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Stigmatization is a complex and deeply ingrained process, not easily amenable to change. The field of systematic behavior change can offer guidance for the improvement of stigma reduction efforts. In this article, we describe Intervention Mapping as a relevant approach for designing stigma reduction interventions. We demonstrate that, for stigma reduction to be effective, a number of actions are essential. We must (1) ascertain, at various socioecological levels, relevant and changeable determinants of stigmatizing behavior and target them specifically in our interventions; (2) delineate exactly what change our stigma reduction interventions aim to achieve at the level of determinants; (3) ensure that the methods employed to reduce stigmatization are aligned with the determinants of stigmatizing behavior and that the theoretically defined conditions under which those methods are most effective are considered, along with characteristics of the target population and intervention context; (4) pretest and pilot test newly developed interventions, and ensure budgetary capacity for these; (5) consider intervention adoption, implementation, and maintenance right from the outset, and approach these systematically as well; and (6) measure, in our evaluations of interventions, not only the desired endpoint (i.e., stigma reduction) but also more direct intervention objectives and changes in the determinants of stigmatizing behavior, and complement effect evaluations with process evaluations that assess implementation reach, completeness, and fidelity. For each of the six Intervention Mapping steps, we provide concrete examples and discuss the current stigma and behavior change literature. Importantly, we also summarize a number of evidence-based stigma reduction methods.

RATIONALE: Translating research evidence into clinical practice to improve care involves healthcare professionals adopting new behaviours and changing or stopping their existing behaviours. However, changing healthcare professional behaviour can be difficult, particularly when it involves changing repetitive, ingrained ways of providing care. There is an increasing focus on understanding healthcare professional behaviour in terms of non-reflective processes, such as habits and routines, in addition to the more often studied deliberative processes. Theories of habit and routine provide two complementary lenses for understanding healthcare professional behaviour, although to date, each perspective has only been applied in isolation. OBJECTIVES: To combine theories of habit and routine to generate a broader understanding of healthcare professional behaviour and how it might be changed. METHODS: Sixteen experts met for a two-day multidisciplinary workshop on how to advance implementation science by developing greater understanding of non-reflective processes. RESULTS: From a psychological perspective 'habit' is understood as a process that maintains ingrained behaviour through a learned link between contextual cues and behaviours that have become associated with those cues. Theories of habit are useful for understanding the individual's role in developing and maintaining specific ways of working. Theories of routine add to this perspective by describing how clinical practices are formed, adapted, reinforced and discontinued in and through interactions with colleagues, systems and organisational procedures. We suggest a selection of theory-based strategies to advance understanding of healthcare professionals' habits and routines and how to change them. CONCLUSION: Combining theories of habit and routines has the potential to advance implementation science by providing a fuller understanding of the range of factors, operating at multiple levels of analysis, which can impa

Purpose: To explore the factors influencing adherence to home-based exercises among community-dwelling stroke survivors using Intervention Mapping (IM) approach.Material and methods: Qualitative interviews were conducted with ten stroke survivors living in semi-urban regions of India. The data were analysed using Atlas.Ti8 software and categorised using the Social Ecological Model.Results: The mean age of the stroke participants was 61 +/- 11 years. Key factors such as lack of awareness about stroke recovery and exercises, poor perceived recovery, hopelessness and lack of emphasis on exercises by healthcare professionals led to non-adherence while commitment, continued supervision, supportive family and society facilitated adherence. Some cultural specific factors such as opting for folk medicine over rehabilitation and social stigma were also identified.Conclusions: The factors which influenced adherence to home-based exercises in stroke are existent at the individual, interpersonal, organisational and community level. This study can lead to the development of effective interventions for promoting exercise adherence among stroke survivors in low and middle income countries (LMICs).

In the medical sector, various imaging methodologies or modalities (e.g. MRI, PET, CT) are used to assess the health of various parts of the bodies of patients. One such investigation is the blood flow or perfusion of the heart muscle, expressed as the (blood) flow rate normalized by the mass of the volume of interest. Currently there is no physical flow standard for the validation of quantitative perfusion measurements. This need has been addressed in the EMPIR 15HLT05 PerfusImaging project. A phantom simulating the heart muscle has been developed with the capability that it can reproducibly generate a flow profile with individual flow rates known with a relative uncertainty of about 10% (k = 2) and total flow rate known with an uncertainty of 1% (k = 2). An overview of the phantom and its validation is given. Next, a new analysis method is presented to analyse the sequence of images which are acquired when using a standard dynamic imaging protocol. It is concluded that the new, alternative approach gives results comparable to the standard analysis method., Multi Phase Systems

Current research funding models for health psychologists tend to be biased toward support for large-scale 'definitive' behavioural trials. This approach emphasizes rigorous tests of one or more key questions, but, unintentionally, may lead to the funding of interventions that are based on myriad untested assumptions. We propose that future funding models should provide support for 'iterative' research that tests assumptions at each stage of the intervention development process, including design, deployment, efficacy, implementation, and sustainability. More funding should be allocated to these developmental stages with funding allocated to testing the efficacy of definitive trials only when it is appropriately supported by research that indicates that key assumptions have been met. This shift should foster more robust behavioural interventions that have appropriate efficacy and effectiveness, and 'work' in the 'real world' contexts. Funders should support assumption testing using a diversity of methods (e.g., qualitative, quantitative, expert consensus), and encourage behavioural researchers to adjust their assumptions according the data produced. We contend that time is now to shift funding models to support assumption-testing research and ensure that funding applications for research testing 'definitive' behavioural trials has clear evidence supporting underlying assumptions.