The role of native language and beat perception ability in the perception of speech rhythm : Native language, beat perception, and speech rhythm perception.

The perception of rhythm has been studied across a range of auditory signals, with speech presenting one of the particularly challenging cases to capture and explain. Here, we asked if rhythm perception in speech is guided by perceptual biases arising from native language structures, if it is shaped by the cognitive ability to perceive a regular beat, or a combination of both. Listeners of two prosodically distinct languages - English and French - heard sentences (spoken in their native and the foreign language, respectively) and compared the rhythm of each sentence to its drummed version (presented at inter-syllabic, inter-vocalic, or isochronous intervals). While English listeners tended to map sentence rhythm onto inter-vocalic and inter-syllabic intervals in this task, French listeners showed a perceptual preference for inter-vocalic intervals only. The native language tendency was equally apparent in the listeners' foreign language and was enhanced by individual beat perception ability. These findings suggest that rhythm perception in speech is shaped primarily by listeners' native language experience with a lesser influence of innate cognitive traits.

Perception of temporal structure in speech is influenced by body movement and individual beat perception ability.

The subjective experience of time flow in speech deviates from the sound acoustics in substantial ways. The present study focuses on the perceptual tendency to regularize time intervals found in speech but not in other types of sounds with a similar temporal structure. We investigate to what extent individual beat perception ability is responsible for perceptual regularization and if the effect can be eliminated through the involvement of body movement during listening. Participants performed a musical beat perception task and compared spoken sentences to their drumbeat-based versions either after passive listening or after listening and moving along with the beat of the sentences. The results show that the interval regularization prevails in listeners with a low beat perception ability performing a passive listening task and is eliminated in an active listening task involving body movement. Body movement also helped to promote a veridical percept of temporal structure in speech at the group level. We suggest that body movement engages an internal timekeeping mechanism, promoting the fidelity of auditory encoding even in sounds of high temporal complexity and irregularity such as natural speech.

The health communication orientations scale: Development and two-country validation of a questionnaire that measures health communication style preferences.

OBJECTIVE: Self-Determination Theory posits that everyone has a basic need for autonomy that needs to be fulfilled to establish autonomous motivation for health behavior (change). Regardless, individual differences exist in health communication style preferences. This paper outlines the development and validation of the Health Communication Orientations Scale (HCOS), a new measure to assess these preferences. METHODS: Nationally representative online panels from the US (n = 603) and the Netherlands (n = 737) completed a survey containing the HCOS, established motivational measures, and demographic questions. RESULTS: Factor analyses identified five subscales valid for both populations: HCOS (1) Expert, (2) Others, (3) Self, (4) Oppositional, and (5) Internet. Scores for Expert and Internet were higher in the US sample; Others, Self, and Oppositional were higher in the Dutch sample. Internal reliability for the five factors was high across samples (range 0.84-0.91). Many significant correlations with established measures were observed in both samples indicating the construct validity of the scale. CONCLUSION: The HCOS subscales have strong psychometric properties. PRACTICE IMPLICATIONS: The HCOS represents a novel approach to assessing communication style preferences for general and patient populations. Further investigation in how the HCOS may be used to tailor health messaging is warranted.

Testing an acoustic model of the P-center in English and Japanese.

The notion of the "perceptual center" or the "P-center" has been put forward to account for the repeated finding that acoustic and perceived syllable onsets do not necessarily coincide, at least in the perception of simple monosyllables or disyllables. The magnitude of the discrepancy between acoustics and perception-the location of the P-center in the speech signal- has proven difficult to estimate, though acoustic models of the effect do exist. The present study asks if the P-center effect can be documented in natural connected speech of English and Japanese and examines if an acoustic model that defines the P-center as the moment of the fastest energy change in a syllabic amplitude envelope adequately reflects the P-center in the two languages. A sensorimotor synchronization paradigm was deployed to address the research questions. The results provide evidence for the existence of the P-center effect in speech of both languages while the acoustic P-center model is found to be less applicable to Japanese. Sensorimotor synchronization patterns further suggest that the P-center may reflect perceptual anticipation of a vowel onset.

Evidence for a universal association of auditory roughness with musical stability.

