designed to enhance consultations by GPs for patients with OA. The success of the behaviour change intervention in practice will be evaluated in the context of the MOSAICS trial as a whole, and will inform understanding of practice level and patient outcomes in the trial.

Rodent motor and neuropsychological behaviour measured in home cages using the integrated modular platform SmartCage™.

PubMed

Khroyan, Taline V; Zhang, Jingxi; Yang, Liya; Zou, Bende; Xie, James; Pascual, Conrado; Malik, Adam; Xie, Julian; Zaveri, Nurulain T; Vazquez, Jacqueline; Polgar, Willma; Toll, Lawrence; Fang, Jidong; Xie, Xinmin

2012-07-01

1. To facilitate investigation of diverse rodent behaviours in rodents' home cages, we have developed an integrated modular platform, the SmartCage(™) system (AfaSci, Inc. Burlingame, CA, USA), which enables automated neurobehavioural phenotypic analysis and in vivo drug screening in a relatively higher-throughput and more objective manner. 2, The individual platform consists of an infrared array, a vibration floor sensor and a variety of modular devices. One computer can simultaneously operate up to 16 platforms via USB cables. 3. The SmartCage(™) detects drug-induced increases and decreases in activity levels, as well as changes in movement patterns. Wake and sleep states of mice can be detected using the vibration floor sensor. The arousal state classification achieved up to 98% accuracy compared with results obtained by electroencephalography and electromyography. More complex behaviours, including motor coordination, anxiety-related behaviours and social approach behaviour, can be assessed using appropriate modular devices and the results obtained are comparable with results obtained using conventional methods. 4. In conclusion, the SmartCage(™) system provides an automated and accurate tool to quantify various rodent behaviours in a 'stress-free' environment. This system, combined with the validated testing protocols, offers powerful a tool kit for transgenic phenotyping and in vivo drug screening. © 2012 The Authors. Clinical and Experimental Pharmacology and Physiology © 2012 Blackwell Publishing Asia Pty Ltd.

Induction of scratching behaviour in cats: efficacy of synthetic feline interdigital semiochemical.

PubMed

Cozzi, Alessandro; Lecuelle, Céline Lafont; Monneret, Philippe; Articlaux, Florence; Bougrat, Laurent; Mengoli, Manuel; Pageat, Patrick

2013-10-01

The aim of the study was to evaluate the effects of synthetic feline interdigital semiochemical (FIS) on the induction of scratching behaviour in cats during a standardised behavioural test. The trial was a randomised blinded study on a single group of subjects, following a crossover design. The scratching behaviour of 19 cats was evaluated during a standardised test in which cats were introduced to an area with one scratching post. Each cat acted as its own control (receiving, at random, FIS then placebo or vice versa). The test lasted for 5 mins, after which the cat was left alone in the test area. Duration, frequency of scratching and latency of first scratching behaviour were noted. Two independent observers analysed the videos. Thirty-eight tests were recorded with a different scratching post each time (two tests per cat). The scratching post with the semiochemical was more scratched in duration and frequency by the cats involved in the study (intention to treat analysis). The same conclusion was found using per-protocol analysis, which included only cats that scratched during the test. Regarding latency, no significant difference was found between treatment and placebo. The results seem of interest in explaining the role of a FIS in inducing scratching behaviour on a scratching post. The semiochemical approach can modify the choice of areas selected spontaneously by cats, and could be used either as a preventive measure for a cat arriving at home or to control or change an inappropriate scratching behaviour.

Motivational and behavioural models of change: A longitudinal analysis of change among men with chronic haemophilia-related joint pain.

PubMed

Elander, J; Richardson, C; Morris, J; Robinson, G; Schofield, M B

2017-09-01

Motivational and behavioural models of adjustment to chronic pain make different predictions about change processes, which can be tested in longitudinal analyses. We examined changes in motivation, coping and acceptance among 78 men with chronic haemophilia-related joint pain. Using cross-lagged regression analyses of changes from baseline to 6 months as predictors of changes from 6 to 12 months, with supplementary structural equation modelling, we tested two models in which motivational changes influence behavioural changes, and one in which behavioural changes influence motivational changes. Changes in motivation to self-manage pain influenced later changes in pain coping, consistent with the motivational model of pain self-management, and also influenced later changes in activity engagement, the behavioural component of pain acceptance. Changes in activity engagement influenced later changes in pain willingness, consistent with the behavioural model of pain acceptance. Based on the findings, a combined model of changes in pain self-management and acceptance is proposed, which could guide combined interventions based on theories of motivation, coping and acceptance in chronic pain. This study adds longitudinal evidence about sequential change processes; a test of the motivational model of pain self-management; and tests of behavioural versus motivational models of pain acceptance. © 2017 European Pain Federation - EFIC®.

Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial

PubMed Central

Simpson, Sharon A; Hood, Kerenza; Cohen, David; Pickles, Tim; Spanou, Clio; McCambridge, Jim; Moore, Laurence; Randell, Elizabeth; Alam, M Fasihul; Kinnersley, Paul; Edwards, Adrian; Smith, Christine; Rollnick, Stephen

2013-01-01

Objectives To evaluate the effect of training primary care health professionals in behaviour change counselling on the proportion of patients self reporting change in four risk behaviours (smoking, alcohol use, exercise, and healthy eating). Design Cluster randomised trial with general practices as the unit of randomisation. Setting General practices in Wales. Participants 53 general practitioners and practice nurses from 27 general practices (one each at all but one practice) recruited 1827 patients who screened positive for at least one risky behaviour. Intervention Behaviour change counselling was developed from motivational interviewing to enable clinicians to enhance patients’ motivation to change health related behaviour. Clinicians were trained using a blended learning programme called Talking Lifestyles. Main outcome measures Proportion of patients who reported making beneficial changes in at least one of the four risky behaviours at three months. Results 1308 patients from 13 intervention and 1496 from 14 control practices were approached: 76% and 72% respectively agreed to participate, with 831 (84%) and 996 (92%) respectively screening eligible for an intervention. There was no effect on the primary outcome (beneficial change in behaviour) at three months (362 (44%) v 404 (41%), odds ratio 1.12 (95% CI 0.90 to 1.39)) or on biochemical or biometric measures at 12 months. More patients who had consulted with trained clinicians recalled consultation discussion about a health behaviour (724/795 (91%) v 531/966 (55%), odds ratio 12.44 (5.85 to 26.46)) and intended to change (599/831 (72%) v 491/996 (49%), odds ratio 2.88 (2.05 to 4.05)). More intervention practice patients reported making an attempt to change (328 (39%) v 317 (32%), odds ratio 1.40 (1.15 to 1.70)), a sustained behaviour change at three months (288 (35%) v 280 (28%), odds ratio 1.36 (1.11 to 1.65)), and reported slightly greater improvements in healthy eating at three and 12 months, plus improved activity at 12 months. Training cost £1597 per practice. Discussion Training primary care clinicians in behaviour change counselling using a brief blended learning programme did not increase patients reported beneficial behaviour change at three months or improve biometric and a biochemical measure at 12 months, but it did increase patients’ recollection of discussing behaviour change with their clinicians, intentions to change, attempts to change, and perceptions of having made a lasting change at three months. Enduring behaviour change and improvements in biometric measures are unlikely after a single routine consultation with a clinician trained in behaviour change counselling without additional intervention. Trial registration ISRCTN 22495456 PMID:23512758

Patterns of adolescent physical activity and dietary behaviours

PubMed Central

Pearson, Natalie; Atkin, Andrew J; Biddle, Stuart JH; Gorely, Trish; Edwardson, Charlotte

2009-01-01

Background The potential synergistic effects of multiple dietary and physical activity behaviours on the risk of chronic conditions and health outcomes is a key issue for public health. This study examined the prevalence and clustering patterns of multiple health behaviours among a sample of adolescents in the UK. Methods Cross-sectional survey of 176 adolescents aged 12–16 years (49% boys). Adolescents wore accelerometers for seven days and completed a questionnaire assessing fruit, vegetable, and breakfast consumption. The prevalence of adolescents meeting the physical activity (≥ 60 minutes moderate-to-vigorous physical activity/day), fruit and vegetable (≥ 5 portions of FV per day) and breakfast recommendations (eating breakfast on ≥ 5 days per week), and clustering patterns of these health behaviours are described. Results Boys were more active than girls (p < 0.001) and younger adolescents were more active than older adolescents (p < 0.01). Boys ate breakfast on more days per week than girls (p < 0.01) and older adolescents ate more fruit and vegetables than younger adolescents (p < 0.01). Almost 54% of adolescents had multiple risk behaviours and only 6% achieved all three of the recommendations. Girls had significantly more risk factors than boys (p < 0.01). For adolescents with two risk behaviours, the most prevalent cluster was formed by not meeting the physical activity and fruit and vegetable recommendations. Conclusion Many adolescents fail to meet multiple diet and physical activity recommendations, highlighting that physical activity and dietary behaviours do not occur in isolation. Future research should investigate how best to achieve multiple health behaviour change in adolescent boys and girls. PMID:19624822

Predictors of health-related behaviour change in parents of overweight children in England.

PubMed

Park, Min Hae; Falconer, Catherine L; Croker, Helen; Saxena, Sonia; Kessel, Anthony S; Viner, Russell M; Kinra, Sanjay

2014-05-01

Providing parents with information about their child's overweight status (feedback) could prompt them to make lifestyle changes for their children. We assessed whether parents of overweight children intend to or change behaviours following feedback, and examined predictors of these transitions. We analysed data from a cohort of parents of children aged 4-5 and 10-11 years participating in the National Child Measurement Programme in five areas of England, 2010-2011. Parents of overweight children (body mass index ≥91st centile) with data at one or six months after feedback were included (n=285). The outcomes of interest were intention to change health-related behaviours and positive behaviour change at follow-up. Associations between respondent characteristics and outcomes were assessed using logistic regression analysis. After feedback, 72.1% of parents reported an intention to change; 54.7% reported positive behaviour change. Intention was associated with recognition of child overweight status (OR 11.20, 95% CI 4.49, 27.93). Parents of older and non-white children were more likely to report behaviour changes than parents of younger or white children. Intention did not predict behaviour change. Parental recognition of child overweight predicts behavioural intentions. However, intentions do not necessarily translate into behaviours; interventions that aim to change intentions may have limited benefits. Copyright © 2014. Published by Elsevier Inc.

Attitudes about sexual disclosure and perceptions of stigma and shame

PubMed Central

Cunningham, S; Tschann, J; Gurvey, J; Fortenberry, J; Ellen, J

2002-01-01

Methods: A household sample of 142 sexually active African-American youths, 13–19 years old, was questioned about STD related stigma (alpha = 0.89), STD related shame (alpha = 0.90), and perceptions about disclosure of sexual behaviours to a doctor or nurse (alpha = 0.81). Results: Among females, stigma was associated with increased anticipation of negative reactions to disclosure of sexual behaviours to a doctor or nurse (odds ratio (OR) = 0.319; 95% confidence interval (CI) =0.12 to 0.85) while shame was not. Stigma was also independently associated with STD related care seeking in the past year (OR = 0.296; 95% CI = 0.09 to 0.94) while shame was not. There was no association between stigma and shame with perceptions about disclosure or past care seeking in males. Perceived outcomes of disclosing sexual behaviours did not moderate the association of stigma, shame, and past STD related care seeking. Conclusions: Stigma about STDs may influence how female adolescents perceive reactions to disclosure of their sexual behaviour to healthcare providers. It may also be an important factor in their decision seek to STD related care. Perceptions about disclosure of sexual behaviour to a doctor or nurse do not change the relation of stigma or shame to past STD related care seeking. PMID:12407233

Using theories of behaviour change to inform interventions for addictive behaviours.

PubMed

Webb, Thomas L; Sniehotta, Falko F; Michie, Susan

2010-11-01

This paper reviews a set of theories of behaviour change that are used outside the field of addiction and considers their relevance for this field. Ten theories are reviewed in terms of (i) the main tenets of each theory, (ii) the implications of the theory for promoting change in addictive behaviours and (iii) studies in the field of addiction that have used the theory. An augmented feedback loop model based on Control Theory is used to organize the theories and to show how different interventions might achieve behaviour change. Briefly, each theory provided the following recommendations for intervention: Control Theory: prompt behavioural monitoring, Goal-Setting Theory: set specific and challenging goals, Model of Action Phases: form 'implementation intentions', Strength Model of Self-Control: bolster self-control resources, Social Cognition Models (Protection Motivation Theory, Theory of Planned Behaviour, Health Belief Model): modify relevant cognitions, Elaboration Likelihood Model: consider targets' motivation and ability to process information, Prototype Willingness Model: change perceptions of the prototypical person who engages in behaviour and Social Cognitive Theory: modify self-efficacy. There are a range of theories in the field of behaviour change that can be applied usefully to addiction, each one pointing to a different set of modifiable determinants and/or behaviour change techniques. Studies reporting interventions should describe theoretical basis, behaviour change techniques and mode of delivery accurately so that effective interventions can be understood and replicated. © 2010 The Authors. Journal compilation © 2010 Society for the Study of Addiction.

Can existing mobile apps support healthier food purchasing behaviour? Content analysis of nutrition content, behaviour change theory and user quality integration.

PubMed

Flaherty, Sarah-Jane; McCarthy, Mary; Collins, Alan; McAuliffe, Fionnuala

2018-02-01

To assess the quality of nutrition content and the integration of user quality components and behaviour change theory relevant to food purchasing behaviour in a sample of existing mobile apps. Descriptive comparative analysis of eleven mobile apps comprising an assessment of their alignment with existing evidence on nutrition, behaviour change and user quality, and their potential ability to support healthier food purchasing behaviour. Mobile apps freely available for public use in GoogePlay were assessed and scored according to agreed criteria to assess nutrition content quality and integration of behaviour change theory and user quality components. A sample of eleven mobile apps that met predefined inclusion criteria to ensure relevance and good quality. The quality of the nutrition content varied. Improvements to the accuracy and appropriateness of nutrition content are needed to ensure mobile apps support a healthy behaviour change process and are accessible to a wider population. There appears to be a narrow focus towards behaviour change with an overemphasis on behavioural outcomes and a small number of behaviour change techniques, which may limit effectiveness. A significant effort from the user was required to use the mobile apps appropriately which may negatively influence user acceptability and subsequent utilisation. Existing mobile apps may offer a potentially effective approach to supporting healthier food purchasing behaviour but improvements in mobile app design are required to maximise their potential effectiveness. Engagement of mobile app users and nutrition professionals is recommended to support effective design.

Impact of individual behaviour change on the spread of emerging infectious diseases.

PubMed

Yan, Q L; Tang, S Y; Xiao, Y N

2018-03-15

Human behaviour plays an important role in the spread of emerging infectious diseases, and understanding the influence of behaviour changes on epidemics can be key to improving control efforts. However, how the dynamics of individual behaviour changes affects the development of emerging infectious disease is a key public health issue. To develop different formula for individual behaviour change and introduce how to embed it into a dynamic model of infectious diseases, we choose A/H1N1 and Ebola as typical examples, combined with the epidemic reported cases and media related news reports. Thus, the logistic model with the health belief model is used to determine behaviour decisions through the health belief model constructs. Furthermore, we propose 4 candidate infectious disease models without and with individual behaviour change and use approximate Bayesian computation based on sequential Monte Carlo method for model selection. The main results indicate that the classical compartment model without behaviour change and the model with average rate of behaviour change depicted by an exponential function could fit the observed data best. The results provide a new way on how to choose an infectious disease model to predict the disease prevalence trend or to evaluate the influence of intervention measures on disease control. However, sensitivity analyses indicate that the accumulated number of hospital notifications and deaths could be largely reduced as the rate of behaviour change increases. Therefore, in terms of mitigating emerging infectious diseases, both media publicity focused on how to guide people's behaviour change and positive responses of individuals are critical. Copyright © 2017 John Wiley & Sons, Ltd.

Five in a row—reactions of smokers to tobacco tax increases: population‐based cross‐sectional studies in Germany 2001–2006

PubMed Central

Hanewinkel, Reiner; Isensee, Barbara

2007-01-01

Objective To assess reactions of smokers to five waves of tobacco tax increases in Germany. Design A 10‐wave cross‐sectional study, with assessments before and after the tax increases. Setting General population of Germany. Participants and methods 10 representative samples from the general population with a total number of 27 608 people aged ⩾14 years, including 8548 smokers (31% of the total sample), were interviewed. Outcome measures Reflection on smoking behaviour, and smoking behaviour (quitting, reducing, switching to a cheaper brand or no change) before and after tobacco tax increases. Results Before the tax increases, one third to more than half of the smokers reflected on their smoking behaviour, 9.7–13.9% intended to quit, 23.4–34.7% intended to reduce smoking and 10.8–16.4% intended to switch to cheaper tobacco products, whereas 36.1–52.1% did not intend any change at all. After the tax increases, one fourth to more than one third reported to have reflected on their smoking behaviour, 4.0–7.9% quit smoking owing to the increase, 11.5–16.6% reduced consumption and 11.0–19.9% switched to cheaper products. Significant associations were found between the height of the price increase and the intentions and reactions of smokers. Conclusions Price increases lead to a substantial reflection on smoking and intended and realised behaviour changes such as reduced consumption and switching to cheaper tobacco products. These effects are more pronounced the more the price rises. Therefore, taxation policy will lead to quitting and reducing smoking. However, complementary measures should also be taken to prevent smokers switching to cheaper tobacco products, which would reduce the effectiveness of taxation policy. PMID:17297071

Behavioural responses to human-induced environmental change.

PubMed

Tuomainen, Ulla; Candolin, Ulrika

2011-08-01

The initial response of individuals to human-induced environmental change is often behavioural. This can improve the performance of individuals under sudden, large-scale perturbations and maintain viable populations. The response can also give additional time for genetic changes to arise and, hence, facilitate adaptation to new conditions. On the other hand, maladaptive responses, which reduce individual fitness, may occur when individuals encounter conditions that the population has not experienced during its evolutionary history, which can decrease population viability. A growing number of studies find human disturbances to induce behavioural responses, both directly and by altering factors that influence fitness. Common causes of behavioural responses are changes in the transmission of information, the concentration of endocrine disrupters, the availability of resources, the possibility of dispersal, and the abundance of interacting species. Frequent responses are alterations in habitat choice, movements, foraging, social behaviour and reproductive behaviour. Behavioural responses depend on the genetically determined reaction norm of the individuals, which evolves over generations. Populations first respond with individual behavioural plasticity, whereafter changes may arise through innovations and the social transmission of behavioural patterns within and across generations, and, finally, by evolution of the behavioural response over generations. Only a restricted number of species show behavioural adaptations that make them thrive in severely disturbed environments. Hence, rapid human-induced disturbances often decrease the diversity of native species, while facilitating the spread of invasive species with highly plastic behaviours. Consequently, behavioural responses to human-induced environmental change can have profound effects on the distribution, adaptation, speciation and extinction of populations and, hence, on biodiversity. A better understanding of the mechanisms of behavioural responses and their causes and consequences could improve our ability to predict the effects of human-induced environmental change on individual species and on biodiversity. © 2010 The Authors. Biological Reviews © 2010 Cambridge Philosophical Society.

Non-pharmacological intervention for gastro-oesophageal reflux disease in primary care

PubMed Central

Dibley, Lesley B; Norton, Christine; Jones, Roger

2010-01-01

Background Up to 50% of patients with gastro-oesophageal reflux disease (GORD) have persistent symptoms despite taking proton pump inhibitors (PPIs) regularly. Lifestyle advice is available to patients, but no previous UK study has tested a behavioural change intervention to help patients self-manage their symptoms. Aim To determine whether a primary care, nurse-led intervention to address behaviours that promote GORD symptoms results in symptom improvement, an increased sense of control, and a reduced requirement for prescribed medication. Design of study A group intervention focusing on diet and stress was delivered to patients with reflux symptoms, recruited in rural general practices. Setting General practice in England. Method Forty-two subjects (male 19, female 23) aged 31–86 years took part. Pre- and post-intervention data were gathered using the Brief Illness Perception Questionnaire (BIPQ), the GORD Impact Scale (GIS), and the Hospital Anxiety and Depression Scale (HAD). Results There was a significant improvement (BIPQ P<0.001, GIS P = 0.008) 3 months after the intervention. There was no reduction in PPI use or change in HAD score. The greatest improvements were demonstrated in domains measuring the patient's sense of control, perception of symptoms, and understanding of reflux. Patients reported benefits including understanding relevant anatomy and physiology, learning behavioural techniques to change eating patterns and manage stress, identifying actual and potential triggers, and developing and executing action plans. Conclusion An education programme for GORD enhances self-management, brings perceived symptom improvement, and promotes a sense of control at 3 months. This type of behavioural intervention, alongside medical management, could improve symptom control for reflux patients with refractory symptoms and should be the subject of a controlled trial. PMID:21144190

Behaviour change in overweight and obese pregnancy: a decision tree to support the development of antenatal lifestyle interventions.

PubMed

Ainscough, Kate M; Lindsay, Karen L; O'Sullivan, Elizabeth J; Gibney, Eileen R; McAuliffe, Fionnuala M

2017-10-01

Antenatal healthy lifestyle interventions are frequently implemented in overweight and obese pregnancy, yet there is inconsistent reporting of the behaviour-change methods and behavioural outcomes. This limits our understanding of how and why such interventions were successful or not. The current paper discusses the application of behaviour-change theories and techniques within complex lifestyle interventions in overweight and obese pregnancy. The authors propose a decision tree to help guide researchers through intervention design, implementation and evaluation. The implications for adopting behaviour-change theories and techniques, and using appropriate guidance when constructing and evaluating interventions in research and clinical practice are also discussed. To enhance the evidence base for successful behaviour-change interventions during pregnancy, adoption of behaviour-change theories and techniques, and use of published guidelines when designing lifestyle interventions are necessary. The proposed decision tree may be a useful guide for researchers working to develop effective behaviour-change interventions in clinical settings. This guide directs researchers towards key literature sources that will be important in each stage of study development.

Evolutionary learning processes as the foundation for behaviour change.

PubMed

Crutzen, Rik; Peters, Gjalt-Jorn Ygram

2018-03-01

We argue that the active ingredients of behaviour change interventions, often called behaviour change methods (BCMs) or techniques (BCTs), can usefully be placed on a dimension of psychological aggregation. We introduce evolutionary learning processes (ELPs) as fundamental building blocks that are on a lower level of psychological aggregation than BCMs/BCTs. A better understanding of ELPs is useful to select the appropriate BCMs/BCTs to target determinants of behaviour, or vice versa, to identify potential determinants targeted by a given BCM/BCT, and to optimally translate them into practical applications. Using these insights during intervention development may increase the likelihood of developing effective interventions - both in terms of behaviour change as well as maintenance of behaviour change.

Stages of Change – Continuous Measure (URICA-E2): psychometrics of a Norwegian version

PubMed Central

Lerdal, Anners; Moe, Britt; Digre, Elin; Harding, Thomas; Kristensen, Frode; Grov, Ellen K; Bakken, Linda N; Eklund, Marthe L; Ruud, Ireen; Rossi, Joseph S

2009-01-01

Title Stages of Change – Continuous Measure (URICA-E2): psychometrics of a Norwegian version. Aim This paper is a report of research to translate the English version of the Stages of Change continuous measure questionnaire (URICA-E2) into Norwegian and to test the validity of the questionnaire and its usefulness in predicting behavioural change. Background While the psychometric properties of the Stages of Change categorical measure have been tested extensively, evaluation of the psychometric properties of the continuous questionnaire has not been described elsewhere in the literature. Method Cross-sectional data were collected with a convenience sample of 198 undergraduate nursing students in 2005 and 2006. The English version of URICA-E2 was translated into Norwegian according to standardized procedures. Findings Principal components analysis clearly confirmed five of the dimensions of readiness to change (Precontemplation Non-Believers, Precontemplation Believers, Contemplation, Preparation and Maintenance), while the sixth dimension, Action, showed the lowest Eigenvalue (0·93). Findings from the cluster analysis indicate distinct profiles among the respondents in terms of readiness to change their exercise behaviour. Conclusion The URICA-E2 was for the most part replicated from Reed’s original work. The result of the cluster analysis of the items associated with the factor ‘Action’ suggests that these do not adequately measure the factor. PMID:19032513

Behavioural Change, Indoor Air Pollution and Child Respiratory Health in Developing Countries: A Review

PubMed Central

Barnes, Brendon R.

2014-01-01

Indoor air pollution caused by the indoor burning of solid biomass fuels has been associated with Acute Respiratory Infections such as pneumonia amongst children of less than five years of age. Behavioural change interventions have been identified as a potential strategy to reduce child indoor air pollution exposure, yet very little is known about the impact of behavioural change interventions to reduce indoor air pollution. Even less is known about how behaviour change theory has been incorporated into indoor air pollution behaviour change interventions. A review of published studies spanning 1983–2013 suggests that behavioural change strategies have the potential to reduce indoor air pollution exposure by 20%–98% in laboratory settings and 31%–94% in field settings. However, the evidence is: (1) based on studies that are methodologically weak; and (2) have little or no underlying theory. The paper concludes with a call for more rigorous studies to evaluate the role of behavioural change strategies (with or without improved technologies) to reduce indoor air pollution exposure in developing countries as well as interventions that draw more strongly on existing behavioural change theory and practice. PMID:24776723

Physical activity and beverage consumption in preschoolers: focus groups with parents and teachers

PubMed Central

2013-01-01

Background Qualitative research is a method in which new ideas and strategies can be discovered. This qualitative study aimed to investigate parents’ and teachers’ opinions on physical activity and beverage consumption of preschool children. Through separate, independent focus groups, they expressed their perceptions on children’s current physical activity and beverage consumption levels, factors that influence and enhance these behaviours, and anticipated barriers to making changes. Methods Multi-cultural and multi-geographical focus groups were carried out in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). In total, twenty-four focus groups with 122 parents and eighteen focus groups with 87 teachers were conducted between October 2010 and January 2011. Based on a semi-structured interview guide, questions on preschoolers’ physical activity (opinions on preschoolers’ physical activity, how to increase physical activity, facilitators and barriers of physical activity) and beverage consumption (rules and policies, factors influencing promotion of healthy drinking, recommendations for future intervention development) were asked. The information was analyzed using qualitative data analysis software (NVivo8). Results The focus group results indicated misperceptions of caregivers on preschoolers’ physical activity and beverage consumption levels. Caregivers perceived preschoolers as sufficiently active; they argue that children need to learn to sit still in preparation for primary school. At most preschools, children can drink only water. In some preschools sugar-sweetened beverages like chocolate milk or fruit juices, are also allowed. It was mentioned that sugar-sweetened beverages can be healthy due to mineral and vitamin content, although according to parents their daily intake is limited. These opinions resulted in low perceived needs to change behaviours. Conclusions Although previous research shows need of change in obesity-related behaviours, the participants in the current study didn’t perceive such. The awareness of parents and teachers needs to be raised concerning their shared responsibility about healthy behaviours in preschoolers. Providing preschool teachers with ready-to-use classroom material will encourage them to change physical activity and beverage consumption, and to implement related activities in the classroom. Involvement in activities that their children perform at preschool will motivate parents to extend these behaviours to the home environment. PMID:23537117

Linking models of human behaviour and climate alters projected climate change

DOE PAGES

Beckage, Brian; Gross, Louis J.; Lacasse, Katherine; ...

2018-01-01

Although not considered in climate models, perceived risk stemming from extreme climate events may induce behavioural changes that alter greenhouse gas emissions. Here, we link the C-ROADS climate model to a social model of behavioural change to examine how interactions between perceived risk and emissions behaviour influence projected climate change. Our coupled climate and social model resulted in a global temperature change ranging from 3.4–6.2 °C by 2100 compared with 4.9 °C for the C-ROADS model alone, and led to behavioural uncertainty that was of a similar magnitude to physical uncertainty (2.8 °C versus 3.5 °C). Model components with themore » largest influence on temperature were the functional form of response to extreme events, interaction of perceived behavioural control with perceived social norms, and behaviours leading to sustained emissions reductions. Lastly, our results suggest that policies emphasizing the appropriate attribution of extreme events to climate change and infrastructural mitigation may reduce climate change the most.« less

Linking models of human behaviour and climate alters projected climate change

NASA Astrophysics Data System (ADS)

Beckage, Brian; Gross, Louis J.; Lacasse, Katherine; Carr, Eric; Metcalf, Sara S.; Winter, Jonathan M.; Howe, Peter D.; Fefferman, Nina; Franck, Travis; Zia, Asim; Kinzig, Ann; Hoffman, Forrest M.

2018-01-01

Although not considered in climate models, perceived risk stemming from extreme climate events may induce behavioural changes that alter greenhouse gas emissions. Here, we link the C-ROADS climate model to a social model of behavioural change to examine how interactions between perceived risk and emissions behaviour influence projected climate change. Our coupled climate and social model resulted in a global temperature change ranging from 3.4-6.2 °C by 2100 compared with 4.9 °C for the C-ROADS model alone, and led to behavioural uncertainty that was of a similar magnitude to physical uncertainty (2.8 °C versus 3.5 °C). Model components with the largest influence on temperature were the functional form of response to extreme events, interaction of perceived behavioural control with perceived social norms, and behaviours leading to sustained emissions reductions. Our results suggest that policies emphasizing the appropriate attribution of extreme events to climate change and infrastructural mitigation may reduce climate change the most.

Linking models of human behaviour and climate alters projected climate change

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beckage, Brian; Gross, Louis J.; Lacasse, Katherine

Although not considered in climate models, perceived risk stemming from extreme climate events may induce behavioural changes that alter greenhouse gas emissions. Here, we link the C-ROADS climate model to a social model of behavioural change to examine how interactions between perceived risk and emissions behaviour influence projected climate change. Our coupled climate and social model resulted in a global temperature change ranging from 3.4–6.2 °C by 2100 compared with 4.9 °C for the C-ROADS model alone, and led to behavioural uncertainty that was of a similar magnitude to physical uncertainty (2.8 °C versus 3.5 °C). Model components with themore » largest influence on temperature were the functional form of response to extreme events, interaction of perceived behavioural control with perceived social norms, and behaviours leading to sustained emissions reductions. Lastly, our results suggest that policies emphasizing the appropriate attribution of extreme events to climate change and infrastructural mitigation may reduce climate change the most.« less

Associations between Depression and Health Behaviour Change: Findings from 8 Cycles of the Canadian Community Health Survey.

PubMed

Clayborne, Zahra M; Colman, Ian

2018-01-01

The primary objective of this study was to examine associations between depression and several measures of health behaviour change across 8 cycles of a population-based, cross-sectional survey of Canadians. The secondary objective of this study was to describe the prevalence of the types of health behaviour changes undergone/sought and types of barriers to change reported, comparing those with and without depression. The sample comprised 65,801 respondents to the Canadian Community Health Survey between 2007 and 2014. Past-year depression was assessed via structured interview (CIDI-SF). Measures of health behaviour change included recent changes made, desire to make changes, and barriers towards making changes. Analyses involved logistic regression, with estimates across cycles pooled using fixed-effects meta-analyses. Pooled prevalences of types of health behaviour changes undergone/sought and types of barriers to change experienced were reported, and associations with depression were examined. Depression was associated with higher odds of reporting a recent health behaviour change (pooled odds ratio [OR] = 1.39; 95% confidence interval [CI], 1.30 to 1.48), desire to make health behaviour changes (pooled OR = 1.61; 95% CI, 1.49 to 1.74), and barriers towards change (pooled OR = 1.54; 95% CI, 1.44 to 1.65). The most common change undergone and sought was increased exercise; the most common barrier reported was a lack of willpower. Individuals dealing with depression are more likely to report recent health behaviour changes and the desire to make changes but are also more likely to report barriers towards change.

Planning, Practising and Prioritising Wellness through an Integrative Behaviour Change Plan

ERIC Educational Resources Information Center

Crossman, Joanne M.

2016-01-01

Study objective: To describe a successful approach to teaching principles and practices of behaviour change through a behaviour change plan (BCP) initiative to improve personal health while advancing health knowledge and general education intellectual skills. Students' perspectives of obstacles, behaviours important towards goal attainment and the…

Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes) RCT.

PubMed

Biddle, Stuart J H; Edwardson, Charlotte L; Gorely, Trish; Wilmot, Emma G; Yates, Thomas; Nimmo, Myra A; Khunti, Kamlesh; Davies, Melanie J

2017-01-14

Reducing sedentary behaviour may have important health implications. This study evaluated the potential enablers and barriers for outcomes of a randomised controlled trial (RCT) designed to evaluate a pragmatic education based intervention designed to reduce sedentary (sitting) behaviour in young adults at high risk of type 2 diabetes. Data were collected from participants in the intervention group immediately after an educational workshop addressing sedentary time and diabetes risk (n = 71), through phone interviews 6 weeks (n = 45) after the workshop, and at the conclusion of the 12-month trial (n = 10). The two education session facilitators were also interviewed about the intervention. The RCT showed no difference in sedentary time at 12 months between intervention and control arms. The lack of behaviour change appeared not to be attributed to the workshops, which were well led and very favourably received according to feedback. However, factors contributing to this lack of behaviour change include lack of perceived health risk from baseline measures feedback; the preference to adopt physically active behaviours rather than to sit less; certain barriers to sitting less; motivational drift after the 3-month follow-up measurements where participants had no contact for a further 9 months; and, for some, unreliability of the self-monitoring tool. The workshop was well led and well received by the attendees but future interventions need to consider more contact with participants, discuss any specific benefits around simply standing to reduce sitting time, address the barriers to sitting less, and provide a more user-friendly and reliable self-monitoring tool. Current controlled trials ISRCTN08434554 , MRC project 91409. Registered retrospectively on 22 February 2011.

A Systematic Review on Health Resilience to Economic Crises

PubMed Central

Glonti, Ketevan; Gordeev, Vladimir S.; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard

2015-01-01

Background The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. Methods We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. Results From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women’s mental health appeared more susceptible to crises than men’s. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. Conclusions Despite widespread rhetoric about the importance of resilience, there was a dearth of studies which operationalised resilience factors. Future conceptual and empirical research is needed to develop the epidemiology of resilience. PMID:25905629

Equipping providers with principles, knowledge and skills to successfully integrate behaviour change counselling into practice: a primary healthcare framework.

PubMed

Vallis, M; Lee-Baggley, D; Sampalli, T; Ryer, A; Ryan-Carson, S; Kumanan, K; Edwards, L

2018-01-01

There is an urgent need for healthcare providers and healthcare systems to support productive interactions with patients that promote sustained health behaviour change in order to improve patient and population health outcomes. Behaviour change theories and interventions have been developed and evaluated in experimental contexts; however, most healthcare providers have little training, and therefore low confidence in, behaviour change counselling. Particularly important is how to integrate theory and method to support healthcare providers to engage in behaviour change counselling competently. In this article, we describe a general training model developed from theory, evidence, experience and stakeholder engagement. This model will set the stage for future evaluation research on training needed to achieve competency, sustainability of competency, as well as effectiveness/cost-effectiveness of training in supporting behaviour change. A framework to support competency based training in behaviour change counselling is described in this article. This framework is designed to be integrative, sustainable, scalable and capable of being evaluated in follow-up studies. Effective training in behaviour change counselling is critical to meet the current and future healthcare needs of patients living with, or at risk of, chronic diseases. Increasing competency in establishing change-based relationships, assessing and promoting readiness to change, implementing behaviour modification and addressing psychosocial issues will be value added to the healthcare system. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Psychological distress among tsunami refugees from the Great East Japan earthquake

PubMed Central

Takahashi, Masahito; Sun, Shaojing; Ben-Ezra, Menachem

2015-01-01

Background The 2011 Great Japan tsunami and nuclear leaks displaced 300 000 people, but there are no large studies of psychological distress suffered by these refugees. Aims To provide a first assessment of major factors associated with distress and dysfunctional behaviour following the disasters. Method All refugee families living in Miyagi were sent a questionnaire 10–12 months after the disasters. 21 981 participants (73%) returned questionnaires. Questions assessed psychological distress (Kessler Psychological Distress Scale, K6), dysfunctional behaviours, demographics, event exposure, change in physical activity, household visitors and emotional support. Results Nine percent scored 13+ on the K6 indicating risk of severe mental illness. Psychological distress was greater among Fukushima refugees. Demographic variables, family loss, illness history and change in physical activity were associated with psychological distress and dysfunctional behaviours. Associations between psychological distress and dysfunction and visitors/supporters depended on relation to supporter. Conclusions Practitioners need to recognise existing disease burden, community histories and family roles when intervening following disasters. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703729

Promoting Therapists’ Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation

PubMed Central

Levac, Danielle E.; Glegg, Stephanie M. N.; Sveistrup, Heidi; Colquhoun, Heather; Miller, Patricia; Finestone, Hillel; DePaul, Vincent; Harris, Jocelyn E.; Velikonja, Diana

2016-01-01

Purpose Therapists use motor learning strategies (MLSs) to structure practice conditions within stroke rehabilitation. Virtual reality (VR)-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use. Method A pre-post design evaluated a knowledge translation (KT) intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy. Self-report and observer-rated outcome measures evaluated therapists’ confidence, clinical reasoning and behaviour with respect to MLS use. A focus group captured therapists’ perspectives on MLS use during VR-based therapy provision. Results The intervention improved self-reported confidence about MLS use as measured by confidence ratings (p <0.001). Chart-Stimulated Recall indicated a moderate level of competency in therapists’ clinical reasoning about MLSs following the intervention, with no changes following additional opportunities to use VR (p = .944). On the Motor Learning Strategy Rating Instrument, no behaviour change with respect to MLS use was noted (p = 0.092). Therapists favoured the strategy of transferring skills from VR to real-life tasks over employing a more comprehensive MLS approach. Conclusion The KT intervention improved therapists’ confidence but did not have an effect on clinical reasoning or behaviour with regard to MLS use during VR-based therapy. PMID:27992492

Thinking about the environment and theorising change: how could Life History Strategy Theory inform mHealth interventions in low- and middle-income countries?

PubMed Central

Morgan, Barak; Hunt, Xanthe; Tomlinson, Mark

2017-01-01

ABSTRACT Background: There is a growing body of literature outlining the promise of mobile information and communication technologies to improve healthcare in resource-constrained contexts. Methods: We reviewed the literature related to mobile information and communication technologies which aim to improve healthcare in resource-constrained contexts, in order to glean general observations regarding the state of mHealth in high-income countries (HIC) and low- and middle-income countries (LMIC). Results: mHealth interventions in LMIC often differ substantively from those in HIC, with the former being simpler, delivered through a single digital component (an SMS as opposed to a mobile phone application, or ‘app’), and, as a result, targeting only one of the many factors which impact on the activation (or deactivation) of the target behaviour. Almost as a rule, LMIC mHealth interventions lack an explicit theory of change. Conclusion: We highlight the necessity, when designing mHealth interventions, of having a theory of change that encompasses multiple salient perspectives pertaining to human behaviour. To address this need, we explore whether the concept of Life History Strategy could provide the mHealth field with a useful theory of change. Life History Strategy Theory may be particularly useful in understanding some of the problems, paradoxes, and limitations of mHealth interventions found in LMIC. Specifically, this theory illuminates questions regarding ‘light-weight’ programmes which solely provide information, reminders, and other virtual ‘nudges’ that may have limited impact on behaviours governed by extrinsic structural factors. PMID:28617198

HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda

PubMed Central

2014-01-01

Background Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. Methods Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. Results Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. Conclusions There is overwhelming support to individuals that disclose their HIV status, especially in the long term. Besides, gender appears to influence responses to HIV disclosure, highlighting the need for gender specific disclosure support strategies. PMID:24950958

Evaluation of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

PubMed Central

Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

2016-01-01

Objectives To gain insights into the process of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Design Qualitative study alongside a cluster randomised controlled trial. Setting 17 long-term care homes spread across the Netherlands. Participants 34 licensed practical nurses supporting 54 dual sensory impaired older adults. Intervention A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Primary outcomes Nurses’ perceptions on relevance and feasibility of the self-management programme collected from nurses’ semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers’ reports. Results Nurses’ initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults’ autonomy needs. However, nurses’ initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Conclusions Longitudinal data collection enabled exploration of nurses’ changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond ‘protocol thinking’, discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should acknowledge that change is a process rather than an event, and should include self-evaluations of professional behaviours over a period of time. Trial registration number NCT01217502, Post-results. PMID:27856482

The role of commitment strength in enhancing safe water consumption: mediation analysis of a cluster-randomized trial.

PubMed

Inauen, Jennifer; Tobias, Robert; Mosler, Hans-Joachim

2014-11-01

The objectives of this study were to investigate the importance of commitment strength in the theory of planned behaviour (TPB) and to test whether behaviour change techniques (BCTs) aimed at increasing commitment strength indeed promote switching to arsenic-safe wells by changing commitment strength. A cluster-randomized controlled trial with four arms was conducted to compare an information-only intervention to information plus one, two, or three commitment-enhancing BCTs. Randomly selected households (N = 340) of Monoharganj, Bangladesh, in seven geographically separate areas, whose members were drinking arsenic-contaminated water at baseline and had access to arsenic-safe wells, participated in this trial. The areas were randomly allocated to the four intervention arms. Water consumption behaviour, variables of the TPB, commitment strength, and socio-demographic characteristics were assessed at baseline and at 3-month follow-up by structured face-to-face interviews. Mediation analysis was used to investigate the mechanisms of behaviour change. Changes in commitment strength significantly increased the explanatory power of the TPB to predict well-switching. Commitment-enhancing BCTs - public self-commitment, implementation intentions, and reminders - increased the behaviour change effects of information by up to 50%. Mediation analyses confirmed that the BCTs indeed increased well-switching by increasing commitment strength. Unexpectedly, however, mediation via changes in behavioural intentions was the strongest mechanism of the intervention effects. Commitment is an important construct to consider in water- and health-related behaviour change and may be for other health behaviours as well. BCTs that alter behavioural intentions and commitment strength proved highly effective at enhancing the behaviour change effects of information alone. Statement of contribution What is already known on this subject? Millions of people drink contaminated water even if they have access to safe water alternatives and despite increased awareness of the consequences to health. The theory of planned behaviour (TPB) and commitment strength are predictive of safe water consumption. The potentially commitment-enhancing behaviour change techniques (BCTs) - reminders, implementation intentions, and public self-commitment - can promote health behaviours, including safe water consumption. What does this study add? Changes in commitment strength significantly added to the prediction of switching to arsenic-safe wells by the TPB. Information-plus-BCTs aimed at increasing commitment strength led to >50% more well-switching than information alone. Behaviour change effects of the BCTs were mediated by changes in commitment strength and behavioural intentions. © 2013 The British Psychological Society.

Using the Behaviour Change Wheel in infection prevention and control practice

PubMed Central

Atkins, Lou

2015-01-01

The Centre for Behaviour Change at University College London (UCL) is a new venture that has grown out of the work that we have been doing in the Health Psychology Research Group at UCL and seeks to harness the different pockets of behaviour change work in different disciplines across UCL. A lot of our work in health focuses on the adoption of evidence-based guidelines in practice; not just designing and evaluating interventions, but also developing usable tools for people who are tasked with changing behaviours. These tools aim to enable those who do not necessarily have a background in behavioural science to understand the behaviours they are trying to change and design appropriate interventions. PMID:28989457

Identification of behaviour change components in swallowing interventions for head and neck cancer patients: protocol for a systematic review.

PubMed

Govender, Roganie; Smith, Christina H; Taylor, Stuart A; Grey, Daphne; Wardle, Jane; Gardner, Benjamin

2015-06-20

Dysphagia (difficulty in swallowing) is a predictable consequence of head and neck cancer and its treatment. Loss of the ability to eat and drink normally has a devastating impact on quality of life for survivors of this type of cancer. Most rehabilitation programmes involve behavioural interventions that include swallowing exercises to help improve swallowing function. Such interventions are complex; consisting of multiple components that may influence outcomes. These interventions usually require patient adherence to recommended behaviour change advice. To date, reviews of this literature have explored whether variation in effectiveness can be attributed to the type of swallowing exercise, the use of devices to facilitate use of swallowing muscles, and the timing (before, during or after cancer treatment). This systematic review will use a behavioural science lens to examine the content of previous interventions in this field. It aims to identify (a) which behaviour change components are present, and (b) the frequency with which they occur in interventions deemed to be effective and non-effective. Clinical trials of behavioural interventions to improve swallowing outcomes in patients with head and neck cancers will be identified via a systematic and comprehensive search of relevant electronic health databases, trial registers, systematic review databases and Web of Science. To ascertain behaviour change intervention components, we will code the content for its theory basis, intervention functions and specific behaviour change techniques, using validated tools: the Theory Coding Scheme, Behaviour Change Wheel and Behaviour Change Technique Taxonomy v1. Study quality will be assessed for descriptive purposes only. Given the specialisation and focus of this review, a small yield of studies with heterogeneous outcome measures is anticipated. Therefore, narrative synthesis is considered more appropriate than meta-analysis. We will also compare the frequency of behavioural components in effective versus non-effective interventions, where effectiveness is indicated by statistically significant changes in swallowing outcomes. This review will provide a synthesis of the behaviour change components in studies that currently represent best evidence for behavioural swallowing interventions for head and neck cancer patients. Results will provide some guidance on the choice of optimal behavioural strategies for the development of future interventions. PROSPERO CRD42015017048.

The behaviour change wheel: a new method for characterising and designing behaviour change interventions.

PubMed

Michie, Susan; van Stralen, Maartje M; West, Robert

2011-04-23

Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.

Exploring the use of a gamified intervention for encouraging physical activity in adolescents: a qualitative longitudinal study in Northern Ireland

PubMed Central

Corepal, Rekesh; Best, Paul; O’Neill, Roisin; Tully, Mark A; Edwards, Mark; Jago, Russell; Miller, Sarah J; Kee, Frank; Hunter, Ruth F

2018-01-01

Objective To explore the temporal changes of adolescents’ views and experiences of participating in a gamified intervention to encourage physical activity behaviour and associated processes of behaviour change. Design A qualitative longitudinal design was adopted whereby focus groups were conducted with the same participants in each intervention school (n=3) at four time-points (baseline, end of each of two intervention phases and 1-year follow-up). The framework method was used to thematically analyse the data. Setting Secondary schools (n=3), Belfast (Northern Ireland). Participants A subsample (n=19 at four time-points) of individuals aged 12–14 years who participated in the StepSmart Challenge, a gamified intervention involving a pedometer competition and material rewards to encourage physical activity behaviour change. Results Three core themes were identified: (1) competition; (2) incentives and (3) influence of friends. Participants indicated that a pedometer competition may help initiate physical activity but suggested that there were a number of barriers such as participants finding it ‘boring’, and feeling as though they had a remote chance of ‘winning’. ‘Incentives’ were viewed favourably, although there were participants who found not winning a prize ‘annoying’. Friends were a motivator to be more physically active, particularly for girls who felt encouraged to walk more when with a friend. Conclusions The intervention in general and specific gamified elements were generally viewed positively and deemed acceptable. Results suggest that gamification may have an important role to play in encouraging adolescents to engage in physical activity and in creating interventions that are fun and enjoyable. The longitudinal approach added additional depth to the analysis as themes were refined and tested with participants over time. The findings also suggest that gamified Behaviour Change Techniques align well with core concepts of Self-determination Theory and that various game elements may require tailoring for specific populations, for example, different genders. Trial registration number NCT02455986; Pre-results. PMID:29678971

TAxonomy of Self-reported Sedentary behaviour Tools (TASST) framework for development, comparison and evaluation of self-report tools: content analysis and systematic review

PubMed Central

Dall, PM; Coulter, EH; Fitzsimons, CF; Skelton, DA; Chastin, SFM

2017-01-01

Objective Sedentary behaviour (SB) has distinct deleterious health outcomes, yet there is no consensus on best practice for measurement. This study aimed to identify the optimal self-report tool for population surveillance of SB, using a systematic framework. Design A framework, TAxonomy of Self-reported Sedentary behaviour Tools (TASST), consisting of four domains (type of assessment, recall period, temporal unit and assessment period), was developed based on a systematic inventory of existing tools. The inventory was achieved through a systematic review of studies reporting SB and tracing back to the original description. A systematic review of the accuracy and sensitivity to change of these tools was then mapped against TASST domains. Data sources Systematic searches were conducted via EBSCO, reference lists and expert opinion. Eligibility criteria for selecting studies The inventory included tools measuring SB in adults that could be self-completed at one sitting, and excluded tools measuring SB in specific populations or contexts. The systematic review included studies reporting on the accuracy against an objective measure of SB and/or sensitivity to change of a tool in the inventory. Results The systematic review initially identified 32 distinct tools (141 questions), which were used to develop the TASST framework. Twenty-two studies evaluated accuracy and/or sensitivity to change representing only eight taxa. Assessing SB as a sum of behaviours and using a previous day recall were the most promising features of existing tools. Accuracy was poor for all existing tools, with underestimation and overestimation of SB. There was a lack of evidence about sensitivity to change. Conclusions Despite the limited evidence, mapping existing SB tools onto the TASST framework has enabled informed recommendations to be made about the most promising features for a surveillance tool, identified aspects on which future research and development of SB surveillance tools should focus. Trial registration number International prospective register of systematic reviews (PROPSPERO)/CRD42014009851. PMID:28391233

Effect of community based behavioural change communication intervention to improve neonatal mortality in developing countries: A Systematic Review.

