Jeremy C Wang, Katharine B Dalke, Rahul Nachnani, Arlene B Baratz, Jason D Flatt
Background: Intersex individuals experience poor health due, in part, to healthcare avoidance. Nonconsensual intersex surgery may contribute to medical mistrust and avoidance among intersex populations.
Purpose: The purpose of this study was to explore the relationship between nonconsensual surgery and healthcare avoidance among intersex populations and to examine if medical mistrust mediates this relationship.
Methods: Data for this cross-sectional study were collected in 2018 and analyzed in 2022. Participants completed a survey collecting information on demographics, medical mistrust, history of nonconsensual surgery, and history of postponing healthcare. One hundred nine participants with valid responses to all regression model variables were included in the study. Multivariable logistic regression models controlling for age, race, and income, examined the relationship between nonconsensual surgery and postponing preventive and emergency healthcare. Mediation analyses of cross-sectional data examined whether medical mistrust mediated the relationship between nonconsensual surgery and postponing preventive and emergency healthcare.
Results: Mean medical mistrust score was 2.8 (range = 1-4; standard deviation = 0.8), 49.7% of participants had nonconsensual surgery in their lifetime, 45.9% postponed emergency healthcare, and 61.5% postponed preventive healthcare in their lifetime. Nonconsensual surgery was associated with increased odds of delaying preventive (adjusted odds ratio [AOR] = 4.17; confidence interval [CI] = 1.76-9.88; p = .016) and emergency healthcare (AOR = 4.26; CI = 1.71-10.59; p = .002). Medical mistrust mediated the relationship between nonconsensual surgery and delaying preventive (indirect effect = 1.78; CI = 1.16-3.67) and emergency healthcare (indirect effect = 1.66; CI = 1.04-3.30).
Conclusions: Nonconsensual surgery contributed to healthcare avoidance in this intersex population by increasing medical mistrust. To decrease healthcare avoidance, intersex health promotion interventions should restrict nonconsensual surgery and build trust through trauma-informed care.
{"title":"Medical Mistrust Mediates the Relationship Between Nonconsensual Intersex Surgery and Healthcare Avoidance Among Intersex Adults.","authors":"Jeremy C Wang, Katharine B Dalke, Rahul Nachnani, Arlene B Baratz, Jason D Flatt","doi":"10.1093/abm/kaad047","DOIUrl":"10.1093/abm/kaad047","url":null,"abstract":"<p><strong>Background: </strong>Intersex individuals experience poor health due, in part, to healthcare avoidance. Nonconsensual intersex surgery may contribute to medical mistrust and avoidance among intersex populations.</p><p><strong>Purpose: </strong>The purpose of this study was to explore the relationship between nonconsensual surgery and healthcare avoidance among intersex populations and to examine if medical mistrust mediates this relationship.</p><p><strong>Methods: </strong>Data for this cross-sectional study were collected in 2018 and analyzed in 2022. Participants completed a survey collecting information on demographics, medical mistrust, history of nonconsensual surgery, and history of postponing healthcare. One hundred nine participants with valid responses to all regression model variables were included in the study. Multivariable logistic regression models controlling for age, race, and income, examined the relationship between nonconsensual surgery and postponing preventive and emergency healthcare. Mediation analyses of cross-sectional data examined whether medical mistrust mediated the relationship between nonconsensual surgery and postponing preventive and emergency healthcare.</p><p><strong>Results: </strong>Mean medical mistrust score was 2.8 (range = 1-4; standard deviation = 0.8), 49.7% of participants had nonconsensual surgery in their lifetime, 45.9% postponed emergency healthcare, and 61.5% postponed preventive healthcare in their lifetime. Nonconsensual surgery was associated with increased odds of delaying preventive (adjusted odds ratio [AOR] = 4.17; confidence interval [CI] = 1.76-9.88; p = .016) and emergency healthcare (AOR = 4.26; CI = 1.71-10.59; p = .002). Medical mistrust mediated the relationship between nonconsensual surgery and delaying preventive (indirect effect = 1.78; CI = 1.16-3.67) and emergency healthcare (indirect effect = 1.66; CI = 1.04-3.30).</p><p><strong>Conclusions: </strong>Nonconsensual surgery contributed to healthcare avoidance in this intersex population by increasing medical mistrust. To decrease healthcare avoidance, intersex health promotion interventions should restrict nonconsensual surgery and build trust through trauma-informed care.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10064141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Experience of stroke is associated with an increased risk for diabetes and metabolic syndrome, yet few interventions exist that have been tailored to the population's unique needs.
