Journal of Behavioral Medicine最新文献

The objective of this study was to measure stability and change in response patterns to a set of hierarchical Physical Activity Self-Efficacy (PASE) Scales with latent transition analysis (LTA). To accomplish this objective a multiple-group LTA modeled binary responses to six ordered items within each PASE scale. Data (N_baseline = 461 and N_{30 days post-baseline} = 428) from the Well-Being and Physical Activity (WBPA; ClinicalTrials.gov, identifier: NCT03194854) study were analyzed. A four-class solution with interpretable parameter restrictions explained response patterns to each PASE scale at baseline. Evidence for temporal measurement invariance of this four-class solution was provided. Stability of latent class membership from baseline (i.e., pre-intervention) to 30 days post-baseline (i.e., post-intervention) was modest, consistent with substantive theory. Desirable differences in LTA probabilities (e.g., transitioning from confidence to engage in 10 min of weekly physical activity at baseline to confidence to engage in 90 min of weekly physical activity at 30 days post-baseline) by intervention group were observed, consistent with objectives of the WBPA study.

Type 2 diabetes is a widespread, chronic metabolic disease with significant consequences for public health. Poor adherence to treatment in type 2 diabetes patients is associated with inadequate glycemic control, increased medical costs, increased use of healthcare services, and increased mortality. Understanding how social support and disease acceptance influence treatment adherence can inform more effective diabetes management strategies. This study investigated the relationship between social support, disease acceptance, and treatment adherence in adults with type 2 diabetes. This cross-sectional correlational study was conducted on 332 individuals with type 2 diabetes in Türkiye. Data were collected using a patient information form, Acceptance of Illness Scale, Multidimensional Perceived Social Support Scale, and type 2 Diabetes Treatment Adherence Scale. Relationships between variables were analyzed using Pearson correlation coefficients, linear regression, and mediation analysis. The regression analysis indicated significant effects of social support on treatment adherence (β=-0.312, p < 0.001) and disease acceptance (β = 0.267, p < 0.001) and of disease acceptance on treatment adherence (β=-0.378, p < 0.001). Additionally, disease acceptance partially mediated the relationship between social support and treatment adherence (β=-0.101, %95 Cl [-0.154, -0.055]). The findings showed that high levels of social support and illness acceptance can improve treatment adherence and that social support may also indirectly enhance treatment adherence by promoting illness acceptance.

The current study explored whether "pain catastrophizing" in a sample of women experiencing menstrual pain can change over time as a function of perceived social support. All participants were cisgender women aged between 18 and 50 years of age, residing in Australia, and who had experienced menstruation within the past year. Participants completed two online surveys approximately 1-year apart, and participants were included if they indicated some degree of menstrual pain at baseline (Time 1, T1) (N = 2006 at T1 and N = 487 at T2). A significant negative association was found between perceived social support (T1) and pain catastrophizing (T2), when reports of pain catastrophizing at T1 were controlled for. This remained significant when the model was adjusted for the potential confounders: age, menstrual pain level, and endometriosis diagnosis (all assessed at T1). These findings demonstrate how "pain catastrophizing" in women with menstrual pain is, at least in part, a function of the broader social environment. This suggests that "pain catastrophizing" might be a well-intentioned and understandable pain-related support seeking strategy that manifests in response to a lack of adequate social support. It might be beneficial for psychological interventions to consider people's social network to ensure that they are able to get the support that they need.

