scholarly journals Integrating Exercise Counseling Into the Medical School Curriculum: A Workshop-Based Approach Using Behavior Change Techniques

2017 ◽  
Vol 15 (1) ◽  
pp. 84-107 ◽  
Author(s):  
Andrea M. Brennan ◽  
Katrina A. D’Urzo ◽  
Alyssa M. Fenuta ◽  
Robyn L. Houlden ◽  
Jennifer R. Tomasone
Keyword(s):  
Medical Students ◽  
Behavior Change ◽  
Repeated Measures ◽  
School Curriculum ◽  
Learning Opportunities ◽  
Subjective Norms ◽  
Social Cognitions ◽  
Behavior Change Techniques ◽  
Exercise Counseling ◽  
Perceived Behavior Control

Objective. Physician physical activity (PA) counseling remains low due partly to lack of knowledge, emphasizing the importance of providing learning opportunities to develop competency, given the strong associations between PA and health. This study aimed to describe the behavior change techniques (BCTs) used in an “Exercise Expo” workshop and examine the workshop’s effectiveness for improving social cognitions to discuss exercise with patients. Methods. Second-year medical students (N = 54; Mage ± SD = 25.4 ± 2.95 years) completed questionnaires assessing attitudes, perceived behavior control (PBC), subjective norms, and intentions to provide PA counseling pre- and postworkshop. Repeated-measures analyses of variance evaluated changes in these theory of planned behavior constructs. Results. The most used BCTs included presenting information from credible sources, with opportunities for practicing the behavior and receiving feedback. Significant increases in attitudes, PBC and intentions to discuss PA were observed from pre-post Exercise Expo ( P ≤ .01). No statistically significant differences in subjective norms were observed ( P = .06). Conclusions. The Exercise Expo significantly improved social cognitions for PA counseling among medical students. Future interventions should target improvements in subjective norms to increase the likelihood the workshop improves PA counseling behavior. The evidence supports the usefulness of a workshop-based educational strategy to enhance medical students’ social cognitions for PA counseling.

scholarly journals Adults’ Preferences for Behavior Change Techniques and Engagement Features in a Mobile App to Promote 24-Hour Movement Behaviors: Cross-Sectional Survey Study (Preprint)

2019 ◽  
Author(s):  
Ann DeSmet ◽  
Ilse De Bourdeaudhuij ◽  
Sebastien Chastin ◽  
Geert Crombez ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Behavior Change ◽  
Repeated Measures ◽  
Self Regulation ◽  
Mobile App ◽  
User Preferences ◽  
Movement Behavior ◽  
Survey Study ◽  
User Engagement ◽  
Behavior Change Techniques ◽  
Self Monitoring

BACKGROUND There is a limited understanding of components that should be included in digital interventions for 24-hour movement behaviors (physical activity [PA], sleep, and sedentary behavior [SB]). For intervention effectiveness, user engagement is important. This can be enhanced by a user-centered design to, for example, explore and integrate user preferences for intervention techniques and features. OBJECTIVE This study aimed to examine adult users’ preferences for techniques and features in mobile apps for 24-hour movement behaviors. METHODS A total of 86 participants (mean age 37.4 years [SD 9.2]; 49/86, 57% female) completed a Web-based survey. Behavior change techniques (BCTs) were based on a validated taxonomy v2 by Abraham and Michie, and engagement features were based on a list extracted from the literature. Behavioral data were collected using Fitbit trackers. Correlations, (repeated measures) analysis of variance, and independent sample <italic>t</italic> tests were used to examine associations and differences between and within users by the type of health domain and users’ behavioral intention and adoption. RESULTS Preferences were generally the highest for information on the health consequences of movement behavior self-monitoring, behavioral feedback, insight into healthy lifestyles, and tips and instructions. Although the same ranking was found for techniques across behaviors, preferences were stronger for all but one BCT for PA in comparison to the other two health behaviors. Although techniques fit user preferences for addressing PA well, supplemental techniques may be able to address preferences for sleep and SB in a better manner. In addition to what is commonly included in apps, sleep apps should consider providing tips for sleep. SB apps may wish to include more self-regulation and goal-setting techniques. Few differences were found by users’ intentions or adoption to change a particular behavior. Apps should provide more self-monitoring (<italic>P</italic>=.03), information on behavior health outcome (<italic>P</italic>=.048), and feedback (<italic>P</italic>=.04) and incorporate social support (<italic>P</italic>=.048) to help those who are further removed from healthy sleep. A virtual coach (<italic>P</italic><.001) and video modeling (<italic>P</italic>=.004) may provide appreciated support to those who are physically less active. PA self-monitoring appealed more to those with an intention to change PA (<italic>P</italic>=.03). Social comparison and support features are not high on users’ agenda and may not be needed from an engagement point of view. Engagement features may not be very relevant for user engagement but should be examined in future research with a less reflective method. CONCLUSIONS The findings of this study provide guidance for the design of digital 24-hour movement behavior interventions. As 24-hour movement guidelines are increasingly being adopted in several countries, our study findings are timely to support the design of interventions to meet these guidelines.

