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BACKGROUND: The physical and the social environment are important predictors of healthy weight, especially in low socioeconomic position (SEP) neighborhoods. Many Dutch municipalities have implemented a healthy weight approach (HWA). Yet, there is room for improvement. This system science study examined what influences the utilization of HWA facilities and activities, and what aspects can help to achieve a desired systems change (also called leverage point themes (LPTs)) in the HWA system as perceived by citizens living in low SEP neighborhoods. METHOD: All research phases were performed with four citizens co-researchers. Forty-seven citizens living in low SEP neighborhoods were semi-structurally interviewed about the neighborhood HWA facilities and municipal HWA activities. A rapid coding qualitative analysis approach was applied per topic. The topics were citizens' healthy living description, personal circumstances, and satisfaction with foot and cycle paths, sports facilities, playgrounds, green spaces, museums and theaters, community centers, churches, healthcare, school, food supplies, contact with neighborhood, unfamiliar and/or unused activities, familiar and used activities, unavailable but desired (lacking) activities, and reaching citizens. RESULTS: The utilization of HWA facilities and activities was influenced by the overarching themes of social cohesion, familiarity, reaching citizens, maintenance, safety, physical accessibility, financial accessibility, social accessibility, fit with personal context, and fit with the neighborhood's specific needs. Different overarching themes stood out across different facilities and activities. LPTs indicated the overarching themes needed in combination with one another for a specific activity or facility to increase utilization. For example, the LPT regarding foot and cycle paths was "accessible, safe, and maintained foot and cycle paths". The LPTs regarding familiar and used activities were "customized activities; information provision (e.g., about possibilities to join without paying); social contact, meeting others, and everyone feels included". CONCLUSION: Conducting inclusive qualitative research from a systems perspective among citizens living in low SEP neighborhoods has contributed valuable insights into their needs. This enables practical implementation of HWAs by providing a deeper understanding of the LPTs within the HWA system. LPTs can help HWA stakeholders to further develop current HWAs toward systems approaches. Future research could study the leverage points that may contribute to LPT implementation.
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Pesquisa Qualitativa , Características de Residência , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Países Baixos , Promoção da Saúde/métodos , Idoso , Meio Social , Análise de Sistemas , Adulto Jovem , Entrevistas como AssuntoRESUMO
BACKGROUND: The COVID-19 pandemic and related control measures affected the mental health of all populations. Particular subgroups are underrepresented in mainstream surveys because they are hard to reach, and study measurements are not adapted to their skills. These subgroups include people with lower cognitive and literacy skills, such as people with mild intellectual disability (MID), who were considered vulnerable during the COVID-19 pandemic given their low socioeconomic status, small social networks, increased risks of health problems, and difficulties understanding health-related information. OBJECTIVE: This study examines the impact of the COVID-19 pandemic on mental health among people with MID or low literacy skills compared with those predominantly represented in national surveys. METHODS: A repeated cross-sectional study of people with MID or low literacy skills and a general population sample was conducted in the Netherlands. An easy-read web-based survey was co-designed with, and tested among, people with MID or low literacy skills and conducted in 3 rounds within 1 year of the COVID-19 pandemic (T1: November to December 2020, T2: March to April 2021, and T3: September to October 2021). The survey contained questions about demographics and 6 aspects of mental health: feeling happy, feeling energized, feeling stressed, worry, feeling lonely, and sleeping problems. RESULTS: Our adapted survey and recruitment procedure enabled 1059 persons with MID or low literacy skills to participate (T1: n=412, 38.9%; T2: n=351, 33.1%; and T3: n=296, 28%). They were significantly younger, had a lower level of education, and more often than not were born outside the Netherlands compared to the general population sample (P<.001). Approximately half of them (604/1059, 57.03%) received professional care. They displayed poorer mental health scores than the general population sample. The percentages of people with MID or low literacy skills who reported more negative feelings in T1 ranged from 20.6% (85/412) reporting feeling lonely often or almost always to 57.8% (238/412) reporting feeling happy almost never or sometimes. The general population sample's percentages were 5.4% (160/2930) and 32.2% (941/2918), respectively. Although scores improved over time in both populations, the disproportional effects remained. CONCLUSIONS: General COVID-19-related restrictions for the entire Dutch population affected people with MID or low literacy skills more negatively than the general population. Our study underscores the relevance of including these subpopulations in public health research because they are often overlooked in regular health data. An accessible web-based survey particularly targeted at this population enabled us to do so, and we reached a group of respondents significantly different from regular survey participants. This survey's results provided insights into the health of people with MID or low literacy skills and gained knowledge to be used by care organizations and policy makers to reduce health disparities during a pandemic and in general.
