scholarly journals Evaluating a large-scale online behaviour change intervention aimed at wildlife product consumers in Singapore

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248144
Author(s):  
Hunter Doughty ◽  
E. J. Milner-Gulland ◽  
Janice Ser Huay Lee ◽  
Kathryn Oliver ◽  
L. Roman Carrasco ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Large Scale ◽  
Species Conservation ◽  
Population Level ◽  
Target Audience ◽  
Wildlife Trade ◽  
Behaviour Change Intervention ◽  
Post Intervention ◽  
Online Behaviour ◽  
Intervention Message

Interventions to shift the behaviour of consumers using unsustainable wildlife products are key to threatened species conservation. Whether these interventions are effective is largely unknown due to a dearth of detailed evaluations. We previously conducted a country-level online behaviour change intervention targeting consumers of the Critically Endangered saiga antelope (Saiga tatarica) horn in Singapore. To evaluate intervention impact, we carried out in-person consumer surveys with >2,000 individuals pre- and post-intervention (2017 and 2019), and 93 in-person post-intervention surveys with traditional Chinese medicine (TCM) shopkeepers (2019). The proportion of self-reported high-usage saiga horn consumers in the target audience (Chinese Singaporean women aged 35–59) did not change significantly from pre- to post-intervention (24.4% versus 22.6%). However, post-intervention the target audience was significantly more likely than the non-target audience to accurately recall the intervention message and to report a decrease in saiga horn usage (4% versus 1% reported a behaviour change). Within the target audience, high-usage consumers were significantly more likely than lower-usage consumers to recall the message and report a behaviour change. Across respondents who reported a decrease in saiga horn usage, they cited the intervention message as a specific reason for their behaviour change significantly more than other reasons. Additionally, across all respondents, the belief that saiga is a common species in the wild decreased significantly from pre- to post-intervention. TCM shopkeepers, however, cited factors such as price and availability as the strongest influences on saiga horn sales. In sum, the intervention did significantly influence some consumers but the reduction of high-usage consumer frequency was not significant at the population level. We explore reasons for these findings, including competing consumer influences, characteristics of the intervention, and evaluation timing. This work suggests our intervention approach has potential, and exemplifies a multi-pronged in-person evaluation of an online wildlife trade consumer intervention.

scholarly journals Evidence-Based Behaviour Change Intervention on Saiga Horn Medicine in Singapore: Research Brief

2021 ◽  
Author(s):  
Hunter Doughty ◽  
Diogo Veríssimo ◽  
Janice Ser Huay Lee ◽  
L Roman Carrasco ◽  
Joss Wright ◽  
...  
Keyword(s):  
Behaviour Change ◽  
News Coverage ◽  
Intervention Development ◽  
Past Research ◽  
Online News ◽  
Wildlife Trade ◽  
Evidence Based ◽  
Behaviour Change Intervention ◽  
Post Intervention ◽  
Intervention Message

Key Points: 1. A rare example of a wildlife trade initiative that covers all stages of an evidence-based behaviour change intervention. 2. Intervention development involved combining extensive consumer research with human behaviour theory and past research. 3. Intervention used a cutting-edge, powerful combination of online news coverage and targeted advertising. 4. Post-intervention, 4% of the target audience changed their behaviour (vs 1% of non-target) and the intervention message was shown as the key cause; but high-level users did not decrease significantly pre-to post-intervention.

Supporting mental health during COVID-19 using a digital behaviour change intervention: an open-label, single-arm, pre-post intervention research study (Preprint)

2021 ◽  
Author(s):  
Charlotte Summers ◽  
Philip Wu
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Perceived Stress ◽  
Digital Health ◽  
Mental Wellbeing ◽  
Behaviour Change Intervention ◽  
Open Label ◽  
Post Intervention ◽  
Convenience Sample ◽  
Health Technologies

