Annals Of Behavioral Medicine[JOURNAL]
Sun
200 papers
Usability, feasibility, and acceptability of a smartphone-supported behavioral activation intervention for patients with advanced cancer.
Low CA, Bartel C, Fedor J … +6 more , Durica KC, Cheng S, Lazris D, Bokil A, Posluszny DM, Schenker Y
Ann Behav Med · 2026 Jan · PMID 41498434 · Full text
BACKGROUND: Advanced cancer can disrupt participation in meaningful daily activities. Sustaining or increasing these activities through behavioral activation may improve mood and quality of life for the growing populatio...
BACKGROUND: Advanced cancer can disrupt participation in meaningful daily activities. Sustaining or increasing these activities through behavioral activation may improve mood and quality of life for the growing population of people living with advanced cancer. PURPOSE: The goal of this study was to develop and evaluate the preliminary usability, feasibility, and acceptability of BALANCE (Behavioral Activation-Led Activity eNgagement for Cancer Empowerment), an 8-week smartphone-based intervention aimed at increasing engagement in meaningful daily activities in the context of advanced cancer. METHODS: We first developed BALANCE in collaboration with a Community Patient Advisory Board. Second, we conducted usability testing of BALANCE with patients with advanced cancer. Finally, we conducted a single-arm pilot trial to evaluate the feasibility and acceptability of BALANCE. We also examined the preliminary effects of the intervention on patient-reported outcomes. RESULTS: Usability testing participants (n = 7) rated the BALANCE app as easy (7.9/10), pleasant (8.6/10), and not burdensome to use (1.8/10). Results of the single-arm trial (n = 22) also suggest good usability (System Usability Scale score of 79.3/100), feasibility (indicated by 100% participant retention, average engagement with the application on 82% of days, and completion of 81% of planned meaningful activities), and acceptability (based on high [8.1/10] likelihood of recommending BALANCE to a friend with cancer). While the primary goal of this work was to assess feasibility and acceptability, we also observed a statistically significant decrease in patient-reported anxiety (F(2, 40) = 3.52, P = .039, ηg2 = 0.017). CONCLUSIONS: BALANCE is a feasible and acceptable smartphone-based intervention that may help patients with advanced cancer maintain and increase valued daily activities.
Exploring quality of life impact on cancer screening in Black subgroups.
Ashing K, Blackman E, Song G … +7 more , Gibbs D, He Z, Harrison S, Manzano JM, Theard O, Tulloch-Reid M, Ragin C
Ann Behav Med · 2025 Jan · PMID 41410424 · Full text
BACKGROUND: Black individuals in United States have the poorest outcomes in cancer and receipt of cancer screening. PURPOSES: This study seeks to describe cancer screening among Black subgroups, especially considering th...
BACKGROUND: Black individuals in United States have the poorest outcomes in cancer and receipt of cancer screening. PURPOSES: This study seeks to describe cancer screening among Black subgroups, especially considering the influence on quality of life (QOL). METHODS: Data from the African Cancer Prevention Project of Philadelphia (CAP3) were analyzed to examine differences among Black subgroups for QOL variables and cancer screening. Descriptive analysis and Fisher's exact test were conducted. RESULTS: The overall sample included 294 participants (177 African Americans, 34 US immigrants from Africa, and 83 US immigrants from Afro-Caribbean) ranging from 21 to 88 years old. Significant differences were found in various cancer screenings, such as Caribbean immigrant female participants receiving cervical cancer screening, African Americans receiving breast cancer screening, and US immigrants from Africa receiving colorectal cancer screening. CONCLUSIONS: Quality-of-life factors varied across the 3 Black subgroups and varied by cancer screening site. QOL factors have a significant impact on cancer screening. More culturally tailored cancer prevention interventions should be developed for the self-reported Black population.
Correction to: Daily, prospective associations between sleep architecture and affect: insights from Bayesian multilevel compositional data analysis.
Ann Behav Med · 2025 Jan · PMID 41359931 · Full text
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Trauma, posttraumatic stress disorder, and incident chronic disease.
Bourassa KJ, Anderson L, Brown JC … +5 more , Dennis PA, Garrett ME, Ashley-Koch AE, Beckham JC, Kimbrel NA
Ann Behav Med · 2025 Jan · PMID 41350112 · Full text
BACKGROUND: Posttraumatic stress disorder (PTSD) is associated with chronic disease risk, particularly cardiovascular disease (CVD). However, few studies have combined detailed measurements of trauma exposure and PTSD wi...
