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Abstract While existing literature has focused on modelling pedestrian movement on platforms, there is a lack of understanding of passengers' perceptions, motivations, and influential factors that shape their on‐board behaviours and choices. This study developed a conceptual framework to assess passengers' post‐boarding behaviours and perceptions, specifically focusing on their actions and choices inside the train carriages. The conceptual framework was tested through survey data of 429 passengers in Melbourne, Australia. The result shows that door access is the most influential factor when passengers choose where to stand or sit on board, followed by comfort, safety, privacy, and random factors. Furthermore, the study explores the relationship between the post‐boarding behaviour variables and travellers’ personal and trip characteristic variables. The analysis shows that carrying large items has a more significant effect on many post‐boarding behaviour variables. Gender, age group, travel frequency, waiting time, and carrying small items also play significant roles. However, variables such as travel time and frequency of group travel have lesser effects. These novel findings offer valuable insights, laying the groundwork for future modelling activities. Moreover, the understanding derived from passenger perceptions can guide transport agencies and operators in shaping strategies to improve onboard services.

The United Nations (UN) and several UN Agencies have started to use behavioural sciences in order to achieve their policy goals, including for achieving the Sustainable Development Goals (SDG). While it is appreciated that insights into actual behavior inform the policymaking of international actors, they also raise scientific and normative considerations that warrant caution. First, for those considerations it matters, who the acting and the targeted actors are: behavioural interventions come in many facets and warrant a differentiated view -- a finely built roadmap is thus desirable. Second, there are concerns about the internal and external validity of experimental research on which behavioural sciences largely, but not solely, draws. Third, taking a differentiated view on behavioral sciences also allows for a more finely grained view on normative concerns underlying the operations of the United Nations in environmental policy. This contribution spells out those considerations while still advocating for the approach as such. [ABSTRACT FROM AUTHOR]

Abstract At present, data obtained from the Global Positioning System (GPS) is significantly valuable in mobility research. However, GPS‐based data lacks include trip purpose information. Consequently, many researchers have endeavoured to predict or impute these missing attributes. Existing studies have focused on constructing more features to improve prediction accuracy, but paid less attention to the model's applicability and transferability. In this study, five trip purposes are extracted, including education, recreation, personal, shopping, and transportation, from Chengdu Household Travel Survey (HTS) data. The individual and trip characteristics that are common and can be easily derived from GPS data are carefully selected and extracted. Point of Interest (POI) data of the trip destination are also collected to enhance input characteristics. To obtain more accurate results, an ensemble learning model, Gradient Boosting Decision Trees (GBDT), is employed to predict trip purposes. grid search and cross‐validation techniques are used to optimize the hyper‐parameters. Empirical results show that the proposed model achieves 0.788 accuracy, which is 22.17%, 14.53%, 10.36%, and 6.77% higher than Multinominal Logit (MNL), Artificial Neural Network (ANN), Random Forest (RF), and Deep Belief Network (DBN), respectively. It is also found that although increasing trip features improve the model's accuracy, it simultaneously impairs model's transferability and generalizability.

At present, data obtained from the Global Positioning System (GPS) is significantly valuable in mobility research. However, GPS‐based data lacks include trip purpose information. Consequently, many researchers have endeavoured to predict or impute these missing attributes. Existing studies have focused on constructing more features to improve prediction accuracy, but paid less attention to the model's applicability and transferability. In this study, five trip purposes are extracted, including education, recreation, personal, shopping, and transportation, from Chengdu Household Travel Survey (HTS) data. The individual and trip characteristics that are common and can be easily derived from GPS data are carefully selected and extracted. Point of Interest (POI) data of the trip destination are also collected to enhance input characteristics. To obtain more accurate results, an ensemble learning model, Gradient Boosting Decision Trees (GBDT), is employed to predict trip purposes. grid search and cross‐validation techniques are used to optimize the hyper‐parameters. Empirical results show that the proposed model achieves 0.788 accuracy, which is 22.17%, 14.53%, 10.36%, and 6.77% higher than Multinominal Logit (MNL), Artificial Neural Network (ANN), Random Forest (RF), and Deep Belief Network (DBN), respectively. It is also found that although increasing trip features improve the model's accuracy, it simultaneously impairs model's transferability and generalizability. [ABSTRACT FROM AUTHOR]

Nudges may play an important role in improving infection prevention and control (IPC) in hospitals. However, despite the novelty of the framework, their objectives, strategies and implementation approaches are not new. This review aims to provide an overview of the methods typically used by nudge interventions in IPC in hospitals targeting healthcare workers (HCWs). The initial search in PubMed yielded nine hits. Consequently, the search criteria were broadened and a second search was conducted, introducing 'nudge sensu lato ' which incorporates insights from sources beyond the traditional nudge framework while maintaining the same objectives, strategies and approaches. During the second search, PubMed, Epistemonikos, Web of Science and PsycInfo were searched in accordance with the PRISMA guidelines. Abstracts were screened, and reviewers from an interdisciplinary team read the full text of selected papers. In total, 5706 unique primary studies were identified. Of these, 67 were included in the review, and only four were listed as nudge sensu stricto , focusing on changing HCWs' hand hygiene. All articles reported positive intervention outcomes. Of the 56 articles focused on improving hand hygiene compliance, 71.4% had positive outcomes. For healthcare equipment disinfection, 50% of studies showed significant results. Guideline adherence interventions had a 66.7% significant outcome rate. The concept of nudge sensu lato was introduced, encompassing interventions that employ strategies, methods and implementation approaches found in the nudge framework. The findings demonstrate that this concept can enhance the scientific development of more impactful nudges. This may help clinicians, researchers and policy makers to develop and implement effective nudging interventions. [ABSTRACT FROM AUTHOR]

