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Zusammenfassung. Personen, die Intentionen haben, körperlich aktiver zu werden, scheitern oft an der Umsetzung dieser Intentionen in Verhalten. Zur Überwindung dieser "Intentions-Verhaltens-Lücke" bieten sich die volitionalen Konstrukte Ausführungsplanung, Bewältigungsplanung und Handlungskontrolle an. Die vorliegende Studie untersuchte die Effektivität einer Intervention zur Verbesserung der Ausführungsplanung, der Bewältigungsplanung und der Handlungskontrolle auf die körperliche Aktivität ein Jahr später im Vergleich zu einer Kontrollgruppe. Weiterhin sollte anhand von Mediatoranalysen ermittelt werden, welche der drei volitionalen Konstrukte die Wirksamkeit der Intervention maßgeblich beeinflussten. Teilnehmer der Studie waren 199 Herzpatienten, die nach Entlassung aus der Rehabilitation einen körperlich aktiven Lebensstil aufnehmen und aufrechterhalten sollten und die auch über eine entsprechende Intention berichteten. Die Ergebnisse zeigen, dass die Intervention die körperliche Aktivität der Teilnehmer, verglichen mit einer Kontrollgruppe, ein Jahr später positiv beeinflusst hat. Die Handlungskontrolle mediierte den Interventionseffekt auf die körperliche Aktivität. Implikationen für die Übertragung der Ergebnisse in die Praxis sowie für die weitere Forschung werden diskutiert.

Zusammenfassung. In diesem Beitrag wird das Multistadienmodell der Gesundheitsverhaltensänderung (MSM) vorgestellt und auf Ernährung angewandt. Das MSM beschreibt Änderungsprozesse von Gesundheitsverhalten als sequentiellen Ablauf über die Stadien Präkontemplation, Kontemplation, Disposition, Präaktion, Implementierung, Fluktuation und Habituation. Zur Erfassung dieser Stadien wird ein interaktiver diagnostischer Algorithmus vorgeschlagen. Um Grundannahmen des Modells zu testen, wird untersucht inwiefern verschiedene sozialkognitive und behaviorale Kontrollvariablen dazu beitragen, zwischen den Stadien des MSMs zu differenzieren. Anhand einer querschnittlichen Online-Studie (N = 812) werden Unterschiede zwischen den untersuchten Kontrollvariablen über die Stufen des MSMs unter Anwendung von Varianzanalysen mit einfachen und polynomialen Kontrasten auf diskontinuierliche Muster hin überprüft. Im Ergebnis zeigen sich diskontinuierliche Muster für die Mehrzahl der untersuchten Variablen. Anhand dieser Unterschiedsmuster lassen sich die im Modell vorgesehenen Stadien begründen. Vor allem die explizite Integration der Planungskognitionen im MSM bewährt sich dabei empirisch. Es zeigt sich, dass für die Bestimmung aktionaler Phasen zeitliche Kriterien nicht sinnvoll sind.

This study examined the relation between health behavior and risk perceptions in the context of an acute livestock epidemic. Participants in a longitudinal web‐based survey (N= 195) were asked to report their meat consumption and their perceived risk in relation to bovine spongiform encephalopathy (BSE) and other related livestock diseases. Cross‐sectional analyses at both measurement points (T1 and T2) showed that participants with low levels of preventive nutrition (high meat consumption) felt more at risk for BSE‐related diseases than those reporting comparable higher levels of preventive behavior (low meat consumption), indicating relative accuracy. These results suggest that people recognize when their behavior is risky. More importantly, perceived risk also showed adaptive accuracy from a change perspective: increases in preventive nutrition from T1 to T2 were significantly associated with decreases in perceived risk between T1 and T2. Possible foundations and implications of an adaptive accuracy of risk perceptions are discussed.

