International Journal of Behavioral Medicine最新文献

Background

Since obesity has emerged as a major public health concern, there is an urgent need to better understand factors related to weight gain and treatment success.

Methods

This study included 118 persons with obesity who participated in a multidisciplinary combined lifestyle intervention with cognitive-behavioral therapy at the outpatient clinic of the Obesity Center CGG at Erasmus University Medical Center, Rotterdam, The Netherlands. Neighborhood characteristics were assessed using a 13-item questionnaire. Multiple regression analyses were performed to examine the association between perceived safety, social cohesion, and the availability of facilities on relative changes in body mass index and waist circumference changes, adjusted for corresponding neighborhood socioeconomic status scores.

Results

Higher total scores, indicating more unfavorable neighborhood perceptions, were associated with less relative improvements in BMI and waist circumference after 1.5 years (β = 3.2, 95%CI 0.3–6.0; β = 3.4, 95%CI 0.3–6.6, respectively). Also, more neighborhood unsafety was associated with less relative improvements in BMI and waist circumference on the long term (β = 3.1, 95%CI 1.1–5.1; β = 2.8, 95%CI 0.6–5.1, respectively).

Conclusion

The results indicate that living in a neighborhood perceived as less favorable may lower the chances of successful weight loss in response to combined lifestyle interventions in persons with obesity.

Purpose: To test the effectiveness and feasibility of a remotely delivered intervention to increase physical activity (walking) in middle-aged and older adults.

Design: This study used a personalized (N-of-1) trial design.

Setting: This study took place at a major healthcare system from November 2021 to February 2022.

Subjects: Sixty adults (45-75 years, 92% female, 80% white) were recruited.

Intervention: A 10-week study comprising a 2-week baseline, followed by four 2-week periods where four behavior change techniques (BCTs) - self-monitoring, goal setting, action planning, and feedback - were delivered one at a time in random order.

Measures: Activity was measured by a Fitbit, and intervention components delivered by email/text. Average daily steps were compared between baseline and intervention. Participants completed satisfaction items derived from the System Usability Scale and reported attitudes and opinions about personalized trials.

Results: Participants rated personalized trial components as feasible and acceptable. Changes in steps between baseline and intervention were not significant, but a large heterogeneity of treatment effects existed, suggesting some participants significantly increased walking while others significantly decreased.

Conclusions: Our intervention was well-accepted but use of BCTs delivered individually did not result in a significant increase in steps. Feasibility and heterogeneity of treatment effects support adopting a personalized trial approach to optimize intervention results.

Background: Encouraging adolescents with overweight/obesity to accurately perceive their weight in the belief that this will improve their lifestyle behaviors (physical activity (PA), sedentary behavior (SB), eating behavior (EB)) may be detrimental to their psychological health. This study aimed to investigate associations between weight underestimation and lifestyle behaviors along with psychological health in French adolescents with overweight or obesity.

Method: Baseline data from adolescents who participated in a school-based trial were used. Lifestyle behaviors and psychological health (anxiety, depression, eating disorders, quality of life (QoL)) were self-reported. Weight underestimation was measured by matching objective and perceived weight status. Multilevel models were computed to investigate associations between weight underestimation and lifestyle behaviors and psychological health, by gender.

Results: Of the 1245 adolescents included (15.3 ± 0.7 years), 15.8% underestimated their objective weight (boys 24.2%; girls 8.2%). Boys with underestimation had higher vigorous PA energy expenditure (β = 372.7 MET-min/week, 95%CI [25.1;720.4]), and lower daily sugar-sweetened beverages and foods consumption (β =  - 0.3 points, 95%CI [- 0.7; - 0.0]) than those with accurate perception. Girls with weight underestimation had lower eating disorder (β =  - 6.0 points, 95%CI [- 9.6; - 2.5]), anxiety (β =  - 7.8 points, 95%CI [- 13.8; - 1.9]), and higher QoL (β = 3.3 points, 95%CI [0.0; 6.5]) scores than girls with accurate perception.

Conclusion: Weight underestimation among adolescents with overweight or obesity was associated with healthier lifestyle behaviors in boys, and better psychological health (eating disorder, anxiety and QoL) in girls. Accurate perception of weight status may not be a relevant lever to improve lifestyle behaviors and psychological health.

Objective: Inflammatory bowel diseases (IBD) are accompanied by symptoms that can vastly affect patients' representations of their bodies. The aim of this study was to investigate alterations in body evaluation and body ownership in IBD and their link to interoceptive sensibility, gastrointestinal-specific anxiety, and history of childhood maltreatment.

