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Abstract Background Action on smoking, obesity, excess alcohol, and physical inactivity in primary care is effective and cost-effective, but implementation is low. The aim was to examine the effectiveness of strategies to increase the implementation of preventive healthcare in primary care. Methods CINAHL, CENTRAL, The Cochrane Database of Systematic Reviews, Dissertations & Theses – Global, Embase, Europe PMC, MEDLINE and PsycINFO were searched from inception through 5 October 2023 with no date of publication or language limits. Randomised trials, non-randomised trials, controlled before-after studies and interrupted time series studies comparing implementation strategies (team changes; changes to the electronic patient registry; facilitated relay of information; continuous quality improvement; clinician education; clinical reminders; financial incentives or multicomponent interventions) to usual care were included. Two reviewers screened studies, extracted data, and assessed bias with an adapted Cochrane risk of bias tool for Effective Practice and Organisation of Care reviews. Meta-analysis was conducted with random-effects models. Narrative synthesis was conducted where meta-analysis was not possible. Outcome measures included process and behavioural outcomes at the closest point to 12 months for each implementation strategy. Results Eighty-five studies were included comprising of 4,210,946 participants from 3713 clusters in 71 cluster trials, 6748 participants in 5 randomised trials, 5,966,552 participants in 8 interrupted time series, and 176,061 participants in 1 controlled before after study. There was evidence that clinical reminders (OR 3.46; 95% CI 1.72–6.96; I 2 = 89.4%), clinician education (OR 1.89; 95% CI 1.46–2.46; I 2 = 80.6%), facilitated relay of information (OR 1.95, 95% CI 1.10–3.46, I 2 = 88.2%), and multicomponent interventions (OR 3.10; 95% CI 1.60–5.99, I 2 = 96.1%) increased processes of care. Multicomponent intervention results were robust to sensitivity analysis. There was no evidence that other implementation strategies affected processes of care or that any of the implementation strategies improved behavioural outcomes. No studies reported on interventions specifically designed for remote consultations. Limitations included high statistical heterogeneity and many studies did not account for clustering. Conclusions Multicomponent interventions may be the most effective implementation strategy. There was no evidence that implementation interventions improved behavioural outcomes. Trial registration PROSPERO CRD42022350912.

Extant research finds that environmental identity is an important motivational factor for proenvironmental behavior. However, studies typically focus on investigating the effects of the strength of this identity. Based on insights from identity research, we theorize that the influence of individuals’ environmental identity on their proenvironmental behavior may depend on other identity dimensions as well. We argue that the frequency of activation of environmental identity in relevant life domains—environmental identity salience—may predict proenvironmental behavior beyond what environmental identity strength can explain. To test our theorizing, we propose a parsimonious measure of environmental identity salience. In four empirical studies, we establish that the new measure has sound psychometric properties in terms of internal consistency and discriminant validity with regard to measures of environmental identity strength. Importantly, our measure of environmental identity salience reliably predicts a range of self-reported and actual proenvironmental behaviors beyond the effects of environmental identity strength. In line with theoretical predictions, our data suggests that environmental identity salience and strength are related but distinct constructs. We conclude that investigating the nature and effects of environmental identity salience leads to a fruitful path to a more comprehensive understanding of proenvironmental behavior. The proposed new measure may serve as a helpful tool in this endeavor.

Most recent epidemics have originated in complex human-nature interactions and yet, our knowledge is very limited regarding the psychological aspects of human-nature relationships that underlie individual human responses in times of pandemic crises. We propose that the concept of connectedness with nature and associated individual difference measures offer a relevant and useful lens to inform us about how humans think, feel and behave in such critical times. Our two-wave study, conducted with 486 United States residents at the end of March 2020 (wave 1) and 533 United States residents at the beginning of May 2020 (wave 2), focuses on the 2020 coronavirus situation. It maps individual responses to the current pandemic in terms of mental representations, behavioral tendencies and perceived impact, and explores the relationships of these constructs to individual levels of connectedness with nature. As this research employs an exploratory methodology, our results provide an account of potential relationships rather than their validation and thus represent an encouraging steppingstone for research on human behavior in the time of a global pandemic. We identify a series of research propositions and questions for systematic future inquiry.