Purpose: To examine adherence and efficacy of the Diabetes Prevention Program Group Lifestyle Balance program (DPP-GLB) modified for individuals post stroke (GLB-CVA) using a randomized controlled trial.
Methods: Adults (18-85 years of age), >12 months post stroke, and body mass index ≥25 kg/m2 were included in this study. Sixty-five individuals were assigned to either the GLB-CVA intervention or a 6-month wait-list control. Participants completed the 12-month GLB-CVA intervention, with attendance and assessment of weight, anthropometric, biomarker, functional, and patient reported outcome data collected at baseline, 3, 6, and 12 months.
Results: High attendance (90%) and dietary and activity tracking (71%) suggest high adherence to the 12-month GLB-CVA. Six-month randomized controlled trial data indicate significant weight loss (p = .005) in the GLB-CVA group (7.4 ± 13.6 lbs, 3.65%) compared with the wait-list control (0.1 ± 10.1 lbs, 0%), and improvements in arm circumference (p = .04), high-density lipoprotein (HDL) cholesterol (p = .028), 8-year diabetes risk (p = .011), and pain interference (p < .001). Combined 12-month data showed participants lost 10.1 ± 16.8 lbs (4.88%) and improved waist circumference (p = .001), HbA1c (3.6%), diastolic blood pressure (p < .001), pain (p = .001), social participation (p = .025), and eating practices (p = .01) and habits (p < .001).
Conclusions: Engagement in the GLB-CVA can result in weight loss and improved health for individuals who are overweight or obese following stroke. Future efforts should examine effectiveness in real-world settings and focus on knowledge translation efforts.
{"title":"Results of a 12-Month Randomized Controlled Trial Testing the Efficacy of the Diabetes Prevention Program Group Lifestyle Balance (DPP-GLB) for People Post Stroke (GLB-CVA).","authors":"Simon Driver, Evan McShan, Chad Swank, Stephanie Calhoun, Megan Douglas, Alexandria Suhalka, Monica Bennett, Librada Callender, Christa Ochoa, Sridevi Mukkamala, Kaye Kramer","doi":"10.1093/abm/kaad045","DOIUrl":"10.1093/abm/kaad045","url":null,"abstract":"<p><strong>Background: </strong>Experience of stroke is associated with an increased risk for diabetes and metabolic syndrome, yet few interventions exist that have been tailored to the population's unique needs.</p><p><strong>Purpose: </strong>To examine adherence and efficacy of the Diabetes Prevention Program Group Lifestyle Balance program (DPP-GLB) modified for individuals post stroke (GLB-CVA) using a randomized controlled trial.</p><p><strong>Methods: </strong>Adults (18-85 years of age), >12 months post stroke, and body mass index ≥25 kg/m2 were included in this study. Sixty-five individuals were assigned to either the GLB-CVA intervention or a 6-month wait-list control. Participants completed the 12-month GLB-CVA intervention, with attendance and assessment of weight, anthropometric, biomarker, functional, and patient reported outcome data collected at baseline, 3, 6, and 12 months.</p><p><strong>Results: </strong>High attendance (90%) and dietary and activity tracking (71%) suggest high adherence to the 12-month GLB-CVA. Six-month randomized controlled trial data indicate significant weight loss (p = .005) in the GLB-CVA group (7.4 ± 13.6 lbs, 3.65%) compared with the wait-list control (0.1 ± 10.1 lbs, 0%), and improvements in arm circumference (p = .04), high-density lipoprotein (HDL) cholesterol (p = .028), 8-year diabetes risk (p = .011), and pain interference (p < .001). Combined 12-month data showed participants lost 10.1 ± 16.8 lbs (4.88%) and improved waist circumference (p = .001), HbA1c (3.6%), diastolic blood pressure (p < .001), pain (p = .001), social participation (p = .025), and eating practices (p = .01) and habits (p < .001).</p><p><strong>Conclusions: </strong>Engagement in the GLB-CVA can result in weight loss and improved health for individuals who are overweight or obese following stroke. Future efforts should examine effectiveness in real-world settings and focus on knowledge translation efforts.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9941204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hill L Wolfe, Taylor L Boyer, Jillian C Shipherd, Michael R Kauth, Guneet K Jasuja, John R Blosnich
Background: In 2011, the Veterans Health Administration (VHA) established a policy for the delivery of transition-related services, including gender-affirming hormone therapy (GAHT), for transgender and gender diverse (TGD) patients. In the decade since this policy's implementation, limited research has investigated barriers and facilitators of VHA's provision of this evidence-based therapy that can improve life satisfaction among TGD patients.