Physicians’ intention to provide exercise counseling to patients in Taiwan: an examination based on the Theory of Planned Behavior

2019 ◽  
Vol 10 (3) ◽  
pp. 713-722 ◽  
Author(s):  
An-Min Lynn ◽  
Jiun-Hau Huang
Keyword(s):  
Medical Education ◽  
Theory Of Planned Behavior ◽  
Planned Behavior ◽  
Behavioral Change ◽  
Perceived Control ◽  
Treatment Effects ◽  
School Curriculum ◽  
Subjective Norms ◽  
Exercise Counseling ◽  
Facilitating Conditions

Abstract Increasingly more clinical guidelines have recommended that physicians provide exercise counseling (EC) to patients to help improve their lifestyle and enhance treatment effects. However, little is known about physicians’ EC intention and associated factors. This study aimed to systematically examine physicians’ EC intention using the Theory of Planned Behavior (TPB). Using the TPB as a theoretical and structural framework, 27 TPB items were developed and factor-analyzed to form five factors (i.e., attitudes toward positive and negative EC outcomes, subjective norms, and perceived control over EC under facilitating and constraining conditions) with satisfactory psychometric properties. Responses from 1,006 physicians (response rate 90.5%) were analyzed using multivariate logistic regression to examine the TPB-based factors associated with greater EC intention. Physicians’ favorable attitudes toward positive EC outcomes (adjusted odds ratio [AOR] 4.03) were most strongly linked to high EC intention, followed by supportive subjective norms (AOR 3.74) and high perceived control under facilitating conditions (AOR 1.64). Specifically, physicians’ EC intention was related to their attitudes toward better treatment effects and gaining respect from patients because of EC, perceived support for EC from patients and senior physicians, and perceived control over EC concerning their behavioral change skills. These findings could inform EC promotion efforts in clinical settings and medical education. EC-related training should be incorporated into medical school curriculum, residency training, and continuing medical education to enhance physicians’ EC-related knowledge and competence, including lifestyle management and behavioral change skills. Attention should also be paid to the role of patients and senior physicians in promoting EC.

scholarly journals Adults’ Preferences for Behavior Change Techniques and Engagement Features in a Mobile App to Promote 24-Hour Movement Behaviors: Cross-Sectional Survey Study

10.2196/15707 ◽  
2019 ◽  
Vol 7 (12) ◽  
pp. e15707 ◽  
Author(s):  
Ann DeSmet ◽  
Ilse De Bourdeaudhuij ◽  
Sebastien Chastin ◽  
Geert Crombez ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Behavior Change ◽  
Repeated Measures ◽  
Self Regulation ◽  
Mobile App ◽  
User Preferences ◽  
Movement Behavior ◽  
Survey Study ◽  
User Engagement ◽  
Behavior Change Techniques ◽  
Self Monitoring

