Using the Persuasive by Design-model to inform the design of complex behaviour change concepts: two case studies

As travel planning’s theoretical underpinnings have broadened from engineering and economics to embrace psychology and sociology, an emphasis has been placed on social marketing and nudge theory. It is argued that this is consistent with a neo-liberal trend towards governing from a distance. Using two case studies, one a qualitative study of reducing short-haul air travel, the other a quantitative study of attempts to reduce local car travel, it is found that actual behaviour change is limited. This seems to arise because behavioural change has been too narrowly defined and overly identified with personal choice.

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The Use of Behavioural Self-Control as a Teaching Tool

Australasian Journal of Special Education ◽

10.1017/s1030011200021394 ◽

1985 ◽

Vol 9 (2) ◽

pp. 24-27

Author(s):

Diana Roe ◽

Sandi Plummer

Keyword(s):

Case Studies ◽

Behaviour Change ◽

Self Control ◽

Teaching Tool ◽

Use Of Self ◽

Self Assessment ◽

Self Monitoring ◽

Control Techniques ◽

Children’S Behaviour ◽

Special Children

AbstractThis paper examines the use of self-control techniques as a teaching tool to change children’s behaviour, and to generalize that behaviour change to other settings. Four case studies are presented to illustrate the use of self-assessment, using the child’s own criteria for rating behaviour, self-modelling with videotapes of the child in the classroom, and self-monitoring using a wrist counter. It is concluded that self-control techniques can be a valuable way of teaching special children to discriminate and evaluate how they are behaving.

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Adapted motivational interviewing for brief healthcare consultations: protocol for a systematic review and meta-analysis of treatment fidelity in real-world evaluations of behaviour change counselling

BMJ Open ◽

10.1136/bmjopen-2018-028417 ◽

2019 ◽

Vol 9 (7) ◽

pp. e028417 ◽

Cited By ~ 1

Author(s):

Alison K Beck ◽

Erin Forbes ◽

Amanda L Baker ◽

Ben Britton ◽

Christopher Oldmeadow ◽

...

Keyword(s):

Behaviour Change ◽

Health Behaviour ◽

Real World ◽

Treatment Effects ◽

Random Effect ◽

Treatment Fidelity ◽

Systematic Evaluation ◽

Complex Behaviour ◽

Behaviour Change Counselling ◽

The Impact

IntroductionTreatment fidelity is an important and often neglected component of complex behaviour change research. It is central to understanding treatment effects, especially for evaluations conducted outside of highly controlled research settings. Ensuring that promising interventions can be delivered adequately (ie, with fidelity) by real-world clinicians within real-world settings is an essential step in developing interventions that are both effective and ‘implementable’. Whether this is the case for behaviour change counselling, a complex intervention developed specifically for maximising the effectiveness of real-world consultations about health behaviour change, remains unclear. To improve our understanding of treatment effects, best practice guidelines recommend the use of strategies to enhance, monitor and evaluate what clinicians deliver during patient consultations. There has yet to be a systematic evaluation of whether and how these recommendations have been employed within evaluations of behaviour change counselling, nor the impact on patient health behaviour and/or outcome. We seek to address this gap.Methods and analysisMethods are informed by published guidelines. Ten electronic databases (Medline, PubMed, EMBASE, PsycINFO, CINAHL Complete, ScienceDirect, Taylor and Francis; Wiley, ProQuest and Open Grey) will be searched for published and unpublished articles that evaluate behaviour change counselling within real-world clinical settings (randomised and non-randomised). Eligible papers will be rated against the National Institute of Health fidelity framework. A synthesis, evaluation and critical overview of fidelity practices will be reported and linear regression used to explore change across time. Random-effect meta-regression is planned to explore whether fidelity (outcomes reported and methods used) is associated with the impact of behaviour change counselling. Standardised effect sizes will be calculated using Hedges’ g (continuous outcomes) and ORs (binary/dichotomous outcomes).Ethics and disseminationNo ethical issues are foreseen. Findings will be disseminated via journal publication and conference presentation(s).PROSPERO registration numberCRD42019131169

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Assessing Adherence, Competence and Differentiation in a Stepped-Wedge Randomised Clinical Trial of a Complex Behaviour Change Intervention

Nutrients ◽

10.3390/nu12082332 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2332

Author(s):

Alison Kate Beck ◽

Amanda L. Baker ◽

Gregory Carter ◽

Chris Wratten ◽

Judith Bauer ◽

...

