The Design of a Digital Behaviour Change Intervention for Third-Level Student Illicit Substance Use: A Persona Building Approach

Illicit substance use among third-level students is an issue of increasing concern. Digital behavioural change interventions have been developed to target this population, but reports of their effectiveness are mixed. The importance of end-user involvement in digital intervention development has been well established, but it appears that many interventions in this area did not engage end-users during development. This absence may have affected engagement, undermining their potential effectiveness. This paper describes the process and contributions of a persona-building approach in the development of a digital behaviour change intervention tailored to the needs of third-level students. Nine exploratory persona-building workshops were carried out with 31 students, and 7 project team members to develop personas for heavy, occasional and non-substance using third-level students. Early analysis has identified five archetypes which will contribute to the design of an acceptable and user-friendly intervention, and to the identification of targeted behavioural change techniques

Changing the Wheels on a Moving Car: Leveraging a Content Management System to Develop an Extensible Digital Intervention

Drug use among higher education students is a pertinent public health issue, with around a quarter of students reporting current use of an illicit drug. MyUSE is an algorithmic, digitally delivered intervention aimed at reducing harms from drug use among higher education students. While many digital interventions around this topic exist, previous work has failed to employ behavioral science in a systematic way. MyUSE focuses on user-centered design (UCD), targeting relevant behavioral changes which are translated into digitally delivered components. This paper describes the challenges of working in an interdisciplinary project team and presents the software-based solutions applied to overcome them. The methodology described demonstrates how sharing the implementation workload can promote synergistic interdisciplinary work in parallel. By providing a flexible centralized platform to manage content and ideas, certain technical requirements become clearly defined and addressed

Capturing the context of drug use for college students:A contextual behavioural science informed qualitative analysis of harm reduction practices using network feedback loops simulation modelling

Drug use during college can have substantial harm on students’ lives and impacts the institutions’ functioningand local communities. Yet existing interventions for drug use at college poorly address the concurrent dynamicinfluences of the experiences in earlier developmental periods of young adults and the proximal contextualtriggers of college life; both risk factors that can contribute to drug use. To address this, we leveraged systemdynamic methods and contextual-behavioural science (CBS) approaches to support the development of interventions focusing at addressin these risk factors. Using Causal Loop Diagram methods (Vensim PLE), wecollected qualitative data from college students to generate Network Feedback Loops (NFLs) (n = 24, Maged 22years old), during the development phase of the MyUse: a contextual behavioural change intervention for harmreduction practices at college students. The findings underscored central nodes (determinants within an intervention) that support our previous identified three CBS-harm-reduction practices for college students (targetededges: mindful drug-use decision making, value-based activities, context-sensitive personalized plan of harmreduction). Analyses revealed 4 NFLs for students with previous drug use, consisting of 13 edges (4 positive, 2negative, and 4 balancing reinforcing relationships) and 3 NFLs for students with no previous drug use, consisting of 4 positives, one negative, and one balancing relationship. All the NFLs were nested with the three CBSrelated targeted outcomes. College students who use drugs need drug-related knowledge about the unpredictableand adverse effects of drugs, presented in a compassionate way and distributed from credible resources (e.g.,students’ unions/club). Students with no previous drug use need education about the effects of drugs andawareness of how drugs can devaluate value-based activities (e.g. sports, friendships, social life). These should bedelivered via proxy cue reminders and mobile-text approaches conveying messages about drug use susceptibility,distributed in real-time. Idiosyncratic, dynamic, and contextual-bound factors of lapse risks or preventivepractices should account for each person-specific vulnerabilities via personalized harm reduction plans

A new clinical algorithm embedded in a contextual behavior change intervention for higher education student drug use

Illicit drug use among higher education populations is a recognized public health issue. Brief personalized digital behavior change interventions with targeted harm-reduction can facilitate immediate support for this population. To make the intervention tailored to students’ needs, we built a clinical algorithm, informed by relevant behavior change theories and with system design features. Given the lack of previously relevant harm-reduction at student population level, functioning with the use of an algorithm, the aim of this work is twofold. We firstly explain how we developed the clinical algorithm using an empirical data synthesis approach. Secondly, we illustrate how the algorithm is implemented within the first prototype of an intervention named MyUSE, by providing an example on how the clinical algorithm is used to allocate users into different personalized intervention components. The prototype is currently in its final development phase and subsequent work will focus on examining its usability, feasibility, and effectiveness

