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We have previously argued thatbehavioral scientists have been testing and advocating individualistic (i-frame) solutions to policy problems that have systemic (s-frame) causes and require systemic solutions. Here, we consider the implications of adopting an s-frame approach for research. We argue that an s-frame approach will involve addressing different types of questions, which will, in turn, require a different toolbox of research methods.
Cognitive decline is intricately linked to various factors such as obesity, stress, poor sleep, and circadian rhythm misalignment, which are interrelated in their impact on cognitive health. Irregular food-intake timing further compounds these issues. The practice of prolonged nightly fasting (PNF) may help synchronize food intake with circadian rhythms, potentially mitigating adverse effects of cognitive decline and associated factors.
Methods:
A pilot nationwide, remotely delivered, 2-arm randomized controlled trial was conducted to assess the 8-week outcomes of cognition, stress, and sleep, after a PNF intervention (14-hr nightly fast, 6 nights/week, no calories after 8 pm) compared to a health education (HED) control condition. Participants were living with memory decline, stress, and obesity and had weekly check-in calls to report fasting times (PNF) or content feedback (HED).
Results:
Participants were enrolled from 37 states in the US; N = 58, 86% women, 71% white, 93% non-Latinx, mean (SD) age 50.1 (5.1) years and BMI 35.6 (3.6) kg/m2. No group differences existed at baseline. Linear mixed-effects models were used to compare outcome change differences between groups. Compared to the HED control, the PNF intervention was associated with improved sleep quality (B = −2.52; SE = 0.90; 95% CI −4.30–−0.74; p = 0.006). Perceived stress and everyday cognition significantly changed over time (p < 0.02), without significant difference by group.
Discussion:
Changing food intake timing to exclude nighttime eating and promote a fasting period may help individuals living with obesity, memory decline, and stress to improve their sleep. Improved sleep quality may lead to additional health benefits.
Phishing emails cost companies millions. In the absence of technology to perfectly block phishing emails, the responsibility falls on employees to identify and appropriately respond to phishing attempts and on employers to train them to do so. We report results from an experiment with around 11,000 employees of a large U.S. corporation, testing the efficacy of just-in-time feedback delivered at a teachable moment – immediately after succumbing to a phishing email – to reduce susceptibility to phishing emails. Employees in the study were sent an initial pseudo-phishing email, and those who either ignored or fell victim to the phishing email were randomized to receive or not receive feedback about their response. Just-in-time feedback for employees who fell victim to or ignored the initial pseudo-phishing email reduced susceptibility to a second pseudo-phishing email sent by the research team. Additionally, for employees who ignored the initial email, feedback also increased reporting rates.
Three scenarios ranging from simple to complex show how appointments with primary care clinicians can include useful conversations about stress and treatments that work.
This study evaluates long-term changes in physical activity and its associations with various predictors after a behavior change program at the Norwegian Healthy Life Centers.
Background:
Physical activity is recommended and is part of public health strategies to prevent noncommunicable diseases.
Methods:
This longitudinal cohort, based on a controlled randomized trial, studies a population of 116 Healthy Life Center participants in South-Western Norway who wore SenseWear Armbands to measure time spent in moderate to vigorous physical activity and sedentary time based on metabolic equivalents. The measurements were obtained at baseline, immediately post-intervention, and 24 months after baseline. Linear mixed model analyses were performed to assess predictors for change in physical activity and sedentary time.
Findings:
High physical activity levels at baseline were maintained during the 24-month study period. Young, male participants with good self-rated health, utilizing local PA facilities were most active, and young participants utilizing local facilities were also less sedentary. The participants with higher levels of education were less active initially but caught up with the difference during follow-up. A high degree of controlled regulation, characterized by bad conscience and external pressure, predicted more sedentary behavior and a trend toward being less physically active. Autonomous motivation was associated with less time spent on sedentary behaviors. People with high self-efficacy for physical activity were more sedentary initially but showed a reduction in their sedentary behavior.
The study supports the importance of attending local training facilities and adopting motivation for behavioral change that is not based on guilt and external rewards. Interventions aimed at improving physical activity among people at risk for noncommunicable diseases benefit from habitual use of local training facilities, strengthening their self-perceived health and the development of internalized motivation. However, it has not been shown to mitigate social health disparities.
