Jan A. Häusser, Janina U. Janurek, Sascha Etgen, Andreas Mojzisch
Objective
Accelerometry provides more objective estimates of physical activity and sleep parameters than self-report data. However, the use of accelerometry may suffer from reactivity to measurement, that is, changes in behaviour under study due to the awareness of being observed.
Design
In two field-experimental studies, we examined reactivity to measurement in physical activity and sleep parameters estimated with accelerometry. We used within-subjects designs and manipulated if participants were made aware of the measurement intention or if it was concealed.
Methods
During a 2-week study, participants received a red accelerometer for one of the weeks and were informed that their physical activity would be monitored in this week. In the other week, participants received a black accelerometer and were informed that it would monitor sleep. In fact, both the red and the black accelerometers monitored both physical activity and sleep.
Results
We consistently found no evidence for reactivity to measurement for any indicator of physical activity (moderate to vigorous physical activity, steps) or sleep (duration, efficiency).
Conclusion
Accelerometry can provide unbiased measures of indicators of physical activity and sleep and is therefore a valuable addition to the common use of self-report data.
{"title":"No evidence of reactivity in accelerometry-based measurement of physical activity and sleep","authors":"Jan A. Häusser, Janina U. Janurek, Sascha Etgen, Andreas Mojzisch","doi":"10.1111/bjhp.70047","DOIUrl":"10.1111/bjhp.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Accelerometry provides more objective estimates of physical activity and sleep parameters than self-report data. However, the use of accelerometry may suffer from reactivity to measurement, that is, changes in behaviour under study due to the awareness of being observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In two field-experimental studies, we examined reactivity to measurement in physical activity and sleep parameters estimated with accelerometry. We used within-subjects designs and manipulated if participants were made aware of the measurement intention or if it was concealed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>During a 2-week study, participants received a red accelerometer for one of the weeks and were informed that their physical activity would be monitored in this week. In the other week, participants received a black accelerometer and were informed that it would monitor sleep. In fact, both the red and the black accelerometers monitored both physical activity and sleep.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We consistently found no evidence for reactivity to measurement for any indicator of physical activity (moderate to vigorous physical activity, steps) or sleep (duration, efficiency).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Accelerometry can provide unbiased measures of indicators of physical activity and sleep and is therefore a valuable addition to the common use of self-report data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12750485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Darko Jekauc, Manuel C. Voelkle, Falko F. Sniehotta, Claudio R. Nigg
Objectives
The intention–behaviour gap (IBG) remains a persistent challenge in health psychology. While intentions are widely recognized as proximal determinants of behaviour, they frequently fail to translate into action. This conceptual review aims to critically evaluate dominant models of the IBG and propose a dynamic, multidimensional reconceptualization of intention–behaviour processes.
Methods
This conceptual review critically evaluates dominant models of the IBG–the Explained Variance Approach and the Action Control Framework. Special emphasis is placed on methodological constraints associated with between-person research designs, which inadequately capture the temporal and contextual variability of behavioural enactment.
Results
Theoretical and empirical limitations are identified in existing IBG models, including their failure to address intra-individual fluctuations, situational contingencies and the time-indexed nature of behavioural regulation. In response, we propose a framework emphasizing intensive longitudinal designs, within-person assessment, ecological momentary methods and person-specific modelling techniques to better capture intention–behaviour dynamics.
Conclusions
To close the IBG, future research should integrate dynamic methodologies and real-time interventions that align with situational and motivational states. We advocate for context-sensitive strategies, such as just-in-time adaptive interventions and implementation intentions, to enhance behavioural enactment. This reconceptualization offers a pathway towards more precise theory and effective intervention in health behaviour change.