Purpose: This study provides a qualitative summary of barriers and facilitators to GAHT at the individual (e.g., knowledge, coping mechanisms), interpersonal (e.g., interactions with other individuals or groups), and structural (e.g., gender norms, policies) levels.
Methods: Transgender and gender diverse patients (n = 30) and VHA healthcare providers (n = 22) completed semi-structured, in-depth interviews in 2019 regarding barriers and facilitators to GAHT access and recommendations for overcoming perceived barriers. Two analysts used content analysis to code and analyze transcribed interview data and employed the Sexual and Gender Minority Health Disparities Research Framework to organize themes into multiple levels.
Results: Facilitators included having GAHT offered through primary care or TGD specialty clinics and knowledgeable providers, with patients adding supportive social networks and self-advocacy. Several barriers were identified, including a lack of providers trained or willing to prescribe GAHT, patient dissatisfaction with prescribing practices, and anticipated or enacted stigma. To overcome barriers, participants recommended increasing provider capacity, providing opportunities for continual education, and enhancing communication around VHA policy and training.
Conclusions: Multi-level system improvements within and outside the VHA are needed to ensure equitable and efficient access to GAHT.
{"title":"Barriers and Facilitators to Gender-affirming Hormone Therapy in the Veterans Health Administration.","authors":"Hill L Wolfe, Taylor L Boyer, Jillian C Shipherd, Michael R Kauth, Guneet K Jasuja, John R Blosnich","doi":"10.1093/abm/kaad035","DOIUrl":"10.1093/abm/kaad035","url":null,"abstract":"<p><strong>Background: </strong>In 2011, the Veterans Health Administration (VHA) established a policy for the delivery of transition-related services, including gender-affirming hormone therapy (GAHT), for transgender and gender diverse (TGD) patients. In the decade since this policy's implementation, limited research has investigated barriers and facilitators of VHA's provision of this evidence-based therapy that can improve life satisfaction among TGD patients.</p><p><strong>Purpose: </strong>This study provides a qualitative summary of barriers and facilitators to GAHT at the individual (e.g., knowledge, coping mechanisms), interpersonal (e.g., interactions with other individuals or groups), and structural (e.g., gender norms, policies) levels.</p><p><strong>Methods: </strong>Transgender and gender diverse patients (n = 30) and VHA healthcare providers (n = 22) completed semi-structured, in-depth interviews in 2019 regarding barriers and facilitators to GAHT access and recommendations for overcoming perceived barriers. Two analysts used content analysis to code and analyze transcribed interview data and employed the Sexual and Gender Minority Health Disparities Research Framework to organize themes into multiple levels.</p><p><strong>Results: </strong>Facilitators included having GAHT offered through primary care or TGD specialty clinics and knowledgeable providers, with patients adding supportive social networks and self-advocacy. Several barriers were identified, including a lack of providers trained or willing to prescribe GAHT, patient dissatisfaction with prescribing practices, and anticipated or enacted stigma. To overcome barriers, participants recommended increasing provider capacity, providing opportunities for continual education, and enhancing communication around VHA policy and training.</p><p><strong>Conclusions: </strong>Multi-level system improvements within and outside the VHA are needed to ensure equitable and efficient access to GAHT.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9773712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Diabetes is associated with disability development. Healthy behaviors and psychosocial support can help patients manage their disease.
Purpose: To examine the role of various behavioral and psychological factors in buffering the effect of diabetes on disability development over time in Taiwanese adults.
Methods: Data on 5,131 adults aged ≥50 years were obtained from the Taiwan Longitudinal Study on Aging. A cohort sequential multilevel design was employed to analyze the association between behavioral and psychosocial factors and the risk of disability over a 11-year period.
