Annals of Behavioral Medicine最新文献

Background: Past reviews have shown that culturally salient resilience interventions buffer the negative effects of racial discrimination on psychological and behavioral outcomes among Black youth. However, these prior reviews neglect to integrate trials targeting physical health and/or health-promoting outcomes, synthesize trials based on methodological rigor, or systematically assess efficacy or resilience intervention components.

Purpose: This systematic review expands on past research by (1) providing an up to-date literature review on family-based cultural resilience interventions across a range of health-related outcomes (physical health, health behaviors, health risk-taking behaviors, and psychological), (2) evaluating the rigor of these interventions, (3) analyzing the efficacy of rigorous interventions, and (4) describing the resilience intervention components of rigorous interventions.

Methods: Using the PRISMA guidelines, a systematic search was conducted from 1992 to 2022. Studies were included if they were family-based resilience interventions targeting health-related outcomes among Black adolescents ages 10-17 years.

Results: Fifteen studies met inclusion criteria, 10 of which were not included in past reviews. Overall, 10 trials demonstrated high methodological rigor, 9 of which were efficacious. Most rigorous, efficacious trials targeted health risk-taking behaviors outcomes (~66%), whereas none targeted health promotion behaviors (physical activity, diet). Resilience components of rigorous efficacious interventions included racial socialization (racial coping, cultural pride) and family resilience (communication, routine), with fewer integrating racial identity (self-concept, role models) and cultural assets (spirituality, communalism).

Conclusions: These findings suggest the need to replicate existing rigorous strengths-based resilience interventions and address broader outcomes, including health-promoting behaviors, in the future.

Background: The association between sedentary behavior (SB) and cardiometabolic risk may differ by SB domain and context. Nonoccupational SB is particularly important because it is discretionary and more amenable to change. This study estimated associations of nonoccupational SB contexts with hypertension (HTN) and diabetes mellitus (DM).

Methods: A total of 3370 middle-aged adults (50.1 ± 3.6 years; 56% F) from the Coronary Artery Risk Development in Young Adults (CARDIA) study were included. Cross-sectional and 5-year prospective associations between self-report total SB and 6 context-specific SBs (television-TV, computer, transportation, phone, music, and paperwork) with HTN and DM were tested using logistic regression. Fully adjusted models controlled for sociodemographic variables, body mass index, and self-report moderate-vigorous intensity physical activity.

Results: Prevalences of HTN and DM at baseline were 48% (1618 cases) and 10% (320 cases), respectively. Each hour per day of total-SB was cross-sectionally associated with HTN (OR: 1.03, 95% CI, 1.01-1.05) but not DM, with nonsignificant prospective associations for HTN and DM. Of the context-specific SBs, only TV-SB was significantly associated with HTN or DM. Each hour of TV-SB was cross-sectionally associated with HTN (OR: 1.09, 95% CI, 1.03-1.15) and DM (OR: 1.18, 95% CI, 1.09-1.29), and prospectively with HTN (OR: 1.14, 95% CI, 1.04-1.26) but not DM.

Conclusion: When comparing total-SB and the 6 context-specific SBs, TV-SB was most robustly associated with HTN. The findings were less clear for DM. Behavior change strategies that target TV-SB reduction may be effective at reducing HTN risk in middle-aged adults.

Background: Nonattendance at colonoscopy is associated with reduced colorectal cancer (CRC) survival.

Purpose: The aim of this research was to quantify barriers to colonoscopy and test the effectiveness of behavior change techniques (BCTs) to address them.

Methods: Two studies were conducted. In the first study, participants were asked to imagine their next CRC screening result was abnormal, and were presented with the standard abnormal result letter used in the English CRC Screening Programme. Participants then completed a short survey. Multivariate regression tested associations between perceived barriers and intentions. In the second study, participants were randomly presented with a modified version of the abnormal results letter, which incorporated one or more BCTs, designed to target barriers identified in study 1, using a 28 factorial design. Participants then completed the same survey used in study 1. Multivariate regression tested the effectiveness of the BCTs to modify target barriers and intentions.

Results: In study 1, 5 items were associated with intentions, namely "Lack of understanding that CRC can be asymptomatic," "Perceived importance of screening," "Transport/travel," "Shared decision making and family influenced participation," and "Fear of pain and discomfort" (all P's < .05). In study 2, the inclusion of a social support message, targeting "shared decision-making and family influenced participation," facilitated independent decision making and increased intentions (both P's < .05). There was no evidence to support the remaining 7 BCTs to modify barriers or intentions (all P's < .05).

