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Effectiveness of Interventions for Changing More Than One Behavior at a Time to Manage Chronic Conditions: A Systematic Review and Meta-analysis. 一次改变一种以上行为以管理慢性疾病的干预措施的有效性:系统回顾与元分析》。
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-05-23 DOI: 10.1093/abm/kaae021
Carolina C Silva, Justin Presseau, Zack van Allen, Paulina M Schenk, Maiara Moreto, John Dinsmore, Marta M Marques

Background: Health behaviors play a significant role in chronic disease management. Rather than being independent of one another, health behaviors often co-occur, suggesting that targeting more than one health behavior in an intervention has the potential to be more effective in promoting better health outcomes.

Purpose: We aimed to conduct a systematic review and meta-analysis of randomized trials of interventions that target more than one behavior to examine the effectiveness of multiple health behavior change interventions in patients with chronic conditions.

Methods: Five electronic databases (Web of Science, PubMed, CINAHL, EMBASE, and Cochrane) were systematically searched in November 2023, and studies included in previous reviews were also consulted. We included randomized trials of interventions aiming to change more than one health behavior in individuals with chronic conditions. Two independent reviewers screened and extracted data, and used Cochrane's Risk of Bias 2 tool. Meta-analyses were conducted to estimate the effects of interventions on change in health behaviors. Results were presented as Cohen's d for continuous data, and risk ratio for dichotomous data.

Results: Sixty-one studies were included spanning a range of chronic diseases: cardiovascular (k = 25), type 2 diabetes (k = 15), hypertension (k = 10), cancer (k = 7), one or more chronic conditions (k = 3), and multiple conditions (k = 1). Most interventions aimed to change more than one behavior simultaneously (rather than in sequence) and most targeted three particular behaviors at once: "physical activity, diet and smoking" (k = 20). Meta-analysis of 43 eligible studies showed for continuous data (k = 29) a small to substantial positive effect on behavior change for all health behaviors (d = 0.081-2.003) except for smoking (d = -0.019). For dichotomous data (k = 23) all analyses showed positive effects of targeting more than one behavior on all behaviors (RR = 1.026-2.247).

Conclusions: Targeting more than one behavior at a time is effective in chronic disease management and more research should be directed into developing the science of multiple behavior change.

背景:健康行为在慢性病管理中发挥着重要作用。目的:我们旨在对针对一种以上行为的干预措施的随机试验进行系统回顾和荟萃分析,以研究多种健康行为改变干预措施对慢性病患者的有效性:2023年11月,我们对五个电子数据库(Web of Science、PubMed、CINAHL、EMBASE和Cochrane)进行了系统性检索,并参考了以往综述中包含的研究。我们纳入了旨在改变慢性病患者一种以上健康行为的干预措施的随机试验。两名独立评审员筛选并提取了数据,并使用了 Cochrane 的 "偏倚风险 2 "工具。通过元分析来估算干预措施对健康行为改变的影响。连续数据以 Cohen's d 表示,二分数据以风险比表示:共纳入 61 项研究,涉及多种慢性疾病:心血管疾病(k = 25)、2 型糖尿病(k = 15)、高血压(k = 10)、癌症(k = 7)、一种或多种慢性疾病(k = 3)以及多种疾病(k = 1)。大多数干预措施旨在同时(而不是依次)改变一种以上的行为,大多数干预措施同时针对三种特定行为:"体育锻炼、饮食和吸烟"(k = 20)。对 43 项符合条件的研究进行的 Meta 分析表明,对于连续数据(k = 29),除吸烟(d = -0.019)外,所有健康行为(d = 0.081-2.003)的行为改变都有小到实质性的积极影响。对于二分法数据(k = 23),所有分析均显示针对一种以上行为对所有行为都有积极影响(RR = 1.026-2.247):在慢性病管理中,同时针对一种以上的行为是有效的,应针对多种行为改变的科学发展开展更多研究。
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引用次数: 0
Main Partner Relationships and the HIV Care Cascade: Examining the Predictive Utility of Sexual Agreements, Partner Concordance, and Drug Use Among Sexual Minority Men Living With HIV in the USA. 主要性伴侣关系与 HIV 护理串联:在美国感染 HIV 的少数性取向男性中检验性协议、伴侣一致性和药物使用的预测效用》(Productive Utility of Sexual Agreements, Partner Concordance, and Drug Use Among Sexual Minority Men Living HIV in the USA)。
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-05-23 DOI: 10.1093/abm/kaae019
Tyrel J Starks, Daniel Sauermilch, Kendell M Doyle, Seth Kalichman, Demetria Cain

Background: The past 15 years have seen increasing attention to relationship factors among sexual minority male (SMM) couples at high risk for HIV infection. Research has largely focused on HIV prevention outcomes. Outcomes relevant to SMM living with HIV have received relatively less attention.

Purpose: This study evaluated associations between relational covariates (relationship status, sexual agreements, and seroconcordance) and HIV care cascade outcomes (having a current antiretroviral therapy [ART] prescription, ART adherence, viral load (VL) testing, and VL detectability) above and beyond cannabis and stimulant drug use.