Intervention development frameworks offer the behavioral sciences a systematic and rigorous empirical process to guide the translation of basic science into practice in pursuit of desirable public health and clinical outcomes. The multiple frameworks that have emerged share a goal of optimization during intervention development and can increase the likelihood of arriving at an effective and disseminable intervention. Yet, the process of optimizing an intervention differs functionally and conceptually across frameworks, creating confusion and conflicting guidance on when and how to optimize. This paper seeks to facilitate the use of translational intervention development frameworks by providing a blueprint for selecting and using a framework by considering the process of optimization as conceptualized by each. First, we operationalize optimization and contextualize its role in intervention development. Next, we provide brief overviews of three translational intervention development frameworks (ORBIT, MRC, and MOST), identifying areas of overlap and divergence thereby aligning core concepts across the frameworks to improve translation. We offer considerations and concrete use cases for investigators seeking to identify and use a framework in their intervention development research. We push forward an agenda of a norm to use and specify frameworks in behavioral science to support a more rapid translational pipeline.
Understanding how sustainable preference change can be achieved is of both scientific and practical importance. Recent work shows that merely responding or not responding to objects during go/no-go training can influence preferences for these objects right after the training, when people choose with a time limit. Here we examined whether and how such immediate preference change in fast choices can affect choices without time limit one week later. In two preregistered experiments, participants responded to go food items and withheld responses toward no-go food items during a go/no-go training. Immediately after the training, they made consumption choices for half of the items (with a time limit in Experiment 1; without time limit in Experiment 2). One week later, participants chose again (without time limit in both experiments). Half of the choices had been presented immediately after the training (repeated choices), while the other half had not (new choices). Participants preferred go over no-go items both immediately after the training and one week later. Furthermore, the effect was observed for both repeated and new choices after one week, revealing a direct effect of mere (non)responses on preferences one week later. Exploratory analyses revealed that the effect after one week is related to the memory of stimulus-response contingencies immediately after the training, and this memory is impaired by making choices. These findings show mere action versus inaction can directly induce preference change that lasts for at least one week, and memory of stimulus-response contingencies may play a crucial role in this effect.
An influential line of thinking in behavioral science, to which the two authors have long subscribed, is that many of society's most pressing problems can be addressed cheaply and effectively at the level of the individual, without modifying the system in which the individual operates. We now believe this was a mistake, along with, we suspect, many colleagues in both the academic and policy communities. Results from such interventions have been disappointingly modest. But more importantly, they have guided many (though by no means all) behavioral scientists to frame policy problems in individual, not systemic, terms: To adopt what we call the “i-frame,” rather than the “s-frame.” The difference may be more consequential than i-frame advocates have realized, by deflecting attention and support away from s-frame policies. Indeed, highlighting the i-frame is a long-established objective of corporate opponents of concerted systemic action such as regulation and taxation. We illustrate our argument briefly for six policy problems, and in depth with the examples of climate change, obesity, retirement savings, and pollution from plastic waste. We argue that the most important way in which behavioral scientists can contribute to public policy is by employing their skills to develop and implement value-creating system-level change.
As the world reckons with the existential threat posed by climate change, the US remains deeply divided about the need for action. The solution to this problem, many have argued, begins with teaching environmentalism in primary and secondary schools and fostering receptivity to environmental issues and environmental science among the next generation. This strategy, of course, comes with its own set of challenges. Where does climate change fit in the school curriculum? What can teachers do in their classrooms to mitigate the influence of partisan politics? How can an abstract global phenomenon be made real at the local level? If K-12 education has a role to play in the broader project of environmental conservation, such questions need to be answered.
For this Policy Dialogue, the HEQ editors asked Zeke Baker and Hunter Gehlbach to explore the challenges and opportunities inherent in educating the next generation about climate change, drawing on analogues from the past and scholarship from the present to help us better understand the future. Gehlbach is a professor and vice dean at the Johns Hopkins University School of Education. Thanks to a mid-career fellowship from the Spencer Foundation, much of his research focus has shifted toward investigating how social psychological approaches might improve environmental education. Baker is an assistant professor of sociology at Sonoma State University. His research explores the development and use of climate science, especially insofar as climate knowledge is embedded in social relationships of power.
