Annals Of Behavioral Medicine[JOURNAL]
Sun
200 papers
Exploring the categorization of barriers to physical activity and their associations with leisure time physical activity and body mass index in a sample of Jamaican adults.
Bateman AG, Schumacher LM, Ricketts C … +5 more , Gyimah A, Brown R, Ramlochan M, Lyew AJ, Harris N
Ann Behav Med · 2025 Jan · PMID 41173547 · Publisher ↗
BACKGROUND: Over 80% of Jamaicans are not meeting World Health Organization physical activity guidelines, and over 50% are overweight or obese. Research on barriers to physical activity and their associations with physic...
BACKGROUND: Over 80% of Jamaicans are not meeting World Health Organization physical activity guidelines, and over 50% are overweight or obese. Research on barriers to physical activity and their associations with physical activity engagement among Jamaican adults is limited. This study explores the measurement and categorization of barriers to physical activity in Jamaican adults to inform the design and implementation of behavioral physical activity-promoting interventions. PURPOSE: This study applied a psychometric approach to explore the perception of barriers to physical activity and their associations with leisure time physical activity (LTPA) and body mass index (BMI) in Jamaican adults. METHODS: A total of 506 Jamaican adults completed self-report measures of demographic data, height, and weight (to calculate BMI), barriers to physical activity, and LTPA in a cross-sectional survey design. Exploratory structural equation modeling was used to determine the best-fitting model for responses to the barriers to physical activity (BPA) scale. Structural equation modeling was used to examine the associations among BPA, LTPA, and BMI. RESULTS: A 15-item BPA scale with 2 categories of barriers was identified: (1) psychosocial (PS-BPA; 7 items; eg, lack of self-motivation or confidence) and (2) environmental/demographic (ED-BPA; 8 items; safety or financial/cost issues) was identified. PS-BPA but not ED-BPA meaningfully associated with LTPA. LTPA was negatively associated with BMI. CONCLUSIONS: Psychosocial barriers may at least partially explain why most Jamaican adults do not meet global physical activity guidelines. Psychosocial correlates of physical activity should be emphasized when investigating and targeting physical activity barriers in behavioral interventions among Jamaican adults.
Childcare engagement among older adults in Australia and subsequent physical, psychosocial, and behavioral health outcomes.
Htun HL, Teshale AB, Ryan J … +4 more , Foong SH, Oster C, Owen AJ, Freak-Poli R
Ann Behav Med · 2025 Jan · PMID 41143543 · Full text
BACKGROUND: While intergenerational caregiving is increasingly prevalent among older individuals, longitudinal evidence on its associations with multidimensional health outcomes remains limited. PURPOSE: This study exami...
BACKGROUND: While intergenerational caregiving is increasingly prevalent among older individuals, longitudinal evidence on its associations with multidimensional health outcomes remains limited. PURPOSE: This study examined the associations between childcare engagement in older adults and various health and behavioral outcomes at follow-up. METHODS: We analyzed data from a cohort of >12 000 (range: 12 124-12 896) community-dwelling adults aged 70+ years, categorizing childcare engagement as never, <weekly, and ≥weekly. Using an outcome-wide approach, we assessed 42 outcomes across physical, cognitive/major health events, psychological, social, and behavioral domains. Follow-up assessments occurred at ∼2 years for most outcomes, with extended follow-up (median 6-9 years) for time-to-event outcomes. We performed gender-disaggregated regressions, adjusting for multiple covariates. RESULTS: Participants were aged 70-95 years (mean: 75.2 ± 4.3) at baseline, and 54.5% were women. Childcare engagement was more common among women (46% vs. 40%). Key findings included: (1) social domain: both genders showed increased social contacts and community participation, with women additionally demonstrating reduced social isolation; (2) mortality: lower mortality was observed in men with a dose-response pattern, while only <weekly childminding was associated with lower mortality in women; (3) physical domain: men showed increased moderate-to-vigorous physical activity while women had higher pain reports and slower gait speed; and (4) null associations: most psychological outcomes, as well as certain physical and health events, showed no significant relationships. CONCLUSION: Childcare engagement during older adulthood was linked to not only selected health outcomes, including notable social benefits and lower mortality, but also some physical trade-offs in women. These findings support considering intergenerational engagement in healthy ageing initiatives.
Longitudinal changes in physical activity and dietary fat intake during an intensive lifestyle intervention: the PROPEL trial.
Wang D, Rojo-Tirado MÁ, Katzmarzyk PT
Ann Behav Med · 2025 Jan · PMID 41136343 · Publisher ↗
BACKGROUND: Lifestyle modifications including physical activity and dietary changes are considered the cornerstone approach for behavioral obesity management. However, there is a lack of knowledge about long-term traject...
