On the stability of norms and norm-following propensity: a cross-cultural panel study with adolescents.

Norm-based accounts of social behavior in economics typically reflect tradeoffs between maximization of own consumption utility and conformity to social norms. Theories of norm-following tend to assume that there exists a single, stable, commonly known injunctive social norm for a given choice setting and that each person has a stable propensity to follow social norms. We collect panel data on 1468 participants aged 11-15 years in Belfast, Northern Ireland and Bogotá, Colombia in which we measure norms for the dictator game and norm-following propensity twice at 10 weeks apart. We test these basic assumptions and find that norm-following propensity is stable, on average, but reported norms show evidence of change. We find that individual-level variation in reported norms between people and within people across time has interpretable structure using a series of latent transition analyses (LTA) which extend latent class models to a panel setting. The best fitting model includes five latent classes corresponding to five sets of normative beliefs that can be interpreted in terms of what respondents view as "appropriate" (e.g. equality vs. generosity) and how they view deviations (e.g. deontological vs. consequentialist). We also show that a major predictor of changing latent classes over time comes from dissimilarity to others in one's network. Our application of LTA demonstrates how researchers can engage with heterogeneity in normative perceptions by identifying latent classes of beliefs and deepening understanding of the extent to which norms are shared, stable, and can be predicted to change. Finally, we contribute to the nascent experimental literature on the economic behavior of children and adolescents. Supplementary Information: The online version contains supplementary material available at 10.1007/s10683-024-09821-5.

Effect of 20 mph speed limits on traffic injuries in Edinburgh, UK: a natural experiment and modelling study.

INTRODUCTION: There is limited research evaluating 20 mph speed limit interventions, and long-term assessments are seldom conducted either globally or within the UK. This study evaluated the impact of the phased 20 mph speed limit implementation on road traffic collisions and casualties in the City of Edinburgh, UK over approximately 3 years post implementation. METHODS: We used four sets of complementary analyses for collision and casualty rates. First, we compared rates for road segments changing to 20 mph against those at 30 mph. Second, we compared rates for the seven implementation zones in the city against paired control zones. Third, we investigated citywide casualty rate trends using generalised additive model. Finally, we used simulation modelling to predict casualty rate changes based on changes in observed speeds. RESULTS: We found a 10% (95% CI -19% to 0%) greater reduction in casualties (8% for collisions) for streets that changed to 20 mph compared with those staying at 30 mph. However, the reduction was similar, 8% (95% CI -22% to 5%) for casualties (10% collisions), in streets that were already at 20 mph. In the implementation zones, we found a 20% (95% CI -22% to -8%) citywide reduction in casualties (22% for collisions) compared with control zones; this compared with a predicted 10% (95% CI -18% to -2%) reduction in injuries based on the changes in speed and traffic volume. Citywide casualties dropped 17% (95% CI 13% to 22%) 3 years post implementation, accounting for trend. CONCLUSION: Our results indicate that the introduction of 20 mph limits resulted in a reduction in collisions and casualties 3 years post implementation. However, the effect exceeded expectations from changes in speed alone, possibly due to a wider network effect.

A comparison of content from across contemporary Australian population health surveys.

OBJECTIVE: Associations between place and population health are of interest to researchers and policymakers. The objective of this paper is to explore, summarise and compare content across contemporary Australian geo-referenced population health survey data sets. METHODS: A search for recent (2015 or later) population health surveys from within Australia containing geographic information from participants was conducted. Survey response frames were analysed and categorised based on demographic, risk factor and disease-related characteristics. Analysis using interactive Sankey diagrams shows the extent of content overlap and differences between population health surveys in Australia. RESULTS: Thirteen Australian geo-referenced population health survey data sets were identified. Information captured across surveys was inconsistent as was the spatial granularity of respondent information. Health and demographic features most frequently captured were symptoms, signs and clinical findings from the International Statistical Classification of Diseases and Related Health Problems version 11, employment, housing, income, self-rated health and risk factors, including alcohol consumption, diet, medical treatments, physical activity and weight-related questions. Sankey diagrams were deployed online for use by public health researchers. CONCLUSIONS: Identifying the relationship between place and health in Australia is made more difficult by inconsistencies in information collected across surveys deployed in different regions in Australia. IMPLICATIONS FOR PUBLIC HEALTH: Public health research investigating place and health involves a vast and inconsistent patchwork of information within and across states, which may impact broad-scale research questions. The tools developed here assist public health researchers to identify surveys suitable for their research queries related to place and health.

