Health Psychology Review最新文献

Many young people are exposed to risk factors that increase their risk of mental illness. Physical activity provision is an increasingly popular approach to protect against mental illness in the face of these risk factors. We examined the effectiveness of physical activity interventions for the promotion of mental health outcomes in at-risk children and adolescents. We searched health databases for randomised and non-randomised intervention studies, with no date restriction, and assessed risk of bias using the Cochrane Risk of Bias tools. We present a narrative synthesis of our results accompanied with a summary of available effect sizes. Thirty-seven reports on 36 studies were included, with multi-sport or yoga interventions the most popular intervention approaches (a combined 50% of included studies). Outcomes measured included internalising, self-evaluative, wellbeing, overall symptomatology, resilience, externalising, and trauma outcomes. We found that 63% of between-groups effects favoured the intervention arm, and 83% of within-groups effects favoured an intervention effect. While recognising high risk of bias, our findings provide evidence in support of the effectiveness of physical activity interventions for promoting mental health outcomes in at-risk young people. We encourage further work designed to better understand the intervention characteristics that may lead to positive benefits.

Selective outcome reporting can result in overestimation of treatment effects, research waste, and reduced openness and transparency. This review aimed to examine selective outcome reporting in trials of behavioural health interventions and determine potential outcome reporting bias. A review of nine health psychology and behavioural medicine journals was conducted to identify randomised controlled trials of behavioural health interventions published since 2019. Discrepancies in outcome reporting were observed in 90% of the 29 trials with corresponding registrations/protocols. Discrepancies included 72% of trials omitting prespecified outcomes; 55% of trials introduced new outcomes. Thirty-eight percent of trials omitted prespecified and introduced new outcomes. Three trials (10%) downgraded primary outcomes in registrations/protocols to secondary outcomes in final reports; downgraded outcomes were not statistically significant in two trials. Five trials (17%) upgraded secondary outcomes to primary outcomes; upgraded outcomes were statistically significant in all trials. In final reports, three trials (7%) omitted outcomes from the methods section; three trials (7%) introduced new outcomes in results that were not in the methods. These findings indicate that selective outcome reporting is a problem in behavioural health intervention trials. Journal- and trialist-level approaches are needed to minimise selective outcome reporting in health psychology and behavioural medicine.

Great disparity is observed among studies investigating the prevalence of PTSD after burns. This systematic review and meta-analysis aimed to explore the pooled prevalence of PTSD in adult burn survivors over the first two years post-burn. Five electronic databases were searched for observational studies assessing the prevalence of PTSD symptoms after burns. Meta-analysis was performed using an auto-correlation and hierarchical effects model to estimate the course of PTSD prevalence rates over time and to establish point-prevalences. The effect of different moderators over time was tested with meta-regression. Thirty-two studies were included in the meta-analysis. The overall pooled prevalence of PTSD was 20.5% (95% CI 16.4-24.6) and the prevalence significantly decreased by about 0.37% per month post-burn over time. Questionnaire-based studies, and studies published from 2000 onwards, were more likely to show a decrease in PTSD prevalence over time compared to diagnostic studies and studies before 2000. A qualitative comparison revealed that inter-continental differences are likely to be complex and multi-factorial. PTSD affects about one in five burn survivors, with moderately decreasing rates from six months post-burn onwards. Early screening and identification of burn survivors who require specialist psychological care are vital for burns services.

The escalating stress epidemic in modern society has raised concerns about its impact on physical and mental health, prompting the need for effective interventions. Yoga, a multifaceted mind-body practice, has gained recognition for its potential in mitigating perceived stress. Our meta-analysis aimed to estimate yoga's impact on lowering perceived stress as measured by the Perceived Stress Scale. We identified 36 studies meeting inclusion criteria and found a statistically significant moderate effect of yoga on reducing perceived stress (g = 0.48, 95% CI = 0.29-0.66). Our analysis uncovered substantial heterogeneity (Q = 117.33, p < .001), with 74.90% of the variation in effect sizes attributed to study characteristics. In planned moderator analyses, we hypothesised that yoga with breathwork, relaxation, high stress symptoms, greater number of hours practiced, and studies conducted in India would yield larger effects. Stress severity was shown to be statistically significant. However, the remaining hypotheses were not supported. Additionally, we examined five exploratory moderator variables, which did not yield significant results. Further research is needed to elucidate the source of heterogeneity across studies and reveal recommendations for specific populations.

How often do we reflect on the potential moral or value implications - what is right, wrong, has value and is (in)appropriate - of seemingly trivial analytical decisions, such as how to dichotomise a variable? I argue that analytical choices relate to multifaceted and oftentimes challenging moral issues that scientists should take into deeper consideration. Here, I illustrate a variety of potential considerations about moral values, including issues like exclusion, marginalisation, autonomy, responsibility, non-maleficence in relation to various common analytical choices and practices, such as the use of thresholds for disease diagnosis or population definition, the use of composite measures in the context of clarifying effects, classification practices, decisions on variable selection, as well as decisions relating to (dis)aggregation of data. I discuss these examples in the context of reasonable theoretical or statistical reservations. I advocate for deeper engagement with the difficult moral implications of analytical decisions, and for a principled and pluralistic science, that is also a more robust science. Such a science can include diverse moral views through a coupled ethical-epistemic approach, sensitivity tests, multiverse analysis, as well as stronger commitments to participatory and mutual learning practices.

