Predicting Factors on Modeling Health Behavior: A Systematic Review.

Objectives: In this study, we summarize current evidence on learning health behaviors through modeling, thereby offering greater insight into the predictors of modeling's effectiveness on health behavior change. Methods: We searched 5 electronic bases (PubMed, ProQuest New Platform, EBSCOHost, ERIC, and ScienceDirect) drawing on articles from January 1986 to April 2018. In addition, we performed follow-up searches of unique citations from identified articles. Results: Overall, our search identified 3339 articles. Based on inclusion and exclusion criteria, we reviewed 20 qualifying articles across 4 conditions of role modeling: attention, retention, motor reproduction, and motivation. Characteristics of role models and observers, use of technology to promote the modeling of health behavior, and use of peers as role models emerged as predictive factors related to attention; types of information and adherence to a specific timeframe were related to retention. Opportunity to practice a modeled health behavior and a specific timeframe to perform what was observed were key elements for motor reproduction. Support by significant others, self-efficacy, self-regulation, and policy incentives were predictive of sustained motivation. Conclusions: This review highlights several predictive factors in each situation in learning healthy behavior through role modeling. Identification and application of these factors may increase health behavior adoption.

Factors influencing healthy role models in medical school to conduct healthy behavior: a qualitative study.

OBJECTIVES: This study aimed to identify the factors that support or inhibit medical teachers as healthy role models in medical school to conduct healthy behavior. METHODS: This qualitative study involved semi-structured in-depth interviews with medical teachers categorized as healthy role models in a medical school from a previous survey. Ten medical teachers were selected using purposive sampling. Three medical teachers were interviewed by direct meetings, and the remaining were phone interviewed, with one interview facilitated by chat using WhatsApp. Transcribed interviews were coded openly. Themes were finalized through discussion and debate to reach a consensus. RESULTS: Two themes were identified: perceived facilitators and perceived barriers, which were classified into four categories and 13 subcategories: intrinsic facilitators (motivation, conscious awareness, having physical limitations, knowledge, and economic reasons); extrinsic facilitators (the impact on doing a particular job, feedback, time, and environment); intrinsic barriers (the lack of self-motivation and having physical limitations); and extrinsic barriers (the burden of responsibilities for being medical teachers and environment). CONCLUSIONS: Factors that support and inhibit medical teachers as healthy role models in medical school are influenced by intrinsic and extrinsic factors. This result could be used by medical schools to design appropriate interventions to help medical teachers as healthy role models in conducting healthy behavior. More studies are needed to explore other factors that influence medical teachers to conduct healthy behavior. During the COVID-19 pandemic, healthy role models in medical schools are vitally important and significantly contribute to the overall health of a nation.

Defining a "Healthy Role-Model" for Medical Schools: Learning Components That Count.

INTRODUCTION: Producing healthy physicians who act as a "healthy role-model" in their environment must be one of the concerns of medical schools today in response to the global movement of "health-promoting university" by the WHO (1995). However, no publications explained the "healthy role-model" in medical school. This study aimed to fill this gap by exploring the definition and characteristics of a "healthy role-model" for medical teachers. METHODS: We used a grounded theory approach with in-depth interviews and e-mail communications to 48 medical teachers from various backgrounds of "health professions education," "health education and behavior"/'health education and promoter,' "general practitioners/family medicine," "adolescent health," "internal medicine," and "cardiology-vascular medicine." The medical teachers were from Indonesia, one other developing country (Bangladesh), and five developed countries (United States of America, Canada, Netherlands, Australia, and United Kingdom). We also invited 19 medical students from Indonesia for three focus group discussions. RESULTS: We identified four categories to define a "healthy role-model" for medical schools as persons who are seen: 1) "physically," "socially," "mentally", and "spiritually" healthy; 2) internalized healthy behaviors; 3) willing to promote healthy lifestyles; and, 4) a life-long learner. In each category, there are several characteristics discussed. CONCLUSION: Our study provides some insights to define a "healthy role-model" of medical teachers by using the characteristics of healthy people and adult learners. The first category describes the characteristics of healthy people, but cultural issues influence the perspectives of medical teachers to define a "healthy role-model" for medical schools.

Variola virus IL-18 binding protein interacts with three human IL-18 residues that are part of a binding site for human IL-18 receptor alpha subunit.

Interleukin-18 (IL-18) plays an important role in host defense against microbial pathogens. Many poxviruses encode homologous IL-18 binding proteins (IL-18BP) that neutralize IL-18 activity. Here, we examined whether IL-18BP neutralizes IL-18 activity by binding to the same region of IL-18 where IL-18 receptor (IL-18R) binds. We introduced alanine substitutions to known receptor binding sites of human IL-18 and found that only the substitution of Leu5 reduced the binding affinity of IL-18 with IL-18BP of variola virus (varvIL-18BP) by more than 4-fold. The substitutions of Lys53 and Ser55, which were not previously known to be part of the receptor binding site but that are spatially adjacent to Leu5, reduced the binding affinity to varvIL-18BP by approximately 100- and 7-fold, respectively. These two substitutions also reduced the binding affinity with human IL-18R alpha subunit (hIL-18Ralpha) by 4- and 2-fold, respectively. Altogether, our data show that varvIL-18BP prevents IL-18 from binding to IL-18R by interacting with three residues that are part of the binding site for hIL-18Ralpha.