Heather Orom, Natasha C Allard, Jennifer L Hay, Marc T Kiviniemi, Erika A Waters, Amy McQueen
Objectives: Guided by the hedonic surplus/mood-as-resource hypotheses, we sought to identify message components that prevent health information avoidance by inducing hedonic psychological states.
Design: Two experimental studies.
Methods: Participants, age 45-75, recruited from the online survey platform, Prolific (Study 1 N = 288, Study 2 N = 505), completed a survey of their colorectal cancer (CRC) information avoidance tendency and demographics. They were reinvited to participate in a study where they were randomized to view one of four types of images: humorous comics, cute animals, coping messages or streetscapes images (control condition). To assess CRC information avoidance behaviour after viewing the stimuli, participants choose whether to be directed to a website to complete a CRC risk calculator (Study 1), or whether to view a CRC information video or a video about foot care (Study 2). Using logistic regression, we regressed each outcome variable on interactions between self-reported CRC information avoidance tendency and experimental condition. We then used the PROCESS macro to test if mood mediated these interaction effects.
Results: In Study 1, to the degree participants reported CRC information avoidance tendency, viewing humorous comics compared to control images increased their odds of choosing to view the risk calculator (OR = 5.26, p = .02). The same was true in Study 2 for choosing to watch the video about CRC vs. foot care (OR = 2.42, p = .04). Effects were not mediated through mood and there were no effects for the cute animals or coping messages.
Conclusions: Using humour at the outset of a health message may increase reach to people who otherwise avoid CRC or other health messaging.
{"title":"Reducing information avoidance: The effectiveness of humour, cute animals and coping messages.","authors":"Heather Orom, Natasha C Allard, Jennifer L Hay, Marc T Kiviniemi, Erika A Waters, Amy McQueen","doi":"10.1111/bjhp.12748","DOIUrl":"https://doi.org/10.1111/bjhp.12748","url":null,"abstract":"<p><strong>Objectives: </strong>Guided by the hedonic surplus/mood-as-resource hypotheses, we sought to identify message components that prevent health information avoidance by inducing hedonic psychological states.</p><p><strong>Design: </strong>Two experimental studies.</p><p><strong>Methods: </strong>Participants, age 45-75, recruited from the online survey platform, Prolific (Study 1 N = 288, Study 2 N = 505), completed a survey of their colorectal cancer (CRC) information avoidance tendency and demographics. They were reinvited to participate in a study where they were randomized to view one of four types of images: humorous comics, cute animals, coping messages or streetscapes images (control condition). To assess CRC information avoidance behaviour after viewing the stimuli, participants choose whether to be directed to a website to complete a CRC risk calculator (Study 1), or whether to view a CRC information video or a video about foot care (Study 2). Using logistic regression, we regressed each outcome variable on interactions between self-reported CRC information avoidance tendency and experimental condition. We then used the PROCESS macro to test if mood mediated these interaction effects.</p><p><strong>Results: </strong>In Study 1, to the degree participants reported CRC information avoidance tendency, viewing humorous comics compared to control images increased their odds of choosing to view the risk calculator (OR = 5.26, p = .02). The same was true in Study 2 for choosing to watch the video about CRC vs. foot care (OR = 2.42, p = .04). Effects were not mediated through mood and there were no effects for the cute animals or coping messages.</p><p><strong>Conclusions: </strong>Using humour at the outset of a health message may increase reach to people who otherwise avoid CRC or other health messaging.</p>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093984","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}
Edyta Charzyńska, Martin Offenbächer, Kjerstin Halverson, Jameson K Hirsch, Niko Kohls, Christian Hanshans, Fuschia Sirois, Loren Toussaint
Objectives: Patients with rheumatic and musculoskeletal diseases (RMDs) often experience poor well-being. Common limitations of the studies on this topic involve using variable-centred and deficit-based approaches. In this study, we used the person-centred approach to identify profiles of positive (life satisfaction and health status) and negative (depression, anxiety, fatigue, and stress) indicators of well-being among patients with RMDs. Moreover, we tested self-forgiveness, forgiveness of others, gratitude, and sociodemographics as contributors to latent profile membership.
Design: A cross-sectional questionnaire survey.
Methods: Using a latent profile analysis, we investigated well-being profiles among 892 patients with RMDs (759 patients with arthritis and 133 with fibromyalgia [FM]) and examined the correlates of latent profile membership.