PubMed

Tilahun, Dejene; Birhanu, Zewdie

2011-01-01

Background A great burden of infant and under-five childhood mortality occurs during the neonatal period, usually within a few days of birth. Community based behavioural change communication (such as interpersonal, group and mass media channels, including participatory methods at community level) intervention trials have been shown to be effective in reducing this mortality. However, to guide policy makers and programme planners, there is a need to systematically appraise and synthesise this evidence.Objective To systematically search, appraise and synthesise the best available evidence on the effect of community based behavioural change communication intervention to improve neonatal mortality in developing countries.Inclusion Criteria This review considered randomised controlled community trials on the effectiveness of community based behavioural change communication interventions aimed at decreasing neonatal mortality that were conducted in developing countries.Search Strategy This review considered English language articles on studies published between December, 2006 to January, 2011 and indexed in PubMed, CINAHL, EMBASE, Mednar, popline, Proquest, or Hinari.Methodological quality Studies that met the inclusion criteria were assessed for methodological quality using the Joanna Briggs Institute Meta Analysis of Statistical Assessment and Review Instrument by two independent reviewers. Data were analysed using a fixed effects model with RevMan5 software. Community based behavioural change communication interventions were found to be associated with a significant reduction in neonatal mortality of 19% (average OR 0.81; 95%CI 0. to 0.88), early neonatal mortality by 20% (average 0.80; 95%CI 0. to 0.91), late neonatal mortality by 21% (average 0.79; 95%CI 0. to 0.99). In addition, the intervention also resulted in significant improvement of newborn care practice; breast feeding initiation, clean cord cutting and delay in bathing were improved by 185%, 110% and 196% respectively.Conclusions Community-based behavioural change communication interventions such as health education, information education and communication, behavioural change communication, social mobilisation, community mobilisation, community conversation, and home based counselling were found to be associated with a significant reduction in neonatal mortality, early neonatal mortality and post neonatal mortality. The findings of this systematic review call for integration of such interventions into conventional strategies in developing countries.Implications for practice This systematic review has shown that community based behavioural change communication interventions that are implemented through community health volunteers and other community based health workers, targeted at pregnant women and also involving influential people such as mothers-in-law, fathers-in-law and husbands/partners, consistently demonstrated that community based intervention packages significantly reduced early neonatal, late neonatal and neonatal mortality rates and also have a pivotal role in improving household newborn care practice. Thus, this review provides encouraging evidence of the value of integrating newborn care and neonatal mortality reduction strategies into community based approaches.Implications for research The review findings were largely derived from a limited number of community trials from developing regions, particularly the African setting. Thus, there is a clear need for additional research on a larger scale and in more varied settings. There is also a need for more evidence based on higher quality research. The cost effectiveness of these community based interventions may impact on their adoption; however it was outside the scope of this review. Cost-effectiveness of these interventions should become a priority area for future research.

Promoting walking and cycling as an alternative to using cars: systematic review

PubMed Central

Ogilvie, David; Egan, Matt; Hamilton, Val; Petticrew, Mark

2004-01-01

Objectives To assess what interventions are effective in promoting a population shift from using cars towards walking and cycling and to assess the health effects of such interventions. Data sources Published and unpublished reports in any language identified from electronic databases, bibliographies, websites, and reference lists. Review methods Systematic search and appraisal to identify experimental or observational studies with a prospective or controlled retrospective design that evaluated any intervention applied to an urban population or area by measuring outcomes in members of the local population. Results 22 studies met the inclusion criteria. We found some evidence that targeted behaviour change programmes can change the behaviour of motivated subgroups, resulting (in the largest study) in a shift of around 5% of all trips at a population level. Single studies of commuter subsidies and a new railway station also showed positive effects. The balance of best available evidence about publicity campaigns, engineering measures, and other interventions suggests that they have not been effective. Participants in trials of active commuting experienced short term improvements in certain measures of health and fitness, but we found no good evidence on effects on health of any effective intervention at population level. Conclusions The best available evidence of effectiveness in promoting a modal shift is for targeted behaviour change programmes, but the social distribution of their effects is unclear and some other types of intervention have yet to be rigorously evaluated. PMID:15385407

Facilitators and barriers for eating behaviour changes in obstructive sleep apnoea and obesity - a qualitative content analysis.

PubMed

Spörndly-Nees, Søren; Igelström, Helena; Lindberg, Eva; Martin, Cathrin; Åsenlöf, Pernilla

2014-01-01

Obesity is a major risk factor for obstructive sleep apnoea syndrome, a condition known causing lack of sleep continuity and daytime sleepiness. Weight loss interventions are recommended, however knowledge on what facilitate and impede eating behaviour change is lacking for this particular population. The aim of this study was to identify personal conceptions of prerequisites for eating behaviour change. A qualitative study on 15 patients with obstructive sleep apnoea syndrome (OSAS; apnoea-hypopnoea index >15) and obesity (Mean body mass index 38.2). Semi-structured interviews were conducted and data were transcribed and analysed using qualitative content analysis with researcher triangulation for trustworthiness. Data were organised according to barriers and facilitators for changing eating behaviour. Identified barriers were desire and reward, cravings and emotional control, low self-confidence, insufficient support, taxing behaviours, cost, lack of knowledge about healthy eating strategies, perceived helplessness and low susceptibility. Identified facilitators were positive expectations, fear of negative consequences, experience of success, support and follow-up, accessibility, applied skills for healthy eating, personal involvement and challenged self-image. This study adds knowledge on important barriers and facilitators of eating behaviour change according to individuals with obesity and OSAS. Information used to inform a tailored behavioural medicine intervention targeting eating behaviours. Patients with obstructive sleep apnoea syndrome (OSAS) benefit from weight loss and eating behaviour changes are recommended. Patients' views on prerequisites for eating behaviour change are important to plan, conduct and tailor behaviour change interventions. These aspects have hitherto not been elaborated in patients with OSAS. Considerations on patient's self-image and perceived susceptibility along with providing strategies for controlling the desire and rewarding feeling associated with eating are emphasised.

A picture's worth a thousand words: a food-selection observational method.

PubMed

Carins, Julia E; Rundle-Thiele, Sharyn R; Parkinson, Joy E

2016-05-04

Issue addressed: Methods are needed to accurately measure and describe behaviour so that social marketers and other behaviour change researchers can gain consumer insights before designing behaviour change strategies and so, in time, they can measure the impact of strategies or interventions when implemented. This paper describes a photographic method developed to meet these needs. Methods: Direct observation and photographic methods were developed and used to capture food-selection behaviour and examine those selections according to their healthfulness. Four meals (two lunches and two dinners) were observed at a workplace buffet-style cafeteria over a 1-week period. The healthfulness of individual meals was assessed using a classification scheme developed for the present study and based on the Australian Dietary Guidelines. Results: Approximately 27% of meals (n = 168) were photographed. Agreement was high between raters classifying dishes using the scheme, as well as between researchers when coding photographs. The subset of photographs was representative of patterns observed in the entire dining room. Diners chose main dishes in line with the proportions presented, but in opposition to the proportions presented for side dishes. Conclusions: The present study developed a rigorous observational method to investigate food choice behaviour. The comprehensive food classification scheme produced consistent classifications of foods. The photographic data collection method was found to be robust and accurate. Combining the two observation methods allows researchers and/or practitioners to accurately measure and interpret food selections. Consumer insights gained suggest that, in this setting, increasing the availability of green (healthful) offerings for main dishes would assist in improving healthfulness, whereas other strategies (e.g. promotion) may be needed for side dishes. So what?: Visual observation methods that accurately measure and interpret food-selection behaviour provide both insight for those developing healthy eating interventions and a means to evaluate the effect of implemented interventions on food selection.

Animal behaviour shapes the ecological effects of ocean acidification and warming: moving from individual to community-level responses.

PubMed

Nagelkerken, Ivan; Munday, Philip L

2016-03-01

Biological communities are shaped by complex interactions between organisms and their environment as well as interactions with other species. Humans are rapidly changing the marine environment through increasing greenhouse gas emissions, resulting in ocean warming and acidification. The first response by animals to environmental change is predominantly through modification of their behaviour, which in turn affects species interactions and ecological processes. Yet, many climate change studies ignore animal behaviour. Furthermore, our current knowledge of how global change alters animal behaviour is mostly restricted to single species, life phases and stressors, leading to an incomplete view of how coinciding climate stressors can affect the ecological interactions that structure biological communities. Here, we first review studies on the effects of warming and acidification on the behaviour of marine animals. We demonstrate how pervasive the effects of global change are on a wide range of critical behaviours that determine the persistence of species and their success in ecological communities. We then evaluate several approaches to studying the ecological effects of warming and acidification, and identify knowledge gaps that need to be filled, to better understand how global change will affect marine populations and communities through altered animal behaviours. Our review provides a synthesis of the far-reaching consequences that behavioural changes could have for marine ecosystems in a rapidly changing environment. Without considering the pervasive effects of climate change on animal behaviour we will limit our ability to forecast the impacts of ocean change and provide insights that can aid management strategies. © 2015 John Wiley & Sons Ltd.

Sexual risk behaviours of high school female learners in Mbonge subdivision of rural Cameroon

PubMed Central

Tarkang, Elvis Enowbeyang

2015-01-01

Introduction Since female learners in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these learners might be exposed to sexual risk behaviours. However, little has been explored on the sexual risk behaviours of high school female learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school female learners in Mbonge subdivision of rural Cameroon. Methods A cross sectional design was adopted, using a self-administered questionnaire for data collection. Respondents were selected through disproportional stratified simple random sampling resulting in 210 female grade 10 to grade 12 learners from three participating high schools in Mbonge subdivision, Cameroon. Descriptive and inferential statistics were calculated using SPSS version 20 software program. Results Majority of the respondents, 54.0% reported being sexually active, of whom only 39.8% used condoms during first sex; 49.5% used condoms during last sex and 29.6% used condoms consistently. Up to 32% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 9.3% had multiple sexual partners during the study period. The mean age of first sex was 15.6 years. Lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors significantly associated with sexual risk behaviours. Conclusion The findings indicate that sexual risk behaviours exist among high school female learners in Mbonge, Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change. PMID:26090007

Can Simply Answering Research Questions Change Behaviour? Systematic Review and Meta Analyses of Brief Alcohol Intervention Trials

PubMed Central

McCambridge, Jim; Kypri, Kypros

2011-01-01

Background Participant reports of their own behaviour are critical for the provision and evaluation of behavioural interventions. Recent developments in brief alcohol intervention trials provide an opportunity to evaluate longstanding concerns that answering questions on behaviour as part of research assessments may inadvertently influence it and produce bias. The study objective was to evaluate the size and nature of effects observed in randomized manipulations of the effects of answering questions on drinking behaviour in brief intervention trials. Methodology/Principal Findings Multiple methods were used to identify primary studies. Between-group differences in total weekly alcohol consumption, quantity per drinking day and AUDIT scores were evaluated in random effects meta-analyses. Ten trials were included in this review, of which two did not provide findings for quantitative study, in which three outcomes were evaluated. Between-group differences were of the magnitude of 13.7 (−0.17 to 27.6) grams of alcohol per week (approximately 1.5 U.K. units or 1 standard U.S. drink) and 1 point (0.1 to 1.9) in AUDIT score. There was no difference in quantity per drinking day. Conclusions/Significance Answering questions on drinking in brief intervention trials appears to alter subsequent self-reported behaviour. This potentially generates bias by exposing non-intervention control groups to an integral component of the intervention. The effects of brief alcohol interventions may thus have been consistently under-estimated. These findings are relevant to evaluations of any interventions to alter behaviours which involve participant self-report. PMID:21998626

[Suicidal behaviour and attempted suicide occurring during assessment by the outreach psychiatric emergency service].

PubMed

de Winter, R F P; de Groot, M H; van Dassen, M; Deen, M L; de Beurs, D P

The outreach emergency psychiatric service plays an important role in recognising, arranging interventions and preventing suicide and suicidal behaviour. However, little is known about the assessments that members of the emergency team make when faced with patients showing suicidal behaviour.
AIM: To describe the relationships that are revealed between patient characteristics, suicidal thoughts and attempted suicide during assessments made by the emergency psychiatric service in The Hague.
METHOD: The emergency service kept a detailed record of 14,705 consultations. We compared the characteristics of patients who had suicidal thoughts with those of patients who had no such thoughts and we also compared the characteristics of patients who had attempted to commit suicide with those of patients who had not. We drew these comparisons by using logistic regression models, adjusting for clustering.
RESULTS: 32.2% of the patients showed signs of suicidal behaviour and 9.2 % appeared likely to attempt suicide. Suicidal behaviour occurred most often in patients with depression. Suicidal patients were more often admitted to hospital than were non-suicidal patients and they were more likely to have been referred by a general practitioner or a general hospital. Medication was the most frequent means employed in attempts to commit suicide.
CONCLUSION: In about one third of the consultations of the outreach emergency psychiatric service, the patient showed suicidal behaviour. The actions and the policy of the emergency psychiatric service with regard to suicidal behaviour were diverse and dependent on factors that could change over the course of time.

Systematic review of health and behavioural outcomes of smoking cessation interventions in prisons

PubMed Central

de Andrade, Dominique; Kinner, Stuart A

2017-01-01

Objective We conducted a systematic review to examine the impact of smoking cessation interventions, including smoking bans, on prisoners and prison staff. Data sources We systematically searched health and criminal justice databases for relevant studies. Search strings were used to combine terms related to smoking cessation interventions with terms related to incarceration. We used forward and backward snowballing to capture additional studies. Study selection Studies were included if: they were published between 1 January 1994 and 23 May 2016; the population was incarcerated adults and/or prison staff; they had a quantitative component; they were published in English; and they reported outcomes of a smoking cessation programme/ban with regard to reported change in smoking behaviour and/or behavioural outcomes. Data extraction Studies were reviewed for methodological rigour using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. Data were independently reviewed for methodological quality by 1 author and a research assistant. Data synthesis Cessation programmes, including free nicotine replacement therapy and/or behavioural counselling can significantly increase the likelihood of quitting in prison and increase abstinence postrelease. Indoor bans have little impact on prisoner smoking behaviour. Prisoners who experience a complete smoking ban typically resume smoking shortly after release from prison. Bans may result in adverse behavioural outcomes, but these are generally minimal and short-lived. Conclusions While there is limited evidence to inform tobacco control policies in custodial settings, outcomes of this review suggest that cessation programmes/bans can be an effective mechanism to interrupt prisoner smoking behaviour when properly enforced. PMID:27798322

Sedentary behaviour and diet across the lifespan: an updated systematic review.

PubMed

Hobbs, Matthew; Pearson, Natalie; Foster, Perry J; Biddle, Stuart J H

2015-09-01

Sedentary behaviour and its association with dietary intake in young people and adults are important topics and were systematically reviewed in 2011. There is a need to update this evidence given the changing nature of sedentary behaviour and continued interest in this field. This review aims to assist researchers in better interpreting the diversity of findings concerning sedentary behaviour and weight status. To provide an update of the associations between sedentary behaviour and dietary intake across the lifespan. Electronic databases searched were MEDLINE, PsychInfo, Cochrane Library, Web of Science and Science Direct for publications between January 2010 and October 2013, thus updating a previous review. Included were observational studies assessing an association between at least one sedentary behaviour and at least one aspect of dietary intake in preschool children (<5 years), school-aged children (6-11 years), adolescents (12-18 years) and adults (>18 years). 27 papers met inclusion criteria (preschool k=3, school-aged children k=9, adolescents k=15, adults k=3). For all three groups of young people, trends were evident for higher levels of sedentary behaviour, especially TV viewing, to be associated with a less healthful diet, such as less fruit and vegetable and greater consumption of energy-dense snacks and sugar sweetened beverages. Data for the three studies with adults were less conclusive. Sedentary behaviour continues to be associated with unhealthy diet in young people in mostly cross-sectional studies. More studies utilising a prospective design are needed to corroborate findings and more studies are needed with adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Efficacy of Three Learning Methods Collaborative, Context-Based Learning and Traditional, on Learning, Attitude and Behaviour of Undergraduate Nursing Students: Integrating Theory and Practice

PubMed Central

Hasanpour-Dehkordi, Ali

2016-01-01

Introduction Communication skills training, responsibility, respect, and self-awareness are important indexes of changing learning behaviours in modern approaches. Aim The aim of this study was to investigate the efficacy of three learning approaches, collaborative, context-based learning (CBL), and traditional, on learning, attitude, and behaviour of undergraduate nursing students. Materials and Methods This study was a clinical trial with pretest and post-test of control group. The participants were senior nursing students. The samples were randomly assigned to three groups; CBL, collaborative, and traditional. To gather data a standard questionnaire of students’ behaviour and attitude was administered prior to and after the intervention. Also, the rate of learning was investigated by a researcher-developed questionnaire prior to and after the intervention in the three groups. Results In CBL and collaborative training groups, the mean score of behaviour and attitude increased after the intervention. But no significant association was obtained between the mean scores of behaviour and attitude prior to and after the intervention in the traditional group. However, the mean learning score increased significantly in the CBL, collaborative, and traditional groups after the study in comparison to before the study. Conclusion Both CBL and collaborative approaches were useful in terms of increased respect, self-awareness, self-evaluation, communication skills and responsibility as well as increased motivation and learning score in comparison to traditional method. PMID:27190926

Effect of quercetin on cadmium chloride-induced impairments in sexual behaviour and steroidogenesis in male Wistar rats.

PubMed

Ujah, G A; Nna, V U; Agah, M I; Omue, L O; Leku, C B; Osim, E E

2018-03-01

Cadmium chloride (CdCl 2 ) has been reported to cause reproductive toxicity in male rats, mainly through oxidative stress. This study examined its effect on sexual behaviour, as one of the mechanisms of reproductive dysfunction, as well as the possible ameliorative effect of quercetin (QE) on same. Thirty male Wistar rats (10 weeks old), weighing 270-300 g, were used for this study. They were either orally administered 2% DMSO, CdCl 2 (5 mg/kg b.w.), QE (20 mg/kg b.w.) or CdCl 2 +QE, once daily for 4 weeks, before sexual behavioural studies. The 5th group received CdCl 2 for 4 weeks and allowed 4-week recovery period, before sexual behavioural test. Rats were sacrificed after sexual behavioural studies. The blood, testis and penis were collected for biochemical assays. Cadmium increased mount, intromission and ejaculatory latencies, but reduced their frequencies, compared to control. Serum nitric oxide increased, while penile cyclic guanosine monophosphate reduced in the CdCl 2 -exposed rats, compared to control. CdCl 2 increased testicular cholesterol, but reduced 3β-hydroxysteroid dehydrogenase (3β-HSD) and 17β-HSD activities, and testosterone concentration. QE better attenuated these negative changes compared to withdrawal of CdCl 2 treatment. In conclusion, CdCl 2 suppressed steroidogenesis, penile erection and sexual behaviour, with poor reversal following withdrawal, while QE attenuated these effects. © 2017 Blackwell Verlag GmbH.

Improving Collaborative Behaviour Planning in Adult Auditory Rehabilitation: Development of the I-PLAN Intervention Using the Behaviour Change Wheel.

PubMed

Barker, Fiona; Lusignan, Simon de; Deborah, Cooke

2018-05-18

The consequences of poorly managed hearing loss can be ameliorated with hearing aid use but rates of use are sub-optimal. The impact of audiologist behaviour on subsequent use, particularly over the long term, is unknown. This study aimed to describe the role of the behaviour change wheel in developing an intervention to introduce and embed particular clinical behaviours into adult hearing aid fitting consultations, within the framework of the Medical Research Council guidance on complex interventions. Following the steps of the behaviour change wheel, audiologist behaviours that might influence hearing aid use were identified based on a systematic review and qualitative work with audiologists. An analysis, using the COM-B model, identified potential drivers of the target behaviours. This was used to select intervention functions and behaviour change techniques likely to influence behaviour in this context. The target behaviours were as follows: giving information about the benefits of hearing aid use and the negative consequences of non-use, providing prompts for use and engaging in collaborative behavioural planning for use. The behavioural analysis suggested that psychological capability, opportunity and motivation were potential drivers of these behaviours. The intervention functions of education, coercion, training, environmental restructuring, modelling and enablement were selected and combined to develop a single complex intervention that seeks to address the target behaviours.

'I wouldn't push that further because I don't want to lose her': a multiperspective qualitative study of behaviour change for long-term conditions in primary care.

PubMed

Hunter, Cheryl; Chew-Graham, Carolyn A; Langer, Susanne; Drinkwater, Jessica; Stenhoff, Alexandra; Guthrie, Elspeth A; Salmon, Peter

2015-12-01

Health outcomes for long-term conditions (LTCs) can be improved by lifestyle, dietary and condition management-related behaviour change. Primary care is an important setting for behaviour change work. Practitioners have identified barriers to this work, but there is little evidence examining practices of behaviour change in primary care consultations and how patients and practitioners perceive these practices. To examine how behaviour change is engaged with in primary care consultations for LTCs and investigate how behaviour change is perceived by patients and practitioners. Multiperspective, longitudinal qualitative research involving six primary health-care practices in England. Consultations between patients with LTCs and health-care practitioners were audio-recorded. Semi-structured interviews were completed with patients and practitioners, using stimulated recall. Patients were re-interviewed 3 months later. Framework analysis was applied to all data. Thirty-two people with at least one LTC (chronic obstructive pulmonary disease, diabetes, asthma and coronary heart disease) and 10 practitioners. Behaviour change talk in consultations was rare and, when it occurred, was characterized by deflection and diffidence on the part of practitioners. Patient motivation tended to be unaddressed. While practitioners positioned behaviour change work as outside their remit, patients felt uncertain about, yet responsible for, this work. Practitioners raised concerns that this work could damage other aspects of care, particularly the patient-practitioner relationship. Behaviour change work is often deflected or deferred by practitioners in consultations, who nevertheless vocalize support for its importance in interviews. This discrepancy between practitioners' accounts and behaviours needs to be addressed within primary health-care organizations. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Reducing patient delay in Acute Coronary Syndrome (RAPiD): research protocol for a web-based randomized controlled trial examining the effect of a behaviour change intervention.

PubMed

Farquharson, Barbara; Johnston, Marie; Smith, Karen; Williams, Brian; Treweek, Shaun; Dombrowski, Stephan U; Dougall, Nadine; Abhyankar, Purva; Grindle, Mark

2017-05-01

To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text + visual and text-only) with usual care. Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for acute coronary syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions. A three-arm web-based, parallel randomized controlled trial of a theory-based intervention. The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n = 177 participants who have experienced acute coronary syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care, ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text + visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of acute coronary syndrome ≥15-minute duration, assessed using two randomized series of eight scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014. Positive results changing intentions would lead to a randomized controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms. Registered at ClinicalTrials.gov: NCT02820103. © 2016 John Wiley & Sons Ltd.

A change in behaviour: getting the balance right for research and policy.

PubMed

O'Sullivan, Maureen; Ryan, Cristín; Downey, Damian G; Hughes, Carmel M

2016-10-01

Behaviour change interventions offer clinical pharmacists many opportunities to optimise the use of medicines. 'MINDSPACE' is a framework used by a Government-affiliated organisation in the United Kingdom to communicate an approach to changing behaviour through policy. The Theoretical Domains Framework (TDF) organises constructs of psychological theories that are most relevant to behaviour change into 14 domains. Both frameworks offer a way of identifying what drives a change in behaviour, providing a target for an intervention. This article aims to compare and contrast MINDSPACE and the TDF, and serves to inform pharmacy practitioners about the potential strengths and weaknesses of using either framework in a clinical pharmacy context. It appears that neither framework can deliver evidence-based interventions that can be developed and implemented with the pace demanded by policy and practice-based settings. A collaborative approach would ensure timely development of acceptable behaviour change interventions that are grounded in evidence.

A neuroscience-based approach to changing organizational behaviour.

PubMed

Rock, David

2018-05-01

The greatest challenge in healthcare management is not identifying what changes are needed but actually changing behaviour on a long-term basis. Traditional approaches to organizational change are doomed to fail because they focus almost entirely on raising awareness. But countless studies show that the mere intention to change is not sufficient to reshape behaviour. In this article, we propose a new approach to organizational change informed by the principles of neuroleadership. The framework is called PHS: Priorities, Habits, Systems. The steps are as follows: (1) priorities: inform people about what changes are desired, (2) habits: teach people new habits, (3) systems: implement organizational systems to support and sustain new habits over the long term. By building solutions informed by the science of how the brain actually works, we believe organizations can bridge the intention behaviour gap and create lasting behaviour change.

A clinical reasoning model focused on clients' behaviour change with reference to physiotherapists: its multiphase development and validation.

PubMed

Elvén, Maria; Hochwälder, Jacek; Dean, Elizabeth; Söderlund, Anne

2015-05-01

A biopsychosocial approach and behaviour change strategies have long been proposed to serve as a basis for addressing current multifaceted health problems. This emphasis has implications for clinical reasoning of health professionals. This study's aim was to develop and validate a conceptual model to guide physiotherapists' clinical reasoning focused on clients' behaviour change. Phase 1 consisted of the exploration of existing research and the research team's experiences and knowledge. Phases 2a and 2b consisted of validation and refinement of the model based on input from physiotherapy students in two focus groups (n = 5 per group) and from experts in behavioural medicine (n = 9). Phase 1 generated theoretical and evidence bases for the first version of a model. Phases 2a and 2b established the validity and value of the model. The final model described clinical reasoning focused on clients' behaviour change as a cognitive, reflective, collaborative and iterative process with multiple interrelated levels that included input from the client and physiotherapist, a functional behavioural analysis of the activity-related target behaviour and the selection of strategies for behaviour change. This unique model, theory- and evidence-informed, has been developed to help physiotherapists to apply clinical reasoning systematically in the process of behaviour change with their clients.

Improved confidence in performing nutrition and physical activity behaviours mediates behavioural change in young adults: Mediation results of a randomised controlled mHealth intervention.

PubMed

Partridge, Stephanie R; McGeechan, Kevin; Bauman, Adrian; Phongsavan, Philayrath; Allman-Farinelli, Margaret

2017-01-01

The burden of weight gain disproportionally affects young adults. Understanding the underlying behavioural mechanisms of change in mHealth nutrition and physical activity interventions designed for young adults is important for enhancing and translating effective interventions. First, we hypothesised that knowledge, self-efficacy and stage-of-change for nutrition and physical activity behaviours would improve, and second, that self-efficacy changes in nutrition and physical activity behaviours mediate the behaviour changes observed in an mHealth RCT for prevention of weight gain. Young adults, aged 18-35 years at risk of weight gain (n = 250) were randomly assigned to an mHealth-program, TXT2BFiT, consisting of a three-month intensive phase and six-month maintenance phase or to a control group. Self-reported online surveys at baseline, three- and nine-months assessed nutrition and physical activity behaviours, knowledge, self-efficacy and stage-of-change. The mediating effect of self-efficacy was assessed in multiple PROCESS macro-models for three- and nine-month nutrition and physical activity behaviour change. Young adults randomised to the intervention increased and maintained knowledge of fruit requirements (P = 0.029) compared to controls. Intervention participants' fruit and takeaway behaviours improved to meet recommendations at nine months, with a greater proportion progressing to action or maintenance stage-of-change (P < 0.001 and P = 0.012 respectively) compared to controls. Intervention participants' vegetable and physical activity behaviours did not meet recommendations, thereby halting progress to action or maintenance stage-of-change. Indirect effects of improved nutrition and physical activity behaviours at three- and nine-months in the intervention group were explained by changes in self-efficacy, accounting for 8%-37% of the total effect. This provides insights into how the mHealth intervention achieved part of its effects and the importance of improving self-efficacy to facilitate improved eating and physical activity behaviours in young adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

Behaviour change and associated factors among female sex workers in Kenya.

PubMed

Nyagero, Josephat; Wangila, Samuel; Kutai, Vincent; Olango, Susan

2012-01-01

Initiatives aimed at behaviour change of key populations such as the female sex workers (FSWs) are pivotal in reducing the transmission of HIV. An 8-year implementation research to establish the predictor factors of behaviour change among FSWs in Kenya was initiated by the African Medical Research Foundation (AMREF) with Sida and DfID support. This cross-sectional survey interviewed 159 female sex workers (FSWs) identified through snowball procedure. The measurement of behaviour change was based on: the consistent use of condoms with both regular and non regular clients, reduced number of clients, routine checks for STIs, and involvement in alternative income generating activities. The adjusted odds ratios at 95% confidence interval computed during binary logistic regression analysis were used to determine the behaviour change predictor factors. Most FSWs (84%) had participated in AMREF's integrated intervention programme for at least one year and 59.1% had gone through behaviour change. The adjusted odds ratio showed that the FSWs with secondary education were 2.23 times likely to change behaviour, protestants were 4.61 times, those in sex work for >4 years were 2.36 times, FSWs with good HIV prevention knowledge were 4.37 times, and those engaged in alternative income generating activities were 2.30 times more likely to change their behaviour compared to respective counterparts. Behaviour change among FSWs was possible and is associated with the level of education, religious affiliation, number of years in sex work and one's level of HIV prevention knowledge. A re-orientation on the peer education programme to focus on HIV preventive measures beyond use of condoms is emphasized.

Changes in private alcohol importation after alcohol tax reductions and import allowance increases in Denmark

PubMed Central

Grittner, Ulrike; Bloomfield, Kim

2010-01-01

AIMS This paper examines changes in alcohol import in Denmark between 2003 and 2006, after the excise tax on spirits in Denmark was lowered by 45% on October 1, 2003 and travellers’ allowances for alcohol import were increased on January1, 2004. Additionally, the paper seeks to develop a profile of alcohol importers and analyse the relation between the distance to the German border and import behaviour, as Germany is the main alcohol import country for Denmark. DATA Cross-sectional and panel data from Denmark, from 2003 to 2006, were analyzed. Samples were collected by telephone interviews, using random digit dialing. RESULTS While the percentage of people who imported alcohol fell over time, the amount of alcohol purchased rose for those who did import. Distance to the German border was inversely related to the likelihood of importing and the level of imported amounts. Heavy drinkers and those with higher incomes were more likely to import, and heavy drinkers imported higher amounts than moderate drinkers or abstainers. CONCLUSION Distance of residence from the German border, socio-economic status and drinking behaviour are related to private alcohol import in Denmark. Policy changes resulted in a shift to fewer people importing higher amounts of alcohol so that the overall import level did not change substantially. PMID:21532978

How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults.

PubMed

Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart J H

2016-01-01

Sedentary behaviour - i.e., low energy-expending waking behaviour while seated or lying down - is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as 'very promising', 'quite promising', or 'non-promising' according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed.

How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults

PubMed Central

Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart JH

2016-01-01

Sedentary behaviour – i.e., low energy-expending waking behaviour while seated or lying down – is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as ‘very promising’, ‘quite promising’, or ‘non-promising’ according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed. PMID:26315814

Effects of licence change on prescribing and poisons enquiries for antipsychotic agents in England and Scotland

PubMed Central

Bateman, D N; Good, A M; Afshari, R; Kelly, C A

2003-01-01

Aims To examine the effect of licence change for thioridazine at the end of 2000 on the prescription of antipsychotic drugs in England and Scotland, and investigate changes in poisons information inquiries and, for Edinburgh, poisons admissions. Methods Prescription data for antipsychotic drugs were obtained for England and Scotland and quarterly trends examined for 2000 and 2001. Accesses to the UK National Poisons Information Service website TOXBASE for antipsychotic products were examined for the same period. For Scotland telephone enquiry data, and admission data to the Edinburgh Poisons Unit were also evaluated. Trends in poisonings were compared with prescribing change. Results In England prescriptions for thioridazine fell rapidly in 2001 from approximately 35% of market share to less than 5%, and were replaced by risperidone, chlorpromazine and olanzapine. TOXBASE accesses fell from 39.3% of antipsychotics to 4.4%. Accesses for chlorpromazine, olanzapine and risperidone increased. In Scotland prescribing of thioridazine was similar to changes in England, but it was principally replaced by chlorpromazine. These changes were mirrored by TOXBASE accesses, telephone enquiries and in-patient admissions. The ratio of TOXBASE accesses for thioridazine to prescription numbers for the drug increased after the licence change. Conclusions Licence change produced rapid change in prescribing behaviour within 3 months. Prescribing behaviour in England and Scotland was different. Changes in prescribing were mirrored by changes in accesses for poisons information in both England and Scotland, and in Edinburgh by hospital admissions. The increase in the ratio of TOXBASE accesses to prescriptions for thioridazine suggests doctors may have become more aware of its potential toxicity. PMID:12814455

Behaviour change techniques to change the postnatal eating and physical activity behaviours of women who are obese: a qualitative study.

PubMed

Smith, D M; Taylor, W; Lavender, T

2016-01-01

To explore the experiences of postnatal women who are obese [body mass index (BMI) ≥ 30 kg/m(2) ] in relation to making behaviour changes and use of behaviour change techniques (BCTs). Qualitative interview study. Greater Manchester, UK. Women who were 1 year postnatal aged ≥18 years, who had an uncomplicated singleton pregnancy, and an antenatal booking BMI ≥ 30 kg/m(2) . Eighteen semi-structured, audio-recorded interviews were conducted by a research midwife with women who volunteered to be interviewed 1 year after taking part in a pilot randomised controlled trial. The six stages of thematic analysis were followed to understand the qualitative data. The Behavior Change Technique Taxonomy (version 1) was used to label the behaviour change techniques (BCTs) reported by women. Themes derived from 1-year postnatal interview transcripts. Two themes were evident: 1. A focused approach to postnatal weight management: women reported making specific changes to their eating and physical activity behaviours, and 2. Need for support: six BCTs were reported as helping women make changes to their eating and physical activity behaviours; three were reported more frequently than others: Self-monitoring of behaviour (2.3), Prompts/cues (7.1) and Social support (unspecified; 3.1). All of the BCTs required support from others for their delivery; food diaries were the most popular delivery method. Behaviour change techniques are useful to postnatal women who are obese, and have the potential to improve their physical and mental wellbeing. Midwives and obstetricians should be aware of such techniques, to encourage positive changes. © 2015 Royal College of Obstetricians and Gynaecologists.

Health professional perspectives on lifestyle behaviour change in the paediatric hospital setting: a qualitative study.

PubMed

Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole

2014-03-13

Research exists examining the challenges of delivering lifestyle behaviour change initiatives in practice. However, at present much of this research has been conducted with primary care health professionals, or in acute adult hospital settings. The purpose of this study was to identify barriers and facilitators associated with implementing routine lifestyle behaviour change brief advice into practice in an acute children's hospital. Thirty-three health professionals (nurses, junior doctors, allied health professionals and clinical support staff) from inpatient and outpatient departments at a UK children's hospital were interviewed about their attitudes and beliefs towards supporting lifestyle behaviour change in hospital patients and their families. Responses were analysed using thematic framework analysis. Health professionals identified a range of barriers and facilitators to supporting lifestyle behaviour change in a children's hospital. These included (1) personal experience of effectiveness, (2) constraints associated with the hospital environment, (3) appropriateness of advice delivery given the patient's condition and care pathway and (4) job role priorities, and (5) perceived benefits of the advice given. Delivery of lifestyle behaviour change advice was often seen as an educational activity, rather than a behaviour change activity. Factors underpinning the successful delivery of routine lifestyle behaviour change support must be understood if this is to be implemented effectively in paediatric acute settings. This study reveals key areas where paediatric health professionals may need further support and training to achieve successful implementation.

A review of patient-centred post-fracture interventions in the context of theories of health behaviour change.

PubMed

Sujic, R; Gignac, M A; Cockerill, R; Beaton, D E

2011-08-01

The purpose of this literature review is to determine whether and to what extent current post-fracture osteoporosis interventions utilize theories of health behaviour change and whether those that are theory-based are more successful in producing desired behaviour changes. Studies were identified by applying additional criteria to the final selection stage of a systematic review of non-surgical osteoporosis interventions in the orthopaedic environment. We identified 42 primary studies targeted at patients and improving post-fracture osteoporosis care. As well as describing the studies (in terms of design, population, interventions, outcomes), we focused on theoretical framework and elements of behaviour change models. The 42 studies included in this review utilized a variety of post-fracture interventions; however, none of them reported using an underlying theoretical base. Only three studies drew on what we felt to be elements of a theoretical framework. The lack of theoretically based studies points to a currently under-utilized area of behaviour change research that could be applied to post-fracture interventions in order to make them more effective. Despite an abundance of literature supporting theories of behaviour change, post-fracture osteoporosis interventions do not report utilizing these theories. Theories of behaviour change could be applied to post-fracture osteoporosis interventions to explain why patients initiate osteoporosis management. Future research should explore the application of theories of health behaviour change to post-fracture interventions.

Improvements in stage of change correlate to changes in dietary intake and clinical outcomes in a 5-year lifestyle intervention in young high-risk Sri Lankans.

PubMed

Guess, N; Vasantharajah, L; Gulliford, M; Viberti, G; Gnudi, L; Karalliedde, J; Wijesuriya, M

2016-09-01

The objectives of a stage-matched approach to lifestyle change are that individuals progress forward through the stages of change. It also posits that progression through the stages of change is associated with positive changes in lifestyle behaviours. Measuring the relationship between stage of change and food intake is challenging due to the plurality of dietary behaviours. Furthermore, it is not clear whether changes in behaviour are sustained long-term. In this study we assess the movement through stages of change in the intensive (visits every 3months) and control groups (visits annually) of a large-scale primary prevention study in cardiovascular disease, carried out in 2637 children and young adults in Sri Lanka between 2007 and 2012. We also examine their relationship to dietary behaviours and clinical outcomes. We demonstrate that individuals in both groups continue to progress through stages of change over the course of the study and that measures of dietary behaviours improved from baseline to final follow-up. We also demonstrate that stage of change positively correlates to dietary behaviours including the ratio of recommended:not-recommended items, unpolished:polished starches and low-fat:high-fat food items throughout each year of the study. Finally, participants in the later stages of change at Y2, Y3 and Y4, had a significantly attenuated increase in weight and waist circumference at the final visit in both groups. We therefore demonstrate the usefulness of stage-matched approach in modifying complex dietary behaviours, and that stage of change is a valid measure of dietary behaviours across a large population over time. Copyright © 2016 Elsevier Inc. All rights reserved.

Testing a Dutch web-based tailored lifestyle programme among adults: a study protocol.

PubMed

Schulz, Daniela N; Kremers, Stef Pj; van Osch, Liesbeth Adm; Schneider, Francine; van Adrichem, Mathieu Jg; de Vries, Hein

2011-02-16

Smoking, high alcohol consumption, unhealthy eating habits and physical inactivity often lead to (chronic) diseases, such as cardiovascular diseases and cancer. Tailored online interventions have been proven to be effective in changing health behaviours. The aim of this study is to test and compare the effectiveness of two different tailoring strategies for changing lifestyle compared to a control group using a multiple health behaviour web-based approach. In our Internet-based tailored programme, the five lifestyle behaviours of smoking, alcohol intake, fruit consumption, vegetable consumption, and physical activity are addressed. This randomized controlled trial, conducted among Dutch adults, includes two experimental groups (i.e., a sequential behaviour tailoring condition and a simultaneous behaviour tailoring condition) and a control group. People in the sequential behaviour tailoring condition obtain feedback on whether their lifestyle behaviours meet the Dutch recommendations. Using a step-by-step approach, they are stimulated to continue with a computer tailored module to change only one unhealthy behaviour first. In the course of the study, they can proceed to change a second behaviour. People in the simultaneous behaviour tailoring condition receive computer tailored feedback about all their unhealthy behaviours during their first visit as a stimulation to change all unhealthy behaviours. The experimental groups can re-visit the website and can then receive ipsative feedback (i.e., current scores are compared to previous scores in order to give feedback about potential changes). The (difference in) effectiveness of the different versions of the programme will be tested and compared to a control group, in which respondents only receive a short health risk appraisal. Programme evaluations will assess satisfaction with and appreciation and personal relevance of the intervention among the respondents. Finally, potential subgroup differences pertaining to gender, age and socioeconomic status regarding the behaviour effects and programme evaluation will be assessed. Research regarding multiple behaviour change is in its infancy. We study how to offer multiple behaviour change interventions optimally. Using these results could strengthen the effectiveness of web-based computer-tailoring lifestyle programmes. This study will yield new results about the need for differential lifestyle approaches using Internet-based expert systems and potential differences in subgroups concerning the effectiveness and appreciation. Dutch Trial Register NTR2168.

The sum of the parts: can we really reduce carbon emissions through individual behaviour change?

PubMed

Reynolds, Lucy

2010-01-01

Individuals are increasingly being urged to 'do their bit' in the fight against climate change, with governments and pro-environmentalists insisting that the collective impact of small behaviour changes will result in a meaningful reduction in global carbon emissions. The following paper considers this debate, as well as offering personal contributions from two leading environmentalists: Dr Doug McKenzie-Mohr, environmental psychologist and author of Fostering Sustainable Behavior: Community-Based Social Marketing; and Dr Tom Crompton, change strategist for WWF and co-author of Meeting Environmental Challenges: The Role of Human Identity, who argues for the role of intrinsic value systems in achieving sustainable behaviour change. As well as considering the responsibility of the individual in mitigating climate change, the paper introduces the discipline of social marketing as an effective tool for facilitating individual behaviour change, drawing on evidence from the field to recommend the key characteristics of effective behaviour change programmes.

Turkish Pre-Service Science Teachers' Awareness, Beliefs, Values, and Behaviours Pertinent to Climate Change

ERIC Educational Resources Information Center

Higde, Emrah; Oztekin, Ceren; Sahin, Elvan

2017-01-01

This study examined Turkish pre-service science teachers' awareness, uncertainty beliefs, values, and behaviours pertinent to climate change. It aimed to determine significant predictors of climate change-related behaviours and uncertainty beliefs about the reality of climate change. A Turkish-adapted survey was administered to 1277 pre-service…

Consumer and community involvement in health and medical research: evaluation by online survey of Australian training workshops for researchers.

PubMed

McKenzie, Anne; Alpers, Kirsten; Heyworth, Jane; Phuong, Cindy; Hanley, Bec

2016-01-01

In Australia, since 2009, the Consumer and Community Involvement Program (formerly the Consumer and Community Participation Program) has developed and run workshops to help people working in health and medical research involve more consumers (patients) and community members (the public) in their research. In 2012, workshop attendees were invited to do an online survey to find out the effect, if any, that attending a workshop had on their awareness of and attitudes to consumer and community involvement. They were also asked about changes in their behaviour when it came to the involvement of consumers and the community in their work. The study found that, for people who answered the survey, more than double the number found consumer and community involvement very relevant after attending a workshop, compared with the number who thought that before attending one. Also, amongst those who answered the survey, 94 % thought that the workshop increased their understanding about involvement. Background There is limited evidence of the benefits of providing training workshops for researchers on how to involve consumers (patients) and the community (public) in health and medical research. Australian training workshops were evaluated to contribute to the evidence base. The key objective was to evaluate the impact of the workshops in increasing awareness of consumer and community involvement; changing attitudes to future implementation of involvement activities and influencing behaviour in the methods of involvement used. A secondary objective was to use a formal evaluation survey to build on the anecdotal feedback received from researchers about changes in awareness, attitudes and behaviours. Methods The study used a cross-sectional, online survey of researchers, students, clinicians, administrators and members of non-government organisations who attended Consumer and Community Involvement Program training workshops between 2009 and 2012 to ascertain changes to awareness, attitudes and behaviours related to consumer and community involvement in health and medical research. Results Changes in awareness and attitudes were demonstrated by more than double the number of respondents finding involvement very relevant after attending a workshop compared with those who did so before attending; 94 % of respondents agreed that the workshops increased their understanding of how involvement can add value to research. Conclusions The training workshops raised awareness and increased relevance of consumer and community involvement among Australian researchers who attended a workshop and responded to the survey. The results of the survey are also suggestive that the training led to behaviour changes through increased consumer and community involvement.

What are the most effective techniques in changing obese individuals' physical activity self-efficacy and behaviour: a systematic review and meta-analysis.

PubMed

Olander, Ellinor K; Fletcher, Helen; Williams, Stefanie; Atkinson, Lou; Turner, Andrew; French, David P

2013-03-03

Increasing self-efficacy is generally considered to be an important mediator of the effects of physical activity interventions. A previous review identified which behaviour change techniques (BCTs) were associated with increases in self-efficacy and physical activity for healthy non-obese adults. The aim of the current review was to identify which BCTs increase the self-efficacy and physical activity behaviour of obese adults. A systematic search identified 61 comparisons with obese adults reporting changes in self-efficacy towards engaging in physical activity following interventions. Of those comparisons, 42 also reported changes in physical activity behaviour. All intervention descriptions were coded using Michie et al's (2011) 40 item CALO-RE taxonomy of BCTs. Meta-analysis was conducted with moderator analyses to examine the association between whether or not each BCT was included in interventions, and size of changes in both self-efficacy and physical activity behaviour. Overall, a small effect of the interventions was found on self-efficacy (d = 0.23, 95% confidence interval (CI): 0.16-0.29, p < 0.001) and a medium sized effect on physical activity behaviour (d = 0.50, 95% CI 0.38-0.63, p < 0.001). Four BCTs were significantly associated with positive changes in self-efficacy; 'action planning', 'time management', 'prompt self-monitoring of behavioural outcome' and 'plan social support/social change'. These latter two BCTs were also associated with positive changes in physical activity. An additional 19 BCTs were associated with positive changes in physical activity. The largest effects for physical activity were found where interventions contained 'teach to use prompts/cues', 'prompt practice' or 'prompt rewards contingent on effort or progress towards behaviour'. Overall, a non-significant relationship was found between change in self-efficacy and change in physical activity (Spearman's Rho = -0.18 p = 0.72). In summary, the majority of techniques increased physical activity behaviour, without having discernible effects on self-efficacy. Only two BCTs were associated with positive changes in both physical activity self-efficacy and behaviour. This is in contrast to the earlier review which found a strong relationship between changes in physical activity self-efficacy and behaviour. Mechanisms other than self-efficacy may be more important for increasing the physical activity of obese individuals compared with non-obese individuals.

Promoting physical activity in rheumatoid arthritis: a narrative review of behaviour change theories.

PubMed

Larkin, Louise; Kennedy, Norelee; Gallagher, Stephen

2015-01-01

Despite physical activity having significant health benefits for people with rheumatoid arthritis (RA), current levels of physical activity in this population are suboptimal. Changing behaviour is challenging and interventions aimed at increasing physical activity in this context have had varying levels of success. This review provides an overview of common behaviour change theories used in interventions to promote physical activity and their application for promoting physical activity in people with RA. A scoping, narrative review was conducted of English language literature, using the search terms "physical activity/exercise" and keywords, which are associated with behaviour change interventions. The theoretical basis of such interventions in people with RA was assessed using the "theory coding scheme". Six theories which have been used in physical activity research are discussed. Further, four studies which aimed to increase physical activity levels in people with RA are explored in detail. To date, behaviour change interventions conducted in RA populations to increase physical activity levels have not had a strong theoretical underpinning. It is proposed that an intervention utilising the theory of planned behaviour is developed with the aim of increasing physical activity in people with RA. Implications for Rehabilitation Interventions to promote physical activity in the rheumatoid arthritis (RA) population have failed to change participants' behaviour. A small number of studies have used behaviour change theories in the development and delivery of interventions. The theory of planned behaviour is recommended as the theoretical basis for an intervention to promote physical activity in the RA population.

The effectiveness of mobile-health behaviour change interventions for cardiovascular disease self-management: A systematic review.

PubMed

Pfaeffli Dale, Leila; Dobson, Rosie; Whittaker, Robyn; Maddison, Ralph

2016-05-01

Mobile wireless devices (mHealth) have been used to deliver cardiovascular disease self-management interventions to educate and support patients in making healthy lifestyle changes. This systematic review aimed to determine the effectiveness of mHealth interventions on behavioural lifestyle changes and medication adherence for cardiovascular disease self-management. A comprehensive literature search was conducted from inception through to 3 March 2015 using MEDLINE, PubMed, PsycINFO, EMBASE and The Cochrane Library. Eligible studies used an experimental trial design to determine the effectiveness of an mHealth intervention to change lifestyle behaviours in any cardiovascular disease population. Data extracted included intervention and comparison group characteristics with a specific focus on the use of behaviour change techniques. Seven studies met our inclusion criteria and were included in the qualitative synthesis. All interventions were delivered in part by mobile phone text messaging. Three studies were effective at improving adherence to medication and two studies increased physical activity behaviour. No effects were observed on dietary behaviour or smoking cessation, measured in one study each. Simple text messaging interventions appeared to be most effective; however, no clear relationships were found between study findings and intervention dose, duration or behaviour change techniques targeted. Our review found mHealth has the potential to change lifestyle behaviour. Results are still limited to a small number of trials, inconsistent outcome measures and ineffective reporting of intervention characteristics. Large scale, longitudinal studies are now warranted to gain a clear understanding of the effects of mHealth on behaviour change in the cardiovascular disease population. © The European Society of Cardiology 2015.

Blindness and behavioural changes in the cat: common neurological causes.

PubMed

Falzone, Cristian; Lowrie, Mark

2011-11-01

Blindness and behavioural changes occur relatively commonly in cats, either separately or in combination, causing devastating consequences for the cat and owner. Blindness can be caused by primary ophthalmic, metabolic or intracranial disease. Similarly behavioural changes may be the primary result of intracranial or systemic disease, but also occur secondarily to visual deficits or changes in interaction with the external environment (ie, non-medical problems). The anatomical pathways involved in vision are very close to those involved in behavioural regulation. It is, therefore, likely that a brain lesion (especially a forebrain lesion) that causes blindness will also cause behavioural abnormalities. In cases of partial or unilateral blindness, obvious visual deficits may not be apparent to the owner or clinician. Rather, the visual impairment may manifest more subtly as changes in behaviour, reluctance to jump or unwillingness to go outside. Similarly, behavioural problems may be episodic and, hence, a cat presenting with behavioural disturbances may appear clinically normal on evaluation. Behavioural changes are unlikely to be noticed unless marked and associated with bilateral blindness or advanced systemic illness. This article discusses these two major disorders separately, with the aim of highlighting for the clinician some of the important aspects of the general clinical and neurological examination that can be performed to identify these challenging cases. Copyright © 2011 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

Initiating and continuing behaviour change within a weight gain prevention trial: a qualitative investigation.

