Capability, opportunity and motivation to enact hygienic practices in the early stages of the COVID-19 outbreak in the UK

2020 ◽  
Author(s):  
Jilly Gibson Miller ◽  
Todd K. Hartman ◽  
Liat Levita ◽  
Anton Philipp Martinez ◽  
Liam Mason ◽  
...  

Objectives The COVID-19 pandemic is one of the greatest global health threats facing humanity in recent memory. This study aimed to explore influences on hygienic practices, a set of key transmission behaviours, in relation to the Capability, Opportunity, Motivation-Behaviour (COM-B) model of behaviour change (Michie et al., 2011).Design Data from the first wave of a longitudinal survey study was used, launched in the early stages of the UK COVID-19 pandemic.Methods Participants were 2025 adults aged 18 and older, representative of the UK population, recruited by a survey company from a panel of research participants. Participants self-reported motivation, capability and opportunity to enact hygienic practices during the COVID-19 outbreak.ResultsUsing regression models, we found that all three COM-B components significantly predicted good hygienic practices, with motivation having the greatest influence on behaviour. Breaking this down further, the sub-scales psychological capability, social opportunity and reflective motivation positively influenced behaviour. Reflective motivation was largely driving behaviour, with those highest in reflective motivation scoring 51% more on the measure of hygienic practices compared with those with the lowest scores.ConclusionsOur findings have clear implications for the design of behaviour change interventions to promote hygienic practices. Interventions should focus on increasing and maintaining motivation to act and include elements that promote and maintain social support and knowledge of COVID-19 transmission. Groups in particular need of targeting for interventions to increase hygienic practices are males and those living in cities and suburbs.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amio Matenga-Ikihele ◽  
Judith McCool ◽  
Rosie Dobson ◽  
Fuafiva Fa’alau ◽  
Robyn Whittaker

Abstract Background Pacific people living in New Zealand, Australia, United States, and the Pacific region continue to experience a disproportionately high burden of long-term conditions, making culturally contextualised behaviour change interventions a priority. The primary aim of this study was to describe the characteristics of behaviour change interventions designed to improve health and effect health behaviour change among Pacific people. Methods Electronic searches were carried out on OVID Medline, PsycINFO, PubMed, Embase and SCOPUS databases (initial search January 2019 and updated in January 2020) for studies describing an intervention designed to change health behaviour(s) among Pacific people. Titles and abstracts of 5699 papers were screened; 201 papers were then independently assessed. A review of full text was carried out by three of the authors resulting in 208 being included in the final review. Twenty-seven studies were included, published in six countries between 1996 and 2020. Results Important characteristics in the interventions included meaningful partnerships with Pacific communities using community-based participatory research and ensuring interventions were culturally anchored and centred on collectivism using family or social support. Most interventions used social cognitive theory, followed by popular behaviour change techniques instruction on how to perform a behaviour and social support (unspecified). Negotiating the spaces between Eurocentric behaviour change constructs and Pacific worldviews was simplified using Pacific facilitators and talanoa. This relational approach provided an essential link between academia and Pacific communities. Conclusions This systematic search and narrative synthesis provides new and important insights into potential elements and components when designing behaviour change interventions for Pacific people. The paucity of literature available outside of the United States highlights further research is required to reflect Pacific communities living in New Zealand, Australia, and the Pacific region. Future research needs to invest in building research capacity within Pacific communities, centering self-determining research agendas and findings to be led and owned by Pacific communities.


2017 ◽  
Vol 21 (5) ◽  
pp. 1-164 ◽  
Author(s):  
Paul Flowers ◽  
Olivia Wu ◽  
Karen Lorimer ◽  
Bipasha Ahmed ◽  
Hannah Hesselgreaves ◽  
...  

