The Ergonomic Behaviors Evaluation Tool (EBET) based on social cognitive theory for the assembly line workers: development and psychometric assessment.

BACKGROUND: Ergonomic behaviors play a crucial role in preventing work-related musculoskeletal disorders (WMSDs). To measure these behaviors, this research aimed to develop and evaluate an ergonomic behaviors tool (EBET) based on the Social Cognitive Theory (SCT) among women workers on assembly lines (WwAL). METHODS: The study was conducted from December 2022 to January 2023 with a focus on the psychometric assessment of EBET. Initially, a literature review and interviews were carried out to identify crucial concepts and primary items. The questionnaire's validity was evaluated using the Content Validity Ratio (CVR) and the Content Validity Index (CVI). To determine the domains of the tool, construct validity was examined by administering the items to 270 eligible women. The reliability of the tool was assessed using McDonald's Omega coefficient. RESULTS: From a total of 67 primary items, 50 were confirmed. The study demonstrated good validity with CVR = 0.92 and CVI = 0.97, along with reliable results indicated by McDonald's Omega coefficient of 0.74. The exploratory factor analysis (EFA) revealed ten distinct dimensions: outcome expectations, outcome expectancies, normative beliefs, perceived barriers, social support, observational learning, reinforcement, behavioral skills, self-efficacy, and intention. Together, these dimensions accounted for 66.25% of the variance in the data. Additionally, the confirmatory factor analysis results supported the presence of these ten constructs and demonstrated a satisfactory fit. CONCLUSIONS: EBET is a dependable and valid instrument for evaluating the ergonomic behaviors of workers, utilizing the principles of SCT. Researchers can employ EBET to gather data and implement suitable training interventions to enhance ergonomic behavior among WwAL. However, it is crucial to recognize that EBET may not encompass all facets of ergonomic behaviors. Therefore, it is imperative for future research to prioritize the evaluation of EBET's suitability among diverse worker populations and to consider additional dimensions of ergonomics to ensure its wider applicability and effectiveness.

Educational Nutritional Intervention Program for Adolescents Based on Social Cognitive Theory: Pilot Study of a Cluster Randomized Controlled Trial.

The eating habits of adolescents are often inadequate, with high consumption of unhealthy foods and low consumption of healthy foods. It is necessary to design and implement effective interventions to improve eating habits at this age and evaluate their feasibility, acceptability, and effectiveness. The use of theories for behavior change in health interventions favors the adoption of healthy behaviors. Due to this, the objective was set to determine the feasibility, acceptability, and effect on food consumption of a new educational nutritional intervention program for adolescents based on the Social Cognitive Theory (SCT) and supported by the Trans-theoretical Model (TTM) and identify areas of improvement in study design and intervention for future larger-scale studies. A pilot study of a cluster randomized controlled trial was conducted in adolescents of both sexes, 12 to 15 years of age, students from a public secondary school in Tonala, Jalisco, Mexico. The results show that a nutritional education intervention for adolescents, based on SCT and supported by the TTM, is feasible, acceptable, and with positive results in the modification of the consumption of ultra-processed foods, vegetables/fruits, and water. This pilot study identified some aspects that could be improved to enhance the effectiveness of the interventions in future studies.

Reliability and Validity of a Theory-Based Determinants of Eating and Physical Activity Behaviors Questionnaire for Chinese Elementary School Children.

OBJECTIVE: The primary objective of this study was to develop and validate a Social Cognitive Theory-based instrument to identify psychosocial factors that influence diet and physical activity among Chinese children aged 10-12 years. DESIGN: This is a cross-sectional study, with data collected from questionnaires. SETTING: Two elementary schools in Beijing, China. PARTICIPANTS: Fourth to sixth-grade students (N = 1,486) aged 10-12 years were recruited. VARIABLES MEASURED: Gender, height, weight, nation, and grade were collected. Energy-balanced eating behaviors and their related sociopsychological factors were surveyed. ANALYSIS: Confirmatory factor analysis, Pearson correlations, Cronbach α index, and mediation analysis were used. RESULTS: (1) Confirmatory factor analysis revealed a 6-factor solution (51 items) and all factor loadings > 0.32, indicating that the model fitness was acceptable. (2) All correlation coefficients are statistically significant. All of the Cronbach α indexes were > 0.65, indicating acceptable reliability. (3) The mediating effect of goal intention and outcome expectations between self-efficacy and habit strength was statistically significant (P < 0.01), verifying the theory structure. CONCLUSIONS AND IMPLICATIONS: This questionnaire exhibits good internal consistency, reliability, and structural validity. It can be effectively employed to investigate energy-balanced eating behaviors related to the Social Cognitive Theory in Chinese children.