PubMed

Kozica, Samantha; Lombard, Catherine; Teede, Helena; Ilic, Dragan; Murphy, Kerry; Harrison, Cheryce

2015-01-01

Preventing obesity is an international health priority. In Australia, young women who live in rural communities are at high risk of unhealthy weight gain. Interventions which engage young women and support sustainable behaviour change are needed and comprehensive evaluation of such interventions generates knowledge for population scale-up. This qualitative sub-study aims to identify enablers and barriers to behaviour change initiation and continuation within a community weight gain prevention program. In-depth semi-structured interviews were conducted with program participants 6 months after baseline. All interviews were audio-taped and transcribed verbatim. Transcripts were analysed independently by two investigators via thematic analysis. A total of 28 women with a mean age of 39.9±6.2years and a BMI of 28.6±5.2kg/m2 were purposively recruited from the larger cohort (n = 649) that participated in the prevention trial. Four behaviour change groups emerged were identified from participant interviews: (i) no change, (ii) relapse, (iii) intermittent and (iv) continued change. Factors influencing behaviour change initiation and continuation included realistic program expectations and the participant's ability to apply the core program elements including: setting small, achievable behaviour change goals, problem solving and using self-management techniques. Personal knowledge, skills, motivation, self-efficacy, accountability and perceived social and environmental barriers also affected behaviour change. Satisfaction with personal program progress and the perceived amount of program supports required to achieve ongoing behaviour change varied amongst participants. Women who relapsed expressed a desire for more intensive and regular support from health professionals, identified more barriers unrelated to the program, anticipated significant weight loss and had lower satisfaction with their progress. Initiating and continuing behaviour change is a complex process. Our findings elucidate that initiation and continuation of behaviour change in women undertaking a weight gain prevention program may be facilitated by accurate and realistic understanding of program expectation, the ability to apply the core program messages, higher internal motivation, self-efficacy and minimal social and environmental barriers. Australia & New Zealand Clinical Trial Registry ACTRN12612000115831 www.anzctr.org.au.

Everything should be as simple as possible, but no simpler: towards a protocol for accumulating evidence regarding the active content of health behaviour change interventions.

PubMed

Peters, Gjalt-Jorn Ygram; de Bruin, Marijn; Crutzen, Rik

2015-01-01

There is a need to consolidate the evidence base underlying our toolbox of methods of behaviour change. Recent efforts to this effect have conducted meta-regressions on evaluations of behaviour change interventions, deriving each method's effectiveness from its association to intervention effect size. However, there are a range of issues that raise concern about whether this approach is actually furthering or instead obstructing the advancement of health psychology theories and the quality of health behaviour change interventions. Using examples from theory, the literature and data from previous meta-analyses, these concerns and their implications are explained and illustrated. An iterative protocol for evidence base accumulation is proposed that integrates evidence derived from both experimental and applied behaviour change research, and combines theory development in experimental settings with theory testing in applied real-life settings. As evidence gathered in this manner accumulates, a cumulative science of behaviour change can develop.

Everything should be as simple as possible, but no simpler: towards a protocol for accumulating evidence regarding the active content of health behaviour change interventions

PubMed Central

Peters, Gjalt-Jorn Ygram; de Bruin, Marijn; Crutzen, Rik

2015-01-01

There is a need to consolidate the evidence base underlying our toolbox of methods of behaviour change. Recent efforts to this effect have conducted meta-regressions on evaluations of behaviour change interventions, deriving each method's effectiveness from its association to intervention effect size. However, there are a range of issues that raise concern about whether this approach is actually furthering or instead obstructing the advancement of health psychology theories and the quality of health behaviour change interventions. Using examples from theory, the literature and data from previous meta-analyses, these concerns and their implications are explained and illustrated. An iterative protocol for evidence base accumulation is proposed that integrates evidence derived from both experimental and applied behaviour change research, and combines theory development in experimental settings with theory testing in applied real-life settings. As evidence gathered in this manner accumulates, a cumulative science of behaviour change can develop. PMID:25793484

Current process in hearing-aid fitting appointments: An analysis of audiologists' use of behaviour change techniques using the behaviour change technique taxonomy (v1).

PubMed

Barker, Fiona; Mackenzie, Emma; de Lusignan, Simon

2016-11-01

To observe and analyse the range and nature of behaviour change techniques (BCTs) employed by audiologists during hearing-aid fitting consultations to encourage and enable hearing-aid use. Non-participant observation and qualitative thematic analysis using the behaviour change technique taxonomy (version 1) (BCTTv1). Ten consultations across five English NHS audiology departments. Audiologists engage in behaviours to ensure the hearing-aid is fitted to prescription and is comfortable to wear. They provide information, equipment, and training in how to use a hearing-aid including changing batteries, cleaning, and maintenance. There is scope for audiologists to use additional BCTs: collaborating with patients to develop a behavioural plan for hearing-aid use that includes goal-setting, action-planning and problem-solving; involving significant others; providing information on the benefits of hearing-aid use or the consequences of non-use and giving advice about using prompts/cues for hearing-aid use. This observational study of audiologist behaviour in hearing-aid fitting consultations has identified opportunities to use additional behaviour change techniques that might encourage hearing-aid use. This information defines potential intervention targets for further research with the aim of improving hearing-aid use amongst adults with acquired hearing loss.

Can the behaviour of threespine stickleback parasitized with Schistocephalus solidus be replicated by manipulating host physiology?

PubMed

Grécias, Lucie; Hébert, François Olivier; Berger, Chloé Suzanne; Barber, Iain; Aubin-Horth, Nadia

2017-01-15

Sticklebacks infected by the parasitic flatworm Schistocephalus solidus show dramatic changes in phenotype, including a loss of species-typical behavioural responses to predators. The timing of host behaviour change coincides with the development of infectivity of the parasite to the final host (a piscivorous bird), making it an ideal model for studying the mechanisms of infection-induced behavioural modification. However, whether the loss of host anti-predator behaviour results from direct manipulation by the parasite, or is a by-product (e.g. host immune response) or side effect of infection (e.g. energetic loss), remains controversial. To understand the physiological mechanisms that generate these behavioural changes, we quantified the behavioural profiles of experimentally infected fish and attempted to replicate these in non-parasitized fish by exposing them to treatments including immunity activation and fasting, or by pharmacologically inhibiting the stress axis. All fish were screened for the following behaviours: activity, water depth preference, sociability, phototaxis, anti-predator response and latency to feed. We were able to change individual behaviours with certain treatments. Our results suggest that the impact of S. solidus on the stickleback might be of a multifactorial nature. The behaviour changes observed in infected fish might result from the combined effects of modifying the serotonergic axis, lack of energy and activation of the immune system. © 2017. Published by The Company of Biologists Ltd.

Intervention fidelity for a complex behaviour change intervention in community pharmacy addressing cardiovascular disease risk.

PubMed

McNamara, K P; O'Reilly, S L; George, J; Peterson, G M; Jackson, S L; Duncan, G; Howarth, H; Dunbar, J A

2015-12-01

Delivery of cardiovascular disease (CVD) prevention programs by community pharmacists appears effective and enhances health service access. However, their capacity to implement complex behavioural change processes during patient counselling remains largely unexplored. This study aims to determine intervention fidelity by pharmacists for behavioural components of a complex educational intervention for CVD prevention. After receiving training to improve lifestyle and medicines adherence, pharmacists recruited 70 patients aged 50-74 years without established CVD, and taking antihypertensive or lipid lowering therapy. Patients received five counselling sessions, each at monthly intervals. Researchers assessed biomedical and behavioural risk factors at baseline and six months. Pharmacists documented key outcomes from counselling after each session. Most patients (86%) reported suboptimal cardiovascular diets, 41% reported suboptimal medicines adherence, and 39% were physically inactive. Of those advised to complete the intervention, 85% attended all five sessions. Pharmacists achieved patient agreement with most recommended goals for behaviour change, and overwhelmingly translated goals into practical behavioural strategies. Barriers to changing behaviours were regularly documented, and pharmacists reported most behavioural strategies as having had some success. Meaningful improvements to health behaviours were observed post-intervention. Findings support further exploration of pharmacists' potential roles for delivering interventions with complex behaviour change requirements. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Physiology modulates social flexibility and collective behaviour in equids and other large ungulates.

PubMed

Gersick, Andrew S; Rubenstein, Daniel I

2017-08-19

Though morphologically very similar, equids across the extant species occupy ecological niches that are surprisingly non-overlapping. Occupancy of these distinct niches appears related to subtle physiological and behavioural adaptations which, in turn, correspond to significant differences in the social behaviours and emergent social systems characterizing the different species. Although instances of intraspecific behavioural variation in equids demonstrate that the same body plan can support a range of social structures, each of these morphologically similar species generally shows robust fidelity to its evolved social system. The pattern suggests a subtle relationship between physiological phenotypes and behavioural flexibility. While environmental conditions can vary widely within relatively short temporal or spatial scales, physiological changes and changes to the behaviours that regulate physiological processes, are constrained to longer cycles of adaptation. Physiology is then the limiting variable in the interaction between ecological variation and behavioural and socio-structural flexibility. Behavioural and socio-structural flexibility, in turn, will generate important feedbacks that will govern physiological function, thus creating a coupled web of interactions that can lead to changes in individual and collective behaviour. Longitudinal studies of equid and other large-bodied ungulate populations under environmental stress, such as those discussed here, may offer the best opportunities for researchers to examine, in real time, the interplay between individual behavioural plasticity, socio-structural flexibility, and the physiological and genetic changes that together produce adaptive change.This article is part of the themed issue 'Physiological determinants of social behaviour in animals'. © 2017 The Author(s).

Robustness of self-organised systems to changes in behaviour: an example from real and simulated self-organised snail aggregations.

PubMed

Stafford, Richard; Williams, Gray A; Davies, Mark S

2011-01-01

Group or population level self-organised systems comprise many individuals displaying group-level emergent properties. Current theory indicates that individual-level behaviours have an effect on the final group-level behaviour; that is, self-organised systems are sensitive to small changes in individual behaviour. Here we examine a self-organised behaviour in relation to environmentally-driven individual-level changes in behaviour, using both natural systems and computer simulations. We demonstrate that aggregations of intertidal snails slightly decrease in size when, owing to hotter and more desiccating conditions, individuals forage for shorter periods--a seemingly non-adaptive behaviour for the snails since aggregation reduces desiccation stress. This decrease, however, only occurs in simple experimental systems (and simulations of these systems). When studied in their natural and more complex environment, and simulations of such an environment, using the same reduced foraging time, no difference in aggregation behaviour was found between hot and cool days. These results give an indication of how robust self-organised systems are to changes in individual-level behaviour. The complexity of the natural environment and the interactions of individuals with this environment, therefore, can result in self-organised systems being more resilient to individual-level changes than previously assumed.

How Abnormal Is the Behaviour of Captive, Zoo-Living Chimpanzees?

PubMed Central

Birkett, Lucy P.; Newton-Fisher, Nicholas E.

2011-01-01

Background Many captive chimpanzees (Pan troglodytes) show a variety of serious behavioural abnormalities, some of which have been considered as possible signs of compromised mental health. The provision of environmental enrichments aimed at reducing the performance of abnormal behaviours is increasing the norm, with the housing of individuals in (semi-)natural social groups thought to be the most successful of these. Only a few quantitative studies of abnormal behaviour have been conducted, however, particularly for the captive population held in zoological collections. Consequently, a clear picture of the level of abnormal behaviour in zoo-living chimpanzees is lacking. Methods We present preliminary findings from a detailed observational study of the behaviour of 40 socially-housed zoo-living chimpanzees from six collections in the United States of America and the United Kingdom. We determined the prevalence, diversity, frequency, and duration of abnormal behaviour from 1200 hours of continuous behavioural data collected by focal animal sampling. Results, Conclusion and Significance Our overall finding was that abnormal behaviour was present in all sampled individuals across six independent groups of zoo-living chimpanzees, despite the differences between these groups in size, composition, housing, etc. We found substantial variation between individuals in the frequency and duration of abnormal behaviour, but all individuals engaged in at least some abnormal behaviour and variation across individuals could not be explained by sex, age, rearing history or background (defined as prior housing conditions). Our data support a conclusion that, while most behaviour of zoo-living chimpanzees is ‘normal’ in that it is typical of their wild counterparts, abnormal behaviour is endemic in this population despite enrichment efforts. We suggest there is an urgent need to understand how the chimpanzee mind copes with captivity, an issue with both scientific and welfare implications. PMID:21698219

Anesthesiologists’ and surgeons’ perceptions about routine pre-operative testing in low-risk patients: application of the Theoretical Domains Framework (TDF) to identify factors that influence physicians’ decisions to order pre-operative tests

PubMed Central

2012-01-01

Background Routine pre-operative tests for anesthesia management are often ordered by both anesthesiologists and surgeons for healthy patients undergoing low-risk surgery. The Theoretical Domains Framework (TDF) was developed to investigate determinants of behaviour and identify potential behaviour change interventions. In this study, the TDF is used to explore anaesthesiologists’ and surgeons’ perceptions of ordering routine tests for healthy patients undergoing low-risk surgery. Methods Sixteen clinicians (eleven anesthesiologists and five surgeons) throughout Ontario were recruited. An interview guide based on the TDF was developed to identify beliefs about pre-operative testing practices. Content analysis of physicians’ statements into the relevant theoretical domains was performed. Specific beliefs were identified by grouping similar utterances of the interview participants. Relevant domains were identified by noting the frequencies of the beliefs reported, presence of conflicting beliefs, and perceived influence on the performance of the behaviour under investigation. Results Seven of the twelve domains were identified as likely relevant to changing clinicians’ behaviour about pre-operative test ordering for anesthesia management. Key beliefs were identified within these domains including: conflicting comments about who was responsible for the test-ordering (Social/professional role and identity); inability to cancel tests ordered by fellow physicians (Beliefs about capabilities and social influences); and the problem with tests being completed before the anesthesiologists see the patient (Beliefs about capabilities and Environmental context and resources). Often, tests were ordered by an anesthesiologist based on who may be the attending anesthesiologist on the day of surgery while surgeons ordered tests they thought anesthesiologists may need (Social influences). There were also conflicting comments about the potential consequences associated with reducing testing, from negative (delay or cancel patients’ surgeries), to indifference (little or no change in patient outcomes), to positive (save money, avoid unnecessary investigations) (Beliefs about consequences). Further, while most agreed that they are motivated to reduce ordering unnecessary tests (Motivation and goals), there was still a report of a gap between their motivation and practice (Behavioural regulation). Conclusion We identified key factors that anesthesiologists and surgeons believe influence whether they order pre-operative tests routinely for anesthesia management for a healthy adults undergoing low-risk surgery. These beliefs identify potential individual, team, and organisation targets for behaviour change interventions to reduce unnecessary routine test ordering. PMID:22682612

Health beliefs and folk models of diabetes in British Bangladeshis: a qualitative study

PubMed Central

Greenhalgh, Trisha; Helman, Cecil; Chowdhury, A Mu’min

1998-01-01

Objective: To explore the experience of diabetes in British Bangladeshis, since successful management of diabetes requires attention not just to observable behaviour but to the underlying attitudes and belief systems which drive that behaviour. Design: Qualitative study of subjects’ experience of diabetes using narratives, semi-structured interviews, focus groups, and pile sorting exercises. A new qualitative method, the structured vignette, was developed for validating researchers’ understanding of primary level culture. Subjects: 40 British Bangladeshi patients with diabetes, and 10 non-Bangladeshi controls, recruited from primary care. Result: Several constructs were detected in relation to body image, cause and nature of diabetes, food classification, and knowledge of complications. In some areas, the similarities between Bangladeshi and non-Bangladeshi subjects were as striking as their differences. There was little evidence of a fatalistic or deterministic attitude to prognosis, and most informants seemed highly motivated to alter their diet and comply with treatment. Structural and material barriers to behaviour change were at least as important as “cultural” ones. Conclusion: Bangladeshi culture is neither seamless nor static, but some widely held beliefs and behaviours have been identified. Some of these have a potentially beneficial effect on health and should be used as the starting point for culturally sensitive diabetes education. PMID:9550958

Effects of selected metal oxide nanoparticles on Artemia salina larvae: evaluation of mortality and behavioural and biochemical responses.

PubMed

Gambardella, Chiara; Mesarič, Tina; Milivojević, Tamara; Sepčić, Kristina; Gallus, Lorenzo; Carbone, Serena; Ferrando, Sara; Faimali, Marco

2014-07-01

The aim was to investigate the toxicity of selected metal oxide nanoparticles (MO-NPs) on the brine shrimp Artemia salina, by evaluating mortality and behavioural and biochemical responses. Larvae were exposed to tin(IV) oxide (stannic oxide (SnO2)), cerium(IV) oxide (CeO2) and iron(II, III) oxide (Fe3O4) NPs for 48 h in seawater, with MO-NP suspensions from 0.01 to 1.0 mg/mL. Mortality and behavioural responses (swimming speed alteration) and enzymatic activities of cholinesterase, glutathione-S-transferase and catalase were evaluated. Although the MO-NPs did not induce any mortality of the larvae, they caused changes in behavioural and biochemical responses. Swimming speed significantly decreased in larvae exposed to CeO2 NPs. Cholinesterase and glutathione-S-transferase activities were significantly inhibited in larvae exposed to SnO2 NPs, whereas cholinesterase activity significantly increased after CeO2 NP and Fe3O4 NP exposure. Catalase activity significantly increased in larvae exposed to Fe3O4 NPs. In conclusion, swimming alteration and cholinesterase activity represent valid endpoints for MO-NP exposure, while glutathione-S-transferase and catalase activities appear to be NP-specific.

Behavioural and faecal glucocorticoid metabolite responses of single caging in six cats over 30 days

PubMed Central

Ellis, J. J.; Protopapadaki, V.; Stryhn, H.; Spears, J.; Cockram, M. S.

2014-01-01

Objectives The aim was to characterize the behaviour and faecal glucocorticoid metabolite (FGM) responses of six cats (Felis catus) to single caging for 30 days. Design In this observational study, changes in outcome measures were monitored with habituation to caging. Continuous focal observations of the activity, location in the cage, and posture were conducted from video recordings for one 24-hour period/week/cat. Cat-Stress-Scores were recorded daily. All faecal samples were collected for analysis of FGM. Results The percentage time spent eating increased, while percentage time spent grooming decreased, from week 1 to week 2. Cat-Stress-Score declined significantly from week 1 to week 2. FGM concentrations were significantly greater in week 1 than in week 5. A posthabituation time budget of the behaviour of the cats in the single cages showed that inactivity dominated the time budget and the cats were located on the shelf almost half of the time. Conclusions Results suggests that a shelf was a resource of value to the cats, and that its inclusion in enclosure design is important. Quantitative and qualitative behavioural data indicated that there was an initial stress response to caging that stabilised after the first week, while FGM concentration took longer to stabilise. PMID:26392880

Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study

PubMed Central

Little, Paul; White, Peter; Kelly, Joanne; Everitt, Hazel; Gashi, Shkelzen; Bikker, Annemieke; Mercer, Stewart

2015-01-01

Background Few studies have assessed the importance of a broad range of verbal and non-verbal consultation behaviours. Aim To explore the relationship of observer ratings of behaviours of videotaped consultations with patients’ perceptions. Design and setting Observational study in general practices close to Southampton, Southern England. Method Verbal and non-verbal behaviour was rated by independent observers blind to outcome. Patients competed the Medical Interview Satisfaction Scale (MISS; primary outcome) and questionnaires addressing other communication domains. Results In total, 275/360 consultations from 25 GPs had useable videotapes. Higher MISS scores were associated with slight forward lean (an 0.02 increase for each degree of lean, 95% confidence interval [CI] = 0.002 to 0.03), the number of gestures (0.08, 95% CI = 0.01 to 0.15), ‘back-channelling’ (for example, saying ‘mmm’) (0.11, 95% CI = 0.02 to 0.2), and social talk (0.29, 95% CI = 0.4 to 0.54). Starting the consultation with professional coolness (‘aloof’) was helpful and optimism unhelpful. Finishing with non-verbal ‘cut-offs’ (for example, looking away), being professionally cool (‘aloof’), or patronising, (‘infantilising’) resulted in poorer ratings. Physical contact was also important, but not traditional verbal communication. Conclusion These exploratory results require confirmation, but suggest that patients may be responding to several non-verbal behaviours and non-specific verbal behaviours, such as social talk and back-channelling, more than traditional verbal behaviours. A changing consultation dynamic may also help, from professional ‘coolness’ at the beginning of the consultation to becoming warmer and avoiding non-verbal cut-offs at the end. PMID:26009530

Addressing sexual health behaviour during emerging adulthood: a critical review of the literature

PubMed Central

Alexander, Kamila A; Jemmott1, Loretta S; Teitelman, Anne M; D’Antonio, Patricia

2016-01-01

Aims and objectives In this critical literature review, we examine evidence-based interventions that target sexual behaviours of 18- to 25-year-old emerging adult women. Background Nurses and clinicians implement theory-driven research programmes for young women with increased risk of HIV/AIDS and sexually transmitted infections. Strategies to decrease transmission of HIV and sexually transmitted infections are rigorously evaluated and promoted by public health agencies such as the United States Centers for Disease Control and Prevention. While many interventions demonstrate episodic reductions in sexual risk behaviours and infection transmission, there is little evidence they build sustainable skills and behaviours. Programmes may not attend to contextual and affective influences on sexual behaviour change. Design Discursive paper. Methods We conducted a conceptually based literature review and critical analysis of the Centers for Disease Control and Prevention’s best-evidence and good-evidence HIV behavioural interventions. In this review, we examined three contextual and affective influences on the sexual health of emerging adult women: (1) developmental age, (2) reproduction and pregnancy desires and (3) sexual security or emotional responses accompanying relationship experiences. Results Our analyses revealed intervention programmes paid little attention to ways age, desires for pregnancy or emotional factors influence sexual decisions. Some programmes included 18- to 25-year-olds, but they made up small percentages of the sample and did not attend to unique emerging adult experiences. Second, primary focus on infection prevention overshadowed participant desires for pregnancy. Third, few interventions considered emotional mechanisms derived from relationship experiences involved in sexual decision-making. Conclusions Growing evidence demonstrates sexual health interventions may be more effective if augmented to attend to contextual and affective influences on relationship risks and decision-making. Modifying currently accepted strategies may enhance sustainability of sexual health-promoting behaviours. PMID:24988875

Creatures of habit: accounting for the role of habit in implementation research on clinical behaviour change

PubMed Central

2012-01-01

Background Social cognitive theories on behaviour change are increasingly being used to understand and predict healthcare professionals’ intentions and clinical behaviours. Although these theories offer important insights into how new behaviours are initiated, they provide an incomplete account of how changes in clinical practice occur by failing to consider the role of cue-contingent habits. This article contributes to better understanding of the role of habits in clinical practice and how improved effectiveness of behavioural strategies in implementation research might be achieved. Discussion Habit is behaviour that has been repeated until it has become more or less automatic, enacted without purposeful thinking, largely without any sense of awareness. The process of forming habits occurs through a gradual shift in cognitive control from intentional to automatic processes. As behaviour is repeated in the same context, the control of behaviour gradually shifts from being internally guided (e.g., beliefs, attitudes, and intention) to being triggered by situational or contextual cues. Much clinical practice occurs in stable healthcare contexts and can be assumed to be habitual. Empirical findings in various fields suggest that behaviours that are repeated in constant contexts are difficult to change. Hence, interventions that focus on changing the context that maintains those habits have a greater probability of success. Some sort of contextual disturbance provides a window of opportunity in which a behaviour is more likely to be deliberately considered. Forming desired habits requires behaviour to be carried out repeatedly in the presence of the same contextual cues. Summary Social cognitive theories provide insight into how humans analytically process information and carefully plan actions, but their utility is more limited when it comes to explaining repeated behaviours that do not require such an ongoing contemplative decisional process. However, despite a growing interest in applying behavioural theory in interventions to change clinical practice, the potential importance of habit has not been explored in implementation research. PMID:22682656

Evolution of central pattern generators and rhythmic behaviours

PubMed Central

Katz, Paul S.

2016-01-01

Comparisons of rhythmic movements and the central pattern generators (CPGs) that control them uncover principles about the evolution of behaviour and neural circuits. Over the course of evolutionary history, gradual evolution of behaviours and their neural circuitry within any lineage of animals has been a predominant occurrence. Small changes in gene regulation can lead to divergence of circuit organization and corresponding changes in behaviour. However, some behavioural divergence has resulted from large-scale rewiring of the neural network. Divergence of CPG circuits has also occurred without a corresponding change in behaviour. When analogous rhythmic behaviours have evolved independently, it has generally been with different neural mechanisms. Repeated evolution of particular rhythmic behaviours has occurred within some lineages due to parallel evolution or latent CPGs. Particular motor pattern generating mechanisms have also evolved independently in separate lineages. The evolution of CPGs and rhythmic behaviours shows that although most behaviours and neural circuits are highly conserved, the nature of the behaviour does not dictate the neural mechanism and that the presence of homologous neural components does not determine the behaviour. This suggests that although behaviour is generated by neural circuits, natural selection can act separately on these two levels of biological organization. PMID:26598733

Evolution of central pattern generators and rhythmic behaviours.

PubMed

Katz, Paul S

2016-01-05

Comparisons of rhythmic movements and the central pattern generators (CPGs) that control them uncover principles about the evolution of behaviour and neural circuits. Over the course of evolutionary history, gradual evolution of behaviours and their neural circuitry within any lineage of animals has been a predominant occurrence. Small changes in gene regulation can lead to divergence of circuit organization and corresponding changes in behaviour. However, some behavioural divergence has resulted from large-scale rewiring of the neural network. Divergence of CPG circuits has also occurred without a corresponding change in behaviour. When analogous rhythmic behaviours have evolved independently, it has generally been with different neural mechanisms. Repeated evolution of particular rhythmic behaviours has occurred within some lineages due to parallel evolution or latent CPGs. Particular motor pattern generating mechanisms have also evolved independently in separate lineages. The evolution of CPGs and rhythmic behaviours shows that although most behaviours and neural circuits are highly conserved, the nature of the behaviour does not dictate the neural mechanism and that the presence of homologous neural components does not determine the behaviour. This suggests that although behaviour is generated by neural circuits, natural selection can act separately on these two levels of biological organization. © 2015 The Author(s).

Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease: A meta-analysis

PubMed Central

Bartlett, Yvonne K; Sheeran, Paschal; Hawley, Mark S

2014-01-01

Purpose The purpose of this study was to identify the behaviour change techniques (BCTs) that are associated with greater effectiveness in smoking cessation interventions for people with chronic obstructive pulmonary disease (COPD). Methods A systematic review and meta-analysis was conducted. Web of Knowledge, CINAHL, EMBASE, PsycINFO, and MEDLINE were searched from the earliest date available to December 2012. Data were extracted and weighted average effect sizes calculated; BCTs used were coded according to an existing smoking cessation-specific BCT taxonomy. Results Seventeen randomized controlled trials (RCTs) were identified that involved a total sample of 7446 people with COPD. The sample-weighted mean quit rate for all RCTs was 13.19%, and the overall sample-weighted effect size was d+ = 0.33. Thirty-seven BCTs were each used in at least three interventions. Four techniques were associated with significantly larger effect sizes: Facilitate action planning/develop treatment plan, Prompt self-recording, Advise on methods of weight control, and Advise on/facilitate use of social support. Three new COPD-specific BCTs were identified, and Linking COPD and smoking was found to result in significantly larger effect sizes. Conclusions Smoking cessation interventions aimed at people with COPD appear to benefit from using techniques focussed on forming detailed plans and self-monitoring. Additional RCTs that use standardized reporting of intervention components and BCTs would be valuable to corroborate findings from the present meta-analysis. Statement of contribution What is already known on this subject? Chronic obstructive pulmonary disease (COPD) is responsible for considerable health and economic burden worldwide, and smoking cessation (SC) is the only known treatment that can slow the decline in lung function experienced. Previous reviews of smoking cessation interventions for this population have established that a combination of pharmacological support and behavioural counselling is most effective. While pharmacological support has been detailed, and effectiveness ranked, the content of behavioural counselling varies between interventions, and it is not clear what the most effective components are. What does this study add? Detailed description of ‘behavioural counselling’ component of SC interventions for people with COPD. Meta-analysis to identify effective behaviour change techniques tailored for this population. Discussion of these findings in the context of designing tailored SC interventions. PMID:24397814

Physical activity attitudes, intentions and behaviour among 18–25 year olds: A mixed method study

PubMed Central

2012-01-01

Background Young people (18–25 years) during the adolescence/adulthood transition are vulnerable to weight gain and notoriously hard to reach. Despite increased levels of overweight/obesity in this age group, physical activity behaviour, a major contributor to obesity, is poorly understood. The purpose of this study was to explore physical activity (PA) behaviour among 18–25 year olds with influential factors including attitudes, motivators and barriers. Methods An explanatory mixed method study design, based on health Behaviour Change Theories was used. Those at university/college and in the community, including those Not in Education, Employment or Training (NEET) were included. An initial self reported quantitative questionnaire survey underpinned by the Theory of Planned Behaviour and Social Cognitive Theory was conducted. 1313 questionnaires were analysed. Results from this were incorporated into a qualitative phase also grounded in these theories. Seven focus groups were conducted among similar young people, varying in education and socioeconomic status. Exploratory univariate analysis was followed by multi staged modelling to analyse the quantitative data. ‘Framework Analysis’ was used to analyse the focus groups. Results Only 28% of 18–25 year olds achieved recommended levels of PA which decreased with age. Self-reported overweight/obesity prevalence was 22%, increasing with age, particularly in males. Based on the statistical modelling, positive attitudes toward PA were strong predictors of physical activity associated with being physically active and less sedentary. However, strong intentions to do exercise, was not associated with actual behaviour. Interactive discussions through focus groups unravelled attitudes and barriers influencing PA behaviour. Doing PA to feel good and to enjoy themselves was more important for young people than the common assumptions of ‘winning’ and ‘pleasing others’. Further this age group saw traditional health promotion messages as ‘empty’ and ‘fear of their future health’ was not a motivating factor to change current behaviour. Conclusion 18–25 year olds are a difficult group to reach and have low levels of PA. Factors such as, ‘enjoyment’, ‘appearance ‘and ‘feeling good’ were deemed important by this specific age group. A targeted intervention incorporating these crucial elements should be developed to improve and sustain PA levels. PMID:22892291

Epidural cortical stimulation as adjunctive treatment for non-fluent aphasia: preliminary findings.

PubMed

Cherney, Leora R; Erickson, Robert K; Small, Steven L

2010-09-01

This study evaluated the safety and feasibility of targeted epidural cortical stimulation delivered concurrently with intensive speech-language therapy for treatment of chronic non-fluent aphasia. Eight stroke survivors with non-fluent aphasia received intensive behavioural therapy for 3 h daily for 6 weeks using a combination of articulation drills, oral reading and conversational practice. Four of these participants (investigational participants) also underwent functional MRI guided surgical implantation of an epidural stimulation device which was activated only during therapy sessions. Behavioural data were collected before treatment, immediately after treatment and at 6 and 12 weeks following termination of therapy. Imaging data were collected before and after treatment. Investigational participants showed a mean Aphasia Quotient change of 8.0 points immediately post-therapy and at the 6 week follow-up, and 12.3 points at 12 weeks. The control group had changes of 4.6, 5.5 and 3.6 points, respectively. Similar changes were noted on subjective caregiver ratings. Functional imaging suggested increased consolidation of activity in interventional participants. Behavioural speech-language therapy improves non-fluent aphasia, independent of cortical stimulation. However, epidural stimulation of the ipsilesional premotor cortex may augment this effect, with the largest effects after completion of therapy. The neural mechanisms underlying these effects are manifested in the brain by decreases in the volume of activity globally and in particular regions. Although the number of participants enrolled in this trial precludes definitive conclusions, targeted epidural cortical stimulation appears safe and may be a feasible adjunctive treatment for non-fluent aphasia, particularly when the aphasia is more severe.

Management of rural drinking water supplies and waste using the participatory hygiene and sanitation transformation (PHAST) initiative in Zimbabwe.

PubMed

Musabayane, N

2000-01-01

This paper focuses on the use of Participatory Hygiene and Sanitation Transformation (PHAST) and how the methodology can be taken to scale. It uses the Zimbabwe experience and highlights some of the benefits in the application of PHAST, conditions necessary for scaling up and possible constraints. The PHAST initiative started off as a pilot process seeking to promote improved hygiene behaviour and promotion of sanitation. Having successfully piloted PHAST, Zimbabwe has scaled up the use of the methodology at a country level. While impact studies have not yet been conducted, reviews of the effects of the process have indicated positive behaviour change in such areas as management of water, construction and use of latrines. The process has also led to a change of institutional approaches in planning for improved water and sanitation from supply driven projects to demand responsive approaches. Some lessons learnt have included the need for baseline surveys at the start of the use of PHAST, the difficulty in developing monitoring indicators and hence difficulty in measuring impacts. Conclusions being drawn using assessment studies are that the use of participatory approaches has led to improved hygiene behaviour with communities being able to link causes and effects. The use of participatory methods also necessitates a change in institutional approaches from supply driven approaches to demand responsiveness. Other lessons drawn were related to the creation of an enabling environment for the application of participatory processes. Such enabling environment includes capacity building, resource allocation, policy and institutional support.

Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa.

PubMed

Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael

2014-01-01

Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large.

Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa

PubMed Central

Chidrawi, H. Christa; Greeff, Minrie; Temane, Q. Michael

2014-01-01

Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large. PMID:25495580

The effectiveness of motivational interviewing for health behaviour change in primary care settings: a systematic review.

PubMed

Morton, Katie; Beauchamp, Mark; Prothero, Anna; Joyce, Lauren; Saunders, Laura; Spencer-Bowdage, Sarah; Dancy, Bernadette; Pedlar, Charles

2015-01-01

Motivational interviewing (MI) is a patient-centred approach to behaviour change that was originally developed in the addiction field but has increasingly been applied to public health settings with a focus on health promotion. The purpose of this review was to examine the evidence base for MI interventions in primary care settings with non-clinical populations to achieve behaviour change for physical activity, dietary behaviours and/or alcohol intake. We also sought to explore the specific behaviour change techniques included in MI interventions within primary care. Electronic databases were searched for relevant articles and 33 papers met inclusion criteria and were included. Approximately 50% of the included studies (n = 18) demonstrated positive effects in relation to health behaviour change. The efficacy of MI approaches is unclear given the inconsistency of MI descriptions and intervention components. Furthermore, research designs that do not isolate the effects of MI make it difficult to determine the effectiveness of such approaches. We offer a number of recommendations for researchers and practitioners seeking to include MI within behaviour change interventions to help improve the quality of the research and the effectiveness of MI-based interventions within primary care settings.

Digital and social media opportunities for dietary behaviour change.

PubMed

McGloin, Aileen F; Eslami, Sara

2015-05-01

The way that people communicate, consume media and seek and receive information is changing. Forty per cent of the world's population now has an internet connection, the average global social media penetration is 39% and 1·5 billion people have internet access via mobile phone. This large-scale move in population use of digital, social and mobile media presents an unprecedented opportunity to connect with individuals on issues concerning health. The present paper aims to investigate these opportunities in relation to dietary behaviour change. Several aspects of the digital environment could support behaviour change efforts, including reach, engagement, research, segmentation, accessibility and potential to build credibility, trust, collaboration and advocacy. There are opportunities to influence behaviour online using similar techniques to traditional health promotion programmes; to positively affect health-related knowledge, skills and self-efficacy. The abundance of data on citizens' digital behaviours, whether through search behaviour, global positioning system tracking, or via demographics and interests captured through social media profiles, offer exciting opportunities for effectively targeting relevant health messages. The digital environment presents great possibilities but also great challenges. Digital communication is uncontrolled, multi-way and co-created and concerns remain in relation to inequalities, privacy, misinformation and lack of evaluation. Although web-based, social-media-based and mobile-based studies tend to show positive results for dietary behaviour change, methodologies have yet to be developed that go beyond basic evaluation criteria and move towards true measures of behaviour change. Novel approaches are necessary both in the digital promotion of behaviour change and in its measurement.

Stability and change in health behaviours as predictors for disability pension: a prospective cohort study of Swedish twins

PubMed Central

2011-01-01

Background Stability or changes of health behaviours have not been studied in association with incidence of disability pension (DP). The aims were to (1) investigate if stability or changes in health behaviours predict DP due to musculoskeletal diagnosis (MSD), (2) to evaluate if an association exists for DP in general, and (3) after taking familial confounding into account. Methods The study sample was 16,713 like-sexed twin individuals born in Sweden between 1935-1958 (6195 complete twin pairs) who had participated in two surveys 25 years apart, were alive, and not pensioned at the time of the latest survey. Cox proportional hazards analysis was used to assess the associations (hazard ratios (HR) with 95% confidence intervals (CI)) between stability and change in health behaviours (physical activity, tobacco and alcohol use, body mass index (BMI)), and number of pain locations collected at two time points 25 years apart and the incidence of DP until 2008. Results During the follow-up, 1843 (11%) individuals were granted DP with 747 of these due to MSD. A higher proportion of women were granted DP than men. Increase in BMI and stable use of tobacco products were predictors for DP due to MSD (HR 1.21-1.48) and DP in general (HR 1.10-1.41). The stability in the frequency of physical activity and increased frequency of physical activity were protective factors for DP due to MSD only when accounting for familial confounding. However, the number of pain locations (stability, increase, or decrease) was the strongest predictor for future DP due to MSD (HR 3.69, CI 2.99-4.56) and DP in general (HR 2.15, CI 1.92-2.42). In discordant pair analysis, the HRs for pain were lower, indicating potential familial confounding. Conclusions Health behaviours in adulthood, including an increase in pain locations were associated with the incidence of DP. The association between physical activity and DP was especially related to adulthood choices or habits, i.e., the individual decision about frequency of exercising. Thus, it is important to e.g. increase public awareness of the potential beneficial effects of exercise throughout life to avoid permanent exclusion from the labour market for medical reasons. PMID:21880151

The benefits and harms of providing parents with weight feedback as part of the national child measurement programme: a prospective cohort study

PubMed Central

2014-01-01

Background Small-scale evaluations suggest that the provision of feedback to parents about their child’s weight status may improve recognition of overweight, but the effects on lifestyle behaviour are unclear and there are concerns that informing parents that their child is overweight may have harmful effects. The aims of this study were to describe the benefits and harms of providing weight feedback to parents as part of a national school-based weight-screening programme in England. Methods We conducted a pre-post survey of 1,844 parents of children aged 4–5 and 10–11 years who received weight feedback as part of the 2010–2011 National Child Measurement Programme. Questionnaires assessed general knowledge about the health risks associated with child overweight, parental recognition of overweight and the associated health risks in their child, child lifestyle behaviour, child self-esteem and weight-related teasing, parental experience of the feedback, and parental help-seeking behaviour. Differences in the pre-post proportions of parents reporting each outcome were assessed using a McNemar’s test. Results General knowledge about child overweight as a health issue was high at baseline and increased further after weight feedback. After feedback, the proportion of parents that correctly recognised their child was overweight increased from 21.9% to 37.7%, and more than a third of parents of overweight children sought further information regarding their child’s weight. However, parent-reported changes in lifestyle behaviours among children were minimal, and limited to increases in physical activity in the obese children only. There was some suggestion that weight feedback had a greater impact upon changing parental recognition of the health risks associated with child overweight in non-white ethnic groups. Conclusions In this population-based sample of parents of children participating in the National Child Measurement Programme, provision of weight feedback increased recognition of child overweight and encouraged some parents to seek help, without causing obvious unfavourable effects. The impact of weight feedback on behaviour change was limited; suggesting that further work is needed to identify ways to more effectively communicate health information to parents and to identify what information and support may encourage parents in making and maintaining lifestyle changes for their child. PMID:24888972

Standard operating procedure changed pre-hospital critical care anaesthesiologists’ behaviour: a quality control study

PubMed Central

2013-01-01

Introduction The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists’ behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region prospectively registered pre-hospital advanced airway-management data according to the Utstein-style template. We collected pre-intervention data from February 1st 2011 to January 31st 2012, implemented the standard operating procedure on February 1st 2012 and collected post intervention data from February 1st 2012 until October 31st 2012. We included transported patients of all ages in need of controlled ventilation treated with pre-hospital endotracheal intubation or the insertion of a supraglottic airways device. The objective was to evaluate whether the development and implementation of a standard operating procedure for controlled ventilation during transport could change pre-hospital critical care anaesthesiologists’ behaviour and thereby increase the use of automated ventilators in these patients. Results The implementation of a standard operating procedure increased the overall prevalence of automated ventilator use in transported patients in need of controlled ventilation from 0.40 (0.34-0.47) to 0.74 (0.69-0.80) with a prevalence ratio of 1.85 (1.57-2.19) (p = 0.00). The prevalence of automated ventilator use in transported traumatic brain injury patients in need of controlled ventilation increased from 0.44 (0.26-0.62) to 0.85 (0.62-0.97) with a prevalence ratio of 1.94 (1.26-3.0) (p = 0.0039). The prevalence of automated ventilator use in patients transported after return of spontaneous circulation following pre-hospital cardiac arrest increased from 0.39 (0.26-0.48) to 0.69 (0.58-0.78) with a prevalence ratio of 1.79 (1.36-2.35) (p = 0.00). Conclusion We have shown that the implementation of a standard operating procedure for pre-hospital controlled ventilation can significantly change pre-hospital critical care anaesthesiologists’ behaviour. PMID:24308781

The role of HIV counselling and testing in sexual health behaviour change among undergraduates in Lagos, Nigeria.

PubMed

Wusu, Onipede; Okoukoni, Saturday

2011-01-01

In developing countries risky sexual behaviour among young people is on the increase. This study examined the likelihood of HIV counselling and testing (HCT) in reducing risky sexual behaviour among undergraduates in Lagos Metropolis in Nigeria. The main hypothesis tested in the study was the uptake of HCT is likely to reduce risky sexual behaviour among young undergraduates. A multistage sampling procedure was adopted to select a sample of 625 undergraduates in the study setting. A structured questionnaire was administered to respondents to elicit information on previous participation in HCT and sexual behaviour before and after participation. Result indicates that 26.1% of males and 28.9% of females ever participated in HCT. The average number of heterosexual partners kept by the respondents declined among males and females from 3.17 and 2.36, respectively before they participated in HCT to 2.27 and 1.6 after they participated in HCT. The differences in the average number of sexual partners by the respondents before and after they participated in HCT were statistically significant (P=0.000). The proportion of male respondents who engaged in frequent sex also declined from 35.8% (before participating in HCT) to 24.1% (after participating in HCT) and from 25% (before participating in HCT) to 24.7% (after participating in HCT) among females. In conclusion, participation in HCT is likely to reduce the prevalence of risky sexual behaviour among undergraduates in the study setting. Therefore, HCT is an intervention that should be emphasized.

Applying the Transtheoretical Model to Investigate Behavioural Change in Type 2 Diabetic Patients

ERIC Educational Resources Information Center

Lin, Shu-Ping; Wang, Ming-Jye

2013-01-01

Background: Long-term behaviour change in type 2 diabetic patients may provide effective glycemic control. Purpose: To investigate the key factors that promote behaviour change in diabetic subjects using the transtheoretical model. Methods: Subjects were selected by purposive sampling from type 2 diabetes outpatients. Self-administered…

Unravelling effectiveness of a nurse-led behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: study protocol for a cluster randomised controlled trial.

PubMed

Westland, Heleen; Bos-Touwen, Irene D; Trappenburg, Jaap C A; Schröder, Carin D; de Wit, Niek J; Schuurmans, Marieke J

2017-02-22

Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focus on behaviour change in both patients and nurses. The intervention aims for change in a single self-management behaviour, namely physical activity, in primary care patients at risk for cardiovascular disease. The aim of this study is to evaluate the effectiveness of the Activate intervention. A two-arm cluster randomised controlled trial will be conducted to compare the Activate intervention with care as usual at 31 general practices in the Netherlands. Approximately 279 patients at risk for cardiovascular disease will participate. The Activate intervention is developed using the Behaviour Change Wheel and consists of 4 nurse-led consultations in a 3-month period, integrating 17 behaviour change techniques. The Behaviour Change Wheel was also applied to analyse what behaviour change is needed in nurses to deliver the intervention adequately. This resulted in 1-day training and coaching sessions (including 21 behaviour change techniques). The primary outcome is physical activity, measured as the number of minutes of moderate to vigorous physical activity using an accelerometer. Potential effect modifiers are age, body mass index, level of education, social support, depression, patient-provider relationship and baseline number of minutes of physical activity. Data will be collected at baseline and at 3 months and 6 months of follow-up. A process evaluation will be conducted to evaluate the training of nurses, treatment fidelity, and to identify barriers to and facilitators of implementation as well as to assess participants' satisfaction. To increase physical activity in patients and to support nurses in delivering the intervention, behaviour change techniques are applied to change behaviours of the patients and nurses. Evaluation of the effectiveness of the intervention, exploration of which patients benefit most, and evaluation of our theory-based training for primary care nurses will enhance understanding of what works and for whom, which is essential for further implementation of self-management in clinical practice. ClinicalTrials.gov identifier: NCT02725203 . Registered on 25 March 2016.

Random Behaviour or Rational Choice? Family Planning, Teenage Pregnancy and Sexually Transmitted Infections

ERIC Educational Resources Information Center

Paton, David

2006-01-01

Rational choice models of teenage sexual behaviour lead to radically different predictions than do models that assume such behaviour is random. Existing empirical evidence has not been able to distinguish conclusively between these competing models. I use regional data from England between 1998 and 2001 to examine the impact of recent increases in…

Change in Photosystem II Photochemistry During Algal Growth Phases of Chlorella vulgaris and Scenedesmus obliquus.

PubMed

Oukarroum, Abdallah

2016-06-01

Sensitivity of photosynthetic processes towards environmental stress is used as a bioanalytical tool to evaluate the responses of aquatic plants to a changing environment. In this paper, change of biomass density, chlorophyll a fluorescence and photosynthetic parameters during growth phases of two microalgae Chlorella vulgaris and Scenedesmus obliquus were studied. The photosynthetic growth behaviour changed significantly with cell age and algae species. During the exponential phase of growth, the photosynthesis capacity reached its maximum and decreased in ageing algal culture during stationary phase. In conclusion, the chlorophyll a fluorescence OJIP method and the derived fluorescence parameters would be an accurate method for obtaining information on maximum photosynthetic capacities and monitoring algal cell growth. This will contribute to more understanding, for example, of toxic actions of pollutants in microalgae test.

Energy behaviours of northern California Girl Scouts and their families

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boudet, H; Ardoin, NM; Flora, J

Climate change is likely the most critical societal challenge to the futures of today's children. Mitigation will require a concerted effort to change household energy behaviour electricity use, transportation and food consumption patterns. A first step to changing behaviour is to better understand current behaviour and its intrapersonal (knowledge and attitudes), interpersonal (norms, communication and behaviour) and contextual (demographics and geography) correlates. To date, our understanding of the energy behaviours of children is limited. To begin to fill this gap, we report the results of a survey on the electricity, transportation and food-related energy behaviours of 323 fourth- and fifth-grademore » girls and their parents in 31 Girl Scout troops in Northern California. Our findings show positive attitudes and perceived norms toward energy-saving behaviours among child and adult respondents, but low or moderate levels of knowledge, communication, and behaviour, particularly for behaviours that require adult assistance. Girls' choices about electricity behaviours appear to be governed by intrapersonal and interpersonal influences, while transportation behaviour is constrained by geographic context. Food-related behaviour, particularly meat consumption, was not readily modelled. Policy and education-related implications for future interventions aimed at enhancing children's energy-saving behaviours are discussed. (C) 2014 Elsevier Ltd. All rights reserved.« less

Network information analysis reveals risk perception transmission in a behaviour-influenza dynamics system.

PubMed

Liao, C-M; You, S-H; Cheng, Y-H

2015-01-01

Influenza poses a significant public health burden worldwide. Understanding how and to what extent people would change their behaviour in response to influenza outbreaks is critical for formulating public health policies. We incorporated the information-theoretic framework into a behaviour-influenza (BI) transmission dynamics system in order to understand the effects of individual behavioural change on influenza epidemics. We showed that information transmission of risk perception played a crucial role in the spread of health-seeking behaviour throughout influenza epidemics. Here a network BI model provides a new approach for understanding the risk perception spread and human behavioural change during disease outbreaks. Our study allows simultaneous consideration of epidemiological, psychological, and social factors as predictors of individual perception rates in behaviour-disease transmission systems. We suggest that a monitoring system with precise information on risk perception should be constructed to effectively promote health behaviours in preparation for emerging disease outbreaks.

Positive affective processes underlie positive health behaviour change.

PubMed

Van Cappellen, Patty; Rice, Elise L; Catalino, Lahnna I; Fredrickson, Barbara L

2018-01-01

Positive health behaviours such as physical activity can prevent or reverse many chronic conditions, yet a majority of people fall short of leading a healthy lifestyle. Recent discoveries in affective science point to promising approaches to circumvent barriers to lifestyle change. Here, we present a new theoretical framework that integrates scientific knowledge about positive affect with that on implicit processes. The upward spiral theory of lifestyle change explains how positive affect can facilitate long-term adherence to positive health behaviours. The inner loop of this spiral model identifies nonconscious motives as a central mechanism of behavioural maintenance. Positive affect experienced during health behaviours increases incentive salience for cues associated with those behaviours, which in turn, implicitly guides attention and the everyday decisions to repeat those behaviours. The outer loop represents the evidence-backed claim, based on Fredrickson's broaden-and-build theory, that positive affect builds a suite of endogenous resources, which may in turn amplify the positive affect experienced during positive health behaviours and strengthen the nonconscious motives. We offer published and preliminary evidence in favour of the theory, contrast it to other dominant theories of health behaviour change, and highlight attendant implications for interventions that merit testing.

