Search Results (49)

Background: Decision fatigue has been studied in medical settings but is rarely explored in the context of food choice. Decision fatigue can lead to depleted mental energy, exhaustion, poorer decision-making abilities, reduced willpower, increased risk aversion, and impaired prioritisation. Food choices are frequent decision-making situations that may be influenced by decision fatigue, potentially leading to impulsive and less health-conscious food selections. Objective: This review consolidates current knowledge on food choice and its complexity, decision fatigue, and ego depletion, and considers how these may interact. The scales used to measure decision fatigue are also reviewed. Methods: Literature was identified through searches in PubMed and Google Scholar databases using combinations of keywords such as “decision fatigue,” “ego depletion,” “food choice,” and “dietary behaviour.” Relevant studies were screened based on English-language publications and relevance to food choice. Results: Existing studies highlight associations between decision fatigue and poorer decision quality, but few have directly examined links to food choice. Evidence suggests potential mechanisms, though findings remain largely speculative. Conclusions: There is currently a paucity of evidence specifically connecting decision fatigue with food choices. Potential solutions to reduce this burden, such as the use of convenience foods as a nudge toward healthier decisions, warrant further exploration. Full article

The rapid expansion of the tourism sector has raised concerns about how to provide satisfaction to visitors while preserving the environment, especially at tourism destinations that are trying to be sustainable. This study, based on Value-Belief-Norm (VBN) and Place attachment theory, investigates how tourism experience satisfaction predicts eco-tourism behaviour through destination bond while moderating the relationship between tourism experience satisfaction and eco-tourism behaviour via ecocentrism. A stratified random sampling technique was employed to capture a diverse representation of tourists visiting eco-heritage destinations. A total of 420 valid responses were retained after thorough screening for completeness and reliability. The final dataset was analyzed using Partial Least Squares Structural Equation Modelling (PLS-SEM) to evaluate both the measurement and structural relationships in the proposed model. The findings indicate that tourism experience satisfaction creates significant destination bonds, which lead to eco-tourism behaviour. Both destination attachment and dependence contribute significantly to eco-tourism behaviour, indicating they both play a mediation role. Furthermore, ecocentrism positively moderates the relationship between satisfaction and eco-behaviour, demonstrating that tourists with stronger ecological value orientations are more likely to translate satisfaction into responsible environmental action. Theoretically, the study contributes to the VBN and place attachment theory by acknowledging the role of attachment and dependence as important belief processes enabling the interacting of experiential fulfilment to moral engagement, and by finding ecocentrism to be a dynamic moderator. To the policy makers, destination managers and community stakeholders, the findings provide a behavioural model of enabling the process of stewardship using experiential design based on values and participative-based conservation initiatives. Full article

Background: Artificial intelligence (AI) has been proposed as a transformative tool in suicide prevention, yet most evidence remains observational. To provide a rigorous benchmark, we systematically reviewed randomized controlled trials (RCTs) evaluating AI-based interventions targeting suicidal thoughts, behaviours, or help-seeking. Methods: Following PRISMA 2020 guidelines, MEDLINE, Web of Science, and Scopus were searched to 31 May 2025. Eligible studies were RCTs in humans that incorporated AI or machine learning for risk prediction, automated intervention, or treatment allocation. Methodological quality was assessed with the PEDro scale and certainty of evidence with GRADE. Results: From 1101 screened records, six RCTs (n = 793) met all criteria. Three studies tested machine learning risk prediction, two evaluated fully automated interventions (a transformer-based recommender and a digital nudge), and one examined AI-assisted treatment allocation. Risk-prediction models stratified short-term suicidal outcomes with accuracies of up to 0.67 and AUC values around 0.70. Digital interventions reduced counsellor response latency or increased crisis-service uptake by 23%. Algorithm-guided allocation reduced the occurrence of suicidal events when randomisation aligned with model recommendations. Methodological quality was moderate to high (median PEDro = 8/10), but GRADE certainty was low due to small samples and imprecision. Conclusions: AI can enhance discrete processes in suicide prevention, including risk stratification, help-seeking, and personalized treatment. However, the current evidence is limited, and larger multisite RCTs with longer follow-up, CONSORT-AI compliance, and equity-focused design are urgently required. Full article

