Use of a smartphone app combined with gamification to increase the level of physical activity of adults and older adults: protocol of a sequential multiple assignment randomized trial.

BACKGROUND: There is scientific evidence suggesting that app-based interventions targeted to increase the level of physical activity might be effective, although multicomponent interventions appear to be more effective than app-based interventions alone. Despite the motivating results, it remains unclear whether or not app-based interventions can increase the level of physical activity and cardiovascular health. Our study aims to investigate the effect of a smartphone app combined with gamification on the level of physical activity of adults and older adults. The specific aims are (1) to verify the effects of the intervention on cardiometabolic and cardiovascular health, lung function, and cardiorespiratory fitness; and (2) to verify the relationship between age group and the response rate. METHODS/DESIGN: We will conduct a sequential multiple assignment randomized trial (SMART). The adaptive intervention protocol will last 6 months. After baseline assessments, participants will be randomized into one of three groups (group 1: app + tailored messages; group 2: app + tailored messages + gamification I; control group: physical activity counseling). For 12 weeks, we will record the average number of steps per day of participants from groups 1 and 2. At 6 weeks from initiation of recording, participants will be classified into responders and non-responders according to their increase in the average number of daily steps; all those considered as non-responders will be re-randomized, with the chance to participate in a third group - group 3: app + tailored messages + gamification II. Finally, at 12 weeks, participants will continue using the app but will no longer receive direct intervention from investigators. All participants will be reassessed at 3 and 6 months from baseline. Our pilot SMART will require 42 participants (14 per arm). Following the SMART pilot, we will calculate the sample size for the trial based on the variation of the average number of steps/day, including an up to 40% loss to follow-up and a less optimistic nonresponse rate of 65%. DISCUSSION: To our knowledge, this will be the first trial with adaptive intervention to test the effectiveness of using a smartphone app to increase the level of physical activity of adults and older adults. TRIAL REGISTRATION: Brazilian Clinical Trials Registry: RBR-8xtc9c. Registered on 3 August 2018, http://www.ensaiosclinicos.gov.br; UTN number: U1111-1218-1092.

Practices for making residents' wishes fit institutional constraints: a case of manipulation in dementia care.

PURPOSE: The study aims to show how practices of manipulation are used by a member of staff in a care situation where the member of staff has to perform two tasks at once. METHOD: The study is an ethnomethodological conversation analytic single-case study of a care situation in residential dementia care. The analyses are based on video recordings and observations conducted during 9 months of fieldwork at a residential care facility for persons with dementia. RESULTS: The study details the methods by which a member of staff engages in manipulation by constructing her actions as responses to a resident's wish which has in fact never been stated. CONCLUSION: The study discusses how manipulation may be understood as care staff practices for making a residents' wishes fit the institutional constraints they are subjected to and for "doing what is best for the resident."

MATI: An efficient algorithm for influence maximization in social networks.

Influence maximization has attracted a lot of attention due to its numerous applications, including diffusion of social movements, the spread of news, viral marketing and outbreak of diseases. The objective is to discover a group of users that are able to maximize the spread of influence across a network. The greedy algorithm gives a solution to the Influence Maximization problem while having a good approximation ratio. Nevertheless it does not scale well for large scale datasets. In this paper, we propose Matrix Influence, MATI, an efficient algorithm that can be used under both the Linear Threshold and Independent Cascade diffusion models. MATI is based on the precalculation of the influence by taking advantage of the simple paths in the node's neighborhood. An extensive empirical analysis has been performed on multiple real-world datasets showing that MATI has competitive performance when compared to other well-known algorithms with regards to running time and expected influence spread.

Impact of an Educational Text Message Intervention on Adolescents' Knowledge and High-Risk Behaviors.

Health care providers need to develop improved methods of educating adolescents. This study was developed to evaluate adolescents' responses to and satisfaction with an educational text message intervention to promote healthy behaviors, reduce the incidence of unhealthy behaviors, and prevent high-risk behaviors. Adolescent participants received weekly text messages regarding high-risk sexual behaviors, healthy dietary habits, exercise, drug, or alcohol use, and social issues. Results indicate adolescents learned something new, made a behavioral change, and overall liked the delivery of educational information via text message. This indicates long-term continuation of a text message intervention is a viable means to deliver adolescent health information, thereby improving an adolescent's current and future health status.

Hypertension Canada's 2017 Guidelines for the Diagnosis, Assessment, Prevention, and Treatment of Pediatric Hypertension.