Training Programs That Facilitate Lasting Change in Student Academic Behaviour

ERIC Educational Resources Information Center

Hodge, Brad

2014-01-01

A range of evidence suggests that changing a person's pattern of behaviour is extremely difficult, with past behaviour being one of the strongest predictors of future behaviour. This is particularly evident in the university setting where students tend to use the same academic processes they have used throughout their schooling despite any…

SiO2 nanoparticles change colour preference and cause Parkinson's-like behaviour in zebrafish

PubMed Central

Li, Xiang; Liu, Bo; Li, Xin-Le; Li, Yi-Xiang; Sun, Ming-Zhu; Chen, Dong-Yan; Zhao, Xin; Feng, Xi-Zeng

2014-01-01

With advances in the development of various disciplines, there is a need to decipher bio-behavioural mechanisms via interdisciplinary means. Here, we present an interdisciplinary study of the role of silica nanoparticles (SiO2-NPs) in disturbing the neural behaviours of zebrafish and a possible physiological mechanism for this phenomenon. We used adult zebrafish as an animal model to evaluate the roles of size (15-nm and 50-nm) and concentration (300 μg/mL and 1000 μg/mL) in SiO2-NP neurotoxicity via behavioural and physiological analyses. With the aid of video tracking and data mining, we detected changes in behavioural phenotypes. We found that compared with 50-nm nanosilica, 15-nm SiO2-NPs produced greater significant changes in advanced cognitive neurobehavioural patterns (colour preference) and caused potentially Parkinson's disease-like behaviour. Analyses at the tissue, cell and molecular levels corroborated the behavioural results, demonstrating that nanosilica acted on the retina and dopaminergic (DA) neurons to change colour preference and to cause potentially Parkinson's disease-like behaviour. PMID:24448416

Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey.

PubMed

Rubin, G James; Amlôt, Richard; Page, Lisa; Wessely, Simon

2009-07-02

To assess whether perceptions of the swine flu outbreak predicted changes in behaviour among members of the public in England, Scotland, and Wales. Cross sectional telephone survey using random digit dialling. Interviews by telephone between 8 and 12 May. 997 adults aged 18 or more who had heard of swine flu and spoke English. Recommended change in behaviour (increases in handwashing and surface cleaning or plans made with a "flu friend") and avoidance behaviours (engaged in one or more of six behaviours such as avoiding large crowds or public transport). 37.8% of participants (n=377) reported performing any recommended behaviour change "over the past four days . . . because of swine flu." 4.9% (n=49) had carried out any avoidance behaviour. Controlling for personal details and anxiety, recommended changes were associated with perceptions that swine flu is severe, that the risk of catching it is high risk, that the outbreak will continue for a long time, that the authorities can be trusted, that good information has been provided, that people can control their risk of catching swine flu, and that specific behaviours are effective in reducing the risk. Being uncertain about the outbreak and believing that the outbreak had been exaggerated were associated with a lower likelihood of change. The strongest predictor of behaviour change was ethnicity, with participants from ethnic minority groups being more likely to make recommended changes (odds ratio 3.2, 95% confidence interval 2.0 to 5.3) and carry out avoidance behaviours (4.1, 2.0 to 8.4). The results support efforts to inform the public about specific actions that can reduce the risks from swine flu and to communicate about the government's plans and resources. Tackling the perception that the outbreak has been "over-hyped" may be difficult but worthwhile. Additional research is required into differing reactions to the outbreak among ethnic groups.

Effectiveness and uptake of screening programmes for coronary heart disease and diabetes: a realist review of design components used in interventions

PubMed Central

Holland, Carol; Cooper, Yvonne; Shaw, Rachel; Pattison, Helen; Cooke, Richard

2013-01-01

Objective To evaluate behavioural components and strategies associated with increased uptake and effectiveness of screening for coronary heart disease and diabetes with an implementation science focus. Design Realist review. Data sources PubMed, Web of Knowledge, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register and reference chaining. Searches limited to English language studies published since 1990. Eligibility criteria Eligible studies evaluated interventions designed to increase the uptake of cardiovascular disease (CVD) and diabetes screening and examined behavioural and/or strategic designs. Studies were excluded if they evaluated changes in risk factors or cost-effectiveness only. Results In 12 eligible studies, several different intervention designs and evidence-based strategies were evaluated. Salient themes were effects of feedback on behaviour change or benefits of health dialogues over simple feedback. Studies provide mixed evidence about the benefits of these intervention constituents, which are suggested to be situation and design specific, broadly supporting their use, but highlighting concerns about the fidelity of intervention delivery, raising implementation science issues. Three studies examined the effects of informed choice or loss versus gain frame invitations, finding no effect on screening uptake but highlighting opportunistic screening as being more successful for recruiting higher CVD and diabetes risk patients than an invitation letter, with no differences in outcomes once recruited. Two studies examined differences between attenders and non-attenders, finding higher risk factors among non-attenders and higher diagnosed CVD and diabetes among those who later dropped out of longitudinal studies. Conclusions If the risk and prevalence of these diseases are to be reduced, interventions must take into account what we know about effective health behaviour change mechanisms, monitor delivery by trained professionals and examine the possibility of tailoring programmes according to contexts such as risk level to reach those most in need. Further research is needed to determine the best strategies for lifelong approaches to screening. PMID:24202056

Decreased social behaviour following 3,4-methylenedioxymethamphetamine (MDMA) is accompanied by changes in 5-HT2A receptor responsivity.

PubMed

Bull, Eleanor J; Hutson, Peter H; Fone, Kevin C F

2004-02-01

This study examined the involvement of the 5-HT(2A) receptor in the long-term anxiogenic effect of a brief exposure of young rats to 3,4-methylenedioxymethamphetamine (MDMA) using the social interaction and elevated plus-maze paradigms. Wistar rats (post-natal day (PND) 28) received either MDMA (5 mg/kg i.p.) or saline (1 ml/kg i.p.) hourly for 4 h on 2 consecutive days. Locomotor activity was measured for 60 min after the first injection and core body temperature was recorded at regular intervals over 4 h. On PND 84, without further drug administration, social interaction was assessed between treatment-matched rat pairs derived from separate litters. On PND 86, rats received either the 5-HT(2A/2C) receptor agonist, 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI, 1 mg/kg i.p.) or saline and locomotor activity, wet-dog shakes and back muscle contractions were monitored. The change in elevated plus-maze behaviour was assessed following the same injection on PND 87. Acutely, MDMA produced a significant hyperlocomotion and hyperthermia (p<0.01). Following 55 days of abstinence, social interaction was reduced by 27% in MDMA pre-treated rats compared with that in controls (p<0.01). On the elevated plus-maze, pre-treatment with MDMA prevented the anxiogenic effect of DOI. On PND 92, hippocampal, frontal cortical and striatal 5-hydroxytryptamine (5-HT) was significantly reduced in MDMA pre-treated rats by between 16% and 22%, without any accompanying change in [(3)H]paroxetine binding in cortical homogenates. In conclusion, exposure of young rats to repeated MDMA caused serotonin depletion and induced 'anxiety-like' behaviour in the social interaction test accompanied by a long-lasting reduction in specific 5-HT(2A) receptor mediated behaviour.

Interventions that involve parents to improve children's weight-related nutrition intake and activity patterns - what nutrition and activity targets and behaviour change techniques are associated with intervention effectiveness?

PubMed

Golley, R K; Hendrie, G A; Slater, A; Corsini, N

2011-02-01

Parent involvement is an important component of obesity prevention interventions. However, the best way to support parents remains unclear. This review identifies interventions targeting parents to improve children's weight status, dietary and/or activity patterns, examines whether intervention content and behaviour change techniques employed are associated with effectiveness. Seventeen studies, in English, 1998-2008, were included. Studies were evaluated by two reviewers for study quality, nutrition/activity content and behaviour change techniques using a validated quality assessment tool and behaviour change technique taxonomy. Study findings favoured intervention effectiveness in 11 of 17 studies. Interventions that were considered effective had similar features: better study quality, parents responsible for participation and implementation, greater parental involvement and inclusion of prompt barrier identification, restructure the home environment, prompt self-monitoring, prompt specific goal setting behaviour change techniques. Energy intake/density and food choices were more likely to be targeted in effective interventions. The number of lifestyle behaviours targeted did not appear to be associated with effectiveness. Intervention effectiveness was favoured when behaviour change techniques spanned the spectrum of behaviour change process. The review provides guidance for researchers to make informed decisions on how best to utilize resources in interventions to support and engage parents, and highlights a need for improvement in intervention content reporting practices. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

Analysis and modification of verbal coaching behaviour: the usefulness of a data-driven intervention strategy.

PubMed

More, K G; Franks, I M

1996-12-01

This study tested a computer-aided coaching analysis instrument (CAI) as part of an intervention strategy designed to modify verbal coaching behaviour. Four coaches were observed and analysed over 12 practice sessions. Coaches A, B and C received intervention feedback through CAI data, where selected behaviours were highlighted for discussion, and videotape images were used to illustrate discussion points. Coach D was provided with videotapes of his own performance and told to formulate and implement any of his own recommendations. The CAI data are primarily quantitative, so target values were created for the different dimensions of verbal behaviour. This benefited the coaches in interpreting their effectiveness and provided a reference to evaluate the magnitude of change. Written journals and audiotape recordings were also used to promote insight into the complexity of verbal behaviour and the "human factors' (e.g. relationship with players, attitude to researcher) that affect behaviour modification. Instructional effectiveness was assessed by time-series analysis. There was evidence from each behaviour dimension that change can occur and be maintained as a result of exposure to the CAI intervention strategy. However, this is clearly contingent upon the coach understanding what is asked of him or her, and remains focused and committed to changing these particular behaviours. The analysis of Coach D's behavioural change suggests there are limitations to the sensitivity of discretionary viewing, as only two dimensions of behaviour were identified for, and resulted in, positive change. The results of this study provide support for Locke's (1984) contention that behaviour modification can occur by using data as direct feedback, as reinforcement and as information in the form of recommendations. However, the study also illuminates several factors that can negate the modification and maintenance of verbal coaching behaviour.

Heritable temperament pathways to early callous–unemotional behaviour

PubMed Central

Waller, Rebecca; Trentacosta, Christopher J.; Shaw, Daniel S.; Neiderhiser, Jenae M.; Ganiban, Jody M.; Reiss, David; Leve, Leslie D.; Hyde, Luke W.

2016-01-01

Background Early callous–unemotional behaviours identify children at risk for antisocial behaviour. Recent work suggests that the high heritability of callous–unemotional behaviours is qualified by interactions with positive parenting. Aims To examine whether heritable temperament dimensions of fearlessness and low affiliative behaviour are associated with early callous–unemotional behaviours and whether parenting moderates these associations. Method Using an adoption sample (n = 561), we examined pathways from biological mother self-reported fearlessness and affiliative behaviour to child callous–unemotional behaviours via observed child fearlessness and affiliative behaviour, and whether adoptive parent observed positive parenting moderated pathways. Results Biological mother fearlessness predicted child callous–unemotional behaviours via earlier child fearlessness. Biological mother low affiliative behaviour predicted child callous–unemotional behaviours, although not via child affiliative behaviours. Adoptive mother positive parenting moderated the fearlessness to callous–unemotional behaviour pathway. Conclusions Heritable fearlessness and low interpersonal affiliation traits contribute to the development of callous–unemotional behaviours. Positive parenting can buffer these risky pathways. PMID:27765772

Research Review: Evaluating and reformulating the developmental taxonomic theory of antisocial behaviour

PubMed Central

Fairchild, Graeme; Goozen, Stephanie HM; Calder, Andrew J; Goodyer, Ian M

2013-01-01

BackgroundThe developmental taxonomic theory proposes that there are two subtypes of antisocial behaviour. The first is a neurodevelopmental disorder which emerges in early childhood and follows a life-course persistent course, whereas the second emerges in adolescence, remits in early adulthood and reflects peer processes such as mimicry of antisocial peers. The aim of this review was to evaluate the developmental taxonomic theory in the light of recent empirical research. MethodsWe conducted a comprehensive literature review comparing these subtypes of antisocial behaviour based on searches on PubMed and other scientific databases covering the period from 1993 to 2013. We focused on research encompassing psychiatric epidemiology, personality assessment, neuropsychology, neuroendocrinology, genetics, and structural and functional neuroimaging. Sixty one empirical studies were identified that investigated one of these forms of antisocial behaviour separately or explicitly compared childhood-onset and adolescence-onset forms of antisocial behaviour. ResultsEmpirical research provides support for the hypothesis that life-course persistent antisocial behaviour is a neurodevelopmental disorder which emerges in the transactions between individual vulnerabilities and environmental adversity. In contrast to the developmental taxonomic theory, however, empirical findings suggest that severe antisocial behaviour that emerges in adolescence frequently has a negative prognosis and is rarely limited to the adolescent period. In addition, both forms of antisocial behaviour are associated with emotion processing deficits, changes in brain structure and function, alterations in cortisol secretion, and atypical personality traits (such as increased callous-unemotional traits). ConclusionsWe conclude that the developmental taxonomic theory is in need of revision, as differences between life-course persistent and adolescence-onset forms of antisocial behaviour appear to be quantitative, rather than qualitative, in nature. In addition, evidence is accumulating that adolescence-onset antisocial behaviour may also be a neurodevelopmental disorder. To account for the similarities between these groups, despite the differences in their age-of-onset, we propose that the quality of the child's early environment moderates the relationship between individual vulnerabilities and the age-of-onset of antisocial behaviour. PMID:23826820

Which behaviour change techniques are most effective at increasing older adults' self-efficacy and physical activity behaviour? A systematic review.

PubMed

French, David P; Olander, Ellinor K; Chisholm, Anna; Mc Sharry, Jennifer

2014-10-01

Increasing self-efficacy is an effective mechanism for increasing physical activity, especially for older people. The aim of this review was to identify behaviour change techniques (BCTs) that increase self-efficacy and physical activity behaviour in non-clinical community-dwelling adults 60 years or over. A systematic search identified 24 eligible studies reporting change in self-efficacy for physical activity following an intervention. Moderator analyses examined whether the inclusion of specific BCTs (as defined by CALO-RE taxonomy) was associated with changes in self-efficacy and physical activity behaviour. Overall, interventions increased self-efficacy (d = 0.37) and physical activity (d = 0.14). Self-regulatory techniques such as setting behavioural goals, prompting self-monitoring of behaviour, planning for relapses, providing normative information and providing feedback on performance were associated with lower levels of both self-efficacy and physical activity. Many commonly used self-regulation intervention techniques that are effective for younger adults may not be effective for older adults.

Infection prevention behaviour and infectious disease modelling: a review of the literature and recommendations for the future.

PubMed

Weston, Dale; Hauck, Katharina; Amlôt, Richard

2018-03-09

Given the importance of person to person transmission in the spread of infectious diseases, it is critically important to ensure that human behaviour with respect to infection prevention is appropriately represented within infectious disease models. This paper presents a large scale scoping review regarding the incorporation of infection prevention behaviour in infectious disease models. The outcomes of this review are contextualised within the psychological literature concerning health behaviour and behaviour change, resulting in a series of key recommendations for the incorporation of human behaviour in future infectious disease models. The search strategy focused on terms relating to behaviour, infectious disease and mathematical modelling. The selection criteria were developed iteratively to focus on original research articles that present an infectious disease model with human-human spread, in which individuals' self-protective health behaviour varied endogenously within the model. Data extracted included: the behaviour that is modelled; how this behaviour is modelled; any theoretical background for the modelling of behaviour, and; any behavioural data used to parameterise the models. Forty-two papers from an initial total of 2987 were retained for inclusion in the final review. All of these papers were published between 2002 and 2015. Many of the included papers employed a multiple, linked models to incorporate infection prevention behaviour. Both cognitive constructs (e.g., perceived risk) and, to a lesser extent, social constructs (e.g., social norms) were identified in the included papers. However, only five papers made explicit reference to psychological health behaviour change theories. Finally, just under half of the included papers incorporated behavioural data in their modelling. By contextualising the review outcomes within the psychological literature on health behaviour and behaviour change, three key recommendations for future behavioural modelling are made. First, modellers should consult with the psychological literature on health behaviour/ behaviour change when developing new models. Second, modellers interested in exploring the relationship between behaviour and disease spread should draw on social psychological literature to increase the complexity of the social world represented within infectious disease models. Finally, greater use of context-specific behavioural data (e.g., survey data, observational data) is recommended to parameterise models.

A Causal Modelling Approach to the Development of Theory-Based Behaviour Change Programmes for Trial Evaluation

ERIC Educational Resources Information Center

Hardeman, Wendy; Sutton, Stephen; Griffin, Simon; Johnston, Marie; White, Anthony; Wareham, Nicholas J.; Kinmonth, Ann Louise

2005-01-01

Theory-based intervention programmes to support health-related behaviour change aim to increase health impact and improve understanding of mechanisms of behaviour change. However, the science of intervention development remains at an early stage. We present a causal modelling approach to developing complex interventions for evaluation in…

‘Making every contact count’: evaluation of the impact of an intervention to train health and social care practitioners in skills to support health behaviour change

PubMed Central

Black, Christina; Tinati, Tannaze; Cradock, Sue; Begum, Rufia; Jarman, Megan; Pease, Anna; Margetts, Barrie; Davies, Jenny; Inskip, Hazel; Cooper, Cyrus; Baird, Janis; Barker, Mary

2015-01-01

A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to one year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost. PMID:24713156

Planning for sedentary behaviour interventions: office workers' survey and focus group responses.

PubMed

McGuckin, Teneale; Sealey, Rebecca; Barnett, Fiona

2017-11-01

As sedentary behaviour is becoming more prominent in office-based work environments, this study aimed to explore office workers' perceptions of sedentary behaviour, explore potential behavioural strategies to reduce sedentary behaviour in the workplace and identify barriers which may hamper behaviour change. A total of 140 office workers were recruited and surveyed from the same workplace. The survey included questions regarding perceptions of the relationship between sitting time and health. Following the survey, 12 employees also participated in focus groups to identify potential sedentary behaviour intervention strategies and barriers. The responses from the survey and focus groups were thematically analysed. In total, 88% of all participants surveyed agreed that there was a relationship between sitting time and their health. The most prominent theme identified was musculoskeletal complaints followed by general health and weight gain or obesity. The focus groups identified that interventions targeting reducing sitting time should include education, supportive and knowledgeable managers, and a variety of behaviour change strategies to address individual preferences and barriers. Multiple behavioural strategies were identified, which appear to be appropriate for sedentary behaviour change.

Shedding light on research participation effects in behaviour change trials: a qualitative study examining research participant experiences.

PubMed

MacNeill, Virginia; Foley, Marian; Quirk, Alan; McCambridge, Jim

2016-01-29

The sequence of events in a behaviour change trial involves interactions between research participants and the trial process. Taking part in such a study has the potential to influence the behaviour of the participant, and if it does, this can engender bias in trial outcomes. Since participants' experience has received scant attention, the aim of this study is thus to generate hypotheses about which aspects of the conduct of behaviour change trials might matter most to participants, and thus have potential to alter subsequent behaviours and bias trial outcomes Twenty participants were opportunistically screened for a health compromising behaviour (unhealthy diet, lack of exercise, smoking or alcohol consumption) and recruited if eligible. Semi structured face to face interviews were conducted, after going through the usual processes involved in trial recruitment, baseline assessment and randomisation. Participants were given information on the contents of an intervention or control condition in a behaviour change trial, which was not actually implemented. Three months later they returned to reflect on these experiences and whether they had any effect on their behaviour during the intervening period. Data from the latter interview were analysed thematically using a modified grounded theory approach. The early processes of trial participation raised awareness of unhealthy behaviours, although most reported having had only fleeting intentions to change their behaviour as a result of taking part in this study, in the absence of interventions. However, careful examination of the accounts revealed evidence of subtle research participation effects, which varied according to the health behaviour, and its perceived social acceptability. Participants' relationships with the research study were viewed as somewhat important in stimulating thinking about whether and how to make lifestyle changes. These participants described no dramatic impacts attributable to taking part in this study. This study demonstrates the likely value of well conducted qualitative studies of subtle research participation effects, which may be particularly important to explore for alcohol. Separating unintended influences in trial participation from the effects of behaviour change interventions being evaluated therein is necessary for valid estimates of intervention effects.

Cognitive behaviour therapy and inflammation: A systematic review of its relationship and the potential implications for the treatment of depression.

PubMed

Lopresti, Adrian L

2017-06-01

There is growing evidence confirming increased inflammation in a subset of adults with depression. The impact of this relationship has mostly been considered in biologically based interventions; however, it also has potential implications for psychological therapies. Cognitive behaviour therapy is the most commonly used psychological intervention for the treatment of depression with theories around its efficacy primarily based on psychological mechanisms. However, cognitive behaviour therapy may have an effect on, and its efficacy influenced by, physiological processes associated with depression. Accordingly, the purpose of this systematic review was to examine the relationship between cognitive behaviour therapy and inflammation. Studies examining the anti-inflammatory effects of cognitive behaviour therapy in people with depression and other medical conditions (e.g. cancer, diabetes and heart disease) were examined. In addition, the relationship between change in inflammatory markers and change in depressive symptoms following cognitive behaviour therapy, and the influence of pre-treatment inflammation on cognitive behaviour therapy treatment response were reviewed. A total of 23 studies investigating the anti-inflammatory effects of cognitive behaviour therapy were identified. In 14 of these studies, at least one reduction in an inflammatory marker was reported, increases were identified in three studies and no change was found in six studies. Three studies examined the relationship between change in inflammation and change in depressive symptoms following cognitive behaviour therapy. In two of these studies, change in depressive symptoms was associated with a change in at least one inflammatory marker. Finally, three studies examined the influence of pre-treatment inflammation on treatment outcome from cognitive behaviour therapy, and all indicated a poorer treatment response in people with higher premorbid inflammation. Preliminary evidence suggests inflammation should be considered within the context of cognitive behaviour therapy, although robust studies examining the relationship are sparse, and heterogeneity between studies and populations examined was high. The potential treatment implications of the bi-directional relationship between inflammation and cognitive behaviour therapy are discussed, and recommendations for future research are proposed.

Attitudes and behaviours of adolescents towards antibiotics and self-care for respiratory tract infections: a qualitative study

PubMed Central

Lecky, Donna M; Touboul Lundgren, Pia; Aldigs, Eman; Abdulmajed, Hind; Ioannidou, Eleni; Paraskeva-Hadjichambi, Demetra; Khouri, Pauline; Gal, Micaela; Hadjichambis, Andreas Ch.; Mappouras, Demetrios; McNulty, Cliodna AM

2017-01-01

Background To understand attitudes and behaviours of adolescents towards antibiotics, antimicrobial resistance and respiratory tract infections. Design Qualitative approach informed by the Theory of Planned Behaviour. Semi-structured interviews and focus groups were undertaken. We aimed to inform the development of an intervention in an international setting to improve antibiotic use among adolescents; therefore on completion of thematic analysis, findings were triangulated with qualitative data from similar studies in France, Saudi Arabia and Cyprus to elucidate differences in the behaviour change model and adaptation to diverse contexts. Setting 7 educational establishments from the south of England. Participants 53 adolescents (16–18 years) participated in seven focus groups and 21 participated in interviews. Results Most participants had taken antibiotics and likened them to other common medications such as painkillers; they reported that their peers treat antibiotics like a ‘cure-all’ and that they themselves were not interested in antibiotics as a discussion topic. They demonstrated low knowledge of the difference between viral and bacterial infections. Participants self-cared for colds and flu but believed antibiotics are required to treat other RTIs such as tonsillitis, which they perceived as more ‘serious’. Past history of taking antibiotics for RTIs instilled the belief that antibiotics were required for future RTIs. Those who characterised themselves as ‘non-science students’ were less informed about antibiotics and AMR. Most participants felt that AMR was irrelevant to them and their peers. Some ‘non-science’ students thought resistance was a property of the body, rather than bacteria. Conclusion Addressing adolescents’ misperceptions about antibiotics and the treatment of RTIs using a behaviour change intervention should help improve antibiotic awareness and may break the cycle of patient demand for antibiotics to treat RTIs amongst this group. Schools should consider educating all students in further education about antibiotic usage and AMR, not only those taking science. PMID:28592579

The temporal behaviour of MHD waves in a partially ionized prominence-like plasma: Effect of heating and cooling

NASA Astrophysics Data System (ADS)

Ballester, J. L.; Carbonell, M.; Soler, R.; Terradas, J.

2018-01-01

Context. During heating or cooling processes in prominences, the plasma microscopic parameters are modified due to the change of temperature and ionization degree. Furthermore, if waves are excited on this non-stationary plasma, the changing physical conditions of the plasma also affect wave dynamics. Aims: Our aim is to study how temporal variation of temperature and microscopic plasma parameters modify the behaviour of magnetohydrodynamic (MHD) waves excited in a prominence-like hydrogen plasma. Methods: Assuming optically thin radiation, a constant external heating, the full expression of specific internal energy, and a suitable energy equation, we have derived the profiles for the temporal variation of the background temperature. We have computed the variation of the ionization degree using a Saha equation, and have linearized the single-fluid MHD equations to study the temporal behaviour of MHD waves. Results: For all the MHD waves considered, the period and damping time become time dependent. In the case of Alfvén waves, the cut-off wavenumbers also become time dependent and the attenuation rate is completely different in a cooling or heating process. In the case of slow waves, while it is difficult to distinguish the slow wave properties in a cooling partially ionized plasma from those in an almost fully ionized plasma, the period and damping time of these waves in both plasmas are completely different when the plasma is heated. The temporal behaviour of the Alfvén and fast wave is very similar in the cooling case, but in the heating case, an important difference appears that is related with the time damping. Conclusions: Our results point out important differences in the behaviour of MHD waves when the plasma is heated or cooled, and show that a correct interpretation of the observed prominence oscillations is very important in order to put accurate constraints on the physical situation of the prominence plasma under study, that is, to perform prominence seismology.

Scottish adolescents’ sun-related behaviours, tanning attitudes and associations with skin cancer awareness: a cross-sectional study

PubMed Central

Kyle, Richard G; MacMillan, Iona; Forbat, Liz; Neal, Richard D; O'Carroll, Ronan E; Haw, Sally; Hubbard, Gill

2014-01-01

Objectives To describe Scottish adolescents’ sun-related behaviours and tanning attitudes and assess associations with skin cancer awareness. Design Cross-sectional study. Setting 20 state secondary schools in one Scottish local authority (Glasgow City). Participants 2173 adolescents (females: 50.7%, n=1102) with a mean age of 12.4 (SD=0.55). Outcome measures Sun-related behaviour (suntan, sunbathing, sunburn, sunscreen use, sunbed use), tanning attitudes, skin cancer-related symptom and risk factor awareness. Results Adolescents reported poor sun-related practice: 51% of adolescents reported sunburn the previous summer of whom 38% indicated sunburn on more than one occasion. Skin cancer awareness was low: 45% recognised ‘change in the appearance of a mole’ as a cancer symptom, and 39% agreed that ‘getting sunburnt more than once as a child’ increased cancer risk. 42% and 26% of adolescents, respectively, reported that friends and family held protanning attitudes. Compared with males, females were statistically significantly more likely to: report sunbathing (p<0.001), use of lotions or oil to aid tanning (p=0.009) and sunburn (p<0.001); know that changes in the appearance of a mole was a skin cancer symptom (p=0.036) and sunburn more than once as a child was a skin cancer risk factor (p=0.005); perceive their friends to hold protanning attitudes (p<0.001) and indicate that a tan made them feel better about themselves (p<0.001), more attractive to others (p=0.011) and healthier (p<0.001). Conclusions Scottish adolescents had poor sun protection practice and low skin cancer awareness. Girls adopted riskier sun-related behaviour despite greater awareness of skin cancer-related risk. Urgent action is required to promote positive sun-related behaviour and increase skin cancer awareness among Scottish adolescents. However, further research is needed to inform the development of effective sun-safe interventions. PMID:24793258

Emotionality Modulates the Effect of Chronic Stress on Feeding Behaviour in Birds

PubMed Central

Favreau-Peigné, Angélique; Calandreau, Ludovic; Constantin, Paul; Gaultier, Bernard; Bertin, Aline; Arnould, Cécile; Laurence, Agathe; Richard-Yris, Marie-Annick; Houdelier, Cécilia; Lumineau, Sophie; Boissy, Alain; Leterrier, Christine

2014-01-01

Chronic stress is a long-lasting negative emotional state that induces negative consequences on animals’ psycho-physiological state. This study aimed at assessing whether unpredictable and repeated negative stimuli (URNS) influence feeding behaviour in quail. Sixty-four quail were exposed to URNS from day 17 to 40, while 64 quail were undisturbed. Two lines divergently selected on their inherent emotionality were used to assess the effect of genetic factors on the sensitivity to URNS. All quail were submitted to a sequential feeding procedure (using two diets of different energetic values) which placed them in a contrasting situation. Behavioural tests were performed to assess the emotional reactivity of the two lines. Results confirmed that differences exist between them and that their emotional reactivity was enhanced by URNS. Diet preferences, motivation and daily intake were also measured. URNS did not change the preferences for the hypercaloric diet compared to the hypocaloric diet in choice tests, but they reduced daily intakes in both lines. Motivations for each diet were differently affected by URNS: they decreased the motivation to eat the hypercaloric diet in quail selected for their low inherent fearfulness whereas they increased the motivation to eat the hypocaloric diet in quail selected for their high inherent fearfulness, which suggested a devaluation process in the former and a compensatory behaviour in the later. Growth was furthermore reduced and laying delayed by URNS in both lines. In conclusion, the exposure to URNS induced interesting changes in feeding behaviour added with an increase in emotional reactivity and an alteration of production parameters. This confirms that both lines of quail experienced a chronic stress state. However differences in feed motivation and emotional reactivity between lines under chronic stress suggested that they experienced different emotional state and use different ways to cope with it depending on their genetic background. PMID:24498302

Effects of ambient temperature and early open-field response on the behaviour, feed intake and growth of fast- and slow-growing broiler strains.

PubMed

Nielsen, B L

2012-09-01

Increased activity improves broiler leg health, but also increases the heat production of the bird. This experiment investigated the effects of early open-field activity and ambient temperature on the growth and feed intake of two strains of broiler chickens. On the basis of the level of activity in an open-field test on day 3 after hatching, fast-growing Ross 208 and slow-growing i657 chickens were allocated on day 13 to one of the 48 groups. Each group included either six active or six passive birds from each strain and the groups were housed in floor-pens littered with wood chips and fitted with two heat lamps. Each group was fed ad libitum and subjected to one of the three temperature treatments: two (HH; 26°C), one (HC; 16°C to 26°C) or no (CC; 16°C) heat lamps turned on. Production and behavioural data were collected every 2 weeks until day 57. For both strains, early open-field activity had no significant effects on their subsequent behaviour or on any of the production parameters measured, and overall, the slow-growing strain was more active than the fast-growing strain. Ambient temperature had significant effects on production measures for i657 broilers, with CC chickens eating and weighing more, and with a less efficient feed conversion than HH chickens, with HC birds intermediate. A similar effect was found for Ross 208 only for feed intake from 27 to 41 days of age. Ross 208 chickens distributed themselves in the pen with a preference for cooler areas in the hottest ambient temperature treatments. In contrast, the behaviour of the slow-growing strain appeared to be relatively unaffected by the ambient temperature. In conclusion, fast-growing broilers use behavioural changes when trying to adapt to warm environments, whereas slow-growing broilers use metabolic changes to adapt to cooler ambient temperatures.

Prey field switching based on preferential behaviour can induce Lévy flights

PubMed Central

Lundy, Mathieu G.; Harrison, Alan; Buckley, Daniel J.; Boston, Emma S.; Scott, David D.; Teeling, Emma C.; Montgomery, W. Ian; Houghton, Jonathan D. R.

2013-01-01

Using the foraging movements of an insectivorous bat, Myotis mystacinus, we describe temporal switching of foraging behaviour in response to resource availability. These observations conform to predictions of optimized search under the Lévy flight paradigm. However, we suggest that this occurs as a result of a preference behaviour and knowledge of resource distribution. Preferential behaviour and knowledge of a familiar area generate distinct movement patterns as resource availability changes on short temporal scales. The behavioural response of predators to changes in prey fields can elicit different functional responses, which are considered to be central in the development of stable predator–prey communities. Recognizing how the foraging movements of an animal relate to environmental conditions also elucidates the evolution of optimized search and the prevalence of discrete strategies in natural systems. Applying techniques that use changes in the frequency distribution of movements facilitates exploration of the processes that underpin behavioural changes. PMID:23054951

Culturally compelling strategies for behaviour change: a social ecology model and case study in malaria prevention.

PubMed

Panter-Brick, Catherine; Clarke, Sian E; Lomas, Heather; Pinder, Margaret; Lindsay, Steve W

2006-06-01

Behaviour change is notoriously difficult to initiate and sustain, and the reasons why efforts to promote healthy behaviours fail are coming under increasing scrutiny. To be successful, health interventions should build on existing practices, skills and priorities, recognise the constraints on human behaviour, and either feature community mobilisation or target those most receptive to change. Furthermore, interventions should strive to be culturally compelling, not merely culturally appropriate: they must engage local communities and nestle within social and ecological landscapes. In this paper, we propose a social ecology perspective to make explicit the links between intention to change, actual behaviour change, and subsequent health impact, as relating to both theory-based models and practical strategies for triggering behaviour change. A social ecology model focuses attention on the contexts of behaviour when designing, implementing or critically evaluating interventions. As a case study, we reflect on a community-directed intervention in rural Gambia designed to reduce malaria by promoting a relatively simple and low-cost behaviour: repairing holes in mosquito bednets. In phase 1, contextual information on bednet usage, transactions and repairs (the 'social lives' of nets) was documented. In phase 2 (intervention), songs were composed and posters displayed by community members to encourage repairs, creating a sense of ownership and a compelling medium for the transmission of health messages. In phase 3 (evaluation), qualitative and quantitative data showed that household responses were particularly rapid and extensive, with significant increase in bednet repairs (p<0.001), despite considerable constraints on human agency. We highlight a promising approach-using songs-as a vehicle for change, and present a framework to embed the design, implementation and critical evaluation of interventions within the larger context-or social ecology-of behaviour practices that are the bedrock of health interventions.

Changes in Sedentary Behaviours and Associations with Physical Activity through Retirement: A 6-Year Longitudinal Study

PubMed Central

Menai, Mehdi; Fezeu, Léopold; Charreire, Hélène; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Simon, Chantal; Weber, Christiane; Andreeva, Valentina A.; Hercberg, Serge; Oppert, Jean-Michel

2014-01-01

Changes in sedentary behaviours and physical activity according to retirement status need to be better defined. Retirement is a critical life period that may influence a number of health behaviours. We assessed past-year sedentary behaviours (television, computer and reading time during leisure, occupational and domestic sitting time, in h/week) and physical activity (leisure, occupational and domestic, in h/week) over 6 years (2000–2001 and 2007) using the Modifiable Activity Questionnaire in 2,841 participants (mean age: 57.3±5.0 y) of the SU.VI.MAX (Supplementation with Antioxidants and Minerals) cohort. Analyses were performed according to retirement status. Subjects retired in 2001 and 2007 (40%) were those who spent most time in sedentary behaviour and in physical activity during and outside leisure (p<0.001). Leisure-time sedentary behaviours increased in all subjects during follow-up (p<0.001), but subjects who retired between 2001 and 2007 (31%) were those who reported the greatest changes (+8.4±0.42 h/week for a combined indicator of leisure-time sedentary behaviour). They also had the greatest increase in time spent in leisure-time physical activity (+2.5±0.2 h/week). In subjects not retired 2001 and 2007 (29%), changes in time spent watching television were found positively associated with an increase in occupational physical activity (p = 0.04) and negatively associated with changes in leisure-time physical activity (p = 0.02). No consistent association between changes in sedentary behaviours and changes in physical activity was observed in subjects retired in 2001 and 2007. Public health interventions should target retiring age populations not only to encourage physical activity but also to limit sedentary behaviours. PMID:25259801

'You need a support. When you don't have that . . . chocolate looks real good'. Barriers to and facilitators of behavioural changes among participants of a Healthy Living Program.

PubMed

Russell, Holly Ann; Rufus, Cheryl; Fogarty, Colleen T; Fiscella, Kevin; Carroll, Jennifer

2013-08-01

Health behavioural change is complex, especially for underserved patients who have higher rates of obesity and physical inactivity. Behavioural change interventions that show high efficacy in clinical trials may be difficult to disseminate and may not be effective in the office. We sought to identify factors that facilitate or hinder behavioural change among past participants of a healthy lifestyle intervention in an urban underserved health centre. Between March and October 2011, we conducted five focus group sessions with a total of 23 past participants. The focus group transcripts were analysed with a framework approach using the Social Ecological Model as a coding structure. We found four interconnected levels of social contexts: individual, interpersonal, programmatic and community levels. Themes of social support and the importance of relationships for making and maintaining behavioural changes were found at all levels. Social support and relatedness were key facilitators of healthy lifestyle changes and influenced individual motivation and perseverance. Harnessing the power of social support and motivation may be a way for future behavioural change interventions to bridge the gap between efficacy and effectiveness.

Application of Intervention Mapping to develop a community-based health promotion pre-pregnancy intervention for adolescent girls in rural South Africa: Project Ntshembo (Hope)

PubMed Central

2014-01-01

Background South Africa (SA) is undergoing multiple transitions with an increasing burden of non-communicable diseases and high levels of overweight and obesity in adolescent girls and women. Adolescence is key to addressing trans-generational risk and a window of opportunity to intervene and positively impact on individuals’ health trajectories into adulthood. Using Intervention Mapping (IM), this paper describes the development of the Ntshembo intervention, which is intended to improve the health and well-being of adolescent girls in order to limit the inter-generational transfer of risk of metabolic disease, in particular diabetes risk. Methods This paper describes the application of the first four steps of IM. Evidence is provided to support the selection of four key behavioural objectives: viz. to eat a healthy, balanced diet, increase physical activity, reduce sedentary behaviour, and promote reproductive health. Appropriate behaviour change techniques are suggested and a theoretical framework outlining components of relevant behaviour change theories is presented. It is proposed that the Ntshembo intervention will be community-based, including specialist adolescent community health workers who will deliver a complex intervention comprising of individual, peer, family and community mobilisation components. Conclusions The Ntshembo intervention is novel, both in SA and globally, as it is: (1) based on strong evidence, extensive formative work and best practice from evaluated interventions; (2) combines theory with evidence to inform intervention components; (3) includes multiple domains of influence (community through to the individual); (4) focuses on an at-risk target group; and (5) embeds within existing and planned health service priorities in SA. PMID:25080940

Psychological research and global climate change

NASA Astrophysics Data System (ADS)

Clayton, Susan; Devine-Wright, Patrick; Stern, Paul C.; Whitmarsh, Lorraine; Carrico, Amanda; Steg, Linda; Swim, Janet; Bonnes, Mirilia

2015-07-01

Human behaviour is integral not only to causing global climate change but also to responding and adapting to it. Here, we argue that psychological research should inform efforts to address climate change, to avoid misunderstandings about human behaviour and motivations that can lead to ineffective or misguided policies. We review three key research areas: describing human perceptions of climate change; understanding and changing individual and household behaviour that drives climate change; and examining the human impacts of climate change and adaptation responses. Although much has been learned in these areas, we suggest important directions for further research.

Behaviour change counselling--how do I know if I am doing it well? The development of the Behaviour Change Counselling Scale (BCCS).

PubMed

Vallis, Michael

2013-02-01

The purpose of this article is to operationalize behaviour change counselling skills (motivation enhancement, behaviour modification, emotion management) that facilitate self-management support activities and evaluate the psychometric properties of an expert rater scale, the Behaviour Change Counselling Scale (BCCS). Twenty-one healthcare providers with varying levels of behaviour change counselling training interviewed a simulated patient. Videotapes were independently rated by 3 experts on 2 occasions over 6 months. Data on item/subscale characteristics, interrater and test-retest reliability, preliminary data on construct reliability, were reported. All items of the BCCS performed well with the exception of 3 that were dropped due to infrequent endorsement. Most subscales showed strong psychometric properties. Interrater and test-retest reliability coefficients were uniformly high. Competency scores improved significantly from pre- to posttraining. Behaviour change counselling skills to guide lifestyle interventions can be operationalized and assessed in a reliable and valid manner. The BCCS can be used to guide clinical training in lifestyle counselling by operationalizing the component skills and providing feedback on skill achieved. Further research is needed to establish cut scores for competency and scale construct and criterion validity. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

[Premorbid personality and aggressive behavior in residents of psychogeriatic nursing homes].

PubMed

Cahn, C; Allewijn, M; Diesfeldt, H F A

2005-11-01

In the present study, the correlation was examined between pre-morbid personality traits and the occurrence of aggressive behaviour in residents of a psychogeriatric nursing home. The participants in the study were the close relatives of 39 residents of a psychogeriatric nursing home. These residents were selected on the basis of two subscales of the BOP assessment scale for elderly patients: Aggressive and annoying behaviour, and mental disability. Residents were divided into two groups: one group did not display aggressive behaviour, the other group displayed a great deal of such behaviour. The groups were comparable with regard to the degree of mental disability. To ascertain pre-morbid personality traits, use was made of the hetero-anamnestic personality questionnaire (HAP) and the Quick Big Five (QBF). We found no significant differences in any of the premorbid personality traits between the two groups. We could not confirm the conclusion of other authors that emotional lability (neuroticism) is a personality trait which makes people susceptible to developing aggressive behaviour. In conclusion, our study did not confirm the hypothesis that pre-morbid personality traits are useful to explain the occurrence of aggressive behaviour in residents of a psychogeriatric nursing home.

Case Study: Using Contemporary Behaviour Change Science to Design and Implement an Effective Nutritional Intervention within Professional Rugby League.

PubMed

Costello, Nessan; McKenna, Jim; Sutton, Louise; Deighton, Kevin; Jones, Ben

2018-01-18

Designing and implementing successful dietary intervention is integral to the role of sport nutrition professionals as they attempt to positively change the dietary behaviour of athletes. High-performance sport is a time-pressured environment where immediate results can often supersede pursuit of the most effective evidence-based practice. However, efficacious dietary intervention necessitates comprehensive, systematic and theoretical behavioural design and implementation if the habitual dietary behaviours of athletes are to be positively changed. Therefore, this case study demonstrates how the Behaviour Change Wheel was used to design and implement an effective nutritional intervention within professional rugby league. The eight-step intervention targeted athlete consumption of a high quality dietary intake of 25.1 MJ each day, to achieve an overall body mass increase of 5 kg across a twelve-week intervention period. The Capability, Opportunity, Motivation-Behaviour model and APEASE criteria were used to identify population-specific intervention functions, policy categories, behaviour change techniques and modes of intervention delivery. The resulting intervention was successful, increasing the average daily energy intake of the athlete to 24.5 MJ, which corresponded in a 6.2 kg body mass gain. Despite consuming 0.6 MJ less per day than targeted, secondary outcome measures of diet quality, strength, body composition and immune function all substantially improved, supporting a sufficient energy intake and the overall efficacy of a behavioural approach. Ultimately, the Behaviour Change Wheel provides sport nutrition professionals with an effective and practical step-wise method via which to design and implement effective nutritional interventions for use within high-performance sport.

Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework.

PubMed

Francis, Jill J; O'Connor, Denise; Curran, Janet

2012-04-24

Behaviour change is key to increasing the uptake of evidence into healthcare practice. Designing behaviour-change interventions first requires problem analysis, ideally informed by theory. Yet the large number of partly overlapping theories of behaviour makes it difficult to select the most appropriate theory. The need for an overarching theoretical framework of behaviour change was addressed in research in which 128 explanatory constructs from 33 theories of behaviour were identified and grouped. The resulting Theoretical Domains Framework (TDF) appears to be a helpful basis for investigating implementation problems. Research groups in several countries have conducted TDF-based studies. It seems timely to bring together the experience of these teams in a thematic series to demonstrate further applications and to report key developments. This overview article describes the TDF, provides a brief critique of the framework, and introduces this thematic series.In a brief review to assess the extent of TDF-based research, we identified 133 papers that cite the framework. Of these, 17 used the TDF as the basis for empirical studies to explore health professionals' behaviour. The identified papers provide evidence of the impact of the TDF on implementation research. Two major strengths of the framework are its theoretical coverage and its capacity to elicit beliefs that could signify key mediators of behaviour change. The TDF provides a useful conceptual basis for assessing implementation problems, designing interventions to enhance healthcare practice, and understanding behaviour-change processes. We discuss limitations and research challenges and introduce papers in this series.

Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework

PubMed Central

2012-01-01

Behaviour change is key to increasing the uptake of evidence into healthcare practice. Designing behaviour-change interventions first requires problem analysis, ideally informed by theory. Yet the large number of partly overlapping theories of behaviour makes it difficult to select the most appropriate theory. The need for an overarching theoretical framework of behaviour change was addressed in research in which 128 explanatory constructs from 33 theories of behaviour were identified and grouped. The resulting Theoretical Domains Framework (TDF) appears to be a helpful basis for investigating implementation problems. Research groups in several countries have conducted TDF-based studies. It seems timely to bring together the experience of these teams in a thematic series to demonstrate further applications and to report key developments. This overview article describes the TDF, provides a brief critique of the framework, and introduces this thematic series. In a brief review to assess the extent of TDF-based research, we identified 133 papers that cite the framework. Of these, 17 used the TDF as the basis for empirical studies to explore health professionals’ behaviour. The identified papers provide evidence of the impact of the TDF on implementation research. Two major strengths of the framework are its theoretical coverage and its capacity to elicit beliefs that could signify key mediators of behaviour change. The TDF provides a useful conceptual basis for assessing implementation problems, designing interventions to enhance healthcare practice, and understanding behaviour-change processes. We discuss limitations and research challenges and introduce papers in this series. PMID:22531601

Changes in weight, physical activity, sedentary behaviour and dietary intake during the transition to higher education: a prospective study.

PubMed

Deforche, Benedicte; Van Dyck, Delfien; Deliens, Tom; De Bourdeaudhuij, Ilse

2015-02-15

The transition to higher education involves a significant life change and might be accompanied with less healthy behaviours. However, the only longitudinal study that spanned the period from high school to college/university was limited to self-reported weight. Other studies assessed objective weight, but only at the start of the first semester at college/university and used retrospective questionnaires to asses health behaviours in high school. This study investigated changes in objectively assessed weight and prospective health behaviours during the transition from high school to college/university in Belgian students and examined which health behaviour changes were related to weight change. A sample of 291 students was followed from the final year of high school until the second year of college/university. Body mass index (BMI) and waist circumference were measured objectively. Physical activity, sedentary behaviours and dietary intake were estimated using validated questionnaires. In order to study changes in BMI and health behaviours, 2 × 2 (time × gender) Repeated Measures ANOVA analyses were conducted. A stepwise multiple regression analysis was executed to investigate the association between changes in health behaviours and BMI changes, and the moderating effect of gender. On average students gained 2.7 kg with a greater increase in boys (boys: 4.2 kg, girls: 1.9 kg). Active transportation and sport participation decreased. Some sedentary behaviours (watching TV/DVD, playing computer games) decreased, while others (internet use, studying) increased. Consumption of different foods decreased, while alcohol consumption increased. A higher decrease in sport participation, a higher increase in internet use and a lower increase in studying were related to a greater increase in BMI. An increase in alcohol consumption only contributed to weight gain in boys, whereas a decrease in fruit/vegetable intake only contributed to weight gain in girls. We can conclude that the transition to higher education is an at risk period for weight gain and unfavourable changes in health behaviours. Interventions to prevent weight gain in college/university students should therefore already start in high school with a somewhat different focus in boys versus girls.

Long-term effects of warming and ocean acidification are modified by seasonal variation in species responses and environmental conditions

PubMed Central

Godbold, Jasmin A.; Solan, Martin

2013-01-01

Warming of sea surface temperatures and alteration of ocean chemistry associated with anthropogenic increases in atmospheric carbon dioxide will have profound consequences for a broad range of species, but the potential for seasonal variation to modify species and ecosystem responses to these stressors has received little attention. Here, using the longest experiment to date (542 days), we investigate how the interactive effects of warming and ocean acidification affect the growth, behaviour and associated levels of ecosystem functioning (nutrient release) for a functionally important non-calcifying intertidal polychaete (Alitta virens) under seasonally changing conditions. We find that the effects of warming, ocean acidification and their interactions are not detectable in the short term, but manifest over time through changes in growth, bioturbation and bioirrigation behaviour that, in turn, affect nutrient generation. These changes are intimately linked to species responses to seasonal variations in environmental conditions (temperature and photoperiod) that, depending upon timing, can either exacerbate or buffer the long-term directional effects of climatic forcing. Taken together, our observations caution against over emphasizing the conclusions from short-term experiments and highlight the necessity to consider the temporal expression of complex system dynamics established over appropriate timescales when forecasting the likely ecological consequences of climatic forcing. PMID:23980249

Service evaluation of the GOALS family-based childhood obesity treatment intervention during the first 3 years of implementation

PubMed Central

Watson, Paula M; Dugdill, Lindsey; Pickering, Katie; Owen, Stephanie; Hargreaves, Jackie; Staniford, Leanne J; Murphy, Rebecca C; Knowles, Zoe; Cable, N Timothy

2015-01-01

Objectives To evaluate the impact of the GOALS (Getting Our Active Lifestyles Started) family-based childhood obesity treatment intervention during the first 3 years of implementation. Design Single-group repeated measures with qualitative questionnaires. Setting Community venues in a socioeconomically deprived, urban location in the North-West of England. Participants 70 overweight or obese children (mean age 10.5 years, 46% boys) and their parents/carers who completed GOALS between September 2006 and March 2009. Interventions GOALS was a childhood obesity treatment intervention that drew on social cognitive theory to promote whole family lifestyle change. Sessions covered physical activity (PA), diet and behaviour change over 18 2 h weekly group sessions (lasting approximately 6 months). A Template for Intervention Description and Replication (TIDieR) checklist of intervention components is provided. Primary and secondary outcome measures The primary outcome measure was child body mass index (BMI) z-score, collected at baseline, post-intervention and 12 months. Secondary outcome measures were child self-perceptions, parent/carer BMI and qualitative changes in family diet and PA (parent/carer questionnaire). Results Child BMI z-score reduced by 0.07 from baseline to post-intervention (p<0.001) and was maintained at 12 months (p<0.05). There was no change in parent/carer BMI or child self-perceptions, other than an increase in perceived social acceptance from baseline to post-intervention (p<0.05). Parents/carers reported positive changes to family PA and dietary behaviours after completing GOALS. Conclusions GOALS completion was associated with small improvements in child BMI z-score and improved family PA and dietary behaviours. Several intervention modifications were necessary during the implementation period and it is suggested childhood obesity treatment interventions need time to embed before a definitive evaluation is conducted. Researchers are urged to use the TIDieR checklist to ensure transparent reporting of interventions and facilitate the translation of evidence to practice. PMID:25652799

Development of a behaviour change communication tool for medical students: the 'Tent Pegs' booklet.