BACKGROUND: Posttraumatic stress disorder (PTSD) is associated with chronic disease risk, particularly cardiovascular disease (CVD). However, few studies have combined detailed measurements of trauma exposure and PTSD with incident chronic disease outcomes assessed using electronic health records (EHRs). PURPOSE: Our study examined associations between traumatic stress (combat exposure, lifetime trauma exposure, PTSD symptoms, and PTSD diagnosis) and chronic disease outcomes, including 7 clinical risk factors and 11 major chronic disease diagnoses assessed using EHRs. METHODS: Participants included 3696 post-9/11 US veterans enrolled in the VISN 6 (Veterans Integrated Service Networks 6) MIRECC (Mental Illness Research, Education, and Clinical Center)'s Post-Deployment Mental Health Study cohort who averaged 38.1 years old at baseline with 13.3 years of follow-up. RESULTS: At baseline, greater PTSD symptoms were associated with higher body mass, more alcohol use, higher rates of smoking, hypertension, and hyperlipidemia. Over follow-up, veterans with more combat exposure (HR, 1.11; 95% CI, 1.04-1.19; P = .002), trauma exposure (HR, 1.15; 95% CI, 1.08-1.23; P < .001), PTSD symptoms (HR, 1.22; 95% CI, 1.14-1.30; P < .001), or a diagnosis of PTSD (HR, 1.39; 95% CI, 1.21-1.59; P < .001) developed more chronic disease. PTSD symptoms and diagnostic status showed consistent associations with incident onset of CVD, diabetes, and pulmonary disease, and associations remained when accounting for non-PTSD psychiatric diagnoses. Compared to veterans with current PTSD, veterans with past PTSD had reduced risk of developing chronic diseases. CONCLUSIONS: Future research should examine if treating PTSD and the sequelae of trauma has the potential to reduce risk for chronic disease, particularly CVD, diabetes, and pulmonary disease.
Changes in physical activity 1 year after breast cancer diagnosis and associations with patient-reported outcomes: results from the AMBER cohort.
Vallance J, Friedenreich C, Zhang R … +10 more , Wang Q, Matthews C, Yang L, McNeely M, Wagoner C, Culos-Reed N, Bell G, McNeil J, Dickau L, Courneya K
Ann Behav Med · 2025 Jan · PMID 41350111 · Full text
BACKGROUND: Few studies have prospectively examined how changes in physical activity in the first year after a breast cancer diagnosis may affect patient-reported outcomes (PROs) including quality of life and fatigue. PU...
BACKGROUND: Few studies have prospectively examined how changes in physical activity in the first year after a breast cancer diagnosis may affect patient-reported outcomes (PROs) including quality of life and fatigue. PURPOSE: The purpose of this study was to examine changes in device-measured physical activity and associations with changes in quality of life [physical composite summary score (PCS) and mental composite summary score (MCS)] and fatigue from the first year after diagnosis among newly diagnosed women with breast cancer in the Alberta Moving Beyond Breast Cancer Study. METHODS: In this prospective cohort study, we assessed women within a median of 60 days postsurgery (N = 1442) and again 1 year later (N = 1194). At both timepoints, participants wore an ActiGraph accelerometer for 7 days to measure light and moderate-to-vigorous physical activity (MVPA) and an activPAL accelerometer for daily steps. We used analysis of covariance to compare PRO change scores (dependent variables: PCS and MCS, and fatigue) across activity change quartiles (Q). RESULTS: Participants were categorized into Q1 (decreased activity: mean changes = -37.2 minutes/day), Q2 (stable activity: mean change = -4.8 minutes/day), Q3 (modest increase in activity: mean change = 13.2 minutes/day), and Q4 (large increase in activity: mean change = +49.8 minutes/day). For MVPA, participants in Q4 had significantly larger improvements in PCS and MCS compared with those in the lowest quartiles (PCS: Q1 Δ = 1.5 points, P = .026; Q2 Δ = 1.6 points, P = .017; MCS: Q1 Δ = 2.2 points, P = .007). Significant differences also emerged for fatigue as participants in Q4 of MVPA reported improvements in fatigue compared to those in Q1 (Δ = 1.9 points, P = .017) and Q2 (Δ = 1.9 points, P = .016). Improvements in PCS, MCS, and fatigue were observed when comparing the highest quartile of change (Q4) in light intensity activity, daily steps, and MVPA in ≥10-minute bouts to those in Q1 and Q2. CONCLUSIONS: Women with breast cancer who increased physical activity from diagnosis to 1 year had significantly better improvements in PCS, MCS, and fatigue compared with those who decreased or maintained their physical activity.
Visual attention and memory retention of cannabis warning labels: an eye-tracking experiment with young adults.
Liu J, Mi RZ, Jeon M … +4 more , Fabbricatore JL, Wicke R, Cojulun LR, Yang S
Ann Behav Med · 2025 Jan · PMID 41338585 · Publisher ↗
BACKGROUND: Cannabis use is rising among young adults, while their perceived risks are declining. Existing cannabis warning labels (CWLs), often dense, generic, and text-only, struggle to sustain attention or promote eff...
