1
|
Liang W, Duan Y, Wang Y, Lippke S, Shang B, Lin Z, Wulff H, Baker JS. Psychosocial Mediators of Web-Based Interventions on Promoting A Healthy Lifestyle among Chinese College Students: Secondary Analysis of a Randomized Controlled Trial (Preprint). J Med Internet Res 2022; 24:e37563. [PMID: 36069840 PMCID: PMC9494225 DOI: 10.2196/37563] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/09/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wei Liang
- Center for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | - Yanping Duan
- Center for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | - Yanping Wang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | | | - Borui Shang
- Department of Social Sciences, Hebei Sport University, Shijiazhuang, China
| | - Zhihua Lin
- Sport Section, Wuhan University, Wuhan, China
| | - Hagen Wulff
- Institute of Exercise and Public Health, University of Leipzig, Leipzig, Germany
| | - Julien Steven Baker
- Center for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| |
Collapse
|
2
|
Bai Y, Copeland WE, Burns R, Nardone H, Devadanam V, Rettew J, Hudziak J. Ecological Momentary Assessment of Physical Activity and Wellness Behaviors in College Students Throughout a School Year: Longitudinal Naturalistic Study. JMIR Public Health Surveill 2022; 8:e25375. [PMID: 34982721 PMCID: PMC8767478 DOI: 10.2196/25375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/21/2021] [Accepted: 10/15/2021] [Indexed: 01/04/2023] Open
Abstract
Background The Wellness Environment app study is a longitudinal study focused on promoting health in college students. Objective The two aims of this study were (1) to assess physical activity (PA) variation across the days of the week and throughout the academic year and (2) to explore the correlates that were associated with PA, concurrently and longitudinally. Methods The participants were asked to report their wellness and risk behaviors on a 14-item daily survey through a smartphone app. Each student was provided an Apple Watch to track their real time PA. Data were collected from 805 college students from Sept 2017 to early May 2018. PA patterns across the days of the week and throughout the academic year were summarized. Concurrent associations of daily steps with wellness or risk behavior were tested in the general linear mixed-effects model. The longitudinal, reciprocal association between daily steps and health or risk behaviors were tested with cross-lagged analysis. Results Female college students were significantly more active than male ones. The students were significantly more active during the weekday than weekend. Temporal patterns also revealed that the students were less active during Thanksgiving, winter, and spring breaks. Strong concurrent positive correlations were found between higher PA and self-reported happy mood, 8+ hours of sleep, ≥1 fruit and vegetable consumption, ≥4 bottles of water intake, and ≤2 hours of screen time (P<.001). Similar longitudinal associations found that the previous day’s wellness behaviors independently predicted the following day’s higher PA except for mood. Conversely, the higher previous-day PA levels were associated with better mood, more fruit and vegetable consumption, and playing less music, but with higher liquor consumption the next day. Conclusions This study provides a comprehensive surveillance of longitudinal PA patterns and their independent association with a variety of wellness and risk behaviors in college students.
Collapse
Affiliation(s)
- Yang Bai
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, United States
| | - William E Copeland
- Vermont Center for Children, Youth, and Families, Division of Child Psychiatry, University of Vermont, Burlington, VT, United States
| | - Ryan Burns
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, United States
| | - Hilary Nardone
- Vermont Center for Children, Youth, and Families, Division of Child Psychiatry, University of Vermont, Burlington, VT, United States
| | - Vinay Devadanam
- Vermont Center for Children, Youth, and Families, Division of Child Psychiatry, University of Vermont, Burlington, VT, United States
| | - Jeffrey Rettew
- Vermont Center for Children, Youth, and Families, Division of Child Psychiatry, University of Vermont, Burlington, VT, United States
| | - James Hudziak
- Vermont Center for Children, Youth, and Families, Division of Child Psychiatry, University of Vermont, Burlington, VT, United States
| |
Collapse
|
3
|
Burns RD, Pfledderer CD, Fu Y. Adolescent Health Behaviors and Difficulty Concentrating, Remembering, and Making Decisions. Am J Lifestyle Med 2021; 15:664-672. [PMID: 34916887 PMCID: PMC8669897 DOI: 10.1177/1559827619860067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/22/2019] [Accepted: 06/07/2019] [Indexed: 12/16/2022] Open
Abstract
The purpose of this study was to examine the associations among physical activity, dietary behaviors, and other salient health behaviors such as smoking, alcohol consumption, and sleeping with self-reported adolescent mental health on the 2017 National Youth Risk Behavior Survey (YBRS). A multistage cluster sampling procedure was employed to yield a representative sample of US adolescents. The number of sampled adolescents with usable data was 14 765. Weighted logistic regression models were employed to examine the predictive utility of independent health behaviors associating with reported mental health problems (difficulty concentrating, remembering, or making decisions), and meeting multiple health behavior criteria with reported mental health problems adjusting for age, sex, body mass index percentile, and race/ethnicity. Meeting physical activity guidelines, consuming breakfast every day, not smoking and/or consuming alcohol in the past 30 days, and sleeping at least 8 hours per night independently associated with lower odds of mental health problems (P < .01). For every one additional positive health behavior met, there were significantly lower odds of reported mental health problems (OR = 0.73, 95%CI 0.68-0.78, P < .001). Meeting salient positive health behavior criteria and meeting multiple positive health behavior criteria associated with lower odds of self-reported difficulty concentrating, remembering, or making decisions on the 2017 National YRBS.
