Following a randomized controlled trial that showed effectiveness of an equity-centered positive behavioral interventions and supports (PBIS) professional development intervention on student discipline in elementary schools, we studied the extent to which the intervention had differential effects on individual teachers\' use of exclusionary discipline. Using the sample of teachers from the randomized controlled trial (n = 348), we assessed whether (a) changes in teacher use of office discipline referrals over the course of 2 school years and (b) intervention acceptability were moderated by teacher demographic characteristics (e.g., race/ethnicity, experience) or teacher attitudes (e.g., awareness of biases and commitment to equity). Results from multilevel models using two discipline outcomes (i.e., office discipline referrals issued to Black students and equity in office discipline referrals) did not show significant moderation effects for any demographic or attitude variables. Results of intervention acceptability found that teachers with pre-existing commitments to bias reduction found the intervention more acceptable, although means were consistently high across the sample. Findings indicate that the intervention was similarly effective on teacher discipline practices, regardless of teacher demographics or pre-existing attitudes, lending more support to the intervention\'s promise.

UNASSIGNED: Mobile health (mHealth) interventions have immense potential to support disease self-management for people with complex medical conditions following treatment regimens that involve taking medicine and other self-management activities. However, there is no consensus on what discrete behavior change techniques (BCTs) should be used in an effective adherence and self-management-promoting mHealth solution for any chronic illness. Reviewing the extant literature to identify effective, cross-cutting BCTs in mHealth interventions for adherence and self-management promotion could help accelerate the development, evaluation, and dissemination of behavior change interventions with potential generalizability across complex medical conditions.
UNASSIGNED: This study aimed to identify cross-cutting, mHealth-based BCTs to incorporate into effective mHealth adherence and self-management interventions for people with complex medical conditions, by systematically reviewing the literature across chronic medical conditions with similar adherence and self-management demands.
UNASSIGNED: A registered systematic review was conducted to identify published evaluations of mHealth adherence and self-management interventions for chronic medical conditions with complex adherence and self-management demands. The methodological characteristics and BCTs in each study were extracted using a standard data collection form.
UNASSIGNED: A total of 122 studies were reviewed; the majority involved people with type 2 diabetes (28/122, 23%), asthma (27/122, 22%), and type 1 diabetes (19/122, 16%). mHealth interventions rated as having a positive outcome on adherence and self-management used more BCTs (mean 4.95, SD 2.56) than interventions with no impact on outcomes (mean 3.57, SD 1.95) or those that used >1 outcome measure or analytic approach (mean 3.90, SD 1.93; P=.02). The following BCTs were associated with positive outcomes: self-monitoring outcomes of behavior (39/59, 66%), feedback on outcomes of behavior (34/59, 58%), self-monitoring of behavior (34/59, 58%), feedback on behavior (29/59, 49%), credible source (24/59, 41%), and goal setting (behavior; 14/59, 24%). In adult-only samples, prompts and cues were associated with positive outcomes (34/45, 76%). In adolescent and young adult samples, information about health consequences (1/4, 25%), problem-solving (1/4, 25%), and material reward (behavior; 2/4, 50%) were associated with positive outcomes. In interventions explicitly targeting medicine taking, prompts and cues (25/33, 76%) and credible source (13/33, 39%) were associated with positive outcomes. In interventions focused on self-management and other adherence targets, instruction on how to perform the behavior (8/26, 31%), goal setting (behavior; 8/26, 31%), and action planning (5/26, 19%) were associated with positive outcomes.
UNASSIGNED: To support adherence and self-management in people with complex medical conditions, mHealth tools should purposefully incorporate effective and developmentally appropriate BCTs. A cross-cutting approach to BCT selection could accelerate the development of much-needed mHealth interventions for target populations, although mHealth intervention developers should continue to consider the unique needs of the target population when designing these tools.

Pediatricians have a critically important role in the care of children with autism, including conducting developmental screening to support early diagnosis and intervention, advising families about evidence-based treatments for autism spectrum disorder, and supporting families\' emotional health as they care for a child with a developmental disability. The purpose of this article is to provide pediatricians with information about evidence-based autism treatments and how to determine which interventions are appropriate for children across the autism spectrum at different ages and developmental stages.

Dietary behavior is a pivotal modifiable determinant in reducing the occurrence of obesity/overweight and chronic non-communicable diseases. Improving the dietary behavior of rural residents in China is imminent due to the poor performance of their dietary behavior. Nutrition knowledge and health literacy are considered as elements that are linked intimately to healthy dietary behaviors but lack research in the Chinese setting.
The study is designed to explore the relationship between nutritional knowledge, health literacy and dietary behaviors and to analyze the performance under different demographic characteristics.
A face-to-face survey of 400 rural residents on their nutrition knowledge, functional health literacy and dietary intake of five food categories consisting of 32 items was conducted based on a validated questionnaire. Descriptive analysis, difference test including ANOVA, t-test and non-parametric test, and multivariate linear regression were used for data analysis.
The results indicate that declarative nutrition knowledge, individuals\' information application capacity, and dietary behaviors, especially the intake of fruits, dairy and beans, and vegetable are not ideal and requires improvement. Male, elder, low-income, unmarried, and low-education populations performed significantly worse and were the high-risk group. Procedural nutrition knowledge, information access capacity, information understanding capacity, and information application capacity have remarkable effects on better dietary behavior.
This study provides evidence-based guidance for prioritizing information and populations for healthy dietary interventions.