Conclusions: Inclusion of a social support message facilitated independent decision-making and improved intentions.

Background: Firearms-related health sciences research has documented disparities in fatal and nonfatal firearm injury impacting populations in the United States defined by race and ethnicity, age, gender, and geography. Recent reports from research and advocacy organizations have highlighted a need for this research to include sexual and gender minority (ie, lesbian, gay, bisexual, transgender, and queer [LGBTQ+]) populations to guide public health efforts to prevent homicide, suicide, and injury.

Purpose: The current review examines and summarizes existing research related to firearms and LGBTQ+ populations in the United States.

Methods: A search of PubMed, Embase, CINAHL, PsycInfo, LGBT Life, and Scopus was conducted in May 2024 using search strings related to LGBTQ+ populations, firearms, and suicide. Articles were included in this review if they were peer-reviewed, empirical studies assessing any construct related to firearms among LGBTQ+ people in the United States.

Results: Ultimately, 35 studies were included. Constructs examined in included studies were suicide (n = 6), homicide (n = 4), responses to the Pulse nightclub shooting (n = 9), nonfatal interpersonal violence (n = 4), and firearm access and ownership (n = 12).

Conclusions: Findings identified substantial gaps in the literature, underscoring an urgent need for LGBTQ+ health researchers and firearm injury prevention researchers to collaboratively extend and improve the evidence base on firearms among LGBTQ+ populations. Key recommendations include improving Sexual Orientation and Gender Identity data collection in firearms research, collecting original data to address LGBTQ+-specific and LGBTQ+-inclusive research questions regarding firearms, broadening the scope of firearms constructs assessed among LGTBQ+ populations, and using intersectionality to guide future research.

Background: Physical activity has been associated with a wide range of health benefits including long-term benefits for cognitive and brain health. Whether episodes of everyday physical activity are associated with immediate cognitive benefits remains unknown.

Purpose: The purpose of the current study was to examine whether episodes of physical activity, occurring over the course of participants' daily lives, are associated with short-term improvements in cognitive health.

Methods: Participants completed a 9-day ecological momentary assessment protocol involving 5 daily assessments of self-reported physical activity and ambulatory cognitive assessments of processing speed and visuospatial working memory. Data were analyzed in a multilevel modeling framework to explore changes in performance on each task associated with physical activity during the period leading up to the assessment as well as individual differences in average frequency of physical activity.

Results: Results of MLMs indicated that engaging in physical activity during the period (~3.5 hr) leading up to an assessment was associated with improvements in processing speed equivalent to 4 years of cognitive aging. Such improvements were observed for both light and moderate-to-vigorous physical activity levels. No association was observed for visuospatial working memory accuracy; however, response time during the working memory task reliably mirrored the association observed for processing speed. The short-term benefits were observed, particularly, for individuals with an overall higher frequency of reported physical activity.

Conclusions: Our findings suggest that engaging in everyday physical activity of any intensity level may have short-term, acute benefits for cognitive health and point to new potential targets for intervention.

Clinical trial information: NCT03240406.

Background: Physical activity is essential for health and wellbeing. However, many individuals fail to reach the recommended levels and obesity rates are increasing. Health-related social control refers to strategies employed by 1 person (agent) to influence another person's (target) health behavior. These strategies can be classified into persuasion (eg, encouraging or motivating) or pressure (eg, nagging or coercing). However, much of the existing research is cross-sectional and mostly focuses on the experiences of the targets.

Purpose: This study investigates how persuasion and pressure within overweight romantic couples relate to outcomes in both agents and targets. Specifically, it examines same-day associations with positive and negative affect, as well as physical activity.

Methods: This study is a secondary analysis of the 14-day follow-up period from a randomized controlled trial. Accelerometers and daily diaries tracked 99 overweight romantic couples. For each outcome and each partner, separate multilevel models were fitted.

Results: Daily persuasion used by agents was associated with increased physical activity in targets and a more favorable affect in agents. Daily pressure was not associated with the physical activity of either partner but was linked to a more unfavorable affect in the agent. Both persuasion and pressure were unrelated to the targets' affect.

Conclusions: Health-related social control in romantic relationships relates to same-day outcomes of both agents and targets. Our findings suggest that health behavior change interventions and weight loss programs could benefit from encouraging persuasion and limiting pressure.