Results: In patients with diabetes, having social support and exercising more than six times a week were associated with 4% and 49% reductions in the risk of disability, respectively (βdiabetes*socialsupport = -0.285, p = .006; βdiabetes*exercise3 = -2.612, p = .007). Exercising more than six times a week had an additional significant protective effect against disability development per year (βdiabetes*exercises3*age = -0.241, p = .038). Depression did not significantly interact with diabetes. However, a trajectory analysis revealed that individuals who had both diabetes and depression had the highest disability score from middle age among all participants.
Conclusions: Engaging in frequent exercise is the most influential factor for reducing the risk of disability in patients with diabetes. Social support provides an additional benefit for disability prevention in individuals with diabetes.
背景:糖尿病与残疾的发展有关。健康的行为和社会心理支持可以帮助患者控制疾病。目的:探讨不同行为及心理因素在台湾成人糖尿病对残疾发展的缓冲作用。方法:从台湾老龄化纵向研究中获得5131名年龄≥50岁的成年人的数据。采用队列序贯多水平设计分析11年期间行为和心理社会因素与残疾风险之间的关系。结果:在糖尿病患者中,拥有社会支持和每周锻炼6次以上分别与残疾风险降低4%和49%相关(βdiabetes*socialsupport = -0.285, p = 0.006;βdiabetes*exercise3 = -2.612, p = .007)。每周锻炼超过6次,每年对残疾发展有额外的显著保护作用(β糖尿病*锻炼3*年龄= -0.241,p = 0.038)。抑郁症与糖尿病没有显著的相互作用。然而,一项轨迹分析显示,在所有参与者中,同时患有糖尿病和抑郁症的人在中年后的残疾得分最高。结论:经常运动是降低糖尿病患者致残风险的最重要因素。社会支持为糖尿病患者预防残疾提供了额外的好处。
{"title":"Behavioral and Psychological Factors in Buffering Diabetes-related Disability Development.","authors":"Yi-Hsuan Tsai, Li-Lun Chuang, Yau-Jiunn Lee, Ching-Ju Chiu","doi":"10.1093/abm/kaad038","DOIUrl":"10.1093/abm/kaad038","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is associated with disability development. Healthy behaviors and psychosocial support can help patients manage their disease.</p><p><strong>Purpose: </strong>To examine the role of various behavioral and psychological factors in buffering the effect of diabetes on disability development over time in Taiwanese adults.</p><p><strong>Methods: </strong>Data on 5,131 adults aged ≥50 years were obtained from the Taiwan Longitudinal Study on Aging. A cohort sequential multilevel design was employed to analyze the association between behavioral and psychosocial factors and the risk of disability over a 11-year period.</p><p><strong>Results: </strong>In patients with diabetes, having social support and exercising more than six times a week were associated with 4% and 49% reductions in the risk of disability, respectively (βdiabetes*socialsupport = -0.285, p = .006; βdiabetes*exercise3 = -2.612, p = .007). Exercising more than six times a week had an additional significant protective effect against disability development per year (βdiabetes*exercises3*age = -0.241, p = .038). Depression did not significantly interact with diabetes. However, a trajectory analysis revealed that individuals who had both diabetes and depression had the highest disability score from middle age among all participants.</p><p><strong>Conclusions: </strong>Engaging in frequent exercise is the most influential factor for reducing the risk of disability in patients with diabetes. Social support provides an additional benefit for disability prevention in individuals with diabetes.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10007807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher J Armitage, Chris Keyworth, Nicola Gartland, Anna Coleman, David Fishwick, Sheena Johnson, Martie van Tongeren
Background: Transmission of airborne viruses can be mitigated by wearing face coverings but evidence suggests that face covering declines with the removal of relevant legislation, partly due to low automatic motivation.
Purpose: Test whether an intervention based on implementation intentions could support people's automatic motivation and promote face covering during the COVID-19 pandemic.
Methods: Randomized controlled design. At baseline (May 20 to June 6, 2022), 7,835 UK adults reported how much time they spent wearing face coverings in work, public transport, and indoor leisure settings as well as their capabilities, opportunities, and motivations. 3,871 participants were randomized to form implementation intentions; 3,964 control participants completed questionnaires only. Measures were repeated 6 months postbaseline (November 1 to November 14, 2022). Data were analyzed using mixed measures ANOVAs and Bayes Factors to examine whether the observed data supported the experimental hypothesis.
