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Background Behavior change is essential for promoting health and preventing illness; yet, motivating individuals to adopt and maintain healthy behaviors remains a significant challenge. Multiple models have been developed in Psychology and Behavioral Sciences to understand and encourage behavior change, including the Capability, Opportunity, Motivation, Behavior model (COM-B model), the Health Belief Model, the Behavior Change Wheel, the Theoretical Domains Framework (TDF), nudge theory, and Behavior Change Techniques (BCTs). Among these, the Fogg Behavior Model (FBM), developed by Dr. BJ Fogg, offers a specific and valuable framework for facilitating behavior change. This scoping review aims to analyze studies that apply the FBM in health, particularly its impact on changing health-related behaviors. By synthesizing the evidence, this review provides valuable insights into the use and impact of the FBM in promoting behavior change in health, with implications for future research and practice. Objective To investigate the application of the FBM within the health domain, focusing on its role in behavior change interventions. Methods A comprehensive search of multiple databases, including MEDLINE/PubMed, Cochrane Library, Epistemonikos, and PsycINFO, was conducted to identify studies applying the FBM in health-related interventions. The search strategy incorporated terms related to the FBM, health behavior change, and relevant health outcomes, with no restrictions on publication date. Unpublished and grey literature was also searched. Eligibility criteria included studies that applied the FBM in health interventions and reported outcomes. The review followed PRISMA-ScR and SAGER guidelines to ensure comprehensive reporting and consideration of sex and gender variables. Data were synthesized using a narrative approach, summarizing findings descriptively and thematically. Results Six studies met the inclusion criteria, covering sexual and reproductive health, vaccination, chronic disease management, general wellness, and healthcare adherence. The FBM was applied through motivation (anticipation, sensation, belonging), ability enhancement (reducing effort, increasing accessibility, integrating behaviors into routines), and prompts (reminders, calls to action, environmental cues). Effectiveness varied across studies. Gestational weight management reduced gestational diabetes (10.34% vs. 34.48%, p = 0.028), hypertension (3.45% vs. 27.59%, p = 0.030), and cesarean rates (41.38% vs. 72.41%, p = 0.017). HPV vaccination interventions increased intent to vaccinate (63.3–96.7%, p < 0.001), with 30% receiving the first dose within three months. Diabetes self-management improved dietary adherence (p = 0.04), physical activity (p = 0.005), and glucose monitoring (p = 0.02). Parental nutrition interventions increased knowledge (d = 1.07), beliefs (d = 0.61), and behavior change (d = 0.59). A vaginal birth intervention raised intention by 29% (p < 0.05). Conclusions Our scoping review highlights the FBM as an effective framework for promoting health behavior change across various domains. By systematically applying motivation, ability, and prompts, FBM-based interventions demonstrated positive outcomes. However, limitations such as the lack of long-term follow-ups and sex- and gender-disaggregated data indicate areas for future research. Expanding its application to diverse populations, integrating digital health technologies, and addressing structural and cultural barriers will enhance its impact. Strengthening methodological rigor and comparative analyses with other behavior change models will further refine its effectiveness for broader public health applications. Despite its potential, the FBM remains underutilized in public health research. Trial registration Open Science Framework osf.io/jpwxg.