{"title":"Beyond the cross-section: Rethinking the intention–behaviour gap through a conceptual and methodological lens","authors":"Darko Jekauc, Manuel C. Voelkle, Falko F. Sniehotta, Claudio R. Nigg","doi":"10.1111/bjhp.70046","DOIUrl":"10.1111/bjhp.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The intention–behaviour gap (IBG) remains a persistent challenge in health psychology. While intentions are widely recognized as proximal determinants of behaviour, they frequently fail to translate into action. This conceptual review aims to critically evaluate dominant models of the IBG and propose a dynamic, multidimensional reconceptualization of intention–behaviour processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This conceptual review critically evaluates dominant models of the IBG–the Explained Variance Approach and the Action Control Framework. Special emphasis is placed on methodological constraints associated with between-person research designs, which inadequately capture the temporal and contextual variability of behavioural enactment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Theoretical and empirical limitations are identified in existing IBG models, including their failure to address intra-individual fluctuations, situational contingencies and the time-indexed nature of behavioural regulation. In response, we propose a framework emphasizing intensive longitudinal designs, within-person assessment, ecological momentary methods and person-specific modelling techniques to better capture intention–behaviour dynamics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To close the IBG, future research should integrate dynamic methodologies and real-time interventions that align with situational and motivational states. We advocate for context-sensitive strategies, such as just-in-time adaptive interventions and implementation intentions, to enhance behavioural enactment. This reconceptualization offers a pathway towards more precise theory and effective intervention in health behaviour change.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12750492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonella Granieri, Maria Domenica Sauta, Giulia Cerutti, Alessandra De Luca, Claudia Ricco, Carola Grimaldi, Marco Gonella, Isabella Giulia Franzoi
Objective
Loneliness can have a variety of negative effects on health, such as chronic stress, altered parasympathetic function, pro-inflammatory immune responses, and psychological distress. The aim of this systematic literature review is to investigate the effects of loneliness on health and the direct relationship between loneliness and cardiovascular health, as well as the relationship between loneliness, the immune system, and the cardiovascular system.
Methods
The review was conducted by searching Scopus, Web of Science, PubMed, PsycInfo, and PsycArticles between January 2010 and March 2025, the date of the search. We used a combination of the following keywords: (alone OR lonel* OR isolation OR exclusion OR companionship) AND (cardiovascular OR heart OR cardiac) AND (immun* OR inflamm*) AND (psych* OR mental). The quality assessment was conducted using the Critical Appraisal Checklist of the Joanna Briggs Institute.
Results
The literature search led to the identification of 23 articles. Loneliness appears to have both direct and indirect negative effects on cardiovascular health. It is associated with inflammation, which in turn affects the cardiovascular system. In addition, the associated negative feelings can have a negative impact on health as they can lead to increased inflammation and negative lifestyle habits such as alcohol consumption and nicotine use, which in turn increase inflammation.
Conclusions
From a clinical psychology perspective, it is important to consider loneliness and social isolation as indicators of fragility, which may be related to cultural differences, an unhealthy environment, the unavailability of services, and a lack of opportunities to develop professional and social roles.
目的：孤独会对健康产生多种负面影响，如慢性应激、副交感神经功能改变、促炎免疫反应和心理困扰。本研究旨在探讨孤独感对健康的影响，以及孤独感与心血管健康的直接关系，以及孤独感与免疫系统和心血管系统的关系。方法：检索Scopus、Web of Science、PubMed、PsycInfo和PsycArticles，检索时间为2010年1月至2025年3月。我们使用了以下关键词的组合：（单独或孤独*或隔离或排斥或陪伴）和（心血管或心脏或心脏）和（免疫*或炎症*）和（心理*或精神）。质量评估使用乔安娜布里格斯研究所的关键评估清单进行。结果：文献检索鉴定出23篇。孤独似乎对心血管健康有直接和间接的负面影响。它与炎症有关，而炎症反过来又影响心血管系统。此外，相关的负面情绪会对健康产生负面影响，因为它们会导致炎症增加和负面的生活习惯，如饮酒和吸烟，而这些习惯又会增加炎症。结论：从临床心理学的角度来看，将孤独和社会孤立视为脆弱性的指标是很重要的，这可能与文化差异、不健康的环境、服务的不可获得性以及缺乏发展专业和社会角色的机会有关。
{"title":"Loneliness, the immune system, and cardiovascular health: A systematic literature review","authors":"Antonella Granieri, Maria Domenica Sauta, Giulia Cerutti, Alessandra De Luca, Claudia Ricco, Carola Grimaldi, Marco Gonella, Isabella Giulia Franzoi","doi":"10.1111/bjhp.70044","DOIUrl":"10.1111/bjhp.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Loneliness can have a variety of negative effects on health, such as chronic stress, altered parasympathetic function, pro-inflammatory immune responses, and psychological distress. The aim of this systematic literature review is to investigate the effects of loneliness on health and the direct relationship between loneliness and cardiovascular health, as well as the relationship between loneliness, the immune system, and the cardiovascular system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review was conducted by searching Scopus, Web of Science, PubMed, PsycInfo, and PsycArticles between January 2010 and March 2025, the date of the search. We used a combination of the following keywords: (alone OR lonel* OR isolation OR exclusion OR companionship) AND (cardiovascular OR heart OR cardiac) AND (immun* OR inflamm*) AND (psych* OR mental). The quality assessment was conducted using the Critical Appraisal Checklist of the Joanna Briggs Institute.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The literature search led to the identification of 23 articles. Loneliness appears to have both direct and indirect negative effects on cardiovascular health. It is associated with inflammation, which in turn affects the cardiovascular system. In addition, the associated negative feelings can have a negative impact on health as they can lead to increased inflammation and negative lifestyle habits such as alcohol consumption and nicotine use, which in turn increase inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>From a clinical psychology perspective, it is important to consider loneliness and social isolation as indicators of fragility, which may be related to cultural differences, an unhealthy environment, the unavailability of services, and a lack of opportunities to develop professional and social roles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Louise Griffiths, Delyth James, Denitza Williams, Lynette James, Andrew Evans, William O. Pickrell, Christine McKnight, Sarah Brown, Rhiannon Phillips
