International Journal of Behavioral Medicine最新文献

Background: Efficacious programs to sustain smoking cessation are limited for postpartum women, particularly for those who are low-income. Social support may help enhance cessation efforts. However, the specific types of support potentially associated with cessation success are not well evaluated. The purpose of this study was to assess the relationship between different types of social support and smoking relapse among low-income women in the postpartum phase.

Method: A secondary data analysis was completed using data from a single-arm pilot study assessing a smoking cessation intervention for low-income postpartum women. Women were recruited from Philadelphia Women, Infants, and Children clinics (N = 106) and completed a baseline and 1-month follow-up survey. Multivariable logistic regression analyses assessed the relationship between types of social support and smoking relapse, specifically cessation-specific support (Ways of Quitting social support subscale) as well as general (non-smoking focused) social support and its subdomains (i.e., emotional/informational, tangible, affectionate, social positive support (Medical Outcomes Study Social Support Survey)).

Results: Participants were predominantly non-Hispanic Black (64%), 33% lived with their significant other, and 71% had a household income below $15,000. Most participants had relapsed by the 1-month postpartum assessment (77%). In the final regression models, cessation-specific support was significantly associated with staying smoke free at 1 month postpartum. However, neither general social support nor its subdomains were associated with staying smoke free.

Conclusion: Cessation-specific support may bolster women's cessation attempts during the stressful postpartum period. Smoking cessation interventions should consider integrating cessation-specific support to decrease relapse rates among low-income postpartum women.

Background: Randomized behavioral clinical trials are the gold standard for evaluating efficacy of a behavioral treatment. However, because participants are generally unblinded to treatment, preference for a specific treatment option can lead to biased results and/or reduced treatment efficacy. The purpose was to describe the relative frequency and correlates of existence of a preference and patient preference for either an in-person group-based or a remote self-directed, lifestyle treatment prior to randomization to one of these treatments.

Methods: The Enhanced Lifestyles for Metabolic Syndrome (ELM) trial is a multi-site behavioral clinical trial that compares efficacy of a group-based vs. a self-directed approach to lifestyle change on 2-year remission of the metabolic syndrome. Prior to randomization, participants were asked whether they had a preference for a particular treatment and, if so, which approach they preferred. Baseline data were used for a series of logistic regression models to determine behavioral correlates of treatment preference, independent of socioeconomic factors.

Results: Of the 331 participants, 131 (39.6%) had no preference for either treatment. Among the 200 with a preference, 56 (28.0%) preferred the self-directed program. Strength of a pre-existing habit of eating vegetables on most days was an independent correlate of no preference (adjusted OR, 1.27; 95% CI, 1.01-1.61; p = 0.03) and preference for a self-directed program (adjusted OR, 1.55; 95% CI, 1.09-2.22; p = 0.01).

Conclusion: A pre-existing habit of eating vegetables was associated with no preference and preference for a less intensive lifestyle treatment. Post-treatment follow-up of the trial results will determine if concordance between preference and treatment assignment influences outcomes.

Background: Vaccination against HPV is an effective strategy for the prevention of HPV infection and cervical cancer. Nevertheless, the HPV vaccine uptake rate is low among ethnic minorities in Hong Kong. This study sought to assess the feasibility and acceptability of motivational interviewing among South Asian mother-daughter dyads and to preliminarily examine its effects on knowledge of HPV infection and vaccination, health beliefs, intention to have the daughters vaccinated, and initiation and completion of HPV vaccine series.

Methods: This was a pilot randomised controlled trial. Forty South Asian mothers with at least one daughter aged 9 to 17 years were recruited. The intervention group received a motivational interviewing intervention whereas the control group received usual care. Structured questionnaires were used to collect data on the participants' characteristics and selected outcome variables. Bias-corrected Hedges' g and rate difference together with their 95% confidence intervals were calculated to estimate the effect sizes of the intervention on the outcomes The acceptability was assessed via semi-structured interviews.

Results: A larger proportion of the daughters of the intervention group participants had received the first dose of HPV vaccine (95% [19 out of 20]) vs 0% [0 out of 20]). The intervention group showed greater improvement in knowledge at 3 months after the intervention (Hedges' g = 0.77 (95%CI:0.13-1.41)). Most interviewees were satisfied with the intervention.

Conclusion: The intervention was feasible and acceptable. The intervention can help to increase South Asian mothers' knowledge and to increase the initiation of HPV vaccine series by their daughters.

Trial registration: This study was registered at the Chinese Clinical Trial Registry (ChiCTR2100052751) on 5 November 2021.

Background: We investigate factors affecting HIV knowledge, stigma, and violence among female sex workers (FSW) in Agadir, Rabat, Fes, and Tangier, Morocco, over three rounds of HIV surveillance surveys (2012, 2016, and 2019) conducted using respondent-driven sampling (RDS). Multivariable analyses from RDS studies examining the relationships between variables are under-utilized, particularly analyses that combine multiple locations and years of data together in a principled manner.

Method: We fit three weighted logistic regression models for HIV transmission knowledge, having been denied service (experienced stigma), and having been hit (experienced violence) in the last 12 months, and perform model selection using 41 possible explanatory variables.

Results: Variables significantly associated with higher risk included reasons for sex work, how FSW solicit clients, if female family members are also involved in sex work, ever being forced to have sex, and ever being arrested or jailed. There were also significant differences between cities and in trends over time, with HIV transmission knowledge increasing and having been denied health services and having been hit decreasing.