Background Unsafe sex is one of the main morbidity and mortality risk factors associated with sexually transmitted infections (STIs) in young people. Behavioral change interventions for promoting safe sex have lacked specificity and theoretical elements about behavior in their designs, which may have affected the outcomes for HIV/AIDS and STI prevention, as well as for safe sex promotion. This study offers an analysis of the barriers and facilitators that, according to the university students who participated in the focus groups, impede or promote the success of interventions promoting healthy sexuality from the perspective of the actions stakeholders should undertake. In turn, this study proposes intervention hypotheses based on the Behavior Change Wheel which appears as a useful strategy for the design of intervention campaigns. Methods Two focus groups were organized with students from Universidad de Santiago de Chile (USACH). The focus groups gathered information about the perceptions of students about sex education and health, risk behaviors in youth sexuality, and rating of HIV/AIDS and STI prevention campaigns. In the focus groups, participants were offered the possibility of presenting solutions for the main problems and limitations detected. After identifying the emerging categories related to each dimension, a COM-B analysis was performed, identifying both the barriers and facilitators of safe sex behaviors that may help orient future interventions. Results Two focus groups were organized, which comprised 20 participants with different sexual orientations. After transcription of the dialogues, a qualitative analysis was performed based on three axes: perception about sex education, risk behaviors, and evaluation of HIV/AIDS and STI prevention campaigns. These axes were classified into two groups: barriers or facilitators for safe and healthy sexuality. Finally, based on the Behavior Change Wheel and specifically on its ‘intervention functions’, the barriers and facilitators were integrated into a series of actions to be taken by those responsible for promotion campaigns at Universidad de Santiago. The most prevalent intervention functions are: education (to increase the understanding and self-regulation of the behavior); persuasion (to influence emotional aspects to promote changes) and training (to facilitate the acquisition of skills). These functions indicate that specific actions are necessary for these dimensions to increase the success of promotional campaigns for healthy and safe sexuality. Conclusions The content analysis of the focus groups was based on the intervention functions of the Behavior Change Wheel. Specifically, the identification by students of barriers and facilitators for the design of strategies for promoting healthy sexuality is a useful tool, which when complemented with other analyses, may contribute improving the design and implementation of healthy sexuality campaigns among university students.

Background and aims The efficacy of using gloves by the general population to prevent COVID‐19 is unknown. We aim to determine the efficacy of routine glove use by the general healthy population in preventing COVID‐19. This is the protocol of a living systematic review. Methods We adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We will conduct searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature, and in a centralized repository in L·OVE (Living OVerview of Evidence). L·OVE is a platform that maps PICO questions to evidence from Epistemonikos database. In response to the COVID‐19 emergency, L·OVE was adapted to expand the range of evidence it covers and customized to group all COVID‐19 evidence in one place. The search will cover the period until the day before submission to a journal. We will include randomized trials evaluating the effect of use of gloves in healthy population to prevent COVID‐19 disease. Randomized trials evaluating the effect of use of gloves during outbreaks caused by MERS‐CoV and SARS‐CoV, and nonrandomized studies in COVID‐19 will be searched in case no direct evidence from randomized trials is found. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random‐effects meta‐analyses and use GRADE to assess the certainty of the evidence for each outcome. A living, web‐based version of this review will be openly available during the COVID‐19 pandemic. We will resubmit it if the conclusions change or there are substantial updates.

Condom use and HIV/STI testing are essential prevention behaviors, yet uptake remains low in Chile. Using data from the 2022–2023 National Health, Sexuality, and Gender Survey (ENSSEX), this study applied a theory-driven mixed-methods approach to identify behavioral determinants influencing these practices among Chilean adults. Considering sexually active respondents, only 23.4% reported consistent condom use and 16.8% reported HIV/STI testing in the past 12 months. Behavioral barriers to condom use were primarily related to perceived reduction in sexual pleasure, social norms within stable relationships, and limited behavioral regulation, while HIV/STI testing was more strongly facilitated by knowledge-related factors but constrained by low-risk perception and structural access barriers. Integrating quantitative classification with theory-informed interpretation using the COM-B model and the Theoretical Domains Framework enabled the identification of key motivational, emotional, and contextual drivers underlying these behaviors. These findings highlight the need for prevention strategies that move beyond information provision to address emotional, social, and structural determinants of behavior. This approach provides actionable guidance for designing behaviorally informed HIV/STI prevention policies and interventions, and demonstrates the value of applying behavioral science frameworks to national survey data in Chile and other middle-income settings.

