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Cardiovascular diseases represent a significant cause of morbidity and mortality worldwide, and an unhealthy lifestyle notoriously accounts for a large percentage of their risk. Identifying resources to stimulate lifestyle changes is an essential goal of primary and secondary cardiovascular prevention. Self‐efficacy beliefs are among the major psychological factors proven to impact health status and lifestyle. This study aimed to confirm the role of self‐efficacy beliefs by investigating their associations over 5 years of adherence to healthy lifestyles in terms of diet and physical activity in a sample of 275 newly diagnosed patients with acute coronary syndrome. Longitudinal profiles of lifestyles and self‐efficacy beliefs in their improvement were identified through latent class growth analysis. Correlations were then performed to explore the associations between lifestyles and self‐efficacy trajectories. Results showed a positive association between virtuous lifestyle profiles and high self‐efficacy in implementing behavioural change. Finally, two logistic regressions were performed to test the hypothesis that a high self‐efficacy profile would predict better lifestyles 5 years after the coronary event. This hypothesis was confirmed for diet. Overall, current findings confirm the importance of implementing repeated psychological interventions that promote patients' efficacy beliefs in self‐regulating their behaviour changes over time. [ABSTRACT FROM AUTHOR]

Household consumption emissions are a major contributor to global greenhouse gas emissions, making them a vital target for emission reductions. While previous research has studied socio-demographic and situational factors in explaining the variation in individuals’ carbon footprints, a more comprehensive exploration of individual drivers, would benefit the development of effective and equitable mitigation policies. The current study examines associations between psychological and socio-demographic factors and carbon footprints of Finnish adults (n = 3,519). Income was found to be the strongest factor explaining the variation in carbon footprints. While environmental attitudes, perceived easiness and perceived importance of climate actions statistically explained differences in carbon footprints, the effect sizes were modest. The factors explaining variation in the carbon footprint varied across different domains (housing, travel, diet, and other consumption of goods and services), with psychological factors having a more substantial effect on diet compared to other domains. Overall, the findings suggest that tailoring policy interventions to reduce emissions from different domains to specific groups and factors could be beneficial. Furthermore, the greatest emission reduction potential lies among higher-income individuals. In the dietary domain, attitude-changing interventions could be more effective, while financial or choice architecture interventions might be better suited for other domains. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effectiveness of interventions to increase physical activity (PA) in people with spinal cord injury (SCI). Method: Online databases PubMed, Medline, AMED and CINAHL were searched from the earliest date available to July 2022. Randomised controlled trials (RCT) exploring the effect of interventions on physical activity in people with SCI were eligible. The search identified 1191 studies, after screening 16 reports of 15 RCT's were included. Data were extracted on participant characteristics, intervention characteristics and physical activity outcomes. Methodological quality was assessed using the PEDro Scale and certainty of evidence assessed using GRADE. Post intervention means and standard deviations were pooled in meta-analyses to calculate standardised mean differences or mean differences and 95% confidence intervals. Results: Fifteen trials with 693 participants (mean age 41–52) were included. There was moderate certainty evidence that exercise interventions had no effect on subjectively or objectively measured PA. There was moderate to high certainty evidence that behavioural interventions and combined behavioural and exercise interventions increased subjectively, but not objectively measured physical activity. Conclusion: Behaviour change techniques are an important intervention component for increasing PA in people with SCI. IMPLICATIONS FOR REHABILITATION: Only half of people with spinal cord injury (SCI) meet physical activity guidelines Physical activity (PA) is important in managing primary and secondary complications Exercise intervention alone does not increase PA in people with SCI Interventions should include behavioural techniques to increase PA in people with SCI Interventions that include behavioural techniques are shown to be effective across a wide range of SCI populations [ABSTRACT FROM AUTHOR]

• Persistent symptoms impair quality of life of individuals with long COVID. • The web-based wellness platform integrates nutrition and mindfulness. • Digital interventions can enhance behaviors and health outcomes in long COVID. Individuals with Post COVID-19 condition (PCC), or long COVID, experience symptoms such as fatigue, muscle weakness, and psychological distress, including anxiety, depression, or sleep disorders that persist after recovery from COVID-19. These ongoing symptoms significantly compromise quality of life and diminish functional capacity and independence. Multimodal digital interventions targeting behavioural factors such as nutrition and mindfulness have shown promise in improving health outcomes of people with chronic health conditions and may be beneficial for those with PCC. The BLEND study (weB-based pLatform to improve nutrition, mindfulnEss, and physical function, in patients with loNg COVID) study is an 8-week pilot randomized controlled trial evaluating the feasibility of a digital wellness platform compared to usual care among individuals with PCC. The web-based wellness platform employed in this study, My Viva Plan (MVP)®, integrates a holistic, multicomponent approach to promote wellness. The intervention group receives access to the digital health platform for 8 weeks with encouragement for frequent interactions to improve dietary intake and mindfulness. The control group receives general content focusing on improvements in dietary intake and mindfulness. Assessments are conducted at baseline and week 8. The primary outcome is the feasibility of platform use. Secondary and exploratory outcomes include a between-group comparison of changes in body composition, nutritional status, quality of life, mindfulness, physical activity, and physical performance after 8 weeks. Findings of this study will inform the development of effective web-based wellness programs tailored for individuals with PCC to promote sustainable behavioural changes and improved health outcomes. [ABSTRACT FROM AUTHOR]