This article examines the role of urban design in integrating biodiversity preservation with the enhancement of environmental and human health and quality of life in urban and peri-urban areas. Building on three complementary perspectives—urban design, the Healthy Habits framework, and socio-ecological networks—the review seeks to bridge short- to medium-term actions for improving the quality of life with long-term strategies for biodiversity preservation. While partial connections between these domains exist, they remain fragmented, underscoring the need for a holistic and transdisciplinary approach to urban socio-ecological health. The study employs a two-stage methodology, combining a scoping review to map existing evidence with a qualitative thematic review across SCOPUS-indexed research, European and international policy frameworks, and practical applications. The One Health paradigm is used as the principal integrative tool to link urban design, the Healthy Habits framework, and the socio-ecological networks. The topics of European environmental policies, evolutionary pillars, and social cohesion are incorporated to strengthen the interrelations between environmental and societal health and well-being. The findings highlight the importance of a holistic approach, behavioural insights, urban nudges, and participation, which can become key elements in fostering social cohesion, ecological resilience, and overall health. The research concludes that health-oriented urban design must go beyond traditional planning paradigms and tools, adopting adaptive, relational, and transdisciplinary approaches to address the challenges posed by contemporary times. Full article

Background: The climate impacts of health professionals’ work are significant. The potential role and opportunities for regulators of health professionals’ work to drive behavioural and practice change have not been adequately explored in the literature. The objective of this research was to examine regulators’ perspectives on the potential role of health professions’ regulatory bodies in advancing the adoption of climate-conscious professional practice. Methods: Semi-structured interviews with 19 regulators overseeing the practice of health professionals in medicine, nursing, pharmacy, and dentistry in Canada were undertaken. Constant comparative data analysis using nVivo v15 was undertaken to identify common themes. The COREQ framework was applied to ensure the quality of the research processes used. Results: Participants highlighted their belief that there are only limited opportunities for health professions’ regulators to lead climate-positive practice change, despite their personal beliefs in the importance of the topic. The use of educational approaches, rather than legal or regulatory tools, was emphasized. Concerns were raised regarding regulatory overreach, practitioner blowback, and practical/logistical considerations. Coalition building across different facets of a profession (including educational institutions, unions, workplaces, and professional/advocacy groups) was identified as potentially most impactful. Conclusions: Previous research had highlighted practitioners’ beliefs that regulators had significant legal and practice-directed levers that could drive behavioural change towards more climate-friendly health care work. This research has highlighted regulators’ discomfort with assuming a legalistic role. Instead, they favoured persuasive techniques such as education and coalition building that may nudge, rather than compel, practitioners towards more climate-friendly practice. Full article

As the prevalence of public discourse pertaining to loneliness increases, digital interventions, such as artificial intelligence companions, are being introduced as methods for fostering connection and mitigating individual negative experiences of loneliness. These tools, while increasing in volume and popularity, operate within and are shaped by the same engagement-driven systems that have been found to contribute to loneliness. This meta-narrative review examines how algorithmic infrastructures, which are optimized for retention, emotional predictability, and behavioural nudging, not only mediate responses to loneliness but participate in its ongoing production. Flattening complex social dynamics into curated, low-friction interactions, these systems gradually displace relational agency and erode users’ capacity for autonomous social decision making. Drawing on frameworks from communication studies and behavioural information design, this review finds that loneliness is understood both as an emotional or interpersonal state and as a logical consequence of hegemonic digital and technological design paradigms. Without addressing the structural logics of platform capitalism and algorithmic control, digital public health interventions risk treating loneliness as an individual deficit rather than a systemic outcome. Finally, a model is proposed for evaluating and designing digital public health interventions that resist behavioural enclosure and support autonomy, relational depth, systemic accountability, and structural transparency. Full article

This study used randomised controlled trials to test the effectiveness of three behavioural interventions, i.e., focalism, social norm, and visualisation, in changing people’s housing and commuting preferences. The experiment was conducted online via Credamo, one of the largest online panel data providers in China. It included only renters who needed to commute in the city of Xi’an, China, as participants in the study. The results show that behavioural interventions significantly increased respondents’ willingness to adopt more sustainable commute modes, such as walking or cycling, and reduced the tendency to use private cars. Among the three behavioural interventions, the social norm intervention had the largest and most significant impact. The findings shed light on the potential of applying behavioural interventions in sustainable urban transport management. More importantly, the results demonstrate the possibility of using behavioural interventions to incorporate sustainable urban development goals into housing decisions. Full article

Circular economy marketing (CEM) represents an innovative approach to aligning business strategies with sustainability objectives. This paper explores the role of CEM as a driver of green marketing innovation, emphasising strategies that minimise environmental impact on business competitiveness while enhancing consumer engagement. Using a systematic literature review based on the PRISMA methodology, we identified 39 high-impact studies across multiple industries, categorising findings into key themes, theoretical frameworks, and marketing strategies. The analysis highlights emerging trends, including the shift toward product-service systems (PSSs), behavioural nudging, transparent sustainability branding, and integration of digital technologies such as AI and blockchain to enhance traceability and consumer trust. Findings reveal that while circular economy marketing presents opportunities for businesses to differentiate themselves and build long-term sustainability strategies, significant challenges remain, including scalability issues, consumer scepticism, and risks of greenwashing. Moreover, gaps in standardising impact measurement and industry-specific adaptation hinder wider implementation. Business model innovation, policy support, and collaborative efforts are crucial in overcoming these barriers. This study provides insights for businesses, policymakers, and researchers, highlighting how CEM fosters green innovation and competitiveness. Future research should compare the effectiveness of various strategies to accelerate the transition toward sustainable marketing practices through regulation and interdisciplinary collaboration. Full article

