Novel multi-method approach investigating behaviour change maintenance

PhD ThesisBackground: Behaviour change, if maintained, can lead to significant health improvements. The aim of this thesis was to advance psychological theory of behaviour change maintenance and the design of behavioural interventions to improve health. This thesis used a novel multi-method approach to explore behaviour maintenance, with a particular focus on weight loss maintenance (WLM). Methods: A three stage, multi-method approach included: (1) A systematic review of behavioural theories to identify theoretical explanations for behaviour maintenance and to examine the relationships between these explanations; (2) An N-of-1 study of WLM assessing theoretical predictors of maintained behaviour based on the systematic theory review, which employed ecologic momentary assessment, wireless body scales, and activity monitors in 12 obese people who had lost at least 5% weight in the previous year, analysed through cross-correlations of time series; (3) Data-prompted semi-structured, longitudinal interviews with individuals who participated in the N-of-1 study to explore their experiences of WLM, prompted by personal data including summaries of N-of-1 data, pictures, notes and graphs, analysed using the Framework method. Findings: (1) Systematic review: out of 117 identified behaviour theories, 100 met the inclusion criteria. The main theoretical themes identified to underpin behaviour change maintenance included maintenance motives, self-regulation, habits, psychological resources and environmental/social influences; (2) N-of-1 study: for 12 participants a range of maintenance-related theoretical variables showed differential impact on ability to maintain weight, engage in physical activity and x follow a personal WLM plan. The combination of predicting variables that had significant impact on outcome variables was unique for each individual; (3) Data-prompted interviews: most of the theoretical explanations from the systematic theory review adequately accounted for participants’ experiences. Additional emergent themes included: competing goals, prioritising, and preparatory strategies that enhanced self-regulation. Using personal data summaries proved valuable in evoking narratives regarding unique experiences of WLM. Discussion: A range of theoretical explanations were identified and proved useful in explaining behaviour maintenance in the area of WLM. The main conclusion derived from the thesis is that behavioural interventions need to tap into relevant behavioural explanations and deliver intervention components in a timely manner to support individuals to maintain behaviour change. Interventions should include elements of choice and customisation and should be adaptable to personal needs. The main study strengths included employment of novel methods and technology. The main limitation included N-of-1 analytical challenges and scalability of the applied design. Future research should develop behaviour maintenance theory further and explore which combinations of WLM strategies, in which individuals, support effective WLM.Fuse Centre for Translational Research in Public Healt

Health and Related Behaviours of Partners of Fly-in Fly-out Workers in Australia : A Cross-sectional Study

OA via the T&F Agreement Research Funder Aberdeen-Curtin Alliance Curtin International Postgraduate Research Scholarship (CIPRS) and Research Stipend Scholarship scheme of the University of Aberdeen, Scotland and Curtin University, AustraliaPeer reviewedPublisher PD

Health and wellbeing of rotation workers in the mining, offshore oil and gas, and construction industry : a systematic review

The study was funded by Aberdeen-Curtin Alliance Curtin International Postgraduate Research Scholarship (CIPRS). BY-AA is a recipient of Aberdeen- Curtin Alliance PhD CIPRS and Research Stipend Scholarship. Acknowledgements The authors extend their sincere gratitude to Ms Diana Blackwood and Ms Vanessa Varis, Librarian for Faculty of Health Sciences, at Curtin University for their professional assistance in developing the review search strategy.Peer reviewedPublisher PD

Application of Ecological Momentary Assessment in Studies with Rotation Workers in the Resources and Related Construction Sectors : A Systematic Review

Funding Information: This study was supported by the Aberdeen-Curtin Alliance Curtin International Postgraduate Research Scholarship and Research Stipend Scholarship awarded to Bernard Yeboah-Asiamah Asare (Curtin ID: 17619778; Aberdeen ID: 51987326). Acknowledgments The authors would like to express their appreciation to Ms Diana Blackwood and Ms Vanessa Varis, Librarians for the Faculty of Health Sciences at Curtin University for their professional assistance in developing the review search strategy.Peer reviewedPublisher PD

Impact of fly-in fly-out work on health behaviours and affective states : A daily diary study