Copyright of Ankara University SBF Journal / Ankara Üniversitesi SBF Dergisi is the property of Ankara University SBF Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

At its core, One Health promotes multidisciplinary cooperation amongst researchers and practitioners to improve the effectiveness and management of complex problems raised by the interplay of human, animal and environment interactions. Contemporary One Health literature has identified reducing disciplinary barriers as key to progress in the field, along with addressing the notable absence of social sciences from One Health frameworks, among other priorities. Efforts to position social scientists as experts on behaviour change and health decision-making has helped to articulate a concrete role for progressing One Health collaborations. Yet, there are other equally valuable functions the social scientist has in understanding complex systems, like One Health. We make explicit the multiple and diverse knowledge contributions the social sciences and humanities can make to progressing the One Health agenda. Articulating these more clearly invites a broader set of interdisciplinary perspectives to One Health discussions, allowing for stronger connections between sectors, actors, disciplines, and sub-systems. This perspective piece identifies a range of entry points for researchers and practitioners to better utilize the potential contributions social sciences and humanities scholars can make to One Health goals.

Abstract Understanding the impact of smartphone‐based multimodal information (SMMI) on travellers' P&R (park‐and‐ride) choice behaviour is very limited so far. The purpose of this study is to better understand how SMMI, social network information, and individual characteristics influence travellers' mode choices. A stated preference experiment consisting of one P&R option and two auto‐driving routes was conducted to collect car commuters’ P&R choice data in Shanghai, China. The panel mixed logit model was utilized to determine the influencing factors. It was found that the panel mixed logit model, accounting for correlations among repeated observations of the same respondent and random taste, significantly outperforms the cross‐sectional multinomial logit model in terms of goodness‐of‐fit. Specifically, travellers are highly sensitive to the information offered by SMMI on travel time, parking fare, and crowding level in subway cars, and heterogeneities do exist in travellers' preferences for these factors. In terms of social network information, the positive propensity of online reviews and information about P&R play a positive role in P&R promotion. In addition, individual characteristics including gender, age, occupation, years of driving, and P&R experience all contribute to explaining the choice of P&R. Finally, the elasticity analysis reveals that commuters are more satisfied with P&R time than with car time, and the cross elasticity of P&R time demonstrates a limited substitution effect of P&R on private cars.

Understanding the impact of smartphone‐based multimodal information (SMMI) on travellers' P&R (park‐and‐ride) choice behaviour is very limited so far. The purpose of this study is to better understand how SMMI, social network information, and individual characteristics influence travellers' mode choices. A stated preference experiment consisting of one P&R option and two auto‐driving routes was conducted to collect car commuters' P&R choice data in Shanghai, China. The panel mixed logit model was utilized to determine the influencing factors. It was found that the panel mixed logit model, accounting for correlations among repeated observations of the same respondent and random taste, significantly outperforms the cross‐sectional multinomial logit model in terms of goodness‐of‐fit. Specifically, travellers are highly sensitive to the information offered by SMMI on travel time, parking fare, and crowding level in subway cars, and heterogeneities do exist in travellers' preferences for these factors. In terms of social network information, the positive propensity of online reviews and information about P&R play a positive role in P&R promotion. In addition, individual characteristics including gender, age, occupation, years of driving, and P&R experience all contribute to explaining the choice of P&R. Finally, the elasticity analysis reveals that commuters are more satisfied with P&R time than with car time, and the cross elasticity of P&R time demonstrates a limited substitution effect of P&R on private cars. [ABSTRACT FROM AUTHOR]

Abstract Background Behavioural sciences have been shown to support the development of more effective interventions aimed at promoting healthy lifestyles. However, the operationalization of this knowledge seems to be sub-optimal in public health. Effective knowledge transfer strategies are thus needed to optimize the use of knowledge from behavioural sciences in this field. To this end, the present study examined public health practitioners’ perceptions and use of theories and frameworks from behavioural sciences to design health promotion interventions. Methods This study adopted an exploratory qualitative design. Semi-structured interviews were conducted among 27 public health practitioners from across Canada to explore current intervention development processes, the extent to which they integrate theory and framework from behavioural sciences, and their perceptions regarding the use of this knowledge to inform intervention design. Practitioners from the public sector or non-profit/private organizations who were involved in the development of interventions aimed at promoting physical activity, healthy eating, or other healthy lifestyle habits (e.g., not smoking) were eligible to participate. Results Public health practitioners generally agreed that behaviour change is an important goal of public health interventions. On the other hand, behavioural science theories and frameworks did not appear to be fully integrated in the design of public health interventions. The main reasons were (1) a perceived lack of fit with current professional roles and tasks; (2) a greater reliance on experiential-produced knowledge rather than academic knowledge (mainly for tailoring interventions to local setting characteristics); (3) the presence of a fragmented knowledge base; (4) the belief that theories and frameworks require too much time and resources to be operationalized; and 4) the belief that using behavioural sciences might undermine partnership building. Conclusions This study provided valuable insights that may inform knowledge transfer strategies that could be optimally designed to support the integration of behavioural sciences theories and frameworks into public health practices.

