A Novel Feature Selection Technique to Better Predict Climate Change Stage of Change

Indications of people’s environmental concern are linked to transport decisions and can provide great support for policymaking on climate change. This study aims to better predict individual climate change stage of change (CC-SoC) based on different features of transport-related behavior, General Ecological Behavior, New Environmental Paradigm, and socio-demographic characteristics. Together these sources result in over 100 possible features that indicate someone’s level of environmental concern. Such a large number of features may create several analytical problems, such as overfitting, accuracy reduction, and high computational costs. To this end, a new feature selection technique, named the Coyote Optimization Algorithm-Quadratic Discriminant Analysis (COA-QDA), is first proposed to find the optimal features to predict CC-SoC with the highest accuracy. Different conventional feature selection methods (Lasso, Elastic Net, Random Forest Feature Selection, Extra Trees, and Principal Component Analysis Feature Selection) are employed to compare with the COA-QDA. Afterward, eight classification techniques are applied to solve the prediction problem. Finally, a sensitivity analysis is performed to determine the most important features affecting the prediction of CC-SoC. The results indicate that COA-QDA outperforms conventional feature selection methods by increasing average testing data accuracy from 0.7 to 5.6%. Logistic Regression surpasses other classifiers with the highest prediction accuracy.

Dyspnea And Outcome Expectations Are Associated With Physical Activity In Persons With Pneumoconiosis: A Cross-Sectional Study

Background: There are various reports on factors associated with physical activity in patients with chronic respiratory diseases. However, there are no studies on the relationship between physical activity and psychological or environmental factors. In this study, we investigated the relationship between physical activity and psychological and environmental factors using questionnaires for patients with pneumoconiosis.Methods: The present study was a cross-sectional study of patients with pneumoconiosis who underwent pneumoconiosis health examination in 2019. A self-administered questionnaire was used to conduct the study. Physical activity was evaluated using the International Physical Activity Questionnaire, and subjective symptoms (dyspnea and quality of life [QOL]), environmental factors (environment around home and life space), psychological factors (depression, stage of change, self-efficacy, decisional balance, and outcome expectations), and others (e.g., experience with pulmonary rehabilitation) were investigated.Results: The number of respondents in the study was 185 (men: 171, women: 14). Age, dyspnea, stage of change, self-efficacy, outcome expectations, QOL, depression, decisional balance, and life space were significantly correlated with physical activity. In the multivariate analysis, outcome expectations and dyspnea were extracted as independent factors. In the path analysis, outcome expectations and dyspnea had a direct influence on physical activity. Dyspnea directly impacted not only physical activity but also outcome expectations, stage of change, QOL, life space, and depression.Conclusions: Dyspnea and outcome expectations were associated with physical activity in patients with pneumoconiosis. To improve the physical activity of patients with pneumoconiosis, it is necessary not only to improve dyspnea but also to promote an understanding of physical activity.

Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity

Background: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. Objective: To evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA. Methods: Using a validated questionnaire, we assessed each patient’s stage of behavioral change according to the Transtheoretical Model (precontemplation, contemplation, preparation, action and maintenance). We also examined four processes of behavioral change, which quantify activities and experiences that patients undergo on the way to behavioral change: emotional re-evaluation (EMR), weight management action (WMA), weight consequence evaluation (WCE), and supporting relationships (SR). Processes scores were compared between patients in the action and maintenance stages and those in the precontemplation, contemplation and preparation stages. Results: Out of 49 patients who provided informed consent, 44 met the inclusion/exclusion criteria. Of these 44 patients, 6 (14%) were in the precontemplation stage of change, 7 (16%) were in contemplation, 2 (5%) were in preparation, 13 (30%) were in action, and 16 (36%) were in maintenance. Those in the action and maintenance stages accounted for the majority of participants (n=29, 66%). Patients in the action and maintenance stages (N=29) had higher EMR scores (mean 79, SD 13 vs mean 68, SD 19, t=2.0, p=0.03) and WMA scores (mean 69, SD 13 vs mean 59, SD 19, t=2.0, p=0.03) as compared to those in the precontemplation, contemplation and preparation stages (N=15). Conclusions: Our results suggest that without counseling or specific intervention, approximately two-thirds of stroke/TIA patients living with obesity are in the action or maintenance stage of behavior change with respect to weight loss and therefore more likely to succeed in intensive lifestyle-based interventions targeted towards weight loss. Patients who score higher in EMR and WMA are more likely to be in the action or maintenance stage of change.

