Positive psychology interventions (PPIs) are effective in increasing well-being across the population. Whilst educators are recognising the importance of well-being in the classroom and of its long-term impact on life trajectory, the transformative potential of PPIs in educational settings is yet to be fully realised. This study investigates, for the first time, the effects of a PPI in school children by means of a daily dairy. Self-report questionnaires were used to measure well-being in school children aged 8–11 years. Across two studies, children kept a positive events diary, recording three experiences every day for a week. The intervention led to an increase in happiness and a decrease in depressive symptoms immediately following the intervention and at a three-month follow-up. Children who had unhappier baseline scores benefitted more from the intervention. This study demonstrates significant scope, in school settings, for targeted light-touch interventions to promote well-being in those with the greatest need.

Traditional approaches to changing health behaviours have primarily focused on education and raising awareness, assuming that increased knowledge leads to better decisions. However, evidence suggests these methods often fail to result in sustained behavioural change. The dual-process theory of decision-making highlights that much of our behaviour is driven by automatic, intuitive processes, which educational interventions typically overlook. Compounding this challenge, behavioural research is often conducted on small groups, making it difficult to scale insights into broader societal issues, where behaviour is influenced by complex, interconnected factors. This review advocates for integrating behavioural science with systems approaches (including systems thinking and approaches to complex adaptive systems) as a more effective approach to resolving complex societal issues, such as public health, sustainability, and social equity. Behavioural science provides insights into individual decision-making, while systems approaches offer ways of understanding, and working with, the dynamic interactions and feedback loops within complex systems. The review explores the commonalities and differences between these two approaches, highlighting areas where they complement one another. Design thinking is identified as a useful structure for bridging behavioural science and systems thinking, enabling a more holistic approach to problem-solving. Though some ideological challenges remain, the potential for creating more effective, scalable solutions is significant. By leveraging the strengths of both behavioural science and systems thinking, one can create more comprehensive strategies to address the “wicked problems” that shape societal health and well-being.

Knowing when to persevere with a plan and knowing when to ditch it and change strategy is highly adaptive and breaks down in several frontal and striatal disorders. Cognitive flexibility is also susceptible to tonic influences of neuromodulators (such as dopamine) and so may be influenced by everyday fluctuations in processes known to depend upon them (such as motivation). The current study employed an attentional shifting paradigm to examine the influence of changes in food-related motivational state in healthy volunteers. Hunger was induced through fasting (physiological manipulation) or through the presentation of appetitive food cues prior to testing (desire manipulation). The desire manipulation produced a stronger effect than fasting by inducing errors when participants were attempting to shift. The results suggest that everyday fluctuations in appetite and desire can produce a significant impact on cognition, highlighting implications for our understanding of excessive motivational control including maladaptive eating behaviour.

The Wales Centre for Behaviour Change is a research project that aims to integrate positive psychology with emerging technologies and behavioral science to promote prosperity and well-being. The behavioral focus emphasizes choice architectures and environmental triggers in their influence on positive change. This paper describes the background for this project, as well the theory and design of the center and its work. We review behavioral intervention technologies that the center is employing, or plans to employ, to augment the decision-making capabilities of its target audience. Technologies can be positioned in the behavioral stream to reduce complexity and distraction and in so doing help individuals make optimal decisions.

Background: Health-care systems across the globe are facing increased pressures to balance the efficient use of resources and at the same time provide high-quality care. There is greater requirement for services to be evidence based, but practices that are of limited clinical effectiveness or cost-effectiveness still occur.Objectives: Our objectives included completing a concept analysis of de-implementation, surfacing decision-making processes associated with de-implementing through stakeholder engagement, and generating an evidence-based realist programme theory of ‘what works’ in de-implementation.Design: A realist synthesis was conducted using an iterative stakeholder-driven four-stage approach. Phase 1 involved scoping the literature and conducting stakeholder interviews to develop the concept analysis and an initial programme theory. In Phase 2, systematic searches of the evidence were conducted to test and develop this theory, expressed in the form of contingent relationships. These are expressed as context–mechanism–outcomes to show how particular contexts or conditions trigger mechanisms to generate outcomes. Phase 3 consisted of validation and refinement of programme theories through stakeholder interviews. The final phase (i.e. Phase 4) formulated actionable recommendations for service leaders.Participants: In total, 31 stakeholders (i.e. user/patient representatives, clinical managers, commissioners) took part in focus groups and telephone interviews.Data sources: Using keywords identified during the scoping work and concept analysis, searches of bibliographic databases were conducted in May 2018. The databases searched were the Cochrane Library, Campbell Collaboration, MEDLINE (via EBSCOhost), the Cumulative Index to Nursing and Allied Health Literature (via EBSCOhost), the National Institute for Health Research Journals Library and the following databases via the ProQuest platform: Applied Social Sciences Index and Abstracts, Social Services Abstracts, International Bibliography of the Social Sciences, Social Sciences Database and Sociological Abstracts. Alerts were set up for the MEDLINE database from May 2018 to December 2018. Online sources were searched for grey literature and snowballing techniques were used to identify clusters of evidence.Results: The concept analysis showed that de-implementation is associated with five main components in context and over time: (1) what is being de-implemented, (2) the issues driving de-implementation, (3) the action characterising de-implementation, (4) the extent that de-implementation is planned or opportunistic and (5) the consequences of de-implementation. Forty-two papers were synthesised to identify six context–mechanism–outcome configurations, which focused on issues ranging from individual behaviours to organisational procedures. Current systems can perpetuate habitual decision-making practices that include low-value treatments. Electronic health records can be designed to hide or remove low-value treatments from choice options, foregrounding best evidence. Professionals can be made aware of their decision-making strategies through increasing their attention to low-value practice behaviours. Uncertainty about diagnosis or patients’ expectations for certain treatments provide opportunities for ‘watchful waiting’ as an active strategy to reduce inappropriate investigations and prescribing. The emotional component of clinician–patient relationships can limit opportunities for de-implementation, requiring professional support through multimodal educational interventions. Sufficient alignment between policy, public and professional perspectives is required for de-implementation success.Limitations: Some specific clinical issues (e.g. de-prescribing) dominate the de-implementation evidence base, which may limit the transferability of the synthesis findings. Any realist inquiry generates findings that are essentially cumulative and should be developed through further investigation that extends the range of sources into, for example, clinical research and further empirical studies.Conclusions: This review contributes to our understanding of how de-implementation of low-value procedures and services can be improved within health-care services, through interventions that make professional decision-making more accountable and the prominence of a whole-system approach to de-implementation. Given the whole-system context of de-implementation, a range of different dissemination strategies will be required to engage with different stakeholders, in different ways, to change practice and policy in a timely manner.Study registration: This study is registered as PROSPERO CRD42017081030.Funding: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 9, No. 2. See the NIHR Journals Library website for further project information.