Annals Of Behavioral Medicine[JOURNAL]
Sun
200 papers
Are affective states associated with disordered eating behaviors in the daily lives of sexual minority and heterosexual young women?: an ecological momentary assessment study.
Heron KE, Shipley JL, Panza E … +4 more , Sandoval CM, Turner MI, Hawn SE, Braitman AL
Ann Behav Med · 2025 Jan · PMID 40815086 · Publisher ↗
BACKGROUND: Affective state-disordered eating associations are often studied to evaluate emotion regulation models of eating disorders. Disordered eating is common among sexual minority women, yet little is known about a...
BACKGROUND: Affective state-disordered eating associations are often studied to evaluate emotion regulation models of eating disorders. Disordered eating is common among sexual minority women, yet little is known about affect-disordered eating associations among this group. PURPOSE: Ecological momentary assessment (EMA) was used to assess affect preceding and following disordered eating among sexual minority and heterosexual young women (ages 18-30) who binge eat. METHOD: Five daily EMA surveys assessed affective states and disordered eating for 2 weeks among 146 sexual minority and 151 heterosexual cisgender women. Concurrent and time-lagged multilevel models were tested with sexual orientation as a moderator. RESULTS: Higher negative affect was associated with a greater likelihood of emotional eating in the next several hours. Higher positive affect was associated with a lower likelihood of subsequent emotional eating for both heterosexual and sexual minority women, and both higher and lower positive affect than average was associated with a lower likelihood of loss of control eating and dietary restraint for heterosexual women only. Negative affect was higher following emotional eating, and skipping meals for both groups, and higher following loss of control eating for heterosexual women only. Positive affect was higher for both groups following times when they did not report emotional eating. CONCLUSIONS: Sexual minority and heterosexual women generally showed similar affect-disordered eating patterns, but several critical differences were noted. In particular, among young sexual minority women, higher positive affect was not associated with lower likelihood of loss of control eating and dietary restraint, whereas it was for heterosexual women. Future research considering how unique sociocultural pressures (eg, heterosexist discrimination, community norms) impact sexual minority women could improve understanding of disordered eating for this at-risk and understudied group.
Stress-responsive biomarkers and sexual behaviors among young women in rural South Africa.
Kelly NK, Stoner MCD, Mall S … +6 more , Rowe K, Gómez-Olivé FX, Wagner LD, Aiello AE, Kahn K, Pettifor AE
Ann Behav Med · 2025 Jan · PMID 40815085 · Full text
BACKGROUND: Adolescence is a critical period when youth develop their decision-making skills and may engage in their first sexual encounters. Stress during this time can affect decision making; however, limited research...
BACKGROUND: Adolescence is a critical period when youth develop their decision-making skills and may engage in their first sexual encounters. Stress during this time can affect decision making; however, limited research has examined the relationship between biological stress correlates and sexual behavior among adolescent girls and young women (AGYW) in high-HIV incidence areas. PURPOSE: To examine whether stress-responsive biomarkers are longitudinally associated with sexual behaviors that are predictive of HIV. METHODS: We used data from a cohort of 897 AGYW nested within the HIV Prevention Trials 068 study in rural South Africa. Stress-responsive biomarkers were tested retrospectively from enrollment: C-reactive protein (CRP), herpes simplex virus type-1 (HSV-1) antibody titers, and cytomegalovirus (CMV) antibody titers. We estimated the longitudinal associations between each biomarker (2011-2012) and each behavior throughout follow-up (2011-2019; transactional sex, age-disparate partnerships, multiple partners, and condomless sex). RESULTS: At enrollment, 25.4% (n = 228) had ever had sex, 7.0% (n = 63) had >1 partner, 7.9% (n = 71) had recent condomless sex, and 3.0% (n = 27) reported transactional sex. Compared to low CRP levels, medium and high CRP levels were associated with having an older partner (RR: 1.41 [95% CI, 1.08-1.84]; RR: 1.33 [95% CI, 1.02-1.74], respectively) and with condomless sex (RR: 1.40 [95% CI, 1.10-1.77]; RR: 1.42 [95% CI, 1.12-1.80], respectively). CONCLUSIONS: Higher CRP levels were longitudinally associated with age-disparate relationships and condomless sex. Inflammation may increase AGYW's engagement in these behaviors; however, future studies should examine whether there is a stress-inflammation-sexual behavior pathway, and if so, evaluate stress-reduction interventions to promote sexual well-being.
Psychosocial interventions to improve quality of life in Hispanic cancer survivors: a meta-analysis.
Pedreira PB, Fleszar-Pavlović SE, Silvera CA … +4 more , Griffin MA, Lopes G, Antoni MH, Penedo FJ
Ann Behav Med · 2025 Jan · PMID 40803354 · Publisher ↗
BACKGROUND: Despite advancements in cancer treatment, Hispanics encounter higher risks of late-stage diagnoses, face challenges in accessing healthcare, and have unmet care needs, all of which negatively affect their qua...