Results: We identified four profiles of well-being: (1) 'life dissatisfaction' (9.2%), (2) 'high well-being' (43.4%), (3) 'suboptimal well-being' (35.2%), and (4) 'very poor well-being' (12.2%). Members of Profile 2 had higher levels of self-forgiveness and gratitude than members of the remaining profiles, had higher levels of forgiveness of others than Profile 3, and were older than members of Profile 4. Moreover, members of Profile 2 had a higher proportion of patients with arthritis relative to those with FM than all other profiles and men to women than Profile 4.
Conclusions: Patients with RMDs are heterogeneous in terms of well-being. Self-forgiveness, gratitude, and forgiveness of others may serve as psychological capital that enhances patients' well-being. Special attention should be paid to patients with FM, women, and younger patients since they can be especially susceptible to poor well-being.
{"title":"Profiles of well-being and their associations with self-forgiveness, forgiveness of others, and gratitude among patients with rheumatic and musculoskeletal diseases.","authors":"Edyta Charzyńska, Martin Offenbächer, Kjerstin Halverson, Jameson K Hirsch, Niko Kohls, Christian Hanshans, Fuschia Sirois, Loren Toussaint","doi":"10.1111/bjhp.12749","DOIUrl":"https://doi.org/10.1111/bjhp.12749","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with rheumatic and musculoskeletal diseases (RMDs) often experience poor well-being. Common limitations of the studies on this topic involve using variable-centred and deficit-based approaches. In this study, we used the person-centred approach to identify profiles of positive (life satisfaction and health status) and negative (depression, anxiety, fatigue, and stress) indicators of well-being among patients with RMDs. Moreover, we tested self-forgiveness, forgiveness of others, gratitude, and sociodemographics as contributors to latent profile membership.</p><p><strong>Design: </strong>A cross-sectional questionnaire survey.</p><p><strong>Methods: </strong>Using a latent profile analysis, we investigated well-being profiles among 892 patients with RMDs (759 patients with arthritis and 133 with fibromyalgia [FM]) and examined the correlates of latent profile membership.</p><p><strong>Results: </strong>We identified four profiles of well-being: (1) 'life dissatisfaction' (9.2%), (2) 'high well-being' (43.4%), (3) 'suboptimal well-being' (35.2%), and (4) 'very poor well-being' (12.2%). Members of Profile 2 had higher levels of self-forgiveness and gratitude than members of the remaining profiles, had higher levels of forgiveness of others than Profile 3, and were older than members of Profile 4. Moreover, members of Profile 2 had a higher proportion of patients with arthritis relative to those with FM than all other profiles and men to women than Profile 4.</p><p><strong>Conclusions: </strong>Patients with RMDs are heterogeneous in terms of well-being. Self-forgiveness, gratitude, and forgiveness of others may serve as psychological capital that enhances patients' well-being. Special attention should be paid to patients with FM, women, and younger patients since they can be especially susceptible to poor well-being.</p>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074216","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}
Body image disturbance is prevalent in people with endometriosis. This study aimed to explore the feasibility, acceptability and preliminary efficacy of the My Changed Body (MyCB) writing activity for body image in people with endometriosis.
Design
Two-arm randomized controlled pilot and feasibility study.
Methods
Australian adults living with endometriosis who identified as having had a negative endometriosis-related body image experience were recruited online through Endometriosis Australia. Participants completed a baseline survey capturing demographic and health data before being randomized into the MyCB or control writing conditions. Additional assessment was administered post-activity and at 1-week follow-up.
Results
A total of 82 participants were recruited and randomized (Mage = 32 years, SD = 7.8). MyCB participants were less likely to complete the writing tasks compared to the control group (51% vs. 83%); MyCB completers had lower self-compassion and quality of life, and higher psychological distress, compared to those who dropped out. The MyCB activity received good satisfaction rates (47%–87%). However, there was significant drop-out in the MyCB group (n = 4 vs. 13 at 1-week follow-up). Limited-efficacy testing showed an increase in the self-compassion self-identification for the MyCB group.
Conclusions
The MyCB writing activity may be feasible for people with endometriosis. A future larger trial will benefit from several methodology changes to enhance recruitment and retention.
Trial Registration
Australian and New Zealand Clinical Trial Registry ACTRN12622000496718; Date: 29/3/2022; retrospectively registered.