Collapse
Affiliation(s)
- Ryan D. Burns
- Ryan D. Burns, PhD, Department of Health, Kinesiology, and Recreation, University of Utah, 250 South 1850 East Room 251, Salt Lake City, UT 84111;
| | - Christopher D. Pfledderer
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, Utah (RDB, CDP)
- School of Community Health Sciences, University of Nevada Reno, Reno, Nevada (YF)
| | - You Fu
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, Utah (RDB, CDP)
- School of Community Health Sciences, University of Nevada Reno, Reno, Nevada (YF)
| |
Collapse
|
4
|
Ray LA, Green R, Enders C, Leventhal AM, Grodin EN, Li G, Lim A, Hartwell E, Venegas A, Meredith L, Nieto SJ, Shoptaw S, Ho D, Miotto K. Efficacy of Combining Varenicline and Naltrexone for Smoking Cessation and Drinking Reduction: A Randomized Clinical Trial. Am J Psychiatry 2021; 178:818-828. [PMID: 34080890 PMCID: PMC8999864 DOI: 10.1176/appi.ajp.2020.20070993] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Pharmacological treatments that can concomitantly address cigarette smoking and heavy drinking stand to improve health care delivery for these highly prevalent co-occurring conditions. This superiority trial compared the combination of varenicline and naltrexone against varenicline alone for smoking cessation and drinking reduction among heavy-drinking smokers. METHODS This was a phase 2 randomized double-blind clinical trial. Participants (N=165) who were daily smokers and drank heavily received either 2 mg/day of varenicline plus 50 mg/day of naltrexone or 2 mg/day of varenicline plus matched placebo pills for 12 weeks. Primary outcomes were 7-day point prevalence of nicotine abstinence (bioverified by a breath CO reading ≤5 ppm) at the 26-week follow-up and number of drinks per drinking day during the 12-week treatment phase. RESULTS Smoking abstinence at week 26 was significantly higher in the varenicline plus placebo condition than in the varenicline plus naltrexone condition (N=37 [45.1%] compared with N=22 [26.5%]). For drinks per drinking day, there was a medication effect favoring the combination of varenicline and naltrexone over varenicline alone across the 12-week treatment phase, although it did not meet the significance threshold. CONCLUSIONS These findings suggest that smoking cessation and drinking reduction can be concomitantly targeted with pharmacotherapy and that while varenicline alone may be sufficient as a smoking cessation aid in heavy-drinking smokers, the combination of varenicline and naltrexone may confer benefits with regard to drinking outcomes, particularly during the 12-week period of active medication treatment.
Collapse
Affiliation(s)
- Lara A. Ray
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| | - ReJoyce Green
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Craig Enders
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Erica N. Grodin
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Gang Li
- Department of Biostatistics, University of California at Los Angeles, Los Angeles, CA
| | - Aaron Lim
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Emily Hartwell
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Alex Venegas
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Lindsay Meredith
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Steven J. Nieto
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Steven Shoptaw
- Department of Family Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Diana Ho
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA
| | - Karen Miotto
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA
| |
Collapse
|
5
|
Jack BW, Bickmore T, Yinusa-Nyahkoon L, Reichert M, Julce C, Sidduri N, Martin-Howard J, Zhang Z, Woodhams E, Fernandez J, Loafman M, Cabral HJ. Improving the health of young African American women in the preconception period using health information technology: a randomised controlled trial. LANCET DIGITAL HEALTH 2021; 2:e475-e485. [PMID: 33328115 DOI: 10.1016/s2589-7500(20)30189-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Preconception care focuses on improving women's health before pregnancy as a means to improve their health and future pregnancy outcomes. How to effectively deliver such care is unknown. The aim of this research was to assess the impact of an embodied conversational agent system on preconception risks among African American and Black women. METHODS We did an open-label, randomised controlled trial of women aged 18-34 years, self-identified as African American or Black, or both, and not pregnant, recruited from 35 states in the USA. Sealed allocation envelopes (in permuted blocks of six and eight, prepared using a random number generator) were opened after enrolment. Intervention participants received an online conversational agent called Gabby that assessed 102 preconception risks and delivered 12 months of tailored dialogue using synthesised speech, non-verbal behaviour, visual aids, and health behaviour change techniques such as motivational interviewing. The control group received a letter listing their preconception risks and encouraging them to talk with a clinician. The primary outcome was the proportion of identified risks at the action or maintenance stage of change at months 6 and 12. The study is registered with ClinicalTrials.gov, NCT01827215. FINDINGS From March 11, 2014, through July 8, 2018, 528 women recruited from 35 states and 242 cities across the USA received the Gabby intervention (n=262) or were assigned to the control group (n=266). Participants identified a mean of 21 preconception risks per woman (SD 9·9). In the intention-to-treat analysis, at 6 months, intervention women reported reaching the action or maintenance stage of change for 50·0% (SD 28·9) of those preconception risks identified compared with 42·7% (28·3) in the control group (incidence rate ratio 1·16, 95% CI 1·07-1·26; p=0·0004). This result persisted at 12 months. INTERPRETATION The Gabby system has the potential to improve women's preconception health. Further research is needed to determine if improving preconception risks impacts outcomes such as preterm delivery. FUNDING National Institute for Minority Health and Health Disparities.
