Negotiating cancer preventative health behaviours and adapting to motherhood: the role of technology in supporting positive health behaviours.

PURPOSE: Across the UK and USA, postpartum smoking relapse rates are high, and rates of breastfeeding and physical activity are low. This project aimed to explore these interrelated health behaviours and technology use, for intervention development to support postpartum cancer prevention. METHODS: Focus groups and interviews with 26 purposively selected women (15 in Vermont, USA and 11 in Norfolk, UK). Recruitment was from deprived areas experiencing multiple disadvantage. Qualitative data were thematically analysed from dual cultural perspectives, underpinned by the social ecological model. RESULTS: Women negotiate interrelated lifestyle behaviours as part of managing an identity in transition, moving through stages of disturbance, adaptation, acceptance and integration towards "becoming" a new Mother. Technology was integral to women's process of engagement with mothering identities. Intersectionality underpins complex patterns of interrelated behaviour. CONCLUSIONS: There is scope to improve electronic/digital support for postpartum women cross-nationally to promote interrelated cancer-preventative lifestyle behaviours. Abbreviations CDC: Center for Disease Control, US; PA: Physical activity; SES: Socioeconomic status; SVI: Social Vulnerability Index; UK: UK; US: USA; WIC: Women infants and children office.

A systematic review and meta-analysis of interventions incorporating behaviour change techniques to promote breastfeeding among postpartum women.

The benefits of exclusive breastfeeding are well documented, yet few women adhere to recommendations. We report the Behaviour Change Techniques (BCTs) within interventions trialled internationally after pregnancy to promote exclusive and mixed breastfeeding as well as evidence of effectiveness. PsycINFO, EMBASE and MEDLINE databases were screened. Twenty-three (n = 23) studies met inclusion criteria. Three authors independently extracted data, coded interventions using the BCT v.1 taxonomy, and assessed study quality. There was a moderate significant effect of the interventions promoting exclusive breastfeeding up to four weeks postpartum (OR 1.77, [95% CI: 1.47-2.13]) but this effect slightly declined beyond thirteen weeks (OR 1.63, [95% CI: 1.07-2.47]). Twenty-nine BCTs were identified within interventions. 'Credible source' and 'instruction on how to perform the behaviour' were the most prevalent and 'social support (unspecified)' contributed to the effectiveness of exclusive breastfeeding interventions five to eight weeks postpartum. Using BCTs with cognitive and behavioural aspects may help women develop coping mechanisms promoting exclusive breastfeeding. Further trials are needed in countries with low breastfeeding rates such as the UK. The use of programme theory during intervention development and clear description of intervention components is recommended. This meta-analysis provides guidance for trials evaluating postpartum breastfeeding interventions.

Using crowd sourcing to locate and characterize conflicts for vulnerable modes.

Most agencies and decision-makers rely on crash and crash severity (property damage only, injury or fatality) data to assess transportation safety; however, in the context of public health where perceptions of safety may influence the willingness to adopt active transportation modes (e.g. bicycling and walking), pedestrian-motor vehicle and other similar conflicts types may define a better performance measure for safety assessment. In the field of transportation safety, an absolute conflict occurs when two parties' paths cross and one of the parties must undertake an evasive maneuver (e.g. change direction or stop) to avoid a crash. Other less severe conflicts where paths cross but no evasive maneuver is required may also impact public perceptions of safety especially for vulnerable modes. Most of the existing literature focuses on vehicle conflicts. While in the past several years, more research has investigated bicycle and pedestrian conflicts, most of this has focused on the intersection environment. A comprehensive analysis of conflicts appears critical. The major objective of this study is two fold: 1) Development of an innovative and cost effective conflict data collection technique to better understand the conflicts (and their severity) involving vulnerable road users (e.g. bicycle/pedestrian, bicycle/motor vehicle, and pedestrian/motor vehicle) and their severity. 2) Test the effectiveness and practicality of the approach taken and its associated crowd sourced data collection. In an endeavor to undertake these objectives, the researchers developed an android-based crowd-sourced data collection app. The crowd-source data collected using the app is compared with traditional fatality data for hot spot analysis. At the end, the app users provide feedback about the overall competency of the app interface and the performance of its features to the app developers. If widely adopted, the app will enable communities to create their own data collection efforts to identify dangerous sites within their neighborhoods. Agencies will have a valuable data source at low-cost to help inform their decision making related to bicycle and pedestrian education, encouragement, enforcement, programs, policies, and infrastructure design and planning.