Behavioral Medicine最新文献

The present study examined the association between adverse childhood experiences (ACEs) and body mass index (BMI) status among children and youth with special health care needs (CYSHCN), and the role of health characteristics and lifestyle factors in predicting BMI. Data from the 2016-2020 National Survey of Children's Health were utilized. Key variables included: ACEs, BMI status, level of functional impairment, depression, weekly level of physical activity, and daily screen time. Multivariable ordinal logistic regression analyses were used to examine associations between selected variables and BMI status. The sample consisted of 19,743 CYSHCN. Respectively, CYSHCN with exposure to 1-2 ACEs (vs. none) and 3+ ACEs (vs. none), had a 22% and 32% increase in odds of a one-level increase in BMI status, controlling for sociodemographic characteristics, level of functional impairment, and depression. When lifestyle factors (i.e., physical activity and screen time) were included in analyses, CYSHCN with exposure to 3+ ACEs (vs. none) had a 27% increase in odds of a one-level increase in BMI status. Thus, we found that ACEs were significantly associated with BMI status. However, the strength of this relation changed when considering CYSHCN health characteristics and CYSHCN lifestyle factors. A higher weekly level of physical activity, in particular, seemed to play a significant role in reducing risk of higher BMI status among CYSHCN with exposure to 3+ ACEs (vs. none). Findings support the development of physical activity promotion programs and education regarding strategic utilization of screen time (e.g., educational apps and games) for CYSHCN and their families.

Lifestyle habits seem interconnected and extant studies suggest that a lifestyle-related modification can impact other related behaviors. For instance, interventions targeting physical activity (PA) could potentially impact dietary patterns and quality. Therefore, we hypothesized that a web-based intervention to increase PA would lead to changes in diet quality without explicit dietary guidance. Our aim was to evaluate changes in diet quality, measured by the Healthy Eating Index 2020 (HEI-2020), following a 12-week web-based PA intervention in adults with obesity. The study consisted of secondary analysis of a 12-week pilot randomized controlled trial, wherein participants (N = 82) were randomized to the Physical Activity for The Heart (PATH) intervention group, which included workout videos and virtual coaching, or a wait-list control group. Diet quality was assessed at baseline and post-intervention using the HEI-2020 based on recalls collected through the Automated Self-Administered 24-h recall (ASA-24) system. Baseline characteristics were similar across groups. Both groups showed small improvements in HEI-2020 total scores after 12 wk (PATH: 65.11 vs. Control: 62.24). Stratification by moderate to vigorous physical activities increase (<60 min. vs. ≥60 min.) revealed greater improvements in specific HEI-2020 components in the ≥60 min group, though overall changes remained modest. The PA intervention led to small improvements in certain diet quality components, suggesting potential interconnectedness between PA and dietary habits. However, overall changes in HEI-2020 scores were modest. Future research with larger samples should explore the effects of PA intervention alone vs. combined with dietary guidance on diet quality in adults with obesity.

Tailored language and communication strategies underpin men's engagement with public health initiatives. The aim of this study was to explore men's preferences for language and communication in mental health promotion and provide recommendations for current and future programs. A sequential mixed-methods design was used including five focus groups and 21 individual interviews with 64 men. Interpretive description was used to inductively derive three themes: (1) Using coded language to confer mental health, which highlighted the tacit meaning and implications of language as well as men's covert strategies to communicate their challenges and emotions; (2) Summoning masculine capital with association and metaphors, wherein men's strategies for conveying mental health in acceptable and relatable ways are chronicled; and (3) Dynamism language to signal action and growth, illustrating participants' preference for strength-based approaches and gain-framed messaging that positions men as drivers of self-management and personal development. Important implications for men's mental health promotion are discussed.