Objectives
Valproate is a highly effective antiseizure medication but carries significant teratogenic and neurodevelopmental risks to offspring if used during pregnancy. A shared decision-making (SDM) approach is recommended to guide clinician/patient discussions on valproate suitability for women with pregnancy potential. This study applied the Capability, Opportunity, Motivation–Behaviour (COM-B) theoretical framework to explore barriers and facilitators to SDM in valproate prescribing from the perspectives of women with epilepsy who have pregnancy potential.
Design
Qualitative study using timeline-facilitated semi-structured interviews informed by the COM-B model.
Method
Twelve UK-based women 18–50 years (Mage = 33.3, SD = 7.59) prescribed valproate were recruited via pharmacies and epilepsy organizations' social media. Interviews were thematically analysed and interpreted using the COM-B model.
Results
Participants were highly motivated to engage in SDM behaviour but reported limited opportunities. Challenges to COM-B domains included insufficient information exchange, low confidence navigating complex epilepsy/reproductive health care discussions, and tensions navigating valproate risks and benefits within broader contexts of seizure control and reproductive health. Initial prescribing during acute seizure crises may have precluded meaningful collaborative discussion. Valproate prescribing/deprescribing incongruent to reproductive goals often resulted in deep regret and deleterious health outcomes for women (and children exposed to valproate in utero).
Conclusion
Comprehensive SDM when valproate is considered clinically appropriate could support informed, patient-centred decision-making. Equipping clinicians to navigate multifaceted risk/benefit discussions and empowering patients with clear, tailored information can help ensure treatment decisions align with reproductive goals. This study highlights the need to embed SDM in valproate prescribing consultations and throughout treatment duration.
{"title":"Capability, opportunity and motivation for shared decision-making about valproate as an antiseizure medication treatment for epilepsy in women with pregnancy potential: A qualitative study of patient perspectives","authors":"Sarah Louise Griffiths, Delyth James, Denitza Williams, Lynette James, Andrew Evans, William O. Pickrell, Christine McKnight, Sarah Brown, Rhiannon Phillips","doi":"10.1111/bjhp.70045","DOIUrl":"10.1111/bjhp.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Valproate is a highly effective antiseizure medication but carries significant teratogenic and neurodevelopmental risks to offspring if used during pregnancy. A shared decision-making (SDM) approach is recommended to guide clinician/patient discussions on valproate suitability for women with pregnancy potential. This study applied the Capability, Opportunity, Motivation–Behaviour (COM-B) theoretical framework to explore barriers and facilitators to SDM in valproate prescribing from the perspectives of women with epilepsy who have pregnancy potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative study using timeline-facilitated semi-structured interviews informed by the COM-B model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Twelve UK-based women 18–50 years (M<sub>age</sub> = 33.3, SD = 7.59) prescribed valproate were recruited via pharmacies and epilepsy organizations' social media. Interviews were thematically analysed and interpreted using the COM-B model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants were highly motivated to engage in SDM behaviour but reported limited opportunities. Challenges to COM-B domains included insufficient information exchange, low confidence navigating complex epilepsy/reproductive health care discussions, and tensions navigating valproate risks and benefits within broader contexts of seizure control and reproductive health. Initial prescribing during acute seizure crises may have precluded meaningful collaborative discussion. Valproate prescribing/deprescribing incongruent to reproductive goals often resulted in deep regret and deleterious health outcomes for women (and children exposed to valproate in utero).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Comprehensive SDM when valproate is considered clinically appropriate could support informed, patient-centred decision-making. Equipping clinicians to navigate multifaceted risk/benefit discussions and empowering patients with clear, tailored information can help ensure treatment decisions align with reproductive goals. This study highlights the need to embed SDM in valproate prescribing consultations and throughout treatment duration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12717438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Marshall, Anne-Marie Minihane, Stephanie T. Jong, Sarah Hanson, Shamima Akter, Nikki Garner, Wendy Hardeman
Purpose
Community behaviour change interventions are a promising strategy for addressing unhealthy eating and physical activity behaviours in underserved populations. This review explores these interventions' characteristics by focusing on behaviour change techniques, evaluates their behaviour change effectiveness and examines participant experiences.
