Enhancing community weight loss groups in a low socioeconomic status area: Application of the COM-B model and Behaviour Change Wheel

Background Obesity rates are higher among people of lower socioeconomic status. While numerous health behaviour interventions targeting obesity exist, they are more successful at engaging higher socioeconomic status populations, leaving those in less affluent circumstances with poorer outcomes. This highlights a need for more tailored interventions. The aim of this study was to enhance an existing weight loss course for adults living in low socioeconomic communities. Methods The Behaviour Change Wheel approach was followed to design an add-on intervention to an existing local authority-run weight loss group, informed by mixed-methods research and stakeholder engagement. Results The COM-B analysis of qualitative data revealed that changes were required to psychological capability, physical and social opportunity and reflective motivation to enable dietary goal-setting behaviours. The resulting SMART-C booklet included 6 weeks of dietary goal setting, with weekly behavioural contract and review. Conclusion This paper details the development of the theory- and evidence-informed SMART-C intervention. This is the first report of the Behaviour Change Wheel being used to design an add-on tool to enhance existing weight loss services. The process benefitted from a further checking stage with stakeholders

The effect of using social pressure in cover letters to improve retention in a longitudinal health study: an embedded randomised controlled retention trial

BackgroundRetention of participants in cohort studies is important for validity. One way to promote retention is by sending a persuasive cover letter with surveys. The study aimed to compare the effectiveness of a covering letter containing social pressure with a standard covering letter on retention in a health cohort study. Social pressure involves persuading people to behave in a certain way by the promise that their actions will be made know to others. We implemented a mild form of social pressure, where the recipient was told that information about whether they responded to the current survey would be noted by the research team and printed on future correspondence from the research team to the recipient.MethodsThe design was an embedded randomised controlled retention trial, conducted between July 2015 and April 2016 in Salford, UK. Participants in the host health cohort study were eligible. They received either: (1) a covering letter with two consecutive surveys (sent six and twelve months after recruitment), containing a social pressure intervention; or (2) a matching letter without the social pressure text. The primary outcome was retention in the host study, defined as return of both surveys. Randomisation was computer-generated, with stratification by household size. Participants were blinded to group assignment. Researchers were blinded for outcome ascertainment.ResultsAdults (n = 4447) aged over 65 years, with a long-term condition and enrolled in the host study, were randomly allocated to receive a social pressure covering letter (n = 2223) or control (n = 2224). All 4447 participants were included in the analysis. Both questionnaires were returned by 1577 participants (71%) sent the social pressure letters and 1511 (68%) sent control letters, a risk difference of 3 percentage points (adjusted odds ratio = 1.16 (95% confidence interval = 1.02–1.33)).ConclusionA mild form of social pressure made a small but significant improvement in retention of older adults in a health cohort study. Investigation of social pressure across other research contexts and stronger social pressure messages is warranted

Scale up and development of microbial electrolysis cells for domestic wastewater treatment and energy recovery

Eng D ThesisMicrobial Electrolysis Cells (MECs) have the potential to transform wastewater treatment, but many studies have been carried out at a very small scale with implausible temperatures and synthetic substrates. The value of laboratory-scale controlled experiments is not questioned, but these studies do not inform us of the realities and challenges that occur when operating MEC in the real world at realistic scales. Addressing this issue led to the installation and operation of a pilot scale MEC which failed within 6 months. It was consequently dissected and analysed, to systematically understand failure, through fault tree analysis (FTA). This process identified areas for further development to move towards a more robust MEC prototype. Meta-analyses and experiments were used to asses some of the challenges still to be overcome, before the commercialisation of MEC is a realistic prospect. With this knowledge, a re-design led to the successful operation of a second pilot, which moved from the L to the m3 scale, thanks to a 16-fold increase in electrode surface area (1 m2 each) and a 5-hour hydraulic retention time (HRT). After nine months, 0.8 L of H2/d (0.003 L-H2/L-MEC/d) was produced from primary treated domestic wastewater where the wastewater temperature was as low as 5.3 ̊C. The European Urban Wastewater Treatment Directive consent of 125 mg/L was achieved 55% of the time, with 64% of the chemical oxygen demand (COD) removed. To break-even energetically each module would need to produce 4 L-H2/day. This is possible, if hydrogen loss through scavenging can be addressed and improvements to the current density can be achieved. Recommendations for both are proposed. A cost benefit analysis (CBA) and multi criteria assessment (MCA) is used to compare four potential MEC products. The model is based on current and realistic projections of MEC performance, to assess the net present value (NPV) of the technology and the potential savings that could be gained in wastewater treatment.Northumbrian Water, along with the EPSRC, who provided financial support through the STREAM industrial doctoral centre