BACKGROUND: Cannabis use is rising among young adults, while their perceived risks are declining. Existing cannabis warning labels (CWLs), often dense, generic, and text-only, struggle to sustain attention or promote effective risk recognition. Drawing on construal-level theory, this study investigates whether the concreteness of textual and pictorial elements improves CWL effectiveness. PURPOSE: This study examines how specific (vs. generic) text related to health consequences and the addition of pictograms or vivid imagery influence sustained attention to CWLs and recognition of cannabis-related health risks. METHODS: In an eye-tracking experiment, 163 young adult participants were randomly assigned to view CWLs featuring: (1) generic text, (2) specific text, (3) specific text with pictogram, or (4) specific text with vivid imagery. Attention was measured via fixation duration, and recognition was assessed using a post-exposure memory test with signal detection scores. RESULTS: CWLs with specific text significantly outperformed generic text in sustaining attention and enhancing general risk recognition. Adding vivid imagery further enhanced attention but did not significantly improve recognition beyond specific text alone. CWLs with pictograms also led to greater attention than generic text, though less than vivid imagery, and similarly did not improve recognition. CONCLUSIONS: Cannabis warnings should prioritize concrete, specific text to optimize both attention and recognition. For raising awareness, incorporating vivid imagery can be beneficial. However, for educational goals centered on enhancing recognition, pictorial elements may be unnecessary if the text is sufficiently concrete. These findings offer practical guidance for designing effective warnings to curb cannabis use among young adults.
Barriers and facilitators to nicotine and cannabis vaping cessation among young adults: a qualitative study using Capability, Opportunity, Motivation, and Behavior (COM-B) model and Theoretical Domains Framework (TDF).
Nguyen N, Satterfield JM, Keyhani S … +2 more , Marcus GM, Ling PM
Ann Behav Med · 2025 Jan · PMID 41325641 · Full text
BACKGROUND: Despite young adults' growing use of nicotine and cannabis vaporized products (vaping), little is known about factors influencing vaping cessation. PURPOSE: Identify barriers and facilitators to nicotine and/...
BACKGROUND: Despite young adults' growing use of nicotine and cannabis vaporized products (vaping), little is known about factors influencing vaping cessation. PURPOSE: Identify barriers and facilitators to nicotine and/or cannabis vaping cessation among young adults (18-29 years old). METHODS: We conducted a thematic analysis of interviews with 20 California young adults (mean age = 22.8, racially and ethnically diverse) who vaped nicotine and/or cannabis (specifically delta-9-tetrahydrocannabinol or THC) in 2024-2025. We mapped cessation-related barriers and facilitators to Capability, Opportunity, Motivation, and Behavior model and Theoretical Domains Framework. RESULTS: Young adults expressed stronger motivation to stop vaping nicotine than cannabis. Psychological Capability barriers involved a lack of self-control over nicotine vaping. Physical Opportunity factors, such as product accessibility and treatment unaffordability, hindered quitting, while the cost burden of vaporized products was a facilitator. Social Opportunity included both barriers (ie, socialization) and facilitators (ie, protection of loved ones or relationships). Automatic Motivation barriers included habitual use and addiction, while negative emotion toward vaping harms facilitated quitting. Reflective Motivation included the most identified factors for barriers (eg, low perceived risk of vaping, coping with mental health, and personal identity linked to vaping) and facilitators (eg, quitting desire and concerns about health and vaporized product quality). Most factors influencing vaping cessation overlapped for nicotine and cannabis. Substance-specific barriers for nicotine (ie, self-control, oral fixation, and flavor appeal) and cannabis (ie, perceived benefits) were identified. CONCLUSIONS: Findings provide insights into potential targets for future interventions to help young adults quit vaping nicotine and/or cannabis.
Nudge-based interventions to improve medication adherence in adults with chronic diseases: systematic review and meta-analysis of randomized controlled trials.
Zhou Z, Zhang Y, Xu J … +1 more , Zhang N
Ann Behav Med · 2025 Jan · PMID 41317406 · Publisher ↗
BACKGROUND: Medication adherence is crucial for managing chronic conditions, yet medication adherence rates are often suboptimal. Nudge-based interventions have shown promise in other health behaviors, but their effectiv...
BACKGROUND: Medication adherence is crucial for managing chronic conditions, yet medication adherence rates are often suboptimal. Nudge-based interventions have shown promise in other health behaviors, but their effectiveness in improving medication adherence remains unclear. PURPOSE: To evaluate the effectiveness of nudge-based interventions in improving medication adherence among adults with chronic diseases. METHOD: We searched 6 electronic databases (PubMed, Embase, Web of Science, PsycINFO, Scopus, and Cochrane) for studies (January 1, 2014, to November 23, 2024). Included studies were randomized controlled trials (RCTs), involving adults (≥18 years) with chronic diseases that compared nudge-based interventions to improve medication adherence with usual care. Two reviewers independently extracted data and assessed the risk of bias. Key study characteristics were summarized. Random-effects meta-analyses were conducted to calculate standardized mean differences (Hedges' g) and 95% CIs. Heterogeneity was assessed using the Cochrane Q test and I2, and sensitivity analyses were performed to evaluate the robustness of the findings. RESULTS: A total of 36 studies were included, with 19 RCTs providing data for meta-analysis (total N = 2690). Nearly half were rated as low risk of bias. The pooled effect size was Hedges' g = 0.68 (95% CI, 0.16-1.20, P < .01). Significant heterogeneity was observed (I2 = 96.3%, P < .01), subgroup analyses were conducted to identify significant sources of this heterogeneity. No publication bias was detected (Egger's test, P = .447). CONCLUSION: Overall, nudge-based interventions have the potential to improve medication adherence among adults with chronic disease. There is a need for further well-designed studies to enhance the strength of the evidence.
