Effective modulation from the ventral medial to the dorsal medial portion of the prefrontal cortex in memory confidence-based behavioral control.

Metacognition includes the ability to refer to one's own cognitive states, such as confidence, and adaptively control behavior based on this information. This ability is thought to allow us to predictably control our behavior without external feedback, for example, even before we take action. Many studies have suggested that metacognition requires a brain-wide network of multiple brain regions. However, the modulation of effective connectivity within this network during metacognitive tasks remains unclear. This study focused on medial prefrontal regions, which have recently been suggested to be particularly involved in metacognition. We examined whether modulation of effective connectivity specific to metacognitive behavioral control is observed using model-based network analysis and dynamic causal modeling (DCM). The results showed that negative modulation from the ventral medial prefrontal cortex to the dorsal medial prefrontal cortex was observed in situations that required metacognitive behavioral control but not in situations that did not require such metacognitive control. Furthermore, this modulation was particularly pronounced in the group of participants who could better use metacognition for behavioral control. These results imply hierarchical properties of metacognition-related brain networks.

The relationship between women's perception of support and control during childbirth on fear of birth and mother's satisfaction.

The study was conducted in order to determine the relationship between women's perception of support and control during childbirth on fear of birth and mother's satisfaction. This descriptive study was carried out at the postpartum clinics of a state hospital. Seven hundred and twenty-five puerperal women were included in the sample. T test in independent groups and Pearson's correlation test were used in the evaluation of the data. Seventy-six percent of the puerperal women had vaginal birth, 24% had caesarean section. The mother's perception of control and support at birth was moderate (99.04 ± 17.30), the fear of birth was at clinical level in most of them (92.8%), and the satisfaction at vaginal and caesarean births was low. Puerperal women who had a planned pregnancy, non-invasive birth, birth without perineal tear had higher support and control perception at birth and lower fear of birth than who had unplanned pregnancy, invasive birth, or birth with a perineal tear (p<.05). Puerperal women who did not have any health problems during pregnancy and postpartum period had higher satisfaction levels compared to those who did (p<.05). The high level of perception of support and control at birth decreases the fear of childbirth and increases the satisfaction levels of puerperal women in vaginal and caesarean births. All health professionals, especially perinatal nurses and midwives, should strive to implement care initiatives that are appropriate to the needs of women.Impact StatementWhat is already known on this subject? The mode of delivery, insufficient supportive care during delivery, or perception of supportive care received are among the causes of trauma among women. Birth trauma may cause women to experience stress, anxiety, fear and loss of control, and maternal and foetal/neonatal health is adversely influenced during the delivery and postpartum period. A literature review revealed no study examining the effect of maternal perception of support and control during delivery on fear of childbirth and maternal satisfaction.What the results of this study add? Stronger perception of support and control during delivery reduces fear of childbirth, and also increases puerperal women's levels of satisfaction from care during vaginal and caesarean deliveries.What the implications are of these findings for clinical practice and/or further research? Facilitating women's achievement of personal control and expectations during childbirth should be the focus of care interventions. In line with these results, it may be recommended that all healthcare professionals, especially perinatal nurses and midwives, strive to implement care initiatives that comply with the needs of women.

Using Theories of Behavior Change to Develop Interventions for Healthy Aging.

Healthy aging requires people to adopt and maintain beneficial behaviors in all stages of the life span. Supporting behavior change, including via the motivation to make and maintain those changes, is therefore important for the promotion of healthy aging. The aim of this overview is to introduce theoretical frameworks from the psychology of motivation that lend themselves to the development of effective interventions promoting behavior change conducive to healthy aging. We discuss theoretical frameworks referring to the determinants, properties, and functionality of goals aimed at behavior change, and consider the implications of the various theories for designing interventions to support healthy aging. We first consider theories that focus on beliefs and attitudes as determinants of goals, then we address theories that focus on the structure and content as important properties of goals, and, finally, we examine theories drawing on conscious and nonconscious processes underlying the functionality of these goals. We will present if-then planning and mental contrasting, as well as nudging and boosting, that is, novel strategies of behavior change that support the creation of scalable interventions for healthy aging across the life span. Against this background, new perspectives emerge for modern, state-of-the-art, and individually tailored interventions with the aim of enhancing older people's healthy living.