Abstract Background and Objective Acquired brain injury (ABI) can result in considerable life changes. Having choice and control over daily life is valued by people following ABI. This meta‐synthesis will analyse and integrate international research exploring perspectives of choice and control in daily life following ABI. Methods Databases were searched from 1980 to 13 January 2022 for eligible qualitative studies. After duplicates were removed, 22,768 studies were screened by title and abstract, and 241 studies received full‐text assessment with 56 studies included after pearling. Study characteristics and findings were extracted that related to personal perspectives on choice and control by people with an ABI (including author interpretation and quotes). Data from each study were coded and then segments of coded data across the studies were compared to create multiple broad categories. Findings Findings were then reduced from categories into 3 overarching themes with 12 subthemes. These themes were: (1) feeling like a second‐class citizen; (2) reordering life and (3) choosing a path. Participants with an ABI tussled between their feelings of loss following brain injury and their thinking about how they start to regain control and become agents of their own choices. The themes describe their sense of self, their changed self and their empowered self in relation to ‘choice and control’. Conclusions Re‐engaging with choice and control after ABI is dynamic and can be challenging. Health professionals and supporters need to facilitate a gradual and negotiated return to agency for people following ABI. A sensitive and person‐centred approach is needed that considers the readiness of the person with ABI to reclaim choice and control at each stage of their recovery. Clear service or process indicators that are built on lived experience research are needed to facilitate changes in service delivery that are collaborative and inclusive. Patient or Public Contribution This review included the voices of 765 people living with ABI and was conducted by a diverse team of allied health professionals with practice knowledge and research experience with people following ABI. Twenty‐nine of the 56 included studies had participants contributing to their design or analysis.

Background: Behavioural sciences have been shown to support the development of more effective interventions aimed at promoting healthy lifestyles. However, the operationalization of this knowledge seems to be sub-optimal in public health. Effective knowledge transfer strategies are thus needed to optimize the use of knowledge from behavioural sciences in this field. To this end, the present study examined public health practitioners’ perceptions and use of theories and frameworks from behavioural sciences to design health promotion interventions. Methods: This study adopted an exploratory qualitative design. Semi-structured interviews were conducted among 27 public health practitioners from across Canada to explore current intervention development processes, the extent to which they integrate theory and framework from behavioural sciences, and their perceptions regarding the use of this knowledge to inform intervention design. Practitioners from the public sector or non-profit/private organizations who were involved in the development of interventions aimed at promoting physical activity, healthy eating, or other healthy lifestyle habits (e.g., not smoking) were eligible to participate. Results: Public health practitioners generally agreed that behaviour change is an important goal of public health interventions. On the other hand, behavioural science theories and frameworks did not appear to be fully integrated in the design of public health interventions. The main reasons were (1) a perceived lack of fit with current professional roles and tasks; (2) a greater reliance on experiential-produced knowledge rather than academic knowledge (mainly for tailoring interventions to local setting characteristics); (3) the presence of a fragmented knowledge base; (4) the belief that theories and frameworks require too much time and resources to be operationalized; and 4) the belief that using behavioural sciences might undermine partnership building. Conclusions: This study provided valuable insights that may inform knowledge transfer strategies that could be optimally designed to support the integration of behavioural sciences theories and frameworks into public health practices. [ABSTRACT FROM AUTHOR]

The objective was to assess active ingredients, change mechanisms, and fidelity in interventions aiming to increase the quality of smoking cessation care in the Dutch primary healthcare setting. We conducted a systematic review searching five scientific databases on August 2nd, 2019, updated on October 28th, 2021. We included effect data of behavioural interventions aiming at improving the provision of smoking cessation support by Dutch primary care providers to their patients. We excluded studies published before 2000 and those without a behavioural support intervention for primary care providers targeting smoking cessation in their patients. We found 1939 articles and included 15 distinct interventions in the review. We provided an overview of study characteristics, intervention effects, fidelity, active ingredients and change mechanisms using the Behaviour Change Techniques (BCT) Taxonomy and Mechanisms of Action (MoAs) protocols. Interventions seemed more effective when including a face-to-face component, using active learning strategies and providing a tool to help follow the guidelines in practice (e.g., physical cards with information). BCTs, MoAs, and fidelity were overall poorly reported on. To support the application of smoking cessation practices in Dutch primary care, we recommend implementation of face-to-face training programs incorporating active skill training elements combined with practical tools. [ABSTRACT FROM AUTHOR]

The County Lines Model (CLM) is a relatively new illicit drugs distribution method found in Great Britain. The CLM has brought modern slavery and public health issues, while challenging the law-enforcement capacity to act, as coordination between different local police forces is necessary. Our objective is to understand the territorial logic behind the line operators when establishing a connection between two places. We use three different spatial models (gravity, radiation and retail models), as each one of them understands flow from place i to j in a different way. Using public data from the Metropolitan Police of London, we train and cross-validate the models to understand which of the different physical and socio-demographic variables are considered when establishing a connection. We analyse hospital admissions by drugs, disposable household income, police presence and knife crime events, in addition to the population of a particular place and the distance and travel times between two different locations. Our results show that knife crime events and hospital admissions by misuse of drugs are the most important variables. We also find that London operators distribute to the territory known as the ‘south’ of England, as negligible presence of them is observed outside of it.