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COVID-19 , Deficiência Intelectual , Saúde Mental , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Países Baixos/epidemiologia , Saúde Mental/estatística & dados numéricos , Deficiência Intelectual/psicologia , Deficiência Intelectual/epidemiologia , Inquéritos e Questionários , Pandemias , Idoso , Letramento em Saúde/estatística & dados numéricos , Internet , Adulto Jovem , Adolescente , Alfabetização/estatística & dados numéricosRESUMO
Citizen science allows the public to participate in various stages of scientific research, including study design, data acquisition, and data analysis. Citizen science has a long history in several fields of the natural sciences, and with recent developments in wearable technology, neuroscience has also become more accessible to citizen scientists. This development was largely driven by the influx of minimal sensing systems in the consumer market, allowing more do-it-yourself (DIY) and quantified-self (QS) investigations of the human brain. While most subfields of neuroscience require sophisticated monitoring devices and laboratories, the study of sleep characteristics can be performed at home with relevant noninvasive consumer devices. The strong influence of sleep quality on waking life and the accessibility of devices to measure sleep are two primary reasons citizen scientists have widely embraced sleep research. Their involvement has evolved from solely contributing to data collection to engaging in more collaborative or autonomous approaches, such as instigating ideas, formulating research inquiries, designing research protocols and methodology, acting upon their findings, and disseminating results. In this article, we introduce the emerging field of citizen neuroscience, illustrating examples of such projects in sleep research. We then provide overviews of the wearable technologies for tracking human neurophysiology and various open-source software used to analyse them. Finally, we discuss the opportunities and challenges in citizen neuroscience projects and suggest how to improve the study of the human brain outside the laboratory.
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Ciência do Cidadão , Dispositivos Eletrônicos Vestíveis , Humanos , Software , Ecossistema , EncéfaloRESUMO
BACKGROUND: People with intellectual disability have a poorer health status than the general population. In The Netherlands, support workers play a key role in meeting health support needs of people with intellectual disability. Research on how people with intellectual disability and their support workers experience the support worker's role in preventing, identifying, and following up health needs of people with intellectual disability is scarce. To enhance health support of people with intellectual disability it is crucial that we understand how health support is delivered in everyday practice. Therefore, this study investigated experiences of people with intellectual disability and support workers with the health support of people with intellectual disability. METHOD: Data collection consisted of six focus group (FG) discussions with between four and six participants (N = 27). The FGs consisted of three groups with support workers (n = 15), two groups with participants with mild to moderate intellectual disability (n = 8), and one group with family members as proxy informants who represented their relative with severe to profound intellectual disability (n = 4). The data was analysed thematically on aspects relating to health support. RESULTS: We identified three main themes relevant to the health support of people with intellectual disability: 1) dependence on health support, 2) communication practices in health support, and 3) organizational context of health support. Dependence on health support adresses the way in which support workers meet a need that people with intellectual disability cannot meet themselves, and communication practices and organizational context are identified as systems in which health support takes place. CONCLUSION: This study investigated experiences with the health support of people with intellectual disability from the perspectives of people with intellectual disability and support workers. We discuss the dependence of people with intellectual disability and the complexity of health support in everyday practice. We provide practical implications that can strengthen support workers in the provision of health support for people with intellectual disability in everyday practice. The findings of this study emphasize the need for intellectual disability care-provider organizations to establish policies around consistency in support staff to make it easier to identify and follow up health needs, and an environment where support staff can develop their expertise concerning communication practices, lifestyle choices, and identifying and following up health needs.
