scholarly journals Modelling decay in effectiveness for evaluation of behaviour change interventions: a tutorial for public health economists

2021 ◽  
Author(s):  
Paolo Candio ◽  
Koen B. Pouwels ◽  
David Meads ◽  
Andrew J. Hill ◽  
Laura Bojke ◽  
...  
Keyword(s):  
Public Health ◽  
Behaviour Change ◽  
Population Level ◽  
Physical Activity Promotion ◽  
Technical Solution ◽  
Behaviour Change Interventions ◽  
Incremental Change ◽  
Robust Model ◽  
Activity Promotion ◽  
Key Factor

Abstract Background and purpose Recent methodological reviews of evaluations of behaviour change interventions in public health have highlighted that the decay in effectiveness over time has been mostly overlooked, potentially leading to suboptimal decision-making. While, in principle, discrete-time Markov chains—the most commonly used modelling approach—can be adapted to account for decay in effectiveness, this framework inherently lends itself to strong model simplifications. The application of formal and more appropriate modelling approaches has been supported, but limited progress has been made to date. The purpose of this paper is to encourage this shift by offering a practical guide on how to model decay in effectiveness using a continuous-time Markov chain (CTMC)-based approach. Methods A CTMC approach is demonstrated, with a contextualized tutorial being presented to facilitate learning and uptake. A worked example based on the stylized case study in physical activity promotion is illustrated with accompanying R code. Discussion The proposed framework presents a relatively small incremental change from the current modelling practice. CTMC represents a technical solution which, in absence of relevant data, allows for formally testing the sensitivity of results to assumptions regarding the long-term sustainability of intervention effects and improving model transparency. Conclusions The use of CTMC should be considered in evaluations where decay in effectiveness is likely to be a key factor to consider. This would enable more robust model-based evaluations of population-level programmes to promote behaviour change and reduce the uncertainty surrounding the decision to invest in these public health interventions.

Moving Through COVID-19: Perspectives of Older Adults in the Getting Older Adults Outdoors Study

2021 ◽  
pp. 1-11
Author(s):  
Kristina Marie Kokorelias ◽  
Jacquie Ripat ◽  
C. Allyson Jones ◽  
Nancy E. Mayo ◽  
Nancy M. Salbach ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Older Adults ◽  
Health Knowledge ◽  
Physical Activity Promotion ◽  
Negative Consequences ◽  
Activity Promotion ◽  
Qualitative Descriptive ◽  
Descriptive Approach ◽  
Safety Guidelines

Safety guidelines resulting from the coronavirus disease 2019 pandemic may reduce physical activity participation of older adults, particularly prefrail and frail individuals. The objective was to explore older adults’ experiences with physical activity during the coronavirus disease 2019 pandemic. Using a qualitative descriptive approach, interviews were conducted with 16 older adults. Data were analyzed thematically. Two themes emerged: (a) coming to a standstill and (b) small steps. Participants described that imposed provincial and federal recommendations caused them to reduce their physical activity with negative consequences. As time progressed, participants used emerging public health knowledge about coronavirus disease 2019 to safely increase physical activity. Many participants developed strategies to remain active during the pandemic (e.g., wearing a pedometer, walking outdoors at particular times of day). Findings from this study can better inform the development of programs, clinical practice, and policy for physical activity promotion in older adults during periods of physical distancing and isolation.

scholarly journals Improving Physical Activity mHealth Interventions: Development of a Computational Model of Self-Efficacy Theory to Define Adaptive Goals for Exercise Promotion

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Dario Baretta ◽  
Fabio Sartori ◽  
Andrea Greco ◽  
Marco D’Addario ◽  
Riccardo Melen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Computational Model ◽  
Behaviour Change ◽  
Self Efficacy ◽  
Protective Factor ◽  
Cognitive Theory ◽  
Physical Activity Promotion ◽  
Physical Activity Guidelines ◽  
Model Based ◽  
Activity Promotion