PubMed

Chisholm, Anna; Hart, Jo; Mann, Karen; Peters, Sarah

2014-01-01

To describe the development and validation of a behaviour change communication tool for medical students. Behaviour change techniques (BCTs) were identified within the literature and used to inform a communication tool to support medical students in discussing health-related behaviour change with patients. BCTs were organized into an accessible format for medical students (the 'Tent Pegs' booklet) and validated using discriminant content validity methods with 11 expert judges. One-sample t-tests showed that judges reliably mapped BCTs onto six of the seven Tent Pegs domains (confidence rating means ranged from 4.0 to 5.1 out of 10, all p≤0.002). Only BCTs within the 'empowering people to change' domain were not significantly different from the value zero (mean confidence rating=1.2, p>0.05); these BCTs were most frequently allocated to the 'addressing thoughts and emotions' domain instead. BCTs within the Tent Pegs booklet are reliably allocated to corresponding behaviour change domains with the exception of those within the 'empowering people to change' domain. The existing evidence-base on BCTs can be used to directly inform development of a communication tool to support medical students facilitate health behaviour change with patients. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

Owners’ Perceptions of Their Animal’s Behavioural Response to the Loss of an Animal Companion

PubMed Central

Walker, Jessica K.; Waran, Natalie K.; Phillips, Clive J. C.

2016-01-01

Simple Summary The loss of a companion animal is recognised as being associated with experiences of grief by the owner, but it is unclear how other animals in the household may be affected by such a loss. This paper investigates the behavioural responses of dogs and cats to the loss of an animal companion through owner-reported observations. There was consensus that behaviour changed as a result of loss including increased affectionate behaviour, territorial behaviour, and changes in food consumption and vocalisation. Abstract The loss of a companion animal is recognised as being associated with experiences of grief by the owner, but it is unclear how other animals in the household may be affected by such a loss. Our aim was to investigate companion animals’ behavioural responses to the loss of a companion through owner-report. A questionnaire was distributed via, and advertised within, publications produced by the Royal Society for the Prevention of Cruelty to Animals (RSPCA) across Australia and New Zealand, and through a selection of veterinary clinics within New Zealand. A total of 279 viable surveys were returned pertaining to 159 dogs and 152 cats. The two most common classes of behavioural changes reported for both dogs and cats were affectionate behaviours (74% of dogs and 78% of cats) and territorial behaviours (60% of dogs and 63% of cats). Both dogs and cats were reported to demand more attention from their owners and/or display affiliative behaviour, as well as spend time seeking out the deceased’s favourite spot. Dogs were reported to reduce the volume (35%) and speed (31%) of food consumption and increase the amount of time spent sleeping (34%). Cats were reported to increase the frequency (43%) and volume (32%) of vocalisations following the death of a companion. The median duration of reported behavioural changes in both species was less than 6 months. There was consensus that the behaviour of companion animals changed in response to the loss of an animal companion. These behavioural changes suggest the loss had an impact on the remaining animal. PMID:27827879

Evaluation of a Theory-Informed Implementation Intervention for the Management of Acute Low Back Pain in General Medical Practice: The IMPLEMENT Cluster Randomised Trial

PubMed Central

French, Simon D.; McKenzie, Joanne E.; O'Connor, Denise A.; Grimshaw, Jeremy M.; Mortimer, Duncan; Francis, Jill J.; Michie, Susan; Spike, Neil; Schattner, Peter; Kent, Peter; Buchbinder, Rachelle; Page, Matthew J.; Green, Sally E.

2013-01-01

Introduction This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP) in general practice. Methods General practices were randomised to either access to a guideline for acute LBP (control) or facilitated interactive workshops (intervention). We measured behavioural predictors (e.g. knowledge, attitudes and intentions) and fear avoidance beliefs. We were unable to recruit sufficient patients to measure our original primary outcomes so we introduced other outcomes measured at the general practitioner (GP) level: behavioural simulation (clinical decision about vignettes) and rates of x-ray and CT-scan (medical administrative data). All those not involved in the delivery of the intervention were blinded to allocation. Results 47 practices (53 GPs) were randomised to the control and 45 practices (59 GPs) to the intervention. The number of GPs available for analysis at 12 months varied by outcome due to missing confounder information; a minimum of 38 GPs were available from the intervention group, and a minimum of 40 GPs from the control group. For the behavioural constructs, although effect estimates were small, the intervention group GPs had greater intention of practising consistent with the guideline for the clinical behaviour of x-ray referral. For behavioural simulation, intervention group GPs were more likely to adhere to guideline recommendations about x-ray (OR 1.76, 95%CI 1.01, 3.05) and more likely to give advice to stay active (OR 4.49, 95%CI 1.90 to 10.60). Imaging referral was not statistically significantly different between groups and the potential importance of effects was unclear; rate ratio 0.87 (95%CI 0.68, 1.10) for x-ray or CT-scan. Conclusions The intervention led to small changes in GP intention to practice in a manner that is consistent with an evidence-based guideline, but it did not result in statistically significant changes in actual behaviour. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN012606000098538 PMID:23785427

Behavioural changes induced by N,N-dimethyl-tryptamine in rodents.

PubMed Central

Jenner, P.; Marsden, C. D.; Thanki, C. M.

1980-01-01

1 N,N-Dimethyltryptamine (DMT) in pargyline pretreated rodents induced a dose-dependent behavioural syndrome consisting of hyperactivity, prostration and hindlimb abduction, mild tremor, Straub tail, retropulsion and jerking. 2 In rats pretreated with pargyline, the behavioural syndrome induced by DMT differed from that induced by L-tryptophan or quipazine, in the lack of forepaw treading and head-weaving and in the presence of only mild tremor. 3 The hyperactivity component of the DMT-induced behavioural syndrome in pargyline-pretreated mice was potentiated by cyproheptadine, methergoline, and mianserin, inhibited by cinanserin, haloperidol, pimozide, methiothepin and propranolol, and not affected by 501C67-sulphate and methysergide. 4 The maximal behavioural changes induced by DMT in rats, other than hyperactivity, were unaffected by pretreatment with cyproheptadine, methysergide, and cinanserin. However, propranolol reduced the intensity of all behavioural effects apart from body jerking, and methergoline decreased the duration of prostration. Phenoxybenzamine and haloperidol, in contrast, enhanced prostration. 5 DMT plus pargyline did not induce circling behaviour in mice with a unilateral 6-hydroxy-dopamine lesion of the nigro-striatal pathway. 6 The DMT-induced behavioural syndrome appears to consist of two components, (a) hyperactivity and (b) other behavioural changes. They differ in their response to drugs affecting brain monoamines. The hyperactivity component may be expressed via dopamine mechanisms, but the other behavioural changes are not. The two behaviours do not respond consistently to drugs believed to alter brain 5-hydroxytryptamine function. PMID:6769527

Extending the Functionality of Behavioural Change-Point Analysis with k-Means Clustering: A Case Study with the Little Penguin (Eudyptula minor).

PubMed

Zhang, Jingjing; O'Reilly, Kathleen M; Perry, George L W; Taylor, Graeme A; Dennis, Todd E

2015-01-01

We present a simple framework for classifying mutually exclusive behavioural states within the geospatial lifelines of animals. This method involves use of three sequentially applied statistical procedures: (1) behavioural change point analysis to partition movement trajectories into discrete bouts of same-state behaviours, based on abrupt changes in the spatio-temporal autocorrelation structure of movement parameters; (2) hierarchical multivariate cluster analysis to determine the number of different behavioural states; and (3) k-means clustering to classify inferred bouts of same-state location observations into behavioural modes. We demonstrate application of the method by analysing synthetic trajectories of known 'artificial behaviours' comprised of different correlated random walks, as well as real foraging trajectories of little penguins (Eudyptula minor) obtained by global-positioning-system telemetry. Our results show that the modelling procedure correctly classified 92.5% of all individual location observations in the synthetic trajectories, demonstrating reasonable ability to successfully discriminate behavioural modes. Most individual little penguins were found to exhibit three unique behavioural states (resting, commuting/active searching, area-restricted foraging), with variation in the timing and locations of observations apparently related to ambient light, bathymetry, and proximity to coastlines and river mouths. Addition of k-means clustering extends the utility of behavioural change point analysis, by providing a simple means through which the behaviours inferred for the location observations comprising individual movement trajectories can be objectively classified.

Exploring the Causes of Change in Adolescent Girls' Sexual Behaviour in Begoro, Ghana.

PubMed

Gyan, Sylvia E

2017-06-01

There is a changing trend in adolescent girls' sexual and reproductive behaviour in Ghana. However, contemporary perspectives on adolescent girls' sexual behaviours are largely missing hence this study. Thematic analysis of data collected through in-depth interviews with adolescent girls and community members as well as focus group discussions with adolescent boys identified several factors accounting for the changes in adolescent girls' sexual and reproductive behaviour. These factors include changes in girls' attitudes to traditional practices, diversity in the agents of socialization as well as the age at menarche. This has resulted in a clash of value system between girls' sexual behaviours and that of the elderly. Thus, the social context in which girls are experiencing sexual and reproductive life in Ghana is changing and this must be taken into consideration when designing any intervention to help adolescent girls become resilient in their sexual and reproductive lives.

A review of behaviour change theories and techniques used in group based self-management programmes for chronic low back pain and arthritis.

PubMed

Keogh, Alison; Tully, Mark A; Matthews, James; Hurley, Deirdre A

2015-12-01

Medical Research Council (MRC) guidelines recommend applying theory within complex interventions to explain how behaviour change occurs. Guidelines endorse self-management of chronic low back pain (CLBP) and osteoarthritis (OA), but evidence for its effectiveness is weak. This literature review aimed to determine the use of behaviour change theory and techniques within randomised controlled trials of group-based self-management programmes for chronic musculoskeletal pain, specifically CLBP and OA. A two-phase search strategy of electronic databases was used to identify systematic reviews and studies relevant to this area. Articles were coded for their use of behaviour change theory, and the number of behaviour change techniques (BCTs) was identified using a 93-item taxonomy, Taxonomy (v1). 25 articles of 22 studies met the inclusion criteria, of which only three reported having based their intervention on theory, and all used Social Cognitive Theory. A total of 33 BCTs were coded across all articles with the most commonly identified techniques being 'instruction on how to perform the behaviour', 'demonstration of the behaviour', 'behavioural practice', 'credible source', 'graded tasks' and 'body changes'. Results demonstrate that theoretically driven research within group based self-management programmes for chronic musculoskeletal pain is lacking, or is poorly reported. Future research that follows recommended guidelines regarding the use of theory in study design and reporting is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Asking for work adjustments or initiating behavioural changes - what makes a 'problematic co-worker' score Brownie points? An experimental study on the reactions towards colleagues with a personality disorder.

PubMed

Muschalla, Beate; Fay, Doris; Seemann, Anne

2016-10-01

People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues' reactions towards a problematic worker dependent on the returning person's reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.

Untapped aspects of mass media campaigns for changing health behaviour towards non-communicable diseases in Bangladesh.

PubMed

Tabassum, Reshman; Froeschl, Guenter; Cruz, Jonas P; Colet, Paolo C; Dey, Sukhen; Islam, Sheikh Mohammed Shariful

2018-01-18

In recent years, non-communicable diseases (NCDs) have become epidemic in Bangladesh. Behaviour changing interventions are key to prevention and management of NCDs. A great majority of people in Bangladesh have low health literacy, are less receptive to health information, and are unlikely to embrace positive health behaviours. Mass media campaigns can play a pivotal role in changing health behaviours of the population. This review pinpoints the role of mass media campaigns for NCDs and the challenges along it, whilst stressing on NCD preventive programmes (with the examples from different countries) to change health behaviours in Bangladesh. Future research should underpin the use of innovative technologies and mobile phones, which might be a prospective option for NCD prevention and management in Bangladesh.

Improving cancer control through a community-based cancer awareness initiative☆

PubMed Central

Smith, Samuel G.; Rendell, Helen; George, Helen; Power, Emily

2014-01-01

Objective To assess the impact of the Cancer Research UK Cancer Awareness Roadshow on intentions to change health behaviours and use local health services related to cancer. Method Feedback forms from visitors to three Roadshows collected data on anticipated lifestyle changes and health service use following their visit to the Roadshow. Demographic predictors of intentions were investigated. Results A total of 6009 individuals completed a feedback form. On average, respondents intended to make between two and three (2.55; SD = 1.77) lifestyle changes, and use between none and one (0.59; SD = 0.77) local health services following their visit. Multivariable analysis showed that age (p = 0.001), ethnicity (p = 0.006), and occupation (p = 0.043) were significant predictors of anticipated lifestyle changes. Anticipated health service use was higher among men (p = 0.001), younger groups (p < 0.001), and smokers (p < 0.001). Overall effects of ethnicity (p = 0.001) and occupation (p < 0.001) on anticipated health service use were also observed. Post-hoc analyses indicated stronger effects of the Roadshow among disadvantaged groups. Conclusion High levels of anticipated health behaviour change and health service use were observed among Roadshow visitors. Disadvantaged groups such as lower socioeconomic groups, ethnic minorities, and smokers showed particularly high levels of intention. A more in-depth evaluation of the Roadshow is warranted. PMID:24239683

Making the links: do we connect climate change with health? A qualitative case study from Canada.

PubMed

Cardwell, Francesca S; Elliott, Susan J

2013-03-08

Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an environmental to a health issue. This paper builds on calls for increased understanding of the public's views of human health risks associated with climate change, focusing on facilitators and barriers to behaviour change. Semi-structured in-depth interviews (n = 22) with residents of the Golden Horseshoe region of Southern Ontario were conducted between August 2010 and January 2011. Topics included individual and community health, climate change, and facilitators and barriers to behaviour change. Few participants recognized the role of the environment in the context of either individual and community health. When asked about health concerns specific to their community, however, environmental issues were mentioned frequently. Health effects as possible impacts of global environmental change were mentioned by 77% of participants when prompted, but this link was not described in great detail or within the context of impacting their communities or themselves. Participants were willing to act in environmentally friendly ways, and possible incentives to undertake behaviour change such as decreasing cost were described. Health co-benefits were not identified as incentives to engaging in mitigative or adaptive behaviours. The results support recent calls for reframing the impact of climate change from an environmental to a public health issue in order to increase public engagement in adaptive and mitigative behaviour change. While previous research has touched on public awareness of the human health risks of climate change, we have further explored the attitude-action link through the examination of facilitators and barriers to behaviour change.

Co-Occurrence of Language and Behavioural Change in Frontotemporal Lobar Degeneration.

PubMed

Harris, Jennifer M; Jones, Matthew; Gall, Claire; Richardson, Anna M T; Neary, David; du Plessis, Daniel; Pal, Piyali; Mann, David M A; Snowden, Julie S; Thompson, Jennifer C

2016-01-01

We aimed to evaluate the co-occurrence of language and behavioural impairment in patients with frontotemporal lobar degeneration (FTLD) spectrum pathology. Eighty-one dementia patients with pathological confirmation of FTLD were identified. Anonymized clinical records from patients' first assessment were rated for language and behavioural features from frontotemporal dementia consensus criteria, primary progressive aphasia (PPA) criteria and 1998 FTLD criteria. Over 90% of patients with FTLD pathology exhibited a combination of at least one behavioural and one language feature. Changes in language, in particular, were commonly accompanied by behavioural change. Notably, the majority of patients who displayed language features characteristic of semantic variant PPA exhibited 'early perseverative, stereotyped or compulsive/ritualistic behaviour'. Moreover, 'executive/generation deficits with relative sparing of memory and visuospatial functions' occurred in most patients with core features of non-fluent variant PPA. Behavioural and language symptoms frequently co-occur in patients with FTLD pathology. Current classifications, which separate behavioural and language syndromes, do not reflect this co-occurrence.

Change in organizational justice as a predictor of insomnia symptoms: longitudinal study analysing observational data as a non-randomized pseudo-trial

PubMed Central

Lallukka, Tea; Halonen, Jaana I; Sivertsen, Børge; Pentti, Jaana; Stenholm, Sari; Virtanen, Marianna; Salo, Paula; Oksanen, Tuula; Elovainio, Marko; Vahtera, Jussi; Kivimäki, Mika

2017-01-01

Abstract Background Despite injustice at the workplace being a potential source of sleep problems, longitudinal evidence remains scarce. We examined whether changes in perceived organizational justice predicted changes in insomnia symptoms. Methods Data on 24 287 Finnish public sector employees (82% women), from three consecutive survey waves between 2000 and 2012, were treated as ‘pseudo-trials’. Thus, the analysis of unfavourable changes in organizational justice included participants without insomnia symptoms in Waves 1 and 2, with high organizational justice in Wave 1 and high or low justice in Wave 2 (N = 6307). In the analyses of favourable changes in justice, participants had insomnia symptoms in Waves 1 and 2, low justice in Wave 1 and high or low justice in Wave 2 (N = 2903). In both analyses, the outcome was insomnia symptoms in Wave 3. We used generalized estimating equation models to analyse the data. Results After adjusting for social and health-related covariates in Wave 1, unfavourable changes in relational organizational justice (i.e. fairness of managerial behaviours) were associated with increased odds of developing insomnia symptoms [odds ratio = 1.15; 95% confidence interval (CI) 1.02-1.30]. A favourable change in relational organizational justice was associated with lower odds of persistent insomnia symptoms (odds ratio = 0.83; 95% CI 0.71-0.96). Changes in procedural justice (i.e. the fairness of decision-making procedures) were not associated with insomnia symptoms. Conclusions These data suggest that changes in perceived relational justice may affect employees’ sleep quality. Decreases in the fairness of managerial behaviours were linked to increases in insomnia symptoms, whereas rises in fairness were associated with reduced insomnia symptoms. PMID:28065888

Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations

PubMed Central

Ketelaar, Nicole ABM; Faber, Marjan J; Flottorp, Signe; Rygh, Liv Helen; Deane, Katherine HO; Eccles, Martin P

2014-01-01

Background It is becoming increasingly common to release information about the performance of hospitals, health professionals or providers, and healthcare organisations into the public domain. However, we do not know how this information is used and to what extent such reporting leads to quality improvement by changing the behaviour of healthcare consumers, providers and purchasers, or to what extent the performance of professionals and providers can be affected. Objectives To determine the effectiveness of the public release of performance data in changing the behaviour of healthcare consumers, professionals and organisations. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, MEDLINE Ovid (from 1966), EMBASE Ovid (from 1979), CINAHL, PsycINFO Ovid (from 1806) and DARE up to 2011. Selection criteria We searched for randomised or quasi-randomised trials, interrupted time series and controlled before-after studies of the effects of publicly releasing data regarding any aspect of the performance of healthcare organisations or individuals. The papers had to report at least one main outcome related to selecting or changing care. Other outcome measures were awareness, attitude, views and knowledge of performance data and costs. Data collection and analysis Two review authors independently screened studies for eligibility and extracted data. For each study, we extracted data about the target groups (healthcare consumers, healthcare providers and healthcare purchasers), performance data, main outcomes (choice of healthcare provider and improvement by means of changes in care) and other outcomes (awareness, attitude, views, knowledge of performance data and costs). Main results We included four studies containing more than 35,000 consumers, and 1560 hospitals. Three studies were conducted in the USA and examined consumer behaviour after the public release of performance data. Two studies found no effect of Consumer Assessment of Healthcare Providers and Systems information on health plan choice in a Medicaid population. One interrupted time series study found a small positive effect of the publishing of data on patient volumes for coronary bypass surgery and low-complication outliers for lumbar discectomy, but these effects did not persist longer than two months after each public release. No effects on patient volumes for acute myocardial infarction were found. One cluster-randomised controlled trial, conducted in Canada, studied improvement changes in care after the public release of performance data for patients with acute myocardial infarction and congestive heart failure. No effects for the composite process-of-care indicators for either condition were found, but there were some improvements in the individual process-of-care indicators. There was an effect on the mortality rates for acute myocardial infarction. More quality improvement activities were initiated in response to the publicly-released report cards. No secondary outcomes were reported. Authors’ conclusions The small body of evidence available provides no consistent evidence that the public release of performance data changes consumer behaviour or improves care. Evidence that the public release of performance data may have an impact on the behaviour of healthcare professionals or organisations is lacking. PMID:22071813

The Effect of Changes in Maternal Employment and Family Composition on Children's Behaviour. Working Paper Series. W-02-3-2E

ERIC Educational Resources Information Center

Roberts, Paul

2002-01-01

Recent research suggests that changing maternal employment and family composition are associated with children's behavioural development. This report assesses whether, and if so to what extent, changes in these areas may affect the behavioural development of children, using information from the National Longitudinal Survey of Children and Youth…

Assessing evidence for behaviour change affecting the course of HIV epidemics: a new mathematical modelling approach and application to data from Zimbabwe.

PubMed

Hallett, Timothy B; Gregson, Simon; Mugurungi, Owen; Gonese, Elizabeth; Garnett, Geoff P

2009-06-01

Determining whether interventions to reduce HIV transmission have worked is essential, but complicated by the potential for generalised epidemics to evolve over time without individuals changing risk behaviour. We aimed to develop a method to evaluate evidence for changes in risk behaviour altering the course of an HIV epidemic. We developed a mathematical model of HIV transmission, incorporating the potential for natural changes in the epidemic as it matures and the introduction of antiretroviral treatment, and applied a Bayesian Melding framework, in which the model and observed trends in prevalence can be compared. We applied the model to Zimbabwe, using HIV prevalence estimates from antenatal clinic surveillance and house-hold based surveys, and basing model parameters on data from sexual behaviour surveys. There was strong evidence for reductions in risk behaviour stemming HIV transmission. We estimate these changes occurred between 1999 and 2004 and averted 660,000 (95% credible interval: 460,000-860,000) infections by 2008. The model and associated analysis framework provide a robust way to evaluate the evidence for changes in risk behaviour affecting the course of HIV epidemics, avoiding confounding by the natural evolution of HIV epidemics.

Testing phase-specific self-efficacy beliefs in the context of dietary behaviour change.

PubMed

Ochsner, Sibylle; Scholz, Urte; Hornung, Rainer

2013-03-01

Self-efficacy is an important predictor of health behaviour change. Within the health action process approach (HAPA; Schwarzer, 2008), motivational and volitional self-efficacy can be distinguished. Motivational self-efficacy is assumed to serve as predictor of intention formation whereas volitional self-efficacy should be relevant for behaviour change. This study examined these assumptions in a sample with overweight and obese individuals. Moreover, we tested whether behavioural intentions moderate the association between volitional self-efficacy and behaviour. Overall, 373 overweight and obese individuals completed a baseline and six months later a follow-up questionnaire on HAPA variables and dietary behaviour. A factor analysis confirmed the phase-specific separation of self-efficacy. Motivational self-efficacy emerged as predictor for behavioural intentions over and above other HAPA variables after six months, whereas volitional self-efficacy did not. Volitional self-efficacy interacted with intention in the prediction of behaviour, indicating that volitional self-efficacy is only beneficial for individuals with high levels of intentions. The results provide evidence for the phase-specific distinction of self-efficacy in the context of dietary change in an overweight or obese sample. Thus, differentiating between motivational and volitional self-efficacy beliefs should be considered when developing future interventions of dietary change. © 2012 The Authors. Applied Psychology: Health and Well-Being © 2012 The International Association of Applied Psychology.

Mothers and teenage daughters walking to health: using the behaviour change wheel to develop an intervention to improve adolescent girls' physical activity.

PubMed

Murtagh, E M; Barnes, A T; McMullen, J; Morgan, P J

2018-05-01

The majority of adolescent girls fail to meet public health guidelines for physical activity. Engaging mothers in the promotion of physical activity for their daughters may be an important strategy to facilitate behaviour change. The aim of this study was to use the behaviour change wheel (BCW) framework to design the components of an intervention to improve adolescent girls' physical activity. Cross-sectional study to inform intervention development. The BCW framework was used to (1) understand the behaviour, (2) identify intervention functions and (3) select content and implementation options. A circular development process was undertaken by the research team to collectively design the intervention in accordance with the steps recommended by the BCW. The BCW design process resulted in the selection of six intervention functions (education, persuasion, incentivization, training, modelling, enablement) and 18 behaviour change techniques delivered via group-based, face-to-face mode. Behaviour change technique groupings include: goals and planning; feedback and monitoring; social support; shaping knowledge; natural consequences; comparison of behaviour; associations; comparison of outcomes; reward and threat; identity; and, self-belief. The BCW process allowed an in-depth consideration of the target behaviours and provided a systematic framework for developing the intervention. The feasibility and preliminary efficacy of the programme will be examined. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Health goal priming as a situated intervention tool: how to benefit from nonconscious motivational routes to health behaviour.

PubMed

Papies, Esther K

2016-12-01

Recent research has shown the limited effects of intentions on behaviour, so that novel methods to facilitate behaviour change are needed that do not rely on conscious intentions. Here, it is argued that nonintentional effects on health behaviour, such as the effects of habits, impulses, and nonconscious goals, occur through the activation of cognitive structures by specific situations. Interventions should therefore be situated to change these effects, either by changing the critical cognitive structures (training interventions), or by changing which cognitive structures get activated (cueing interventions). The current article presents this framework for situated interventions, as well as examples of interventions of each type. Then, it introduces goal priming as a cueing intervention tool to activate health goals and thus facilitate healthier behaviour, even in tempting situations that typically activate short-term hedonic goals. Following a review of empirical evidence, five principles for the effective application of health goal primes are proposed, namely (1) to target individuals who value the primed goals, (2) by activating their specific motivation, (3) through effective cues (4) that attract attention at the right time. Finally, (5) an effective goal-directed behaviour needs to be known and accessible to the primed individual. These principles are illustrated with examples of different health behaviours in order to facilitate their application for successful behaviour change.

Health goal priming as a situated intervention tool: how to benefit from nonconscious motivational routes to health behaviour

PubMed Central

Papies, Esther K.

2016-01-01

ABSTRACT Recent research has shown the limited effects of intentions on behaviour, so that novel methods to facilitate behaviour change are needed that do not rely on conscious intentions. Here, it is argued that nonintentional effects on health behaviour, such as the effects of habits, impulses, and nonconscious goals, occur through the activation of cognitive structures by specific situations. Interventions should therefore be situated to change these effects, either by changing the critical cognitive structures (training interventions), or by changing which cognitive structures get activated (cueing interventions). The current article presents this framework for situated interventions, as well as examples of interventions of each type. Then, it introduces goal priming as a cueing intervention tool to activate health goals and thus facilitate healthier behaviour, even in tempting situations that typically activate short-term hedonic goals. Following a review of empirical evidence, five principles for the effective application of health goal primes are proposed, namely (1) to target individuals who value the primed goals, (2) by activating their specific motivation, (3) through effective cues (4) that attract attention at the right time. Finally, (5) an effective goal-directed behaviour needs to be known and accessible to the primed individual. These principles are illustrated with examples of different health behaviours in order to facilitate their application for successful behaviour change. PMID:27144729

Participants' perspectives on making and maintaining behavioural changes in a lifestyle intervention for type 2 diabetes prevention: a qualitative study using the theory domain framework.

PubMed

Penn, Linda; Dombrowski, Stephan U; Sniehotta, Falko F; White, Martin

2013-06-28

In a qualitative substudy, we sought to elicit participants' perspectives of their behavioural change and maintenance of new behaviours towards intervention optimisation. The intervention was delivered in leisure and community settings in a local authority, which according to the UK government statistics ranks as 1 of the 10 most socioeconomically deprived areas in England. We recruited 218 adults aged 40-65 years at elevated risk of type 2 diabetes (Finnish Diabetes Risk Score≥11) to the intervention. Follow-up at 12 months was completed by 134 (62%). We recruited 15 participants, purposively sampled for physical activity increase, to the qualitative substudy. Lifestyle intervention can prevent type 2 diabetes, but translation to service provision remains challenging. The 'New life, New you' intervention aimed to promote physical activity, healthy eating and weight loss, and included supervised group physical activity sessions. Behavioural change and weight loss at 12-month follow-up were encouraging. We conducted 15 individual semistructured interviews. The Framework approach, with a comparison of emerging themes, was used in analysis of the transcribed data and complemented by the Theory Domains Framework. Themes emerging from the data were grouped as perceptions that promoted initiating, enacting and maintaining behavioural change. The data were then categorised in accordance with the Theory Domains Framework: intentions and goals; reinforcement; knowledge; social role and identity; social influences; skills and beliefs about capabilities; behavioural regulation, memory, emotion, attention and decision processes and environmental context and resources. Participant perceptions of intervention features that facilitated behavioural change processes were then similarly analysed. Social influences, reference to social role and identity (eg, peer support), and intentions and goals (eg, to lose weight) were dominant themes across the three phases of behavioural change. Reinforcement, regulation and decision processes were more evident in the maintenance phase. The socioeconomic status of participants was reflected in the environmental context and resource theme. Analysis of phases and theoretical domains of behavioural change added depth and utility to inform intervention optimisation. We will develop the intervention with improved peer support and explicit monitoring of the behavioural change techniques used, prior to a definitive trial.

A Longitudinal Study on Feeding Behaviour and Activity Patterns of Released Chimpanzees in Conkouati-Douli National Park, Republic of Congo

PubMed Central

Renaud, Amandine; Jamart, Aliette; Goossens, Benoit; Ross, Caroline

2013-01-01

Simple Summary Wild chimpanzee populations are dramatically declining due to anthropogenic pressure. One way of increasing wild population numbers and/or repopulating areas where local extinction has occurred is to release captive animals. HELP Congo was the first project to successfully release wild-born orphan chimpanzees in their natural environment. We studied the behaviour of eight released chimpanzees over eight years. Over time, they modified their behaviour, suggesting long-term behavioural and ecological adaptations. This suggests that successful release programmes may reinforce existing populations of endangered species. Abstract Wild chimpanzee populations are still declining due to logging, disease transmission and hunting. The bushmeat trade frequently leads to an increase in the number of orphaned primates. HELP Congo was the first project to successfully release wild-born orphan chimpanzees into an existing chimpanzee habitat. A collection of post monitoring data over 16 years now offers the unique opportunity to investigate possible behavioural adaptations in these chimpanzees. We investigated the feeding and activity patterns in eight individuals via focal observation techniques from 1997–1999 and 2001–2005. Our results revealed a decline in the number of fruit and insect species in the diet of released chimpanzees over the years, whereas within the same period of time, the number of consumed seed species increased. Furthermore, we found a decline in time spent travelling, but an increase in time spent on social activities, such as grooming, as individuals matured. In conclusion, the observed changes in feeding and activity patterns seem to reflect important long-term behavioural and ecological adaptations in wild-born orphan released chimpanzees, demonstrating that the release of chimpanzees can be successful, even if it takes time for full adaptation. PMID:26487416

The effect of farrowing environment and previous experience on the maternal behaviour of sows in indoor pens and outdoor huts.

PubMed

Wülbers-Mindermann, M; Berg, C; Illmann, G; Baulain, U; Algers, B

2015-04-01

Outdoor farrowing huts facilitate a less restricted maternal behaviour in sows compared with sows kept indoors in farrowing pens. The aim of our study was to investigate whether there are behavioural differences between primiparous sows kept outdoors in farrowing huts and indoors in pens, and whether the maternal behaviour during the second parity, when all sows were kept outdoors in farrowing huts, would differ between sows that have experienced the indoor or the outdoor environment, respectively, during their first parturition. A total of 26 Yorkshire×Swedish Landrace sows were studied. Of these, 11 sows were housed outdoors in farrowing huts during both parturitions (group=OUTOUT). The other 15 sows were kept indoors in a barn with single farrowing pens during their first parturition. During their second parturition, sows were kept outdoors in farrowing huts (group=INOUT). The behaviour was video recorded from 2 h prepartum to 48 h postpartum. The sows' responsiveness to playbacks of a piglet's screams was tested on days 2 to 3 postpartum. Parity 1: during the last 2 h prepartum, OUTOUT sows had a higher proportion of observations in the sternal lying position (P<0.01). During parturition, OUTOUT sows changed posture more often (P<0.05) and were lying less (P<0.05) than INOUT sows. All sows in both groups responded with 'lifting head' towards the playback of piglet scream, whereas 100% of OUTOUT sows and only 43% of INOUT sows thereafter were 'getting up' (P <0.01). Parity 2: There were no behavioural differences between INOUT and OUTOUT sows. In conclusion, it is not problematic for a second parity sow with initial maternal experience from an indoor farrowing pen to be kept outdoors in farrowing huts during its following farrowing.

Influence of internet exposure on sexual behaviour of young persons in an urban district of Southwest Nigeria

PubMed Central

Arulogun, Oyedunni Sola; Ogbu, Ifeyinwa Arinze; Dipeolu, Isaac Oluwafemi

2016-01-01

Introduction The proportion of young people exposed to pornographic materials through the internet in Nigeria is increasing. However, the influence of the exposure on their sexual behaviour has not been fully explored. This study therefore explored the effects of internet exposure on the sexual behaviour of young persons in Ibadan North Local Government Area of southwest Nigeria. Methods A survey of 413 young persons was done using a pretested self-administered questionnaire which included questions on internet exposure and its influence on behaviour. Data were analysed using descriptive statistics, Chi-square test and logistic regression. Results Mean age of males was 21.7 ± 3.4 years while that of females was 20.9 ± 3.2 years. Forty-nine percent of the respondents used the internet for the first time between the ages of 15-19 years. Main source of information about the internet was friends (63.3%) and 99.3% accessed the internet from cybercafé. Seventy-two percent had ever stumbled on pornographic sites. Reactions included glancing through before closing (45.2%), closure of the sites (38.5%), and minimizing page to view later (12.5%). Post-exposure influence on behaviour included engagement in oral sex (48.3%), body tattoo (18.3%), having multiple sexual partners (11.6%) and homosexuality (5.0%). More males (95% CI OR =1.245-6.465) and frequent users (95% CI OR =1.168-3.497) were likely to report a change in sexual behaviour. Conclusion Internet use was common among the young persons. Interventions aimed at reducing exposure to sexual content on internet targeting young persons especially the males and cybercafé operators are advocated. PMID:28293377

Systematic Review of the Measurement Properties of Tools Used to Measure Behaviour Problems in Young Children with Autism

PubMed Central

Hanratty, Jennifer; Livingstone, Nuala; Robalino, Shannon; Terwee, Caroline B.; Glod, Magdalena; Oono, Inalegwu P.; Rodgers, Jacqui; Macdonald, Geraldine; McConachie, Helen

2015-01-01

Background Behaviour problems are common in young children with autism spectrum disorder (ASD). There are many different tools used to measure behavior problems but little is known about their validity for the population. Objectives To evaluate the measurement properties of behaviour problems tools used in evaluation of intervention or observational research studies with children with ASD up to the age of six years. Methods Behaviour measurement tools were identified as part of a larger, two stage, systematic review. First, sixteen major electronic databases, as well as grey literature and research registers were searched, and tools used listed and categorized. Second, using methodological filters, we searched for articles examining the measurement properties of the tools in use with young children with ASD in ERIC, MEDLINE, EMBASE, CINAHL, and PsycINFO. The quality of these papers was then evaluated using the COSMIN checklist. Results We identified twelve tools which had been used to measure behaviour problems in young children with ASD, and fifteen studies which investigated the measurement properties of six of these tools. There was no evidence available for the remaining six tools. Two questionnaires were found to be the most robust in their measurement properties, the Child Behavior Checklist and the Home Situations Questionnaire—Pervasive Developmental Disorders version. Conclusions We found patchy evidence on reliability and validity, for only a few of the tools used to measure behaviour problems in young children with ASD. More systematic research is required on measurement properties of tools for use in this population, in particular to establish responsiveness to change which is essential in measurement of outcomes of intervention. PROSPERO Registration Number CRD42012002223 PMID:26659821

Behavioural ecotoxicology, an “early warning” signal to assess environmental quality

PubMed Central

2010-01-01

Background In this review, the position of behavioural ecotoxicology within the available means to assess the status of marine environments is described as filling the gap for the needed “early warning” signals. A few examples of studies performed since the 1960s are discussed to highlight the sensitivity of these approaches in investigating the effects of chemicals, including priority pollutants and emerging contaminants, relative to conventional toxicity tests measuring survival. Discussion The advantage of the behavioural response is due to the integration of biochemical and physiological processes that reflect changes at higher levels of organisation with ecological relevance. Avoidance often represents a behavioural symptom easily detected in many animals exposed to contaminants and would be a useful test to explore more widely. This rapid response would reflect a defence mechanism protective against further exposure and the potential development of more pronounced deleterious effects, whilst in some cases, escape could lead to the relocation of a species with negative consequences. An investigation of the avoidance behaviour of mud shrimp, Corophium volutator, along with the chemical analyses of sediments and amphipods to assess the quality of harbour sediments is summarised. The body burden of the amphipods was 1,000 times lower than the one associated with narcosis, emphasizing the sensitivity of this endpoint. The application of this acute toxicity test is briefly compared to additional work that involved intertidal mussels collected in the field. Conclusions Recent research undertaken with mud snails, Ilyanassa obsoleta, and harbour sediments confirmed the usefulness of the escape behaviour as an assessment tool. However, the limits of the state of knowledge regarding the fate of contaminants in species with the ability to metabolise contaminants is further discussed along with directions to be pursued to address questions arising from the reviewed literature. PMID:20614196

Valence of physical stimuli, not housing conditions, affects behaviour and frontal cortical brain activity in sheep.

PubMed

Vögeli, Sabine; Lutz, Janika; Wolf, Martin; Wechsler, Beat; Gygax, Lorenz

2014-07-01

Modulation of short-term emotions by long-term mood is little understood but relevant to understand the affective system and of importance in respect to animal welfare: a negative mood might taint experiences, whilst a positive mood might alleviate single negative events. To induce different mood states in sheep housing conditions were varied. Fourteen ewes were group-housed in an unpredictable, stimulus-poor and 15 ewes in a predictable, stimulus-rich environment. Sheep were tested individually for mood in a behavioural cognitive bias paradigm. Also, their reactions to three physical stimuli thought to differ in their perceived valence were observed (negative: pricking, intermediate: slight pressure, positive: kneading). General behaviour, activity, ear movements and positions, and haemodynamic changes in the cortical brain were recorded during stimulations. Generalised mixed-effects models and model probabilities based on the BIC (Bayesian information criterion) were used. Only weak evidence for mood difference was found. Sheep from the unpredictable, stimulus-poor housing condition had a somewhat more negative cognitive bias, showed slightly more aversive behaviour, were slightly more active and moved their ears somewhat more. Sheep most clearly differentiated the negative from the intermediate and positive stimulus in that they exhibited more aversive behaviour, less nibbling, were more active, showed more ear movements, more forward ear postures, fewer backward ear postures, and a stronger decrease in deoxyhaemoglobin when subjected to the negative stimulus. In conclusion, sheep reacted towards stimuli according to their presumed valence but their mood was not strongly influenced by housing conditions. Therefore, behavioural reactions and cortical brain activity towards the stimuli were hardly modulated by housing conditions. Copyright © 2014 Elsevier B.V. All rights reserved.

A cross-country comparison of intensive care physicians’ beliefs about their transfusion behaviour: A qualitative study using the theoretical domains framework

PubMed Central

2012-01-01

Background Evidence of variations in red blood cell transfusion practices have been reported in a wide range of clinical settings. Parallel studies in Canada and the United Kingdom were designed to explore transfusion behaviour in intensive care physicians. The aim of this paper is three-fold: first, to explore beliefs that influence Canadian intensive care physicians’ transfusion behaviour; second, to systematically select relevant theories and models using the Theoretical Domains Framework (TDF) to inform a future predictive study; and third, to compare its results with the UK study. Methods Ten intensive care unit (ICU) physicians throughout Canada were interviewed. Physicians’ responses were coded into theoretical domains, and specific beliefs were generated for each response. Theoretical domains relevant to behaviour change were identified, and specific constructs from the relevant domains were used to select psychological theories. The results from Canada and the United Kingdom were compared. Results Seven theoretical domains populated by 31 specific beliefs were identified as relevant to the target behaviour. The domains Beliefs about capabilities (confident to not transfuse if patients’ clinical condition is stable), Beliefs about consequences (positive beliefs of reducing infection and saving resources and negative beliefs about risking patients’ clinical outcome and potentially more work), Social influences (transfusion decision is influenced by team members and patients’ relatives), and Behavioural regulation (wide range of approaches to encourage restrictive transfusion) that were identified in the UK study were also relevant in the Canadian context. Three additional domains, Knowledge (it requires more evidence to support restrictive transfusion), Social/professional role and identity (conflicting beliefs about not adhering to guidelines, referring to evidence, believing restrictive transfusion as professional standard, and believing that guideline is important for other professionals), and Motivation and goals (opposing beliefs about the importance of restrictive transfusion and compatibility with other goals), were also identified in this study. Similar to the UK study, the Theory of Planned Behaviour, Social Cognitive Theory, Operant Learning Theory, Action Planning, and Knowledge-Attitude-Behaviour model were identified as potentially relevant theories and models for further study. Personal project analysis was added to the Canadian study to explore the Motivation and goals domain in further detail. Conclusions A wide range of beliefs was identified by the Canadian ICU physicians as likely to influence their transfusion behaviour. We were able to demonstrate similar though not identical results in a cross-country comparison. Designing targeted behaviour-change interventions based on unique beliefs identified by physicians from two countries are more likely to encourage restrictive transfusion in ICU physicians in respective countries. This needs to be tested in future prospective clinical trials. PMID:22999460

Cool and Hot Executive Function Impairments in Violent Offenders with Antisocial Personality Disorder with and without Psychopathy

PubMed Central

De Brito, Stephane A.; Viding, Essi; Kumari, Veena; Blackwood, Nigel; Hodgins, Sheilagh

2013-01-01

Background Impairments in executive function characterize offenders with antisocial personality disorder (ASPD) and offenders with psychopathy. However, the extent to which those impairments are associated with ASPD, psychopathy, or both is unknown. Methods The present study examined 17 violent offenders with ASPD and psychopathy (ASPD+P), 28 violent offenders with ASPD without psychopathy (ASPD−P), and 21 healthy non-offenders on tasks assessing cool (verbal working memory and alteration of motor responses to spatial locations) and hot (reversal learning, decision-making under risk, and stimulus-reinforcement-based decision-making) executive function. Results In comparison to healthy non-offenders, violent offenders with ASPD+P and those with ASPD−P showed similar impairments in verbal working memory and adaptive decision-making. They failed to learn from punishment cues, to change their behaviour in the face of changing contingencies, and made poorer quality decisions despite longer periods of deliberation. Intriguingly, the two groups of offenders did not differ significantly from the non-offenders in terms of their alteration of motor responses to spatial locations and their levels of risk-taking, indicated by betting, and impulsivity, measured as delay aversion. The performance of the two groups of offenders on the measures of cool and hot executive function did not differ, indicating shared deficits. Conclusions These documented impairments may help to explain the persistence of antisocial behaviours despite the known risks of the negative consequences of such behaviours. PMID:23840340

Local Individual Preferences for Nest Materials in a Passerine Bird

PubMed Central

Mennerat, Adèle; Perret, Philippe; Lambrechts, Marcel M.

2009-01-01

Background Variation in the behavioural repertoire of animals is acquired by learning in a range of animal species. In nest-building birds, the assemblage of nest materials in an appropriate structure is often typical of a bird genus or species. Yet plasticity in the selection of nest materials may be beneficial because the nature and abundance of nest materials vary across habitats. Such plasticity can be learned, either individually or socially. In Corsican populations of blue tits Cyanistes caeruleus, females regularly add in their nests fragments of several species of aromatic plants during the whole breeding period. The selected plants represent a small fraction of the species present in the environment and have positive effects on nestlings. Methodology/Principal Findings We investigated spatiotemporal variations of this behaviour to test whether the aromatic plant species composition in nests depends on 1) plant availability in territories, 2) female experience or 3) female identity. Our results indicate that territory plays a very marginal role in the aromatic plant species composition of nests. Female experience is not related to a change in nest plant composition. Actually, this composition clearly depends on female identity, i.e. results from individual preferences which, furthermore, are repeatable both within and across years. A puzzling fact is the strong difference in plant species composition of nests across distinct study plots. Conclusions/Significance This study demonstrates that plant species composition of nests results from individual preferences that are homogeneous within study plots. We propose several hypotheses to interpret this pattern of spatial variation before discussing them in the light of preliminary results. As a conclusion, we cannot exclude the possibility of social transmission of individual preferences for aromatic plants. This is an exciting perspective for further work in birds, where nest construction behaviour has classically been considered as a stereotypic behaviour. PMID:19337365

Asymmetric Warfare in the Simulation and Training Environment: Comprehensive Approach Wanted!

DTIC Science & Technology

2009-10-01

Covering Support to Operations, Human Behaviour Representation, Irregular Warfare, Defence against Terrorism and Coalition Tactical Force Integration...learned behaviours arising from shared knowledge and it is passed on from one generation to the next. The behaviours that have become embedded as part of...symbols and behaviours . While culture changes, the change is usually slow, particularly in terms of military operations timeframes. Urban environments

Changes in Attributions as a Consequence of Training for Challenging and Complex Behaviour for Carers of People with Learning Disabilities: A Systematic Review

ERIC Educational Resources Information Center

Williams, Sophie; Dagnan, Dave; Rodgers, Jacqui; McDowell, Kathryn

2012-01-01

Aim: This paper reviews the evidence for changes in carers' attributions regarding the behaviour of people with intellectual disabilities as a consequence of carer training in challenging and complex behaviour. Method: Papers were included in the review if they reported outcomes for carer training on the behaviour of people with intellectual…

What are the most effective techniques in changing obese individuals’ physical activity self-efficacy and behaviour: a systematic review and meta-analysis

PubMed Central

2013-01-01

Increasing self-efficacy is generally considered to be an important mediator of the effects of physical activity interventions. A previous review identified which behaviour change techniques (BCTs) were associated with increases in self-efficacy and physical activity for healthy non-obese adults. The aim of the current review was to identify which BCTs increase the self-efficacy and physical activity behaviour of obese adults. A systematic search identified 61 comparisons with obese adults reporting changes in self-efficacy towards engaging in physical activity following interventions. Of those comparisons, 42 also reported changes in physical activity behaviour. All intervention descriptions were coded using Michie et al’s (2011) 40 item CALO-RE taxonomy of BCTs. Meta-analysis was conducted with moderator analyses to examine the association between whether or not each BCT was included in interventions, and size of changes in both self-efficacy and physical activity behaviour. Overall, a small effect of the interventions was found on self-efficacy (d = 0.23, 95% confidence interval (CI): 0.16-0.29, p < 0.001) and a medium sized effect on physical activity behaviour (d = 0.50, 95% CI 0.38-0.63, p < 0.001). Four BCTs were significantly associated with positive changes in self-efficacy; ‘action planning’, ‘time management’, ‘prompt self-monitoring of behavioural outcome’ and ‘plan social support/social change’. These latter two BCTs were also associated with positive changes in physical activity. An additional 19 BCTs were associated with positive changes in physical activity. The largest effects for physical activity were found where interventions contained ‘teach to use prompts/cues’, ‘prompt practice’ or ‘prompt rewards contingent on effort or progress towards behaviour’. Overall, a non-significant relationship was found between change in self-efficacy and change in physical activity (Spearman’s Rho = −0.18 p = 0.72). In summary, the majority of techniques increased physical activity behaviour, without having discernible effects on self-efficacy. Only two BCTs were associated with positive changes in both physical activity self-efficacy and behaviour. This is in contrast to the earlier review which found a strong relationship between changes in physical activity self-efficacy and behaviour. Mechanisms other than self-efficacy may be more important for increasing the physical activity of obese individuals compared with non-obese individuals. PMID:23452345

Signalling changes to individuals who show resistance to change can reduce challenging behaviour.

PubMed

Bull, Leah E; Oliver, Chris; Woodcock, Kate A

2017-03-01

Several neurodevelopmental disorders are associated with resistance to change and challenging behaviours - including temper outbursts - that ensue following changes to routines, plans or expectations (here, collectively: expectations). Here, a change signalling intervention was tested for proof of concept and potential practical effectiveness. Twelve individuals with Prader-Willi syndrome participated in researcher- and caregiver-led pairing of a distinctive visual-verbal signal with subsequent changes to expectations. Specific expectations for a planned subset of five participants were systematically observed in minimally manipulated natural environments. Nine caregivers completed a temper outburst diary during a four week baseline period and a two week signalling evaluation period. Participants demonstrated consistently less temper outburst behaviour in the systematic observations when changes imposed to expectations were signalled, compared to when changes were not signalled. Four of the nine participants whose caregivers completed the behaviour diary demonstrated reliable reductions in temper outbursts between baseline and signalling evaluation. An active control group for the present initial evaluation of the signalling strategy using evidence from caregiver behaviour diaries was outside the scope of the present pilot study. Thus, findings cannot support the clinical efficacy of the present signalling approach. Proof of concept evidence that reliable pairing of a distinctive cue with a subsequent change to expectation can reduce associated challenging behaviour is provided. Data provide additional support for the importance of specific practical steps in further evaluations of the change signalling approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reducing occupational sitting: Workers' perspectives on participation in a multi-component intervention.

