Vaccine hesitancy and behavior change theory-based social media interventions: a systematic review

It is widely acknowledged that vaccine hesitancy is a multifaceted problem that cannot be addressed by a single strategy. Behavior change theories and social media tools may together help to guide the design of interventions aimed at improving vaccination uptake. This systematic review aims to identify the breadth and effectiveness of such theories and tools. The systematic review search was performed in PubMed, Scopus, ACM, Cochrane Library, ProQuest, and Web of Science databases for studies between January 2011 and January 2021 that applied social media tools to increase vaccine confidence or improve vaccination uptake. The literature search yielded a total of 3,065 publications. Twenty articles met the eligibility criteria, 12 of which were theory-based interventions. The result shows that the Health Belief Model was the most frequently deployed theory, and the most common social media tool was educational posts, followed by dialogue-based groups, interactive websites, and personal reminders. Theory-based interventions were generally more measurable and comparable and had more evidence to trigger the positive behavior change. Fifteen studies reported the effectiveness in knowledge gain, intention increase, or behavior change. Educational messages were proved to be effective in increasing knowledge but less helpful in triggering behavior change. Dialogue-based social media intervention performed well in improving people’s intention to vaccinate. Interventions informed by behavior change theory and delivered via social media platforms offer an important opportunity for addressing vaccine hesitancy. This review highlights the need to use a multitheory framework and tailoring social media interventions to the specific circumstances and needs of the target audience in future interventions. The results and insights gained from this review will be of assistance to future studies.

Short and Long-Term Innovations on Dietary Behavior Assessment and Coaching: Present Efforts and Vision of the Pride and Prejudice Consortium

Overweight, obesity and cardiometabolic diseases are major global health concerns. Lifestyle factors, including diet, have been acknowledged to play a key role in the solution of these health risks. However, as shown by numerous studies, and in clinical practice, it is extremely challenging to quantify dietary behaviors as well as influencing them via dietary interventions. As shown by the limited success of ‘one-size-fits-all’ nutritional campaigns catered to an entire population or subpopulation, the need for more personalized coaching approaches is evident. New technology-based innovations provide opportunities to further improve the accuracy of dietary assessment and develop approaches to coach individuals towards healthier dietary behaviors. Pride & Prejudice (P&P) is a unique multi-disciplinary consortium consisting of researchers in life, nutrition, ICT, design, behavioral and social sciences from all four Dutch Universities of Technology. P&P focuses on the development and integration of innovative technological techniques such as artificial intelligence (AI), machine learning, conversational agents, behavior change theory and personalized coaching to improve current practices and establish lasting dietary behavior change.

Environmental Issues Are Health Issues

Increasing demands on ecosystems, decreasing biodiversity, and climate change are among the most pressing environmental issues of our time. As changing weather conditions are leading to increased vector-borne diseases and heat- and flood-related deaths, it is entering collective consciousness: environmental issues are human health issues. In public health, the field addressing these issues is known as environmental health. This field addresses both the effects people have on their environment as well as the effects of the environment on people. Psychology, as a discipline concerned with explaining, predicting, and changing behavior has much to contribute to these issues because human behavior is key in promoting environmental health. To date, however, an integrative view of environmental health in psychology is lacking, hampering urgently needed progress. In this paper, we review how the environment and human health are intertwined, and that much can be gained through a systemic view of environmental health in psychology. Based on a review of the literature, we suggest that psychologists unite efforts to promote an integrative science and practice of environmental health psychology, and jointly address environmental-health related behavior. The research agenda for this field will include integrating behavior change theory and intervention approaches. Thereby, psychology can potentially make an important contribution to sustained environmental health for generations to come.

Evaluation of the design and implementation of municipal ice cleat distribution programs for the prevention of ice-related fall injuries among older adults in Sweden

Introduction The risk for outdoor falls tends to increase during winter due to icy road conditions. Several Swedish municipalities have introduced programs that provide their senior citizens with a pair of ice cleats in an attempt to tackle this problem. In this paper, we perform a process evaluation to identify potential barriers to the success of these programs and analyze the logic of their design. Methods We sent a survey to all 290 Swedish municipalities to collect data on the characteristics of ice cleat distribution programs. We also performed focus-group interviews with older adults to gain insight into their thoughts about ice cleat programs. We synthesized our data with existing literature on ice cleats and behavior change theory to populate a logic model to identify and analyze hidden assumptions and potential flaws using program theory analysis. Results On average, about 40% of the eligible population living in the intervention municipalities collected a pair of ice cleats. While we identified some other, but mostly minor, barriers to implementation, the main barrier appears to be a lack of scale (i.e., insufficient procurement and distribution of ice cleats), as 90% of all purchased ice cleats were eventually distributed. While previous research suggests that ice cleats can decrease injury risks if worn, we find that there is limited evidence on the effects of distribution on ice cleat use. Our interviewees emphasized the potential utility of ice cleats for staying safe and active during winter but stressed that ice cleats need to be user-friendly and of high-quality to increase the likelihood that a distribution program encourages behavior change. Conclusion Existing ice cleat distribution programs appear to have reached a meaningful share of the targeted population. Additional research is required to assess their effects on ice cleat use and injury rates.