Methods: Adult SMM (n = 36,874) living with HIV in the USA were recruited between November 1, 2017 and March 15, 2020 through social networking applications. They completed a cross-sectional survey online.

Results: Nonmonogamous SMM with serodiscordant partners were most likely to have an ART prescription. Those with seroconcordant partners (regardless of sexual agreements) were least likely to be adherent. While relational covariates were not associated with VL testing, SMM in nonmonogamous relationships with serodiscordant partners were significantly more likely to have an undetectable VL. Those in monogamous relationships with seroconcordant partners were significantly less likely to have an undetectable VL.

Conclusions: SMM with seroconcordant partners and monogamous sexual agreements may experience diminished interpersonal motivation for HIV care engagement. HIV care cascade retention messages that emphasize the prevention of onward transmission may have limited relevance for these SMM. Novel intervention strategies are needed to enhance HIV care outcomes in this population, ideally ones that incorporate attention to drug use.

背景:在过去的 15 年中,人们越来越关注艾滋病感染高风险男性性少数群体(SMM)夫妇之间的关系因素。研究主要集中在 HIV 预防结果上。目的:本研究评估了关系协变量(关系状态、性协议和血清一致性)与 HIV 护理级联结果(当前抗逆转录病毒疗法 [ART] 处方、坚持抗逆转录病毒疗法、病毒载量 (VL) 检测和 VL 可检测性)之间的关联,以及大麻和兴奋剂的使用情况:在 2017 年 11 月 1 日至 2020 年 3 月 15 日期间,通过社交网络应用程序招募了美国感染艾滋病毒的成年 SMM(n = 36,874 人)。他们在线完成了一项横断面调查:有血清不一致伴侣的非一夫一妻制 SMM 最有可能拥有抗逆转录病毒疗法处方。与血清不一致的伴侣(无论是否有性协议)在一起的 SMM 最不可能坚持抗逆转录病毒疗法。虽然关系协变量与 VL 检测无关,但与血清不一致的伴侣保持非一夫一妻制关系的 SMM 检测不到 VL 的可能性明显更高。而与血清不一致的伴侣保持一夫一妻制关系的 SMM 检测不到 VL 的可能性则明显较低:有血清一致伴侣和一夫一妻性协议的 SMM 可能会降低参与 HIV 护理的人际动机。强调预防继续传播的 HIV 护理级联保留信息对这些 SMM 的意义可能有限。需要采取新的干预策略来提高这类人群的艾滋病护理效果,最好是能够关注吸毒问题。
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引用次数: 0
Associations Between Psychological Factors and Adherence to Health Behaviors After Percutaneous Coronary Intervention: The Role of Cardiac Rehabilitation. 经皮冠状动脉介入治疗后心理因素与坚持健康行为之间的关系:心脏康复的作用。
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-11 DOI: 10.1093/abm/kaae008
Emma R Douma, Willem J Kop, Nina Kupper

Background: Cardiac rehabilitation (CR) participation after percutaneous coronary intervention (PCI) for coronary heart disease lowers the disease burden and risk of recurrent cardiac events. Examining psychological factors may improve post-PCI health behavior adherence.

Purpose: To determine whether psychological factors are associated with post-PCI health behavior adherence, and the role of CR participation.

Methods: Data from 1,682 patients (22.1% female, Mage = 64.0, SDage = 10.5 years) from the THORESCI cohort were included. Adjusted mixed models were used to examine associations between psychological factors and the 1-year course of health behaviors, using interactions to test for moderation by CR participation.

Results: Psychological factors were associated with the trajectories of adherence to medical advice, exercise, and diet. The strongest association found was between optimism and the trajectory of dietary adherence (B: = -0.09, p = .026). Patients with high optimism levels had a worse trajectory of dietary adherence compared to patients with low to middle optimism levels. Participation in CR buffered the associations of high anxiety, pessimism, and low to middle resilience, but strengthened the associations of high stress in the past year with the probability of smoking.

Conclusions: Psychological factors are associated with post-PCI health behavior adherence, but the pattern of associations is complex. Patients with high levels of anxiety, pessimism, and low to middle resilience levels may disproportionately benefit from CR. Cardiac rehabilitation programs could consider this to improve post-PCI health behavior adherence.

Clinical trials registration #: NCT02621216.