Indicators of Dietary Behavior and Physical Activity Change Associated with Metabolic Control of Obesity, Hypertension, and Type 2 Diabetes Mellitus in Mexican Adults: National Nutrition and Health Survey in Mexico, 2016.

Introduction: Obesity (OB), type 2 diabetes mellitus (T2D), and hypertension (HTN) are health issues in Mexico linked to unhealthy behaviors. This study investigates the relationship between behavior change indicators and metabolic control in Mexican adults with OB, T2D, and HTN. Methods: We used data from the 2016 National Health and Nutrition Survey Midway (ENSANUT MC-2016), representing ∼59.5 million Mexican adults aged 20-59 with these conditions. We assessed behavior change indicators, including stages of change, self-efficacy, and perceptions of benefits and barriers. In addition, we conducted descriptive analyses and used statistical tests, such as Pearson's chi-squared test and logistic regression models, adjusted for multiple variables. Results: We found that adults in the action and maintenance stages of physical activity (PA) were four times more likely to have adequate HTN control than those in the precontemplation stage. Self-efficacy for PA was related to better control in T2D and HTN. Self-efficacy for reducing the consumption of sugary beverages was positively associated with control in OB and T2D. No significant association was observed with self-efficacy for consuming fruits and vegetables. Conclusion: Behavior-change indicators are significantly linked to metabolic control in adults with HTN. These results support the importance of these indicators in managing chronic diseases such as HTN and their potential use in public health strategies.

I Treated the Way You Treated Me: The Effect of Leader Hypocrisy on Employees' Voice Behavior.

Purpose: In recent years, due to the increasingly prominent role of voice behavior in leader decision-making and organizational performance, such behavior has become a central topic for scholars. A majority of studies explore the "uphold" effects of multiple leader behavior toward the voice behavior; nonetheless, our study revealed the "undo" effect --- leader hypocrisy on voice behavior. Drawing on social cognitive theory, we investigated the relationship between leader hypocrisy and voice behavior, examined the mediating effects of cognition-based trust and affect-based trust, and the moderating effect of moral identity. Patients and Methods: We conducted a three-wave survey in a large Chinese corporation to test the hypothesized model. We collected 562 employees to participate in this survey. Results: The results show that leader hypocrisy negatively impacts employees' cognition-based and affect-based trust, and both types of trust mediate the relationship between leader hypocrisy and voice behavior, respectively. In the meantime, moral identity manifested the negative effect of leader hypocrisy on cognition-based and affect-based trust. Conclusion: Our research not only enriches the related research on leader hypocrisy and voice behavior but also uncovers the underlying mechanism through which leader hypocrisy affects voice behavior and the boundary conditions of this effect. Meanwhile, our research provides a theoretical reference for increasing employees' voice behavior and promoting the healthy development of enterprises.

The social-cognitive clinician: On the implications of social cognitive theory for psychotherapy and assessment.

We review Bandura's contributions to cognitive-behavioural theory, research and practice. His basic research on the causal role of cognitive processes in social learning was a major factor in the emergence of cognitive-behavioural therapies in the 1970s. His investigations on observational learning and self-efficacy beliefs led to the development of guided mastery therapy, a specific cognitive-behavioural intervention for anxiety disorders. His research on self-regulatory processes provided an empirical basis for the emergence of numerous therapies targeting self-regulation. We conclude by discussing how Bandura's social cognitive theory, as well as more recent advances in social cognitive theorising, might be further applied to innovative approaches to therapeutic interventions, assessment and clinical case conceptualization.

The relationships between parental attachment, peer attachment, automatic thoughts, and mindfulness skills among Iranian adolescents.

