No time to waste: applying social psychological methods and theories to household food waste reduction

The amount of food thrown away by UK households is substantial and, to a large extent, avoidable. Despite the obvious imperative for research to identify key factors that motivate, enable or prevent household food waste reduction, little research to date has directly addressed this objective. The research presented in this thesis had two clear aims: (1) to investigate antecedents of household food waste reduction and barriers to change, and (2) to explore whether self-affirmation techniques can increase motivation to reduce household food waste. Four empirical studies were conducted. The first study qualitatively explored thoughts, feelings and experiences of 15 UK household food purchasers. Analysis revealed seven core categories representing both motivations and barriers to household food waste reduction. The second study (N = 279) applied an extended theory of planned behaviour (TPB) model to predict household food waste reduction intention and behaviour. Results revealed that the extended TPB variables predicted 64.55% of intention to reduce household food waste and 5.03% of the variance in household food waste behaviour. Studies 3 and 4 explored whether self-affirmation techniques would promote openness to information detailing the negative consequences of household food waste. Study 3 (N = 224) found that self-affirmed participants reported more positive cognitions towards household food waste reduction on a number of outcomes compared to their nonaffirmed counterparts. However, there was no impact of the self-affirmation manipulation on behaviour at follow-up. Study 4 (N = 362) failed to replicate the impact of selfaffirmation on cognitions. However, self-affirmed participants reported that they threw away less household food waste at follow-up. Further research in the context of selfaffirmation on food waste reduction behaviour is required

Identifying motivations and barriers to minimising household food waste

The amount of food discarded by UK households is substantial and, to a large extent, avoidable. Furthermore, such food waste has serious environmental consequences. If household food waste reduction initiatives are to be successful they will need to be informed by people's motivations and barriers to minimising household food waste. This paper reports a qualitative study of the thoughts, feelings and experiences of 15 UK household food purchasers, based on semi-structured interviews. Two core categories of motives to minimise household food waste were identified: (1) waste concerns and (2) doing the ‘right’ thing. A third core category illustrated the importance of food management skills in empowering people to keep household food waste to a minimum. Four core categories of barriers to minimising food waste were also identified: (1) a ‘good’ provider identity; (2) minimising inconvenience; (3) lack of priority; and (4) exemption from responsibility. The wish to avoid experiencing negative emotions (such as guilt, frustration, annoyance, embarrassment or regret) underpinned both the motivations and the barriers to minimising food waste. Findings thus reveal potentially conflicting personal goals which may hinder existing food waste reduction attempts

