Health Psychology最新文献

Objective: New approaches to mitigate vaccine hesitancy and improve vaccine uptake are urgently needed. Nudging has shown effective results in several health areas. However, the effectiveness of interventions involving nudge theory in increasing COVID-19 vaccination remains unclear.

Method: We searched PubMed, Web of Science, and Scopus for randomized controlled trials published before December 31, 2022, to determine whether interventions involving nudge theory improved COVID-19 vaccination behavior and intent. Risk ratio (RR) and a 95% confidence interval (CI) were used as pooled measures to assess vaccination behavior. Intention to vaccinate was reported in a narrative synthesis.

Results: Sixteen randomized controlled trials involving 176,125 participants were included. Interventions involving nudge theory weakly boosted the COVID-19 vaccine uptake rate (RR = 1.21, 95% CI [1.07, 1.36], p < .01). Subgroup analysis showed a weak positive effect of social norms (RR = 2.04, 95% CI [1.61, 2.57]), defaults (RR = 1.32, 95% CI [1.03, 1.69]), and salient reminders (RR = 1.19, 95% CI [1.04, 1.36]). Nudge interventions integrating multiple components were more efficacious in increasing vaccination rates compared to nudge alone. The effect of nudging interventions weakened over time (p < .001). Most studies (10 of 11) involving vaccination intention outcomes showed positive or partially positive results.

Conclusions: Interventions involving nudge theory can promote COVID-19 vaccination behavior and intentions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Does loneliness predict premature death? Much prior research suggests so, but this evidence draws primarily on populations from individualistic societies, such as North America and Western Europe. Here, we aimed to extend this evidence by testing a hypothesis that loneliness would predict greater mortality risk in collectivistic societies, where social interdependence is normatively sanctioned.

Method: Using a harmonized dataset from two individualistic (England and the United States) and two collectivistic (Korea and Mexico) countries (combined N = 41,869), we tested whether cultural contexts moderate the extent to which loneliness predicts 10-year all-cause mortality.

Results: After adjustment of demographic variables and health behaviors, loneliness was associated with increased 10-year mortality in all four countries, with hazard ratios (HRs) of 1.13 in England, 1.21 in the United States and Mexico, and 1.51 in Korea. When health conditions were additionally controlled, this association became negligible in two individualistic countries, with HRs of 0.98 for both England and the United States. In contrast, the HR remained highly significant in Korea (HR = 1.27). Curiously, the mortality risk of loneliness in Mexico (HR = 1.03), another collectivistic country, was no different from the risks in England and the United States.

Conclusions: When people feel that they are chronically isolated from social networks, this perception can be fatal in Korea, but it is less so in the other three countries. Discussion focuses on other cultural factors, besides the cultural dimension of individualism-collectivism, that may account for the current finding. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Patients with head and neck cancer (HNC) report some of the highest levels of psychological distress amid managing their disease as well as debilitating and disfiguring treatment side effects. Fear of cancer recurrence (FCR) is a top unmet need and concern of patients with HNC. Prior research suggests elevated symptoms of anxiety and depression are potential antecedents to FCR, but findings have been limited in HNC populations. The aim of the present study was to examine the early level and change in symptoms of anxiety and depression in relation to later change in FCR among patients with HNC.

Method: The study is a secondary analysis of data collected from 2011 to 2014 through the Head and Neck 5000 Study in the United Kingdom. A sample of 4,891 patients completed self-report longitudinal assessments of anxiety and depression symptoms at baseline, 4, and 12 months and FCR at 4 and 12 months.

Results: Utilizing multiple indicator latent change score modeling, results revealed baseline anxiety and increases in anxiety from baseline to 4 months were both positively associated with increases in FCR from 4 to 12 months. Neither baseline depression nor change in depression from baseline to 4 months were significantly associated with FCR change.

Conclusions: Findings indicate that early level and increases in symptoms of anxiety were markers of increased FCR in patients with HNC. Future research may consider anxiety as a unique antecedent and maintaining factor of FCR and targeting anxiety early in the cancer trajectory may have downstream effects on FCR development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: While behavior change counseling (BCC) targeting health risk behaviors has shown efficacy for improving patient health outcomes, barriers to knowledge translation have resulted in poor uptake among health care providers (HCPs). This article outlines the development of a new BCC training framework for HCPs, from inception to readiness for efficacy testing. It provides an example of integrated knowledge translation (iKT) used in alignment with the obesity-related behavioral intervention trials model.

Method: (a) A modified Delphi process identified essential BCC skills for HCPs; (b) a survey assessed HCP attitudes and training needs; (c) an online competency assessment tool was developed using iKT mixed methods; (d) a training program was developed and refined using a logic model; and (e) the program was optimized using iterative rounds of participant feedback. A future proof-of-concept trial (f) will determine the program's readiness for full efficacy testing.