PubMed

Hadgraft, Nyssa T; Willenberg, Lisa; LaMontagne, Anthony D; Malkoski, Keti; Dunstan, David W; Healy, Genevieve N; Moodie, Marj; Eakin, Elizabeth G; Owen, Neville; Lawler, Sheleigh P

2017-05-30

Office workers spend much of their time sitting, which is now understood to be a risk factor for several chronic diseases. This qualitative study examined participants' perspectives following their involvement in a cluster randomised controlled trial of a multi-component intervention targeting prolonged workplace sitting (Stand Up Victoria). The intervention incorporated a sit-stand workstation, individual health coaching and organisational support strategies. The aim of the study was to explore the acceptability of the intervention, barriers and facilitators to reducing workplace sitting, and perceived effects of the intervention on workplace culture, productivity and health-related outcomes. Semi-structured interviews (n = 21 participants) and two focus groups (n = 7) were conducted with intervention participants at the conclusion of the 12 month trial and thematic analysis was used to analyse the data. Questions covered intervention acceptability, overall impact, barriers and facilitators to reducing workplace sitting, and perceived impact on productivity and workplace culture. Overall, participants had positive intervention experiences, perceiving that reductions in workplace sitting were associated with improved health and well-being with limited negative impact on work performance. While sit-stand workstations appeared to be the primary drivers of change, workstation design and limited suitability of standing for some job tasks and situations were perceived as barriers to their use. Social support from team leaders and other participants was perceived to facilitate behavioural changes and a shift in norms towards increased acceptance of standing in the workplace. Multi-component interventions to reduce workplace sitting, incorporating sit-stand workstations, are acceptable and feasible; however, supportive social and environmental conditions are required to support participant engagement. Best practice approaches to reduce workplace sitting should address the multiple levels of influence on behaviour, including factors that may act as barriers to behavioural change.

Allez Hop, a nationwide programme for the promotion of physical activity in Switzerland: what is the evidence for a population impact after one decade of implementation?

PubMed Central

Wanner, Miriam; Martin-Diener, Eva; Bauer, Georg F; Stamm, Hanspeter; Martin, Brian W

2011-01-01

Objectives To present evidence for a population impact of a national physical activity promotion programme after a decade of implementation. Methods The programme Allez Hop offered local physical activity courses (mainly walking and Nordic walking) once a week over 12 weeks. Data from a pretest posttest survey in 2005 course participants (N=2157 at baseline (of 4130, 52.2%), 1587 at first follow-up (73.6%); smaller subsample with second follow-up) and from repeated cross-sectional national surveys have been analysed regarding changes in physical activity behaviour. Results The total number of Allez Hop courses was 18 684 between 1997 and 2008. 89.2% of participants were women, the mean age was 48.5 years. The proportion meeting the physical activity recommendations was 31.7% at baseline, in participants with first follow-up data it increased from 33.1% to 42.3% (p<0.001). On the population level in the main user group of Allez Hop (middle-aged women) the proportion not engaging in any sport decreased from 50.1% (1997) to 47.2% (2002) and to 43.1% (2007) (p<0.01). Walking/hiking was the second most frequently performed sport (33.7%) in 2007, with the most remarkable increase since 2000 (+11.1%). Conclusions Allez Hop was successfully implemented for more than a decade, reached middle-aged women and a high proportion of insufficiently active individuals. Changes in participants' physical activity behaviour must be interpreted cautiously because of low response rates and short follow-up. However, indications for behavioural changes were observed at the population level, even though these data do not allow a causal link to Allez Hop. PMID:20542973

Evaluating the Fabreville Heart Health Program in Laval, Canada: a dialogue between two paradigms, positivism and constructivism.

PubMed

Nguyen, Minh Nguyet; Otis, Joanne

2003-06-01

As part of the Canadian Federal-Provincial Initiative in Heart Health, the goal of the Fabreville Heart Health Program was to sensitize a district of Laval, Quebec's second most populous city, to heart-healthy behaviours. The program was planned and implemented by a committee composed of Fabreville community leaders and professionals from the Public Health Department. Between 1992 and 1994, intervention objectives were defined by the department in terms of changing individual behaviours associated with cardiovascular risk factors, namely diet, sedentariness and smoking, as well as adapting physical and social environments to facilitate these changes. However, from 1994 to its conclusion in 1997, the program was re-oriented to engage the population in mobilizing their own community and taking charge of interventions themselves. Actions then became dependent on the interests and motivation of Fabreville residents to transform their lifestyles and aspects of their physical environment. The initial evaluation process, based on the positivist paradigm, was designed to measure changes in individual behaviours and certain physical environments, such as an increase in designated non-smoking areas. However, following the re-orientation towards community mobilization, it was decided that evaluation should go beyond the professional production of data to include a process of the collective construction of knowledge. Evaluation methodology then became based on the constructivist paradigm. Yet field constraints such as lack of community involvement in both leadership and process evaluation, and the need to ensure evaluation standards and fulfil sponsor obligations, compelled the Public Health Department to return to using a certain number of positivist methods. The ensuing inter-paradigm dialogue helped broaden the scope of evaluation and contributed to gaining a more in-depth understanding of the processes and outcomes of community mobilization.

Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams

PubMed Central

2010-01-01

Background Transferring knowledge from research into practice can be challenging, partly because the process involves a change in attitudes, roles and behaviour by individuals and teams. Helping teams to identify then target potential barriers may aid the knowledge transfer process. The aim of this study was to identify barriers and enablers, as perceived by allied health professionals, to delivering an evidence-based (Level 1) outdoor journey intervention for people with stroke. Methods A qualitative design and semi-structured interviews were used. Allied health professionals (n = 13) from two community rehabilitation teams were interviewed, before and after receiving feedback from a medical record audit and attending a training workshop. Interviews allowed participants to identify potential and actual barriers, as well as enablers to delivering the intervention. Qualitative data were analysed using theoretical domains described by Michie and colleagues. Results Two barriers to delivery of the intervention were the social influence of people with stroke and their family, and professionals' beliefs about their capabilities. Other barriers included professionals' knowledge and skills, their role identity, availability of resources, whether professionals remembered to provide the intervention, and how they felt about delivering the intervention. Enablers to delivering the intervention included a belief that they could deliver the intervention, a willingness to expand and share professional roles, procedures that reminded them what to do, and feeling good about helping people with stroke to participate. Conclusions This study represents one step in the quality improvement process. The interviews encouraged reflection by staff. We obtained valuable data which have been used to plan behaviour change interventions addressing identified barriers. Our methods may assist other researchers who need to design similar behaviour change interventions. PMID:20082725

The impact of social norm change strategies on smokers' quitting behaviours.

PubMed

Zhang, Xueying; Cowling, David W; Tang, Hao

2010-04-01

Using a social norm change paradigm model that reflects the California Tobacco Control Program's (CTCP) priorities, we compare the strength of the relationship of the social norm constructs to key smoking behavioural outcomes. Social norm constructs that correspond to CTCP's priority areas were created from selected California Adult Tobacco Survey knowledge, attitude and belief questions using confirmatory factor analysis. We then examined the relationship between these constructs and quitting behaviours using logistic regression. The secondhand smoke (SHS) and countering pro-tobacco influences'(CPTI) constructs followed a dose-response curve with quitting behaviours. Respondents who rated high on the SHS construct were about 70% more likely to have made a recent quit attempt in the last 12 months and about 100% more likely to intend to quit in the next 6 months than respondents who rated low on the SHS construct. For CPTI, respondents who rated high on this construct were 67% more likely to have made a recent quit attempt in the last 12 months and 62% more likely to have intentions to quit in the next 6 months than respondents who rated low on the CPTI construct. Social norm change constructs represent CTCP's priorities and are strongly related to desired individual behaviour outcomes. This analysis provides strong support for the framework underlying CTCP--namely, that changing social norms affects behaviour change at the individual level through changing population-level smoking-related behaviours.

Stability and change in screen-based sedentary behaviours and associated factors among Norwegian children in the transition between childhood and adolescence

PubMed Central

2012-01-01

Background In order to inform interventions to prevent sedentariness, more longitudinal studies are needed focusing on stability and change over time in multiple sedentary behaviours. This paper investigates patterns of stability and change in TV/DVD use, computer/electronic game use and total screen time (TST) and factors associated with these patterns among Norwegian children in the transition between childhood and adolescence. Methods The baseline of this longitudinal study took place in September 2007 and included 975 students from 25 control schools of an intervention study, the HEalth In Adolescents (HEIA) study. The first follow-up took place in May 2008 and the second follow-up in May 2009, with 885 students participating at all time points (average age at baseline = 11.2, standard deviation ± 0.3). Time used for/spent on TV/DVD and computer/electronic games was self-reported, and a TST variable (hours/week) was computed. Tracking analyses based on absolute and rank measures, as well as regression analyses to assess factors associated with change in TST and with tracking high TST were conducted. Results Time spent on all sedentary behaviours investigated increased in both genders. Findings based on absolute and rank measures revealed a fair to moderate level of tracking over the 2 year period. High parental education was inversely related to an increase in TST among females. In males, self-efficacy related to barriers to physical activity and living with married or cohabitating parents were inversely related to an increase in TST. Factors associated with tracking high vs. low TST in the multinomial regression analyses were low self-efficacy and being of an ethnic minority background among females, and low self-efficacy, being overweight/obese and not living with married or cohabitating parents among males. Conclusions Use of TV/DVD and computer/electronic games increased with age and tracked over time in this group of 11-13 year old Norwegian children. Interventions targeting these sedentary behaviours should thus be introduced early. The identified modifiable and non-modifiable factors associated with change in TST and tracking of high TST should be taken into consideration when planning such interventions. PMID:22309715

A behavioural approach in the development of work-related interventions for cancer survivors: an exploratory review.

PubMed

Duijts, S F A; Bleiker, E M A; Paalman, C H; van der Beek, A J

2017-09-01

The application of behavioural change models and theories has not been studied, and behavioural determinants have not been considered, in the context of cancer and work. The aim of this study is to assess the relevance of a behavioural approach in the development of work-related interventions for cancer survivors. Two search strategies were conducted to identify studies on (1) lifestyle interventions (exercise, smoking, alcohol intake and diet), based on behavioural models and theories, in cancer survivors; (2) behavioural determinants regarding work. Medline, Embase, PsycInfo, CINAHL and the Cochrane Controlled Trial Register were searched (2000-2015). Studies were assessed on their eligibility, and findings were listed and categorised. Thirty-four studies exploring lifestyle interventions in cancer survivors were retrieved. The behavioural change models and theories most regularly used were the Transtheoretical Model and Social Cognitive Theory. Furthermore, 26 studies on the role of behavioural determinants regarding work were found. The most frequently considered determinants were self-efficacy, social norms, workers' expectations towards work or recovery, attitude, motivation and meaning of work. The results indicate the significance of behavioural change models and theories and of behavioural determinants in related research areas, which encourages a behavioural approach in the development of work-related interventions for cancer survivors. © 2016 John Wiley & Sons Ltd.

The importance of invertebrates when considering the impacts of anthropogenic noise

PubMed Central

Morley, Erica L.; Jones, Gareth; Radford, Andrew N.

2014-01-01

Anthropogenic noise is now recognized as a major global pollutant. Rapidly burgeoning research has identified impacts on individual behaviour and physiology through to community disruption. To date, however, there has been an almost exclusive focus on vertebrates. Not only does their central role in food webs and in fulfilling ecosystem services make imperative our understanding of how invertebrates are impacted by all aspects of environmental change, but also many of their inherent characteristics provide opportunities to overcome common issues with the current anthropogenic noise literature. Here, we begin by explaining why invertebrates are likely to be affected by anthropogenic noise, briefly reviewing their capacity for hearing and providing evidence that they are capable of evolutionary adaptation and behavioural plasticity in response to natural noise sources. We then discuss the importance of quantifying accurately and fully both auditory ability and noise content, emphasizing considerations of direct relevance to how invertebrates detect sounds. We showcase how studying invertebrates can help with the behavioural bias in the literature, the difficulties in drawing strong, ecologically valid conclusions and the need for studies on fitness impacts. Finally, we suggest avenues of future research using invertebrates that would advance our understanding of the impact of anthropogenic noise. PMID:24335986

The importance of invertebrates when considering the impacts of anthropogenic noise.

PubMed

Morley, Erica L; Jones, Gareth; Radford, Andrew N

2014-02-07

Anthropogenic noise is now recognized as a major global pollutant. Rapidly burgeoning research has identified impacts on individual behaviour and physiology through to community disruption. To date, however, there has been an almost exclusive focus on vertebrates. Not only does their central role in food webs and in fulfilling ecosystem services make imperative our understanding of how invertebrates are impacted by all aspects of environmental change, but also many of their inherent characteristics provide opportunities to overcome common issues with the current anthropogenic noise literature. Here, we begin by explaining why invertebrates are likely to be affected by anthropogenic noise, briefly reviewing their capacity for hearing and providing evidence that they are capable of evolutionary adaptation and behavioural plasticity in response to natural noise sources. We then discuss the importance of quantifying accurately and fully both auditory ability and noise content, emphasizing considerations of direct relevance to how invertebrates detect sounds. We showcase how studying invertebrates can help with the behavioural bias in the literature, the difficulties in drawing strong, ecologically valid conclusions and the need for studies on fitness impacts. Finally, we suggest avenues of future research using invertebrates that would advance our understanding of the impact of anthropogenic noise.

A crossover trial evaluating an educational-behavioural joint protection programme for people with rheumatoid arthritis.

PubMed

Hammond, A; Lincoln, N; Sutcliffe, L

1999-05-01

Joint protection (JP) is a self-management technique widely taught to people with rheumatoid arthritis (RA). JP education aims to enable people with RA to reduce pain, inflammation, joint stress and reduce risks of deformity through using assistive devices and alternative movement patterns of affected joints to perform everyday activities. Previous studies evaluating JP education methods common in the UK have identified JP adherence is poor. A group education programme was developed using the Health Belief Model and Self-efficacy Theory. Strategies used to maximise JP adherence included goal-setting, contracting, modelling, homework programmes, motor learning theory, recall enhancing methods and mental practice. A crossover trial (n = 35) was conducted. Adherence with JP was measured using an objective observational test (the Joint Protection Behaviour Assessment). Significant improvements in use of JP were recorded at 12 and 24 weeks post-education (P < 0.01). No significant changes in measures of pain, functional disability, grip strength, self-efficacy or helplessness occurred post-education, although this may have been due to the small sample size recruited. In conclusion, JP adherence can be facilitated through the use of educational-behavioural strategies, suggesting this approach should be more widely adopted in clinical practice.

Do behavioural self-blame and stigma predict positive health changes in survivors of lung or head and neck cancers?

PubMed

Lebel, Sophie; Feldstain, Andrea; McCallum, Megan; Beattie, Sara; Irish, Jonathan; Bezjak, Andrea; Devins, Gerald M

2013-01-01

Survivors of lung or head and neck cancers often change tobacco and alcohol consumption after diagnosis, but few studies have examined other positive health changes (PHCs) or their determinants in these groups. The present study aims to: (a) document PHCs in survivors of lung (n = 107) or head and neck cancers (n = 99) and (b) examine behavioural self-blame and stigma as determinants of PHCs. We hypothesised that: (a) survivors would make a variety of PHCs; (b) behavioural self-blame for the disease would positively predict making PHCs; and (c) stigma would negatively predict making PHCs. Respondents self-administered measures of PHC, behavioural self-blame, and stigma. Hierarchical multiple regression analysis tested the hypotheses. More than 65% of respondents reported making PHCs, the most common being changes in diet (25%), exercise (23%) and tobacco consumption (16.5%). Behavioural self-blame significantly predicted PHCs but stigma did not. However, both behavioural self-blame and stigma significantly predicted changes in tobacco consumption. Many survivors of lung or head and neck cancers engage in PHCs, but those who do not attribute the disease to their behaviour are less likely to do so. Attention to this problem and additional counselling may help people to adopt PHCs.

The Coaching on Lifestyle (CooL) Intervention for Overweight and Obesity: A Longitudinal Study into Participants’ Lifestyle Changes

PubMed Central

Gerards, Sanne; Rutten, Geert; Philippens, Nicole; Janssen, Ester; Winkens, Bjorn; van de Goor, Ien; Kremers, Stef

2018-01-01

Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents) at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, motivation, perceived barriers, lifestyle behaviours, quality of life and weight. Among children and their parents, few improvements were found regarding behaviours and quality of life. CooL has been successful in coaching adult participants towards sustained behavioural change during the intervention period. Mixed results and smaller effect sizes were found for children and their parents. PMID:29617337

Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal.

PubMed

McMichael, Celia; Robinson, Priscilla

2016-08-01

Behaviour change is central to the prevention of many population health problems, yet it is typically difficult to initiate and sustain. This paper reports on an evaluation of a water, sanitation and hygiene (WASH) intervention in mid-western Nepal, with particular focus on the drivers and barriers for handwashing with soap/ash and elimination of open defecation. The research was conducted during October-November 2014, two and half years following the intervention's end-point. Qualitative data were collected from the target community (n = 112) via group discussions, interviews and drawings/stories of 'most significant change'. Households' handwashing/water facilities and toilets were observed. Analysis was informed by a model that highlights environmental, psychosocial and technological factors that shape hygiene behaviours across multiple levels, from the habitual to the structural (Dreibelbis et al. 2013). Findings indicate the intervention has supported development of new norms around hygiene behaviours. Key drivers of sustained hygiene behaviour were habit formation, emotional drivers (e.g. disgust, affiliation), and collective action and civic pride; key constraints included water scarcity and socio-economic disadvantage. Identifying and responding to the drivers and constraints of hygiene behaviour change in specific contexts is critical to sustained behaviour change and population health impact. Copyright © 2016 Elsevier Ltd. All rights reserved.

Which behaviours? Identifying the most common and burdensome behaviour changes in amyotrophic lateral sclerosis.

PubMed

Andrews, Sophie Claire; Pavlis, Alexia; Staios, Mathew; Fisher, Fiona

2017-04-01

Behaviour change is increasingly recognised as a common feature of amyotrophic lateral sclerosis (ALS), and may be similar to that seen in frontotemporal dementia (FTD). The behaviours most disturbed in ALS, and those that relate most significantly to caregiver burden, however, have not been well established. Forty ALS participants and their caregivers, and 27 age- and gender-matched healthy controls and their relatives, participated in this study. ALS participants were assessed on a disease rating scale, and caregivers and control informants completed the revised version of the Cambridge Behaviour Inventory and a measure of burden. ALS caregivers reported significantly more disturbance than healthy control informants on the functional domains of everyday skills, self-care, and sleep, and in the behavioural domains of mood and motivation. There were no differences between groups in frequency of memory and orientation difficulties, or behaviours characteristic of FTD, such as changes to eating habits or stereotypic and motor behaviour, indicating that the behavioural profile in ALS may differ from FTD. In the ALS group, the domains with the strongest relationship to caregiver burden were everyday skills, motivation and memory, likely because poor motivation, memory dysfunction and difficulties completing activities of daily living require more carer support via direct supervision, prompting or hands on care. Services to support ALS patients and caregivers need to provide targeted interventions for those functional and behavioural changes which are most burdensome in the disease.

Extending the Functionality of Behavioural Change-Point Analysis with k-Means Clustering: A Case Study with the Little Penguin (Eudyptula minor)

PubMed Central

Zhang, Jingjing; Dennis, Todd E.

2015-01-01

We present a simple framework for classifying mutually exclusive behavioural states within the geospatial lifelines of animals. This method involves use of three sequentially applied statistical procedures: (1) behavioural change point analysis to partition movement trajectories into discrete bouts of same-state behaviours, based on abrupt changes in the spatio-temporal autocorrelation structure of movement parameters; (2) hierarchical multivariate cluster analysis to determine the number of different behavioural states; and (3) k-means clustering to classify inferred bouts of same-state location observations into behavioural modes. We demonstrate application of the method by analysing synthetic trajectories of known ‘artificial behaviours’ comprised of different correlated random walks, as well as real foraging trajectories of little penguins (Eudyptula minor) obtained by global-positioning-system telemetry. Our results show that the modelling procedure correctly classified 92.5% of all individual location observations in the synthetic trajectories, demonstrating reasonable ability to successfully discriminate behavioural modes. Most individual little penguins were found to exhibit three unique behavioural states (resting, commuting/active searching, area-restricted foraging), with variation in the timing and locations of observations apparently related to ambient light, bathymetry, and proximity to coastlines and river mouths. Addition of k-means clustering extends the utility of behavioural change point analysis, by providing a simple means through which the behaviours inferred for the location observations comprising individual movement trajectories can be objectively classified. PMID:25922935

Interventions for sustained healthcare professional behaviour change: a protocol for an overview of reviews.

PubMed

Dombrowski, Stephan U; Campbell, Pauline; Frost, Helen; Pollock, Alex; McLellan, Julie; MacGillivray, Steve; Gavine, Anna; Maxwell, Margaret; O'Carroll, Ronan; Cheyne, Helen; Presseau, Justin; Williams, Brian

2016-10-13

Failure to successfully implement and sustain change over the long term continues to be a major problem in health and social care. Translating evidence into routine clinical practice is notoriously complex, and it is recognised that to implement new evidence-based interventions and sustain them over time, professional behaviour needs to change accordingly. A number of theories and frameworks have been developed to support behaviour change among health and social care professionals, and models of sustainability are emerging, but few have translated into valid and reliable interventions. The long-term success of healthcare professional behavioural change interventions is variable, and the characteristics of successful interventions unclear. Previous reviews have synthesised the evidence for behaviour change, but none have focused on sustainability. In addition, multiple overlapping reviews have reported inconsistent results, which do not aid translation of evidence into practice. Overviews of reviews can provide accessible succinct summaries of evidence and address barriers to evidence-based practice. We aim to compile an overview of reviews, identifying, appraising and synthesising evidence relating to sustained social and healthcare professional behaviour change. We will conduct a systematic review of Cochrane reviews (an Overview). We plan to systematically search the Cochrane Database of Systematic Reviews. We will include all systematic reviews of randomised controlled trials comparing a healthcare professional targeted behaviour change intervention to a standard care or no intervention control group. Two reviewers will independently assess the eligibility of the reviews and the methodological quality of included reviews using the ROBIS tool. The quality of evidence within each comparison in each review will be judged based on the GRADE criteria. Disagreements will be resolved through discussion. Effects of interventions will be systematically tabulated and the quality of evidence used to determine implications for clinical practice and make recommendations for future research. This overview will bring together the best available evidence relating to the sustainability of health professional behaviour change, thus supporting policy makers with decision-making in this field.

National policies for the promotion of physical activity and healthy nutrition in the workplace context: a behaviour change wheel guided content analysis of policy papers in Finland.

PubMed

Seppälä, Tuija; Hankonen, Nelli; Korkiakangas, Eveliina; Ruusuvuori, Johanna; Laitinen, Jaana

2017-08-02

Health policy papers disseminate recommendations and guidelines for the development and implementation of health promotion interventions. Such documents have rarely been investigated with regard to their assumed mechanisms of action for changing behaviour. The Theoretical Domains Framework (TDF) and Behaviour Change Techniques (BCT) Taxonomy have been used to code behaviour change intervention descriptions, but to our knowledge such "retrofitting" of policy papers has not previously been reported. This study aims first to identify targets, mediators, and change strategies for physical activity (PA) and nutrition behaviour change in Finnish policy papers on workplace health promotion, and second to assess the suitability of the Behaviour Change Wheel (BCW) approach for this purpose. We searched all national-level health policy papers effectual in Finland in August 2016 focusing on the promotion of PA and/or healthy nutrition in the workplace context (n = 6). Policy recommendations targeting employees' nutrition and PA including sedentary behaviour (SB) were coded using BCW, TDF, and BCT Taxonomy. A total of 125 recommendations were coded in the six policy papers, and in two additional documents referenced by them. Psychological capability, physical opportunity, and social opportunity were frequently identified (22%, 31%, and 24%, respectively), whereas physical capability was almost completely absent (1%). Three TDF domains (knowledge, skills, and social influence) were observed in all papers. Multiple intervention functions and BCTs were identified in all papers but several recommendations were too vague to be coded reliably. Influencing individuals (46%) and changing the physical environment (44%) were recommended more frequently than influencing the social environment (10%). The BCW approach appeared to be useful for analysing the content of health policy papers. Paying more attention to underlying assumptions regarding behavioural change processes may help to identify neglected aspects in current policy, and to develop interventions based on recommendations, thus helping to increase the impact of policy papers.

Assessing the effectiveness of antismoking television advertisements: do audience ratings of perceived effectiveness predict changes in quitting intentions and smoking behaviours?

PubMed

Brennan, Emily; Durkin, Sarah J; Wakefield, Melanie A; Kashima, Yoshihisa

2014-09-01

Decisions about which antismoking advertisements should be aired are often guided by audience ratings of perceived effectiveness (PE). Given that the usefulness of PE measures depends on their ability to predict the likelihood that a message will have a positive impact on outcomes such as behaviour change, in the current study we used pre-exposure, postexposure and follow-up measures to test the association between PE and subsequent changes in quitting intentions and smoking behaviours. Daily smokers (N=231; 18 years and older) completed baseline measures of quitting intentions before watching an antismoking advertisement. Immediately following exposure, intentions were measured again and PE was measured using six items that factored into two scales: ad-directed PE (ADPE) and personalised PE (PPE). A follow-up telephone survey conducted within 3 weeks of exposure measured behaviour change (reduced cigarette consumption or quit attempts). From pre-exposure to postexposure, 18% of smokers showed a positive change in their intentions. Controlling for baseline intentions, PPE independently predicted intention change (OR=2.57, p=0.004). At follow-up, 26% of smokers reported that they had changed their behaviour. PPE scores also predicted the likelihood of behaviour change (OR=1.93, p=0.009). Audience ratings of PPE, but not ADPE, were found to predict subsequent intention and behaviour change. These findings increase confidence in the use of PE measures to pretest and evaluate antismoking television advertisements, particularly when these measures tap the extent to which a smoker has been personally affected by the message. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

From Theory-Inspired to Theory-Based Interventions: A Protocol for Developing and Testing a Methodology for Linking Behaviour Change Techniques to Theoretical Mechanisms of Action.

PubMed

Michie, Susan; Carey, Rachel N; Johnston, Marie; Rothman, Alexander J; de Bruin, Marijn; Kelly, Michael P; Connell, Lauren E

2018-05-18

Understanding links between behaviour change techniques (BCTs) and mechanisms of action (the processes through which they affect behaviour) helps inform the systematic development of behaviour change interventions. This research aims to develop and test a methodology for linking BCTs to their mechanisms of action. Study 1 (published explicit links): Hypothesised links between 93 BCTs (from the 93-item BCT taxonomy, BCTTv1) and mechanisms of action will be identified from published interventions and their frequency, explicitness and precision documented. Study 2 (expert-agreed explicit links): Behaviour change experts will identify links between 61 BCTs and 26 mechanisms of action in a formal consensus study. Study 3 (integrated matrix of explicit links): Agreement between studies 1 and 2 will be evaluated and a new group of experts will discuss discrepancies. An integrated matrix of BCT-mechanism of action links, annotated to indicate strength of evidence, will be generated. Study 4 (published implicit links): To determine whether groups of co-occurring BCTs can be linked to theories, we will identify groups of BCTs that are used together from the study 1 literature. A consensus exercise will be used to rate strength of links between groups of BCT and theories. A formal methodology for linking BCTs to their hypothesised mechanisms of action can contribute to the development and evaluation of behaviour change interventions. This research is a step towards developing a behaviour change 'ontology', specifying relations between BCTs, mechanisms of action, modes of delivery, populations, settings and types of behaviour.

Smart health and innovation: facilitating health-related behaviour change.

PubMed

Redfern, J

2017-08-01

Non-communicable diseases (NCD) are the leading cause of death globally. Smart health technology and innovation is a potential strategy for increasing reach and for facilitating health behaviour change. Despite rapid growth in the availability and affordability of technology there remains a paucity of published and robust research in the area as it relates to health. The objective of the present paper is to review and provide a snapshot of a variety of contemporary examples of smart health strategies with a focus on evidence and research as it relates to prevention with a CVD management lens. In the present analysis, five examples will be discussed and they include a physician-directed strategy, consumer directed strategies, a public health approach and a screening strategy that utilises external hardware that connects to a smartphone. In conclusion, NCD have common risk factors and all have an association with nutrition and health. Smart health and innovation is evolving rapidly and may help with diagnosis, treatment and management. While on-going research, development and knowledge is needed, the growth of technology development and utilisation offers opportunities to reach more people and achieve better health outcomes at local, national and international levels.

The impact of receiving predictive genetic information about Lynch syndrome on individual colonoscopy and smoking behaviors

PubMed Central

Kim, Joanne Soo-Min; Coyte, Peter C.; Cotterchio, Michelle; Keogh, Louise A.; Flander, Louisa B.; Gaff, Clara; Laporte, Audrey

2016-01-01

Background This study investigated whether receiving the results of predictive genetic testing for Lynch syndrome—indicating the presence or absence of an inherited predisposition to various cancers, including colorectal cancer—was associated with change in individual colonoscopy and smoking behaviours, which could prevent colorectal cancer. Methods The study population included individuals with no previous diagnosis of colorectal cancer, whose families had already-identified deleterious mutations in the mismatch repair or EPCAM genes. Hypotheses were generated from a simple health economics model and tested against individual-level panel data from the Australasian Colorectal Cancer Family Registry. Results The empirical analysis revealed evidence consistent with some of the hypotheses, with a higher likelihood of undergoing colonoscopy in those who discovered their genetic predisposition to colorectal cancer and a lower likelihood of quitting smoking in those who discovered their lack thereof. Conclusion Predictive genetic information about Lynch syndrome was associated with change in individual colonoscopy and smoking behaviours but not necessarily in ways to improve population health. Impact The study findings suggest that the impact of personalized medicine on disease prevention is intricate, warranting further analyses to determine the net benefits and costs. PMID:27528600

Behavioural Change in Type 1 Diabetes Self-Management: Why and How?

ERIC Educational Resources Information Center

Wilson, Valerie L.

2009-01-01

Objective: To examine whether the communication process between diabetes health professionals and people intensively self-managing their type 1 diabetes influenced behavioural change. Design: Telephone interviews to provide insight into the communication process and its influence on diabetes intensive self-management behaviour. Setting:…

D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

PubMed

Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

2014-06-01

To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Social interactions of eating behaviour among high school students: a cellular automata approach

PubMed Central

2012-01-01

Background Overweight and obesity in children and adolescents is a global epidemic posing problems for both developed and developing nations. The prevalence is particularly alarming in developed nations, such as the United States, where approximately one in three school-aged adolescents (ages 12-19) are overweight or obese. Evidence suggests that weight gain in school-aged adolescents is related to energy imbalance exacerbated by the negative aspects of the school food environment, such as presence of unhealthy food choices. While a well-established connection exists between the food environment, presently there is a lack of studies investigating the impact of the social environment and associated interactions of school-age adolescents. This paper uses a mathematical modelling approach to explore how social interactions among high school adolescents can affect their eating behaviour and food choice. Methods In this paper we use a Cellular Automata (CA) modelling approach to explore how social interactions among school-age adolescents can affect eating behaviour, and food choice. Our CA model integrates social influences and transition rules to simulate the way individuals would interact in a social community (e.g., school cafeteria). To replicate these social interactions, we chose the Moore neighbourhood which allows all neighbours (eights cells in a two-dimensional square lattice) to influence the central cell. Our assumption is that individuals belong to any of four states; Bring Healthy, Bring Unhealthy, Purchase Healthy, and Purchase Unhealthy, and will influence each other according to parameter settings and transition rules. Simulations were run to explore how the different states interact under varying parameter settings. Results This study, through simulations, illustrates that students will change their eating behaviour from unhealthy to healthy as a result of positive social and environmental influences. In general, there is one common characteristic of changes across time; students with similar eating behaviours tend to form groups, represented by distinct clusters. Transition of healthy and unhealthy eating behaviour is non-linear and a sharp change is observed around a critical point where positive and negative influences are equal. Conclusions Conceptualizing the social environment of individuals is a crucial step to increasing our understanding of obesogenic environments of high-school students, and moreover, the general population. Incorporating both contextual, and individual determinants found in real datasets, in our model will greatly enhance calibration of future models. Complex mathematical modelling has a potential to contribute to the way public health data is collected and analyzed. PMID:23046793

Mind-mindedness and maternal responsiveness in infant-mother interactions in mothers with severe mental illness.

PubMed

Pawlby, S; Fernyhough, C; Meins, E; Pariante, C M; Seneviratne, G; Bentall, R P

2010-11-01

Previous cross-diagnosis studies of interaction between mothers with severe mental illness and their babies have concluded that mothers with schizophrenia have deficits in interaction, but these studies have not included healthy controls. In-patients on a mother and baby unit, with diagnoses of schizophrenia (n=15), depressive mood disorders with or without psychosis (n=23), or mood disorders where mania was the predominant feature, with or without psychosis (n=12), were observed interacting with their infants on admission and discharge. Mothers' mind-mindedness and other measures of the quality of maternal and infant behaviour were coded. Findings from this sample were compared with those from healthy mothers and their infants (n=49). Compared with healthy controls, on admission depressed mothers were marginally less likely to comment appropriately on their infants' mental states. Both the depressed and mania groups were more likely to touch their babies and engage in attention-seeking behaviours. Interactional behaviours of mothers in the schizophrenia group were not markedly different from healthy controls. On discharge there were fewer differences between the clinical and healthy groups, although the depressed group continued to engage in more attention-seeking and touching behaviour and the mania group continued to touch their infants more. Only mothers in the schizophrenia group showed changes in interactional behaviours between admission and discharge, talking more to their infants. The findings challenge previous conclusions that mothers with schizophrenia have deficits in their interactions with their babies, and demonstrate that mothers with severe mental illness are able to respond appropriately to their infants' cues.

Response kinetics of tethered bacteria to stepwise changes in nutrient concentration.

PubMed

Chernova, Anna A; Armitage, Judith P; Packer, Helen L; Maini, Philip K

2003-09-01

We examined the changes in swimming behaviour of the bacterium Rhodobacter sphaeroides in response to stepwise changes in a nutrient (propionate), following the pre-stimulus motion, the initial response and the adaptation to the sustained concentration of the chemical. This was carried out by tethering motile cells by their flagella to glass slides and following the rotational behaviour of their cell bodies in response to the nutrient change. Computerised motion analysis was used to analyse the behaviour. Distributions of run and stop times were obtained from rotation data for tethered cells. Exponential and Weibull fits for these distributions, and variability in individual responses are discussed. In terms of parameters derived from the run and stop time distributions, we compare the responses to stepwise changes in the nutrient concentration and the long-term behaviour of 84 cells under 12 propionate concentration levels from 1 nM to 25 mM. We discuss traditional assumptions for the random walk approximation to bacterial swimming and compare them with the observed R. sphaeroides motile behaviour.

A Longitudinal Operant Assessment of Cognitive and Behavioural Changes in the HdhQ111 Mouse Model of Huntington’s Disease

PubMed Central

Dunnett, Stephen B.; Brooks, Simon P.

2016-01-01

Huntington’s disease (HD) is characterised by motor symptoms which are often preceded by cognitive and behavioural changes, that can significantly contribute to disease burden for people living with HD. Numerous knock-in mouse models of HD are currently available for scientific research. However, before their use, they must be behaviourally characterised to determine their suitability in recapitulating the symptoms of the human condition. Thus, we sought to longitudinally characterise the nature, severity and time course of cognitive and behavioural changes observed in HdhQ111 heterozygous knock-in mice.To determine changes in cognition and behaviour an extensive battery of operant tests including: fixed ratio, progressive ratio, the five choice serial reaction time task and the serial implicit learning task, were applied longitudinally to HdhQ111 and wild type mice. The operant test battery was conducted at 6, 12 and 18 months of age. Significant deficits were observed in HdhQ111 animals in comparison to wild type animals in all operant tests indicating altered cognition (attentional and executive function) and motivation. However, the cognitive and behavioural deficits observed were not shown to be progressive over time in the longitudinal testing paradigm that was utilised. The results therefore demonstrate that the HdhQ111 mouse model of HD reflects some features of the cognitive and behavioural changes shown in the human condition of HD. Although, the cognitive and behavioural deficits demonstrated were not shown to be progressive over time. PMID:27701442

Aetiological influences on stability and change in emotional and behavioural problems across development: a systematic review.

PubMed

Hannigan, L J; Walaker, N; Waszczuk, M A; McAdams, T A; Eley, T C

2017-01-01

Emotional and behavioural problems in childhood and adolescence can be chronic and are predictive of future psychiatric problems. Understanding what factors drive the development and maintenance of these problems is therefore crucial. Longitudinal behavioural genetic studies using twin, sibling or adoption data can be used to explore the developmental aetiology of stability and change in childhood and adolescent psychopathology. We present a systematic review of longitudinal, behavioural genetic analyses of emotional and behavioural problems between ages 0 to 18 years. We identified 58 studies, of which 19 examined emotional problems, 30 examined behavioural problems, and 9 examined both. In the majority of studies, stability in emotional and behavioural problems was primarily genetically influenced. Stable environmental factors were also widely found, although these typically played a smaller role. Both genetic and environmental factors were involved in change across development. We discuss the findings in the context of the wider developmental literature and make recommendations for future research.

Aetiological influences on stability and change in emotional and behavioural problems across development: a systematic review

PubMed Central

Hannigan, L.J.; Walaker, N.; Waszczuk, M.A.; McAdams, T.A.; Eley, T.C.

2016-01-01

Emotional and behavioural problems in childhood and adolescence can be chronic and are predictive of future psychiatric problems. Understanding what factors drive the development and maintenance of these problems is therefore crucial. Longitudinal behavioural genetic studies using twin, sibling or adoption data can be used to explore the developmental aetiology of stability and change in childhood and adolescent psychopathology. We present a systematic review of longitudinal, behavioural genetic analyses of emotional and behavioural problems between ages 0 to 18 years. We identified 58 studies, of which 19 examined emotional problems, 30 examined behavioural problems, and 9 examined both. In the majority of studies, stability in emotional and behavioural problems was primarily genetically influenced. Stable environmental factors were also widely found, although these typically played a smaller role. Both genetic and environmental factors were involved in change across development. We discuss the findings in the context of the wider developmental literature and make recommendations for future research. PMID:28337341

The role of behaviour in adaptive morphological evolution of African proboscideans.

PubMed

Lister, Adrian M

2013-08-15

The fossil record richly illustrates the origin of morphological adaptation through time. However, our understanding of the selective forces responsible in a given case, and the role of behaviour in the process, is hindered by assumptions of synchrony between environmental change, behavioural innovation and morphological response. Here I show, from independent proxy data through a 20-million-year sequence of fossil proboscideans in East Africa, that changes in environment, diet and morphology are often significantly offset chronologically, allowing dissection of the roles of behaviour and different selective drivers. These findings point the way to hypothesis-driven testing of the interplay between habitat change, behaviour and morphological adaptation with the use of independent proxies in the fossil record.

How do anthropogenic contaminants (ACs) affect behaviour? Multi-level analysis of the effects of copper on boldness in hermit crabs.

PubMed

White, Stephen J; Briffa, Mark

2017-02-01

Natural animal populations are increasingly exposed to human impacts on the environment, which could have consequences for their behaviour. Among these impacts is exposure to anthropogenic contaminants. Any environmental variable that influences internal state could impact behaviour across a number of levels: at the sample mean, at the level of among-individual differences in behaviour ('animal personality') and at the level of within-individual variation in behaviour (intra-individual variation, 'IIV'). Here we examined the effect of exposure to seawater-borne copper on the startle response behaviour of European hermit crabs, Pagurus bernhardus across these levels. Copper exposure rapidly led to longer startle responses on average, but did not lead to any change in repeatability indicating that individual differences were present and equally consistent in the presence and absence of copper. There was no strong evidence that copper exposure led to changes in IIV. Our data show that exposure to copper for 1 week produces sample mean level changes in the behaviour of hermit crabs. However, there is no evidence that this exposure led to changes in repeatability through feedback loops.

Celebrating variability and a call to limit systematisation: the example of the Behaviour Change Technique Taxonomy and the Behaviour Change Wheel.

PubMed

Ogden, Jane

2016-09-01

Within any discipline there is always a degree of variability. For medicine it takes the form of Health Professional's behaviour, for education it's the style and content of the classroom, and for health psychology, it can be found in patient's behaviour, the theories used and clinical practice. Over recent years, attempts have been made to reduce this variability through the use of the Behaviour Change Technique Taxonomy, the COM-B and the Behaviour Change Wheel. This paper argues that although the call for better descriptions of what is done is useful for clarity and replication, this systematisation may be neither feasible nor desirable. In particular, it is suggested that the gaps inherent in the translational process from coding a protocol to behaviour will limit the effectiveness of reducing patient variability, that theory variability is necessary for the health and well-being of a discipline and that practice variability is central to the professional status of our practitioners. It is therefore argued that we should celebrate rather than remove this variability in order for our discipline to thrive and for us to remain as professionals rather than as technicians.

Health Behaviour Change Through Computer Games: Characterising Interventions.

PubMed

Poultney, Nathan; Maeder, Anthony; Ginige, Jeewani Anupama

2016-01-01

Recently games in the form of video, computer, or mobile apps have been utilised as an effective component of interventions for health behaviour change. This paper provides an overview of related projects reported in peer-review literature in the period 2006 to 2016. Nine highly relevant references were considered for analysis. The findings are presented according to 3 dimensions of characterisation: health intention, behaviour change principle, and health purpose.

Fear of Fear and Broad Dimensions of Psychopathology over the Course of Cognitive Behavioural Therapy for Panic Disorder with Agoraphobia in Japan.

PubMed

Ogawa, S; Kondo, M; Ino, K; Ii, T; Imai, R; Furukawa, T A; Akechi, T

2017-12-01

To examine the relationship of fear of fear and broad dimensions of psychopathology in panic disorder with agoraphobia over the course of cognitive behavioural therapy in Japan. A total of 177 Japanese patients with panic disorder with agoraphobia were treated with group cognitive behavioural therapy between 2001 and 2015. We examined associations between the change scores in Agoraphobic Cognitions Questionnaire or Body Sensations Questionnaire and the changes in subscales of Symptom Checklist-90 Revised during cognitive behavioural therapy controlling the change in panic disorder severity using multiple regression analysis. Reduction in Agoraphobic Cognitions Questionnaire score was related to a decrease in all Symptom Checklist-90 Revised (SCL-90-R) subscale scores. Reduction in Body Sensations Questionnaire score was associated with a decrease in anxiety. Reduction in Panic Disorder Severity Scale score was not related to any SCL-90-R subscale changes. Changes in fear of fear, especially maladaptive cognitions, may predict broad dimensions of psychopathology reductions in patients of panic disorder with agoraphobia over the course of cognitive behavioural therapy. For the sake of improving a broader range of psychiatric symptoms in patients of panic disorder with agoraphobia, more attention to maladaptive cognition changes during cognitive behavioural therapy is warranted.

The development of measures of organizational citizenship behaviour and changes in job behaviours related to quality management in health care.

PubMed

Irvine, D

1995-08-01

A study was conducted at two tertiary care hospitals in Canada for the purpose of developing instruments to measure organizational citizenship behaviours (OCB) and changes in job behaviours that occur as a result of participation on hospital quality improvement (CQI) teams. Semi structured interviews were conducted among 52 hospital employees in order to elicit critical incidents of OCB and changes in job behaviours related to CQI. The results of the staff interviews were used to develop a measure of OCB in the hospital setting, and a measure of changes in job behaviours related to CQI. 39 employees, who were drawn from the major departments within the two hospitals on the basis of their membership on CQI teams, participated in a test of the psychometric properties of the two research instruments. Exploratory factor analysis, employing an orthogonal rotation, yielded two factors that accounted for 30% of the variation among the OCB items. The Cronbach alpha for items loading highly on the first factor was .88. The factor was labelled 'OCB directed towards individuals within the organization'. This factor was dominated by items reflecting the kinds of extra-role job behaviours employees engage in to assist patients, family members, visitors, and other employees within the organization. The Cronbach alpha for items loading highly on the second factor was 0.71. The second factor was labelled 'organizationally directed OCB', and consisted of behaviours that reflected an impersonal form of OCB in the hospital setting. Factor analysis, employing an orthogonal rotation, yielded four factors that accounted for 48% of the variation among the items measuring changes in job behaviours related to CQI. The four factors were labelled 'problem-solving', Cronbach alpha 0.82; 'customer awareness', Cronbach alpha 0.79; 'use of CQI knowledge', Cronbach alpha 0.77; and 'organizational interests', Cronbach alpha 0.79. The two OCB factors were moderately correlated, there were no significant correlations among any of the factors measuring changes in job behaviours related to CQI, and the problem-solving job behaviours factor was moderately correlated with the two OCB factors. Directions for future research are discussed.

Changes in illness perceptions mediated the effect of cognitive behavioural therapy in severe functional somatic syndromes.

PubMed

Christensen, Sara Sletten; Frostholm, Lisbeth; Ørnbøl, Eva; Schröder, Andreas

2015-04-01

Although there is substantial evidence that cognitive behavioural therapy alleviates symptoms in functional somatic syndromes, the mechanisms of change are less investigated. This study examined whether changes in illness perceptions mediated the effect of cognitive behavioural therapy. We analysed additional data from a randomised controlled trial comparing completers of cognitive behavioural group therapy (46 patients) to an enhanced usual care group (66 patients). Proposed mediators (illness perceptions) and primary (physical health) and secondary (somatic symptoms and illness worry) outcomes were assessed by means of questionnaires at referral, baseline, end of treatment, and 10 and 16 months after randomisation. Multiple mediation analysis determined whether (1) changes in specific illness perceptions during treatment mediated the effect of cognitive behavioural therapy (primary analysis), and (2) whether changes in illness perceptions during the whole trial period were associated with improved outcome (secondary analysis). Improvements in illness perceptions during treatment partially mediated the effect of cognitive behavioural therapy on physical health one year after treatment (sum of indirect effects 1.556, BCa 95% CI (0.006; 3.620)). Improving perceived control was particularly important. Changes in illness perceptions from baseline to 16 months after randomisation were associated with clinically meaningful improvements in physical health, somatic symptoms and illness worry during the same period. Our results suggest that changing patients' illness perceptions is an important process in cognitive behavioural therapy for functional somatic syndromes. Challenging patients' own understanding of their illness may hence be a key element of successful treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Changes in the acoustic environment alter the foraging and sheltering behaviour of the cichlid Amititlania nigrofasciata.

PubMed

McLaughlin, Kirsty Elizabeth; Kunc, Hansjoerg P

2015-07-01

Anthropogenic noise can affect behaviour across a wide range of species in both terrestrial and aquatic environments. However, behaviours might not be affected in isolation. Therefore, a more holistic approach investigating how environmental stressors, such as noise pollution, affect different behaviours in concert is necessary. Using tank-based noise exposure experiments, we tested how changes in the acoustic environment affect the behaviour of the cichlid Amatitlania nigrofasciata. We found that exposure to anthropogenic noise affected a couple of behaviours: an increase in sheltering was accompanied by a decrease in foraging. Our results highlight the multiple negative effects of an environmental stressor on an individual's behaviour. Copyright © 2015 Elsevier B.V. All rights reserved.

Developmental origins, behaviour change and the new public health.

PubMed

Barker, M

2015-10-01

A developmental approach to public health focuses attention on better nourishing girls and young women, especially those of low socio-economic status, to improve mothers' nutrition and thereby the health of future generations. There have been significant advances in the behavioural sciences that may allow us to understand and support dietary change in young women and their children in ways that have not previously been possible. This paper describes some of these advances and aims to show how they inform this new approach to public health. The first of these has been to work out what is effective in supporting behaviour change, which has been achieved by careful and detailed analysis of behaviour change techniques used by practitioners in intervention, and of the effectiveness of these in supporting change. There is also a new understanding of the role that social and physical environments play in shaping our behaviours, and that behaviour is influenced by automatic processes and 'habits' as much as by reflective processes and rational decisions. To be maximally effective, interventions therefore have to address both influences on behaviour. An approach developed in Southampton aims to motivate, support and empower young women to make better food choices, but also to change the culture in which those choices are being made. Empowerment is the basis of the new public health. An empowered public demand for better access to better food can go a long way towards improving maternal, infant and family nutrition, and therefore the health of generations to come.

Developmental origins, behaviour change and the new public health

PubMed Central

Barker, Mary

2016-01-01

A developmental approach to public health focuses attention on better nourishing girls and young women, especially those of low socio-economic status, to improve mothers’ nutrition and thereby the health of future generations. There have been significant advances in the behavioural sciences that may allow us to understand and support dietary change in young women and their children in ways that have not previously been possible. This paper describes some of these advances and aims to show how they inform this new approach to public health. The first of these has been to work out what is effective in supporting behaviour change which has been achieved by careful and detailed analysis of behaviour change techniques used by practitioners in intervention, and of the effectiveness of these in supporting change. There is also a new understanding of the role that social and physical environments play in shaping our behaviours, and that behaviour is influenced by automatic processes and ‘habits’ as much as by reflective processes and rational decisions. To be maximally effective, interventions therefore have to address both influences on behaviour. An approach developed in Southampton aims to motivate, support and empower young women to make better food choices, but also to change the culture in which those choices are being made. Empowerment is the basis of the new public health. An empowered public demand for better access to better food can go a long way towards improving maternal, infant and family nutrition, and therefore the health of generations to come. PMID:26152930

Child-orientated environmental education influences adult knowledge and household behaviour

NASA Astrophysics Data System (ADS)

Damerell, P.; Howe, C.; Milner-Gulland, E. J.

2013-03-01

Environmental education is frequently undertaken as a conservation intervention designed to change the attitudes and behaviour of recipients. Much conservation education is aimed at children, with the rationale that children influence the attitudes of their parents, who will consequently change their behaviour. Empirical evidence to substantiate this suggestion is very limited, however. For the first time, we use a controlled trial to assess the influence of wetland-related environmental education on the knowledge of children and their parents and household behaviour. We demonstrate adults exhibiting greater knowledge of wetlands and improved reported household water management behaviour when their child has received wetland-based education at Seychelles wildlife clubs. We distinguish between ‘folk’ knowledge of wetland environments and knowledge obtained from formal education, with intergenerational transmission of each depending on different factors. Our study provides the first strong support for the suggestion that environmental education can be transferred between generations and indirectly induce targeted behavioural changes.

Changing from primary to secondary school highlights opportunities for school environment interventions aiming to increase physical activity and reduce sedentary behaviour: a longitudinal cohort study.