{"title":"A randomized feasibility trial evaluating the “My Changed Body” writing activity for people with endometriosis","authors":"Taryn Lores, Christa Kwok, Jacqueline Mills, Kerry Sherman","doi":"10.1111/bjhp.12743","DOIUrl":"10.1111/bjhp.12743","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Body image disturbance is prevalent in people with endometriosis. This study aimed to explore the feasibility, acceptability and preliminary efficacy of the My Changed Body (MyCB) writing activity for body image in people with endometriosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Two-arm randomized controlled pilot and feasibility study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Australian adults living with endometriosis who identified as having had a negative endometriosis-related body image experience were recruited online through Endometriosis Australia. Participants completed a baseline survey capturing demographic and health data before being randomized into the MyCB or control writing conditions. Additional assessment was administered post-activity and at 1-week follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 82 participants were recruited and randomized (<i>M</i><sub>age</sub> = 32 years, <i>SD</i> = 7.8). MyCB participants were less likely to complete the writing tasks compared to the control group (51% vs. 83%); MyCB completers had lower self-compassion and quality of life, and higher psychological distress, compared to those who dropped out. The MyCB activity received good satisfaction rates (47%–87%). However, there was significant drop-out in the MyCB group (<i>n</i> = 4 vs. 13 at 1-week follow-up). Limited-efficacy testing showed an increase in the self-compassion self-identification for the MyCB group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The MyCB writing activity may be feasible for people with endometriosis. A future larger trial will benefit from several methodology changes to enhance recruitment and retention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Australian and New Zealand Clinical Trial Registry ACTRN12622000496718; Date: 29/3/2022; retrospectively registered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"1017-1030"},"PeriodicalIF":3.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074215","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}
Mindfulness-based interventions can improve psychological health; yet the mechanisms of change are underexplored. This pre-registered remote RCT evaluated a freely accessible digital mindfulness programme aiming to improve well-being, mental health and sleep quality. Health behaviour cognitions were explored as possible mediators.
Methods
Participants from 91 countries (N = 1247, Mage = 27.03 [9.04]) were randomized to 30 days of mindfulness practice or attention-matched control condition. Measures of well-being, depression, anxiety, stress, sleep quality, barriers self-efficacy, self-regulation and behavioural predictors (e.g., attitudes and behavioural intentions) were taken at baseline, 1-month (post-intervention) and 2-months (follow-up). Linear regression examined intervention effects between and within groups. Longitudinal mediation analyses explored indirect effects through health behaviour cognitions.
Results
Three hundred participants completed post-intervention measures. Those receiving mindfulness training reported significantly better well-being (Mdifference = 2.34, 95%CIs .45–4.24, p = .016), lower depression (Mdifference = −1.47, 95%CIs −2.38 to −.56, p = .002) and anxiety symptoms (Mdifference = −.77, 95%CIs −1.51 to −.02, p = .045) than controls. Improvements in well-being and depression were maintained at follow-up. Intervention effects on primary outcomes were mediated by attitudes towards health maintenance and behavioural intentions. Mediating effects of attitudes remained when controlling for prior scores in models of depression and well-being.
Conclusions
Digital, self-administered mindfulness practice for 30 days meaningfully improved psychological health, at least partially due to improved attitudes towards health behaviours and stronger behavioural intentions. This trial found that digital mindfulness is a promising and scalable well-being tool for the general population, and highlighted its role in supporting health behaviours.
背景：以正念为基础的干预措施可以改善心理健康；然而，对其变化机制的探索还很不够。这项预先登记的远程 RCT 评估了一项可免费获取的数字正念计划，该计划旨在改善幸福感、心理健康和睡眠质量。研究方法：来自 91 个国家的参与者（N = 1,000 人）参加了这项研究：来自 91 个国家的参与者（N = 1247，Mage = 27.03 [9.04]）被随机分配到为期 30 天的正念练习或注意力匹配对照组。分别在基线、1 个月（干预后）和 2 个月（随访）对幸福感、抑郁、焦虑、压力、睡眠质量、障碍自我效能、自我调节和行为预测因素（如态度和行为意向）进行测量。线性回归分析了组间和组内的干预效果。纵向中介分析探讨了通过健康行为认知产生的间接影响：结果：300 名参与者完成了干预后的测量。与对照组相比，接受正念训练者的幸福感（Mdifference = 2.34, 95%CIs .45-4.24, p = .016）、抑郁（Mdifference = -1.47, 95%CIs -2.38 to -.56, p = .002）和焦虑症状（Mdifference = -.77, 95%CIs -1.51 to -.02, p = .045）均显著改善。幸福感和抑郁方面的改善在随访中得以保持。对健康维护的态度和行为意向对主要结果的干预效果具有中介作用。当控制抑郁和幸福感模型中的先前得分时，态度的中介效应依然存在：为期 30 天的数字式自我管理正念练习能有效改善心理健康，至少部分原因是人们对健康行为的态度有所改善，行为意向有所加强。这项试验发现，数字正念对普通人群来说是一种有前景且可扩展的幸福工具，并强调了它在支持健康行为方面的作用。