Background There is a limited understanding of components that should be included in digital interventions for 24-hour movement behaviors (physical activity [PA], sleep, and sedentary behavior [SB]). For intervention effectiveness, user engagement is important. This can be enhanced by a user-centered design to, for example, explore and integrate user preferences for intervention techniques and features. Objective This study aimed to examine adult users’ preferences for techniques and features in mobile apps for 24-hour movement behaviors. Methods A total of 86 participants (mean age 37.4 years [SD 9.2]; 49/86, 57% female) completed a Web-based survey. Behavior change techniques (BCTs) were based on a validated taxonomy v2 by Abraham and Michie, and engagement features were based on a list extracted from the literature. Behavioral data were collected using Fitbit trackers. Correlations, (repeated measures) analysis of variance, and independent sample t tests were used to examine associations and differences between and within users by the type of health domain and users’ behavioral intention and adoption. Results Preferences were generally the highest for information on the health consequences of movement behavior self-monitoring, behavioral feedback, insight into healthy lifestyles, and tips and instructions. Although the same ranking was found for techniques across behaviors, preferences were stronger for all but one BCT for PA in comparison to the other two health behaviors. Although techniques fit user preferences for addressing PA well, supplemental techniques may be able to address preferences for sleep and SB in a better manner. In addition to what is commonly included in apps, sleep apps should consider providing tips for sleep. SB apps may wish to include more self-regulation and goal-setting techniques. Few differences were found by users’ intentions or adoption to change a particular behavior. Apps should provide more self-monitoring (P=.03), information on behavior health outcome (P=.048), and feedback (P=.04) and incorporate social support (P=.048) to help those who are further removed from healthy sleep. A virtual coach (P<.001) and video modeling (P=.004) may provide appreciated support to those who are physically less active. PA self-monitoring appealed more to those with an intention to change PA (P=.03). Social comparison and support features are not high on users’ agenda and may not be needed from an engagement point of view. Engagement features may not be very relevant for user engagement but should be examined in future research with a less reflective method. Conclusions The findings of this study provide guidance for the design of digital 24-hour movement behavior interventions. As 24-hour movement guidelines are increasingly being adopted in several countries, our study findings are timely to support the design of interventions to meet these guidelines.

Behavior change techniques in mobile apps targeting self-harm in young people: a systematic review

2021 ◽  
Author(s):  
Elena Panagiotopoulou ◽  
Celeste Peiris ◽  
Daniel Hayes
Keyword(s):  
Young People ◽  
Behavior Change ◽  
Dialectical Behavior Therapy ◽  
Mobile Apps ◽  
Mental Healthcare ◽  
Future Research ◽  
Active Components ◽  
Behavior Change Techniques ◽  
Other Information ◽  
Self Harm

Abstract Despite the high prevalence of self-harm among young people, as well as their extensive use of mobile apps for seeking support with their mental healthcare, it is unclear whether the design of mobile apps aimed at targeting self-harm is underpinned by behavior change techniques (BCTs). To systematically analyze and identify (a) what BCTs and (b) what theories are present in self-harm apps for young people in an attempt to understand their active components. Systematic searches in Apple store, followed by thorough screening, were conducted to identify free mobile apps targeting self-harm in young people. Five apps met the inclusion criteria and were used by trained researchers, who coded identified features against the BCT Taxonomy V1. Despite the majority of apps being underpinned by principles of Dialectical Behavior Therapy (DBT), no other information is available about specific theories underpinning these apps. Nineteen of the 93 BCTs were identified across the five apps. The most frequently used BCT was “Distraction” (54.2%), offering ideas for activities to distract users from self-harming. Other techniques that were used often were “Social Support (unspecified)” (27.0%) and “Behavior Substitution” (10.6%). This study provides the first analysis of BCTs present in mental health apps which are designed to target the reduction of self-harm in young people. Future research is needed to evaluate the effectiveness of the apps, as well as assess the effectiveness of the BCTs present.

scholarly journals The impact of integrating environmental health into medical school curricula: a survey-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benjamin Kligler ◽  
Genevieve Pinto Zipp ◽  
Carmela Rocchetti ◽  
Michelle Secic ◽  
Erin Speiser Ihde
Keyword(s):  
Climate Change ◽  
Medical Education ◽  
Medical Students ◽  
Medical School ◽  
Environmental Health ◽  
School Curriculum ◽  
Learning Objectives ◽  
Lead Contamination ◽  
Institute Of Medicine ◽  
The Impact

