Health Psychology and Behavioral Medicine最新文献

Background: Individuals who undergo metabolic and bariatric surgery are at increased risk for an alcohol use disorder. Clarity on the relationships between mood, food, and alcohol use could inform interventions to reduce alcohol use and mitigate risk of alcohol use disorders after metabolic and bariatric surgery (MBS).

Methods: Twenty patients who underwent MBS at a single health care system and reported engaging in post-operative alcohol use were recruited. Participants were between 6 months and 3 years post-operative and reported consuming alcohol at least 2-3 times per month. Participants engaged in a 1-hour semi-structured interview about factors influencing post-operative mood, eating behaviors, and alcohol use. All interviews were recorded, transcribed, and coded by two independent raters.

Results: Statements by participants were deductively coded within different themes: (1) changes in mood, (2) changes in eating patterns, and (3) unintended alcohol use and eating. Participants reported positive changes in mood and eating behaviors following MBS, but also indicated potential for negative mood states and new eating patterns. They also suggested that mood was a driver of both eating and alcohol use, including unintended (i.e. unplanned) eating and unintended alcohol use. However, most did not consume food and alcohol at the same time.

Discussion: Food and alcohol may be used as a coping strategy for mood, though they are not often consumed together. There is currently a lack of post-operative interventions to reduce alcohol use and findings suggest that interventions could simultaneously target mood, unintended eating, and alcohol use.

Introduction: The aim of this study was to investigate how the dynamics of the social environment impacted the alcohol consumption of individuals who self-identified as heavy drinkers.

Methods: A mixed methods approach including N-of-1 study with daily Ecological Momentary Assessment (EMA) followed by a social network egonet interview. Qualitative data was analysed using deductive and inductive approaches. The main quantitative outcomes were a number of social contacts and the supportiveness of social networks.

Results: Fifteen participants provided sufficient EMA data regarding social contact and six of these took part in the egonet interviews. EMA respondents reported 10.8 social contacts on average and rated approximately half of their networks as positive supports; approximately 10% of each respondents' networks were perceived as 'drinking a lot'. Interview data illustrated the influence of peer and family networks; stress; motivation levels; and coping strategies within the context of the social world. EMA and egonet methods proved feasible with this specific population demonstrating the utility of innovative approaches to study dynamic social contexts related to substance use.

Discussion: Respondents either drew upon their social resources and implemented strategies to support behaviour change or experienced social strain and poor mental health in the absence of supportive social strategies. Future research should explore how social networks can impact maintaining non-drinking status and accessing supports. Mixed methods research combining N-of-1, EMA, and egonets can provide novel insights into social dynamics.

Background: Physical activity (PA) provides maternal and fetal health benefits, but only 27.5% of Canadian pregnant women meet PA recommendations. Theory-based interventions like the theory of planned behavior (TPB) are useful in explaining what drives behavior. The first objective of this study was to validate the TPB model to predict prenatal moderate-to-vigorous physical activity (MVPA), including testing of the novel interaction between intention and perceived behavioral control (PBC). The second objective was to identify which specific beliefs predict intention toward prenatal MVPA to support intervention.

Method: We used a prospective correlational design. Healthy pregnant women completed two electronic questionnaires: at baseline, to assess TPB constructs, and one month later, to assess MVPA practice. Structural equation modeling was conducted with Latent Moderated Structural Equations. The interaction was interpreted with the pick-a-point method and the Johnson-Neyman graphical method.

Results: The sample consists of 193 women (M _age = 31.2±3.6). Results indicate that prenatal MVPA at one month was marginally predicted by intention (β = 0.149; p < 0.10) and PBC (β = 0.322; p < 0.05, MVPA R ²= 20%), but when their interaction was added to the model, MVPA R ² increased to 44%. Specifically, the relationship between intention and MVPA is stronger when PBC is high (0.5 standard deviation over the mean). In the full model including the interaction, attitude (β = 0.59; p < 0.001), subjective norm (β = 0.20; p < 0.01) and PBC (β = 0.26; p < 0.05) all made a significant contribution to predicting MVPA intention (R ²= 88%). Finally, the following beliefs displayed significant indirect paths toward the intention of being physically active: behavioral beliefs: unlikely to be more tired and likely feel better mentally; normative beliefs: approval from friends and from mother/father; and control beliefs: being tired and missing social support.

Conclusion: Interventions aiming to promote regular MVPA during pregnancy should prioritized the six significant beliefs identified to significantly predict intention toward prenatal MVPA.