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Deficiência Intelectual , Humanos , Família , Grupos Focais , Apoio Social , ComunicaçãoRESUMO
INTRODUCTION: Despite all efforts of national and local approaches, obesity rates continue to rise worldwide. It is increasingly recognized that the complexity of obesity should be further addressed by incorporating a systems perspective when implementing approaches. Such an approach has four interconnected system levels: events, structures, goals, and beliefs, in which small changes ('leverage points') can lead to substantial changes in the functioning of the entire system. The current research examined the functioning of five Dutch municipalities' healthy weight approaches (HWAs) and the leverage point themes that can be identified in their system. METHODS: Thirty-four semi-structured interviews were conducted with various stakeholders about the HWA, including policy advisors, care professionals, practice professionals, and citizens. An inductive thematic analysis was performed. RESULTS: Three main themes were identified: 1) HWA organization structure, 2) collaboration between professionals, and 3) citizen participation. Across all system levels, we identified leverage point themes. The upper-levels events and structures occurred the most and were explained by underlying goals and beliefs. Leverage point themes regarding "HWA organization structure" were municipal processes, such as perceived impact; diversity of themes, activities, and tasks; network; and communication strategies, such as messages about the HWA. Leverage point themes regarding "collaboration between professionals" were linking pins, indicating central players within the network; motivation and commitment including support base; and stimulating one another to work on the HWA by spurring other professionals into action. Lastly, leverage point themes under "citizen participation" included reaching the target group, e.g., look for entry points; and citizens' motivation, including customization. DISCUSSION: This paper provides unique insights into HWAs' leverage point themes that can lead to substantial changes in how the entire system functions and makes suggestions about underlying leverage points to help stakeholders improve their HWA. Future research could focus on studying leverage points within leverage point themes.
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Obesidade , Programas de Redução de Peso , Humanos , Cidades/epidemiologia , Países Baixos/epidemiologia , Obesidade/epidemiologia , Obesidade/prevenção & controle , Pesquisa Qualitativa , Programas de Redução de Peso/métodos , Programas de Redução de Peso/organização & administraçãoRESUMO
BACKGROUND: The use of eHealth is more challenging for people with intellectual disabilities (IDs) than for the general population because the technologies often do not fit the complex needs and living circumstances of people with IDs. A translational gap exists between the developed technology and users' needs and capabilities. User involvement approaches have been developed to overcome this mismatch during the design, development, and implementation processes of the technology. The effectiveness and use of eHealth have received much scholarly attention, but little is known about user involvement approaches. OBJECTIVE: In this scoping review, we aimed to identify the inclusive approaches currently used for the design, development, and implementation of eHealth for people with IDs. We reviewed how and in what phases people with IDs and other stakeholders were included in these processes. We used 9 domains identified from the Centre for eHealth Research and Disease management road map and the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability framework to gain insight into these processes. METHODS: We identified both scientific and gray literature through systematic searches in PubMed, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, Google Scholar, and (websites of) relevant intermediate (health care) organizations. We included studies published since 1995 that showed the design, development, or implementation processes of eHealth for people with IDs. Data were analyzed along 9 domains: participatory development, iterative process, value specification, value proposition, technological development and design, organization, external context, implementation, and evaluation. RESULTS: The search strategy resulted in 10,639 studies, of which 17 (0.16%) met the inclusion criteria. Various approaches were used to guide user involvement (eg, human or user-centered design and participatory development), most of which applied an iterative process mainly during technological development. The involvement of stakeholders other than end users was described in less detail. The literature focused on the application of eHealth at an individual level and did not consider the organizational context. Inclusive approaches in the design and development phases were well described; however, the implementation phase remained underexposed. CONCLUSIONS: The participatory development, iterative process, and technological development and design domains showed inclusive approaches applied at the start of and during the development, whereas only a few approaches involved end users and iterative processes at the end of the process and during implementation. The literature focused primarily on the individual use of the technology, and the external, organizational, and financial contextual preconditions received less attention. However, members of this target group rely on their (social) environment for care and support. More attention is needed for these underrepresented domains, and key stakeholders should be included further on in the process to reduce the translational gap that exists between the developed technologies and user needs, capabilities, and context.
