A New Approach to Analyzing Behavioral Change Propagation in Redesigning of Drone Camera Stabilizer

Redesigning of complex products is not an easy task. Engineering change requirements can be extracted at any stage of the product redesign process, and it makes the management of engineering change become a challenging mission. The motivation for this study is to find the shortest path of behavioral change propagation (BCP), minimize the BCP, access to the special behavioral elements in order to better managing the BCP and classifying the behavioral attribute of the elements in terms of their relationship to change by betweenness centrality coefficient (BNCC), clustering coefficient (CLC), reachability coefficient (RC) and change propagation index (CPI). In this article, the procedure of managerial decision-making is proposed by combining system restrictions in behavioral clustering design structure matrix (BCDSM) with optimization algorithms. The practicality of suggested method is verified in redesign procedure of a phantom drone camera stabilizer as a case study. The results, indicate that the absorption of change by behavioral elements is dominant in the mechanical (63.9%), electrical (61.1%) and thermal (38.9%) behaviors of the drone camera stabilizer system in redesign process. These elements are best candidates for reducing the cost and time of behavioral changes in the system redesign and are desirable for the designer.

Timing theory integrated nursing combined behavior change integrated theory of nursing on primiparous influence

BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.

Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

A randomized controlled trial of Promoting Physical Activity in Regional and Remote Cancer Survivors(PPARCS)

Background:Physical activity(PA)is important for cancer survivors.Trials of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer survivors.The objective of this study was to ascertain whether wearable technology,coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in Australia.Methods:Cancer survivors from 5 states were randomized to intervention and control arms.Intervention participants were given a Fitbit Charge 2TMand received up to 6 telephone health coaching sessions.Control participants received PA print materials.Accelerometer assessments at baseline and 12 weeks measured moderate-to-vigorous PA(MVPA),light PA,and sedentary behavior.Results:Eighty-seven participants were recruited(age=63±11 years;74(85%)female).There was a significant net improvement in MVPA of 49.8 min/week,favoring the intervention group(95%confidence interval(95%CI):13.6-86.1,p=0.007).There was also a net increase in MVPA bouts of 39.5 min/week(95%CI:11.9-67.1,p=0.005),favoring the intervention group.Both groups improved light PA and sedentary behavior,but there were no between-group differences.Conclusion:This’s the first study to demonstrate that,when compared to standard practice(i.e.,PA education),a wearable technology intervention coupled with distance-based health coaching,improves MVPA in non-metropolitan cancer survivors.The results display promise for the use of scalable interventions using smart wearable technology in conjunction with phone-based health coaching to foster increased PA in geographically disadvantaged cancer survivors.

Activity-related typologies and longitudinal change in physical activity and sedentary time in children and adolescents:The UP&DOWN Study

Background:Children and adolescents can be distinguished by different typologies(clusters) of physical activity and sedentary behavior.How physical activity and sedentary behaviors change over time within different typologies is not known.This study examined longitudinal changes in physical activity and sedentary time among children and adolescents with different baseline typologies of activity-related behavior.Methods:In this longitudinal study(3 annual time points) of children(n=600,age=9.2±0.4 years(mean±SD),50.3% girls) and adolescents(n=1037,age=13.6±1.7 years,48.4% girls),participants were recruited in Spain in 2011-2012.Latent class analyses identified typologies based on self-reported screen,educational,social and relaxing sedentary behaviors,active travel,muscle strengthening activity,and sport at baseline.Within each typology,linear mixed growth models explored longitudinal changes in accelerometer-derived moderate-to-vigorous physical activity and sedentary time,as well as time by class interactions.Results:Three typologies were identified among children( "social screenies",12.8%;"exercisers",61.5%;and "non-sporty active commuters",25.7%) and among adolescents "active screenies",43.5%;"active academics",35.0%;and "non-sporty active commuters",21.5%) at baseline.Sedentary time increased within each typology among children and adolescents,with no significant differences between typologies.No changes in physical activity were found in any typology among children.In adolescents,physical activity declined within all typologies,with "non-sporty active commuters" declining significantly more than "active screenies" over 3 years.Conclusion:These results support the need for interveation to promote physical activity and prevent increases in sedentary time during childhood and adolescence.Adolescents characterized as "non-sporty active commuters" may require specific interventions to maintain their physical activity over time.

