Missed hospital appointments (Do Not Attend [DNAs]) undermine healthcare efficiency and access. A high-profile study found that adding descriptive social norms (DSNs) or specific institutional cost (SIC) messages to SMS reminders could substantially reduce DNAs. This prompts optimism that integrating behavioural insights, besides reminders themselves, offers a cost-effective approach to mitigate DNAs. However, subsequent similar interventions have reported heterogeneous findings, echoing broader debates on recent meta-analyses about how to evaluate such findings. We address this issue by framing Behavioural Insights as Applied Science, which structures validation in three phases inspired by clinical research. We treat the aforementioned study as a Phase 1 proof of concept and conduct a Phase 2 replication under comparable operational conditions in a quasi-experimental, time-blocked field trial at South-western Jutland Hospital (20,867 appointments) across Cardiology, Endocrinology and Pulmonology. Patients received SMS reminders rotating every 2 months between a standard message, DSN framing or SIC framing. Neither DSN nor SIC reduced DNAs overall. SIC increased cancellations (OR = 1.41, p < 0.001) but not DNAs; DSN reduced DNAs in Cardiology (OR = 0.76, p = 0.027), while SIC increased DNAs in Endocrinology (OR = 1.31, p = 0.021). Our findings underscore the importance of applying a systematic approach in the evaluation of Behavioural Insights.

Processes of repression, criminalization and penalization were importantly affected by the COVID-19 pandemic. Mobilizing data produced through an ethnographic study of plea courts in Ottawa, this article reports on the ways in which lower criminal courts administered what judges described as “COVID justice.” In this transitory form of justice, we observed a) a dilated reward system for guilty pleas; b) the work of the virtual resolution team, a workgroup dedicated to unburdening the courts from backlogs attributed to the pandemic; c) requests to increase the credits granted for time served in locked-down, noxious prisons, and; d) the diversion of sentenced individuals from prison on the grounds of the primacy of public health over criminal justice.

Chronic stress can lead to physical and mental health conditions. This study aimed to identify the different stress profiles and stress relief methods among Filipinos living in the Philippines using latent class analysis. A secondary analysis of a cross-sectional study was employed in this study. The stressors and stress-relief practices among Filipinos were investigated using the I-HEART-FILIPINOS data set. Latent class analysis was used to identify the different profiles of stress causes and management methods among 1,196 Filipinos residing in the Philippines, specifically the Northern Luzon area. Four stress-related profiles were identified: (1) low financial stress relieved by eating and exercise; (2) work-related stress relieved by self-care; (3) familial and economic turmoil relieved by eating, exercise and prayer; (4) high financial stress relieved by staying at home and remaining indoors. The four-class solution explained 58% of the variation in the data through classification. Disparities were observed between classes in terms of emotional distress and sociodemographic variables, implying how sociocultural factors could affect stress presentation and management in Filipinos. The findings of this study inform the development of stress management interventions specifically designed to address the needs of underserved populations in the Philippines and neighboring countries to improve overall health.

This article explores possible connections between health crises, economic policy choices, and the rise of populist movements, drawing on evidence from the interwar period. It considers how differing policy responses to the Great Depression may have been associated with contrasting trajectories in both public health and political developments. In Germany, the adoption of austerity measures in the early 1930s appears to have coincided with worsening economic conditions, declining health indicators, and growing electoral support for far-right movements. By contrast, expansionary initiatives introduced under the New Deal in the U.S. were likely accompanied by strengthened social protections, improvements in health outcomes, and what some observers have interpreted as a mitigation of pressures toward political radicalisation. Taken together, these historical experiences offer insights into contemporary developments, where perceived inadequacies in responding to intertwined health and economic crises could potentially contribute to eroding institutional trust and increasing receptiveness to populist narratives.

This article, which relies on underutilized archival collections as well as oral histories, is one of the first comprehensive examinations of the feminist struggle to decriminalize abortion during Brazil’s transition to democracy during the 1980s. We discuss how the consolidation of the antiabortion Christian right and its proximity to several political parties, including ones on the left, coupled with the politically moderate tone of the transition from dictatorship to democracy, constrained the space in which Brazilian feminists could make radical demands of the state. Moreover, we contend that although the creation of the state-funded feminist organ Conselho Nacional dos Direitos da Mulher in 1985 brought important visibility to feminist issues and inserted the movement’s agenda squarely within the government apparatus, it also fragmented feminists, threatened co-optation by the state, and ultimately compelled abortion rights activists to prioritize the more palatable strategy of expanding access to therapeutic abortions, which were already permitted by law. In addition to divergences in political strategy, feminists struggled to create multiracial and multiclass coalitions during this period, when many Black feminists and working-class women were organizing around other concerns. As a result, feminists were not able to fundamentally alter public opinion about the political importance of abortion, and their efforts to enshrine the termination of pregnancy as a human right in the 1988 Constitution were unsuccessful.

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.

Public health research faces challenges in recruiting socio-economically disadvantaged groups. This study evaluated whether machine learning (ML) algorithms developed using data from a general population could predict indices of diet quality among a socio-economically disadvantaged group. Data from 5367 adults (77·5 % females) in the NutriQuébec project and on 122 variables potentially associated with dietary intakes were used. Dietary intakes were measured using a web-based 24-h recall. Participants were categorised by fifths of a deprivation score based on income, education and material and social deprivation. Participants in the first four fifths formed the general NutriQuébec sample (n 4180) and those above the fifth quintile formed the high deprivation sample (n 1187). Three indices of diet quality defined as ‘high’ or ‘low’ were used: vegetable and fruit consumption (VFC, ≥ 5·0 reference amounts (RA)/d), ‘other foods’ consumption, meaning, foods not recommended in Canada’s Food Guide 2019 (OFC, > 5·0 RA/d) and overall diet quality measured using the Healthy Eating Food Index-2019 (HEFI-2019, > 48·9 points). The algorithms developed and tested in the general NutriQuébec sample predicted high VFC, OFC and HEFI-2019 with accuracies of 0·60 (95 % CI 0·58, 0·62), 0·58 (95 % CI 0·56, 0·60) and 0·61 (95 % CI 0·59, 0·63), respectively. In the high deprivation sample, the algorithms predicted the diet quality indices with comparable accuracies (VFC, 0·69, 95 % CI 0·67, 0·71; OFC, 0·56, 95 % CI 0·54, 0·58; HEFI-2019, 0·66, 95 % CI 0·65, 0·67). ML algorithms trained to predict three diet quality indices in the general NutriQuébec sample were applicable to a high deprivation group.