A Consolidated Framework for Implementation Research-based process to develop theoretically-informed human papillomavirus vaccination educational materials for young adults.

OBJECTIVE: To develop theory-informed human papillomavirus (HPV) vaccine education materials that appeal to 18-26-year-olds. METHODS: First, draft materials informed by Theory of Planned Behavior (TPB) and Health Belief Model (HBM) were developed. Next, an initial set of Consolidated Framework for Implementation Research (CFIR)-guided interviews were conducted with 18-26-year-old participants to receive feedback about content, format, appeal, implementation facilitators and barriers, and potential delivery modalities. Then, interviews were transcribed, coded, and analyzed using thematic analysis. Next, materials were modified based upon feedback. Finally, another set of interviews was conducted. RESULTS: Most participants (n = 15) were female (93%), White (60%), and non-Hispanic (93%). All (100%) had heard of HPV and the HPV vaccine, and 80% reported having received the vaccine. Participant feedback on materials included emphasizing vaccine benefits and efficacy, rewording to enhance comprehension, and adding images represent diversity beyond race/ethnicity and sexual orientation. Suggested delivery methods included social media, print materials, and posters. CONCLUSION: Qualitative interviews with young adults suggest that HPV education materials targeted to 18-26-year-olds should include health behavior theory-aligned messaging, inclusive imagery, and be disseminated through multiple modalities. PRACTICE IMPLICATIONS: Providers should consider utilizing theory-based education materials that are relevant and appealing to young adults.

The Moderating Power of Impulsivity: A Systematic Literature Review Examining the Theory of Planned Behavior.

The theory of planned behavior (TPB) states that behavioral intention is the best predictor of actual behavior change. However, intention explains only a portion of the variance in behavior. Of specific interest is the question of which moderating or mediating variables can be leveraged to aid health promotion interventions utilizing the tenets of behavioral economics (delay discounting and commitment contracts) in the intention-behavior pathway. Impulsivity has been postulated to fill this role and may be applied to multiple behaviors. We aim to determine if impulsivity moderates the association between intention and actual behavior in the TPB, to discover what other variables may moderate or mediate this association, and to apply the findings to future studies in the field of behavioral economics. To this end, a systematic review was conducted using the PubMed, PsychINFO, and Embase online databases. Eligible studies in peer-reviewed journals published prior to November 2021 were selected. Thirty-three studies were included in the final review, examining physical activity, diet, preventive health, mental health, addiction, and medication adherence behaviors. Three main concepts emerged: (1) impulsivity moderates the association between intention and behavior change; (2) self-efficacy moderates the association between intention and behavior change; and (3) planning and self-efficacy contribute to moderated mediation. This review demonstrates a gap in the literature regarding the application of the TPB to the intention-behavior pathway for health behaviors. Future studies in behavioral economics may leverage the variables of impulsivity, self-efficacy, and planning to predict follow-through in this area and to develop targeted change initiatives.

The application of health behavior theories to promote cervical cancer screening uptake.

BACKGROUND: While cervical cancer is a major cause of mortality, its progress and survival rate can be improved through screening. Yet despite their wide availability, women's participation in cervical cancer screening (CCS) programs is often suboptimal, especially in low- and middle-income countries. Besides demographic and organizational characteristics, screening uptake is influenced by psychological factors, most of which are included in health behavior theories. This systematic review compared different health behavior theories in terms of their capacity to explain CCS uptake and inform CCS promotion campaigns. METHODS: A comprehensive search and analysis of published intervention and non-intervention (observational) studies that applied at least one health behavior theory to CCS participation. RESULTS: After quality screening, 48 observational and 21 intervention studies were identified that applied the Health Belief Model (HBM), Theory of Reasoned Action (TRA), Theory of Planned Behaviour (TPB), Transtheoretical model (TTM), Social-ecological Model (SEM), and/or Theory of Triadic Influence (TTI) to CCS. The HBM was most frequently used to explain behavior, whereas the TPB was better at explaining screening intentions. Tailored intervention studies focusing on all theoretical constructs were most effective in modifying perceptions and increasing CCS uptake. CONCLUSIONS: Despite their inconsistent use, health behavior theories can explain CCS intentions and behavior and contribute to the development of targeted interventions to promote screening uptake.

Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children.