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Deficiência Intelectual , Telemedicina , Humanos , Deficiência Intelectual/terapia , Telemedicina/métodos , Gerenciamento Clínico , Tecnologia , Literatura CinzentaRESUMO
Substituting the consumption of sugar-sweetened beverages (SSB) with that of water can have a positive effect on adolescents' health. However, despite the attention on this topic in the Global North, it is relatively understudied in other regions of the world, such as the Caribbean. To guide the development of future interventions, understanding the factors determining water consumption among Caribbean adolescents is important. This study examined the behavioral determinants of water consumption among adolescents in Aruba (the Caribbean) and compared them to those in the Netherlands (Western Europe). We used a theoretical model that integrates the dominant theoretical perspectives in the field of public health, including theories of planned behavior, social norms, and intrinsic motivation. This cross-country study included 1,584 adolescents from Aruba and the Netherlands (52% girls; M = 12.34 years; SD = 2.14). The data were analyzed using regression analyses. This study found that in Aruba, adolescents with higher scores of intrinsic motivation, friends' descriptive norms, attitudes, and behavioral control regarding water consumption drank more water. Moreover, the associations between water consumption and both intrinsic motivation as well as friends' descriptive norms for adolescents in Aruba were stronger than those found in the Netherlands. These associations imply that it is even more important for Aruban adolescents than Dutch adolescents to be intrinsically motivated or to perceive their friends often consuming water to drink more water. The cross-country comparison implies that future interventions in Aruba aimed at increasing adolescents' water consumption as an alternative to SSB should focus on enhancing their intrinsic motivation while considering their friends' social norms.
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Social influencers are widely known as the promotors of purchase behavior as well as for their potential to change health behaviors among individuals in their social networks. For social influencers to be successful in changing behaviors, it is essential that they convey their message in an authentic, original, credible, and persistent manner. In the context of health behavior interventions, this requires a focus on the motivation of social influencers to engage in the intervention. This perspective article describes the importance of motivating social influencers to engage in the desired health behaviors themselves and to promote it within their social network. We briefly describe the current state of knowledge and our empirical experience in implementing health interventions with social influencers. Using insights from self-determination theory, we demonstrate how social influencers can be motivated optimally in health behavior interventions and, thereby, improving the success of the intervention. To illustrate these insights and guide intervention practice, we provide concrete examples of techniques that can be applied in health interventions involving social influencers. We conclude with directions for further research and intervention practice to improve the delivery of health behavior interventions.
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[This corrects the article DOI: 10.1371/journal.pone.0260952.].
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The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30-39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods/access. Trail registration: https://www.trialregister.nl/trial/7955.
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Encéfalo/fisiologia , Meio Social , Adulto , Afeto/fisiologia , Comportamento , Encéfalo/diagnóstico por imagem , COVID-19/diagnóstico , Cognição/fisiologia , Feminino , Humanos , Masculino , Neuroimagem , Sensação/fisiologia , Inquéritos e QuestionáriosRESUMO
Hardly any research has been conducted regarding coping strategies that children can use in response to negative news, although they are frequently exposed to and emotionally affected by such news. Chat conversations with peers about the news could be a coping strategy for children in this regard. To investigate this, children (N = 307; 46.3% girls; Mage = 10.51; SDage = 0.98; range 8-13 years old) participated in a preregistered experiment in which their emotions were measured before and after exposure to a news video on a smartphone and also after a postexposure activity (i.e., chatting about the news as an experimental condition versus chatting about something else or solving a puzzle as control conditions). The results showed that the decrease in negative emotions and the increase in positive emotions were weaker for children who chatted about the news than for those in the control conditions. Thus, seeking social support in online chat conversations did not have the anticipated effect-and might even have an adverse effect.
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Adaptação Psicológica , Emoções , Adolescente , Criança , Feminino , Humanos , Masculino , Grupo Associado , Apoio Social , Inquéritos e QuestionáriosRESUMO
BACKGROUND: There is a need to develop and improve interventions promoting healthy drinking behaviors among children. A promising method could be to stimulate peer influence within children's social networks. In the Share H2O social network intervention (SNI), peer influence was utilized by selecting a subset of influential children and training them as 'influence agents' to promote water consumption-as an alternative to SSBs. Previous research has mainly focused on the process of selecting influence agents. However, the process of motivating influence agents to promote the behavior has hardly received any research attention. Therefore, in the SNI Share H2O SNI, this motivation process was emphasized and grounded in the self-determination theory (SDT). This study evaluated the implementation of the Share H2O SNI, focusing on whether and how applying SDT-based techniques can motivate the influence agents and, indirectly, their peers. METHODS: This study included data collected in the Netherlands from both the influence agents (n = 37) and the peers (n = 112) in the classroom networks of the influence agents. Self-reported measurements assessed the influence agents' enjoyment of the training, duration and perceived autonomy support during the training, and changes in their intrinsic motivation and water consumption before and after the start of the intervention. Changes in the peers' intrinsic motivation, perceived social support, and social norms were measured before and after the start of the intervention. RESULTS: The influence agents enjoyed the training, the duration was adequate, and perceived it as autonomy supportive. There was an increase in the influence agents' intrinsic motivation to drink water and their actual water consumption. Providing personal meaningful rationales seemed to have motivated the influence agents. The intrinsic motivation and perceived descriptive norm of the peers remained stable. The peers reported an increase in their perceived social support and injunctive norm concerning water drinking after the intervention. Influence agents appeared to mainly use face-to-face strategies, such as modeling, talking to peers, and providing social support to promote the behavior. CONCLUSIONS: The current findings provided preliminary evidence of the promising effects of using SDT-based techniques in an SNI to motivate the influence agents and, indirectly, their peers. TRIAL REGISTRATION: NTR, NL6905, Registered 9 January 2018, https://www.trialregister.nl/trial/6905.