BACKGROUND: Despite advancements in cancer treatment, Hispanics encounter higher risks of late-stage diagnoses, face challenges in accessing healthcare, and have unmet care needs, all of which negatively affect their quality of life (QOL). Psychosocial interventions that are culturally tailored for Hispanic contexts have shown potential in enhancing QOL, yet their overall effectiveness remains unmeasured. PURPOSE: This study comprised 5 meta-analyses investigating the effectiveness of psychosocial interventions on various QOL outcomes (ie, physical, emotional, functional, social/family, and general well-being) among Hispanic cancer survivors. Additionally, it evaluated their effects on secondary outcomes, including cancer-related distress, anxiety, depression, fatigue, insomnia, and pain intensity. Potential moderators including cultural adaptation and intervention characteristics were explored. METHODS: A search of electronic databases for English-language articles published through December 2024 identified 28 eligible studies. Random effects multilevel meta-analytic models were utilized. RESULTS: Interventions did not demonstrate significant advantages over control conditions for general, functional, or social/family well-being. After accounting for publication bias and influential cases, both emotional (g = 0.170, 95% CI, 0.004-0.335) and physical well-being (g = 0.192, 95% CI, 0.063-0.321) revealed small but significant effects. No significant effects were found for secondary outcomes. Although moderator tests were not significant, subgroup analyses showed that interventions that were culturally adapted or included 6 or more sessions had significant effects compared to control conditions. CONCLUSIONS: Findings supported psychosocial interventions for enhancing emotional and physical well-being in Hispanic cancer survivors. Future interventions should emphasize cultural responsiveness while addressing barriers to functional and social well-being.
Increases in adherence to a simplified Mediterranean diet predicts improved next day cognitive functioning.
Parker KRB, Hamm JM
Ann Behav Med · 2025 Jan · PMID 40803353 · Full text
BACKGROUND: Although differences in adherence to a Mediterranean diet (MD) have been linked to cognitive aging over extended periods of time, little is known about how day-to-day fluctuations in this health behavior may...
BACKGROUND: Although differences in adherence to a Mediterranean diet (MD) have been linked to cognitive aging over extended periods of time, little is known about how day-to-day fluctuations in this health behavior may influence micro-longitudinal changes in cognition. Our study examined how increases in daily adherence to a simplified Mediterranean diet (sMD) impacted next day cognitive functioning over the course of 1 week. PURPOSE: This study examined the extent to which dynamic, day-to-day changes in sMD predicted subsequent changes in daily cognitive functioning for middle-aged and older adults. METHODS: Participants (N = 217, Mage = 54 ± 15, 65% female) completed daily surveys and cognitive tasks over 1 week to measure their daily adherence to the sMD and their daily cognition. Lagged multilevel models assessed the impact of (within-person centered) daily sMD on next day cognition including: episodic memory, executive functioning, and processing speed. Age, sex, race, and education were controlled in all models. RESULTS: Results showed that on days following higher than participants' usual adherence to the sMD, they had faster processing speeds (shorter latencies; γ = -43.85, P < .001) and improved executive functioning (γ = 0.47, P = .039) than on days after lower than usual sMD adherence. CONCLUSION: These findings show that day-to-day shifts in sMD adherence have implications for micro-longitudinal changes in cognition for middle-aged and older adults, suggesting even small changes in sMD could add up and contribute to healthy cognitive aging over time. Simple changes such as increasing fruit, vegetable, and fish intake and reducing sugar-sweetened beverage consumption may thus result in improved cognitive functioning over even very brief time periods.
Social undermining of weight management behaviors among young adult African American women: an ecological momentary assessment and mixed-method study.
Scotti KB, Ross KM, Baskin ML … +4 more , Jake-Schoffman DE, Deceus D, O'Neal LJ, McVay MA
Ann Behav Med · 2025 Jan · PMID 40803352 · Full text
BACKGROUND: Social undermining of weight management behaviors represents a meaningful intervention target as social undermining may lead to dietary and exercise lapses. Young adult African American women, who exhibit the...
BACKGROUND: Social undermining of weight management behaviors represents a meaningful intervention target as social undermining may lead to dietary and exercise lapses. Young adult African American women, who exhibit the highest prevalence of obesity compared to young adults of all other races and ethnicities, may experience different types of social undermining or respond differently to social undermining due to various cultural factors (eg, cultural value of traditional foods). PURPOSE: This study characterizes the sources and settings of weight management social undermining experiences of young adult African American women. METHODS: Young adult African American women who were attempting to lose weight or prevent weight gain were recruited. Participants completed 2 weeks of ecological momentary assessment (EMA) surveys sent 5 times daily related to social undermining experiences. Participants were asked to describe the source and setting of social undermining experiences. Qualitative interviews were conducted following the EMA period to further characterize reported social undermining. RESULTS: Participants (n = 36) were 21.8 ± 1.7 years of age with a body mass index of 33.8 ± 7.4 kg/m2. On average, participants experienced 2.3 social undermining experiences per week (range: 0-7). Most social undermining was diet-related (79.3%) and perceived by participants as not culturally relevant (85.2%). Most social undermining happened at home (31.4%) and came from friends (31.4%). Qualitative interviews revealed that social undermining often occurred during culturally specific social gatherings and was related to cultural perspectives on body weight. CONCLUSION: These results can aid in the development of relevant and acceptable strategies for responding to social undermining within young adult African American women.
Barriers, facilitators, and best practices for successful vaping prevention campaigns for sexual and gender minority youth.