PubMed

Marks, Jennifer; Barnett, Lisa M; Strugnell, Claudia; Allender, Steven

2015-05-08

There is little empirical evidence of the impact of transition from primary to secondary school on obesity-related risk behaviour. The purpose of this study was to examine the effect of a change of school system on physical activity (PA) and sedentary behaviour in pre-early adolescents. Fifteen schools in Victoria, Australia were recruited at random from the bottom two strata of a five level socio-economic scale. In nine schools, students in year 6 primary school transitioned to a different school for year 7 secondary school, while in six schools (combined primary-secondary), students remained in the same school environment from year 6 to year 7. Time 1 (T1) measures were collected from students (N=245) in year 6 (age 11-13). Time 2 (T2) data were collected from 243 (99%) of the original student cohort when in year 7. PA and sedentary behaviour data were collected objectively (via ActiGraph accelerometer) and subjectively (via child self-report recall questionnaire). School environment data were collected via school staff survey. Change of behaviour analyses were conducted longitudinally i) for all students and ii) by change/no change of school. Mixed model regression analysis tested for behavioural interaction effects of changing/not changing school. Sixty-three percent (N=152) changed schools from T1 to T2. Across all students we observed declines in average daily moderate to vigorous physical activity (MVPA) (-4 min) and light PA (-23 min), and increases in average daily sedentary behaviour (16 min), weekday leisure screen time (17 min) and weekday homework screen time (25 min), all P<0.05. Compared to students who remained in the same school environment, students who changed school reported a greater reduction in PA intensity at recess and lunch, less likelihood to cycle to/from school, greater increase in weekday (41 mins) and weekend (45 mins) leisure screen time (P<0.05) and greater encouragement to participate in sport. School staff surveys identified that sport participation encouragement was greater in primary and combined primary-secondary than secondary schools (P<0.05). Transitioning from primary to secondary school negatively impacts on children's PA and sedentary behaviour, and has further compounding effects on behaviour type by changing school environments.

Protocol for the ADDITION-Plus study: a randomised controlled trial of an individually-tailored behaviour change intervention among people with recently diagnosed type 2 diabetes under intensive UK general practice care.

PubMed

Griffin, Simon J; Simmons, Rebecca K; Williams, Kate M; Prevost, A Toby; Hardeman, Wendy; Grant, Julie; Whittle, Fiona; Boase, Sue; Hobbis, Imogen; Brage, Soren; Westgate, Kate; Fanshawe, Tom; Sutton, Stephen; Wareham, Nicholas J; Kinmonth, Ann Louise

2011-04-04

The increasing prevalence of type 2 diabetes poses both clinical and public health challenges. Cost-effective approaches to prevent progression of the disease in primary care are needed. Evidence suggests that intensive multifactorial interventions including medication and behaviour change can significantly reduce cardiovascular morbidity and mortality among patients with established type 2 diabetes, and that patient education in self-management can improve short-term outcomes. However, existing studies cannot isolate the effects of behavioural interventions promoting self-care from other aspects of intensive primary care management. The ADDITION-Plus trial was designed to address these issues among recently diagnosed patients in primary care over one year. ADDITION-Plus is an explanatory randomised controlled trial of a facilitator-led, theory-based behaviour change intervention tailored to individuals with recently diagnosed type 2 diabetes. 34 practices in the East Anglia region participated. 478 patients with diabetes were individually randomised to receive (i) intensive treatment alone (n = 239), or (ii) intensive treatment plus the facilitator-led individual behaviour change intervention (n = 239). Facilitators taught patients key skills to facilitate change and maintenance of key behaviours (physical activity, dietary change, medication adherence and smoking), including goal setting, action planning, self-monitoring and building habits. The intervention was delivered over one year at the participant's surgery and included a one-hour introductory meeting followed by six 30-minute meetings and four brief telephone calls. Primary endpoints are physical activity energy expenditure (assessed by individually calibrated heart rate monitoring and movement sensing), change in objectively measured dietary intake (plasma vitamin C), medication adherence (plasma drug levels), and smoking status (plasma cotinine levels) at one year. We will undertake an intention-to-treat analysis of the effect of the intervention on these measures, an assessment of cost-effectiveness, and analyse predictors of behaviour change in the cohort. The ADDITION-Plus trial will establish the medium-term effectiveness and cost-effectiveness of adding an externally facilitated intervention tailored to support change in multiple behaviours among intensively-treated individuals with recently diagnosed type 2 diabetes in primary care. Results will inform policy recommendations concerning the management of patients early in the course of diabetes. Findings will also improve understanding of the factors influencing change in multiple behaviours, and their association with health outcomes.

Tobacco price increase and smoking behaviour changes in various subgroups: a nationwide longitudinal 7-year follow-up study among a middle-aged Japanese population

PubMed Central

Fujiwara, Takeo; Shinozaki, Tomohiro

2017-01-01

Objective Few longitudinal studies have examined the effect of tobacco price increase on both cessation among smokers and relapse among quitters. Our objective was to investigate the differential impact of the tobacco price increase on the changes in smoking status in the total population and various subgroups. Methods We analysed data from a Japanese nationally representative longitudinal study of 30 773 individuals aged 50–59 years (weighted sum of discrete-time number = 215 411) with smoking information, using inverse probability weighting to account for non-response at follow-up. Generalised estimating equation models were used to calculate the odds ratios (ORs) for smoking behavioural changes (cessation among smokers and relapse among quitters), using discrete-time design. Stratified analyses were conducted according to demographic, socioeconomic and health behavioural characteristics. Results From 2005 to 2012, current smoker prevalence among the middle-aged Japanese population decreased from 30.5% to 24.3%. Of all the factors surveyed, only the tobacco price increase in 2010 (up by 37%, the highest increase during the period) was significantly associated with both cessation among smokers (OR 2.14, 95% confidence interval 1.90 to 2.41) and prevention of relapse among quitters (0.60, 0.46 to 0.77). Regarding the subgroup analysis, the tobacco price increase was associated with a significant reduction in relapse in the lowest income, recent quitters and very poor health subgroups. However, different associations were observed for cessation; a significant association between price increase and cessation was observed among all subgroups except for the heavy smoker and recently unemployed subgroups. Conclusions We confirmed that the tobacco price rise was associated with increasing cessation and decreasing relapse concurrently. Furthermore, this price rise was associated with favourable smoking changes in nearly all population subgroups; a large differential impact was not observed across the various subgroups. PMID:26880743

The Impact of Curtin University's Activity, Food and Attitudes Program on Physical Activity, Sedentary Time and Fruit, Vegetable and Junk Food Consumption among Overweight and Obese Adolescents: A Waitlist Controlled Trial

PubMed Central

Straker, Leon M.; Howie, Erin K.; Smith, Kyla L.; Fenner, Ashley A.; Kerr, Deborah A.; Olds, Tim S.; Abbott, Rebecca A.; Smith, Anne J.

2014-01-01

Background To determine the effects of participation in Curtin University's Activity, Food and Attitudes Program (CAFAP), a community-based, family-centered behavioural intervention, on the physical activity, sedentary time, and healthy eating behaviours of overweight and obese adolescents. Methods In this waitlist controlled clinical trial in Western Australia, adolescents (n = 69, 71% female, mean age 14.1 (SD 1.6) years) and parents completed an 8-week intervention followed by 12 months of telephone and text message support. Assessments were completed at baseline, before beginning the intervention, immediately following the intervention, and at 3-, 6-, and 12- months follow-up. The primary outcomes were physical activity and sedentary time assessed by accelerometers and servings of fruit, vegetables and junk food assessed by 3-day food records. Results During the intensive 8-week intervention sedentary time decreased by −5.1 min/day/month (95% CI: −11.0, 0.8) which was significantly greater than the rate of change during the waitlist period (p = .014). Moderate physical activity increased by 1.8 min/day/month (95% CI: −0.04, 3.6) during the intervention period, which was significantly greater than the rate of change during the waitlist period (p = .041). Fruit consumption increased during the intervention period (monthly incidence rate ratio (IRR) 1.3, 95% CI: 1.10, 1.56) and junk food consumption decreased (monthly IRR 0.8, 95% CI: 0.74, 0.94) and these changes were different to those seen during the waitlist period (p = .004 and p = .020 respectively). Conclusions Participating in CAFAP appeared to have a positive influence on the physical activity, sedentary and healthy eating behaviours of overweight and obese adolescents and many of these changes were maintained for one year following the intensive intervention. Trial Registration Australia and New Zealand Clinical Trials Registry ACTRN12611001187932 PMID:25375109

Effectiveness of interventions to reduce ordering of thyroid function tests: a systematic review.

PubMed

Zhelev, Zhivko; Abbott, Rebecca; Rogers, Morwenna; Fleming, Simon; Patterson, Anthea; Hamilton, William Trevor; Heaton, Janet; Thompson Coon, Jo; Vaidya, Bijay; Hyde, Christopher

2016-06-03

To evaluate the effectiveness of behaviour changing interventions targeting ordering of thyroid function tests. Systematic review. MEDLINE, EMBASE and the Cochrane Database up to May 2015. We included studies evaluating the effectiveness of behaviour change interventions aiming to reduce ordering of thyroid function tests. Randomised controlled trials (RCTs), non-randomised controlled studies and before and after studies were included. There were no language restrictions. 2 reviewers independently screened all records identified by the electronic searches and reviewed the full text of any deemed potentially relevant. Study details were extracted from the included papers and their methodological quality assessed independently using a validated tool. Disagreements were resolved through discussion and arbitration by a third reviewer. Meta-analysis was not used. 27 studies (28 papers) were included. They evaluated a range of interventions including guidelines/protocols, changes to funding policy, education, decision aids, reminders and audit/feedback; often intervention types were combined. The most common outcome measured was the rate of test ordering, but the effect on appropriateness, test ordering patterns and cost were also measured. 4 studies were RCTs. The majority of the studies were of poor or moderate methodological quality. The interventions were variable and poorly reported. Only 4 studies reported unsuccessful interventions but there was no clear pattern to link effect and intervention type or other characteristics. The results suggest that behaviour change interventions are effective particularly in reducing the volume of thyroid function tests. However, due to the poor methodological quality and reporting of the studies, the likely presence of publication bias and the questionable relevance of some interventions to current day practice, we are unable to draw strong conclusions or recommend the implementation of specific intervention types. Further research is thus justified. CRD42014006192. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Diet behaviour among young people in transition to adulthood (18-25 year olds): a mixed method study.

PubMed

Poobalan, Amudha S; Aucott, Lorna S; Clarke, Amanda; Smith, William Cairns S

2014-01-01

Background : Young people (18-25 years) during the adolescence/adulthood transition are vulnerable to weight gain and notoriously hard to reach. Despite increased levels of overweight/obesity in this age group, diet behaviour, a major contributor to obesity, is poorly understood. The purpose of this study was to explore diet behaviour among 18-25 year olds with influential factors including attitudes, motivators and barriers. Methods : An explanatory mixed method study design, based on health Behaviour Change Theories was used. Those at University/college and in the community, including those Not in Education, Employment or Training (NEET) were included. An initial quantitative questionnaire survey underpinned by the Theory of Planned Behaviour and Social Cognitive Theory was conducted and the results from this were incorporated into the qualitative phase. Seven focus groups were conducted among similar young people, varying in education and socioeconomic status. Exploratory univariate analysis was followed by multi-staged modelling to analyse the quantitative data. 'Framework Analysis' was used to analyse the focus groups. Results : 1313 questionnaires were analysed. Self-reported overweight/obesity prevalence was 22%, increasing with age, particularly in males. Based on the survey, 40% of young people reported eating an adequate amount of fruits and vegetables and 59% eating regular meals, but 32% reported unhealthy snacking. Based on the statistical modelling, positive attitudes towards diet and high intention (89%), did not translate into healthy diet behaviour. From the focus group discussions, the main motivators for diet behaviour were 'self-appearance' and having 'variety of food'. There were mixed opinions on 'cost' of food and 'taste'. Conclusion : Elements deemed really important to young people have been identified. This mixed method study is the largest in this vulnerable and neglected group covering a wide spectrum of the community. It provides evidence base to inform tailored interventions for a healthy diet within this age group.

Diet behaviour among young people in transition to adulthood (18–25 year olds): a mixed method study

PubMed Central

Poobalan, Amudha S.; Aucott, Lorna S.; Clarke, Amanda; Smith, William Cairns S.

2014-01-01

Background : Young people (18–25 years) during the adolescence/adulthood transition are vulnerable to weight gain and notoriously hard to reach. Despite increased levels of overweight/obesity in this age group, diet behaviour, a major contributor to obesity, is poorly understood. The purpose of this study was to explore diet behaviour among 18–25 year olds with influential factors including attitudes, motivators and barriers. Methods: An explanatory mixed method study design, based on health Behaviour Change Theories was used. Those at University/college and in the community, including those Not in Education, Employment or Training (NEET) were included. An initial quantitative questionnaire survey underpinned by the Theory of Planned Behaviour and Social Cognitive Theory was conducted and the results from this were incorporated into the qualitative phase. Seven focus groups were conducted among similar young people, varying in education and socioeconomic status. Exploratory univariate analysis was followed by multi-staged modelling to analyse the quantitative data. ‘Framework Analysis’ was used to analyse the focus groups. Results: 1313 questionnaires were analysed. Self-reported overweight/obesity prevalence was 22%, increasing with age, particularly in males. Based on the survey, 40% of young people reported eating an adequate amount of fruits and vegetables and 59% eating regular meals, but 32% reported unhealthy snacking. Based on the statistical modelling, positive attitudes towards diet and high intention (89%), did not translate into healthy diet behaviour. From the focus group discussions, the main motivators for diet behaviour were ‘self-appearance’ and having ‘variety of food’. There were mixed opinions on ‘cost’ of food and ‘taste’. Conclusion: Elements deemed really important to young people have been identified. This mixed method study is the largest in this vulnerable and neglected group covering a wide spectrum of the community. It provides evidence base to inform tailored interventions for a healthy diet within this age group. PMID:25750826

Post-treatment Stage of Change Predicts 12-month Outcome of Treatment for Alcohol Problems

PubMed Central

Heather, Nick; McCambridge, Jim

2013-01-01

Aims: To evaluate relationships between clients' self-reported ‘stage of change’ and outcomes after treatment for alcohol problems. Methods: Using data from the ‘United Kingdom Alcohol Treatment Trial’, clients who had received at least one session of treatment and who had complete data (n = 392) entered the analysis. Two continuous measures of drinking behaviour (% days abstinent (PDA) and drinks per drinking day (DDD)) and categorical outcomes at the 12-month follow-up were compared between clients in Pre-action and Action stages of change at either pre- or post-treatment assessment. Multiple and logistic regression analyses examined the relationships between stage of change and treatment outcomes, evaluating the strength of these relationships by controlling for likely confounders. Results: Pre-treatment stage of change did not predict outcome but post-treatment stage of change predicted PDA and DDD at the 12-month follow-up. In unadjusted and adjusted analyses, clients in Action at post-treatment were two to three times more likely to show a favourable categorical outcome, variously defined, than those in Pre-action. There were no differences between clients who had received Motivational Enhancement Therapy and those who had received Social Behaviour and Network Therapy in proportions maintaining or moving towards Action from before to after treatment. Conclusions: These findings confirm previous reports that motivational variables predict outcome of treatment but add that such a relationship is seen for post-treatment stage of change. For therapists, it would seem important to monitor the client's stage of change—which in good clinical practice often occurs in informal ways—and have strategies to deal with low motivation to change whenever it occurs throughout treatment. The findings are also consistent with a ‘common factors’ perspective on effective treatment for alcohol problems. PMID:23408241

Predictors of Change in Sports Participation in Latino and non-Latino Children

PubMed Central

Corder, Kirsten; Crespo, Noe C.; van Sluijs, Esther M. F.; Sallis, James F.; Shadron, Lisa M.; Moody, Jamie S.; Elder, John P.

2013-01-01

Background Few prospective studies have examined predictors of change in specific physical activity (PA) behaviours in different ethnic groups. Purpose To assess predictors of change in sports participation in Latino and non-Latino 5-8 year-old children in San Diego, California. Methods Average sports participation frequency (days/week) was assessed by validated parent-report at baseline (Nov 2006 to May 2008) and one year later in 541 children (45.0% male, 41.1% Latino; Mean±SD age: 6.6±0.7 yrs) taking part in an obesity prevention study (Project MOVE). Biological (sex, age, BMI z-score), socio-cultural (ethnicity, income, caregiver education), parental (PA rules, PA encouragement) and environmental factors (home PA equipment, PA location) were assessed at baseline. Associations between change in sports participation and potential predictors were studied using multi-level linear regression stratified by Latino ethnicity, adjusted for sex, baseline sport participation, study condition and recruitment area. Results Sports participation increased over one year (mean change: +0.5 days; p<0.001) and change was similar for boys and girls (p=0.95), but Latino children showed a greater increase (p=0.03). The number of locations used for PA (p=0.024) and the total frequency of PA location use (p=0.018) were positively associated with increased sports participation among Latinos. No predictors were identified for non-Latino children. Conclusions Only factors relating to PA location were identified as predictors of change in sports participation for Latino children. Interventions targeting specific PA behaviours such as sports participation may need to consider PA locations for Latino children and be tailored for specific ethnic groups. PMID:21903618

The Power of Behavioural Approaches--We Need a Revival

ERIC Educational Resources Information Center

Buckley, Sue

2008-01-01

Behavioural approaches can be used effectively to teach new skills and to change behaviours that are challenging and not socially adaptive. The behaviour modification approach--now called applied behaviour analysis--is based on the assumption that all behaviours are learned, both the useful ones (new skills) and the ones that are not so useful…

The role of training dose in drug discrimination: a review

PubMed Central

Stolerman, Ian P; Childs, Emma; Ford, Matthew M; Grant, Kathleen A

2011-01-01

Drug discrimination has been an important technique in behavioural pharmacology for at least 40 years. The characteristics of drug-produced discriminative stimuli are influenced by behavioural and pharmacological variables, including the doses used to establish discriminations. This review covers studies on the effects of varying the training dose of a drug in a search for general principles that are applicable across different drug classes and methodological approaches. With respect to quantitative changes, relationships between training dose and rate of acquisition or magnitude of stimulus control were found for most drug classes. Acquisition accelerated with dose up to a point beyond which drug-induced impairments of performance had a deleterious impact. Sensitivity to the training drug as measured by ED50 values typically increased when the training dose was reduced. Qualitative changes were more complex and appeared to fall into three categories: (i) changes in profiles of generalisation between partial and full agonists; (ii) reduced specificity of some discriminations at small training doses and (iii) changes in the relative salience of actions mediated through different neurotransmitter systems or from central and peripheral sites. Three-lever discrimination procedures incorporating ‘drug versus drug’ or “dose versus dose” contingencies enabled detection of more subtle differences than the simple ‘drug versus no drug’ approach when applied to the opioid, hallucinogen and barbiturate classes of drugs. These conclusions have implications for the interpretation of data from studies that utilise either within- or between-subject designs for studying the discriminative stimulus effects of drugs. PMID:21808191

Surfing depth on a behaviour change website: predictors and effects on behaviour.

PubMed

Jacobs, Nele; De Bourdeaudhuij, Ilse; Claes, Neree

2010-03-01

The primary objectives of the present study were to gain insight into website use and to predict the surfing depth on a behaviour change website and its effect on behaviour. Two hundred eight highly educated adults from the intervention condition of a randomised trial received access to a medical intervention, individual coaching (by e-mail, post, telephone or face-to-face) and a behaviour change website. Website use (e.g. surfing depth, page view duration) was registered. Online questionnaires for physical activity and fat intake were filled out at baseline and after 6 months. Hierarchical linear regression was used to predict surfing depth and its effect on behaviour. Seventy-five per cent of the participants visited the website. Fifty-one and fifty-six per cent consulted the physical activity and fat intake feedback, respectively. The median surfing depth was 2. The total duration of interventions by e-mail predicted deeper surfing (beta=0.36; p<0.001). Surfing depth did not predict changes in fat intake (beta=-0.07; p=0.45) or physical activity (beta=-0.03; p=0.72). Consulting the physical activity feedback led to more physical activity (beta=0.23; p=0.01). The findings from the present study can be used to guide future website development and improve the information architecture of behaviour change websites.

Self-Monitoring vs. Implementation Intentions: a Comparison of Behaviour Change Techniques to Improve Sleep Hygiene and Sleep Outcomes in Students.

PubMed

Mairs, Lucinda; Mullan, Barbara

2015-10-01

This study seeks to investigate and compare the efficacy of self-monitoring and implementation intentions-two post-intentional behaviour change techniques-for improving sleep hygiene behaviours and sleep outcomes in university students. Seventy-two undergraduate students completed baseline measures of four sleep hygiene behaviours (making the sleep environment restful, avoiding going to bed hungry/thirsty, avoiding stress/anxiety-provoking activities near bed time and avoiding caffeine in the evening), as well as the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI). Participants were randomly assigned to an active-control diary-keeping, self-monitoring condition or completed implementation intentions for each behaviour. Post-intervention measurement was completed 2 weeks after baseline. Repeated measures analyses of variance found significant main effects of time for improvements in making the sleep environment restful and avoiding going to bed hungry or thirsty, as well as PSQI and ISI scores. Non-significant interactions suggested no group differences on any variable, except for increasing avoidance of stress and anxiety-provoking activities before bed time, for which only implementation intentions were found to be effective. Attrition was higher amongst self-monitoring participants. Both self-monitoring and implementation intentions appear to be promising behaviour change techniques for improving sleep hygiene and sleep. Future research should examine the acceptability of the two behaviour change techniques and the relationship with differential attrition, as well as effect size variations according to behaviour and technique. Researchers should investigate potential additive or interactive effects of the techniques, as they could be utilised in a complementary manner to target different processes in effecting behaviour change.

Beyond Lip Service: A Council Approach to Planning for Behaviour Change

ERIC Educational Resources Information Center

Collier, Grahame; Smith, Phil

2009-01-01

The Council of the City of Sydney--like many other councils around Australia--has embarked on a whole-of-council approach to establishing sustainable behaviours amongst its residents. In developing its "Residential Environmental Action Plan"--designed to motivate and bring about real change in resident choices and behaviours--the City…

Behavioural Excesses and Deficits Associated with Dementia in Adults Who Have Down Syndrome

ERIC Educational Resources Information Center

Oliver, Chris; Kalsy, Sunny; McQuillan, Sharna; Hall, Scott

2011-01-01

Background: Informant-based assessment of behavioural change and difference in dementia in Down syndrome can aid diagnosis and inform service delivery. To date few studies have examined the impact of different types of behavioural change. Methods: The Assessment for Adults with Developmental Disabilities (AADS), developed for this study, assesses…

Effects of an Awareness Raising Campaign on Intention and Behavioural Determinants for Handwashing

ERIC Educational Resources Information Center

Seimetz, E.; Kumar, S.; Mosler, H.-J.

2016-01-01

This article assesses the effectiveness of The Great WASH Yatra handwashing awareness raising campaign in India on changing visitors' intention to wash hands with soap after using the toilet and the underlying behavioural determinants. Interviews based on the RANAS (Risk, Attitudes, Norms, Abilities, Self-regulation) model of behaviour change were…

A systematic review of patient reported factors associated with uptake and completion of cardiovascular lifestyle behaviour change.

PubMed

Murray, Jenni; Craigs, Cheryl Leanne; Hill, Kate Mary; Honey, Stephanie; House, Allan

2012-12-08

Healthy lifestyles are an important facet of cardiovascular risk management. Unfortunately many individuals fail to engage with lifestyle change programmes. There are many factors that patients report as influencing their decisions about initiating lifestyle change. This is challenging for health care professionals who may lack the skills and time to address a broad range of barriers to lifestyle behaviour. Guidance on which factors to focus on during lifestyle consultations may assist healthcare professionals to hone their skills and knowledge leading to more productive patient interactions with ultimately better uptake of lifestyle behaviour change support. The aim of our study was to clarify which influences reported by patients predict uptake and completion of formal lifestyle change programmes. A systematic narrative review of quantitative observational studies reporting factors (influences) associated with uptake and completion of lifestyle behaviour change programmes. Quantitative observational studies involving patients at high risk of cardiovascular events were identified through electronic searching and screened against pre-defined selection criteria. Factors were extracted and organised into an existing qualitative framework. 374 factors were extracted from 32 studies. Factors most consistently associated with uptake of lifestyle change related to support from family and friends, transport and other costs, and beliefs about the causes of illness and lifestyle change. Depression and anxiety also appear to influence uptake as well as completion. Many factors show inconsistent patterns with respect to uptake and completion of lifestyle change programmes. There are a small number of factors that consistently appear to influence uptake and completion of cardiovascular lifestyle behaviour change. These factors could be considered during patient consultations to promote a tailored approach to decision making about the most suitable type and level lifestyle behaviour change support.

Identifying mechanisms of change in a conversation therapy for aphasia using behaviour change theory and qualitative methods.

PubMed

Johnson, Fiona M; Best, Wendy; Beckley, Firle Christina; Maxim, Jane; Beeke, Suzanne

2017-05-01

Conversation therapy for aphasia is a complex intervention comprising multiple components and targeting multiple outcomes. UK Medical Research Council (MRC) guidelines published in 2008 recommend that in addition to measuring the outcomes of complex interventions, evaluation should seek to clarify how such outcomes are produced, including identifying the hypothesized mechanisms of change. To identify mechanisms of change within a conversation therapy for people with aphasia and their partners. Using qualitative methods, the study draws on behaviour change theory to understand how and why participants make changes in conversation during and after therapy. Data were derived from 16 participants (eight people with aphasia; eight conversation partners) who were recruited to the Better Conversations with Aphasia research project and took part in an eight session conversation therapy programme. The dataset consists of in-therapy discussions and post-therapy interviews, which are analysed using Framework Analysis. Seven mechanisms of conversational behaviour change are identified and linked to theory. These show how therapy can activate changes to speakers' skills and motivation for using specific behaviours, and to the conversational opportunities available for strategy use. These clinically relevant findings offer guidance about the processes involved in producing behavioural change via conversation therapy. A distinction is made between the process involved in motivating change and that involved in embedding change. Differences are also noted between the process engaged in reducing unhelpful behaviour and that supporting new uses of compensatory strategies. Findings are expected to have benefits for those seeking to replicate therapy's core processes both in clinical practice and in future research. © 2016 Royal College of Speech and Language Therapists.

Use of mass media campaigns to change health behaviour

PubMed Central

Wakefield, Melanie A.; Loken, Barbara; Hornik, Robert C.

2014-01-01

Mass media campaigns are widely used to expose high proportions of large populations to messages through routine uses of existing media, such as television, radio, and newspapers. Exposure to such messages is, therefore, generally passive. Such campaigns are frequently competing with factors, such as pervasive product marketing, powerful social norms, and behaviours driven by addiction or habit. In this Review we discuss the outcomes of mass media campaigns in the context of various health-risk behaviours (eg, use of tobacco, alcohol, and other drugs, heart disease risk factors, sex-related behaviours, road safety, cancer screening and prevention, child survival, and organ or blood donation). We conclude that mass media campaigns can produce positive changes or prevent negative changes in health-related behaviours across large populations. We assess what contributes to these outcomes, such as concurrent availability of required services and products, availability of community-based programmes, and policies that support behaviour change. Finally, we propose areas for improvement, such as investment in longer better-funded campaigns to achieve adequate population exposure to media messages. PMID:20933263

Use of mass media campaigns to change health behaviour.

PubMed

Wakefield, Melanie A; Loken, Barbara; Hornik, Robert C

2010-10-09

Mass media campaigns are widely used to expose high proportions of large populations to messages through routine uses of existing media, such as television, radio, and newspapers. Exposure to such messages is, therefore, generally passive. Such campaigns are frequently competing with factors, such as pervasive product marketing, powerful social norms, and behaviours driven by addiction or habit. In this Review we discuss the outcomes of mass media campaigns in the context of various health-risk behaviours (eg, use of tobacco, alcohol, and other drugs, heart disease risk factors, sex-related behaviours, road safety, cancer screening and prevention, child survival, and organ or blood donation). We conclude that mass media campaigns can produce positive changes or prevent negative changes in health-related behaviours across large populations. We assess what contributes to these outcomes, such as concurrent availability of required services and products, availability of community-based programmes, and policies that support behaviour change. Finally, we propose areas for improvement, such as investment in longer better-funded campaigns to achieve adequate population exposure to media messages. Copyright © 2010 Elsevier Ltd. All rights reserved.

Cultural heuristics in risk assessment of HIV/AIDS.

PubMed

Bailey, Ajay; Hutter, Inge

2006-01-01

Behaviour change models in HIV prevention tend to consider that risky sexual behaviours reflect risk assessments and that by changing risk assessments behaviour can be changed. Risk assessment is however culturally constructed. Individuals use heuristics or bounded cognitive devices derived from broader cultural meaning systems to rationalize uncertainty. In this study, we identify some of the cultural heuristics used by migrant men in Goa, India to assess their risk of HIV infection from different sexual partners. Data derives from a series of in-depth interviews and a locally informed survey. Cultural heuristics identified include visual heuristics, heuristics of gender roles, vigilance and trust. The paper argues that, for more culturally informed HIV/AIDS behaviour change interventions, knowledge of cultural heuristics is essential.

Changes in Alcohol Behaviour among Adolescents in North-West Russia between 1995 and 2004

PubMed Central

Verho, Anastasiya; Laatikainen, Tiina; Vartiainen, Erkki; Puska, Pekka

2012-01-01

Background. Among Russian adults, alcohol consumption with binge drinking was high and increased during past decades. Little is known regarding adolescents' drinking. The present study investigates changes in alcohol-related behaviour among Russian youth between 1995 and 2004. Methods. A cross-sectional survey was conducted among the 15-year-old youths from all schools in Pitkäranta, Republic of Karelia, Russia. In 1995, 385 students participated (response 95%), in 2004—395 (response 85%). Results. The proportion of abstainers decreased: boys from 26% to 13% (P = 0.002), girls from 23% to 12% (P = 0.007). The age of first alcohol consumption decreased among both genders. First alcohol drinking with friends increased among boys from 65% to 79% (P = 0.031), among girls from 49% to 70% (P = 0.001). Weekly drinking increased: boys from 13% to 28% (P < 0.001), girls from 6% to 15% (P = 0.001). The prevalence on inebriation increased among girls from 45% to 60% (P = 0.012), beer consumption from 8% to 21% (P = 0.006) by 2004. Gender differences were less prominent in 2004. Conclusion. Negative changes: early drinking initiation and more frequent alcohol consumption were observed among Russian youth by 2004. Regular monitoring, effective policy measures, and health education are necessary to prevent further increase in alcohol consumption and subsequent burden of alcohol-related diseases in Russia. PMID:23056064

CEOS Theory: A Comprehensive Approach to Understanding Hard to Maintain Behaviour Change.

PubMed

Borland, Ron

2017-03-01

This paper provides a brief introduction to CEOS theory, a comprehensive theory for understanding hard to maintain behaviour change. The name CEOS is an acronym for Context, Executive, and Operational Systems theory. Behaviour is theorised to be the result of the moment by moment interaction between internal needs (operational processes) in relation to environmental conditions, and for humans this is augmented by goal-directed, executive action which can transcend immediate contingencies. All behaviour is generated by operational processes. Goal-directed behaviours only triumph over contingency-generated competing behaviours when operational processes have been sufficiently activated to support them. Affective force can be generated around executive system (ES) goals from such things as memories of direct experience, vicarious experience, and emotionally charged communications mediated through stories the person generates. This paper makes some refinements and elaborations of the theory, particularly around the role of feelings, and of the importance of stories and scripts for facilitating executive action. It also sketches out how it reconceptualises a range of issues relevant to behaviour change. CEOS provides a framework for understanding the limitations of both informational and environmental approaches to behaviour change, the need for self-regulatory strategies and for taking into account more basic aspects of human functioning. © 2016 The Authors. Applied Psychology: Health and Well-Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.

Evidence that long-lasting potentiation in limbic circuits mediating defensive behaviour in the right hemisphere underlies pharmacological stressor (FG-7142) induced lasting increases in anxiety-like behaviour: role of benzodiazepine receptors.

PubMed

Adamec, R E

2000-01-01

The hypothesis that benzodiazepine receptors mediate initiation of lasting behavioural changes induced by FG-7142 was supported in this study. Behavioural changes normally induced by FG-7142 were blocked by prior administration of the competitive benzodiazepine receptor blocker, Flumazenil. When cats were subsequently given FG-7142 alone, the drug produced lasting behavioural changes in species characteristic defensive responses to rodent and cat vocal threat. FG-7142 also induced long-lasting potentiation (LLP) of evoked potentials in a number of efferent pathways from the amygdala in both hemispheres. Flumazenil given prior to FG-7142 blocked LLP in all but one of the amygdala efferent pathways, suggesting benzodiazepine receptor dependence of initiation of LLP. Three physiological changes were most closely correlated with behavioural changes. LLP in the right amygdalo-ventromedial hypothalamic (VMH) and amygdalo-periacqueductal gray (PAG) pathways coincided closely with behavioural changes, as did a reduced threshold for the right amygdalo-VMH evoked potential. Administration of Flumazenil after FG-7142 returned defensive behaviour to pre FG-7142 baseline levels in a drug-dependent manner. At the same time LLP only in the right amygdalo-PAG pathway was reduced by Flumazenil. LLP in other pathways and amygdalo-VMH threshold were unaltered by Flumazenil. Moreover, covariance analyses indicated that increased defensiveness depended solely on LLP in the right amygdalo-PAG. These findings support the view that maintenance of lasting increases in defensive behaviour depend upon LLP of excitatory neural transmission between amygdala and lateral column of the PAG in the right hemisphere. Moreover, FG-7142 may be a useful model of the effects of traumatic stressors on limbic system function in anxiety, especially in view of the recent data in humans implicating right hemispheric function in persisting negative affective states in post-traumatic stress disorder.

Fluvial Apophenia

NASA Astrophysics Data System (ADS)

Coulthard, Tom; Armitage, John

2017-04-01

Apophenia describes the experience of seeing meaningful patterns or connections in random or meaningless data. Francis Bacon was one of the first to identify its role as a "human understanding is of its own nature prone to suppose the existence of more order and regularity in the world than it finds". Examples include pareidolia (seeing shapes in random patterns), gamblers fallacy (feeling past events alter probability), confirmation bias (bias to supporting a hypothesis rather than disproving), and he clustering illusion (an inability to recognise actual random data, instead believing there are patterns). Increasingly, researchers use records of past floods stored in sedimentary archives to make inferences about past environments, and to describe how climate and flooding may have changed. However, it is a seductive conclusion, to infer that drivers of landscape change can lead to changes in fluvial behaviour. Using past studies and computer simulations of river morphodynamics we explore how meaningful the link between drivers and fluvial changes is. Simple linear numerical models would suggest a direct relation between cause and effect, despite the potential for thresholds, phase changes, time-lags and damping. However, a comparatively small increase in model complexity (e.g. the Stream Power law) introducing non-linear behaviour and Increasing the complexity further can lead to the generation of time-dependent outputs despite constant forcing. We will use this range of findings to explore how apophenia may manifest itself in studies of fluvial systems, what this can mean and how we can try to account for it. Whilst discussed in the context of fluvial systems the concepts and inferences from this presentation are highly relevant to many other studies/disciplines.

Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review.

PubMed

Srigley, J A; Corace, K; Hargadon, D P; Yu, D; MacDonald, T; Fabrigar, L; Garber, G

2015-11-01

Despite the importance of hand hygiene in preventing transmission of healthcare-associated infections, compliance rates are suboptimal. Hand hygiene is a complex behaviour and psychological frameworks are promising tools to influence healthcare worker (HCW) behaviour. (i) To review the effectiveness of interventions based on psychological theories of behaviour change to improve HCW hand hygiene compliance; (ii) to determine which frameworks have been used to predict HCW hand hygiene compliance. Multiple databases and reference lists of included studies were searched for studies that applied psychological theories to improve and/or predict HCW hand hygiene. All steps in selection, data extraction, and quality assessment were performed independently by two reviewers. The search yielded 918 citations; seven met eligibility criteria. Four studies evaluated hand hygiene interventions based on psychological frameworks. Interventions were informed by goal setting, control theory, operant learning, positive reinforcement, change theory, the theory of planned behaviour, and the transtheoretical model. Three predictive studies employed the theory of planned behaviour, the transtheoretical model, and the theoretical domains framework. Interventions to improve hand hygiene adherence demonstrated efficacy but studies were at moderate to high risk of bias. For many studies, it was unclear how theories of behaviour change were used to inform the interventions. Predictive studies had mixed results. Behaviour change theory is a promising tool for improving hand hygiene; however, these theories have not been extensively examined. Our review reveals a significant gap in the literature and indicates possible avenues for novel research. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

The effectiveness of behaviour change interventions to increase physical activity participation in people with multiple sclerosis: a systematic review and meta-analysis.

PubMed

Sangelaji, Bahram; Smith, Catherin M; Paul, Lorna; Sampath, Kesava Kovanur; Treharne, Gareth J; Hale, Leigh Anne

2016-06-01

A systematic review and meta-analysis was conducted to illustrate whether people with multiple sclerosis engage in more physical activity following behaviour change interventions. MEDLINE, CINAHL, PubMed, Web of Sciences, Cochrane Library, SCOPUS, EMBASE and PEDro were searched from their inception till 30 April 2015. Randomized and clinical controlled trials that used behaviour change interventions to increase physical activity in people with multiple sclerosis were selected, regardless of type or duration of multiple sclerosis or disability severity. Data extraction was conducted by two independent reviewers and the Cochrane Collaboration's recommended method was used to assess the risk of bias of each included study. A total of 19 out of 573 studies were included. Focusing on trials without risk of bias, meta-analysis showed that behaviour change interventions can significantly increase physical activity participation (z = 2.20, p = 0.03, standardised main difference 0.65, 95% confidence interval 0.07 to 1.22, 3 trials, I(2) = 68%) (eight to 12 weeks' duration). Behaviour change interventions did not significantly impact on the physical components of quality of life or fatigue. Behaviour change interventions provided for relatively short duration (eight to 12 weeks) may increase the amount of physical activity people with multiple sclerosis engage in, but appear to have no effect on the physical components of quality of life and fatigue. Further high quality investigations of the efficacy of behaviour change interventions to increase physical activity participation that focus on dose, long-term impact and method of delivery are warranted for people with multiple sclerosis. © The Author(s) 2015.

Prevalence and risk factors of maladaptive behaviour in young children with Autistic Disorder

PubMed Central

Hartley, S. L.; Sikora, D. M.; McCoy, R.

2010-01-01

Background Children with Autistic Disorder (AD) evidence more co-occurring maladaptive behaviours than their typically developing peers and peers with intellectual disability because of other aetiologies. The present study investigated the prevalence of Clinically Significant maladaptive behaviours during early childhood and identified at-risk subgroups of young children with AD. Method Parents rated their child’s maladaptive behaviours on the Child Behaviour Checklist (CBCL) in 169 children with AD aged 1.5 to 5.8 years. Results One-third of young children with AD had a CBCL Total Problems score in the Clinically Significant range. The highest percentage of Clinically Significant scores were in the Withdrawal, Attention, and Aggression CBCL syndrome scales. There was a high degree of co-morbidity of Clinically Significant maladaptive behaviours. Several subject characteristic risk factors for maladaptive behaviours were identified. Conclusions Findings highlight the need to include behavioural management strategies aimed at increasing social engagement, sustained attention and decreasing aggressive behaviour in comprehensive intervention programmes for young children with AD. PMID:18444989

Achieving success in intervention studies: an analysis of variable staff engagement across three midwifery settings.

PubMed

Henderson, Amanda; Schoonbeek, Sue; Ossenberg, Christine; Caddick, Alison; Wing, Diane; Capell, Lorna; Gould, Karen

2014-06-01

To critically analyse the success of staff's behaviour changes in the practice setting. Facilitators were employed to initiate and facilitate a four-step process (optimism, overcoming obstacles, oversight and reinforcing outcomes) that fostered development of behaviours consistent with learning in everyday practice. Many studies seek to engage staff in workplace behaviour improvement. The success of such studies is highly variable. Little is known about the work of the facilitator in ensuring success. Understanding the contextual factors that contribute to effective facilitation of workplace improvement is essential to ensure best use of resources. Mixed methods Facilitators employed a four-step process - optimism, overcoming obstacles, oversight and reinforcing outcomes - to stage behaviour change implementation. The analysis of staff engagement in behaviour changes was assessed through weekly observation of workplaces, informal discussions with staff and facilitator diaries. The impact of behaviour change was informed through pre- and postsurveys on staff's perception across three midwifery sites. Surveys measured (1) midwives' perception of support for their role in facilitating learning (Support Instrument for Nurses Facilitating the Learning of Others) and (2) development of a learning culture in midwifery practice settings (Clinical Learning Organisational Culture Survey). Midwives across three sites completed the presurvey (n = 216) and postsurvey (n = 90). Impact varied according to the degree that facilitators were able to progress teams through four stages necessary for change (OOORO). Statistically significant results were apparent in two subscales important for supporting staff, namely teamwork and acknowledgement; in the two areas, facilitators worked through 'obstacles' and coached staff in performing the desired behaviours and rewarded them for their success. Elements of the learning culture also statistically improved in one site. Findings suggest behaviour change success is dependent on facilitators to systematically engage staff through all four stages of implementation. It is important that investment is made to commitment and resources to all four stages before embarking on change processes. © 2013 John Wiley & Sons Ltd.

Characterising an implementation intervention in terms of behaviour change techniques and theory: the 'Sepsis Six' clinical care bundle.

PubMed

Steinmo, Siri; Fuller, Christopher; Stone, Sheldon P; Michie, Susan

2015-08-08

Sepsis is a major cause of death from infection, with a mortality rate of 36 %. This can be halved by implementing the 'Sepsis Six' evidence-based care bundle within 1 h of presentation. A UK audit has shown that median implementation rates are 27-47 % and interventions to improve this have demonstrated minimal effects. In order to develop more effective implementation interventions, it is helpful to obtain detailed characterisations of current interventions and to draw on behavioural theory to identify mechanisms of change. The aim of this study was to illustrate this process by using the Behaviour Change Wheel; Behaviour Change Technique (BCT) Taxonomy; Capability, Opportunity, Motivation model of behaviour; and Theoretical Domains Framework to characterise the content and theoretical mechanisms of action of an existing intervention to implement Sepsis Six. Data came from documentary, interview and observational analyses of intervention delivery in several wards of a UK hospital. A broad description of the intervention was created using the Template for Intervention Description and Replication framework. Content was specified in terms of (i) component BCTs using the BCT Taxonomy and (ii) intervention functions using the Behaviour Change Wheel. Mechanisms of action were specified using the Capability, Opportunity, Motivation model and the Theoretical Domains Framework. The intervention consisted of 19 BCTs, with eight identified using all three data sources. The BCTs were delivered via seven functions of the Behaviour Change Wheel, with four ('education', 'enablement', 'training' and 'environmental restructuring') supported by the three data sources. The most frequent mechanisms of action were reflective motivation (especially 'beliefs about consequences' and 'beliefs about capabilities') and psychological capability (especially 'knowledge'). The intervention consisted of a wide range of BCTs targeting a wide range of mechanisms of action. This study demonstrates the utility of the Behaviour Change Wheel, the BCT Taxonomy and the Theoretical Domains Framework, tools recognised for providing guidance for intervention design, for characterising an existing intervention to implement evidence-based care.

Can We Identify the Active Ingredients of Behaviour Change Interventions for Coronary Heart Disease Patients? A Systematic Review and Meta-Analysis.

PubMed

Goodwin, Laura; Ostuzzi, Giovanni; Khan, Nadia; Hotopf, Matthew H; Moss-Morris, Rona

2016-01-01

The main behaviour change intervention available for coronary heart disease (CHD) patients is cardiac rehabilitation. There is little recognition of what the active ingredients of behavioural interventions for CHD might be. Using a behaviour change technique (BCT) framework to code existing interventions may help to identify this. The objectives of this systematic review are to determine the effectiveness of CHD behaviour change interventions and how this may be explained by BCT content and structure. A systematic search of Medline, EMBASE and PsycInfo electronic databases was conducted over a twelve year period (2003-2015) to identify studies which reported on behaviour change interventions for CHD patients. The content of the behaviour change interventions was coded using the Coventry Aberdeen and London-Refined (CALO-RE) taxonomy. Meta-regression analyses examined the BCT content as a predictor of mortality. Twenty two papers met the criteria for this review, reporting data on 16,766 participants. The most commonly included BCTs were providing information, and goal setting. There was a small but significant effect of the interventions on smoking (risk ratio (RR) = 0.89, 95% CI 0.81-0.97). The interventions did not reduce the risk of CHD events (RR = 0.86, 95% CI 0.68, 1.09), but significantly reduced the risk of mortality (RR = 0.82, 95% CI 0.69, 0.97). Sensitivity analyses did not find that any of the BCT variables predicted mortality and the number of BCTs included in an intervention was not associated with mortality (β = -0.02, 95% CI -0.06-0.03). Behaviour change interventions for CHD patients appear to have a positive impact on a number of outcomes. Using an existing BCT taxonomy to code the interventions helped us to understand which were the most commonly used techniques, providing information and goal setting, but not the active components of these complex interventions.

The use of memory recall strategies in the management of behaviours associated with dementia.

PubMed

Stern, Cindy; Gibb, Heather

2011-01-01

Background Many people who develop dementia are placed in long-term care facilities, as they often require high-level care that can no longer be provided by family and friends. As yet no cure for dementia exists and management of dementia-associated behaviours can be complex. Mental recall is one type of behaviour therapy whereby a representation of past experience is elicited. To date there has not been a systematic review conducted that focuses specifically on recall techniques for managing behaviours associated with dementia.Aim To determine the effects of using recall strategies in managing behaviours associated with dementia. Types of studies Any quantitative and qualitative study designs were considered.Types of participants People aged over 60 years who had a clinical diagnosis of dementia and displayed behaviours associated with dementia.Types of intervention Any behaviour therapy modality that used recall was considered for this review. For the purpose of this review memory or mental recall related to the ability to recall previously encountered items from memory.Types of outcome measures The outcome of interest was a positive change in the behaviour associated with dementia.Search strategy Using a collection of keywords and MeSH terms, a selection of electronic bibliographic databases were searched for both published and unpublished studies between the years 1990 and 2009. A three-step search strategy was utilised: firstly an initial limited search of MEDLINE and CINAHL was undertaken, followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms was then performed across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies.Critical appraisal Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review.Data extraction and synthesis Data was extracted from papers included in the review using the appropriate standardised data extraction tool. Due to the heterogeneity of papers statistical pooling was not appropriate and the findings are summarised in narrative form.Results Only three papers met inclusion criteria; one quasi-experimental and two case series.Methodological quality was weak and caution is required when interpreting results. The quasi-experimental study focussed on teaching and supporting spousal caregivers of people with dementia to use a cueing system to modify the frequency of repetitive verbalisations. Results suggested that for those caregivers who followed the intervention as advised by the therapist, reductions in verbalisations were demonstrated compared to pre-intervention. There was however, a wide variation in the severity of the problem, with results showing a variable amount of change in vocalisations following the intervention. The results of the case series suggest that incorporating a behavioural approach that includes a cueing system with or without fading cues may be successful for some residents with dementia but not all.Implications for practice Due to the strength of the results no conclusive recommendations can be made regarding the utilisation of cueing systems to change problem behaviours associated with dementia. There is weak evidence to suggest that recall approaches can be of benefit to some people with dementia who exhibit behaviours such as demanding and repetitive verbalisations and aggression. Issues regarding expertise in developing and delivering such interventions, as well as training and support of caregivers, both formal and informal, will need to be considered.Implications for research Primary research utilising rigorous research methods that evaluate the effects of cueing systems to modify behaviours associated with dementia is imperative in order to recommend or refute such a behavioural approach. Other issues such as factors likely to affect a person's response to recall strategies and the optimal training methods for staff and informal caregivers of people with dementia, including strategies for encouragement and support should be considered.

Oath-taking: a divine prescription for health-related behaviour change?

PubMed

Buetow, Stephen A; Adams, Peter

2010-03-01

Approaches to personal behaviour change include contractual and negotiation models. This paper elaborates these partnership models by linking a religious act to desired behaviour change beyond narrow and specific domains, such as promotion of sexual abstinence. It discusses the hypothesis that oath-taking can facilitate positive, health-related behaviour change in human individuals. The change must be desired by these individuals when they nevertheless feel conflicted in their motives, and believe in a divine presence to which they can oath-take. In support of this meta-hypothesis of the effectiveness of oath-taking to a hypothetical divinity, we first describe the nature of oaths and oath-taking, including legitimacy and satisfaction conditions, and then postulate how ten interrelated sets of mechanisms can be expected to facilitate oath-keeping. We playfully and heuristically express these mechanisms as 'ten commandments'. Constituting a divine prescription for health-related change, the mechanisms require oath-takers to: believe in the oath, recognise oath-taking as an established and legitimate social behaviour, crystallise the content of the oath, declare the oath aloud, oath-take privately if they prefer, commit to relationships that support oath-taking, replace their relationship with the unwanted behaviour, sanctify the divine presence, honour obligations produced by the oath-taking, and fear oath-breaking. Limitations of oath-taking are then considered as are some of the implications of our arguments. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Assessing the feasibility of distributing child poison safety messages through three existing parent information pathways.

PubMed

Gibbs, L; Waters, E; Robinson, J; Young, S; Hutchinson, A

2009-12-01

The objective of this exploratory study was to assess the feasibility of increasing parents' poison safety awareness and behaviours using existing pathways. The aim was to compare the release of true stories of child unintentional poisoning via three modes: (a) parent "networker"; (b) maternal and child health nurse; (c) the media. The stories spread by the parent networker were readily recalled by the parents, with examples of changed behaviour and spreading of the stories. Parents who were part of the maternal and child health nurse strategy were not able to recall the stories without prompts. The media strategy could not be implemented because of difficulties finding parents ready to publicise their story. Given that it is an exploratory study, it is not possible to draw conclusions about the effectiveness of each of the intervention strategies. However, it appears that a low-resource intervention using stories shared via parent networkers may have exciting potential as a health promotion tool. A stronger study design to examine its effectiveness is proposed.