{"title":"Mindfulness improves psychological health and supports health behaviour cognitions: Evidence from a pragmatic RCT of a digital mindfulness-based intervention","authors":"Masha Remskar, Max J. Western, Ben Ainsworth","doi":"10.1111/bjhp.12745","DOIUrl":"10.1111/bjhp.12745","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mindfulness-based interventions can improve psychological health; yet the mechanisms of change are underexplored. This pre-registered remote RCT evaluated a freely accessible digital mindfulness programme aiming to improve well-being, mental health and sleep quality. Health behaviour cognitions were explored as possible mediators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants from 91 countries (<i>N</i> = 1247, <i>M</i><sub>age</sub> = 27.03 [9.04]) were randomized to 30 days of mindfulness practice or attention-matched control condition. Measures of well-being, depression, anxiety, stress, sleep quality, barriers self-efficacy, self-regulation and behavioural predictors (e.g., attitudes and behavioural intentions) were taken at baseline, 1-month (post-intervention) and 2-months (follow-up). Linear regression examined intervention effects between and within groups. Longitudinal mediation analyses explored indirect effects through health behaviour cognitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred participants completed post-intervention measures. Those receiving mindfulness training reported significantly better well-being (<i>M</i><sub>difference</sub> = 2.34, 95%CIs .45–4.24, <i>p</i> = .016), lower depression (<i>M</i><sub>difference</sub> = −1.47, 95%CIs −2.38 to −.56, <i>p</i> = .002) and anxiety symptoms (<i>M</i><sub>difference</sub> = −.77, 95%CIs −1.51 to −.02, <i>p</i> = .045) than controls. Improvements in well-being and depression were maintained at follow-up. Intervention effects on primary outcomes were mediated by attitudes towards health maintenance and behavioural intentions. Mediating effects of attitudes remained when controlling for prior scores in models of depression and well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Digital, self-administered mindfulness practice for 30 days meaningfully improved psychological health, at least partially due to improved attitudes towards health behaviours and stronger behavioural intentions. This trial found that digital mindfulness is a promising and scalable well-being tool for the general population, and highlighted its role in supporting health behaviours.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"1031-1048"},"PeriodicalIF":3.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12745","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019173","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}
Eva Cooney, Elaine Toomey, Kathleen Ryan, Oonagh Meade, Jenny McSharry
Objectives
Digital health behaviour change interventions may be adapted from in-person interventions, without appropriate consideration of how the digital context might differ. Drawing on the wider literature on behaviour change intervention development, this research aims to explore the digital adaptation process of health behaviour change interventions and the specific considerations for digital modes of delivery.
Design
A qualitative interview study.
Methods
Interviews with 15 intervention developers/facilitators were analysed using inductive thematic analysis.
Results
Findings highlight a continuum of digitalization, where variation in technology available and human support influences considerations for digital adaptation. ‘What vs how: “trying to do the impossible”’ describes the balance between retaining the intervention's active ingredients while modifying for digital delivery. Through ‘Trial and error’, participants described an iterative process based on experience of delivery. ‘Creating connection and engagement’ emphasizes the importance of social support and the challenges of replicating this.
Conclusions
Several considerations for digital adaptations are proposed including the involvement of end-users (facilitators and recipients) during adaptation, the need to understand the original intervention and new context for use, and the different motivational needs of digital intervention recipients.
{"title":"What's different about digital? A qualitative interview study exploring experiences of adapting in-person behaviour change interventions for digital delivery","authors":"Eva Cooney, Elaine Toomey, Kathleen Ryan, Oonagh Meade, Jenny McSharry","doi":"10.1111/bjhp.12741","DOIUrl":"10.1111/bjhp.12741","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Digital health behaviour change interventions may be adapted from in-person interventions, without appropriate consideration of how the digital context might differ. Drawing on the wider literature on behaviour change intervention development, this research aims to explore the digital adaptation process of health behaviour change interventions and the specific considerations for digital modes of delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative interview study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Interviews with 15 intervention developers/facilitators were analysed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings highlight a continuum of digitalization, where variation in technology available and human support influences considerations for digital adaptation. ‘What vs how: “trying to do the impossible”’ describes the balance between retaining the intervention's active ingredients while modifying for digital delivery. Through ‘Trial and error’, participants described an iterative process based on experience of delivery. ‘Creating connection and engagement’ emphasizes the importance of social support and the challenges of replicating this.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Several considerations for digital adaptations are proposed including the involvement of end-users (facilitators and recipients) during adaptation, the need to understand the original intervention and new context for use, and the different motivational needs of digital intervention recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"972-999"},"PeriodicalIF":3.5,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793802","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}
Eun-Jung Shim, Sang Jin Park, Gyu Hyeong Im, Ruth A. Hackett, Paola Zaninotto, Andrew Steptoe
Objective
We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality.