This paper reports on human rights violation of trans women in Umlazi township in South Africa. Violation of trans women's human rights happens in several countries regardless of their constitutional stance regarding LGBTQI policies. Although South Africa was the first country to outlaw discrimination based on sexual orientation with its democratic Constitution of 1996, it is not an exception to these violations of transgender people's human rights. This paper presents human rights violations experienced by trans women's in Umlazi township in South African. The study was qualitative in nature utilising an interpretative phenomenological analysis design. Data was collected through semi-structured interviews from eight criterion purposively selected trans women from Umlazi township. Data was analysed guided by an interpretative analytics framework. Two key themes emerged from the study: the types of human rights violations and their sources. The findings indicated that trans women experience several types of human rights violations, including violations of their right to safety, freedom of expression, access to employment, and the right to human dignity. The sources of these human rights violations for trans women include cis-normative infrastructure, transphobic communities, and transphobic public officials. Understanding these experiences is crucial in developing measures to conscientize communities, foster tolerance and promoting social inclusivity of transgender people in society. The findings provide insights that can facilitate positive changes in how communities perceive transgender persons.

Young adult women have unique barriers to exercise, but assessing the psychological and behavioral strategies of women who overcome these barriers may be beneficial for informing future exercise programs. This study assessed differences in motives and self-regulation by type (aerobic or muscle-strengthening) and frequency of exercise, along with preferences for exercise amongst young adult women who exercise regularly.

Methods: A survey assessed exercise frequency (International Physical Activity Questionnaire), intensity (Borg's scale), type, and social and physical preferences. The Exercise Motivations Inventory-2 measured motivators for exercise and the Physical Activity Self-Regulation Scale measured self-regulation. Characteristics and preferences for exercise were examined using descriptives and frequencies. MANOVAs assessed differences in motivators and self-regulation by frequency of exercise, and regression analyses assessed differences in exercise predictors by type.

Results: The sample consisted of 269 women ages 18-34 (66.5% White), of whom 80.3% met the national guidelines for aerobic exercise, 78.4% met the guidelines for muscle-strengthening exercise, and 32.3% identified resistance exercise as their preferred type of exercise. Weight management and self-regulation (p = .021, R² = .073) were the strongest predictors of aerobic exercise. Positive health, strength and endurance, and self-regulation (p = .023, R² = .161) were predictors of muscle-strengthening exercise. Women who participated in high amounts of aerobic exercise were motivated by interpersonal factors while psychological factors motivated high frequency of muscle-strengthening exercise.

Conclusions: Programs for young adult women should consider incorporating resistance exercise as this study shows it may evoke motivation that could lead to regular participation. Self-regulation strategies were associated with adherence to both aerobic and muscle-strengthening exercises, highlighting the potential importance for inclusion in future interventions.

Background: Bardet-Biedl syndrome (BBS) is a rare disorder involving a complex combination of eye and kidney diseases, obesity and learning difficulties. To better understand the roles of family caregivers, this study sought to explore parents' experiences of supporting adult children with BBS.

Method: This study included 17 parents of adult children with BBS. Semi-structured interviews were used as the research method. The generated data were interpreted using a reflexive thematic analysis, which employed a phenomenological and hermeneutical approach.

Result: Four themes were identified - namely, worries and expectations for the child's future, advocate and companion, in the power of the health and support system, and sources of support and coping. The findings indicate that the parents' everyday lives are affected in many ways by caring for adult children with BBS.

Conclusion: This study highlights the various roles and responsibilities of parents of adult children with BBS, including advocating for health services and attempting to fill gaps in care and social relationships. Hence, the findings of this study provide valuable insights for health professionals and support systems, helping to identify key areas for future initiatives aimed at better addressing the needs of adults with BBS and their parents.

Objective: Huntington's disease (HD) is a rare neurodegenerative condition characterised by progressive symptoms affecting motricity, cognition, neuropsychiatric function and behaviour. HD develops during a period of life in which many live in partnership and have children. HD impacts all family members through its cognitive and psychological symptoms, mid-life onset, long disease trajectory and genetic risk. The aim of the study was to explore how parents without HD experience and manage parenthood when their partner is affected by HD.

Methods: Qualitative interviews with 14 caregivers were analysed using reflexive thematic analysis.

Results: Three main themes with corresponding subthemes were identified, followed by an underlying theme: Genetic risk: An underlying layer of complexity. The first theme, Balancing competing demands, describes the challenges involved when attempting to attend to conflicting needs within the family. Theme 2, Needing a shoulder to lean on, covers participants' feelings of loneliness and their need to be seen by others, whereas Theme 3, Restoring and building strength, encompasses coping strategies used by caregivers to protect themselves and their children from potential negative experiences. The underlying theme describes how the genetic aspect of the disease permeates the participants' experiences across all other themes.

Conclusion: Support providers may be unaware of the extensive repercussions HD can have on a family. Acknowledging the central role of partners without HD and their risk of psychological distress is crucial. Exhausted partners may struggle to support their children, which may lead to childhoods overshadowed by HD. For family members to prioritise their own needs, tailored support must be set in place for parents with HD.

