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AbstractThis scoping review explores the integration of Artificial Intelligence (AI) with communication, behavioral, and social theories to enhance health behavior interventions. A systematic search of articles published through February 2024, following PRISMA guidelines, identified 28 relevant studies from 13,723 screened. These studies, conducted across various countries, addressed health issues such as smoking cessation, musculoskeletal injuries, diabetes, chronic diseases and mental health using AI-driven tools like chatbots and apps. Despite AI’s potential, a gap exists in aligning technical advancements with theoretical frameworks. The proposed AI Impact Communications Model (AI-ICM) aims to bridge this gap, offering a road map for future research and practice. [ABSTRACT FROM AUTHOR]

Background: Despite the high non-communicable disease (NCD) mortality in Ethiopia, NCD screening in the country remains suboptimal. This study assessed the health communication process and materials designed to promote NCD screening among adult primary healthcare facility attendants in the Gurage Zone, Ethiopia. Methods: A parallel mixed-methods approach was employed. Seven health communication materials were evaluated using the Modified Clear Communication Index Score by the Center for Disease Control and Prevention (CDC). Seven key informants who were involved in the production were interviewed to explore the process. Users' satisfaction with the materials was assessed through a cross-sectional survey (N = 412). We used multivariable logistic regression with SPSS version 27 software to determine the factors associated with users' satisfaction. Thematic analysis was applied for the qualitative data analysis using Opencode 4.03 software. Results: Qualitative interviews indicated that the production process relied on evidence, involved stakeholders, and included pretesting. The CDC index score revealed that five of the seven materials were considered clear and user-friendly, whereas two required improvement. Overall users' satisfaction with the material was high with a mean score of 22.10 (SD ± 2.34; min: 14, max: 25). Age and educational status had significant positive association with users' satisfaction. Conclusions: Developing health communication materials on promoting NCD screening based on evidence, stakeholders' input, and pretesting can lead to good quality material and user satisfaction. We recommend future research works to measure changes in NCD screening service uptake as a result of using the health communication materials considered in this study. [ABSTRACT FROM AUTHOR]

Introduction: The presence of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is a pivotal diagnostic marker for multiple sclerosis (MS). These bands play a crucial role in the diagnosis and understanding of a wide array of immune diseases. In this study, we explore the relationship between the cognitive profile of autoimmune encephalitis (AIE) and the presence of OCBs in CSF, with a particular emphasis on NMDA receptor antibodies. Methods: We studied a cohort of 21 patients across five tertiary centers, segregated into two distinct categories. One group comprised individuals who tested positive only for autoimmune encephalitis antibodies indicative of encephalitis, while the other group included patients whose CSF was positive for both autoimmune encephalitis antibodies and OCBs. Our investigation focused primarily on cognitive functions and behavioral alterations, supplemented by auxiliary diagnostic assessments such as CSF cell count, magnetic resonance imaging (MRI), and electroencephalogram (EEG) results, evaluated for the two patient groups. To validate our findings, we employed statistical analyses such as Fisher’s exact test with Benjamini-Hochberg correction. Results: Our study included 21 patients, comprising 14 who were presented with only autoimmune encephalitis antibodies, and 7 who were dual-positive. Among these patients, we focused on those with NMDA receptor antibodies. Of these, five were dual positive, and nine were positive only for NMDA receptor antibodies. The dual-positive NMDA group, with an average age of 27 ± 16.47 years, exhibited significantly higher CSF cell counts (p=0.0487) and more pronounced language and attention deficits (p= 0.0264). MRI and EEG results did not differ significantly between the groups. Conclusions: Our results point to OCBs as an additional marker of disease severity in AIE, especially in NMDA receptor-antibody positive patients, possibly indicating a broader inflammatory process, as reflected in elevated CSF lymphocytes. Regular testing for OCBs in cases of suspected AIE may aid in disease prognosis and identification of patients more prone to language and attention disorders, improving diagnosis and targeting treatment for these cognitive aspects. [ABSTRACT FROM AUTHOR]

Social work practices in many forms have societal value via exploratory pathways and motivational methods toward self-awareness and personal betterment. Such practices exist among, and are adapted to, varied cultural norms. This research examined the use of spirituality-based approaches, as implemented in Indonesia, to help people who have been affected by drug addictions or by disabilities. By interviewing social workers who engage spirituality to assist clients at rehabilitation centers, we elicited details of such workers’ methods for aiding in their clients’ recovery. Analysis of our verbatim transcripts identified characteristics of the social workers’ self-reports and concomitant overall themes. Findings identified positive effects that were achieved while social workers incorporated spirituality as a part of their methodology with clients. Beneficial behavioral changes were associated with spirituality invoked as a part of the social workers’ process, which encouraged clients to recognize their inner values, to keep a positive attitude toward overcoming difficulties, and to develop useful social skills. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Trial Registration This study examines the perspectives of individuals with coronary heart disease (CHD) on a nurse‐led eHealth cardiac rehabilitation (NeCR) program, which included a website, tele‐monitoring device, and social media chatroom.Using a descriptive qualitative approach, semi‐structured interviews were conducted with 18 participants to capture their feedback and experiences with the NeCR program.Participants found the NeCR program valuable in addressing gaps in cardiac rehabilitation services in China, empowering them to make behavioral changes and enhancing their social motivation. However, they also highlighted the need for a more user‐friendly website, better symptom management during exercise, and stronger privacy protections in the peer networking chatroom. The study concludes that the NeCR program is feasible in providing accessible rehabilitative services at home post‐discharge. Recommendations include improving the self‐monitoring platform for ease of use, incorporating immediate symptom management guidance during exercise, and ensuring a secure environment for online peer support.These findings offer crucial insights for developing patient‐centered eHealth cardiac rehabilitation services, emphasizing the importance of user‐friendly design, effective symptom management features, and privacy protection in promoting participant engagement with e‐platforms.ChiCTR1800020411 (http://www.chictr.org.cn/showprojen.aspx?proj=33906) [ABSTRACT FROM AUTHOR]

Background Antimicrobial resistance (AMR) is a significant global public health threat and key priority for the public health, especially health protection, workforce to lead by example. There is a paucity of learning resources on this for public health professionals (PHPs) in the UK. This project aimed to develop and disseminate a tailored interactive learning resource and evaluate impact on self-reported intention to change behaviour. Methods Learning objectives were agreed, content developed by the multi-disciplinary team and piloted by PHPs in 2022 alongside a matched pre- and post-implementation evaluation survey. Questions were mapped to the capability–opportunity–motivation–behaviour change model. Before and after responses were calculated to compare change in self-reported knowledge, understanding and behaviour. Significance of change in binary responses was estimated. Results The resource was delivered using an interactive, user-friendly and cost-free internal platform. Thirty-one PHPs completed the pilot e-learning and survey. Perceived and actual knowledge increased in parallel. Actual knowledge on AMR burden increased from 6.45 to 35.48% (P  = 0.004). Self-reported confidence to explain AMR to others improved by 0.71 (95% CI; 0.38–1.04: P  = 0.0001) Likert points on a five-point scale. Motivation to advocate for antimicrobial stewardship (AMS) in day-to-day work, improved by 0.71 (95% CI; 0.34–1.08: P  < 0.00001) Likert points. Case scenarios were well-received as an effective way to apply theory to practice. Conclusion Ensuring a well-informed and confident public health workforce is vital for reducing the AMR threat and advocating for AMS with the public and partner organizations. This targeted e-learning module is an effective additional learning medium in contributing to PHPs knowledge, understanding and self-reported intention to change behaviours. [ABSTRACT FROM AUTHOR]

