Health Psychology and Behavioral Medicine最新文献

Background: Mental health first aid (MHFA) has gained popularity over the years. This study retrospectively maps the MHFA intervention to characterise its content using the Behavioural Change Wheel to identify the active ingredients and mechanisms of action.

Methods: Three data sources formed the data for the current study. Namely, the MHFA training manual, a roleplay video demonstrating how to implement the intervention, and interviews with six participants of whom five were MHFAers and five were MHFA recipients, on their experiences of the MHFA intervention. The interview data source formed part of the EMPOWER trial. The study presented here utilised a two-step approach: a) The MHFA intervention was described using the Template for Intervention Description and Replication (TIDieR) framework, and b) the content was analysed to identify the behavioural change techniques (BCTs) using the behavioural change techniques taxonomy version 1 and intervention functions using the behavioural change wheel. The mechanisms of action were specified using the capability, opportunity, motivation model of behaviour and theoretical domains framework.

Results: Twelve BCTs and four intervention functions were identified across the three data sources. Only social support BCTs and the intervention functions of enablement and persuasion were consistently identified across the three data sources in the MHFA. The most frequent mechanisms of action were reflective motivation (particularly 'beliefs about capabilities' and 'goals') and social opportunity (particularly 'social influences').

Conclusions: The MHFA intervention incorporates BCTs to increase reflective motivation and social opportunity to seek help for mental health concerns. However, psychological capability and physical opportunity need to be addressed to enhance help-seeking behaviours in those experiencing mental health difficulties. Future research should evaluate the impact of integrating additional BCTs and intervention functions into the MHFA programme to determine the most effective combination for promoting help-seeking behaviour and improving mental health outcomes.

Background and objectives: Obstetric and gynaecological care profoundly affects individuals' health and well-being. However, many international studies reveal negative and even dehumanizing experiences of this type of healthcare. This study documents recent experiences of obstetric and gynaecological care in Québec. We examine patient-healthcare provider interactions, respect for patient rights, whether patient needs are met, and how these factors impact satisfaction with the treatment provided and trust in the healthcare system.

Methods: The PAROLES project is based on a self-report questionnaire posted online from July 2023 to January 2024. The sample comprises 1490 respondents who reported 1599 recent experiences of obstetric and gynaecological care. Descriptive analyses and linear regressions were performed.

Results: Generally, patient-healthcare provider interactions were perceived positively, but some significant shortcomings were revealed in terms of unmet needs for shared decision-making and disrespected rights. Although patients were relatively satisfied with their care, there was considerable distrust in the healthcare system. Meeting needs in terms of shared decision-making and respecting rights were associated with overall satisfaction and trust in the healthcare system.

Conclusion: The results uncover substantial inadequacies in obstetric and gynaecological care in Québec. To optimize patient-healthcare provider interactions and better meet patient needs, there must be greater respect for patients' rights.

Background: Effective persuasive messages can contribute to enhancing pandemic preparedness and public health. An essential requirement for this is an excellent understanding of the effects of exposure to persuasive messages on compliance with behavioral measures against the spread of respiratory viruses. This field study tested the effects of persuasive messages on compliance with two behavioral measures to prevent the spread of viruses that cause respiratory infections such as COVID-19 and the flu: coughing/sneezing into the elbow and staying home when ill with respiratory infection symptoms.

Materials and methods: A field study with an observational pre-post design was conducted at four educational institutions representing all common post-secondary school educational levels in the Netherlands. Data were collected among students and employees via online questionnaires before (n = 2096) and after (n = 1098) exposure to a set of persuasive messages with six different message framings. Two-way MANOVA, logistic regression analysis and repeated measures ANOVA were conducted.

Results: Exposure frequency, behavioral measure type, demographic characteristics, trust in government, prosocial orientation, perceived health, educational institution, and student/employee status showed significant multivariate main effects and univariate main and/or interaction effects on the outcomes (intention to comply, attitude, social norms, moral norm, self-efficacy, response-efficacy, and risk perception; p < .05). The odds of compliance with staying home when ill were lower than the odds of compliance with coughing/sneezing into the elbow, regardless of exposure frequency (p < .001).

Conclusion: In conclusion, messages positively influenced behavioral determinants - a critical prerequisite for behavior change and compliance. Findings also highlight that people are likely more willing to comply with measures that have less adverse personal and social impact. To enhance compliance more is needed, for instance explanations of the relevance and effectiveness of measures, and practical support to enact the measures. Practical and theoretical implications are discussed.