Background: Adolescent and young adult survivors of childhood cancer (AYA) are at risk for treatment-related late effects (eg, heart and lung problems) which may be mitigated by physical activity (PA). To design effective, tailored PA interventions for this population, predictors and benefits of PA behavior need to be measured in real-time.

Purpose: To examine the feasibility and acceptability of ecological momentary assessment (EMA) combined with accelerometry and explore the dynamic associations between PA and real-time physical and psychosocial factors among AYA.

Methods: AYA (N = 20, mean age = 18.9 years) recently off cancer treatment participated in a 2-week intensive monitoring protocol in which they completed up to 4 EMA surveys/day assessing current mood, pain, fatigue, arousal, PA intentions and motivation, and social-environmental context, while PA levels were passively monitored using a wrist-worn ActiGraph GT9X accelerometer. Acceptability was measured via self-report.

Results: EMA and accelerometry were feasible and acceptable (≥70% compliance and study endorsement) for AYA. Multilevel models showed that AYA engaged in more PA when they were away from home, with others, in a better mood, less fatigued, more energetic, and more motivated than their own average levels. Further, when AYA engaged in more PA than their usual levels in the hour before completing an EMA survey, they subsequently reported less fatigue, less pain, more energy, and a more positive mood.

Conclusions: EMA and accelerometry are acceptable and feasible among AYA survivors of childhood cancer. This methodology can be utilized for understanding the real-time barriers, facilitators, and benefits of PA behaviors in this at-risk population to design effective, dynamic PA interventions.

Background: The mechanisms through which the blended mindfulness-based stress reduction (MBSR) program improves diabetes self-management among individuals with Type 2 diabetes mellitus (T2DM) remain unclear.

Purpose: This study aims to evaluate the effectiveness of blended MBSR on perceived stress, anxiety, and depressive symptoms, while also exploring the potential mechanisms underlying its effects on improving diabetes self-management.

Methods: One hundred individuals with T2DM were recruited and randomly assigned to two groups (50 participants each) from March 2020 to July 2020. A randomized clinical trial, combined with generalized estimating equations for repeated measures, was employed to assess the intervention effects of the blended MBSR on perceived stress, anxiety, and depressive symptoms compared to standard care. Mediation analyses using Model 4 in SPSS PROCESS were conducted to evaluate the contributions of the blended MBSR to diabetes self-management.

Results: Participants in the blended MBSR group showed a significant reduction in perceived stress, anxiety, and depressive symptoms compared to the control group over 12 weeks. Bootstrap mediation analyses indicated that changes in perceived stress and anxiety fully mediated the effect of the blended MBSR on diabetes self-efficacy. In contrast, depressive symptoms were not associated with diabetes self-efficacy and therefore did not qualify as mediators. Additionally, diabetes distress was found to be an insignificant mediator. Furthermore, changes in diabetes self-efficacy served as a partial mediator of the positive effects of the blended MBSR on diabetes self-management.

Conclusions: The blended MBSR program effectively reduced perceived stress, anxiety, and depressive symptoms in individuals with T2DM. The intervention's impact on perceived stress and anxiety contributed to an increase in diabetes self-efficacy, subsequently enhancing diabetes self-management. Interventions that aim to reduce perceived stress and anxiety, while also increasing diabetes self-efficacy, are recommended to develop diabetes self-management strategies with clearly defined mechanistic pathways.

Glucagon-like peptide-1 (GLP-1) agonist medications are receiving high levels of attention because of their dramatic efficacy in causing weight loss. This commentary discusses several ways that those in behavioral medicine and health psychology might think about these medications-whether they should be fully in support of them or whether they pose a risk. The positive aspects of GLP-1s include their great promise in improving health independent of weight loss and the perspective that their efficacy frees individuals from the difficulties of behavioral weight maintenance and the associated stigma of "failing" to lose weight. However, GLP-1 agonist medications also risk medicalizing weight and increasing weight stigma (in addition to those on GLP-1 medications being stigmatized for taking the "easy way out"). From a social identity perspective, GLP-1 medications could even be perceived as a tool to eradicate an entire social group-those that identify as higher weight. In terms of clinical care, a patient-centered, weight-inclusive approach will allow for individuals to receive the treatment that fits with their own social and health context. In terms of research, behavioral medicine should shift away from weight loss interventions simply to lower body mass index, and instead intervene on actual health markers, disease endpoints, or healthy behaviors. Doing so will improve health regardless of a person's weight or whether they are on GLP-1 agonist medications.