Introduction: Improving peri‐ and postnatal facility‐based care in low‐resource settings (LRS) could save over 6000 babies' lives per day. Most of the annual 2.4 million neonatal deaths and 2 million stillbirths occur in healthcare facilities in LRS and are preventable through the implementation of cost‐effective, simple, evidence‐based interventions. However, their implementation is challenging in healthcare systems where one in four babies admitted to neonatal units die. In high‐resource settings healthcare systems strengthening is increasingly delivered via learning healthcare systems to optimise care quality, but this approach is rare in LRS. Methods: Since 2014 we have worked in Bangladesh, Malawi, Zimbabwe, and the UK to co‐develop and pilot the Neotree system: an android application with accompanying data visualisation, linkage, and export. Its low‐cost hardware and state‐of‐the‐art software are used to support healthcare professionals to improve postnatal care at the bedside and to provide insights into population health trends. Here we summarise the formative conceptualisation, development, and preliminary implementation experience of the Neotree. Results: Data thus far from ~18 000 babies, 400 healthcare professionals in four hospitals (two in Zimbabwe, two in Malawi) show high acceptability, feasibility, usability, and improvements in healthcare professionals' ability to deliver newborn care. The data also highlight gaps in knowledge in newborn care and quality improvement. Implementation has been resilient and informative during external crises, for example, coronavirus disease 2019 (COVID‐19) pandemic. We have demonstrated evidence of improvements in clinical care and use of data for Quality Improvement (QI) projects. Conclusion: Human‐centred digital development of a QI system for newborn care has demonstrated the potential of a sustainable learning healthcare system to improve newborn care and outcomes in LRS. Pilot implementation evaluation is ongoing in three of the four aforementioned hospitals (two in Zimbabwe and one in Malawi) and a larger scale clinical cost effectiveness trial is planned. [ABSTRACT FROM AUTHOR]

Background and Objective: Acquired brain injury (ABI) can result in considerable life changes. Having choice and control over daily life is valued by people following ABI. This meta‐synthesis will analyse and integrate international research exploring perspectives of choice and control in daily life following ABI. Methods: Databases were searched from 1980 to 13 January 2022 for eligible qualitative studies. After duplicates were removed, 22,768 studies were screened by title and abstract, and 241 studies received full‐text assessment with 56 studies included after pearling. Study characteristics and findings were extracted that related to personal perspectives on choice and control by people with an ABI (including author interpretation and quotes). Data from each study were coded and then segments of coded data across the studies were compared to create multiple broad categories. Findings: Findings were then reduced from categories into 3 overarching themes with 12 subthemes. These themes were: (1) feeling like a second‐class citizen; (2) reordering life and (3) choosing a path. Participants with an ABI tussled between their feelings of loss following brain injury and their thinking about how they start to regain control and become agents of their own choices. The themes describe their sense of self, their changed self and their empowered self in relation to 'choice and control'. Conclusions: Re‐engaging with choice and control after ABI is dynamic and can be challenging. Health professionals and supporters need to facilitate a gradual and negotiated return to agency for people following ABI. A sensitive and person‐centred approach is needed that considers the readiness of the person with ABI to reclaim choice and control at each stage of their recovery. Clear service or process indicators that are built on lived experience research are needed to facilitate changes in service delivery that are collaborative and inclusive. Patient or Public Contribution: This review included the voices of 765 people living with ABI and was conducted by a diverse team of allied health professionals with practice knowledge and research experience with people following ABI. Twenty‐nine of the 56 included studies had participants contributing to their design or analysis. [ABSTRACT FROM AUTHOR]

Copyright of Revista Iberoamericana de Enfermería Comunitaria (RIdEC) is the property of Revista Iberoamericana de Enfermeria Comunitaria de la Asociacion de Enfermeria Comunitaria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Introduction Improving peri‐ and postnatal facility‐based care in low‐resource settings (LRS) could save over 6000 babies' lives per day. Most of the annual 2.4 million neonatal deaths and 2 million stillbirths occur in healthcare facilities in LRS and are preventable through the implementation of cost‐effective, simple, evidence‐based interventions. However, their implementation is challenging in healthcare systems where one in four babies admitted to neonatal units die. In high‐resource settings healthcare systems strengthening is increasingly delivered via learning healthcare systems to optimise care quality, but this approach is rare in LRS. Methods Since 2014 we have worked in Bangladesh, Malawi, Zimbabwe, and the UK to co‐develop and pilot the Neotree system: an android application with accompanying data visualisation, linkage, and export. Its low‐cost hardware and state‐of‐the‐art software are used to support healthcare professionals to improve postnatal care at the bedside and to provide insights into population health trends. Here we summarise the formative conceptualisation, development, and preliminary implementation experience of the Neotree. Results Data thus far from ~18 000 babies, 400 healthcare professionals in four hospitals (two in Zimbabwe, two in Malawi) show high acceptability, feasibility, usability, and improvements in healthcare professionals' ability to deliver newborn care. The data also highlight gaps in knowledge in newborn care and quality improvement. Implementation has been resilient and informative during external crises, for example, coronavirus disease 2019 (COVID‐19) pandemic. We have demonstrated evidence of improvements in clinical care and use of data for Quality Improvement (QI) projects. Conclusion Human‐centred digital development of a QI system for newborn care has demonstrated the potential of a sustainable learning healthcare system to improve newborn care and outcomes in LRS. Pilot implementation evaluation is ongoing in three of the four aforementioned hospitals (two in Zimbabwe and one in Malawi) and a larger scale clinical cost effectiveness trial is planned.