Scientific evidence suggests that smokers who experience varying levels of pain are more likely to maintain their addiction to tobacco. The relationship between pain intensity and cognitive-based smoking processes within a mechanistic framework has received relatively little attention. Pain avoidance may influence the association between pain intensity and smoking, as it is a construct that is related to adverse pain and smoking processes. Thus, the current cross-sectional study examined the indirect effect of pain intensity on three clinically significant smoking processes (i.e., prior quit problems, perceived barriers for cessation, and negative affect reduction smoking expectancies) through pain avoidance among 95 treatment-seeking adult smokers. Regression analyses were conducted using bootstrapping techniques through PROCESS, a conditional modeling program that utilizes an ordinary least squares-based path analytical framework to test for both direct and indirect associations. Results indicated that pain intensity had a statistically significant indirect association with quit problems and perceived barriers for cessation, through pain avoidance. Pain intensity did not have a statistically significant indirect association with the negative affect reduction of smoking expectancies through pain avoidance. The current findings provide evidence for the role of pain avoidance as a potential transdiagnostic mechanism that contributes to maladaptive smoking outcomes within the larger context of the reciprocal model of pain and substance use.

Mexican-origin youth, as a large and growing population among U.S. youth, have been disproportionately affected by COVID-19. Understanding what, when, and how sociocultural factors may influence their COVID-19 vaccine uptake could inform current and future pandemic-response interventions promoting vaccination behaviors among Mexican-origin youth. The current study takes a developmental approach to reveal the long-term and short-term sociocultural antecedents of 198 Mexican-origin adolescents' COVID-19 vaccination uptake behaviors and explores the underlying mechanism of these associations based on the Knowledge-Attitude-Behavior model. The current study adopted Wave 1 (2012-2015) and Wave 4 (2021-2022) self-reported data from a larger study. Analyses were conducted to examine four mediation models for four sociocultural antecedents-daily discrimination, ethnic discrimination, foreigner stress, and family economic stress-separately. Consistent indirect effects of higher levels of concurrent sociocultural risk factors on a lower probability of COVID-19 vaccine uptake were observed to occur through less knowledge about the COVID-19 vaccines and less positive attitudes toward the COVID-19 vaccines at Wave 4. Significant direct effects, but in opposite directions, were found for the associations between Wave 1 ethnic discrimination/Wave 4 daily discrimination and the probability of COVID-19 vaccine uptake. The findings highlight the importance of considering prior and concurrent sociocultural antecedents and the Knowledge-Attitude-Behavior pathway leading to COVID-19 vaccination uptake among Mexican-origin youth and suggest that the impact of discrimination on COVID-19 vaccination uptake may depend on the type (e.g., daily or ethnic) and the context (e.g., during the COVID-19 pandemic or not) of discrimination experienced.

There is increasing interest by researchers and clinicians in behavior change interventions for promoting physical activity in persons newly diagnosed with MS. Ideally, such interventions require the delivery of behavior change techniques (BCTs) based on theory and the selection of BCTs might further require tailoring for this MS subpopulation. The current study examined BCTs preferred by persons newly diagnosed with MS for informing the design and delivery of physical activity behavior change interventions in early-stages of MS. We recruited and interviewed 20 persons newly diagnosed with MS (i.e., disease duration ≤ 2 years). The interviews were conducted online via video conferencing platform and followed a semi-structured script. During the interviews, participants provided opinions regarding an ideal physical activity behavior change program, and the opinions of participants were mapped with the Intervention Functions of the Behavior Change Wheel, BCTs, and BCT groups. Ten frequently mentioned BCTs were identified as preferred strategies for a physical activity behavior change intervention among persons newly diagnosed with MS. These BCTs focused on providing social support, skills and strategies for physical activity performance and regulation, and knowledge on benefits of physical activity in MS. This research provides a refined list of BCTs that can be included when designing tailored physical activity behavior change interventions for persons newly diagnosed with MS.

