International Journal of Behavioral Medicine最新文献

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: Many adults do not meet physical activity recommendations for optimal health, and this is often because people find it difficult to maintain physical activity in the long term. This study focuses on identifying and synthesising factors that may influence the maintenance of physical activity in adults with and without known health conditions.

Method: A systematic review and qualitative synthesis using thematic analysis was conducted. Four databases (MEDLINE, SPORT Discus, APA, and Web of Science) were systematically searched for studies published from inception to February 2023 that included qualitative data about people's experiences of maintaining physical activity.

Results: A total of 9337 abstracts were screened and 68 studies from 14 countries were included. Six main themes were identified: (1) influence of others (e.g. four forms of social support, accountability); (2) contextual and environmental influences (e.g. cost and access of physical activity, weather); (3) health-related influences (e.g. reflexivity about how physical activity improves health conditions, weight control); (4) making it work (e.g. flexibility, prioritising exercise); (5) habits; and (6) psychological processes (e.g. enjoyment, identifying as a physically active person).

Conclusion: People who maintained their participation in physical activity found it enjoyable, prioritised it, and integrated it into their daily routine. Participants were motivated to continue being physically active when they realised the benefits for their health. Social support, in particular companion support, was a key component facilitating continued engagement. Findings specific to maintenance of physical activity included reflexivity of how physical activity benefited health, flexibility, and identifying as a physically active person.

Background: Due to various reasons explored in previous studies, adults with congenital heart disease (ACHD) are at risk of developing post-traumatic stress symptoms (PTSS). The aim of this study is to explore multiple potential psychosocial protective factors in ACHD and to understand their role in different complexities of congenital heart disease (CHD) and PTSS.

Method: This study was part of the "ABS-AHF" study, where 234 ACHD were recruited from November 2021 to August 2022 at a tertiary CHD care center. Data were collected on PTSS (PDS), resilience (RS-13), sense of coherence (SOC-L9), and social support (F-SozU K-14).

Results: The mean scores were 70.55 + / - 12.31 [21-91] for resilience, 35.83 + / - 4.81 [15-60] for sense of coherence (SOC), and 4.30 + / - 0.79 [0.93-5] for social support. SOC (OR, .91; p = .024 [.84; 9.98]) and social support (OR, .48; p = .001 [.29; 7.96]) were shown to reduce the likelihood of PTSS. Low resilience (OR, 2.40, p = .0248 [1.18; 5.18]) seems to increase this likelihood.

Conclusion: Integrating parents and relatives early on seems to be an important protective resource. Parental support in childhood affects the development of SOC which is in line with social support related to lower PTSS. With regard to resilience and SOC, a brief and manageable screening option for personal resources is available to refer potentially vulnerable patients to specialized psychosocial care. Care offers should address coping styles and life with CHD. Offering multidisciplinary care, integrating the patient's social network, and education for patients to increase resilience and SOC might provide a way to enhance psychosocial outcomes, quality of life, and adherence in ACHD.

Background: Cognitive complaints (e.g., health anxiety and illness disruption) are commonly experienced by patients with coronary heart disease (CHD). While it is known that sex and gender affect health, their influence on cognitive complaints remains unknown. The current study explored sex and gender differences in cognitive complaints during the first month (acute phase) and beyond, up to 2 years (recovery phase) after percutaneous coronary intervention (PCI).

Method: A total of 514 (M_age = 64.2 ± 8.9, 84.2% male) completed the cognitive scale of the Health Complaints Scale (i.e., overall cognitive complaints, health worry, illness disruption) at baseline, 1, 12, and 24 months post-PCI. Additional questionnaires to gauge gender identity, traits, and norms were administered in a follow-up study. General linear mixed model analyses were conducted to examine the influence of sex, gender, sex × gender, and covariates on cognitive complaints.

Results: Cognitive complaints only decreased in the first month post-PCI (all p < .01). There were no clear sex differences. However, gender generally predicted cognitive complaints in the first 2 years post-PCI: masculinity was related to less complaints, whereas feminine individuals reported higher absolute levels of complaints.

