Protecting and restoring freshwater biodiversity across urban areas in Aotearoa New Zealand: Citizens' reporting of pollution in stormwater drains and waterways.

Urbanization poses numerous challenges to freshwater biodiversity. This paper describes two studies with the joint aim of demonstrating the benefits of applying a systematic behaviour change framework and providing the foundational knowledge to inform future behavior change work to protect and restore urban freshwater biodiversity. In Study 1 we used a mixed-methods research design, involving 14 key informant interviews followed by an online survey targeting 17 freshwater biodiversity experts and another targeting a representative sample of 550 urban residents, to identify and prioritize the most promising resident behaviors to target to reduce stormwater pollution and improve natural waterway habitats in urban areas. Study 2 focused on the top-ranked short-term behavior identified in Study 1, citizen reporting of pollution in stormwater drains and waterways. We surveyed a representative sample of 1901 urban residents across Aoteraoa New Zealand to identify four main determinants influencing this behavior: awareness and uncertainty about reporting, lack of opportunity to report, social motivation and personal motivation to report, and five potential target audiences: 'Supportive', 'Unaware but receptive', 'Motivated but lack support', 'Reluctant', and 'Not my problem'. We make recommendations for the most appropriate intervention designs to target each of these audience segments to promote the reporting of stormwater pollution in urban areas. This knowledge will allow for a more coordinated and effective approach for addressing the 'human element' that lies at the heart of many urban freshwater management problems.

Web-Based Video Education to Improve Uptake of Influenza Vaccination and Other Preventive Health Recommendations in Adults With Inflammatory Bowel Disease: Randomized Controlled Trial of Project PREVENT.

BACKGROUND: Patients with inflammatory bowel disease (IBD) are at increased risk of infections, bone fractures, and skin cancers. OBJECTIVE: We developed preventive health videos using a patient-centered approach and tested their impact on preventive health uptake. METHODS: Five animated videos explaining preventive health recommendations in IBD were iteratively developed with patient-centered focus groups and interviews. A randomized controlled trial was then conducted in a web-based IBD cohort to test the impact of video- versus text-based educational interventions. The primary outcome was receipt of the influenza vaccine. Secondary outcomes included intention to receive other preventive health services. RESULTS: Five animated videos were developed with patient input. A total of 1056 patients with IBD were then randomized to receive the video (n=511) or text-only (n=545) interventions; 55% (281/511) of the video group and 57% (311/545) of the text-only group had received their influenza vaccine in the prior year. Immediately after the intervention, 73% (502/683) of patients reported their intention to receive the vaccine, with no difference by the type of intervention (75%, 231/307, for the video group and 72%, 271/376, for the text-only group). The proportion of patients who actually received the influenza vaccine after the intervention also did not differ by messaging type (P=.07). The strongest predictor of both intention to receive and actual receipt of the influenza vaccine was prior influenza vaccination. Older age was also associated with a higher likelihood of the intention to receive (age 36-75 years relative to 18-35 years; P=.006) and actual receipt (age >75 years relative to 18-35 years; P=.05) of the influenza vaccine. CONCLUSIONS: The proportion of patients receiving the influenza vaccine was high in both groups, but there was no difference in receipt of or in the intention to receive preventive health recommendations by type of messaging. Notably, a portion of patients in both groups had intended to be vaccinated but did not ultimately receive the vaccine. Further evaluation of patient-education strategies is warranted to improve preventive health uptake among patients with IBD. TRIAL REGISTRATION: ClinicalTrials.gov NCT05997537; https://clinicaltrials.gov/ct2/show/NCT05997537.