BACKGROUND: Lifestyle modifications including physical activity and dietary changes are considered the cornerstone approach for behavioral obesity management. However, there is a lack of knowledge about long-term trajectory patterns during interventions. AIMS: This study aims to (1) assess physical activity and dietary fat intake trajectory during a 24-month intensive lifestyle intervention; and (2) identify baseline characteristics and sociodemographic predictors associated with different behavioral trajectory patterns. METHODS: The PROPEL trial recruited and randomly assigned primary care clinics to a 2-year intensive lifestyle intervention or a usual care group. A total of 439 individuals (88.4% female, 73.8% Black) enrolled in the intervention group. Participants were included in the analysis if they provided valid data for physical activity and dietary fat intake at a minimum of 2 of the 4 assessment time points. Physical activity was measured via the short-form International Physical Activity Questionnaire, and the percentage of energy from fat was measured using a validated fat screener. A group-based trajectory model was used to identify the physical activity and dietary fat intake trajectory groups. Multilevel multinomial logistic regression models were used with the dependent variable of trajectory group membership, adjusting for baseline covariates. All statistical analyses were performed using R statistical software (version 4.4.2, macOS), and P < .05 was considered statistically significant. RESULTS: Trajectory analysis identified 5 groups of physical activity and dietary fat intake over 24 months. Group 1 (21%) maintained moderate physical activity with a gradual decrease after 6 months, accompanied by an initial fat reduction that plateaued at 31%. Group 2 (16%) had low activity levels while showing a U-shaped fat intake during the intervention. Group 3 (33%) reached a peak of high activity at 6 months before declining, maintaining the lowest percentage of fat intake. Group 4 (20%) increased activity through 12 months with a reverse U-shaped change and with fat reduction, while group 5 (10%) also had low activity and persistently high fat intake. Multinomial regression indicated that participants with diabetes at baseline were more likely to be classified as group 5 with a lower activity level and high dietary fat intake. CONCLUSION: Identifying the trajectory of behavior can facilitate the development of more tailored interventions, particularly for long-term behavior change.
A scoping review of pain and tobacco use among cancer survivors.
Powers JM, Ferguson E, Miller CH … +2 more , Hitsman B, Rini C
Ann Behav Med · 2025 Jan · PMID 41083218 · Full text
BACKGROUND: Pain and tobacco use frequently co-occur in the general population; however, less is known about whether these relationships extend to cancer survivors, who report high levels of chronic pain. PURPOSE: This s...
BACKGROUND: Pain and tobacco use frequently co-occur in the general population; however, less is known about whether these relationships extend to cancer survivors, who report high levels of chronic pain. PURPOSE: This scoping review aimed to inform future research by identifying, characterizing, and synthesizing the research literature on pain and nicotine/tobacco use among cancer survivors. METHODS: We developed and executed a comprehensive search strategy in December 2023 and September 2024, identifying 5901 peer-reviewed citations after systematic search of Embase (Elsevier), MEDLINE (Ovid), PsycINFO (EBSCO), Cochrane Library (Wiley), and ClinicalTrials.gov. Fifty-four studies published from 2004 to 2024 met inclusion criteria. RESULTS: Most studies focused on combustible cigarette smoking (∼94%), and minimal research focused on treatment and tobacco cessation. Approximately half (n = 27) of studies were prospective/longitudinal in design, followed by cross-sectional (n = 25), qualitative (n = 1), and a pilot randomized controlled trial (n = 1). Most studies (∼74%) demonstrated a positive relationship between pain and cigarette/tobacco use. Former smoking was linked to lower pain levels, although findings were more mixed in this area. Only 2 studies found a negative relationship between pain and tobacco use. CONCLUSIONS: This review demonstrates that associations between pain and cigarette smoking in cancer survivors are the same as those found in the general population. Future research would benefit from: (1) incorporating more rigorous designs capable of determining causality, (2) focusing on use of other nicotine/tobacco products (eg, electronic cigarettes), (3) elucidating mechanisms in pain and tobacco use, and (4) considering impact of pain on smoking cessation and treatment among cancer survivors.
Interventions that inform patients about nocebo effects: A systematic review of the current evidence.
Spotts EK, Geers AL
Ann Behav Med · 2025 Jan · PMID 41062244 · Publisher ↗
BACKGROUND: The disclosure of side-effect information can negatively contribute to one's health by giving rise to nocebo side-effects, in which simply learning about potential side-effects increases their occurrence. Noc...
