Objective: Goal setting is a common feature of behavior change interventions, but it is unclear when goal setting is optimally effective. The aims of this systematic review and meta-analysis were to ...evaluate: (a) the unique effects of goal setting on behavior change, and (b) under what circumstances and for whom goal setting works best. Method: Four databases were searched for articles that assessed the unique effects of goal setting on behavior change using randomized controlled trials. One-hundred and 41 papers were identified from which 384 effect sizes (N = 16,523) were extracted and analyzed. A moderator analysis of sample characteristics, intervention characteristics, inclusion of other behavior change techniques, study design and delivery, quality of study, outcome measures, and behavior targeted was conducted. Results: A random effects model indicated a small positive unique effect of goal setting across a range of behaviors, d = .34 (CI .28, .41). Moderator analyses indicated that goal setting was particularly effective if the goal was: (a) difficult, (b) set publicly, and (c) was a group goal. There was weaker evidence that goal setting was more effective when paired with external monitoring of the behavior/outcome by others without feedback and delivered face-to-face. Conclusions: Goal setting is an effective behavior change technique that has the potential to be considered a fundamental component of successful interventions. The present review adds novel insights into the means by which goal setting might be augmented to maximize behavior change and sets the agenda for future programs of research.
What is the public health significance of this article?
The findings reported in the present review show that goal setting is an effective behavior change technique that can be considered a fundamental component of successful behavior change interventions. Findings suggest that optimally goals should be: (a) difficult but achievable, (b) set publicly, (c) set face to face, (d) set as a group goal, and (e) set without drawing attention to goal commitment. There is also some indication that goal setting is particular effective in certain samples (i.e., schoolchildren, general population, male, younger people, and those of Asian ethnicity) in particular settings (i.e., schools and workplaces).
Novel viral pandemics present significant challenges to global public health. Non-pharmaceutical interventions (e.g. social distancing) are an important means through which to control the ...transmission of such viruses. One of the key factors determining the effectiveness of such measures is the level of public adherence to them. Research to date has focused on quantitative exploration of adherence and non-adherence, with a relative lack of qualitative exploration of the reasons for non-adherence. To explore participants' perceptions of non-adherence to COVID-19 policy measures by self and others in the UK, focusing on perceived reasons for non-adherence. Qualitative study comprising 12 focus groups conducted via video-conferencing between 25th September and 13th November 2020. Participants were 51 UK residents aged 18 and above, reflecting a range of ages, genders and race/ethnicities. Data were analysed using a thematic approach.
Health status is widely considered to be closely associated with subjective well-being (SWB), yet this assumption has not been tested rigorously. The aims of this first systematic review and ...meta-analysis are to examine the association between health status and SWB and to test whether any association is affected by key operational and methodological factors.
A systematic search (January 1980-April 2017) using Web of Science, Medline, Embase, PsycInfo and Global health was conducted according to Cochrane and PRISMA guidelines. Meta-analyses using a random-effects model were performed.
Twenty nine studies were included and the pooled effect size of the association between health status and SWB was medium, statistically significant and positive (pooled r = 0.347, 95% CI = 0.309-0.385; Q = 691.51, I2 = 94.99%, P < 0.001). However, the association was significantly stronger: (i) when SWB was operationalised as life satisfaction (r = 0.365) as opposed to happiness (r = 0.307); (ii) among studies conducted in developing countries (r = 0.423) than it was in developed countries (r = 0.336) and (iii) when multiple items were used to assess health status and SWB (r = 0.353) as opposed to single items (r = 0.326).
Improving people's health status may be one means by which governments can improve the SWB of their citizens. Life satisfaction might be preferred to happiness as a measure of SWB because it better captures the influence of health status.
Background
During the 2020 COVID‐19 pandemic, one of the key components of many countries’ strategies to reduce the spread of the virus is contact tracing.
Objective
To explore public attitudes to a ...COVID‐19 contact tracing app in the United Kingdom.