After the 2016 guidelines for blood pressure measurement, diagnosis, and investigation of pediatric hypertension, we now present evidence-based guidelines for the prevention and treatment of hypertension in children. These guidelines were developed by Hypertension Canada's Guideline Committee pediatric subgroup after thorough evaluation of the available literature. Included are 10 guidelines specifically addressing health behaviour management, indications for drug therapy in children with hypertension, choice of therapy for children with primary hypertension, and goals of therapy for children with hypertension. Although the pediatric literature is inherently limited by small numbers of participants, fewer trials, and a prolonged latency to the development of vascular outcomes, this report reflects the current and highest level of evidence and provides guidance for primary care practitioners on the management of pediatric hypertension. Studies of therapeutic lifestyle modifications in children are available to guide current management and more antihypertensive drugs have been studied in children since the Food and Drug Administration Modernization Act. Consistent with Hypertension Canada's guideline policy, diagnostic and therapeutic algorithm tools will be developed and the guidelines will be reviewed annually and updated according to new evidence.

Contrasting ABA, AAB and ABC renewal in a free operant procedure

One experiment used a free operant procedure with rats to compare ABA, AAB and ABC renewal by using a within-subject testing procedure. All rats were first trained to press a lever for food in context A. Lever pressing was then extinguished in either context A or context B. For rats in the groups ABA and ABC extinction took place in context B, while the rats in group AAB received extinction in the same context in which acquisition took place (context A). Finally, all rats were tested for renewal in two sessions. One extinction session was carried out in the same extinction context and another session in a different context. Rats in the group ABA were tested in context B and in context A; rats in the group AAB were tested in contexts A and B, whereas the group ABC was tested in contexts B and C. The results of the ANOVA showed context renewal since all groups had higher rates of responding when they were tested outside the extinction context, F(2, 21) = 15.32, p = .001, ηp 2 = .59; however, AAB and ABC renewal was lesser than ABA renewal, F(1, 21) = 16.70, p = .0001, ηp 2 = .61 (AU)

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Safewards: the empirical basis of the model and a critical appraisal.

ACCESSIBLE SUMMARY: In the previous paper we described a model explaining differences in rates of conflict and containment between wards, grouping causal factors into six domains: the staff team, the physical environment, outside hospital, the patient community, patient characteristics and the regulatory framework. This paper reviews and evaluates the evidence for the model from previously published research. The model is supported, but the evidence is not very strong. More research using more rigorous methods is required in order to confirm or improve this model. ABSTRACT: In a previous paper, we described a proposed model explaining differences in rates of conflict (aggression, absconding, self-harm, etc.) and containment (seclusion, special observation, manual restraint, etc.). The Safewards Model identified six originating domains as sources of conflict and containment: the patient community, patient characteristics, the regulatory framework, the staff team, the physical environment, and outside hospital. In this paper, we assemble the evidence underpinning the inclusion of these six domains, drawing upon a wide ranging review of the literature across all conflict and containment items; our own programme of research; and reasoned thinking. There is good evidence that the six domains are important in conflict and containment generation. Specific claims about single items within those domains are more difficult to support with convincing evidence, although the weight of evidence does vary between items and between different types of conflict behaviour or containment method. The Safewards Model is supported by the evidence, but that evidence is not particularly strong. There is a dearth of rigorous outcome studies and trials in this area, and an excess of descriptive studies. The model allows the generation of a number of different interventions in order to reduce rates of conflict and containment, and properly conducted trials are now needed to test its validity.

Effectiveness of mealtime interventions on behavior symptoms of people with dementia living in care homes: a systematic review.

OBJECTIVE: Elderly residents with dementia commonly exhibit increased agitation at mealtimes. This interferes with eating and can be distressing for both the individual and fellow residents. This review examines the effectiveness of mealtime interventions aimed at improving behavioral symptoms in elderly people living with dementia in residential care. DESIGN: Systematic review. DATA SOURCES: Medline, PsycINFO, Embase, HMIC, AMED (OvidSP); CDSR, CENTRAL, DARE (Cochrane Library, Wiley); CINAHL (EBSCOhost); British Nursing Index (NHS Evidence); ASSIA (ProQuest); Social Science Citation Index (Web of Knowledge); EThOS (British Library); Social Care Online and OpenGrey from inception to November 2012. Forward and backward citation chases, hand searches of other review articles identified in the search, and key journals. TYPES OF STUDY: All comparative studies were included. Articles were screened for inclusion independently by 2 reviewers. Data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Data were not suitable for meta-analysis so narrative synthesis was carried out. RESULTS: A total of 6118 articles were identified in the original search. Eleven articles were finally included. Mealtime interventions were categorized into 4 types: music, changes to food service, dining environment alteration, and group conversation. Study quality was poor, making it difficult to reach firm conclusions. Although all studies showed a trend in favor of the intervention, only 6 reported a statistically significant improvement in behavioral symptoms. Four studies suggest cumulative or lingering effects of music on agitated and aggressive behaviors. CONCLUSION: There is some evidence to suggest that mealtime interventions improve behavioral symptoms in elderly people with dementia living in residential care, although weak study designs limit the generalizability of the findings. Well designed, controlled trials are needed to further understand the utility of mealtime interventions in this setting.