BACKGROUND: The disclosure of side-effect information can negatively contribute to one's health by giving rise to nocebo side-effects, in which simply learning about potential side-effects increases their occurrence. Nocebo side-effects can decrease treatment adherence, and reduce quality of life, so it is valuable to establish interventions to decrease nocebo effects. One promising method is to inform individuals about the nocebo effect, termed nocebo education. METHODS: A systematic review following the PRISMA guidelines was conducted across databases, including PubMed, Web of Science, and PsychInfo, to summarize and assess the results of research that has administered nocebo education as an intervention. RESULTS: We identified 18 records with 21 studies that met the criteria of controlled experiments manipulating nocebo education. Six experiments included patient-only samples (cancer patients, depressive disorder patients), with 5 resulting in evidence for symptom and/or psychological changes induced by nocebo education. Fifteen experiments included subpatient or nonpatient samples, with 11 resulting in either significant symptom, behavioral, and/or psychological changes from nocebo education. Effect sizes were highly variable across studies. CONCLUSIONS: The studies provide preliminary support that nocebo education can reduce side-effects and change possible mechanisms of action underlying nocebo effects from side effect disclosure. The main conclusion, however, is that presently, the literature is quite limited and there is a need for additional research testing the impact of nocebo education on side effect symptoms, particularly in patient samples. We close the review by discussing unanswered questions, conflicting results, and potential strategies for optimizing future interventions.
Evaluating the role of interpersonal support on daily physical activity across systems, contexts, and time among African American women: an ecological momentary assessment study.
Sweeney AM, Prine H, Yang CH … +3 more , Wilson DK, Forthofer M, Martin P
Ann Behav Med · 2025 Jan · PMID 41047466 · Full text
BACKGROUND: Extensive research demonstrates the importance of the social environment for physical activity (PA) among African American (AA) women. Such studies rarely evaluate the simultaneous impact of interpersonal fac...
BACKGROUND: Extensive research demonstrates the importance of the social environment for physical activity (PA) among African American (AA) women. Such studies rarely evaluate the simultaneous impact of interpersonal factors across multiple systems or fluctuations across time. PURPOSE: This study used Ecological Momentary Assessment (EMA) within a group-based PA intervention to evaluate how interpersonal factors impacted daily PA. METHODS: Data were collected from 45 AA women (Mage = 52.7 ± 14) in the Together Everyone Achieves More Physical Activity randomized controlled trial. Participants used a smartphone-based EMA application and received two daily prompts across three 7-day phases of the intervention period while simultaneously wearing a Fitbit. Participants answered questions about interpersonal factors within their intervention group (social support given and received, relatedness, collective efficacy, and group cohesion) and external social support. RESULTS: Participants engaged in greater steps on days with higher than usual external social support (relative to one's usual level) (B = 535.25, P <.001) and higher than usual social support given to others in the intervention group (B = 673.10, P = .003). Participants were more likely to engage in any moderate to vigorous PA (MVPA) on days with higher than usual social support received from the intervention group (OR = 1.59, P = .014) and engaged in greater overall MVPA on days with higher than usual external social support (B = 0.18, p <.001). CONCLUSIONS: By evaluating within-person changes over time and with a systems-level focus, this study provides novel insights into the role of interpersonal support for promoting PA among AA women.
Prevalence and scholarly impact of observational versus experimental research in health psychology and behavioral medicine.
Sheeran P, Pei Y, Rothman AJ
Ann Behav Med · 2025 Jan · PMID 41047237 · Publisher ↗
OBJECTIVE: This study examines what kinds of evidence are used and valued in advancing the goals of health psychology and behavioral medicine. As no systematic analysis of the prevalence and scholarly impact of different...
OBJECTIVE: This study examines what kinds of evidence are used and valued in advancing the goals of health psychology and behavioral medicine. As no systematic analysis of the prevalence and scholarly impact of different research designs appears to be available, the present research addressed three questions: How often are observational and experimental designs used in psychological research on health? Has the prevalence of these designs changed over time? And what is the scholarly impact of research using observational versus experimental designs? METHOD: All quantitative, empirical studies published in six prominent journals between 2012 and 2016, and during the first six months of 2024 were coded for use of observational and experimental designs. Citations were identified using Scopus. RESULTS: Observational studies were 2.3 times more prevalent than experimental studies during the period, 2012-2016 (69.4% vs. 30.6%) and were even more common in the first half of 2024 (77.1% vs. 22.9%). Citation rates for observational and experimental studies were equivalent (M = 31.2 and 33.0, respectively). CONCLUSIONS: This study indicates the prevalence and scholarly impact of different research designs in health psychology and behavioral medicine and offers a starting point for discussions concerning the optimal balance between observational and experimental research. The findings invite researchers to contemplate and debate what proportion of observational and experimental studies will best promote the goals of our field.
Improving access to gender-affirming care: a mixed-methods exploration of the role of telehealth.
Duffy CMC, Wall CSJ, Cull SL … +6 more , Otieno JA, Schult D, Mardigian FR, Cardinale-McGinnis G, Easter R, Benotsch EG
Ann Behav Med · 2025 Jan · PMID 40991839 · Publisher ↗
BACKGROUND: Transgender and gender diverse (TGD) individuals experience bias, discrimination, and heightened levels of psychological distress and suicidality compared to cisgender individuals. Gender-affirming care (GAC)...