Conclusion: The current findings reveal that gender is a valuable factor concerning health complaints and indicate the need to further elaborate on the discrepancies between sex and gender in health research.

Background: Although rates of cigarette smoking have declined in the US, many individuals report experiencing significant barriers to quitting smoking, including poor mental health. Two prominent affective vulnerability factors that independently underlie both smoking behavior and processes and mental health include distress tolerance and anxiety sensitivity. However, limited work has examined the concurrent role of these factors on motivational reasons for smoking.

Method: The current study is a secondary analysis of baseline data from a nationally recruited sample of individuals (N = 156; M_age = 29.74, SD = 7.72; 69.2% female) interested in participating in a digitally delivered intervention for comorbid smoking and low distress tolerance. Two-step hierarchical linear regression was used to examine the unique role of self-reported distress tolerance and anxiety sensitivity in relation to reasons for smoking (i.e., habitual, negative affect reduction, addictive, pleasurable/relaxation, stimulation, and sensorimotor manipulation).

Results: Results indicated that lower levels of distress tolerance and greater levels of anxiety sensitivity were associated with greater sensorimotor manipulation reasons for smoking. Only distress tolerance was related to addictive, negative affect reduction, and stimulation reasons for smoking, whereas only anxiety sensitivity was related to habitual reasons for smoking.

Conclusion: The current findings suggest that there is an explanatory utility for unique and multi-risk effects for distress tolerance and anxiety sensitivity for understanding smoking motives.

Background: Type 2 diabetes (T2D) and depression co-occur, and rates are on the rise in adolescents, disproportionately affecting teenagers in rural communities and those who identify as members of historically disadvantaged racial/ethnic groups. Addressing the promotion of health behaviors is important for prevention of these comorbid health concerns; however, disparities in their prevalence highlight that a healthy lifestyle is not equally accessible for all individuals. Thus, holistic and multi-level approaches that address structural inequities, leverage cultural and family assets, and are effectively integrated into the community are critically needed. This project is an initial phase of a broader community-academic collaboration that aims to address preventable chronic diseases and mental health in adolescents living in the rural Mountain West by tailoring an evidence-based health behavior and lifestyle intervention for these communities.

Method: Interviewers conducted semi-structured interviews with N = 19 individuals (n = 11 adolescents, 11-17 years, n = 8 mothers) who lived in neighboring counties in the rural Mountain Western USA and had a family history of T2D. Interview schedules were developed by an interdisciplinary team, with community input, and covered topics such as food and staying active, stress, T2D risk, and community and culture. Using thematic analysis, data were reduced through coding, categorization, and development of themes.

Results: Data revealed three major themes: "Families Face Systemic Barriers to Health," "Family Routines Support Health," and "Connection is Crucial to Holistic Health."

Conclusion: Findings reveal opportunities for addressing health inequities and developing effective, integrated T2D and depression prevention strategies within this specific community. They also potentially contain insights that may be applicable to others interested in adapting interventions for diverse groups.

Background: Many young adults report sleep problems, including insufficient sleep and poor sleep quality. Young adults are heavily reliant on electronic devices, even using them during bedtime with adverse effects on sleep. Given the importance of adequate sleep, the present study examined the daily association between using electronic devices during bedtime and sleep in a diverse sample of young adults with poor sleep.

Method: We analyzed data from a pilot randomized controlled trial in which young adults with poor sleep [n = 46; 84% female; mean age 19.3 (SD = 2.9); 30% Asian, 19% Black/African American, 9% multiracial; 34% Hispanic/Latino] wore an electronic sleep tracking device (Fitbit Charge 3) and completed daily sleep diaries including questions about sleep and bedtime routine for 4 weeks following a behavioral sleep intervention. The effect of bedtime device use on sleep latency-time needed to fall asleep-and sleep duration was estimated by generalized linear mixed models (GLMM), adjusting for weeknights/weekend nights.