Okker-Edging K, Pilla J, Tan ASL … +14 more , Salloum RG, Hanby E, Wu J, Liu S, LeLaurin JH, Theis RP, Pluta K, Lydon-Staley DM, Potter J, Maziak W, Gordon B, Charlton BM, Hoang ML, Katz-Wise SL
Ann Behav Med · 2025 Jan · PMID 40803351 · Publisher ↗
BACKGROUND: Sexual and gender minority youth (SGMY) vape at higher rates than their heterosexual and/or cisgender peers. SGMY prefer SGM-specific anti-tobacco messaging; however, there have been no vaping prevention camp...
BACKGROUND: Sexual and gender minority youth (SGMY) vape at higher rates than their heterosexual and/or cisgender peers. SGMY prefer SGM-specific anti-tobacco messaging; however, there have been no vaping prevention campaigns designed for SGMY. PURPOSE: Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, we sought to explore specific barriers, facilitators, and best practices for health promotion for SGMY that will inform future vaping prevention campaigns. METHODS: We conducted 11 qualitative interviews with key stakeholders from government and non-profit organizations who work in public health campaigns or with SGMY at national, state, and local levels. Data were coded and analyzed using thematic analysis. RESULTS: We identified 4 main themes from our analysis: (1) youth engagement, (2) sociopolitical context, (3) dissemination and measurement, and (4) inter-organizational collaboration. Participants described barriers and facilitators in the 4 themes. CONCLUSIONS: Based on these findings, we developed 3 recommendations to guide and improve the success of future vaping prevention campaigns for SGMY. First, youth engagement should be at the forefront of campaign development and dissemination. Second, SGMY of color should be centered and represented in campaigns due to racial inequity in tobacco-related illness and death. Third, inter-organizational collaboration is strongly encouraged to minimize the resource burden on each organization and maximize potential collective output.
Prevalence and predictors of medical information avoidance: a systematic review and meta-analysis.
Offer K, Oglanova N, Oswald L … +1 more , Hertwig R
Ann Behav Med · 2025 Jan · PMID 40795090 · Full text
BACKGROUND: Medical information avoidance-the prevention or delay of acquiring health-related information-is a growing concern for physicians, healthcare professionals, and policymakers. Yet, its prevalence and predictor...
BACKGROUND: Medical information avoidance-the prevention or delay of acquiring health-related information-is a growing concern for physicians, healthcare professionals, and policymakers. Yet, its prevalence and predictors have remained poorly understood. PURPOSE: We conducted a systematic review and meta-analysis to clarify the prevalence and predictors of medical information avoidance, offering key insights into the worldwide empirical evidence. METHODS: We performed a systematic search, preregistered on the OSF and in accordance with PRISMA and MOOSE reporting guidelines. Additional individual participant datasets were obtained from the National Institutes of Health (NIH). Data analysis was performed using random--effects and mixed-effects models. RESULTS: A total of 92 studies and 6 individual participant datasets (564 497 unique participants, 25 countries) were analyzed. We found that almost 1 in 3 participants avoided or were likely to avoid information. Specifically, we estimated prevalence rates of 24% for diabetes, 29% for cancer, 32% for HIV, 40% for Huntington's disease, and 41% for Alzheimer's disease. We did not find any reliable association with gender or with race and ethnicity. Instead, we identified 16 significant predictors across cognitive, health-related, and sociodemographic domains. The strongest predictors were all cognitive: information overload (r = 0.26), perceived stigma (r = 0.36), self-efficacy (r = -0.28), and trust in the medical system (r = -0.25). CONCLUSIONS: Nearly 1 in 3 participants avoided or were likely to avoid medical information. The highest prevalence rates were found for Huntington's disease and Alzheimer's disease, 2 incurable neurodegenerative diseases. Key cognitive predictors suggest entry points for policy interventions and future research. LAY SUMMARY: Medical information is more accessible than ever, but many people choose to avoid it. How common is this behavior, and what predicts it? To find out, we analyzed data from over 90 studies involving more than half a million people across 25 countries. We found that nearly 1 in 3 people avoided or were likely to avoid medical information. Avoidance was highest for incurable neurodegenerative diseases (Alzheimer's disease: 41%, Huntington's disease: 40%), moderate for severe but treatable conditions (HIV: 32%, cancer: 29%), and lowest for a chronic, manageable illness (diabetes: 24%). We identified 16 key predictors of medical information avoidance. Surprisingly, gender, race, and ethnicity were not among them. Instead, the strongest predictors were cognitive and emotional: mistrust in the medical system, feeling overwhelmed, low confidence in managing one's health, and fear of being judged. Patterns of avoidance varied across world regions, suggesting that differences in healthcare systems may influence behavior. In this study, we do not judge whether medical information avoidance is good or bad. Instead, we offer the first comprehensive review of how common it is and what predicts it. More research is needed to understand the psychological and medical consequences of avoiding medical information.
Exercise and eating motivation in weight loss maintenance: revisiting the motivational spillover with the NoHoW study.
Palmeira AL, Carraça EV, Santos I … +6 more , Silva MN, Sánchez-Oliva D, Horgan G, Stubbs RJ, Heitmann BL, Mata J
Ann Behav Med · 2025 Jan · PMID 40795089 · Publisher ↗
OBJECTIVE: Physical activity and nutrition-related behaviors are crucial factors in maintaining weight loss. The interplay between the motivations to consistently engage in both behaviors is a fundamental yet understudie...
