Planned, motivated and habitual hygiene behaviour: an eleven country review.

Handwashing with soap (HWWS) may be one of the most cost-effective means of preventing infection in developing countries. However, HWWS is rare in these settings. We reviewed the results of formative research studies from 11 countries so as to understand the planned, motivated and habitual factors involved in HWWS. On average, only 17% of child caretakers HWWS after the toilet. Handwash 'habits' were generally not inculcated at an early age. Key 'motivations' for handwashing were disgust, nurture, comfort and affiliation. Fear of disease generally did not motivate handwashing, except transiently in the case of epidemics such as cholera. 'Plans' involving handwashing included to improve family health and to teach children good manners. Environmental barriers were few as soap was available in almost every household, as was water. Because much handwashing is habitual, self-report of the factors determining it is unreliable. Candidate strategies for promoting HWWS include creating social norms, highlighting disgust of dirty hands and teaching children HWWS as good manners. Dividing the factors that determine health-related behaviour into planned, motivated and habitual categories provides a simple, but comprehensive conceptual model. The habitual aspects of many health-relevant behaviours require further study

Idylls

An “Idyll” is defined as a happy, peaceful, or picturesque scene. The term references poetry that describes a small intimate world, and scenes from everyday life. This exhibition, Idylls, showcases the little world of my home here in Lincoln, Nebraska. The paintings mirror my experience of the domestic spaces in my life, and the peaceful moments I encounter. In Idylls you are encouraged to be idle. We do ourselves a disservice when we don’t take the time to slow down. My work begins as an excitement about a specific formal quality, a shape of light, a hint of color, repetition of form, or a composition of layered spaces. The paintings are quiet, crisp, orderly, and controlled representations of places around my home executed at an intimate scale in acrylic on panel. This body of work began as a series of paintings that came out of the start of the COVID-19 pandemic. They focused on a single window in my home here in Lincoln. Being home for long stretches of time was not a new experience for me; I’ve always been a homebody. I had only been in Lincoln for eight months; the first weeks of isolation forced me to become more familiar with this house. Making that series of paintings gave me something to focus on while the world outside felt out of control. I aim to capture instances that pull me out of the day and bring me into the moment. Light that only briefly touches a specific spot, shadows that stretch and disappear within minutes, spaces seen through barriers, and colors reflecting from unknown sources highlight and bring my attention to the spaces that might normally fade into the background or go unnoticed. Each painting explores a distinct moment I’ve experienced while moving through a typical day; I do not change my routines or go searching for compositions. With a focus on the visual experience of the place, saturated colors and sharp shadows replicate the feeling of having fresh eyes and the surprises that each new moment can hold. This work encourages the viewer to slow down and take notice of their presence in spaces. While the paintings are grounded in observation and representation, I edit and intensify certain elements to imbue each with a more palpable sensation of the moment. An interest in the structure of the spaces I inhabit leads to a distillation of form and heightening of contrast. Exactness of things like peeling paint, dirt, screws, or imperfections of manufacturing are ignored. In this body of work I am not interested in whether the space is brand new or falling apart, but in the design and composition of the image. In these moments my vision narrows, I don’t see the space’s imperfections. I idealize the scene and remove distractions to extend the brevity of the moment and hold the viewer in the space before you snap back into seeing every detail. I am drawn to the patterns and repetitious shapes created by specific instances of light hitting structural forms and the shifts of perceptual color created by this light. Simplifying the construction of the architecture emphasizes these value and hue modulations. Angles of light, sizes of shadows, and proportions of elements are adjusted intuitively to suit the composition. There is balance to be found between the visual weights of light and dark, areas of reduction and busyness, and subtlety of hue or amplified saturation. Different points of view, varied proximity to barriers like walls, windows, and fences, and distances between spaces present the viewer with opportunities to notice how they engage with the places they are most comfortable in and the visual surprises contained within them. Layered spaces and the interstices between, like windows and alleys, create interactions between different places and between paintings. In my work, color and light are vital. The white surfaces of window trim and siding and intense shadows or cast light take on surprising colors, while light cascades in through blinds and cuts across surfaces. Light is a character in the world of my work, interacting with everything in its path. It is predictable, inviting the viewer to speculate the time of day depicted, but it can also be surprising and catch you off guard. Light can carve out special moments of peace in our hectic daily lives if we pause to observe it. Light and color are constantly changing and shifting and act as a reminder of the present moment. The moment of pause is prolonged in the making of the painting. Idylls showcases the moments I savor. The scenes I paint are peaceful, idealized and picturesque. Idylls embodies the elements that are core to my practice. The paintings are quiet and contemplative explorations of solitude in domestic space. Each captures a unique moment of light and color, through heightened contrast and manipulated saturation. Spaces are repeated, architectural barriers are layered, and gaps are explored. They romanticize the places where I spend my time by documenting the specificity in everyday moments, as well as provide snapshots into this brief period of my life. Idylls invites the viewer to slow down, step into my space, and recognize that these moments can be found within their own worlds. Adviser: Matthew Sontheime

