Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were ‘negative feeling states’ (21%) and ‘motivation and goals’ (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k = 348) and did not differ by target behaviour but was somewhat higher in student (vs. general population) samples, when EMAs were delivered via mobile phones/smartphones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context.

Objective We investigated the association between women’s healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa. Design Secondary data from the Demographic and Health Surveys of six countries in sub-Saharan Africa were used. We employed multilevel binary logistic regression modelling. Setting Sub-Saharan Africa. Participants Women aged 15–49 years in Benin (n=5282), Côte d’Ivoire (n=1925), Cameroon (n=7558), Kenya (n=6696), Namibia (n=1990) and Zimbabwe (n=5006). Primary outcome measures Cervical cancer screening uptake. Results The overall prevalence of cervical cancer screening across the six sub-Saharan African countries was 13.4%. Compared with women whose healthcare decisions were made solely by husbands/partners/someone else, the likelihood of cervical cancer screening uptake was significantly higher among women who took healthcare decisions in consultation with their husbands/partners (aOR=1.38; 95% CI 1.19 to 1.59), but highest among those who made healthcare decisions alone (aOR=1.66; 95% CI 1.44 to 1.91). Women aged between 40 and 45 years (aOR=5.18; 95% CI 3.15 to 8.52), those with higher education (aOR=2.13; 95% CI 1.57 to 2.88), those who had ever heard of cervical cancer (aOR=32.74; 95% CI 20.02 to 53.55), read newspaper or magazine at least once a week (aOR=2.11; 95% CI 1.83 to 2.44), listened to the radio at least once a week (aOR=1.35; 95% CI1.18 to 1.52) and those in households with richest wealth index (aOR=1.55; 95% CI 1.20 to 2.00) had significantly higher odds of screening for cervical cancer compared to their counterparts. Conclusion Women who are able to make autonomous healthcare decisions and those who practice shared decision making are more likely to uptake cervical cancer screening. Therefore, policy interventions should focus on empowering women to be able to take autonomous healthcare decisions or shared decision making while targeting subpopulations (ie, multiparous and rural-dwelling women, as well as those in other religious affiliations aside from Christianity) that are less likely to uptake cervical cancer screening. Also, the radio and print media could be leveraged in raising awareness about cervical cancer screening to accelerate cervical cancer screening uptake in sub-Saharan Africa.

Introduction Rotation work, characterised by travelling long distances to work in isolated areas where workers typically rotate consecutive days working and living on-site with periods at home, is increasingly used in the resources and construction sectors globally. Such employment practices may have an impact on workers’ health and well-being. This systematic review explores the impact rotation work has on mental and physical outcomes in rotation workers in the resources and construction sectors. Method The PubMed, Medline, EMBASE, CINAHL, PsycINFO, and Scopus databases were systematically searched on 1 May 2020 to identify quantitative, qualitative and mixed-method studies addressing the health of rotation workers published in peer-reviewed journals. Findings from the studies were summarised narratively. Results Of 6268 studies retrieved, 90 studies were included in the review. Studies suggested higher prevalence of psychological distress in onshore rotation workers and higher overweight/obesity rates among rotation workers as compared with the general population. We found more sleep problems and higher levels of smoking during work periods compared with off-site days; and higher alcohol intake during off-site days compared with on-site days. Workers generally perceived their physical health status as good. High-perceived job demands (such as workload, repetitive work) were associated with mental distress and exhaustion, sleep problems and perceived poor physical health status, while high-perceived job resources (such as job clarity/control, support) were associated with low mental distress and exhaustion, less smoking and alcohol intake, and better sleep. Conclusion Rotation work is associated with several poorer health behaviours and outcomes, such as sleep problems, smoking, alcohol consumption and overweight/obesity. Interventions needed to improve rotation workers’ health should include maximising available job resources and reducing job demands. Further longitudinal studies are needed to explore the long-term health effects of rotation work and the short-term contextual effects of the different aspects of rotation work.

