International Journal of Behavioral Medicine最新文献

Background: The purpose of the current study was to examine habitual sleep duration trajectories across the first 2 years of college and determine whether the trajectories were related to weight gain risk behaviors and increases in body mass index (BMI) and percent body fat.

Method: A sample of 115 students with a BMI between 18.5 and 29.9 was enrolled prior to beginning their first year of college. Data were collected in the laboratory and remotely at three time points across the first 2 years of college. Participants completed a total of eight in-person sessions and three 8-day, at-home recording periods. There were objective measures of body fat composition (i.e., dual-energy X-ray absorptiometry), BMI, sleep (i.e., Phillips Respironics Actiwatch 2 Device), and physical activity (i.e., Actigraph wGT3x-BT accelerometer). Self-report measures of sleep quality (i.e., Pittsburgh Sleep Quality Index) and food and beverage intake (i.e., Automated Self-Administered 24-h Dietary Assessment Tool) were also collected.

Results: The findings suggest that there were no habitual sleep duration trajectories observed; therefore, none of the outcome variables was examined in relation to trajectories. Follow-up mixed effects models suggest that as subjective poor sleep quality worsened, BMI increased both within participants and across the sample. No other significant relationships were found between sleep duration and quality and the other outcome variables.

Conclusion: The findings highlight subjective sleep quality as a potential key component in relation to obesity-related changes. Sample characteristics may have also played a role in the limited findings between the sleep variables and the other obesity-risk outcome variables.

Background: The Appalachian region in the USA has some of the highest rates of cancer and cancer mortality in the country, due in part to suboptimal screening. Routine screening for cervical and colorectal cancer can decrease cancer morbidity and mortality. The current study sought to assess the feasibility and preliminary impact of an intervention guided by the Common-sense Model of Self-regulation to improve cervical and colorectal cancer attitudes and screening intentions.

Method: Participants were approached in safety net clinics in Appalachian communities. Individuals completed surveys before and after an intervention that was designed to address lay understandings about the risks and causes of cervical and colorectal cancer and screening. Interventions were conducted with up to three family members, but at least one person in the family was not within screening guidelines. Paired t-tests assessed the impact of the intervention.

Results: Participants (n = 121) were predominantly women (76.0%) and White (69.4%) and had incomes of $20,000 or less (69.4%). Overall, screening barriers were moderate and did not change after the intervention. In response to the intervention, perceived risk and cervical cancer causes (risk factors) became more accurate, individuals increased in knowledge of colorectal cancer screening, the perceived deadliness of cervical and colorectal cancers decreased, intentions to screen increased, and the appraisal of the effectiveness of screening increased (all p's < 0.05, Holm adjusted).

Conclusion: The intervention had a positive impact on lay understanding of cervical and colorectal cancer and increased intentions to have cancer screening. A larger, randomized control trial is merited to investigate the impact of the intervention on screening rates.

Background: Adaptations of behavioral interventions can optimize the health impact for minoritized groups, including racial and ethnic minorities. While cultural adaptation frameworks exist, there is no singular approach to identifying the contexts that likely matter during early-phase intervention development, outside of those exclusive to a cultural frame. We developed the "Listen In" approach to address this gap; "Listen In" involves a series of steps, resulting in two levels of analysis, that increase an understanding of the target population and inform intervention adaptation.

Methods: We applied "Listen In" to explore how context interfaced with core intervention targets of Goal-focused Emotion-regulation Therapy (developed for young adult testicular cancer survivors) among Latino participants.

Results: Thirty-six hours of audio-recorded intervention sessions from a pilot trial across nine participants (all Latino, aged 20-33) were analyzed. Latino cultural values were found to be an important context for goal navigation processes directly and indirectly. For example, participants described family as being an important value and identified family as having an impact on goal achievement. Recommendations for intervention adaptation, then, included offering the opportunity to invite family into conversations around goal navigation.

Conclusions: An integration of the cultural context, facilitated by using the "Listen In" approach, enhanced our understanding of how GET can be adapted for young Latino survivors in the present study. "Listen In" may be a valuable approach to highlighting nuanced contexts in which intervention mechanisms are enacted. Future researchers may apply this method to help inform early-phase evidence-based intervention adaptations.

Background: This study investigates whether sedentary behavior patterns-such as inter-day variability and intraday accumulation patterns-are associated with dynamic glycemic outcomes, an association not previously examined in women with overweight and obesity.