Results: A Delphi panel (n = 46) identified 11 core BCC competencies for HCPs, defining "motivational communication." The HCP survey (n = 80) showed willingness to devote 4 hr to introductory training in BCC. The Motivational Communication Competency Assessment Test (MC-CAT: an online, interactive evaluation tool) and a motivational communication training program (MOTIVATOR: accredited for continuing education by the Royal College of Physicians and Surgeons of Canada) were collaboratively developed with knowledge users. The optimization process (n = 11) provided key feedback, with minor changes being made to the program.

Conclusions: In developing a new BCC framework, obstacles to BCC implementation were addressed through an iterative iKT process. This should improve eventual intervention uptake. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Health-related quality of life (HRQoL) is a multidimensional indicator of overall health associated with premature mortality. Black men score low on measures of HRQoL, but it is unclear how Black men conceptualize HRQoL and whether there have been efforts to promote HRQoL among these men. The present qualitative study to understand Black men's conceptualization of HRQoL and strategies to improve HRQoL was based in community-based participatory research and the social-ecological model of health.

Method: A community advisory board (CAB) was established, and the need for an effort to promote HRQoL promotion among Black men was assessed and supported. A focus group protocol was developed in conjunction with the CAB and a group of barbers. Seven focus groups were conducted consisting of 56 Black men in the Southeastern United States. The mean age of participants was 45 years. Two reviewers coded each focus group. Reliability ranged from 71% to 76%. A thematic analysis was conducted, and the findings were confirmed with the CAB.

Results: Three themes emerged: (a) a holistic conceptualization of health that includes spiritual functioning among Black men; (b) a state of HRQoL among Black men predominately marked by mental health concerns, in addition to physical and social health concerns; and (c) multilevel determinants of HRQoL among Black men. This last theme consisted of three subthemes related to community-level, interpersonal, and intrapersonal determinants of HRQoL.

Conclusions: Findings from this study can help inform the development of strategies to improve HRQoL and reduce health disparities among Black men. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Caregivers' ambivalent feelings toward the care recipient have been found to be associated with depression and anxiety. There is no research linking caregivers' ambivalent feelings and cardiovascular risk. This study was aimed to analyze longitudinally the effect of ambivalence on caregivers' cardiovascular risk, defined by circulating levels of high-sensitivity C-reactive protein, interleukin-6 (IL-6), and D-dimer.

Method: Participants were 121 dementia family caregivers who were assessed three times during a 2-year period. Sociodemographic and health variables, behavioral and psychological symptoms of dementia (BPSD), ambivalent feelings, and C-reactive protein (CRP), IL-6, and D-dimer values were assessed. Mixed linear models were used to analyze the association between variables, including testing whether ambivalent feelings moderated the links between BPSD and biomarkers.

Results: Increases over time in D-dimer were associated with increases in ambivalence, older age, female gender, and body mass index (BMI). Increases over time in CRP were associated with increases in BMI, older age, female gender, and the interaction of BPSD with caregivers' ambivalent feelings. The moderation analysis showed that increased BPSD was significantly associated with increased CRP when caregivers experienced high levels of ambivalence (p = .006). In contrast, BPSD were not significantly associated with CRP when caregivers experienced low levels of ambivalence (p = .73). Increases in IL-6 were associated with female gender and BMI. The tested model explained 42.85%, 33.15%, and 5.36% of longitudinal variance in CRP, D-dimer, and IL-6 levels, respectively.

Conclusion: The findings suggest that high ambivalent feelings are relevant for understanding cardiovascular vulnerability in dementia caregivers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study aimed to examine asthma disparities at the intersection of four sociodemographic characteristics, inhaled substance use, and bias-based bullying as metrics of stigma. We hypothesized that high prevalence groups for asthma would be those with marginalized social positions and those reporting bullying experiences, independent of inhaled substance use.

Method: The analytic sample (N = 90,367) included eighth, ninth, and 11th grade students who participated in the 2022 Minnesota Student Survey. Exhaustive Chi-square Automatic Interaction Detection tested all combinations of sociodemographic characteristics (gender identity, sexual orientation, racial/ethnic identity, and access to resources), inhaled substance use (none vs. any), and bias-based bullying about sexuality, gender identity/expression, racial identity, and weight/size to predict mutually exclusive groups of youth based on self-reported asthma diagnosis.

Results: Approximately 15% of the sample reported asthma. Sexually, gender, and racially/ethnically diverse youth reported higher rates of asthma relative to their heterosexual, cisgender, and White counterparts. High prevalence groups for asthma (rates between 24% and 41%) were characterized by having multiple marginalized identities, experiencing bias-based bullying, and engaging in inhaled substance use. Three of the 10 intersectional groups with a high prevalence of asthma were not inhaled substance users.