Background/Objectives: Traditional diet management for type 2 diabetes (T2DM) is often complex and effortful to sustain. Nudging offers low-effort and automatic approaches to dietary behaviour change yet remains underexplored in T2DM. This study evaluated the independent and combined 6-month effects of nudging education (NE) and nudging tableware (NT) on HbA1c, along with other secondary health outcomes, among adults with T2DM and overweight/obesity, compared to their non-nudge counterparts (control education, CE; control tableware, CT). Methods: A 2 × 2 factorial cluster RCT was conducted in 12 primary healthcare settings in China (pre-registered as ChiCtr2100044471). Participants were randomly assigned to the nudging education group (NE + CT), the nudging tableware group (CE + NT), the combined group (NE + NT) or the full-control group (CE + CT) for 1 month. The primary outcome was HbA1c. Secondary outcomes included dietary behaviours, metabolic indicators, and psychological health. Generalized linear mixed models were used for analysis. Results: A total of 284 participants (mean age, 52.28 years; 54.3% male) were randomly assigned and included in the analysis. After 6 months, NE and NT independently led to HbA1c reductions (−0.76%, p < 0.001; −0.33%, p = 0.042, vs. controls), with an additive but non-interactive effect when combined, resulting in a 1.04% reduction (p < 0.001) in the combined group. They also improved total calorie, macronutrient, and vegetable intake, FBG, plasma lipids, and BMI. NE additionally reduced diabetes distress and enhanced self-efficacy. Conclusions: Both NE and NT improved dietary and metabolic outcomes without increasing the psychological burden. The combined group showed the greatest benefits. Findings highlighted the importance of considering automatic processes in diabetes management. Full article

Traditional approaches to changing health behaviours have primarily focused on education and raising awareness, assuming that increased knowledge leads to better decisions. However, evidence suggests these methods often fail to result in sustained behavioural change. The dual-process theory of decision-making highlights that much of our behaviour is driven by automatic, intuitive processes, which educational interventions typically overlook. Compounding this challenge, behavioural research is often conducted on small groups, making it difficult to scale insights into broader societal issues, where behaviour is influenced by complex, interconnected factors. This review advocates for integrating behavioural science with systems approaches (including systems thinking and approaches to complex adaptive systems) as a more effective approach to resolving complex societal issues, such as public health, sustainability, and social equity. Behavioural science provides insights into individual decision-making, while systems approaches offer ways of understanding, and working with, the dynamic interactions and feedback loops within complex systems. The review explores the commonalities and differences between these two approaches, highlighting areas where they complement one another. Design thinking is identified as a useful structure for bridging behavioural science and systems thinking, enabling a more holistic approach to problem-solving. Though some ideological challenges remain, the potential for creating more effective, scalable solutions is significant. By leveraging the strengths of both behavioural science and systems thinking, one can create more comprehensive strategies to address the “wicked problems” that shape societal health and well-being. Full article

Transformative learning processes that can trigger deep and long-lasting behaviour changes are highly sought after for targeted improvements ranging from human diet and health to pro-environmental behaviours. A step forward was the reporting of a method that reliably produces transformative learning outcomes (TLOs) as an (incidental) effect of group shared values crystallisation, but the theme of the TLOs could not be targeted, e.g., for pro-environmental behaviours. A recent exploratory study bolted on environmentally themed pre-Nudging and unexpectedly produced a heavy bias towards pro-environmental behaviour changes. Here, we investigated more systematically the influences of different Nudging types upon TLO themes produced using two further case study designs created for comparability with earlier studies and using the same process (WeValue InSitu) and post-event data collection of TLOs categorised as environmental/not and behavioural/not. Our findings show that most Nudging had no effect, including raising the profile of environmental photos and the materials used in the crystallisation process, having participants reflect on their environmental identities, or emphasising environmental topics before going home. However, Nudging which involved answering written questions on specific personal pro-environmental actions such as recycling, applied early on, was linked to desired results. This has pragmatic significance for sustainability practitioners and raises questions for further research on the mechanisms of both active learning and Nudging. Full article