Adolescents with chronic diseases must adhere to medication regimens to control their symptoms and avoid long-term complications. Despite its importance, medication adherence is low among adolescents. This commentary briefly covers the challenges described in the literature associated with measuring and addressing low medication adherence in adolescents. Next, it presents the evidence for the link between medication adherence and two prevalent psychological characteristics that have not been properly assessed so far: delay discounting (i.e. the relative value assigned to the future compared to the present), and risk tolerance. These psychological traits deserve further studies and are potentially amenable to interventions to improve medication adherence in adolescents with chronic conditions. [ABSTRACT FROM AUTHOR]

Background: HPV test-based primary cervical screening is replacing cytology in Canada. In other countries, women's unpreparedness and concerns hindered the transition and post-implementation screening uptake. We investigated psychosocial correlates of intentions of screening in eligible individuals to participate in HPV-based primary cervical screening., Methods: We conducted a nationwide web-based survey of individuals aged 21-70 years in 2022 and oversampled under-screened individuals. We used five Canadian-validated scales to measure HPV test-based screening knowledge, attitudes, and beliefs. Using the multistage Precaution Adoption Process Model, we assessed women's stage of intentions to participate in HPV testing and self-sampling. We estimated associations of psychosocial factors with intentions' stage using multinomial logistic regression., Findings: In both groups (adequately screened n = 1778; under-screened n = 1570), higher HPV knowledge was associated with intention for HPV testing and more personal barriers to the HPV test were associated with lower intentions to participate in HPV testing or use of self-sampling. In both groups, higher self-sampling concerns were associated with lower intentions for self-sampling and higher women's need for autonomy was associated with increased intentions for self-sampling. In the under-screened group, increased age was associated with lower intentions for HPV testing and self-sampling, while living in Canada for <10 years was associated with higher intentions., Interpretation: Our results could be used by policymakers and healthcare professionals to design communication strategies and ensure a smooth transition to HPV-based primary cervical screening, especially for under-screened individuals., Funding: Canadian Institutes of Health Research project grant 165905., Competing Interests: OT received support from the Canadian Institutes of Health Research (CIHR) through the Frederick Banting and Charles Best Doctoral award (Award No. FBD-170837) outside the scope of the submitted work. OT also serves as a part-time Research Associate Research Associate at the Lady Davis Institute for Medical Research (Montreal, Canada). GKS is supported by the Edith Kirchmann Postdoctoral Fellowship at Princess Margaret Cancer Centre and holds a CIHR 2019 fellowship award (CIHR MFE 171271) unrelated to the submitted study. GZ has received grants, contracts and consulting fees from Merck, has participated on the Data Safety Monitoring Board or Advisory Board for Merck and Moderna, and is a member of the Board of Directors of Unity Consortium, a non-profit organization. JW reports consultancy payments from Hologic to her institution for attending a cervical cancer patient advocacy workshop and participating in a discussion panel. She also received support from Hologic for travel expenses to attend patient advocacy meetings. MS has received grants and lecture honoraria from Abbott, Roche Diagnostics, Laboratories Biron and Attila Diagnostic. MS is the President of the International Society for STD Research, Co-President of the STI&HIV 2025 World Congress, and a board member of the International Papillomavirus Society. MS also reports receiving equipment from the National Cancer Institute. ZR reports unpaid leadership involvement as Vice-President of HPV Global Action, in a non-governmental organization, outside of the submitted work. LS reports consulting fees from the Canadian Partnership Against Cancer (Non-profit organization) EM, JB, KD, PZ, AL, BH, GO, SP, and MHM declare no conflicts of interest., (© 2024 The Author(s).)

The capacity to deliver programmes that prevent and control infectious diseases is a key public health function. The European Centre for Disease Prevention and Control (ECDC) aims to support and strengthen this capacity in European Union/ European Economic Area (EU/EEA) countries as part of its 2021-27 strategy which includes explicit attention to social and behavioural aspects of disease prevention. To achieve its strategic goals, it is important that ECDC improves its knowledge of prevention strategies, actors and activities in EU/EEA countries. In this Perspective, we summarise three challenges to implementing the prevention framework proposed by ECDC: (i) defining, recognising and identifying with 'prevention', (ii) integrating new understandings into established ways of thinking, and (iii) the need for more attention to prevention in governance. These challenges are derived from the findings of a project which conducted a preliminary mapping of prevention actors, networks and activities in four EU countries to support the development of a community of practice within the new ECDC prevention framework. This Perspective serves to draw attention to this prevention framework and the three identified challenges for those working on its implementation.

As healthcare professionals, we have a duty to promote the wellbeing of individuals living with chronic diseases and this could be accomplished through the establishment of self-care strategies that are both collaborative and self-directed. Insight into the complex behaviours and backgrounds of individuals who show initiative in dealing with chronic disease could help achieve this by revealing drivers of health-seeking and engaging behaviours. Therefore, by deducing the complex interactions between attitude, past experiences and disease outlook, broader patient welfare could be championed through the implementation of targeted interventions which promote self-care in chronic disease. This article aims to explore these ideas by focusing on the story of a former marathon runner and proactive secondary progressive Multiple Sclerosis sufferer, Mr. Evans, who has taken charge in leading an active and healthy lifestyle to manage his condition. His sense of patience and self-worth are rooted in his attitude and upbringing and are factors which have championed his ongoing wellbeing and understanding of his condition. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens.