Collapse
Affiliation(s)
- Brian W Jack
- Department of Family Medicine, School of Medicine and Boston Medical Center, Boston University, Boston, MA, USA; Institute for Health Systems Innovation and Policy, Boston University, Boston, MA, USA.
| | - Timothy Bickmore
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
| | - Leanne Yinusa-Nyahkoon
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA, USA
| | - Matthew Reichert
- Department of Government, Harvard University, Cambridge, MA, USA
| | - Clevanne Julce
- Department of Family Medicine, School of Medicine and Boston Medical Center, Boston University, Boston, MA, USA
| | - Nireesha Sidduri
- Department of Family Medicine, School of Medicine and Boston Medical Center, Boston University, Boston, MA, USA
| | - Jessica Martin-Howard
- Department of Family Medicine, School of Medicine and Boston Medical Center, Boston University, Boston, MA, USA; Institute for Health Systems Innovation and Policy, Boston University, Boston, MA, USA
| | - Zhe Zhang
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
| | - Elisabeth Woodhams
- Department of Obstetrics and Gynecology, School of Medicine and Boston Medical Center, Boston University, Boston, MA, USA
| | - Juan Fernandez
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
| | - Mark Loafman
- Department of Family Medicine, Cook County Health System, Chicago, IL, USA
| | - Howard J Cabral
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA
| |
Collapse
|
6
|
Health Promotion, Wellness, and Prevention Practice in Oncologic Physical Therapy: A Survey Study. REHABILITATION ONCOLOGY 2020. [DOI: 10.1097/01.reo.0000000000000244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
7
|
Promotion of Preconception Care Among Adolescents and Young Adults by Conversational Agent. J Adolesc Health 2020; 67:S45-S51. [PMID: 32718515 DOI: 10.1016/j.jadohealth.2019.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/23/2019] [Accepted: 09/12/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Preconception care is important for all women to improve infant and maternal health outcomes and may be especially important for adolescents and young adults. This study assesses the acceptance, usability, and use of an automated intervention to screen women on 108 preconception care risks and address them over the course of a year via a Web-based virtual animated health counselor and compares these measures for the adolescent and young adult users aged 18-25 years with those of users aged 26-34 years. We hypothesize that the younger cohort will have significantly greater use of and satisfaction with the online intervention. METHODS A randomized controlled trial involving a national sample of 528 women was conducted. We present a secondary data analysis on the system use and self-reported usability and satisfaction of the 79 women aged 18-25 years randomized to the intervention group, compared with the 183 women aged 26-34 years in the intervention group. Participants were required to self-identify as female, black or African American, aged 18-34 years, not pregnant, and English-speaking and were recruited through a variety of advertisements and outreach activities. RESULTS Of the adolescent and young adult participants (aged 18-25 years) enrolled and randomized to the intervention, 20.25% of participants accessed the system 0 times; 29.11%, 1-3 times; and 50.63%, >3 times over the course of a year. At the end of the year, almost all (96.4%) indicated they had either acted on recommendations made by the agent or planned to. Most (75.0%) said they would recommend the system to someone they knew. There were no significant differences between the two age groups on intervention use or satisfaction. CONCLUSIONS Web-based conversational agents are a viable medium for delivering longitudinal preconception care counseling to adolescents and young adults.