Results: The proportion of time spend wearing face coverings declined substantially across the 6-month study period, from 15.28% to 9.87% in work settings, 38.31% to 24.55% on public transport, and 9.58% to 7.85% in leisure settings. Bayes Factors indicated moderate relative evidence of no effect of implementation intentions on behavior in work and leisure settings, and inconclusive evidence of a positive effect on public transport.
Conclusions: In the context of declining COVID-19 rates and removal of legal mandates, implementation intentions were not effective in sustaining face covering. Further research is required to ensure that evidence-based interventions are prepared and deployed in the event of future pandemics.
{"title":"Theory-based Trial to Promote Uptake and Sustained Use of Face Coverings During the COVID-19 Pandemic.","authors":"Christopher J Armitage, Chris Keyworth, Nicola Gartland, Anna Coleman, David Fishwick, Sheena Johnson, Martie van Tongeren","doi":"10.1093/abm/kaad039","DOIUrl":"10.1093/abm/kaad039","url":null,"abstract":"<p><strong>Background: </strong>Transmission of airborne viruses can be mitigated by wearing face coverings but evidence suggests that face covering declines with the removal of relevant legislation, partly due to low automatic motivation.</p><p><strong>Purpose: </strong>Test whether an intervention based on implementation intentions could support people's automatic motivation and promote face covering during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Randomized controlled design. At baseline (May 20 to June 6, 2022), 7,835 UK adults reported how much time they spent wearing face coverings in work, public transport, and indoor leisure settings as well as their capabilities, opportunities, and motivations. 3,871 participants were randomized to form implementation intentions; 3,964 control participants completed questionnaires only. Measures were repeated 6 months postbaseline (November 1 to November 14, 2022). Data were analyzed using mixed measures ANOVAs and Bayes Factors to examine whether the observed data supported the experimental hypothesis.</p><p><strong>Results: </strong>The proportion of time spend wearing face coverings declined substantially across the 6-month study period, from 15.28% to 9.87% in work settings, 38.31% to 24.55% on public transport, and 9.58% to 7.85% in leisure settings. Bayes Factors indicated moderate relative evidence of no effect of implementation intentions on behavior in work and leisure settings, and inconclusive evidence of a positive effect on public transport.</p><p><strong>Conclusions: </strong>In the context of declining COVID-19 rates and removal of legal mandates, implementation intentions were not effective in sustaining face covering. Further research is required to ensure that evidence-based interventions are prepared and deployed in the event of future pandemics.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manuel J Galvan, B Keith Payne, Jason Hannay, Alexis R Georgeson, Keely A Muscatell
Background: Subjective socioeconomic status is robustly associated with many measures of health and well-being. The MacArthur Scale of Subjective Social Status (i.e., the MacArthur ladder) is the most widely used measure of this construct, but it remains unclear what exactly the MacArthur ladder measures.
Purpose: The present research sought to explore the social and economic factors that underlie responses to the MacArthur ladder and its relationship to health.
Methods: We investigated this issue by examining the relationship between scores on the MacArthur ladder and measures of economic circumstances and noneconomic social status, as well as health and well-being measures, in healthy adults in the USA.
Results: In three studies (total N = 1,310) we found evidence that economic circumstances and social status are distinct constructs that have distinct associations with scores on the MacArthur ladder. We found that both factors exhibit distinct associations with measures of health and well-being and accounted for the association between the MacArthur ladder and each measure of health and well-being.
Conclusions: Our findings suggest that the MacArthur ladder's robust predictive validity may result from the fact that it measures two factors-economic circumstances and social status-that are each independently associated with health outcomes. These findings provide a novel perspective on the large body of literature that uses the MacArthur ladder and suggests health researchers should do more to disentangle the social and economic aspects of subjective socioeconomic status.