This study aimed to examine the relationship between parental attachment, peer attachments, and automatic thoughts with adolescent mindfulness skills in Iranian adolescents, drawing on internal working models and social cognitive theory. The data was collected from a sample of Iranian adolescents in Tehran using standardized measurement instruments previously developed by researchers. The collected data was analyzed using both simple and multiple regression analyses. The results revealed a positive and significant association between parental attachment and peer attachments with adolescent mindfulness skills. Conversely, automatic thoughts were found to have a negative impact on adolescent mindfulness skills. These findings suggest that strengthening attachments can contribute to the enhancement of mindfulness skills in adolescents, while addressing automatic thoughts is crucial in preventing the erosion of mindfulness skills. Consequently, experts can design interventions that focus on improving attachments and addressing automatic thoughts to promote adolescent mindfulness skills.

Driving employee organizational citizenship behaviour through CSR: An empirical study in the context of luxury hotels.

In the recent years, there has been a rising interest among luxury brands to be environmentally responsible and promote employee discretionary behaviour. However, the underlying mechanisms that explain why, when, and how employees demonstrate discretionary environmental attitudes and behaviour in luxury contexts are not well-known. To accelerate this discourse; the current study examines the impact of environmental corporate social responsibility (CSR) on employees' organizational citizenship behaviour towards environment. Drawing insights from social cognitive theory, this study empirically validates a conceptual model through the data collected from 406 employees of luxury hotels and analysed using structural equation modelling. The results confirm the significant effect of environmental CSR on employees' organizational citizenship behaviour towards environment. The results also reveal that employee environmental commitment and green work engagement partially mediate the proposed relationship. Moreover, contrary to expectations, gender did not moderate the influence of environmental CSR on employee environmental commitment and employee green work engagement, whereas the relationship between environmental CSR and organizational citizenship behaviour towards environment was stronger for males than females. We argue that creative environmental CSR assignments in luxury hotel chains help employees develop engagement, identification, and commitment with the environmental strategy of the hotels towards solving grave environmental problems that modern societies are grappling with.

Developing the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia program.

INTRODUCTION: With Alzheimer's disease and related dementias (ADRD) representing an enormous public health challenge, there is a need to support individuals in learning about and addressing their modifiable risk factors (e.g., diet, sleep, and physical activity) to prevent or delay dementia onset. However, there is limited availability for evidence-informed tools that deliver both quality education and support for positive behavior change such as by increasing self-efficacy and personalizing goal setting. Tools that address the needs of Latino/a, at higher risk for ADRD, are even more scarce. METHODS: We established a multidisciplinary team to develop the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia (HALT-AD) program, a bilingual online personalized platform to educate and motivate participants to modify their risk factors for dementia. Grounded in social cognitive theory and following a cultural adaptation framework with guidance from a community advisory board, we developed HALT-AD iteratively through several cycles of rapid prototype development, user-centered evaluation through pilot testing and community feedback, and refinement. RESULTS: Using this iterative approach allowed for more than 100 improvements in the content, features, and design of HALT-AD to improve the program's usability and alignment with the interests and educational/behavior change support needs of its target audience. Illustrative examples of how pilot data and community feedback informed improvements are provided. DISCUSSION: Developing HALT-AD iteratively required learning through trial and error and flexibility in workflows, contrary to traditional program development methods that rely on rigid, pre-set requirements. In addition to efficacy trials, studies are needed to identify mechanisms for effective behavior change, which might be culturally specific. Flexible and personalized educational offerings are likely to be important in modifying risk trajectories in ADRD.

Academic resilience, self-efficacy, and motivation: the role of parenting style.