背景:冠心病经皮冠状动脉介入治疗(PCI)后参与心脏康复(CR)可降低疾病负担和复发心脏事件的风险。目的:确定心理因素是否与经皮冠状动脉介入术后健康行为的坚持有关,以及参与心脏康复的作用:方法:纳入 THORESCI 队列中 1682 名患者(22.1% 为女性,平均年龄 = 64.0 岁,平均年龄 = 10.5 岁)的数据。使用调整后的混合模型来检验心理因素与健康行为 1 年历程之间的关联,并使用交互作用来检验 CR 参与的调节作用:结果:心理因素与遵从医嘱、运动和饮食的轨迹有关。乐观情绪与饮食依从性轨迹之间的关系最为密切(B:=-0.09,P=0.026)。与中低度乐观的患者相比,高度乐观的患者的饮食依从性更差。参与 CR 可以缓冲高度焦虑、悲观和中低复原力之间的关联,但加强了过去一年中高度压力与吸烟概率之间的关联:心理因素与PCI术后的健康行为依从性有关,但其关联模式非常复杂。焦虑、悲观程度高、抗压能力处于中低水平的患者可能更容易从心脏康复中获益。心脏康复项目可以考虑这一点,以提高PCI术后健康行为的依从性。临床试验注册号:NCT02621216。
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引用次数: 0
The Longitudinal Reciprocal Relationships of Tooth Brushing Behaviors Between Underserved Children and Their Caregivers. 未得到充分服务的儿童与其照顾者之间刷牙行为的纵向互惠关系。
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-11 DOI: 10.1093/abm/kaae010
Romano Endrighi, Michelle Henshaw, William G Adams, Erin Montion, Hannah Park, Belinda Borrelli

Background: Tooth brushing is effective in preventing early childhood caries. However, it is unclear how children's and caregiver's tooth brushing are reciprocally related.

Purpose: The current study investigated whether the longitudinal relationships between children and caregiver tooth brushing are moderated by a caregiver-targeted child oral health intervention and caregiver depression.

Methods: Secondary analysis of a randomized clinical trial that tested whether caregiver-targeted oral health text messages (OHT) outperformed child wellness text messages (CWT) on pediatric dental caries and oral health behaviors (n = 754, mean child age = 2.9 years, 56.2% Black, 68.3%

Results: Within-participants analyses revealed that caregiver tooth brushing at Months 4 and 12 positively predicted their child's tooth brushing at Months 12 and 24 for caregivers in the OHT condition with low depressive symptoms (i.e., moderation by depressive symptoms and condition). Similarly, children's tooth brushing at Month 4 positively predicted caregiver tooth brushing at Month 12 for caregivers in the OHT condition with low depressive symptoms. There were no significant associations among participants in the CWT condition, regardless of depressive symptoms.

Conclusions: Child and caregiver tooth brushing have reciprocal influences, but only for those in the OHT condition with low depressive symptoms.

背景:刷牙能有效预防儿童早期龋齿。目的:本研究调查了儿童刷牙与照顾者刷牙之间的纵向关系是否会受到以照顾者为目标的儿童口腔健康干预和照顾者抑郁的调节:方法: 对一项随机临床试验进行二次分析,该试验测试了在儿童龋齿和口腔健康行为方面,以护理者为目标的口腔健康短信(OHT)是否优于儿童健康短信(CWT)(n = 754,儿童平均年龄 = 2.9 岁,56.2% 为黑人,68.3% 为黑人):参与者内部分析表明,对于抑郁症状较轻的 OHT 条件下的照顾者而言,其子女在第 4 个月和第 12 个月的刷牙情况对其子女在第 12 个月和第 24 个月的刷牙情况有积极的预测作用(即抑郁症状和条件的调节作用)。同样,对于抑郁症状较轻的 OHT 条件下的照顾者而言,儿童在第 4 个月的刷牙情况对照顾者在第 12 个月的刷牙情况具有正向预测作用。在CWT条件下,无论抑郁症状如何,参与者之间都没有明显的关联:结论:儿童和照顾者刷牙具有相互影响的作用,但只适用于抑郁症状较轻的 OHT 条件下的照顾者。
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引用次数: 0
The Impact of Monetary Incentives on Delay Discounting Within a Year-Long Physical Activity Intervention. 在为期一年的体育锻炼干预中,货币激励对延迟贴现的影响。
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-11 DOI: 10.1093/abm/kaae009
Vincent Berardi, Christine B Phillips, Mindy L McEntee, Chad Stecher, Michael Todd, Marc A Adams

Background: Delay discounting is the depreciation in a reward's perceived value as a function of the time until receipt. Monetary incentive programs that provide rewards contingent on meeting daily physical activity (PA) goals may change participants' delay discounting preferences.

Purpose: Determine if monetary incentives provided in close temporal proximity to meeting PA goals changed delay discounting, and if such changes mediated intervention effects.

Methods: Inactive adults (n = 512) wore accelerometers during a 12-month intervention where they received proximal monetary incentives for meeting daily moderate-to-vigorous PA (MVPA) goals or delayed incentives for study participation. Delay discount rate and average MVPA were assessed at baseline, end of intervention, and a 24-month follow-up. Using structural equation modeling, we tested effects of proximal versus delayed rewards on delay discounting and whether any changes mediated intervention effects on MVPA. PA self-efficacy was also evaluated as a potential mediator, and both self-efficacy and delay discounting were assessed as potential moderators of intervention effects.

Results: Proximal rewards significantly increased participants' delay discounting (β = 0.238, confidence interval [CI]: -0.078, 0.380), indicating greater sensitivity to reinforcement timing. This change did not mediate incentive-associated increases in MVPA at the end of the 12-month intervention (β = -0.016, CI: -0.053, 0.019) or at a 24-month follow-up (β = -0.020, CI: -0.059, 0.018). Moderation effects were not found.