Setting
Online video‐conferencing.
Participants
27 participants, UK residents aged 18 years and older.
Methods
Qualitative study consisting of six focus groups carried out between 1st‐12th May, 2020 (39‐50 days into the UK ‘lockdown’).
Results
Participants were divided as to whether or not they felt they would use the app. Analysis revealed five themes: (1) lack of information and misconceptions surrounding COVID‐19 contact tracing apps; (2) concerns over privacy; (3) concerns over stigma; (4)concerns over uptake; and (5) contact tracing as the ‘greater good’. Concerns over privacy, uptake and stigma were particularly significant amongst those stated they will not be using the app, and the view that the app is for the ‘greater good’ was particularly significant amongst those who stated they will be using the app. One of the most common misconceptions about the app was that it could allow users to specifically identify and map COVID‐19 cases amongst their contacts and in their vicinity.
Conclusions
Our participants were torn over whether digital contact tracing is a good idea or not, and views were heavily influenced by moral reasoning.
Patient or Public Contribution
No patients were involved in this study. The public were not involved in the development of the research questions, research design or outcome measures. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Summary results were disseminated via email to participants prior to publication for feedback and comment.
Background Reducing income inequality is one possible approach to boost subjective well-being (SWB). Nevertheless, previous studies have reported positive, null and negative associations between ...income inequality and SWB. Objectives This study reports the first systematic review and meta-analysis of the relationship between income inequality and SWB, and seeks to understand the heterogeneity in the literature. Methods This systematic review was conducted according to guidance (PRISMA and Cochrane Handbook) and searches (between January 1980 and October 2017) were carried out using Web of Science, Medline, Embase and PsycINFO databases. Results Thirty-nine studies were included in the review, but poor data reporting meant that only 24 studies were included in the meta-analysis. The narrative analysis of 39 studies found negative, positive and null associations between income inequality and SWB. The meta-analysis confirmed these findings. The overall association between income inequality and SWB was almost zero and not statistically significant (pooled r=-0.01, 95% CI-0.08 to 0.06; Q=563.10, I²=95.74%, p<0.001), suggesting no association between income inequality and SWB. Subgroup analyses showed that the association between income inequality and SWB was moderated by the country economic development (i.e. developed countries: r=-0.06, 95% CI-0.10 to -0.02 versus developing countries: r=0.16, 95% CI 0.09-0.23). The association between income inequality and SWB was not influenced by: (a) the measure used to assess SWB, (b) geographic region, or (c) the way in which income inequality was operationalised. Conclusions The association between income inequality and SWB is weak, complex and moderated by the country economic development.
Objective: In this study, the aim was to (a) test for the first time whether implementation intentions formed outside the laboratory can overcome the effects of habits, and (b) see whether the ...operation of implementation intentions could be improved by asking people to form certain "when-then" plans as opposed to uncertain "if-then" plans. Method: The study employed a 2 × 2 fully factorial design with baseline and follow-up measures of smoking status and habits. Smokers (N = 168; circa 33 years of age; 79 women, 89 men) were randomly allocated to 1 of 2 intervention groups to form either if-then plans or when-then plans using supporting tools, or to 1 of 2 control conditions in which they were exposed to identical supporting tools but were not asked to form if-then plans or when-then plans. Results: Certainty did not affect the operation of implementation intentions, but smokers who formed implementation intentions were significantly more likely to quit, χ2(1, N = 168) = 8.86, p < .01, and the effect was mediated by changes in smoking habits (95% CI 0.02, 0.14). Similar effects were observed when cigarettes smoked per day, nicotine dependence, and craving served as the dependent variables. Conclusion: The findings demonstrate that people who have formed implementation intentions can overcome habits, such as smoking, outside the laboratory. The supporting tools described in the present research could be deployed at low cost with high public health reach to support behavior change.