Previous research has found that parenting style influences academic resilience. Nonetheless, few studies have focused on the mechanism underlying the relationship between parenting style and academic resilience. This study aims to examine the relationship between adolescents' parenting style and academic resilience, drawing upon the framework of Social Cognitive Theory. Specifically, it wants to explore the mediating roles of self-efficacy and academic motivation in this relationship. The participants were 518 students chosen at random from educational institutions in the Chinese provinces of Zhejiang, Shanghai, and Jiangsu. Social Cognitive Theory was the theoretical foundation for the study, and the Parental Authority Questionnaire was used to measure parenting style. Out of the respondents, 55.5% were male and 45.5% female. The student allocation in the study sample was as follows: 62.34% undergraduate, 28.22% master's, and 9.44% PhD. More than 60% of participants were over 25 years old. Moreover, the findings revealed that parenting style was directly and positively related to academic resilience. Parenting style was also found to be indirectly and positively related to academic resilience via self-efficacy and academic motivation, respectively, and sequentially. More crucially, it was discovered that the direct association was far lower than the indirect effects, with self-efficacy being the most effective. The study indicates a relationship between parenting style and academic resilience in adolescents, with self-efficacy and academic motivation acting as the main mediators. These findings emphasize the significance of these intermediary elements, implying that they play a larger role than the direct influence of parenting style alone.

Behaviors and influencing factors of Chinese oncology nurses towards hospice care: a cross-sectional study based on social cognitive theory in 2022.

BACKGROUND: Although there is growing demand for hospice care in China due to its aging population and increasing cancer rates, the sector remains slow to expand. Oncology nurses are the primary providers of hospice care, but little is known about their behaviors towards hospice care and related factors. METHODS: This cross-sectional study conveniently sampled 933 oncology nurses from six grade A tertiary hospitals in Hubei Province between January to March 2022. The questionnaire was composed of seven parts: general information (including sociodemographic and work-related information), hospice care behaviors, hospice care knowledge, hospice care attitudes, hospice care self-efficacy, hospice care outcome expectancy, and hospice care environment. Data were analyzed using descriptive analysis, independent sample t-tests, one-way ANOVA, Pearson's correlation, multiple linear regression, random forest regression, and BP neural network model analysis. RESULTS: A total of 852 questionnaires were valid. The mean score of hospice care behaviors was 50.47 ± 10.56, with a mean item score of 3.61 ± 0.75. The three highest scoring behaviors were "pain assessment of patients (4.21 ± 0.91)", "satisfying the physical and mental needs of dying patients (4.04 ± 0.92)", and "creating good relationships between the medical staff and family members (4.02 ± 0.87)". The two lowest-scoring behaviors were "proactively recommending medical institutions for hospice care to terminally ill patients and their families (2.55 ± 1.10)" and "proactively talking to patients and families about death-related topics for patients who are critically ill and cannot be reversed (2.87 ± 1.03)." Multiple linear regression, random forest regression, and BP neural network models all showed that the frequency of sharing hospice care experiences with colleagues, hospice care attitudes, hospice care self-efficacy, and hospice care environments were positively associated with hospice care behaviors. CONCLUSIONS: The frequency of hospice care behaviors among Chinese oncology nurses is generally at a moderate to high level. The results provide a basis for promoting hospice care behaviors among oncology nurses in order to improve the quality of life for terminally ill cancer patients.

The effect of cognition in combination with an ACBT on dyspnea-related kinesiophobia in patients with moderate to severe COPD: Quasirandomized controlled trial study.

Patients with moderate to severe COPD frequently experience dyspnea, which causes these patients to acquire a fear of dyspnea and a fear of activity. This study developed a cognitive intervention combined with active cycle of breathing technique (ACBT) intervention program based on the fear-avoidance model, with the goal of evaluating the program's effectiveness in improving dyspnea-related kinesiophobia in patients with moderate to severe COPD. This study had a total of 106 participants. For 8 weeks, the intervention group (N=53) received cognitive combined with ACBT, while the control group (N=53) received standard care. The findings of the four times the dyspnea belief questionnaire were collected indicated that the combined intervention had a better impact on reducing dyspnea-related kinesiophobia than did routine nursing (P<0.05), and the impact persisted even after the intervention. Additionally, it may enhance dyspnea and quality of life, increase exercise capacity, and lower the BODE index.

The Psychosocial Benefits of Biblioguidance Book Clubs.