Unsafe sexual practices remain a major contributor to global morbidity, premature mortality, and health care burden. More than 1 million people acquire a sexually transmitted infection (STI) daily, including HIV. Although biomedical innovations such as pre-exposure prophylaxis have expanded prevention options, consistent condom use and regular HIV and STI testing remain essential behavioral strategies. Adherence to these behaviors remains uneven, underscoring the need for complementary digital and behavioral approaches. Digital behavior change interventions (DBCIs), technology-based programs designed to support health-related behavior change, offer scalable and personalized tools for safer-sex promotion. However, evidence regarding their behavioral components and effectiveness remains fragmented across systematic reviews (SRs). This study aims to synthesize and critically appraise evidence on the effectiveness of DBCIs for preventing STIs and HIV, and to identify which behavior change techniques (BCTs) and theoretical domains framework (TDF) have been used to improve safe-sex behaviors. A search was conducted in MEDLINE, Cochrane Database of SRs, Epistemonikos, and PsycINFO for all publications up to November 12, 2025, without language or date restrictions. Eligible SRs examined DBCIs targeting STI and HIV prevention or reduction of risky sexual behaviors. Two reviewers (GDA and DLA) independently screened, extracted data, and appraised methodological quality using the AMSTAR-2 tool. The reporting followed the PRIOR (Preferred Reporting Items for Overviews of Reviews) and PRISMA-S (Preferred Reporting Items for SRs and Meta-Analyses Literature Search Extension) recommendations. Overall, 23 SRs, comprising 514 primary studies and 129,481 participants, met the inclusion criteria. Most interventions were SMS-based, mobile app-based, or web-delivered. Digital interventions consistently improved STI and HIV testing uptake and engagement with sexual health services. Evidence for condom use and biological outcomes was mixed. Improvements in cognitive determinants, such as HIV-related knowledge, motivation, and self-efficacy, were frequently reported. Only 4 reviews explicitly applied BCT or TDF taxonomies, identifying goal setting, feedback on behavior, and prompts and cues as commonly used techniques. Research predominantly originated from high-income settings, with limited evidence from low- and middle-income countries and minimal reporting of sex- or gender-disaggregated outcomes. DBCIs show promise for strengthening STI/HIV prevention, particularly by increasing testing behaviors and supporting cognitive determinants of risk reduction. However, sustained condom use and biological outcomes remain inconsistent, and reporting of behavioral mechanisms is limited. This overview is the first to integrate effectiveness evidence with a systematic, mechanism-focused mapping of BCTs and TDF constructs, providing an innovation not present in earlier reviews. Clarifying which active components of digital interventions are most consistently linked to beneficial outcomes offers concrete guidance for designing culturally tailored, theory-driven, and equity-focused digital strategies. These insights have direct implications for researchers, clinicians, and policymakers seeking to develop digital prevention programs that more effectively address behavioral determinants of STI and HIV risk. PROSPERO CRD42023485887; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023485887. RR2-10.5867/medwave.2025.02.3020.

Background Despite ongoing prevention efforts, rates of consistent condom use and testing for human immunodeficiency virus (HIV)/sexually transmitted infections (STI) remain low in Chile. Understanding how individual and socio-structural behavioral determinants influence these prevention behaviors is essential to developing effective interventions. Methods We analyzed nationally representative data from the ENSSEX 2022–2023 survey ( n  = 20,392), mapping 44 behavioral indicators to the COM-B model and the Theoretical Domains Framework. Multivariable logistic regression models assessed associations between behavioral determinants and two key outcomes: consistent condom use and HIV/STI testing, adjusted by sex and other covariates. Results Consistent condom use was reported by 15.5% of respondents, and HIV/STI testing by 23.1%. Injunctive norms favoring condom use were strongly associated with consistent condom use (aOR = 1.89), while access to sexual health services (aOR = 2.07) and PrEP awareness (aOR = 1.67) were strongly associated with HIV/STI testing. General knowledge about HIV was not independently associated with either behavior after adjustment. Conclusions In this cross-sectional study of a nationally representative sample of Chilean adults, socio-structural factors—particularly injunctive norms and access to sexual health services—showed stronger and more consistent associations with condom use and HIV/STI testing than did knowledge-related factors after multivariable adjustment. These findings highlight the need for comprehensive, culturally tailored, multi-component interventions that integrate structural, normative, and motivational elements to enhance HIV/STI prevention in Chile and similar settings. Trial registration Not applicable. Key Messages ⦁ Effective HIV/STI prevention requires combining individual skills, socio-structural supports, and normative change. ⦁ Consistent condom use and HIV/STI testing remain low in Chile despite national prevention efforts. ⦁ Socio-structural determinants—including injunctive norms, access to services, and social support—exert a stronger influence on prevention behaviors than knowledge alone. ⦁ Reflective motivation and psychological capability are associated with prevention behaviors, but their effects differ by sex. ⦁ These findings identify priority targets for the design of culturally responsive behavioral interventions.