A randomized controlled pilot trial of low and high arousal resilience interventions for depressive symptoms.
Epel ES, Don BP, Mayer SE … +10 more , Blades R, Mason AE, Fromer E, O'Bryan JF, Dileo R, Guan JY, Schilf SJ, Cheng SS, Prather AA, Mendes WB
Ann Behav Med · 2025 Jan · PMID 41309213 · Publisher ↗
BACKGROUND: To cope with chronic stress, which can contribute to depression, humans often pursue arousal-reducing activities. Yet, hormetic stressors (intermittent, acute stressors) might also reduce chronic stress. PURP...
BACKGROUND: To cope with chronic stress, which can contribute to depression, humans often pursue arousal-reducing activities. Yet, hormetic stressors (intermittent, acute stressors) might also reduce chronic stress. PURPOSE: We compared the effects of arousal-reducing and arousal-enhancing interventions on depressive symptoms and perceived stress. METHODS: Female adults (N = 141; predominantly White, 63%, and Asian, 34%) reporting high perceived stress were randomized to 1 of 4 three-week stress resilience interventions in 2019-2020. Low arousal conditions included mindfulness meditation or slow breathing with warm showers (Control). Hormetic stress conditions included fast paced breathing with cold showers (the Wim Hof Method; WHM) or high-intensity interval training. We assessed depressive symptoms and perceived stress at baseline, postintervention, and 3 months later, and cortisol reactivity to a lab stressor. RESULTS: At postintervention, all 4 groups had decreases in depressive symptoms (15.93% reduction, r = .76, P < .001) and perceived stress (9.70% reduction, r = .48, P < .001), with no group differences. "As treated" analysis showed the WHM group had better maintenance of reduced depression 3 months later (r = .17, P < .01). The WHM group had greater increases in daily positive affect across days (r = .16, P ≤ .05) and at postintervention (r = .17, P < .015) compared to the control group. Groups were similar in cortisol reactivity pre- and postintervention. CONCLUSIONS: All groups experienced reduced stress and depressive symptoms and did not differ from each other after 3 weeks. After 3 months, a post hoc analysis of adherent subjects showed the WHM group had more sustained improvements in depression and positive affect, a finding that needs replication with larger and more diverse samples.
Adaptation of family-based health promotion to pediatric acute lymphoblastic leukemia treatment: NOURISH-ALL.
Bates CR, Van Asselt A, Gilbert RM … +6 more , Okuno H, Dean KM, August KJ, Befort CA, Stern M, Davis AM
Ann Behav Med · 2025 Jan · PMID 41241961 · Full text
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer in the United States, with significant rates of overweight and obesity among affected youth. Excessive weight gain during early ALL treat...
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer in the United States, with significant rates of overweight and obesity among affected youth. Excessive weight gain during early ALL treatment is linked to poorer health outcomes, including higher relapse rates and long-term morbidities, highlighting the need for interventions to prevent weight gain and improve prognosis. PURPOSE: This study's purpose was to adapt family-based health promotion strategies to the early phases of pediatric ALL treatment. Adaptations aimed to create a new intervention (NOURISH-ALL) with the potential to prevent excessive weight gain during ALL treatment. METHODS: Guided by the Obesity-Related Behavioral Intervention Trials model phase 1a, this adaptation framework included integrating evidence-based recommendations for family stress, nutrition, and physical activity during pediatric cancer treatment into an existing intervention (NOURISH-T). Multimethod formative assessments were conducted with families, youth with ALL, and multidisciplinary experts to further adapt intervention content, format, and delivery to meet the specific needs of families of youth in the early phases of ALL treatment. RESULTS: Sixteen families (11 caregivers; 6 youth with ALL ages 8-12 years) and 11 multidisciplinary experts participated in formative assessments. Adaptations included integration of evidence-based methods to support caregiver distress, consistent messaging around nutrition and activity behaviors, and tailored intervention formats to improve engagement for families with logistical and time-related barriers. CONCLUSIONS: This study adapted the NOURISH-T intervention to address the unique challenges faced by families during early pediatric ALL treatment (NOURISH-ALL). Further testing is required to evaluate NOURISH-ALL feasibility and efficacy.
Self-efficacy, diabetes distress, self-management, and glycemic regulation: within-person pathways in type 1 diabetes.
Gonzalez JS, Schneider S, Hoogendoorn C … +2 more , Nandoo L, Pyatak E
Ann Behav Med · 2025 Jan · PMID 41236802 · Full text
BACKGROUND: Despite extensive research on the role of self-efficacy in behavioral performance across various domains, its specific influence on self-management behaviors in type 1 diabetes (T1D) remains unclear. While st...