Targeting Versus Tailoring Educational Videos for Encouraging Deceased Organ Donor Registration in Black-Owned Barbershops

In the U.S., Black men have highest risk for requiring kidney transplants but are among those least likely to register for organ donation. Prior outreach used videos culturally targeted for Black communities, yet registration rates remain insufficient to meet demand. Therefore, we assessed whether generic versus videos culturally targeted or personally tailored based on prior organ donation beliefs differentially increase organ donor registration. In a randomized controlled trial, 1,353 participants in Black-owned barbershops viewed generic, targeted, or tailored videos about organ donation. Logistic regression models assessed relative impact of videos on: 1) immediate organ donor registration, 2) taking brochures, and 3) change in organ donation willingness stage of change from baseline. Randomization yielded approximately equal groups related to demographics and baseline willingness and beliefs. Neither targeted nor tailored videos differentially affected registration compared with the generic video, but participants in targeted and tailored groups were more likely to take brochures. Targeted (OR=1.74) and tailored (OR=1.57) videos were associated with incremental increases in organ donation willingness stage of change compared to the generic video. Distributing culturally targeted and individually tailored videos increased organ donor willingness stage of change among Black men in black-owned barbershops but was insufficient for encouraging registration.

Applying the Transtheoretical Model to Stuttering Management Among Adolescents: Part II. Exploratory Scale Validation

Purpose This article is the second in a two-part series on the application of the Transtheoretical Model to stuttering management among adolescents. The purpose of this article was to apply and explore the validity of newly developed Transtheoretical measures for adolescents who stutter. Method The online survey was completed by a national sample of 173 adolescents who stutter between the ages of 13 and 21 years. The multipart survey included a Stage of Change scale, Decisional Balance scale, and Situational Self-Efficacy scale. Participants also completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), either the teenage or adult version depending on the participant's age, so preliminary construct validity of the new scales could be examined. Exploratory factor analyses were conducted to determine model fit and reduce the scales to the most meaningful items. External validity of the three-part survey was examined by comparing OASES scores across stage of change as well as evaluating the functional relations between the three scales. Results Adolescents' readiness to manage stuttering could be clearly described with five discrete stages, although most of the respondents reported being in the Maintenance stage. The pros of managing stuttering reliably predicted stage placement. Internal consistency of the scales ranged from good to excellent. OASES scores differed across stages of readiness in complex but predictable ways. Conclusions These findings suggest that the Transtheoretical Model fits the target behaviors involved stuttering management among adolescents. Further examination of the application of the model to validate a stage-based framework for change among individuals who stutter is warranted.

Integrating Planned Behavior and Stage-of-Change into a Cycling Campaign

A cycling campaign was assessed that used three different nudging conditions to progress people’s stage of motivation to make travel behavioral changes. The results of three waves of survey data showed that this cycling campaign generally strengthened their stage of motivation to reduce car use and that this stage-change, in turn, reduced actual car use while increasing bike use. It was observed that an improvement of cognitive psychological mechanisms was positively related to people’s motivation to change. Although the effect of the campaign was stronger just after it had ended (Wave 2), a reduction in car use, an increase in bike use, and an increase in the stage of motivation were still found three months after the campaign had ended. This is important as it shows that effects favoring sustainable travel last beyond the timeframe of the intervention. We conclude that travel interventions should aim to integrate processes that emphasize cognitive psychological mechanisms and people’s motivation to change as these drive a sustainable behavioral change.

Predictors of physical activity behavior change based on the current stage of change—an analysis of young people from Hawai’i

This study investigated the corresponding change between psycho-social predictors and physical activity (PA) behavior and if these relationships were dependent on the stages of change from the Transtheoretical Model in Minority American adolescents. We conducted a longitudinal field study with N = 357 students aged 13–18 years (M = 14.24 years, SD = 0.88); predominantly Filipino (61.2%) using a test–retest design assessing psycho-social PA predictors (enjoyment, self-efficacy, family support, friends’ support, knowledge, stage of change) and moderate-to-vigorous physical activity (MVPA) at two time points over six months. Hierarchical regression results indicated that a positive change of enjoyment, knowledge about PA and family support predicted a change of MVPA, independently of stage. The time-varying covariation showed the importance of the current stage of change for enjoyment, self-efficacy and support of friends for a change of MVPA. Overall, our findings suggest that an individual’s current stage of change should be considered to determine individually appropriate starting points and goals for designing interventions to promote PA among Minority American adolescents.