BACKGROUND: Pedagogical approaches that support young people's well-being and maximize their potential are among the Journal of School Health research priorities. A unique form of observational learning called biblioguidance could be a pedagogical approach. METHODS: We, a team of researchers and teachers, implemented biblioguidance book clubs with 10th-grade health education students. While the initial focus was health literacy skills, we also aimed to generate psychosocial benefits. Those benefits are the focus of the current descriptive phenomenological research. A final book club reflection captured the benefits students received and documented their transformation. We randomly selected 42 reflections from the sample pool (n = 168) and coded them via descriptive document analysis. RESULTS: The results indicate that the book clubs provided psychosocial benefits. Students identified with the stories and characters, gained insight into others' perspectives, lived experiences, and "ways of the world," and were, in many ways, transformed. Some students even experienced catharsis, citing hope, validation, and feeling less alone. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Biblioguidance book clubs could offer an innovative pedagogical approach to advance students' psychosocial well-being and engage them as active participants in their own learning and health.

Goal pursuit increases more after dietary success than after dietary failure: examining conflicting theories of self-regulation using ecological momentary assessment.

BACKGROUND: Maintaining a healthy body weight and reaching long-term dietary goals requires ongoing self-monitoring and behavioral adjustments. How individuals respond to successes and failures is described in models of self-regulation: while cybernetic models propose that failures lead to increased self-regulatory efforts and successes permit a reduction of such efforts, motivational models (e.g., social-cognitive theory) make opposite predictions. Here, we tested these conflicting models in an ecological momentary assessment (EMA) context and explored whether effort adjustments are related to inter-individual differences in perceived self-regulatory success in dieting (i.e., weight management). METHODS: Using linear mixed effects models, we tested in 174 diet-interested individuals whether current day dietary success or failure (e.g., on Monday) was followed by self-regulatory effort adjustment for the next day (e.g., on Tuesday) across 14 days. Success vs. failure was operationalized with two EMA items: first, whether food intake was higher vs. lower than usual and second, whether food intake was perceived as more vs. less goal-congruent than usual. Trait-level perceived self-regulatory success in dieting was measured on a questionnaire. RESULTS: Intended self-regulatory effort increased more strongly after days with dietary success (i.e., eating less than usual / rating intake as goal-congruent) than after days with dietary failure (i.e., eating more than usual / rating intake as goal-incongruent), especially in those individuals with lower scores on perceived self-regulatory success in dieting. CONCLUSIONS: Findings support mechanisms proposed by social-cognitive theory, especially in unsuccessful dieters. Thus, future dietary interventions could focus on preventing the decrease in self-regulatory effort after instances of dietary failures and thereby mitigate the potential risk that a single dietary failure initiates a downward spiral into unhealthy eating.

Efficacy of StepAdd, a Personalized mHealth Intervention Based on Social Cognitive Theory to Increase Physical Activity Among Patients With Type 2 Diabetes Mellitus: Protocol for a Randomized Controlled Trial.

BACKGROUND: Increasing physical activity improves glycemic control in patients with type 2 diabetes (T2D). Mobile health (mHealth) interventions have been proven to increase exercise, but engagement often fades with time. As the use of health behavior theory in mHealth design can increase effectiveness, we developed StepAdd, an mHealth intervention based on the constructs of social cognitive theory (SCT). StepAdd improves exercise behavior self-efficacy and self-regulation through the use of goal-setting, barrier-identifying, and barrier-coping strategies, as well as automatic feedback functions. A single-arm pilot study of StepAdd among 33 patients with T2D showed a large increase in step count (mean change of 4714, SD 3638 daily steps or +86.7%), along with strong improvements in BMI (mean change of -0.3 kg/m2) and hemoglobin A1c level (mean change of -0.79 percentage points). OBJECTIVE: In this study, we aim to investigate the efficacy and safety of StepAdd, an mHealth exercise support system for patients with T2D, via a large, long, and controlled follow-up to the pilot study. METHODS: This is a randomized, open-label, multicenter study targeting 160 patients with T2D from 5 institutions in Japan with a 24-week intervention. The intervention group will record daily step counts, body weight, and blood pressure using the SCT-based mobile app, StepAdd, and receive feedback about these measurements. In addition, they will set weekly step count goals, identify personal barriers to walking, and define strategies to overcome these barriers. The control group will record daily step counts, body weight, and blood pressure using a non-SCT-based placebo app. Both groups will receive monthly consultations with a physician who will advise patients regarding lifestyle modifications and use of the app. The 24-week intervention period will be followed by a 12-week observational period to investigate the sustainability of the intervention's effects. The primary outcome is between-group difference in the change in hemoglobin A1c values at 24 weeks. The secondary outcomes include other health measures, measurements of steps, measurements of other behavior changes, and assessments of app use. The trial began in January 2023 and is intended to be completed in December 2025. RESULTS: As of September 5, 2023, we had recruited 44 patients. We expect the trial to be completed by October 8, 2025, with the follow-up observation period being completed by December 31, 2025. CONCLUSIONS: This trial will provide important evidence about the efficacy of an SCT-based mHealth intervention in improving physical activities and glycemic control in patients with T2D. If this study proves the intervention to be effective and safe, it could be a key step toward the integration of mHealth as part of the standard treatment received by patients with T2D in Japan. TRIAL REGISTRATION: Japan Registry of Clinical Trials (JRCT) jRCT2032220603; https://rctportal.niph.go.jp/en/detail?trial_id=jRCT2032220603. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53514.