BACKGROUND: Despite extensive research on the role of self-efficacy in behavioral performance across various domains, its specific influence on self-management behaviors in type 1 diabetes (T1D) remains unclear. While studies find inconsistent evidence on whether self-efficacy actively drives future behaviors or is instead shaped by prior performance, research directly examining these temporal relationships in T1D is limited. PURPOSE: This study aims to examine the within-person, bidirectional, temporal relationships among self-efficacy, diabetes distress, self-management behavior, and glycemic regulation in T1D using intensive longitudinal data. METHODS: The current analyses used data from the Function and Emotion in Everyday Life with Type 1 Diabetes study (N = 173). Participants wore a blinded continuous glucose monitor (CGM) for 14 days and completed 5-6 smartphone-based surveys daily. Data were analyzed using dynamic structural equation modeling. RESULTS: Diabetes self-efficacy, distress, and self-management were significantly related within-person. Morning self-efficacy predicted lower diabetes distress and better management, both of which improved CGM outcomes. Lagged analyses revealed that prior-day self-efficacy, distress, and self-management predicted next-morning self-efficacy, but prior-day glucose did not. Feedback from personal use of unblinded CGM did not influence these relationships. CONCLUSIONS: Findings support self-efficacy as both an influence on future T1D self-management behavior change and an outcome of prior emotional states and self-management performance. Results suggest that diabetes self-efficacy predicts short-term glycemic regulation primarily through its associations with changes in diabetes distress and self-management.
Daily stress and worry are additional triggers of symptom fluctuations in individuals living with Long COVID: results from an intensive longitudinal cohort study.
O'Connor DB, Greenwood DC, Mansoubi M … +19 more , Bakerly ND, Bhatia A, Collett J, Davies HE, Dawes J, Delaney BC, Ezekiel L, Leveridge P, Mir G, Muehlhausen W, Rayner C, Scott JT, Sivan M, Tucker-Bell I, Vashisht H, Ward T, Winch D, Dawes H, LOCOMOTION Consortium
Ann Behav Med · 2025 Jan · PMID 41231196 · Full text
BACKGROUND: Recent research has shown that exertion in physical, cognitive, social, and self-care activities triggers symptom severity in individuals with Long COVID. PURPOSE: The current study aimed to investigate wheth...
BACKGROUND: Recent research has shown that exertion in physical, cognitive, social, and self-care activities triggers symptom severity in individuals with Long COVID. PURPOSE: The current study aimed to investigate whether daily emotional exertions (stress, worry, rumination) were associated with symptom exacerbation, over and above influences of effortful daily activities, in individuals with Long COVID. METHODS: In total, 376 participants were recruited from UK Long COVID clinics and community settings and completed daily assessments of activity and severity of 8 core symptoms every 3 hours for up to 24 days; 155 participants completed daily assessments of stress, worry, and rumination for at least 7 consecutive days. RESULTS: Days with higher stress scores were associated with increased severity of all symptoms on the same day, after adjusting for activities, demographic and medical factors (P-values ≤ .007). Days with higher stress scores also predicted more severe anxiety and depression symptoms 1 day later (P < .001) and more severe anxiety (P < .001) and dizziness symptoms (P = .003) 2 days later. Days with higher worry scores were associated with increased fatigue (P < .001), anxiety (P < .001), depression (P < .001), and cognitive dysfunction (P = .002) on the same day, but decreased anxiety (P = .003) and depression (P = .002) symptoms 1 day later and less severe pain (P = .002) symptoms 2 days later. Daily rumination was only associated with 2 symptoms. CONCLUSIONS: Daily stress and worry are distinct factors linked to fluctuations in same-day and next-day Long COVID symptoms, with daily stress showing the strongest association-consistent with patterns of postexertional symptom exacerbation. These findings highlight the importance of considering stress and worry as potential therapeutic targets and integrating their management into self-care programs.
Within-person associations between psychological and contextual factors and dietary lapse in adults: a machine learning-assisted systematic review and meta-analysis.
Liu G, Ma H, Pei R … +10 more , Chen B, Yang Z, Li S, Lei L, Wang A, Tang X, Su C, Gu J, Sheng Y, Piao M
Ann Behav Med · 2025 Jan · PMID 41224247 · Publisher ↗
AIMS: To systematically review and meta-analyze the evidence from ecological momentary assessment (EMA) studies on how psychological and contextual factors influence dietary lapses in adults striving for healthy eating h...
AIMS: To systematically review and meta-analyze the evidence from ecological momentary assessment (EMA) studies on how psychological and contextual factors influence dietary lapses in adults striving for healthy eating habits. BACKGROUND: Dietary lapses, deviations from intended eating patterns, are influenced by both psychological and contextual factors. While psychological aspects like stress and negative emotional states have been widely studied, the role of contextual influences, such as food availability and social environments, remains underexplored. EMA offers a real-time, context-sensitive approach to better understanding these lapses. METHODS: We conducted a comprehensive search across Ovid MEDLINE, Embase, PsycINFO, and Web of Science, employing machine learning to enhance the efficiency and accuracy of literature screening. This search aimed to identify studies that utilized EMA to investigate the predictors of dietary lapses. Our analysis included a qualitative synthesis of the definitions of "lapse" and "relapse" used in the studies, as well as the theoretical frameworks underpinning EMA study designs. RESULTS: Eighty-seven articles were selected for the systematic review, and 53 articles were eligible for meta-analysis. Our analysis revealed a positive correlation between the occurrence of dietary lapses and negative emotional states (OR = 1.12, 95% CI = 1.07-1.18, P < .0001, I2 = 3.0%), environmental and social influences (OR = 1.07, 95% CI = 1.00-1.55, P = .048, I2 = 0%), and the craving (OR = 1.32, 95% CI = 1.11-1.55, P < .001, I2 = 21.5%). In addition, we found that the definition of "lapse" was relatively consistent across studies, while the definition of "relapse" varied significantly across studies. Meanwhile, although most studies mentioned at least 1 psychological theory to guide the assessment of psychological or situational variables, the theory was less used in the specific application of determining EMA frequency and study duration. CONCLUSIONS: This study underscores the complexity of dietary behavior and the multifaceted influences that lead to lapses in healthy eating. By highlighting the significant predictors of dietary lapses, our findings provide valuable insights for developing targeted interventions that support individuals in achieving healthy eating habits. In addition, the application of machine learning in literature screening represents an innovative approach that could be utilized in systematic reviews and meta-analyses in the future to enhance the efficiency and outcomes of studies.