BACKGROUND: Transgender and gender diverse (TGD) individuals experience bias, discrimination, and heightened levels of psychological distress and suicidality compared to cisgender individuals. Gender-affirming care (GAC) is associated with decreased psychological distress among TGD individuals. Telehealth might help to address barriers TGD individuals face in accessing GAC because it enables patients to receive care in a safe, comfortable environment and seek out TGD-friendly healthcare providers. PURPOSE: This mixed-methods study aimed to assess TGD individuals' perspectives of telehealth for GAC. METHODS: Transgender and gender diverse participants in the present research (N = 346) were recruited via Prolific and completed an online questionnaire in March 2024. Participants who reported using telehealth for GAC were invited to a follow-up survey with 7 open-ended questions about their experiences. Responses (N = 57) were coded and analyzed using reflexive thematic analysis. RESULTS: Approximately 20% of participants have used telehealth for GAC and 50% reported that they are likely to use telehealth for GAC in the future. Qualitative responses revealed that telehealth is appropriate for many GAC services and increases access for individuals who face barriers to in-person GAC. Furthermore, telehealth enables patients to receive care in a comfortable environment and meet with their preferred provider. CONCLUSIONS: Our findings suggest that telehealth is a widely used and appropriate method of delivering GAC with potential to expand access to care for TGD individuals.
Differential effects of a stakeholder-informed intensive perinatal eHealth behavioral weight gain intervention between non-Hispanic Black and non-Hispanic White individuals: a secondary analysis of a randomized clinical trial.
Falkenhain K, Kracht CL, Flanagan EW … +5 more , Altazan AD, Hsia DS, Cabre HE, Apolzan JW, Redman LM
Ann Behav Med · 2025 Jan · PMID 40991838 · Full text
BACKGROUND: Aberrant gestational weight gain (GWG) increases the risk of adverse perinatal outcomes such as preterm birth; these poor outcomes are disproportionately higher in non-Hispanic Black individuals relative to W...
BACKGROUND: Aberrant gestational weight gain (GWG) increases the risk of adverse perinatal outcomes such as preterm birth; these poor outcomes are disproportionately higher in non-Hispanic Black individuals relative to White individuals. Lifestyle interventions effectively manage GWG but often fail to reach those most in need. "Healthy Beginnings," a co-developed intensive perinatal eHealth behavioral weight gain intervention, successfully enrolled individuals from disadvantaged, underrepresented communities living in neighborhoods characterized by higher socioeconomic disadvantage and greater maternal and social vulnerability. However, it is unclear whether the intervention demonstrated effectiveness in this population. PURPOSE: To evaluate potential treatment heterogeneity between non-Hispanic Black and White individuals differentially experiencing systemic inequalities while enrolled in the trial. METHODS: This analysis examined data from a statewide parallel-arm randomized clinical trial that demonstrated the effectiveness of a GWG intervention tailored for pregnant individuals enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children. Participants identifying as non-Hispanic Black (N = 201) or non-Hispanic White (N = 109) were included in this secondary analysis to evaluate intervention effectiveness between these groups on GWG, body composition, dietary intake, physical activity, and perinatal outcomes. RESULTS: Intervention-by-race interaction effects were not statistically significant for any outcome. Non-Hispanic Black participants in the Intervention Group exhibited attenuated weekly GWG (-0.10 kg/week; 95% CI: -0.18 to -0.01) and fat mass gain (-1.7 kg; 95% CI: -3.1 to -0.3) compared to Usual Care. Preterm birth incidence was lower in non-Hispanic Black participants receiving the intervention (adjusted odds ratio 0.38; 95% CI: 0.16-0.90) compared to Usual Care. No intervention effects in White participants were observed. CONCLUSIONS: This multicomponent eHealth lifestyle intervention effectively attenuated GWG and lowered incidence of preterm birth in non-Hispanic Black but not non-Hispanic White participants, suggesting potential for mitigating racial disparities in pregnancy health.
Comparing the effects of message framing and nocebo education on psychological outcomes.
Spotts EK, Coleman L, Geers AL
Ann Behav Med · 2025 Jan · PMID 40991837 · Publisher ↗
BACKGROUND: Nocebo effects from side effect disclosure are an unfortunate yet common occurrence in health care. Two prominent methods proposed for reducing nocebo effects from side effect disclosure are positive framing...
BACKGROUND: Nocebo effects from side effect disclosure are an unfortunate yet common occurrence in health care. Two prominent methods proposed for reducing nocebo effects from side effect disclosure are positive framing and nocebo education. PURPOSE: The present study examined the unique and combined effects of these two intervention approaches on an array of nocebo-relevant psychological outcomes. METHODS: In an online pre-registered experiment, community participants (N = 210) learned about a symptomatic treatment for COVID-19 along with the potential treatment side effects. Participants were randomly assigned in a 2 (side effect attribute framing: positive or negative) × 2 -(education: nocebo education video or a common health problems control video) between-subjects design. RESULTS: Both positive framing and nocebo education altered psychological outcomes related to nocebo effects. Importantly, nocebo education and positive framing affected entirely different outcomes, with positive framing reducing global side effect expectations and worry about side effects, and nocebo education improving perceptions of side effect control, tolerance, and decreasing side effect information-seeking intentions. Side effect avoidance intentions, treatment adherence intentions, and specific side effect expectations were not altered by either intervention. Interestingly, nocebo education and positive framing did not significantly interact on any outcome measure in this study. CONCLUSIONS: The present results are consistent with the view that the most commonly proposed interventions for reducing nocebo effects from side effect disclosure, nocebo education and positive framing, operate through different psychological mechanisms.