Perioperative patient safety management activities: A modified theory of planned behavior.

Patient safety is an important healthcare issue worldwide, and patient accidents in the operating room can lead to serious problems. Accordingly, we investigated the explanatory ability of a modified theory of planned behavior to improve patient safety activities in the operating room. Questionnaires were distributed to perioperative nurses working in 12 large hospitals in Korea. The modified theory of planned behavior data from a total of 330 nurses were analyzed. The conceptual model was based on the theory of planned behavior data, with two additional organizational factors-job factors and safety management system. Individual factors included attitude, subjective norms, perceived behavioral control, behavioral intention, and patient safety management activities. Results indicated that job factors were negatively associated with perceived behavioral control. The patient safety management system was positively associated with attitude, subjective norm, and perceived behavioral control. Attitude, subjective norm, and perceived behavioral control were positively associated with behavioral intention. Behavioral intention was positively associated with patient safety management activities. The modified theory of planned behavior effectively explained patient safety management activities in the operating room. Both organizations and individuals are required to improve patient safety management activities.

Disease History and Life History Predict Behavioral Control of the COVID-19 Pandemic.

It is puzzling why countries do not all implement stringent behavioral control measures to prevent the spread of COVID-19 even though preventive behaviors have been proven to be the only effective means to stop the pandemic. We provide a novel evolutionary life history explanation whereby pathogenic and parasitic prevalence represents intrinsic rather than extrinsic mortality risk that drives slower life history strategies and the related disease control motivation in all animals but especially humans. Our theory was tested and supported based on publicly available data involving over 150 countries. Countries having a higher historical prevalence of infectious diseases are found to adopt slower life history strategies that are related to prompter COVID-19 containment actions by the government and greater compliance by the population. Findings could afford governments novel insight into the design of more effective COVID-19 strategies that are based on enhancing a sense of control, vigilance, and compliance in the general population.

Parental control and support for physical activity predict adolescents' moderate to vigorous physical activity over five years.

BACKGROUND: Social factors are important determinants of youth physical activity (PA), but the longitudinal association between parental behaviours and adolescent PA has not been clearly assessed. This prospective study examined average and lagged associations between perceived parental support and control with adolescents' moderate to vigorous PA (MVPA); and assessed the independent associations between specific parental support and control behaviours and adolescents' MVPA. METHODS: Data from three cycles of the MATCH study, when 374 participants were 12, 16 and 17 years old, were included in this analysis. At each cycle, participants self-reported questionnaires on perceived tangible parental support, intangible support, and control behaviours as well as number of days per week attaining at least 60 min of MVPA. Mixed effect models were used to assess the longitudinal relationship between parental behaviours and MVPA. Cross-lagged panel design was used to assess the association of parental behaviours during early adolescence with MVPA during late adolescence. RESULTS: Overall parental support (coef. = 0.46, P < 0.0001), tangible support (coef. = 0.37, P < 0.0001), encouragement (coef. = 0.12, P = 0.025) and transportation (coef. = 0.25, P < 0.0001) were positively associated with MVPA, whereas parental control was a negative predictor of MVPA (coef. = - 0.18, P = 0.003). Perceived parental behaviours appeared to have long term associations (5 y.) with MVPA as parent support (coef. = 0.40, P = 0.006) and co-participation (coef. = 0.33, P = 0.017) reported around age 12 were positively associated with MVPA measured 5 years later. CONCLUSIONS: Parental support for PA, particularly in the form of tangible support, may be a key factor to include in interventions aiming to promote PA during adolescence. In contrast, parents should be encouraged to avoid control behaviours as these appear to lead to lower MVPA among adolescents.

Intraindividual Variability of Sleep Opportunity Attitudes, Perceived Norms, Perceived Behavioral Control, and Intentions.