Conclusion: We found associations indicating that some particularly vulnerable FSW may be subject to multiple intersecting risks related to HIV knowledge, stigma, and violence which may decrease their agency to receive proper HIV testing, care, and treatment. Although Morocco has made excellent progress in providing HIV services to vulnerable populations, this additional analysis will be useful as Morocco makes programmatic decisions related to ending HIV by 2030.

Background: Individuals with obesity who use glucagon-like peptide 1 receptor agonists (GLP-1s) for weight loss are often judged for taking a "shortcut" rather than using "optimal" methods (i.e., diet/exercise). This is linked with beliefs that weight is highly controllable, which predict both anti-fat attitudes and maladaptive weight-related behaviors. This study tested how exposure to a woman whose weight was framed as highly controllable or largely uncontrollable and who was described as losing weight with a GLP-1 vs. diet/exercise affected weight stigma attitudes and maladaptive weight-related cognitions through social comparison processes.

Method: Women with overweight and obesity (N = 163) were exposed to a woman with obesity who varied by described weight controllability and weight loss method. Participants reported the extent to which they engaged in global downward social comparison and weight and body size comparisons to the woman, as well as weight stigma attitudes and maladaptive weight-related cognitions (likelihood of engaging in binge eating, restrictive eating, and exercising hard to control weight).

Results: When the woman lost weight with a GLP-1 (vs. diet/exercise) she was judged more negatively due, in part, to higher global downward social comparison. Reading about weight loss with diet/exercise (vs. GLP-1) led to more maladaptive weight-related cognitions through higher weight and body size comparisons. Emphasizing that weight is less controllable did not reduce stigmatizing attitudes towards a GLP-1 user and had a limited effect on weight-related cognitions.

Conclusion: Further research is necessary to identify interventions to reduce weight stigma towards GLP-1 users and maladaptive weight-related cognitions.

Background: Daily airway clearance therapy (ACT) is a critical aspect of treatment in cystic fibrosis (CF), but poor adherence is a prominent concern. Identifying factors that might enhance or diminish adherence is a priority for treatment centers. Gratitude, a generalized tendency to notice and appreciate positive facets of experience, is a psychosocial resource that has commanded growing research interest. This longitudinal study examined whether gratitude at baseline was associated with ongoing or persistent ACT adherence over the course of a year.

Methods: Trait gratitude was evaluated at baseline using a validated measure, among adults receiving care at a regional CF treatment center. Self-reported adherence to ACT was assessed at baseline, 6 months, and 12 months using the Cystic Fibrosis Treatment Questionnaire. Average age of participants was 27.2 years, 45.5% were women, and 19.7% had severe disease.

Results: In multivariable logistic regression models that accounted for disease severity (Forced Expiratory Volume₁% predicted) and other clinical and demographic variables, individuals with higher baseline gratitude were significantly more likely to demonstrate persistent adherence over the course of the year. Gratitude remained predictive after additionally adjusting for other well-known psychosocial resource variables (social support and emotional well-being).

Conclusion: This is among the first demonstrations that gratitude is associated with persistent self-reported adherence to treatment over time. Findings suggest that gratitude may be important psychosocial resource for adults with CF, as they contend with complex, highly burdensome treatment regimens. Further research is warranted to examine these relationships and their impact on downstream health outcomes.

Background: This study aimed to determine if motivations to use alcohol (coping and social motivations) mediate the relationship between trait mindfulness and a variety of alcohol-related consequences and to determine if the relationship between motivations to use alcohol and alcohol-related consequences is moderated by alcohol use. We determined the factor structure of positive and negative consequences of alcohol use and used this structure as outcomes across eight moderated mediation models.

Methods: Data were obtained from 296 undergraduate students to confirm the alcohol-related consequences factor structure and to test eight moderated-mediation models.

Results: Four alcohol-related consequences scales (romantic/sexual, positive, mild negative, and severe negative consequences) were confirmed. The motive of drinking to cope significantly mediated the relationship between trait mindfulness and all four of the alcohol-related consequences scales. Drinking to socialize did not significantly mediate the relationship between trait mindfulness and all of the alcohol-related consequences scales.

Conclusions: The identified four-factor structure suggests that alcohol-related consequences should be assessed in a more specific manner. Additionally, different motivations for alcohol use relate differentially to trait mindfulness and different alcohol-related consequences; drinking to cope is particularly problematic for this population. Future research on the usefulness of promoting mindfulness to reduce problematic drinking appears warranted.

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: 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: There is a scarcity of research on the potential impact of disclosing HIV status to friends and family in moderating the adverse effects of discrimination on the mental health of people living with HIV (PLWH). This study assessed the experiences of discrimination and HIV status disclosure among PLWH in Japan, and evaluated their potential associations with psychological distress.

Method: Data were derived from a nationwide cross-sectional survey of PLWH conducted in Japan between 2019 and 2020. The interaction effects of HIV-related discrimination and HIV status disclosure on the psychological distress were examined using logistic and linear regression analyses.

Results: The median age of the 804 respondents was 46 years old. Most respondents were male and 85.4% (687/804) identified as homosexuals or bisexuals. A total of 12.7% (102/804) of the respondents reported that they had recently experienced discrimination because of their HIV status. Experience of HIV-related discrimination was independently associated with high psychological distress (adjusted OR 2.02; 95% CI, 1.15-3.57), and HIV status disclosure to friends partially weakened the association between discrimination and the level of psychological distress (regression coefficient -3.115; p = 0.004).

Conclusion: While measures that aim to end discrimination remain vital, increasing the opportunities of PLWH to communicate with friends they feel comfortable disclosing their HIV status may also be helpful in protecting their mental health.