OBJECTIVE: Physical activity and nutrition-related behaviors are crucial factors in maintaining weight loss. The interplay between the motivations to consistently engage in both behaviors is a fundamental yet understudied topic. The current study examines the reciprocal effects between exercise and eating motivation and their effect on steps and energy intake over a 12-month period. METHODS: Data were gathered from 678 NoHoW participants (a weight loss management intervention) in 3 European countries (the United Kingdom, Denmark, and Portugal), with baseline, 6-, and 12-month measures (46 ± 11 years, 70% women, 83 ± 15 kg), assessing exercise motivation, eating motivation, steps taken, and energy intake. The analytical plan included latent growth models and cross-lagged panels. RESULTS: Both autonomous and controlled motivation models indicated a positive spillover effect from exercise to eating motivation and vice versa for 12 months. Increased exercise autonomous motivation was linked to heightened eating autonomous motivation, and the same relation was observed with controlled motivation. However, when it came to the relationship between motivation and steps taken or food intake, the effects were either smaller or nonexistent, except for higher initial levels of exercise-controlled motivation being associated with higher food intake after 6 months. CONCLUSIONS: These findings suggest that during the yearlong study, there was a motivational spillover from exercise motivation to eating motivation and vice versa. This suggests that interventions focusing on increasing motivation toward behavior change in one domain also benefit other domains and thus might help increase the effectiveness of interventions.
Religious affiliations, religious practices, and health behaviors in US South Asians.
Stroope S, Kent BV, Kanaya AM … +2 more , Shah NS, Shields AE
Ann Behav Med · 2025 Jan · PMID 40795088 · Publisher ↗
OBJECTIVES: This study examined how religious affiliations and religious practices are related to health behaviors and clinical health behavior-related outcomes in US South Asians, an under-researched group. DESIGN: A no...
OBJECTIVES: This study examined how religious affiliations and religious practices are related to health behaviors and clinical health behavior-related outcomes in US South Asians, an under-researched group. DESIGN: A novel religion/spirituality questionnaire was used in the Mediators of Atherosclerosis Among South Asians Living in America study (N = 983), the most comprehensive population-based health study of US South Asians. Analyses relied on covariate-adjusted multiple regression. RESULTS: Religious attendance was associated with higher ideal diet scores and lower alcohol use. Group prayer was associated with lower physical activity. Solitary prayer was associated with lower ideal body mass index (BMI) scores. Scripture reading was associated with higher ideal BMI scores and lower alcohol use. Yoga was associated with higher Life's Essential 8 (LE8) scores, higher ideal diet, higher physical activity, higher ideal smoking scores, higher ideal BMI scores, and lower alcohol use. Hindu/Jain affiliation was associated with higher ideal diet, and Muslim affiliation with lower LE8, lower ideal diet, lower physical activity, and less alcohol use. Sikh affiliation was associated with lower ideal BMI scores and more alcohol use. CONCLUSIONS: This study advanced understanding of the role of religious affiliations and practices in health behaviors and related clinical outcomes in US South Asians. Results highlighted yoga and religious attendance as particularly important topics for future study. Religious affiliation results suggest that among US South Asians, nonaffiliates, Muslims, and Sikhs may be populations in need of scholarly and programmatic attention regarding particular health behavior and clinical outcomes.
Physical activity coaching in people with chronic obstructive pulmonary disease: a systematic literature review with meta-analysis.
Diciolla NS, Yuste-Sánchez MJ, Torres-Lacomba M … +2 more , Paixão C, Marques A
Ann Behav Med · 2025 Jan · PMID 40673868 · Publisher ↗
BACKGROUND: Physical activity (PA) coaching, defined as a structured one-to-one intervention using behavior-change techniques, may increase PA in people with chronic obstructive pulmonary disease (COPD). This systematic...
BACKGROUND: Physical activity (PA) coaching, defined as a structured one-to-one intervention using behavior-change techniques, may increase PA in people with chronic obstructive pulmonary disease (COPD). This systematic review aimed to assess the effects of individual PA coaching components. METHODS: Randomized clinical trials comparing PA coaching vs usual care in COPD were searched. Effect direction plots synthesized results, and meta-analyses were conducted for selected outcomes, subgroup analyses exploring individual PA coaching components. RESULTS: Thirty-two studies involving 5483 people with COPD (67 ± 9 years; 55% male; 53 ± 18 FEV1%predicted) were included. PA coaching, mostly delivered remotely, weekly, for 12 weeks, consisted of education, exercise, feedback, goal setting/review, motivational interviews, problem-solving, self-monitoring, and social support. Effect direction plots showed a positive impact of PA coaching on PA (73%, 95%CI 58-89% of studies), with minimal or no effects on emotional, physical, symptoms, and health-related quality of life domains. Meta-analyses revealed a significant increase in steps/day (MD[95%CI] = 806.84[478.99,1134.70]steps/day, I2 = 66, P < 0.01); however, no clinically relevant changes were observed in other outcomes. Compliance rate across studies was 86% 95%CI, 83%-89%.Subgroups analyses for self-monitoring (MD[95%CI] = 861[555 1166]steps/day; I2 = 66, P < 0.01) and goal setting/review (MD[95%CI] = 916[563 1296]steps/day; I2 = 69, P < 0.01) demonstrated significant and clinically relevant improvements in steps/day. Significant between-group differences in whether self-monitoring (χ2 = 9.84, P < 0.01) and goal setting/review (χ2 = 7.59, P < 0.01) were included suggest these components may moderate PA coaching effectiveness. CONCLUSIONS: PA coaching increases daily steps in people with COPD without significantly affecting emotional, physical, symptoms or health-related quality of life domains. Including self-monitoring and goal setting/review may enhance its effectiveness.