• Study protocol of a web-based wellness platform on chronic disease risk factors. • Participants engage with platform individually or with online group for 16 weeks. • Primary outcome focuses on between-group difference in weight loss at week 16. • The entire study is conducted remotely. • The study hopes to inform scalable interventions for chronic disease prevention. Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30 to <35 kg/m2 and aged 40–65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5% or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity. [ABSTRACT FROM AUTHOR]

Using food and drink disposable containers has heavy environmental and economic consequences. The widespread adoption of reusable containers is a challenge that requires understanding the psychological determinants and barriers of the behaviour. Two studies were conducted: one with a sample from the general public (study 1, N = 302) and one with respondents having access to a reusable container system at work (study 2, N = 737). Online surveys measured self-reported use of single-use and reusable containers for food and drinks takeaway (studies 1 and 2) and for food delivery (study 1). Stages of change and psychological determinants were also measured to provide behavioural levers. Results indicate that in study 1, most of the sample is aware of the issue associated with single-use containers but has not switched to reusable. In study 2, most respondents say they are already using few single-use and are willing to continue, particularly for drinks to go. Thus, accessibility at the workplace to a reusable container system is associated with higher stages of change. However, many respondents are also in the preactional phase for food takeaway, that is, willing to change but have not started yet. In both studies, perception of control on the behaviour and volitional variables are positively associated with stages of change. This suggests that making reusable containers easier to use and helping individuals plan how and when they can do it could encourage behaviour change. [ABSTRACT FROM AUTHOR]

AbstractThe catalytic effect of climate change on the emergence and prevalence of invasive alien pests along with weak pesticide regulatory frameworks in developing countries calls for a transition towards sustainable pest management. Agro-ecological pest management (APM) offers a nature-based, cost-effective alternative for addressing systemic pest challenges, such as mango fruit fly invasion. We applied a two-part fractional regression to sequentially model APM adoption and intensity decisions among 423 smallholder mango orchard managers from Makueni County, Kenya. Despite APM’s potential, we observed moderate adoption rates (56.7%), with the average adopter implementing only 25% of the APM practices concurrently. Farmers’ socio-psychological attributes significantly influenced both adoption and intensity decisions. While perceptions of technology attributes and institutional and social factors primarily influenced both the adoption and intensity decisions, information constraints, resource endowment, gender and inter-generational factors significantly influenced only the intensity decision. To support the transition from synthetic insecticides to APM measures, policymakers should create more opportunities for awareness creation, training and knowledge co-creation and co-production, particularly through social networks and gender-disaggregated participatory group approaches. [ABSTRACT FROM AUTHOR]

Recent advancements have been made in our understanding of transformative tourism, but the gap between conceptualisations and experiences has yet to be bridged. Using existing theories defining tourist transformation, this study empirically examines male and female travellers' subjective experiences and identifies types of transformation. A survey of 514 participants was conducted, and the data analysed through an exploratory factor analysis. The results suggest that tourist transformation corresponds to reflection, changing worldviews, existential transformation processes and outcomes, transformative learning outcomes, environmental sustainability awareness, cross-cultural understanding, wellbeing, and behavioural change. Significant differences between women and men's experiences were only found in two factors, namely reflection and transformative learning outcomes. These results contribute to the theoretical and practical understanding of tourist transformation and indicate that there might be more to 'the' transformative travel experience. [ABSTRACT FROM AUTHOR]

Abstract Household consumption emissions are a major contributor to global greenhouse gas emissions, making them a vital target for emission reductions. While previous research has studied socio-demographic and situational factors in explaining the variation in individuals’ carbon footprints, a more comprehensive exploration of individual drivers, would benefit the development of effective and equitable mitigation policies. The current study examines associations between psychological and socio-demographic factors and carbon footprints of Finnish adults (n = 3,519). Income was found to be the strongest factor explaining the variation in carbon footprints. While environmental attitudes, perceived easiness and perceived importance of climate actions statistically explained differences in carbon footprints, the effect sizes were modest. The factors explaining variation in the carbon footprint varied across different domains (housing, travel, diet, and other consumption of goods and services), with psychological factors having a more substantial effect on diet compared to other domains. Overall, the findings suggest that tailoring policy interventions to reduce emissions from different domains to specific groups and factors could be beneficial. Furthermore, the greatest emission reduction potential lies among higher-income individuals. In the dietary domain, attitude-changing interventions could be more effective, while financial or choice architecture interventions might be better suited for other domains.

Abstract Background Indoor lighting, exposure to outdoor daylight, physical activity and sleep interact to influence functioning, mood and cicadian rhythm. Older adults (≥ 65 years), who often spend more time at home, are less physically active and experience more sleep problems, could benefit from strategies to support behavioural change and self-managed modifications in the home. The study’s primary objective was to assess the usability and feasibility of the ‘Light, activity and sleep in my daily life’ intervention, delivered as a web-based course. Methods This 9-week intervention was delivered in a municipality in Sweden (55.70° N). Participants were eight healthy women (age 71–84), community-living in one-person households. We recruited through municipal staff and posters at senior citizen meeting points. Both qualitative and quantitative data were collected before and after the intervention. The outcome measures were intervention usability (ease of use, usefulness) and study feasibility (e.g., recruitment procedure, online engagement). Measures also included changes to routines and self-managed home adjustments to determine whether the participants applied what they had learnt. Results All participants completed the intervention. Time logged in varied between 25 min and 3 h (M = 1 h 50 min) per week. Seven participants’ system usability scores were between 90 and 100 (‘Excellent’) out of 100. When interviewed, participants reported overall high satisfaction with what they had learnt. Six participants were particularly satisfied with the modules targeting light. Seven participants made changes to their lighting or darkness conditions, such as replaced bulbs with either 3-step dimming or higher colour temperature LEDs (samples were included in the intervention test kit). One suggestion to improve the online delivery was to enable participants to add text comments to the weekly evaluation form. Conclusions The web-based intervention was feasible to deliver but time for recruitment should be extended and advertisement in the local newspaper should be considered. Participants’ computer proficiency and access to the internet at home will be critical in a future study with a larger sample. Only minor changes to the online content of the intervention are needed based on participants’ feedback. The intervention will be possible to evaluate in a future pilot study.