We provide evidence that the roughness of chords-a psychoacoustic property resulting from unresolved frequency components-is associated with perceived musical stability (operationalized as finishedness) in participants with differing levels and types of exposure to Western or Western-like music. Three groups of participants were tested in a remote cloud forest region of Papua New Guinea (PNG), and two groups in Sydney, Australia (musicians and non-musicians). Unlike prominent prior studies of consonance/dissonance across cultures, we framed the concept of consonance as stability rather than as pleasantness. We find a negative relationship between roughness and musical stability in every group including the PNG community with minimal experience of musical harmony. The effect of roughness is stronger for the Sydney participants, particularly musicians. We find an effect of harmonicity-a psychoacoustic property resulting from chords having a spectral structure resembling a single pitched tone (such as produced by human vowel sounds)-only in the Sydney musician group, which indicates this feature's effect is mediated via a culture-dependent mechanism. In sum, these results underline the importance of both universal and cultural mechanisms in music cognition, and they suggest powerful implications for understanding the origin of pitch structures in Western tonal music as well as on possibilities for new musical forms that align with humans' perceptual and cognitive biases. They also highlight the importance of how consonance/dissonance is operationalized and explained to participants-particularly those with minimal prior exposure to musical harmony.

Self-determination theory and the smoking cessation process: Daily electronic self-reports can identify the initiation of quit attempts.

OBJECTIVES: To examine the motivational predictors of the smoking cessation process at the between-persons and within-persons levels. METHODS: Mediation analyses were conducted on self-report data (N = 236) that were collected using interval contingent sampling over a 39-day study period. RESULTS: There was a high rate of attrition, as nearly 50% of participants were lost to follow-up. There were credible indirect effects of autonomous self-regulation on smoking behavior on the next day and seven-day abstinence through perceived competence and medication use. At the between-persons level, these models explained 17% of the variance in smoking behavior on the next day and 31% of the variance in seven-day abstinence; at the within-persons level, these estimates were 39% and 57%, respectively. CONCLUSIONS: Day-to-day changes in autonomous self-regulation, perceived competence, and medication use are important initiators of the smoking cessation process. PRACTICE IMPLICATIONS: Smokers might be more likely to make a quit attempt if practitioners "tune into" the day-to-day fluctuations of their patients' motivation for stopping smoking, perhaps using an electronic platform to assess and compare smokers' current reports to their previous experiences. Such "motivational attunement" can afford practitioners an opportunity to provide need support when patients are willing and able to initiate a quit attempt.

Using a complexity science approach to evaluate the effectiveness of just-in-time adaptive interventions: A meta-analysis.

Objective: Just-in-time adaptive interventions (JITAIs), which allow individuals to receive the right amount of tailored support at the right time and place, hold enormous potential for promoting behavior change. However, research on JITAIs' implementation and evaluation is still in its early stages, and more empirical evidence is needed. This meta-analysis took a complexity science approach to evaluate the effectiveness of JITAIs that promote healthy behaviors and assess whether key design principles can increase JITAIs' impacts. Methods: We searched five databases for English-language papers. Study eligibility required that interventions objectively measured health outcomes, had a control condition or pre-post-test design, and were conducted in the real-world setting. We included randomized and non-randomized trials. Data extraction encompassed interventions' features, methodologies, theoretical foundations, and delivery modes. RoB 2 and ROBINS-I were used to assess risk of bias. Results: The final analysis included 21 effect sizes with 592 participants. All included studies used pre- and post-test design. A three-level random meta-analytic model revealed a medium effect of JITAIs on objective behavior change (g = 0.77 (95% confidence interval (CI); 0.32 to 1.22), p < 0.001). The summary effect was robust to bias. Moderator analysis indicated that design principles, such as theoretical foundations, targeted behaviors, and passive or active assessments, did not moderate JITAIs' effects. Passive assessments were more likely than a combination of passive and active assessments to relate to higher intervention retention rates. Conclusions: This review demonstrated some evidence for the efficacy of JITAIs. However, high-quality randomized trials and data on non-adherence are needed.

Is the uptake, engagement, and effectiveness of exclusively mobile interventions for the promotion of weight-related behaviors equal for all? A systematic review.