Objectives
The Capabilities, Opportunities, Motivations, Behaviour (COM‐B) model is being used extensively to inform intervention design, but there is no standard measure with which to test the ...predictive validity of COM or to assess the impact of interventions on COM. We describe the development, reliability, validity, and acceptability of a generic 6‐item self‐evaluation COM questionnaire.
Design and methods
The questionnaire was formulated by behaviour change experts. Acceptability was tested in two independent samples of health care professionals (N = 13 and N = 85, respectively) and a sample of people with low socio‐economic status (N = 214). Acceptability (missing data analyses and user feedback), reliability (test–retest reliability and Bland–Altman plots) and validity (floor and ceiling effects, Pearson's correlation coefficient r, exploratory factor analysis EFA, and confirmatory factor analysis CFA were tested using a national survey of 1,387 health care professionals.
Results
The questionnaire demonstrated acceptability (missing data for individual items: 5.9–7.7% at baseline and 18.1–32.5% at follow‐up), reliability (ICCs .554–.833), and validity (floor effects 0.6–5.5% and ceiling effects 4.1–22.9%; pairwise correlations rs significantly <1.0). The regression models accounted for between 21 and 47% of the variance in behaviour. CFA (three‐factor model) demonstrated a good model fit, (χ26 = 7.34, p = .29, RMSEA = .02, CFI = .99, TLI = .99, BIC = 13,510.420, AIC = 13,428.067).
Conclusions
The novel six‐item questionnaire shows evidence of acceptability, validity, and reliability for self‐evaluating capabilities, opportunities, and motivations. Future research should aim to use this tool in different populations to obtain further support for its reliability and validity.
Statement of contribution
What is already known on the subject?
The Capability, Opportunity, Motivation (COM), Behaviour (‐B) model is being used extensively to inform intervention design.
The lack of an accepted universal measure hinders progress in behaviour change.
What does this study add?
There is evidence of acceptability, validity, and reliability for self‐evaluating COM.
Our measure may be sufficiently generic for any behaviour or population, although this requires further testing.
General Practitioners (GPs) are expected to provide patients with health behaviour change interventions, yet little is known about the views of patients themselves. We aimed to understand recent ...patients': (1) general expectations about GPs delivering health behaviour change interventions during routine consultations (including perceptions of appropriateness and helpfulness for receiving interventions), (2) perceptions of responsibility for GPs to talk about health behaviours, and (3) experiences of receiving behaviour change interventions. Twenty-four semi-structured interviews were conducted with people who had recently attended a routine GP consultation. Data were analysed thematically. Three major themes were identified: (1) acceptability of discussions about behaviour change, (2) establishing clinician-patient rapport, and (3) healthcare professionals as a credible source and well placed to offer behaviour change interventions. Most patients were positive about, and were willing to accept behaviour change interventions from their GP during a routine consultation. Although behaviour change was perceived as a sensitive topic for patients, the doctor-patient relationship was perceived to provide an effective platform to discuss behaviour change, with the GP perceived as an appropriate and important healthcare professional from whom to receive advice. Contrary to the views of GPs, behaviour change interventions were perceived by patients as appropriate and helpful during routine medical consultations, particularly where behaviour change could have a positive effect on long-term condition management. Behaviour change interventions delivered by GPs during routine consultations could be used effectively in time-restricted consultations.
Meta‐analysis was used to determine the predictive validity of anticipated affect and moral norms in the theory of planned behavior (TPB; Ajzen, 1991). Medium‐to‐large sample‐weighted average ...correlations were obtained. Anticipated affect and moral norms increased the variance explained in intentions by 5% and 3%, respectively, controlling for TPB variables. Intention mediated the influence of both variables on behavior. Moderator analyses showed that younger samples and behaviors with a moral dimension were associated with stronger moral‐norm/intention relations, and anticipated regret was associated with a stronger anticipated‐affect/intention relation. The implications of the findings for the TPB are discussed.
PDF