Espérance de vie : diagnostics et pronostics concernant l’avenir des communautés francophones en Amérique

Quel est l’avenir des communautés francophones en Amérique ? Cet article présente les principales communautés francophones, documente l’évolution de leurs effectifs et fait des projections à partir des tendances observées. Il évalue également la condition actuelle de ces communautés en examinant les trois grands déterminants de la vitalité linguistique : les facteurs démographiques, les structures institutionnelles et les politiques linguistiques. Au Québec, la convergence positive de ces éléments inspire l’optimisme : les francophones jouissent d’une concentration territoriale, d’une complétude institutionnelle et d’un appui politique. Ailleurs au Canada, l’avenir reste incertain ; aux États-Unis, il est sombre.Is there a future for French-speaking communities in North America? This article identifies the principal French-speaking communities, traces the changes in their population numbers, and projects these trends into the future. It also diagnoses the present condition of these communities by examining the three major determinants of linguistic vitality: demographic factors, institutional structures and language policies. In Quebec, the favourable convergence of these elements inspires optimism: French-speakers benefit from geographic concentration, the full complement of institutions, and political support. Elsewhere in Canada the future remains uncertain; in the United States, it appears dismal

Behaviour Centred Design: towards an applied science of behaviour change.

Behaviour change has become a hot topic. We describe a new approach, Behaviour Centred Design (BCD), which encompasses a theory of change, a suite of behavioural determinants and a programme design process. The theory of change is generic, assuming that successful interventions must create a cascade of effects via environments, through brains, to behaviour and hence to the desired impact, such as improved health. Changes in behaviour are viewed as the consequence of a reinforcement learning process involving the targeting of evolved motives and changes to behaviour settings, and are produced by three types of behavioural control mechanism (automatic, motivated and executive). The implications are that interventions must create surprise, revalue behaviour and disrupt performance in target behaviour settings. We then describe a sequence of five steps required to design an intervention to change specific behaviours: Assess, Build, Create, Deliver and Evaluate. The BCD approach has been shown to change hygiene, nutrition and exercise-related behaviours and has the advantages of being applicable to product, service or institutional design, as well as being able to incorporate future developments in behaviour science. We therefore argue that BCD can become the foundation for an applied science of behaviour change

Determinants of hand hygiene compliance among nurses in US hospitals: A formative research study.

Hand hygiene is the simplest and most effective measure for preventing healthcare-associated infections. Despite the simplicity of this procedure and advances made in infection control, hospital health care workers' compliance to hand hygiene recommendations is generally low. Nurses have the most frequent patient care interactions, and thus more opportunities to practice hand hygiene. As such, it is important to identify and understand determinants of nurses' reported compliance. Formative research was undertaken to assess the potential impact of several unexamined factors that could influence HH among nurses: professional role and status, social affiliation, social norms, and physical modifications to the work environment (as well as institutional factors like safety climate). A survey questionnaire was developed primarily to inform the creation of a behaviour change intervention. The survey looked at how these factors influence HH among nurses and sought to identify barriers and levers to reported hand hygiene. It was administered to a survey panel of acute care nurses, working in US hospitals, with a year or more of experience. Multivariate regression modelling suggested that reported hand hygiene compliance was most likely to be a function of a hospital management's communication openness, perceived performance by peers, increased interactions with patients and other staff members, and the reduction in stress, busyness, and cognitive load associated with role performance. A powerful, effective intervention on HH among nurses therefore could be directed at improving communication openness, consider the impact of perceived performance by peers, increase interactions with patients and staff, and determine how to reduce the stress and cognitive load associated with role performance

Objective and subjective measurement of sedentary behavior in human adults : a toolkit.

Objectives: Human biologists are increasingly interested in measuring and comparing physical activities in different societies. Sedentary behavior, which refers to time spent sitting or lying down while awake, is a large component of daily 24 hours movement patterns in humans and has been linked to poor health outcomes such as risk of all‐cause and cardiovascular mortality, independently of physical activity. As such, it is important for researchers, with the aim of measuring human movement patterns, to most effectively use resources available to them to capture sedentary behavior. Methods: This toolkit outlines objective (device‐based) and subjective (self‐report) methods for measuring sedentary behavior in free‐living contexts, the benefits and drawbacks to each, as well as novel options for combined use to maximize scientific rigor. Throughout this toolkit, emphasis is placed on considerations for the use of these methods in various field conditions and in varying cultural contexts. Results: Objective measures such as inclinometers are the gold‐standard for measuring total sedentary time but they typically cannot capture contextual information or determine which specific behaviors are taking place. Subjective measures such as questionnaires and 24 hours‐recall methods can provide measurements of time spent in specific sedentary behaviors but are subject to measurement error and response bias. Conclusions: We recommend that researchers use the method(s) that suit the research question; inclinometers are recommended for the measurement of total sedentary time, while self‐report methods are recommended for measuring time spent in particular contexts of sedentary behavior

Unintentional behaviour change.