Childhood obesity and poor dietary habits represent significant public health challenges globally. Schools provide a crucial environment for interventions promoting physical activity and healthy eating behaviors due to their extensive reach and influential role in child development. This overview aims to synthesize evidence on the effectiveness of school-based interventions promoting physical activity and healthy eating behaviors among school-aged children, examining the role of behavior change techniques (BCTs) and behavioral determinants influencing their success. This study is an overview of systematic reviews and follows the Cochrane Handbook for Systematic Reviews of Interventions as well as the PRIOR (Preferred Reporting Items for Overviews of Reviews) statement. A literature searches until September 30, 2024, was performed in four electronic databases for this Overview: Cochrane database of systematic reviews, MEDLINE via PubMed, Epistemonikos, and PsycINFO. No language restrictions were imposed. Data were included and extracted from all systematic reviews evaluating interventions implemented in school settings targeting physical activity, healthy eating, or both, in children aged 6–11 years. Two reviewers independently screened the identified articles and extracted data related to the study characteristics, intervention components, behavioral outcomes (e.g., moderate-to-vigorous physical activity, dietary quality), cognitive outcomes (e.g., self-efficacy, knowledge, attitudes), and biological outcomes (e.g., BMI, waist circumference), classifying BCTs using standardized classifications whenever available. The AMSTAR-2 tool was used to evaluate the methodological quality of the included studies. Six systematic reviews, encompassing over 230,000 participants, were included. Multicomponent interventions combining physical activity, dietary education, cognitive strategies, and environmental modifications demonstrated consistent positive outcomes. Effective BCTs frequently identified included goal setting, self-monitoring, restructuring the physical environment, and providing feedback on behavior, especially via digital platforms. While significant improvements were consistently noted in behavioral outcomes such as increased physical activity and improved dietary habits, evidence regarding cognitive and biological outcomes like BMI reduction was moderate yet favorable. Methodological quality varied, with most reviews rated critically low, except for one high-quality Cochrane review. School-based interventions integrating multiple BCTs, particularly goal setting, self-monitoring, feedback, and environmental restructuring, are effective in promoting physical activity and healthy eating among school-aged children. Future interventions should emphasize long-term sustainability, technological integration, and address existing methodological limitations to enhance effectiveness and generalizability. Systematic review registration Registered in PROSPERO CRD42024587296 on September 16, 2024.

Background The long-term use of benzodiazepines (BZDs) poses significant health risks, including cognitive impairment, falls, and dependency, despite guidelines recommending against prolonged use. Effective deprescribing interventions are essential, but evidence on optimal strategies in primary healthcare remains fragmented. Objective This overview synthesizes evidence from systematic reviews of interventions aimed at reducing inappropriate BZD prescribing in primary care. It identifies barriers and facilitators, assesses the use of behavioral theories, evaluates intervention effectiveness, and appraises methodological quality. Methods A comprehensive literature search was conducted across four electronic databases (MEDLINE via PubMed, Cochrane Database of Systematic Reviews, Epistemonikos, and PsycINFO) up to September 15, 2024. Systematic reviews evaluating deprescription strategies targeting healthcare professionals in primary care settings were included. Two independent reviewers screened studies and extracted data on intervention characteristics, behavior change techniques, and outcomes. The AMSTAR-2 tool was used to assess methodological quality. Results From 2,577 records identified, 14 systematic reviews met inclusion criteria, comprising 279 primary studies with minimal overlap (Corrected Covered Area = 1.24%). The majority of interventions were randomized controlled trials from high-income countries, with only one review including a lower-middle-income country. Common deprescribing strategies were gradual dose reduction (71%), patient education (50%), cognitive-behavioral therapy (43%), and pharmacist-led interventions (36%). Only one review explicitly used a behavioral theory. Key barriers included patient dependency, fear of withdrawal, provider resistance, insufficient training, low self-efficacy, and limited healthcare resources. Facilitators were structured education, shared decision-making, pharmacist involvement, and goal-setting. Multifaceted interventions that integrated behavioral components, especially those involving pharmacists and structured patient education, consistently demonstrated greater and more sustained effectiveness. Conclusions This overview demonstrates that multifaceted interventions—particularly those integrating patient education, audit-and-feedback, and pharmacist involvement—are the most effective for reducing inappropriate benzodiazepine use in primary care. Evidence also suggests that even brief, theory-informed interventions can achieve moderate effectiveness. Despite this progress, most studies lack explicit theoretical frameworks, underscoring the need for theory-driven approaches to enhance intervention design, implementation, and sustainability. Future research should focus on patient-centered strategies, long-term adherence, and broader representation from diverse socioeconomic settings. Registered in PROSPERO (CRD42024548653).