Revisiones de seguridad basadas en la conducta / BBS: behaviour based on safety reviews

Las Revisiones de seguridad basadas en la conducta (BBS: Behaviour based on Safety Reviews) son una herramienta preventiva que ayuda a identificar las conductas inseguras antes de que lleguen a tener lugar cualquier tipo de incidente. Con su práctica diaria en Arcelor Mittal Tailored Blanks Zaragoza se promueve la mejora de la percepción de los riesgos, las conductas seguras y la cultura preventiva de todos los trabajadores. Este es el camino hacia el 0 accidentes por elección; - Percepción del riesgo - Conducta Preventiva - Actitud Proactiva (AU)

Behaviour Based Safety audits system is a preventive tool which helps us to identify unsafe behaviours before the generation of any incident. Thanks to a daily practice at Arcelormittal Tailored Blanks Zaragoza we promote the risk perception improvement, safe behaviours and the preventive culture of all workers. This is the way to 0 accidents... by choice; - Risk perception - Preventive behavior - Proactive approach (AU)

The BASES expert statement on emotion regulation in sport.

Emotions experienced before and during sports competition have been found to influence sports performance. Emotion regulation is defined as the automatic or deliberate use of strategies to initiate, maintain, modify or display emotions (Gross & Thompson, 2007) and is proposed to occur when a discrepancy exists between current and desired emotions. Two distinct motivations to regulate emotion - hedonic and instrumental (in short, for pleasure or for purpose) - have been proposed (Tamir, 2009). The instrumental approach might provide a more fruitful area of investigation for sports researchers as some athletes hold beliefs that supposedly pleasant emotions such as happiness and calmness associate with poor performance and supposedly unpleasant emotions such as anxiety and anger associate with good performance (Hanin, 2010). Athletes are more likely to try to regulate an emotion if they believe that doing so will facilitate performance. Strategies that encourage re-appraisal of factors that trigger emotions are proposed to be preferable. In this British Association of Sport and Exercise Sciences (BASES) expert statement, a summary of the key theoretical issues are offered leading to evidence-based recommendations for practitioners and researchers.

Validation of the theoretical domains framework for use in behaviour change and implementation research.

BACKGROUND: An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework. METHODS: Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis. RESULTS: There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): 'Knowledge', 'Skills', 'Social/Professional Role and Identity', 'Beliefs about Capabilities', 'Optimism', 'Beliefs about Consequences', 'Reinforcement', 'Intentions', 'Goals', 'Memory, Attention and Decision Processes', 'Environmental Context and Resources', 'Social Influences', 'Emotions', and 'Behavioural Regulation'. CONCLUSIONS: The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development.

Measuring behavioral regulation in four societies.

The present study examined the psychometric properties of scores from a direct measure of behavioral regulation, the Head-Toes-Knees-Shoulders task (HTKS) with 3- to 6-year-old children in the United States, Taiwan, South Korea, and China. Specifically, we investigated (a) the nature and variability of HTKS scores, including relations to teacher-rated classroom behavioral regulation; and (b) relations between the HTKS and early mathematics, vocabulary, and literacy skills. Higher HTKS scores were significantly related to higher teacher ratings of classroom behavioral regulation in the United States and South Korea but not in Taiwan and China. Also, higher HTKS scores were significantly related to higher early mathematics, vocabulary, and literacy skills beyond the influence of demographic variables and teacher-rated classroom behavioral regulation. These initial findings suggest that HTKS scores may be interpreted as reflecting early behavioral regulation in these 4 societies and that behavioral regulation is important for early academic success in the United States and in Asian countries.

Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy.

BACKGROUND: The Internet is increasingly used as a medium for the delivery of interventions designed to promote health behavior change. However, reviews of these interventions to date have not systematically identified intervention characteristics and linked these to effectiveness. OBJECTIVES: The present review sought to capitalize on recently published coding frames for assessing use of theory and behavior change techniques to investigate which characteristics of Internet-based interventions best promote health behavior change. In addition, we wanted to develop a novel coding scheme for assessing mode of delivery in Internet-based interventions and also to link different modes to effect sizes. METHODS: We conducted a computerized search of the databases indexed by ISI Web of Knowledge (including BIOSIS Previews and Medline) between 2000 and 2008. Studies were included if (1) the primary components of the intervention were delivered via the Internet, (2) participants were randomly assigned to conditions, and (3) a measure of behavior related to health was taken after the intervention. RESULTS: We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d(+) = 0.16, 95% CI 0.09 to 0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d(+) = 0.36, 95% CI 0.15 to 0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages. CONCLUSIONS: The review provides a framework for the development of a science of Internet-based interventions, and our findings provide a rationale for investing in more intensive theory-based interventions that incorporate multiple behavior change techniques and modes of delivery.