{"title":"What Does the MacArthur Scale of Subjective Social Status Measure? Separating Economic Circumstances and Social Status to Predict Health.","authors":"Manuel J Galvan, B Keith Payne, Jason Hannay, Alexis R Georgeson, Keely A Muscatell","doi":"10.1093/abm/kaad054","DOIUrl":"10.1093/abm/kaad054","url":null,"abstract":"<p><strong>Background: </strong>Subjective socioeconomic status is robustly associated with many measures of health and well-being. The MacArthur Scale of Subjective Social Status (i.e., the MacArthur ladder) is the most widely used measure of this construct, but it remains unclear what exactly the MacArthur ladder measures.</p><p><strong>Purpose: </strong>The present research sought to explore the social and economic factors that underlie responses to the MacArthur ladder and its relationship to health.</p><p><strong>Methods: </strong>We investigated this issue by examining the relationship between scores on the MacArthur ladder and measures of economic circumstances and noneconomic social status, as well as health and well-being measures, in healthy adults in the USA.</p><p><strong>Results: </strong>In three studies (total N = 1,310) we found evidence that economic circumstances and social status are distinct constructs that have distinct associations with scores on the MacArthur ladder. We found that both factors exhibit distinct associations with measures of health and well-being and accounted for the association between the MacArthur ladder and each measure of health and well-being.</p><p><strong>Conclusions: </strong>Our findings suggest that the MacArthur ladder's robust predictive validity may result from the fact that it measures two factors-economic circumstances and social status-that are each independently associated with health outcomes. These findings provide a novel perspective on the large body of literature that uses the MacArthur ladder and suggests health researchers should do more to disentangle the social and economic aspects of subjective socioeconomic status.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41101535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily J Jones, Anna L Marsland, Thomas E Kraynak, Elizabeth Votruba-Drzal, Peter J Gianaros
Background: Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status.
Purpose: We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex.
Methods: Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race.
Results: Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (β = -0.06), hopelessness (β = -0.06), and depressive symptoms (β = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (β = -0.06), but was slightly attenuated after adjusting for hopelessness (β = -0.06) and depressive symptoms (β = -0.06). There were no associations for CRP or moderation by race or sex.
Conclusions: Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.
{"title":"Subjective Social Status and Longitudinal Changes in Systemic Inflammation.","authors":"Emily J Jones, Anna L Marsland, Thomas E Kraynak, Elizabeth Votruba-Drzal, Peter J Gianaros","doi":"10.1093/abm/kaad044","DOIUrl":"10.1093/abm/kaad044","url":null,"abstract":"<p><strong>Background: </strong>Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status.</p><p><strong>Purpose: </strong>We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex.</p><p><strong>Methods: </strong>Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race.</p><p><strong>Results: </strong>Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (β = -0.06), hopelessness (β = -0.06), and depressive symptoms (β = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (β = -0.06), but was slightly attenuated after adjusting for hopelessness (β = -0.06) and depressive symptoms (β = -0.06). There were no associations for CRP or moderation by race or sex.</p><p><strong>Conclusions: </strong>Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10426337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie M C Green, Louise H Hall, David P French, Nikki Rousseau, Catherine Parbutt, Rebecca Walwyn, Samuel G Smith
Background: Adherence to adjuvant endocrine therapy (AET) is low in women with breast cancer. Negative beliefs about the necessity of AET and high concerns are barriers to adherence.
Purpose: To use the multiphase optimization strategy to optimize the content of an information leaflet intervention, to change AET beliefs.
Methods: We conducted an online screening experiment using a 25 factorial design to optimize the leaflet. The leaflet had five components, each with two levels: (i) diagrams about AET mechanisms (on/off); (ii) infographics displaying AET benefits (enhanced/basic); (iii) AET side effects (enhanced/basic); (iv) answers to AET concerns (on/off); (v) breast cancer survivor (patient) input: quotes and photographs (on/off). Healthy adult women (n = 1,604), recruited via a market research company, were randomized to 1 of 32 experimental conditions, which determined the levels of components received. Participants completed the Beliefs about Medicines Questionnaire before and after viewing the leaflet.
Results: There was a significant main effect of patient input on beliefs about medication (β = 0.063, p < .001). There was one significant synergistic two-way interaction between diagrams and benefits (β = 0.047, p = .006), and one antagonistic two-way interaction between diagrams and side effects (β = -0.029, p = .093). There was a synergistic three-way interaction between diagrams, concerns, and patient input (β = 0.029, p = .085), and an antagonistic four-way interaction between diagrams, benefits, side effects, and concerns (β = -0.038, p = .024). In a stepped approach, we screened in four components and screened out the side effects component.
Conclusions: The optimized leaflet did not contain enhanced AET side effect information. Factorial experiments are efficient and effective for refining the content of information leaflet interventions.