An empirical test of the Information-Motivation-Behavioral Skills model of willingness and intention to use HIV pre-exposure prophylaxis among adolescent men who have sex with men.
Yellin H, Wang Y, Huebner DM … +5 more , Rodríguez-Díaz CE, Macapagal K, Newcomb ME, Mustanski B, Ruiz MS
Ann Behav Med · 2025 Jan · PMID 40971723 · Full text
BACKGROUND: Adolescent men who have sex with men (AMSM) are disproportionately affected by HIV, yet uptake of HIV pre-exposure prophylaxis (PrEP) among AMSM is low. Theory-based research is needed to increase PrEP adopti...
BACKGROUND: Adolescent men who have sex with men (AMSM) are disproportionately affected by HIV, yet uptake of HIV pre-exposure prophylaxis (PrEP) among AMSM is low. Theory-based research is needed to increase PrEP adoption for HIV prevention among AMSM. PURPOSE: Using the Information-Motivation-Behavioral Skills (IMB) model, we aimed to (1) examine information, motivation, and behavioral skills as determinants of willingness and intention to use PrEP and (2) determine whether these relationships were moderated by depressive symptoms and substance use. METHODS: A secondary analysis was performed using cross-sectional baseline data from 1,364 AMSM ages 13-18 who participated in the SMART eHealth HIV prevention intervention between 2018 and 2020. Structural equation modeling and multigroup analysis were used to investigate the aims. RESULTS: Information and social motivation were indirectly associated with PrEP willingness and intention through behavioral skills. Personal motivation was directly associated with PrEP willingness and intention. Depressive symptoms and substance use were not moderators. CONCLUSIONS: AMSM who were more informed about and socially motivated to take PrEP had stronger PrEP-related behavioral skills, and in turn were more likely to be willing and have an intention to use PrEP. AMSM who were more personally motivated to use PrEP were more likely to be willing and have an intention to use PrEP. Results suggest that the IMB model may remain robust in the presence of depression and substance use. These findings support the use of the IMB model in interventions designed to promote PrEP uptake among AMSM. CLINICAL TRIALS REGISTRATION NUMBER: NCT03511131.
Sociocultural correlates of cervical cancer prevention behaviors among Hispanic/Latina women in the United States.
Hua J, Klein WMP, Acevedo AM
Ann Behav Med · 2025 Jan · PMID 40930714 · Publisher ↗
BACKGROUND: Hispanic/Latina women in the United States have high rates of cervical cancer and little is known regarding how sociocultural factors might be related to their cervical cancer prevention behaviors. PURPOSE: T...
BACKGROUND: Hispanic/Latina women in the United States have high rates of cervical cancer and little is known regarding how sociocultural factors might be related to their cervical cancer prevention behaviors. PURPOSE: Two studies examined correlates of human papillomavirus (HPV) vaccine initiation, HPV vaccine completion, ever screening for cervical cancer, and being up to date with screening among screening- and vaccine-eligible Hispanic/Latina women. METHODS: Study 1 examined sociodemographic correlates of these behaviors using data from the Behavioral Risk Factor Surveillance System. Study 2 examined whether endorsement of simpatía (ie, expressing warmth to avoid conflict and promote harmony in interpersonal interactions) and familism (ie, supportive familial relationships that emphasize commitment to and prioritization of the family) explained unique variance in these behaviors while controlling for the sociodemographic variables from study 1. RESULTS: In study 1, women who were younger, insured, and who had higher income had greater odds of vaccine initiation. Heterosexual women and those with higher education had greater odds of vaccine completion. Women who were older, married, insured, heterosexual, and who had higher education and income had greater odds of ever screening. Women who were younger and heterosexual had greater odds of being up to date with screening. In study 2, endorsement of simpatía explained unique variance in vaccine initiation even while controlling for sociodemographic variables. CONCLUSIONS: Age, income, sexual orientation, and insurance status were consistently related to cervical cancer prevention behaviors among Hispanic/Latina women. Future research should examine the mechanisms through which the association between simpatía and HPV vaccine initiation occurs.
Testing autonomous motivation as a mechanism of anticipated regret intervention techniques for seasonal flu vaccination.
Baldwin AS, Rochefort C, Rothman AJ
Ann Behav Med · 2025 Jan · PMID 40884508 · Full text
BACKGROUND: Anticipated regret is associated with vaccination. However, gaps in understanding mechanisms of anticipated regret and how to intervene using anticipated regret limit its use as an intervention to promote vac...