One of the pending challenges facing Education for Sustainable Development is to change students' behavior in favor of sustainability so that these are lasting and even transferable to other people. This study analyzes how various psychological factors, including motivation, attitudes, beliefs and emotions, can be channeled to enhance social and ecological awareness through education. This paper presents an innovative approach to Sustainable Development (SD) in education, focusing on Physical Education. It highlights the intersection of Psychology, education and sustainability, showing how the first two can contribute significantly to lasting changes in students' behavior. Based on this, the Intervention Model for Sustainable Development in Physical Education (PESDIM), which combines psychological theories with specific educational strategies, is presented. In this model, which can be replicated in other educational disciplines, psychological theories are based on social interaction and norms, identity construction, motivation, beliefs and individual efficacy to improve awareness of sustainable development. The paper highlights the need for a holistic and practical approach to sustainability education in general and Physical Education in particular, stresses the importance of psychology and advocates for an educational transformation that holistically integrates sustainability into teaching methods and objectives. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims The utilization of long‐term effect of internet of things (IoT) on glycemic control is controversial. This trial aimed to examine the effect of an IoT‐based approach for type 2 diabetes. Materials and Methods This randomized controlled trial enrolled 1,159 adults aged 20–74 years with type 2 diabetes with a HbA1c of 6.0–8.9% (42–74 mmol/mol), who were using a smartphone on a daily basis were randomly assigned to either the IoT‐based approach group (ITG) or the control group (CTG). The ITG were supervised to utilize an IoT automated system that demonstrates a summary of lifelogging data (weight, blood pressure, and physical activities) and provides feedback messages that promote behavioral changes in both diet and exercise. The primary end point was a HbA1c change over 52 weeks. Results Among the patients, 581 were assigned to the ITG and 578 were in the CTG. The changes in HbA1c from baseline to the final measurement at 52 weeks [mean (standard deviation)] were −0.000 (0.6225)% in ITG and − 0.006 (0.6449)% in CTG, respectively (P = 0.8766). In the per protocol set, including ITG using the IoT system almost daily and CTG, excluding those using the application almost daily, the difference in HbA1c from baseline to 52 weeks were −0.098 (0.579)% and 0.027 (0.571)%, respectively (P = 0.0201). We observed no significant difference in the adverse event profile between the groups. Conclusions The IoT‐based approach did not reduce HbA1c in patients with type 2 diabetes. IoT‐based intervention using data on the daily glycemic control and HbA1c level may be required to improve glycemic control.

Background The control rate for patients with hypertension remains suboptimal, with hypertensive patients experiencing a lower quality of life compared to healthy individuals. Enhancing life quality and lowering blood pressure in patients with hypertension through behavioral interventions is currently a critical area of research. Theoretical-based behavioral interventions are shown to be more effective and sustainable in modifying the behaviors of hypertensive patients. The Behavior Change Wheel (BCW) and Behavior Change Techniques (BCTs) are widely utilized in the management of chronic diseases globally to maximize the exploration of modifiable factors. Nevertheless, in the domestic context, studies on the impact of BCW and BCTs-driven behavioral interventions on the ambulatory blood pressure and quality of life of hypertensive patients are relatively limited, indicating a need for more comprehensive research. Objective This study aims to develop and evaluate the intervention based on BCW and BCTs, focusing on its impact on behavior, ambulatory blood pressure, and quality of life in hypertensive patients. Methods From December 2021 to August 2022, a hundred hypertensive patients who met the inclusion criteria were selected as study participants. They were allocated into an intervention group and a control group using a simple randomization method, with each group comprising fifty participants. Patients in the control group received conventional outpatient medication and health education lifestyle guidance. In contrast, patients in the intervention group was treated with standard medication supplemented by the BCW and BCTs-based intervention guidance.Before and after the intervention, assessments were conducted using the Hypertension Knowledge-Level Scale, the Chinese Version of the 8-item Morisky Medication Adherence Scale, the International Physical Activity Questionnaire-Short, the Patient Health Questionnaire-9, the General Anxiety Disorder-7, ambulatory blood pressure monitoring, and the 12-Item Short-Form Health Survey. The study examined changes in behavioral indicators, results of ambulatory blood pressure monitoring, and quality of life pre- and post-intervention. Results The results indicated that after the intervention, the intervention group exhibited significantly higher levels of hypertension knowledge, medication adherence, quality of life scores, proportions of high medication adherence and engagement in moderate physical activity compared to the control group (P

Considering the multifaceted nature of neurodegenerative diseases like dementia and the necessity for interprofessional knowledge, this research extends its scope to encompass professionals with diverse levels of training and experience in dementia care. A need analysis for the project “My INdividual Digital EDucation.RUHR” (MINDED.RUHR) is conducted to develop an automatized recommender system for individual learning content using AI. In this sub-study, the aim was to reveal didactic specialties, knowledge gaps, and structural challenges of further education in dementia care of different health professions and to derive learning preference personae. Eight focus group interviews among nine health professions and up to six participants (N = 34) each took place to survey distinct didactic experiences and learning needs. The results reflect various learning preferences, with a propensity to multimedia, practical, and interactive tasks. Health professions are used to digital education but show aversions against synchronous e-learning formats. The derived learning preference personae constitute profound blueprints for a user-centered digital education design process, aiming to establish personalized and representative further education in dementia care applicable to various individual preferences and structural workplace challenges of healthcare professions.