Mobile health interventions are promising behavior change tools. However, there is a concern that they may benefit some populations less than others and thus widen inequalities in health. This systematic review investigated differences in uptake of, engagement with, and effectiveness of mobile interventions for weight-related behaviors (i.e., diet, physical activity, and sedentary behavior) based on a range of inequality indicators including age, gender, race/ethnicity, and socioeconomic status. The protocol was registered on PROSPERO (CRD42020192473). Six databases (CINAHL, EMBASE, ProQuest, PsycINFO, Pubmed, and Web of Science) were searched from inception to July 2021. Publications were eligible for inclusion if they reported the results of an exclusively mobile intervention and examined outcomes by at least one inequality indicator. Sixteen publications reporting on 13 studies were included with most reporting on multiple behaviors and inequality indicators. Uptake was investigated in one study with no differences reported by the inequality indicators studied. Studies investigating engagement (n = 7) reported differences by age (n = 1), gender (n = 3), ethnicity (n = 2), and education (n = 2), while those investigating effectiveness (n = 9) reported differences by age (n = 3), gender (n = 5), education (n = 2), occupation (n = 1), and geographical location (n = 1). Given the limited number of studies and their inconsistent findings, evidence of the presence of a digital divide in mobile interventions targeting weight-related behaviors is inconclusive. Therefore, we recommend that inequality indicators are specifically addressed, analyzed, and reported when evaluating mobile interventions.

Using tailored eHealth programmes to stimulate primary health care professionals' lifestyle counselling guideline adherence - Lessons learned from the STAR project.

BACKGROUND: Although individually tailored eHealth programmes have shown to be effective in changing patient and citizen health behaviours, they have so far not been applied to lifestyle counselling guideline adherence in primary health care professionals beyond our STAR project. The programme aimed to support general practice nurses adhering to national smoking cessation counselling guidelines and showed encouraging positive impacts on both nurse and patient level. OBJECTIVE: To identify lessons learned from our successful application of a tailored eHealth programme in primary health care. METHODS: Triangulation of information from different sources collected throughout the project run time (e.g., project meetings, discussions with experts in the fields of computer tailoring, smoking cessation and professional education and interactions with general practice nurses). RESULTS: We identify four lessons learned which developers and testers of tailored eHealth programmes in primary health care should consider, relating to 1) Choosing outcome measures, 2) Measuring outcomes, 3) Practical feedback application & Programme accessibility, and 4) Programme interaction. PRACTICE IMPLICATIONS: We share this information in the hope that we will see more applications of this promising intervention strategy - that can build on our work - in the future.

Profiling Cancer Patients Based on Their Motives for Seeking Informational and Emotional Support Online.

Understanding why patients seek informational and/or emotional support online is fundamental to providing patients with accurate and reliable support that is tailored to their needs, preferences, and personal situation. Based on the stress and coping theory and uses and gratifications theory (UGT), this study aimed to identify theoretically-founded profiles of cancer patients differing in their motives for seeking informational and/or emotional support online, and to compare the profiles in terms of patients' psychological and background characteristics, and perception of health care services. Hierarchical cluster analysis was conducted, using questionnaire data from patients visiting a large Dutch health website (N = 181). This revealed three distinctive profiles, i.e., overall seekers (n = 83, 46.0%), occasional information seekers (n = 83, 46.0%), and contact exchangers (n = 15, 8.0%). Patients across these profiles differed in their eHealth literacy, with the contact exchangers being more eHealth literate than the overall seekers and occasional information seekers. The results can be used to create awareness among health care providers, web designers, and patient organizations on different types of cancer patients with different motives for seeking informational and/or emotional support online, and help them to tailor recommendations to and development of (online) sources that fit patients' needs. Future research could further investigate the integration of stress and coping theory with UGT by acknowledging the interplay of different coping strategies and different gratifications.

Active Ingredients of Interventions Improving Smoking Cessation Support by Dutch Primary Care Providers: A Systematic Review.