Conclusions: Incentive-induced increases in delay discounting did not deleteriously impact MVPA. This finding may help assuage concerns about using monetary incentives for PA promotion, but further research regarding the consequences of changes in delay discounting is warranted.

背景:延迟折现是指奖励的感知价值随收到奖励的时间而贬值。目的:确定与实现体育锻炼目标在时间上接近的货币激励措施是否会改变延迟折现,以及这种变化是否会调节干预效果:不运动的成年人(n = 512)在为期 12 个月的干预期间佩戴加速度计,他们因达到每日中强度运动(MVPA)目标而获得近距离金钱奖励,或因参与研究而获得延迟奖励。延迟折扣率和平均 MVPA 分别在基线、干预结束和 24 个月的随访中进行评估。通过结构方程模型,我们测试了近距离奖励与延迟奖励对延迟折扣率的影响,以及这些变化是否对 MVPA 的干预效果起到了中介作用。运动自我效能感也被评估为潜在的中介因素,自我效能感和延迟折扣也被评估为干预效果的潜在调节因素:结果:近距离奖励明显增加了参与者的延迟折扣(β = 0.238,置信区间[CI]:-0.078, 0.380),这表明参与者对强化时机更加敏感。在为期 12 个月的干预结束时(β = -0.016,置信区间[CI]:-0.053,0.019)或在为期 24 个月的随访中(β = -0.020,CI:-0.059,0.018),这种变化并没有促进与激励相关的 MVPA 的增加。没有发现调节效应:结论:由激励引起的延迟折现的增加不会对 MVPA 产生有害影响。这一发现可能有助于消除人们对使用金钱激励来促进PA的担忧,但还需要进一步研究延迟折现变化的后果。
{"title":"The Impact of Monetary Incentives on Delay Discounting Within a Year-Long Physical Activity Intervention.","authors":"Vincent Berardi, Christine B Phillips, Mindy L McEntee, Chad Stecher, Michael Todd, Marc A Adams","doi":"10.1093/abm/kaae009","DOIUrl":"10.1093/abm/kaae009","url":null,"abstract":"<p><strong>Background: </strong>Delay discounting is the depreciation in a reward's perceived value as a function of the time until receipt. Monetary incentive programs that provide rewards contingent on meeting daily physical activity (PA) goals may change participants' delay discounting preferences.</p><p><strong>Purpose: </strong>Determine if monetary incentives provided in close temporal proximity to meeting PA goals changed delay discounting, and if such changes mediated intervention effects.</p><p><strong>Methods: </strong>Inactive adults (n = 512) wore accelerometers during a 12-month intervention where they received proximal monetary incentives for meeting daily moderate-to-vigorous PA (MVPA) goals or delayed incentives for study participation. Delay discount rate and average MVPA were assessed at baseline, end of intervention, and a 24-month follow-up. Using structural equation modeling, we tested effects of proximal versus delayed rewards on delay discounting and whether any changes mediated intervention effects on MVPA. PA self-efficacy was also evaluated as a potential mediator, and both self-efficacy and delay discounting were assessed as potential moderators of intervention effects.</p><p><strong>Results: </strong>Proximal rewards significantly increased participants' delay discounting (β = 0.238, confidence interval [CI]: -0.078, 0.380), indicating greater sensitivity to reinforcement timing. This change did not mediate incentive-associated increases in MVPA at the end of the 12-month intervention (β = -0.016, CI: -0.053, 0.019) or at a 24-month follow-up (β = -0.020, CI: -0.059, 0.018). Moderation effects were not found.</p><p><strong>Conclusions: </strong>Incentive-induced increases in delay discounting did not deleteriously impact MVPA. This finding may help assuage concerns about using monetary incentives for PA promotion, but further research regarding the consequences of changes in delay discounting is warranted.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":"341-352"},"PeriodicalIF":3.8,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11008587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179181","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}
引用次数: 0
Patient Navigation Plus Tailored Digital Video Disc Increases Colorectal Cancer Screening Among Low-Income and Minority Patients Who Did Not Attend a Scheduled Screening Colonoscopy: A Randomized Trial. 患者导航加定制数字视频光盘提高了未参加预定结肠镜筛查的低收入和少数民族患者的结直肠癌筛查率:随机试验。
IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-11 DOI: 10.1093/abm/kaae013
Susan M Rawl, Susan M Perkins, Yan Tong, Mira L Katz, Lisa Carter-Bawa, Thomas F Imperiale, Peter H Schwartz, Hala Fatima, Connie Krier, Kevin Tharp, Rivienne Shedd-Steele, Mark Magnarella, Caeli Malloy, Laura Haunert, Netsanet Gebregziabher, Electra D Paskett, Victoria Champion

Background: Up to 50% of people scheduled for screening colonoscopy do not complete this test and no studies have focused on minority and low-income populations. Interventions are needed to improve colorectal cancer (CRC) screening knowledge, reduce barriers, and provide alternative screening options. Patient navigation (PN) and tailored interventions increase CRC screening uptake, however there is limited information comparing their effectiveness or the effect of combining them.