Conclusions: These findings suggest that stigma may help explain the asthma disparities among marginalized youth. Efforts to reduce asthma disparities in marginalized youth should move beyond pathologizing the individual through overfocusing on health behaviors and attend to root causes, like experiences of stigma. Future studies should examine systemic inflammation as the potential connection between stigma and asthma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Psychological factors, including psychological distress and well-being, have been associated with cardiometabolic disease risk. Here, we examined whether a psychological process, namely how individuals cope with stressors, relates to such risk, which has been understudied.

Method: During 2004-2006, 2,142 participants without heart disease and diabetes from the Midlife in the U.S. study completed a validated coping inventory assessing six strategies (positive reinterpretation and growth, active coping, planning, focus on and venting of emotion, denial, and behavioral disengagement) and relevant covariates. As a proxy for coping flexibility, participants were also classified as having lower, moderate, or greater variability in their use of these strategies. Heart disease and diabetes were documented in 2013-2015. Logistic regressions modeled adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of developing heart disease and diabetes, separately, with coping exposures.

Results: In sociodemographic-adjusted models, greater use of adaptive strategies predicted lower diabetes risk (e.g., positive reinterpretation and growth: AOR = 0.83; 95% CI [0.72, 0.96]); estimates were weaker for maladaptive strategies, and all strategies were unrelated to heart disease. All associations for coping variability were null. In secondary analyses, greater use of adaptive strategies predicted lower heart disease risk in more educated participants only (e.g., active coping: AOR = 0.71; 95% CI [0.55, 0.92]) and lower diabetes risk in females only (e.g., planning: AOR = 0.75; 95% CI [0.61, 0.91]). Results were maintained additionally adjusting for health, behavioral, and social factors.

Conclusions: Findings suggest sex and education differences in coping's association with heart disease and diabetes. Future studies should recognize adaptive strategies may be more potent for health among certain populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: We aim to identify vaccination invitations that foster trust and improve vaccination uptake overall, especially among ethnic minority groups who are more at risk from coronavirus disease (COVID-19) and less likely to be vaccinated.

Method: In a preregistered 4 × 4 mixed-design experiment, we manipulated how much risk-benefit information the message included within-subjects and the message source between-subjects (N = 4,038 U.K. and U.S. participants, 50% ethnic minority). Participants read four vaccine invitations that varied in vaccination risk-benefit information (randomized order): control (no information), benefits only, risk and benefit, and risk and benefit that mentions vulnerable groups. The messages were sent by one of four sources (random allocation): control (health institution), medical professional (unnamed), warm and competent medical professional (unnamed), and named warm and competent medical professional (Sanjay/Lamar). Participants assessed how much they trusted the message and how likely they would be to book their vaccination appointment.

Results: Information about vaccination benefits and risks increased trust, especially among ethnic minority groups-for whom the effect replicated within each group. Trust also increased when the message was sent by a warm and competent medical professional relative to a health institution, but the importance of the source mattered less when more information was shared.

Conclusions: Our research demonstrates the positive impact of outlining the benefits and disclosing the risks of COVID vaccines in vaccination invitation messages. Having a warm and competent medical professional source can also increase trust, especially where the message is limited in scope. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Positive affect may influence health by promoting physical activity, but evidence evaluating this association is mostly cross-sectional and cannot discern directionality. This study used a counterfactual-based framework to estimate the causal effect of positive affect on physical activity patterns over 25 years, accounting for potential reverse associations.

Method: Data were from 3,352 participants in the Coronary Artery Risk Development in Young Adults study. Repeated assessments of positive affect and physical activity were collected from 1990 to 2016. Longitudinal associations were evaluated in two ways: (a) using baseline positive affect in traditional linear mixed models that accounted for reverse causal associations by adjusting for baseline physical activity, and (b) using marginal structural models that treated positive affect as a time-varying exposure, thus accounting for dynamic reverse causal associations due to bidirectional relationships.

Results: Fully adjusted traditional models found no association with physical activity at the first follow-up assessment, but positive affect was related to a slower decline in physical activity over time. Marginal structural models similarly found that positive affect was unrelated to physical activity at the first follow-up assessment but robustly associated with a slower decline in activity levels (5-year change: β = -3.33, 95% confidence interval [CI] = -5.80, -0.86; difference in 5-year change per 1 - SD positive affect: β = 4.99, 95% CI = 2.52, 7.46).

Conclusions: Positive affect may play a causal role in slowing the decline in physical activity adults generally experience during through midlife. Efforts to enhance positive affect at the population level may be a promising new approach to help individuals stay active as they age. (PsycInfo Database Record (c) 2024 APA, all rights reserved).