International Journal of Behavioral Medicine最新文献

Background: Addressing the effects of non-compliance with health-related recommendations in pandemics is needed for informed decision-making. This longitudinal study investigated the effects of non-compliance on mental health and academic self-efficacy among university students in Sweden.

Methods: Baseline assessments were conducted in May 2020, with follow-ups after 5 and 10 months. Students (n = 3123) from 19 universities completed online questionnaires covering compliance, mental health, and academic self-efficacy. Effects of non-compliance were estimated using causal inference and multilevel multinomial regression.

Results: Non-compliant students constituted a minority, but their proportion increased over time. Regarding mental health and academic self-efficacy, few differences were observed between compliant and non-compliant students. When differences were identified, non-compliant students experienced fewer negative effects on mental health and academic self-efficacy than compliant students.

Conclusion: The findings may suggest that non-compliance may have involved a trade-off between increased individual freedom and mitigating negative outcomes. Addressing the research gap on non-compliance effects is crucial for informed decision-making and promoting the common good. This may guide strategies balancing individual autonomy and collective well-being during future pandemics.

Pre-registration: Center for Open Science (OSF), https://accounts.osf.io/login?service=https://osf.io/37dhm/ .

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.

Background: This scoping review aims to map the quantitative literature investigating vaccine-related individual and contextual determinants of COVID-19 vaccination uptake, identify and define constructs assessed, and describe the characteristics of self-report measures.

Methods: A systematic search of electronic databases was conducted to capture peer-reviewed journal articles published between December 31, 2019, and December 25, 2021. Studies conducted in English and collecting data from general population samples using self-report measures of vaccine-related determinants of COVID-19 vaccination behavior were eligible. Data were analyzed using a descriptive statistics and content analysis, and constructs were mapped onto the COM-B model. The review pre-registration is available on the Open Science Framework ( https://osf.io/82fsz ).

Results: This review identified 157 studies (6153 abstracts and 997 full texts screened) and 425 vaccine-related constructs were retrieved from included studies. Of these, 4% were mapped to capability factors, 85% to motivation, and 11% to opportunity. The most frequently assessed constructs were positive attitudes (19% of constructs), negative attitudes (16%), intention (10%), and beliefs (8%). Only 11% of studies used or adapted pre-existing measures in their surveys. Psychometric properties of self-report measures used were not reported in the majority of studies (60%).

Conclusions: Findings suggest a predominant focus on perceived individual-level predictors of COVID-19 vaccination with inconsistent measurement, potentially compromising research validity. This research highlights opportunities to explore social/environmental factors, establish unified definitions, and employ validated self-report measures for robust survey-based studies on COVID-19 vaccination determinants.

Background: Previous studies have investigated the encouragement of healthy behaviors through both conscious manipulation and unconscious priming. However, direct comparisons between these two approaches are limited, resulting in interventions that may lack precision. This study aimed to evaluate the effects of conscious and unconscious priming on the intention to engage in physical activity, with the goal of identifying and applying the most effective method as a targeted intervention to bridge the gap between intention and actual physical activity.

Method: In study 1, 116 participants were screened in a 2 × 2 (conscious vs. unconscious) × (prime vs. control) online experiment to examine the influence of implementation intention manipulation and goal priming on physical activity. Building on these results, study 2 employed a randomized controlled trial with 127 participants to assess the effects of conscious mental simulation interventions on physical activity behavior.

Results: Study 1 showed that both conscious manipulation (p = .046) and unconscious priming (p = .004) significantly increased the choice of sports activities, with conscious manipulation being more effective. Study 2 found significant impacts of mixed simulation on activity levels immediately and one-week post-intervention (p = .001), with day-after intervention effects notable in the simulation group.

Conclusions: This study explored the causal relationship between priming process physical activity, and found out the promotion effect of conscious mental simulation intervention on physical activity.