Magnetization and photomagnetic effects in diluted magnetic microcrystalline Cd 1-xMn xTe

NASA Astrophysics Data System (ADS)

He, X.-F.; Kotlicki, A.; Dosanjh, P.; Turrell, B. G.; Carolan, J. F.; Jimenez-Sandoval, S.; Lozano-Tovar, P.

1993-12-01

We have investigated the magnetic and photomagnetic properties of microcrystalline Cd 1-xMn xTe prepared by rf sputtering. Magnetization measurements were carried out using an rf SQUID magnetometer in the temperature range of 1.8 to 300 K at various magnetic fields up to 5.5 T. For temperatures above 40 K, the sample showed Curie-Weiss behaviour with a Curie temperature indicating predominantly antiferromagnetic interactions. A spin-glass phase transition was also observed. Photomagnetization measurements were performed using a fibre-optic system. The light was shone onto the sample utilizing an optical fibre and the subsequent change in the magnetization was sensed by the SQUID. Photo-induced magnetization was observed when the sample was illuminated by unpolarized light. Our results enable qualitative and quantitative conclusions to be drawn on the magnetic behaviour and the interplay between optical and magnetic properties of the diluted magnetic microcrystalline semiconductors. PACS: 68.55.Gi; 75.50.Pp.

Adsorption behaviour of SF6 decomposed species onto Pd4-decorated single-walled CNT: a DFT study

NASA Astrophysics Data System (ADS)

Cui, Hao; Zhang, Xiaoxing; Zhang, Jun; Tang, Ju

2018-07-01

Metal nanocluster decorated single-walled carbon nanotubes (SWCNT) with improved adsorption behaviour towards gaseous molecules compared with intrinsic ones, have been widely accepted as a workable media for gas interaction due to their strong catalysis. In this work, Pd4 cluster is determined as a catalytic centre to theoretically study the adsorption property of Pd4-decorated SWCNT upon SF6 decomposed species. Results indicate that Pd4-SWCNT possessing good responses and sensitivities towards three composed species of SF6 could realise selective detection for them according to the different conductivity changes resulting from the varying adsorption ability. The response of Pd4-SWCNT upon three molecules in order is SOF2 > H2S > SO2, and the conductivity of the proposed material is about to increase in SOF2 and H2S systems, while declining in SO2 system. Such conclusions would be helpful for experimentalists to explore novel SWCNT-based sensors in evaluating the operating state of SF6 insulation devices.

Improving Diabetes care through Examining, Advising, and prescribing (IDEA): protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals

PubMed Central

2014-01-01

Background New clinical research findings may require clinicians to change their behaviour to provide high-quality care to people with type 2 diabetes, likely requiring them to change multiple different clinical behaviours. The present study builds on findings from a UK-wide study of theory-based behavioural and organisational factors associated with prescribing, advising, and examining consistent with high-quality diabetes care. Aim To develop and evaluate the effectiveness and cost of an intervention to improve multiple behaviours in clinicians involved in delivering high-quality care for type 2 diabetes. Design/methods We will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes: prescribing for hypertension; prescribing for glycaemic control; providing physical activity advice; providing nutrition advice; providing on-going education; and ensuring that feet have been examined. The primary outcome will be the proportion of patients appropriately prescribed and examined (using anonymised computer records), and advised (using anonymous patient surveys) at 12 months. We will use behaviour change techniques targeting motivational, volitional, and impulsive factors that we have previously demonstrated to be predictive of multiple health professional behaviours involved in high-quality type 2 diabetes care. We will also investigate whether the intervention was delivered as designed (fidelity) by coding audiotaped workshops and interventionist delivery reports, and operated as hypothesised (process evaluation) by analysing responses to theory-based postal questionnaires. In addition, we will conduct post-trial qualitative interviews with practice teams to further inform the process evaluation, and a post-trial economic analysis to estimate the costs of the intervention and cost of service use. Discussion Consistent with UK Medical Research Council guidance and building on previous development research, this pragmatic cluster randomised trial will evaluate the effectiveness of a theory-based complex intervention focusing on changing multiple clinical behaviours to improve quality of diabetes care. Trial registration ISRCTN66498413. PMID:24886606

Using a Smartphone Application to Promote Healthy Dietary Behaviours and Local Food Consumption

PubMed Central

Gilliland, Jason; Sadler, Richard; Clark, Andrew; O'Connor, Colleen; Milczarek, Malgorzata; Doherty, Sean

2015-01-01

Smartphone “apps” are a powerful tool for public health promotion, but unidimensional interventions have been ineffective at sustaining behavioural change. Various logistical issues exist in successful app development for health intervention programs and for sustaining behavioural change. This study reports on a smartphone application and messaging service, called “SmartAPPetite,” which uses validated behaviour change techniques and a behavioural economic approach to “nudge” users into healthy dietary behaviours. To help gauge participation in and influence of the program, data were collected using an upfront food survey, message uptake tracking, experience sampling interviews, and a follow-up survey. Logistical and content-based issues in the deployment of the messaging service were subsequently addressed to strengthen the effectiveness of the app in changing dietary behaviours. Challenges included creating relevant food goal categories for participants, providing messaging appropriate to self-reported food literacy and ensuring continued participation in the program. SmartAPPetite was effective at creating a sense of improved awareness and consumption of healthy foods, as well as drawing people to local food vendors with greater frequency. This work serves as a storehouse of methods and best practices for multidimensional local food-based smartphone interventions aimed at improving the “triple bottom line” of health, economy, and environment. PMID:26380298

Using a Smartphone Application to Promote Healthy Dietary Behaviours and Local Food Consumption.

PubMed

Gilliland, Jason; Sadler, Richard; Clark, Andrew; O'Connor, Colleen; Milczarek, Malgorzata; Doherty, Sean

2015-01-01

Smartphone "apps" are a powerful tool for public health promotion, but unidimensional interventions have been ineffective at sustaining behavioural change. Various logistical issues exist in successful app development for health intervention programs and for sustaining behavioural change. This study reports on a smartphone application and messaging service, called "SmartAPPetite," which uses validated behaviour change techniques and a behavioural economic approach to "nudge" users into healthy dietary behaviours. To help gauge participation in and influence of the program, data were collected using an upfront food survey, message uptake tracking, experience sampling interviews, and a follow-up survey. Logistical and content-based issues in the deployment of the messaging service were subsequently addressed to strengthen the effectiveness of the app in changing dietary behaviours. Challenges included creating relevant food goal categories for participants, providing messaging appropriate to self-reported food literacy and ensuring continued participation in the program. SmartAPPetite was effective at creating a sense of improved awareness and consumption of healthy foods, as well as drawing people to local food vendors with greater frequency. This work serves as a storehouse of methods and best practices for multidimensional local food-based smartphone interventions aimed at improving the "triple bottom line" of health, economy, and environment.

Health behaviour models and patient preferences regarding nutrition and physical activity after breast or prostate cancer diagnosis.

PubMed

Green, H J; Steinnagel, G; Morris, C; Laakso, E L

2014-09-01

This study aimed to improve understanding of prostate and breast cancer survivors' physical activity and nutrition and the association of these behaviours with two models. The first model, the Commonsense Self-Regulation Model (CSM), addresses cognitive and emotional perceptions of illness whereas the Transtheoretical Model (TTM) focuses on stage of readiness to engage in a behaviour. Participants who had been diagnosed with either breast (n = 145) or prostate cancer (n = 92) completed measures of demographic and health information, illness representations, stage of change, self-efficacy and preferences regarding health behaviour interventions. Health behaviours in the past seven days were measured via the International Physical Activity Questionnaire and concordance with national dietary guidelines. As hypothesised, TTM variables (stage of change and self-efficacy) demonstrated independent associations with physical activity and nutrition in regression analyses. CSM variables were not independently associated with absolute levels of health behaviours but both TTM and CSM variables were independently associated with self-reported changes in physical activity and nutrition following prostate or breast cancer diagnosis. Many participants reported high interest in receiving lifestyle interventions, particularly soon after diagnosis. Results supported application of the TTM and CSM models for strengthening behaviour change intentions and actions in breast and prostate cancer survivors. © 2014 John Wiley & Sons Ltd.

Health behaviour change theories: contributions to an ICF-based behavioural exercise therapy for individuals with chronic diseases.

PubMed

Geidl, Wolfgang; Semrau, Jana; Pfeifer, Klaus

2014-01-01

The purpose of this perspective is (1) to incorporate recent psychological health behaviour change (HBC) theories into exercise therapeutic programmes, and (2) to introduce the International Classification of Functioning (ICF)-based concept of a behavioural exercise therapy (BET). Relevant personal modifiable factors of physical activity (PA) were identified based on three recent psychological HBC theories. Following the principles of intervention mapping, a matrix of proximal programme objectives specifies desirable parameter values for each personal factor. As a result of analysing reviews on behavioural techniques and intervention programmes of the German rehabilitation setting, we identified exercise-related techniques that impact the personal determinants. Finally, the techniques were integrated into an ICF-based BET concept. Individuals' attitudes, skills, emotions, beliefs and knowledge are important personal factors of PA behaviour. BET systematically addresses these personal factors by a systematic combination of adequate exercise contents with related behavioural techniques. The presented 28 intervention techniques serve as a theory-driven "tool box" for designing complex BET programmes to promote PA. The current paper highlights the usefulness of theory-based integrative research in the field of exercise therapy, offers explicit methods and contents for physical therapists to promote PA behaviour, and introduces the ICF-based conceptual idea of a BET. Implications for Rehabilitation Irrespective of the clients' indication, therapeutic exercise programmes should incorporate effective, theory-based approaches to promote physical activity. Central determinants of physical activity behaviour are a number of personal factors: individuals' attitudes, skills, emotions, beliefs and knowledge. Clinicians implementing exercise therapy should set it within a wider theoretical framework including the personal factors that influence physical activity. To increase exercise-adherence and promote long-term physical activity behaviour change, the concept of a behavioural exercise therapy (BET) offers a theory-based approach to systematically address relevant personal factors with a combination of adequate contents of exercise with exercise-related techniques of behaviour change.

Behavioural disorders in children with epilepsy: early improvement after surgery

PubMed Central

Lendt, M; Helmstaedter, C; Kuczaty, S; Schramm, J; Elger, C

2000-01-01

OBJECTIVES—Epilepsy surgery has proved to be a successful intervention method to achieve freedom from seizures or seizure relief in children with pharmacoresistant epilepsy. Long term studies on operated children suggest that behavioural disorders, which are often seen before surgery, improve after surgery. However, the early postoperative development of behavioural problems has not been systematically evaluated.
METHODS—Parents of 28 children with pharmacoresistant focal epilepsies completed the child behaviour checklist (CBCL) preoperatively and 3 months after surgery. Surgeries comprised 24 focal resections (13 temporal, 11 extratemporal), two hemispherectomies, and two callosotomies. Twenty eight conservatively treated children with comparable CBCL scores served as a control group. A repeated measurement multivariate analysis of variance (MANOVA) and a regression analysis were computed to compare the development of behaviour between both groups and to identify predictors of postoperative changes in behaviour.
RESULTS—Preoperatively 39% of the children exhibited significant behavioural problems, a further 11% were within the borderline range. The MANOVA disclosed a significant interaction between time of examination and group (F=2.23, p<0.05). The surgery group showed significant improvements on the scales "internalising problems", "externalising problems", "attention problems", and "thought problems". Behavioural problems in the control group, however, remained unchanged. No changes were seen in social problems in both groups. The significant predictor of total behavioural improvement was a good seizure outcome (R2=0.11, p<0.05). Age, sex, onset, and duration of epilepsy, the site of the focus, and changes in antiepileptic drug regimen did not influence changes in behaviour.
CONCLUSIONS—The data demonstrate an early improvement of behavioural problems after epilepsy surgery in children. The behavioural improvements can be assumed to result directly from the removal of the epileptic focus. They are not predictable on the basis of information available preoperatively, but depend on the seizure outcome.

 PMID:11080225

Predicting Change in Emotional and Behavioural Problems during Inpatient Treatment in Clients with Mild Intellectual Disability

ERIC Educational Resources Information Center

Tenneij, Nienke; Didden, Robert; Koot, Hans M.

2011-01-01

Background: Little is known about client characteristics that are related to outcome during inpatient treatment of adults with mild intellectual disability (ID) and severe behavioural problems. Method: We explored variables that were related to a change in behavioural problems in 87 individuals with mild ID during inpatient treatment in facilities…

Correlational selection does not explain the evolution of a behavioural syndrome.

PubMed

Han, C S; Brooks, R C

2013-10-01

Correlated suites of behaviours, or behavioural syndromes, appear to be widespread, and yet few studies have explored how they arise and are maintained. One possibility holds that correlational selection can generate and maintain behavioural syndrome if certain behavioural combinations enjoy greater fitness than other combinations. Here we test this correlational selection hypothesis by comparing behavioural syndrome structure with a multivariate fitness surface based on reproductive success of male water striders. We measured the structure of a behavioural syndrome including dispersal ability, exploration behaviour, latency to remount and sex recognition sensitivity in males. We then measured the relationship between these behaviours and mating success in a range of sex ratio environments. Despite the presence of some significant correlational selection, behavioural syndrome structure was not associated with correlational selection on behaviours. Although we cannot conclusively reject the correlational selection hypothesis, our evidence suggests that correlational selection and resulting linkage disequilibrium might not be responsible for maintaining the strong correlations between behaviours. Instead, we suggest alternative ways in which this behavioural syndrome may have arisen and outline the need for physiological and quantitative genetic tests of these suggestions. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

Hope and cardiovascular health-promoting behaviour: education alone is not enough.

PubMed

Feldman, David B; Sills, Jonathan R

2013-01-01

We investigated hope's ability to predict cardiovascular disease (CVD) knowledge and health-promoting behaviours. Snyder defined hope as the combination of goal-directed planning and motivation, and theorised that high-hope people seek knowledge relevant to goal pursuits. We surveyed 391 Latino and Asian participants undergoing CVD risk screening, nearly all immigrants to the USA. This was a particularly important sample because, in general, these populations are considered underserved and under-researched. Pre-screening hope levels were measured. After screening and education, participants rated perceived importance of behaviour change. Behaviour change (salt/fat intake, exercise, CVD information-seeking and visiting a physician) and CVD knowledge were assessed one month later by telephone. Unexpectedly, hope did not predict knowledge. However, hope predicted self-reported behaviour change, though results differed by ethnicity. Among Asian individuals, hope × knowledge predicted reduced salt/fat, CVD information-seeking and physician visits. Among Latino individuals, hope × perceived importance of diet change predicted reduced salt/fat and hope × perceived importance of exercise change predicted increased exercise.

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study.

PubMed

Waters, Lauren; George, Alexis S; Chey, Tien; Bauman, Adrian

2012-08-08

Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis.

Supporting change in chronic disease risk behaviours for people with a mental illness: a qualitative study of the experiences of family carers.

PubMed

Bailey, Jacqueline M; Hansen, Vibeke; Wye, Paula M; Wiggers, John H; Bartlem, Kate M; Bowman, Jennifer A

2018-03-27

People with a mental illness experience greater chronic disease morbidity and mortality, and associated reduced life expectancy, compared to those without such an illness. A higher prevalence of chronic disease risk behaviours (inadequate nutrition, inadequate physical activity, tobacco smoking, and harmful alcohol consumption) is experienced by this population. Family carers have the potential to support change in such behaviours among those they care for with a mental illness. This study aimed to explore family carers': 1) experiences in addressing the chronic disease risk behaviours of their family members; 2) existing barriers to addressing such behaviours; and 3) perceptions of potential strategies to assist them to provide risk behaviour change support. A qualitative study of four focus groups (n = 31), using a semi-structured interview schedule, was conducted with carers of people with a mental illness in New South Wales, Australia from January 2015 to February 2016. An inductive thematic analysis was employed to explore the experience of carers in addressing the chronic disease risk behaviours. Two main themes were identified in family carers' report of their experiences: firstly, that health behaviours were salient concerns for carers and that they were engaged in providing support, and secondly that they perceived a bidirectional relationship between health behaviours and mental well-being. Key barriers to addressing behaviours were: a need to attend to carers' own well-being; defensiveness on behalf of the family member; and not residing with their family member; with other behaviour-specific barriers also identified. Discussion around strategies which would assist carers in providing support for health risk behaviours identified a need for improved communication and collaboration between carers and health services accessed by their family members. Additional support from general and mental health services accessed by family members is desired to assist carers to address the barriers to providing behaviour change support. Carers have the potential to support and extend health service interventions aimed at improving the chronic disease risk behaviours of people with a mental illness but may require additional information, and collaboration from services. Further research is needed to explore these constructs in a large representative sample.

Efficacy of physical activity interventions in post-natal populations: systematic review, meta-analysis and content coding of behaviour change techniques.

PubMed

Gilinsky, Alyssa Sara; Dale, Hannah; Robinson, Clare; Hughes, Adrienne R; McInnes, Rhona; Lavallee, David

2015-01-01

This systematic review and meta-analysis reports the efficacy of post-natal physical activity change interventions with content coding of behaviour change techniques (BCTs). Electronic databases (MEDLINE, CINAHL and PsychINFO) were searched for interventions published from January 1980 to July 2013. Inclusion criteria were: (i) interventions including ≥1 BCT designed to change physical activity behaviour, (ii) studies reporting ≥1 physical activity outcome, (iii) interventions commencing later than four weeks after childbirth and (iv) studies including participants who had given birth within the last year. Controlled trials were included in the meta-analysis. Interventions were coded using the 40-item Coventry, Aberdeen & London - Refined (CALO-RE) taxonomy of BCTs and study quality assessment was conducted using Cochrane criteria. Twenty studies were included in the review (meta-analysis: n = 14). Seven were interventions conducted with healthy inactive post-natal women. Nine were post-natal weight management studies. Two studies included women with post-natal depression. Two studies focused on improving general well-being. Studies in healthy populations but not for weight management successfully changed physical activity. Interventions increased frequency but not volume of physical activity or walking behaviour. Efficacious interventions always included the BCTs 'goal setting (behaviour)' and 'prompt self-monitoring of behaviour'.

Antibiotic prescribing in long-term care facilities: a qualitative, multidisciplinary investigation

PubMed Central

Fleming, Aoife; Bradley, Colin; Cullinan, Shane; Byrne, Stephen

2014-01-01

Objectives To explore healthcare professionals’ views of antibiotic prescribing in long-term care facilities (LTCFs). To use the findings to recommend intervention strategies for antimicrobial stewardship in LTCFs. Design Qualitative semistructured interviews were conducted. The data were analysed by thematic content analysis. After the interviews, the emerging findings were mapped to the theoretical domains framework (TDF), and the behaviour change wheel and behaviour change technique (BCT) taxonomy were used to recommend future intervention strategies. Participants Interviews were conducted with 37 healthcare professionals who work in LTCFs (10 general practitioners, 4 consultants, 14 nurses, 9 pharmacists) between December 2012 and March 2013. Setting Interviews were conducted in the greater Cork region. Results The main domains from the TDF which emerged were: ‘Knowledge’, ‘Environmental context and resources’, ‘Social influences’, ‘Beliefs about consequences’, ‘Memory, attention and decision making’, with the findings identifying a need for ‘Behavioural regulation’. Many participants believed that antibiotic prescribing was satisfactory at their LTCF, despite the lack of surveillance activities. Conclusions This study, using the TDF and BCT taxonomy, has found that antibiotic prescribing in LTCFs is influenced by many social and contextual factors. The challenges of the setting and patient population, the belief about consequences to the patient, and the lack of implementation of guidelines and knowledge regarding antibiotic prescribing patterns are significant challenges to address. On the basis of the study findings and the application of the TDF and BCT taxonomy, we suggest some practical intervention functions for antimicrobial stewardship in LTCFs. PMID:25377014

Association between Repeated Unpredictable Chronic Mild Stress (UCMS) Procedures with a High Fat Diet: A Model of Fluoxetine Resistance in Mice

PubMed Central

Isingrini, Elsa; Camus, Vincent; Le Guisquet, Anne-Marie; Pingaud, Maryse; Devers, Séverine; Belzung, Catherine

2010-01-01

Major depressive disorder is a debilitating disease. Unfortunately, treatment with antidepressants (ADs) has limited therapeutic efficacy since resistance to AD is common. Research in this field is hampered by the lack of a reliable natural animal model of AD resistance. Depression resistance is related to various factors, including the attendance of cardiovascular risk factors and past depressive episodes. We aimed to design a rodent model of depression resistance to ADs, associating cardiovascular risk factors with repeated unpredicted chronic mild stress (UCMS). Male BALB/c mice were given either a regular (4% fat) or a high fat diet (45% fat) and subjected to two 7-week periods of UCMS separated by 6 weeks. From the second week of each UCMS procedure, vehicle or fluoxetine (10 mg/kg, i.p.) was administrated daily. The effects of the UCMS and fluoxetine in both diet conditions were assessed using physical (coat state and body weight) and behavioural tests (the reward maze test and the splash test). The results demonstrate that during the second procedure, UCMS induced behavioural changes, including coat state degradation, disturbances in self-care behaviour (splash test) and anhedonia (reward maze test) and these were reversed by fluoxetine in the regular diet condition. In contrast, the high-fat diet regimen prevented the AD fluoxetine from abolishing the UCMS-induced changes. In conclusion, by associating UCMS—an already validated animal model of depression—with high-fat diet regimen, we designed a naturalistic animal model of AD resistance related to a sub-nosographic clinical entity of depression. PMID:20436931

The context and practice of handwashing among new mothers in Serang, Indonesia: a formative research study

PubMed Central

2013-01-01

Background This article reports on formative research into the context and practice of handwashing with soap by new mothers, which can substantially impact child morbidity and mortality. New mothers are an important target group for handwashing interventions: they are considered particularly susceptible to behaviour change and their actions can directly affect a child’s health. Methods Twenty-seven mothers of infants (including neonates) from urban and rural sub-districts of Serang were recruited and filmed over a period of eight hours. Video footage was used to identify handwashing occasions and to understand the context in which behaviour took place. Each woman was subsequently interviewed. Results Handwashing with soap was found to be infrequent, typically occurring after eating, cooking and household chores or after cleaning a child’s bottom. Handwashing before preparing food or eating was rare. Pre-pregnancy routines were reported to have been disrupted. Advice on child care comes from many sources, particularly the midwife and new child’s grandmother. Conclusions Developing interventions to change perceptions and practice of handwashing would seed an important behaviour and could save lives. New mothers represent an ideal target group for such an intervention. We suggest that interventions target an increase in handwashing with soap after contact with own and a baby’s faecal matter as part of the post-defecation hygiene routines. As the child’s grandmother is an authoritative source of information about parenting, interventions focussed on improving newborn care could target grandmothers as well as midwives. PMID:24020804

Open-mindedness can decrease persuasion amongst adolescents: The role of self-affirmation

PubMed Central

Good, Anna; Harris, Peter R; Jessop, Donna; Abraham, Charles

2015-01-01

Objectives Self-affirmation (e.g., by reflecting on important personal values) has been found to promote more open-minded appraisal of threatening health messages in at-risk adults. However, it is unclear how self-affirmation affects adolescents and whether it has differential effects on the impact of these messages amongst those at relatively lower and higher risk. The current study explored moderation by risk. Design Participants were randomly assigned to either a self-affirmation or a control condition before receiving a health message concerning physical activity. Methods Older adolescents (N = 125) completed a self-affirmation or control writing task before reading about the health consequences of not meeting recommendations to be physically active for at least 60 min daily. Most of the sample did not achieve these levels of activity (98%, N = 123). Consequently, the message informed these participants that – unless they changed their behaviour – they would be at higher risk of heart disease. Participants completed measures of responses to the message and behaviour-specific cognitions (e.g., self-efficacy) for meeting the recommendations. Results For relatively inactive participants, self-affirmation was associated with increased persuasion. However, for those who were moderately active (but not meeting recommendations), those in the self-affirmation condition were less persuaded by the message. Conclusions Whilst self-affirmation can increase message acceptance, there are circumstances when the open-mindedness it induces may decrease persuasion. The evidence provided in this study suggests that caution may be needed when recommendations are challenging and it could be considered reasonable to be sceptical about the need to change behaviour. PMID:24471418

Development of a chronic disease management program for stroke survivors using intervention mapping: The Stroke Coach

PubMed Central

Sakakibara, Brodie M.; Lear, Scott A.; Barr, Susan I.; Benavente, Oscar; Goldsmith, Charlie H.; Silverberg, Noah D.; Yao, Jennifer; Eng, Janice J.

2018-01-01

Objective To describe the systematic development of the Stroke Coach, a theory- and evidence-based intervention to improve control of lifestyle behaviour risk factors in stroke patients. Design Intervention development. Setting Community. Participants Individuals who have had a stroke. Intervention We used Intervention Mapping to guide the development of the Stroke Coach. Intervention Mapping is a systematic process used for intervention development and comprised of steps that progress from the integration of theory and evidence to the organization of realistic strategies to facilitate the development of a practical intervention supported by empirical evidence. Social Cognitive Theory was the underlying premise for behaviour change, while Control Theory methods were directed towards sustaining the changes to ensure long-term health benefits. Practical evidence-based strategies were linked to behavioural determinants to improve stroke risk factor control. Main outcome measures Not applicable. Results The Stroke Coach is a patient-centred, community-based, telehealth intervention to promote healthy lifestyles after stroke. Over six months, participants receive seven 30 to 60 minute telephone sessions with a lifestyle coach who provides education, facilitates motivation for lifestyle modification, and empowers participants to self-management their stroke risk factors. Participants also receive a self-management manual and a self-monitoring kit. Conclusion Through the use of Intervention Mapping we developed a theoretically sound and evidence-grounded intervention to improve risk factor control in stroke patients. If empirical evaluation of the Stroke Coach produces positive results, the next step will be to develop an implementation intervention to ensure successful uptake and delivery of the program in community and outpatient settings. PMID:28219685

Antibiotic stewardship: does it work in hospital practice? A review of the evidence base.

PubMed

Hulscher, M E J L; Prins, J M

2017-11-01

Guidelines for developing and implementing stewardship programmes include recommendations on appropriate antibiotic use to guide the stewardship team's choice of potential stewardship objectives. They also include recommendations on behavioural change interventions to guide the team's choice of potential interventions to ensure that professionals actually use antibiotics appropriately in daily practice. To summarize the evidence base of both appropriate antibiotic use recommendations (the 'what') and behavioural change interventions (the 'how') in hospital practice. Published systematic reviews/Medline. The literature shows low-quality evidence of the positive effects of appropriate antibiotic use in hospital patients. The literature shows that any behavioural change intervention might work to ensure that professionals actually perform appropriate antibiotic use recommendations in daily practice. Although effects were overall positive, there were large differences in improvement between studies that tested similar change interventions. The literature showed a clear need for studies that apply appropriate study designs- (randomized) controlled designs-to test the effectiveness of appropriate antibiotic use on achieving meaningful outcomes. Most current studies used designs prone to confounding by indication. In the process of selecting behavioural change interventions that might work best in a chosen setting, much should be learned from behavioural sciences. The challenge for stewardship teams lies in selecting change interventions on the careful assessment of barriers and facilitators, and on a theoretical base while linking determinants to change interventions. Future studies should apply more robust designs and evaluations when assessing behavioural change interventions. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Tomato Infection by Whitefly-Transmitted Circulative and Non-Circulative Viruses Induce Contrasting Changes in Plant Volatiles and Vector Behaviour

PubMed Central

Fereres, Alberto; Peñaflor, Maria Fernanda G. V.; Favaro, Carla F.; Azevedo, Kamila E. X.; Landi, Carolina H.; Maluta, Nathalie K. P.; Bento, José Mauricio S.; Lopes, Joao R.S.

2016-01-01

Virus infection frequently modifies plant phenotypes, leading to changes in behaviour and performance of their insect vectors in a way that transmission is enhanced, although this may not always be the case. Here, we investigated Bemisia tabaci response to tomato plants infected by Tomato chlorosis virus (ToCV), a non-circulative-transmitted crinivirus, and Tomato severe rugose virus (ToSRV), a circulative-transmitted begomovirus. Moreover, we examined the role of visual and olfactory cues in host plant selection by both viruliferous and non-viruliferous B. tabaci. Visual cues alone were assessed as targets for whitefly landing by placing leaves underneath a Plexiglas plate. A dual-choice arena was used to assess whitefly response to virus-infected and mock-inoculated tomato leaves under light and dark conditions. Thereafter, we tested the whitefly response to volatiles using an active air-flow Y-tube olfactometer, and chemically characterized the blends using gas chromatography coupled to mass spectrometry. Visual stimuli tests showed that whiteflies, irrespective of their infectious status, always preferred to land on virus-infected rather than on mock-inoculated leaves. Furthermore, whiteflies had no preference for either virus-infected or mock-inoculated leaves under dark conditions, but preferred virus-infected leaves in the presence of light. ToSRV-infection promoted a sharp decline in the concentration of some tomato volatiles, while an increase in the emission of some terpenes after ToCV infection was found. ToSRV-viruliferous whiteflies preferred volatiles emitted from mock-inoculated plants, a conducive behaviour to enhance virus spread, while volatiles from ToCV-infected plants were avoided by non-viruliferous whiteflies, a behaviour that is likely detrimental to the secondary spread of the virus. In conclusion, the circulative persistent begomovirus, ToSRV, seems to have evolved together with its vector B. tabaci to optimise its own spread. However, this type of virus-induced manipulation of vector behaviour was not observed for the semi persistent crinivirus, ToCV, which is not specifically transmitted by B. tabaci and has a much less intimate virus-vector relationship. PMID:27529271

Predictors for patient knowledge and reported behaviour regarding driving under the influence of medicines: a multi-country survey

PubMed Central

2012-01-01

Background Reports on the state of knowledge about medicines and driving showed an increased concern about the role that the use of medicines might play in car crashes. Much of patient knowledge regarding medicines comes from communications with healthcare professionals. This study, part of the DRUID (Driving Under the Influence of Drugs, alcohol and medicines) project, was carried out in four European countries and attempts to define predictors for knowledge of patients who use driving-impairing medicines. The influence of socio-demographic variables on patient knowledge was investigated as well as the influence of socio-demographic factors, knowledge and attitudes on patients' reported behaviour regarding driving under the influence of medicines. Methods Pharmacists handed out questionnaires to patients who met the inclusion criteria: 1) prevalent user of benzodiazepines, antidepressants or first generation antihistamines for systemic use; 2) age between 18 and 75 years old and 3) actual driver of a motorised vehicle. Factors affecting knowledge and reported behaviour towards driving-impairing medicines were analysed by means of multiple linear regression analysis and multiple logistic regression analysis, respectively. Results A total of 633 questionnaires (out of 3.607 that were distributed to patients) were analysed. Patient knowledge regarding driving under the influence of medicines is better in younger and higher educated patients. Information provided to or accessed by patients does not influence knowledge. Patients who experienced side effects and who have a negative attitude towards driving under the influence of impairing medicines are more prone to change their driving frequency behaviour than those who use their motorised vehicles on a daily basis or those who use anti-allergic medicines. Conclusions Changes in driving behaviour can be predicted by negative attitudes towards driving under the influence of medicines but not by patients' knowledge regarding driving under the influence of medicines. Future research should not only focus on information campaigns for patients but also for healthcare providers as this might contribute to improve communications with patients regarding the risks of driving under the influence of medicines. PMID:22264358

Tomato Infection by Whitefly-Transmitted Circulative and Non-Circulative Viruses Induce Contrasting Changes in Plant Volatiles and Vector Behaviour.

PubMed

Fereres, Alberto; Peñaflor, Maria Fernanda G V; Favaro, Carla F; Azevedo, Kamila E X; Landi, Carolina H; Maluta, Nathalie K P; Bento, José Mauricio S; Lopes, Joao R S

2016-08-11

Virus infection frequently modifies plant phenotypes, leading to changes in behaviour and performance of their insect vectors in a way that transmission is enhanced, although this may not always be the case. Here, we investigated Bemisia tabaci response to tomato plants infected by Tomato chlorosis virus (ToCV), a non-circulative-transmitted crinivirus, and Tomato severe rugose virus (ToSRV), a circulative-transmitted begomovirus. Moreover, we examined the role of visual and olfactory cues in host plant selection by both viruliferous and non-viruliferous B. tabaci. Visual cues alone were assessed as targets for whitefly landing by placing leaves underneath a Plexiglas plate. A dual-choice arena was used to assess whitefly response to virus-infected and mock-inoculated tomato leaves under light and dark conditions. Thereafter, we tested the whitefly response to volatiles using an active air-flow Y-tube olfactometer, and chemically characterized the blends using gas chromatography coupled to mass spectrometry. Visual stimuli tests showed that whiteflies, irrespective of their infectious status, always preferred to land on virus-infected rather than on mock-inoculated leaves. Furthermore, whiteflies had no preference for either virus-infected or mock-inoculated leaves under dark conditions, but preferred virus-infected leaves in the presence of light. ToSRV-infection promoted a sharp decline in the concentration of some tomato volatiles, while an increase in the emission of some terpenes after ToCV infection was found. ToSRV-viruliferous whiteflies preferred volatiles emitted from mock-inoculated plants, a conducive behaviour to enhance virus spread, while volatiles from ToCV-infected plants were avoided by non-viruliferous whiteflies, a behaviour that is likely detrimental to the secondary spread of the virus. In conclusion, the circulative persistent begomovirus, ToSRV, seems to have evolved together with its vector B. tabaci to optimise its own spread. However, this type of virus-induced manipulation of vector behaviour was not observed for the semi persistent crinivirus, ToCV, which is not specifically transmitted by B. tabaci and has a much less intimate virus-vector relationship.

Mass social contact interventions and their effect on mental health related stigma and intended discrimination

PubMed Central

2012-01-01

Background Stigma and discrimination associated with mental health problems is an important public health issue, and interventions aimed at reducing exposure to stigma and discrimination can improve the lives of people with mental health problems. Social contact has long been considered to be one of the most effective strategies for improving inter-group relations. For this study, we assess the impact of a population level social contact intervention among people with and without mental health problems. Methods This study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential): (1) improves intended stigmatising behaviour; (2) increases future willingness to disclose a mental health problem; and (3) promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England’s Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online) and 83 completed follow-up questionnaires online 4–6 weeks later. Results This study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential): (1) improves intended stigmatising behaviour; (2) increases future willingness to disclose a mental health problem; and (3) promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England’s Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online) and 83 completed follow-up questionnaires online 4–6 weeks later. Campaign events facilitated meaningful intergroup social contact between individuals with and without mental health problems. Presence of facilitating conditions predicted improved stigma-related behavioural intentions and subsequent campaign engagement 4–6 weeks following social contact. Contact, however, was not predictive of future willingness to disclose mental health problems. Conclusions Findings emphasise the importance of facilitating conditions to promote positive social contact between individuals and also suggest that social contact interventions can work on a mass level. Future research should investigate this type of large scale intervention among broader and more representative populations. PMID:22742085

Clustering of diet- and activity-related parenting practices: cross-sectional findings of the INPACT study

PubMed Central

2013-01-01

Background Various diet- and activity-related parenting practices are positive determinants of child dietary and activity behaviour, including home availability, parental modelling and parental policies. There is evidence that parenting practices cluster within the dietary domain and within the activity domain. This study explores whether diet- and activity-related parenting practices cluster across the dietary and activity domain. Also examined is whether the clusters are related to child and parental background characteristics. Finally, to indicate the relevance of the clusters in influencing child dietary and activity behaviour, we examined whether clusters of parenting practices are related to these behaviours. Methods Data were used from 1480 parent–child dyads participating in the Dutch IVO Nutrition and Physical Activity Child cohorT (INPACT). Parents of children aged 8–11 years completed questionnaires at home assessing their diet- and activity-related parenting practices, child and parental background characteristics, and child dietary and activity behaviours. Principal component analysis (PCA) was used to identify clusters of parenting practices. Backward regression analysis was used to examine the relationship between child and parental background characteristics with cluster scores, and partial correlations to examine associations between cluster scores and child dietary and activity behaviours. Results PCA revealed five clusters of parenting practices: 1) high visibility and accessibility of screens and unhealthy food, 2) diet- and activity-related rules, 3) low availability of unhealthy food, 4) diet- and activity-related positive modelling, and 5) positive modelling on sports and fruit. Low parental education was associated with unhealthy cluster 1, while high(er) education was associated with healthy clusters 2, 3 and 5. Separate clusters were related to both child dietary and activity behaviour in the hypothesized directions: healthy clusters were positively related to obesity-reducing behaviours and negatively to obesity-inducing behaviours. Conclusion Parenting practices cluster across the dietary and activity domain. Parental education can be seen as an indicator of a broader parental context in which clusters of parenting practices operate. Separate clusters are related to both child dietary and activity behaviour. Interventions that focus on clusters of parenting practices to assist parents (especially low-educated parents) in changing their child’s dietary and activity behaviour seems justified. PMID:23531232

Evidence that displacement activities facilitate behavioural transitions in ring-tailed lemurs.

PubMed

Buckley, Victoria; Semple, Stuart

2012-07-01

Displacement activities are behavioural patterns defined by their apparent irrelevance to an animal's ongoing actions. Despite being identified in diverse taxa, their function remains poorly understood. One hypothesis posits that displacement activities facilitate transitions between different behaviours by mediating changes in animals' motivational state. Under this hypothesis, it is predicted that displacement activities will occur more frequently around changes in behaviour than at other times, and also that rates of displacement activities will be higher before than after such behavioural transitions. We tested these two predictions in wild ring-tailed lemurs (Lemur catta). During focal observations, animals' behavioural state was continuously recorded, as were all occurrences of self-scratching, a common displacement activity in this species. Self-scratching rates were found to be significantly elevated both before and after behavioural transitions. Furthermore, self-scratching rates were significantly higher before behavioural transitions occurred than after. These results, therefore, provide support for the hypothesis that displacement activities facilitate behavioural transitions in L. catta. Copyright © 2012 Elsevier B.V. All rights reserved.

A strong genetic correlation underlying a behavioural syndrome disappears during development because of genotype–age interactions

PubMed Central

Class, Barbara; Brommer, Jon E.

2015-01-01

In animal populations, as in humans, behavioural differences between individuals that are consistent over time and across contexts are considered to reflect personality, and suites of correlated behaviours expressed by individuals are known as behavioural syndromes. Lifelong stability of behavioural syndromes is often assumed, either implicitly or explicitly. Here, we use a quantitative genetic approach to study the developmental stability of a behavioural syndrome in a wild population of blue tits. We find that a behavioural syndrome formed by a strong genetic correlation of two personality traits in nestlings disappears in adults, and we demonstrate that genotype–age interaction is the likely mechanism underlying this change during development. A behavioural syndrome may hence change during organismal development, even when personality traits seem to be strongly physiologically or functionally linked in one age group. We outline how such developmental plasticity has important ramifications for understanding the mechanistic basis as well as the evolutionary consequences of behavioural syndromes. PMID:26041348

Can education alter attitudes, behaviour and knowledge about organ donation? A pretest–post-test study

PubMed Central

McGlade, Donal; Pierscionek, Barbara

2013-01-01

Objective The emergence of evidence suggests that student nurses commonly exhibit concerns about their lack of knowledge of organ donation and transplantation. Formal training about organ donation has been shown to positively influence attitude, encourage communication and registration behaviours and improve knowledge about donor eligibility and brain death. The focus of this study was to determine the attitude and behaviour of student nurses and to assess their level of knowledge about organ donation after a programme of study. Design A quantitative questionnaire was completed before and after participation in a programme of study using a pretest–post-test design. Setting Participants were recruited from a University based in Northern Ireland during the period from February to April 2011. Participants 100 preregistration nurses (female : male=96 : 4) aged 18–50 years (mean (SD) 24.3 (6.0) years) were recruited. Results Participants’ knowledge improved over the programme of study with regard to the suitability of organs that can be donated after death, methods available to register organ donation intentions, organ donation laws, concept of brain death and the likelihood of recovery after brain death. Changes in attitude postintervention were also observed in relation to participants’ willingness to accept an informed system of consent and with regard to participants’ actual discussion behaviour. Conclusions The results provide support for the introduction of a programme that helps inform student nurses about important aspects of organ donation. PMID:24381257

Effects of a Range-Expanding Sea Urchin on Behaviour of Commercially Fished Abalone

PubMed Central

Strain, Elisabeth M. A.; Johnson, Craig R.; Thomson, Russell J.

2013-01-01

Background Global climate change has resulted in a southerly range expansion of the habitat modifying sea urchin Centrostephanus rodgersii to the east coast of Tasmania, Australia. Various studies have suggested that this urchin outcompetes black-lipped abalone (Haliotis rubra) for resources, but experiments elucidating the mechanisms are lacking. Methodology/Principal Findings We outline a new framework involving experimental manipulations and Markov chain and Pareto modelling to examine the effects of interspecific competition between urchins and abalone and the effect of intraspecific competition in abalone, assessed as effects on behaviour. Manipulations of abalone densities had no detectable effect on urchin behavioural transitions, movement patterns or resightability through time. In contrast, additions of urchins resulted in abalone shifting microhabitats from exposed to sheltered positions, an increase in the proportion of mobile abalone, and declines in abalone resightability through time relative to controls without the urchins. Our results support the hypothesis of asymmetrical competitive interactions between urchins and abalone. Conclusions/Significance The introduction of urchins to intact algal beds causes abalone to flee and seek shelter in cryptic microhabitat which will negatively impact both their accessibility to such microhabitats, and productivity of the abalone fishery, and will potentially affect their growth and survival, while the presence of the abalone has no detectable effect on the urchin. Our approach involving field-based experiments and modelling could be used to test the effects of other invasive species on native species behaviour. PMID:24073195

Alcohol drinking among college students: college responsibility for personal troubles

PubMed Central

2013-01-01

Background One young adult in two has entered university education in Western countries. Many of these young students will be exposed, during this transitional period, to substantial changes in living arrangements, socialisation groups, and social activities. This kind of transition is often associated with risky behaviour such as excessive alcohol consumption. So far, however, there is little evidence about the social determinants of alcohol consumption among college students. We set out to explore how college environmental factors shape college students' drinking behaviour. Methods In May 2010 a web questionnaire was sent to all bachelor and master students registered with an important Belgian university; 7,015 students participated (participation = 39%). The survey looked at drinking behaviour, social involvement, college environmental factors, drinking norms, and positive drinking consequences. Results On average each student had 1.7 drinks a day and 2.8 episodes of abusive drinking a month. We found that the more a student was exposed to college environmental factors, the greater the risk of heavy, frequent, and abusive drinking. Alcohol consumption increased for students living on campus, living in a dormitory with a higher number of room-mates, and having been in the University for a long spell. Most such environmental factors were explained by social involvement, such as participation to the student folklore, pre-partying, and normative expectations. Conclusions Educational and college authorities need to acknowledge universities’ responsibility in relation to their students’ drinking behaviour and to commit themselves to support an environment of responsible drinking. PMID:23805939

Sensory complementation and antipredator behavioural compensation in acid-impacted juvenile Atlantic salmon.

PubMed

Elvidge, C K; Macnaughton, C J; Brown, G E

2013-05-01

Prey incorporate multiple forms of publicly available information on predation risk into threat-sensitive antipredator behaviours. Changes in information availability have previously been demonstrated to elicit transient alterations in behavioural patterns, while the effects of long-term deprivation of particular forms of information remain largely unexplored. Damage-released chemical alarm cues from the epidermis of fishes are rendered non-functional under weakly acidic conditions (pH < 6.6), depriving fish of an important source of information on predation risk in acidified waterbodies. We addressed the effects of long-term deprivation on the antipredator responses to different combinations of chemical and visual threat cues via in situ observations of wild, free-swimming 0(+) Atlantic salmon (Salmo salar) fry in four neutral and four weakly acidic nursery streams. In addition, a cross-population transplant experiment and natural interannual variation in acidity enabled the examination of provenance and environment as causes of the observed differences in response. Fish living under weakly acidic conditions demonstrate significantly greater or hypersensitive antipredator responses to visual cues compared to fish under neutral conditions. Under neutral conditions, fish demonstrate complementary (additive or synergistic) effects of paired visual and chemical cues consistent with threat-sensitive responses. Cross-population transplants and interannual comparisons of responses strongly support the conclusion that differences in antipredator responses between neutral and weakly acidic streams result from the loss of chemical information on predation risk, as opposed to population-derived differences in behaviours.

A taste of the deep-sea: The roles of gustatory and tactile searching behaviour in the grenadier fish Coryphaenoides armatus

NASA Astrophysics Data System (ADS)

Bailey, David M.; Wagner, Hans-Joachim; Jamieson, Alan J.; Ross, Murray F.; Priede, Imants G.

2007-01-01

The deep-sea grenadier fishes ( Coryphaenoides spp.) are among the dominant predators and scavengers in the ocean basins that cover much of Earth's surface. Baited camera experiments were used to study the behaviour of these fishes. Despite the apparent advantages of rapidly consuming food, grenadiers attracted to bait spend a large proportion of their time in prolonged periods of non-feeding activity. Video analysis revealed that fish often adopted a head-down swimming attitude (mean of 21.3° between the fish and seafloor), with swimming velocity negatively related to attitude. The fish also swam around and along vertical and horizontal structures of the lander with their head immediately adjacent to the structure. We initially hypothesised that this behaviour was associated with the use of the short chin barbel in foraging. Barbel histology showed numerous taste buds in the skin, and a barbel nerve with about 20,000 axons in adult fish. A tracing experiment in one undamaged animal revealed the termination fields of the barbel neurons in the trigeminal and rhombencephalic regions, indicating both a mechanoreceptory and a gustatory role for the barbel. Our conclusion was that olfactory foraging becomes ineffective at close ranges and is followed by a search phase using tactile and gustatory sensing by the barbel. The development of this sensory method probably co-evolved alongside behavioural changes in swimming mechanics to allow postural stability at low swimming speeds.

Exploring Physical Activity Behaviour of Persons with Multiple Sclerosis: A Qualitative Pilot Study

PubMed Central

Resnik, Linda; Allen, Susan

2015-01-01

Purpose Identify facilitators and barriers to physical activity (PA), and explore the utility of Social Cognitive Theory (SCT) and Transactional Model of Stress and Coping (TMSC) in understanding PA behaviour among persons with multiple sclerosis (MS). Methods Thirteen participants from a clinical trial were interviewed and classified as physically active, sometimes active, or inactive based on the Health-Promoting Lifestyle Profile-II. Interviews were analysed using analytical induction, which consisted of coding data into pre-established categories and then exploring similarities and differences between groups. Pre-established coding categories were constructs from SCT (i.e. environment, expectations, self-efficacy, and self-regulation) and TMSC (i.e. stress appraisal and coping style). Results Inactive and active participants differed in their self-regulation skills, self-efficacy, and coping styles. Common barriers to PA included symptoms and the physical and social environment. Facilitators of PA included strong self-regulation skills, confidence to overcome symptoms to engage in PA (i.e. barrier self-efficacy), and positive coping styles. Conclusion Results from this pilot study suggest that PA interventions will need to implement multiple strategies that target self-efficacy, social environment, and coping styles. We found SCT and TMSC useful in understanding PA behaviour among persons with MS; however, a limitation to these theories is that they are not explicit in the relationship between health and cognitions. Future research will need to explore how to incorporate models of health and function into existing behaviour change theories. PMID:19479491

Screen-related sedentary behaviours: Children’s and parents’ attitudes, motivations, and practices

PubMed Central

He, Meizi; Piché, Leonard; Beynon, Charlene; Harris, Stewart

2016-01-01

Objective To investigate school-aged children’s and parents’ attitudes, social influences, and intentions toward excessive screen-related sedentary behaviour (S-RSB). Design A cross-sectional study using a survey methodology. Setting Elementary schools in London, Ontario, Canada. Participants All grades five and six students, their parents and teachers in the participating schools were invited to voluntarily participate; 508 student-parent pairs completed the surveys. Main Outcome Measure Children’s screen-related behaviours. Analysis Data were analyzed using the Independent Student t-test to compare differences of continuous variables and the Chi-Square test to test for differences of categorical variables. Results Children spent 3.3 ± 0.15 (standard error) hours per day engaged in screen-related activities. Entertainment, spending time with family, and boredom were cited as the top three reasons for television viewing and video game playing. Compared to “low-screen-users” (i.e. < 2hours/day), “high-screen-users” (i.e. ≥2hours/day) held less negative attitudes toward excessive S-RSB and perceived loosened parental rules on screen use. Parents of “high-screen-users” held less negative attitudes towards children’s S-RSB, had fewer rules about their children’s screen use, and were more likely to be sedentary themselves. Conclusions and Implications Intervention strategies aimed at reducing S-RSB should involve both parents and children and should focus on fostering behavioural changes and promoting parental role-modeling. PMID:19914872

Owners' Perceptions of Their Animal's Behavioural Response to the Loss of an Animal Companion.

PubMed

Walker, Jessica K; Waran, Natalie K; Phillips, Clive J C

2016-11-03

The loss of a companion animal is recognised as being associated with experiences of grief by the owner, but it is unclear how other animals in the household may be affected by such a loss. Our aim was to investigate companion animals' behavioural responses to the loss of a companion through owner-report. A questionnaire was distributed via, and advertised within, publications produced by the Royal Society for the Prevention of Cruelty to Animals (RSPCA) across Australia and New Zealand, and through a selection of veterinary clinics within New Zealand. A total of 279 viable surveys were returned pertaining to 159 dogs and 152 cats. The two most common classes of behavioural changes reported for both dogs and cats were affectionate behaviours (74% of dogs and 78% of cats) and territorial behaviours (60% of dogs and 63% of cats). Both dogs and cats were reported to demand more attention from their owners and/or display affiliative behaviour, as well as spend time seeking out the deceased's favourite spot. Dogs were reported to reduce the volume (35%) and speed (31%) of food consumption and increase the amount of time spent sleeping (34%). Cats were reported to increase the frequency (43%) and volume (32%) of vocalisations following the death of a companion. The median duration of reported behavioural changes in both species was less than 6 months. There was consensus that the behaviour of companion animals changed in response to the loss of an animal companion. These behavioural changes suggest the loss had an impact on the remaining animal.

Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey.

PubMed

Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C

2011-01-01

Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.