Moving Away from Coercion: Social Justice and Behavior Change in Disability Services

The use of coercion to alter behavior in persons with intellectual and other developmental disabilities has a long history. Despite the work of leaders in the development of Positive Behaviour Support (PBS), the use of chemical, mechanical, physical or personal, and environmental restraints continues, resulting in traumatization, physical and emotional harm, and in some instances, death. When coercion is used, the trust between people breaks down, and the lack of trust is reinforced by the power differentials present when coercion occurs. Social justice provides an avenue for rebalancing power and regaining trust, but people affected by disabilities have historically been excluded from theories of social justice and, in some cases, do not fall within the definition of what it means to be a person in the paradigms put forth by a number of different authors. The term non-coercive has been used in an attempt to reframe behavior change theories and practices, but this term describes the absence of negative circumstances and interventions, rather than the presence of positive and affirming interactions which improve the quality of life of all stakeholders.

Promoting Health Behavior Change in Canada: A Quality Improvement Project Integrating Prevention and Wellness in Frontline Care

Background: The critical need for Health Behaviour Change (HBC) for preventative care has been highlighted by the COVID-19 pandemic. This quality improvement project assessed the effectiveness and acceptability of Fountain of Health HBC tools as a minimal intervention for primary and secondary prevention among Canadian clinicians and their patients. Methods: Clinicians received HBC education and tools (paper tools and app-based) to assist their patients in setting a S.M.A.R.T (Specific, Measurable, Action-oriented, Realistic, Time-limited) goal at baseline and assessed four weeks later. Primary outcome measures were: 1) patient self-report of success at goal attainment;2) patient self-reported evaluation of change in well-being and health attitudes;and 3) clinician experience and engagement. Results: A total of 2184 clinicians received HBC education. Of these, 759 clinicians registered to participate in the project. 961 patients set S.M.A.R.T. HBC goals using either the paper tools (PT) or the app format. Patient data revealed nearly all patients (89% of PT users and 90% of app users) at least partially succeeded in attaining their goal at a four-week follow-up. Most patients (85% of PT and 80% of app users) also reported improvement in their well-being. A significant difference in health beliefs and attitudes was found in both PT (p < 0.001) and app users (p = 0.003). Conclusions: HBC is challenging. Educating and providing clinicians with HBC tools as a minimal intervention was found to be a successful health prevention strategy to improve patient well-being and health attitudes, and achieve S.M.A.R.T. goals. Results show HBC tools, education, and support for clinicians are both acceptable and effective for HBC in frontline care. These findings are relevant and timely given greater reliance on virtual care in the wake of the COVID-19 pandemic. Further research with rigorous methodology is needed to implement programs to achieve sustainable HBC to promote health on a large scale.

Upshots of health education among patients with type 2 diabetes mellitus: A field study in Mysuru

Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.

Dynamics of a two-group model for assessing the impacts of pre-exposure prophylaxis,testing and risk behaviour change on the spread and control of HIV/AIDS in an MSM population

Although much progress has been made in reducing the public health burden of the human immunodeficiency virus(HIV),which causes acquired immunodeficiency syndrome(AIDS),since its emergence in the 1980s(largely due to the large-scale use and availability of potent antiviral therapy,improved diagnostic and intervention and mitigation measures),HIV remains an important public health challenge globally,including in the United States.This study is based on the use of mathematical modeling approaches to assess the population-level impact of pre-exposure prophylaxis(PrEP),voluntary testing(to detect undetected HIV-infected individuals),and changes in human behavior(with respect to risk structure),on the spread and control of HIV/AIDS in an MSM(men-who-have sex-with-men)population.Specifically,a novel two-group mathematical model,which stratifies the total MSM population based on risk(low or high)of acquisition of HIV infection,is formulated.The model undergoes a PrEP-induced backward bifurcation when the control reproduction number of the model is less than one if the efficacy of PrEP to prevent a high-risk susceptible MSM individual from acquiring HIV infection is not perfect(the consequence of which is that,while necessary,having the reproduction number of the model less than one is no longer sufficient for the elimination of the disease in the MSM population).For the case where the efficacy of PrEP is perfect,this study shows that the disease-free equilibrium of the two-group model is globally-asymptotically stable when the associated control reproduction number of the model is less than one.Global sensitivity analysis was carried out to identify the main parameters of the model that have the highest influence on the value of the control reproduction number of the model(thereby,having the highest influence on the disease burden in the MSM population).Numerical simulations of the model,using a plausible range of parameter values,show that if half of the MSM population considered adhere strictly to the specified PrEP regimen(while other interventions are maintained at their baseline values),a reduction of about 22%of the new yearly HIV cases recorded at the peak of the disease could be averted(compared to the worst-case scenario where PrEP-based intervention is not implemented in the MSM population).The yearly reduction at the peak increases to about 50%if the PrEP coverage in the MSM population increases to 80%.This study showed,based on the parameter values used in the simulations,that the prospects of elimination of HIV/AIDS in the MSM community are promising if high-risk susceptible individuals are no more than 15%more likely to acquire HIV infection,in comparison to their low-risk counterparts.Furthermore,these prospects are significantly improved if undetected HIV-infected individuals are detected within an optimal period of time.