Results: Bedtime device use on a given night was significantly associated with shorter self-reported sleep duration (b =  - 19.80, p = .011), but not with sleep latency. Concordance between the self-reported and Fitbit-measured sleep variables was low, and bedtime device use was not associated and Fitbit-measured sleep variables.

Conclusion: Using electronic devices before bed negatively affected self-reported sleep duration the following night. This finding highlights the importance of minimizing nightly device use among young adults with poor sleep and suggests that the inconsistency between self-reported sleep and device use warrants further investigation.

Background: Although people with HIV have a markedly higher risk of anal squamous cell carcinoma (ASCC), there are few evaluations of anal Pap screening determinants within safety-net HIV clinics.

Method: We conducted an evaluation of anal Pap screening correlates within a safety-net HIV clinic in Miami. Medical records were reviewed for 298 people ages 45 and older receiving HIV primary care. Demographic information and the prevalence of anal Pap screening over 1 year (i.e., 2018-2019) were extracted.

Results: Between 2018 and 2019, approximately half (46%) of patients completed anal Pap screening although this varied by sex assigned at birth. More than three-fourths of females (77%) compared to one-fourth (23%) of males were screened between 2018 and 2019 (p < 0.0001).

Conclusion: Findings underscore the need for multi-level intervention approaches to optimize anal Pap screening among males with HIV within the Miami-based safety-net clinic.

Background: US adults find it challenging to meet disease prevention dietary recommendations and may participate in interventions to improve dietary quality. Social influences outside of the intervention, including level of social support and undermining of healthy eating in the home, may affect an individual's dietary intake. This secondary analysis examined (1) changes in household social support and undermining of healthy eating across a dietary intervention with household member participation and (2) the relationship between changes in social influences and dietary intake.

Method: Adults (N = 62) with low adherence to cancer prevention dietary recommendations recruited from the Philadelphia area participated in a 20-week dietary intervention focused on psychoeducation about NCI dietary recommendations and skills for behavior change. Half of the participants were also randomized to have an adult household member participate in some intervention contacts with them. Participants completed measures of social support and undermining of healthy eating and dietary intake at baseline and post-treatment (20 weeks).

Results: Fifty-two participants had available data for baseline and post-treatment (i.e., completers). Household social support of healthy eating increased more among participants randomized to have household involvement in the intervention with a medium effect (η² = .11). Fruit and vegetable intake significantly increased among participants with meaningful increases in household social support with a large effect (η² = .37). There were no significant interaction effects of change in household undermining and time on change in dietary intake.

Conclusion: Dietary interventions with a household support component show promise for improving household social support and may impact magnitude of dietary change.

Background: Why do some adults with chronic pain misuse their prescription opioids when others do not? Based on the extended Common-Sense Model, the study evaluated whether adults' beliefs about their pain have an indirect effect on risk of opioid misuse through beliefs about opioids when controlling for depression.

Methods: The sample included 297 adult participants in the U.S. recruited from Prolific, an online crowdsourcing website. Study measures included the Illness Perception Questionnaire-Revised (IPQ-R; protective and threat-related illness beliefs about chronic pain), the Beliefs about Medicines Questionnaire-Specific subscale (BMQ-Specific; concern and necessity medication beliefs about prescription opioids), and the Current Opioid Misuse Measure (COMM; risk of current opioid misuse). This cross-sectional parallel mediation analysis was conducted using MPlus.

Results: After controlling for depression, the indirect effect of protective illness beliefs on opioid misuse risk through concern medication beliefs (b = -0.01, 95% CI (-0. 038, -0.001), and the indirect effect of threat-related illness beliefs on opioid misuse risk through necessity medication beliefs (b = 0.02, 95% CI (0.004, 0.036) were significant. The full model explained 35% of the variance of opioid misuse risk.

Conclusions: Adults with chronic pain with stronger protective beliefs about pain were less likely to have concerns about their opioids and were at lower risk for opioid misuse, while those with greater threat-related beliefs about pain were more likely to believe that their opioids were necessary and be at greater risk for opioid misuse. Results have implications for medical and mental health providers and future research.