UK Nurses Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study.

There are a multitude of health benefits gained from regular physical activity (PA). Currently, PA advice implementation from NHS nurses is inadequate despite their ever-increasing role in lifestyle and preventive medicine. By assessing their knowledge of current PA guidance, this study proposed to investigate the issues with regular PA advice being given and expand upon nurses' proposed barriers and solutions. A qualitative approach using semi structured interviews was undertaken between March and August 2023 involving 13 NHS nurses. Thematic analysis was undertaken using Braun and Clarke's six step approach. Four themes and fifteen subthemes emerged as barriers and solutions in delivering PA advice. Intrinsic barriers included a lack of nurse knowledge on the topic and PA being seen as an afterthought. Extrinsic barriers included time pressures and a lack of staff engagement. Solutions involved increasing staff awareness of guidelines through teaching, policy, encouraging staff to be active and optimising PA advice delivery through a piecemeal approach and utilising online and visual resources. This study displayed an insight into nurses' thoughts on their consultations with patients regarding PA, and proposed several barriers and solutions. Further work is needed to improve nurses' PA knowledge and to assess the proposed strategies to improve its delivery.

Association between friendship quality and subjective wellbeing in adolescents: a cross-sectional observational study.

BACKGROUND: Friendships play a vital role in the social lives of teenagers, and friendship quality can substantially impact the adolescents' overall health and wellbeing. This study aimed to investigate the association between friendship quality and subjective wellbeing in Northern Irish adolescents. METHODS: In this cross-sectional observational study, we used data from the second wave of the Wellbeing in Schools Survey, conducted in Northern Ireland from April 2 to May 31, 2018. This survey used a clustering sampling method and included students aged 15-19 years. The survey was approved by the School of Social Sciences, Education and Social Work's Research Ethics Committee, with pupil opt-in and parental opt-out consents. Participants from the survey's initial wave in 2016 were considered eligible. Data on friendship quality and classroom friendships were gathered. Subjective wellbeing was assessed using the 7-item Short Warwick-Edinburgh Mental Wellbeing Scale. Metrics for psychological wellbeing (6 items), mood (7 items), and friendship quality (6 items) were taken from the KIDSCREEN-52 questionnaire. All items were rated on a 1-5 point Likert scale. We examined the association between friendship network quality and subjective wellbeing outcomes through social network analysis and network autocorrelation modelling. FINDINGS: Of 1542 students invited, 1189 (77%) from 83 schools responded to the friendship network queries. Slightly more than half of these participants were female (609 [51%] girls and 580 [49%] boys), and the median age was 16 years (range 14-19, IQR 16-16). The median overall friendship score stood at 20 (IQR 18-26, with possible scores ranging from 6 to 30). Adjusted network autocorrelation models indicated that higher friendship quality scores were significantly associated with improved psychological wellbeing (ß=0·3448, p<0·0001), subjective wellbeing (ß=0·3075, p<0·0001), and a reduction in negative mood (ß=-0·1934, p<0·0001). INTERPRETATION: The study found that friendship quality had a significant association with mood, psychological wellbeing, and subjective wellbeing in adolescents. The results emphasise the value of fostering positive social relationships among adolescents, with a particular focus on the quality of their friendships. Next stages of this research include longitudinal analysis to test these associations more robustly. FUNDING: Taibah University.

How Do Adolescent Smoking Prevention Interventions Work in Different Contextual Settings? A Qualitative Comparative Study Between the UK and Colombia.