Introduction: Poor perceptions and attitudes about prostate cancer screening are some reasons for late reporting for PC screening and treatment. Understanding perceptions of PC and how it translates to screening and treatment is important for physicians and public health practitioners as this information clarifies existing knowledge and provides valuable information for the design of public health programmes to reduce the disease burden of PC. Objective: This study examined perceptions and knowledge about PC and attitudes towards screening among male teachers in the Sunyani Municipality. Subjects and methods: This is a cross-sectional study involving 160 teachers aged 45–60 years randomly sampled from primary, junior and senior high schools in the municipality. A structured questionnaire on background characteristics of respondents, perceptions about PC and attitudes towards early screening was used to elicit responses. Preliminary analysis summarised data on socio-demographic characteristics of respondents, perceptions and attitudes about PC screening. The Pearson’s chi square (χ2) and Fisher’s exact tests, and logistic regression analysis were later used to examine the association between socio-demographic variables, knowledge, perceptions and attitudes about PC screening. Results: The mean age of respondents was 49.52 (SD = ±3.95). PC was not considered to be transmitted sexually (58.8%) and caused by radiations from mobile phones, (40.6%). Majority of respondents agreed that PC screening is beneficial (95.0%) and disagreed with the assertion that going through PC screening is embarrassing (72%) and painful (49.3%), although the majority had never been screened (90%). There was no association between demographic variables and perceptions about PC. However, knowledge about PC was found to be significantly associated with perceptions about PC (p < 0.001). There was a significant association between knowledge of PC (p < 0.0001) and attitudes towards PC screening. Conclusion: Considering the public health significance of PC, public health programmes should go beyond awareness creation to organise educational campaigns for all socio-economic groups. These programmes should provide clarity on healthy lifestyles to prevent cancer, the health benefits of early screening, detection and treatment, screening and treatment options and the peculiarities of each to inform health-seeking choices

Introduction Ecological momentary assessment (EMA) involves repeated, real-time assessments of phenomena (eg, cognitions, emotions, behaviours) over a period of time in naturalistic settings. EMA is increasingly used to study both within-person and between-person processes. We will review EMA studies investigating key health behaviours and synthesise: (1) study characteristics (eg, frequency of assessments, adherence, incentives), (2) associations between psychological predictors and behaviours and (3) moderators of adherence to EMA protocols. Methods and analysis This review will focus on EMA studies conducted across five public health behaviours in adult, non-clinical populations: movement behaviour (including physical activity and sedentary behaviour), dietary behaviour, alcohol consumption, tobacco smoking and preventive sexual health behaviours. Studies need to have assessed at least one psychological or contextual predictor of these behaviours. Studies reporting exclusively on physiological outcomes (eg, cortisol) or those not conducted under free-living conditions will be excluded. We will search OVID MEDLINE, Embase, PsycINFO and Web of Science using terms relevant to EMA and the selected health behaviours. Reference lists of existing systematic reviews of EMA studies will be hand searched. Identified articles will be screened by two reviewers. This review is expected to provide a comprehensive summary of EMA studies assessing psychological or contextual predictors of five public health behaviours. Ethics and dissemination The results will be disseminated through peer-reviewed publications and presentations. Data from included studies will be made available to other researchers. No ethics are required. PROSPERO registration number CRD42020168314.

Background: Fly-In Fly-Out (FIFO), which entails travelling mostly from the urban areas to stay and work in remote areas for designated periods and travel back home to spend designated days of leave, has become a common work arrangement in the mining sector globally. This study examined the mental and physical health of FIFO workers and described their health-related behaviours during on-and off-shift periods. Methods: A cross-sectional study was conducted with FIFO workers (N = 216) in the mining industry in Australia who completed an online survey. Paired t-test and McNemer’s analysis examined the differences in health-related behaviours during workers’ on-and off-shift days. Logistic regression examined the predictors of physical health and psychological distress status of FIFO workers. Results: Workers reported longer sleep duration (7.5 ± 1.5 h vs 6.3 ± 1.2 h, p < 0.001) and better sleep quality (78.2% vs 46.3%, p < 0.001) during off-shift nights than on on-shift nights. Smoking prevalence was 26.4%, and workers reported smoking a similar number of cigarettes per day during on-and off-shift days. Most workers reported drinking alcohol (86.1%) and more often at risky levels during off-shift than on-shift days (57.9% vs 34.3%, p < 0.001). Fruits and vegetable consumption was low but with higher vegetable intake during off-shift days (2.8 ± 1.4 vs 2.3 ± 1.3 serves, p < 0.001). Workers had good physical health status (91.2%), but 71.4% were overweight/obese and 33.4% indicated high levels of psychological distress. Working on long shifts (OR 6.63, 95% CI 1.84–23.91) and smoking (OR 7.17, 95% CI 2.67–19.26) were linked to high psychological distress. Conclusions: The prevalence of psychological distress and risky health behaviours was high. Interventions should aim to reduce psychological distress and support multiple behaviour changes, considering FIFO work-related characteristics including long shift hours.