Background: Obesity is a major global health issue, increasing morbidity and mortality through its association with non communicable diseases. Black African women experience disproportionately high obesity rates, reaching 37 percent in the UK. They face cultural, social, and systemic barriers to achieving sustainable lifestyle changes. To address these disparities, the Black African Lifestyle and Nutrition Change for Empowerment and Development (BALANCED) intervention was developed. This paper describes the development of the BALANCED intervention and the evidence, theory, and community informed processes that shaped its design.

Methods: A stepwise approach guided by the Behaviour Change Wheel and COM B model (Capability, Opportunity, Motivation Behaviour) was used. Formative research, including a systematic review, dietary pattern analysis, and qualitative interviews, identified key behavioural determinants and barriers to healthy eating among Black African women with overweight and obesity in the UK. These insights informed the selection of intervention functions and behaviour change techniques (BCTs). Intervention components were co designed with key stakeholders to support acceptability and feasibility.

Results: Formative research showed that Black African women face barriers to adopting healthy behaviours, including limited access to culturally appropriate dietary guidance, time constraints, and systematic healthcare challenges. In response, the intervention addressed these barriers through educational and training modules, culturally tailored counselling, and structured peer support, focusing on dietary and physical activity behaviours. Seven Behaviour Change Wheel intervention functions were applied, incorporating BCTs aligned with identified determinants.

Conclusion: The BALANCED intervention offers an innovative, culturally tailored approach to supporting sustainable behaviour change among Black African women living with overweight and obesity. Grounded in behavioural theory and informed by empirical evidence, it addresses multidimensional barriers and supports engagement. Future research will pilot the intervention and evaluate its effectiveness and scalability to inform public health strategies to reduce health disparities in this population.

Purpose: A growing number of studies have investigated the effectiveness of exergaming on the executive functions (EFs) in children with ADHD. Whilst some studies have shown beneficial effects, other studies provide mixed effects and there has yet to be a focused synthesis of the literature on this topic.

Methods: A systematic review (PROSPERO; CRD42024549395) was conducted following PRISMA guidance, drawing from eligible studies across eleven databases. Studies were screened based on eligibility criteria by two independent reviewers. Risk of bias (Cochrane ROB2) and certainty of evidence (GRADE criteria) were independently assessed by two reviewers. The Synthesis Without Meta-analysis (SWiM) using vote counting based on direction of effect was conducted on studies with incomplete data. Separate meta-analyses were performed for each EF process using random-effect meta-analysis.

Results: A total of 2,263 studies were identified. After removing duplicates and non-RCTs automatically, 1,546 studies were screened by title and abstract resulting in 35 full texts being retained for detailed screening with 4 studies meeting all inclusion criteria. Two studies in the SWiM showed beneficial effects on overall EFs. Meta-analyses on two studies found exergaming was beneficial for inhibition (SMD = -5.07; 95%-CI [-14.08, 3.95]), working memory (SMD = -0.31; 95%-CI [-0.88, 0.26]), and cognitive flexibility (SMD = -0.84; 95%-CI [-1.50, -0.19]). The mean drop-out rate was 13.82% indicating high adherence. Implementation data identified that a console, game license, a room, television, and supervision from trainers/parents are needed to implement exergaming across different settings and contexts.

Conclusion: The results indicate that although the direction of effects shows positive trends, the evidence remains insufficient and imprecise to determine the clear conclusion whether exergaming can increase EFs and adherence to PA in children with ADHD. Future research with high-quality measurement of the outcome and completely reporting outcome data is necessary to strengthen the evidence and to inform the implementation.

Background: Exercise is an integral component of cardiac rehabilitation after open-heart surgery in both hospital and community settings, and such programs are designed to reduce adverse physical and mental health outcomes in patients undergoing cardiac surgery. Virtual reality (VR)-based aerobic exercises are used for cardiac rehabilitation. We aimed to analyze the effects of an eight-week home-based phase II cardiac rehabilitation program performed in VR on depression and quality of life (QOL) in community-dwelling individuals who underwent open-heart surgery.

Methods: A randomized controlled trial was conducted, and 49 patients who underwent elective open-heart surgery were assigned to either the VR group (n=24) or the control group. Members of the control group received a paper booklet (n=25) during phase II cardiac rehabilitation. Depression and SF-36 scores were assessed at baseline and at eight weeks.

Results: The VR group showed a significant decrease in depression after eight weeks, compared to the control group (D-1.75, p=.003, n2p=0.175). The SF-36 showed no significant differences between the VR and control groups.

Conclusions: A home-based VR exercise program has applications in phase II cardiac rehabilitation for open-heart surgery by reducing depression but not QOL. Therefore, integrating VR exercise into cardiac rehabilitation programs may offer a novel strategy to address mental health challenges.