The practice of regular physical exercise is a protective factor against noncommunicable diseases and premature mortality. In spite of that, large part of the population does not meet physical activity guidelines and many individuals live a sedentary life. Recent technological progresses and the widespread adoption of mobile technology, such as smartphone and wearables, have opened the way to the development of digital behaviour change interventions targeting physical activity promotion. Such interventions would greatly benefit from the inclusion of computational models framed on behaviour change theories and model-based reasoning. However, research on these topics is still at its infancy. The current paper presents a smartphone application and wearable device system called Muoviti! that targets physical activity promotion among adults not meeting the recommended physical activity guidelines. Specifically, we propose a computational model of behaviour change, grounded on the social cognitive theory of self-efficacy. The purpose of the computational model is to dynamically integrate information referring to individuals’ self-efficacy beliefs and physical activity behaviour in order to define exercising goals that adapt to individuals’ changes over time. The paper presents (i) the theoretical constructs that informed the development of the computational model, (ii) an overview of Muoviti! describing the system dynamics, the graphical user interface, the adopted measures and the intervention design, and (iii) the computational model based on Dynamic Decision Network. We conclude by presenting early results from an experimental study.

scholarly journals What influences people’s responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations

2020 ◽  
Author(s):  
Daniela Ghio ◽  
Sadie Lawes-Wickwar ◽  
Mei Yee Tang ◽  
Tracy Epton ◽  
Neil Howlett ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Infectious Diseases ◽  
Behaviour Change ◽  
Population Level ◽  
Personal Control ◽  
Health Messages ◽  
Public Health Messages ◽  
Managing Risk ◽  
Health Messaging

Background Population level behaviour change, requiring individual behaviour change such as hand hygiene and physical distancing, are central to reducing transmission of infectious diseases, including COVID-19, but little is known about how best to communicate this type of risk reducing information, and how populations might respond. We conducted a rapid systematic review to identify and synthesise evidence relating to: a) What characterises effective public-health messages for managing risk and preventing infectious disease, and b) What influences people’s responses to public-health messages.Methods Rapid systematic review methodology was used. We included all study designs and grey literature. Non-English language papers were excluded. Ovid Medline, Ovid PsycINFO and Healthevidence.org were searched alongside PsyarXiv and OSF Preprints up to May 2020. A narrative synthesis was conducted.Findings We identified 70 eligible papers: 3 systematic reviews, 54 individual papers and 14 pre-prints. To influence behaviour effectively at the population level, public-health messages need to be acceptable, credible and trustworthy, to increase the public’s understanding and perceptions of the threat. Interpretation Key recommendations are to: engage communities in the development of public-health messaging, use credible and legitimate sources, address uncertainty immediately and with transparency, focus on unifying messages from all sources, and develop messages aimed at increasing understanding, induce social responsibility and empower personal control. Embedding these principles of behavioural science into public-health messaging is an important step towards more effective health-risk communication for managing risk, promoting protective behaviours and preventing disease during epidemics/pandemics.

scholarly journals The Norwegian Healthy Life Centre Study: A pragmatic RCT of physical activity in primary care

2018 ◽  
Vol 47 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Gro Beate Samdal ◽  
Eivind Meland ◽  
Geir Egil Eide ◽  
Sveinung Berntsen ◽  
Eirik Abildsnes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Controlled Trial ◽  
Intervention Group ◽  
Population Level ◽  
Drop Out ◽  
Healthy Life ◽  
Level Of Education ◽  
Behaviour Change Interventions ◽  
Individual Level

Aims: The aim of this study was to evaluate the effect of behaviour change interventions at Norwegian Healthy Life Centres (HLCs) on participants’ moderate to vigorous intensity physical activity (MVPA) six months after baseline. We also explore predictors of change in MVPA, and if level of education and MVPA at baseline modify the effect. Methods: A randomised controlled trial with inclusion criteria age ⩾ 18 years and ability to participate in group-based physical activity. Participants were randomised to either behaviour change interventions or a waiting list (control). Objective recordings of physical activity were the main outcome, analysed with simple and multiple linear regression. Results: We recruited 118 participants from six HLCs. Participants with mental, musculoskeletal, or chronic somatic disease were more likely to drop out. We revealed no differences in MVPA or sedentary time between the groups. Types of motivation or several characteristics of disadvantage at baseline could not explain changes in MVPA. Across both groups, 83% achieved the recommended 150 minutes of MVPA per week, and participants with a lower level of education were less likely to improve. Participants in the intervention group who were least active at baseline significantly increased their MVPA. Conclusions: The study revealed that the intervention had no short-term effect on time spent on MVPA or sedentary. This study does not support a strong emphasis on behaviour change on an individual level as a way of targeting general health and risk reduction at a population level. Although less active people benefitted more from the HLC intervention, the intervention was unable to counteract widening of inequity across educational groups.

scholarly journals The effects of long-term physical activity interventions in communities: Scoping review in the Nordic countries

