Evidence-based selection of theories for designing behaviour change interventions : using methods based on theoretical construct domains to understand clinicians' blood transfusion behaviour

Peer reviewedPostprin

Effect of prosocial public health messages for population behaviour change in relation to respiratory infections: a systematic review protocol.

INTRODUCTION: The COVID-19 pandemic represents a major societal challenge that requires large-scale behaviour change, widespread collective action and cooperation to reduce viral transmission. Existing literature indicates that several messaging approaches may be effective, including emphasising the benefits to the recipient, aligning with the recipient's moral values and focusing on protecting others. Current research suggests that prosocial public health messages that highlight behaviours linked to societal benefits (eg, protecting 'each other'), rather than focusing on behaviours that protect oneself (eg, protecting 'yourself'), may be a more effective method for communicating strategies related to infectious disease. To investigate this we will conduct a systematic review that will identify what messages and behaviour change techniques have the potential to optimise the effect on population behaviour in relation to reducing transmission of respiratory infections. METHODS AND ANALYSIS: A systematic literature search of published and unpublished studies (including grey literature) in electronic databases will be conducted to identify those that meet our inclusion criteria. The search will be run in four electronic databases: MEDLINE, EMBASE, PsycINFO and Scopus. We will also conduct supplementary searches in databases of 'grey' literature such as PsycEXTRA, Social Science Research Network and OSF PREPRINTS, and use the Google Scholar search engine. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Titles, abstracts and full texts for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using the Cochrane Risk of Bias Tool and the Risk of Bias in Non-randomized Studies-of Interventions tool. Disagreements will be resolved by a consensus procedure. ETHICS AND DISSEMINATION: This protocol has been registered with PROSPERO. No ethical approval is required, as there will be no collection of primary data. The synthesised findings will be disseminated through peer-reviewed publication. PROSPERO REGISTRATION NUMBER: CRD42020198874

Effect of prosocial public health messages for population behaviour change in relation to respiratory infections: a systematic review protocol.

INTRODUCTION: The COVID-19 pandemic represents a major societal challenge that requires large-scale behaviour change, widespread collective action and cooperation to reduce viral transmission. Existing literature indicates that several messaging approaches may be effective, including emphasising the benefits to the recipient, aligning with the recipient's moral values and focusing on protecting others. Current research suggests that prosocial public health messages that highlight behaviours linked to societal benefits (eg, protecting 'each other'), rather than focusing on behaviours that protect oneself (eg, protecting 'yourself'), may be a more effective method for communicating strategies related to infectious disease. To investigate this we will conduct a systematic review that will identify what messages and behaviour change techniques have the potential to optimise the effect on population behaviour in relation to reducing transmission of respiratory infections. METHODS AND ANALYSIS: A systematic literature search of published and unpublished studies (including grey literature) in electronic databases will be conducted to identify those that meet our inclusion criteria. The search will be run in four electronic databases: MEDLINE, EMBASE, PsycINFO and Scopus. We will also conduct supplementary searches in databases of 'grey' literature such as PsycEXTRA, Social Science Research Network and OSF PREPRINTS, and use the Google Scholar search engine. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Titles, abstracts and full texts for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using the Cochrane Risk of Bias Tool and the Risk of Bias in Non-randomized Studies-of Interventions tool. Disagreements will be resolved by a consensus procedure. ETHICS AND DISSEMINATION: This protocol has been registered with PROSPERO. No ethical approval is required, as there will be no collection of primary data. The synthesised findings will be disseminated through peer-reviewed publication. PROSPERO REGISTRATION NUMBER: CRD42020198874

Reducing SARS-CoV-2 transmission in the UK: A behavioural science approach to identifying options for increasing adherence to social distancing and shielding vulnerable people.