Assessment of the cortisol awakening response: expert consensus guidelines

The cortisol awakening response (CAR), the marked increase in cortisol secretion over the first 30–45 min after morning awakening, has been related to a wide range of psychosocial, physical and mental health parameters, making it a key variable for psychoneuroendocrinological research. The CAR is typically assessed from self-collection of saliva samples within the domestic setting. While this confers ecological validity, it lacks direct researcher oversight which can be problematic as the validity of CAR measurement critically relies on participants closely following a timed sampling schedule, beginning with the moment of awakening. Researchers assessing the CAR thus need to take important steps to maximize and monitor saliva sampling accuracy as well as consider a range of other relevant methodological factors. To promote best practice of future research in this field, the International Society of Psychoneuroendocrinology initiated an expert panel charged with (i) summarizing relevant evidence and collective experience on methodological factors affecting CAR assessment and (ii) formulating clear consensus guidelines for future research. The present report summarizes the results of this undertaking. Consensus guidelines are presented on central aspects of CAR assessment, including objective control of sampling accuracy/adherence, participant instructions, covariate accounting, sampling protocols, quantification strategies as well as reporting and interpreting of CAR data. Meeting these methodological standards in future research will create more powerful research designs, thus yielding more reliable and reproducible results and helping to further advance understanding in this evolving field of research

Ambulatory assessment of psychophysiological stress among police officers: A proof-of-concept study.

Occupational stress has been widely recognized as a global challenge and has received increased attention by the academic community. Ambulatory Assessment methodologies, combining psychophysiological measures of stress, offer a promising avenue for future prevention and/or rehabilitation stress research. Considering that policing is well known for being a particularly stressful occupation, Emergency Responders Officers (EROs) stress levels were investigated. Particularly, this study analyzed: (i) physiological stress data obtained during shifts and compared these data with baseline levels (days off), as well as (ii) with normative values for healthy populations; (iii) stress symptoms differences from beginning to end of shift; (iv) stress events and events intensity and (v) the acceptability and feasibility of this proof-of-concept study in a highly stressful occupation. A Geo-location event system was used to help retrospective accounts of psychological stress, combined with electrocardiogram (ECG) data and mobile self-reports, that include stress symptoms, event types and event intensity. Results suggest that EROs experience high levels of stress (both on-duty and off duty) when compared to healthy populations. Stress symptoms increase from the beginning to end of the shift. However, the mean events intensity was very low. It can be concluded that stress may not always be diagnosed when using merely self-reports. These findings highlight the importance of combining both self-report and physiological stress measures in occupational health contexts. Finally, results confirm the acceptability and feasibility of the multi-method used. Key implications for policy makers and applied practitioners in the area of occupational health and future research directions are discussed

Helicobacter pylori cag-Pathogenicity Island-Dependent Early Immunological Response Triggers Later Precancerous Gastric Changes in Mongolian Gerbils

Infection with Helicobacter pylori, carrying a functional cag type IV secretion system (cag-T4SS) to inject the Cytotoxin associated antigen (CagA) into gastric cells, is associated with an increased risk for severe gastric diseases in humans. Here we studied the pathomechanism of H. pylori and the role of the cag-pathogenicity island (cag-PAI) for the induction of gastric ulcer and precancerous conditions over time (2–64 weeks) using the Mongolian gerbil model. Animals were challenged with H. pylori B128 (WT), or an isogenic B128ΔcagY mutant-strain that produces CagA, but is unable to translocate it into gastric cells. H. pylori colonization density was quantified in antrum and corpus mucosa separately. Paraffin sections were graded for inflammation and histological changes verified by immunohistochemistry. Physiological and inflammatory markers were quantitated by RIA and RT-PCR, respectively. An early cag-T4SS-dependent inflammation of the corpus mucosa (4–8 weeks) occurred only in WT-infected animals, resulting in a severe active and chronic gastritis with a significant increase of proinflammatory cytokines, mucous gland metaplasia, and atrophy of the parietal cells. At late time points only WT-infected animals developed hypochlorhydria and hypergastrinemia in parallel to gastric ulcers, gastritis cystica profunda, and focal dysplasia. The early cag-PAI-dependent immunological response triggers later physiological and histopathological alterations towards gastric malignancies