Positive social modeling attenuates nocebo side effects.
Saunders C, Tan W, Ng D … +3 more , Burchett A, McNair N, Colagiuri B
Ann Behav Med · 2025 Jan · PMID 40662257 · Full text
BACKGROUND: Receiving negative instructions and observing another's adverse treatment-related experience can lead to worsened health outcomes via the nocebo effect. However, it is unknown whether the observation of a pos...
BACKGROUND: Receiving negative instructions and observing another's adverse treatment-related experience can lead to worsened health outcomes via the nocebo effect. However, it is unknown whether the observation of a positive treatment-related experience can mitigate these effects. PURPOSE: To investigate whether a positive social modeling intervention can reduce nocebo side effects induced by instruction and social modeling. METHODS: Participants (N = 160) were told the study assessed a new cognitive enhancer (actually a placebo). Participants received side effect warnings and viewed an informational video describing the medication. Placebo-treated groups were randomized to either watch an additional clip where a peer reported a positive experience with no side effects or not. These groups were further randomized to either encounter a live model exhibiting side effects or not. A Natural History group did not view any modeling nor receive the placebo. The primary outcome was the severity of side effects. RESULTS: A significant nocebo effect was observed, with increased symptom severity in placebo-treated groups compared to the Natural History group. The positive social modeling intervention (i.e., viewing a peer experience no side effects) significantly reduced symptom severity. No significant difference in symptom severity was found between instruction alone and instruction with side effect modeling, nor was there an interaction between the induction method and the positive social modeling intervention. CONCLUSIONS: Positive social modeling reduces nocebo side effects induced by instruction alone and instruction with side effect modeling. Positive social modeling may be an effective method to mitigate the burden of nocebo side effects in clinical settings.
Yoga in autoimmune disorders: a systematic review of randomized controlled trials.
Baishya A, Sharma S, Hazarika D … +3 more , Saini S, Sharma H, Metri K
Ann Behav Med · 2025 Jan · PMID 40631512 · Publisher ↗
BACKGROUND: Yoga, a mind-body therapy, is widely utilized for managing health outcomes in autoimmune disorders (ADs). Despite its extensive use, no systematic review has been conducted to assess the impact of yoga on ADs...
BACKGROUND: Yoga, a mind-body therapy, is widely utilized for managing health outcomes in autoimmune disorders (ADs). Despite its extensive use, no systematic review has been conducted to assess the impact of yoga on ADs. PURPOSE: The objective was to evaluate the evidence of yoga on health outcomes in ADs based on randomized controlled trials (RCTs). METHODS: A comprehensive search was conducted across Scopus, Web of Science, PubMed, Medline, and PsycINFO from January 2000 to June 2024, as well as relevant reference lists. RCTs evaluating the efficacy of yoga-based interventions with at least 8 weeks duration in the 5 most commonly studied ADs-multiple sclerosis (MS), rheumatoid arthritis (RA), ankylosing spondylitis (AS), inflammatory bowel disease (IBD), and autoimmune periodontitis-were included. The methodological quality was assessed using the PEDro scale. Vote counting based on the direction of effect was used to determine effectiveness. RESULTS: Twenty-six RCTs involving 1,960 patients with intervention durations ranging from 8 to 24 weeks were included. Twelve studies were of good methodological quality, 8 were fair, and the remaining 2 were of poor quality. Yoga demonstrated positive evidence in improving fatigue, balance, QoL, and depression among MS patients, along with reductions in inflammatory biomarkers and depression in RA patients. Studies on AS showed positive evidence in physical function, disease activity, and quality of life, as well as in clinical attachment loss in autoimmune periodontitis. However, the small number of RCTs in IBD, AS, and autoimmune periodontitis limited the strength of these findings. No adverse events were reported, although studies were limited by small sample sizes and short-term interventions. CONCLUSION: This systematic review found a positive impact of Yoga on various physical, biochemical, and psychological measures in 5 common ADs. Yoga may be considered an adjunct therapy in the conventional management of ADs.
Digital versus nondigital behavioral interventions on cardiovascular risk reduction: systematic review and meta-analysis.
Berhe FT, Shifti DM, Veerman JL … +16 more , Aminde L, Ahmed KY, Mesfin YM, Kibret KT, Bizuayehu HM, Ketema DB, Odo DB, Thapa S, Dadi A, Belachew SA, Bore MG, Kassa ZY, Seid AM, Hassen TA, Amsalu E, Tegegne TK
Ann Behav Med · 2025 Jan · PMID 40576235 · Full text
OBJECTIVES: We aimed to assess whether digital behavioral interventions improve cardiovascular risk factors more effectively than nondigital behavioral interventions. METHODS: We searched 7 electronic databases from Janu...
