Health Psychology and Behavioral Medicine最新文献

Objective: Non-adherence to immunosuppression medication (ISM) is common in kidney transplant recipients (KTRs), despite being associated with poor clinical outcomes. Understanding potentially modifiable contributors to non-adherence is essential for developing effective interventions. This study explored the relationship between components of the Common-Sense Model (CSM), including illness perceptions (graft-specific and of kidney disease more broadly) and beliefs about ISM, as well as perceived behavioural control (PBC), and total, intentional and unintentional ISM non-adherence in KTRs.

Methods and measures: A cross-sectional observational study was conducted with N = 296 KTRs. Participants completed self-report measures including the Brief Illness Perception Questionnaire, Beliefs about Medicines Questionnaire, questions assessing PBC, and the Medication Adherence Report Scale. Hierarchical binary logistic regression analyses were conducted to examine the explanatory value of variables on adherence outcomes.

Results: Over half of participants (57%) reported any indication of non-adherence. Unintentional non-adherence was reported more frequently (54%) than intentional non-adherence (14%). Combining CSM components with PBC best explained variance in total (Nagelkerke R ² = 19.8%), intentional (Nagelkerke R ² = 15.5%), and unintentional non-adherence (Nagelkerke R ² = 19.3%).

Conclusion: Enhancing PBC around taking ISM may offer a valuable intervention target, particularly when addressed alongside CSM components to reduce both intentional and unintentional non-adherence.

Background: While considerable research has centered on the concept of self-efficacy and its impact on behavior, relatively few studies have delved into the sources of self-efficacy beliefs. Bandura posited that the genesis of self-efficacy beliefs is based on the following four aspects: personal experience, vicarious experience, verbal persuasion, and emotional state. The objective of this research paper is to ascertain the relative importance of each source concerning self-efficacy for physical activity to determine whether some sources should be accorded with greater emphasis than others in future studies aiming to foster self-efficacy beliefs for physical activity.

Methods: An online study with 335 healthy German adults (162 men, 173 women) aged 18-68 was conducted. The sources of self-efficacy were compared by employing dominance analysis. This approach allows for the ordering of predictors according to their contribution to the explained variance, thereby providing more substantial insights and allowing for more concrete conclusions in comparison to the conventional multiple regression approach.

Results: As expected, mastery experience was shown to be the most important source of self-efficacy for physical activity, interestingly followed by verbal self-persuasion and positive affective state. Together, the sources of self-efficacy accounted for about 60% of the variance in self-efficacy.

Conclusions: Overall, understanding the etiology of self-efficacy is essential for developing effective and sustainable interventions to promote healthy behaviors. By focusing on the specific sources of self-efficacy that are most pertinent, interventions can be designed to be more effective.

Background: Clinical guidelines recommend addressing alcohol and tobacco use simultaneously, but few providers offer brief alcohol interventions routinely, and these behaviours are often treated separately. While several interventions targeted dual use, there remains a gap in identifying behaviour change techniques (BCTs) designed to modify processes controlling dual use.

Objective: To identify commonly used BCTs in interventions targeting both alcohol and tobacco use, their modes of delivery, and explore which BCTs are associated with smoking cessation and/or alcohol reduction.

Methods: Following Cochrane recommendations, a rapid review to identify BCTs showing promise for reducing dual use was conducted. Using an eligibility criteria, we retrieved relevant papers from databases and used the Behavioural Change Taxonomy V1 tool to identify BCTs showing promise.

Results: Thirty-eight articles of the initial systematic search of 2987 papers met the criteria for full article review. Goal setting, action planning, and pharmacological support were the most common BCTs identified. Most studies (33, 87%) had a low or moderate risk of bias. Of these 33 studies, 13 studies (39%) reported statistically significant outcomes of reduction or cessation in smoking behaviour and alcohol consumption. Face to face (25, 76%) was the most common intervention delivery method.

Conclusion: Clinical trials identify goal setting, action planning and problem solving to address the dual use of tobacco and alcohol. Systematic reviews and meta-analyses are needed to evaluate the true impact of these programmes. Future studies should minimally include these BCTs and study the interactional effects of these BCTs on the efficacy of the intervention.

Introduction: Mobile health (mHealth) technologies such as wearable activity trackers (e.g. Fitbit) and digital applications (apps), can support behavior change in real-world contexts. Since effectiveness is dependent, in part, on participants' engagement with the digital technology (e.g. app page views) and the intervention components (e.g. anti-sedentary messages), there is a need for modeling approaches that support the investigation of engagement in digital interventions and the refinement of dynamic theories of behavior change.