The objective was to assess active ingredients, change mechanisms, and fidelity in interventions aiming to increase the quality of smoking cessation care in the Dutch primary healthcare setting. We conducted a systematic review searching five scientific databases on August 2nd, 2019, updated on October 28th, 2021. We included effect data of behavioural interventions aiming at improving the provision of smoking cessation support by Dutch primary care providers to their patients. We excluded studies published before 2000 and those without a behavioural support intervention for primary care providers targeting smoking cessation in their patients. We found 1939 articles and included 15 distinct interventions in the review. We provided an overview of study characteristics, intervention effects, fidelity, active ingredients and change mechanisms using the Behaviour Change Techniques (BCT) Taxonomy and Mechanisms of Action (MoAs) protocols. Interventions seemed more effective when including a face-to-face component, using active learning strategies and providing a tool to help follow the guidelines in practice (e.g., physical cards with information). BCTs, MoAs, and fidelity were overall poorly reported on. To support the application of smoking cessation practices in Dutch primary care, we recommend implementation of face-to-face training programs incorporating active skill training elements combined with practical tools.

Explaining L2 Lexical Learning in Multiple Scenarios: Cross-Situational Word Learning in L1 Mandarin L2 English Speakers.

Adults commonly struggle with perceiving and recognizing the sounds and words of a second language (L2), especially when the L2 sounds do not have a counterpart in the learner's first language (L1). We examined how L1 Mandarin L2 English speakers learned pseudo English words within a cross-situational word learning (CSWL) task previously presented to monolingual English and bilingual Mandarin-English speakers. CSWL is ambiguous because participants are not provided with direct mappings of words and object referents. Rather, learners discern word-object correspondences through tracking multiple co-occurrences across learning trials. The monolinguals and bilinguals tested in previous studies showed lower performance for pseudo words that formed vowel minimal pairs (e.g., /dit/-/dɪt/) than pseudo word which formed consonant minimal pairs (e.g., /bɔn/-/pɔn/) or non-minimal pairs which differed in all segments (e.g., /bɔn/-/dit/). In contrast, L1 Mandarin L2 English listeners struggled to learn all word pairs. We explain this seemingly contradicting finding by considering the multiplicity of acoustic cues in the stimuli presented to all participant groups. Stimuli were produced in infant-directed-speech (IDS) in order to compare performance by children and adults and because previous research had shown that IDS enhances L1 and L2 acquisition. We propose that the suprasegmental pitch variation in the vowels typical of IDS stimuli might be perceived as lexical tone distinctions for tonal language speakers who cannot fully inhibit their L1 activation, resulting in high lexical competition and diminished learning during an ambiguous word learning task. Our results are in line with the Second Language Linguistic Perception (L2LP) model which proposes that fine-grained acoustic information from multiple sources and the ability to switch between language modes affects non-native phonetic and lexical development.

Effects of an Explicit Value Clarification Method With Computer-Tailored Advice on the Effectiveness of a Web-Based Smoking Cessation Decision Aid: Findings From a Randomized Controlled Trial.

BACKGROUND: Smoking continues to be a driver of mortality. Various forms of evidence-based cessation assistance exist; however, their use is limited. The choice between them may also induce decisional conflict. Offering decision aids (DAs) may be beneficial; however, insights into their effective elements are lacking. OBJECTIVE: This study tested the added value of an effective element (ie, an "explicit value clarification method" paired with computer-tailored advice indicating the most fitting cessation assistance) of a web-based smoking cessation DA. METHODS: A web-based randomized controlled trial was conducted among smokers motivated to stop smoking within 6 months. The intervention group received a DA with the aforementioned elements, and the control group received the same DA without these elements. The primary outcome measure was 7-day point prevalence abstinence 6 months after baseline (time point 3 [t=3]). Secondary outcome measures were 7-day point prevalence of abstinence 1 month after baseline (time point 2 [t=2]), evidence-based cessation assistance use (t=2 and t=3), and decisional conflict (immediately after DA; time point 1). Logistic and linear regression analyses were performed to assess the outcomes. Analyses were conducted following 2 (decisional conflict) and 3 (smoking cessation) outcome scenarios: complete cases, worst-case scenario (assuming that dropouts still smoked), and multiple imputations. A priori sample size calculation indicated that 796 participants were needed. The participants were mainly recruited on the web (eg, social media). All the data were self-reported. RESULTS: Overall, 2375 participants were randomized (intervention n=1164, 49.01%), of whom 599 (25.22%; intervention n=275, 45.91%) completed the DAs, and 276 (11.62%; intervention n=143, 51.81%), 97 (4.08%; intervention n=54, 55.67%), and 103 (4.34%; intervention n=56, 54.37%) completed time point 1, t=2, and t=3, respectively. More participants stopped smoking in the intervention group (23/63, 37%) than in the control group (14/52, 27%) after 6 months; however, this was only statistically significant in the worst-case scenario (crude P=.02; adjusted P=.04). Effects on the secondary outcomes were only observed for smoking abstinence after 1 month (15/55, 27%, compared with 7/46, 15%, in the crude and adjusted models, respectively; P=.02) and for cessation assistance uptake after 1 month (26/56, 46% compared with 18/47, 38% only in the crude model; P=.04) and 6 months (38/61, 62% compared with 26/50, 52%; crude P=.01; adjusted P=.02) but only in the worst-case scenario. Nonuse attrition was 34.19% higher in the intervention group than in the control group (P<.001). CONCLUSIONS: Currently, we cannot confidently recommend the inclusion of explicit value clarification methods and computer-tailored advice. However, they might result in higher nonuse attrition rates, thereby limiting their potential. As a lack of statistical power may have influenced the outcomes, we recommend replicating this study with some adaptations based on the lessons learned. TRIAL REGISTRATION: Netherlands Trial Register NL8270; https://www.trialregister.nl/trial/8270. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/21772.