OBJECTIVES: We aimed to assess whether digital behavioral interventions improve cardiovascular risk factors more effectively than nondigital behavioral interventions. METHODS: We searched 7 electronic databases from January 1, 1990, to April 4, 2024. We performed a random-effects meta-analysis to pool the effects of digital versus nondigital interventions on body composition, blood pressure, blood glucose, and lipid concentrations. We also conducted subgroup analyses based on intervention duration, risk of bias, and intervention types. We reported outcomes as mean differences with their 95% confidence intervals (CIs). We assessed the quality of the included studies using the Cochrane Risk of Bias 2 tool. RESULTS: We included 34 randomized controlled trials with 17 389 participants. The meta-analysis found no significant differences between digital and nondigital behavioral interventions for 11 cardiovascular risk factors. However, subgroup analyses showed that digital dietary interventions significantly reduced body weight (MD = -0.66, 95% CI [-1.26, -0.06]), body mass index-BMI (MD = -0.25, 95% CI [-0.43, -0.07]), and fasting blood glucose (MD = -0.31, 95% CI [-0.57, -0.05]) compared to nondigital interventions. Digital physical activity interventions lowered total cholesterol (MD = -3.55, 95% CI [-4.63, -2.46]) compared to nondigital interventions. Combined digital interventions (dietary, physical activity, and smoking cessation) significantly decreased BMI (MD = -0.20, 95% CI [-0.36, -0.04]) compared to nondigital interventions. No significant differences were found by risk of bias or intervention duration. CONCLUSIONS: Digital behavioral interventions are as effective as nondigital interventions in reducing cardiovascular risk factors, making both essential components of cardiovascular disease prevention and management.
Daily, prospective associations between sleep architecture and affect: insights from Bayesian multilevel compositional data analysis.
Le F, Yap Y, Dumuid D … +1 more , Wiley JF
Ann Behav Med · 2025 Jan · PMID 40557584 · Full text
BACKGROUND: Emerging statistical methods addressing the multilevel compositional nature of sleep architecture can offer insights into how daily time reallocations between sleep stages (total wake time in bed [TWT], light...
BACKGROUND: Emerging statistical methods addressing the multilevel compositional nature of sleep architecture can offer insights into how daily time reallocations between sleep stages (total wake time in bed [TWT], light sleep [Non rapid eye movement stage 1 and 2], slow wave sleep [SWS], and rapid eye movement [REM] sleep) are associated with post-sleep affect. PURPOSE: This study investigated the daily, prospective association between sleep architecture and affect. METHODS: In 96 healthy, young adults across 15 consecutive days, sleep architecture was measured at night using electroencephalography (Z-Machine Insight+) and affect was self-reported using the PANAS-X at awakening. Bayesian multilevel compositional data analysis examined how reallocating time between sleep stages was associated with affect. RESULTS: Various reallocations of sleep stages predicted affect, at both within- and between-person levels. Between-person reallocation of 30 min/night from light or REM sleep to SWS was associated with ≥0.38 points higher high and low arousal positive affect, and from SWS to any other sleep stages was associated with ≥0.21 points higher high arousal negative affect. Within-person reallocation of 30 min/night from REM to any other stages predicted ≥0.05 points higher high arousal negative affect, and 30 min/night from TWT to SWS or REM predicted ≤-0.07 lower low arousal negative affect. CONCLUSIONS: Findings highlight the distinct constellations of sleep architecture associated with affect in everyday life. Extension of SWS and REM for improving affect, while considering other off-set sleep stages, should be confirmed in experimental research in daily settings, to inform diagnostic and intervention strategies for sleep and affective disorders.
Cannabinoid content on product labels influences cannabis health perceptions.
Stanz JL, Ladd BO, Magnan RE
Ann Behav Med · 2025 Jan · PMID 40553093 · Publisher ↗
BACKGROUND: Cannabis use in the United States is increasing and research is needed to understand factors contributing to decisions to use. Features of cannabis product labels communicating product content may influence h...
BACKGROUND: Cannabis use in the United States is increasing and research is needed to understand factors contributing to decisions to use. Features of cannabis product labels communicating product content may influence health perceptions and willingness to use. PURPOSE: We tested how individuals who use cannabis respond to different cannabinoid content and the inclusion of a visual aid to communicate cannabinoid potency. METHOD: We used a 3 (within-subjects: THC-dominant, CBD-dominant, and equal THC:CBD ratio) × 2 (between-subjects: numeric information vs numeric information plus visual aid) mixed experimental design administered online through Prolific.com. Participants (N = 431) evaluated cannabis product packages on perceived health harms and benefits and likelihood to purchase and use cannabis. RESULTS: Relative to other products, CBD-dominant products were evaluated as least harmful, most beneficial, and least likely to purchase or use (all Ps < 005; ds 0.10-0.68) while THC-dominant products were evaluated as most harmful, least beneficial, and most likely to purchase and use (all Ps < .02; ds 0.11-0.68). Perceptions did not vary based on the inclusion of a visual aid (Ps > .10). In a parallel mediation model, cannabinoid content was indirectly associated with likelihood to use through perceived benefits (b = -.14, CI = -.22, -.07) but not perceived harms (b = -.01, CI = -.04, .07). CONCLUSIONS: Communicating about cannabinoid content could have intended and unintended consequences. Cannabinoid content contributed to product health perceptions and willingness to purchase and use; visual depictions of cannabinoid content did not. Perceived benefits of cannabis could be a valuable intervention target to reduce potential harm.
The differential role of spousal collaboration on pain reactivity to daily stressors in older couples with and without multiple chronic conditions.