Purpose: Compare the effectiveness of two interventions to increase CRC screening among minority and low-income individuals who did not attend their screening colonoscopy appointment-a mailed tailored digital video disc (DVD) alone versus the mailed DVD plus telephone-based PN compared to usual care.

Methods: Patients (n = 371) aged 45-75 years at average risk for CRC who did not attend a screening colonoscopy appointment were enrolled and were randomized to: (i) a mailed tailored DVD; (ii) the mailed DVD plus phone-based PN; or (iii) usual care. CRC screening outcomes were from electronic medical records at 12 months. Multivariable logistic regression analyses were used to study intervention effects.

Results: Participants randomized to tailored DVD plus PN were four times more likely to complete CRC screening compared to usual care and almost two and a half times more likely than those who were sent the DVD alone.

Conclusions: Combining telephone-based PN with a mailed, tailored DVD increased CRC screening among low-income and minority patients who did not attend their screening colonoscopy appointments and has potential for wide dissemination.

背景:多达 50% 的计划接受结肠镜筛查的人没有完成这项检查,而且没有针对少数民族和低收入人群的研究。需要采取干预措施来提高人们对结直肠癌(CRC)筛查的认识,减少筛查障碍,并提供其他筛查选择。目的:比较两种干预措施对提高未参加结肠镜筛查预约的少数民族和低收入人群的结肠镜筛查率的效果--一种是单独邮寄定制的数字视频光盘(DVD),另一种是邮寄的 DVD 加上电话定制的患者指导,与常规护理相比,效果如何:方法: 年龄在 45-75 岁之间、具有 CRC 平均风险且未参加结肠镜筛查预约的患者(n = 371)被纳入研究,并随机接受以下治疗:(i)邮寄的定制 DVD;(ii)邮寄的 DVD 加电话 PN;或 (iii)常规护理。CRC 筛查结果来自 12 个月的电子病历。多变量逻辑回归分析用于研究干预效果:结果:随机接受定制 DVD 加 PN 的参与者完成 CRC 筛查的几率是常规护理的四倍,是仅接受 DVD 的参与者的近 2.5 倍:结论:将基于电话的 PN 与邮寄的定制 DVD 相结合,可提高未参加结肠镜筛查预约的低收入和少数民族患者的 CRC 筛查率,具有广泛推广的潜力。
{"title":"Patient Navigation Plus Tailored Digital Video Disc Increases Colorectal Cancer Screening Among Low-Income and Minority Patients Who Did Not Attend a Scheduled Screening Colonoscopy: A Randomized Trial.","authors":"Susan M Rawl, Susan M Perkins, Yan Tong, Mira L Katz, Lisa Carter-Bawa, Thomas F Imperiale, Peter H Schwartz, Hala Fatima, Connie Krier, Kevin Tharp, Rivienne Shedd-Steele, Mark Magnarella, Caeli Malloy, Laura Haunert, Netsanet Gebregziabher, Electra D Paskett, Victoria Champion","doi":"10.1093/abm/kaae013","DOIUrl":"10.1093/abm/kaae013","url":null,"abstract":"<p><strong>Background: </strong>Up to 50% of people scheduled for screening colonoscopy do not complete this test and no studies have focused on minority and low-income populations. Interventions are needed to improve colorectal cancer (CRC) screening knowledge, reduce barriers, and provide alternative screening options. Patient navigation (PN) and tailored interventions increase CRC screening uptake, however there is limited information comparing their effectiveness or the effect of combining them.</p><p><strong>Purpose: </strong>Compare the effectiveness of two interventions to increase CRC screening among minority and low-income individuals who did not attend their screening colonoscopy appointment-a mailed tailored digital video disc (DVD) alone versus the mailed DVD plus telephone-based PN compared to usual care.</p><p><strong>Methods: </strong>Patients (n = 371) aged 45-75 years at average risk for CRC who did not attend a screening colonoscopy appointment were enrolled and were randomized to: (i) a mailed tailored DVD; (ii) the mailed DVD plus phone-based PN; or (iii) usual care. CRC screening outcomes were from electronic medical records at 12 months. Multivariable logistic regression analyses were used to study intervention effects.</p><p><strong>Results: </strong>Participants randomized to tailored DVD plus PN were four times more likely to complete CRC screening compared to usual care and almost two and a half times more likely than those who were sent the DVD alone.</p><p><strong>Conclusions: </strong>Combining telephone-based PN with a mailed, tailored DVD increased CRC screening among low-income and minority patients who did not attend their screening colonoscopy appointments and has potential for wide dissemination.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":"314-327"},"PeriodicalIF":3.6,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11008590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140108782","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}
引用次数: 0
Black Young Adult Superwomen in the Face of Gendered Racial Microaggressions: Contextualizing Challenges With Acceptance and Avoidance and Emotional Eating. 黑人青年女超人面对性别化的种族微词:将接受和回避以及情绪化饮食的挑战情境化》(Contextualizing Challenges With Acceptance and Avoidance and Emotional Eating)。
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-11 DOI: 10.1093/abm/kaae017
Vanessa V Volpe, Abbey N Collins, Julia M Ross, Katrina R Ellis, Jioni A Lewis, Brianna A Ladd, Stephanie L Fitzpatrick

Background: Black young adult women (ages 18-35) are at disproportionate risk for obesity and emotional eating. Emotional eating interventions target psychological flexibility, such as reducing experiential avoidance and increasing acceptance of food-related thoughts. Yet Black women face gendered racism, and some endorse roles that reduce psychological flexibility, such as the superwoman schema role. Culturally centered stress and coping has often been overlooked, leading to an incomplete understanding of processes that engender emotional eating and the implications for appropriate and effective interventions for Black young adult women.