The temporal dynamics of the association between daily physical activity and life satisfaction.
Elavsky S, Brabec M, Maly M … +7 more , Knapova L, Kastovska B, Sebera M, Ely M, Jandackova VK, Keller J, Pavel M
Ann Behav Med · 2025 Jan · PMID 41224246 · Full text
PURPOSE: Life satisfaction (LS) is increasingly recognized as a crucial indicator and predictor of health and well-being across the lifespan. The impact of LS may be enhanced through physical activity (PA), although stud...
PURPOSE: Life satisfaction (LS) is increasingly recognized as a crucial indicator and predictor of health and well-being across the lifespan. The impact of LS may be enhanced through physical activity (PA), although studies exploring the dynamic and bidirectional nature of the relationship are scarce. One principal goal of this project is to examine the dynamic, personalized interactions between LS and PA and exercise identity (the degree to which exercise is a fundamental aspect of one's self-concept) in geographic areas with different air pollution loads. METHOD: We used data from a 12-month prospective cohort study (N = 1314, mean age = 38.09 [12.55]; range 18-65) with four 2-week intensive measurement bursts to evaluate the bidirectional relationship between LS (assessed at the end of the day) and PA (assessed by Fitbit Charge 3 or 4 throughout the day). The sample included both active (runners; n = 747, 57%) and inactive (n = 567, 43%) individuals living in Moravia-Silesia and South Bohemia, geographic areas with different levels of air pollution. A dynamic Bayesian model based on an extension of the vector autoregressive model was used to estimate both lagged and contemporaneous associations between LS and PA. RESULTS: There were meaningful autoregressive effects of first order for both LS (β = 0.394) and PA (β = 0.316), and a within-person contemporaneous association between LS and PA (β = 0.087) that was also associated with temporal factors and trends (weekly and monthly seasonal variation, day in study), gender, age, and exercise identity. CONCLUSION: This study highlights the importance of periodicity on 2 temporal scales for both PA and LS, with age and gender also playing crucial roles. The findings underscore the importance of tailored, context-aware interventions to sustain engagement and enhance well-being through PA.
Exposure to intimate partner violence and subsequent substance use among a nationwide sample of LGBTQIA+ people: results of The PRIDE Study.
Metheny N, Tran NK, Dusing GJ … +5 more , Scott D, Lubensky ME, Lunn MR, Obedin-Maliver J, Flentje A
Ann Behav Med · 2025 Jan · PMID 41214893 · Full text
BACKGROUND: Individuals who are lesbian, gay, bisexual, transgender, queer or questioning, intersex, aromantic, asexual, or another sexual or gender minority (LGBTQIA+) are at greater risk of both intimate partner violen...
BACKGROUND: Individuals who are lesbian, gay, bisexual, transgender, queer or questioning, intersex, aromantic, asexual, or another sexual or gender minority (LGBTQIA+) are at greater risk of both intimate partner violence (IPV) and substance use compared to their cisgender, heterosexual counterparts. However, knowledge regarding the complex relationship between IPV and substance use in LGBTQIA+ communities is limited. METHODS: This study used data from 2 years of The PRIDE (Population Research in Identity and Disparities for Equality) Study, a nationwide, community-based sample of LGBTQIA+ adults in the United States. Past-year IPV in 2021 was measured using the Extended-Hurt, Insulted, Threaten, Scream scale. Substances used in 2022 were measured via the NIDA-Modified Alcohol, Smoking, and Substance Involvement Screening Test (NM ASSIST). Linear and modified Poisson regression models explored temporal relationships between past-year IPV and prospective substance use. RESULTS: Participants (n = 3745) were relatively young (median= 34 years, interquartile range: 27.6-48.5) and represented diverse LGBTQIA+ subcommunities. Approximately one-quarter (23.7%) were cisgender women and 17% were cisgender men. Half (49.2%) were gender minority people. Overall, one-quarter (24.6%) reported exposure to IPV in 2021. In adjusted models, past-year IPV was associated with prospective substance use (risk ratio [RR]: 1.11; 95% CI, 1.03-1.19). Additionally, more frequent IPV was associated with a higher prospective NM ASSIST score for cannabis (B: 0.22; 95% CI, 0.08-0.36), stimulants (B: 0.20; 95% CI, 0.06-0.35), hallucinogens (B: 0.07; 95% CI, 0.02-0.12), and narcotics (B: 0.12; 95% CI, 0.03-0.20). CONCLUSIONS: Exposure to IPV in 2021 was linked to greater substance use in 2022. Findings underscore the role of IPV in substance use among LGBTQIA+ people. Furthermore, they point to the need for increased IPV screening and referral among LGBTQIA+ people, as well as the potential efficacy of trauma-informed substance use interventions that address IPV.