High rates of medication non-adherence have been reported in Chilean patients with type 2 diabetes mellitus (T2DM). Although habit is relevant to medication adherence, few studies have examined the antecedents of habit strength in taking diabetes medication. The aim of the present study was to assess the mediating role of habit strength in the association between determinants of habit formation and medication adherence in Chilean patients with T2DM. Participants were 245 T2DM patients from Chile. Variables were measured using self-report scales. Hypotheses were tested using a series of mediation models. Results supported the mediating role of habit strength in the relationships of medication adherence with planning, exposure to contextual cues, behavior repetition, perceived benefits, and intrinsic motivation. The theoretical and practical implications of these findings for the treatment of T2DM are discussed.

Depression is a significant public health challenge. However, limited research exists regarding the risk of sociodemographic factors, health-risk behavior, and chronic conditions in relation to the development of depression in Indonesia. This study assesses the prevalence of depressive symptoms in adolescents and adults, and identifies its potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions. A national cross-sectional population-based survey was performed, using the Indonesian Family Life Survey (IFLS-5), to assess depressive symptoms in respondents aged 15 years and older. Depression was evaluated using the Center for Epidemiologic Studies-Depression (CES-D) scale, and potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions were examined using logistic regression analysis. The study revealed a high prevalence of depressive symptoms, with the highest incidence observed in the age group of 25-34 years. Factors such as unmarried status, younger age, good physical activity, and having chronic conditions showed associations with depression. These findings have implications for developing public mental health strategies to reduce the prevalence of depression in Indonesia.

The dietary behaviors of Asian American (AA) young adults, who face a growing non-communicable disease burden, are impacted by complex socio-ecological forces. Family plays a crucial role in the lifestyle behaviors of AA young adults; however, little is known on the methods, contributors, and impact of familial dietary influence. This study aims to deconstruct the mechanisms of AA young adult familial dietary influence through a multi-perspective qualitative assessment. A five-phase method of dyadic analysis adapted from past research was employed to extract nuanced insights from dyadic interviews with AA young adults and family members, and ground findings in behavioral theory (the Social Cognitive Theory, SCT). 37 interviews were conducted: 18 young adults, comprising 10 different AA ethnic subgroups, and 19 family members (10 parents, 9 siblings). Participants described dietary influences that were both active (facilitating, shaping, and restricting) and passive (e.g., sharing foods or environment, mirroring food behaviors). Influences connected strongly with multiple SCT constructs (e.g., behavioral capacity, reinforcements for active influences, and expectations, observational learning for passive influences). Familial influence contributed to changes in the total amount, variety, and healthfulness of foods consumed. Intra-family dynamics were crucial; family members often leveraged each other's persuasiveness or food skills to collaboratively influence diet. AA family-based interventions should consider incorporating both passive and active forms of dietary influence within a family unit, involve multiple family members, and allow for individualization to the unique dynamics and dietary behaviors within each family unit.

Women were more affected than men during the COVID-19 pandemic. This study aimed to investigate COVID-19-related stress response in adult women and its association with the relevant socioeconomic, lifestyle and COVID-19-related factors. This research was carried out in eight randomly chosen cities from September 2020 to October 2021. To examine stress, we distributed the COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS). Women also fulfilled a general socio-epidemiologic questionnaire. The study included 1,264 women. Most women were healthy, highly educated, employed, married, nonsmokers who consumed alcohol. The average total CSS score suggested a relatively low COVID-19 related stress), while 1.7% of women had CSS ≥ 100. The mean PSS was around the mid-point value of the scale. Older women, who were not in a relationship, didn't smoke, didn't drink alcohol, but used immune boosters, had chronic illnesses and reported losing money during the pandemic had higher CSS scores. A higher level of stress was also experienced by women exposed to the intense reporting about COVID-19, had contact with COVID-19 positive people or took care of COVID-19 positive family members. In this sample of predominantly highly educated women few women experienced very high stress level, probably due to the study timing (after the initial wave) when the pandemic saw attenuated stress levels. To relieve women from stress, structural organization and planning in terms of health care delivery, offsetting economic losses, controlled information dissemination and psychological support for women are needed.