Collapse
|
8
|
Nordhagen S, Nielsen J, van Mourik T, Smith E, Klemm R. Fostering CHANGE: Lessons from implementing a multi-country, multi-sector nutrition-sensitive agriculture project. EVALUATION AND PROGRAM PLANNING 2019; 77:101695. [PMID: 31400655 DOI: 10.1016/j.evalprogplan.2019.101695] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/19/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
Using agriculture to improve nutrition is an approach growing in popularity, with programs becoming increasingly complex and multisectoral. While there is an active line of research assessing the impacts of such programs, little has been written about the process of successfully implementing them. As such, this paper uses a multisectoral nutrition-sensitive agriculture program implemented in four African countries as a case study to address key challenges in and lessons learned from implementation. We highlight the overall flexibility of nutrition-sensitive agriculture but also the need to adapt certain aspects to the particular context, as well as the opportunities for cross-context learning (and the limits to this). Integrating rigorous evaluation into such complex programs and forging diverse cross-sectoral partnerships offer both rewards and challenges, upon which we reflect. Main lessons learned from the program include the importance of carefully sequencing interventions, retaining flexibility in implementation, allowing for considerable time for cross-sector integration and coordination, and considering community impacts when designing research.
Collapse
Affiliation(s)
- Stella Nordhagen
- Helen Keller International Africa Regional Office, BP 29.898, Dakar, Senegal.
| | - Jennifer Nielsen
- Helen Keller International, One Dag Hammarskjold Plaza, Floor 2, New York, NY, 10017, USA
| | - Tom van Mourik
- Helen Keller International Africa Regional Office, BP 29.898, Dakar, Senegal
| | - Erin Smith
- Helen Keller International Tanzania, PO Box 34424, Dar es Salaam, Tanzania
| | - Rolf Klemm
- Helen Keller International, c/o Organization of American States (OAS), 1889 F Street, NW, Floor 4, Washington, DC, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
9
|
Havigerová JM, Dosedlová J, Burešová I. One health behavior or many health-related behaviors? Psychol Res Behav Manag 2018; 12:23-30. [PMID: 30643472 PMCID: PMC6311327 DOI: 10.2147/prbm.s173692] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective Of the many existing health models, models of health behavior are considered optimal for research and application as they focus on concrete forms of behavior that support, maintain, or undermine one’s health, and they accentuate the individual as the initiator of this behavior. Research in this area follows a broad range of concrete partial manifestations of health behavior. Is it necessary to differentiate between various types of health behavior or could these partial manifestations be combined under one common scale? Methods Data acquisition tool: Health-Related Behavior Scale (HRBS, 42 items). Data processing methods: principal component analysis (the internal structure of HRBS), confirmatory factor analysis (the latent factor structure of four tested models). Sample: N=1,664 adult respondents. Results The HRBS described ten areas of health-related behavior (ten extracted factors). All tested models of latent structure showed almost identical mathematical and statistical values of the model. Conclusion Health-related behavior includes a set of partial behaviors (behavior related to nutrition, addictive substances, movement, and physical exercises). An unambiguous latent factor structure has not been revealed. An open question remains whether there is one latent factor behind all health-related behaviors or whether there are multiple latent factors. The use of one or the other model should be deduced from the underlying theory and research objectives. To find a reliable model of health behavior, it is necessary to include moderators and mediators such as personality, attitude, or economic status.
Collapse
Affiliation(s)
- Jana Marie Havigerová
- Institute of Psychology, Faculty of Arts, Masaryk Univeristy, 603 00 Brno, Czech Republic,
| | - Jaroslava Dosedlová
- Institute of Psychology, Faculty of Arts, Masaryk Univeristy, 603 00 Brno, Czech Republic,
| | - Iva Burešová
- Institute of Psychology, Faculty of Arts, Masaryk Univeristy, 603 00 Brno, Czech Republic,
| |
Collapse
|
10
|
Dunton GF, O'Connor SG, Belcher BR, Maher JP, Schembre SM. Objectively-Measured Physical Activity and Sedentary Time are Differentially Related to Dietary Fat and Carbohydrate Intake in Children. Front Public Health 2018; 6:198. [PMID: 30079332 PMCID: PMC6062636 DOI: 10.3389/fpubh.2018.00198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 06/27/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Research on the clustering of physical activity, sedentary, and dietary intake behaviors in children has relied on retrospective and parent-report measures, which may obscure true associations. The current study combined objectively-measured moderate-to-vigorous intensity physical activity (MVPA) and sedentary time (ST) data from waist-worn accelerometers, with multiple child-report 24-h dietary recalls to assess specific components of dietary intake (i.e., dietary fat, carbohydrates, protein; glycemic load, fruits and vegetables) in children. Methods: Participants (n = 136, ages 8–12 years) wore an accelerometer for 7 days. On two of those days, children completed 24-h recall phone interviews to assess dietary intake. Results: After adjusting for child age, sex, ethnicity, annual household income, and body mass index (BMI) percentile; ST was positively associated with percent dietary fat intake, and negatively associated with percent dietary carbohydrate intake and glycemic load (p's < 0.01). MVPA was positively associated with percent dietary carbohydrate intake and daily glycemic load, and negatively associated with percent dietary fat intake (p's < 0.05). Conclusion: Despite its direct health benefits, physical activity may be associated with consuming greater proportion of total intake from carbohydrates, especially those with a higher glycemic index. Further research is needed to understand the differential implications of these unique behavioral interrelations for diabetes, cardiovascular, and obesity risk.