The effectiveness of strategic psychology‐based marketing techniques for increasing public support for conservation is poorly understood. We assessed how such techniques affect support for tropical rainforest restoration with a controlled online experiment with 1166 nationally representative residents of the United Kingdom. We tested whether support increased when adding ecosystem service (ES) framings to typical nongovernmental organizations’ (NGOs) biodiversity‐focused messages that emphasize benefits to UK residents or people living near the tropical restoration site and a dynamic social norm nudge that emphasized increasing popularity of environmental restoration. We considered how respondents’ psychological traits (nature connection, self‐efficacy, psychological benefits of supporting charities, awareness of environmental degradation in the Global South, and climate change skepticism) influenced responses. Outcomes included respondents’ reported advertisement sufficiency, sympathetic attitudes, behavioral support, and financial support. The study population typically found advertisements sufficient and exhibited sympathetic attitudes and financial, but not behavioral, support. Younger people exhibited greater conservation support than older respondents. Messages framed solely on biodiversity conservation were as effective as those highlighting additional ES benefits received by UK residents and people near the tropical restoration site. This suggests that framing around ESs, rather than nature's intrinsic value, may not strengthen public support for conservation. The dynamic social norm nudge had perverse effects. It reduced perceived social norms and most outcome variables. Alternative dynamic norm nudges warrant testing, but our results support research suggesting dynamic norm nudges can be ineffective when associated with activism, challenging their use by conservation NGOs. Psychological benefits of supporting charities and perceived self‐efficacy increased support for advertisements, highlighting the benefits of including impact statements relating respondents’ support to specific outcomes. Climate change skepticism decreased support, whereas nature connection and perceived static social norms increased it, highlighting the need to increase nature connection and pro‐environmental social norms to elevate public support for conservation. [ABSTRACT FROM AUTHOR]

Aims: The utilization of long‐term effect of internet of things (IoT) on glycemic control is controversial. This trial aimed to examine the effect of an IoT‐based approach for type 2 diabetes. Materials and Methods: This randomized controlled trial enrolled 1,159 adults aged 20–74 years with type 2 diabetes with a HbA1c of 6.0–8.9% (42–74 mmol/mol), who were using a smartphone on a daily basis were randomly assigned to either the IoT‐based approach group (ITG) or the control group (CTG). The ITG were supervised to utilize an IoT automated system that demonstrates a summary of lifelogging data (weight, blood pressure, and physical activities) and provides feedback messages that promote behavioral changes in both diet and exercise. The primary end point was a HbA1c change over 52 weeks. Results: Among the patients, 581 were assigned to the ITG and 578 were in the CTG. The changes in HbA1c from baseline to the final measurement at 52 weeks [mean (standard deviation)] were −0.000 (0.6225)% in ITG and − 0.006 (0.6449)% in CTG, respectively (P = 0.8766). In the per protocol set, including ITG using the IoT system almost daily and CTG, excluding those using the application almost daily, the difference in HbA1c from baseline to 52 weeks were −0.098 (0.579)% and 0.027 (0.571)%, respectively (P = 0.0201). We observed no significant difference in the adverse event profile between the groups. Conclusions: The IoT‐based approach did not reduce HbA1c in patients with type 2 diabetes. IoT‐based intervention using data on the daily glycemic control and HbA1c level may be required to improve glycemic control. [ABSTRACT FROM AUTHOR]

Modern transportation amenities and lifestyles have changed people's behavioral patterns while using the road, specifically at nighttime. Pedestrian and driver maneuver behaviors change based on their exposure to the environment. Pedestrians are more vulnerable to fatal injuries at junctions due to increased conflict points with vehicles. Generation of precrash scenarios allows drivers and pedestrians to understand errors on the road during driver maneuvering and pedestrian walking/crossing. This study aims to generate precrash scenarios using comprehensive nighttime fatal pedestrian crashes at junctions in Tamil Nadu, India. Though numerous studies were available on identifying pedestrian crash patterns, only some focused on identifying crash patterns at junctions at night. We used cluster correspondence analysis (CCA) to address this research gap to identify the patterns in nighttime pedestrian fatal crashes at junctions. Further, high-risk precrash scenarios were generated based on the positive residual means available in each cluster. This study used crash data from the Road Accident Database Management System of Tamil Nadu State in India from 2009 to 2018. Characteristics of pedestrians, drivers, vehicles, crashes, light, and roads were input to the CCA to find optimal clusters using the average silhouette width, Calinski-Harabasz measure, and objective values. CCA found 4 clusters with 2 dimensions as optimal clusters, with an objective value of 3.3618 and a valence criteria ratio of 80.03%. Results from the analysis distinctly clustered the pedestrian precrash behaviors: Clusters 1 and 2 on pedestrian walking behaviors and clusters 3 and 4 on crossing behaviors. Moreover, a hidden pattern was observed in cluster 4, such as transgender drivers involved in fatal pedestrian crashes at junctions at night. The generated precrash scenarios may be used to train drivers (novice and inexperienced for nighttime driving), test scenario creation for developing advanced driver/rider assistance systems, hypothesis creation for researchers, and planning of effective strategic interventions for engineers and policymakers to change pedestrian and driver behaviors toward sustainable safety on Indian roads. [ABSTRACT FROM AUTHOR]

Considering the multifaceted nature of neurodegenerative diseases like dementia and the necessity for interprofessional knowledge, this research extends its scope to encompass professionals with diverse levels of training and experience in dementia care. A need analysis for the project "My INdividual Digital EDucation.RUHR" (MINDED.RUHR) is conducted to develop an automatized recommender system for individual learning content using AI. In this sub-study, the aim was to reveal didactic specialties, knowledge gaps, and structural challenges of further education in dementia care of different health professions and to derive learning preference personae. Eight focus group interviews among nine health professions and up to six participants (N = 34) each took place to survey distinct didactic experiences and learning needs. The results reflect various learning preferences, with a propensity to multimedia, practical, and interactive tasks. Health professions are used to digital education but show aversions against synchronous e-learning formats. The derived learning preference personae constitute profound blueprints for a user-centered digital education design process, aiming to establish personalized and representative further education in dementia care applicable to various individual preferences and structural workplace challenges of healthcare professions. [ABSTRACT FROM AUTHOR]

Background: There is scarcity of data exploring the dynamics of barriers to changing physical activity (PA) and eating habits during a lifestyle intervention in a primary care setting. The aim of the present study was to investigate barriers to lifestyle change before and during a primary care lifestyle intervention in adults with different sociodemographic backgrounds. Methods: Barriers to healthy eating and PA were assessed in 114 adults (age = 55 ± 9 years) using a questionnaire before inclusion in the intervention. During the lifestyle intervention, factors perceived as obstacles to reach goals for PA and healthy eating habits were collected using focus group interviews in a sub-sample of 25 adults and analyzed using thematic analysis. Results: At least 1 barrier to changing eating and PA habits was reported in 65% and 67% of the population, respectively, without differences due to sex, place of birth, and educational level. Before entering the lifestyle intervention, intrapersonal factors including lack of willpower and lack of enjoyment were the dominant barriers to PA and healthy eating, irrespective of place of birth, sex, and education level. In contrast, environmental factors such as lack of support from family and work-related constraints emerged as important barriers to overcome during the action phase of the lifestyle intervention. Conclusions: The present study highlights the dynamics of barriers to changing PA and eating habits in a primary care lifestyle intervention, emphasizing the need for barrier assessment during the different phases of an intervention to tailor support activities for successful lifestyle behavioral change. [ABSTRACT FROM AUTHOR]