BACKGROUND: Anticipated regret is associated with vaccination. However, gaps in understanding mechanisms of anticipated regret and how to intervene using anticipated regret limit its use as an intervention to promote vaccination. PURPOSE: Address gaps in anticipated regret interventions to promote seasonal flu vaccination. In a randomized intervention, we tested the novel hypothesis that autonomous motivation is a target mechanism of anticipated regret and the effects of 2 techniques to elicit anticipated regret: self-generated and mere measurement. METHODS: College students (N = 263) were randomized to complete (1) an open-ended anticipated regret prompt (self-generated), (2) anticipated regret questions (mere measurement), or (3) no anticipated regret questions or prompts. Participants then completed measures of motivation and vaccination intentions. The following spring, participants reported their vaccination status. Analyses were guided by the experimental medicine approach. RESULTS: Self-generated anticipated regret led to greater autonomous motivation for vaccination (d = 0.39), evidence of target mechanism engagement. Self-generated anticipated regret also had a significant indirect effect on intentions (estimate = 0.335, 95% CI = 0.117-0.55) and vaccination (estimate = 0.035, 95% CI = 0.008-0.08) through autonomous motivation, evidence of target mechanism validation. However, neither anticipated regret intervention technique had a direct effect on intentions or vaccination. CONCLUSIONS: Autonomous motivation is a viable target mechanism of anticipated regret interventions to promote seasonal flu vaccination, and self-generated anticipated regret is an effective technique to engage autonomous motivation. Findings provide ample evidence for testing autonomous motivation as a mechanism of anticipated regret interventions in other contexts.
The daily enactment of behavior change techniques among physically active university students with physical disabilities and chronic conditions.
Bedard GD, Pastore OL, Herbison JD … +6 more , Tomasone JR, Liska TM, Mullan MARS, Burns A, Jeans A, Sweet SN
Ann Behav Med · 2025 Jan · PMID 40858331 · Full text
BACKGROUND: While behavior change techniques (BCTs) support physical activity (PA) behavior change, further examination aimed at understanding their enactment is needed. PURPOSE: This study aimed to examine the daily ena...
BACKGROUND: While behavior change techniques (BCTs) support physical activity (PA) behavior change, further examination aimed at understanding their enactment is needed. PURPOSE: This study aimed to examine the daily enactment of BCTs and the factors that impact their daily usage. METHODS: Using experience sampling methods, we sampled 53 university students (Mage = 22 years; SDage = 3.93 years) from McGill (n = 40) and Queen's (n = 13) University to examine BCT usage among university students with physical disabilities and chronic conditions. A daily online survey was delivered for 10 consecutive days where participants answered a checklist of 28 BCTs, a modified 6-item Capability, Opportunity, and Motivation (COM) questionnaire and questions on situational disruptions. Descriptive analysis summarized BCT usage, COM, and contextual factors. A generalized linear mixed model examined the relationship between demographic variables, COM, and contextual factors on the usage of BCTs. RESULTS: On average, participants used 11 BCTs daily, while 22 distinct BCTs were used over the 10 days. The most frequently used BCTs were task crafting and goal integration. The least used BCTs included self-monitoring and obtaining information on how to perform PA. Women were more likely than men to enact certain BCTs, while students with physical disabilities were less likely than those with chronic conditions to enact others. Participants reported higher daily capability and opportunity to use BCTs compared to motivation. Situational disruptions such as personal commitments (eg, work) followed by flare-ups (eg, pain) were frequently reported. Motivation and opportunity predicted the usage of 15 to 24 BCTs, while capability predicted the usage of 2 BCTs. CONCLUSION: Our findings provide valuable context on BCT enactment, thereby improving the structure of future PA behavior change interventions.
Bidirectional week-to-week relationships between weekly psychological stress across multiple life domains and engagement with an exercise intervention: secondary analysis of data from a randomized trial.
Hives BA, Zumbo BD, Beauchamp MR … +2 more , Liu Y, Puterman E
Ann Behav Med · 2025 Jan · PMID 40854326 · Full text
BACKGROUND: Engaging in physical activity can reduce the risk of multiple morbidities and premature mortality. Psychological stress can hinder the development and maintenance of physical activity behaviors. There is a de...
BACKGROUND: Engaging in physical activity can reduce the risk of multiple morbidities and premature mortality. Psychological stress can hinder the development and maintenance of physical activity behaviors. There is a dearth of research on how these two processes interact. PURPOSE: The purpose of this study was to identify the week-to-week bidirectional associations between weekly psychological stress across multiple domains (e.g. social, economic) and adherence to a six-week mHealth exercise program among a previously inactive sample. METHODS: The secondary analyses reported in this study examine data derived from adults randomized to one of three mobile application(s)-based exercise arms embedded within the COPE trial (N = 251). The interventions delivered to participants in each arm involved six weeks of at-home exercise requiring no additional equipment. Relationships between psychological stress (as measured by a modified version of the Chronic Burden Scale) and engagement with the commercially available exercise apps were explored using a random intercept cross-lagged panel model (RI-CLPM). This model simultaneously assessed the longitudinal and bidirectional associations between psychological stress and exercise engagement and vice versa. RESULTS: Both psychological stress and engagement with the exercise interventions demonstrated significant positive autoregressive effects across successive weeks. However, the cross-lagged associations between stress and engagement with the exercise intervention were not significant. CONCLUSIONS: While the cross-lagged effects were non-significant, there was high variability between individuals. Future studies should use larger samples and methods that would allow an examination of an individual's relationship between psychological stress and exercise engagement.
