Behavioural design processes have proliferated in recent years across a diverse set of fields including policy, product development and health. However, this diversity of perspectives also increases ambiguity regarding which (and when) processes should be enacted, which hinders research and practice across fields. This drives two research questions: (1) How are behavioural design processes currently framed, described, and enacted? and (2) How can we consistently understand commonalities and differences across behavioural design processes? In response to these questions, we adopt a critical interpretive synthesis (CIS) approach, reviewing 12 processes from academic and practitioner sources selected through purposive sampling and analysed using a theory-informed coding protocol. Through interpretive synthesis, we re-characterise behavioural design in terms of an ecosystem of distinct but complementary processes rather than its typical presentation in fixed sequences of steps. This increases behavioural design’s ability to respond to different degrees of uncertainty and dynamism in the problem and solution as well as its ability to reflect diverse assumptions about uncertainty, iteration, outcomes and practitioner capability. This research supports an important and developing interdisciplinary area by bringing design process into a design science research context through which many of these topics can be further discussed and developed.

To halt and reverse the ongoing biodiversity crisis, substantial changes in human behaviour will be required. One important challenge in achieving such changes is the ‘extinction of experience’ – the progressive loss of direct human interactions with nature (hereafter ‘personalised ecologies’). Diminished personalised ecologies can erode emotional ties to nature, weaken pro-conservation attitudes and reduce engagement in the diverse actions needed to support biodiversity. Although the extent of this decline has increasingly been documented, far less attention has been paid to the processes through which it unfolds over time, particularly across generations. In this Perspective, we examine how the extinction of experience may become entrenched within societies. We propose a conceptual framework, drawing on ideas from behavioural genetics, to explore how personalised ecologies could be transmitted across generations through genetic, environmental and interactive pathways. We then use this framework to consider why, once initiated, the extinction of experience may persist and intensify over time. Finally, we outline potential strategies to help disrupt this cycle of disconnection and to foster more positive, self-reinforcing trajectories of human–nature interactions. Achieving this will likely require coordinated efforts across sectors, including conservation organisations, education systems, urban planning and public health initiatives.

The aim of this study is to describe the development and implementation of a novel Readiness to Change Nutritional Habits (RCNH) survey for use along with dietary assessment and gut microbiome profiling in a proof-of-concept study in individuals with early Alzheimer’s disease dementia (eAD), mild cognitive impairment (MCI), and healthy controls (HC). Overall, this methods paper contributes to emerging research examining how behavioural readiness for change can be integrated with dietary assessment and gut microbiome profiling to better understand the microbiome’s influence on the nervous system. This is a sub-study embedded within a multi-prong proof-of-concept, observational study mapping the gut microbiome in 45 participants (15 HC, 15 MCI, 15 eAD) at baseline, 3 months, and 6 months. The parent study collects gut microbiome profiles, dietary patterns, and cognitive assessments. The sub-study develops and administers the 32-item RCNH survey to characterize participants’ readiness to adopt nutritional change. This manuscript reports the RCNH survey, its development process, the sub-study protocol including data collection procedures, and planned exploratory analyses. This protocol presents a novel intervention to assess the gut microbiome, individual dietary patterns, and readiness to make lifestyle changes related to diet.

The gambling industry tends to frame gambling harms as a matter of personal responsibility, which is implicit in their messages like ‘gamble responsibly’ or ‘take time to think’. Jurisdictions such as Australia and the UK are replacing industry messages with a range of independently designed ones, like in tobacco warning labels. Counter-industry messages have been proposed to challenge industry narratives, e.g., ‘gambling products are designed to be addictive’. Here we tested 10 potential counter-industry messages among UK gamblers (N = 4,094) using a mixed-methods approach. Results showed that the three best-performing messages came from existing counter-industry campaigns. Participants believed the messages and agreed that they were relevant to people experiencing gambling harm. Participants experiencing higher levels of harm tended to see the messages as more personally relevant to them. Free-text analysis showed that ‘gambling products are designed to be addictive’ received the most positive responses, and also that personal responsibility views were widespread among participants. Messages randomly shown later in the experiment were appraised more positively, suggesting that counter-industry messaging may become more effective when its core message is repeated in multiple ways. Continual design and testing will contribute to the development of best approaches and inform future implementation.