Design
Longitudinal, prospective observational study.
Methods
We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006–2018).
Results
Three trajectories of depressive symptomology were identified in growth mixture models: low/stable (i.e., low and stable levels of symptoms; 85.56%), high/decreasing (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and moderate/increasing (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the moderate/increasing or high/decreasing classes than in the low/stable class. The moderate/increasing class had the lowest satisfaction with quality of life, followed by the high/decreasing and low/stable classes. The moderate/increasing and the high/decreasing classes had lower satisfaction with relationships with spouse and children than the low/stable class. The high/decreasing class had a higher mortality risk than the low/stable class.
Conclusions
Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.
{"title":"Trajectories of depressive symptoms in Korean adults with diabetes: Individual differences and associations with life satisfaction and mortality","authors":"Eun-Jung Shim, Sang Jin Park, Gyu Hyeong Im, Ruth A. Hackett, Paola Zaninotto, Andrew Steptoe","doi":"10.1111/bjhp.12742","DOIUrl":"10.1111/bjhp.12742","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Longitudinal, prospective observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006–2018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three trajectories of depressive symptomology were identified in growth mixture models: <i>low/stable</i> (i.e., low and stable levels of symptoms; 85.56%), <i>high/decreasing</i> (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and <i>moderate/increasing</i> (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the <i>moderate/increasing</i> or <i>high/decreasing</i> classes than in the <i>low/stable</i> class. The <i>moderate/increasing</i> class had the lowest satisfaction with quality of life, followed by the <i>high/decreasing</i> and <i>low/stable</i> classes. The <i>moderate/increasing</i> and the <i>high/decreasing</i> classes had lower satisfaction with relationships with spouse and children than the <i>low/stable</i> class. The <i>high/decreasing</i> class had a higher mortality risk than the <i>low/stable</i> class.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"1000-1016"},"PeriodicalIF":3.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761762","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}
Shokraneh Moghadam, Laura Hollands, Raff Calitri, Dawn Swancutt, Jenny Lloyd, Lily Hawkins, Rod Sheaff, Sarah Dean, Steve Perry, Ross Watkins, Jonathan Pinkney, Mark Tarrant, the PROGROUP Team
Introduction
Interventions to support behaviour change in people living with chronic health conditions increasingly use patient groups as the mode of delivery, but these are often designed without consideration of the group processes that can shape intervention outcomes. This article outlines a new approach to designing group-based behaviour change interventions that prioritizes recipients' shared social identity as group members in facilitating the adoption of established behaviour change techniques (BCTs). The approach is illustrated through an example drawn from research focused on people living with severe obesity.
Methods
A prioritization process was undertaken in collaboration with stakeholders, including behaviour change experts, clinicians, and a former patient to develop an evidence-based, group intervention informed by the social identity approach to health. Three phases of development are reported: (1) identification of the health problem; (2) delineation of intervention mechanisms and operationalization of BCTs for group delivery and (3) intervention manualization. The fourth phase, intervention testing and optimization, is reported elsewhere.
Results
A group-based behaviour change intervention was developed, consisting of 12 group sessions and 3 one-to-one consultations. The intervention aimed to support the development of shared social identity among recipients, alongside the delivery of evidence-based BCTs, to improve the likelihood of successful intervention and health outcomes among people living with severe obesity.
Conclusions
A manualized intervention, informed by the social identity approach to health, was systematically designed with input from stakeholders. The development approach employed can inform the design of behavioural interventions in other health contexts where group-based delivery is planned.