This study reports on the qualitative phase of a study that seeks to design a digital intervention for the prevention of STI / HIV and promotion of sexual health in university students. The experience and perception that university students have about sexuality, risk and prevention campaigns are addressed through focus groups. Semi-structured interviews are conducted with key informants. The results reveal that sexual education is limited and restricted to the biological aspect, as well as loaded with prejudices and gender biases, which narrows the information provided to the student population. Wavering prevention strategies that fail to motivate students or offer them opportunities for making informed and independent decisions about their sexual health are apparent. The STI / HIV campaigns assessed are distant, fear-based and not inclusive. Interventions in sexual health do not weigh experiential aspects of youth sexuality, as they are based on models of ideal and stereotyped behavior, discarding first-person narratives and their rich complexity. It is imperative to innovate in the prevention of STI/HIV, formulating interventions based on an integrative, multidisciplinary and contextualized design that values the theory and experience of the target populations.

Resumen Damos cuenta de la fase cualitativa de una investigación que busca diseñar una intervención digital de prevención de ITS/VIH y promoción de salud sexual en jóvenes universitarios. A partir de grupos focales se abordó la experiencia y percepción que universitarios tienen sobre sexualidad, riesgo y campañas de prevención. Se realizan entrevistas semiestructuradas a informantes claves. Los resultados muestran que la educación sexual es escasa, reducida a lo biológico, cargada de prejuicios y sesgos de género, limitando el manejo de información por la población estudiantil. Se evidencian estrategias vacilantes de prevención, no logrando motivar ni ofrecer oportunidades para la toma de decisiones conscientes y autónomas en salud sexual. Las campañas de ITS/VIH se evaluaron poco inclusivas, lejanas y basadas en el miedo. Las intervenciones en salud sexual han fallado en sopesar aspectos experienciales de la sexualidad juvenil, basándose en modelos de comportamiento ideal y estereotipado, desechando narrativas en primera persona y su rica complejidad. Es imperativo innovar en la prevención de ITS/VIH, formulando intervenciones basadas en un diseño integrador, multidisciplinar y situado, que valore la teoría y la experiencia de las poblaciones objetivo. Abstract This study reports on the qualitative phase of a study that seeks to design a digital intervention for the prevention of STI / HIV and promotion of sexual health in university students. The experience and perception that university students have about sexuality, risk and prevention campaigns are addressed through focus groups. Semi-structured interviews are conducted with key informants. The results reveal that sexual education is limited and restricted to the biological aspect, as well as loaded with prejudices and gender biases, which narrows the information provided to the student population. Wavering prevention strategies that fail to motivate students or offer them opportunities for making informed and independent decisions about their sexual health are apparent. The STI / HIV campaigns assessed are distant, fear-based and not inclusive. Interventions in sexual health do not weigh experiential aspects of youth sexuality, as they are based on models of ideal and stereotyped behavior, discarding first-person narratives and their rich complexity. It is imperative to innovate in the prevention of STI/HIV, formulating interventions based on an integrative, multidisciplinary and contextualized design that values the theory and experience of the target populations.