{"title":"Optimization of an Information Leaflet to Influence Medication Beliefs in Women With Breast Cancer: A Randomized Factorial Experiment.","authors":"Sophie M C Green, Louise H Hall, David P French, Nikki Rousseau, Catherine Parbutt, Rebecca Walwyn, Samuel G Smith","doi":"10.1093/abm/kaad037","DOIUrl":"10.1093/abm/kaad037","url":null,"abstract":"<p><strong>Background: </strong>Adherence to adjuvant endocrine therapy (AET) is low in women with breast cancer. Negative beliefs about the necessity of AET and high concerns are barriers to adherence.</p><p><strong>Purpose: </strong>To use the multiphase optimization strategy to optimize the content of an information leaflet intervention, to change AET beliefs.</p><p><strong>Methods: </strong>We conducted an online screening experiment using a 25 factorial design to optimize the leaflet. The leaflet had five components, each with two levels: (i) diagrams about AET mechanisms (on/off); (ii) infographics displaying AET benefits (enhanced/basic); (iii) AET side effects (enhanced/basic); (iv) answers to AET concerns (on/off); (v) breast cancer survivor (patient) input: quotes and photographs (on/off). Healthy adult women (n = 1,604), recruited via a market research company, were randomized to 1 of 32 experimental conditions, which determined the levels of components received. Participants completed the Beliefs about Medicines Questionnaire before and after viewing the leaflet.</p><p><strong>Results: </strong>There was a significant main effect of patient input on beliefs about medication (β = 0.063, p < .001). There was one significant synergistic two-way interaction between diagrams and benefits (β = 0.047, p = .006), and one antagonistic two-way interaction between diagrams and side effects (β = -0.029, p = .093). There was a synergistic three-way interaction between diagrams, concerns, and patient input (β = 0.029, p = .085), and an antagonistic four-way interaction between diagrams, benefits, side effects, and concerns (β = -0.038, p = .024). In a stepped approach, we screened in four components and screened out the side effects component.</p><p><strong>Conclusions: </strong>The optimized leaflet did not contain enhanced AET side effect information. Factorial experiments are efficient and effective for refining the content of information leaflet interventions.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jianhua Hou, Rong Fu, Taiyi Jiang, Nancy Xiaonan Yu
Background: Since HIV has evolved into a lifelong but manageable condition, improving the quality of life (QoL) of persons living with HIV (PLWHs) has become increasingly important. Living with HIV is life-altering and poses substantial challenges for both PLWHs and their partners, so identifying how HIV serodiscordant couples cope with HIV together is crucial. Here, Bodenmann's Systemic Transaction Model highlights common dyadic coping (CDC), which refers to both partners working together to alleviate the negative effects of stress.
Purpose: We examined the mediating role of CDC in linking we-disease appraisal with relationship satisfaction and QoL.
Methods: We recruited a convenience sample of 231 HIV serodiscordant couples via local grassroots organizations between June and October 2022. Participants completed measures of we-disease appraisal, CDC, relationship satisfaction, and QoL. We examined the mediation effect of CDC on the association between we-disease appraisal and outcomes using the common fate mediation model.
Results: The mean age of PLWHs was 32.18 years (standard deviation = 8.61 years), and that of their partners was 32.55 years (standard deviation = 9.24 years). The average time since HIV diagnosis was 4.18 years. Most couples were same-sex male couples. We found that CDC mediated the effect of we-disease appraisal on relationship satisfaction. Moreover, CDC significantly mediated the effect of we-disease appraisal on the QoL of PLWHs and their partners.
Conclusions: Our findings highlight the importance of CDC in dyadic illness management among Chinese HIV serodiscordant couples.