Background: Gulf War Illness (GWI) is a chronic multi-symptom illness that affects up to one-third of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991. We conducted a randomized controlled trial to examine feasibility and the relative efficacy of two 12-week in-person group treatments (Tai Chi and Wellness) to address GWI symptoms of chronic pain, fatigue, and changes in mood and cognitive functioning.

Method: Male and female veterans were randomly assigned to Tai Chi (n = 27) or Wellness (n = 26) group interventions and assessed at four time points: baseline, post-treatment, 3-, and 9-month follow-up. Multilevel models with a treatment-by-time interaction term were utilized to evaluate treatment effects and changes in GWI-related outcomes over time.

Results: Satisfaction was high, there were no adverse events, and over half the participants attended 75% or more sessions with no significant differences between groups. For pain interference, analyses revealed a significant quadratic effect of time with no differences between treatment groups. For general fatigue and a cognitive test of trail making, no significant effects were detected. For depressed mood, linear and quadratic time effects and the group x linear time interaction were significant indicating greater reductions for Tai Chi participants. For a verbal learning test, linear and quadratic time and the group x quadratic time interaction significantly predicted total recall with Tai Chi participants demonstrating more rapid initial improvements.

Conclusion: Findings indicate that both Tai Chi and Wellness are feasible and acceptable. Both interventions may have a salutary impact on pain interference, depression, and verbal learning with some advantages for Tai Chi.

Background: How does living with a chronic disease of the lymphatic system affect quality of life and mortality? Lymphedema is a chronic disease mostly affecting women and research is sparse. To this date, longitudinal studies evaluating biopsychosocial predictors for mortality and quality of life in lymphedema are largely missing. This study aims to identify possible predictors and could open innovative ways for treatment options.

Method: Two hundred ninety-two patients with lymphedema partaking in a rehabilitation program in a lymphedema clinic were longitudinally assessed. The sample consisted of 86.2% women, aged between 18 and 83 years (M = 53.42, SD = 12.54), with a mean BMI (kg/m²) of 31.64 (SD = 8.26). Beginning with baseline assessment in 2002-2006, follow-up was evaluated 15-19 years later (N = 91). We assessed a variety of potential biopsychosocial predictors of mortality and quality of life (i.e., depression, anxiety, cancer). At follow-up, 19.5% of participants were deceased.

Results: Age, gender, and cancer significantly predicted mortality (R² = .27) and quality of life (R² = .29). Anxiety and depression significantly predicted both quality of life and mortality when entered simultaneously. However, further analyses indicated suppressor effects and when entered separately, effects solely for depression or anxiety did not reach significance level.

Conclusion: Age, gender, and cancer were the main predictors of mortality and quality of life in patients with lymphedema. Psychological predictors of mortality and quality of life were mainly due to suppressor effects, thus calling for caution when analyzing the contribution of mental health indicators for clinical outcomes.

Trial registration: This study was preregistered with the German Clinical Trials Register (Identifier DRKS00024450) and Open Science Framework ( https://doi.org/10.17605/OSF.IO/RHXQJ ).

Background: In the context of cancer research, identifying social isolation and loneliness is a priority given how both exacerbate poor outcomes and lead to increased mortality in oncological populations. The purpose of this systematic review is to identify all quantitative instruments that have been used to assess either social isolation or loneliness in patients previously or currently diagnosed with cancer in the pre-COVID-19 period.

Method: PubMed (Web), Scopus, CINAHL, and PsycINFO were searched on August 22, 2019. All databases were searched from inception with no filters applied. The search strategies included terms that captured the following concepts: instruments/tools, social isolation or loneliness, and cancer.