Interventions addressing more than one health behaviour at a time could be an efficient way of intervening to manage chronic conditions. Within a systematic review of multiple health behaviour change (MBHC) interventions, we identified key components of interventions in patients with chronic conditions, assessed how they are linked to theory, behaviour change techniques implemented, and evaluated their impact on intervention effectiveness. Studies were identified by systematically searching five electronic databases. Subgroup analyses and meta-regressions were conducted to analyse the association between intervention components and behavioural changes. In total, 61 studies were included spanning different chronic conditions (e.g., cardiovascular conditions, type 2 diabetes). Most interventions sought to change behaviours simultaneously (72%), often targeting the 'physical activity, diet and smoking' cluster of behaviours (33%), and were not theory informed (55%). A total of 36 behaviour change techniques were identified, most commonly goal setting behaviour and self-monitoring of behaviour. Subgroup analyses indicated that MHBC interventions delivered entirely face-to-face might not be as effective for physical activity outcomes, and not using goal setting (behaviour) might be more effective for smoking cessation outcomes. Meta-regressions indicated that a longer intervention duration may work best to achieve better physical activity outcomes. This review provides a comprehensive understanding of interventions and contributes to the field of MHBC by facilitating data-driven insights for future optimisation and dissemination.

Despite evidence supporting genetic testing's utility in hereditary cancer risk management, uptake remains low among at-risk relatives of a hereditary cancer patient. The qualitative systematic review aims to identify the psychosocial barriers and facilitators associated with the uptake of genetic counselling services and/or genetic testing (GC/GT). A systematic literature search was performed across six databases in June 2023, limited to studies published in English from 2010 onwards. Qualitative studies interviewing hereditary cancer patients, their relatives, and/or healthcare providers to identify the psychosocial barriers and facilitators associated with the uptake of genetic testing for hereditary cancer syndrome were eligible for inclusion. A thematic analysis was conducted on the extracted data from 41 eligible qualitative studies. 54% of the studies were from the United States and 75% of the participants were female. 14 psychosocial barriers and nine facilitators to the uptake of genetic testing services were identified. The most frequently cited psychosocial barriers to genetic testing uptake were 'emotional roller coaster', 'threat of genetic discrimination', and 'no perceived benefit of genetic testing'. In contrast, the most common facilitators were 'concern for family', 'easing personal worries', and 'knowledge is empowering'. Our findings reveal complex factors affecting GC/GT service uptake, some with dual effects.

Protection motivation theory is a pre-eminent health behaviour theory purposed to predict participation in health protection and risk behaviours. It has been widely applied across multiple behaviours, populations and contexts. In this conceptual review, we summarise research applying the theory and identify shortcomings and evidence gaps that limit reported inferences and impede theory and intervention development. Accordingly, we provide recommendations for best practices and suggestions for future research to resolve these limitations. Limitations identified include a dearth of comprehensive theory tests, sparse evidence of theory sufficiency, a lack of studies including additional constructs, overuse of correlational and cross-sectional research designs, a paucity of intervention studies and tests of theory-consistent mechanisms of action, few tests intrapersonal and environmental moderators of theory effects and measurement concerns. We provide recommendations to address these limitations including conducting comprehensive theory tests in support of nomological validity; incorporating past behaviour and other constructs to establish theory sufficiency and extend its scope; adopting cross-lagged panel and factorial experimental research designs to test directional effects, permit better causal inference and test mechanisms of action; testing effects of moderators to identify conditions that may affect theory applicability and developing measurement standards for study constructs and adopting non-self-report behaviour measures.

Background/aims: Inhibitory control training (ICT) is a cognitive intervention that has been suggested to reduce problematic appetitive behaviours, such as unhealthy eating and excessive alcohol consumption. We conducted a meta-analytic review of ICT for reducing appetitive behaviours.

Methods: Two meta-analyses were conducted for behavioural (objective) outcomes and self-report outcomes, along with 14 moderator analyses, and two secondary analyses investigating changes in cue-devaluation and inhibitory control.

Results: The review included 46 articles (67 effect sizes and 4231 participants) and four appetitive health behaviours (eating, drinking, smoking, gambling). A significant effect of ICT on behavioural outcomes was found (SMD = 0.241, p .001). The self-report outcomes meta-analysis was not significant (p > .05). Secondary analyses also demonstrated greater inhibitory control (p < .05) and cue devaluation (p < .05) following ICT.

Conclusions: This meta-analytic review is the largest synthesis of ICT interventions for appetitive behaviours. ICT significantly reduced problematic eating behaviours when adopting behavioural outcomes, but this was not found for other appetitive behaviours. ICT also significantly improved inhibitory control and reduced cue evaluations. Further studies are required before drawing any conclusions regarding impacts on other appetitive behaviours.

This meta-review synthesises evidence concerning individual-level psychosocial characteristics associated with alternative protein food (APF) choices. We investigated the associations between: (i) individual-level determinants based on the COM-B model (capabilities, perceived opportunities, motivation), sociodemographic factors, and (ii) indicators of APF choices (e.g., intention to eat, buy, pay, acceptance, intake). Differences in characteristics of APF made from plants, insects, mushrooms, and other APF sources were explored. Thirteen databases were searched in this pre-registered (CRD42023388694) meta-review and 28 reviews were included. The risk of bias was assessed using the ROBIS tool. For plant-based APF choices, consistent support was obtained for associations with (i) capabilities, including cooking skills, exposure to/familiarity with APF; (ii) motivations, including perceived health-related, pro-environmental, and sustainability benefits, and animal welfare; (iii) younger age and higher education. For insect-based APF choices, consistent support was obtained for (i) capabilities, including formal knowledge about APF, exposure to/familiarity with APF; (ii) perceived opportunities, encompassing positive social and cultural norms, distrust in technology; (iii) motivations, including perceived health benefits, pro-environmental and sustainability benefits, perceived health risks, being adventurous/daring, curiosity, neophilia, disgust; (iv) male gender and younger age. Recognising differences in potential determinants across various APF sources is essential for designing interventions aimed at promoting APF uptake.