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Ingestão de Líquidos , Influência dos Pares , Criança , Humanos , Países Baixos , Grupo Associado , Rede Social , Normas SociaisRESUMO
OBJECTIVE: To test the effectiveness of a social network intervention (SNI) to improve children's healthy drinking behaviours. DESIGN: A three-arm cluster randomised control trial design was used. In the SNI, a subset of children were selected and trained as 'influence agents' to promote water consumption-as an alternative to sugar-sweetened beverages (SSB)-among their peers. In the active control condition, all children were simultaneously exposed to the benefits of water consumption. The control condition received no intervention. SETTING: Eleven schools in the Netherlands. PARTICIPANTS: Four hundred and fifty-one children (Mage = 10·74, SDage = 0·97; 50·8 % girls). RESULTS: Structural path models showed that children exposed to the SNI consumed 0·20 less SSB per day compared to those in the control condition (ß = 0·25, P = 0·035). There was a trend showing that children exposed to the SNI consumed 0·17 less SSB per day than those in the active control condition (ß = 0·20, P = 0·061). No differences were found between conditions for water consumption. However, the moderation effects of descriptive norms (ß = -0·12, P = 0·028) and injunctive norms (ß = 0·11-0·14, both P = 0·050) indicated that norms are more strongly linked to water consumption in the SNI condition compared to the active control and control conditions. CONCLUSIONS: These findings suggest that a SNI promoting healthy drinking behaviours may prevent children from consuming more SSB. Moreover, for water consumption, the prevailing social norms in the context play an important role in mitigating the effectiveness of the SNI.
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Ingestão de Líquidos , Bebidas Adoçadas com Açúcar , Bebidas , Criança , Feminino , Humanos , Masculino , Instituições Acadêmicas , Rede SocialRESUMO
BACKGROUND: Positive associations exist between physical activity and happiness in adolescents. However, previous studies have mostly used self-reported measures and cross-sectional designs. There is a need for more insight into the directionality and duration of this association. The current study was the first to investigate whether an increase in physical activity leads to happiness and whether adolescents become more physically active when they are happier. These two effects were studied between (on a day-to-day basis) and within days (on an hour-to-hour basis). METHODS: The study used data from the MyMovez project in which 1484 adolescents between the ages of 8 and 17 years wore an accelerometer on their wrist and answered experience sampling questions on happiness at random moments during the day for several weeks in 2016-2018. RESULTS: The preregistered analyses demonstrated an association between physical activity and happiness. More specifically, the number of steps per day predicted the experienced happiness on that day. In addition, a short-term reciprocal effect of physical activity and happiness was observed. Happiness was predicted by the number of steps accumulated in the previous hour and it also predicted the number of steps accumulated in the subsequent hour. However, convincing evidence was found that these effects did not occur in the long-term between days. The number of steps on the previous day did not predict happiness, nor did happiness predict the number of steps of the subsequent day. CONCLUSIONS: This study confirms an association between physical activity and happiness in adolescents and shows that in the short-term, physical activity promotes happiness and vice versa. Therefore, we conclude that physical activity is not only important for the physical health of youth, but also plays an important role in their mental well-being. In addition, this knowledge can be used to further understand the importance of physical activity in adolescents' health and help in promoting a healthy lifestyle among youth. TRIAL REGISTRATION: The data used are stored at the Data Archiving and Networked Services ( https://doi.org/10.17026/dans-zz9-gn44 ). Hypotheses, study design, sample, data collection procedure, measured variables, and plan of analysis were preregistered on the Open Science Framework (OSF, https://osf.io/5yk7r/ ).