Lameness remains an ongoing challenge to the health and welfare of UK sheep flocks. Whilst effective recommended practice exists in the UK in the form of the five-point plan (5PP), it is not always used or used effectively, particularly in relation to culling. A more in-depth understanding of farmer lameness management behaviours and decision-making is crucial for driving positive change. Behaviour change frameworks offer useful tools to do this, specifically the Behaviour Change Wheel and its central tenets of capability, opportunity and motivation (COM-B). This research sought to explore on-farm management practices surrounding lameness, particularly focused on the 5PP and culling in relation to COM-B. Findings are drawn from five online focus groups with UK farmers (n = 19) and one with veterinarians (n = 4). Thematic analysis led to the identification of themes in relation to the role of capability, opportunity and motivation to enact the steps of the 5PP, particularly culling. Culling, alongside prompt treatment, were the only tools used by all participants. Yet, culling practices did not always follow recommended advice. Factors that influenced behaviours included those self-controlled by farmers, e.g. records kept; outside of their control, e.g. space available, and those controlled by other actors, such as market prices. Considerations of the individual farm and the wider UK sheep sector context were important. Findings suggest a need for interventions aimed at encouraging good record-keeping, collective industry action against lameness and opportunities for vet-farmer interactions. These should be pursued together to achieve the goal of reducing lameness and subsequently improving sheep welfare.

Many charities rely on donations to support their work addressing some of the world’s most pressing problems. We conducted a meta-review to determine what interventions work to increase charitable donations. We found 21 systematic reviews incorporating 1339 primary studies and over 2,139,938 participants. Our meta-meta-analysis estimated the average effect of an intervention on charitable donation size and incidence: r = 0.08 (95% CI [0.03, 0.12]). Due to limitations in the included systematic reviews, we are not certain this estimate reflects the true overall effect size. The most robust evidence found suggests charities could increase donations by (1) emphasising individual beneficiaries, (2) increasing the visibility of donations, (3) describing the impact of the donation, and (4) enacting or promoting tax-deductibility of the charity. We make recommendations for improving primary research and reviews about charitable donations, and how to apply the meta-review findings to increase charitable donations.

Individuals with severe mental illness face a significantly reduced life expectancy compared to the general population. Addressing key modifiable risk factors is essential to reduce these alarming rates of mortality in this population. Nutritional psychiatry has emerged as an important field of research, highlighting the important role of nutrition on mental health outcomes. However, individuals with severe mental illness often encounter barriers to healthy eating, including poor diet quality, medication-related side effects such as increased appetite and weight gain, food insecurity and limited autonomy over food choices. While nutrition interventions play a key role in improving health outcomes and should be a standard part of care, their implementation remains challenging. Digital technology presents a promising alternative support model, with the potential to address many of the structural and attitudinal barriers experienced by this population. Nonetheless, issues such as digital exclusion and low digital literacy persist. Integrating public and patient involvement, along with behavioural science frameworks, into the design and delivery of digital nutrition interventions can improve their relevance, acceptability and impact. This review discusses the current and potential role of digital nutrition interventions for individuals with severe mental illness, examining insights, challenges and future directions to inform research and practice.

Cancer-related fatigue is a common problem among colorectal cancer (CRC) survivors even after completion of treatment. In a randomised trial, we assessed the effect of a person-centred lifestyle programme on cancer-related fatigue among CRC survivors who completed treatment. Survivors who completed treatment at least 6 months but no longer than 5 years ago and who were experiencing cancer-related fatigue were randomised to intervention or control group. The intervention group worked with a lifestyle coach for 6 months during twelve sessions to stepwise increase adherence to the World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines on healthy diet and physical activity. The control group did not receive lifestyle coaching. Changes in cancer-related fatigue from baseline to 6 months were assessed with the FACIT (Functional Assessment of Chronic Illness Therapy) – Fatigue Scale. As a secondary outcome, we assessed changes in health-related quality of life (HRQoL). Higher scores indicate less fatigue and better HRQoL. Eighty participants were randomised to the intervention group; eighty-one to the control group. Baseline characteristics were similar: mean age 64·1 (sd 10·9) years; 55·3 % were women; and 72 % had colon cancer. There were favourable changes in dietary behaviours and physical activity in the intervention group; the control group did not show changes to the same extent. The programme did not result in statistically significant differential changes over time between intervention and control group in cancer-related fatigue (0·8; 95 % CI −1·6, 3·2) or HRQoL (1·3; 95 % CI −2·2, 4·8). A person-centred lifestyle programme improved the lifestyle of CRC survivors, but the programme was not effective in reducing cancer-related fatigue or in improving HRQoL.