Funding Information: We thank Mineral Resource Limited, Australia for supporting the study and advertising the study to their employees. We also extend our sincere thanks to all FIFO workers for taking part and contributing to this study. The study was funded by the Aberdeen‐Curtin Alliance International Postgraduate Research Scholarship and Research Stipend Scholarship of the University of Aberdeen, Scotland and Curtin University, Australia, awarded to Bernard Kwadwo Yeboah Asiamah‐Asare (Curtin ID: 17619778; Aberdeen ID: 51987326). Mineral Resources Limited, Australia also supported the study by providing AUD 200 shopping voucher to the winner of a raffle draw as reimbursement for study participation. The Mineral Resources Limited played no role in the design of the study, data collection and analysis, interpretation of study findings, preparation or decision to submit this manuscript for publication.Peer reviewe

Cost of Health-Related Work Productivity Loss among Fly-In Fly-Out Mining Workers in Australia

Sufficient knowledge on the work productivity impact of the health of fly-in fly-out (FIFO) workers in the mining sector in Australia is lacking. This study examined the impact of health and lifestyle behaviours on the work productivity of FIFO workers in the mining industry in Australia. FIFO workers completed an online questionnaire on health and work productivity loss measures. Linear regressions were used to model annual work productivity losses through absenteeism, presenteeism and total productivity loss. Workers with a high risk for health conditions were, on average, associated with 3.87% more productivity loss (absenteeism: 1.27% and presenteeism: 2.88%) than those with low risk. Workers who had multiple health risks classified as medium (3–4 health conditions) and high (5 or more health conditions) reported 1.75% and 7.46% more total productivity loss, respectively, than those with fewer multiple health risks (0–2 health conditions). Health conditions were estimated to account for an annual additional productivity cost due to absenteeism of AUD 8.82 million, presenteeism of AUD 14.08 million and a total productivity loss of AUD 20.96 million per 1000 workers. FIFO workers with high health risks experience more absenteeism, presenteeism and overall productivity loss. These measures provide strong economic justifications that could support the need for targeted workplace health interventions

Understanding health behaviours in context: A systematic review and meta-analysis of ecological momentary assessment studies of five key health behaviours

Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were ‘negative feeling states’ (21%) and ‘motivation and goals’ (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k = 348) and did not differ by target behaviour but was somewhat higher in student (vs. general population) samples, when EMAs were delivered via mobile phones/smartphones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context

Multiple health-related behaviours among Fly-In Fly-Out workers in the mining industry in Australia : A cross-sectional survey during the COVID-19 pandemic

Funding: The study received funding from Mineral Resources Limited (Australia). Mineral ResourcesLimited provided AUS$ 200 shopping voucher to the winner of a raffle draw as reimbursement for study participation. Mineral Resources Limited (Australia) provided support for this study in the form of salaries to authors MS and CH. The specific roles of these authors are articulated in the ‘author contributions’ section. Employees of Mineral Resources Limited played role in the datacollection, interpretation of study findings, preparation and decision to submit this manuscript for publication but not in the design of the study and data analysis. The preparation of this manuscript was supported by the Aberdeen-Curtin Alliance International Postgraduate Research Scholarship scheme awarded to BY-AA.Peer reviewedPublisher PD

Understanding health behaviours in context : A systematic review and meta-analysis of Ecological Momentary Assessment studies of five key health behaviours

Acknowledgments The review team would like to thank Dr. David Simons for his help with the R code, as well as Dr. Pierre Gerain, Sally Di Maio, Rike Panse, Noemi Lorbeer, Malte Stollwerck, Dr. Paul Gellert, and Dr. Ann DeSmet for their contributions to the data extraction. Funding Olga Perski and Dimitra Kale receive salary support from Cancer Research UK (C1417/A22962). Daniel Powell is funded by the Scottish Government’s Rural and Environment Science and Analytical Services (RESAS) and by the School of Medicine, Medical Sciences, and Nutrition (SMMSN) at the University of Aberdeen. Felix Naughton’s salary is covered by the Faculty of Medicine and Health Sciences at the University of East Anglia. Dominika Kwasnicka’s work is carried out within the HOMING program of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund (grant number POIR.04.04.00-00-5CF3/18-00; HOMING 5/2018) and she is also funded by the NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Australia.Peer reviewedPublisher PD