Pan Z, Nie J, Zhou X … +4 more , Wang S, Chen H, Zhang M, Liu H
Ann Behav Med · 2025 Jan · PMID 40553092 · Publisher ↗
BACKGROUND: Spousal collaboration has been considered as important coping resource to deal with aging-related health problems, but little is known about the role of spousal collaboration on the everyday stress-reactivity...
BACKGROUND: Spousal collaboration has been considered as important coping resource to deal with aging-related health problems, but little is known about the role of spousal collaboration on the everyday stress-reactivity process in couples facing multiple chronic conditions (MCCs). PURPOSE: We examined the within-person association of daily stressors and pain, and whether spousal collaboration played a differential role in moderating this association in older couples living with and without MCCs. METHODS: Data were drawn from an ecological momentary assessment (EMA) research, wherein two sub-samples of older married couples (including 52 dyads facing couple-level MCCs and 55 dyads without couple-level MCCs) reported 7671 (89.61%) valid EMA surveys across 20 consecutive days. A multilevel model was used to examine the effect of spousal collaboration on momentary pain reactivity to daily stressors. RESULTS: Exposure to daily stressors was associated with an increased level of momentary pain, and such pain reactivity was more prominent in couples facing both spouses' MCCs than in those not facing such couple-level MCCs. Spousal collaboration played a differential role in momentary pain reactivity to daily stressors in two sub-samples. In couples facing both spouses' MCCs, spousal collaboration buffered momentary pain reactivity to health-related stressors and home-related stressors. Similar buffering effect was not found in the couples not facing both spouses' MCCs. CONCLUSIONS: These findings highlighted the importance of dyadic coping resources for managing aging-related health problems and pain experiences, offering insights to inform the development of couple-based health interventions by incorporating the enhancement of spousal collaboration as a key element.
Mitigating fraud in a fully decentralized clinical trial of a digital health intervention.
Moore JB, Chieng A, Pirner MC … +6 more , Pajarito S, Vogel EA, Bowdring MA, Bullard L, Robinson A, Prochaska JJ
Ann Behav Med · 2025 Jan · PMID 40548528 · Full text
BACKGROUND: Decentralized clinical trials (DCT), digital survey methodologies, and health monitoring technologies create the potential to reduce study participant burden as well as enhance sample diversity and enrollment...
BACKGROUND: Decentralized clinical trials (DCT), digital survey methodologies, and health monitoring technologies create the potential to reduce study participant burden as well as enhance sample diversity and enrollment pace. However, fraudulent participant activity poses a significant threat to study validity and data integrity. PURPOSE: This study quantifies fraudulent attempts at participation in a DCT of a mobile mental health intervention for problematic substance use and discusses methods to prevent and detect fraudulent activity. METHODS: Adults residing in the US reporting problematic substance use were recruited for a fully remote DCT via 2 primary channels: social media advertisements and survey panels. The DCT offered incentives totaling up to $100 for completing assessments over the 12-week study. To prevent and detect fraudulent activity, the research team utilized VPN and proxy detection, checked for duplicate identifiers (e.g., emails, phone numbers, IP Addresses), and compared age and date of birth (DOB) responses across timepoints. Descriptive statistics and group comparisons across the 2 sources of recruitment methodology were utilized to quantify and characterize fraudulent activity. RESULTS: Of the 2,781 eligible screeners completed, 1,725 (62%) were determined to be fraudulent prior to randomization, detected most commonly by duplicate identifiers (65%) and/or VPN and proxy detection (47%). Of the 258 randomized participants, 51 (20%) were later determined to be fraudulent based upon age and/or DOB mismatch. Notable patterns in fraudulent activity (e.g., 42% of fraudulent screening respondents reported the exact age of 30 years; stylistic formatting of email address accounts) were identified. The fraudulent recruitment rate was higher for social media advertising (85%) than survey panels (26%). CONCLUSIONS: Both social media and survey panel recruitment resulted in high levels of fraudulent activity in a DCT of a mobile mental health intervention. Researchers conducting DCTs and/or online surveys are urged to take several precautions and preventative measures to insulate against fraudulent activity including embedding identity verification procedures in consent processes. Researchers should consider making personal contact with a participant to verify identity as well as remain vigilant for fraudulent activity and its real-time dynamic potential. TRIAL REGISTRATION: NCT04925570.
Resilience in advanced cancer patients who obtain a long-term response to immunotherapy or targeted therapy: an Ecological Momentary Assessment study.
Zwanenburg LC, van Roekel E, Suijkerbuijk KPM … +5 more , Koldenhof JJ, Schuurbiers-Siebers OCJ, van der Stap J, van der Lee ML, Schellekens MPJ
Ann Behav Med · 2025 Jan · PMID 40542627 · Full text
BACKGROUND: Approximately half of advanced cancer patients with a long-term response to immuno- or targeted therapy (IT/TT) (ie, long-term responders (LTRs)) experience heightened distress due to persistent uncertainty....