Background: Disordered eating behaviors are a growing public health concern among adolescents, with implications for both physical and psychological well-being. The availability of culturally valid assessment tools is critical for early identification and prevention.

Objectives: This study aimed to (i) examine how self-esteem, sport participation, and Body Mass Index (BMI) predict eating disorder symptoms in a large cohort of Tunisian schoolchildren, and (ii) assess the psychometric properties of the Arabic version of the Eating Disorder Examination Questionnaire (EDE-Q).

Methods: A total of 1,748 adolescents (629 boys, 1119 girls; mean age ≈ 16.8 years) from Zaghouan, Tunisia, completed self-report assessments of BMI, self-esteem (Rosenberg Self-Esteem Scale), physical and sports activity, and disordered eating (Arabic EDE-Q). Correlation, regression, and confirmatory factor analyses were conducted.

Results: Eating disorders were negatively associated with physical activity (boys: r = -0.456; girls: r = -0.260; p < 0.01) and self-esteem (β = 0.651; p < 0.001) and positively associated with BMI (β = 0.219; p < 0.001). The Arabic EDE-Q demonstrated a robust four-factor structure and high internal consistency (CFI = 0.996; RMSEA = 0.026). Gender differences were observed, with girls reporting higher disordered eating scores.

Conclusions: Self-esteem and BMI are significant predictors of disordered eating, underscoring the need for integrated public health strategies that promote mental well-being and healthy body image among adolescents. The validated Arabic EDE-Q offers a reliable tool for screening and monitoring disordered eating in Arabic-speaking youth populations, enabling early intervention in school-based mental health programs.

Background: Mobile health (mHealth) applications are becoming increasingly popular for delivering mental health support, yet insights on how to tailor them effectively for autistic individuals remain limited.

Methods: This paper describes the co-creation process of the Stress Autism Mate (SAM), a free, evidence-based stress management application for autistic adults.

Results: Development was guided by the five stages of the Design Thinking framework: Empathise, Define, Ideate, Prototype, and Test. Various challenges encountered over seven years of development are outlined, along with the iterative refinements made to address them. Based on continuous feedback from autistic adults, development emphasised a minimalist, predictable interface, essential personalisation options, and stress-related insights readily applicable to daily life.

Discussion: The lessons learned may offer practical guidance for designing tailored mHealth applications for autistic adults and other populations with specific needs or preferences.

Background and objective: Overweight and obesity have been associated to metabolic and psychological diseases, even at young ages. Most studies have analysed separately the physical and mental correlates of high BMI and global approaches are required for detailed comprehensive descriptions of the diverse endophenotypes. This study aimed to identify empirical clusters among overweight and obese young adults based on their nutritional patterns and mental well-being (depression, anxiety and stress levels).

Methods: The sample comprised N = 188 university students. Two-Step cluster explored the existence of empirical groups based on dietary intake, psychological and cardiometabolic state, and gender.

Results: The 4-cluster model was selected as the optimal solution. Men and women were separately distributed within the clusters. Cluster 2 obtained the highest mean in carbohydrates eating, while cluster 1 achieved the highest mean in fats and sodium ingesting. The worse psychopathological state was associated to cluster 4, nearly followed by cluster 2. The highest BMI and metabolic risks were associated to clusters 2 and 4 (also the highest proportion of metabolically unhealthy obese individuals).

Conclusions: Evidence-based and cost-effective public health programs aimed at preventing obesity should promote healthy eating patterns, as well as mental well-being and resilience.

Background: This randomized pilot study examined the relationships between objectively measured sleep characteristics and food cravings in adolescents and examined whether a brief sleep intervention would reduce food cravings from baseline to post-intervention compared to an active control group.

Methods: A community sample of 51 adolescents aged 13-17 years old were randomized to complete a cognitive behavioral therapy (CBT) sleep intervention or a study skills control intervention. The sleep intervention involved one telehealth CBT session, while the control group completed one telehealth CBT session to improve study skills. Sleep was assessed using actigraphs and adolescents reported on food cravings using a validated questionnaire at baseline and post-intervention.

Results: Sleep fragmentation, but not sleep duration, was a significant predictor of food cravings at baseline, controlling for age, β = 0.35, t = 2.41, p = 0.02, 95% CI [0.01-0.11]. The sleep intervention significantly reduced food cravings from baseline to post-intervention compared to the control group (significant time × intervention interaction, F(1, 45) = 4.30, p = 0.044, partial η² = 0.09, medium effect).

Conclusions: The results of this study support the relationship between poor sleep quality and more frequent food cravings, as well as the preliminary efficacy of a brief, CBT-based sleep intervention in reducing food cravings. The brief and digital delivery of this intervention enhances its accessibility.