Search Results (70)

Background/Objectives: Healthcare workers (HCWs) have a crucial role in addressing vaccine hesitancy in ethnic minority populations as they are a trusted source of information. The aim of this systematic review is to synthesise and evaluate behaviour change techniques (BCTs) and strategies in interventions aimed at HCWs to promote vaccine uptake among ethnic minority populations. Methods: The literature was systematically searched in peer-reviewed databases and the grey literature. Studies were included if they reported interventions for respiratory and routinely recommended vaccine-preventable diseases which were delivered by HCWs to increase vaccine uptake in ethnic minority groups. Interventions were coded using the Behaviour Change Wheel (BCW) and BCT Taxonomy. Results: From 7250 records identified, 14 studies were included in the review. Vaccines targeted by interventions included influenza, pneumococcal disease, pertussis, tetanus, diphtheria, meningitis and hepatitis B. Seven BCW intervention types, six policy options and 22 BCTs were identified. Main intervention types used were persuasion, enablement and education. Effective interventions had multi-components and were tailored to specific populations. Staff training to improve vaccine recommendation and dialogue with patients, and prompts/cues were associated with positive effects, but there was no strong evidence to recommend one specific intervention strategy over another as effectiveness was linked to a multitude of BCTs and intervention types. Conclusions: Several strategies aimed at HCWs can be used and tailored to increase vaccine uptake among ethnic minority communities; however, this does not address all issues related to low vaccine uptake. While HCWs are necessary, without system-level enablement, they cannot fully address barriers to vaccine uptake. Full article

Background: Sleep disturbances are common in dementia and adversely affect both the person with dementia and their caregiver. Non-pharmacological options exist but are seldom dyadic or culturally tailored, limiting their reach and relevance across diverse communities. Objective: We aimed to co-develop DREAM (Dyadic Resilience, Engagement, Awareness & Mind–body intervention)—an 8-week dyadic mind–body programme (mindfulness + gentle Tai Chi) for improving sleep and wellbeing in people with dementia and their caregivers. Methods: The process was informed by Intervention Mapping (Stages 1–4) and underpinned by established behaviour change frameworks, including the Behaviour Change Wheel (BCW), the COM-B model (Capability, Opportunity, Motivation → Behaviour), and the Theoretical Domains Framework (TDF), to systematically identify determinants of engagement. Co-design involved dementia–caregiver dyads, Patient and Public Involvement (PPI) contributors, clinicians, mind–body practitioners, and community stakeholders. Results: The intervention was co-developed and culturally grounded through engagement with White British, Caribbean, Chinese, and South Asian communities. Participants reported high cultural resonance, endorsing DREAM’s concise practices, caregiver-supported home routines, and delivery in trusted community venues. Behavioural insights highlighted the importance of motivational framing (perceived dyadic benefits, cultural meaning), practical enablement (simplified guidance, prompts/cues, environmental restructuring), and caregiver facilitation to support adherence. Conclusions: DREAM demonstrates the practicability of using Intervention Mapping to co-develop a culturally responsive, theory-informed dyadic mind–body intervention for people with dementia and their caregivers. This groundwork supports progression to a feasibility trial focused on implementation processes and preliminary sleep and wellbeing outcomes. Full article

Background: Human papillomavirus (HPV) infection is the leading cause of cervical cancer, which presents a significant health burden in low- and middle-income settings such as Kosovo^†, where it is the second leading cause of death among women. HPV vaccines are highly effective and integral to global cervical cancer elimination efforts. In 2024, Kosovo^† introduced the HPV vaccine into its immunisation schedule via a school-based program targeting sixth-grade girls. Rapid, theory-based insights supported development of a tailored communication and intervention plan ahead of the introduction. Methods: Over a two-week period, qualitative research was conducted with 102 participants, including healthcare professionals, parents, girls in the target age group, school staff, and community influencers. Data collection, analysis, and intervention development were carried out using the Behaviour Change Wheel (BCW) model, underpinned by the Capability, Opportunity, and Motivation for Behaviour change (COM-B) theoretical framework. Results: Trust in school-based immunisation and healthcare professionals emerged as key drivers, while a predominance of capability- and physical-opportunity-related barriers across target groups underscored the need for targeted communication and capacity-building efforts for all stakeholders. Using the BCW model, communication and intervention activities were developed for implementation by partners. Conclusions: Using rapid insight research grounded in the BCW model enabled the timely identification of behavioural drivers and barriers to HPV vaccine acceptance and supported development of a targeted intervention plan. The findings echoed global research on HPV vaccine introduction, highlighting context-specific needs and enablers and contributing to a successful rollout marked by high uptake within the first six months. Full article