Compendium of dyadic behavior change techniques v2.0: results from a Delphi study.
Berli C, Villinger K, Di Maio S … +11 more , Spliesgart A, Stadler G, Gawrilow C, Bolger N, Hankonen N, Luszczynska A, Rothman AJ, Schneider F, Simpson JA, Knoll N, Scholz U
Ann Behav Med · 2025 Jan · PMID 41208198 · Full text
BACKGROUND: Dyadic interventions involving a close other (eg, romantic partner) have gained increased awareness and shown initial promise, but a shared language and systematic approach to describing their intervention co...
BACKGROUND: Dyadic interventions involving a close other (eg, romantic partner) have gained increased awareness and shown initial promise, but a shared language and systematic approach to describing their intervention content (ie, dyadic behavior change techniques [DBCTs]) is lacking. PURPOSE: This study aimed to further develop a comprehensive and expert-validated Compendium of DBCTs focused on health behavior change in romantic couples to support intervention development and facilitate intervention reporting. METHODS: A 2-round Delphi process with international experts (1: N = 20; 2: N = 19) was conducted. Experts rated the clarity and comprehensibility of DBCTs, as well as their expected link with the most proximal mechanisms of action. Additionally, 14 experts convened for an online discussion via video conferencing to address key issues and emerging questions. RESULTS: The resulting Compendium of DBCTs v2.0 includes 219 DBCTs that specify who (ie, execution) does what (ie, intervention task) for whom (ie, target). DBCTs are linked to 32 hypothesized most proximal mechanisms of action. An interactive Webtool (www.dbctcompendium.com) was created to facilitate access to and use of the Compendium. CONCLUSIONS: The Compendium of DBCTs v2.0 offers a classification of DBCTs validated through expert consensus. It supports systematic development and reporting of dyadic interventions aimed at health behavior change in couples by specifying hypothesized links with underlying mechanisms of action. Future research should focus on identifying the effectiveness of DBCTs under various conditions and the Compendium's applicability to other dyad types and behavioral domains.
Couple synchrony in physical activity: effects on individuals with knee osteoarthritis.
Cho YW, Huang Y, Chow SM … +1 more , Martire LM
Ann Behav Med · 2025 Jan · PMID 41206026 · Full text
BACKGROUND: Physical activity (PA) is crucial for managing osteoarthritis (OA) symptoms, but maintaining an active lifestyle remains challenging. Given the influence of spouses on each other's health behaviors, PA synchr...
BACKGROUND: Physical activity (PA) is crucial for managing osteoarthritis (OA) symptoms, but maintaining an active lifestyle remains challenging. Given the influence of spouses on each other's health behaviors, PA synchrony-the concurrent PA engagement between partners-may enhance PA levels and emotional well-being in individuals with knee osteoarthritis (IKOAs). PURPOSE: We investigate whether daily PA synchrony in couples is associated with PA levels and emotional well-being in IKOAs. METHODS: We analyzed 22 days of actigraphy data from 140 couples, each with 1 partner with knee OA (IKOAs: age 50-92, M = 65.3; 42% male). PA synchrony was operationalized as the association between partners' PA levels measured concurrently within each 1-hour time window throughout the day. Using multilevel structural equation modeling, synchrony was estimated and decomposed into 2 components: day level (capturing daily fluctuations) and couple level (reflecting overall average synchrony). Associations between synchrony at each level and IKOAs' PA and emotional well-being were examined. We accounted for shared diurnal rhythms in PA, a potential source of spurious synchrony, to enhance the precision of synchrony estimates. RESULTS: While couples generally showed synchronized PA, there were significant day-to-day fluctuations. On days when couples exhibited higher-than-usual PA synchrony, IKOAs engaged in significantly more PA. Regarding emotional well-being, increased daily synchrony was associated with higher positive and lower negative affect. CONCLUSIONS: Findings highlight the importance of separating short-term fluctuations from stable couple dynamics. Findings suggest that promoting short-term synchronized PA between partners may improve both PA and emotional well-being in IKOAs. Our analytic framework is broadly applicable to couple-based research on shared health behaviors.
Associations between environmental burdens and modifiable lifestyle risk factors among cancer survivors in NCI's HINTS-SEER survey.
Boyle J, Dimaranan CR, Barsell DJ … +3 more , Miller CA, Hundley WG, Fuemmeler BF
Ann Behav Med · 2025 Jan · PMID 41192962 · Publisher ↗
BACKGROUND: Improving cancer survivorship outcomes is a priority in cancer prevention and control. As global cancer incidence rises each year, cancer survivors are living longer and are uniquely susceptible to developing...