Purpose: We investigated direct and indirect pathways of associations between stress from gendered racial microaggressions to emotional eating through the endorsement of superwoman schema and two aspects of psychological flexibility.

Methods: Black young adult women (N = 504; Mage = 24.72; 75.2% African American; 98.4% cisgender) participated in an online survey wherein they reported demographics, stress from gendered racial microaggressions, superwoman schema, experiential avoidance, acceptance of food-related thoughts, and emotional eating. Path analysis was conducted to examine direct and indirect effects.

Results: Results provided evidence for indirect associations between more stress from gendered racial microaggressions and more emotional eating. More stress was associated with greater endorsement of the superwoman schema which was associated with more experiential avoidance and less acceptance of food-related thoughts, which were each associated with more emotional eating.

Conclusions: Endorsement of superwoman schema and concomitant avoidance and less acceptance may be one way that gendered racial stress propels emotional eating. Future research could test intervention components that disrupt this path.

背景:黑人年轻成年女性(18-35 岁)肥胖和情绪化饮食的风险过高。情绪性进食干预以心理灵活性为目标,如减少体验性回避和增加对食物相关想法的接受度。然而,黑人女性面临着性别种族主义,有些人认可的角色会降低心理灵活性,如女超人模式角色。以文化为中心的压力和应对方法常常被忽视,导致人们对引起情绪性进食的过程以及对黑人年轻成年女性进行适当、有效干预的影响了解不全面。目的:我们通过认可超级女性图式和心理灵活性的两个方面,研究了性别化种族微攻击与情绪性进食之间压力关联的直接和间接途径:黑人年轻成年女性(N = 504;Mage = 24.72;75.2%为非裔美国人;98.4%为顺性性别)参与了一项在线调查,她们在调查中报告了人口统计学、来自性别化种族微冒犯的压力、女超人模式、经验性回避、接受与食物有关的想法以及情绪化饮食。我们进行了路径分析,以研究直接和间接影响:结果:研究结果证明,性别化种族微观诽谤造成的更大压力与更多情绪化饮食之间存在间接联系。压力越大,对女超人模式的认可度就越高,而女超人模式又与更多的体验性回避和更少的接受与食物有关的想法有关,这两种情况都与更多的情绪化进食有关:结论:对 "女超人 "模式的认可以及伴随而来的回避和较少接受可能是性别种族压力推动情绪化饮食的一种方式。未来的研究可以测试干扰这一途径的干预措施。
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引用次数: 0
Genome-Wide Genetic Analysis of Dropout in a Controlled Exercise Intervention in Sedentary Adults With Overweight or Obesity and Cardiometabolic Disease. 对患有超重或肥胖症及心脏代谢疾病的久坐成人退出受控运动干预的全基因组遗传分析。
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-11 DOI: 10.1093/abm/kaae011
Rong Jiang, Katherine A Collins, Kim M Huffman, Elizabeth R Hauser, Monica J Hubal, Johanna L Johnson, Redford B Williams, Ilene C Siegler, William E Kraus

Background: Despite the benefits of exercise, many individuals are unable or unwilling to adopt an exercise intervention.

Purpose: The purpose of this analysis was to identify putative genetic variants associated with dropout from exercise training interventions among individuals in the STRRIDE trials.

Methods: We used a genome-wide association study approach to identify genetic variants in 603 participants initiating a supervised exercise intervention. Exercise intervention dropout occurred when a subject withdrew from further participation in the study or was otherwise lost to follow-up.

Results: Exercise intervention dropout was associated with a cluster of single-nucleotide polymorphisms with the top candidate being rs722069 (T/C, risk allele = C) (unadjusted p = 2.2 × 10-7, odds ratio = 2.23) contained within a linkage disequilibrium block on chromosome 16. In Genotype-Tissue Expression, rs722069 is an expression quantitative trait locus of the EARS2, COG7, and DCTN5 genes in skeletal muscle tissue. In subsets of the STRRIDE genetic cohort with available muscle gene expression (n = 37) and metabolic data (n = 82), at baseline the C allele was associated with lesser muscle expression of EARS2 (p < .002) and COG7 (p = .074) as well as lesser muscle concentrations of C2- and C3-acylcarnitines (p = .026).

Conclusions: Our observations imply that exercise intervention dropout is genetically moderated through alterations in gene expression and metabolic pathways in skeletal muscle. Individual genetic traits may allow the development of a biomarker-based approach for identifying individuals who may benefit from more intensive counseling and other interventions to optimize exercise intervention adoption.