PURPOSE: To describe and discuss a systematic method for producing a very rapid response (3 days) to a UK government policy question in the context of reducing SARS-CoV-2 transmission. METHODS: A group of behavioural and social scientists advising the UK government on COVID-19 contributed to the analysis and writing of advice through the Government Office for Science. The question was as follows: What are the options for increasing adherence to social distancing (staying at home except for essential journeys and work) and shielding vulnerable people (keeping them at home and away from others)? This was prior to social distancing legislation being implemented. The first two authors produced a draft, based on analysis of the current government guidance and the application of the Behaviour Change Wheel (BCW) framework to identify and evaluate the options. RESULTS: For promoting social distancing, 10 options were identified for improving adherence. They covered improvements in ways of achieving the BCW intervention types of education, persuasion, incentivization, and coercion. For promoting shielding of vulnerable people, four options were identified covering the BCW intervention types of incentivization, coercion, and enablement. CONCLUSIONS: Responding to policymakers very rapidly as has been necessary during the COVID-19 pandemic can be facilitated by using a framework to structure the thinking and reporting of multidisciplinary academics and policymakers

Harnessing behavioural science in public health campaigns to maintain 'social distancing' in response to the COVID-19 pandemic: key principles.

Coronavirus Disease 2019 (COVID-19), like Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), is an infection arising from a coronavirus. The COVID-19 pandemic is unprecedented in recent times in terms of the global spread of infection and the resultant morbidity, mortality and burden on health systems. In the absence of a vaccine, reducing transmission of the COVID-19 virus requires rapid and extensive behaviour change to enact protective behaviours and ‘social distancing’ across whole populations. Although ‘social distancing’ is the current most used term, it actually refers to maintaining physical separation by reducing the number of times people come into close contact with each other across whole populations. Social distancing applies regardless of infection status and is thus distinctive from quarantine or the isolation of those with suspected or diagnosed infection, which is also an important element of infection control. Governments across the world are implementing a diverse range of interventions to promote adherence to social distancing measures, which include elements of education, persuasion, incentivisation, coercion, environmental restructuring, restriction and enablement. Interventions have been developed rapidly and could not be informed directly by evidence, given the novelty of the virus and rapid spread of the pandemic. Despite this lack of direct evidence, a body of behavioural science exists which can usefully inform the current interventions and promote adherence to these restrictive measures. This body of science has been developed through the study of other infections (including other coronaviruses such as MERS and SARS), other areas of health and other areas of behaviour. This body of science suggests a number of principles which could ensure that interventions are more likely to achieve their intended outcomes and less likely to generate unintended harmful consequences. As a group of behavioural and social scientists who have shared their advice with government through the UK’s Government Office for Science, the researchers of this paper have collaborated to develop a series of principles to inform interventions to promote whole population adherence to social distancing measures. These were informed by members’ expertise and knowledge of existing theory and evidence, rather than by any formal review of the literature

Automatic Annotation of Subsea Pipelines using Deep Learning

Regulatory requirements for sub-sea oil and gas operators mandates the frequent inspection of pipeline assets to ensure that their degradation and damage are maintained at acceptable levels. The inspection process is usually sub-contracted to surveyors who utilize sub-sea Remotely Operated Vehicles (ROVs), launched from a surface vessel and piloted over the pipeline. ROVs capture data from various sensors/instruments which are subsequently reviewed and interpreted by human operators, creating a log of event annotations; a slow, labor-intensive and costly process. The paper presents an automatic image annotation framework that identifies/classifies key events of interest in the video footage viz. exposure, burial, field joints, anodes, and free spans. The reported methodology utilizes transfer learning with a Deep Convolutional Neural Network (ResNet-50), fine-tuned on real-life, representative data from challenging sub-sea environments with low lighting conditions, sand agitation, sea-life and vegetation. The network outputs are configured to perform multi-label image classifications for critical events. The annotation performance varies between 95.1 and 99.7 in terms of accuracy and 90.4 and 99.4 in terms of F1-Score depending on event type. The performance results are on a per-frame basis and corroborate the potential of the algorithm to be the foundation for an intelligent decision support framework that automates the annotation process. The solution can execute annotations in real-time and is significantly more cost-effective than human-only approaches

Identification of the rumination in cattle using support vector machines with motion-sensitive bolus sensors

