Health Psychology最新文献

Objective: This study aims to assess the effectiveness, ethics, and sustainability of nudge-based interventions in improving self-monitoring behaviors among patients with hypertension (HTN) and type 2 diabetes mellitus (T2DM).

Method: A systematic search of seven databases (January 2008-October 2024) identified studies on nudge-based interventions for HTN and T2DM self-monitoring. Nudge strategies were categorized using Münscher et al.'s taxonomy of choice architecture, which includes "decision information," "decision architecture," and "decision assistance." The included nudge-based interventions were evaluated across three domains: effectiveness, ethical quality, and sustainability.

Results: Seventeen studies (19 trials) were included in this review; 58% of the nudge-based interventions significantly improved self-monitoring adherence, and 47% yielded measurable improvements in clinical outcomes, such as reductions in blood pressure and glycated haemoglobin levels compared to usual care. Ethical evaluations revealed that the majority of nudge-based interventions exhibited above-average ethical quality. Regarding sustainability, while multicomponent interventions were common, they proved more difficult to implement due to higher resource demands.

Conclusions: This review highlights the potential of nudge-based interventions to improve self-monitoring adherence among patients with HTN and T2DM. However, balancing effectiveness, ethical considerations, and sustainability will be crucial for optimizing these interventions in real-world settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Purpose in life (PIL), referring to an individual's sense of direction and meaning, may enhance well-being among cancer survivors. However, its relationship with survival remains unclear. This study investigates the association between PIL and mortality among breast cancer survivors and explores potential underlying pathways.

Method: We analyzed 3,692 breast cancer survivors from the Women's Health Initiative, a cohort of postmenopausal women aged 50-79 recruited between 1993 and 1998. PIL was assessed in 2012 using a modified seven-item measure from Ryff and Keyes' Psychological Well-Being scale. Breast cancer cases and causes of death were confirmed through medical record review and death certificates. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), with mediation analysis exploring underlying pathways.

Results: Over 9.1 years of follow-up, 1,627 women (44.1%) died. Women in the highest PIL quartile had a 33% lower mortality risk than those in the lowest quartile (HR = 0.67, 95% CI = [0.58, 0.78], p for trend < .0001). Stronger associations were observed among women under 70 (HR = 0.34, 95% CI = [0.19, 0.63]) and those diagnosed within the past year (HR = 0.28, 95% CI = [0.13, 0.58]). Physical activity, low perceived stress, and social engagement mediated 14.2%, 18.3%, and 13.7% of the association, respectively, collectively explaining 51% of the association.

Conclusion: Higher PIL is associated with improved survival in breast cancer survivors, with physical activity, stress reduction, and social engagement as key pathways. Goal-oriented interventions promoting PIL may improve survivorship outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: This article assesses the intersections among race/ethnicity and sexuality on C-reactive protein (CRP) levels in a national sample of midlife adults. It also explores how race/ethnicity and educational attainment may differentially influence CRP among sexually diverse adults.

Method: This study uses data from 1,401 adults who participated in the 2016 biomarker module of the Health and Retirement Study. Individuals identifying as lesbian, gay, or bisexual (sexually diverse) were compared to those who identified as heterosexual. The associations between race/ethnicity and sexuality on CRP levels were assessed using ordinary least squares regression, with interactions examined between sexuality and race/ethnicity and between sexuality and educational attainment, adjusted for demographic and socioeconomic characteristics and depressive symptoms.

Results: We found that higher educational attainment had greater protective effects for sexually diverse respondents' CRP levels compared to heterosexual respondents. Additionally, sexuality was marginally significant and differentially protective for non-Hispanic Black respondents, suggesting that sexually diverse Black adults experienced lower risk for elevated CRP relative to their peers.

Conclusion: Educational attainment may be a particularly important protective factor against elevated CRP levels for sexually diverse adults. However, differences in CRP among racially/ethnically diverse older adults did not vary by educational attainment. It is possible that greater selectivity in resiliency factors and affirming relationships differentially protect lesbian, gay, or bisexual and non-Hispanic Black adults. Additional research is necessary to investigate these proposed pathways. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: During the COVID-19 pandemic, concerns emerged that pandemic fatigue might undermine people's adherence to recommended protective behaviors, such as mask wearing and physical distancing. Consistent with psychological resource theories, empirical evidence has partly supported this, suggesting that pandemic fatigue is negatively related to protective behaviors. However, most findings are based on cross-sectional research designs, leaving open the possibility for reverse causality, such that engaging in protective behaviors reduces pandemic fatigue. Indeed, such negative effects of protective behavior on pandemic fatigue are consistent with arguments based on self-perception theory. This study aims to advance the understanding of how pandemic fatigue and protective behavior are related to one another over time by examining reciprocal within-person associations between these variables.