Racial/ethnic disparities in COVID-19, including incidence, hospitalization, and death rates, are serious and persistent. Among those at highest risk for COVID-19 and its adverse effects are African American/Black and Latine (AABL) frontline essential workers in public-facing occupations (e.g., food services, retail). Testing for COVID-19 in various scenarios (when exposed or symptomatic, regular screening testing) is an essential component of the COVID-19 control strategy in the United States. However, AABL frontline workers have serious barriers to COVID-19 testing at the individual (insufficient knowledge, distrust, cognitive biases), social (norms), and structural levels of influence (access). Thus, testing rates are insufficient and interventions are needed. The present study is grounded in the multiphase optimization strategy (MOST) framework. It tests the main and interaction effects of a set of candidate behavioral intervention components to increase COVID-19 testing rates in this population. The study enrolled adult AABL frontline essential workers who were not up-to-date on COVID-19 vaccination nor recently tested for COVID-19. It used a factorial design to examine the effects of candidate behavioral intervention components, where each component was designed to address a specific barrier to COVID-19 testing. All participants received a core intervention comprised of health education. The candidate components were motivational interviewing counseling (MIC), a behavioral economics intervention (BEI), peer education (PE), and access to testing (either self-test kits [SK] or a navigation meeting [NM]). The primary outcome was COVID-19 testing in the follow-up period. Participants were assessed at baseline, randomly assigned to one of 16 experimental conditions, and assessed six- and 12-weeks later. The study was carried out in English and Spanish. We used a logistic regression model and multiple imputation to examine the main and interaction effects of the four factors (representing components): MIC, BEI, PE, and Access. We also conducted a sensitivity analysis using the complete case analysis. Participants (N = 438) were 35 years old on average (SD = 10). Half identified as men/male (52%), and 48% as women/female/other. Almost half (49%) were African American/Black, and 51% were Latine/Hispanic (12% participated in Spanish). A total of 32% worked in food services. Attendance in components was very high (~ 99%). BEI had positive effect on the outcome (OR = 1.543; 95% CI: [0.977, 2.438]; p-value = 0.063) as did Access, in favor of SK (OR = 1.351; 95% CI: [0.859, 2.125]; p-value = 0.193). We found a three-way interaction among MIC*PE*Access (OR: 0.576; 95% CI: [0.367, 0.903]; p-value = 0.016): when MIC was present, SK tended to increase COVID testing when PE was not present. The study advances intervention science and takes the first step toward creating an efficient and effective multi-component intervention to increase COVID-19 testin

The majority of Canadian adults are not meeting the recommended physical activity and sedentary behaviour guidelines. Previous studies have highlighted experiences of weight bias as a potential barrier to physical activity and an enabler of sedentary behaviours. Few studies have examined whether endorsing or internalizing weight bias is associated with these health behaviours. A secondary analysis was conducted on a sample of Canadian adults (N = 891, 52% female, mean age group = 45-54 years; mean body mass index [BMI] = 27.04 ± 6 kg/m²). Participants completed the International Physical Activity Questionnaire, the Sedentary Behaviour Questionnaire, the Modified Weight Bias Internalization Scale, and the Anti-Fat Attitudes Questionnaire (explicit weight bias). Linear regressions were conducted to determine the relationships between weight bias internalization (WBI), explicit weight bias, physical activity and sedentary behaviours. WBI predicted more weekly hours spent engaging in sedentary behaviours (F(6,897) = 14.73, p <.001, R² = 0.09) and anti-fat attitudes (AFA) predicted more weekly minutes of vigorous physical activity (F(6,891) = 5.42, p <.001, adj. R² = 0.03). WBI was not significantly associated with physical activity at any intensity. AFA was not significantly associated with sedentary behaviour, or moderate and mild physical activity. Findings suggest that some elements of weight bias may be related to certain health behaviours like sedentary behaviours and physical activity. Our results warrant further study on other factors that may play a role in the relationships between weight bias and health behaviours. Future research should include longitudinal studies and interventions that investigate the impact of weight bias on health behaviours.

This study examined the impact of social norms-descriptive, injunctive, and subjective norms-on COVID-19 vaccination intentions among Black Americans. It also investigated how Black Americans affiliated with Democrats and Republicans perceived norms within their groups and how such perceptions influenced their COVID-19 vaccination intentions. We conducted an online national survey with Black Americans (N = 1497) between February and March 2021. Results showed that all three types of norms were significantly and positively associated with vaccination intentions, with subjective norms exerting the strongest effect. Additionally, higher subjective norms amplified the positive relationship between descriptive norms and vaccination intentions. Republicans were influenced by both in-group and out-group norms, while Democrats were primarily guided by in-group norms, underscoring the potential of bipartisan messaging to boost vaccine uptake. These findings highlight how social norms impact COVID-19 vaccination intentions and reveal that individuals with differing party affiliations are influenced differently based on their perceived identification with reference groups. The study provides insights for designing targeted interventions to improve vaccine uptake among Black Americans and for developing broader public health messaging strategies. It contributes to the literature by revealing how the interplay of descriptive, injunctive, and subjective norms shapes vaccination intentions and by offering a novel perspective on the differentiated effects of in-group and out-group norms based on partisan identity.