{"title":"Development of a group-based behaviour change intervention for people with severe obesity informed by the social identity approach to health","authors":"Shokraneh Moghadam, Laura Hollands, Raff Calitri, Dawn Swancutt, Jenny Lloyd, Lily Hawkins, Rod Sheaff, Sarah Dean, Steve Perry, Ross Watkins, Jonathan Pinkney, Mark Tarrant, the PROGROUP Team","doi":"10.1111/bjhp.12737","DOIUrl":"10.1111/bjhp.12737","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Interventions to support behaviour change in people living with chronic health conditions increasingly use patient groups as the mode of delivery, but these are often designed without consideration of the group processes that can shape intervention outcomes. This article outlines a new approach to designing group-based behaviour change interventions that prioritizes recipients' shared social identity <i>as group members</i> in facilitating the adoption of established behaviour change techniques (BCTs). The approach is illustrated through an example drawn from research focused on people living with severe obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prioritization process was undertaken in collaboration with stakeholders, including behaviour change experts, clinicians, and a former patient to develop an evidence-based, group intervention informed by the social identity approach to health. Three phases of development are reported: (1) identification of the health problem; (2) delineation of intervention mechanisms and operationalization of BCTs for group delivery and (3) intervention manualization. The fourth phase, intervention testing and optimization, is reported elsewhere.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A group-based behaviour change intervention was developed, consisting of 12 group sessions and 3 one-to-one consultations. The intervention aimed to support the development of shared social identity among recipients, alongside the delivery of evidence-based BCTs, to improve the likelihood of successful intervention and health outcomes among people living with severe obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A manualized intervention, informed by the social identity approach to health, was systematically designed with input from stakeholders. The development approach employed can inform the design of behavioural interventions in other health contexts where group-based delivery is planned.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"907-924"},"PeriodicalIF":3.5,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535704","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}
Cassandra Yuill, Andrea Sinesi, Rose Meades, Louise R. Williams, Amy Delicate, Helen Cheyne, Margaret Maxwell, Judy Shakespeare, Fiona Alderdice, Rachael Leonard, Susan Ayers, The MAP Study Team
Background
Anxiety in pregnancy and postnatally is highly prevalent but under-recognized. To identify perinatal anxiety, assessment tools must be acceptable to women who are pregnant or postnatal.
Methods
A qualitative study of women's experiences of anxiety and mental health assessment during pregnancy and after birth and views on the acceptability of perinatal anxiety assessment. Semi-structured interviews were conducted with 41 pregnant or postnatal women. Results were analysed using Sekhon et al.'s acceptability framework, as well as inductive coding of new or emergent themes.
Results
Women's perceptions of routine assessment for perinatal anxiety were generally favourable. Most participants thought assessment was needed and that the benefits outweighed potential negative impacts, such as unnecessary referrals to specialist services. Six themes were identified of: (1) Raising awareness; (2) Improving support; (3) Surveillance and stigma; (4) Gatekeeping; (5) Personalized care and (6) Trust. Assessment was seen as a tool for raising awareness about mental health during the perinatal period and a mechanism for normalizing discussions about mental health more generally. However, views on questionnaire assessments themselves were mixed, with some participants feeling they could become an administrative ‘tick box’ exercise that depersonalizes care and does not provide a space to discuss mental health problems.
Conclusion
Routine assessment of perinatal anxiety was generally viewed as positive and acceptable; however, this was qualified by the extent to which it was informed and personalized as a process. Approaches to assessment should ideally be flexible, tailored across the perinatal period and embedded in continuity of care.
{"title":"Women's experiences and views of routine assessment for anxiety in pregnancy and after birth: A qualitative study","authors":"Cassandra Yuill, Andrea Sinesi, Rose Meades, Louise R. Williams, Amy Delicate, Helen Cheyne, Margaret Maxwell, Judy Shakespeare, Fiona Alderdice, Rachael Leonard, Susan Ayers, The MAP Study Team","doi":"10.1111/bjhp.12740","DOIUrl":"10.1111/bjhp.12740","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anxiety in pregnancy and postnatally is highly prevalent but under-recognized. To identify perinatal anxiety, assessment tools must be acceptable to women who are pregnant or postnatal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative study of women's experiences of anxiety and mental health assessment during pregnancy and after birth and views on the acceptability of perinatal anxiety assessment. Semi-structured interviews were conducted with 41 pregnant or postnatal women. Results were analysed using Sekhon et al.'s acceptability framework, as well as inductive coding of new or emergent themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women's perceptions of routine assessment for perinatal anxiety were generally favourable. Most participants thought assessment was needed and that the benefits outweighed potential negative impacts, such as unnecessary referrals to specialist services. Six themes were identified of: (1) <i>Raising awareness</i>; (2) <i>Improving support</i>; (3) <i>Surveillance and stigma</i>; (4) <i>Gatekeeping</i>; (5) <i>Personalized care</i> and (6) <i>Trust</i>. Assessment was seen as a tool for raising awareness about mental health during the perinatal period and a mechanism for normalizing discussions about mental health more generally. However, views on questionnaire assessments themselves were mixed, with some participants feeling they could become an administrative ‘tick box’ exercise that depersonalizes care and does not provide a space to discuss mental health problems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Routine assessment of perinatal anxiety was generally viewed as positive and acceptable; however, this was qualified by the extent to which it was informed and personalized as a process. Approaches to assessment should ideally be flexible, tailored across the perinatal period and embedded in continuity of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"958-971"},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493935","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}
Asuman Buyukcan-Tetik, Lara Seefeld, Luisa Bergunde, Turan Deniz Ergun, Pelin Dikmen-Yildiz, Antje Horsch, Susan Garthus-Niegel, Mirjam Oosterman, Joan Lalor, Tobias Weigl, Annick Bogaerts, Sarah Van Haeken, Soo Downe, Susan Ayers
Objectives
During the perinatal period, women and their birth companions form expectations about childbirth. We aimed to examine whether a mismatch between birth expectations and experiences predict childbirth-related post-traumatic stress symptoms (CB-PTSS) for mothers and birth companions. We also explored the influence of the mismatch between mothers' and birth companions' expectations/experiences on CB-PTSS.