Long-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors:A randomized controlled trial

Background Physical activity(PA)can improve the physical and psychological health of prostate and colorectal cancer survivors,but PA behavior change maintenance is necessary for long-term health benefits.OncoActive is a print-and web-based intervention in which prostate and colorectal cancer patients and survivors receive automatically generated,personalized feedback aimed at integrating PA into daily life to increase and maintain PA.We evaluated the long-term outcomes of OncoActive by examining the 12-month follow-up differences between OncoActive and a control group,and we explored whether PA was maintained during a 6-month non-intervention follow-up period.Methods Prostate or colorectal cancer patients were randomly assigned to an OncoActive(n=249)or a usual care waitlist control group(n=229).OncoActive participants received PA advice and a pedometer.PA outcomes(i.e.,ActiGraph and self-report moderate-to-vigorous intensity PA(MVPA)min/week and days with≥30 min PA)and health-related outcomes(i.e.,fatigue,depression,physical functioning)were assessed at baseline,6 months,and 12 months.Differences between groups and changes over time were assessed with multilevel linear regressions for the primary outcome(ActiGraph MVPA min/week)and all additional outcomes.Results At 12 months,OncoActive participants did not perform better than control group participants at ActiGraph MVPA min/week,self-report MVPA min/week,or ActiGraph days with PA.Only self-report days with PA were significantly higher in OncoActive compared to the control group.For health-related outcomes only long-term fatigue was significantly lower in OncoActive.When exploratively examining PA within OncoActive,the previously found PA effects at the end of the intervention(6 months follow-up)were maintained at 12 months.Furthermore,all PA outcomes improved significantly from baseline to 12 months.The control group showed small but non-significant improvements from 6 months to 12 months(and from baseline to 12 months),resulting in a decline of differences between groups.Conclusion The majority of previously reported significant between-group differences at 6 months follow-up were no longer present at long-term follow-up,possibly because of natural improvement in the control group.At long-term follow-up,fatigue was significantly lower in OncoActive compared to control group participants.Computer-tailored PA advice may give participants an early start toward recovery and potentially contributes to improving long-term health.

Design of a Social Marketing Plan on Salt Reduction for the Control and Treatment of Noncommunicable Diseases in Costa Rica

High blood pressure and other non-communicable diseases associated with excessive salt/sodium consumption represent a major challenge to the health of the world’s population. Consumption is a human behavior that is usually influenced by significant factors, internal and external to people. The design of a national social marketing intervention is described. The whole process was developed by a national interdisciplinary team over the course of a decade (2011-2022). Its purpose is to promote changes in this behavior, through gradual reduction of salt/sodium consumption in the target populations of Costa Rica, for the prevention and control of associated diseases. The process includes four phases: research, situation analysis, creation of a proposal for the social marketing strategy, and implementation and evaluation. Last phase was not developed by the research team. The main inputs used to design this intervention were the data generated in three qualitative researchers carried out by the national work team and the social marketing regional plan for salt consumption reduction in Latin America. By analyzing these research data, marketing mix components were determined for designing the intervention. The marketing strategy is promotional and is based on encouraging a natural diet with less sodium using natural seasonings and adding less discretional salt and industrialized products high in sodium, in the preparation of food and dishes. The primary key audience is the mother of the school-aged child, and the secondary is the adult caregivers of this child. It is expected that in the short term, health promoters from different government and non-state sectors will contribute to the implementation of the national social marketing plan, to achieve, in the medium or long term, a consumption that approaches five grams of salt per person per day. This plan is a country initiative to position the value of a natural diet with less sodium and to contribute to the prevention and treatment of HT and NCD associated diseases.