Transition zones are located at points on a track where there has been a change in the main composition of the railway infrastructure; as such, there are many sections that undergo a sudden change in the stiffness of the structures built. When trains are running, a longitudinal shockwave is created by the wheels, hitting these building objects with a greater stiffness and deforming the surroundings of these zones. The greatest amount of attention should be paid to the transition points from the fixed track to the classic track with a track bed, including objects of the railway substructure, such as bridges and portals of tunnels. As part of the research on the main corridor lines, long-term inspection and monitoring studies were carried out using a trolley with a continuous measurement system; height changes in the deflections of rails are evidence of their behaviour. The measurements took place on a fixed track and a track with ballast. The changes in the height jumps between the fixed railway track and the track with a gravel bed are significant. These height deflections allow designers to develop new, more durable construction designs. Full article

Background/Objectives: A healthy diet is essential for managing Polycystic Ovary Syndrome (PCOS), yet optimal recommendations remain unclear, highlighting the need to explore alternative lifestyle interventions. The Mediterranean diet (MedDiet) supports cardiometabolic health; however, challenges with adherence within this population are unknown. This study examines the acceptability and experiences of an ad libitum MedDiet in women with PCOS, offering recommendations for implementation. Methods: A 12-week MedDiet intervention was conducted with women aged 18–45 years, diagnosed with PCOS and a BMI ≥ 25 kg/m² (n = 12). Adherence was assessed using the Mediterranean Diet Adherence Screener. Surveys and semi-structured interviews, guided by the Capability, Opportunity, Motivation–Behaviour (COM-B) model, explored participants’ experiences. Thematic analysis identified barriers and facilitators, which were mapped to the COM-B and Theoretical Domains Framework (TDF), with all findings subsequently aligned with the Behaviour Change Wheel to inform implementation strategies. Results: MedDiet adherence significantly improved from baseline to week 12 (Baseline: 4.1 ± 1.8; week 12: 8.3 ± 2.3; p = 0.001), alongside increases in knowledge (p = 0.004), cooking confidence (p = 0.01), and time management (p = 0.01). Adherence factors were mapped to 12 of the 14 TDF domains. Key facilitators included health benefits, reduced weight pressure, educational resources, and simple guidelines. Barriers involved organisation, food availability, and external influences. Effective implementation should integrate MedDiet education, behaviour change support, practical resources, and professional training for nutrition professionals and healthcare providers to support referrals and weight-neutral dietary management. Conclusions: A short-term ad libitum MedDiet is acceptable for women with PCOS. Strategies for patients and healthcare providers, aligned with the intervention functions of education, training, and enablement, are key to supporting adherence. Full article

Previous research suggests a goal-based intervention called ‘mental contrasting and implementation intentions’ improves participants’ health and wellbeing. The present study sought to extend these findings to workplaces in the United Kingdom. A mixed-methods cluster randomised controlled trial was conducted with 28 workplaces and 225 staff. All participants deliberated on wishes (potential goals) about improving their health and wellbeing. In the intervention arm, participants were guided to think about the benefits and obstacles to achieving a wish (mental contrasting) and to plan actions to overcome these obstacles (implementation intentions). The results showed no substantive effect of the intervention on average self-reported progress towards what they wished to do for their health and wellbeing four weeks later (mean difference on a 1–7 scale: −0.19; 95% credible interval: −1.08–0.71). Unexpectedly, anxiety increased, and we found evidence that might suggest people identifying as men or of Asian ethnicity made less progress in the intervention group. To explain the results, qualitative focus group data were analysed, guided by normalisation process theory (NPT) and the behaviour change wheel (BCW). Three key themes emerged: insufficient differentiation from other approaches using writing/drawing (NPT), a mismatch between an internal motivational intervention and external barriers (NPT/BCW), and poor timing of opportunities (NPT/BCW). The discussion explores how these results can enhance future workplace health and wellbeing initiatives. Full article

This paper describes the co-design of a participatory group intervention developed to promote and enhance parental involvement in supporting the education of children with disabilities in Malawi. The intervention was developed through participatory co-design workshops and consensus meetings involving 23 stakeholders, including parents, teachers, and community leaders. The Behaviour Change Wheel framework and the Delphi technique guided the intervention development process, ensuring theoretical robustness and contextual relevance. The proposed intervention, Tiyanjane (‘Let Us Unite’), includes facilitator and participant training and practical face-to-face sessions over 12 weeks. The intervention targets four key areas: developing family action plans, holding regular meetings, providing ongoing support at home and school, and facilitating training and information exchange. This participatory approach, involving a wide range of local stakeholders, offers valuable insights into the process and outcomes of co-developing culturally relevant and theoretically grounded interventions to address the needs of families with children with disabilities in low-resource settings. Future research should include an evaluation of the feasibility and acceptability of the intervention and examine its applicability in diverse sociocultural settings within LMICs (low- and middle-income countries). Full article