BACKGROUND: Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings. METHOD: A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-seven focus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11-15 years). The Theoretical Domains Framework guided a content analysis of the data. RESULTS: We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape. CONCLUSION: These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping.

Advancing urban green and blue space contributions to public health.

Urban green and blue spaces (UGBS) have the potential to improve public health and wellbeing, address health inequities, and provide co-benefits for the environment, economy, and society. To achieve these ambitions, researchers should engage with communities, practitioners, and policy makers in a virtuous circle of research, policy, implementation, and active citizenship using the principles of co-design, co-implementation, co-evaluation, and co-translation. This Viewpoint provides an integrated perspective on the challenges that hinder the delivery of health-enhancing UGBS and recommendations to address them. Our recommendations include: strengthening the evidence beyond cross-sectional research designs, strengthening the evidence base on UGBS intervention approaches, evaluating the effects on diverse population groups and communities, addressing inequities in the distribution and quality of UGBS, accelerating research on blue space, providing evidence for environmental effects, incorporating co-design approaches, developing innovative modelling methods, fostering whole-system evidence, harnessing political drivers, creating collaborations for sustainable UGBS action, and advancing evidence in low-income and middle-income countries. The full potential of UGBS as public health, social, economic, and environmental assets is yet to be realised. Acting on the research and translation recommendations will aid in addressing these challenges in collaboration with research, policy, practice, and communities.

Capturing the whole-school food environment in primary schools.

OBJECTIVE: The school food environment (SFE) is an ideal setting for encouraging healthy dietary behaviour. We aimed to develop an instrument to assess whole-SFE, test the instrument in the school setting and demonstrate its use to make food environment recommendations. DESIGN: SFE literature and UK school food guidance were searched to inform instrument items. The instrument consisted of (i) an observation proforma capturing canteen areas systems, food presentation and monitoring of food intake and (ii) a questionnaire assessing food policies, provision and activities. The instrument was tested in schools and used to develop SFE recommendations. Descriptive analyses enabled narrative discussion. SETTING: Primary schools. PARTICIPANTS: An observation was undertaken at schools in urban and rural geographical regions of Northern Ireland of varying socio-economic status (n 18). School senior management completed the questionnaire with input from school caterers (n 16). RESULTS: The instrument captured desired detail and potential instrument modifications were identified. SFE varied. Differences existed between food policies and how policies were implemented and monitored. At many schools, there was scope to enhance physical eating environments (n 12, 67 %) and food presentation (n 15, 83 %); emphasise healthy eating through food activities (n 7, 78 %) and increase parental engagement in school food (n 9, 56 %). CONCLUSIONS: The developed instrument can measure whole-SFE in primary schools and also enabled identification of recommendations to enhance SFE. Further assessment and adaptation of the instrument are required to enable future use as a research tool or for self-assessment use by schools.

Exploring the mechanistic pathways of how social network influences social norms in adolescent smoking prevention interventions.

We know little about how smoking prevention interventions might leverage social network structures to enhance protective social norms. In this study we combined statistical and network science methods to explore how social networks influence social norms related to adolescent smoking in school-specific settings in Northern Ireland and Colombia. Pupils (12-15 years old) participated in two smoking prevention interventions in both countries (n = 1344). A Latent Transition Analysis identified three groups characterized by descriptive and injunctive norms towards smoking. We employed a Separable Temporal Random Graph Model to analyze homophily in social norms and conducted a descriptive analysis of the changes in the students' and their friends' social norms over time to account for social influence. The results showed that students were more likely to be friends with others who had social norms against smoking. However, students with social norms favorable towards smoking had more friends with similar views than the students with perceived norms against smoking, underlining the importance of network thresholds. Our results support the notation that the ASSIST intervention takes advantage of friendship networks to leverage greater change in the students' smoking social norms than the Dead Cool intervention, reiterating that social norms are subject to social influence.

Investigating the feasibility and acceptability of using Instagram to engage post-graduate students in a mass communication social media-based health intervention, #WeeStepsToHealth.