Methods: Dynamic Bayesian Networks (DBN) were used to model the idiographic (individual) dynamic relationships between a participant's daily app engagement (page views), walking behavior, and intervention messages, accounting for context (e.g. temperature), and psychological variables (e.g. perceived restedness and perceived busyness). Additionally, we explored differences in the resulting DBN models between participants of Hispanic/Latino and non-Hispanic/Latino White backgrounds.

Results: Data from 10 participants in the HeartSteps II study (n = 5 Hispanic/Latinos and n = 5 non-Hispanic/Latino Whites) was used. Across participants (100%, n = 10), there was a strong positive effect of the number of messages/prompts received on their daily app page views with a predicted increase range of 12.84 (12.19-13.57) to 25.84 (24.28-27.59) app page views per day per message received. Among the majority of Hispanic/Latino participants (n = 4/5, 80%), there was a strong positive relationship between daily app page views and walking behavior with predictions ranging from a mean of 6.70 (6.37-7.05) to 10.93 (10.14-11.78) steps per minute of Fitbit wear time per app page view. Both groups showed idiographic differences in the effects of temperature and perceived busyness on walking behavior.

Conclusion: The results demonstrate the benefits of DBNs to model the daily-level idiographic behavioral dynamics of engagement in digital intervention studies. This approach can be leveraged to support the refinement of dynamic theories of behavior change and improving personalized mHealth intervention strategies.

Objective: A key concept in health psychology is behavioral maintenance. However, previous research has struggled to establish shared conceptualizations and operational definitions. This study aimed to contribute to this debate by examining whether a simple conceptual proposition of physical activity maintenance as 'the performance of physical activity according to an intended target threshold over a specific period of observation' can be empirically supported, and under which boundary conditions. Specifically, we explored different formulations of two boundary conditions: activity threshold and timescale of change.

Methods: We analyzed 350 time series (length = 182 days) of moderate-to-vigorous physical activity (MVPA) collected daily with Fitbit from participants in a weight loss intervention. All participants reported an intention to engage in at least 150 min of MVPA per week over the following six months. Activity thresholds were defined based on each participant's baseline MVPA. Generalized Additive Models were used to model individual trajectories across varying timescales (7, 14, 28, and 56 days).

Results: At short timescales (7-14 days) trajectories crossed the threshold frequently, indicating high variability. At longer timescales (28-56 days) trajectories were more stable, with participants tending to stay either above or below their threshold, aligning with our target conceptualization of maintenance. Relaxing the threshold by 10-20% relatively increased the proportion of participants classified as maintainers, though maintenance remained uncommon for participants with higher thresholds.

Conclusions: Our findings provide initial evidence on which boundary conditions support detecting physical activity maintenance as conceptually defined. These results underscore the importance of systematically testing boundary conditions to advance understanding of behavioral maintenance.Trial registration: ClinicalTrials.gov identifier: NCT03907462.

Background: Despite the benefits smartphone technology offers, our phones are available to us almost all of the time and excessive smartphone use may be linked to problematic behaviours and mental illness symptoms. Therefore management of our daily screen time is integral to wellbeing in the digital era.

Design: A recent randomised controlled trial (NCT06353451) randomised university students (N = 111) to either reduce their daily phone use (intervention) or continue use as normal (control). Using a cross-over design, the control group later received the intervention. The results demonstrated that reducing smartphone use to <2hrs/day improved self-reported mental health, as compared to a control group with no change in screentime.

Methods: The aim of this paper was a secondary analysis of daily heart rate variability data (HRV) measured with Fitbit devices to assess physiological changes during the intervention. A total of 45 participants provided baseline, intervention and follow-up HRV data. Mental health variables were measured using standardised questionnaires.

Results: A linear multilevel regression indicated HRV significantly declined during the intervention compared to baseline. HRV during the intervention significantly correlated with craving and sleep quality. Conclusions: This may suggest that participants are experiencing a response akin to withdrawal from a behavioural addiction. Importantly, participants reported improved mental wellbeing, suggesting benefits of controlled smartphone use, but our findings provide a deeper insight into the processes underlying reduction in smartphone use and suggest craving and sleep hygiene may be important factors to additionally consider in future studies.Trial registration: ClinicalTrials.gov identifier: NCT06353451.

Background: The prevalence of chronic noncommunicable diseases is high among Mexican adults. Adherence to healthy lifestyles, such as regular exercise, is essential for managing these diseases and preventing their complications. However, 60% of Mexican adults living in urban areas are not active. This study aimed to identify the association between psychosocial factors and adherence to exercise recommendations among Mexican adults receiving primary healthcare services.