We argue that the authors ignore a broad range of possible means of changing behaviour: unintentional change. Most of the behaviours that people seek to change - either in themselves or that are the subject of public health campaigns-are habitual, and hence not necessarily responsive to intentions. An evolutionary approach should take into account all kinds of evolved behavioural responses

Toward a Model of Situations and Their Context

Developing a widely accepted theory of behavior causation has been hampered by the lack of a rigorous approach to understanding the kinds of determinants at work. Interest in behavior change is also burgeoning, and requires a profound understanding of how personal and environmental determinants interact dynamically to predict changed behavioral outcomes. Behavior settings theory, a powerful naturalistic theory with a huge empirical underpinning, has long been available for describing the recurrent, everyday behavioral episodes in which many social and psychological scientists are interested. In this article, I review settings theory and update it in the light of a number of recent contributions from various quarters. I argue that this syncretic model should be seen as defining the proximate causal network surrounding these common behavioral episodes, which I call “situations.” I further propose that “contexts” should be thought of as the more distal, second-order causes circumscribing situations. I argue that these situational and contextual “spheres” of causation are a powerful way to understand behavior determination. I conclude by introducing a quasi-computational model of situations that is worthy of the further development necessary to make psychology a predictive science of behavioral causation and change

Development of a behaviour change intervention using a theory-based approach, Behaviour Centred Design, to increase nurses' hand hygiene compliance in the US hospitals.

Background A behaviour change campaign is unlikely to be effective if its intervention is not carefully designed. While numerous frameworks are widely used to develop and evaluate interventions, the steps detailing how to create an intervention are not as clear because the process of linking behaviour analysis to the intervention design is seldom discussed. We document the application of the Behaviour Centred Design (BCD) approach to the development of an intervention to improve hand hygiene (HH) rates among nurses' hospital units in the USA. Methods Intervention development is divided into the first three steps of the BCD approach: Assess, Build, and Create. The Assess step centres on understanding the target behaviour. The Build step expands the knowledge of the target behaviour and population through formative research which leads to a creative brief that explains the focus of the intervention. In the Create step, the creative brief guides the intervention design. Results Drawing from the main findings of the Asses and Build steps, a focal insight was developed positing that nurses can rediscover the meaning and purpose of their role as a nurse and thus as a caregiver by practicing HH; in the process of cleaning their hands, nurses are living up to their ideal nurse-self. The focal insight was linked linguistically into a theory and change. The outcome was a simple intervention, called the Mainspring Intervention, which consisted of three major parts: a self-affirmation exercise to reduce defensiveness, a message that challenged nurses' perceptions about their HH practice, and an implementation intention activity to help nurses link HH behaviour to a cue. Conclusions We detailed the creation of an original HH intervention that used the BCD approach. The intervention is relatively simple compared to most HH initiatives in the literature, both in terms of having relatively few components to the intervention and relatively easy field implementation. This intervention will allow us to test how specific psychological processes contribute to the problem of low HH rates, how our proposed intervention changes these processes in the hospital setting, and how the expected change in nurses' cognition transforms over time because of the intervention

Testing the human superorganism approach to morality

Current theories in moral psychology do not agree about the kinds and range of offenses that people should moralize. In this study, a new approach to defining the moral domain, Human Superorganism Theory (HSoT), is presented and tested. HSoT proposes that the primary function of moral action is the suppression of cheaters in the unusually large societies recently established by our species (i.e., human 'superorganisms'). It suggests that a broad range of moral concerns exist beyond traditional notions of harm and fairness, including actions that inhibit functions such as group-level social control, physical and social structuring, reproduction, communication, signaling and memory. Roughly 80,000 respondents completed a web-based experiment hosted by the British Broadcasting Corporation, which elicited a suite of responses to characteristics of a set of 33 short scenarios representing the areas identified by the HSoT perspective. Results indicate that all 13 superorganism functions are moralized, while violations of scenarios falling outside this area (social customs and individual decisions) are not. Several hypotheses derived specifically from HSoT were also supported. Given this evidence, we believe this new approach to defining a broader moral domain has implications for fields ranging from psychology to legal theory