Objectives: In a qualitative substudy, we sought to elicit participants' perspectives of their behavioural change and maintenance of new behaviours towards intervention optimisation. Setting: The intervention was delivered in leisure and community settings in a local authority, which according to the UK government statistics ranks as 1 of the 10 most socioeconomically deprived areas in England. Participants: We recruited 218 adults aged 40-65 years at elevated risk of type 2 diabetes (Finnish Diabetes Risk Score≥11) to the intervention. Follow-up at 12 months was completed by 134 (62%). We recruited 15 participants, purposively sampled for physical activity increase, to the qualitative substudy. Intervention: Lifestyle intervention can prevent type 2 diabetes, but translation to service provision remains challenging. The 'New life, New you' intervention aimed to promote physical activity, healthy eating and weight loss, and included supervised group physical activity sessions. Behavioural change and weight loss at 12-month follow-up were encouraging. Design: We conducted 15 individual semistructured interviews. The Framework approach, with a comparison of emerging themes, was used in analysis of the transcribed data and complemented by the Theory Domains Framework. Results: Themes emerging from the data were grouped as perceptions that promoted initiating, enacting and maintaining behavioural change. The data were then categorised in accordance with the Theory Domains Framework: intentions and goals; reinforcement; knowledge; social role and identity; social influences; skills and beliefs about capabilities; behavioural regulation, memory, emotion, attention and decision processes and environmental context and resources. Participant perceptions of intervention features that facilitated behavioural change processes were then similarly analysed. Conclusions: Social influences, reference to social role and identity (eg, peer support), and intentions and goals (eg, to lose weight) were dominant themes across the ...

Abstract. More people than ever are living longer with chronic conditions such as obesity, type 2 diabetes, and heart disease. Behavior change for effective self-management can improve health outcomes and quality of life in people living with such chronic illnesses. The science of developing behavior change interventions with impact for patients aims to optimize the reach, effectiveness, adoption, implementation, and maintenance of interventions and rigorous evaluation of outcomes and processes of behavior change. The development of new services and technologies offers opportunities to enhance the scope of delivery of interventions to support behavior change and self-management at scale. Herein, we review key contemporary approaches to intervention development, provide a critical overview, and integrate these approaches into a pragmatic, user-friendly framework to rigorously guide decision-making in behavior change intervention development. Moreover, we highlight novel emerging methods for rapid and agile intervention development. On-going progress in the science of intervention development is needed to remain in step with such new developments and to continue to leverage behavioral science's capacity to contribute to optimizing interventions, modify behavior, and facilitate self-management in individuals living with chronic illness.

BACKGROUND: During the COVID-19 pandemic, antibody testing was proposed by several countries as a surveillance tool to monitor the spread of the virus and potentially to ease restrictions. In the UK, antibody testing originally formed the third pillar of the UK Government's COVID-19 testing programme and was thought to offer hope that those with a positive antibody test result could return to normal life. However, at that time scientists and the public had little understanding of the longevity of COVID-19 antibodies, and whether they provided immunity to reinfection or transmission of the virus. OBJECTIVE: This paper explores the UK public's understanding of COVID-19 testing, perceived test accuracy, the meaning of a positive test result, willingness to adhere to restrictive measures in response to an antibody test result and how they expect other people to respond. METHODS: On-line synchronous focus groups were conducted in April/May 2020 during the first wave of the pandemic and the most stringent period of the COVID-19 restrictive measures. Data were analysed thematically. RESULTS: There was confusion in responses as to whether those with a positive or negative test should return to work and which restrictive measures would apply to them or their household members. Participants raised concerns about the wider public response to positive antibody test results and the adverse behavioural effects. There were worries that antibody tests could create a divided society particularly if those with a positive test result were given greater freedoms or chose to disregard the restrictive measures. CONCLUSION: Should these tests be offered more widely, information should be developed in consultation with the public to ensure clarity and address uncertainty about test results and subsequent behaviours.

BACKGROUND: During the COVID-19 pandemic, antibody testing was proposed by several countries as a surveillance tool to monitor the spread of the virus and potentially to ease restrictions. In the UK, antibody testing originally formed the third pillar of the UK Government's COVID-19 testing programme and was thought to offer hope that those with a positive antibody test result could return to normal life. However, at that time scientists and the public had little understanding of the longevity of COVID-19 antibodies, and whether they provided immunity to reinfection or transmission of the virus. OBJECTIVE: This paper explores the UK public's understanding of COVID-19 testing, perceived test accuracy, the meaning of a positive test result, willingness to adhere to restrictive measures in response to an antibody test result and how they expect other people to respond. METHODS: On-line synchronous focus groups were conducted in April/May 2020 during the first wave of the pandemic and the most stringent period of the COVID-19 restrictive measures. Data were analysed thematically. RESULTS: There was confusion in responses as to whether those with a positive or negative test should return to work and which restrictive measures would apply to them or their household members. Participants raised concerns about the wider public response to positive antibody test results and the adverse behavioural effects. There were worries that antibody tests could create a divided society particularly if those with a positive test result were given greater freedoms or chose to disregard the restrictive measures. CONCLUSION: Should these tests be offered more widely, information should be developed in consultation with the public to ensure clarity and address uncertainty about test results and subsequent behaviours.