Keyword(s):

Behaviour Change ◽

Real World ◽

Best Practice ◽

Research Question ◽

Randomised Clinical Trial ◽

Routine Care ◽

Stepped Wedge ◽

Behaviour Change Intervention ◽

Complex Behaviour ◽

Behaviour Change Counselling

Background: A key challenge in behavioural medicine is developing interventions that can be delivered adequately (i.e., with fidelity) within real-world consultations. Accordingly, clinical trials should (but tend not to) report what is actually delivered (adherence), how well (competence) and the distinction between intervention and comparator conditions (differentiation). Purpose: To address this important clinical and research priority, we apply best practice guidelines to evaluate fidelity within a real-world, stepped-wedge evaluation of “EAT: Eating As Treatment”, a new dietitian delivered health behaviour change intervention designed to reduce malnutrition in head and neck cancer (HNC) patients undergoing radiotherapy. Methods: Dietitians (n = 18) from five Australian hospitals delivered a period of routine care and following a randomly determined order each site received training and began delivering the EAT Intervention. A 20% random stratified sample of audio-recorded consultations (control n = 196; intervention n = 194) was coded by trained, independent, raters using a study specific checklist and the Behaviour Change Counselling Inventory. Intervention adherence and competence were examined relative to apriori benchmarks. Differentiation was examined by comparing control and intervention sessions (adherence, competence, non-specific factors, and dose), via multiple linear regression, logistic regression, or mixed-models. Results: Achievement of adherence benchmarks varied. The majority of sessions attained competence. Post-training consultations were clearly distinct from routine care regarding motivational and behavioural, but not generic, skills. Conclusions: Although what level of fidelity is “good enough” remains an important research question, findings support the real-world feasibility of integrating EAT into dietetic consultations with HNC patients and provide a foundation for interpreting treatment effects.

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Developing a theory-driven method to design for behaviour change: two case studies

DRS2016: Future-Focused Thinking ◽

10.21606/drs.2016.71 ◽

2016 ◽

Author(s):

Anita van Essen ◽

◽

Sander Hermsen ◽

Reint Jan Renes

Keyword(s):

Case Studies ◽

Behaviour Change

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Study protocol for a randomised controlled trial of a web-based behavioural lifestyle programme for emPOWERment in early Multiple Sclerosis (POWER@MS1)

BMJ Open ◽

10.1136/bmjopen-2020-041720 ◽

2021 ◽

Vol 11 (2) ◽

pp. e041720

Author(s):

Nicole Krause ◽

Karin Riemann-Lorenz ◽

Tanja Steffen ◽

Anne Christin Rahn ◽

Jana Pöttgen ◽

...

Keyword(s):

Multiple Sclerosis ◽

Randomised Controlled Trial ◽

Process Evaluation ◽

Behaviour Change ◽

Standard Care ◽

Controlled Trial ◽

Web Based ◽

Complex Behaviour ◽

Randomised Controlled ◽

Lifestyle Programme

IntroductionMultiple sclerosis (MS) is an inflammatory and degenerative disease of the central nervous system that mainly affects young adults. Uncertainty is a major psychological burden of the disease from diagnosis to prognosis, enhanced by the pressure to make early decisions on a diverse set of immunotherapies. Watchful waiting for 1–2 years while adapting goals and lifestyle habits to life with a chronic disease represents another reasonable option for persons with MS (PwMS). A behaviour change programme based on evidence-based patient information (EBPI) is not available in standard care. This randomised controlled trial (RCT) with an embedded process evaluation investigates the efficacy and cost-effectiveness of a web-based behavioural lifestyle programme to change lifestyle behaviour and reduce inflammatory disease activity in PwMS.Methods and analysisA web-based behavioural intervention will be evaluated in an RCT aiming to recruit 328 persons with clinically isolated syndrome, suspected MS or confirmed MS for less than 1 year, who have not yet started immunotherapy. Moreover, a mixed-methods process evaluation and a health economic evaluation will be carried out. Participants will be recruited in at least 16 MS centres across Germany and randomised to an intervention group with 12 months of access to EBPI about lifestyle factors in MS, combined with a complex behaviour change programme or to a control group (optimised standard care). The combined primary endpoint is the incidence of new T2 lesions on MRI or confirmed relapses.Ethics and disseminationThe study has been approved by the Ethics Committee of the Hamburg Chamber of Physicians (PV6015). Trial results will be communicated at scientific conferences and meetings and presented on relevant patient websites and in patient education seminars.Trial registration numberClinicalTrials.gov Registry (NCT03968172); Pre-results.