The behavioural sciences curriculum in dental education is often fragmented and its clinical relevance is not always apparent to learners. Curriculum integration is vital to understand behavioural subjects that are interrelated but frequently delivered as separate issues in dental programmes. In this commentary, we discuss behavioural change as a curricular theme that can integrate behavioural sciences in dental programmes. Specifically, we discuss behavioural change in the context of dental education guidelines and describe four general phases of behavioural change (defining the target behaviour, identifying the behavioural determinants, applying appropriate behavioural change techniques and evaluating the behavioural intervention) to make the case for content that can be covered within this curricular theme, including its sequencing. This commentary is part of ongoing efforts to improve the behavioural sciences curriculum in dental education in order to ensure that dental students develop the behavioural competencies required for entry‐level general dentists. [ABSTRACT FROM AUTHOR]

The purpose of this study was to employ the theoretical domains framework (TDF) to identify behaviour change factors related to leisure-time physical activity (LTPA) in spinal cord injury (SCI) ambulators. A cross-sectional design was employed. Among 43 SCI ambulators, the TDF behaviour change factors were assessed, along with the duration, types, and intensities of LTPA performed over the previous week. The TDF behaviour change factors identified as barriers to LTPA included: knowledge, beliefs about capabilities, coping planning, and goal conflict. Approximately 71.81 mins/day (SD = 75.41) was spent doing LTPA. Participants reported aerobic and resistance training activities, along with several other types of LTPA (e.g., rock climbing). Coping planning, action planning, goal conflict, and skills explained significant variance in time spent on LTPA (R2adjusted = 0.259, p < 0.01), but only action planning uniquely predicted LTPA. Greater use of coping and action planning, lower levels of goal conflict and stronger skills were associated with greater participation in LTPA. These factors will be targeted for a future LTPA-enhancing intervention for SCI ambulators, informed by behaviour change theory. SCI ambulators participate in a surprisingly wide range of LTPA. Rehabilitation specialists can use this list to suggest activities for patients with SCI who ambulate. Barriers to leisure-time physical activity for individuals with spinal cord injury (SCI) who ambulate include lack of knowledge, weak beliefs about capabilities, lack of coping planning, and high goal conflict. Physical activity interventions for individuals with SCI who ambulate should include action and coping planning, goal conflict, and skills. Physical activity interventions should be created systematically using behaviour change theory and involvement of stakeholders throughout the development process. Practitioners can promote skills training in adapted activities like gardening, cycling, and rock-climbing for ambulators with SCI. [ABSTRACT FROM AUTHOR]

Antimicrobial stewardship (AMS) programmes include actions to improve antibiotic use. This study aimed to identify factors of AMS interventions associated with behaviour change toward antibiotic use in hospitals, applying behavioural sciences. PubMed and Scopus online databases were searched. Studies published between January 2015 and December 2020 were included. The required study outcomes were as follows: effect of the intervention reported in terms of antibiotic consumption, antibiotic costs, appropriateness of prescription, duration of therapy, proportion of patients treated with antibiotics, or time to appropriate antibiotic therapy. Participants included health care professionals involved in antibiotic prescription and use in hospitals and patients receiving or susceptible to receiving antibiotics. Studies investigating AMS interventions in hospitals were included. Risk of bias was determined using the integrated quality criteria for review of multiple study designs tool. A systematic review of AMS interventions was conducted using the behaviour change wheel to identify behaviour changes functions of interventions; and the action, actor, context, target, and time framework to describe how they are implemented. Relationships between intervention functions and the action, actor, context, target, and time domains were explored to deduce factors for optimal implementation. Among 124 studies reporting 123 interventions, 64% were effective in reducing antibiotic use or improving the quality of antibiotic prescription. In addition, 91% of the studies had a high risk of bias. The main functions retrieved in the effective interventions were enablement, environmental restructuring, and education. The most common subcategories were audit and feedback and real-time recommendation for enablement function, as well as material resources, human resources, and new tasks for environmental restructuring function. Most AMS interventions focused on prescriptions, targeted prescribers, and were implemented by pharmacists, infectious diseases specialists, and microbiologists. Interventions focusing on specific clinical situation were effective in 70% of cases. Knowledge of factors associated with behaviour changes will help address local barriers and enablers before implementing interventions. [ABSTRACT FROM AUTHOR]

Background: National clinical audit programmes aim to improve patient care by reviewing performance against explicit standards and directing action towards areas not meeting those standards. Their impact can be improved by (1) optimising feedback content and format, (2) strengthening audit cycles and (3) embedding randomised trials evaluating different ways of delivering feedback. Objectives: The objectives were to (1) develop and evaluate the effects of modifications to feedback on recipient responses, (2) identify ways of strengthening feedback cycles for two national audits and (3) explore opportunities, costs and benefits of national audit participation in a programme of trials. Design: An online fractional factorial screening experiment (objective 1) and qualitative interviews (objectives 2 and 3). Setting and participants: Participants were clinicians and managers involved in five national clinical audits – the National Comparative Audit of Blood Transfusions, the Paediatric Intensive Care Audit Network, the Myocardial Ischaemia National Audit Project, the Trauma Audit & Research Network and the National Diabetes Audit – (objective 1); and clinicians, members of the public and researchers (objectives 2 and 3). Interventions: We selected and developed six online feedback modifications through three rounds of user testing. We randomised participants to one of 32 combinations of the following recommended specific actions: comparators reinforcing desired behaviour change; multimodal feedback; minimised extraneous cognitive load for feedback recipients; short, actionable messages followed by optional detail; and incorporating ‘the patient voice’ (objective 1). Main outcome measures: The outcomes were intended actions, including enactment of audit standards (primary outcome), comprehension, user experience and engagement (objective 1). Results: For objective 1, the primary analysis included 638 randomised participants, of whom 566 completed the outcome questionnaire. No modification independently increased intended enactment of audit standards. Minimised cognitive load improved comprehension (+0.1; p = 0.014) and plans to bring audit findings to colleagues’ attention (+0.13, on a –3 to +3 scale; p = 0.016). We observed important cumulative synergistic and antagonistic interactions between modifications, participant role and national audit. The analysis in objective 2 included 19 interviews assessing the Trauma Audit Research Network and the National Diabetes Audit. The identified ways of strengthening audit cycles included making performance data easier to understand and guiding action planning. The analysis in objective 3 identified four conditions for effective collaboration from 31 interviews: compromise – recognising capacity and constraints; logistics – enabling data sharing, audit quality and funding; leadership – engaging local stakeholders; and relationships – agreeing shared priorities and needs. The perceived benefits of collaboration outweighed the risks. Limitations: The online experiment assessed intended enactment as a predictor of actual clinical behaviour. Interviews and surveys were subject to social desirability bias. Conclusions: National audit impacts may be enhanced by strengthening all aspects of feedback cycles, particularly effective feedback, and considering how different ways of reinforcing feedback act together. Future work: Embedded randomised trials evaluating different ways of delivering feedback within national clinical audits are acceptable and may offer efficient, evidence-based and cumulative improvements in outcomes. Trial registration: This trial is registered as ISRCTN41584028. Funding details: This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 15. See the NIHR Journals Library website for further project information.

