Physical distancing messages targeting youth on the social media accounts of Canadian public health entities and the use of behavioral change techniques

Introduction Physical distancing (PD) is an important public health strategy to reduce the transmission of COVID-19 and has been promoted by public health authorities through social media. Although youth have a tendency to engage in high-risk behaviors that could facilitate COVID-19 transmission, there is limited research on the characteristics of PD messaging targeting this population on social media platforms with which youth frequently engage. This study examined social media posts created by Canadian public health entities (PHEs) with PD messaging aimed at youth and young adults aged 16–29 years and reported behavioral change techniques (BCTs) used in these posts. Methods A content analysis of all social media posts of Canadian PHEs from Facebook, Twitter, Instagram and YouTube were conducted from April 1st to May 31st, 2020. Posts were classified as either implicitly or explicitly targeting youth and young adults. BCTs in social media posts were identified and classified based on Behavior Change Technique Taxonomy version 1 (BCTTv1). Frequency counts and proportions were used to describe the data. Results In total, 319 youth-targeted PD posts were identified. Over 43% of the posts originated from Ontario Regional public health units, and 36.4 and 32.6% of them were extracted from Twitter and Facebook, respectively. Only 5.3% of the total posts explicitly targeted youth. Explicit posts were most frequent from federal PHEs and posted on YouTube. Implicit posts elicited more interactions than explicit posts regardless of jurisdiction level or social media format. Three-quarters of the posts contained at least one BCT, with a greater portion of BCTs found within implicit posts (75%) than explicit posts (52.9%). The most common BCTs from explicit posts were instructions on how to perform a behavior (25.0%) and restructuring the social environment (18.8%). Conclusions There is a need for more PD messaging that explicitly targets youth. BCTs should be used when designing posts to deliver public health messages and social media platforms should be selected depending on the target population.

What Makes Opportunistic GP Interventions Effective? An Analysis of Behavior Change Techniques Used in 237 GP-Delivered Brief Interventions for Weight Loss

Background Evidence shows that clinician-delivered brief opportunistic interventions are effective in obesity, and guidelines promote their use. However, there is no evidence on how clinicians should do this, and guidelines are not based on clinical evidence. Purpose A trial (Brief Interventions for Weight Loss [BWeL]) showed that brief opportunistic interventions on obesity that endorsed, offered, and facilitated referral to community weight management service (CWMS) led to 77% agreeing to attend, and 40% attending CWMS, as well as significantly greater weight loss than control at 12 months. We assessed which behavior change techniques (BCTs) doctors used that were associated with CWMS attendance. Methods We coded 237 recorded BWeL interventions using the behavioral change techniques version one taxonomy. We also coded the BWeL training video to examine delivery of recommended BCTs. Mixed effects logistic regression assessed the association between each BCT, the total number of BCTs, and delivery of recommended BCTs, with patient’s agreement to attend and actual CWMS attendance. Results Of 237 patients, 133 (56%) agreed to attend and 109 (46%) attended. Thirteen BCTs were used more than eight times but none of the 13 were associated with increased attendance. One, “practical social support,” was significantly associated with increased patient agreement (odds ratio [OR] = 4.80, 95% confidence interval [CI] = 1.15, 20.13). Delivery of recommended BCTs and the total number of BCTs used were both associated with increased agreement (OR = 1.56, 95% CI = 1.09, 2.23 and OR = 1.34, 95% CI = 1.03, 1.75, respectively), but not attendance at CWMS (OR = 1.20, 95% CI = 0.98–1.47 and OR = 1.08, 95% CI = 0.94–1.24, respectively). Conclusions There is no evidence that particular BCT can increase the effectiveness of brief opportunistic interventions for obesity in adults. However, using more BCTs and delivery of recommended BCTs may increase agreement to attend community weight management services.

Social norm-based gamification to promote eco-friendly food choice

Purpose Digital applications and thus new digital intervention possibilities such as gamification have made their way into our everyday lives. This paper aims to examine to what extent social norm information (SNI) in a game element feedback may increase eco-friendly food choices. Design/methodology/approach The effect of social norm-based feedback (SNBF), provided by a “GreenMeter”, was investigated experimentally. The SNI was integrated into the feedback by comparing the subject’s GreenMeter rating with either an injunctive, descriptive or combined SNI. Findings Injunctive SNBF was found to be effective in encouraging people to make an eco-friendly food purchasing decision. Combining injunctive with descriptive SNBF or simply providing descriptive SNBF was also found to be better than no intervention at all. Research limitations/implications To take further advantage of social norms to make gamification more effective, additional studies are needed in which long-term effects on behavior are investigated, as well as other game elements and target groups are taken into account. Practical implications Many people want to choose food that is more eco-friendly but often struggle because of deeply ingrained habits or strong social influences. Consequently, their intentions do not translate into changes in their behavior. Alternative motivational, gamification approaches, like SNBF, may be considered when designing Web-based applications. Originality/value The study provides insights into the effectiveness of SNI going beyond text-based interventions. Considering SNI in a specific design of gamification (“GreenMeter”) provided insights into how they could be integrated into dynamic, digital, behavioral change techniques to increase eco-friendly food choices.