Methods
A mixed-methods rapid review was conducted. Five databases and the grey literature were searched and supplemented by hand searching. Results were screened, assessed for methodological quality and data extracted using the Behaviour Change Techniques Ontology. A convergent segregated approach was used to synthesize the results.
Results
Twenty-one studies were included. Commonly used behaviour change techniques were social support, guidance on how to perform the behaviour and monitoring. Intervention effects on healthy eating and physical activity behaviour change were small, but outcomes that measured influences on behaviour change (e.g., social support) improved. Participants reported largely positive experiences, mostly attributed to the intervention's tailoring to the target population's contexts and the engagement and expertise of those who delivered the intervention.
Conclusions
Evidence of direct behaviour change remains limited; there is stronger evidence for improvements in factors that influence behaviour change. Qualitative evidence highlights the value of tailoring interventions to participants' lives and using relatable, knowledgeable sources for delivery. This could enhance engagement and contribute to improved outcomes over time. Further research is needed on how contextual tailoring is implemented and how the characteristics of those delivering interventions influence effectiveness and experience. Findings support the potential of community-centred approaches, but long-term evaluations in underserved contexts are needed.
{"title":"Understanding healthy eating and physical activity community-centred behaviour change interventions for underserved populations: A mixed methods rapid review","authors":"Jessica Marshall, Anne-Marie Minihane, Stephanie T. Jong, Sarah Hanson, Shamima Akter, Nikki Garner, Wendy Hardeman","doi":"10.1111/bjhp.70043","DOIUrl":"10.1111/bjhp.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Community behaviour change interventions are a promising strategy for addressing unhealthy eating and physical activity behaviours in underserved populations. This review explores these interventions' characteristics by focusing on behaviour change techniques, evaluates their behaviour change effectiveness and examines participant experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods rapid review was conducted. Five databases and the grey literature were searched and supplemented by hand searching. Results were screened, assessed for methodological quality and data extracted using the Behaviour Change Techniques Ontology. A convergent segregated approach was used to synthesize the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one studies were included. Commonly used behaviour change techniques were social support, guidance on how to perform the behaviour and monitoring. Intervention effects on healthy eating and physical activity behaviour change were small, but outcomes that measured influences on behaviour change (e.g., social support) improved. Participants reported largely positive experiences, mostly attributed to the intervention's tailoring to the target population's contexts and the engagement and expertise of those who delivered the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Evidence of direct behaviour change remains limited; there is stronger evidence for improvements in factors that influence behaviour change. Qualitative evidence highlights the value of tailoring interventions to participants' lives and using relatable, knowledgeable sources for delivery. This could enhance engagement and contribute to improved outcomes over time. Further research is needed on how contextual tailoring is implemented and how the characteristics of those delivering interventions influence effectiveness and experience. Findings support the potential of community-centred approaches, but long-term evaluations in underserved contexts are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12706567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Hagan, Melanie J. Davies, Jane Speight, Michelle Hadjiconstantinou
Objectives
Diabetes-related stigma has been previously investigated in people with type 1 diabetes and older people with type 2 diabetes. However, stigma in early-onset type 2 diabetes (EOT2D) remains understudied, despite increasing prevalence and the unique characteristics of this population. Hence, this study aimed to explore perceptions and experiences of stigma in people living with EOT2D, from the perspectives of people living with EOT2D and HCPs who have work in EOT2D care.