2021 ◽  
pp. 140349482110205
Author(s):  
Elsi H. Haverinen ◽  
Hanna M. Elonheimo ◽  
Hanna K. Tolonen ◽  
Pekka J. Jousilahti ◽  
Heini J.C. Wennman
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Behaviour Change ◽  
Scoping Review ◽  
Current Knowledge ◽  
Health Planning ◽  
Age Groups ◽  
Population Level ◽  
Nordic Countries

Aims: Physical activity (PA) is an important part of maintaining good overall health. Currently, the number of insufficiently physically active adults and children is alarmingly high worldwide. To tackle the challenge, several interventions have been conducted, however, current knowledge on intervention effectiveness is still inconclusive. This scoping review aimed to summarize the effects of long-term PA interventions across all age groups in the Nordic countries. Methods: A scoping review was conducted by including all age groups and interventions lasting more than 12 months. The aims of the interventions had to focus on increasing PA and/or fitness. The Behaviour Change Wheel framework was used to describe components of the intervention functions. Results: Initially, 1937 studies were identified. Twelve intervention studies fulfilled the inclusion criteria and were included in the analysis. From the included studies, seven focused on children and/or their parents and five on working-age adult populations. Most of the studies built on theoretical backgrounds and included several behaviour change functions. A hindering factor for synthesis was variation in measurement methods: both subjective and objective outcome measures were reported. Among all age groups, intervention effects on PA were modest. Conclusions: There was no clear evidence of increased PA or fitness from long-term interventions in communities. However, even small improvements in PA are important for increasing PA at a population level and enhancing public health. More research is required for evidence-based community and public health planning.

Creating a Robust Public Health Infrastructure for Physical Activity Promotion

2007 ◽  
Vol 32 (1) ◽  
pp. 68-78 ◽  
Author(s):  
Antronette K. Yancey ◽  
Jonathan E. Fielding ◽  
George R. Flores ◽  
James F. Sallis ◽  
William J. McCarthy ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Physical Activity Promotion ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
Activity Promotion

scholarly journals Walking and Walkability: Is Wayfinding a Missing Link? Implications for Public Health Practice

2016 ◽  
Vol 13 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Ann E. Vandenberg ◽  
Rebecca H. Hunter ◽  
Lynda A. Anderson ◽  
Lucinda L. Bryant ◽  
Steven P. Hooker ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Problem Solving ◽  
Public Health Practice ◽  
Physical Activity Promotion ◽  
Health Practice ◽  
Research And Practice ◽  
Environmental Features ◽  
Activity Promotion ◽  
Problem Solving Process

Background:Research on walking and walkability has yet to focus on wayfinding, the interactive, problem-solving process by which people use environmental information to locate themselves and navigate through various settings.Methods:We reviewed the literature on outdoor pedestrian-oriented wayfinding to examine its relationship to walking and walkability, 2 areas of importance to physical activity promotion.Results:Our findings document that wayfinding is cognitively demanding and can compete with other functions, including walking itself. Moreover, features of the environment can either facilitate or impede wayfinding, just as environmental features can influence walking.Conclusions:Although there is still much to be learned about wayfinding and walking behaviors, our review helps frame the issues and lays out the importance of this area of research and practice.

Training Clinicians to Implement Behaviour Change Strategies for Physical Activity Promotion in Neurorehab

2017 ◽  
Vol 98 (10) ◽  
pp. e138
Author(s):  
Sarah Donkers ◽  
Katherine Chan ◽  
Maureen Pakosh ◽  
Stephan Milosavljevic ◽  
Kristin Musselman
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Physical Activity Promotion ◽  
Change Strategies ◽  
Activity Promotion

Powerful Partnering: Courting New Realms to Boost Global Physical Activity Promotion

2010 ◽  
Vol 7 (s3) ◽  
pp. S356-S368 ◽  
Author(s):  
Becky H. Lankenau ◽  
Dianne Culhane ◽  
Maria Stefan
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Leadership Practices ◽  
Relationship Management ◽  
Physical Activity Promotion ◽  
Trade Associations ◽  
Industry Trade ◽  
Activity Promotion ◽  
Potential Benefits ◽  
Stakeholder Relationship

This symposium addressed the importance of selective partnering between public health and other sectors in order to enhance physical activity promotion. The speakers reviewed the potential benefits of partnering, common partnering concerns and their remedies, and important tasks for developing successful partnerships. Key leadership practices and a framework for convening conversations with potential partners were presented. Motivations for industry, trade associations, and other partners to engage with public health to promote physical activity were discussed, and the importance of using stakeholder relationship management to engage partners was emphasized.

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