Method: Data were collected from n = 1,488 employed adults in Germany across 20 monthly measurement waves during the COVID-19 pandemic (May 2021-December 2022).

Results: A random intercept cross-lagged panel model revealed that pandemic fatigue negatively predicted protective behavior in the subsequent month at the within-person level-and, notably, the reverse effect was also observed, such that protective behavior negatively predicted pandemic fatigue in the subsequent month.

Conclusions: Our findings highlight the reciprocal nature of relations between pandemic fatigue and protective behavior and challenge the assumption that adherence to protective behaviors inevitably results in increasing pandemic fatigue over time. These insights can inform the design of more effective interventions to sustain adherence to protective measures and mitigate the risk of pandemic fatigue in future public health crises. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Use of complementary and alternative medicines (CAM) is often associated with vaccine hesitancy. However, the nature of-and reasons for-this association are obscure as CAM and vaccine hesitancy are both complex, heterogeneous phenomena. This study aims to identify which aspects of CAM are associated with vaccine hesitancy and to probe the psychological roots of that association.

Method: Over two recruitment stages (N₁ = 1,905, N₂ = 1,443), participants from Argentina, Germany, and the United States reported vaccine/CAM behaviors, intentions, and beliefs. They also responded to scales probing nonscientific mindsets, including negative attitudes to expertise and anomalous belief formation.

Results: An item response theory model of vaccine responses revealed that, outside of total acceptance or outright refusal, vaccine hesitancy reflected a gap between past vaccination behaviors and future behavioral intentions. Vaccine hesitancy was weakly predicted by CAM use but was better predicted by certain CAM beliefs, particularly an oppositional view of natural versus biomedical care. Nonscientific mindsets showed similar patterns of association with vaccine hesitancy and with aspects of CAM beliefs.

Conclusions: Observed associations between CAM and vaccine hesitancy are primarily a matter of health-relevant beliefs centered on natural versus scientific medicine. This relationship-and in particular, the gap between past vaccine behaviors and future behavioral intentions-reflects nonscientific mindsets. Thus, a key challenge in addressing this form of vaccine hesitancy is one of perspective taking: Scientists must find persuasive reasons to vaccinate which still appeal to some who do not see science as the main route to medical knowledge. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Social media is a daily part of adolescent life. Although adolescents use social media primarily to interact with peers, they also use it to acquire information. This study examines the relations between adolescents' likelihood of using social media to obtain information about sexual health and changes in self-efficacy for refusing unwanted sex and for using condoms and intentions to have sex.

Method: Early adolescents from 21 urban middle schools (Grades 7 and 8) received a medically accurate sexually transmitted infection/pregnancy prevention curriculum during the 2021-2022 and 2022-2023 academic years. Students completed surveys 5 times-before, during, and after implementation of the curriculum. The sample was ethnically diverse and representative of the urban population.

Results: The likelihood of using interactive social media sites was related to increased intentions to have sex and lower condom negotiation efficacy and refusal self-efficacy. The likelihood of using informational social media was related to increased condom negotiation efficacy. The negative relation between refusal self-efficacy beliefs (i.e., perceived ability to refuse having sex with a partner) and the likelihood of using interactive social media was diminished when students also reported high levels of potential informational social media site usage.

Conclusions: Findings demonstrate that the types of social media that early adolescents use to acquire information about sexual health are related to adaptive health outcomes in different ways. Our results suggest that the likelihood of using informational social media sources to acquire sexual health information may be more adaptive than the use of interactive sites. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: This study examines young adult oral nicotine pouch (ONP) users' cognitive and emotional responses to user-generated antioral nicotine pouch (a-ONP) TikTok (a video-based social media platform) videos varying in the presence and absence of disgust-eliciting content.

Method: One hundred and two young adult ONP users were exposed to a TikTok simulation that contained user-generated a-ONP TikTok videos. Participants' psychophysiological responses were recorded while participants viewed the TikTok simulations. Self-reported craving, behavioral intentions to use ONPs, perceived harm reduction, arousal, and negative emotional valence were measured at baseline and post TikTok simulation exposure.

Results: In support of the negativity bias hypothesis, the psychophysiological data indicated that a-ONP TikTok videos present in disgust-eliciting content led to increased negative emotional valence, arousal, and greater second-by-second attention versus a-ONP TikTok videos absent in disgust-eliciting content. Self-reported outcomes revealed a decrease in behavioral intentions to use ONPs for a-ONP TikTok videos present in disgust-eliciting content versus those absent in disgust-eliciting content. Craving, behavioral intentions to use ONPs, and perceived harm reduction of ONPs decreased after exposure to a-ONP TikTok videos present in disgust-eliciting content when compared to participants' baseline reports.