Collapse
Affiliation(s)
- Genevieve F Dunton
- Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Sydney G O'Connor
- Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Britni R Belcher
- Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jaclyn P Maher
- Department of Kinesiology, University of North Carolina, Greensboro, NC, United States
| | - Susan M Schembre
- University of Texas MD Anderson Cancer Center, Houston, TX, United States
| |
Collapse
|
11
|
Johnson SK, von Sternberg K, Velasquez MM. Changing multiple health risk behaviors in CHOICES. Prev Med Rep 2018; 11:69-73. [PMID: 29984141 PMCID: PMC6030232 DOI: 10.1016/j.pmedr.2018.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 11/29/2022] Open
Abstract
Multiple health behavior change (MHBC) intervention trials to date have only considered behaviors that were directly targeted. Research has yet to consider how untargeted behaviors can affect change in behaviors directly targeted by an intervention or how changes in targeted behaviors might lead to changes in other, untargeted behaviors. This study addresses these gaps with a secondary analysis of change in risk drinking (targeted behavior) and smoking (behavior that was not addressed) in the efficacy trial of CHOICES, an intervention for the prevention of alcohol-exposed pregnancies. Measures included the Timeline Followback for daily alcohol consumption and questions about smoking behavior. Participants were women of childbearing age who were at risk of alcohol-exposed pregnancy at baseline. Baseline smokers were less likely to change their drinking behavior than baseline non-smokers at nine months (n = 579) with Odds Ratio (OR) of 0.681 (95% CI = 0.471–0.985); 41.1% of smokers vs 50.6% of non-smokers reduced drinking to below risk levels (<5 drinks/day and < 8 drinks per week). Meanwhile, smokers who had changed their drinking behavior were more likely than smokers who had not changed their drinking behavior to have also quit smoking at nine months (OR = 2.769; 95% CI = 1.533–5.000); 19.5% vs. 8.1%, respectively. Together, these findings suggest a natural tendency towards change of multiple related behaviors and indicate that while the presence of unaddressed risk behaviors may make a targeted behavior change more difficult, change in one behavior may facilitate change in related behaviors, even when they are not addressed.
Collapse
Affiliation(s)
- Shannon K Johnson
- The Catholic University of America, National Catholic School of Social Service, Washington, DC, United States
| | - Kirk von Sternberg
- The University of Texas at Austin School of Social Work, Health Behavior Research and Training Institute, Austin, TX, United States
| | - Mary M Velasquez
- The University of Texas at Austin School of Social Work, Health Behavior Research and Training Institute, Austin, TX, United States
| |
Collapse
|
12
|
Nudelman G, Shiloh S. Connectionism and Behavioral Clusters: Differential Patterns in Predicting Expectations to Engage in Health Behaviors. Ann Behav Med 2018; 52:890-901. [DOI: 10.1093/abm/kax063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gabriel Nudelman
- Faculty of Psychology, Philipps University of Marburg, Marburg, Hesse, Germany
| | - Shoshana Shiloh
- The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
13
|
O’Malley SS, Zweben A, Fucito LM, Wu R, Piepmeier ME, Ockert DM, Bold KW, Petrakis I, Muvvala S, Jatlow P, Gueorguieva R. Effect of Varenicline Combined With Medical Management on Alcohol Use Disorder With Comorbid Cigarette Smoking: A Randomized Clinical Trial. JAMA Psychiatry 2018; 75:129-138. [PMID: 29261824 PMCID: PMC5838706 DOI: 10.1001/jamapsychiatry.2017.3544] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Individuals with alcohol use disorder have high rates of cigarette smoking. Varenicline tartrate, an approved treatment for smoking cessation, may reduce both drinking and smoking. OBJECTIVES To test the efficacy of varenicline with medical management for patients with alcohol use disorder and comorbid smoking seeking alcohol treatment, and to evaluate the secondary effects on smoking abstinence. DESIGN, SETTING, AND PARTICIPANTS This phase 2, randomized, double-blind, parallel group, placebo-controlled trial was conducted at 2 outpatient clinics from September 19, 2012, to August 31, 2015. Eligible participants met alcohol-dependence criteria and reported heavy drinking (≥5 drinks for men and ≥4 drinks for women) 2 or more times per week and smoking 2 or