Chief Scientist Office, Scottish Government. Grants CZH/4/518 and CZG/2/569. ; Peer reviewed ; Publisher PDF

Background:
There has been a rapid increase in the number of, and demand for, organisations offering behavioural science advice to government over the last ten years. Yet we know little of the state of science and the experiences of these evidence providers.
Aims and objectives:
To identify current practice in this emerging field and the factors that impact on the production of high-quality and policy-relevant research.
Methods:
A qualitative study using one-to-one interviews with representatives from a purposeful sample of 15 units in the vanguard of international behavioural science research in policy. The data were analysed thematically.
Findings:
Relationships with policymakers were important in the inception of units, research conduct, implementation and dissemination of findings. Knowledge exchange facilitated a shared understanding of policy issues/context, and of behavioural science. Sufficient funding was crucial to maintain critical capacity in the units' workforces, build a research portfolio beneficial to policymakers and the units, and to ensure full and transparent dissemination.
Discussion and conclusion:
Findings highlight the positive impact of strong evidence-provider/user relationships and the importance of governments' commitment to co-produced research programmes to address policy problems and transparency in the dissemination of methods and findings. From the findings we have created a framework, 'STEPS' (Sharing, Transparency, Engagement, Partnership, Strong relationships), of five recommendations for units working with policymakers. These findings will be of value to all researchers conducting research on behalf of government.

Afterweightloss,mostindividualsregainlostweight.Interventionsto supportthetransitionfromsuccessfullosstoweightlossmaintenance (WLM),regardlessofthemethodofpriorweightloss,areneeded.The aims of this study were to (1) develop a face-to-face behavioural intervention session to support overweight and obese individuals who have recently lost a clinically significant amount of weight in the transition to WLM; (2) to assess the single-session intervention for acceptability and feasibility prior to its use in a larger, 12-month, multi-component trial; and (3) to optimise the intervention session for future use based on participant feedback. Participants with a Body Mass Index of ≥25 kg/m2 prior to a ≥5% weight loss in the previous 12 months were recruited via the local government authority and community-based advertisements. Each attended the one-hour session with a trained facilitator, which focused on setting maintenance-relevant weight, eating, and physical activity goals. Semi-structured interviews were carried out immediately postsession to obtain feedback on the acceptability of this intervention component. Data were used to generate recommendations for changes to the session, which were discussed by the team, and used to optimise the session. Seventeen participants (13 female; median WL=13%) were recruited. All participants evaluated the intervention session positively; 11 participants suggested improvements including reducing information provision in favour ofgreaterfocusonidentifyingandcopingwithbarriers,andtheinclusion of practical examples. The systematic refinement and optimisation process resulted in an acceptable and feasible face-to-face behavioural intervention session (described here), which will be tested as part of a multi-component intervention. We anticipate the session could be used to supplement existing support including online services, and has the potential to benefit people who have lost a clinically significant amount of weight to achieve WLM over the long term.

After weight loss, most individuals regain lost weight. Interventions to support the transition from successful loss to weight loss maintenance (WLM), regardless of the method of prior weight loss, are needed. The aims of this study were to (1) develop a face-to-face behavioural intervention session to support overweight and obese individuals who have recently lost a clinically significant amount of weight in the transition to WLM; (2) to assess the single-session intervention for acceptability and feasibility prior to its use in a larger, 12-month, multi-component trial; and (3) to optimise the intervention session for future use based on participant feedback. Participants with a Body Mass Index of ≥25 kg/m2 prior to a ≥5% weight loss in the previous 12 months were recruited via the local government authority and community-based advertisements. Each attended the one-hour session with a trained facilitator, which focused on setting maintenance-relevant weight, eating, and physical activity goals. Semi-structured interviews were carried out immediately post-session to obtain feedback on the acceptability of this intervention component. Data were used to generate recommendations for changes to the session, which were discussed by the team, and used to optimise the session. Seventeen participants (13 female; median WL = 13%) were recruited. All participants evaluated the intervention session positively; 11 participants suggested improvements including reducing information provision in favour of greater focus on identifying and coping with barriers, and the inclusion of practical examples. The systematic refinement and optimisation process resulted in an acceptable and feasible face-to-face behavioural intervention session (described here), which will be tested as part of a multi-component intervention. We anticipate the session could be used to supplement existing support including online services, and has the potential to benefit people who have lost a clinically significant amount of weight to achieve WLM over ...