Social validity refers to the social significance and acceptability of intervention goals, procedures, and outcomes. Animal practitioners, who are often guided by the principles of ABA, lack the benefit of verbal participants (at least with respect to target animals) with which to assess a client\'s needs and preferences. The study of a learner\'s welfare is useful for determining areas where intervention is needed or how the learner feels about an intervention that is underway. Three tenets of animal welfare measurement include physiological function, naturalistic behavior, and affect, where affect refers to private events, including emotions, which are a function of the same variables and contingencies responsible for controlling public behavior. The development of new technologies allows us to look \"under the skin\" and account for subjective experiences that can now be observed objectively. We introduce the reader to tools available from the animal welfare sciences for the objective measurement of social validity from the learner\'s perspective.

Gastroesophageal reflux disease (GERD) is a widely prevalent gastrointestinal disorder, affecting ∼13.3% of the global population. There are shortages and limitations of current GERD treatment modalities, and complementary and alternative therapy (CAT) is a promising option to fill in the gap. Dietary and lifestyle modifications might play an important and complementary role in alleviating GERD symptoms. Traditional Chinese medicine and brain-gut behavior therapy, particularly transcutaneous electrical acustimulation and diaphragmatic breathing therapy were shown to be useful adjuncts or alternatives in treating GERD. CAT may help to relieve GERD symptoms, minimize medication dosage, and slow the demand for surgery. The aim of this review was to summarize the existing evidence of some common CATs in treating symptomatic GERD, including dietary modification, lifestyle change, traditional Chinese medicine, and brain-gut behavior therapy.

Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and disciplines. The Behavior Change Technique Taxonomy version 1 (BCTTv1) was developed to decrease ambiguity in defining specific characteristics inherent in health interventions, but it was developed outside the context of digital technology. In contrast, the Persuasive System Design Model (PSDM) was developed to define and evaluate the persuasive content in software solutions but did not have a specific focus on health. Both the BCTTv1 and PSDM have been used to define eHealth interventions in the literature, with some researchers combining or reducing the taxonomies to simplify their application. It is unclear how well the taxonomies accurately define eHealth and whether they should be used alone or in combination.
This scoping review explored how the BCTTv1 and PSDM capture the content and intervention features of parent-focused eHealth as part of a program of studies investigating the use of technology to support parents with therapy home programs for children with special health care needs. It explored the active ingredients and persuasive technology features commonly found in parent-focused eHealth interventions for children with special health care needs and how the descriptions overlap and interact with respect to the BCTTv1 and PSDM taxonomies.
A scoping review was used to clarify concepts in the literature related to these taxonomies. Keywords related to parent-focused eHealth were defined and used to systematically search several electronic databases for parent-focused eHealth publications. Publications referencing the same intervention were combined to provide comprehensive intervention details. The data set was coded using codebooks developed from the taxonomies in NVivo (version 12; QSR International) and qualitatively analyzed using matrix queries.
The systematic search found 23 parent-focused eHealth interventions described in 42 articles from various countries; delivered to parents with children aged 1 to 18 years; and covering medical, behavioral, and developmental issues. The predominant active ingredients and intervention features in parent-focused eHealth were concerned with teaching parents behavioral skills, encouraging them to practice and monitor the new skills, and tracking the outcomes of performing the new skills. No category had a complete set of active ingredients or intervention features coded. The two taxonomies conceptually captured different constructs even when their labels appeared to overlap in meaning. In addition, coding by category missed important active ingredients and intervention features.
The taxonomies were found to code different constructs related to behavior change and persuasive technology, discouraging the merging or reduction of the taxonomies. This scoping review highlighted the benefit of using both taxonomies in their entirety to capture active ingredients and intervention features important for comparing and analyzing eHealth across different studies and disciplines.
RR2-doi.org/10.15619/nzjp/47.1.05.