Poor solid waste management in Kisumu, Kenya, contributes to adverse health, social, and environmental outcomes as a result of open burning, illegal dumping, and reliance on landfills. Taking Kisumu as a case study, we use behavioural systems mapping (BSM) for the purpose of understanding the role of behaviour in this complex problem. We qualitatively analysed transcripts from focus groups and interviews with 45 stakeholders in Kisumu to construct a BSM of the perceived actors, behaviours, and behavioural influences affecting waste management, as well as causal links. Influences were analysed using the capability, opportunity, and motivation model of behaviour (COM-B). The resulting BSM connects 24 behaviours by 12 different actors and 49 unique influences (30 related to opportunity, 16 to motivation, and 3 to capability). It reflects three sub-systems: policy-making, public waste management, and the policy–public interface. Six key feedback loops are described, which suggest that cycles of underfunding are interlinked with problematic practices around the build-up, handling, and segregation of waste and conflicting public and political views around responsibility. We demonstrate how the BSM method can be used with transcript data and provide steps that others can follow to inform the design of systemic behaviour change interventions. Further research to validate and adapt this approach may extend the learnings to other countries and health and sustainability challenges. Full article

The numerical simulation of wear of railway wheel profiles can be a game changer in the railway field, as it can drive the planning of wheel re-turning operations, thrust the identification of optimized profiles and evaluate the safety of railway vehicles at the early stages of design. Today, commercial multibody codes are provided with dedicated routines that can evaluate the worn profile shape due to the dynamic behaviour of the vehicle. As the outputs of such modules can depend on different user-selectable parameters and modelling choices, it is vital to assess the capabilities of these codes and get a further understanding of the implemented algorithms. This paper aims to benchmark the effects of different modelling parameters and choices, mainly related to the selected wear law and wheel–rail contact method, on the final wear outputs, with special reference to the wear module provided by the SIMPACK commercial multibody code. A relevant novelty of the paper deals with the benchmarking of the wear algorithm available in the commercial code with in-house wear routines, comparing different strategies and choices for the calculation of wear. This allows us to better understand the most critical differences and modelling issues, as well as to highlight possible improvements in wear algorithms that can lead to enhanced numerical stability. More in detail, this work suggests a change in the wear algorithm that proves to be beneficial to removing local wear peaks produced by numerical sources, which could cause instabilities in the computation. Full article

Disposable diapers contribute to the generation of plastic waste globally, with more than 8 million tonnes of diapers ending up in landfills or incinerated each year. One strategy for reducing this waste while maintaining child and parent health and well-being is to increase reusable diaper use and reduce delays in toilet training. We outline a protocol for applying behavioural science to understand the factors influencing these behaviours and to generate intervention recommendations. The research will be conducted in two stages. Stage 1 involves semi-structured interviews and surveys, guided by the Capability, Opportunity, Motivation-Behaviour (COM-B) model, to explore factors influencing reusable diaper use and toilet training at 18–30 months. Data will be analyzed using quantitative (regression and ANOVA) and qualitative (deductive and inductive) methods. Stage 2 involves triangulating findings to identify key barriers and enablers. Intervention frameworks (Behaviour Change Wheel and BCT Taxonomy) will help identify potential behaviour change intervention strategies to target key barriers and enablers identified within COM-B domains. Interventions will be presented to multidisciplinary stakeholders and nominal group technique process will be used to agree on the most promising, feasible, and acceptable options for development and piloting. The findings will help generate recommendations for supporting UK government policy and practice change in this area. Full article

In the dynamic landscape of autonomous transport, the integration of intelligent transport systems and embedded control technology is pivotal. While strides have been made in the development of autonomous agents and multi-agent systems, the unique challenges posed by two-wheeled vehicles remain largely unaddressed. Dedicated control strategies for these vehicles have yet to be developed. The vertical balance of an autonomous two-wheeled single-track vehicle is a challenge for engineering. This type of vehicle is unstable and its dynamic behaviour changes with the forward velocity. We designed a scheduled-gain proportional–integral controller that adapts its gains to the forward velocity, maintaining the vertical balance of the vehicle by means of the steering front-wheel angle. The control law was tested with a prototype designed by the authors under different scenarios, smooth and uneven floors, maintaining the vertical balance in all cases. Full article