Abstract Background Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise to address patients’ environmental illnesses, nor speak to prevention. Methods Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine (Nutley, New Jersey), via a two-hour interactive large group learning module with follow up activities. Students completed the Environmental Health in Med School (EHMS) survey before and after the year 1 EH module. This survey evaluates medical students’ attitudes, awareness and professionalism regarding environmental health. In year 2, students completed the Environmental Health Survey II, which measured students’ perceptions of preparedness to discuss EH with future patients. The research team created both surveys based upon learning objectives that broadly aligned with the Institute of Medicine six competency-based environmental health learning objectives. Results 36 year 1 students completed both the pre and post EHMS surveys. McNemar’s test was used for paired comparisons. Results identified no statistically significant changes from pre to post surveys, identifying a dramatic ceiling. When comparing year 2, EHS II pre-survey (n = 84) and post-survey (n = 79) responses, a statistically significant positive change in students’ self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention was noted. Conclusions Our conclusion for the EHMS in Year 1 was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health. Through the EHS II in Year 2, we found that the six-week environmental health module combining didactic and experiential elements significantly increased medical students’ self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.

scholarly journals Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy

2021 ◽  
Vol 8 ◽  
pp. 238212052110104
Author(s):  
Timothy P Daaleman ◽  
Mindy Storrie ◽  
Gary Beck Dallaghan ◽  
Sarah Smithson ◽  
Kurt O Gilliland ◽  
...  
Keyword(s):  
Leadership Development ◽  
Medical Students ◽  
Medical School ◽  
Business School ◽  
Medical Curriculum ◽  
School Curriculum ◽  
Learning Model ◽  
Lessons Learned ◽  
Self Awareness ◽  
Program Outcomes

Background: There is an ongoing call for leadership development in academic health care and medical students desire more training in this area. Although many schools offer combined MD/MBA programs or leadership training in targeted areas, these programs do not often align with medical school leadership competencies and are limited in reaching a large number of students. Methods: The Leadership Initiative (LI) was a program created by a partnership between a School of Medicine (SOM) and Business School with a learning model that emphasized the progression from principles to practice, and the competencies of self-awareness, communication, and collaboration/teamwork. Through offerings across a medical school curriculum, the LI introduced leadership principles and provided an opportunity to apply them in an interactive activity or simulation. We utilized the existing SOM evaluation platform to collect data on program outcomes that included satisfaction, fidelity to the learning model, and impact. Results: From 2017 to 2020, over 70% of first-year medical students participated in LI course offerings while a smaller percentage of fourth-year students engaged in the curriculum. Most students had no prior awareness of LI course material and were equivocal about their ability to apply lessons learned to their medical school experience. Students reported that the LI offerings provided opportunities to practice the skills and competencies of self-awareness, communication, and collaboration/teamwork. Discussion: Adding new activities to an already crowded medical curriculum was the greatest logistical challenge. The LI was successful in introducing leadership principles but faced obstacles in having participants apply and practice these principles. Most students reported that the LI offerings were aligned with the foundational competencies.

Culinary Medicine Training in Core Medical School Curriculum Improved Medical Student Nutrition Knowledge and Confidence in Providing Nutrition Counseling

2021 ◽  
pp. 155982762110217
Author(s):  
Christopher R. D’Adamo ◽  
Kayli Workman ◽  
Christine Barnabic ◽  
Norman Retener ◽  
Bernadette Siaton ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Patient Care ◽  
School Curriculum ◽  
Nutrition Knowledge ◽  
Medical School Curriculum ◽  
Nutrition Counseling ◽  
Patient Counseling ◽  
Culinary Medicine

Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t-tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved ( P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling.

scholarly journals Relationships between medical students’ co-regulatory network characteristics and self-regulated learning: a social network study