BACKGROUND: Recent research has used the theory of planned behavior (TPB) to predict sleep. However, this research has focused on between-person effects and has failed to capture the intraindividual variability of sleep-related attitudes, subjective norms, perceived behavioral control, and intentions. PURPOSE: The current study sought to characterize the between- and within-day patterns of these constructs. METHODS: Participants (N = 79) completed a 1 week ecological momentary assessment protocol in which they reported their attitudes, subjective norms, perceived behavioral control, and intentions toward nightly sleep opportunity four times per day. RESULTS: Analyses revealed both between- and within-day variability of these constructs, with perceived behavioral control and intentions demonstrating greater variability than attitudes and subjective norms. Mixed linear models revealed that attitudes and subjective norms significantly increased throughout the week, while perceived behavioral control and intentions significantly decreased throughout the day. CONCLUSIONS: The between- and within-day patterns of the TPB constructs highlight important methodological considerations and provide insight into the potential refinement of sleep promotion efforts.

Behaviour change approaches for individuals with diabetes to improve foot self-management: a scoping review.

BACKGROUND: Diabetes related foot complications are increasing in complexity, frequency and cost. The application of self-management strategies can reduce the risk of individuals developing foot complications. The type, range and nature of the literature focusing on interventions that support patients with diabetic foot self-management is unknown. This scoping review aimed to i) identify self-management actions and risky behaviour avoidance strategies within interventions, ii) map the theoretical functions through which these behaviour change interventions have an effect, iii) display gaps in the research. METHODOLOGY: Arksey and Malley's (2003) 5 stage framework was followed to conduct the scoping study. This methodological framework was selected because it was developed specifically for scoping reviews and therefore offered clear methodological distinction from systematic review methodology. . Databases were searched from inception of the project until June 2020 supplemented by hand searching of reference lists. In total 988 papers were identified. These were independently screened by three reviewers, identifying 19 eligible papers. Data extraction and charting of data was independently conducted by three reviewers to identify study characteristics, self-management actions and risky behaviours. Data was charted against the COM-B (capability, opportunity, motivation, behaviour) model of behaviour to determine intervention function. RESULTS: In total 25 different foot self-management actions and risk behaviours were classified into three themes; routine self-management, trauma avoidance and warning signs and actions. Inspect feet daily received the most attention. The majority of interventions focused on knowledge and skills, but overlooked taking action and decision making. Intervention mapping identified four primary intervention functions (education, persuasion, training and enablement) used to address deficits in capability, opportunity and motivation that positively improved foot self-management behaviour. No studies targeted first ulcer prevention, and most either did not measure or improve foot health outcomes. CONCLUSION: This review charted the evidence for interventions promoting diabetic foot self-management through a theoretical behaviour change perspective. A core set of behaviour change activities and intervention functions associated with positive changes in behaviour were identified. This information will provide researchers with a useful basis for developing self-management interventions.

Perceived Psychological Control in Early Adolescence Predicts Lower Levels of Adaptation into Mid-Adulthood.

This study examined perceived parental psychological control in early adolescence as a critical stressor likely to be associated with lower levels of adaptation into mid-adulthood. A diverse sample of 184 adolescents was followed from age 13 through 32 to assess predictions to adult adaptation. Perceived parental psychological control at age 13 predicted relative decreases in observed support, lower likelihood of being in a romantic relationship, and lower academic attainment (after accounting for grade point average at baseline) by age 32. Many outcomes were mediated by lower levels of psychosocial maturity and peer acceptance in mid-adolescence. Overall, results suggest that perceived parental psychological control in early adolescence potentially undermines autonomy so as to lead to less favorable outcomes well into adulthood.

The Fast Track intervention's impact on behaviors of despair in adolescence and young adulthood.

How to mitigate the dramatic increase in the number of self-inflicted deaths from suicide, alcohol-related liver disease, and drug overdose among young adults has become a critical public health question. A promising area of study looks at interventions designed to address risk factors for the behaviors that precede these -often denoted-"deaths of despair." This paper examines whether a childhood intervention can have persistent positive effects by reducing adolescent and young adulthood (age 25) behaviors that precede these deaths, including suicidal ideation, suicide attempts, hazardous drinking, and opioid use. These analyses test the impact and mechanisms of action of Fast Track (FT), a comprehensive childhood intervention designed to decrease aggression and delinquency in at-risk kindergarteners. We find that random assignment to FT significantly decreases the probability of exhibiting any behavior of despair in adolescence and young adulthood. In addition, the intervention decreases the probability of suicidal ideation and hazardous drinking in adolescence and young adulthood as well as opioid use in young adulthood. Additional analyses indicate that FT's improvements to children's interpersonal (e.g., prosocial behavior, authority acceptance), intrapersonal (e.g., emotional recognition and regulation, social problem solving), and academic skills in elementary and middle school partially mediate the intervention effect on adolescent and young adult behaviors of despair and self-destruction. FT's improvements to interpersonal skills emerge as the strongest indirect pathway to reduce these harmful behaviors. This study provides evidence that childhood interventions designed to improve these skills can decrease the behaviors associated with premature mortality.