Identifying behavioral determinants and stage of readiness for performing knee massage among individuals with knee osteoarthritis:An observational study

Objective Patients who experience knee osteoarthritis or chronic knee pain can alleviate their symptoms by performing self-knee massage.Understanding the readiness and types of determinants needed to facilitate self-knee massage is needed to design effective,theory-informed interventions.The primary objective of this study was to apply the transtheoretical model of behavior change to identify how factors,which include the type of knee condition and pain level,predict an individual’s readiness to adopt self-knee massage.The secondary objective employed the capability,opportunity and motivation-behavior(COM-B)model to identify relevant determinants that are predictive of an individual’s readiness to undertake self-knee massage.Methods An observational study design was used to recruit individuals with knee osteoarthritis(n=270)and chronic knee pain(n=130).Participants completed an online survey that assessed the transtheoretical model of behavior change stages,COM-B determinants(capability,opportunity and motivation),along with self-administered massage behavior.Multivariate analysis of covariance and structural equation modeling were used to test the primary and secondary objective,respectively.Results Participants who had knee osteoarthritis scored higher on the action stage compared to those with chronic pain(P=0.003),and those who experienced greater level of pain scored higher in the contemplation(P<0.001)and action phases(P<0.001)of performing knee massage compared to those with milder pain.The COM-B structural equation model revealed self-administered knee massage to be predicted by capability(β=0.31,P=0.004)and motivation(β=0.29,P<0.001),but not opportunity(β=–0.10,P=0.39).Pain level predicted motivation(β=0.27,P<0.001),but not capability(β=0.09,P=0.07)or opportunity(β=0.01,P=0.83).Tests for mediating effects found that determinants of COM-B(motivation and capability)mediate between pain level and self-administered massage behavior(β=0.10,P=0.002).Conclusion Clinicians and researchers can expect that patients diagnosed with knee osteoarthritis or who have chronic knee pain are ready(action stage)or are considering the behavior(contemplation stage)of self-knee massage.Individuals who report having knee osteoarthritis or chronic knee pain should be coached to develop the skills to perform self-knee massage and helped to develop the motivation to carry out the therapy.

Does knowledge of physical activity recommendations increase physical activity among Chinese college students？ Empirical investigations based on the transtheoretical model

Background: Based on the transtheoretical model, the current study investigated whether awareness of physical activity(PA) recommendations had an impact on the stages of PA behavior change and levels of PA among Chinese college students.Methods: In Study 1, with a cross-sectional study design, 9826 students were recruited, and their knowledge of international PA recommendations,PA stage distribution, and self-reported PA level were surveyed. Pearson's χ2 test was used to test whether those participants who were aware and not aware of PA guidelines were equally distributed across the stages of PA behavior, and independent t test was conducted to test the group difference in the actual levels of PA. In Study 2, 279 students who were not aware of the PA recommendations were randomly allocated to either an intervention group or a control group, and only those in the intervention group were presented with international PA guidelines. In both groups,students' PA stages and PA level were examined before the test and then 4 months post-test. Mc Nemar's test for correlated proportions and repeated-measures analysis of variance were conducted to examine the changes in PA stage membership and PA level after the intervention.Results: Study 1 results revealed that only 4.4% of the surveyed students had correct knowledge of PA recommendations. Those who were aware of the recommendations were in later stages of PA behavior(χ~2(4) = 167.19, p < 0.001). They were also significantly more physically active than those who were not aware of the recommendations(t(443.71) = 9.00, p < 0.001, Cohen's d = 0.53). Study 2 results demonstrated that the intervention group participants who were at the precontemplation and contemplation stages at the pre-test each progressed further in the PA stages in the post-test(χ~2(1) = 112.06, p < 0.001; χ~2(1) = 118.76, p = 0.03, respectively), although no significant change in PA level was observed(t(139) < 1, p = 0.89).Conclusion: The results showed that awareness of the PA recommendations was associated with higher stages and levels of PA behavior, and a brief educational exposure to PA recommendations led to improved stages of PA behavior but no change in the levels of PA among Chinese college students. More effective public health campaign strategies are needed to promote the dissemination of the PA recommendations and to raise the awareness of the Chinese student population.