Human behaviour significantly affects the dynamics of infectious disease transmission as people adjust their behavior in response to outbreak intensity, thereby impacting disease spread and control efforts. In recent years, there have been efforts to incorporate behavioural change into spatio-temporal individual-level models within a Bayesian MCMC framework. In this past work, parametric spatial risk functions were employed, depending on strong underlying assumptions regarding disease transmission mechanisms within the population. However, selecting appropriate parametric functions can be challenging in real-world scenarios, and incorrect assumptions may lead to erroneous conclusions. As an alternative, non-parametric approaches offer greater flexibility. The goal of this study is to investigate the utilization of semi-parametric spatial models for infectious disease transmission, integrating an “alarm function” to account for behavioural change based on infection prevalence over time within a Bayesian MCMC framework. In this paper, we discuss findings from both simulated and real-life epidemics, focusing on constant piecewise distance functions with fixed change points. We also demonstrate the selection of the change points using the Deviance Information Criteria (DIC).

Abstract Introduction Behaviourally informed soft policies, such as nudges, have become popular in areas like health, environment, and energy use as cost-effective instruments to change behaviour and decision-making. However, the effectiveness of soft policies in the transport sector is modest at best. One reason for this relative ineffectiveness might be their one-size-fits-all nature, and personalizing soft interventions has been suggested to increase their effectiveness. The Trans-theoretical Model (TTM) suggests that people progress through five stages of behavioural change, from pre-contemplating a behaviour to maintaining the behaviour, and behavioural interventions could be designed for specific stages. However, it is not always feasible to conduct surveys to place people at different stages of the TTM. Methods This paper explores whether it is possible to use multimodality data taken from a travel diary to place people at different stages of the TTM. The analysis uses an existing dataset from 826 respondents that includes self-reported TTM stages regarding cycling and data on multimodality. In the analysis, the multimodality data are used to allocate respondents to categories and assign them to TTM stages. The performances of the stage assignment approaches are evaluated using the self-reported TTM data and confusion matrices. Findings The accuracy of the allocation of participants to TTM stages using multimodality data is approximately 75%. The accuracy is higher for early stages (pre-contemplation) and later stages (maintenance) of the TTM. A data-driven approach to dealing with multimodality data performs slightly better than an approach that relies on pre-defined categorization. Conclusion The paper suggests that it will be possible in the future to personalise behavioural interventions according to the stages of the TTM even in the absence of self-reported survey data that classifies people to TTM stages if objective multimodality data are available.

Abstract Household consumption accounts for 65–72% of total greenhouse gas emissions globally, and therefore, a change in current consumption patterns has the potential to mitigate climate change and provide emission reductions. There is knowledge on the consumption options with a high mitigation potential, but this information has not been combined with a consumer behavior information. This study examines the emission-reduction potential of suburban residents in Finland through a survey that assesses their willingness to adopt climate actions, and by calculating the potential impact of various actions. Finnish suburban households have already implemented low-impact climate actions (recycling, reducing food waste), but the implementation of high-impact actions in households could also be increased. Transitioning to a vegetarian diet, reducing air travel and limiting consumption are identified as the most effective mitigation actions when the potential increase in the implementation rate and impact on greenhouse gas emissions are considered. However, the results suggest that voluntary individual efforts alone are not sufficient to achieve the 1.5 °C carbon budget. Thus, alongside behavioural changes, strong policy measures and technological advancements are necessary. These findings emphasise the specific individual actions that should be prioritised when formulating climate policies at the national or city levels.