Purpose: Numerous oral health promotion programs are directed at reducing the prevalence of early childhood caries. Smartphone applications (app) may be beneficial in oral health promotion. The purpose of this study was to evaluate the effect of a smartphone app, based on the Theory of Planned Behavior (TPB), on the oral health behaviors of the parents of preschoolers.Methods: A two-phase, sequential, embedded mixed methods design explored how the app influenced the attitudes, beliefs, perceived behavioral control, and intentions of parents of preschoolers. Phase 1 was a quasi-experimental, one-group pretest-posttest design. Parents of preschool aged children (n=26) participated in the 4-week intervention. Phase 2 consisted of qualitative interviews with a purposive sample of parents from Phase 1 (n=11).Results: Parents' behavioral intentions or oral health behaviors with their preschoolers did not significantly change from pre- to post-intervention (p>.05). Social norms (SN) and perceived behavioral control (PBC) predicted behavioral intentions pre-intervention and behavioral change post-intervention. Thematic analysis revealed that parents' belief in the importance of establishing oral health habits and brushing reminders and videos delivered via a mobile application supported efforts to form oral health habits.Conclusion: The use of TPB constructs in the development of oral health promotions aimed at parents of preschoolers was partially supported. Intention and behavior were not affected post-intervention, but SN and PBC emerged as significant predictors of intentions and behavior. A dental smartphone app may aid parents to make good oral health habits part of their preschooler's daily routine.

The Use of Health Behavioral Theories in HIV/AIDS Research: A Bibliometric Analysis (Gap Research).

With emerging contextual factors and epidemiological transition of HIV/AIDS, the role and contributions of health behavior theories (HBT) are a compelling question after three decades of efforts to eradicate HIV. This study aims at exploring the global and historical evolution of literature and suggesting the most frequent research topics and research gaps in relation to the use of HBT in HIV/AIDS. A cross-sectional analysis of global HIV/AIDS bibliography was conducted through Web of Science (WoS) up to December 31, 2017. We utilized exploratory factor analysis to test the likelihood of research domains and landscape from the abstracts. A total of 29,997 papers in 153 HIV-related research areas were retrieved from the WoS database. This study suggests that HIV/AIDS research based on HBTs is increasing, and mainly focuses on elucidating traditional HIV driven factors and consonant with western perspectives most HBTs tend to be individually focused. Despite its important advancement, more research based on HBTs is essential to provide cultural background, social value, and contextualized factors where the HIV pandemic is dynamic; where new cases are transmitted from high-risk subgroups to the general population; and where epidemiological, social, and behavioral transitions change new infection routes, new perspectives for health service delivery especially non-medical services, and resource allocation.

Development and Testing of a Smartphone Application Prototype for Oral Health Promotion.

Purpose: The purpose of this study was to develop and test a smartphone application (app) prototype, ToothSense, as an oral health promotion tool for the prevention of Early Childhood Caries (ECC) based on the Theory of Planned Behavior (TPB).Methods: A quantitative and qualitative design process based on the TPB was used for the app development in the first phase of the study. A behavioral intervention technologic model was used to document the app features design, accounting for Doshi's intervention strategies for the TPB. Beta-testing of the app was hosted via an online software program. Testers were presented with a series of tasks and prompts followed by a 5-point Likert-scale questionnaire that quantitatively measured perceptions of the app's interactive design based on Jakob Nielsen's principles and behavioral strategies. A Net Promotor Score was calculated to determine the tester's likelihood to recommend the app prototype. Audio and video aspects of the app were qualitatively measured using a template approach.Results: Beta testers agreed the app met the majority of the five usability statements. The Net Promotor Score indicated a likelihood to recommend the app prototype. Thematic analyses revealed the following themes: interface design, navigation, terminology, information, and oral health promotion.Conclusion: Beta testing results from this study provided health promotion project design information for the prevention of ECC using the TPB and highlighted the importance and usability of smartphone app for oral health promotion.

Persuasive technology for health and wellness: State-of-the-art and emerging trends.

The evolving field of persuasive and behavior change technology is increasingly targeted at influencing behavior in the area of health and wellness. This paper provides an empirical review of 16 years (85 papers) of literature on persuasive technology for health and wellness to: (1.) answer important questions regarding the effectiveness of persuasive technology for health and wellness, (2.) summarize and highlight trends in the technology design, research methods, motivational strategies, theories, and health behaviors targeted by research to date, (3.) uncover pitfalls of existing persuasive technological interventions for health and wellness, and (4.) suggest directions for future research.

Towards a Comprehensive Conceptual Framework of Active Travel Behavior: a Review and Synthesis of Published Frameworks.

PURPOSE OF REVIEW: This paper reviews the use of conceptual frameworks in research on active travel, such as walking and cycling. Generic framework features and a wide range of contents are identified and synthesized into a comprehensive framework of active travel behavior, as part of the Physical Activity through Sustainable Transport Approaches project (PASTA). PASTA is a European multinational, interdisciplinary research project on active travel and health. RECENT FINDINGS: Along with an exponential growth in active travel research, a growing number of conceptual frameworks has been published since the early 2000s. Earlier frameworks are simpler and emphasize the distinction of environmental vs. individual factors, while more recently several studies have integrated travel behavior theories more thoroughly. Based on the reviewed frameworks and various behavioral theories, we propose the comprehensive PASTA conceptual framework of active travel behavior. We discuss how it can guide future research, such as data collection, data analysis, and modeling of active travel behavior, and present some examples from the PASTA project.