167 research outputs found

    Improving community health and social care practitioners' confidence, perceived competence and intention to use behaviour change techniques in health behaviour change conversations.

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    Community health and social care practitioners play an increasingly important role in the health promotion agenda, but lack confidence in having effective health behaviour change (HBC) conversations with members of the public. This study reports the development and evaluation of a training intervention based on health psychology to improve health and social care practitioner self-rated confidence, competence and intention to use five behaviour change techniques (BCTs) in their HBC conversations. A 2-day behavioural science interprofessional skills training course plus online learning module was designed for health and social care staff across North East Scotland, teaching five evidence-based BCTs (e.g. Action Planning), plus person-centred communication skills. Participants rated confidence, competence and future intention to use the BCTs on likert scales (1-10) pre-course and post-course, and provided acceptability data. 177 participants aged 20-64 took part, qualitative and quantitative data suggested that the course had high acceptability. Paired samples t tests (n = 120 with complete data) showed significant improvements in confidence, competence and intention following the course, which remained significant with a conservative analysis (n = 174) assuming no change for missing data. Perceived competence in Action Planning increased most during the course (mean change 3.09). In conclusion, health psychology-based skills training can improve practitioner confidence, competence and intention to use evidence-based BCTs; further evaluation is needed to assess practice change

    Developing applied behaviour change interventions to improve healthcare and reduce health inequalities

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    Improving public healthcare quality and reducing health inequalities are two major challenges for population health in the 21st century. Health initiatives require members of the public or their healthcare professionals to do things differently, so effective interventions to encourage health behaviour change (HBC) are needed. To accelerate behavioural science, psychologists recently developed the Behaviour Change Wheel (BCW) method and related Behaviour Change Technique Taxonomy (BCTT) tool. These help to systematically design and describe theory-based HBC interventions. This thesis presents some of the first research to apply and further develop the BCW and BCTT. I conducted seven applied research projects whilst embedded in multidisciplinary healthcare teams as an academic-practitioner health psychologist to help ‘set the wheel in motion’. Most took place in the UK; one applied the BCW in Mozambique. Three projects were with vulnerable groups at risk of health inequalities, exploring healthy eating, physical activity, smoking and sexually transmitted infection testing. Four projects were with health and social care professionals and focussed on their HBC conversation skills, medication safety, integrated team working and other healthcare quality improvements. Research methods included a systematic review with meta-analysis to identify effective intervention components, cross-sectional questionnaire research exploring psychological influences on behaviour, an observational study of training and pragmatic mixed-methods action research piloting new BCW interventions. These resulted in nine peer-reviewed publications and accompanying translational materials. Collectively, this programme of research A) identified new target populations, B) described and evaluated existing interventions, C) identified behaviours and psychological influences on change for key problems, D) developed new interventions bringing about positive changes in participants’ confidence, intentions and health behaviours and E) offered tools and guidance to optimise the BCW and BCTT’s feasibility for use in frontline healthcare. This work contributes knowledge to help translate psychological science into usable forms and co-develop feasible, theory-based HBC interventions

    Exploring the human-nature nexus towards effective nature-based solutions: the Aral Sea case

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    Incorporating societal challenges and values into the design of locally appropriate nature-based solutions (NbS) is an integral strategy for ensuring benefits for both communities and the environment. But how are human-nature relations impacted when the environments containing resources which are valued and relied on, undergo dramatic and sustained change on decadal timescales? To explore this interplay, we selected Muynak as a case study, once a thriving town on the shores of the former Aral Sea in Uzbekistan. We conducted a social survey among the residents to identify the use of natural resources and the values they assign to the most common and yet highly degraded resources in the area (wetlands, rangelands, afforested areas, the Aral Sea, and wildlife). The survey was complemented with expert interviews. Our study suggests that grasslands are the most frequently used of the resources under study, while wetlands and wildlife are generally more valued. Overall, resources were more culturally valued than financially, historically, or recreationally. The majority of respondents perceived a degradation in most natural resources over the past decade, particularly wetlands (79 %), followed by grasslands (48 %), and the Aral Sea (42 %). Wetlands were reported to be in a state of ongoing degradation by 79 % of respondents, which negatively affected the livelihoods of almost half of the households in the survey area. Afforested areas were the only resources reported to have a positive perceived change in both status and their effect on well-being. The vast majority of respondents (83 %) felt that human well-being was linked to environmental conditions. This study lays the foundation for future interventions to develop nature-based solutions to benefit both people and nature, and highlights the continuing value placed on nature by residents of an area that has suffered substantial anthropogenic degradation

    Behavior change techniques in health professional training: developing a coding tool

