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Investigate associations between quantity, content and specificity of action-plans and weight loss in a diabetes prevention study. Prospective cohort study nested within a randomised controlled trial. Participants completed action-planning worksheets during intervention sessions. Action-plans were coded in terms of: number of plans set, their content, and specificity. Multivariate regression analyses assessed associations with weight loss at four-months. 890 planning-worksheets from 106 participants were analysed. Participants wrote a mean of 2.12 (SD = 1.20) action-plans per worksheet, using a mean of 2.20 (SD = 0.68) specificity components per action-plan. Quantity of action-plans per worksheet decreased over time (r = −0.137, p < 0.001) and increased quantity was associated with reduced specificity [r = −.215, p < 0.001]. Walking (34.9% of action-plans) and reducing high fat/sugar snacks (26.1%) were the most commonly planned lifestyle actions. In multivariate modelling, increased quantity of action-plans was associated with greater weight loss (R2 = 0.135, Unstandardised Beta = 0.144, p = 0.002). Specificity was not significantly associated with weight-loss (p = 0.096). Producing more action-plans was associated with greater weight loss. Further research should directly compare more versus less specific action-plans and explore ways to sustain engagement in action-planning. Our findings imply that participants should freely set numerous action-plans, rather than being encouraged to focus on specificity Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2055026. [ABSTRACT FROM AUTHOR]

'Participation' in a 'community of practice' is often proposed as a mechanism for clinical learning; however, the use of both terms is variable – ranging from technical to vernacular. Belongingness is a related single concept and development of a tool that measures belongingness may therefore be useful in adding to our understanding of when participation and hence learning takes place in clinical settings. After identifying relevant material from the literature, a draft belongingness assessment tool was developed, based on previously published work. This was piloted on 181 undergraduate medical students and the results subjected to factor analysis. The final version was then used to identify whether differences exist between two different clinical teaching environments. Our belongingness assessment tool had internal and external validity, with Cronbach's alpha = 0.940, and detected statistically significant differences between primary and secondary care teaching environments. The belongingness scale described in this paper is a valid tool for the study of undergraduate medical students. This has the potential to investigate how variation in student experiences of participation in communities of practice influences learning. This tool revealed significant differences in student belongingness between primary and secondary care learning environments. [ABSTRACT FROM AUTHOR]

Group-based interventions are widely used to promote health-related behaviour change. While processes operating in groups have been extensively described, it remains unclear how behaviour change is generated in group-based health-related behaviour-change interventions. Understanding how such interventions facilitate change is important to guide intervention design and process evaluations. We employed a mixed-methods approach to identify, map and define change processes operating in group-based behaviour-change interventions. We reviewed multidisciplinary literature on group dynamics, taxonomies of change technique categories, and measures of group processes. Using weight-loss groups as an exemplar, we also reviewed qualitative studies of participants' experiences and coded transcripts of 38 group sessions from three weight-loss interventions. Finally, we consulted group participants, facilitators and researchers about our developing synthesis of findings. The resulting 'Mechanisms of Action in Group-based Interventions' (MAGI) framework comprises six overarching categories: (1) group intervention design features, (2) facilitation techniques, (3) group dynamic and development processes, (4) inter-personal change processes, (5) selective intra-personal change processes operating in groups, and (6) contextual influences. The framework provides theoretical explanations of how change occurs in group-based behaviour-change interventions and can be applied to optimise their design and delivery, and to guide evaluation, facilitator training and further research. [ABSTRACT FROM AUTHOR]

Sail training refers to sea voyages designed to foster personal and social change. Such training has mainly involved young people but may have the potential to benefit adults who are recovering from drug and alcohol addiction. During the voyage described here clients in drug rehabilitation centres across the UK were given the opportunity to participate in a 5-day sail training voyage. Pre- and post-voyage interviews were conducted with 11 clients to explore their experiences of being selected and participating in this voyage. Clients enjoyed the experience and found it to be beneficial, promoting self-insight, new life plans and social skills development. Living in an unfamiliar, potentially dangerous and inescapable environment necessitating close proximity to others and teamwork under the supervision of expert authority figures generated bonding with and caring for others; as well as the development of new competencies and greater self-confidence. The findings suggest that sail training can be beneficial to clients in recovery from addiction and highlight key features that may optimise effectiveness. [ABSTRACT FROM AUTHOR]

Research highlights psychosocial factors associated with adverse asthma events. This systematic review therefore examined whether psycho-educational interventions improve health and self-management outcomes in adults with severe or difficult asthma. Seventeen controlled studies were included. Characteristics and content of interventions varied even within broad types. Study quality was generally poor and several studies were small. Any positive effects observed from qualitative and quantitative syntheses were mainly short term and, in planned subgroup analyses (involving < 5 trials), effects on hospitalizations, quality of life, and psychological morbidity in patients with severe asthma did not extend to those in whom multiple factors complicate management. [ABSTRACT FROM AUTHOR]

Our aim was to determine whether clinician-identified poor compliance is useful in identifying, from among adults with severe asthma, patients with characteristics likely to put them at risk of adverse outcomes. Patients with severe asthma (previous hospital admissions and/or prescribed step 4-5 treatment according to British Thoracic Society guidelines) considered by clinicians to be either compliant (C, N = 41) or poorly compliant (PC, N = 92) with aspects of their recommended management (attendance at appointments, taking medication, and monitoring asthma) provided data on symptoms, health service use, medication, self-management practices, physical and psychological comorbidities, and sociodemographic/socioeconomic characteristics. Cross-sectional univariate analyses were used to examine whether the groups differed with respect to self-reported indicators of asthma morbidity and self-management. Logistic regressions were additionally used to explore psychosocial factors independently associated with patients being identified as PC. Compared with C patients, PC patients had significantly poorer self-reported asthma control in terms of medication use, symptoms, time off work, asthma-specific quality of life, primary care visits, emergency attendances, and hospital admissions. This was coupled with poorer self-management practices. Patients identified as PC also had higher levels of physical and psychological comorbidities, were younger, and faced more difficult social and economic circumstances. We identified significant psychological (anxiety) and social (younger age, not working, number of benefits, adverse family circumstances) factors independently associated with patients being identified as PC. Among adults with severe asthma, clinician-assessed poor compliance was useful in distinguishing between two groups that differed significantly in terms of asthma morbidity indicators, self-management practices, and psychosocial characteristics, which have been previously shown to be associated with hospital admissions, near-fatal attacks, and fatal asthma. We conclude that clinician-assessed poor compliance is a useful marker for identifying patients at risk of these adverse outcomes. [ABSTRACT FROM AUTHOR]