Operationalizing Behavior Change Theory as Part of Persuasive Technology: A Scoping Review on Social Comparison

Theories from psychology or the social sciences are commonly used as a starting point when designing persuasive technologies that aim to evoke a specific behavior change. Ideally, using these theories would (1) help guide the design of the persuasive technology and (2) help evaluate and inform the theory. In this paper, we focused on the first aspect and looked at how papers report on how a theory guided the design of persuasive technology. We performed a scoping review focused on the operationalization of social comparison theory as part of persuasive design. We chose social comparison due to its ubiquitous use in persuasive design as well as its potential positive or negative influence on the user. The former requires careful consideration in a persuasive design prototype. We focused on the proceedings of the Persuasive Technology conference from 2006 to 2020 to gain an understanding of the use of social comparison theory as part of persuasive design. Twelve studies met our inclusion criteria. Explanations of how the theory guides design decisions leading to the final operationalization were sparse. We suggest that conducting manipulation checks and using a systematic approach to reporting design decisions including the potential grounding of design elements in theory could highlight and clarify theoretical insights, and could increase our understanding of how social comparison—and behavior change theory in general—could be efficiently operationalized in persuasive technologies.

Mobile Applications for Behavioral Change

Access to the internet and the proliferation of mobile phones has resulted in a rising trend of mobile apps developed for disease self-management. This use of mobile health technology (mHealth) is viewed as an effective way to induce health behavior change. The authors conducted an evidence review of articles published in PubMed/Medline, Web of Science, and ACM Digital Library between January 2015 and January 2020 that developed and evaluated mHealth apps informed by behavior change theory. A total of 31 studies reviewed developed apps to encourage physical activity, dietary changes, diabetes, Alzheimer's disease, and others. The prevalent way of applying behavior theory to apps was through behavior change techniques (BCT) applied in 45% of the selected studies. Over 54% of the selected studies reported positive outcomes in inducing health behavior change. The results indicate that the use of behavior change theory to inform application design will result in statistically significant effects in improving health outcomes of a condition.

Recommendations for Implementing Gamification for Mental Health and Wellbeing

Gamification is increasingly being proposed as a strategy to increase engagement for mental health and wellbeing technologies. However, its implementation has been criticized as atheoretical, particularly in relation to behavior change theory and game studies theories. Definitions of the term “gamification” vary, sometimes widely, between and within academic fields and the effectiveness of gamification is yet to be empirically established. Despite this, enthusiasm for developing gamified mental health technologies, such as interventions, continues to grow. There is a need to examine how best to implement gamification in mental health and wellbeing technologies in a way that takes quick production cycles into account while still emphasizing empirical investigation and building a rigorous evidence base. With reference to game studies and the medical (eHealth/mHealth) literature, this article interrogates gamification for mental health and wellbeing by examining core properties of the game form. It then explores how gamification can best be conceptualized and implemented for mental health and wellbeing goals from conceptualization through to iterative co-development and evaluation that accommodates software development schedules. Finally, it summarizes its conceptual analysis into recommendations for researchers and designers looking to do so. These recommendations are: (1) assess suitability, (2) implement to support, (3) assess acceptability, (4) evaluate impact, and (5) document comprehensively. These recommendations aim to encourage clear language, unified terminology, the application and evaluation of theory, comprehensive and constant documentation, and transparent evaluation of outcomes.

Nutrition Strategies for Reducing Risk of Burnout Among Physicians and Health Care Professionals

Under typical circumstances, up to half of physicians, 31% of nurses who provide direct patient care, and 37% of nurses working in nursing homes experience burnout, and these rates are likely exacerbated following the Coronavirus disease 2019 pandemic. Diet is a mediating and modifiable factor with regard to burnout risk. Chronic stress, such as the stress experienced by individuals suffering from burnout, has been shown to influence the amounts and types of foods individuals eat, contributing both to excessive eating and undereating and the development of chronic diseases. Dietary strategies to mitigate burnout for physicians and health care professionals should be developed based on existing evidence related to nutrition and mental health, incorporate effective behavior change theory, and include systems-level change to promote healthy eating among health care professionals. Evidence supports the application of the Mediterranean diet, cognitive behavioral theory, and mindful eating interventions. Policy and systems approaches should support the availability of healthy foods at employer-sponsored events and eating outlets, worksite wellness, and nutrition education in medical training curriculum.