{"title":"Common Dyadic Coping Mediates the Associations Between We-Disease Appraisal and Relationship Satisfaction and Quality of Life in HIV Serodiscordant Couples: The Common Fate Mediation Model.","authors":"Jianhua Hou, Rong Fu, Taiyi Jiang, Nancy Xiaonan Yu","doi":"10.1093/abm/kaad036","DOIUrl":"10.1093/abm/kaad036","url":null,"abstract":"<p><strong>Background: </strong>Since HIV has evolved into a lifelong but manageable condition, improving the quality of life (QoL) of persons living with HIV (PLWHs) has become increasingly important. Living with HIV is life-altering and poses substantial challenges for both PLWHs and their partners, so identifying how HIV serodiscordant couples cope with HIV together is crucial. Here, Bodenmann's Systemic Transaction Model highlights common dyadic coping (CDC), which refers to both partners working together to alleviate the negative effects of stress.</p><p><strong>Purpose: </strong>We examined the mediating role of CDC in linking we-disease appraisal with relationship satisfaction and QoL.</p><p><strong>Methods: </strong>We recruited a convenience sample of 231 HIV serodiscordant couples via local grassroots organizations between June and October 2022. Participants completed measures of we-disease appraisal, CDC, relationship satisfaction, and QoL. We examined the mediation effect of CDC on the association between we-disease appraisal and outcomes using the common fate mediation model.</p><p><strong>Results: </strong>The mean age of PLWHs was 32.18 years (standard deviation = 8.61 years), and that of their partners was 32.55 years (standard deviation = 9.24 years). The average time since HIV diagnosis was 4.18 years. Most couples were same-sex male couples. We found that CDC mediated the effect of we-disease appraisal on relationship satisfaction. Moreover, CDC significantly mediated the effect of we-disease appraisal on the QoL of PLWHs and their partners.</p><p><strong>Conclusions: </strong>Our findings highlight the importance of CDC in dyadic illness management among Chinese HIV serodiscordant couples.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10129499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yanping Jiang, Katherine M Knauft, Clarissa M E Richardson, Tammy Chung, Bei Wu, Samuele Zilioli
Background: Low socioeconomic status (SES) is robustly associated with increased risks of morbidity and mortality. Affective reactivity to daily stressors has been proposed to be a mediator for this association. However, few longitudinal studies have empirically tested the indirect effect of SES on health through affective reactivity to daily stressors.
Purpose: This study aimed to test the indirect effect of SES on physical health via affective reactivity to daily stressors over a 10-year period and to explore age and sex differences in such indirect effect.
Methods: Data were drawn from a subsample of 1,522 middle-aged and older adults (34-83 years of age, 57.2% female, 83.5% White) from the Midlife in the United States study. SES (i.e., education, household income, indicators of financial distress) was assessed in 2004-2006. Affective reactivity to daily stressors was computed using data collected during the 8-day daily stress assessment in 2004-2009. Self-reported physical health conditions were assessed in 2004-2006 and 2013-2014.
Results: There was a significant indirect effect of lower SES on more physical health conditions via elevated negative affective reactivity to daily stressors among women but not men. The indirect effect of SES on physical health conditions via negative affective reactivity to daily stressors was consistent across the middle and older adulthood.
Conclusions: Our findings suggest that negative affective reactivity to daily stressors might be a key intermediate process contributing to persistent SES disparities in physical health, particularly among women.
{"title":"Age and Sex Differences in the Associations Among Socioeconomic Status, Affective Reactivity to Daily Stressors, and Physical Health in the MIDUS Study.","authors":"Yanping Jiang, Katherine M Knauft, Clarissa M E Richardson, Tammy Chung, Bei Wu, Samuele Zilioli","doi":"10.1093/abm/kaad034","DOIUrl":"10.1093/abm/kaad034","url":null,"abstract":"<p><strong>Background: </strong>Low socioeconomic status (SES) is robustly associated with increased risks of morbidity and mortality. Affective reactivity to daily stressors has been proposed to be a mediator for this association. However, few longitudinal studies have empirically tested the indirect effect of SES on health through affective reactivity to daily stressors.</p><p><strong>Purpose: </strong>This study aimed to test the indirect effect of SES on physical health via affective reactivity to daily stressors over a 10-year period and to explore age and sex differences in such indirect effect.</p><p><strong>Methods: </strong>Data were drawn from a subsample of 1,522 middle-aged and older adults (34-83 years of age, 57.2% female, 83.5% White) from the Midlife in the United States study. SES (i.e., education, household income, indicators of financial distress) was assessed in 2004-2006. Affective reactivity to daily stressors was computed using data collected during the 8-day daily stress assessment in 2004-2009. Self-reported physical health conditions were assessed in 2004-2006 and 2013-2014.</p><p><strong>Results: </strong>There was a significant indirect effect of lower SES on more physical health conditions via elevated negative affective reactivity to daily stressors among women but not men. The indirect effect of SES on physical health conditions via negative affective reactivity to daily stressors was consistent across the middle and older adulthood.</p><p><strong>Conclusions: </strong>Our findings suggest that negative affective reactivity to daily stressors might be a key intermediate process contributing to persistent SES disparities in physical health, particularly among women.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10154875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}