Methods: Body evaluation and ownership was assessed in 41 clinically remitted patients with IBD and 44 healthy controls (HC) using a topographical self-report method. Interoceptive sensibility, gastrointestinal-specific anxiety and a history of childhood maltreatment were assessed via self-report questionnaires.

Results: Patients reporting higher interoceptive sensibility perceived their bodies in a more positive manner. Higher gastrointestinal-specific anxiety was linked to a more negative body evaluation particularly of the abdomen in patients with IBD. Childhood maltreatment severity strengthened the positive association between interoceptive sensibility and body ownership only in those patients reporting higher trauma load.

Conclusion: Altered body representations of areas associated with abdominal pain are linked to higher symptom-specific anxiety and lower levels of interoceptive sensibility in IBD. Particularly in patients with a history of childhood maltreatment, higher levels of interoceptive sensibility might have a beneficial effect on the patients' sense of body ownership.

Background: Perceived weight discrimination is associated consistently with worse health outcomes. Coping strategies may be one mechanism of this association. The present research examined the association between perceived weight discrimination and strategies used to cope with general stress (not weight-specific) and whether these strategies accounted for part of the association with markers of health.

Method: Participants (N = 1882) completed a cross-sectional survey with a comprehensive measure of coping strategies and reported on their perceived experience of weight discrimination and markers of physical, mental, and social health.

Results: Perceived weight discrimination was associated with greater use of disengaged coping strategies (β = .19, p < .01) and was unrelated to active and support coping strategies. Disengaged coping mediated the association between weight discrimination and worse physical, mental, and social health (proportion of mediation ranged from 14 to 47%). This pathway was independent of body mass index (BMI). Individuals in the obesity weight category (BMI ≥ 30 kg/m²) were less likely to use active (β =  - .11, p < .01) and support (β =  - .09, p < .01) coping strategies, which did not consistently mediate the association with health.

Conclusion: Perceived experiences of weight discrimination are associated with disengaged coping strategies to manage stressful experiences, and these strategies are one mechanism that may contribute to the worse health associated with unfair treatment due to weight.

Background: Social media is one of the major platforms for disseminating essential health messages. The present study examined the effect of message framing (self-interest motive, prosocial motive) on an online platform for parental intention to vaccinate against COVID-19. It also examined how the effect may vary across participants' levels of parental identity centrality/salience and community orientation before the vaccine was officially available.

Methods: Six hundred and sixty-three Hong Kong Chinese parents were recruited, and a total of 278 valid responses were retained in the analyses. Participants were randomly assigned to one of the three conditions: self-interest motive, prosocial motive, and control. Participants in the self-interest motive condition and the prosocial motive condition read a condition-specific message about the COVID-19 vaccine. Then, they reported their levels of intention to vaccinate against COVID-19, including parent-vaccination, child-vaccination, and medical information-seeking.

Results: A significant group effect on child-vaccination was found. Participants in the self-interest motive condition reported a higher intention to vaccinate their children against COVID-19 compared with the other two conditions. Results of moderation analyses indicated that communal orientation moderated the effect of a self-interest-motive-emphasized message on parental intention to vaccinate against COVID-19. The effect of a self-interest-motive-emphasized message appeared to be stronger on parent-vaccination, child-vaccination, and medical information-seeking among parents who reported lower levels of communal orientation.

Conclusion: These findings provided some initial evidence of the effectiveness of message-framing in promoting parents' intention to vaccinate their children on online platforms.

Background: Attentional bias may influence the emotional experiences of breast cancer patients, both positively and negatively. This study aimed to investigate attentional bias in breast cancer patients and its impact on their emotions.

Method: Thirty-eight breast cancer patients completed a modified dot-probe task and the Depression Anxiety and Stress Scale to assess attentional bias and emotional states. Attentional bias was measured by analyzing response times to different stimuli in the modified dot-probe task. Emotional stimuli included 80 pairs of facial images depicting sad-neutral, fearful-neutral, happy-neutral, and neutral-neutral expressions. Attentional bias components were observed at stimulus presentation durations of 300 ms and 1500 ms. Differences in emotional responses among breast cancer patients with varying attentional biases were compared.

Results: Breast cancer patients exhibited attentional avoidance of sad and happy stimuli at 300 ms. Further analysis revealed that patients who exhibited attentional avoidance of sad stimuli at 300 ms reported higher levels of anxiety and stress. Those with attentional avoidance of fearful stimuli at 1500 ms reported increased anxiety, while individuals showing attentional avoidance of happy stimuli or difficulty disengaging from happy stimuli at 1500 ms reported higher levels of depression and stress.