Attractive Flu Shot: A Behavioral Approach to Increasing Influenza Vaccination Uptake Rates.

Background. We suggest and examine a behavioral approach to increasing seasonal influenza vaccine uptake. Our idea combines behavioral effects generated by a dominated option, together with more traditional tools, such as providing information and recommendations. Methods. Making use of the seasonal nature of the flu, our treatments present participants with 2 options to receive the shot: early in the season, which is recommended and hence "attractive," or later. Three additional layers are examined: 1) mentioning that the vaccine is more likely to run out of stock late in the season, 2) the early shot is free while the late one costs a fee, and 3) the early shot carries a monetary benefit. We compare vaccination intentions in these treatments to those of a control group who were invited to receive the shot regardless of timing. Results. Using a sample of the Israeli adult population (n = 3271), we found positive effects of all treatments on vaccination intentions, and these effects were significant for 3 of the 4 treatments. In addition, the vast majority of those who are willing to vaccinate intend to get the early shot. Conclusions. Introducing 2 options to get vaccinated against influenza (early or late) positively affects intentions to receive the flu shot. In addition, this approach nudges participants to take the shot in early winter, a timing that has been shown to be more cost-effective.

Does Perceived Lack of Control Lead to Conspiracy Theory Beliefs? Findings from an online MTurk sample.

It is widely believed that conspiracy theory beliefs are the product of perceived lack of control. However, to date there is mixed evidence, at best, to support this claim. We consider the reasons why conspiracy theory beliefs do not appear to be based in any straightforward way on control beliefs, interrogating existing findings and presenting new data that call the relationship into question. Across six studies conducted online using MTurk samples, we observed no effect of control manipulations on conspiracy theory beliefs, while replicating previously reported correlational evidence of their association. The results suggest that conspiracy beliefs are not suitable for compensating for threats to control. We discuss possible reasons for the discrepancy between experimental and correlational effects and examine the limitations of the studies.

Assessing the Intention to Provide Human Genetic Resources: An Explanatory Model.

BACKGROUND: Human genetic resources are an important material component for life science research and have strategic significance for medical science and technological innovation. In this study, we employ frameworks from social psychology and the science of human behavior to study human genetic resource providers. AIMS: We used structural equation techniques to explain factors affecting the intention to provide human genetic resources and the mechanisms for providing such resources. METHODS: We conducted an online survey with respondents from ethnic minorities (n = 912). Our model integrates key variables informed by the theory of planned behavior (TPB), the theory of benefit and risk assessment (BRA), as well as variables that represent the policy and political system. RESULTS: Our results show that the factors affecting the intention to provide human genetic resources, ranked from highly influential to less influential, are perceived benefits, privacy risk, attitudes toward providing human genetic resources, perceived behavioral efficacy, psychological risk, subjective norms, and physical risk. The variables informed by the TPB all have a significant positive effect on the intention to provide human genetic resources. With the exception of physical risk, the variables informed by the theory of BRA have a significant effect on the intention to provide human genetic resources. Respondents with different health conditions have significantly different levels of physical risk. CONCLUSIONS: The results of our study provide insights into how to improve people's intention to provide human genetic resources. We also proposed ways to protect such resources globally.

Motivational Interviewing to Increase Physical Activity Behavior in Cancer Patients: A Pilot Randomized Controlled Trials.