Clinical trial information: STRRIDE I = NCT00200993; STRRIDE AT/RT = NCT00275145; STRRIDE-PD = NCT00962962.

背景:目的:本分析的目的是确定与 STRRIDE 试验中个人退出运动训练干预相关的假定遗传变异:我们采用全基因组关联研究的方法,在 603 名开始接受监督锻炼干预的参与者中识别基因变异。当受试者不再继续参与研究或因其他原因失去随访机会时,就会退出运动干预:结果:运动干预退出与一组单核苷酸多态性有关,其中最大的候选基因是rs722069(T/C,风险等位基因=C)(未调整p=2.2×10-7,几率比=2.23),该基因包含在16号染色体上的一个连锁不平衡区块中。在基因型-组织表达中,rs722069 是骨骼肌组织中 EARS2、COG7 和 DCTN5 基因的表达定量性状位点。在具有肌肉基因表达(n = 37)和代谢数据(n = 82)的 STRRIDE 遗传队列子集中,在基线时,C 等位基因与较低的 EARS2(p < .002)和 COG7(p = .074)肌肉表达以及较低的 C2-和 C3-酰肉碱肌肉浓度(p = .026)相关:我们的观察结果表明,通过改变骨骼肌中的基因表达和代谢途径,运动干预辍学会受到遗传因素的调节。个体遗传特征可能有助于开发一种基于生物标志物的方法,用于识别可能从更深入的咨询和其他干预措施中获益的个体,以优化运动干预措施的采用:strride i = NCT00200993; strride at/rt = NCT00275145; strride-pd = NCT00962962.
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引用次数: 0
Ecological Momentary Assessment of Weight Stigma and Eating Behavior in Everyday Life 对日常生活中的体重羞辱和饮食行为进行生态学瞬间评估
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-09 DOI: 10.1093/abm/kaae012
Jeffrey M Hunger, Amanda K Montoya, Kristienne Edrosolan, Juanyi Tan, Anne S Hubbard, A Janet Tomiyama
Background Weight stigma is widespread, but the existing literature on its harmful consequences remains largely limited to lab-based experiments and large-scale longitudinal designs. Purpose The purpose of this study was to understand how weight stigma unfolds in everyday life, and whether it predicts increased eating behavior. Methods In this event-contingent ecological momentary assessment study, 91 participants reported every time they experienced weight stigma and documented whether they ate, how much they ate, and what they ate. These reports were compared against a timepoint when they did not experience stigma. Results Participants reported a wide variety of stigmatizing events from a variety of sources, with the most common ones being the self, strangers, the media, and family. Multilevel models showed that participants were no more likely to eat post-stigma (vs. the comparison point), but if they did eat, they ate more servings of food (on average consuming 1.45 more servings, or 45% more). Moderation analyses indicated that this effect was amplified for men versus women. Conclusion Experiencing weight stigma appears to beget behavioral changes, potentially driving future weight gain, placing individuals at ever more risk for further stigmatization.
研究背景 体重蔑视现象十分普遍,但有关其有害后果的现有文献仍主要局限于实验室实验和大规模纵向设计。目的 本研究旨在了解体重烙印在日常生活中是如何产生的,以及它是否会预测饮食行为的增加。方法 在这项以事件为条件的生态瞬间评估研究中,91 名参与者报告了他们每次遭遇体重鄙视的情况,并记录了他们是否进食、进食多少以及进食的内容。这些报告与他们未遭遇鄙视时的时间点进行了比较。结果 参与者报告了各种来源的鄙视事件,其中最常见的是自己、陌生人、媒体和家人。多层次模型显示,成见发生后(与比较点相比),参与者进食的可能性并没有增加,但如果他们进食,则会吃更多的食物(平均多吃 1.45 份,即增加 45%)。调节分析表明,男性与女性相比,这种影响更大。结论 体重烙印似乎会导致行为改变,有可能导致未来体重增加,使个人面临更大的进一步烙印风险。
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引用次数: 0
Daily and Momentary Associations Between Gender Minority Stress and Resilience With Alcohol Outcomes 性别少数群体的压力和复原力与酒精结果之间的日常和瞬间关联
IF 3.8 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY Pub Date : 2024-04-06 DOI: 10.1093/abm/kaae015
Sarah S Dermody, Alexandra Uhrig, Jeffrey D Wardell, Carmina Tellez, Tara Raessi, Karla Kovacek, Trevor A Hart, Christian S Hendershot, Alex Abramovich
Background and purpose Minority stressors have been linked with alcohol use among transgender and gender diverse (TGD); however, no ecological momentary assessment studies have examined daily links between minority stress and alcohol use specifically among TGD. This study examined gender minority stressors and resilience as predictors of same-day or momentary alcohol-related outcomes. Feasibility and acceptability of procedures were evaluated. Methods Twenty-five TGD adults (mean age = 32.60, SD = 10.82; 88% White) were recruited Canada-wide and participated remotely. They completed 21 days of ecological momentary assessment with daily morning and random surveys (assessing alcohol outcomes, risk processes, gender minority stressors, resilience), and an exit interview eliciting feedback. Results Gender minority stress had significant and positive