Lab
Behavioral Science in Health - BSiH Lab
Institution: Cyprus University of Technology
Department: Department of Nursing
About the lab
The Behavioral Science in Health Lab at Cyprus University of Technology is led by Dr Angelos Kassianos, integrating behavioral sciences with health-related sciences such as medicine, nursing and public health. The focus of the Lab is to conduct high-quality research in areas such as:
- Determinants of health behaviors and health behavior change including vaccination, breastfeeding, physical activity, smoking and eating
- Design and evaluation of community, public health and digital health interventions
- Patient-Reported Outcome Measure (PROM) monitoring including digital tools for monitoring quality of life
- Psychophysiological responses
- Psycho-Oncology
- Medical Education using virtual simulations
In addition we conduct public outreach and training activities.
www.bsihlab.com
- Determinants of health behaviors and health behavior change including vaccination, breastfeeding, physical activity, smoking and eating
- Design and evaluation of community, public health and digital health interventions
- Patient-Reported Outcome Measure (PROM) monitoring including digital tools for monitoring quality of life
- Psychophysiological responses
- Psycho-Oncology
- Medical Education using virtual simulations
In addition we conduct public outreach and training activities.
www.bsihlab.com
Featured research (29)
Medication adherence (MA) to recommended treatment is a multi-faceted problem and an ongoing challenge for healthcare providers (HCPs) to monitor. This qualitative study with 10 HCPs in Cyprus aims to explore HCPs’ perceptions and strategies used on addressing medication non-adherence (MNA) in patients with chronic conditions. Two main themes emerged from the analysis reflecting the ways that HCPs described their reactions to MNA of their patients: (1) “Relying on information provision to improve MA” and (2) “Trying to understand patients’ perspective.” HCPs reported empathizing with patients and engaging in discussions to understand patients’ perspective and reasons for MNA, so as to explore alternative solutions. Simultaneously, some HCPs reflected that the techniques used to improve MA are solely centered around information on medication and side-effects. HCPs experienced an internal conflict between providing patient-centered care versus using directive approaches to improve MA. Findings suggest how HCPs could thoroughly address patients’ individual barriers.
Plain Language Summary
The social contagion theory suggests that people’s attitudes and behaviors can spread from one individual to another in different types of social networks such as families, schools and communities. This study explores how this theory can be applied in vaccination for COVID-19 using a series of interviews with individuals in Cyprus that hold differing views about vaccinations. Participants were screened first on their attitudes toward vaccines and therefore purposively recruited individuals who hold positive, negative and hesitant views toward vaccines. A sample of 11 interviews were included for analysis. Study participants first provided information on their exposure to information about vaccines mainly from the media and the web and most discussed their concerns with a healthcare provider whom they consider the most trusted source of information irrespective of their personal views about vaccines. They further elaborated that other influences such as politicians were not perceived as experts. Participants were mostly influenced on their decision to vaccinate by their family and friends thus those with whom they trusted more and felt more intimate with or they share similar views with. Participants finally demonstrated that exposure to positive attitudes had an impact on themselves and contributed to vaccination. Therefore the meaning people pose on their surrounding world is of utmost importance on their decision-making. In terms of policymaking this study suggests that public health interventions could include trusted sources when delivering campaigns and interventions.
Introduction
We aim to understand the factors that drive citizens of different countries to adhere to recommended self-protective behaviors during the COVID-19 pandemic.
Methods
Survey data was obtained through the COVID-19 Impact project. We selected countries that presented a sufficiently complete time series and a statistically relevant sample for running the analysis: Cyprus, Germany, Greece, Ireland, Latvia, Spain, Switzerland, the United Kingdom, and the United States of America. To identify country-specific differences in self-protective behaviors, we used previous evidence and change-point detection analysis to establish variations across participating countries whose effect was then assessed by means of interrupted series analysis.
Results
A high level of compliance with health and governmental authorities’ recommendations were generally observed in all included countries. The level of stress decreased near the period when countries such as Cyprus, Greece or the United Kingdom relaxed their prevention behavior recommendations. However, this relaxation of behaviors did not occur in countries such as Germany, Ireland, or the United States. As observed in the change-point detection analysis, when the daily number of recorded COVID-19 cases decreased, people relaxed their protective behaviors (Cyprus, Greece, Ireland), although the opposite trend was observed in Switzerland.
Discussion
COVID-19 self-protective behaviors were heterogeneous across countries examined. Our findings show that there is probably no single winning strategy for exiting future health crises, as similar interventions, aimed to promote self-protective behaviors, may be received differently depending on the specific population groups and on the particular geographical context in which they are implemented.
Background
Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies.
Method
In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category).
Results
In total, 2189 adult participants (82% female, 57.2% aged 31–59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04).
Conclusions
This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.
Purpose:
Recommendations for exclusive breastfeeding are not often adhered to despite the robust evidence of its benefits. This systematic review aims to collate evidence on the attitudes mothers and health care providers have towards breastfeeding interventions to understand what aspects best contribute to acceptability and feasibility.
Methods:
This review further investigates the value of identifiable behaviour change techniques (BCTs) to uncover which components of an intervention are perceived to be most useful and acceptable. The main biomedical databases were searched, and 17 (n = 17) studies met the inclusion criteria.
Results:
A total of nine BCTs were identified within the interventions. The thematic analysis produced four main domains: usefulness, accessibility, value and sustainability. Women discussed the importance of the support they received in these interventions and demonstrated a positive view towards three BCTs: 'social support (unspecified)', 'instruction on how to perform behaviour' and 'demonstration of behaviour'. Additionally, women highlighted the benefit of personal, non-clinical and flexible emotional and practical support from peers, lactation consultants and support groups. Health care providers echoed these opinions and specifically highlighted the usefulness of interventions that allowed for continuity of care and more personal breastfeeding support.
Conclusions:
These findings suggest that ongoing practical as well as emotional support is crucial for standard in-hospital support to succeed at increasing breastfeeding rates. Future research would need to better understand the nuances of the interventions among women and providers to enhance their implementation.
Lab head

Department
- Department of Nursing
About Angelos P. Kassianos
- I am interested in questions around cancer prevention, early diagnosis and using patient-reported outcomes (like Health-Related Quality of Life, depression, anxiety etc.) in cancer management and palliative care. I am also interested in using technology to optimise early diagnosis, monitor patient health, change health behaviour and collect validated patient data. My secondary interests are on medication adherence among chronic patients, cognitive errors which may lead to diagnostic delays, medical education and health-research in low and middle income countries.