Using the Ghanaian LEAP benefit programme as a case study, we investigate how administrators, service personnel and beneficiaries perceive and respond to implementation dilemmas. The investigation focuses on the LEAP benefit for caregivers of children, which is conditional on children's school attendance, health check‐ups and vaccinations. An ethical dilemma concerns whether non‐compliance should be sanctioned, since this may push caregivers and their children deeper into poverty. Other dilemmas concern how administrative resources should be allocated for the targeting, monitoring, sanctioning and exiting of beneficiaries; how spending should be allocated between providing cash benefits and securing health and education services of sufficient quality; whether available money should be spread widely but thinly to provide incentives for many caregivers to send children to schools and attend health check‐ups, or be targeted more narrowly to enhance relief for the very poorest; and whether funding would be less forthcoming if the minimum benefit was not a conditional cash transfer (CCT). We discuss whether similar dilemmas are likely to be present in other low‐ and middle‐income countries operating similar CCTs, and whether some of these also apply to "active" minimum benefits implemented in high‐income countries [ABSTRACT FROM AUTHOR]

Abstract Background Overuse of antibiotics has contributed to antimicrobial resistance; a growing public health threat. In long-term care facilities, levels of inappropriate prescribing are as high as 75%. Numerous interventions targeting long-term care facilities’ antimicrobial stewardship have been reported with varying, and largely unexplained, effects. Therefore, this review aimed to apply behavioural science frameworks to specify the component behaviour change techniques of stewardship interventions in long-term care facilities and identify those components associated with improved outcomes. Method A systematic review (CRD42018103803) was conducted through electronic database searches. Two behavioural science frameworks, the Behaviour Change Wheel and Behaviour Change Technique Taxonomy were used to classify intervention descriptions into intervention types and component behaviour change techniques used. Study design and outcome heterogeneity prevented meta-analysis and meta-regression. Interventions were categorised as ‘very promising’ (all outcomes statistically significant), ‘quite promising’ (some outcomes statistically significant), or ‘not promising’ (no outcomes statistically significant). ‘Promise ratios’ (PR) were calculated for identified intervention types and behaviour change techniques by dividing the number of (very or quite) promising interventions featuring the intervention type or behaviour change technique by the number of interventions featuring the intervention type or behaviour change technique that were not promising. Promising intervention types and behaviour change techniques were defined as those with a PR ≥ 2. Results Twenty studies (of19 interventions) were included. Seven interventions (37%) were ‘very promising’, eight ‘quite promising’ (42%) and four ‘not promising’ (21%). Most promising intervention types were ‘persuasion’ (n = 12; promise ratio (PR) = 5.0), ‘enablement’ (n = 16; PR = 4.33) and ‘education’ (n = 19; PR = 3.75). Most promising behaviour change techniques were ‘feedback on behaviour’ (n = 9; PR = 8.0) and ‘restructuring the social environment’ (e.g. staff role changes; n = 8; PR = 7.0). Conclusion Systematic identification of the active ingredients of antimicrobial stewardship in long-term care facilities was facilitated through the application of behavioural science frameworks. Incorporating environmental restructuring and performance feedback may be promising intervention strategies for antimicrobial stewardship interventions within long-term care facilities.

Abstract Background Research on the psychological impact of low‐dose computed tomography (LDCT) lung cancer screening has typically been narrow in scope and restricted to the trial setting. Objective To explore the range of psychological and behavioural responses to LDCT screening offered as part of a Lung Heath Check (LHC), including lung cancer risk assessment, spirometry testing, a carbon monoxide reading and smoking cessation advice. Methods Semi‐structured interviews were carried out with 28 current and former smokers (aged 60‐75), who had undergone LDCT screening as part of a LHC appointment and mostly received an incidental or indeterminate result (n = 23). Framework analysis was used to map the spectrum of responses participants had across the LHC appointment and screening pathway, to their LDCT results and to surveillance. Results Interviewees reported a diverse range of both positive and negative psychological responses, beginning at invitation and spanning the entire LHC appointment (including spirometry) and LDCT screening pathway. Similarly, positive behavioural responses extended beyond smoking cessation to include anticipated implications for other cancer prevention and early detection behaviours, such as symptom presentation. Individual differences in responses appeared to be influenced by smoking status and LDCT result, as well as modifiable factors including perceived risk and health status, social support, competing priorities, fatalism and perceived stigma. Conclusions The diverse ways in which participants responded to screening, both psychologically and behaviourally, should direct a broader research agenda to ensure all stages of screening delivery and communication are designed to promote well‐being, motivate positive behaviour change and maximize patient benefit.