Direct-acting antiviral medications have the potential to eliminate the hepatitis C virus (HCV) epidemic among people who inject drugs; yet, suboptimal adherence remains a barrier. Directly observed treatment (DOT), an effective strategy for optimizing adherence, has been frequently implemented in opioid treatment programs but less commonly in community health settings due to the heavy burden of daily visits. An alternative is video-observed therapy (VOT), which uses mobile health technology to monitor adherence. VOT has not been widely studied among people who inject drugs with HCV.
This qualitative study, part of a larger implementation evaluation, investigates stakeholder perceptions and experiences with VOT in Project HERO (Hepatitis C Real Outcomes), a multisite pragmatic trial testing treatment delivery models for people who inject drugs with HCV. Our goal was to understand the potential barriers and facilitators to the implementation of the VOT technology.
Qualitative interviews were conducted with 27 Project HERO study staff and 7 patients. Interviews focused on perceptions and experiences with the VOT app and barriers and facilitators to implementation. Team meeting minutes over the first 2 years of the project were transcribed. A coding system was developed and applied to the data. We summarized thematic data and compared participant perceptions to generate a close understanding of the data.
Frequent barriers to VOT included mechanical failure, stolen or lost phones, and a steep learning curve for participants and study staff. In sites with older and less technically skilled participants, staff found it difficult to implement the VOT app. Research staff found that the routine monitoring of app use led to closer engagement with participants. This was both a benefit and a potential threat to the validity of this pragmatic trial. Patient participants reported mixed experiences.
VOT may be a useful alternative to DOT for some patients, but it may not be feasible for all. Significant staff involvement may be required.

Most mobile cessation studies have found that such interventions have a higher quitting rate than interventions providing minimal smoking cessation support. However, why such interventions are effective has been almost unstudied by researchers.
This paper describes the principles of the personalized mobile cessation intervention-based WeChat app and used generalized estimated equations to assess why a personalized mobile cessation intervention was more likely to promote smokers from the preparation stage to the action stage than a nonpersonalized intervention.
This is a 2-arm, double-blind, randomized controlled trial in five cities in China. The intervention group received a personalized mobile cessation intervention. The control group received a nonpersonalized SMS text message smoking cessation intervention. All information was sent by the WeChat app. The outcomes were the change in protection motivation theory construct scores and the change in transtheoretical model stages.
A total of 722 participants were randomly assigned to the intervention or control group. Compared with those who received the nonpersonalized SMS text message intervention, smokers who received the personalized intervention presented lower intrinsic rewards, extrinsic rewards, and response costs. Intrinsic rewards were determinants of stage change, thus explaining why the intervention group was more likely to promote smokers from the preparation stage to the action stage (odds ratio 2.65, 95% CI 1.41-4.98).
This study identified the psychological determinants at different stages to facilitate smokers moving forward to the next stage of quitting behavior and provides a framework to explore why a smoking cessation intervention is effective.
Chinese Clinical Trial Registry ChiCTR2100041942; https://tinyurl.com/2hhx4m7f.

Despite the increasing popularity of mHealth, little evidence indicates that they can improve health outcomes. Mobile health interventions (mHealth) have been shown as an attractive approach for health-care systems with limited resources. To determine whether mHealth would reduce blood pressure, promote weight loss, and improve hypertension compliance, self-efficacy and life quality in individuals with hypertension living in low-resource rural settings in Hubei, China.
In this parallel-group, randomized controlled trial, we recruited individuals from health-care centers, home visits, and community centers in low-resource rural settings in Hubei, China. Of 200 participants who were screened, 148 completed consent, met inclusion criteria, and were randomly assigned in a ratio of 1:1 to control or intervention. Intervention group participants were instructed to use the Monitoring Wearable Device and download a Smartphone Application, which includes reminder alerts, adherence reports, medical instruction and optional family support. Changes in the index of Cardiovascular health risk factors from baseline to end of follow-up. Secondary outcomes were change in hypertension compliance, self-efficacy and life quality at 12 weeks.
Participants (n = 134; 66 in the intervention group and 68 controls) had a mean age of 61.73 years, 61.94% were male. After 12 weeks, the mean (SD) systolic blood pressure decreased by 8.52 (19.73) mm Hg in the intervention group and by 1.25 (12.47) mm Hg in the control group (between-group difference, -7.265 mm Hg; 95% CI, -12.89 to -1.64 mm Hg; P = 0.012), While, there was no difference in the change in diastolic blood pressure between the two groups (between-group difference, -0.41 mm Hg; 95% CI, -3.56 to 2.74 mm Hg; P = 0.797). After 12 weeks of follow-up, the mean (SD) hypertension compliance increased by 7.35 (7.31) in the intervention group and by 3.01 (4.92) in the control group (between-group difference, 4.334; 95% CI, 2.21 to -6.46; P < 0.01), the mean (SD) hypertension compliance increased by 12.89 (11.95) in the intervention group and by 5.43 (10.54) in the control group (between-group difference, 7.47; 95% CI, 3.62 to 11.31; P < 0.01), the mean (SD) physical health increased by 12.21 (10.77) in the intervention group and by 1.54 (7.18) in the control group (between-group difference, 10.66; 95% CI, 7.54-13.78; P < 0.01), the mean (SD) mental health increased by 13.17 (9.25) in the intervention group and by 2.55 (5.99) in the control group (between-group difference, 10.93; 95% CI, 7.74 to 14.12; P < 0.01).
Among participants with uncontrolled hypertension, individuals randomized to use a monitoring wearable device with a smartphone application had a significant improvement in self-reported hypertension compliance, self-efficacy, life quality, weight loss and diastolic blood pressure, but no change in systolic blood pressure compared with controls.