OBJECTIVE: This pilot randomized controlled trial (RCT) aimed at evaluating the feasibility and potential efficacy of a motivational interviewing (MI) intervention to increase physical activity (PA) behavior in cancer patients. METHODS: Participants were randomly assigned to an experimental group with standard care plus 12 MI sessions within 12 weeks or a control group with standard care only. The number of recruited participants and the modality of recruitment were recorded to describe the reach of the study. The acceptability of the study was estimated using the attrition rate during the intervention phase. The potential efficacy of the intervention was evaluated by analyzing the PA behavior. RESULTS: Twenty-five participants were recruited within the 16-month recruitment period (1.6 participants per month). Five participants (38.5%) from the experimental group (n = 13) and one participant (8.3%) from the control group (n = 12) dropped out of the study before the end of the intervention phase. No group by time interaction effect for PA behavior was observed at the end of the intervention. CONCLUSION: Due to the low recruitment rate and compliance, no conclusion can be drawn regarding the efficacy of MI to increase PA behavior in cancer patients. Moreover, the current literature cannot provide any evidence on the effectiveness of MI to increase PA in cancer survivors. Future RCTs should consider that the percentage of uninterested patients to join the study may be as high as 60%. Overrecruitment (30% to 40%) is also recommended to accommodate the elevated attrition rate.

A cross-sectional survey examining motivation and beliefs to participating in a web-based prospective cohort study on nutrition and health among individuals with a low socioeconomic status.

BACKGROUND: Prospective cohort studies may support public health efforts in reducing health inequalities. However, individuals with a low socioeconomic status (SES) are generally underrepresented in health research. This study aimed to examine the intention and determinants of intention of individuals with a low SES towards participation in a Web-based prospective project on nutrition and health (NutriQuébec) in order to develop recruitment and retention strategies. METHODS: A cross-sectional survey based on the Theory of planned behaviour was conducted in the Province of Québec, Canada. Low SES individuals (high school or less and annual household income < $55,000 CAN) were recruited through a Web panel of a polling firm to assess intention, attitude, subjective norm and perceived behavioural control (PBC) towards participation in the NutriQuébec project. Linear regression and logistic regression analyses were conducted. RESULTS: Mean age of respondents (184 women, 141 men) was 57.6 y (SD = 13.6). Attitude (ß = 0.54, 95%CI: 0.41-0.68) and PBC (ß = 0.50, 95%CI: 0.37-0.63) were significantly associated with intention. Participants who agreed that participating in the study would contribute to an improvement in 1) collective health (odds ratio [OR] = 2.15, 95%CI: 1.27-3.64) and in 2) one's lifestyle habits (OR = 1.70, 95%CI: 1.04-2.78) were more likely to express positive intention compared to participants who did not agree with these statements. Participants who agreed to participate in the study even 1) in the absence of a financial incentive (OR = 1.43, 95%CI: 1.04-1.99) and even 2) if the completion of questionnaires took up to two hours (OR = 1.78, 95%CI: 1.27-2.48) were also more likely to express high intention. Receiving a personalized brief health assessment (OR = 1.61, 95%CI: 1.13-2.30) and the use of simple questions in the questionnaires (OR = 1.54, 95%CI: 1.05-2.25) were facilitating factors associated with high intention. Participants believing that participation would be too time-consuming were less likely to have positive intention (OR = 0.57, 95%CI: 0.43-0.75). CONCLUSIONS: The development of a positive attitude and a high PBC towards participation in the NutriQuébec project will be necessary to obtain representative data of low SES adults.

The Influence of Information Intervention Cognition on College Students' Energy-Saving Behavior Intentions.

Based on the theory of planned behavior, this research examines the influence of different types of information on the behavioral intentions of college students in the context of perceived behavioral control (perceived self-efficacy and perceptual control) as mediating variables. The results showed that: (1) Different types of information intervention factors have different effects on perceptual self-efficacy and perceptual control; the influence degree of economic cost has the strongest effect, followed by group pressure, while the influence degree of publicity and education has the weakest effect. However, policy intervention has no statistically significant effect on both of them (perceived self-efficacy and perceptual control). (2) Two variables, perceived self-efficacy and perceptual control, serve as mediators between information intervention factors and energy-saving behavior intention. (3) Individual characteristic factors have significant moderating effects on each path in the model of information intervention-perceived behavior control-intention. Finally, suggestions are made on how to encourage college students to more effectively save energy.