The purpose of this study is to cross-culturally adapt the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) to Turkish and test its validity and reliability. This is a methodological study. This study was conducted with 121 children aged 1 to 12 years who underwent ambulatory surgery. The data of the study were collected using a Descriptive Information Form, PHBQ-AS, and the Parents' Postoperative Pain Measure. Data analysis and evaluation were performed using factor analysis, Cronbach's α analysis, item-total score correlation analysis, content validity, construct validity, and concurrent validity. PHBQ-AS showed a high level of internal consistency (Cronbach's α = 0.801). The item-total correlation values of PHBQ-AS were found to be 0.458 to 0.753. PHBQ-AS was determined to be a single-factor scale explaining 66% of the variance in the examined variable. PHBQ-AS and Parents' Postoperative Pain Measure scores were moderately correlated. The Turkish version of PHBQ-AS was highly valid and reliable for the Turkish population. A recommendation for health care professionals in Turkey is to use the PHBQ-AS scale to evaluate posthospitalization behavioral changes in children who are admitted for ambulatory surgery. [ABSTRACT FROM AUTHOR]

Development and legal researchers hypothesize that a moderate law may be more effective than a radical one in changing behavior. This study tests this hypothesis in the context of discriminatory sharing norms practiced by high-caste individuals against low-caste individuals in India. The study employs a lab-in-the-field experiment in which it influences (a) high-caste participants' social norms of sharing money with a low-caste participant and (b) introduces either a "moderate" or a "radical" rule, that is, a rule that is closer or further away from the social norm and requires high-caste participants to share a minimum amount of their money with the low-caste participant. Breaking the rule entails incurring a small fine. This study finds that the effectiveness of the moderate versus radical rule in changing behavior and norms depends on the status quo social norm. This paper provides causal empirical evidence on how social norms influence laws' effectiveness in inducing behavioral and norm change. [ABSTRACT FROM AUTHOR]

In this study, we examined whether weight management is necessary for working female athletes during and after pregnancy. Postpartum obesity, behavioral change, working women and sportspersons were the literature review topics. Pregnancy complications due to obesity, such as infertility, hypertension, gestational diabetes and neural tube defects in the child are associated with higher rates of early miscarriage and congenital defects. A woman's behavior changes during the postpartum period, including depression, stress and anxiety. For working women, maternity leave (over 12 weeks) positively impacts their vitality and mental health. It is common for elite athletes to become pregnant easily due to their healthy lifestyle, they deliver healthy babies, reduce their training during pregnancy, and resume sports usually occurs between 6 weeks to 12 weeks after giving birth. Women who are working, and especially those who are postpartum, must manage their weight during this period. [ABSTRACT FROM AUTHOR]

Social norm interventions hold the potential to change people's behavior. Five field experiments (N = 1,163) examined the effects of a simple and easily realizable social norm nudge based on the social media format "Be like Bill." The nudge consisted of a stick figure named Toni that communicated descriptive and injunctive norms regarding pro-environmental or pro-social behaviors. Nudge conditions were compared to no-intervention control conditions. Experiment 1 (N = 179) focused on paper towel consumption in a women's restroom at a German university. The nudge condition used less paper towels than the control condition, d = 0.48. Experiment 2 (N = 183) replicated this result (d = 0.32) in a more diverse setting of a women's restroom at a German Christmas market. Experiment 3 (N = 250) examined differences in the effects of prescriptive (i.e., 'do-norm') versus proscriptive (i.e., 'do not-norm') social norms on paper towel consumption again in a university women's restroom. The effectiveness of both social norm nudge conditions was shown in comparison to the control condition (d = 0.46; d = 0.40), while the prescriptive and proscriptive social norm manipulations did not differ. Experiment 4 (N = 206) applied the nudging approach to the use of plastic lids in a coffee shop, where no effect was found. Finally, Experiment 5 (N = 345) focused on the pro-social behavior of mask wearing in a bakery toward the end of the Covid-19 pandemic restrictions in Germany. In the nudge condition, more visitors put on face masks compared to the control group, d = 0.39. Limitations and contextual factors regarding the applicability of our social norm nudge are discussed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic challenged the public health system to respond to an emerging, difficult-to-understand pathogen through demanding behaviors, including staying at home, masking for long periods, and vaccinating multiple times. We discuss key challenges of the pandemic health communication efforts deployed in the United States from 2020 to 2022 and identify research priorities. One priority is communicating about uncertainty in ways that prepare the public for disagreement and likely changes in recommendations as scientific understanding advances: How can changes in understanding and recommendations foster a sense that "science works as intended" rather than "the experts are clueless" and prevent creating a void to be filled by misinformation? A second priority concerns creating a culturally fluent framework for asking people to engage in difficult and novel actions: How can health messages foster the perception that difficulties of behavior change signal that the change is important rather than that the change "is not for people like me?" A third priority entails a shift from communication strategies that focus on knowledge and attitudes to interventions that focus on norms, policy, communication about policy, and channel factors that impair behavior change: How can we move beyond educating and correcting misinformation to achieving desired actions? [ABSTRACT FROM AUTHOR]

Introduction Evidence on smokeless tobacco (ST) cessation interventions is scarce. The South Asian (SA) region that shares more than 90% of the burden of ST use is grossly underrepresented in research on ST cessation. This study aimed to assess the feasibility of delivering and investigating a behavioral support intervention for ST cessation in dental settings in Pakistan. Methods A multicenter, pilot, two-armed parallel-group, individually randomized control trial, with a 1:1 allocation ratio, was conducted at two dental hospitals. Eligibility criteria included being an ST user seeking dental treatment and not currently accessing cessation support. All participants were provided written self-help ST cessation material. The intervention group also received a dentist-delivered, bespoke behavioral support intervention for ST cessation developed for users of SA origin. Participants were followed up telephonically at 3 and 6 months. Self-reported 6-month abstinence was verified by salivary cotinine. Analysis was descriptive, with 95% confidence intervals presented where appropriate. Results One hundred participants were successfully recruited from the selected hospitals. Of these, 78% continued to engage throughout the study duration and provided primary outcome data, whereas 63% completed all hospital visits. The outcome measures were successfully collected. Biochemically verified 6-month abstinence in the intervention and control groups was 10% and 4%. Conclusions It was feasible to deliver and evaluate a dentist-delivered behavioral support intervention for ST cessation in Pakistan. The data suggested that the intervention may improve ST quit rates. The findings of this study will be useful in informing the design of future definitive studies. Implications To our knowledge, this is the first pragmatic pilot trial on ST cessation in dental settings in Pakistan and the first trial on dentist-delivered structured behavioral support intervention for ST cessation. It adds to the scarce, trial evidence based on ST cessation interventions. The findings suggest behavioral support intervention for ST cessation may improve quit rates. The trial was conducted in a country with poor ST control measures, where ST products are not taxed, the products are sold openly to and by minors, and the users are offered negligible cessation support. The findings may, therefore, be generalizable to low–middle-income countries, particularly SA countries, with similar policy backgrounds. [ABSTRACT FROM AUTHOR]