Resource-based models of self-regulation propose that fatigue-induced depletion of cognitive resources is an impetus for overeating. Data provide preliminary support for resource-based models for eating in adults, but the relevance of this pathway for youth is unknown. The aim of this study was to test a resource-based model of eating behavior in youth. It was hypothesized that energy intake would be greater following the completion of a cognitive fatigue (versus control) condition. Using a randomized crossover design, each participant completed two, 2-h experimental paradigms (cognitive fatigue [an attention demanding computer task], control [watching movies]), on separate days. Immediately following the conditions, participants were presented with a buffet-style meal from which their energy intake (kcal) and proportion of intake from palatable snack foods (e.g., cookies, chips) were measured. Participants (N = 90) had an average age of 12.5 years (SD = 2.5y) and were 50% female, 50% non-Hispanic White, 20% non-Hispanic Black, and 13% Asian. Participants did not differ in total energy intake (p = 0.72) or palatable food intake (p = 0.40) across the two conditions. Our findings do not provide support for resource-based models of eating behavior. More comprehensive investigations of resource-based models of eating behavior among youth are needed, including tests of potential moderators, to determine the relevance of these models for pediatric eating behavior. The aims of this study were retrospectively registered on 12/07/2024 ( https://clinicaltrials.gov/study/NCT02390765 ).

Introduction: Managing obesity in patients with chronic kidney disease is crucial for managing disease progression. Psychological interventions, particularly cognitive behavioral therapy, can support lifestyle changes. This study aimed to evaluate the efficacy of a cognitive behavioral therapy intervention for obesity management in patients with chronic kidney disease.

Methods: Forty patients with chronic kidney disease (stages 2-4) were randomized to either an intervention group (nutritional and physical activity counseling and 16-week cognitive behavioral therapy) or a control group (nutritional and physical activity counseling only). Primary outcomes were body mass index (BMI) and proteinuria.

Results: The intervention group lost an average of 5.42 kg (BMI decrease: 1.82 kg/m²), compared to 1.53 kg (BMI decrease: 0.53 kg/m²) in the control group. A significant group-by-time interaction was observed for BMI (F(1,36) = 32.24, p = 0.004, ŋ²=0.21), favoring the intervention group. Effects remained significant at three-month follow-up, with an average weight loss of 4.63 kg (BMI decrease: 1.59 kg/m²) in the intervention group and 2.51 kg (BMI decrease: 0.87 kg/m²) in control group (F(2,70) = 5.54, p = 0.026, ŋ²=0.12). Changes in proteinuria did not differ between groups.

Conclusion: Cognitive behavioral therapy was effective and well-tolerated for promoting weight loss with most of the lost weight maintained at the three-month follow-up. This intervention may offer a valuable non-pharmacological treatment option for weight management in patients with chronic kidney disease.

In Taiwan, sexual minority men (SMM) account for a significant portion of new HIV cases, highlighting the need for effective prevention measures. However, pre-exposure prophylaxis (PrEP) use remains limited, necessitating a comprehensive examination of barriers. This study examined PrEP engagement and its predictors among 284 SMM in Taiwan. Participants were categorized into five stages, based on the Transtheoretical Model of Health Behavior Change, reflecting distinct levels of PrEP engagement. Ordinal logistic regression, informed by the Behavioral Model of Health Service Use, identified factors associated with being positioned at higher stages of the cascade. Significant predictors of PrEP engagement included predisposing (i.e., relationship status), enabling (i.e., PrEP knowledge, community connectedness), and need factors (i.e., number of sexual partners, chemsex). Findings highlight the need for further research on education, relationship dynamics, and sexual risk behaviors to inform tailored interventions that enhance PrEP engagement among SMM in Taiwan and the broader Asia region.