In different parts of the world the claim is increasingly being made that continuous confinement of pet cats (Felis catus) is beneficial for both wildlife conservation and cat welfare. The first part of the claim is almost incontrovertible, but the second is misleading. The assertion that confined animals have superior welfare is rooted in thinking pre-dating the 1960s that equates welfare with physical health. By contemporary accounts of animal welfare, confinement of animals presents major welfare risks, and this recognition has been a major driver of refinement in livestock industries, e.g. moves towards free-range systems. Yet, these risks have not been widely acknowledged in debates over pet cat management. We argue that the current pervasive rhetoric from conservationists and some regulators that cat confinement is beneficial for wildlife and cats is, at best, confusing health with welfare. At worst, it is a deliberate attempt to mislead the public through portraying a win-win scenario where, instead, a trade-off must be navigated. Failure to recognise this trade-off undermines conservation goals three-fold. First, it limits the efficacy of behaviour change interventions to increase confinement. Second, it erodes public trust in organisations perceived as knowingly misleading the public. Finally, it reduces the incentive to make the one decision yielding long-term benefits for both cats and ecosystems; ceasing to own cats at all. Policy-makers should be wary of the allure of false win-win narratives when tackling contentious issues that require trade-offs to be made.

There is a growing attention towards personalised digital health interventions such as health apps. These often depend on the collection of sensitive personal data, which users generally have limited control over. This work explores perspectives on data sharing and health apps in two different policy contexts, London and Hong Kong. Through this study, our goal is to generate insight about what digital health futures should look like and what needs to be done to achieve them. Using a survey based on a hypothetical health app, we considered a range of behavioural influences on personal health data sharing with the Capability, Opportunity, Motivation model of Behaviour (COM-B) to explore some of the key factors affecting the acceptability of data sharing. Results indicate that willingness to use health apps is influenced by users’ data literacy and control, comfort with sharing health and location data, existing health concerns, access to personalised health advice from a trusted source, and willingness to provide data access to specific parties. Gender is a statistically significant factor, as men are more willing to use health apps. Survey respondents in London are statistically more willing to use health apps than respondents in Hong Kong. Finally, we propose several policy approaches to address these factors, which include the co-creation of standards for using artificial intelligence (AI) to generate health advice, innovating app design and governance models that allow users to carefully control their data, and addressing concerns of gender-specific privacy risks and public trust in institutions dealing with data.

This paper introduces Setting-Driven Design (SDD) and supporting tool – the Behaviour Setting Canvas (BSC) – which together address a critical gap in behavioural design by shifting the focus from individual behaviour to the broader context in which behaviour occurs. Rooted in behaviour setting theory, SDD is a powerful approach to behavioural design that offers an end-to-end structure for understanding and intervening in a behavioural design challenge. The process comprises three iterative phases: scoping the behavioural challenge, understanding the setting and intervention development. The process structure revolves around the BSC, a tool for mapping key contextual elements such as roles, motives, norms and routines. While SDD is particularly effective for behaviour change interventions, its utility extends to other design challenges, including introducing new products, shifting social norms and enhancing existing systems where behaviour remains constant. The approach integrates a theory of change to guide intervention development, prototyping and evaluation, ensuring alignment with behavioural objectives and contextual realities. A case study on handwashing in low-income Tanzanian households illustrates the method’s utility, culminating in the creation of Tab Soap, a single-use, biodegradable soap designed to improve hygiene behaviours. The study demonstrates how SDD facilitates insight generation and iterative refinement and complements user-centred design. SDD advances behavioural design by combining theoretical rigour with practical application, offering a scalable and adaptable framework for addressing complex design challenges across diverse fields.

Overconsumption of unhealthy, discretionary, foods and beverages are associated with an increased risk of weight gain and non-communicable diseases, including diabetes, heart disease, and cancer. This cross-sectional study explored preferences for setting goals to reduce discretionary food and beverage consumption. The online survey included items about discretionary food and beverage intake, goal setting preferences to reduce intake, habit strength, personality traits, and demographic characteristics. A total of 2664 Australian adults completed the survey. The sample was mostly female (65.9%), half (52.8%) were aged between 30–49 years, and the median intake of discretionary food and beverages was 4.9 (IQR: 3.6 to 7.2) serves per day. Multinomial logistic regression and ordinal logistic regression models were used to explore demographic and psychological predictors of the helpfulness of long-term and short-term goals, elimination and gradual goals, specific food goals, specific eating occasion and food goals, self-set goals, collaboratively set goals, and assigned goals. The results showed participants with higher habit strength had greater odds of finding short-term (OR 1.40, 95% CI 1.06–1.86), gradual (OR 1.14, 95% CI 1.01–1.29), specific (OR 1.35, 95% CI 0.84–1.76), assigned (OR 1.38, 95% CI 1.14–1.66) and collaborative goals (OR 1.24, 95% CI 1.01–1.53) helpful. The results also indicated that age and gender were important predictors of goal setting preferences, particularly for long-term goals, elimination goals, broad goals, and collaborative goals. Interventions to reduce discretionary food and beverage intake are needed and consideration of goal setting preferences could be a novel way to developing more tailored and effective dietary interventions.