Background: Very few comprehensive treatments are currently available for weight loss maintenance (WLM). Research suggests that if interventions are to be effective in promoting sustained health behaviour change they should use theory- and evidence-based techniques. Information and Communication Technologies (ICT) have the potential for wide reach and low cost interventions, offering attractive tools for the implementation of effective behaviour change techniques. The NoHoW project is a European Union H2020-funded project bringing together leading experts in behaviour change, technology providers, and weight loss/ obesity to develop tools to help people maintain previously lost weight. Aim: NoHoW will carry out a large-scale European randomized controlled trial to test whether different evidence-based and novel behavior change, emotion- and self-regulation techniques delivered via an ICT Toolkit (TK), promote successful WLM. Method/Results: The TK includes a set of web-app tools and inputs from other technologies, such as smart scales and activity trackers, and offers a personalised behaviour modification feed-back system targeting weight, sleep, physical activity, and dietary behaviours. The TK is based on (1) evidence-based state-of-art theories of behaviour change, including techniques associated with self-regulation skills (Self-regulation Theory), building autonomous motivation (Self-Determination Theory), and emotional regulation, (2) web-design expertise, and (3) user-testing. Informed by the guidelines for the development of complex behavior change interventions and principles applied in previous theory-based behavior change interventions, we used a systematic approach to the translation of theory and evidence to ICT intervention components. This includes (1) developing theory-driven logic models of the TK, (2) identifying key theoretical constructs targeted, (3) selecting theory- and evidence-based techniques that are expected to impact on target constructs, and (4) translating these techniques into the ...

The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring. Evidence of the effectiveness of preconception interventions for improving outcomes for mothers and babies is scarce. However, given the large potential health return, and relatively low costs and risk of harm, research into potential interventions is warranted. We identified three promising strategies for intervention that are likely to be scalable and have positive effects on a range of health outcomes: supplementation and fortification; cash transfers and incentives; and behaviour change interventions. On the basis of these strategies, we suggest a model specifying pathways to effect. Pathways are incorporated into a life-course framework using individual motivation and receptiveness at different preconception action phases, to guide design and targeting of preconception interventions. Interventions for individuals not planning immediate pregnancy take advantage of settings and implementation platforms outside the maternal and child health arena, since this group is unlikely to be engaged with maternal health services. Interventions to improve women's nutritional status and health behaviours at all preconception action phases should consider social and environmental determinants, to avoid exacerbating health and gender inequalities, and be underpinned by a social movement that touches the whole population. We propose a dual strategy that targets specific groups actively planning a pregnancy, while improving the health of the population more broadly. Modern marketing techniques could be used to promote a social movement based on an emotional and symbolic connection between improved preconception maternal health and nutrition, and offspring health. We suggest that speedy and scalable benefits to public health might be achieved through strategic engagement with the private sector. Political theory supports the development of an advocacy coalition of groups interested in preconception health, to harness the political will and leadership necessary to turn high-level policy into effective coordinated action.

The nutritional status of women and men before conception has profound implications for the growth, development and long-term health of their offspring. Evidence of the effectiveness of preconception interventions in improving outcomes for mothers or babies is scarce, though given the large potential health return, relatively low costs and risk of harm, intervention is still warranted. We identify three promising strategies for intervention that are likely to be scalable and to have positive effects on a range of health outcomes: supplementation and fortification; cash transfers; and behaviour change interventions. Based on this, we suggest a model specifying pathways to effect. Pathways are incorporated into a lifecourse framework using individual motivation and receptiveness at different 'preconception action phases' to guide design and targeting of preconception interventions. Interventions with those not planning immediate pregnancy take advantage of settings and implementation platforms outside the maternal and child health arena, since this group is unlikely to be engaged with maternal health services. Interventions to improve women's nutritional status and health behaviours at all preconception action phases need to take account of social and environmental determinants to avoid exacerbating health and gender inequalities, and should be underpinned by a social movement that touches the whole population. A dual strategy that targets specific groups actively planning a pregnancy, while improving the health of the population more broadly, is proposed. The engagement of modern marketing techniques points to a social movement based on an emotional and symbolic connection between improved maternal nutrition and health prior to conception and offspring health. We suggest that speedy and scalable public health benefit might be achieved through strategic engagement with the private sector. Political theory supports the development of an advocacy coalition of groups interested in preconception health, to harness the ...