During the COVID-19 pandemic, the term “behavioural fatigue” became the centre of policy debates in Great Britain. These debates involved deciding when to go into lockdown and whether behavioural interventions could be effective. Behavioural interventions can only succeed where people’s Capabilities, Opportunities, and Motivations to perform target behaviours are supported. Our retrospective data analyses examine the relationships between people’s Capabilities, Opportunities, Motivations, and Behaviours, i.e., adherence to lockdown guidelines. Our cross-sectional analyses include 17,962 unique participants in Great Britain who completed a survey over the initial 30 days of the first lockdown (April 2020). We examine trends in responses to each scale and then the relationships between the scales using Granger’s causality test with tests for stationarity and cointegration. A mixture of increasing and decreasing trends was identified for Capabilities and Opportunities. Decreasing trends were identified for Motivation and Behaviour. Granger’s causality tests found that Capability forecasts Opportunity and Behaviour and that Motivation forecasts Opportunity. The discussion reiterates that to realise and maintain Behaviour changes, policies surrounding people’s Capabilities, Opportunities, and Motivations must continue to support target behaviours. Full article

Targeting households with food waste reduction interventions represents a critical opportunity to meet global targets to halve food loss and waste. While the evidence base on the effectiveness of food waste interventions is growing generally, less is known about the outcomes of household-focused interventions. This mixed methods study explores how households experienced a behaviourally orientated nudge (the OzHarvest Use it Up Tape^TM) and examines its impact on food waste and behaviour change. The “Tape” served multiple functions for households—including as a visual prompt, a labelling device, a planning tool, and a communication tool—and was more effective for large families and for individuals who were disorganised when shopping and cooking. Significant reductions were also identified in participants’ fresh vegetable and fruit waste and in the total food amounts they wasted. This study demonstrates the effectiveness of behaviourally orientated nudges, like the Tape, in reducing food waste. Full article

Healthcare-associated infections (HAIs) are considered to be one of the biggest health problems as they continue to be an important cause of morbidity and mortality worldwide. They cannot be completely prevented, but their incidence can be significantly limited. Preventive action is the most important measure in this case. Due to the frequent interaction between healthcare professionals and patients, the crucial importance of hand hygiene is therefore emphasised. Adherence to good disinfection and hand washing practices remains around 40%, which can be improved by using a variety of nudge tools to promote desired hygienic behaviour. We conducted an open observation of employees and visitors with participation. The aim of this study was to determine the actual status of hand disinfection in a selected healthcare facility amongst doctors, registered nurses, medical technicians, cleaners, and visitors or parents of children; then, we selected and introduced three nudge tools of desired hygiene behaviour and analysed their effectiveness; finally, we provided suggestions for the use of nudge tools of desired hygiene behaviour with the aim of influencing doctors, registered nurses, medical technicians, cleaners, and visitors or parents of children so that they disinfect their hands properly. The actual state of hand disinfection was determined on the basis of observation without introducing any changes; then, we separately introduced three nudge tools, posters with an inscription and picture, the scent of citrus, and flashing lights. The obtained results were analysed with the help of the SpeedyAudit Lite application, and the effectiveness of each nudge tool and the adequacy of hand disinfection by categories of people were compared. In general, posters with a picture and an inscription contributed the most to more consistent disinfection of employees’ hands, while the scent of citrus and flashing lights contributed slightly less. Full article

While policies targeting education in schools, marketing campaigns, and taxation strategies are of great importance to tackle our population’s malnutrition, there is growing concern about enhancing the supermarket environment to promote healthier food consumption. Public and private policies targeting the food retail sector can contribute to achieving this goal. Supermarkets play a significant role in presenting food options. As gatekeepers of the food system’s impact on consumers’ health, they have the power to help people make better food choices. Examples include making healthy checkouts and nudging consumption of vegetables through infographics. Currently, few policies specify how supermarkets’ environments could be set up to improve healthy purchases (e.g., the “Partnership for a healthy diet” in Norway and “hange4Life Convenience Stores” in the UK). Furthermore, we see recent shifts in the policy agendas of countries like Germany and Argentina, with new nutrition behavioural policies being legislated and implemented. However, we lack general guidelines that unify the available information on this topic. Addressing this gap has the potential to guide future supermarket policy recommendations. We will perform a review and delve deeper to search for governmental policies and policies of major supermarket brands in selected countries (i.e., Germany and Argentina) to taxonomize the policy initiatives, examining their projects and campaigns designed to improve supermarket environments and encourage consumers to choose healthy options. We will harvest sources published since the release of the SDGs (2015), from ScienceDirect, the FAO policy search engine Informas, and the NOURISHING platform. We will identify the grey literature by searching related websites and databases as well as national government pages or private supermarket policy documents. We will extract the information relevant to policymaking to improve environments in terms of product reformulation, labelling strategies, placement, product processes, and sweet beverage representation. While spotting incentive, procurement, and regulative policies, we will group them in terms of interventions and further taxonomize the different approaches/initiatives. Our objective is to provide unified policy recommendations by leveraging existing experiences and policies and designing applicable recommendations to improve the food environment in supermarkets. Furthermore, we aim to promote the creation of science-based policies that consider these recommendations. Full article