Methods: A cross-sectional study was conducted with 406 adults aged 20-64 years. The dependent variable was adherence to exercise recommendations for the adult population. Participants were classified into three categories - Active, Insufficiently Active, and Inactive - based on the metabolic equivalents per week expended on exercise. The Global Physical Activity Questionnaire was used to assess physical activity. The metabolic equivalents per week spent on leisure-time exercise were calculated. The psychosocial variables from the Transtheoretical Model included stages of readiness for change, self-efficacy, and decisional balance, and sociodemographic and health factors were also considered. In the statistical analysis, ordered logistic regression was used.

Results: Associations were identified between stages of readiness for change and self-efficacy with exercise adherence categories. The multivariate analysis revealed that for each one-point increase on the self-efficacy scale, the likelihood of being in the Active category increased by 2.4%, while the likelihood of being in the Inactive category decreased. Males, compared to females, and adults aged 20-31 years, compared to those aged 32-64 years, were more likely to be in the Insufficiently Active and Active categories.

Conclusions: Psychosocial factors such as stages of readiness for change and self-efficacy were associated with meeting the recommendation for exercise; these factors could be incorporated into the design and development of exercise promotion strategies for Mexican adults using primary healthcare services.

Employee well-being is essential for both individual fulfillment and organizational productivity. This registered report outlines a mixed-methods daily diary study designed to understand how employees use needs-based crafting strategies to fulfill their psychological needs across work and nonwork domains. Over a four-week period, 100 employees from diverse occupational sectors in Germany will participate. Data collection includes a baseline survey, daily diary assessments over two weeks, and a follow-up survey in the final week. The study captures both quantitative and qualitative data on daily crafting strategies, contextual influences, and individual differences. Quantitative analyses will examine within-person fluctuations and between-person differences in needs-based crafting and well-being indicators using multilevel modeling. Qualitative responses will be analyzed thematically and further explored for variations across employee subgroups defined by individual characteristics and well-being profiles. The study aims to uncover how employees actively shape their daily experiences to meet core psychological needs, how these strategies vary across individuals and contexts, and how they relate to employee well-being. Findings are expected to inform future interventions and practical recommendations for supporting employee well-being through needs-based crafting approaches in both work and nonwork life domains.

Purpose: The study is part of a larger structural change programme, where Participatory Appreciative Action and Reflection (PAAR) has been used with the aim of changing home care practices to align with individuals' needs and goals. The purpose of this study was to describe how the knowledge process in PAAR was conducted to develop a new way of working based on the individual's needs and goals in home care.

Method: A total of 160 co-researchers i.e. older persons, relatives, staff, administrators, first-line managers, case managers and persons from the authority were included in the study. Data was collected through fieldwork, including interviews, participant observations, informal conversations, focus group discussions, reference groups, and appreciative inquiry circles.

Results: Co-creating knowledge was revealed as a three-step process: preparation for access to the field, being together in the field, and leaving the field. Each step describes several cycles of how the PAAR process proceeded, with actions leading to reflections and vice versa, which drove the knowledge process forward.

Conclusions: The knowledge process of PAAR, gave rise to seven lessons learnt for future practice development: Contact pathways and trusting relationships, Loving struggle over time, An appreciative gaze, Patience and courage, Different ways of learning, A shared goal and Flexibility to adapt PAAR to changes in the field.

Background: Data Note articles describe openly available research datasets. They detail how and why the data were created, with the aim of increasing research transparency and facilitating data reuse. However, existing guidelines and templates for Data Note articles have been designed for quantitative research datasets and are unsuitable for qualitative research datasets. As qualitative health and social care datasets have unique sensitivities, they must be treated and reported differently to quantitative datasets.

Aim: To describe the protocol for developing a novel reporting guideline for Data Note articles describing qualitative health and social care datasets (i.e. the DeNOTE reporting guideline).

Methods: The DeNOTE study includes (i) a rapid scoping exercise of existing documents and expert knowledge to identify and synthesise relevant reporting 'items' or 'statements' for a Data Note article describing qualitative health and social care data, (ii) an online questionnaire with expert participants to rate their agreement with items identified in (i) and to propose new or amended items, (iii) an online workshop with participants to co-develop the reporting items and reach consensus, (iv) eliciting participant feedback on the draft reporting guideline, and (v) finalising the guideline.

Conclusion: Our plans to develop the DeNOTE reporting guideline are registered on the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The guideline will support researchers producing Data Note articles describing qualitative health and social care data. We will create a tailored resource to address the needs of qualitative researchers to facilitate transparency and to support data reuse.