HEQ Policy Dialogues are, by design, intended to promote an informal, free exchange of ideas between scholars. At the end of the exchange, we offer references for readers who wish to follow up on sources relevant to the discussion.
Recovery from alcohol use disorder (AUD) is a dynamic process of behavior change. This chapter explores the biological, psychological, social, and contextual factors that are associated with AUD recovery. Models of AUD remission and AUD relapse are reviewed, and some possible extensions of these models to our understanding of AUD recovery are offered. The chapter focuses on a broad range of research that has examined biopsychosocial predictors and correlates of AUD remission, AUD relapse, and AUD recovery processes in treatment seeking samples and in the context of natural recovery. Also highlighted are current findings and gaps in the literature, as well as discussion of directions for future research. The literature reviewed encourages a broadening of the research agenda to focus on dynamic interactions between biological, psychological, social, contextual, cultural, and life course developmental factors in predicting the onset and maintenance of recovery processes.
In 1994, a general population survey was conducted to evaluate Montanans’ knowledge about noxious weeds, and results from that survey launched an ongoing statewide education campaign. In 2019, we conducted another general population survey to assess the views and behaviors of Montanans as they relate to noxious weeds and to identify new approaches for disseminating noxious weed information. We also asked questions to evaluate changes over the 25-yr period, although our ability to make direct comparisons is subject to limitations. We implemented a mail-based survey in March through May 2019. The response rate was 18%, with 830 responses from 4,582 valid mailing addresses. Just under half (48%) of respondents report “little” or “no” knowledge about noxious weeds, which would constitute a 19-point improvement since 1994. A large majority (68%) of respondents indicate that noxious weeds are a “serious” or “very serious” problem, and appreciation for the range of negative impacts associated with noxious weeds is considerable. Most respondents (61%) identify humans as contributing “a lot” to noxious weed spread, and respondents report that their behaviors to prevent the spread of noxious weeds have increased over time. While the 1994 respondents rated television, newspaper, and radio as the best ways to disseminate information about noxious weeds, respondents now also recognize methods such as websites and social media pages as effective. Our survey identifies a need for increased educational messaging for women and people in the 18 to 39 age group. Overall, our results indicate that individuals who have seen different forms of advertisements and have participated in educational programs are more likely to consider noxious weeds a serious problem and to engage in behaviors to stop their spread.
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Part IV
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Conclusions and Recommendations to Improve Peace Communication Research, (Evidence-Based) Practice and Conflict Intractability Interpretation
This chapter parses the study’s conclusions: it took only five years for these young stateless nation, state-bearing nation, and state minority audiences to become militarily, politically, economically, and socially encoded by the global interstate system. The children unwittingly replicated the violence of the conflicts surrounding them and expressed political opinions that their partners’ elimination was the sole solution. The glocal, hybrid, open and closed mediated text imagined the achievement of what each audience defined peace to be—justice of an independent Palestine; security of a safe Israel, and equality inside Israel. But it sidestepped the structural and narrative realities of the political conflicts and so could not address and change political beliefs. While communicating peacebuilding, the text did not communicate peacemaking. And even much of its peacebuilding thrust was “lost upon” audience members when they resisted the texts pro-social depictions of friendships between and among Palestinians and Israelis, in particular, between Palestinians and Jewish Israelis.
This chapter introduces an evidence-based model for personal change called BET I CAN. BET I CAN stands for Behaviors, Emotions, Thoughts, Interactions, Context, Awareness, and Next steps. When it comes to mattering, you can easily see that it involves all the BET I CAN levers. For instance, we can add value by doing something (behaviors), relating to people in certain ways (interactions), and shaping the community where we live (context). In turn, we can feel valued through emotions or thoughts. Our plans to add value, or feel valued, as the case may be, always require awareness of our situation and next steps. Each letter of the BET I CAN model encompassed two skills. This is what we teach in the chapter: Behaviors (Set a Goal and Create a Positive Habits), Emotions (Cultivate Positive Emotions and Manage Negative Emotions), Thoughts (Challenge Negative Assumptions and Write a New Story), Interactions (Connect and Communicate), Context (Read the Cues and Change the Cues), Awareness (Know Yourself and Know the Issue), and Next Steps (Make a Plan and Make it Stick).