By offering the opportunity to make longer trips at a lower level of physical activity, the e-bike provides a promising alternative to car use. Despite all advantages (e-)cycling brings to urban accessibility, the environment, physical and mental health, not all car commuters regard the e-bike as a suitable alternative yet in their daily activity patterns. This study reports on changes in behavioral intention and actual e-cycling brought about by an e-cycling incentive program in the province of Noord-Brabant, the Netherlands. The impact of the program on behavioral intention and the actual change to e-cycling were analyzed based on a longitudinal three-wave survey design on past, intended, and actual commuting behavior. To explore the changes in behavioral intentional, the differences between intention and actual behavior and the factors influencing them, descriptive and ordinal logistic regression analyses were conducted. To explore the dynamics between e-cycling intentions and behavior a longitudinal structural equation model was developed. In general, this study shows that the incentive program has a positive impact on participants’ behavioral change to e-cycling during the incentive program. Results show that two-third of the participants actually use the e-bike as much as they intended at the start of the program. People who were used to taking the conventional bicycle to work before the stimulation program, are more consistent between their intention and behavior. Results also show that personal beliefs, habits, and goal-related variables do not influence the intention–behavior consistency.

While universal quality pre-primary education is a global agenda, the shortage of qualified teachers and teaching materials is a major challenge in low-income countries. In Madagascar, the proportion of teachers with minimum required qualification in pre-primary education is less than half. To improve the quality of pre-primary education, the Ministry of Education in Madagascar piloted a set of interventions, including teacher training and the distribution of Kamishibai, a simple picture-story show for children. This study investigated whether Kamishibai changed children's behaviors and learning using a randomized controlled trial. The experiment targeted senior-class pupils (five to six years old) in 14 public pre-primary activity centers. The results of the experiment showed that Kamishibai improved children's behaviors of hygiene, understanding of security, responsibility, and autonomy. Kamishibai also enhanced their foundational literacy and numeracy. The results of this study suggest that it is possible to improve the quality of pre-primary education with simple teaching materials in the challenging context of a low-income country.

Concerns about the over-extraction of groundwater and the environmental effects of that have increased the need to change mental patterns about water consumption. This study is aimed on the psychological analysis of the blockage of unauthorized water wells in the agricultural sector of Iran through the integration of PMT and TPB models. The research model was tested with 384 farmers. A questionnaire was used for data collection, the validity and reliability of which were obtained to be at an optimal level. For testing the research hypotheses Smart-PLS4 software was used. The research findings showed that the effects of six variables being attitude, subjective norm, perceived severity, response cost, response efficacy, and self-efficacy on intention were significant; however, the effect of perceived vulnerability on intention was not significant. Based on structural equation modeling results, the intention variable mediates significantly the relationship between dependent and independent variables. The independent and mediating variables were able to explain 49 % of the variance of farmers' behavior toward blockage of unauthorized water wells. Other than providing a new theoretical perspective toward understanding the blocking behavior of unauthorized water wells, the present study findings provide valuable insights for enhancing conservation behavior. To encourage people to participate in conservation behaviors, practical suggestions are provided for relevant policy-makers and planners as well as water conservation advocates.

Abstract Adherence to exercise is a crucial aspect of behavioral changes related to exercise. However, current models fail to predict behavioral change, and exercise programs struggle to foster adherence. In this Current Opinion article, we defined adherence as a process linking behavior and attitude. More specifically, exercise adherence is the process by which people’s behaviors conform to their attitudes and vice versa. Behavioral change theories should be able to predict changes, transformations, and modifications of behaviors; however, this is not currently the case. Prediction models of behavior are mainly focused on how to predict behavioral changes by affecting attitudes; however, these models have not considered the target behavior as a facilitator of adherence. Herein, a behavioral perspective is considered in three directions: first, exercise is a therapeutic modality that has the potential to improve motivation; second, chronic exercise helps sustain effort over time and increase executive functions and willpower; and third, exercise is an active behavior that has the potential to facilitate attitude change.

Rongge Jiang,1 Haibai Liu,2 Xue Jiang,2 Ding Wang,2 Xiaoyu Li,2 Yi Shang3 1Neurosurgery Department 1, Baoding No.1 Central Hospital, Baoding, 071000, People’s Republic of China; 2Department of Nursing, Shijiazhuang Medical College, Shijiazhuang, 050599, People’s Republic of China; 3Department of Mammary, Shijiazhuang Fourth Hospital, Shijiazhuang, 050000, People’s Republic of ChinaCorrespondence: Xiaoyu Li, Shijiazhuang Medical College, No. 1 Tongxin Road, Lingshou County, Shijiazhuang, Hebei, 050599, People’s Republic of China, Tel + 8613603117321, Email lixiaoyu_li03@126.comObjective: This study explores the impact of a nursing intervention grounded in empowerment theory, focusing on behavioral change, on brain metastasis patients post-breast cancer surgery.Methods: Between June 2021 and June 2023, 102 patients diagnosed with brain metastasis after breast cancer surgery at Bao Ding No.1 Central Hospital were randomized into two groups. The control group (51 patients) received standard nursing care, while the observation group (51 patients) participated in a behavioral change nursing intervention influenced by empowerment theory. The evaluation metrics included measures of negative emotions, compliance with treatment protocols, overall quality of life, and nursing satisfaction, assessed at multiple time points during the study period.Results: The intervention led to significant reductions in negative emotions for all patients when compared to their pre-intervention statuses, with the observation group exhibiting notably lower depression and anxiety scores at one and three months post-intervention (P < 0.05). Additionally, this group achieved higher compliance scores and demonstrated greater improvements in quality of life than the control group (P < 0.05). Nursing satisfaction was also significantly higher in the observation group, with 96.08% reporting high satisfaction compared to 80.39% in the control group (P < 0.05).Conclusion: Implementing a nursing intervention that emphasizes behavioral changes and leverages empowerment theory significantly enhances the quality of life, reduces negative emotions, boosts compliance with treatment, and increases nursing satisfaction among patients with brain metastasis following breast cancer surgery. This suggests that such interventions could be a valuable component of postoperative care for this patient population.Keywords: behavioral change, empowerment theory, negative emotions, nursing intervention, brain metastasis, breast cancer, quality of life