Healthcare information dissemination via digital media is crucial for enhancing public health awareness and decision-making. This study investigates the effectiveness, reach, and barriers of digital media in healthcare communication. Utilizing a sample of 186 respondents from Delhi, India, the study employs chi-square tests to examine the relationships between digital media reach and healthcare information accessibility, improvements in health knowledge and behavioural changes, and the perception of barriers and facilitators. Results indicate significant relationships between the perception of digital media reach and information accessibility (χ² = 38.796, p = 0.001), health knowledge improvement and behavior change (χ² = 37.772, p = 0.002), and between perceived barriers and facilitators (χ² = 118.721, p < 0.001). These findings highlight the potential of digital media to enhance healthcare information dissemination and promote positive health behaviour's, while highlighting the need to address digital literacy and access disparities. Recommendations include enhancing user engagement through personalized content, improving digital literacy, ensuring robust quality control, and safeguarding privacy and security. This study contributes valuable insights for healthcare practitioners, policymakers, and digital media professionals aiming to optimize health communication strategies in the digital era. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo explore influences on the capability, opportunity and motivation of physiotherapists integrating new evidence into routine care.Mixed-methods study utilising the Theoretical Domains Framework and Capability-Opportunity-Motivation-Behaviour model. Metropolitan inpatient rehabilitation physiotherapists participated by integrating the Balance Intensity Scale into routine care for 6 weeks. Evidence integration was supported by a tailored theory-informed approach. Participants completed pre- and post-evidence integration surveys and a post-evidence integration focus group.Pre- and post-surveys were completed by 24 and 12 participants, respectively. One focus group (n = 7) was conducted. Framework analysis identified themes in Capability (n = 4), Opportunity (n = 4) and Motivation (n = 5) domains influencing behaviour when implementing new evidence. The evidence integration process enhanced participants’ Knowledge (p = 0.04), Skills (p = 0.003) and Belief in capabilities (p = 0.03) when prescribing and measuring balance exercises.This study identified perceived barriers and enablers to evidence integration of a new outcome measure into routine care. It highlights strategies that may support physiotherapy teams in incorporating new evidence into routine care. These strategies include education on the evidence being implemented, physical resources, change champions to facilitate social support, management endorsement, and recognition of the time and effort required for evidence integration in the short term.When integrating new evidence into routine physiotherapy care in rehabilitation settings, the theoretical domains framework can provide a suitable framework to identify potential barriers and enablers of evidence integration at a local level, to guide the tailoring of support strategies.Rehabilitation physiotherapists can integrate the Balance Intensity Scale into balance exercise prescription as part of routine care.Targeted education provides support to change practice and implement evidence-informed care.Clinical change champions and sharing the effort to change as a team are pivotal in fostering the adoption of new evidence, such as the Balance Intensity Scale, into practice.When integrating new evidence into routine physiotherapy care in rehabilitation settings, the theoretical domains framework can provide a suitable framework to identify potential barriers and enablers of evidence integration at a local level, to guide the tailoring of support strategies.Rehabilitation physiotherapists can integrate the Balance Intensity Scale into balance exercise prescription as part of routine care.Targeted education provides support to change practice and implement evidence-informed care.Clinical change champions and sharing the effort to change as a team are pivotal in fostering the adoption of new evidence, such as the Balance Intensity Scale, into practice. [ABSTRACT FROM AUTHOR]

Cultural change is often positioned as central to transformation within the Australian Public Service (APS). The ongoing focus on cultural change suggests it has not yet been realised, which is unsurprising, given it is so difficult to change. However, cultural change may also be impeded due to the way it is portrayed within the APS. This article draws on the work of Schein to identify three problems with how organisational culture and cultural change are portrayed in the APS, including the focus on a unified APS culture, the simplistic way in which culture is portrayed, and the general and high‐level claims for how to achieve cultural change. It provides three recommendations for how these problems can be addressed, including focusing on high‐level principles for conduct across the APS (rather than a unified APS culture), focusing on cultural evolution at the department, agency, and subunit levels, and supporting cultural evolution through establishing mechanisms for behavioural change. Adopting this approach could enable the APS to realise desired changes and enable success of the Albanese Government's APS reform agenda. Points for practitioners: Cultural change is difficult to achieve due to culture being deeply embedded, underpinned by a stable system of values, beliefs, and assumptions.Change could be realised within the APS through focusing on cultural evolution, rather than cultural change—specifically at the department, agency, and subunit levels where there is some compatibility between existing and desired cultures.Cultural evolution requires the identification of the specific behaviours required for effective change, followed by a reconfiguration of a range of mechanisms required to embed and reinforce behavioural change.Leaders play a central role in facilitating behavioural change and cultural evolution, but doing this effectively may require leadership cognitive shifts; therefore, leaders need support and development. [ABSTRACT FROM AUTHOR]

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Introduction: Behaviourally informed soft policies, such as nudges, have become popular in areas like health, environment, and energy use as cost-effective instruments to change behaviour and decision-making. However, the effectiveness of soft policies in the transport sector is modest at best. One reason for this relative ineffectiveness might be their one-size-fits-all nature, and personalizing soft interventions has been suggested to increase their effectiveness. The Trans-theoretical Model (TTM) suggests that people progress through five stages of behavioural change, from pre-contemplating a behaviour to maintaining the behaviour, and behavioural interventions could be designed for specific stages. However, it is not always feasible to conduct surveys to place people at different stages of the TTM. Methods: This paper explores whether it is possible to use multimodality data taken from a travel diary to place people at different stages of the TTM. The analysis uses an existing dataset from 826 respondents that includes self-reported TTM stages regarding cycling and data on multimodality. In the analysis, the multimodality data are used to allocate respondents to categories and assign them to TTM stages. The performances of the stage assignment approaches are evaluated using the self-reported TTM data and confusion matrices. Findings: The accuracy of the allocation of participants to TTM stages using multimodality data is approximately 75%. The accuracy is higher for early stages (pre-contemplation) and later stages (maintenance) of the TTM. A data-driven approach to dealing with multimodality data performs slightly better than an approach that relies on pre-defined categorization. Conclusion: The paper suggests that it will be possible in the future to personalise behavioural interventions according to the stages of the TTM even in the absence of self-reported survey data that classifies people to TTM stages if objective multimodality data are available. [ABSTRACT FROM AUTHOR]