BACKGROUND COVID-19 is taking its toll on people's mental health, particularly as people are advised to adhere to social distancing, self-isolation measures and government imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and supporting mental health and wellbeing. Particularly in the wake of the COVID-19 pandemic as even before this unprecedented time, mental health and social services were already stretched. OBJECTIVE Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health platform, a digital behaviour change intervention for self-management of mental wellbeing, sleep, activity, and nutrition. METHODS The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. From adults who had joined the intervention and had a complete baseline dataset (GAD-7 Anxiety Test Questionnaire, Perceived Stress Scale, PHQ-9 Patient Health Questionnaire), we followed all users for 12 weeks (N=273), including 33 (12.1%) who reported a positive COVID-19 diagnosis during the study period. Users engagement with the Gro Health platform was tracked by active minutes. RESULTS Of the 347 study participants, 273 (78.67%) completed both baseline and follow up surveys. Change in scores for anxiety, perceived stress and depression was predicted by app engagement with the strongest effect being seen in change perceived stress scores F(1,271)=251.397, p<0.001, with an R2 of .479. CONCLUSIONS A digital behaviour change platform that provides remote mental wellbeing support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. CLINICALTRIAL Approved by Royal Holloway, University of London Ethics Board.

Evaluation of a staff behaviour change intervention to increase the use of ward-based practice books and active practice during inpatient stroke rehabilitation: a phase-1 pre–post observational study

2020 ◽  
Vol 34 (5) ◽  
pp. 607-616
Author(s):  
Claire Stewart ◽  
Emma Power ◽  
Annie McCluskey ◽  
Suzanne Kuys ◽  
Meryl Lovarini
Keyword(s):  
Observational Study ◽  
Behaviour Change ◽  
Phase 1 ◽  
Inpatient Rehabilitation ◽  
Support Staff ◽  
Audit And Feedback ◽  
Behaviour Change Intervention ◽  
Post Intervention ◽  
Audit Data ◽  
Medical Record Audit

Objective: The aim of this study was to evaluate a staff behaviour change intervention to increase the use of ward-based practice books and active practice by stroke inpatients. Design: This is a pre–post observational study. Setting: This study was conducted in a inpatient rehabilitation unit in Australia. Subjects: Stroke inpatients participated in the study. Intervention: A staff behaviour change intervention was designed to support staff to implement practice books. The intervention included staff training on motivation and coaching, and weekly audit and feedback for six months. The environment was restructured to bring staff together weekly at the bedside to review audit data and share skills. Main measures: Medical record audit and behavioural mapping were used to compare the number of stroke participants with/using a practice book pre- and post-intervention. Pre- and post-intervention, the percentage of observations where a stroke participant was actively practising, repetitions of practice recorded and type of supervision were compared. Results: A total of 24 participants were observed ( n = 12 pre, n = 12 post). Post-intervention, the number of participants with practice books increased from one to six (OR = 11, 95% CI = (0.9, 550.7)), but this change was not statistically significant ( P = 0.069). Five participants recorded repetitions in their practice books post-intervention, three were observed using practice books. There was no change in median repetitions recorded ( rpbs = 0.00, 95% CI = (−0.4, 0.4), P = 1.000) or observed active practice ( rpbs = –0.02, 95% CI = (−0.4, 0.4), P = 0.933). Active practice was often fully supervised by a therapist. Conclusion: A staff behaviour change intervention has the potential to increase the number of stroke survivors receiving ward-based practice books but did not increase active practice.

Supporting mental health during COVID-19 using a digital behaviour change intervention: an open-label, single-arm, pre-post intervention research study (Preprint)

2021 ◽  
Author(s):  
Charlotte Summers ◽  
Philip Wu ◽  
Alisdair J G Taylor
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Perceived Stress ◽  
Digital Health ◽  
Mental Wellbeing ◽  
Behaviour Change Intervention ◽  
Open Label ◽  
Post Intervention ◽  
Convenience Sample ◽  
Health Technologies

BACKGROUND COVID-19 is taking its toll on people's mental health, particularly as people are advised to adhere to social distancing, self-isolation measures and government imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and supporting mental health and wellbeing. Particularly in the wake of the COVID-19 pandemic as even before this unprecedented time, mental health and social services were already stretched. OBJECTIVE Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health platform, a digital behaviour change intervention for self-management of mental wellbeing, sleep, activity, and nutrition. METHODS The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. From adults who had joined the intervention and had a complete baseline dataset (GAD-7 Anxiety Test Questionnaire, Perceived Stress Scale, PHQ-9 Patient Health Questionnaire), we followed all users for 12 weeks (N=273), including 33 (12.1%) who reported a positive COVID-19 diagnosis during the study period. Users engagement with the Gro Health platform was tracked by active minutes. RESULTS Of the 347 study participants, 273 (78.67%) completed both baseline and follow up surveys. Change in scores for anxiety, perceived stress and depression was predicted by app engagement with the strongest effect being seen in change perceived stress scores F(1,271)=251.397, p<0.001, with an R2 of .479. CONCLUSIONS A digital behaviour change platform that provides remote mental wellbeing support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic.