within-person relationships with same-day alcohol use (incidence risk ratio (IRR) = 1.12, 95% confidence interval [CI] [1.02, 1.23]), alcohol-related harms (IRR = 1.14, 95% CI [1.02, 1.28]), and coping motives (IRR = 1.06, 95% CI [1.03, 1.08]), as well as momentary (past 30-min) alcohol craving (IRR = 1.32, 95% CI [1.18, 1.47]), coping motives (IRR = 1.35, 95% CI [1.21, 1.51]), and negative affect (IRR = 1.28, 95% CI [1.20, 1.36]). Gender minority stress indirectly predicted same-day drinking via coping motives (ab = 0.04, 95% CI [0.02, 0.08]). Resilience was positively associated with same-day alcohol use (IRR = 1.25, 95% CI [1.03, 1.51]) but not harms. Conclusions TGD adults may use alcohol to cope with gender minority stress, which can increase the risk for alcohol-related harms. Interventions are needed to eliminate gender minority stressors and support adaptive coping strategies.
背景和目的 在变性者和性别多元化者(TGD)中,少数群体的压力因素与酗酒有关;但是,还没有生态学瞬间评估研究专门研究少数群体压力与 TGD 酗酒之间的日常联系。本研究将性别少数群体的压力和复原力作为当天或瞬间酒精相关结果的预测因素。研究还对程序的可行性和可接受性进行了评估。方法 在加拿大范围内招募了 25 名 TGD 成年人(平均年龄 = 32.60,SD = 10.82;88% 为白人),并让他们远程参与研究。他们完成了为期 21 天的生态瞬间评估,包括每日早晨调查和随机调查(评估酒精结果、风险过程、性别少数压力因素、复原力),以及一次征求反馈意见的退出访谈。结果 性别少数群体压力与当日酒精使用量(发生风险比 (IRR) = 1.12,95% 置信区间 [CI] [1.02, 1.23])、酒精相关伤害(IRR = 1.14,95% 置信区间 [1.02, 1.28])以及应对动机有明显的正相关关系。28])、应对动机(IRR = 1.06,95% CI [1.03,1.08])以及瞬间(过去 30 分钟)酒精渴求(IRR = 1.32,95% CI [1.18,1.47])、应对动机(IRR = 1.35,95% CI [1.21,1.51])和负面情绪(IRR = 1.28,95% CI [1.20,1.36])。性别少数压力通过应对动机间接预测当日饮酒(ab = 0.04,95% CI [0.02,0.08])。复原力与当日饮酒呈正相关(IRR = 1.25,95% CI [1.03,1.51]),但与危害无关。结论 性别少数群体成年人可能会通过饮酒来应对性别少数群体的压力,这可能会增加酒精相关危害的风险。需要采取干预措施来消除性别少数压力并支持适应性应对策略。
{"title":"Daily and Momentary Associations Between Gender Minority Stress and Resilience With Alcohol Outcomes","authors":"Sarah S Dermody, Alexandra Uhrig, Jeffrey D Wardell, Carmina Tellez, Tara Raessi, Karla Kovacek, Trevor A Hart, Christian S Hendershot, Alex Abramovich","doi":"10.1093/abm/kaae015","DOIUrl":"https://doi.org/10.1093/abm/kaae015","url":null,"abstract":"Background and purpose Minority stressors have been linked with alcohol use among transgender and gender diverse (TGD); however, no ecological momentary assessment studies have examined daily links between minority stress and alcohol use specifically among TGD. This study examined gender minority stressors and resilience as predictors of same-day or momentary alcohol-related outcomes. Feasibility and acceptability of procedures were evaluated. Methods Twenty-five TGD adults (mean age = 32.60, SD = 10.82; 88% White) were recruited Canada-wide and participated remotely. They completed 21 days of ecological momentary assessment with daily morning and random surveys (assessing alcohol outcomes, risk processes, gender minority stressors, resilience), and an exit interview eliciting feedback. Results Gender minority stress had significant and positive within-person relationships with same-day alcohol use (incidence risk ratio (IRR) = 1.12, 95% confidence interval [CI] [1.02, 1.23]), alcohol-related harms (IRR = 1.14, 95% CI [1.02, 1.28]), and coping motives (IRR = 1.06, 95% CI [1.03, 1.08]), as well as momentary (past 30-min) alcohol craving (IRR = 1.32, 95% CI [1.18, 1.47]), coping motives (IRR = 1.35, 95% CI [1.21, 1.51]), and negative affect (IRR = 1.28, 95% CI [1.20, 1.36]). Gender minority stress indirectly predicted same-day drinking via coping motives (ab = 0.04, 95% CI [0.02, 0.08]). Resilience was positively associated with same-day alcohol use (IRR = 1.25, 95% CI [1.03, 1.51]) but not harms. Conclusions TGD adults may use alcohol to cope with gender minority stress, which can increase the risk for alcohol-related harms. Interventions are needed to eliminate gender minority stressors and support adaptive coping strategies.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583306","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}
引用次数: 0
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Annals of Behavioral Medicine
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