Meaning matters: linking proactive vitality management to subjective well-being.

Prior research has indicated that positive affect, energy, and vitality are positively related to subjective well-being. Unfortunately, most scholars have overlooked the possibility that individuals may proactively manage their energetic, affective, and cognitive resources to boost their subjective well-being. Grounded in social cognitive theory, the current research focuses on explaining why students' proactive vitality management (PVM) leads to positive outcomes (i.e., meaning in life, subjective well-being) and considers how school support climate moderates these effects. One experimental study (Study 1) and a three-wave lagged survey (Study 2) were conducted to examine the benefits of PVM. The results demonstrated that PVM was positively related to students' meaning in life, further promoting their subjective well-being. Moreover, school support climate accentuated PVM's effect on meaning in life and its indirect effect on subjective well-being via meaning in life. Implications for research and practice are also discussed, along with study limitations and future research directions.

Study protocol of a randomized controlled trial to assess the efficacy of the "PrEPare for Work" intervention to enhance PrEP uptake and optimize adherence for HIV prevention among male sex workers in the U.S.

BACKGROUND: Male sex workers (MSWs), specifically cisgender men who exchange sex for money, goods, drugs, or other items of value with other cisgender men, are at high risk for HIV infection. Compared to men not engaged in sex work, MSWs are more likely to engage in frequent condomless sex with paying and non-paying sexual partners. While MSWs are often included as a subgroup of gay and bisexual men, data show that a large proportion identify as heterosexual; additionally, most MSWs do not identify as "sex workers." This places MSWs in a unique position where they may not engage with traditional HIV prevention programs, and when they do, they may not feel comfortable, leading to poor retention. Thus, HIV prevention interventions that address MSWs' unique life circumstances and provide support in exploring their sexual health options are needed. METHODS: In this protocol paper, we describe the design and procedures for a National Institute of Health-funded, randomized controlled trial testing the efficacy of "PrEPare for Work,"- a theory-based, manualized PrEP uptake and adherence intervention for MSW - using a 2-stage randomization design. Stage 1: MSWs are equally randomized to receive either the "PrEPare for Work Stage 1 intervention" (strength-based case management and facilitated PrEP linkage) or Standard of Care (SOC) to evaluate successful PrEP uptake (prescription filled) within two months post-randomization. Stage 2: Those who initiate PrEP are then equally re-randomized to receive either the "PrEPare for Work Stage 2 intervention" (1-on-1 skills training, problem-solving, and motivational interviewing adherence counseling and personalized, daily text message reminders) or SOC to assess adherence (Tenofovir concentrations in hair) over 12 months of follow up. Planned analyses will examine intervention efficacy, specific conceptual mediators, and hypothesized moderators. DISCUSSION: Based on our extensive preliminary research, multi-component, theory-informed interventions targeting this subpopulation of MSWs' unique life circumstances are urgently needed. In this study, we are evaluating whether "PrEPare for Work" can improve PrEP uptake and adherence among MSWs. If this intervention is efficacious, it would be readily disseminated to diverse community organizations that serve MSWs and possibly other community or clinic-based settings. TRIAL REGISTRATION: ClinicalTrials.gov number NCT05736614, registered February 8, 2023.

Addressing health challenges in rural Japan: a thematic analysis of social isolation and community solutions.