Conclusion: Breast cancer patients demonstrated an attentional bias toward emotional stimuli, particularly avoidance of sad and happy stimuli in 300 ms. Different components of attentional bias were associated with distinct negative emotional outcomes.

Background: Several studies have reported on the benefits of social support for health behaviour, including risky sex. Social support may thus be an important resource for promoting individual health and well-being, particularly in regions where HIV rates are high and healthcare resources are scarce. However, prior research on the implications of social support for the health behaviour of young women has yielded mixed and inconclusive findings. Using prospective data from young women in South Africa, this study examines the associations of social support with subsequent sexual practices, health behaviour, and health outcomes.

Method: We used two rounds of longitudinal data from a sample of n = 1446 HIV-negative emerging adult women, aged 18 to 29 years, who participated in a population-based HIV study in KwaZulu-Natal, South Africa. Applying the analytic template for outcome-wide longitudinal designs, we estimated the associations between combinations of social support (i.e. tangible, educational, emotional) and ten HIV risk-related outcomes.

Results: Combinations of tangible, educational, and emotional support, as well as tangible support by itself, were associated with lower risk for several outcomes, whereas educational and emotional support, by themselves or together, showed little evidence of association with the outcomes.

Conclusion: This study highlights the protective role of tangible support in an environment of widespread poverty, and the additional effect of combining tangible support with non-tangible support. The findings strengthen recent evidence on the benefits of combining support in the form of cash and food with psychosocial care in mitigating risk behaviours associated with HIV and negative health outcomes among young women.

Background: The study of the COVID-19 disease consequences on healthcare professionals' mental health has drawn a great interest in psychology and other behavioral sciences. Previous studies mainly focused on professionals' health in terms of psychopathology, therefore, there is no research examining their positive mental health during both the first and the second wave. Also, there is no research studying healthcare professionals' social recognition during the pandemic and the influence of this variable on professionals' positive health.

Methods: Following the WHO's recommendations, our objective was to measure pathology (i.e., anxiety and traumatic intensity), positive health (i.e., Hedonic, Psychological and Social Well-being) and social recognition in a sample of 200 healthcare professionals in the frontline care of Covid-19 patients.

Results: In both waves, participants showed high levels of anxiety and traumatic intensity, although, as expected, in the second (vs. the first) wave psychopathological symptoms decreased. Concerning positive health indicators, in the second wave, health professionals showed more hedonic and psychological well-being than in the first one. However, in the second wave social well-being was lower than in the first wave, an expected though apparently paradoxical result, linked to the decrease in healthcare professionals' social recognition between the first and the second wave. In fact, bootstrapping procedures and Sobel Test confirm the mediating role of social recognition on the effect of Covid-19 wave on social well-being.

Conclusions: Public institutions, governments, and society in general, should recognize health professionals' work, given that social recognition is a fundamental protection factor for social well-being.

Background: This study aimed to examine the relationship between family history of diabetes, irrational beliefs, and health anxiety in the development of type 2 diabetes mellitus (T2DM).

Method: ATTICA is a prospective, cohort study (2002-2012). The working sample included 845 participants (18-89 years), free of diabetes at baseline. Α detailed biochemical, clinical, and lifestyle evaluation was performed, while participants' irrational beliefs and health anxiety were assessed through the Irrational Beliefs Inventory and the Whiteley index scale, respectively. We evaluated the association between the participants' family history of diabetes mellitus with the 10-year risk of diabetes mellitus, both in the total study's sample and separately according to their levels of health anxiety and irrational beliefs.

Results: The crude 10-year risk of T2DM was 12.9% (95%CI: 10.4, 15.4), with 191 cases of T2DM. Family history of diabetes was associated with 2.5 times higher odds (2.53, 95%CI 1.71, 3.75) of T2DM compared to those without family history. Among participants with family history of diabetes, the highest likelihood of developing T2DM, regarding their tested psychological features (i.e., low/high irrational beliefs in the entire group, low/high health anxiety in the entire group, and low/high irrational beliefs, low/high healthy anxiety), had people with high irrational beliefs, low health anxiety (OR 3.70, 95%CI 1.83, 7.48).

Conclusions: The findings underline the important moderating role of irrational beliefs and health anxiety in the prevention of T2DM, among participants at increased risk of T2DM.