Results: A total of 289 titles/abstracts were returned. Upon review, 114 titles/abstracts were deemed to be potentially eligible and the full text was retrieved. Of the 114 full texts, 69 articles met inclusion criteria and comprised the final sample. Publications span years 1980 through 2019, with the majority (71%) occurring in the last decade prior to this review, between 2009 and 2019. Average age of the study samples, with few exceptions, was often over 50 years old. Many studies used all-female samples, while only one study used an all-male sample. The most common cancer diagnosis of participants was breast cancer. The most common measure was the UCLA Loneliness Scale, used in 22 studies. Most measures we identified were used only once, and 11 measures were used 2-3 times. When the information was given, response ranges were always Likert-type scales most often ranging from 1-4 or 1-5, and sometimes from 1-10 possible response options. In terms of psychometrics, test-retest reliability and validity were rarely reported; by contrast, internal consistency (Cronbach's alpha) was reported more than half of the time (60.9%).

Conclusion: When selecting a measure to assess loneliness in cancer populations, the UCLA Loneliness Scale is both psychometrically strong and versatile across patients with different cancers, ages, and racial backgrounds. When selecting a measure to assess social isolation in cancer populations, both the PROMIS-SF V 2.0 social isolation and the Berkman-Syme Network Index are brief and have been used in patients with non-White racial backgrounds.

Background: Improving quality of life (QOL) in advanced and metastatic cancer is a priority with increasing survivorship. This systematic review synthesizes psychosocial and behavioral interventions incorporating culture with the goal of examining their benefit for understudied and medically underserved populations with advanced and metastatic cancer.

Method: Reports were systematically screened for (1) a focus on advanced and metastatic cancer survivors, (2) psychosocial or behavioral intervention intended to improve QOL, (3) evidence of incorporating the culture(s) of understudied/underserved populations, and (4) availability in English. Bias was evaluated using the JBI Critical Appraisal Checklist and the Methodological index for non-randomized studies. Qualitative synthesis and quantitative meta-analyses were completed.

Results: Eighty-six reports containing 5981 participants' data were examined. Qualitative synthesis of 23 studies identified four overarching themes relevant for incorporating culture in interventions. Meta-analysis of 19 RCTs and 4 quasi-experimental studies containing considerable heterogeneity indicated greater improvements in QOL (g = 0.84), eudaimonic well-being (g = 0.53), distress (g = -0.49), and anxiety (g = -0.37) for main intervention conditions compared to controls. Meta-analysis of 10 single-arm trials containing minimal to moderate heterogeneity found benefit for anxiety (g = -0.54), physical symptoms (g = -0.39), and depression (g = -0.38).

Conclusion: Psychosocial and behavioral interventions with cultural incorporation appear beneficial for improving QOL-related outcomes in advanced and metastatic cancer. Studies incorporating culture in psychosocial or behavioral interventions offer noteworthy insight and suggestions for future efforts such as attending to deep cultural structure.

Background: Technological advancements and ease of Internet access have increased the number of digital behavior change interventions (DBCIs). This systematic review and meta-analysis aimed to assess the effectiveness of DBCIs in reducing sedentary behavior (SB) and promoting physical activity (PA) in adults with diabetes.

Methods: A comprehensive search of seven databases-PubMed, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, and Sedentary Behavior Research Database-was performed. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence evaluation. Meta-analyses were performed where feasible; otherwise, narrative summaries were performed.

Results: A total of 13 randomized controlled trials with 980 participants met the inclusion criteria. Overall, DBCIs could significantly increase steps and the number of breaks in sedentary time. The subgroup analyses exhibited significant effects in DBCIs with over 10 behavior change techniques (BCTs) in improving steps, the time spent in light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). The subgroup analyses showed a significant step increment in DBCIs of moderate and long durations, with over 4 BCT clusters, or in conjunction with a face-to-face component. The subgroup analyses also indicated significant effects in studies with ≥ 2 DBCI components in improving steps, the time spent in LPA and MVPA, and reducing sedentary time.

Conclusion: There is some evidence that DBCI may increase PA and reduce SB in adults with type 2 diabetes. However, more high-quality studies are required. Future studies are needed to examine the potential of DBCIs in adults with type 1 diabetes.