Method: Fifteen participants (age: 20.6 ± 1.0 years; BMI: 28.1 ± 2.2 kg/m²) underwent simultaneous accelerometer and continuous glucose monitoring. Associations between sedentary behavior patterns (including breaks in sitting, time spent in ≥ 30-min sedentary bouts, and median sedentary bout duration), and their inter-day variability computed as the coefficient of variation (CV), and overall glycemic outcomes were examined using linear regression. Intraday associations between daytime sedentary behavior patterns and time-matched daytime and subsequent nighttime glycemic outcomes were examined using linear mixed models.

Results: Data from 144 person-days were analyzed. After adjustment for total sitting time and relevant covariates, a higher inter-day variability in time spent in ≥ 30-min sedentary bouts was associated with a higher percentage of time spent within the target glucose range (β = 1.281% 95% CI [0.107, 2.454], P = 0.037). A longer intraday median sedentary bout duration was associated with an increased nighttime CV of glucose (β = 0.13% 95% CI [0.012, 0.248], P = 0.031).

Conclusion: Women with overweight and obesity who alternated between days with more prolonged (≥ 30 min) sitting and days with less, and who had a shorter median sedentary bout duration, showed more favorable glycemic outcomes.

Background: Many cultures promote ideals for women's bodies that are difficult to meet, and not meeting these ideals may result in body shame. Body shame predicts discomfort in and avoidance of situations in which the body may be scrutinized. As the healthcare setting frequently involves examination of the body, body shame may predict discomfort in and avoidance of the healthcare setting. However, these relationships have been tested minimally and only in higher-weight women. Since body shame may occur regardless of BMI, body shame may predict healthcare discomfort and avoidance across the weight spectrum. Moreover, these relationships may occur because body shame predicts low body responsiveness, or the detection and valuing of bodily signals, which in turn may predict healthcare discomfort and avoidance.

Method: The present investigation tested these ideas in weight-diverse undergraduate women (N = 467) using cross-sectional (studies 1 and 2) and experimental (study 3) designs and imagined healthcare settings.

Results: In study 1, body shame correlated positively with healthcare discomfort, and low body responsiveness mediated this relationship. In study 2, body shame was not directly related to healthcare avoidance, but low body responsiveness mediated this relationship. In study 3, participants who underwent a body shame induction reported lower state body responsiveness than control participants, and lower state body responsiveness mediated the links between condition and healthcare discomfort and avoidance.

Conclusion: Attitudes toward internal bodily functions may link body shame to healthcare avoidance and discomfort in college women across the weight spectrum. Future research may examine this model in more diverse populations.

Purpose: Health is an intrinsic goal strongly related to individuals's well-being. Many individuals make efforts to achieve their health goals through different means. Based on the health regulatory focus theory, we proposed a health regulatory fit effect to understand individuals's health behaviors, and further examined the moderating role of scarcity mindset on these relationships.

Design: Using a two-wave longitudinal design, our research recruited a sample of 453 adult participants (350 Women, Age = 20.39 ± 2.30 Years) from China via an online survey platform.

Results: The results indicated that health individuals with health promotion-focus were more likely to exercise, whereas those with health prevention-focus were more inclined to prefer a healthy diet. Notably, such effect was moderated by scarcity mindset. Specifically, individuals with low promotion-focus were more susceptible to the impact of scarcity mindset, thus exhibiting less health-promoting behaviors.

Conclusion: This research suggested a health regulatory fit effect for two health behaviors. Intriguingly, our findings reveal an asymmetric impact of the scarcity mindset on this fit effect. These results hold significant implications for developing health promotion strategies to mitigate the negative impact of scarcity mindset on healthy behaviors.

Background: Experimental research has established the benefits of interrupting prolonged periods of sedentary behaviour in the evening with regular activity breaks. Research should now focus on how people can be encouraged and supported to engage in this behaviour. This study explores the barriers and facilitators unique to performing regular activity breaks in the evening mapped to the Capability Opportunity and Motivation model of Behaviour (COM-B), to inform future free-living intervention development.

Methods: Individual, face-to-face, semi-structured interviews were conducted with 28 participants (female n = 20, mean (SD) age 25.4 (5.5) years) who had participated in a laboratory-based, evening regular activity breaks intervention. Questions explored barriers and facilitators to incorporating regular activity breaks into their everyday lives at home in the evening. The interview transcripts were analyzed inductively first using thematic analysis, and then mapped, where relevant, to the COM-B model to link the themes to theoretical factors influencing behaviour change.

Results: 'Awareness of the benefits' of performing regular activity breaks, along with having the 'Memory and attention required to change behaviour' (e.g., reminders to overcome forgetfulness) influenced participant's psychological capability to perform this behaviour in the evening at home. 'Characteristics of the regular activity break exercises' enhanced physical capability as the exercises were easy and simple. The theme 'Social influences on behaviour' was mapped to social opportunity and described that others present in their home environment could support or hinder the behaviour, dependent on whether they were also taking regular activity breaks or not. 'Motivation' such as working towards a goal (facilitator) or not wanting to interrupt current sedentary behaviours (barrier) explained how reflective motivation, could influence taking regular activity breaks. Additionally, this theme explained how laziness, tiredness and reinforcement of sedentary behaviour via the nature of streaming services could hinder individuals' automatic motivation to perform regular activity breaks in their habitual evening routines.