Design
Secondary qualitative analysis of semi-structured interviews.
Methods
Semi-structured interviews were conducted with 25 young adults with EOT2D and 25 HCPs. Data were analysed using inductive reflexive thematic analysis and subsequently presented using a framework for understanding diabetes-related stigma.
Results
Findings highlight causes, experiences, and consequences of stigma in EOT2D, in addition to potential mitigating strategies. The media, healthcare professionals and others perpetuate stigma, underpinned by misconceptions that type 2 diabetes is self-inflicted, and attitudes of blame. PEOT2D experience judgement and harmful stereotypes, including ‘fat’, ‘unhealthy’, ‘lazy’, and type 2 diabetes being an ‘old-person's disease’. Psychological consequences of stigma were reported, including self-blame, embarrassment, and shame, leading to behavioural consequences of non-disclosure and reluctance to seek help. Education, raising awareness, and non-judgemental communication were highlighted as strategies to minimize stigma and its consequences.
Conclusions
Stigma is highly pervasive in the lives of young adults living with EOT2D and can cause harmful consequences. Given the increased risk of physiological and psychological complications in this population, efforts to reduce stigma in EOT2D should be prioritized.
{"title":"Stigma associated with early-onset type 2 diabetes: A secondary qualitative analysis","authors":"Jennifer Hagan, Melanie J. Davies, Jane Speight, Michelle Hadjiconstantinou","doi":"10.1111/bjhp.70042","DOIUrl":"10.1111/bjhp.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Diabetes-related stigma has been previously investigated in people with type 1 diabetes and older people with type 2 diabetes. However, stigma in early-onset type 2 diabetes (EOT2D) remains understudied, despite increasing prevalence and the unique characteristics of this population. Hence, this study aimed to explore perceptions and experiences of stigma in people living with EOT2D, from the perspectives of people living with EOT2D and HCPs who have work in EOT2D care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary qualitative analysis of semi-structured interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with 25 young adults with EOT2D and 25 HCPs. Data were analysed using inductive reflexive thematic analysis and subsequently presented using a framework for understanding diabetes-related stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings highlight causes, experiences, and consequences of stigma in EOT2D, in addition to potential mitigating strategies. The media, healthcare professionals and others perpetuate stigma, underpinned by misconceptions that type 2 diabetes is self-inflicted, and attitudes of blame. PEOT2D experience judgement and harmful stereotypes, including ‘fat’, ‘unhealthy’, ‘lazy’, and type 2 diabetes being an ‘old-person's disease’. Psychological consequences of stigma were reported, including self-blame, embarrassment, and shame, leading to behavioural consequences of non-disclosure and reluctance to seek help. Education, raising awareness, and non-judgemental communication were highlighted as strategies to minimize stigma and its consequences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stigma is highly pervasive in the lives of young adults living with EOT2D and can cause harmful consequences. Given the increased risk of physiological and psychological complications in this population, efforts to reduce stigma in EOT2D should be prioritized.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Previous meta-analyses have shown that loneliness is associated with poor health (r = −.35) and sleep challenges (r = .29). However, that work is confounded by the inclusion of unhealthy populations, with chronic conditions, such as HIV, Alzheimer's disease, diabetes, and severe mental illness. This pre-registered meta-analysis (PROSPERO CRD42019119135) examined whether loneliness is linked to poorer health in healthy populations.
Design
Meta-analysis.
Methods
PsycINFO, ERIC, PubMed, and Web of Science were searched for articles before January 2024 to examine the association between loneliness and health outcomes (categorized as general health, physical health [functional disability], sleep function, sensory acuity, and health service use) for healthy samples.
Results
A total of 167 articles (303,643 participants; 334 effect sizes; 158 independent samples) from 36 countries were included in the meta-analysis. Loneliness is associated with worse health for healthy populations (r = −.22), with the largest effect (r = −.23) for general health. Loneliness was not related to health service use for healthy populations. Heterogeneity was substantial, with only 7.2% of the total variance attributable to sampling error, indicating that over 92% of the variability in effect sizes reflected true differences across studies.
Conclusions
Higher loneliness was associated with poorer health for healthy people. There are limited studies using (1) objective measurements of health outcomes in relation to loneliness, and (2) studies exploring the association among young people, highlighting a need for more work in those areas.