Introduction: Aspirin is increasingly recommended for colorectal cancer prevention for people with Lynch syndrome, who are at higher risk. Before starting aspirin, patients should be reviewed by a healthcare professional for contraindications. We conducted interviews to explore the views of people with Lynch syndrome and healthcare professionals on aspirin for cancer prevention. While open data sharing is increasingly implemented for quantitative research, it is less likely to be adopted for qualitative data. We aimed to create and share a qualitative dataset of the interview transcripts in a restricted access repository.

Methods: We interviewed 15 people with Lynch syndrome and 23 healthcare professionals. Healthcare professionals included general practitioners (GPs), community pharmacists, genetic counsellors, and specialist hospital clinicians (e.g. genetics, gastroenterology). The interview schedule was informed by the Theoretical Domains Framework. Interviews were conducted over video or telephone.

Results: Participants could consent to their anonymised interview transcript being deposited in a restricted repository, with access limited to people using the data for non-commercial research, learning or teaching purposes. Those who did not consent could still participate in the interview. Several transcripts were removed due to identifiability concerns. In total, we deposited 12 transcripts with people with Lynch syndrome, and 8 transcripts with GPs.

Discussion: To safeguard participants' identities, we fully anonymised the dataset. While this acted to protect participants' identities, it also potentially reduced its usability due to the removal of rich contextual detail. When sharing qualitative data, it is important to balance confidentiality with data reusability.

Introduction: There is accumulating evidence of ineffective decision-making between birthing individuals and healthcare providers during childbirth. While research syntheses have demonstrated that negative birth experiences are associated with postpartum mental health, primary quantitative studies linking specific decision-making measures and mental health outcomes have not been synthesised. The present study aims to fill this gap in order to provide hands-on evidence on how to further improve perinatal care.

Methods: A systematic literature search using Bolean logic was conducted. A final set of 34 publications from 14 different countries could be included in our meta-analysis. Measures of intrapartum decision-making were consolidated into four key domains: information, respect, control, and involvement. We conducted multi-level meta-analyses to assess the overall relationship of intra-partum decision-making and mental-health outcomes, as well as the specific correlations associated with each decision-making domain.

Results: Our analysisrevealed that less effective intrapartum decision-making is associated with more postpartum overall mental health problems (r = -.25), depression (r = -.19), and posttraumatic stress disorder (r = -.29). More precisely, while all domains of intrapartum decision-making (information: r = -.22, involvement: r = -.23, respect: r = -.28, control: r = -.25) were associated with postpartum overall psychopathology, only information (r = -.18), respect (r = -.25), and control (r = -.12) were associated with depression, and only involvement (r = -.31), respect (r = -.32), and control (r = -.25) were associated with posttraumatic stress disorder. A higher percentange of planned cesarean sections in a sample and longer time lags between birth and post-effect measurement were identified as moderating variables.

Conclusions: Ineffective decision-making is a significant contributing factor to the development of adverse postpartum mental health problems outcomes. Implications for practice concern establishing numerous antenatal care contacts as a standard to enhance birth preparedness for both birthing individuals and providers. Additionally, measuring the experience of intrapartum decision-making as an indicator of quality of care as a default to monitor, analyse, and improve decision-making and to facilitate accountability systems.

Background: Sunburn and intermittent sun exposure elevate melanoma skin cancer risk. Sun protection behaviours, including limiting sun exposure, seeking shade, wearing protective gear, and using sunscreen, help mitigate excessive sun exposure. Smartphone apps present a promising platform to enhance these behaviours.

Objective: Part 1 aimed to analyse and evaluate the content of mobile apps that encourage sun protection behaviours, focusing on features, and behaviour change techniques (BCTs). Part 2 explored user preferences and usability post-initial use and two weeks later.

Results: Part 1 identified 1294 apps; after applying exclusion criteria, 87 apps were downloaded, with 48 included for analysis. The apps presented opportunities for enhancement in their theoretical and evidence basis, and visualisations use (e.g. UV-index). The apps mapped across a total of 12 BCTs (M = 1.71, SD = 1.07; range = 0-5). The most frequently identified BCTs were 'instruction on how to perform behaviour' (65%), 'information about health consequences' (29%), and 'prompts/cues' (27%). In Part 2, participants favoured features supporting knowledge and ease of use. Participants expressed a preference for apps that are free of paid features, advertisements, and external purchases. Tailored advice (e.g. location, skin type) was deemed crucial, particularly for initial exposure. Proactive features integrating behavioural, personal, and contextual information for adaptive and just-in-time sun protection advice were seen as essential for sustaining engagement.

Conclusions: Sun protection apps emphasizing knowledge, ease of use, tailored advice, and proactive features are likely to encourage sustained engagement. Suggestions for optimising current and future sun protection apps are provided.