International Journal of Behavioral Medicine最新文献

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.

Background: Tension (often times called "Tenshun" in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducing tension among alcohol-consuming men living with HIV in India.

Method: This secondary data analysis paper utilized data from a randomized trial study titled "Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India." The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics, tension, and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects on tension.

Results: Out of 940 participants, 666 reported experiencing tension, including 54% reporting high tension. At site 1, the GI-CA-IC sequence resulted in a slope of -0.06, indicating that this sequence reduced tension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of -0.06, indicating that the intervention package also reduced tension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly higher tension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reduce tension.

Conclusion: This study contributes valuable insights on the issue of tension among alcohol-consuming men living with HIV. The significant reduction in tension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs for tension reduction. Further research is needed to validate these observations and broaden our understanding of effective tension management strategies among people living with HIV in diverse settings.

Trial registration: URL: clinicaltrials.gov.

Registration number: NCT03746457.

Background: A novel 'whole day' approach that could motivate the public to be more physically active is Snacktivity™. The Snacktivity™ approach encourages individuals to accumulate 150 min of physical activity in short 2-5-min 'snacks' of moderate-vigorous intensity physical activity (MVPA) throughout the day/week.

Method: A randomised controlled trial to assess the feasibility/acceptability of a Snacktivity™ intervention and trial processes was conducted. The trial aimed to recruit 80 physically inactive adults from healthcare services and via social media. Participants were randomised to the Snacktivity™ intervention or usual care and followed up at 12 weeks. The intervention was predominately delivered by health professionals within consultations. Assessment of whether the Snacktivity™ intervention and trial methods were acceptable to participants, adherence to Snacktivity™ (assessed by Fitbit) and physical activity (assessed by accelerometer), and retention were considered according to traffic light stop-go progression criteria (green-amber-red).

Results: Seventy-two participants (n = 37 Snacktivity™ intervention; n = 35 usual care) were recruited across 14 months (72/80, 90%, (green) 95% CI: 83% to 97%). Snacktivity™ adherence was achieved in 12/37 participants (32%, (red) 95% CI: 17% to 48%). Physical activity adherence was achieved in 17/37 participants (46%, (amber) 95% CI: 30% to 62%). Seven participants (10%, (green) 95% CI: 3% to 17%) withdrew from follow-up and 25/72 (35%, (amber) 95% CI: 24% to 46%) had no accelerometer data at follow-up (retention).

Conclusion: The Snacktivity™ intervention may be feasible and acceptable to implement. Findings can inform subsequent research that seeks to investigate whether Snacktivity™ based approaches are effective in promoting physical activity in the population.

Trial registration: ISRCTN: 64851242. Registration date: 31/01/21.

Background: In this paper, a meta-analytical approach was used to test the effect of exercise on the relevant indicators of fertility in young men, with a view to providing a scientifically sound exercise intervention program for male fertility.

Method: We systematically searched PubMed, MEDLINE, PsycINFO, SportDiscus, Web of Science, CNKI (China National Knowledge Infrastructure), and Wanfang Database for randomized controlled trials and quasi-experimental studies examining the relationship between exercise and male fertility, with the search conducted up to July 31, 2025. Primary outcomes were semen concentration and sperm motility; secondary outcomes included testosterone, pregnancy rate, and live birth rate. Review Manager 5.3 was used for risk of bias assessment, heterogeneity testing, subgroup/effect size analysis, and sensitivity analysis.

Results: (1) A total of 10 studies were included (n = 1511). (2) Exercise was effective in improving semen concentration (SMD=0.35, 95% CI (0.16, 0.54), P < 0.001), sperm motility (SMD = 0.79, 95% CI (0.31, 1.28), P < 0.01), testosterone (SMD = 1.21, 95% CI (0.84, 1.58), P < 0.001), pregnancy rate in young men (RR, 12.60; 95% CI (2.43, 65.35); P < 0.01), live birth rate (RR, 1.90; 95% CI (1.04, 3.46); P < 0.05), and other fertility-related indicators. (3) Three to four times/week (SMD = 0.51, 95% CI (0.12, 0.90), P < 0.05), 30-60 min per intervention (SMD=0.34, 95%(0.14, 0.54), P < 0.001), and duration of 2-8 weeks (SMD = 0.70, 95% CI (0.14, 1.26), P < 0.05), moderate-intensity (SMD = 0.36, 95% CI (0.06, 0.67), P < 0.05) exercise was more effective as an intervention for semen concentration in young men. (4) Three to four times/week (SMD = 1.01, 95% CI (0.60, 1.42), P < 0.001), with a duration of 30-60 min per intervention (SMD = 0.76, 95% CI (0.19, 1.33), P < 0.05), and lasting 9-16 weeks (SMD = 0.66, 95% CI (0.16, 1.15), P < 0.01), moderate-intensity (SMD = 0.82, 95% CI (0.16, 1.48), P < 0.05) exercise was optimal for sperm motility intervention in young men.