Estudio empírico de las variables de la Teoría de la Conducta Planificada como factores de riesgo para el consumo de cocaína en tres grupos diferentes / Empirical study of the Planned Behavior Theory variables as risk factors for cocaine use in three different groups

Objetivo: Explorar empíricamente la presencia de determinados factores como elementos de riesgo para el consumo de cocaína. Método: Estudio transversal que compara las puntuaciones obtenidas en un conjunto de ítems que miden las variables de la Teoría de la Conducta Planificada (actitud, norma subjetiva, control conductual percibido e intención conductual) en tres grupos: el grupo A está formado por 192 sujetos consumidores de cocaína sin tratamiento, el grupo B está formado por 110 sujetos consumidores de cocaína en tratamiento y el grupo C lo componen 100 sujetos que nunca habían consumido cocaína. Resultados: El grupo A puntuó significativamente más alto en todas las variables, mientras que el grupo C fue el que obtuvo menores puntuaciones. El grupo B no mostró diferencias significativas con el grupo A en la variable norma subjetiva, ni con el grupo C en las variables control conductual percibido e intención conductual. Discusión: Se subraya la importancia de las actitudes y la norma subjetiva para la explicación del consumo actual de cocaína, pero especialmente, la función del control conductual percibido como factor de riesgo necesario a tomar en cuenta en el diseño de medidas preventivas (AU)

Objective: To explore empirically the presence of certain factors as risk elements for cocaine consumption. Method: Analysis of the data obtained in a set of items that measure the variables of the Planned Behavior Theory (attitude, subjective norm, perceived behavioral control and behavioral intention) in three groups: Group A is made up of 192 cocaine users without treatment, Group B comprises 110 cocaine users in treatment, and Group C is made up of 100 individuals who had never used cocaine. Results: Group A scored significantly higher in all the variables, while Group C was which obtained the lowest scores. Group B showed no significant differences from Group A in the subjective norm variable, nor from Group C in the perceived behavioral control and behavioral intention variables. Discussion: This study highlights the importance of attitudes and subjective norm in the explanation of current cocaine use, but especially the function of perceived behavioral control as a risk factor that should be taken into account in the design of preventive strategies (AU)

Physical activity counseling and prescription among canadian primary care physicians.

BACKGROUND: Primary care physicians are ideally positioned to affect a large population at risk for epidemics of sedentary lifestyle; however, it is unclear what type of counseling they provide. METHODS: A questionnaire was used to obtain information on primary care physicians' behaviors with respect to counseling and prescribing physical activity, physician demographics, and practice characteristics. Registered primary care physicians in Canada were contacted in all 10 provinces and 2 territories. RESULTS: Of 27 980 primary care physicians, 14 319 returned usable questionnaires and 13 166 were eligible for study participation (response rate, 51.2%). Respondents were predominantly male (61.1%), practiced in private office/clinic settings (73.4%), and had graduated from medical school more than 22 years earlier. Eighty-five percent of respondents reported asking patients about their physical activity levels, whereas only 26.2% assessed patient fitness as part of a physical examination or through a fitness test and only 10.9% referred patients to others for fitness assessment or appraisal. Most physicians (69.8%) reported using verbal counseling to promote physical activity, whereas only 15.8% used written prescriptions for a physical activity promotion program. Male and female physicians responded differently. Men more frequently assessed fitness than did women, whereas women more frequently asked and provided verbal and written directions. CONCLUSIONS: This large sample of Canadian primary care physicians regularly asked patients about physical activity levels and advised them using verbal counseling. Few respondents provided written prescriptions, performed fitness assessments, or referred patients. These results suggest possible opportunities to improve physicians' counseling and prescription efforts.

The utility of the Trans-theoretical Model of Behavior Change in the treatment of sex offenders.

This paper discusses the use of the Trans-theoretical Model of Behavior Change in the treatment of sex offenders. Constructs within this theory are the Stages of Change, Processes of Change and Decisional Balance. The first section of this paper provides a brief description of these constructs. The second section provides a brief review of research related to these constructs and discusses the implications of this research in relation to the treatment of sex offenders. The third section of this paper provides a practical description of the use of the constructs of the Trans-theoretical Model of Behaviour Change in the treatment of sex offenders. Although the validity of this model among sex offenders requires further investigation, the Trans-theoretical Model of Behavior Change appears to have considerable utility as an overarching theoretical model to conceptualize and facilitate behavior change among sex offenders.