BACKGROUND: Improving cancer survivorship outcomes is a priority in cancer prevention and control. As global cancer incidence rises each year, cancer survivors are living longer and are uniquely susceptible to developing subsequent chronic conditions. Current strategies for preventing chronic conditions emphasize modifying risk factors including lifestyle and environmental exposures. PURPOSE: However, few studies have analyzed how multiple pollution-related and built environment characteristics influence lifestyle behaviors among cancer survivors. In this study, we examined associations between environmental burdens and lifestyle behaviors in cancer survivors (N = 984) using data from the 2022 Environmental Justice Index (EJI) and the 2021 Health Information National Trends Survey-Surveillance, Epidemiology, and End Results (HINTS-SEER) survey. METHODS: We used multivariable regression modeling to assess associations between environmental burdens and 5 lifestyle behaviors: physical activity, alcohol consumption, overweight status, sitting habits, and smoking. Additionally, we performed Bayesian index modeling to identify which environmental factors contributed most to significant associations with these outcomes. RESULTS: Results revealed several significant adjusted associations between environmental burdens and overweight status and sitting habits. In particular, the presence of potentially hazardous industrial sites, railroads, and high-volume roads, and fine particulate matter concentrations were all positively associated with sitting time. The prevalence of high-volume roads had the strongest impact (weight = 23.3%) on sitting time in the combined Bayesian index (β = 0.214 [95% credible interval, 0.092-0.338], exceedance probability = 99.9%). CONCLUSION: Our study provides preliminary evidence suggesting environmental burdens contribute to sedentary lifestyles among cancer survivors, emphasizing the need for further research on this interplay in this population.
Foreseeing versus feeling: how accuracy of affective forecasting relates to health behavior change.
Yang MZ, Conner M, Sheeran P
Ann Behav Med · 2025 Jan · PMID 41177145 · Publisher ↗
BACKGROUND: Whereas the importance of affective processes for health-related motivation and behavior is well established, little research has assessed either the accuracy or potential impact of accurate affective forecas...
BACKGROUND: Whereas the importance of affective processes for health-related motivation and behavior is well established, little research has assessed either the accuracy or potential impact of accurate affective forecasts about health behaviors. PURPOSE: The present study addressed 3 research questions: (1) How accurate are affective forecasts about health behaviors? (2) Does forecasting accuracy influence health behavior performance, and (3) future motivation? METHODS: We conducted a longitudinal study of 8 health behaviors (N = 857). Measures of the reasoned action approach variables, habit, and intention were taken at baseline. At the 3-month follow-up, participants reported behavioral performance, future motivation, and the affect experienced in relation to each behavior. Accuracy of affective forecasting was indexed by the difference between anticipated versus experienced affect. RESULTS: Participants generally underestimated how good performing health behaviors would make them feel. Overestimating and underestimating affect were both associated with lower behavioral performance and future motivation, whereas greater forecasting accuracy predicted increased behavior and future motivation, even controlling for reasoned action approach variables and habit. Importantly, forecasting accuracy interacted with anticipated affect, such that forecasts that were both positive and accurate were associated with increased behavior and motivation. CONCLUSIONS: This study demonstrates that affective expectations and experiences both matter for motivation and action and underscores the importance of affective forecasting for health behavior change.
The Effect of Health Literacy Interventions on Self-management in Chronic Diseases: A Systematic Review.
Cabezas MF, Nazar G, Ranchor AV … +1 more , Annema C
Ann Behav Med · 2025 Jan · PMID 41176327 · Full text
BACKGROUND: Patients need cognitive and social skills in order to be able to make informed healthcare decisions. Health literacy (HL) encompasses these skills, enabling individuals to manage their conditions and adapt to...
BACKGROUND: Patients need cognitive and social skills in order to be able to make informed healthcare decisions. Health literacy (HL) encompasses these skills, enabling individuals to manage their conditions and adapt to challenges. HL interventions in patients could be a powerful way of optimizing self-management (SM) in individuals with chronic diseases. PURPOSE: To examine the efficacy of HL interventions on the medical, emotional, and role management domains of SM, theoretical foundations, conceptualizations of HL and SM, and intervention components. METHODS: Health literacy interventions aimed at increasing SM in adults (≥18 years) with chronic diseases were considered. A database search was conducted in PubMed, Scopus, SciELO (Scientific Electronic Library Online), and Web of Science from 2014 to 2024. Results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Risk of bias was assessed using the Joanna Briggs Institute Checklist. RESULTS: Fourteen studies were included. Interventions improved 3 components of medical management: medication adherence, disease knowledge, and self-efficacy. However, the effects on adherence to diet and exercise regimens, also part of medical management, were inconclusive. Emotional and role management received limited attention. There was inconsistency between HL definitions and instruments. Most interventions were delivered through in-person sessions. Overall, studies showed moderate risk of bias, which may have influenced the results. CONCLUSIONS: Theory-based interventions, methodological consistency, and comprehensive HL and SM measures are needed to understand interventions' effectiveness. To support behavioral change, HL interventions must address emotional and role management. Future high-quality research is required to determine optimal strategies for strengthening SM through HL interventions.
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