Emotional responses in Papua New Guinea show negligible evidence for a universal effect of major versus minor music.

Music is a vital part of most cultures and has a strong impact on emotions [1-5]. In Western cultures, emotive valence is strongly influenced by major and minor melodies and harmony (chords and their progressions) [6-13]. Yet, how pitch and harmony affect our emotions, and to what extent these effects are culturally mediated or universal, is hotly debated [2, 5, 14-20]. Here, we report an experiment conducted in a remote cloud forest region of Papua New Guinea, across several communities with similar traditional music but differing levels of exposure to Western-influenced tonal music. One hundred and seventy participants were presented with pairs of major and minor cadences (chord progressions) and melodies, and chose which of them made them happier. The experiment was repeated by 60 non-musicians and 19 musicians in Sydney, Australia. Bayesian analyses show that, for cadences, there is strong evidence that greater happiness was reported for major than minor in every community except one: the community with minimal exposure to Western-like music. For melodies, there is strong evidence that greater happiness was reported for those with higher mean pitch (major melodies) than those with lower mean pitch (minor melodies) in only one of the three PNG communities and in both Sydney groups. The results show that the emotive valence of major and minor is strongly associated with exposure to Western-influenced music and culture, although we cannot exclude the possibility of universality.

Music Perception Abilities and Ambiguous Word Learning: Is There Cross-Domain Transfer in Nonmusicians?

Perception of music and speech is based on similar auditory skills, and it is often suggested that those with enhanced music perception skills may perceive and learn novel words more easily. The current study tested whether music perception abilities are associated with novel word learning in an ambiguous learning scenario. Using a cross-situational word learning (CSWL) task, nonmusician adults were exposed to word-object pairings between eight novel words and visual referents. Novel words were either non-minimal pairs differing in all sounds or minimal pairs differing in their initial consonant or vowel. In order to be successful in this task, learners need to be able to correctly encode the phonological details of the novel words and have sufficient auditory working memory to remember the correct word-object pairings. Using the Mistuning Perception Test (MPT) and the Melodic Discrimination Test (MDT), we measured learners' pitch perception and auditory working memory. We predicted that those with higher MPT and MDT values would perform better in the CSWL task and in particular for novel words with high phonological overlap (i.e., minimal pairs). We found that higher musical perception skills led to higher accuracy for non-minimal pairs and minimal pairs differing in their initial consonant. Interestingly, this was not the case for vowel minimal pairs. We discuss the results in relation to theories of second language word learning such as the Second Language Perception model (L2LP).

Message Frame-Tailoring in Digital Health Communication: Intervention Redesign and Usability Testing.