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Exercício Físico/psicologia , Felicidade , Acelerometria , Adolescente , Criança , Feminino , Monitores de Aptidão Física , Humanos , Estudos Longitudinais , MasculinoRESUMO
BACKGROUND: Most studies on social influencer marketing techniques have focused on the promotion of unhealthy foods whereas little is known about the promotion of healthier foods. The present experimental study investigated whether a popular real versus fictitious fit influencer is more successful in promoting healthy food products. In addition, we examined the role of parasocial interaction as an underlying mechanism of healthy food product endorsement. METHODS: We used a randomized between-subject design with 154 participants (mean age: 24.0 years). Viewers' product attitude and purchase intention were tested after exposure to an Instagram post by a popular real fit influencer (n = 77) or fictitious fit influencer (n = 77). RESULTS: Results showed that parasocial interaction mediated the relation between the type of influencer and product attitude as well as purchase intention. Parasocial interaction was higher for participants exposed to the popular real fit influencer compared to the fictitious fit influencer, leading to higher healthy food brand attitude and purchase intention. DISCUSSION: The findings showed that it is crucial for social influencers to establish a warm personal relationship and connection with the their followers when promoting a healthy product successfully. We suggest that the promotion of healthy foods could be more successful in public health when using popular fit influencers.
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Comportamento do Consumidor , Intenção , Adulto , Atitude , Alimentos , Humanos , Adulto JovemRESUMO
Bluetooth (BT) data has been extensively used for recognizing social patterns and inferring social networks, as BT is widely present in everyday technological devices. However, even though collecting BT data is subject to random noise and may result in substantial measurement errors, there is an absence of rigorous procedures for validating the quality of the inferred BT social networks. This paper presents a methodology for inferring and validating BT-based social networks based on parameter optimization algorithm and social network analysis (SNA). The algorithm performs edge inference in a brute-force search over a given BT data set, for deriving optimal BT social networks by validating them with predefined ground truth (GT) networks. The algorithm seeks to optimize a set of parameters, predefined considering some reliability challenges associated to the BT technology itself. The outcomes show that optimizing the parameters can reduce the number of BT data false positives or generate BT networks with the minimum amount of BT data observations. The subsequent SNA shows that the inferred BT social networks are unable to reproduce some network characteristics present in the corresponding GT networks. Finally, the generalizability of the proposed methodology is demonstrated by applying the algorithm on external BT data sets, while obtaining comparable results.
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BACKGROUND: Social network interventions targeted at children and adolescents can have a substantial effect on their health behaviors, including physical activity. However, designing successful social network interventions is a considerable research challenge. In this study, we rely on social network analysis and agent-based simulations to better understand and capitalize on the complex interplay of social networks and health behaviors. More specifically, we investigate criteria for selecting influence agents that can be expected to produce the most successful social network health interventions. OBJECTIVE: The aim of this study was to test which selection criterion to determine influence agents in a social network intervention resulted in the biggest increase in physical activity in the social network. To test the differences among the selection criteria, a computational model was used to simulate different social network interventions and observe the intervention's effect on the physical activity of primary and secondary school children within their school classes. As a next step, this study relied on the outcomes of the simulated interventions to investigate whether social network interventions are more effective in some classes than others based on network characteristics. METHODS: We used a previously validated agent-based model to understand how physical activity spreads in social networks and who was influencing the spread of behavior. From the observed data of 460 participants collected in 26 school classes, we simulated multiple social network interventions with different selection criteria for the influence agents (ie, in-degree centrality, betweenness centrality, closeness centrality, and random influence agents) and a control condition (ie, no intervention). Subsequently, we investigated whether the detected variation of an intervention's success within school classes could be explained by structural characteristics of the social networks (ie, network density and network centralization). RESULTS: The 1-year simulations showed that social network interventions were more effective compared with the control condition (beta=.30; t100=3.23; P=.001). In addition, the social network interventions that used a measure of centrality to select influence agents outperformed the random influence agent intervention (beta=.46; t100=3.86; P<.001). Also, the closeness centrality condition outperformed the betweenness centrality condition (beta=.59; t100=2.02; P=.046). The anticipated interaction effects of the network characteristics were not observed. CONCLUSIONS: Social network intervention can be considered as a viable and promising intervention method to promote physical activity. We demonstrated the usefulness of applying social network analysis and agent-based modeling as part of the social network interventions' design process. We emphasize the importance of selecting the most successful influence agents and provide a better understanding of the role of network characteristics on the effectiveness of social network interventions.