scholarly journals A behaviour change intervention to reduce home exposure to second hand smoke during pregnancy in India and Bangladesh: a theory and evidence-based approach to development

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Veena A. Satyanarayana ◽  
Cath Jackson ◽  
Kamran Siddiqi ◽  
Prabha S. Chandra ◽  
Rumana Huque ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Behaviour Change ◽  
Delphi Survey ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behaviour Change Intervention ◽  
Behaviour Change Interventions ◽  
Modified Delphi ◽  
Qualitative Interview Study ◽  
At Home

Abstract Background Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce. Methods We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband’s smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components. Results The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members. Conclusion A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.

scholarly journals 214 Longitudinal Changes in Sleep Duration, Timing, Variability, and Stages during the COVID-19 Pandemic: Large-Scale Fitbit Data

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A86-A86
Author(s):  
Michael Grandner ◽  
Naghmeh Rezaei
Keyword(s):  
New York ◽  
Los Angeles ◽  
San Francisco ◽  
Sleep Duration ◽  
Large Scale ◽  
Age Groups ◽  
Population Level ◽  
Sleep Stages ◽  
Longitudinal Changes ◽  
Timing Variability

Abstract Introduction The COVID-19 pandemic has resulted in societal-level changes to sleep and other behavioral patterns. Objective, longitudinal data would allow for a greater understanding of sleep-related changes at the population level. Methods N= 163,524 deidentified active Fitbit users from 6 major US cities contributed data, representing areas particularly hard-hit by the pandemic (Chicago, Houston, Los Angeles, New York, San Francisco, and Miami). Sleep variables extracted include nightly and weekly mean sleep duration and bedtime, variability (standard deviation) of sleep duration and bedtime, and estimated arousals and sleep stages. Deviation from similar timeframes in 2019 were examined. All analyses were performed in Python. Results These data detail how sleep duration and timing changed longitudinally, stratified by age group and gender, relative to previous years’ data. Overall, 2020 represented a significant departure for all age groups and both men and women (P&lt;0.00001). Mean sleep duration increased in nearly all groups (P&lt;0.00001) by 5-11 minutes, compared to a mean decrease of 5-8 minutes seen over the same period in 2019. Categorically, sleep duration increased for some and decreased for others, but more extended than restricted. Sleep phase shifted later for nearly all groups (p&lt;0.00001). Categorically, bedtime was delayed for some and advanced for others, though more delayed than advanced. Duration and bedtime variability decreased, owing largely to decreased weekday-weekend differences. WASO increased, REM% increased, and Deep% decreased. Additional analyses show stratified, longitudinal changes to sleep duration and timing mean and variability distributions by month, as well as effect sizes and correlations to other outcomes. Conclusion The pandemic was associated with increased sleep duration on average, in contrast to 2019 when sleep decreased. The increase was most profound among younger adults, especially women. The youngest adults also experienced the greatest bedtime delay, in line with extensive school-start-times and chronotype data. When given the opportunity, the difference between weekdays and weekends became smaller, with occupational implications. Sleep staging data showed that slightly extending sleep minimally impacted deep sleep but resulted in a proportional increase in REM. Wakefulness during the night also increased, suggesting increased arousal despite greater sleep duration. Support (if any) This research was supported by Fitbit, Inc.

‘No one ever asked us’: a feasibility study assessing the co-creation of a physical activity programme with adolescent girls

2019 ◽  
Vol 27 (3) ◽  
pp. 34-43
Author(s):  
Méabh Corr ◽  
Elaine Murtagh
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Behaviour Change ◽  
Adolescent Girls ◽  
Retention Rate ◽  
Controlled Trial ◽  
Activity Level ◽  
Health Concern ◽  
Post Intervention ◽  
Behaviour Change Wheel