Application of network meta-analysis in the field of physical activity and health promotion

Continued advancement in the field of physical activity and health promotion relies heavily on the synthesis of rigorous scientific evidence.As such,systematic reviews and meta-analyses of randomized controlled trials have led to a better understanding of which intervention strategies are superior(i.e.,produce the greatest effects)in physical activity-based health behavior change interventions.Indeed,standard meta-analytic approaches have allowed researchers in the field to synthesize relevant experimental evidence using pairwise procedures that produce reliable estimates of the homogeneity,magnitude,and potential biases in the observed effects.However,pairwise meta-analytic procedures are only capable to discerning differences in effects between a select intervention strategy and a select comparison or control condition.In order to maximize the impact of physical activity interventions on health-related outcomes,it is necessary to establish evidence concerning the comparative efficacy of all relevant physical activity intervention strategies.The development of network meta-analysis(NMA)-most commonly used in medical-based clinical trials-has allowed for the quantification of indirect comparisons,even in the absence of direct,head-to-head trials.Thus,it stands to reason that NMA can be applied in physical activity and health promotion research to identify the best intervention strategies.Given that this analysis technique is novel and largely unexplored in the field of physical activity and health promotion,care must be taken in its application to ensure reliable estimates and discernment of the effect sizes among interventions.Therefore,the purpose of this review is to comment on the potential application and importance of NMA in the field of physical activity and health promotion,describe how to properly and effectively apply this technique,and suggest important considerations for its appropriate application in this field.In this paper,overviews of the foundations of NMA and commonly used approaches for conducting NMA are provided,followed by assumptions related to NMA,opportunities and challenges in NMA,and a step-by-step example of developing and conducting an NMA.

Health communication campaigns: A brief introduction and call for dialogue

This article provides a brief introduction to health communication campaigns as an important method for health promotion.The general approach to campaign development is described and patterns of campaign effects across behavioral contexts are noted.Several high-profile campaigns in the United States are presented as examples and key learnings from each campaign are highlighted.The roles of theory,as well as major types of theories commonly used in campaign research,are also discussed.The article urges greater efforts to document and understand diverse campaign experience around the world.(c)2020 The author(s).Published by Elsevier B.V.on behalf of the Chinese Nursing Association.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).

Treatment Interventions of Type 2 Diabetes: A Systematic Review

Objective: This study looks to review different methods of lifestyle changing interventions, examine and compare them to determine usefulness, efficiency, and outcome in regard to future ventures to help control the rise of this type 2 diabetes. Methods: Three systematic reviews were found and compared based on efficacy and key differences in their approach to the ever-growing problem of type 2 diabetes. Outcomes and intervention styles of the studies were noted and critiqued based on their statistical significance. Conclusion: The first study revealed that multiple behavior change techniques (BCTs) correlate with a reduction in weight and HbA1c, especially when they work synergistically alongside one another. The second study spoke of how community intervention had an inclusive quality about it, which allowed for population variability to not affect implementation. It also showed that small incremental changes were best when trying to establish a change long-term across a large population. Finally, the third study revealed that, as the participant got closer to maintaining a good physical activity regiment, their self-efficacy also increased. The attributes of these studies give evidence that interventions that use multiple approaches are most effective when looking to improve physical activity and diet in Type 2 diabetics.

The Comparative Role of Intervening Variables in Understanding Farmers＇ Adoption Behavior

The purpose of this study was to indentify the most important determinants associated with behavior change by comparing the influence of intervening variables and the characteristics of the farmer and the farm （independent variables） on the adoption behavior of farmers for recommended agronomic practices. A total of 107 farmers out of a population of 214 were randomly selected from two adjoining districts of South Africa and Lesotho. Chi-square and correlations and regression analyses were used to determine the relationship between the independent, dependent and intervening variables. The results show clear differences between the independent in regard to their influence on adoption behavior, but these influences also vary significantly between the practices. In general the influence of independent variable is limited, and together their total contribution in explaining the variance in adoption （R2） varied between about 20 to 40 percent whilst that of the intervening variables varied between 50 and over 70 percent, which clearly supports the research hypothesis that their prediction arid explanation value in terms of behavior is much bigger than that of independent, personal and environmental factors.