more times per week; 131 participants were randomized to either varenicline or placebo stratified by sex and site. All analyses were of the intention-to-treat type. Data analysis was conducted from February 5, 2016, to September 29, 2017. INTERVENTIONS Varenicline tartrate, 1 mg twice daily, and matching placebo pills for 16 weeks. Medical management emphasized medication adherence for 4 weeks followed by support for changing drinking. MAIN OUTCOMES AND MEASURES Percentage of heavy drinking days (PHDD) weeks 9 to 16, no heavy drinking days (NHDD) weeks 9 to 16, and prolonged smoking abstinence weeks 13 to 16. RESULTS Of 131 participants, 39 (29.8%) were women and 92 (70.2%) were men, the mean (SD) age was 42.7 (11.7) years, and the race/ethnicity self-identified by most respondents was black (69 [52.7%]). Sixty-four participants were randomized to receive varenicline, and 67 to receive placebo. Mean change in PHDD between varenicline and placebo across sex and site was not significantly different. However, a significant treatment by sex by time interaction for PHDD (F1,106 = 4.66; P = .03) revealed that varenicline compared with placebo resulted in a larger decrease in log-transformed PHDD in men (least square [LS] mean difference in change from baseline, 0.54; 95% CI, -0.09 to 1.18; P = .09; Cohen d = 0.45) but a smaller decrease in women (LS mean difference, -0.69; 95% CI, -1.63 to 0.25; P = .15; Cohen d = -0.53). Thirteen of 45 men (29%) had NHDD taking varenicline compared with 3 of 47 men (6%) taking placebo (Cohen h = 0.64; 95% CI, 0.22-1.03), whereas 1 of 19 women (5%) had NHDD compared with 5 of 20 women (25%) taking placebo (Cohen h = -0.60; 95% CI, -1.21 to 0.04). Taking varenicline, 8 of 64 participants (13%) achieved prolonged smoking abstinence; no one (0 of 67) quit smoking taking placebo (P = .003; Cohen h = 0.72; 95% CI, 0.38-1.07). CONCLUSIONS AND RELEVANCE Varenicline with medical management resulted in decreased heavy drinking among men and increased smoking abstinence in the overall sample. Varenicline could be considered to promote improvements in men with these dual behavioral health risks. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01553136.
Collapse
Affiliation(s)
| | - Allen Zweben
- School of Social Work, Columbia University, New York, New York
| | - Lisa M. Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Ran Wu
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | | | | | - Krysten W. Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Ismene Petrakis
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Srinivas Muvvala
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Peter Jatlow
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut,Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut,Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| |
Collapse
|
14
|
Amato K, Park E, Nigg CR. Prioritizing multiple health behavior change research topics: expert opinions in behavior change science. Transl Behav Med 2017; 6:220-7. [PMID: 27356992 DOI: 10.1007/s13142-015-0381-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Multiple health behavior change (MHBC) approaches are understudied. The purpose of this study is to provide strategic MHBC research direction. This cross-sectional study contacted participants through the Society of Behavioral Medicine email listservs and rated the importance of 24 MHBC research topics (1 = not at all important, 5 = extremely important) separately for general and underserved populations. Participants (n = 76) were 79 % female; 76 % White, 10 % Asian, 8 % African American, 5 % Hispanic, and 1 % Native Hawaiian/Pacific Islander. Top MHBC research priorities were predictors of behavior change and the sustainability, long-term effects, and dissemination/translation of interventions for both populations. Recruitment and retention of participants (t(68) = 2.17, p = 0.000), multi-behavioral indices (t(68) = 3.54, p = 0.001), and measurement burden (t(67) = 5.04, p = 0.001) were important for the underserved. Results identified the same top research priorities across populations. For the underserved, research should emphasize recruitment, retention, and measurement burden.
Collapse
Affiliation(s)
- Katie Amato
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, 96822, USA
| | - Eunhee Park
- College of Medicine, Seoul National University, Seoul, South Korea
| | - Claudio R Nigg
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, 96822, USA.