A longitudinal study of the association between the teachable moment heuristic and smoking of head and neck cancer patients.
Borger T, Southward MW, Maras J … +2 more , Feather AR, Burris JL
Ann Behav Med · 2025 Jan · PMID 40853974 · Full text
BACKGROUND: The Teachable Moment Heuristic (TMH) posits that change in its three components (ie, affective response, risk perception, and social role/self-concept) could increase motivation and confidence for health prom...
BACKGROUND: The Teachable Moment Heuristic (TMH) posits that change in its three components (ie, affective response, risk perception, and social role/self-concept) could increase motivation and confidence for health promotion, such as smoking cessation. For patients with cancer, smoking cessation can extend survival, while persistent smoking causes numerous problems (eg, cancer recurrence). PURPOSE: This intensive longitudinal study with cancer patients aimed to evaluate the link between TMH constructs and smoking outcomes. METHODS: Participants included 42 newly diagnosed head/neck cancer patients who reported smoking in the past month. Participants completed a baseline questionnaire before a 30-day daily assessment. Single-item measures were used for all constructs. RESULTS: Participants who perceived more benefits of quitting smoking smoked fewer cigarettes, P < .05. Also, participants who reported less cancer worry smoked fewer cigarettes, P = .03. Within-persons, less cancer worry than one's personal average predicted decreases in cigarettes the next day, P = .01. Perceiving greater benefits of quitting, and social support than one's average predicted lower motivation but higher confidence to quit the same day, Ps < .05. Greater cancer worry than one's average predicted day-to-day increases in cigarettes smoked, P < .01. Perceiving greater benefits of quitting and greater social support than one's average predicted smoking fewer cigarettes that day, Ps < .05. CONCLUSIONS: Components of the TMH are associated with favorable smoking cessation outcomes after a cancer diagnosis. Interventions to aid cancer patients with smoking cessation should focus on the benefits of quitting, bolster social support, and reduce cancer-related worry.
Combinations of light, moderate, and vigorous physical activity in midlife and old age: implications for healthy cognitive aging.
Hamm JM, Lachman ME, McGrath R … +2 more , Duggan KA, Parker K
Ann Behav Med · 2025 Jan · PMID 40834402 · Full text
BACKGROUND: Although the relationship between physical activity (PA) and healthy cognitive aging is well-established, little is known about how different combinations of PA across intensities and life domains may uniquel...
BACKGROUND: Although the relationship between physical activity (PA) and healthy cognitive aging is well-established, little is known about how different combinations of PA across intensities and life domains may uniquely buffer against declines in cognitive health. PURPOSE: This study examined the role of modifiable profiles of light, moderate, and vigorous PA that may operate in tandem across domains to protect cognition in midlife and old age. METHODS: Using prospective 9-year data from the Midlife in the United States Study (n = 2688; Mage = 55 ± 11 years), we employed factor mixture models to identify baseline profiles (combinations) of light, moderate, and vigorous PA in the domains of work, home, and leisure. We subsequently examined profile differences in 9-year trajectories of cognitive aging across 2-waves of data using autoregressive analyses of covariance (ANCOVAs). RESULTS: Factor mixture model results showed that 5 common profiles emerged: low PA, low work PA, average PA, balanced PA, and high PA. Autoregressive ANCOVAs showed the balanced PA profile, which paired very high levels of light PA with relatively average levels of moderate and vigorous PA, experienced less decline in executive functioning than the low PA (P = .038) and low work PA profiles (P = .001). Contextualized effect sizes suggested that rates of 9-year decline in executive functioning for the balanced PA profile were reduced by more than 25% relative to the low PA and low work PA profiles. CONCLUSIONS: Findings suggest that balanced PA across life domains, with an emphasis on maintaining light PA, may help slow age-related cognitive declines in midlife and old age.
Managing multimorbidity together: relationship dynamics and dual medication adherence for hypertension and HIV in Malawi.
Conroy AA, Bidwell JT, Ruark A … +5 more , Neilands TB, Weiser SD, Butterfield RM, Mulauzi N, Mkandawire J
Ann Behav Med · 2025 Jan · PMID 40829127 · Full text
BACKGROUND: Cardiometabolic disorders are highly prevalent among people living with HIV, complicating the medication management of both conditions. Primary partners provide key sources of support for antiretroviral thera...