BACKGROUND: Message frame-tailoring based on the need for autonomy is a promising strategy to improve the effectiveness of digital health communication interventions. An example of a digital health communication intervention is Personal Advice in Stopping smoking (PAS), a web-based content-tailored smoking cessation program. PAS was effective in improving cessation success rates, but its effect sizes were small and disappeared after 6 months. Therefore, investigating whether message frame-tailoring based on the individual's need for autonomy might improve effect rates is worthwhile. However, to our knowledge, this has not been studied previously. OBJECTIVE: To investigate whether adding message frame-tailoring based on the need for autonomy increases the effectiveness of content-tailored interventions, the PAS program was redesigned to incorporate message frame-tailoring also. This paper described the process of redesigning the PAS program to include message frame-tailoring, providing smokers with autonomy-supportive or controlling message frames-depending on their individual need for autonomy. Therefore, we aimed to extend framing theory, tailoring theory, and self-determination theory. METHODS: Extension of the framing theory, tailoring theory, and self-determination theory by redesigning the PAS program to include message frame-tailoring was conducted in close collaboration with scientific and nonscientific smoking cessation experts (n=10), smokers (n=816), and communication science students (n=19). Various methods were used to redesign the PAS program to include message frame-tailoring with optimal usability: usability testing, think-aloud methodology, heuristic evaluations, and a web-based experiment. RESULTS: The most autonomy-supportive and controlling message frames were identified, the cutoff point for the need for autonomy to distinguish between people with high and those with low need for autonomy was determined, and the usability was optimized. CONCLUSIONS: This resulted in a redesigned digital health communication intervention that included message frame-tailoring and had optimal usability. A detailed description of the redesigning process of the PAS program is provided. TRIAL REGISTRATION: Netherlands Trial Register NL6512 (NRT6700); https://www.trialregister.nl/trial/6512.

An economic evaluation of an online computer-tailored smoking cessation intervention that includes message frame-tailoring: A randomized controlled trial.

Evidence of economic evaluations of behaviour change interventions is scarce, but needed to guide policy makers' decision-making. This study economically evaluated 4 versions of an innovative online computer-tailored smoking cessation intervention. The economic evaluation from a societal perspective was embedded in a randomized controlled trial among 532 smokers using a 2 (message frame-tailoring, i.e. how messages are presented: autonomy-supportive vs controlling) x 2 (content-tailoring, i.e. what content is presented: tailored vs. generic) design. Both kinds of tailoring, content-tailoring and message frame-tailoring, were based on a set of questions asked at baseline. Self-reported costs, prolonged smoking abstinence (cost-effectiveness) and quality of life (cost-utility) were assessed during a 6-month-follow-up. For cost-effectiveness analysis, costs per abstinent smoker were calculated. For cost-utility analysis, costs per QALY (i.e. quality-adjusted life year) gained were calculated. A willingness-to-pay (WTP) threshold of €20.000 was used. Bootstrapping and sensitivity analysis were conducted. Cost-effectiveness analysis showed that up to a WTP of €2.000, the combination of message frame- and content-tailoring dominated all study groups. From a WTP of €2.005, the content-tailored group dominated all study groups. Cost-utility analysis revealed that the combination of message frame-tailoring and content-tailoring had the highest probability of being the most efficient study group at all levels of the WTP. The combination of message frame-tailoring and content-tailoring in online smoking cessation programmes seemed to have high potential for cost-effectiveness (smoking abstinence) and cost-utility (quality of life), thus providing good value for money. Yet, when the WTP for each abstinent smoker is high (i.e., €2.005 or higher), the addition of message frame-tailoring might not be worth the effort and content-tailoring only is preferred.

Identifying Active Ingredients, Working Mechanisms, and Fidelity Characteristics Reported in Smoking Cessation Interventions in Dutch Primary Care: A Systematic Review.

