Assessing Open Science practices in physical activity behaviour change intervention evaluations

Objectives: Concerns on the lack of reproducibility and transparency in science have led to a range of research practice reforms, broadly referred to as Open Science. The extent that physical activity interventions are embedding Open Science practices is currently unknown. In this study, we randomly sampled 100 reports of recent physical activity behaviour change interventions to estimate the prevalence of Open Science practices. Methods: One hundred reports of randomised controlled trial physical activity behaviour change interventions published between 2018-2021 were identified. Open Science practices were coded in identified reports, including: study pre-registration, protocol sharing, data-, materials- and analysis scripts-sharing, replication of a previous study, open access publication, funding sources and conflict of interest statements. Coding was performed by two independent researchers, with inter-rater reliability calculated using Krippendorffs alpha. Results: 78% of the 100 reports provided details of study pre-registration and 41% provided evidence of a published protocol. 4% provided accessible open data, 8% provided open materials and 1% provided open analysis scripts. 73% of reports were published as open access and no studies were described as replication attempts. 93% of reports declared their sources of funding and 88% provided conflicts of interest statements. A Krippendorffs alpha of 0.73 was obtained across all coding. Conclusion: Open data, materials, analysis and replication attempts are currently rare in physical activity behaviour change intervention reports, whereas funding source and conflict of interest declarations are common. Future physical activity research should increase the reproducibility of their methods and results by incorporating more Open Science practices.

PARIS: protocol for a prospective single arm, theory-based, group-based feasibility intervention study to increase Physical Activity and reduce sedentary behaviouR after barIatric Surgery

IntroductionIncreased physical activity and reduced sedentary behaviour can encourage favourable outcomes after bariatric surgery. However, there is a lack of evidence as to how to support patients with behaviour change. The aim of this study is to assess the feasibility of a physiotherapist led, online group-based behaviour change intervention to increase physical activity and reduce sedentary behaviour following bariatric surgery.Methods and analysisSingle arm feasibility study of a theory and evidence-based group behaviour change intervention based on the Behaviour Change Wheel and Theoretical Domains Framework using behaviour change techniques from the Behaviour Change Technique Taxonomy v1. The intervention has eight objectives and specifies behaviour change techniques that will be used to address each of these. Groups of up to eight participants who have had surgery within the previous 5 years will meet weekly over 6 weeks for up to 1½ hours. Groups will be held online led by a physiotherapist and supported by an intervention handbook. Feasibility study outcomes include: rate of recruitment, retention, intervention fidelity, participant engagement and acceptability. Secondary outcomes include: physical activity, sedentary behaviour, body composition, self-reported health status and will be analysed descriptively. Change in these outcomes will be used to calculate the sample size for a future evaluation study. Qualitative interviews will explore participants’ views of the intervention including its acceptability. Data will be analysed according to the constant comparative approach of grounded theory.Ethics and disseminationThis study has National Health Service Research Ethics Committee approval; Haydock 20/NW/0472. All participants will provide informed consent and can withdraw at any point. Findings will be disseminated through peer-reviewed journals, conference and clinical service presentations.Trial registration numberISRCTN31524689.

Active Living Becomes Achievable (ALBA): An Evaluation of the Effectiveness of a Behaviour Change Intervention at Promoting Physical Activity for Improved Mental Wellbeing

Physical activity (PA) has been shown to be beneficial for physical and mental wellbeing. However, there is evidence to indicate people with mental health conditions are significantly less active than the general population. The aim of the research is to evaluate the effectiveness of Active Living Becomes Achievable (ALBA), a behaviour change intervention designed to specifically target individuals with mental and physical health conditions to increase motivation and adherence to physical activity to improve physical and mental wellbeing. 318 participants were recruited through existing exercise referral schemes in three areas of Scotland. A quantitative outcome evaluation, with a before and after design was carried out to assess the effectiveness of the intervention. Participants completed 5 outcome measures—the Scottish Physical Activity Questionnaire (SPAQ), the Self-Efficacy for Exercise Scale (SEE), the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), the Patient Activation Measure (PAM) and the Rosenberg Self Esteem Scale—and wore an activity tracker for 16 weeks. Participants who opted into the long-term study were monitored for up to 12-months. ALBA significantly improved mental wellbeing, patient activation and self-efficacy. Although the intervention did not appear to increase adherence to PA. The ALBA intervention was effective at improving mental wellbeing but did not have a significant effect on PA levels. This suggests that the additional support offered through the ALBA intervention was key to improving wellbeing.