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A Geometric Design Model for the Circolimaçon Positive Displacement Machine

Journal of Mechanical Design ◽

10.1115/1.2901143 ◽

2008 ◽

Vol 130 (6) ◽

Cited By ~ 3

Author(s):

Ibrahim A. Sultan

Keyword(s):

Case Studies ◽

Design Process ◽

Geometric Parameters ◽

Design Model ◽

Inverse Design ◽

Design Parameters ◽

Design Models ◽

Positive Displacement ◽

Circular Arcs ◽

Design Requirements

A circolimaçon positive displacement machine is driven by a limaçon mechanism, but the profiles of its rotor and housing are circular arcs. As such, its design models are different from those of the limaçon-to-limaçon machines, whose profiles are cut to the limaçon equations. For the benefit of the reader, the paper starts with a brief background on the general geometric aspects of the limaçon fluid processing technology. However, the focus is then turned to the circolimaçon machine, where its design parameters are introduced and geometric models are proposed to assist with the design process. Also, a computational inverse design model has been employed to work out a set of congruent geometric parameters to meet certain design requirements. Case studies are presented at the end of the paper to give the reader a numerical perspective on the design process of this class of positive displacement machines.

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Fidelity in complex behaviour change interventions: a standardised approach to evaluate intervention integrity

BMJ Open ◽

10.1136/bmjopen-2013-003555 ◽

2013 ◽

Vol 3 (11) ◽

pp. e003555 ◽

Cited By ~ 43

Author(s):

Tom Mars ◽

David Ellard ◽

Dawn Carnes ◽

Kate Homer ◽

Martin Underwood ◽

...

Keyword(s):

Behaviour Change ◽

Complex Behaviour ◽

Behaviour Change Interventions ◽

Intervention Integrity

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ThinkCancer! The multi-method development of a complex behaviour change intervention to improve the early diagnosis of cancer in primary care

10.1101/2020.11.20.20235614 ◽

2020 ◽

Author(s):

A Surgey ◽

S Disbeschl ◽

R Lewis ◽

J Hiscock ◽

S Nafees ◽

...

Keyword(s):

Primary Care ◽

Early Diagnosis ◽

Behaviour Change ◽

Complex Intervention ◽

Evidence Synthesis ◽

System Level ◽

Randomised Control Trial ◽

Complex Behaviour ◽

Early Cancer Diagnosis ◽

Safety Netting

ABSTRACTBackgroundRelatively poor UK cancer outcomes are blamed upon late diagnosis. Despite most cancer patients presenting to their GP with symptoms, diagnostic delay remains a common theme, with many clinical and non-clinical factors responsible. Early diagnosis is key to improving outcomes and survival. This paper reports the multi-method process to design a complex intervention to improve the timely diagnosis of symptomatic cancer.MethodsA review of reviews, survey, discrete choice experiment, qualitative interviews and focus groups, all informed a realist evidence synthesis. This in turn informed the design of a complex intervention, guided by the Behaviour Change Wheel framework using a multi-step process.ResultsKey themes from the realist evidence synthesis included effective safety netting at practitioner and practice system level, increased vigilance and lowering referral thresholds. Qualitative findings explored the tensions, barriers and facilitators affecting suspected cancer referral. The Think Cancer! intervention is an educational and quality improvement workshop directed at the whole primary care team. Bespoke cancer safety netting plans and appointment of cancer champions are key components.ConclusionsThink Cancer! is a novel primary care early cancer diagnosis intervention, requiring evaluation through a cluster randomised control trial.

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The role of co-housing in building sustainable communities：Case studies from the UK

Environment-Behaviour Proceedings Journal ◽

10.21834/e-bpj.v2i6.898 ◽

2017 ◽

Vol 2 (6) ◽

Author(s):

Jingjing Wang ◽

Karim Hadjri ◽

Junjie Huang

Keyword(s):

Case Studies ◽

Behaviour Change ◽

Daily Living ◽

Age Groups ◽

Social Sustainability ◽

Structured Interviews ◽

New Members ◽

Sustainable Living ◽

The Uk

This paper explored the role of cohousing model in the UK and discussed the benefits and limitations of cohousing model by exploring cohousing residents’ motivation and daily living. Through case studies in the UK, semi-structured interviews were carried out to establish the environmental and social sustainability in cohousing and understand residents thinking and behaviour. This study found that cohousing can benefit various age groups, and promote residents’ thinking and behaviour change towards sustainable living. The study also found that the financial limitation and new members recruitment are the top two difficulties in cohousing development. The findings of this research will establish a better understanding of UK cohousing and highlight the potentials and possibilities of cohousing communities.

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