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    Health professional Continuing Professional Development (CPD) courses often aim to change practice; understanding which training techniques drive behavior change can help educators facilitate this. The 93-item Behaviour Change Technique Taxonomy (BCTT) describes behavior change techniques (BCTs) used in behavior change interventions but was not designed for understanding CPD; it is necessary to explore how best to use the BCTT in this context. This study aimed to explore the BCTs used by CPD course educators to change healthcare practice and to develop and pilot an e-tool, based on the BCTT, to enable course designers and educators to understand which BCTs are in their training. This understanding could lead to enhanced CPD and an experimental approach to assessing the benefits of including a variety of BCTs in CPD. Two psychologists, trained in using the BCTT, observed three postgraduate medical CPD courses. In Phase 1, the BCTT was used to code 26 hours of observations. An e-tool including observed BCTs was developed and used to code 35 hours of observations in Phase 2. Feedback was collected through short discussions with educators from each course. The tool was further refined in Phase 3. Thirty-seven BCTs were identified in Phase 1, a further four in Phase 2, and a further two in Phase 3. The final e-tool comprised 43 BCTs with examples of their use based on course observations to aid identification, since educators fed back that they would value an uncomplicated tool with practice-related examples. A coding tool to understand the active ingredients in health professional CPD could enable educators to maximize the impact of CPD on practice. Further work should explore whether educators themselves are able to use the tool to code their training interventions

    Understanding the psychological process of avoidance-based self-regulation on Facebook

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    In relation to social network sites, prior research has evidenced behaviors (e.g., censoring) enacted by individuals used to avoid projecting an undesired image to their online audiences. However, no work directly examines the psychological process underpinning such behavior. Drawing upon the theory of self-focused attention and related literature, a model is proposed to fill this research gap. Two studies examine the process whereby public self-awareness (stimulated by engaging with Facebook) leads to a self-comparison with audience expectations and, if discrepant, an increase in social anxiety, which results in the intention to perform avoidance-based self-regulation. By finding support for this process, this research contributes an extended understanding of the psychological factors leading to avoidance-based regulation when online selves are subject to surveillance

    Are interventions for low-income groups effective in changing healthy eating, physical activity and smoking behaviours? A systematic review and meta-analysis

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    Objective To conduct a systematic review and meta-analysis examining the effectiveness of behavioural interventions targeting diet, physical activity or smoking in low-income adults. Design Systematic review with random effects meta-analyses. Studies before 2006 were identified from a previously published systematic review (searching 1995–2006) with similar but broader inclusion criteria (including non-randomised controlled trials (RCTs)). Studies from 2006 to 2014 were identified from eight electronic databases using a similar search strategy. Data sources MEDLINE, EMBASE, PsycINFO, ASSIA, CINAHL, Cochrane Controlled Trials, Cochrane Systematic Review and DARE. Eligibility criteria for selecting studies RCTs and cluster RCTs published from 1995 to 2014; interventions targeting dietary, physical activity and smoking; low-income adults; reporting of behavioural outcomes. Main outcome measures Dietary, physical activity and smoking cessation behaviours. Results 35 studies containing 45 interventions with 17 000 participants met inclusion criteria. At postintervention, effects were positive but small for diet (standardised mean difference (SMD) 0.22, 95% CI 0.14 to 0.29), physical activity (SMD 0.21, 95% CI 0.06 to 0.36) and smoking (relative risk (RR) of 1.59, 95% CI 1.34 to 1.89). Studies reporting follow-up results suggested that effects were maintained over time for diet (SMD 0.16, 95% CI 0.08 to 0.25) but not physical activity (SMD 0.17, 95% CI −0.02 to 0.37) or smoking (RR 1.11, 95% CI 0.93 to 1.34). Conclusions Behaviour change interventions for low-income groups had small positive effects on healthy eating, physical activity and smoking. Further work is needed to improve the effectiveness of behaviour change interventions for deprived populations

    Excited-state barrier controls E → Z photoisomerization in p-hydroxycinnamate biochromophores

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    Molecules based on the deprotonated p-hydroxycinnamate moiety are widespread in nature, including serving as UV filters in the leaves of plants and as the biochromophore in photoactive yellow protein. The photophysical behavior of these chromophores is centered around a rapid E → Z photoisomerization by passage through a conical intersection seam. Here, we use photoisomerization and photodissociation action spectroscopies with deprotonated 4-hydroxybenzal acetone (pCK–) to characterize a wavelength-dependent bifurcation between electron autodetachment (spontaneous ejection of an electron from the S1 state because it is situated in the detachment continuum) and E → Z photoisomerization. While autodetachment occurs across the entire S1(ππ*) band (370–480 nm), E → Z photoisomerization occurs only over a blue portion of the band (370–430 nm). No E → Z photoisomerization is observed when the ketone functional group in pCK– is replaced with an ester or carboxylic acid. The wavelength-dependent bifurcation is consistent with potential energy surface calculations showing that a barrier separates the Franck–Condon region from the E → Z isomerizing conical intersection. The barrier height, which is substantially higher in the gas phase than in solution, depends on the functional group and governs whether E → Z photoisomerization occurs more rapidly than autodetachment
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