| |
Collapse
|
15
|
Laska MN, Lytle LA, Nanney MS, Moe SG, Linde JA, Hannan PJ. Results of a 2-year randomized, controlled obesity prevention trial: Effects on diet, activity and sleep behaviors in an at-risk young adult population. Prev Med 2016; 89:230-236. [PMID: 27283096 PMCID: PMC5038135 DOI: 10.1016/j.ypmed.2016.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 05/31/2016] [Accepted: 06/04/2016] [Indexed: 12/14/2022]
Abstract
Excess weight gain tends to occur in young adulthood. However, research examining effective weight-related interventions for this age group has been limited. As one of seven trials in the EARLY Trials consortium (Early Adult Reduction of weight through LifestYle intervention), the CHOICES Study (Choosing Healthy Options in College Environments and Settings) tested effects of a technology-integrated, young adult weight gain prevention intervention. It was a randomized controlled trial with assessments at baseline (2011) and 4-, 12- and 24-months post-intervention initiation and included 441 participants (ages 18-35) who were students at three Minnesota community colleges. The 24-month intervention included a 1-credit academic course and social networking and support online intervention. This analysis examined effects on 12 secondary behavioral outcomes across three domains: diet (fast food, sugary beverages, breakfast, at-home meal preparation), physical activity/screen time (minutes and energy expenditure in leisure time physical activity, television viewing, leisure time computer use) and sleep (hours of sleep, time required to fall asleep, days not getting enough rest, difficulty staying awake). The intervention resulted in significant reductions in fast food (p=0.007) but increases in difficulty staying awake (p=0.015). There was limited evidence of other behavior changes at 4months (0.05<p<0.1) in the expected direction but differences by treatment condition dissipated over time. Analyses examining summary treatment effects (i.e., modeling effects on all behavioral outcomes simultaneously) indicated significant overall effects (p=0.014), largely driven by 4-month results (p=0.005). Additional research is needed to understand effective obesity prevention among young adults, particularly when addressing multiple weight-related outcomes.
Collapse
Affiliation(s)
- Melissa N Laska
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA.
| | - Leslie A Lytle
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Marilyn S Nanney
- University of Minnesota, Medical School, Department of Family Medicine and Community Health, Minneapolis, MN, USA
| | - Stacey G Moe
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Jennifer A Linde
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Peter J Hannan
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| |
Collapse
|
16
|
Brown J, West R, Beard E, Brennan A, Drummond C, Gillespie D, Hickman M, Holmes J, Kaner E, Michie S. Are recent attempts to quit smoking associated with reduced drinking in England? A cross-sectional population survey. BMC Public Health 2016; 16:535. [PMID: 27443348 PMCID: PMC4957412 DOI: 10.1186/s12889-016-3223-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/27/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Alcohol consumption during attempts at smoking cessation can provoke relapse and so smokers are often advised to restrict their alcohol consumption during this time. This study assessed at a population-level whether smokers having recently initiated an attempt to stop smoking are more likely than other smokers to report i) lower alcohol consumption and ii) trying to reduce their alcohol consumption. METHOD Cross-sectional household surveys of 6287 last-year smokers who also completed the Alcohol Use Disorders Identification Test consumption questionnaire (AUDIT-C). Respondents who reported attempting to quit smoking in the last week were compared with those who did not. Those with AUDIT-C≥5 were also asked if they were currently trying to reduce the amount of alcohol they consume. RESULTS After adjustment for socio-demographic characteristics and current smoking status, smokers who reported a quit attempt within the last week had lower AUDIT-C scores compared with those who did not report an attempt in the last week (βadj = -0.56, 95 % CI = -1.08 to -0.04) and were less likely to be classified as higher risk (AUDIT-C≥5: ORadj = 0.57, 95 % CI = 0.38 to 0.85). The lower AUDIT-C scores appeared to be a result of lower scores on the frequency of 'binge' drinking item (βadj = -0.25, 95 % CI = -0.43 to -0.07), with those who reported a quit attempt within the last week compared with those who did not being less likely to binge drink at least weekly (ORadj = 0.54, 95 % CI = 0.29 to 0.999) and more likely to not binge drink at all (ORadj = 1.70, 95 % CI = 1.16 to 2.49). Among smokers with higher risk consumption (AUDIT-C≥5), those who reported an attempt to stop smoking within the last week compared with those who did not were more likely to report trying to reduce their alcohol consumption (ORadj = 2.98, 95 % CI = 1.48 to 6.01). CONCLUSION Smokers who report starting a quit attempt in the last week also report lower alcohol consumption, including less frequent binge drinking, and appear more likely to report currently attempting to reduce their alcohol consumption compared with smokers who do not report a quit attempt in the last week.
Collapse
Affiliation(s)
- Jamie Brown
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK.