Conclusions: Capability, opportunity and motivation were all perceived to influence individuals' ability to interrupt habitual evening sedentary behaviour by performing regular activity breaks. To encourage people to perform this behaviour, a multicomponent intervention is required to improve capability by understanding the benefits, opportunity by utilizing social support and motivation by creating goals and action planning.

Background: Previous research has shown that screen-based leisure time is related to physical and mental health, relationships, and prosocial behaviors. However, it remains unclear whether screen-based leisure time causally affects wellbeing, as previous studies have relied on cross-sectional data, focused on one type of media use (e.g., social media, video games, or internet), or assessed a narrow set of outcomes.

Method: We used three waves (2016, 2017, 2019) of national longitudinal data from the New Zealand Attitudes and Values Study to investigate the effects of screen-based leisure time on 24 parameters of wellbeing (n = 11,085). We operationalized screen-based leisure as the sum of time spent browsing the internet, using social media, watching/reading the news, watching videos, and playing video games. We followed the outcome-wide analytic design for observational data by performing a series of multivariable regression models estimating the effect of screen-based leisure time on 24 wellbeing outcomes and assessed potential unmeasured confounding using sensitivity analyses.

Results: In our primary analysis with the total sample, total screen-based leisure time was associated with a very modest decrease in body satisfaction and a very modest increase in body mass index. Possible evidence of associations was found with increases in number of hours spent exercising and volunteering each week, as well as decreases in number of average daily hours of sleep, self-control, and subjective health.

Conclusion: Screen-based leisure time has the potential to affect health and wellbeing. Results are discussed in light of the high prevalence of screen-based leisure time.

Background: Examine the role of income, perceived healthy foods availability, and consumption as mediators of rural-urban health disparities.

Method: Pre-registered simple mediation models with post hoc multi-mediator models were tested using national- and state-level survey data. Oregon data was collected in an online Qualtrics survey between October 8 and November 9, 2021 using CloudResearch; Health Information National Trends Survey (HINTS) 5, a nationally representative dataset, was collected over 4 cycles from 2017 to 2020. Oregon residents (n = 771; rural = 313, urban = 458) self-reported online: income, perceived fruits and vegetable (FV) availability, FV consumption, and BMI measures (height, weight). HINTS respondents (rural n = 1235; urban n = 13,912) self-reported the same variables of interest without FV availability, and with an additional self-rated health variable detailed below.  RESULTS: The effect of rurality on BMI (b = 0.012, SE = 0.005, p = 0.01) and self-rated health (b = 0.003, SE = 0.001, p = 0.008) when combining datasets was mediated by a series of income, perceived FV availability, and FV consumption.

Conclusion: To address rural-urban health disparities, individual (cognition, behavior), social (household income), and community (healthy food availability) factors should be targeted together.

Background: Cognitive impairment is common in haemodialysis patients and associated with adverse health outcomes. Previous work focused primarily on neuropsychological tests, the gold standard measure of cognition. However, these tests reflect performance under optimal conditions rather than performance in everyday life. This study aims to assess both objective and subjective cognition in haemodialysis patients.

Methods: Adult haemodialysis patients completed measures of objective cognitive impairment (Montreal Cognitive Assessment), subjective cognitive complaints, mood and fatigue symptoms, and provided sociodemographic information. Clinical data such as comorbidity were extracted from patients' medical record.

Results: A total of 268 haemodialysis patients (mean age = 59.87 years; 42.5% female) participated. Only 25.0% of the sample had normal cognition, while the rest had either objective cognitive impairments or clinically significant cognitive complaints, or both (both objective impairments and subjective complaints: 26.1%; objective impairments without complaint: 38.4%; significant complaints without objective impairments: 10.4%). Lower education was associated with the presence of objective cognitive impairments, whereas depression was associated with the presence of clinically significant cognitive complaints. Patients who exhibited both objective cognitive impairments and significant cognitive complaints were more likely to have diabetes and higher dialysis dose (Kt/V). Patients with objective cognitive impairments but no significant complaints were significantly older.

Conclusions: The cognitive burden of haemodialysis patients can be manifested as objective impairments and/or subjective complaints. When combined the two indicators may better represent the overall cognitive well-being in this population. There is a need to screen for cognitive difficulties and develop cognitive rehabilitative strategies in dialysis settings.