AbstractBackgroundMen who have sex with men (MSM) experience significant inequalities in health and well-being. They are the group in the UK at the highest risk of acquiring a human immunodeficiency virus (HIV) infection. Guidance relating to both HIV infection prevention, in general, and individual-level behaviour change interventions, in particular, is very limited.ObjectivesTo conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate intervention.Data sourcesAll major electronic databases (British Education Index, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Educational Resource Index and Abstracts, Health and Medical Complete, MEDLINE, PsycARTICLES, PsycINFO, PubMed and Social Science Citation Index) were searched between January 2000 and December 2014.Review methodsA systematic review of the clinical effectiveness of individual behaviour change interventions was conducted. Interventions were examined using the behaviour change technique (BCT) taxonomy, theory coding assessment, mode of delivery and proximity to HIV infection testing. Data were summarised in narrative review and, when appropriate, meta-analysis was carried out. Supplemental analyses for the development of the candidate intervention focused on post hoc realist review method, the assessment of the sequential delivery and content of intervention components, and the social and historical context of primary studies. Expert panels reviewed the candidate intervention for issues of implementation and optimisation.ResultsOverall, trials included in this review (n = 10) demonstrated that individual-level behaviour change interventions are effective in reducing key HIV infection risk-related behaviours. However, there was considerable clinical and methodological heterogeneity among the trials. Exploratory meta-analysis showed a statistically significant reduction in behaviours associated with high risk of HIV transmission (risk ratio 0.75, 95% confidence interval 0.62 to 0.91). Additional stratified analyses suggested that effectiveness may be enhanced through face-to-face contact immediately after testing, and that theory-based content and BCTs drawn from ‘goals and planning’ and ‘identity’ groups are important. All evidence collated in the review was synthesised to develop a candidate intervention. Experts highlighted overall acceptability of the intervention and outlined key ways that the candidate intervention could be optimised to enhance UK implementation.LimitationsThere was a limited number of primary studies. All were from outside the UK and were subject to considerable clinical, methodological and statistical heterogeneity. The findings of the meta-analysis must therefore be treated with caution. The lack of detailed intervention manuals limited the assessment of intervention content, delivery and fidelity.ConclusionsEvidence regarding the effectiveness of behaviour change interventions suggests that they are effective in changing behaviour associated with HIV transmission. Exploratory stratified meta-analyses suggested that interventions should be delivered face to face and immediately after testing. There are uncertainties around the generalisability of these findings to the UK setting. However, UK experts found the intervention acceptable and provided ways of optimising the candidate intervention.Future workThere is a need for well-designed, UK-based trials of individual behaviour change interventions that clearly articulate intervention content and demonstrate intervention fidelity.Study registrationThe study is registered as PROSPERO CRD42014009500.FundingThe National Institute for Health Research Health Technology Assessment programme.


Author(s):  
S. Myers ◽  
A. E. Page ◽  
E. H. Emmott

Social support is a known determinant of breastfeeding behaviour and is generally considered beneficial. However, social support encompasses a myriad of different supportive acts, providing scope for diverse infant feeding outcomes. Given the vulnerability of postpartum mental health, this paper aims to explore both how support prolongs breastfeeding and which forms of support promote the positive experience of all infant feeding. Using survey data collected online from 515 UK mothers with infants aged 0–108 weeks, Cox regression models assessed the relationship between receiving different types of support, support need and breastfeeding duration. Quasi-binomial logistic regression models assessed the relationship between receiving support, infant feeding mode and maternal experience of infant feeding. Rates of negative infant feeding experience indicate the widespread need for support: e.g. 38% of currently, 47% of no longer and 31% of never breastfeeding women found infant feeding stressful. Overall, practical support via infant feeding broadly predicted shorter breastfeeding durations and poorer feeding experience; results in relation to other forms of support were more complex. Our findings indicate different forms of support have different associations with infant feeding experience. They also highlight the wide range of individuals beyond the nuclear family on which postpartum mothers in the UK rely. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.


2015 ◽  
Vol 19 (99) ◽  
pp. 1-188 ◽  
Author(s):  
Susan Michie ◽  
Caroline E Wood ◽  
Marie Johnston ◽  
Charles Abraham ◽  
Jill J Francis ◽  
...  

BackgroundMeeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) – the ‘active ingredients’, for example goal-setting, self-monitoring of behaviour. BCTs are ‘the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs’ (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change.Health Psychol Rev2012;6:1–6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health.Objective(1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development.Design and participantsFour hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs.Development of the taxonomyinvolved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts;hierarchical structureof the list was developed using inductive ‘bottom-up’ and theory-driven ‘top-down’ open-sort procedures (n = 36);trainingin use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) wasevaluatedby changes in intercoder reliability and validity (agreement with expert consensus);evaluatingthe taxonomy for coding interventions was assessed by reliability (intercoder; test–retest) and validity (n = 40 trained coders); andevaluatingthe taxonomy for writing descriptions was assessed by reliability (intercoder; test–retest) and by experimentally testing its value (n = 190).ResultsNinety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a ‘bottom-up’ open-sort procedure; there was overlap between these and groupings produced by a theory-driven, ‘top-down’ procedure. Both training methods improved validity (bothp < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (bothp < 0.001) but did not improve intercoder reliability. Good intercoder reliability was observed for 80 of the 93 BCTs. Good within-coder agreement was observed after 1 month (p < 0.001). Validity was good for 14 of 15 BCTs in the descriptions. The usefulness of BCTTv1 to report descriptions of observed interventions had mixed results.ConclusionsThe developed taxonomy (BCTTv1) provides a methodology for identifying content of complex BCIs and a foundation for international cross-disciplinary collaboration for developing more effective interventions to improve health. Further work is needed to examine its usefulness for reporting interventions.FundingThis project was funded by the Medical Research Council Ref: G0901474/1. Funding also came from the Peninsula Collaboration for Leadership in Applied Health Research and Care.


2021 ◽  
Author(s):  
Jilly Gibson-Miller ◽  
Orestis Zavlis ◽  
Todd Hartman ◽  
Orla McBride ◽  
Kate Bennett ◽  
...  