To evaluate if the inclusion of nutritional warnings in food ordering websites can discourage consumers from purchasing foods with excessive content of nutrients associated with non-communicable diseases (NCD).
Design:
Participants were randomly assigned to one of the two experimental conditions: control (n 225) or nutritional warnings (n 222). Nutritional warnings corresponded to separate black octagonal signs containing the word ‘Excess’ followed by the corresponding nutrient: total fat, saturated fat, sugars and sodium. Participants were asked to purchase a lunch for themselves using a simulated food ordering website.
Setting:
Online study in Uruguay.
Participants:
Convenience sample of 447 Uruguayan participants, recruited using social media.
Results:
In the control condition, 76 % of the participants selected a dish or a beverage with excessive content of at least one nutrient in the simulated food ordering website. When nutritional warnings were included, this percentage significantly decreased to 62 % (P = 0·002). In addition, nutritional warnings caused a significant reduction in the percentage of participants who selected dishes with excessive content of total fat: 50 % v. 62 % (P = 0·012).
Conclusions:
Results from the present work provide preliminary evidence that the inclusion of nutritional warnings in food ordering websites could discourage consumers from selecting dishes and beverages with excessive content of nutrients associated with NCD.
Smoking is a major cause of worldwide morbidity and mortality. Almost no evidence-based intervention programs are available to help youth quit smoking. We argue that ineffective targeting of peer influence and engagement difficulties are significant barriers to successful youth smoking cessation. To address these barriers, we developed the mobile game intervention HitnRun. A two-armed randomized controlled trial (RCT; n = 144) was conducted and young smokers (Mage = 19.39; SDage = 2.52) were randomly assigned to either play HitnRun or read a psychoeducational brochure. Prior to, directly following the intervention period, and after three-month follow-up, weekly smoking behavior, abstinence rates, intervention dose, and peer- and engagement-related factors were assessed. Results indicated similar reductions in weekly smoking levels and similar abstinence rates for both groups. Yet, we found a dose effect with HitnRun only: The longer participants played HitnRun, the lower their weekly smoking levels were. In the brochure group, a higher dose was related to higher weekly smoking levels at all measurement moments. Exploratory analyses showed the most powerful effects of HitnRun for participants who connected with and were engaged by the intervention. Future work should build on the promising potential of HitnRun by increasing personalization efforts and strengthening peer influence components.
Several fall prevention programs have been implemented to reduce falls among seniors. In some rural areas or in French-speaking minority communities, the availability of such programs is limited. The objectives of this paper are to: (a) describe the Fall Prevention Program Marche vers le futur, offered in French, by videoconference; and (b) present the results of the evaluation of the program objectives. Results demonstrate that participants have improved their physical abilities, gained knowledge, adopted new behaviors and lifestyle habits. In short, Marche vers le futur reduces fall risk factors in a manner equal or superior to other programs. Marche vers le futur has made possible the provision of services in French in communities where availability of French-language resources is very limited, therefore fostering equity in access to health services.
In a previous paper, we presented results from a 12-week study of a Psychomotor DANCe Therapy INtervention (DANCIN) based on Danzón Latin Ballroom that involves motor, emotional-affective, and cognitive domains, using a multiple-baseline single-case design in three care homes. This paper reports the results of a complementary process evaluation to elicit the attitudes and beliefs of home care staff, participating residents, and family members with the aim of refining the content of DANCIN in dementia care.
Methods:
An external researcher collected bespoke questionnaires from ten participating residents, 32 care home staff, and three participants’ family members who provided impromptu feedback in one of the care homes. The Behavior Change Technique Taxonomy v1 (BCTTv1) provided a methodological tool for identifying active components of the DANCIN approach warranting further exploration, development, and implementation.