Conclusion: Moderate exercise can increase semen concentration, sperm motility, and testosterone levels in men, increasing pregnancy rates and the number of live births. The ideal exercise intervention program to improve men's reproductive health consists of moderate exercise for 3-4 sessions per week, lasting 30-60 min each, over a total of 2-8 weeks.

Purpose: Depression is the second most prevalent mental disease among adolescents, yet only a small percentage seek or receive treatment for the disease. Physical activity (PA) interventions hold promise as an alternative or adjunct to clinical treatment for depression. However, previous studies have been inconsistent regarding the relationship between PA and depressive symptoms in children and adolescents. The purpose of this study was to assess the effect of PA intervention on depressive symptoms in children and adolescents through a meta-analysis.

Methods: Literature from 10 electronic databases and 4 registries was systematically searched. Combined estimates (standardized mean difference, SMD) and 95% CIs were calculated using a random-effects model to assess the effect of PA on depressive symptoms in adolescents. Relevant subgroup analyses and sensitivity analyses were also performed.

Results: Results showed that PA improved depressive symptoms in children and adolescents (SMD = -0.707, 95% CI: -0.901 to -0.514). Subgroup analyses showed that PA improved adolescent depressive symptoms in different regions, different types of PA, moderate- to vigorous-intensity PA, different single-session time PA, different frequency PA, and different duration PA.

Conclusions: PA interventions could be used to reduce depressive symptoms in children and adolescents. A mixed program and vigorous-intensity PA intervention was the most effective in improving depressive symptoms in children and adolescents. The selection of a 4 to 8-week, no less than 4 times per week, single-session PA program of no more than 30 min may yield desirable results.

Background: Tobacco use among adolescents remains an important public health issue. This study investigated the association between parental migration and adolescents' tobacco use among adolescents in western China, including its mediating and moderating mechanism.

Method: This study was conducted in Qinghai Province, China, from April 1 to May 31, 2023. The participants were recruited via stratified random sampling. A total of 2811 adolescents were involved. Univariate logistic regressions were conducted to examine the associated factors of adolescents' tobacco use, including cigarette and electronic cigarette (e-cigarette) use. Pathway analysis was used to examine the moderation effect of tobacco sales exposure and mediation effect of loneliness in the relationship between parental migration and tobacco use.

Results: The study found that the proportion of adolescents who had ever used cigarette and e-cigarette in the sample were 19.5% and 12.2%, respectively. Among adolescents who were exposed to tobacco sales, parental migration was directly associated with cigarette use (standardized b = 0.18, 95%CI 0.04, 0.32) and e-cigarette use (standardized b = 0.24, 95%CI 0.09, 0.38). Meanwhile, loneliness served as a mediator in the association between parental migration and both the use of cigarette (standardized b = 0.014, 95%CI 0.01, 0.02) and e-cigarette (standardized b = 0.02, 95%CI 0.01, 0.03) among adolescents who were not exposed to tobacco sales.

Conclusion: The tobacco control strategies and surveillance should be strengthened in school neighborhood. Health education and interventions are warranted for adolescents, especially those with parental migration in underdeveloped areas in China.

Background: Clinical decision-making in oncology is influenced not only by clinical guidelines but also by psychological, emotional, and social factors, especially in end-of-life care. One such influence is Concorde syndrome, known as the sunk cost fallacy, where past investments lead physicians to continue treatment even when it is no longer medically justified. Although discussed in behavioral science, this phenomenon has not been systematically measured in oncology practice. Therefore, this study aimed to develop and validate a psychometric instrument to assess the psychosocial factors contributing to potentially irrational continuation of treatment among medical oncologists managing patients with no remaining therapeutic options.

Method: This cross-sectional psychometric study comprised both scale development and validation phases. Item generation was informed by literature review and expert consultation, followed by a two-round Delphi panel for content validation and pilot testing. The final 20-item CONCORD Scale underwent exploratory and confirmatory factor analyses, as well as assessments of internal consistency, test-retest reliability, and construct validity.

Results: Exploratory factor analysis (EFA) was conducted with a sample of 116 medical oncologists, and confirmatory factor analysis with 337 participants in Turkey. EFA revealed a four-factor structure: (1) Emotionally Driven Decision-Making, (2) Impact of Prior Clinical Experience, (3) Professional Pressure and Anxiety, and (4) Patient-Centered Decision Conflict. These factors accounted for 74.2% of the total variance, with item loadings ranging from 0.594 to 0.754. Confirmatory factor analysis confirmed good model fit (CFI = 0.937, RMSEA = 0.052, GFI = 0.834). Cronbach's alpha coefficients ranged from 0.834 to 0.948 across subscales and reached 0.969 for the overall scale. Significant inter-subscale and total score correlations further supported structural validity.