BACKGROUND: Instagram's popularity among young adults continues to rise, and previous work has identified diffusion of unhealthy messages and misinformation throughout the platform. However, we know little about how to use Instagram to promote health messages. This study aims to assess the feasibility and acceptability of using Instagram to engage post-graduate students in a mass communication social media (SM)-based health intervention. METHODS: A 4-week intervention targeting post-graduate students with physical activity (PA), nutrition, and general wellbeing messages was conducted via Instagram. Feasibility and acceptability were assessed using SM metrics (likes, comments, and shares), pre- and post-intervention online surveys (knowledge, attitude, and behavioural outcomes), and a focus group conducted with a sample of individuals in the target population (to assess intervention recall, feedback on message framing, and acceptability of Instagram). RESULTS: The two independent samples captured by online surveys (pre-intervention, n = 43, post-intervention, n = 41, representing 12.3% and 11.7% of Instagram followers, respectively) were predominantly female (88.4%, 80.5%) aged 18-34 (95.4%, 95.1%). Respondents in the second survey reported higher weekly PA levels (+ 13.7%) and more frequent nutritional behaviours including consumption of five or more fruits and vegetables (+ 23.3%) and looking at nutritional labels (+ 10.3%). However, respondents in the second survey also reported less frequent meal preparation (- 18.0%) and a small increase in fast food consumption (+ 2.8% consuming fast food 3-4 days a week). A total of 247 'likes' were collected from 28 Instagram posts (mean 8.8 likes per post). Humorous posts achieved a moderately higher level of engagement than non-humorous posts (median 10 and 8 likes, respectively). Focus group participants liked the campaign content and trusted the information source. CONCLUSIONS: Findings indicate that Instagram could be a feasible and acceptable platform for engaging post-graduate students in a SM-based mass communication health intervention, and that humour may have the potential to encourage further engagement.

Association between friendship quality and subjective wellbeing among adolescents: a systematic review.

BACKGROUND: Social integration with friends has an important role in shaping adolescents' behavior and determining their wellbeing. Friendship features such as companionship, trust, closeness, intimacy, and conflicts all form the concept of friendship quality. The quality of friendships can either enhance or impede mental development during adolescence. Therefore, this systematic review was conducted to understand the association between friendship quality and adolescents' mental wellbeing. METHODS: In November 2020 and later in August 2022, the search for evidence was conducted on five databases (Medline, Embase, ProQuest, Scopus, and PsycINFO). Only peer-reviewed quantitative studies published from January 2000 to August 2022 that investigated friendship quality as their exposure variable in relation to six constructs of subjective wellbeing (mood, loneliness, life satisfaction, happiness, self-esteem, and subjective wellbeing) were included. After screening for eligibility, two reviewers independently extracted the data based on population characteristics, study design, exposure and outcome variables, outcome measures used, and results. Risk of bias assessment was performed utilizing the NIH Quality Assessment Tool. Narrative evidence synthesis was performed based on the constructs of subjective wellbeing. RESULTS: Forty-three articles out of 21,585 records were included in the review. The relationship between friendship quality and depression has been investigated extensively in the literature and negative (beneficial) associations were found in eighteen studies out of twenty-three. Poor peer relationship was associated with loneliness in nine studies out of ten. All seven studies on life satisfaction and quality of peer connection found a positive association. In five studies, better peer relationship was found to be associated with happiness. A positive association between friendship quality and self-esteem was observed in five out of six applicable studies. Friendship quality was found to be positively associated with subjective well-being in all of five included studies. CONCLUSIONS: Although majority of the included studies were cross-sectional in nature, this review demonstrates the paramount value of promoting healthy friendship to adolescents' subjective wellbeing constructs. Interventions that aim to promote subjective wellbeing among adolescents should consider the development and maintenance of healthy friendships. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020219312.

Investigating the impact of a 20 miles per hour speed limit intervention on road traffic collisions, casualties, speed and volume in Belfast, UK: 3 year follow-up outcomes of a natural experiment.