Postpartum women experience unique barriers to maintaining healthy lifestyles after birth. Theory-based behaviour change techniques and intervention strategies can be integrated into postpartum lifestyle interventions to enable women to overcome barriers to change. This study aims to explore barriers and facilitators to engaging in healthy postpartum lifestyle behaviours and develop intervention strategies for integration in a postpartum lifestyle intervention using the Behaviour Change Wheel (BCW). Semi-structured interviews were conducted with women up to two years postpartum (n = 21). Interviews were thematically analysed, themes were mapped to the Capability, Opportunity, and Motivation Model of Behaviour Change and intervention strategies were developed using the BCW. Findings suggest that women face barriers and facilitators within capability (sleep deprivation, mental exhaustion, ability to plan), opportunity (support of friends, partners and extended families) and motivation (challenges with prioritising self, exercise to cope with stress). Intervention strategies included supporting behaviour regulation and sleep to enhance capability, engaging partners, strengthening peer support to create opportunities and highlighting the mental health benefits of healthy lifestyles to inspire motivation. Integrating targeted evidence-based behaviour change strategies into postpartum lifestyle interventions may support women in overcoming commonly reported barriers to a healthy lifestyle. Full article

Activity-based therapy (ABT) is a therapeutic approach with multiple benefits including promoting neurorecovery and reducing the likelihood of secondary complications in people living with spinal cord injury (SCI). Barriers and facilitators to ABT implementation for SCI rehabilitation have been studied from various perspectives through qualitative research. However, these viewpoints have not been synthesized to identify challenges of and strategies for implementing ABT across the Canadian healthcare system. Thus, the purpose of our study was to examine the current state of ABT in Canadian healthcare settings according to users’ perspectives. Our main objectives were to compare barriers and facilitators to ABT implementation across Canadian healthcare settings according to users’ perspectives and to identify optimal intervention strategies for ABT delivery across the Canadian healthcare system from acute to community care. We searched Scopus, CINAHL, OvidMedline, and other sources. Eligible articles were qualitative or mixed methods studies exploring ABT for adults with SCI in a Canadian healthcare setting. We analyzed qualitative findings through a thematic synthesis followed by a deductive content analysis. The Mixed Methods Appraisal Tool was used for critical appraisal. Nine articles were included. The thematic synthesis revealed two main themes: (1) factors influencing acceptance and adaptation of ABT across healthcare settings in Canada and (2) proposed solutions. The deductive analysis applied the Behaviour Change Wheel (BCW) to identify limited components of behaviour and appropriate interventions. To address ABT implementation challenges across the Canadian healthcare system, evidence-based interventions should target BCW subcategories of reflective motivation, social opportunity, and physical opportunity. Full article

Adopting a plant-based diet (PBD) has been shown to reduce the risk of developing certain diseases and is linked to environmental benefits. This review synthesises the evidence on the barriers adults aged 18 to 65 living in high-income countries (HIC) may experience when adopting a PBD. A systematic literature review was conducted using four search databases: Medline, Embase, Global Health, and Web of Science. Barriers were mapped to behaviour change strategies using the COM-B model. Ten studies were included in the final review, including 1740 participants. Five were qualitative, four were cross-sectional, and one was a pre- and-post-intervention study. In total, 40 barriers were identified and synthesised into 11 themes: financial, lack of knowledge, emotional, health, convenience, social, enjoyment of meat, environmental, accessibility, personal ability, and media. Of the 40 barriers, nutritional intake/requirements (categorised into the “health” theme) had the most evidence. This barrier encompassed concerns around being able to meet nutritional needs if an individual were to adopt a PBD. Habits (in the “personal ability” theme), which included established eating habits and habitual behaviours relating to animal-source foods, had the second most evidence alongside the barrier of not knowing what to eat as part of a PBD (in the “lack of knowledge” theme). Education interventions and communication/marketing policies were the behaviour change mechanisms mapped onto these barriers. Future interventions should focus on informing individuals about what to consume as part of a nutritionally balanced PBD and facilitating habitual dietary change. Full article

An important method that coal-fired power plants use to realise low-cost zero discharge of desulfurisation wastewater (FGD wastewater) is to utilise wet slag removal systems. However, the high Cl⁻ content of FGD wastewater in wet slag removal systems causes environmental damage. In this study, the corrosion behaviour of the inner guide wheel material, 20CrMnTi, was studied using dynamic weight loss and electrochemical methods. X-ray diffraction, scanning electron microscopy, and energy spectroscopy were used to analyse the organisational and phase changes on the surfaces and cross sections of the samples at different Cl⁻ concentrations. The corrosion rate increased with the Cl⁻ concentration up to 20 g/L, but it decreased slightly when the Cl⁻ concentration exceeded 20 g/L. In all the cases, the corrosion rate exceeded 0.8 mm/a. The corrosion product film density initially increased and then decreased as the Cl⁻ concentration increased. The corrosion products comprised mainly α-FeOOH, γ-FeOOH, β-FeOOH, Fe₃O₄, and γ-Fe₂O₃. Full article