Efeito de softwares educativos em adolescentes

RESUMO Objetivo: evidenciar o efeito da utilização de aplicativos/softwares educativos no conhecimento/comportamento de adolescentes sobre a atividade física e a alimentação saudável. Método: trata-se de estudo bibliográfico, descritivo, tipo revisão integrativa, de estudos publicados entre 2013 e 2017, nas bases de dados PUBMED/MEDILINE, LILACS e Cochrane central. Realizou-se a busca nos meses de abril e maio de 2017, utilizando-se descritores controlados contemplados no DeCS, e os resultados apresentados em forma de figuras, discutidos com a literatura. Resultados: percebeu-se que não há um consenso na literatura sobre os efeitos da utilização de aplicativos/softwares na melhoria do conhecimento e do comportamento de adolescentes acerca da atividade física e da alimentação saudável. Conclusão: acredita-se, dessa forma, ser de suma importância a realização de mais estudos no desenvolvimento de aplicativos/softwares educativos que visem a aplicar técnicas de mudança comportamental a fim de que o uso dos aplicativos/softwares, pelos adolescentes, possa apresentar a melhoria do conhecimento e do comportamento acerca da atividade física e da alimentação saudável. Descritores: Adolescente; Obesidade; Software; Estado Nutricional; Tecnologia Educacional; Aplicativos Móveis.ABSTRACT Objective: to demonstrate the effect of the use of educational applications / softwares on adolescents' knowledge / behavior about physical activity and healthy eating. Method: this is a descriptive, descriptive, integrative review, of studies published between 2013 and 2017 in the PUBMED / MEDILINE, LILACS and Cochrane central databases. The search was carried out in April and May 2017, using controlled descriptors included in DeCS, and the results presented in the form of figures, discussed with the literature. Results: it was noticed that there is no consensus in the literature about the effects of the use of applications / softwares in improving the knowledge and behavior of adolescents about physical activity and healthy eating. Conclusion: it is believed, therefore, to be of great importance to carry out further studies in the development of educational applications / software aimed at applying behavioral change techniques so that the use of the applications / softwares by the adolescents can present the improvement of knowledge and behavior about physical activity and healthy eating. Descriptors: Adolescent; Obesity; Software; Nutritional Status; Educational Technology; Mobile Applications.RESUMEN Objetivo: evidenciar el efecto del uso de aplicaciones / softwares educativos en el conocimiento / comportamiento de adolescentes sobre la actividad física y la alimentación sana. Método: se trata de un estudio bibliográfico, descriptivo, tipo revisión integrativa, de estudios publicados entre 2013 y 2017, en las bases de datos PUBMED / MEDILINE, LILACS y Cochrane central. Se realizó la búsqueda en los meses de abril y mayo de 2017, utilizando descriptores controlados contemplados en el DeCS, y los resultados presentados en forma de figuras, discutidos con la literatura. Resultados: se percibió que no hay consenso en la literatura sobre los efectos del uso de aplicaciones / softwares en la mejora del conocimiento y del comportamiento de adolescentes acerca de la actividad física y de la alimentación sana. Conclusión: se considera de suma importancia la realización de más estudios en el desarrollo de aplicaciones / softwares educativos que apunte a aplicar técnicas de cambio comportamental a fin de que el uso de las aplicaciones / softwares, por los adolescentes, pueda presentar la mejora del desempeño el conocimiento y el comportamiento acerca de la actividad física y de la alimentación sana. Descriptores: Adolescente; Obesidad; Programas Informáticos; Estado Nutricional; Tecnología Educacional; Aplicaciones Móviles.

Features, Behavioral Change Techniques, and Quality of the Most Popular Mobile Apps to Measure Physical Activity: Systematic Search in App Stores (Preprint)

BACKGROUND It is estimated that 23% of adults and 55% of older adults do not meet the recommended levels of physical activity. Thus, improving the levels of physical activity is of paramount importance, but it requires the use of low-cost resources that facilitate universal access without depleting the health system. The high number of apps available constitutes an opportunity, but it also makes it quite difficult for the layperson to select the most appropriate app. Furthermore, the information available in the app stores is often insufficient, lacks quality, and is not evidence based, and the systematic reviews fail to assess app quality using standardized and validated instruments. OBJECTIVE The objective of this study was to systematically assess the features, content, and quality of the most popular apps that can be used to measure and, potentially, promote physical activity. METHODS Systematic searches were conducted on Apple App Store, Google Play, and Windows Phone Store between December 2017 and January 2018. Apps were included if their primary objective was to assess the aspects of physical activity, if they had a user rating of at least 4, if their number of ratings was ≥100, and if they were free. Apps meeting these criteria were independently assessed by two reviewers regarding their general and technical information, aspects of physical activity, presence of behavioral change techniques, and quality. Data were analyzed using means and SDs or frequencies and percentages. RESULTS Of 51 apps included, none specified the age of the target group and only one mentioned the involvement of health professionals. Most apps offered the possibility to work in background (n=50) and allowed data sharing (n=40). Regarding physical activity, most apps measured steps and distance (n=11) or steps, distance, and time (n=17). Only 18 apps, all of which measured number of steps, followed the guidelines on recommendations for physical activity. On average, 5.5 (SD 1.8) behavioral change techniques were identified per app; the most frequently used techniques were “provide feedback on performance” (n=50) and “prompt self-monitoring of behavior” (n=50). The overall quality score was 3.88 (SD 0.34). CONCLUSIONS Although the overall quality of the apps was moderate, the quality of their content, particularly the use of international guidelines on physical activity, should be improved. Additionally, a more in-depth assessment of apps should be performed before releasing them for public use, particularly regarding their reliability and validity.