Background: Globally, the poor activity level of adolescent girls is a public health concern. Little research has involved adolescents in the design of interventions. This study assessed the feasibility of involving girls in the co-creation of an activity programme. Methods: Thirty-one students (15–17 years old) were recruited from a post-primary school. The Behaviour Change Wheel guided intervention design, providing insights into participants’ capability, opportunity and motivation for change. Step counts and self-reported physical activity levels were recorded pre- and post-intervention. Feasibility benchmarks assessed recruitment, data collection, acceptability and adherence. Results: Activity and educational sessions were delivered for six weeks during physical education class. Average attendance was 87% (benchmark = 80%). Eligibility was 61% (benchmark = 60%). There was a 100% retention rate (benchmark = 90%). All participants ( n = 31) completed baseline measures and 71% ( n = 22) completed post-measures. 54% ( n = 17) of students completed pedometer measurements, with 32% ( n = 10) having complete data. Average daily steps were 13,121 pre-intervention and 14,128 post-intervention ( p > 0.05). Data collection was feasible, receiving a mean score > 4/5 (benchmark > 3.5/5). Conclusions: The Behaviour Change Wheel can be used to co-create an activity programme with adolescent girls. Predetermined benchmarks, except for pedometer recordings, were reached or exceeded, providing evidence for the need of a randomised controlled trial to test effectiveness.

scholarly journals Novel Method to Evaluate Diagnostic Shifting After a Pediatric Antibiotic Stewardship Intervention

2020 ◽  
Vol 41 (S1) ◽  
pp. s332-s333
Author(s):  
Nora Fino ◽  
Benjamin Haaland ◽  
Karl Madaras-Kelly ◽  
Katherine Fleming-Dutra ◽  
Adam Hersh ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Population Attributable Fraction ◽  
Acute Otitis Media ◽  
Population Level ◽  
Estimating Equation ◽  
Audit And Feedback ◽  
Antibiotic Prescribing ◽  
Post Intervention ◽  
Intervention Effect ◽  
Diagnostic Coding

Background: Audit-and-feedback interventions track clinician practice patterns for a targeted practice behavior. Audit and feedback of antibiotic prescribing data for acute respiratory infections (ARI) is an effective stewardship strategy that relies on administrative coding to identify eligible visits for audit. Diagnostic shifting is the misclassification of a patient’s diagnosis in response to audit and feedback and is a potential unintended consequence of audit and feedback. Objective: To develop a method to identify patterns consistent with diagnostic shifting including both positive shifting (improved diagnosis and documentation) and negative shifting (intentionally altering documentation of diagnosis to justify antibiotic prescribing), after implementation of an audit-and-feedback intervention to improve ARI management. Methods: We evaluated the intervention effect on diagnostic shifting within 12 University of Utah pediatric clinics (293 providers). Data included 66,827 ARI diagnoses: pneumonia, sinusitis, bronchitis, pharyngitis, upper respiratory infection (URI), acute otitis media (AOM), or serous otitis with effusion (OME). To determine whether rates of ARI diagnoses changed after the intervention, we developed logistic generalized estimating equation (GEE) models with robust sandwich standard error estimates to account for clinic-wise clustering. Outcomes included the change in each ARI diagnosis relative to the competing 6 diagnoses included in audit-and-feedback reports before and after intervention implementation. Models tested for a change in outcomes after the intervention (ie, diagnostic shift) after adjustment for month of diagnosis. For each diagnosis, we estimated the population attributable fraction (PAF) for antibiotic prescriptions due to combined shifts in diagnostic frequencies and prescription rates for each diagnosis. The PAF is the estimated fraction of antibiotic prescriptions that would have changed under a population-level intervention. Results: In month-adjusted analyses, diagnoses of pneumonia and OME decreased after the intervention: odds ratio (OR), 0.46 (95% CI, 0.31–0.68) and OR, 0.81 (95% CI, 0.67–0.99), respectively. In addition, URI diagnoses increased: OR, 1.05 (95% CI 1.00, 1.11). We did not detect changes in the diagnosis rates of sinusitis, AOM, bronchitis, and pharyngitis post intervention. The intervention effect on the PAF for antibiotics prescriptions was consistently positive but relatively small in magnitude. PAF was highest for URIs (PAF, 8.87%), followed by AOM (PAF, 3.56%) and sinusitis (PAF, 2.76%), and was lowest for pneumonia and bronchitis (PAF, 0.41% for both). Conclusions: Our analysis found minimal evidence overall of diagnostic shifting after a stewardship intervention using audit and feedback in these pediatric clinics. Small changes in diagnostic coding may reflect more appropriate diagnosis and coding, a positive effect of audit and feedback, rather than intentional negative diagnostic shift.Funding: NoneDisclosures: None

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