BACKGROUND: Approximately half of advanced cancer patients with a long-term response to immuno- or targeted therapy (IT/TT) (ie, long-term responders (LTRs)) experience heightened distress due to persistent uncertainty. PURPOSE: We aimed to study to what extent supportive factors (ie, illness acceptance, tolerance of uncertainty, mindfulness, social support, optimism, emotion regulation variability, and positive affect in general and prior to a stressor) predict micro-level resilience in response to unpleasant daily life events. METHODS: We conducted an observational cohort study with a baseline assessment of supportive factors, followed by Ecological Momentary Assessment with 8 assessments a day for 14 consecutive days. Resilience was operationalized as maintenance of low negative affect (NA) or a smaller increase in NA to an unpleasant event, as this suggests that partial recovery has already taken place. We used Dynamic Structural Equation Models to study supportive factors of resilience. RESULTS: We included data from 61 patients with advanced melanoma or lung cancer with confirmed response to or long-term stable disease while on IT/TT. More unpleasant daily life events were associated with increases in NA. The multivariate model did not identify any supportive factors. Exploratory analysis using separate models tentatively indicated that LTRs with higher levels of illness acceptance, mindfulness, optimism, and general positive affect showed a smaller increase in NA in response to an unpleasant event (ie, more resilient response). CONCLUSIONS: Preliminary findings suggest that illness acceptance, mindfulness, optimism, and general positive affect are supportive factors of resilience in LTRs. Future research should include these factors at momentary level to enhance insight into the resilience process.
Diminished valuation in the brain: how repeated exposure reduces health message engagement.
Liu J, So J, Pei R
Ann Behav Med · 2025 Jan · PMID 40503982 · Full text
BACKGROUND: Public health campaigns traditionally aim to maximize message reach, assuming that more exposure leads to greater intended effects. However, recent research on message fatigue suggests that repeated exposure...
BACKGROUND: Public health campaigns traditionally aim to maximize message reach, assuming that more exposure leads to greater intended effects. However, recent research on message fatigue suggests that repeated exposure can lead to diminished message engagement. The goal of the current study is to understand the neuropsychological processes involved in repeated health message exposure in key brain regions known to facilitate or inhibit persuasion. PURPOSE: This study examines how repeated exposure to health campaign messages is linked to neural activity in brain regions implicated in valuation, which is in turn linked to key processes of message engagement, including attention, elaboration, and counterarguing. METHODS: Thirty-seven adolescent nonsmokers viewed 12 public service announcements (PSAs) from The Real Cost anti-tobacco campaign in a functional magnetic resonance imaging scan session. We examined the relationship between the number of PSA exposures and neural activity in the hypothesized brain regions of interest (ROIs). We also investigated whether the observed neural activity, in turn, was associated with the levels of message engagement reflected in participants' subsequent verbal descriptions of the PSAs, assessed with automated linguistic coding. RESULTS: Increased message exposure was negatively associated with neural activity in the valuation ROI, which was positively associated with activity in the attention, elaboration, and counterarguing ROIs. Neural activity in the attention ROI was linked to higher message engagement, while activity in the counterarguing ROI was negatively associated with message engagement. No significant link was found between neural activity in the elaboration ROI and message engagement. Mediation analysis suggested that increased exposure may indirectly reduce message engagement by diminishing positive valuation of the messages, thereby decreasing attention to and elaboration of the messages. CONCLUSIONS: This study elucidates the counterproductive effects of repeated message exposure on message engagement by examining the neurocognitive and psychological processes involved when target audiences are repeatedly exposed to similar anti-tobacco campaign messages. These insights are crucial for planning and designing public health campaigns that typically are repeated via various media channels.
Evaluating adolescent eating autonomy through ecological momentary assessment.
Ziegler AM, Hatzinger LA, Barich RA … +4 more , Mansouri TH, Tilyou K, Goldschmidt AB, Temple JL
Ann Behav Med · 2025 Jan · PMID 40492683 · Full text
BACKGROUND: Adolescence is marked by increases in autonomy, establishment of health behaviors, and changes in self-regulation. Numerous facets of adolescents' eating behavior occur in the context of increased autonomy, i...
BACKGROUND: Adolescence is marked by increases in autonomy, establishment of health behaviors, and changes in self-regulation. Numerous facets of adolescents' eating behavior occur in the context of increased autonomy, including food choices when apart from parents/caregivers, on weekend times with less structure than the school week, and during snacking occasions (versus meals). While previous studies have examined situations with assumed autonomy differences, ours is the first to directly examine eating autonomy in adolescents' food choices, using a momentary design. PURPOSE: The purpose of this study was to examine the construct of eating autonomy through smartphone-based ecological momentary assessment (EMA). METHODS: Over seven days, adolescents (n = 48; 12-17y) reported their perceived control in selecting recent food/drinks alongside contextual data from each eating occasion. We hypothesized that, within-subjects, eating autonomy would be higher on weekends, during snacks, and when eating with friends/peers compared to weekdays, during meals, and eating with parents respectively. We also hypothesized that there would be between-subjects differences in adolescents' eating autonomy by age and gender. RESULTS: Generalized Linear Mixed Models (GLMM) analyses found within-subjects effects showing higher autonomy during snacks and when eating alone, whereas autonomy decreased when eating with parents and during after-school and dinnertimes. There was no significant association between age and eating autonomy. CONCLUSIONS: These findings suggest that adolescents demonstrate significant autonomy over food choices, that varies by social context, type of eating occasion, and time of day. Understanding these patterns can inform adolescent-focused and parental support interventions aimed at improving adolescents' dietary behaviors by targeting specific contexts where autonomy is greater. The insights gained from this study can help shape strategies that promote healthier eating habits among adolescents by enhancing their decision-making autonomy in various contexts.
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