Design
Dyadic longitudinal data from the Self-Hypnosis IntraPartum Trial.
Methods
Participants (n = 469 mothers; n = 358 birth companions) completed questionnaires at 27 and 36 weeks of gestation and 2 and 6 weeks post-partum. We used the measures of birth expectations (36 weeks gestation), birth experiences (2 weeks post-partum) and CB-PTSS (6 weeks post-partum).
Results
Correlations revealed that birth expectations were associated with experiences for both mothers and birth companions but were not consistently associated with CB-PTSS. Birth experiences related to CB-PTSS for both mothers and birth companions. The response surface analysis results showed no support for the effect of a mismatch between expectations and experiences on CB-PTSS in mothers or birth companions. Similarly, a mismatch between mothers' and birth companions' expectations or experiences was unrelated to CB-PTSS.
Conclusions
Following previous literature, birth expectations were associated with experiences, and experiences were associated with CB-PTSS. By testing the effect of the match between birth experiences and expectations using an advanced statistical method, we found that experiences play a more substantial role than the match between experiences and expectations in CB-PTSS. The impact of birth experiences on CB-PTSS highlights the importance of respectful and supportive maternity care.
{"title":"Birth expectations, birth experiences and childbirth-related post-traumatic stress symptoms in mothers and birth companions: Dyadic investigation using response surface analysis","authors":"Asuman Buyukcan-Tetik, Lara Seefeld, Luisa Bergunde, Turan Deniz Ergun, Pelin Dikmen-Yildiz, Antje Horsch, Susan Garthus-Niegel, Mirjam Oosterman, Joan Lalor, Tobias Weigl, Annick Bogaerts, Sarah Van Haeken, Soo Downe, Susan Ayers","doi":"10.1111/bjhp.12738","DOIUrl":"10.1111/bjhp.12738","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>During the perinatal period, women and their birth companions form expectations about childbirth. We aimed to examine whether a mismatch between birth expectations and experiences predict childbirth-related post-traumatic stress symptoms (CB-PTSS) for mothers and birth companions. We also explored the influence of the mismatch between mothers' and birth companions' expectations/experiences on CB-PTSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Dyadic longitudinal data from the Self-Hypnosis IntraPartum Trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 469 mothers; <i>n</i> = 358 birth companions) completed questionnaires at 27 and 36 weeks of gestation and 2 and 6 weeks post-partum. We used the measures of birth expectations (36 weeks gestation), birth experiences (2 weeks post-partum) and CB-PTSS (6 weeks post-partum).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Correlations revealed that birth expectations were associated with experiences for both mothers and birth companions but were not consistently associated with CB-PTSS. Birth experiences related to CB-PTSS for both mothers and birth companions. The response surface analysis results showed no support for the effect of a mismatch between expectations and experiences on CB-PTSS in mothers or birth companions. Similarly, a mismatch between mothers' and birth companions' expectations or experiences was unrelated to CB-PTSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Following previous literature, birth expectations were associated with experiences, and experiences were associated with CB-PTSS. By testing the effect of the match between birth experiences and expectations using an advanced statistical method, we found that experiences play a more substantial role than the match between experiences and expectations in CB-PTSS. The impact of birth experiences on CB-PTSS highlights the importance of respectful and supportive maternity care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"925-942"},"PeriodicalIF":3.5,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459970","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}
Samuel T. Orange, Jessica Roebuck, Phil Marshall, Leigh A. Madden, Rebecca V. Vince, Beth T. Bell
Objectives
Living within a larger body brings unique challenges to exercise participation, which are poorly understood. This qualitative study explored the attitudes towards, and experiences of, exercise participation in adults with class III obesity.