Pédrö Pallangyo,1,2 Makrina Sotel Komba,1 Zabella Seif Mkojera,1 Loveness Mfanga,1 Janeth Elidaima Mmari,1,2 Neema Victor Kailembo,1 Smita Bhalia,2 Mohamed Aloyce,2 Genofeva Gerald Matemu,3 Husna Yasin Faraji,2 Jasmine Said Keria,4 Tatizo Waane,2 Peter R Kisenge2 1Department Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 2Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 3Department of Public Relations, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania; 4Department of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, TanzaniaCorrespondence: Pédrö Pallangyo, Jakaya Kikwete Cardiac Institute, P.O. Box 65141, Dar es Salaam, Tanzania, Tel +255 755 351 165, Email pedro.pallangyo@gmail.comBackground: In Tanzania, where over a third of the society is impoverished, the burden of NCDs which account for about two-fifths of all disability-adjusted life years (DALYs) and one-third of premature deaths has doubled in the past two decades. However, notwithstanding a wider realization of the escalating burden of NCDs across Tanzania, the link between NCD awareness and lifestyle practices at the population level is not well characterized. We aimed to establish the gap between NCD knowledge and healthy behaviors.Methods: This multi-regional community-based cross-sectional study was conducted in 5 regions of Tanzania between September 2022 and June 2023. A 22-item standardized tool evaluating various NCD risk behaviors was used in knowledge assessment and a cut-off of ≥ 70% was used to denote good knowledge. Bivariate analyses were performed to compare knowledge of NCD risk factors across various NCD risk subgroups. All tests were two tailed, and the significance was set at p< 0.05.Results: A total of 5121 individuals were consecutively enrolled. The mean age was 47.2 years and females comprised over three-fifths (60.8%) of the participants. With regard to behavioral NCD risks, physical inactivity, unhealthy diet, smoking and alcohol consumption were present in 79.0%, 70.2%, 2.1% and 17.6% of participants, respectively. Moreover, biological risk factors, ie, excess body weight, hypertension, and diabetes were present in 68.4%, 55.8% and 13.0% of participants, respectively. The mean knowledge score was 77.1% and 70.3% of participants demonstrated good knowledge of NCD risk factors. Except for smoking, individuals who showed awareness of various NCD risk factors were found to have significant rates of risky behaviors.Conclusion: Despite sufficient NCD risk knowledge, incongruent lifestyle practices persist, highlighting a crucial concern. This suggests that awareness of NCDs and their risks may influence motivation for change but may not necessarily result in lifestyle modification.Keywords: noncommunicable diseases, NCDs, lifestyle practices, behavioral change, modifiable risk factors, knowledge of NCDs

Objectives: The objective of this review is to examine the changes in food consumption pattern of Indians over the years and to recommend evidence-based policy making regarding all the factors affecting food consumption. Methods: We have reviewed the articles frommajor databases such as PubMed and Google Scholar. The keywords used for the search included dietary pattern, dietary trend, dietary intake, food system, nutrition system, prehistoric food systems, drought, famine, whole grains, diets, prices, income, environment, urban food consumption, processed foods, food security, food preferences, demographic transition, fat intake, food production, public distribution system, food consumption pattern, Indian agriculture, and India. Results: There is no facilitating environment for the production and cultivation of healthy and sustainable food. Conclusion: Policymakers should make major amendments to food and agricultural policies, and demotivate the consumption of junk food. [ABSTRACT FROM AUTHOR]

Rural populations experience a number of disparities that place them at increased risk of morbidity and mortality related to chronic disease, including lower health literacy and greater distance to medical care. Community-based free healthcare education can offer targeted preventive care to these vulnerable populations; however, limited quantitative research exists measuring their impact, specifically on health literacy and likelihood for behavior change. To investigate this, a student-led health education clinic was held in January 2023 in the rural community of Lykens, Pennsylvania by the Student-run and Collaborative Outreach Program for Health Equity (SCOPE). Fifty-five pre- and post-clinic surveys using Likert-style questions measured the knowledge and likelihood of behavioral change for several preventive health topics, including hypertension, diabetes mellitus, cancer screenings, childhood vaccinations, skin cancer, mental health, addiction, and nutrition. From pre- to post-clinic, there was a significant increase in knowledge of hypertension (p = 0.023) and diabetes (p = 0.014), likelihood of attending cancer screenings (p = 0.038), and confidence in identifying cancerous moles (p = < 0.001). There was a non-significant increase in understanding of mental health and nutrition, and no change in understanding of addiction or childhood vaccinations. It is likely that the level of interaction in education provided and relevance of information to participants contributed to effective uptake of information. The results demonstrate an immediate impact on health literacy and likelihood of behavioral change for several important preventive health topics, and advocate for the use of student-run healthcare interventions in addressing the prevalence of chronic disease in rural communities. [ABSTRACT FROM AUTHOR]

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n  = 50) and control groups (n  = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t -tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4–5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P  < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations. [ABSTRACT FROM AUTHOR]

Adherence to exercise is a crucial aspect of behavioral changes related to exercise. However, current models fail to predict behavioral change, and exercise programs struggle to foster adherence. In this Current Opinion article, we defined adherence as a process linking behavior and attitude. More specifically, exercise adherence is the process by which people's behaviors conform to their attitudes and vice versa. Behavioral change theories should be able to predict changes, transformations, and modifications of behaviors; however, this is not currently the case. Prediction models of behavior are mainly focused on how to predict behavioral changes by affecting attitudes; however, these models have not considered the target behavior as a facilitator of adherence. Herein, a behavioral perspective is considered in three directions: first, exercise is a therapeutic modality that has the potential to improve motivation; second, chronic exercise helps sustain effort over time and increase executive functions and willpower; and third, exercise is an active behavior that has the potential to facilitate attitude change. Key Points: • Behavioral change techniques should take into account processes involved during exercise or processes for long-term change. • Attitude change can be facilitated by committing people to their exercise behaviors. • The repetition of a short-term cycle linking exercise to effort-based decision-making leads to long-term changes in the strength of the link between attitude and behavior. [ABSTRACT FROM AUTHOR]

Best management practices (BMPs) are practical, affordable alternatives to conventional production systems. They contribute to improving the agricultural production system's ability to address social, economic, and ecological challenges. BMPs enhance the viability and sustainability of agriculture when successfully applied, but in systems where intensive industrial agriculture predominates, their use is limited. Working with potato producers (large, medium, and small scale) in South-Western and Central Ontario, Canada this project applied a Systems Thinking approach to understand motivating drivers and structural, institutional, and organizational barriers impacting the adoption of BMPs for potato cultivation. This study used a mixed-methods approach for two years to collect quantitative and qualitative data using a farm-level survey, focus groups, workshops, and participant observation. Data was collected regarding demographics, management approaches, social networking, and perceived challenges with BMPs uptake. Our data analysis revealed that family and future generations, ecosystem, soil and human health, community and social relationships, and efficiency and profitability were motivating drivers (based on beliefs and values) influencing management decisions. However, structural, institutional, and organizational barriers (including market access, regulation, production efficiencies and competition), mediate producers' abilities to act according to these motivations. Small-scale, medium-scale and large-scale producers are impacted by these barriers differently. In understanding the decision-making factors which drive BMP uptake in Ontario's potato sector, policy and program design can leverage drivers and reduce barriers. [ABSTRACT FROM AUTHOR]