BACKGROUND: Evidence regarding the effectiveness of 20 miles per hour (mph) speed limit interventions is limited, and rarely have long-term outcomes been assessed. We investigate the effect of a 20 mph speed limit intervention on road traffic collisions, casualties, speed and volume at 1 and 3 years post-implementation. METHODS: An observational, repeated cross-sectional design was implemented, using routinely collected data for road traffic collisions, casualties, speed and volume. We evaluated difference-in-differences in collisions and casualties (intervention vs control) across three different time series and traffic speed and volume pre-implementation, at 1 and 3 years post-implementation. RESULTS: Small reductions in road traffic collisions were observed at year 1 (3%; p=0.82) and year 3 post-implementation (15%; p=0.31) at the intervention site. Difference-in-differences analyses showed no statistically significant differences between the intervention and control sites over time for road traffic collisions. There were 16% (p=0.18) and 22% (p=0.06) reductions in casualty rates at years 1 and 3 post-implementation, respectively, at the intervention site. Results showed little change in mean traffic speed at year 1 (0.2 mph, 95% CI -0.3 to 2.4, p=0.14) and year 3 post-implementation (0.8, 95% CI -1.5 to 2.5, p=0.17). For traffic volume, a decrease in 57 vehicles per week was observed at year 1 (95% CI -162 to -14, p<0.00) and 71 vehicles at year 3 (95% CI -213 to 1, p=0.05) post-implementation. CONCLUSION: A 20 mph speed limit intervention implemented at city centre scale had little impact on long-term outcomes including road traffic collisions, casualties and speed, except for a reduction in traffic volume. Policymakers considering implementing 20 mph speed limit interventions should consider the fidelity, context and scale of implementation.

The personality and cognitive traits associated with adolescents' sensitivity to social norms.

Little is known about the personality and cognitive traits that shape adolescents' sensitivity to social norms. Further, few studies have harnessed novel empirical tools to elicit sensitivity to social norms among adolescent populations. This paper examines the association between sensitivity to norms and various personality and cognitive traits using an incentivised rule-following task grounded in Game Theory. Cross-sectional data were obtained from 1274 adolescents. Self-administered questionnaires were used to measure personality traits as well as other psychosocial characteristics. Incentivised rule-following experiments gauged sensitivity to social norms. A series of multilevel mixed effects ordered logistic regression models were employed to assess the association between sensitivity to norms and the personality and cognitive traits. The results highlighted statistically significant univariate associations between the personality and cognitive traits and sensitivity to norms. However, in the multivariate adjusted model, the only factor associated with sensitivity to norms was gender. The gender-stratified analyses revealed differences in the personality and cognitive traits associated with sensitivity to norms across genders. For males need to belong was significantly negatively associated with sensitivity to norms in the multivariate model. By comparison, emotional stability was negatively associated with sensitivity to norms for females. This study reinforced the findings from an earlier study and suggested female adolescents had higher levels of sensitivity to norms. The results indicated no consistent pattern between sensitivity to norms and the personality and cognitive traits. Our findings provide a basis for further empirical research on a relatively nascent construct, and bring a fresh perspective to the question of norm-following preferences among this age group.

City planning policies to support health and sustainability: an international comparison of policy indicators for 25 cities.

City planning policies influence urban lifestyles, health, and sustainability. We assessed policy frameworks for city planning for 25 cities across 19 lower-middle-income countries, upper-middle-income countries, and high-income countries to identify whether these policies supported the creation of healthy and sustainable cities. We systematically collected policy data for evidence-informed indicators related to integrated city planning, air pollution, destination accessibility, distribution of employment, demand management, design, density, distance to public transport, and transport infrastructure investment. Content analysis identified strengths, limitations, and gaps in policies, allowing us to draw comparisons between cities. We found that despite common policy rhetoric endorsing healthy and sustainable cities, there was a paucity of measurable policy targets in place to achieve these aspirations. Some policies were inconsistent with public health evidence, which sets up barriers to achieving healthy and sustainable urban environments. There is an urgent need to build capacity for health-enhancing city planning policy and governance, particularly in low-income and middle-income countries.