Development of a secondary school-based digital behaviour change intervention to improve tooth brushing

Background Dental caries in adolescents remains a significant public health problem with few oral health promotion interventions aimed at reducing dental caries in secondary school-aged students. Previous oral health and mobile health (mHealth) research has suggested the need for the development of a school-based behaviour change intervention incorporating a digital component. This study aimed to describe the development process of a behaviour change intervention to improve the oral health of students aged 11–16 years attending secondary schools in the UK. Methods A six-step process was used to develop the complex intervention informed by behaviour change theory and involving students, young people, parents and teachers in the process. The steps were: (1) identifying the target behaviours, namely tooth brushing with a fluoride toothpaste (2) identifying the theoretical basis and developing the causal model (3) reviewing the relevant literature and developing the logic model (4) designing the intervention with young people, parents and school staff (5) specifying the intervention content and (6) translating this content into features of the intervention and piloting. Results The resultant intervention included a quality-assured classroom-based session (CBS) (guided by a lesson plan and teaching resources), delivered by school teachers which was embedded within the school curriculum. This CBS was followed by a series of (Short Message Service) SMS texts delivered twice daily to student’s mobile telephones with the content, duration and timing of the messages informed by involvement of students and young people. Conclusions An intervention to improve the oral health of secondary school students through improved tooth brushing was rigorously developed based on behaviour change theory and work with young people, parents and school staff. Further research is needed to evaluate the outcomes and processes involved following the delivery of this intervention. BRIGHT Trial Trial Registration ISRCTN12139369.

Informing behaviour change intervention design using Bayesian meta-analysis: physical activity in heart failure

Embracing the Bayesian approach, we aimed to synthesise evidence regarding barriers and enablers to physical activity in HF in a way that can inform behaviour change intervention development. This approach helps in concluding on the uncertainty in the evidence and facilitates the synthesis of qualitative and quantitative evidence. Qualitative and observational studies investigating barriers and enablers to physical activity in adults diagnosed with HF were included in a Bayesian meta-analysis. Evidence from three qualitative and 16 quantitative studies was synthesised. Qualitative evidence was annotated using Theoretical Domains Framework and represented as a prior distribution using an expert elicitation task. The maximum a posteriori probability (MAP) and Credible Intervals (CrI) was calculated as a summary statistic for the probability distribution of physical activity conditioned on each determinant, according to qualitative evidence alone and qualitative and quantitative evidence combined. Evidence concerning the modifiable barriers and enablers is highly uncertain: social support (MAP=0.11,CrI:[0.08;0.13]), negative attitude (MAP=0.22,CrI:[0.17;0.27]), positive attitude ( MAP=0.27,CrI:[0.23;0.31]), self-efficacy( MAP=0.31,CrI:[0.29;0.33]), symptom distress (MAP=021,CrI:[0.18;0.24]). The contextual barriers – low, moderate and high uncertainty respectively – are age (MAP=0.22,CrI:[0.22;0.23]), low Left Ventricular Ejection Fraction (MAP=0.20,CrI:[0.19;0.22]), and depression (MAP=0.14,CrI:[0.12;0.16]). This work extends the limited research on the modifiable barriers and enablers for physical activity by individuals living with HF.

Understanding behaviour change to promote regular dental attendance

Regular dental attendance is a key oral health behaviour. Behaviour change interventions are increasingly being used to promote positive oral health behaviours. A systematic approach to understanding behaviour has led to the development of frameworks which aim to guide the process of designing behaviour change interventions. One such framework is the Behaviour Change Wheel (BCW). This article aims to explore and identify barriers to regular dental attendance which may be targeted using behaviour change interventions based on the Capability, Opportunity and Motivation Behaviour model (COM-B) and the BCW, and suggests potential behaviour change techniques which could be utilised into a behaviour change intervention with the aim to promote regular dental attendance.

Barriers And Facilitators To Implementing A Continuing Medical Education Intervention In A Primary Health Care Setting

Background: Continuing medical education (CME), as a systematic attempt to facilitate change in General Practitioners’ (GPs) practices, is considered crucial, assuming that if physicians are up-to-date, they will change and improve their practice, resulting in better performance and ultimately better patient care. However, studies continue to demonstrate considerable gaps between the real and ideal performance and patient-related outcomes. The objective of this study was to explore GP’s perception of the factors affecting the implementation of a CME digital platform in a primary health care setting. Methods: Our work is framed in a larger effectiveness-implementation hybrid type 1 study, where a Digital Behaviour Change Intervention (DBCI), called ePrimaPrescribe, was developed and implemented with the aim of changing benzodiazepines (BZD) prescribing patterns. Our design used mixed methodologies to obtain an enriched knowledge on GPs’ perspectives on the facilitators and barriers to implementing a Digital Behaviour Change Intervention (DBCI) applied to CME. To do so, we used data coming from an onsite questionnaire, an adapted version of the Barriers and Facilitators Assessment Instrument (BaFAI) and in-depth interviews. Results: From the 47 GPs successfully included in the intervention arm of our cluster-randomized effectiveness study, we collected 37 onsite questionnaires, 24 BaFAIs, and performed 12 in-depth interviews. GPs reported as the main barriers to CME a lack of time, a perception of work overload, a lack of digital competence, a lack of digital infrastructure, and motivational and emotional factors. They reported as facilitators to CME delivered through a DBCI the convenience of the delivery method, the practical and pragmatic characteristics of the content, the liaison with specialists, and the possibility for CME to be mandatory. Conclusions: The perceptions of the barriers and facilitators reported by GPs represent an important contribution to improving knowledge regarding the factors influencing the implementation of CME in primary health care settings. We consider that our study might bring useful insights to other countries where primary health care plays a central role in the provision of care. Trial registration: ClinicalTrials.gov number NCT04925596