Background: Seasonal malaria chemoprevention (SMC) is a World Health Organization-recommended intervention for the prevention of malaria among children at high risk in areas with seasonal transmission. During the coronavirus disease 2019 (COVID-19) pandemic, SMC drug distribution was rapidly adapted to reduce contact and mitigate the risk of transmission between communities and community distributors, with caregivers administering doses. To address the challenges and find local solutions to improve administration and adherence, the role model approach was designed, implemented and evaluated in selected communities of Burkina Faso, Chad and Togo. This paper describes the results of this evaluation. Methods: Focus group discussions were held with primary caregivers in all three countries to understand their perceptions of the approach's acceptability and feasibility. In Burkina Faso and Togo, household surveys assessed the characteristics of caregivers reached by role model activities. Key indicators on SMC coverage and adherence allowed for an assessment of caregiver engagement outcomes related to participation in activities. Statistical associations between participation in study's activities and caregiver beliefs related to SMC had been tested. Results: The majority of caregivers believed the approach to have a positive effect on drug administration, with most adopting the promoted strategies. Greater involvement of fathers in drug administration and acknowledgement of their joint responsibility was a notable positive outcome. However, several barriers to participation were noted and there was criticism of the group approach. In Burkina Faso and Togo, end-of-round survey results revealed that 98.4% of respondents agreed the approach improved their knowledge and skills in malaria prevention, while 100% expressed a desire to continue practicing the behaviours learned. However, there was a relatively low level of awareness of the approach among communities. Participation was strongly associated with participants' self-reported belief in ease of remembering to administer, and ease of administering, SMC medicines. Conclusion: Caregivers perceived the role model approach to be beneficial in aiding drug administration, with other positive impacts also reported. Replication and scale-up should utilize the most popular communication channels and existing community structures to ensure activities are promoted effectively. A mixture of group and one-on-one approaches should be used where appropriate and feasible. [ABSTRACT FROM AUTHOR]

Epidemic trajectories can be substantially impacted by people modifying their behaviours in response to changes in their perceived risk of spreading or contracting the disease. However, most infectious disease models assume a stable population behaviour. We present a flexible new class of models, called behavioural change individual‐level models (BC‐ILMs), that incorporate both individual‐level covariate information and a data‐driven behavioural change effect. Focusing on spatial BC‐ILMs, we consider four “alarm” functions to model the effect of behavioural change as a function of infection prevalence over time. Through simulation studies, we find that if behavioural change is present, using an alarm function, even if specified incorrectly, will result in an improvement in posterior predictive performance over a model that assumes stable population behaviour. The methods are applied to data from the 2001 U.K. foot and mouth disease epidemic. The results show some evidence of a behavioural change effect, although it may not meaningfully impact model fit compared to a simpler spatial ILM in this dataset. [ABSTRACT FROM AUTHOR]

Household consumption accounts for 65–72% of total greenhouse gas emissions globally, and therefore, a change in current consumption patterns has the potential to mitigate climate change and provide emission reductions. There is knowledge on the consumption options with a high mitigation potential, but this information has not been combined with a consumer behavior information. This study examines the emission-reduction potential of suburban residents in Finland through a survey that assesses their willingness to adopt climate actions, and by calculating the potential impact of various actions. Finnish suburban households have already implemented low-impact climate actions (recycling, reducing food waste), but the implementation of high-impact actions in households could also be increased. Transitioning to a vegetarian diet, reducing air travel and limiting consumption are identified as the most effective mitigation actions when the potential increase in the implementation rate and impact on greenhouse gas emissions are considered. However, the results suggest that voluntary individual efforts alone are not sufficient to achieve the 1.5 °C carbon budget. Thus, alongside behavioural changes, strong policy measures and technological advancements are necessary. These findings emphasise the specific individual actions that should be prioritised when formulating climate policies at the national or city levels. [ABSTRACT FROM AUTHOR]

Unfortunately, though we are seeing more acceptance/tolerance in society, Rainbow communities/LGBTQIA+ community continue to be marginalised and discriminated against. Many of these negative pressures and barriers create negative outcomes. Rainbow communities represent an umbrella term for sexually and gender diverse people including but not limited to transgender, non-binary, gay, lesbian and bisexual individuals. Social marketing offers a medium for pro-social change. However, interventions focused on Rainbow communities are comparatively scant, and little critiques have been put forward to ensure inclusion and facilitate appropriate representation and engagement. Therefore, the aim of this paper is to critique and evaluate existing Rainbow social marketing literature. To complete this evaluation, queering was used to highlight gaps, inaccuracies or limitations in the literature. Given reflection on the literature, three main problem areas emerged (1) a heavily skewed focus on the sexual health of gay men and MSM (men who have sex with men), (2) issues surrounding the individual(s) leading the intervention and (3) misrepresentation of identities in analysis and reporting. In identifying these issues, areas for further development, scrutiny and investigation can be revealed. Synthesising this, the other major contribution of this article is a discussion regarding vital future research that highlights areas of focus for Rainbow research and social marketing. The queering approach used supposes an emancipatory disposition and aims to highlight practical changes for that normative environment. Therefore, complementing the overarching aim, an objective and contribution of this paper are practical recommendations to ensure that social marketers appropriately support and engage Rainbow communities. [ABSTRACT FROM AUTHOR]

Background: A key role of general practice professionals (that is, GPs, and general practice nurses [GPNs]) is to support patients to change behaviours. Traditional approaches to assisting patients with, and learning about, behaviour change have modest outcomes. Aim: To explore behaviour change with GPs and GPNs and the availability of related professional development (PD) opportunities. Design & setting: Multi-methods study comprising an environmental scan survey of behaviour change tools and PD opportunities, and online workshops with Australian GPs and GPNs. Method: Survey data were analysed using qualitative content analysis, informing the design of the workshops. Workshop data included observation, note-taking, and collaborative reflection, which were analysed thematically and synthesised with survey data. Results: The survey had 18 complete responses. For the two virtual workshops, workshop 1 had 16 participants and workshop 2 had eight participants. There was diversity in awareness of existing behaviour change tools and resources. Preferences for future tools and PD opportunities related to specific aspects of its design, content, activities, and delivery. The following three themes developed from the workshop data: recognising the importance of relationships; recognising the importance of continuity; and keeping context in mind. In the absence of tools and resources, GPs and GPNs discussed behaviour change as something that occurs best through a patient-centred alliance that is continuing, respectful, grounded in trust and an understanding of their patient, and prioritises patient autonomy. Conclusion: Future general practice behaviour change PD should support clinicians to ‘assist’ patients and recognise the social and contextual influences on behaviour. [ABSTRACT FROM AUTHOR]