Feasibility of a Fully Automated Multiple Session Alcohol Intervention to University Students,Using Different Modes of Electronic Delivery—The TOPHAT 1 Study

Background: In recent years more and more electronic health behaviour interventions have been developed in order to reach individuals with an unhealthy behaviour such as risky drinking. This is especially relevant in university students who are among those who most frequently are risky drinkers. This study explored the acceptability and feasibility, in an unselected group of university students, of a fully automated multiple session alcohol intervention offering different modes of delivery such as email, SMS and Android. Material and Methods: A total of 11,283 students at Link?ping University in Sweden were invited to perform a single session alcohol intervention and among those accepting this (4916 students) a total of 24.7% accepted to further participate in the extended multiple intervention lasting 3 - 6 weeks. The students could choose mode of delivery, total length of the intervention (between 3 - 6 weeks) and number of messages per week (3, 5, or 7 per week). A follow-up questionnaire was applied after the intervention to which 82.7% responded. Results: most students wanted to receive the messages by email with the shortest intervention length (3 weeks) and as few messages as possible per week (3 messages). However, no major difference was seen regarding satisfaction with the length and frequency of the intervention despite chosen length and frequency. Most students also expressed satisfaction with the content of the messages and would recommend the intervention to a fellow student in need of reducing drinking. Discussion and Conclusion: Based upon feedback from the students, a multiple push-based intervention appears to be feasible to offer students interested in additional support after a single session alcohol intervention. In a forthcoming study we will further explore the optimal mode of delivery and length of intervention and number of messages per week.

Psychological status and behavior changes of the public during the COVID-19 epidemic in China

Background:A cluster of pneumonia cases were reported by Wuhan Municipal Health Commission,China in December 2019.A novel coronavirus was eventually identified,and became the COVID-19 epidemic that affected public health and life.We investigated the psychological status and behavior changes of the general public in China from January 30 to February 3,2020.Methods:Respondents were recruited via social media(WeChat)and completed an online questionnaire.We used the State-Trait Anxiety Inventory,Self-rating Depression Scale,and Symptom Checklist-90 to evaluate psychological status.We also investigated respondents’behavior changes.Quantitative data were analyzed by t-tests or analysis of variance,and classified data were analyzed with chi-square tests.Results:In total,608 valid questionnaires were obtained.More respondents had state anxiety than trait anxiety(15.8%vs 4.0%).Depression was found among 27.1%of respondents and 7.7%had psychological abnormalities.About 10.1%of respondents suffered from phobia.Our analysis of the relationship between subgroup characteristics and psychological status showed that age,gender,knowledge about COVID-19,degree of worry about epidemiological infection,and confidence about overcoming the outbreak significantly influenced psychological status.Around 93.3%of respondents avoided going to public places and almost all respondents reduced Spring Festival-related activities.At least 70.9%of respondents chose to take three or more preventive measures to avoid infection.The three most commonly used prevention measures were making fewer trips outside and avoiding contact(98.0%),wearing a mask(83.7%),and hand hygiene(82.4%).Conclusions:We need to pay more attention to public psychological stress,especially among young people,as they are likely to experience anxiety,depression,and psychological abnormalities.Different psychological interventions could be formulated according to the psychological characteristics of different gender and age groups.The majority of respondents followed specific behaviors required by the authorities,but it will take time to observe the effects of these behaviors on the epidemic.

Evaluation of an HIV-related behavior change project for female sex workers in Central China

Background As female sex workers （FSWs） were becoming the driving force behind the HIV epidemic in Central China, a project to promote condom use by FSWs was implemented from 2004 to 2009. In this study, we discussed the evaluation of the project, the factors associated with condom use among FSWs within the Chinese context, and proposed suggestions for future interventions for FSWs in China. Methods Two surveys using structured questionnaires were conducted in 2004 and 2009. Data collected from the surveys were analyzed and guided by a behavior change framework. We reviewed relevant articles to supplement the information that was not able to be obtained from the surveys. Results In general, the HIV prevalence among FSWs remained low （less than 1%） in the 5 years. With a high coverage of interventions for all FSWs in Central China, the project yielded better outcomes than the national average over the same time period. The awareness about HIV and condom use grew dramatically during the project period. The four factors/ determinants that influence the behavior of FSWs using condoms are population characteristics, opportunity, ability, and motivation. Statistical model shows that the significant variables for using a condom are age, availability of services, HIV- related knowledge, and intention. Conclusions With a high coverage of interventions for FSWs, the project achieved its goals. The differences among workplaces of FSWs may serve as a symbol of their socioeconomic status, patterns of condom use, and therefore risks of acauirina HIV.