BACKGROUND: The establishment of sustainable connections between medical professionals and rural citizens is pivotal for effective community healthcare. Our study focuses on understanding and resolving health problems arising from social isolation, a critical barrier to achieving this goal, especially in the context of the coronavirus disease 2019(COVID-19) pandemic's impact on community dynamics respecting social cognitive theory. This study investigates the link between social isolation and rural community healthcare. We aim to develop methods that improve interaction and collaboration between healthcare providers and rural communities, ultimately enhancing the region's healthcare system. METHODS: Employing thematic analysis based on social cognitive theory, we conducted semi-structured interviews with 57 community workers in rural communities. This qualitative approach enabled us to delve into the nuances of social isolation and its multifaceted impact on health and community well-being. RESULTS: Our analysis revealed four key themes: the impact of aging on social dynamics, shifts in community relationships, unique aspects of rural community networking, and the role of these networks in driving community health. Notably, we identified specific challenges, such as the erosion of intergenerational interactions and the hesitancy to seek support, exacerbated by social isolation and negatively impacting community health. CONCLUSIONS: Our study reveals the complex factors affecting rural community sustainability, particularly social isolation influenced by privacy concerns and changing social dynamics. Emphasizing the importance of social cognitive theory, it highlights the need for adaptable healthcare systems and strong community-medical collaborations. Future research should focus on developing culturally sensitive, practical strategies for enhancing these collaborations, especially involving physicians, to address rural communities' unique challenges.

A Multi-Stage Dyadic Qualitative Analysis to Disentangle How Dietary Behaviors of Asian American Young Adults are Influenced by Family.

The dietary behaviors of Asian American (AA) young adults, who face a growing non-communicable disease burden, are impacted by complex socio-ecological forces. Family plays a crucial role in the lifestyle behaviors of AA young adults; however, little is known on the methods, contributors, and impact of familial dietary influence. This study aims to deconstruct the mechanisms of AA young adult familial dietary influence through a multi-perspective qualitative assessment. A five-phase method of dyadic analysis adapted from past research was employed to extract nuanced insights from dyadic interviews with AA young adults and family members, and ground findings in behavioral theory (the Social Cognitive Theory, SCT). 37 interviews were conducted: 18 young adults, comprising 10 different AA ethnic subgroups, and 19 family members (10 parents, 9 siblings). Participants described dietary influences that were both active (facilitating, shaping, and restricting) and passive (e.g., sharing foods or environment, mirroring food behaviors). Influences connected strongly with multiple SCT constructs (e.g., behavioral capacity, reinforcements for active influences, and expectations, observational learning for passive influences). Familial influence contributed to changes in the total amount, variety, and healthfulness of foods consumed. Intra-family dynamics were crucial; family members often leveraged each other's persuasiveness or food skills to collaboratively influence diet. AA family-based interventions should consider incorporating both passive and active forms of dietary influence within a family unit, involve multiple family members, and allow for individualization to the unique dynamics and dietary behaviors within each family unit.

Feasibility and potential efficacy of a family-based intervention on promoting physical activity levels and fundamental movement skills in preschoolers: A cluster randomised controlled trial.

Physical activity (PA) is crucial for preschool-aged children's health and development. However, limited evidence exists regarding the feasibility of implementing home-based interventions and how program components influence parent cognitions and practices and child PA. This study evaluated the feasibility and potential efficacy of a family-based PA intervention on objectively measured PA, fundamental movement skills (FMS), parental efficacy, support, goal setting and parent-child co-activity. Guided by social cognitive theory, an 8-week cluster randomised controlled trial was conducted in Hong Kong. The trial included parental workshops, FMS training, PA homework, social media activity sharing and exercise equipment provision. Data were collected at baseline (Time 1; April 2019) and at the end of the intervention period (Time 2; approximately 2 months later) from 108 parent-child pairs in five preschools. The intervention led to increased moderate-to-vigorous PA and FMS in children, along with improved parental self-efficacy, goal setting, supportiveness and co-participation. However, parental PA did not show significant changes. Parents expressed high satisfaction, supporting the need for tailoring interventions to address the unique needs and preferences of young children and their parents. Reinforcing the parental role and providing informative materials and training can promote healthy lifestyles in early childhood.