This article takes us into the world of municipal solid waste entrepreneurs, revealing how public awareness campaigns and behavioural change efforts intertwine with entrepreneurial endeavours. Through conversations with 11 key participants—entrepreneurs from four geopolitical zones of Nigeria and a senior management figure from the Lagos State Waste Management Authority—I hear firsthand accounts of the challenges they face and their strategies to transform waste into opportunity. Guided by the theory of planned behaviour, this study sheds light on how these entrepreneurs perceive the role of public awareness in shaping waste management behaviour and driving business innovation. From their stories, a common theme emerges: the need to educate the public about responsible waste practices while developing creative business models that engage communities. Concepts like “freemium-to-premium” offerings are explored as ways to break through psychological barriers and inspire wider participation in waste management initiatives. These voices illustrate how awareness campaigns are not only about fostering environmental responsibility, but also about creating pathways for entrepreneurial growth, ultimately contributing to a more sustainable and circular economy. This study contends that public awareness extends beyond mere knowledge; it acts as a form of infrastructure in its own right. Rather than being just an end goal, awareness becomes a vital foundation in the pursuit of improved waste management practices, serving as a key driver for meaningful environmental action.

Abstract The ongoing degradation of Earth's ecosystems through human activities poses a severe threat to biodiversity. To mitigate this crisis, substantial changes in human behaviour are required. The frequency of nature experiences, particularly during childhood, has been established as a key predictor of actions that support biodiversity (hereafter, pro‐biodiversity behaviours). However, the significance of the quality of these experiences remains poorly understood. In this study, we analysed a large sample of Japanese adults and observed positive associations between both the frequency and diversity of nature experiences during childhood and increased pro‐biodiversity behaviours. These associations held true across a range of behaviours, including the purchase of eco‐friendly products, reduced use of pesticides in domestic gardens and contributions to conservation organisations. Our findings indicate that the association between pro‐biodiversity behaviours and the diversity of childhood nature experiences is comparable to that of the frequency of such experiences. These findings suggest that expanding people's access to diverse and frequent nature experiences can play a crucial role in promoting positive behavioural changes to prevent biodiversity loss. Read the free Plain Language Summary for this article on the Journal blog.

Background : Cancer is a major public health problem. Four million new cancer cases are diagnosed annually in Europe, of which around 40% could be prevented. The European Code Against Cancer (ECAC) is a health education tool to raise awareness about risk factors and evidence-based measures to prevent cancer. The ECAC 4th edition consists of 12 recommendations to reduce individuals' cancer risk and related deaths. This study explores perceived barriers to adopting the cancer prevention actions recommended by the ECAC fourth edition in the European Union (EU). Methods : The COM-B model of behaviour change will be used as a framework for the design and analysis of the study since it identifies factors (capability, opportunity, motivation) that need to be present for any behaviour change to occur. A qualitative study using an exploratory research methodology was designed to obtain information from adults with no previous cancer diagnosis by employing in-depth semi-structured interviews. Participants are selected using a quota sampling strategy according to sex, age, and education level (18 profiles/country). Interviews will be conducted in participants' native language by trained researchers. Afterward, a thematic content analysis will be conducted to identify common topics, followed by a critical analysis of their discourse. Discussion : This study will contribute to informing the fifth edition of the ECAC –currently under development; by providing insights on how EU citizens perceive the cancer prevention recommendations of the fourth edition and whether they can motivate them to change unhealthy behaviours. Additionally, the study will help to identify the main facilitators and barriers (perceived or already confronted) to adopt these cancer prevention recommendations so that this knowledge will contribute to updating the recommendations of the fifth edition of the ECAC. [ABSTRACT FROM AUTHOR]

Background: While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. Methods: A semi-structured focus group was conducted with rehabilitation clinicians and those with lived experience of paediatric acquired brain injury (ABI). The 90-min focus group was audio-recorded and transcribed verbatim. Data were thematically coded and mapped against the Theoretical Domains Framework (TDF) to understand influencing factors, which were then linked to the Capability, Opportunity, Motivation – Behaviour (COM-B) model. Results: A total of 11 participants (nine paediatric rehabilitation clinicians, one parent and one young person with lived experience of paediatric ABI) participated in the focus group. Factors influencing collaborative goal setting mapped to the COM-B and six domains of the TDF: Capabilities (Skills, Knowledge, Beliefs about capabilities, and Behavioural regulation), Opportunities (Environmental context and resources), and Motivation (Social/professional role and identity). Results suggest that a multifaceted intervention is needed to enhance rehabilitation clinicians' and families' skills and knowledge of goal setting, restructure the goal communication processes, and clarify the roles clinicians play in goal setting within the interdisciplinary team. Conclusion: The use of the TDF and COM-B enabled a systematic approach to understanding the factors influencing goal setting for children with acquired brain injury in a large interdisciplinary rehabilitation team, and develop a targeted, multifaceted intervention for clinical use. These represent important considerations for the improvement of collaborative goal setting in paediatric rehabilitation services to ensure that best practice approaches to goal setting are implemented effectively in clinical practice. While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. This article belongs to the Collection Clinical Implementation to Optimise Outcomes. [ABSTRACT FROM AUTHOR]