We recruited 30 adults with class III obesity (body mass index: 45.8 ± 8.6 kg/m2) from a specialist multidisciplinary weight management service. Participants took part in semi-structured interviews while participating in a 6-month home-based aerobic and resistance exercise intervention. Open-ended questions were used flexibly to explore their views and experiences of exercise, encompassing barriers, motives and perceived benefits. Transcripts were analysed using reflexive thematic analysis.
Results
Three themes were developed: (1) a web of barriers; (2) tailored exercise facilitates positive experiences; and (3) a desire to live a normal life. People with class III obesity perceived that they were unable to do exercise; a view that was attributed to perceived judgement, low physical function, pain during everyday activities and failed weight loss attempts. These complex physical and psychosocial barriers to exercise were described as contributing to exercise avoidance. High value was placed on tailored exercise that accommodates the unique needs of moving in a larger body. A desire to carry out everyday tasks underpinned motivations for exercise.
Conclusions
Our findings suggest that multi-component obesity interventions should move away from generic exercise prescriptions designed to maximize energy expenditure, and instead move towards addressing the unique physical and psychosocial needs of people who have class III obesity with tailored person-centred and weight-neutral exercise prescriptions.
目的：肥胖给运动参与带来了独特的挑战，而人们对这些挑战的了解却很少。这项定性研究探讨了患有 III 级肥胖症的成年人参与运动的态度和经历：设计：个人半结构化定性访谈：我们从专业的多学科体重管理服务机构招募了 30 名 III 级肥胖症成人（体重指数：45.8 ± 8.6 kg/m2）。参与者在参加为期 6 个月的家庭有氧运动和阻力运动干预的同时，参加了半结构化访谈。访谈中灵活使用了开放式问题，以探讨他们对运动的看法和体验，包括障碍、动机和感知到的益处。采用反思性主题分析法对记录誊本进行了分析：得出了三个主题：(1) 障碍网；(2) 量身定制的运动促进积极体验；(3) 希望过上正常生活。三级肥胖症患者认为他们无法进行锻炼；这一观点可归因于他们的判断力、身体机能低下、日常活动中的疼痛以及减肥尝试失败。这些复杂的身体和社会心理障碍被认为是导致患者逃避运动的原因。他们非常重视量身定制的运动，这种运动可以满足较大身体的独特运动需求。完成日常任务的愿望是运动动机的基础：我们的研究结果表明，多成分肥胖症干预措施应摒弃旨在最大限度地增加能量消耗的通用运动处方，转而采用以人为本、体重中性的定制运动处方，满足 III 级肥胖症患者独特的身体和社会心理需求。
{"title":"‘I'm a failure again, I can't do it’: Attitudes towards, and experiences of, exercise participation in adults with class III obesity","authors":"Samuel T. Orange, Jessica Roebuck, Phil Marshall, Leigh A. Madden, Rebecca V. Vince, Beth T. Bell","doi":"10.1111/bjhp.12739","DOIUrl":"10.1111/bjhp.12739","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Living within a larger body brings unique challenges to exercise participation, which are poorly understood. This qualitative study explored the attitudes towards, and experiences of, exercise participation in adults with class III obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Individual semi-structured qualitative interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 30 adults with class III obesity (body mass index: 45.8 ± 8.6 kg/m<sup>2</sup>) from a specialist multidisciplinary weight management service. Participants took part in semi-structured interviews while participating in a 6-month home-based aerobic and resistance exercise intervention. Open-ended questions were used flexibly to explore their views and experiences of exercise, encompassing barriers, motives and perceived benefits. Transcripts were analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three themes were developed: (1) a web of barriers; (2) tailored exercise facilitates positive experiences; and (3) a desire to live a normal life. People with class III obesity perceived that they were unable to do exercise; a view that was attributed to perceived judgement, low physical function, pain during everyday activities and failed weight loss attempts. These complex physical and psychosocial barriers to exercise were described as contributing to exercise avoidance. High value was placed on tailored exercise that accommodates the unique needs of moving in a larger body. A desire to carry out everyday tasks underpinned motivations for exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that multi-component obesity interventions should move away from generic exercise prescriptions designed to maximize energy expenditure, and instead move towards addressing the unique physical and psychosocial needs of people who have class III obesity with tailored person-centred and weight-neutral exercise prescriptions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"29 4","pages":"943-957"},"PeriodicalIF":3.5,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.12739","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459971","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}
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