Discussion: User-generated a-ONP TikTok videos with disgust-eliciting content that were presented in a natural TikTok simulation led to effective message outcomes reflected by increased attention and self-reported outcomes. This study extends future opportunities to identify other potential message content used on social media to reduce ONP use and demonstrates the validity of viewing a-ONP TikTok videos in a natural media context. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Referred to as "skin-deep resilience," previous studies have found that striving-characterized by high levels of self-control and perseverance-is linked with better psychological health, but worse physical health, particularly among youth of color who have low socioeconomic status. However, the underlying mechanisms are unclear. This study investigated the role of sleep reactivity (poorer sleep following daily stress) in skin-deep resilience by examining the associations among striving, sleep reactivity, psychological health, and a subclinical marker of cardiovascular disease.

Method: Participants were 315 Black youth with low socioeconomic status, who completed self-reported measures of striving (self-control and grit) and psychological health (well-being and internalizing symptoms). Using an 8-day diary and actigraphy approach, sleep reactivity was operationalized as changes in sleep duration, efficiency, and awakenings on days youth reported more stress. Subclinical cardiovascular disease was assessed by measuring peripheral endothelium-dependent vasodilation, determined by measuring brachial artery flow-mediated dilation.

Results: High strivers exhibited good psychological health (well-being: β = .46; internalizing symptoms: β = -.31) but had sleep systems that were more responsive to daily stress (i.e., striving was associated with shorter, β = .17, less efficient, β = .13, and less continuous, β = .11, sleep on days with more stress); in turn, sleep reactivity to daily stress was associated with poorer flow-mediated dilation (efficiency β = -.17, awakenings β = -.13).

Conclusion: These findings highlight the sleep system's reactivity to daily stressors as a potential mechanism underlying skin-deep resilience. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Socioeconomic disparities in cardiovascular health are well established, but the role that stress and related physiological changes play in such disparities is still unclear. There is tentative evidence for a correlation between lower socioeconomic position and poorer cardiovascular response to stress, but observational designs do not allow for conclusions regarding causality. The current study presents results from a systematic review and meta-analysis on experimental manipulations of social rank and changes in cardiovascular reactivity and cortisol.

Method: A meta-analysis was conducted (N = 2,005), including 25 studies (20 cardiovascular and five cortisol) and 71 effects (66 cardiovascular and five cortisol).

Results: Primary analyses showed a nonsignificant effect of social rank manipulations on physiological outcomes (g = -0.04, p = .54, SE = 0.07, 95% confidence interval [CI] [-0.18, 0.09]). However, moderator analyses revealed that for studies that manipulated social rank based on socioeconomic factors (e.g., personal income, parental income/education), lower rank was significantly associated with heightened cardiovascular reactivity (g = -0.24, p = .006, SE = 0.09, 95% CI [-0.41, -0.07]). No significant effect was found for studies that used performance-based social rank manipulations (i.e., cognitive tasks such as word tracing and number counting).

Conclusion: Results support the potentially causal influence of lower socioeconomic position on poorer cardiovascular health through elevated cardiovascular stress reactivity. We discuss the relevance of these findings to the role of psychophysiology for socioeconomic disparities in cardiovascular health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Research on psychosocial interventions for survivors of adolescent and young adult (AYA) cancer is lacking, despite many experiencing adverse sequelae, including disruptions in psychosocial well-being.

Method: The AYA Writing Project, an online randomized controlled trial, tested the efficacy of two prosocial writing interventions-peer helping and expressive writing + peer helping-against a cancer-specific fact-writing control. Young adults (18-39 years old) diagnosed with cancer at age 15-39 completed one 20-min writing activity each week for 4 weeks. Assessments were conducted at preintervention, postintervention, and 1-month postintervention. Analyses compared each intervention to the control condition using linear mixed models. The primary outcome was a change in well-being (i.e., total, hedonic, eudaimonic social, and eudaimonic psychological well-being) from preintervention to postintervention. Secondary outcomes included social support and depressive symptoms.

Results: Participants (N = 201, M_age = 32.33 years, 76% female) were, on average, 5.07 years since diagnosis. Those assigned to the peer helping condition had significantly greater increases in eudaimonic psychological well-being (p = .038, f² = 0.03) and ratings of social support (p = .043, f² = 0.04) from preintervention to postintervention (but not 1 month later) relative to controls. Similar nonsignificant trends were observed when comparing the expressive writing + peer helping condition to controls (ps ≥ .051, f²s ≤ 0.04). For all other outcomes, no significant interaction effects emerged.

Conclusion: Engaging in online peer helping via prosocial writing is an effective and accessible means of enhancing eudaimonic psychological well-being and social support among young adult survivors of AYA cancer. (PsycInfo Database Record (c) 2025 APA, all rights reserved).