BACKGROUND: Evidence-based smoking cessation interventions provided by healthcare professionals can be successful in helping citizens to quit smoking. Yet, evidence is needed about the active ingredients of these interventions, how these ingredients work and how they are implemented in practice. Such knowledge is required to effectively support healthcare professionals to optimally put evidence-based smoking cessation interventions to (inter)national practice. OBJECTIVE: To identify active ingredients (including behavior change techniques), mechanisms of action and implementation fidelity reported in smoking cessation interventions in Dutch primary care settings and to relate these to intervention effectiveness. METHODS: A systematic review was conducted by searching nine national intervention or funding databases, five international scientific databases and consulting 17 national smoking cessation experts. Out of 1066 identified manuscripts, 40 interventions were eligible for this review. Based on published protocols, information regarding behavior change techniques and mechanisms of action was systematically abstracted. Additionally, information regarding study characteristics and other active ingredients, effects on smoking behavior and implementation fidelity was abstracted. Comparative effectiveness concerning abstracted intervention characteristics was qualitatively explored. RESULTS: Active ingredients, mechanisms of action and implementation fidelity were moderately to poorly reported. Interventions applying behavior change techniques and interventions with a single behavioral target (i.e. smoking-only versus multiple behaviors) seemed to provide stronger evidence for successfully changing smoking behavior. CONCLUSION: Attention to and reporting on interventions' active ingredients (e.g. behavior change techniques), mechanisms of action and implementation fidelity are prerequisites for developing more effective evidence-based smoking cessation interventions to be successfully implemented in primary healthcare. IMPLICATIONS: This systematic review provides an overview of smoking cessation interventions in Dutch primary care settings, identified since the year 2000. Smoking cessation support is offered in various forms, but our qualitative findings show that interventions including more behavior change techniques and interventions targeting only smoking cessation (compared to multiple behaviors) might be more effective. Results also show that-based on available intervention reports-it is difficult to distinguish patterns of active ingredients (such as behavior change techniques), mechanisms of action and fidelity of implementation in relation to interventions' effectiveness. This means (quality of) reporting on these intervention characteristics should improve.

Integrating behaviour change interventions and patient decision aids: How to accomplish synergistic effects?

People make numerous health-related choices each day: For example, deciding to brush one's teeth or to eat well and healthy - or not to do these activities. To support complex decisions and subsequent behaviour change, both Behaviour Change Interventions (BCIs) and Patient Decision Aids (PtDAs) have been developed and evolved independently to support people in health-related decision making. In this paper, we critically review BCIs and PtDAs, examine their similarities and differences, and identify potential for integration of expertise to increase the benefits for people engaging with healthcare and health behaviours. The two approaches appear to mainly differ in terms of their (1) goals and foci, (2) theoretical basis, (3) development frameworks, (4) active ingredients and (5) effect evaluation. To facilitate the integration of scientific insights from these two fields, we recommend to (1) bring both fields together and promote interprofessional discussions, (2) train (health) professionals to recognise strengths of both approaches, (3) investigate the synergy of the two fields, (4) be prepared for and try to mitigate a culture shock when the fields start to interact. Knowledge generated by researching PtDAs could be used to facilitate decisional processes that enable patients to choose goals that are in line with their values and preferences, while insights from researching BCIs could be used to facilitate engagement with, and implementation of those goals. This integration could allow researchers and intervention providers to increase the benefits for people engaging with healthcare and health behaviours.

Inter-rater reliability and test-retest reliability of the Performance and Fitness (PERF-FIT) test battery for children: a test for motor skill related fitness.

BACKGROUND: The Performance and Fitness (PERF-FIT) test battery for children is a recently developed, valid assessment tool for measuring motor skill-related physical fitness in 5 to 12-year-old children living in low-income settings. The aim of this study was to determine: (1) inter-rater reliability and (2) test-retest reliability of the PERF-FIT in children from 3 different countries (Ghana, South Africa and the Netherlands). METHOD: For inter-rater reliability 29 children, (16 boys and 13 girls, 6-10 years) were scored by 2 raters simultaneously. For test-retest reliability 72 children, (33 boys and 39 girls, 5-12 years) performed the test twice, minimally 1 week and maximally 2 weeks apart. Relative and absolute reliability indices were calculated. ANOVA was used to examine differences between the three assessor teams in the three countries. RESULTS: The PERF-FIT demonstrated excellent inter-rater reliability (ICC, 0.99) and good test-retest reliability (ICC, ≥ 0.80) for 11 of the 12 tasks, with a poor ICC for the Jumping item, due to low spread in values. A significant difference between first and second test occasion was present on half of the items, but the differences were small (Cohen's d 0.01-0.17), except for Stepping, Side jump and Bouncing and Catching (Cohen's d 0.34, 0.41 and 0.33, respectively). Overall, measurement error, Limits of Agreement and Coefficient of Variation had acceptable levels to support clinical use. No systematic dissimilarities in error were found between first and second measurement between the three countries but for one item (Overhead throw). CONCLUSIONS: The PERF-FIT can reliably measure motor skill related fitness in 5 to 12-year-old children in different settings and help clinicians monitor levels of fundamental motor skills (throwing, bouncing, catching, jumping, hopping and balance), power and agility.