Food waste is a global challenge that threatens the sustainable development of human societies. Although food waste is produced in all stages of the food supply chain, household food waste is the biggest contributor to the food waste fraction. In this research, we systematically reviewed 54 empirical studies to explore drivers and barriers to household food waste reduction and prevention. Key aspects, such as comprehension and perception of food waste issues, practices and lifestyles, were examined. Our findings suggest that a great understanding of the impact of one's food waste on health, environment and economy directly promotes food waste management. Additionally, the food waste issue is not attributed to a single factor, it may differ varies across countries. The majority of the reviewed literature on household food waste comes from European countries, where similar geographical, economic and cultural characteristics may lead to comparable drivers and barriers. This could be the reason for showing optimistic experience to the respective food waste management interventions. However, the applicability of these findings and interventions to regions beyond Europe are uncertain. Future studies should also be expanded to include regions such as Asia, North America, Africa, Oceania, Latin America and the Caribbean. To support the sustainable management of household food waste, mapping country-specific food waste determinants is crucial in developing easy-to-implement food waste interventions that can specifically address the food waste issue in each country. [ABSTRACT FROM AUTHOR]

Background Aims Study Design Results Conclusions Relevance to Clinical Practice The health care sector is among the most carbon‐intensive sectors, contributing to societal problems like climate change. Previous research demonstrated that especially the use of personal protective equipment (e.g., aprons) in critical care contributes to this problem. To reduce personal protective equipment waste, new sustainable policies are needed.Policies are only effective if people comply. Our aim is to examine whether compliance with sustainable policies in critical care can be increased through behavioural influencing. Specifically, we examined the effectiveness of two sets of nudges (i.e., a Prime + Visual prompt nudge and a Social norm nudge) on decreasing apron usage in an intensive care unit (ICU).We conducted a field experiment with a pre‐ and post‐intervention measurement. Upon the introduction of the new sustainable policy, apron usage data were collected for 9 days before (132 observations) and 9 days after (114 observations) the nudge interventions were implemented.Neither the Prime + Visual prompt nudge, nor the Social norm nudge decreased apron usage.While previous studies have found that primes, visual nudges and social norm nudges can increase sustainable behaviour, we did not find evidence for this in our ICU field experiment. Future research is needed to determine whether this null finding reflects reality, or whether it was due to methodological decisions and limitations of the presented experiment.The presented study highlights the importance of studying behavioural interventions that were previously proven successful in the lab and in other field contexts, in the complex setting of critical care. Results previously found in other contexts may not generalize directly to a critical care context. The unique characteristics of the critical care context also pose methodological challenges that may have affected the outcomes of this experiment. [ABSTRACT FROM AUTHOR]

Introduction: Adult caregivers (ACGs) are largely responsible for caring for their family members, which can increase their stress levels. This increased stress makes them more susceptible to chronic illnesses. The adoption of health-promoting behaviours, particularly through mindfulness-based behavioural education (MBBE), can significantly impact the daily habits of ACGs. However, there is limited research on this topic in the context of Thailand. Thus, this study aimed to explore the perceptions and experiences of ACGs receiving MBBE, focusing on physical, mental, social and other influential factors. Methods: A qualitative study was conducted among 19 ACGs living in the Bangkok Metropolitan Area. Focus group discussions (FGDs) and observations were conducted. The FGDs were digitally recorded, and their contents were analysed. Results: The ACGs were found to perceive and experience improvements in their mental stability and habitual behaviour. These improvements manifested as increased calmness, relaxation, clear communication, empathy, reduced risky behaviour, decreased desire for excessive consumption and travel and reduced pain. Furthermore, mindful behaviour was influenced by both internal and external personal factors as well as the specific situational environment. Conclusion: MBBE could lead to an increase in promotional behaviour, especially when combined with awareness, self-recollection and a self-efficacy approach. This finding encourages health personnel to consider incorporating regular skill practice as a complement to health education. [ABSTRACT FROM AUTHOR]

The spread of COVID-19 resulted in restrictive lockdowns. For families supporting young people with autism spectrum disorder (ASD), the service system was stripped away. The aim of this study was to explore the impact of this challenging situation on a group of Australian carers and parents of children and young people with ASD, with an intention to inform policy and practice based on the lived experiences of these families. A survey of parents of children and young people with ASD in Australia returned 117 responses, of which 86 responded to open-ended questions about COVID-19 lockdowns. Twelve parents responded to the invitation to be interviewed. Interview and survey data were analysed thematically. Five themes emerged: accessing support services, receiving support services online, changes in behaviour, higher levels of conflict, and impact on health and relationships. The experience of lockdowns under COVID-19 undermined informal and formal support systems, and had a particularly strong negative impact on the experiences of children with ASD and their families. These findings also provide support for understanding the social model of disability as a mainstay in the lives of children with disabilities and their carers. IMPLICATIONS The social model of disability was dismantled for children and young people and their carers during the COVID crisis. This unacceptable attack on the human rights of disabled people (people with a disability) needs future planning to ensure that it does not occur again. Future crises require more nuanced policy and practice responses that do not close off all child and family supports to children with ASD and their carers. [ABSTRACT FROM AUTHOR]