AbstractGamification has arguably emerged as the most dominant of persuasive technologies, giving rise to a multidisciplinary field and diverse associated industries. As the field has grown, so too has the need for further resolution, nuance, and conceptual acuity; it is important to be able to distinguish different facets once the use of umbrella terminology becomes insufficient. One notable area of interest is gamblification, the study of which is not yet as well-developed; while gamblification is often conceptualized as an extension of gamification, recent research has found it to be an effective means of engaging users in alternative ways. This article examines points of similarity and difference between gamblification and gamification, with the intention to highlight the scope of gamblification as a means to promote specific user behavior and, furthermore, to provide a clear theoretical basis for the ongoing investigation into this phenomenon. The most significant point of difference is that while successful gamification primarily utilizes intrinsic motivations to effect meaningful change, gamblification does so predominantly through leveraging extrinsic motivations. Consequently, gamification and gamblification are used to achieve different aims and are suited to different contexts. Finally, a future research agenda for developing the study of gamblification is presented. [ABSTRACT FROM AUTHOR]

Integrating host movement and pathogen data is a central issue in wildlife disease ecology that will allow for a better understanding of disease transmission. We examined how adult female mule deer (Odocoileus hemionus) responded behaviorally to infection with chronic wasting disease (CWD). We compared movement and habitat use of CWD‐infected deer (n = 18) to those that succumbed to starvation (and were CWD‐negative by ELISA and IHC; n = 8) and others in which CWD was not detected (n = 111, including animals that survived the duration of the study) using GPS collar data from two distinct populations collared in central Wyoming, USA during 2018–2022. CWD and predation were the leading causes of mortality during our study (32/91 deaths attributed to CWD and 27/91 deaths attributed to predation). Deer infected with CWD moved slower and used lower elevation areas closer to rivers in the months preceding death compared with uninfected deer that did not succumb to starvation. Although CWD‐infected deer and those that died of starvation moved at similar speeds during the final months of life, CWD‐infected deer used areas closer to streams with less herbaceous biomass than starved deer. These behavioral differences may allow for the development of predictive models of disease status from movement data, which will be useful to supplement field and laboratory diagnostics or when mortalities cannot be quickly retrieved to assess cause‐specific mortality. Furthermore, identifying individuals who are sick before predation events could help to assess the extent to which disease mortality is compensatory with predation. Finally, infected animals began to slow down around 4 months prior to death from CWD. Our approach for detecting the timing of infection‐induced shifts in movement behavior may be useful in application to other disease systems to better understand the response of wildlife to infectious disease. [ABSTRACT FROM AUTHOR]

Introduction: Although the use of application (app)s and wearable devices supporting diabetes treatment has spread rapidly in recent years, evidence of their impact, especially in combination of them, is limited. TOMOCO™ is a lifestyle improvement support app that features interactive virtual conversations according to the programmed algorithm guiding users toward their goals of lifestyle improvement. We hypothesized that TOMOCO™ in combination with Fitbit, which accurately tracks users' activity level, would encourage people with type 2 diabetes mellitus (T2DM) to change their lifestyles and improve their glycated hemoglobin (HbA1c) levels without changes in conventional therapy. Thus, we performed the present study to explore the effectiveness of this combination in Japanese participants with T2DM who had not achieved their glycemic targets. Methods: In this single-arm exploratory study, participants with T2DM used the TOMOCO™ and Fitbit in addition to the conventional diet/exercise therapy and anti-diabetic drug for 12 weeks. They were provided with feedback/advice by health care providers based on the TOMOCO™ and Fitbit records. The primary endpoint was the change in HbA1c from baseline to the end of the observation period. Data were expressed as mean ± standard deviation. Results: Fifty-nine (96.7%) of the 61 participants (male, 42 [71.2%]; age, 60.1 ± 8.7 years; HbA1c level, 7.48 ± 0.37% at screening) completed the study. At the end of the observation period, the HbA1c was significantly reduced (− 0.41 ± 0.41%, p < 0.001). This trend was consistent across the preselected patient characteristics, including sex, age, and body mass index. However, it was more pronounced in the participants with earlier stages of behavioral changes defined by the transtheoretical model at baseline. Conclusions: The unique features of TOMOCO™ in combination with Fitbit, together with conventional therapy, may promote a healthy lifestyle and thus contribute to improving HbA1c in people with T2DM. Clinical Trial Registration: jRCT1070220007. [ABSTRACT FROM AUTHOR]

Science can provide accurate information to society to inform decision-making and behavior. One contemporary topic in which the science is very clear, yet behavioral change has lagged, is climate change mitigation. Climate change scientists use evidence-based research to advocate to the public to adopt emission-reducing behaviors in various sectors such as transportation and food. However, scientists themselves often do not change their own behaviors according to the scientific consensus. We present a case study of a group of natural sciences PhD students, who, when presented with evidence and an opportunity for a behavioral change with implications for climate change mitigation, demonstrated defensive reactions that would undoubtedly frustrate these same scientists if they were doing public outreach about their own work. Our goal is to raise awareness that we scientists do not always practice what we preach but could perhaps overcome this by understanding the defense mechanisms that impede meaningful change. [ABSTRACT FROM AUTHOR]

• To reduce waste effectively, accurate at-source measurements are required. • Gender-based difference in viewpoints are identified. • Younger respondents find automated waste collection more necessary than older adults. • Smart bin prototypes are under development in Japan. • Existing habits of waste separation and cleaning predicted PAYT waste reduction. Smart bins can increase transparency and accuracy in monitoring waste characteristics such as weight, volume, and disposal times. This information can aid in enforcing waste reduction policies, including the pay-as-you-throw (PAYT) system. However, the public's response to this technology remains uncertain. Despite Japan's reputation for high waste separation compliance and collection rates, it has one of the world's highest per capita rates of plastic and packaging waste generation. This study surveyed 1000 Japanese individuals regarding their perception of smart bin features and their potential to encourage waste reductions. Multiple correspondence analysis (MCA) was used to explore the relationships between respondents' social attributes and their responses. The findings indicate a slightly higher responses from younger respondents (above 85 % of those age 10–29 compared to around 75 % of those aged 60 and older) who were in favour of smart bin technology functions such as unscheduled waste pick up and automatized waste separation. On the other hand, there was a strong unwillingness (0.57 count ratio) to reduce plastic waste even if a smart bin assisted PAYT is introduced from those who did not engage in waste separation and cleaning in the first place. Finally, an open-ended question about strategies to reduce plastic waste resulted in a large portion of mindset change ideas (24.8 % of the female respondents) and technology innovations proposals (24 % of male respondents). Although development of a smart-bin prototype is taking place, behavioral change strategies to foster a willingness to reduce waste must take place along with technological interventions. [ABSTRACT FROM AUTHOR]