Internet-delivered attentional bias modification training (iABMT) for the management of chronic musculoskeletal pain: a protocol for a randomised controlled trial.

INTRODUCTION: Chronic musculoskeletal pain is a complex medical condition that can significantly impact quality of life. Patients with chronic pain demonstrate attentional biases towards pain-related information. The therapeutic benefits of modifying attentional biases by implicitly training attention away from pain-related information towards neutral information have been supported in a small number of published studies. Limited research however has explored the efficacy of modifying pain-related biases via the internet. This protocol describes a randomised, double-blind, internet-delivered attentional bias modification intervention, aimed to evaluate the efficacy of the intervention on reducing pain interference. Secondary outcomes are pain intensity, state and trait anxiety, depression, pain-related fear, and sleep impairment. This study will also explore the effects of training intensity on these outcomes, along with participants' perceptions about the therapy. METHODS AND ANALYSIS: The study is a double-blind, randomised controlled trial with four arms exploring the efficacy of online attentional bias modification training versus placebo training theorised to offer no specific therapeutic benefit. Participants with chronic musculoskeletal pain will be randomised to one of four groups: (1) 10-session attentional modification group; (2) 10-session placebo training group; (3) 18-session attentional modification group; or (4) 18-session placebo training group. In the attentional modification groups, the probe-classification version of the visual-probe task will be used to implicitly train attention away from threatening information towards neutral information. Following the intervention, participants will complete a short interview exploring their perceptions about the online training. In addition, a subgroup analysis for participants aged 16-24 and 25-60 will be undertaken. ETHICS AND DISSEMINATION: This study has been approved by the University of Southampton Research Ethics Committee. Results will be published in peer-reviewed journals, academic conferences, and in lay reports for pain charities and patient support groups. TRIAL REGISTRATION NUMBER: NCT02232100; Pre-results.

Guilty displeasures: How imagined guilt dampens consumer enjoyment.

Within the domain of food consumption, we explore the antecedents and consequences of "guilty displeasures," or experiences that consumers should enjoy, but do not. Food is an emotionally charged stimulus, with consumption leading to both positive (e.g., joy) and negative (e.g., guilt) emotions. Individuals who are high in dietary restraint are particularly susceptible to experiencing negative emotions given their heightened state of arousal in the presence of indulgent food. We show that these negative emotions arise even when individuals simply imagine the food. Across one pilot study and three experiments, we provide evidence that restrained eaters actively dampen their enjoyment of indulgences (i.e., guilty displeasures). We manipulate guilt using imagery type, with outcome imagery leading to greater guilt than process imagery (study 1). We also demonstrate that individuals high, compared to low, in dietary restraint dampen their savoring of even a hypothetical indulgence when guilt is evoked (study 2). Finally, we show these effects within the context of actual food consumption (study 3). Our exploration shows that merely anticipating an indulgence can elicit guilt among consumers high in dietary restraint, thus resulting in the dampening of enjoyment during a subsequent consumption experience.

School personnel and community members' perspectives in implementing PAX good behaviour game in first nations grade 1 classrooms.

First Nations peoples in Canada have a history of poor mental health outcomes, as the result of colonisation and the legacy of residential schools. The PAX Good Behaviour Game (PAX-GBG) is a school-based intervention shown to improve student behaviour, academic outcomes, and reduce suicidal thoughts and actions. This study examines the use of PAX-GBG in First Nations Grade 1 classrooms in Manitoba. Researchers collected qualitative data via interviews and focus groups from 23 participants from Swampy Cree Tribal Council (SCTC) communities. Participants reported both positive effects and challenges of implementing PAX-GBG in their classrooms. PAX-GBG created a positive environment where children felt included, recognised, and empowered. Children were calmer, more on-task, and understood the behaviours that are expected of them. However, for many reasons, PAX-GBG is not being used consistently across SCTC schools. Participants described barriers in implementation due to teacher turnover, lack of on-going training and support, developmental and behavioural difficulties of students, and larger community challenges. Participants provided suggestions on how to improve PAX-GBG to be a better fit for these communities, including important cultural and contextual adaptations. PAX-GBG has the potential to improve outcomes for First Nations children, however attention must be given to implementation within community context.