BACKGROUND: Cardiometabolic disorders are highly prevalent among people living with HIV, complicating the medication management of both conditions. Primary partners provide key sources of support for antiretroviral therapy; however, little research has considered their role in the context of comorbidities. PURPOSE: Using baseline data from the Healthy Hearts cohort study, we investigated associations between relationship dynamics and dual medication adherence for HIV and hypertension (HTN) in Malawi. METHODS: Healthy Hearts is an observational cohort study with people living with HIV and either HTN or diabetes and their primary partners. Study assessments occur at baseline, 4, 8, and 12 months. We examined baseline data from participants with HIV and HTN on their adherence to medications, relationship quality (eg, closeness, intimate partner violence [IPV]), shared illness appraisal, and communal coping (eg, partner support, illness communication). Our outcome variable was a composite measure consisting of 4 categories: complete HIV/optimal HTN adherence (reference category), incomplete HIV/suboptimal HTN adherence, incomplete HIV/optimal HTN adherence, and complete HIV/suboptimal HTN adherence. Multinomial regression models tested for associations between relationship variables with dual medication adherence, controlling for covariates. RESULTS: Participants with HIV and HTN (N = 228) were split evenly on gender, 53 years on average, and most had a primary school education or less (70%). Compared to the group with higher HIV/HTN adherence, the odds of reporting incomplete HIV/suboptimal HTN adherence were associated with lower closeness, shared illness appraisal, couple communication, and partner support. Similar patterns were found for the incomplete HIV/optimal HTN adherence group, which was also associated with higher physical, sexual, and emotional IPV as compared to those in the reference group. Lower communication and partner support were associated with being in the complete HIV/suboptimal HTN adherence group. CONCLUSIONS: Lower HIV or HTN adherence (or both) was associated with lower relationship quality and functioning, and IPV. Successful approaches that involve primary partners in disease management for HIV should be extended for cardiometabolic conditions such as HTN. The role of primary partners may be even more important in helping people successfully manage multiple competing health priorities such as HIV and HTN. Couple-based interventions should target dyadic processes such as relationship quality, illness communication, and disease-specific social support while also mitigating the potential harms of IPV on adherence.
Oral medication adherence predicts cyclosporine blood level variability and graft versus host disease following pediatric allogeneic hematopoietic stem cell transplant.
Klages KL, Chardon ML, Schwartz LA … +4 more , Phipps S, Drake SN, Skeens M, Pai AL
Ann Behav Med · 2025 Jan · PMID 40829126 · Full text
BACKGROUND: Medication adherence is vital for optimal outcomes following pediatric allogeneic hematopoietic cell transplant (HCT), but current assessment methods have limitations. Cyclosporine (CSA), an immunosuppressive...
BACKGROUND: Medication adherence is vital for optimal outcomes following pediatric allogeneic hematopoietic cell transplant (HCT), but current assessment methods have limitations. Cyclosporine (CSA), an immunosuppressive drug used post-HCT, is routinely monitored in post-transplant care. Variability in CSA blood levels has been linked to adherence in other pediatric populations, and the medication level variability index (MLVI) has shown strong associations with adherence behaviors. However, its utility in assessing CSA adherence post-HCT has not been explored. This study aimed to evaluate CSA blood level variability as an objective measure of adherence and establish MLVI as a predictor of disease-related outcomes in pediatric HCT recipients. PURPOSE: To investigate the utility of CSA blood level variability as a measure of medication adherence and the MLVI as a predictor of graft versus host disease (GVHD) in pediatric HCT recipients. METHOD: Medical and adherence data were collected from 127 children within 90 days post-discharge. Regression analyses assessed relationships between oral CSA adherence, CSA MLVI, and the incidence and grade of acute and chronic GVHD. RESULTS: Greater oral CSA adherence significantly predicted increased incidence (Est. = .008, P = .001) and severity of chronic GVHD (Est. = .006, P = .023), as well as greater severity of acute GVHD (Est. = .006, P = .002). Adherence did not predict acute GVHD incidence. Higher adherence variability was associated with increased MLVI (Est. = .225, P < .001) and greater severity of both acute (Est. = .004, P = .004) and chronic GVHD (Est. = .014, P < .001), but not their incidence. Greater MLVI significantly predicted increased incidence and severity of both acute (incidence: Est. = .005, P = .001; severity: Est. = .004, P = .002) and chronic GVHD (incidence: Est. = .004, P < .001; severity: Est. = .007, P < .001). CONCLUSIONS: Inconsistent CSA adherence significantly predicted higher CSA MLVI, which was linked to increased GVHD incidence and severity. These findings highlight the potential of MLVI as a reliable adherence measure and the importance of ongoing adherence support in pediatric HCT care.
Correction to: Ecological Momentary Assessment of Weight Stigma and Eating Behavior in Everyday Life.
Ann Behav Med · 2025 Jan · PMID 40818068 · Publisher ↗
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