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- National Centre for Smoking Cessation and Training, London, UK
| | - Emma Beard
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
| | - Alan Brennan
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- Sheffield Alcohol Research Group, ScHARR, The University of Sheffield, Sheffield, UK
| | - Colin Drummond
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Duncan Gillespie
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- Sheffield Alcohol Research Group, ScHARR, The University of Sheffield, Sheffield, UK
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - John Holmes
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- Sheffield Alcohol Research Group, ScHARR, The University of Sheffield, Sheffield, UK
| | - Eileen Kaner
- Institute of Health & Society, Newcastle University, Newcastle, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), Nottingham, UK
- National Centre for Smoking Cessation and Training, London, UK
| |
Collapse
|
17
|
Schneider KL, Coons MJ, McFadden HG, Pellegrini CA, DeMott A, Siddique J, Hedeker D, Aylward L, Spring B. Mechanisms of Change in Diet and Activity in the Make Better Choices 1 Trial. Health Psychol 2016; 35:2016-17145-001. [PMID: 27054299 PMCID: PMC5055406 DOI: 10.1037/hea0000333] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The Make Better Choices 1 trial demonstrated that participants with unhealthy diet and activity behaviors who were randomized to increase fruits/vegetables and decrease sedentary leisure achieved greater diet and activity improvement than those randomized to change other pairs of eating and activity behaviors. Participants randomized to decrease saturated fat and increase physical activity achieved the least diet-activity improvement. This study examined which psychological mechanisms mediated the effects of the study treatments on healthy behavior change. METHODS Participants (n = 204) were randomized to 1 of 4 treatments: increase fruits/vegetables and physical activity; decrease saturated fat and sedentary leisure; decrease saturated fat and increase physical activity; increase fruits/vegetables and decrease sedentary leisure. Treatments provided 3 weeks of remote coaching supported by mobile decision support technology and financial incentives. Mediational analyses were performed to examine whether changes in positive and negative affect, and self-efficacy, stages of readiness to change, liking, craving and attentional bias for fruit/vegetable intake, saturated fat intake, physical activity, and sedentary leisure explained the impact of the treatments on diet-activity improvement. RESULTS Greater diet-activity improvement in those randomized to increase fruits/vegetables and decrease sedentary leisure was mediated by increased self-efficacy (indirect effect estimate = 0.04; 95% bias corrected CI, 0.003-0.11). All treatments improved craving, stage of change and positive affect. CONCLUSION Accomplishing healthy lifestyle changes for 3 weeks improves positive affect, increases cravings for healthy foods and activities, and enhances readiness to make healthy behavior changes. Maximal diet and activity improvement occurs when interventions enhance self-efficacy to make multiple healthy behavior changes. (PsycINFO Database Record
Collapse
Affiliation(s)
- Kristin L. Schneider
- University of Massachusetts Medical School, Department of Preventive & Behavioral Medicine
| | - Michael J. Coons
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - H. Gene McFadden
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | | | - Andrew DeMott
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Juned Siddique
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Don Hedeker
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago
| | | | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| |
Collapse
|
18
|
Effects of a multiple health behavior change intervention for colorectal cancer survivors on psychosocial outcomes and quality of life: a randomized controlled trial. Ann Behav Med 2015; 48:359-70. [PMID: 24722960 DOI: 10.1007/s12160-014-9610-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Multiple health behavior change can ameliorate adverse effects of cancer. PURPOSE The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life. METHODS A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care. Posttraumatic growth, spirituality, acceptance, mindfulness, distress, and quality of life were assessed at baseline, 6 and 12 months. RESULTS Significant intervention effects were observed for posttraumatic growth at 6 (7.5, p < 0.001) and 12 months (4.1, p = 0.033), spirituality at 6 months (1.8, p = 0.011), acceptance at 6 months (0.2, p = 0.005), and quality of life at 6 (0.8, p = 0.049) and 12 months (0.9, p = 0.037). CONCLUSIONS The intervention improved psychosocial outcomes and quality of life (physical well-being) at 6 months with most effects still present at 12 months. ( TRIAL REGISTRATION NUMBER ACTRN12608000399392).
Collapse
|
19
|
Pellowski JA, Kalichman SC. Health behavior predictors of medication adherence among low health literacy people living with HIV/AIDS. J Health Psychol 2015; 21:1981-91. [PMID: 25706334 DOI: 10.1177/1359105315569617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One particularly vulnerable population for HIV treatment non-adherence is persons with poor health literacy skills. For these individuals, it is important to simplify medication taking as much as possible by integrating medication adherence into other routine health behaviors. This study aims to ascertain the relationship between medication adherence and other health behaviors. Adults living with HIV (N = 422) completed intake measures and 3 months of unannounced pill counts. Endorsement of diet and exercise behaviors at intake predicted higher medication adherence, over and above other known predictors of medication adherence such as HIV symptoms, depression, social support, and stress. These results support integrating strategies for medication management into a constellation of routine health practices.
Collapse
|
20
|
Bice-Wigington T, Simmons LA, Huddleston-Casas C. An ecological perspective on rural, low-income mothers' health. SOCIAL WORK IN PUBLIC HEALTH 2014; 30:129-143. [PMID: 25491274 DOI: 10.1080/19371918.2014.969860] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Using structural equation modeling, this study examined interactions among factors traditionally associated with health outcomes within a sample of rural low-income mothers. Prior research has established that education, employment, income, marital status, and health insurance coverage independently predict health outcomes. However, no studies have examined the simultaneous influence of these factors as conceptualized from an ecological systems perspective. Results indicate that when the multiple factors are considered simultaneously, different effects emerge. Implications are that the context in which these women live and the interactions between and among key influencing factors must be considered when addressing health challenges in rural areas.
Collapse
|