The aims of this study were to (a) qualitatively determine former students' perceptions of environment, personal and behaviour factor changes that were due to the teachers involved in the Strengthening of Mathematics and Science in Secondary Education (SMASSE) project in Kenya and (b) reveal the long-term influence of these qualitative changes on their lives. The study also clarified the significance of using life story analysis to this end. The theoretical framework we utilised is social learning theory. Data collected from interviews were examined using Steps for Coding and Theorisation (SCAT) analysis, as well as NVivo, to identify respondents' experiences as former SMASSE students. First, SCAT analysis revealed that participants' lives were influenced in the long term owing to changes in: (a) environmental factors, such as interaction with SMASSE teachers and collaboration with other students; (b) personal factors, such as changes in cognitive and affective aspects; (c) behavioural factors, such as learning methods. Second, by using NVivo to integrate all the stories, we showed that former students' perceptions of the environmental, personal and behaviour changes that were due to the teachers involved the SMASSE project were mutually interrelated. The analysis has also identified long-term effects on various aspects of human resource development: post-graduation career development, employment opportunities, and mindset. Finally, the results of this study emphasise the robustness of qualitative research in identifying the qualitative changes in the participants in a multi-dimensional manner for this international project. [ABSTRACT FROM AUTHOR]

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With its unique position, primary health care (PHC) can provide health promotion and prevention services, including lifestyle behavioural counselling. Unhealthy lifestyle behaviours are very prevalent among patients attending PHC, with many patients unwilling to change or in the precontemplation stage. While patients in the contemplation stage are better managed using the 5As approach of motivational interviewing counselling, those unwilling or not ready for change necessitate a different approach, such as the 5Rs of motivational interviewing (MI) counselling. The 5Rs MI approach holds promise in motivating unwilling individuals to consider embarking on the journey of behavioural change. The 5Rs approach is not a stand-alone checklist of tasks implemented in isolation but is best integrated within a theoretical behavioural change framework. Of the four health-related behavioural change theoretical frameworks that are frequently used, the transtheoretical stages of the change model are the most used. This continued professional development article provides a summary review of the literature on behavioural change theories as they apply to lifestyle health behaviour change and presents the 5Rs approach as a feasible and practical approach to manage patients who are unwilling to change or in the precontemplation stage. This offers a beacon of hope for improved patient outcomes in a PHC system saddled with high prevalence of modifiable unhealthy lifestyle behaviours.

Background: A key role of general practice professionals (that is, GPs, and general practice nurses [GPNs]) is to support patients to change behaviours. Traditional approaches to assisting patients with, and learning about, behaviour change have modest outcomes. Aim: To explore behaviour change with GPs and GPNs and the availability of related professional development (PD) opportunities. Design & setting: Multi-methods study comprising an environmental scan survey of behaviour change tools and PD opportunities, and online workshops with Australian GPs and GPNs. Method: Survey data were analysed using qualitative content analysis, informing the design of the workshops. Workshop data included observation, note-taking, and collaborative reflection, which were analysed thematically and synthesised with survey data. Results: The survey had 18 complete responses. For the two virtual workshops, workshop 1 had 16 participants and workshop 2 had eight participants. There was diversity in awareness of existing behaviour change tools and resources. Preferences for future tools and PD opportunities related to specific aspects of its design, content, activities, and delivery. The following three themes developed from the workshop data: recognising the importance of relationships; recognising the importance of continuity; and keeping context in mind. In the absence of tools and resources, GPs and GPNs discussed behaviour change as something that occurs best through a patient-centred alliance that is continuing, respectful, grounded in trust and an understanding of their patient, and prioritises patient autonomy. Conclusion: Future general practice behaviour change PD should support clinicians to ‘assist’ patients and recognise the social and contextual influences on behaviour.

Abstract Mobility as a Service (MaaS) has recently gained popularity as an opportunity to encourage a more sustainable mobility model and improve urban liveability. Today, it is still uncertain if travellers are willing to uptake MaaS and transform their habits. In the paper, we explore individuals’ behavioural intention based on a survey comprising 418 respondents in the metropolitan area of Randstad (The Netherlands). The application of a Structural Equation Model allows to uncover a series of explanatory (attitudinal and personality) factors relevant for MaaS acceptance. Then, a cluster analysis determines four profiles of travellers in relation to their intention to embrace this new solution: ‘Short-duration commuters’, ‘Active travellers’, ‘Traditional car-supporters’, and ‘MaaS admirers’. Overall, we identify three main barriers for the potential adoption of MaaS: low willingness to combine different modes of transport, low affinity with technology, and low reliability on the new mobility services. We also recognise that low environmental concerns seem to frustrate individuals’ innovativeness.

Acknowledging the importance of climate challenges to our environment, landscape and cities, this review focuses on the exploration of visual methods (e.g., design, drawing, sketches) in relation to a deeper understanding of climate emergency and sustainability on a spatial scale. It provides an overview of existing research and highlights the role design and drawing can play in landscape-led projects, as well as the impact these might have on behavioural change and decision-making. Looking at how design and drawing are perceived in landscape architecture and what their contribution is to the narrative of a project as well as the decisions made, this paper establishes a connection between pictorial forms and landscape. At the same time, this paper explores whether visualisations are used in relation to the climate and environmental challenges we face, sharing some light on the role they can play with regards to climate awareness and sustainability and how important they might be for our communities, cities and regions. This review highlights the need for further research around this topic and explains that there is a minor part of the literature looking at ways in which landscape design can be integrated into the wider climate emergency agenda and how this might influence behavioural change and the decision-making of various stakeholders. [ABSTRACT FROM AUTHOR]