Interventions to increase attendance for diabetic retinopathy screening

BACKGROUND: Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels.OBJECTIVES: The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To critically appraise and summarise current evidence on the resource use, costs and cost effectiveness.SEARCH METHODS: We searched the Cochrane Library, MEDLINE, Embase, PsycINFO, Web of Science, ProQuest Family Health, OpenGrey, the ISRCTN, ClinicalTrials.gov, and the WHO ICTRP to identify randomised controlled trials (RCTs) that were designed to improve attendance for DRS or were evaluating general quality improvement (QI) strategies for diabetes care and reported the effect of the intervention on DRS attendance. We searched the resources on 13 February 2017. We did not use any date or language restrictions in the searches.SELECTION CRITERIA: We included RCTs that compared any QI intervention to usual care or a more intensive (stepped) intervention versus a less intensive intervention.DATA COLLECTION AND ANALYSIS: We coded the QI strategy using a modification of the taxonomy developed by Cochrane Effective Practice and Organisation of Care (EPOC) and BCTs using the BCT Taxonomy version 1 (BCTTv1). We used Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social capital (PROGRESS) elements to describe the characteristics of participants in the included studies that could have an impact on equity of access to health services.Two review authors independently extracted data. One review author entered the data into Review Manager 5 and a second review author checked them. Two review authors independently assessed risks of bias in the included studies and extracted data. We rated certainty of evidence using GRADE.MAIN RESULTS: We included 66 RCTs conducted predominantly (62%) in the USA. Overall we judged the trials to be at low or unclear risk of bias. QI strategies were multifaceted and targeted patients, healthcare professionals or healthcare systems. Fifty-six studies (329,164 participants) compared intervention versus usual care (median duration of follow-up 12 months). Overall, DRS attendance increased by 12% (risk difference (RD) 0.12, 95% confidence interval (CI) 0.10 to 0.14; low-certainty evidence) compared with usual care, with substantial heterogeneity in effect size. Both DRS-targeted (RD 0.17, 95% CI 0.11 to 0.22) and general QI interventions (RD 0.12, 95% CI 0.09 to 0.15) were effective, particularly where baseline DRS attendance was low. All BCT combinations were associated with significant improvements, particularly in those with poor attendance. We found higher effect estimates in subgroup analyses for the BCTs 'goal setting (outcome)' (RD 0.26, 95% CI 0.16 to 0.36) and 'feedback on outcomes of behaviour' (RD 0.22, 95% CI 0.15 to 0.29) in interventions targeting patients, and 'restructuring the social environment' (RD 0.19, 95% CI 0.12 to 0.26) and 'credible source' (RD 0.16, 95% CI 0.08 to 0.24) in interventions targeting healthcare professionals.Ten studies (23,715 participants) compared a more intensive (stepped) intervention versus a less intensive intervention. In these studies DRS attendance increased by 5% (RD 0.05, 95% CI 0.02 to 0.09; moderate-certainty evidence).Fourteen studies reporting any QI intervention compared to usual care included economic outcomes. However, only five of these were full economic evaluations. Overall, we found that there is insufficient evidence to draw robust conclusions about the relative cost effectiveness of the interventions compared to each other or against usual care.With the exception of gender and ethnicity, the characteristics of participants were poorly described in terms of PROGRESS elements. Seventeen studies (25.8%) were conducted in disadvantaged populations. No studies were carried out in low- or middle-income countries.AUTHORS' CONCLUSIONS: The results of this review provide evidence that QI interventions targeting patients, healthcare professionals or the healthcare system are associated with meaningful improvements in DRS attendance compared to usual care. There was no statistically significant difference between interventions specifically aimed at DRS and those which were part of a general QI strategy for improving diabetes care. This is a significant finding, due to the additional benefits of general QI interventions in terms of improving glycaemic control, vascular risk management and screening for other microvascular complications. It is likely that further (but smaller) improvements in DRS attendance can also be achieved by increasing the intensity of a particular QI component or adding further components.</p

How can health psychology research help reduce risky health behaviours?

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Are worksite interventions effective in increasing physical activity? A systematic review and meta-analysis

Worksite interventions have the potential to reach a broad and captive audience and overcome one of the most widely cited barriers to increasing physical activity (PA), namely, a lack of time. A systematic review and random effects, meta-analysis assessed the effectiveness of worksite interventions to enhance PA. Thirty-seven intervention evaluations reporting 55 unique interventions met our inclusion criteria. Results indicate that, overall, worksite interventions have small, positive effects on PA and this effect is smaller when fitness, as opposed to self-report, outcome measures are reported (ds = 0.15 versus 0.23). Worksite interventions targeting PA specifically as opposed to general lifestyle change were found to be more effective whether evaluated in terms of increased fitness (0.29 versus 0.08) or increased self-reported PA (0.27 versus 0.14). Those promoting walking as opposed to other forms of PA were also more effective (0.54 versus 0.16). Interventions providing individually tailored information or instructions were not found to be more effective, but there was evidence that specific goal setting and goal review techniques may enhance fitness gains

Predicting household food waste reduction using an extended theory of planned behaviour