Results:
Ten residents found DANCIN beneficial in terms of mood and socialization in the care home. Overall, 78% of the staff thought DANCIN led to improvements in residents’ mood; 75% agreed that there were improvements in behavior; 56% reported increased job satisfaction; 78% of staff were enthusiastic about receiving further training. Based on participants’ responses, four BCTTv1 labels–Social support (emotional), Focus on past success and verbal persuasion to boost self-efficacy, Restructuring the social environment and Habit formation–were identified to describe the intervention. Residents and staff recommended including additional musical genres and extending the session length. Discussions of implementing a supervision system to sustain DANCIN regularly regardless of management or staff turnover were suggested.
Conclusions:
Care home residents with mild to moderate dementia wanted to continue DANCIN as part of their routine care and staff and family members were largely supportive of this approach. This study argues in favor of further dissemination of DANCIN in care homes. We provide recommendations for the future development of DANCIN based on the views of key stakeholder groups.
A Psychomotor DANCe Therapy INtervention (DANCIN) using Latin Ballroom (Danzón) in care homes has previously been shown to enhance well-being for both residents with dementia and staff. The aim of this study was to understand the effect of this approach on the mood and behavior of individual people living with mild to moderate dementia.
Method:
A multiple-baseline single-case study across two care homes and one nursing home with 3–6 weeks baseline, 12-weeks DANCIN (30 minutes/twice-weekly sessions), and 12-weeks follow-up was conducted. Seventeen items from the Dementia Mood Assessment Scale (DMAS) outcome measure were adapted with input from senior staff to match participants’ behavior and mood symptoms. Daily monitoring diaries were collected from trained staff on reporting individualized items for ten residents. Data were analyzed, using a non-parametric statistical method known as Percentage of All Non-Overlapping Data (PAND) which provides Phi effect size (ES). Medication use, falls, and life events were registered.
Results:
Seven residents participated throughout DANCIN whilst three became observers owing to health deterioration. One participant showed adverse effects in three DMAS items. Nine participants, dancers and observers, showed a small to medium magnitude of change (PAND) in 21 DMAS items, indicating a decrease in the frequency of behavior and mood indices which were regarded as problematic; eight items showed no change.
Conclusion:
Despite methodological challenges, the DANCIN model has the potential to facilitate and sustain behavior change and improve mood (e.g. decrease irritability, increase self-esteem) of the residents living with dementia. The study was conducted in two care homes and one nursing home, strengthening the interventions’ validity. Findings suggest DANCIN is appropriate for a larger controlled feasibility study.
The use of universal, evidence-based social-emotional curricula in early educational settings is expanding. Although these programs have the potential to enhance target outcomes, their success depends on the quality with which they are conducted in community settings. This chapter provides guidelines to practitioners who are planning to implement these types of interventions to ensure quality implementation and maximize effectiveness. First, it summarizes the most effective intervention models that are currently available for communities to enhance the social competence of young children. Next, the chapter defines the core process components of social-emotional interventions because these reflect high-quality implementation and are the primary mechanisms responsible for behavior change in participants. Instructional core components of social-emotional interventions include general teaching practices and specific promotion strategies. There are a number of ways to assess implementation, but the most common approaches include indicators of fidelity, dosage, and quality of delivery.
A qualitative study was conducted with a subset of a Community Supported Agriculture (CSA) membership base in Wisconsin, USA to examine attitude and behavior change associated with membership. Changes that were examined included: modified eating or cooking habits, increased consideration of food seasonality and associated consumer preferences for seasonal products, and an enhanced appreciation for farming. Although this study investigated ‘spillover’ attitude or behavior changes (e.g. reduced driving or increased use of environmentally friendly cleaning products), none were observed. This study indicates that attitude and behavior changes are generated by the structural elements of CSA including exposure to the farm, interactions with the farmer, and the constraints imposed by a pre-selected bundle of vegetables. There was no indication that changes occur due to the development and enforcement of social norms within the CSA membership base. Community, in the context of this CSA, is expressed primarily as a conceptual community of interest. Our results suggest that demonstrated attitude and behavior change increases the likelihood that a consumer will renew their CSA membership.