{"title":"Impact of loneliness on health in healthy populations: A meta-analysis","authors":"Yixuan Zheng, Pamela Qualter, Cecilia Rollano, Xinyang Hu, Arianna Martin, Maria Nukui, Wahida Walibhai, Marlies Maes","doi":"10.1111/bjhp.70040","DOIUrl":"10.1111/bjhp.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Previous meta-analyses have shown that loneliness is associated with poor health (<i>r</i> = −.35) and sleep challenges (<i>r</i> = .29). However, that work is confounded by the inclusion of unhealthy populations, with chronic conditions, such as HIV, Alzheimer's disease, diabetes, and severe mental illness. This pre-registered meta-analysis (PROSPERO CRD42019119135) examined whether loneliness is linked to poorer health in healthy populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PsycINFO, ERIC, PubMed, and Web of Science were searched for articles before January 2024 to examine the association between loneliness and health outcomes (categorized as general health, physical health [functional disability], sleep function, sensory acuity, and health service use) for healthy samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 167 articles (303,643 participants; 334 effect sizes; 158 independent samples) from 36 countries were included in the meta-analysis. Loneliness is associated with worse health for healthy populations (<i>r</i> = −.22), with the largest effect (<i>r</i> = −.23) for general health. Loneliness was not related to health service use for healthy populations. Heterogeneity was substantial, with only 7.2% of the total variance attributable to sampling error, indicating that over 92% of the variability in effect sizes reflected true differences across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher loneliness was associated with poorer health for healthy people. There are limited studies using (1) objective measurements of health outcomes in relation to loneliness, and (2) studies exploring the association among young people, highlighting a need for more work in those areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Hurley-Wallace, Sophie Fletcher, Talar R. Moukhtarian, Krishane Patel, Agatha Payne, Tabitha Jackson, Carla Toro, Guy Daly, Sean Russel, Lukasz Walasek, Nicole K. Y. Tang, Caroline Meyer
Introduction
Sleep and mental health problems are common across the working adult population. This process evaluation provides insight into the experiences of employees who took part in a digital intervention trial: Supporting Employees with Insomnia and Emotional Regulation Problems (SLEEP). The programme combined digital CBT for insomnia with emotion regulation. Digital content was supported by remote therapy. The objectives of this process evaluation were to explore participants' experiences of the intervention, and identify how the intervention achieved change.
Methods
Twenty-one semi-structured interviews were conducted using videoconferencing. A stratified sample of participants from within each of five cohorts of the SLEEP trial was interviewed. Thematic analysis utilized a collaborative codebook and framework approach. To conceptualize mechanisms of change, behaviour change techniques were retrospectively coded onto participant interview data.
Results
An overarching theme: ‘Better sleep, better wellbeing’ was generated, with three interlinking themes conceptualizing the process by which positive changes to sleep and wellbeing were achieved. These were: ‘Procedure: The value of therapy sessions versus digital-only’, ‘Context: Working on mental health from home during COVID-19’, and ‘Mechanisms: Practice, feedback and problem solving.’
Conclusions
Participants' experiences of SLEEP were predominantly positive and suggested a spillover effect of improved sleep on overall wellbeing. Triangulation of quantitative outcomes showed congruent improvements. Maintaining therapist contact to facilitate behaviour change throughout the programme was important. Furthermore, providing a private space for therapist calls was essential to facilitate the intervention in the workplace; an important insight for the development of digital mental health interventions intended for the workplace.