The reticuloruminal function is central to the digestive efficiency in ruminants. For cattle, collar- and ear tag-based accelerometer monitors have been developed to assess the time spent ruminating on an individual animal. Cattle that are ill feed less and so ruminate less, thus, the estimation of the time spent ruminating provides insights into the health of individual animals. pH boluses directly provide information on the reticuloruminal function within the rumen and extended (three hours or more) periods during which the ruminal pH value remains below 5.6 is an indicator that dysfunction and poor welfare are likely. Accelerometers, incorporated into the pH boluses, have been used to indicate changes in behaviour patterns (high/low activity), utilised to detect the onset of oestrus. The paper demonstrates for the first time that by processing the reticuloruminal motion, it is possible to recover rumination periods. Reticuloruminal motion energy and the time between reticuloruminal contractions are used as inputs to a Support Vector Machine (SVM) to identify rumination periods with an overall accuracy of 86.1%, corroborated by neck mounted rumination collars

Communication style and exercise compliance in physiotherapy (CONNECT). A cluster randomized controlled trial to test a theory-based intervention to increase chronic low back pain patients’ adherence to physiotherapists’ recommendations: study rationale, design, and methods

Physical activity and exercise therapy are among the accepted clinical rehabilitation guidelines and are recommended self-management strategies for chronic low back pain. However, many back pain sufferers do not adhere to their physiotherapist’s recommendations. Poor patient adherence may decrease the effectiveness of advice and home-based rehabilitation exercises. According to self-determination theory, support from health care practitioners can promote patients’ autonomous motivation and greater long-term behavioral persistence (e.g., adherence to physiotherapists’ recommendations). The aim of this trial is to assess the effect of an intervention designed to increase physiotherapists’ autonomy-supportive communication on low back pain patients’ adherence to physical activity and exercise therapy recommendations. \ud \ud This study will be a single-blinded cluster randomized controlled trial. Outpatient physiotherapy centers (N =12) in Dublin, Ireland (population = 1.25 million) will be randomly assigned using a computer-generated algorithm to either the experimental or control arm. Physiotherapists in the experimental arm (two hospitals and four primary care clinics) will attend eight hours of communication skills training. Training will include handouts, workbooks, video examples, role-play, and discussion designed to teach physiotherapists how to communicate in a manner that promotes autonomous patient motivation. Physiotherapists in the waitlist control arm (two hospitals and four primary care clinics) will not receive this training. Participants (N = 292) with chronic low back pain will complete assessments at baseline, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after their first physiotherapy appointment. Primary outcomes will include adherence to physiotherapy recommendations, as well as low back pain, function, and well-being. Participants will be blinded to treatment allocation, as they will not be told if their physiotherapist has received the communication skills training. Outcome assessors will also be blinded. \ud \ud We will use linear mixed modeling to test between arm differences both in the mean levels and the rates of change of the outcome variables. We will employ structural equation modeling to examine the process of change, including hypothesized mediation effects. \ud \ud This trial will be the first to test the effect of a self-determination theory-based communication skills training program for physiotherapists on their low back pain patients’ adherence to rehabilitation recommendations. Current Controlled Trials ISRCTN63723433\u

Public understanding of COVID-19 antibody testing and test results: A qualitative study conducted in the U.K. early in the pandemic.

BACKGROUND: During the COVID-19 pandemic, antibody testing was proposed by several countries as a surveillance tool to monitor the spread of the virus and potentially to ease restrictions. In the UK, antibody testing originally formed the third pillar of the UK Government's COVID-19 testing programme and was thought to offer hope that those with a positive antibody test result could return to normal life. However, at that time scientists and the public had little understanding of the longevity of COVID-19 antibodies, and whether they provided immunity to reinfection or transmission of the virus. OBJECTIVE: This paper explores the UK public's understanding of COVID-19 testing, perceived test accuracy, the meaning of a positive test result, willingness to adhere to restrictive measures in response to an antibody test result and how they expect other people to respond. METHODS: On-line synchronous focus groups were conducted in April/May 2020 during the first wave of the pandemic and the most stringent period of the COVID-19 restrictive measures. Data were analysed thematically. RESULTS: There was confusion in responses as to whether those with a positive or negative test should return to work and which restrictive measures would apply to them or their household members. Participants raised concerns about the wider public response to positive antibody test results and the adverse behavioural effects. There were worries that antibody tests could create a divided society particularly if those with a positive test result were given greater freedoms or chose to disregard the restrictive measures. CONCLUSION: Should these tests be offered more widely, information should be developed in consultation with the public to ensure clarity and address uncertainty about test results and subsequent behaviours