This chapter will explore psychological and demographic influences on citizens’ ability to enact protective health behaviours during the COVID-19 pandemic. Such behaviours include social distancing and hygienic practices that have been recommended across the globe to reduce the spread of infection from the coronavirus. Such behaviours represent a seismic change in usual social behaviour and have been particularly difficult to adopt under urgent circumstances. However, human behaviour is the essential driver of the rate and spread of infection. Using evidence from a large-scale longitudinal survey conducted throughout the pandemic in the UK, this chapter explores protective behaviours in relation to the Capability, Opportunity, Motivation-Behaviour (COM-B) model of behaviour change, which presents a framework for understanding the influences on behaviour. We will illustrate how the components of the COM-B model can inform behaviour change interventions and the importance of the role of anxiety in shaping behavioural responses to the pandemic.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ellen Moseholm ◽  
Inka Aho ◽  
Åsa Mellgren ◽  
Gitte Pedersen ◽  
Terese L. Katzenstein ◽  
...  

Abstract Background The success of antiretroviral therapy has normalized pregnancy among women living with HIV (WWH) with a very low risk of perinatal transmission of HIV. Despite these advances, WWH still face complex medical and psychosocial issues during pregnancy and postpartum. The aim of this study was to assess differences in psychosocial health outcomes between pregnant WWH, non-pregnant WWH, and pregnant women without HIV, and further identify factors associated with probable depression in the third trimester and postpartum. Methods In a longitudinal survey study, participants were included from sites in Denmark, Finland, and Sweden during 2019–2020. Data was collected in the 3rd trimester, 3 and 6 months postpartum using standardized questionnaires assessing depression, perceived stress, loneliness, and social support. Mixed regression models were used to assess changes over time within and between groups. Logistic regression models were used to identify factors associated with depression in pregnancy and postpartum. Results A total of 47 pregnant WWH, 75 non-pregnant WWH, and 147 pregnant women without HIV were included. The prevalence of depression was high among both pregnant and non-pregnant WWH. There was no significant difference between pregnant and non-pregnant WWH in depression scores, perceived stress scores, or social support scores at any time point. Compared to pregnant women without HIV, pregnant WWH reported worse outcomes on all psychosocial scales. Social support and loneliness were associated with an increased odds of depressive symptoms in the adjusted analysis. Conclusions A high burden of adverse psychosocial outcomes was observed in both pregnant and non-pregnant women living with HIV compared to pregnant women without HIV. Loneliness and inadequate social support were associated with increased odds of depression in pregnancy and should be a focus in future support interventions.


2020 ◽  
Author(s):  
Moritz Herle ◽  
Andrea Smith ◽  
Feifei Bu ◽  
Andrew Steptoe ◽  
Daisy Fancourt

Background: The COVID-19 pandemic has led to the implementation of stay-at-home and lockdown measures. It is currently unknown if the experience of lockdown leads to long term changes in individual’s eating behaviors.Objective: The objectives of this study were: i) to derive longitudinal trajectories of change in eating during UK lockdown, and ii) to identify risk factors associated with eating behavior trajectories. Design: Data from 22,374 UK adults from the UCL COVID-19 Social study (a panel study collecting weekly data during the pandemic) were analyzed from 28th March to 29th May 2020. Latent Class Growth Analysis was used to derive trajectories of change in eating. These were then associated with prior socio-economic, heath-related and psychological factors using multinomial regression models. Results: Analyses suggested five trajectories, with the majority (64%) showing no change in eating. In contrast, one trajectory was marked by persistently eating more, whereas another by persistently eating less. Overall, participants with greater depressive symptoms were more likely to report any change in eating. Loneliness was linked to persistently eating more (OR= 1.07), whereas being single or divorced, as well as stressful life events, were associated with consistently eating less (OR= 1.69). Overall, higher education status was linked to lower odds of changing eating behavior (OR= 0.54-0.77). Secondary exploratory analyses suggest that participants self-reported to have overweight were most common amongst the consistently overeaters, whereas underweight participants persistently ate less. Conclusion: In this study, we found that one third of the sample report changes in quantities eaten throughout the first UK lockdown period. Findings highlight the importance of adjusting public health programs to support eating behaviors in future lockdowns both in this and potential future pandemics. This is particularly important as part of on-going preventive efforts to prevent nutrition-related chronic diseases.


2017 ◽  
Author(s):  
Andy Skinner ◽  
Andy ◽  
Ian Penton-Voak ◽  
Marcus Robert Munafo

Background and aims: Smoking is associated with negative health of skin and increased signs of facial aging. We aimed to address two questions about smoking and appearance: 1) how does smoking affect the attractiveness of faces, and 2) does facial appearance alone provide an indication of smoking status?Methods: Faces of identical twins discordant for smoking were averaged to make male and female smoking and non-smoking prototypes faces. In Task 1, we presented same sex smoking and non-smoking prototypes side-by-side and participants (n=590) indicated which face was more attractive. Participants were blind to prototype smoking status. In Task 2 a separate sample (n=580) indicated which prototype was the smoker.Results: In Task 1 both male and female participants judged non-smoking prototypes more attractive, irrespective of the sex of the prototype face. In Task 2, both male and female participants selected the smoking prototype as the smoker more often, again irrespective of the sex of the prototype face.Conclusions: Our findings provide evidence that smoking may negatively impact facial appearance, and that facial appearance alone may be sufficient to indicate smoking status. We discuss the possible use of these findings in smoking behaviour change interventions.


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