Overconsumption of highly sugary foods contributes to increases in obesity and diabetes in our population, and initiatives are issued worldwide to reduce sugar content in food products. However, it is unclear how the presentation of reduced sugar content on food packages affects taste expectations of consumers. Based on the learned knowledge about negative health effects of sugar and the common belief that unhealthy food tastes better than healthy food, consumers might conclude that lower sugar levels are associated with higher healthiness and lower tastiness. Addressing this concern, we examined how quantitative information about sugar content without any verbal description influences consumers' health and taste expectations of dairy desserts. We asked participants to indicate the expected healthiness and tastiness of randomly sampled dairy desserts, while varying systematically the quantitative sugar information provided in a label presented with the desserts (numerical sugar level in grams per 100 grams of product: low vs. original vs. high). We assumed that quantitative sugar content is not equally associated with healthiness and tastiness of products and that numerical information about sugar content informs health more than taste expectations. Therefore, we predicted that consumers expect higher healthiness, but not to the same degree lower tastiness for products with reduced sugar contented compared to products with higher sugar content. The results of the present study are in line with this hypothesis. We found that consumers expected desserts with less sugar to be healthier than desserts with higher levels of sugar. The experimentally varied sugar levels did not affect the tastiness expectations. Notably, consumers did not follow the unhealthy = tasty intuition and did not devaluate the tastiness of desserts because of heightened healthiness expectations. Our findings suggest that sole numerical information about sugar content-an important nutritional value-is more diagnostic in the construction of healthiness rather than tastiness expectations of food products.

The aim of traffic light labels on food products is to help consumers assess their healthiness. However, it is not clear whether traffic light labels do not have undesired side effects by signaling lower tastiness of healthy product alternatives and reducing purchase intentions. We therefore conducted a study with consumers from Austria (N = 173) in which we presented the amount of sugar contained in products on labels with or without traffic light colors based on the coding criteria of the UK Food Standards Agency. Expectations of products’ healthiness and tastiness, as well as purchase intentions were assessed. The products were randomly sampled from the category of desserts from a supermarket. The declared amount of sugar was experimentally varied. The traffic light labels helped participants differentiate between the healthiness of products with different sugar levels. They did not affect the expected tastiness of the healthier alternatives. Moreover, participants did not report lower purchase intentions for products high in sugar, but a higher purchase intention for products low in sugar when traffic light colors were used compared to when they were not used.

Imagined food consumption is a method of elaborately imagining oneself eating a specific food that, when repeated 30 times, has been shown to decrease subsequent intake of the same food. The technique relies on a memory-based habituation process when behavioral and motivational responses to a stimulus decrease after its repeated presentation. Thus, repeatedly imagining food consumption leads to food-specific habituation effects. Large numbers of imagined consumption repetitions are effortful and time consuming and can be problematic when applied in interventions with the goal of reducing food intake. In the present study, we assessed the efficacy of the technique at smaller numbers of repetitions while testing motor simulation as a potential facilitator of the habituation-based consumption-reduction effect. 147 participants imagined eating chocolate pudding 15 or 3 consecutive times and simultaneously performed either facilitating or not-facilitating eating movements. Results showed that participants who imagined eating the chocolate pudding 15 times (M15 = 178.20, SD15 = 68.08) ate more of the pudding than those who imagined consuming it 3 times (M3 = 150.73, SD3 = 73.31). The nature of the motor movements that were performed did not impact this effect. The data suggest that the imagined food consumption technique can result in an unexpected increase in food consumption, when smaller numbers of imagination repetitions are performed.