{"title":"‘Better sleep, better wellbeing’: Qualitative process evaluation of a hybrid, digital cognitive behavioural therapy programme for employees with sleep and emotion regulation problems","authors":"Anna Hurley-Wallace, Sophie Fletcher, Talar R. Moukhtarian, Krishane Patel, Agatha Payne, Tabitha Jackson, Carla Toro, Guy Daly, Sean Russel, Lukasz Walasek, Nicole K. Y. Tang, Caroline Meyer","doi":"10.1111/bjhp.70041","DOIUrl":"10.1111/bjhp.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sleep and mental health problems are common across the working adult population. This process evaluation provides insight into the experiences of employees who took part in a digital intervention trial: Supporting Employees with Insomnia and Emotional Regulation Problems (SLEEP). The programme combined digital CBT for insomnia with emotion regulation. Digital content was supported by remote therapy. The objectives of this process evaluation were to explore participants' experiences of the intervention, and identify how the intervention achieved change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one semi-structured interviews were conducted using videoconferencing. A stratified sample of participants from within each of five cohorts of the SLEEP trial was interviewed. Thematic analysis utilized a collaborative codebook and framework approach. To conceptualize mechanisms of change, behaviour change techniques were retrospectively coded onto participant interview data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An overarching theme: ‘Better sleep, better wellbeing’ was generated, with three interlinking themes conceptualizing the process by which positive changes to sleep and wellbeing were achieved. These were: ‘Procedure: The value of therapy sessions versus digital-only’, ‘Context: Working on mental health from home during COVID-19’, and ‘Mechanisms: Practice, feedback and problem solving.’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participants' experiences of SLEEP were predominantly positive and suggested a spillover effect of improved sleep on overall wellbeing. Triangulation of quantitative outcomes showed congruent improvements. Maintaining therapist contact to facilitate behaviour change throughout the programme was important. Furthermore, providing a private space for therapist calls was essential to facilitate the intervention in the workplace; an important insight for the development of digital mental health interventions intended for the workplace.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mental illness stigma is widely examined in healthcare, yet less is known about its intersections with the stigma of chronic physical conditions in shaping distinct forms of disadvantage. Here, we investigate whether patients with concurrent mental and physical health conditions are perceived and treated differently by prospective medical doctors.
Methods
Using a mixed-methods design, preclinical medical students (N = 463) evaluated clinical vignettes describing patients with single (i.e., mental or physical chronic disease) and multiple health conditions (i.e., concurrent mental and physical conditions). We assessed emotional reactions, attributions of disease aetiology, caregiving attitudes and meta-beliefs about patients' disclosure behaviour. Participants were also asked to report as accurately as possible on symptoms presented by each patient in the vignette.
Results
Findings revealed that stigmatized conditions were associated with higher levels of caregiving discomfort, greater disease disclosure reticence and lower levels of symptom recall accuracy. Compared with patients with single conditions, those with concurrent mental and physical illnesses were less likely to receive care, were attributed a lesser tendency to conceal their conditions and had their symptoms recalled less accurately.
Conclusions
Results indicate that when mental and physical illnesses intersect, patients with multiple stigmatized conditions may be differentially perceived in the eyes of medical students and may become (in)visible targets of discrimination in a healthcare setting. We discuss implications for enhancing awareness of social determinants of health and disease for a more representative, responsive and inclusive healthcare curriculum and practice.
{"title":"The (in)visible cloak: How intersecting stigmas associated with mental and chronic physical disease shape perceptions in a healthcare setting","authors":"Edita Fino, Paolo Maria Russo, Maria Ida Gobbini","doi":"10.1111/bjhp.70038","DOIUrl":"https://doi.org/10.1111/bjhp.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Mental illness stigma is widely examined in healthcare, yet less is known about its intersections with the stigma of chronic physical conditions in shaping distinct forms of disadvantage. Here, we investigate whether patients with concurrent mental and physical health conditions are perceived and treated differently by prospective medical doctors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a mixed-methods design, preclinical medical students (<i>N</i> = 463) evaluated clinical vignettes describing patients with single (i.e., mental or physical chronic disease) and multiple health conditions (i.e., concurrent mental and physical conditions). We assessed emotional reactions, attributions of disease aetiology, caregiving attitudes and meta-beliefs about patients' disclosure behaviour. Participants were also asked to report as accurately as possible on symptoms presented by each patient in the vignette.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings revealed that stigmatized conditions were associated with higher levels of caregiving discomfort, greater disease disclosure reticence and lower levels of symptom recall accuracy. Compared with patients with single conditions, those with concurrent mental and physical illnesses were less likely to receive care, were attributed a lesser tendency to conceal their conditions and had their symptoms recalled less accurately.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results indicate that when mental and physical illnesses intersect, patients with multiple stigmatized conditions may be differentially perceived in the eyes of medical students and may become (in)visible targets of discrimination in a healthcare setting. We discuss implications for enhancing awareness of social determinants of health and disease for a more representative, responsive and inclusive healthcare curriculum and practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial Acknowledgement","authors":"","doi":"10.1111/bjhp.70036","DOIUrl":"https://doi.org/10.1111/bjhp.70036","url":null,"abstract":"","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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