Identifying the antecedents of household food waste reduction is an important step in the development of effective and efficient interventions. This prospective study tested the utility of applying an extended theory of planned behaviour (TPB) model to household food waste reduction. At baseline, participants (N = 279) completed a questionnaire designed to measure the following cognitive constructs derived from the extended TPB model: intention, attitude, subjective norm, perceived behavioural control, self-identity, anticipated regret, moral norm and descriptive norm. At follow-up, participants (N = 204) completed a questionnaire assessing their household food waste behaviour. The extended TPB model accounted for a substantial amount (64%) of the variance in intention, with attitude, subjective norm, perceived behavioural control, self-identity and anticipated regret emerging as significant linear predictors. Furthermore intention significantly predicted the likelihood that participants had reduced their household fruit and vegetable waste at follow-up; however, the amount of variance in behaviour accounted for by the TPB model was relatively small (5%). Results demonstrate the utility of applying an extended theory of planned behaviour model to predict motivation and – to a lesser extent – behaviour, in the context of household fruit and vegetable waste reduction

Self-affirmation theory and pro-environmental behaviour: promoting a reduction in household food waste

Household food waste has a significant detrimental impact on the environment. However, despite national campaigns, people in high income countries throw away a sizeable proportion of the food they purchase. The present study investigated whether self-affirmation could promote openness to information detailing the negative consequences of household food waste, with a particular focus on fruit and vegetable waste. Participants (N = 362) completed either a standard self-affirmation manipulation, an integrated self-affirmation manipulation or a control task before reading the information and completing a series of measures assessing cognitive antecedents of behaviour. Household fruit and vegetable waste was self-reported one-week later. Compared to their non-affirmed counterparts, participants in the standard self-affirmation condition wasted less fruit and vegetables at follow-up. The findings suggest that self-affirmation has the potential to promote engagement with pro-environmental behaviour. Research should continue to explore how to integrate self-affirmation successfully within pro-environmental campaigns

Can we reduce car use and, if so, how? A review of available evidence

Transport accounts for nearly a quarter of current energy-related carbon dioxide emissions with car travel constituting more than three quarters of all vehicle kilometres travelled. Interventions to change transport behaviour, and especially to reduce car use, could reduce CO2 emissions from road transport more quickly than technological measures. It is unclear, however, which interventions are effective in reducing car use and what the likely impact of these interventions would be on CO2 emissions. A two-stage systematic search was conducted focusing on reviews published since 2000 and primary intervention evaluations referenced therein. Sixty-nine reviews were considered and 47 primary evaluations found. These reported 77 intervention evaluations, including measures of car-use reduction. Evaluations of interventions varied widely in the methods they employed and the outcomes measures they reported. It was not possible to synthesise the findings using meta-analysis. Overall, the evidence base was found to be weak. Only 12 of the 77 evaluations were judged to be methodologically strong, and only half of these found that the intervention being evaluated reduced car use. A number of intervention approaches were identified as potentially effective but, given the small number of methodologically strong studies, it is difficult to draw robust conclusions from current evidence. More methodologically sound research is needed in this area

Can we reduce car use and, if so, how? A review of available evidence

Transport accounts for nearly a quarter of current energy-related carbon dioxide emissions with car travel constituting more than three quarters of all vehicle kilometres travelled. Interventions to change transport behaviour, and especially to reduce car use, could reduce CO2 emissions from road transport more quickly than technological measures. It is unclear, however, which interventions are effective in reducing car use and what the likely impact of these interventions would be on CO2 emissions. A two-stage systematic search was conducted focusing on reviews published since 2000 and primary intervention evaluations referenced therein. Sixty-nine reviews were considered and 47 primary evaluations found. These reported 77 intervention evaluations, including measures of car-use reduction. Evaluations of interventions varied widely in the methods they employed and the outcomes measures they reported. It was not possible to synthesise the findings using meta-analysis. Overall, the evidence base was found to be weak. Only 12 of the 77 evaluations were judged to be methodologically strong, and only half of these found that the intervention being evaluated reduced car use. A number of intervention approaches were identified as potentially effective but, given the small number of methodologically strong studies, it is difficult to draw robust conclusions from current evidence. More methodologically sound research is needed in this area.Car-use reduction Driving reduction Intervention CO2 emissions Policy Review