The Climate Change urgency requires a swift reduction of energy consumption. One way to achieve this is through increased energy efficiency. Over the past decades, the debate on how to encourage energy efficiency has been guided by the physical–technical–economic model, which has a strong focus on technologies and cost savings, and in which human behaviour has been seen as a trivial factor. However, the advent of behavioural economics has started enabling the integration of the human factor also into energy efficiency policy. Still, this integration is only in its infancy. While the perspectives taken by economics and behavioural sciences enable to capture the individual dimension of energy efficiency as a problem of individual choice, the collective and social aspect of energy efficiency is still largely overlooked on the energy policy agenda. With its emphasis on how social structures interpenetrate individual actions and construction of reality, sociology offers an additional important insight that goes beyond the identification of barriers-drivers underlying investment choices. This paper aims to increase policy makers’ awareness of complementary disciplinary resources, on which they can draw to better define and address the problems associated to energy efficiency. Second, it provides a case to develop an interdisciplinary perspective as a basis to develop a more scientifically valid and socially relevant energy efficiency policy advice.

Objectives: Voluntary HIV testing rates are still low in several Asian countries including Singapore. HIV self-testing (HIVST) has the potential to increase testing, leading to earlier diagnosis and better prognosis. However, the views of at-risk individuals, especially heterosexual men (HSM), who are not coming forward for testing are still poorly understood. In this study, we examined the barriers and facilitators to and delivery preferences for HIVST in order to implement an effective intervention in Singapore.Methods: From May 2017 to June 2018, 48 in-depth interviews were conducted with HSM aged 21-66 years and at risk of HIV infection. Participants were purposively sampled based on ethnicity, age and testing behaviour. Recruitment was done mainly at brothels and entertainment establishments in Singapore. Participants gave their views on HIV testing, factors affecting HIVST use and their preferred HIVST service delivery model.Results: Most participants preferred HIVST over conventional testing for its convenience, privacy, anonymity and autonomy, but older men still preferred conventional testing. Low self-perceived risk, low awareness and self-efficacy for HIVST, and non-comprehensive test for other STIs were reported as barriers to HIVST. There were mixed opinions on kit preference. A blood-based kit was favoured for higher accuracy, while the oral-fluid-based kit was favoured for ease of use. Participants wanted a human touch for post-test counselling and linkage to care only if they self-tested positive. Traditional media, internet and social media, and venue-based outreach were potential advertising platforms mentioned.Conclusions: A locally acceptable and feasible HIVST intervention must address the barriers and facilitators of using HIVST in order to improve HIV testing rates among this at-risk population who might otherwise delay or fail to present for testing. [ABSTRACT FROM AUTHOR]

To compare the effect of a mindfulness-based mobile application versus an in-person mindfulness-based training program in terms of reducing anxiety and increasing empathy, self-compassion, and mindfulness in a population of healthcare students. The authors conducted a single-blind, randomised controlled trial with three parallel groups. Participants were allocated to the mobile app, the in-person mindfulness-based program (IMBP), or a control group. Assessments at baseline and postintervention (8 weeks) included measures of anxiety, empathy, self-compassion, and mindfulness. Of 168 students randomised, 84 were analysed on an intention-to-treat basis (app: n = 31; IMBP: n = 23; control: n = 30). The mobile app group showed a large effect size for reductions in trait anxiety compared with controls (g = 0.85, p = 0.003), and a medium, nonsignificant effect compared with the IMBP group (g = 0.52, p = 0.152). Participants from both interventions experienced a significant increase in self-compassion and mindfulness compared with controls. Levels of empathy remained unchanged for the 3 arms. A mobile app can be as effective as an IMBP in reducing anxiety and increasing self-compassion and mindfulness among healthcare students. [ABSTRACT FROM AUTHOR]

At its core, One Health promotes multidisciplinary cooperation amongst researchers and practitioners to improve the effectiveness and management of complex problems raised by the interplay of human, animal and environment interactions. Contemporary One Health literature has identified reducing disciplinary barriers as key to progress in the field, along with addressing the notable absence of social sciences from One Health frameworks, among other priorities. Efforts to position social scientists as experts on behaviour change and health decision-making has helped to articulate a concrete role for progressing One Health collaborations. Yet, there are other equally valuable functions the social scientist has in understanding complex systems, like One Health. We make explicit the multiple and diverse knowledge contributions the social sciences and humanities can make to progressing the One Health agenda. Articulating these more clearly invites a broader set of interdisciplinary perspectives to One Health discussions, allowing for stronger connections between sectors, actors, disciplines, and sub-systems. This perspective piece identifies a range of entry points for researchers and practitioners to better utilize the potential contributions social sciences and humanities scholars can make to One Health goals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Carter, Mankad and Okello.)

Machine learning models have been widely adopted for passenger flow prediction in urban metros; however, the authors find machine learning models may underperform under anomalous large passenger flow conditions. In this study, they develop a prediction framework that combines the advantage of complex network models in capturing the collective behaviour of passengers and the advantage of online learning algorithms in characterising rapid changes in real‐time data. The proposed method considerably improves the accuracy of passenger flow prediction under anomalous conditions. This study can also serve as an exploration of interdisciplinary methods for transportation research. [ABSTRACT FROM AUTHOR]