Machine Learning Approaches to Understanding and Predicting Patterns of Adherence

In cognitive training of older adults, adherence is a major challenge, but appropriate just-in-time adaptive interventions can improve adherence. To understand adherence patterns and predictors of adherence lapses, we aggregated data from two previous trials (N > 230) involving home-based cognitive interventions. This dataset, detailing 40,000 intervention interactions, contains information about intervention engagement and measures of objective and subjective cognitive performance, demographics, technology proficiency, and attitudes. Exploratory analyses were conducted to understand patterns and predictors of faltering adherence, using classification models, together with feature selection to remove redundant variables. Adherence behaviors in a week were predictive of quitting the following week. Game parameters such as the time of play were weak indicators of future playing patterns, whereas game success was a strong predictor of adherence. These and other useful observations will be incorporated in the design and development of the smart reminder system to be deployed in the APPT project.

If-then planning, self-control, and boredom as predictors of adherence to social distancing guidelines: Evidence from a two-wave longitudinal study with a behavioral intervention

In the wake of the Coronavirus Disease 2019 (COVID-19), social distancing is instrumental for containing the pandemic. To maximize its effectiveness, it is paramount to investigate psychological factors that predict adherence to social distancing guidelines and examine corresponding interventions. We focused on individual differences in if-then planning, self-control, and boredom, and tested an intervention based on if-then planning. We conducted a two-wave longitudinal study combining observational and experimental methods. Participants (N = 574, 35.7% female, age: M = 37.5 years, SD = 10.8) reported their adherence to social distancing guidelines and the perceived difficulty of adherence at T1, along with trait measures of if-then planning, self-control, and boredom. Afterwards, they were randomly assigned to an if-then planning intervention to increase adherence, or to a control intervention. One week later at T2, participants again reported their adherence and the perceived difficulty of adhering. Multiple regression and structural equation modeling were used to establish whether trait if-then planning, self-control, and boredom predicted adherence, and to examine the effects of the if-then planning intervention. Trait if-then planning, self-control, and boredom were associated with T1 adherence, while only if-then planning and boredom predicted T2 adherence. No overall treatment effect of the if-then planning intervention emerged; however, participants who complied with the intervention (75.6%) maintained higher levels of adherence over time than control participants. In sum, individual differences in if-then planning, self-control, and boredom predicted adherence to social distancing guidelines. If-then planning interventions are promising but require further steps to ascertain compliance.

Face Covered and Six Feet Apart: Behavioral Awareness Predicts Greater Adherence to Public Health Guidelines during the COVID-19 Pandemic

The COVID-19 pandemic has deleteriously impacted physical and mental health. Guidelines to limit the spread of COVID-19 include wearing a face covering in public, limiting close contacts, and physical distancing. In combatting this and future pandemics, it is essential to understand predictors of adherence, such as psychological flexibility. We hypothesized higher psychological flexibility would relate to greater adherence to public health guidelines. Participants (n = 265) were English-reading/speaking adults in the United States and were recruited through Amazon’s Mechanical Turk. Included in the present analyses are data from June (n = 360) and July 2020 (n = 265). Measures included the Comprehensive Assessment of ACT Processes (CompACT), which measured psychological flexibility. Outcome measures included mask-wearing and number of close contacts, which were operationalized categorically (100% mask-wearing in public, ≤10 close contacts in past week). Two logistic regression models examined psychological flexibility and distress as predictors of adherence to mask-wearing and limiting close contacts, while controlling for demographic correlates. Results indicated that greater behavioral awareness predicted greater odds of mask-wearing and limiting close contacts. Psychological flexibility, and behavioral awareness specifically, should be investigated in future research as targets for intervention amidst global disasters.

Profiling lockdown adherence and poor coping responses towards the COVID-19 crisis in an international cross-sectional survey

This study uses international respondents to a COVID-lockdown related questionnaire (n = 1,688) to assess the determinants of adherence and poor coping in response to lockdown measures. A regression analysis was used to compare the relative importance of clusters derived from a K-means cluster analysis as well as various demographics (age, gender, level of education, political affiliation, a factor reflecting social security and a factor reflecting the lockdown harshness). Three distinct clusters (General Population, Extreme Responders and Sufferers) were identified, corresponding well to a previous study. Clusters appeared to be the best overall predictors of coping and adherence although gender, political affiliation and lockdown harshness were also important predictors. The large proportion of variance that remains unexplained, combined with the relatively weak effects of traditional demographics, suggest that less concrete variables such as personality traits, health and environmental factors may be better predictors of adherence and coping during a pandemic.

Adherance to Public Health Measures in Adolescents versus Adults duing the COVID-19 Pandemic in Canada

To mitigate the burden of COVID-19 on healthcare systems and to reduce infections and associated deaths, public health measures including physical distancing and mask-wearing have been recommended. We know little regarding important predictors of adherence and motivation to engage in public guidelines among at-risk populations, such as adolescents. Objectives. The purpose of the present study was to examine differences in adherence to public health measures across provinces, and to examine developmental differences in both adherence and motivations to engage in public health among adolescents and adults across Canada during the COVID-19 pandemic. Methods. Participants from two samples, including adolescents (N=788, 56.7% female, M=15.68, SD=1.36) and adults (N=578, 94.6% female; M=45.12, SD=5.83) completed online quesionnaires during the summer 2020. Results. Both adolescents and adults in provinces mandating masks were more likely to wear a mask. There were no provincial differences in adherence to social distancing. Adolescents were more likely to be motivated by social reasons, while adults were motivated by social responsibility. For both adults and adoeslcents, social responsibility was associated with more adherence to public health measures, while social concerns(e.g., maintaining social ties, social judgment) was associated with less adherence. Conclusion. Adherence to public health measures was mixed, with most participants reporting socializing in-person with people outside of their home. At the time of the survey, provincial mask mandates were associated with more mask-wearing. Results also suggest social responsibility was the main predictor of increased adherence to public health measures.

Evidence-Based Practice for Non-Specific Low Back Pain: Canadian Physiotherapists’ Adherence, Beliefs, and Perspectives

Purpose: Physiotherapists are key providers of care for patients with low back pain (LBP); however, information on Canadian physiotherapists’ use of evidence-based clinical practice guidelines (EBCPGs) for LBP is lacking. We aimed to (1) describe Canadian physiotherapists’ adherence to EBCPGs for LBP; (2) compare beliefs and attitudes of physiotherapists with higher and lower adherence; (3) identify predictors of adherence; and (4) gather physiotherapists’ perceptions about the care provided to patients with LBP. Method: This mixed methods study involved two phases: (1) a survey containing a LBP clinical scenario and (2) qualitative semi-structured interviews with physiotherapists. Results: A total of 406 (77%) of the 525 survey respondents demonstrated higher adherence (score of 3 or 4) to EBCPGs; however, only 29.5% chose interventions to address psychosocial issues. Postgraduate training was the strongest predictor of higher adherence. Interviewed physiotherapists reported being highly satisfied with the care provided to patients with LBP even when psychosocial issues are present, despite low confidence in addressing those issues. Conclusions:Although overall adherence was high, Canadian physiotherapists do not frequently address psychosocial issues with LBP patients, and often do not feel confident or competent in that aspect of practice. This suggests an opportunity for developing additional training for addressing psychosocial issues in LBP patients.