2021 ◽  
Author(s):  
Derk Bransen ◽  
Marjan J. B. Govaerts ◽  
Dominique M. A. Sluijsmans ◽  
Jeroen Donkers ◽  
Piet G. C. Van den Bossche ◽  
...  
Keyword(s):  
Social Network ◽  
Medical Students ◽  
Regulatory Network ◽  
Regulatory Networks ◽  
Learning Opportunities ◽  
Network Size ◽  
Tie Strength ◽  
Network Characteristics ◽  
Self Regulated Learning ◽  
Regulated Learning

Abstract Introduction Recent conceptualizations of self-regulated learning acknowledge the importance of co-regulation, i.e., students’ interactions with others in their networks to support self-regulation. Using a social network approach, the aim of this study is to explore relationships between characteristics of medical students’ co-regulatory networks, perceived learning opportunities, and self-regulated learning. Methods The authors surveyed 403 undergraduate medical students during their clinical clerkships (response rate 65.5%). Using multiple regression analysis, structural equation modelling techniques, and analysis of variance, the authors explored relationships between co-regulatory network characteristics (network size, network diversity, and interaction frequency), students’ perceptions of learning opportunities in the workplace setting, and self-reported self-regulated learning. Results Across all clerkships, data showed positive relationships between tie strength and self-regulated learning (β = 0.095, p < 0.05) and between network size and tie strength (β = 0.530, p < 0.001), and a negative relationship between network diversity and tie strength (β = −0.474, p < 0.001). Students’ perceptions of learning opportunities showed positive relationships with both self-regulated learning (β = 0.295, p < 0.001) and co-regulatory network size (β = 0.134, p < 0.01). Characteristics of clerkship contexts influenced both co-regulatory network characteristics (size and tie strength) and relationships between network characteristics, self-regulated learning, and students’ perceptions of learning opportunities. Discussion The present study reinforces the importance of co-regulatory networks for medical students’ self-regulated learning during clinical clerkships. Findings imply that supporting development of strong networks aimed at frequent co-regulatory interactions may enhance medical students’ self-regulated learning in challenging clinical learning environments. Social network approaches offer promising ways of further understanding and conceptualising self- and co-regulated learning in clinical workplaces.

scholarly journals Driving Mechanism of Farmers’ Utilization Behaviors of Straw Resources—An Empirical Study in Jilin Province, the Main Grain Producing Region in the Northeast Part of China

2021 ◽  
Vol 13 (5) ◽  
pp. 2506
Author(s):  
Hongpeng Guo ◽  
Shuang Xu ◽  
Xiaotong Wang ◽  
Wen Shu ◽  
Jia Chen ◽  
...  
Keyword(s):  
Structural Equation ◽  
Positive Impact ◽  
Agricultural Waste ◽  
Equation Model ◽  
Subjective Norms ◽  
Jilin Province ◽  
Policy Implications ◽  
Driving Mechanism ◽  
Perceived Behavior Control

In recent years, the unsustainable behaviors of straw utilization have led to waste straw being one of the sources of agricultural non-point source pollution. Studying the resource utilization of crop straw is conducive to expediate the development of ecological and green agriculture. More importantly, it has long-term significance for the recycling of agricultural waste, improving the quality of rural life, and the employment of farmers. Based on the theory of planned behavior (TPB), taking the representative survey questionnaire of farmers in Jilin Province, China as the sample, the structural equation model (SEM) was constructed to study the main factors that drive the utilization behaviors of straw resources of farmers and to explore the driving mechanism of the farmers behaviors in Jilin Province. The results show that the behavioral attitude and subjective norms of farmers in Jilin Province not only indirectly affect their actual behaviors through behavioral willingness, but also has significant direct effects on their behaviors. The most critical factors that affect the willingness of farmers to utilize the straw resources in Jilin Province are subjective norms and moral responsibilities. The subjective norms of farmers have a direct and significant positive impact on their willingness and behaviors. Behavioral attitude and perceived behavior control have a significant positive impact on their willingness. The behavioral willingness has a significant positive impact on their actual behaviors. This study provides guidance for the utilization of straw resources policy implications.

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