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Exercício Físico , Influência dos Pares , Instituições Acadêmicas , Rede Social , Adolescente , Criança , Simulação por Computador , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Análise de SistemasRESUMO
There is a need to stimulate physical activity among adolescents, but unfortunately, they are hard to reach with traditional mass media interventions. A promising alternative is to carry out social network interventions. In social network interventions, a small group of individuals (influence agents) is selected to promote health-related behaviors within their social network. This study investigates whether a social network intervention is more effective to promote physical activity, compared to a mass media intervention and no intervention. Adolescents (N = 446; M age = 11.35, SD age = 1.34; 47% male) were randomly allocated by classroom (N = 26, in 11 schools) to one of three conditions: social network intervention, mass media intervention, or control condition. In the social network intervention, 15% of the participants (based on peer nominations) was approached to become an influence agent, who created vlogs about physical activity that were shown during the intervention. In the mass media intervention, participants were exposed to vlogs made by unfamiliar peers (i.e., vlogs of the social network intervention). The control condition did not receive vlogs about physical activity. All participants received a research smartphone to complete questionnaires and a wrist-worn accelerometer to measure physical activity. The trial was registered a priori in the Dutch Trial Registry (NTR6903). There were no differences in objectively measured physical activity between this social network intervention and the control condition in the short-term, but there was an unexpected increase in the control condition compared to the social network intervention in the long-term. No differences between the social network intervention and mass media intervention were observed. The current study does not provide evidence that this social network intervention is effective in increasing physical activity in adolescents. Exploratory analyses suggest that this social network intervention increased the perceived social norm toward physical activity and responses to the vlogs were more positive in the social network intervention than in the mass media intervention. These initial results warrant further research to investigate the role of the social norms and the added benefit of using influence agents for social network interventions. Clinical Trial Registration: https://www.trialregister.nl/, identifier NTR6903.
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Over the past years vlogs rapidly have become an attractive platform for food industries, sponsoring social media influencers to promote their products. As with more traditional media, social media influencers predominantly promote unhealthy drinks and foods that are high in sugar, fat, and salt - consumption of which may increase the risk of overweight, obesity, and non-communicable diseases. The aim of the current Brief Research Report is to examine the impact of vlogs on children's unhealthy dietary behaviors. Drawing on longitudinal survey data from 453 8- to 12-year-old children, we analyzed the longitudinal relations between children's frequency of watching vlogs and their consumption of unhealthy beverages and snacks. Structural path modeling analyses of three waves of data with 1-year intervals showed that children's self-reported frequency of watching vlogs influenced consumption of unhealthy beverages 2 years later. The analyses did not yield significant relations for Unhealthy Snacks Consumption. The strength of the observed longitudinal relation between children's Frequency of Watching Vlogs and Consumption of unhealthy beverages was comparable to previous findings regarding more traditional types of food marketing.
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OBJECTIVE: In this study, we tested an integrated model for why young adolescents consume fruit, vegetables, and water. The model was based on evidence from studies applying three dominant theoretical approaches, including planned behavior, social norms, and intrinsic motivation. METHOD: The integrated model was tested with structural equation modeling using four data-collection waves of the MyMovez Project (MyMovez, 2017) in which 953 young adolescents (53.9% girls; Mage = 11.19, SDage = 1.36) participated. Self-reported measures were used to assess young adolescents' fruit, vegetable, and water consumption, self-efficacy, attitude, social norms of parents and peers, behavioral intentions, and intrinsic motivation. RESULTS: The analyses revealed that young adolescents' intrinsic motivation to eat fruits and vegetables or drink water predicted changes in their fruit, vegetable, and water consumption. Furthermore, adolescents' perceived descriptive norm of parents (i.e., perception of the prevalence of their parents' water consumption) also predicted changes, but only for water consumption. CONCLUSION: The current findings show that young adolescents' intrinsic motivation (and, to some extent, parental social norms) is the strongest predictor of their consumption of fruit, vegetables, and water. It is important to note, behavioral intentions do not predict their actual behavior over time. Consequently, interventions should focus on increasing young adolescents' intrinsic motivation to perform the targeted behavior while incorporating the influence of the social context. (PsycINFO Database Record (c) 2018 APA, all rights reserved).