When governments and healthcare providers offer people cash rewards for weight loss, an assumption is that cash rewards are versatile, working equally well for everyone – for example, for all genders. No research to date has tested for gender difference in response to financial incentives for weight loss. We show in an randomized controlled trial (RCT) (n = 472) that cash incentives for weight loss only worked for males. The RCT consisted of a 3-month, self-administered online weight loss program. Offering a US$150 incentive for a 5% weight loss more than tripled the proportion of males who were successful, compared with a no-incentive Control arm (20.9% vs. 5.9%). On average, males in the incentive arm lost 2.4% of weight over 3 months, compared with 0.9% in the Control arm. The same incentive had no such effect on females: The average weight loss in the incentive arm was not significantly different than in the Control (1.03% and 1.44%, respectively), nor was the proportion of participants meeting the 5% weight loss goal (8.6% and 8.7%, respectively). This study shows that males respond better than females to financial incentives for weight loss. [ABSTRACT FROM AUTHOR]

Personalized incentive-based strategies that aim at encouraging commuters to shift their travel modes to public transit modes have long been supposed to release road congestion and promote green travel. However, previous studies didn't explore the heterogeneity of how incentives change commuters' travel mode choice in different cities or their sensitivity to different types of incentives. To address this gap, we propose a two-stage analysis framework to categorize cities based on the willingness of commuters in different cities to change their travel modes and further analyze the differences in commuters' sensitivity to various types of incentives. The results indicate that the perceived value of commuters for the same incentives in different categories of cities is remarkably different. The willingness of commuters to use public transit modes after the implementation of incentives is not significantly correlated to the level of economic development of cities. These results could generate significant implications for formulating differentiated and personalized incentives to increase the commuters' willingness to travel by public transitmodes in different types of cities. [ABSTRACT FROM AUTHOR]

Persistent musculoskeletal pain (PMP) is multifactorial and causes both societal and financial burdens. Integration of multifactorial management in patients with PMP remains challenging. A single-case experimental design was performed on three patients suffering from high impact PMP (lumbar spine, shoulder and knee) to i) assess the potential for Cognitive Functional Therapy (CFT) in interdisciplinary care, ii) describe in detail the clinical journey patients experienced during the intervention, and iii) evaluate the changes and associations in relation to the outcome measures of pain, disability, maladaptive movement behavior, subjective overall improvement, health related quality of life and work status. These were monitored over one year, at the end of each of the six intervention modules. After introducing the intervention systematic changes were seen, with medium to large changes (Non-overlap of All Pairs 0.67–1) for all outcome measures. Associations between changes of the outcome measures were large (r ≥ 0.50) and changes occurred concurrently. Minimally clinically important difference thresholds were exceeded for all outcome measures and two patients achieved relevant improvements related to work reintegration. The positive results of this study are comparable with recent CFT studies. However, the difference regarding the number of sessions and duration of the intervention is evident. The length of the intervention in this study seemed to enable continuous significant improvements up until 12 months post onset and follow-up. CFT in interdisciplinary care was effective for all measures. The detailed descriptions of the clinical processes aim to improve clinical care. • A SCED with patients experiencing high disability, persistent pain in lower back, shoulder, and knee. • A one-year intervention applying Cognitive Functional Therapy (CFT) principles within an interdisciplinary program. • CFT in an interdisciplinary setting proved effective in reducing functional disability and pain. • Pain, disability, and movement behavior changed simultaneously. • Descriptions of the clinical journeys may serve as a valuable tool for clinical translation. [ABSTRACT FROM AUTHOR]

This study extended the theory of planned behavior (TPB) by integrating two additional factors: low-carbon sports tourism cognition and environmental literacy. Subsequently, the expanded model was tested to gauge its effectiveness in determining low-carbon sports tourism behavior. The results showed that including environmental literacy and low-carbon sports tourism cognition considerably enhances the extended TPB model's capacity to elucidate low-carbon sports tourism behavior. The independent variables in the comprehensive model account for 20.5% of the variation in low-carbon sports tourism behavior conflict and 36.4% of the variability in behavioral intention. Upon comparing the augmented TPB model for low-carbon sports tourism behavioral intention to the original model, there was a rate of change in the explanatory power of ΔR2 = 0.65. Similarly, for low-carbon sports tourism behavior, the developed TPB model demonstrated a rate of change in the explanatory power of ΔR2 = 0.41. Several recommendations emerged from the findings, including the need for heightened awareness of low-carbon sports tourism, fostering greater accountability among tourists for their low-carbon sports tourism activities, enhancing publicity and educational efforts regarding low-carbon sports tourism, and reducing the financial barriers associated with low-carbon sports tourism for travelers. Further examination suggests that these strategies not only enhance the practical applicability of the model but also promote more sustainable practices within the industry. In conclusion, the study underscores the need to integrate environmental considerations into sports tourism planning and promotion because such integration can substantially enhance individual and collective environmental responsibility. [ABSTRACT FROM AUTHOR]

Introduction: Understanding what drives differences in values toward wild meat is important for developing legislation and behavioral change campaigns that promote sustainable use. Value orientations (VOs) underly behavior. VOs are influenced by personal (e.g., gender, generation), social (e.g., media, family), location (e.g., rural versus urban), and experience determinants. In Guyana, an ethnic diverse nation in South America, the national hunting laws have recently been instated. The wildlife management agency is rolling out a behavioral change campaign in collaboration with a sustainable use initiative. To support this campaign, we evaluated VOs toward wild meat across Guyana. Methods: Applying Multiple Correspondence Analysis and generalized linear models to data from interviews, we examined location, personal, and societal determinants for their influence on these VOs and explored how VOs translated into behavior, specifically wild meat consumption frequency. Results: Location (Indigenous and coastal: rural, town, urban), intertwined with ethnicity, and gender showed the strongest associations with variation in VOs. Respondents from Indigenous territories expressed mostly positive VOs compared to coastal Guyanese. Women expressed more neutral or negative, and more negative biocentric VOs compared to men, and this difference was largest among Indigenous but non-existent in urban sites. Negative anthropocentric VOs toward wild meat consistently grouped together and dominated among those not consuming wild meat. Highest consumption was seen among those expressing positive materialistic VOs. Positive anthropocentric VOs were associate with intermediate consumption frequencies and most typical for men. Those expressing negative values toward wild meat based on biocentric orientations toward wildlife consumed wild meat, but rarely. Discussion: Our results direct behavioral change efforts to men on the coast who consume wild meat for enjoyment at bars, restaurants, or family events. Based on our study, positive messaging promoting the coexistence between consumption of mostly resilient species and caring about wildlife would be well-received to support sustainable use policies. [ABSTRACT FROM AUTHOR]