The Ascent of Man: Theoretical and Empirical Evidence for Blatant Dehumanization

Dehumanization is a central concept in the study of intergroup relations. Yet although theoretical and methodological advances in subtle, “everyday” dehumanization have progressed rapidly, blatant dehumanization remains understudied. The present research attempts to refocus theoretical and empirical attention on blatant dehumanization, examining when and why it provides explanatory power beyond subtle dehumanization. To accomplish this, we introduce and validate a blatant measure of dehumanization based on the popular depiction of evolutionary progress in the “Ascent of Man.” We compare blatant dehumanization to established conceptualizations of subtle and implicit dehumanization, including infrahumanization, perceptions of human nature and human uniqueness, and implicit associations between ingroup–outgroup and human–animal concepts. Across 7 studies conducted in 3 countries, we demonstrate that blatant dehumanization is (a) more strongly associated with individual differences in support for hierarchy than subtle or implicit dehumanization, (b) uniquely predictive of numerous consequential attitudes and behaviors toward multiple outgroup targets, (c) predictive above prejudice, and (d) reliable over time. Finally, we show that blatant—but not subtle—dehumanization spikes immediately after incidents of real intergroup violence and strongly predicts support for aggressive actions like torture and retaliatory violence (after the Boston Marathon bombings and Woolwich attacks in England). This research extends theory on the role of dehumanization in intergroup relations and intergroup conflict and provides an intuitive, validated empirical tool to reliably measure blatant dehumanization

“Not one of us”: predictors and consequences of denying ingroup characteristics to ambiguous targets

We investigated individual difference predictors of ascribing ingroup characteristics to negative and positive ambiguous targets. Studies 1 and 2 investigated events involving negative targets whose status as racial (Tsarnaev brothers) or national (Woolwich attackers) ingroup members remained ambiguous. Immediately following the attacks, we presented White Americans and British individuals with the suspects’ images. Those higher in social dominance orientation (SDO) and right-wing authoritarianism (RWA)—concerned with enforcing status boundaries and adherence to ingroup norms, respectively—perceived these low status and low conformity suspects as looking less White and less British, thus denying them ingroup characteristics. Perceiving suspects in more exclusionary terms increased support for treating them harshly, and for militaristic counter-terrorism policies prioritizing ingroup safety over outgroup harm. Studies 3 and 4 experimentally manipulated a racially ambiguous target’s status and conformity. Results suggested that target status and conformity critically influence SDO’s (status) and RWA’s (conformity) effects on inclusionary versus exclusionary perceptions

How to Maximize the Usefulness of Behaviour Change Conversations with Patients during Routine Dental Consultations

Clinicians can use behaviour change techniques effectively in routine consultations in healthcare settings, including dentistry. Professional guidelines support their use for preventing and managing a range of dental diseases. Theory and evidence from behavioural science can inform effective behaviour change interventions. This article examines the relevance of these techniques to the whole dental team and how they can be implemented within routine dental consultations

Randomised evaluation of pre-notification of trial participants before self-report outcome data collection to improve retention: SWAT86

Background Retention is considered the second highest trial methods priority in the UK after recruitment. There is limited evidence on whether notifying trial participants that a follow-up questionnaire will be sent soon (‘pre-notification’) affects retention. Methods This Study Within a Trial (SWAT) evaluated whether sending a pre-notification letter or email around 2 weeks before sending a self-report questionnaire increased retention, in terms of provision of the host trial primary outcome. The SWAT was a randomised, two-arm, parallel-design (1:1 allocation ratio) trial, controlled by ‘no pre-notification letter’. It was embedded within the WORKWELL host trial, which evaluated the impact of job retention vocational rehabilitation on work-related and health-related outcomes of employed people with inflammatory arthritis. The SWAT primary outcome was a valid response for the WORKWELL primary outcome. Results Two hundred forty-four trial participants took part in the SWAT. All were included in the analysis. Among those sent a pre-reminder, 100/121 (83%) provided a valid response for the WORKWELL primary outcome, compared to 97/123 (79%) of those not sent a pre-reminder. The estimated adjusted odds ratio was 1.28 (95% confidence interval 0.67–2.42), with a risk difference of 3.8% (95% CI -6.1 to 13.6%), favouring the prereminder. The estimated intervention cost per additional participant retained was £53.42, and the total cost per additional participant retained was £46.52. Conclusion Researchers may have a small improvement in trial retention by using pre-notification. The cost per additional participant retained is relatively low. However, further evaluations are merited