Conclusion: The CONCORD (Continuation Over Necessity: Cognitive and Overriding Reasons in Decision-making) Scale is the first validated instrument to quantify emotional, experiential, professional, and interpersonal factors that may lead oncologists to continue treatment beyond clinical necessity in end-of-life care. It offers a novel tool for both research and educational use in ethically sensitive clinical contexts.

Background: Diagnostic shifts commonly occur in young adulthood and are often associated with medication changes. Such changes can have a profound influence on how an individual experiences and perceives mental health services. Prior research on how young adults experience and make meaning of diagnostic shifts and medication changes is limited. This exploratory study seeks to describe how young adults with serious mental health conditions (SMHC) in the United States experience diagnostic adjustments of their SMHC and associated medication changes.

Method: Qualitative interviews were conducted among young adults (ages 25-30) with SMHCs in community-based settings in the Northeast region of the United States. Participatory research methods and qualitative descriptive analysis techniques were used to explore themes around SMHC diagnoses, symptoms, and treatment.

Results: Most young adults identified as women, non-Hispanic, White, self-identified as having major depression or anxiety disorders, and had received multiple diagnoses from providers. Many young adults described being given alternate or "corrected" diagnoses to replace original diagnoses. Pharmacological treatment was common, and many reported periods of "medication trial and error." Shifting diagnoses and changing medications were associated with confusion, ambivalence, and doubt. Medication changes were disruptive to young adults' ability to function in their daily lives.

Conclusion: Diagnostic and medication changes can create "secondary doubt and disruptions" in the perceptions and lives of young adults. More research is needed to understand how secondary doubts and disruptions influence young adults' long-term mental health trajectories. Findings indicate the importance of clear communication and shared decision-making between provider and patient.

Background: Front-of-Pack Nutrition Labeling (FOPNL) is a promising public health measure to promote healthier food choices in the population. The present study tested the impact of the Nutri-Score and warning labels on purchasing intentions and product perceptions in Indonesia and Türkiye, where no FOPNL system is currently in place, and Mexico, where warning labels are mandatory since October 2020.

Method: Adult participants (N = 639; n_Indonesia = 212, n_Mexico = 203, n_Türkiye = 224) were randomly assigned to viewing eight product pairs (chips, instant noodles, meats, condiments, sweet spreads, cookies, yoghurt, fruit drinks) with either no label, a Nutri-Score, or warning labels, and indicated which product (or neither) they would rather buy, and which product was healthier, contained more calories, sugar, saturated fat, and sodium.

Results: Nutri-Score influenced purchasing intentions for four categories; warning labels only for one. Overall, Nutri-Score was somewhat more effective in guiding consumers to identify healthier choices and products higher in nutrients that should be consumed in moderation compared to the warning labels, although effects varied substantially between product categories and nutrients.

Conclusion: Both Nutri-Score and warning labels potentially promote healthier food choices, with Nutri-Score producing somewhat larger and more consistent effects. More research is needed on potential negative consequences of labels and the conditions under which they might appear to maximize public health benefit.

Background: Episodic migraine carries a significant social burden beyond medical symptoms that disrupt interpersonal relationships with family, friends, and coworkers. This study aimed to explore its influence on interpersonal relationships from the perspective of patients.

Method: A sample of N = 20 participants, including 10 males and 10 females, with an age range of 27 to 32 years, was engaged in semi-structured interviews. A reflexive thematic approach within a post-positivist framework was used to explore themes derived from qualitative data.

Results: The analysis revealed a predominance of adverse impacts across the data, including work and productivity challenges (sub-themes: social and activity restrictions, impaired functioning at work, workplace stigma, and pressure) and interpersonal conflict and strain (sub-themes: reactions from friends and family, family life, and communication barriers). However, the results indicated positive impacts under the theme of growth (sub-themes: strengthened relationships and growth and adaptation). Network visualization was employed to represent these themes, with numeric codes (0 and 1) used to indicate the absence or presence of specific sub-themes in individual responses. The size of each node in the network was based on its dominance and significance in the analysis.

Conclusion: This study highlighted that episodic migraine significantly disrupts interpersonal relationships. However, it can also strengthen interpersonal bonds and foster growth in some individuals. Future research should examine how interpersonal relationships function both as a source of strain and a potential source of strength. Understanding the factors contributing to growth and adaptation may offer valuable insights for individualized migraine management strategies.