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Sekizawa Y. Japan's intensive health guidance program has limited effects on cardiovascular risk factors: a regression discontinuity analysis. Public Health 2024; 232:108-113. [PMID: 38772198 DOI: 10.1016/j.puhe.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/03/2024] [Accepted: 04/16/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES It is uncertain whether the effects of health counselling programs differ depending on their intensity. This study compared the effectiveness of intensive health guidance (IHG) and less intensive motivation-enhancing guidance (MEG) on cardiovascular risk factors. STUDY DESIGN A regression discontinuity design (RDD) was applied. METHODS In Japan's specific health checkup (SHC) and guidance program, those with a high risk of metabolic syndrome are assigned to IHG or MEG. An RDD was applied using an SHC results database. Four groups were created in which IHG or MEG assignment was solely determined by single cut-off values of the running variables of triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), or haemoglobin A1c (HbA1c) measured during SHC. Outcomes were one year's changes in body mass index (BMI), waist circumference (WCF), systolic and diastolic blood pressure, HDL-C, low-density lipoprotein cholesterol, FBG, and HbA1c. RESULTS A total of 541,809 observations among 225,115 people from 2008 to 2017 were analysed. Men assigned to IHG had a significantly but slightly lower BMI and WCF than those assigned to MEG the next year, only when TG or FBG was a running variable. There were no significant differences between IHG and MEG for women's BMI and WCF and other cardiovascular risk factors for both sexes. CONCLUSION Since IHG has limited additional effects on cardiovascular risk factors compared with MEG, abolishing IHG may have little negative impact on the general public's health.
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Affiliation(s)
- Y Sekizawa
- Research Institute of Economy, Trade, and Industry, Chiyoda-ku, Kasumigaseki 1-3-1, Tokyo, 100-8901, Japan.
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Ilan Y. Free Will as Defined by the Constrained Disorder Principle: a Restricted, Mandatory, Personalized, Regulated Process for Decision-Making. Integr Psychol Behav Sci 2024:10.1007/s12124-024-09853-9. [PMID: 38900370 DOI: 10.1007/s12124-024-09853-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2024] [Indexed: 06/21/2024]
Abstract
The concept of free will has challenged physicists, biologists, philosophers, and other professionals for decades. The constrained disorder principle (CDP) is a fundamental law that defines systems according to their inherent variability. It provides mechanisms for adapting to dynamic environments. This work examines the CDP's perspective of free will concerning various free will theories. Per the CDP, systems lack intentions, and the "freedom" to select and act is built into their design. The "freedom" is embedded within the response range determined by the boundaries of the systems' variability. This built-in and self-generating mechanism enables systems to cope with perturbations. According to the CDP, neither dualism nor an unknown metaphysical apparatus dictates choices. Brain variability facilitates cognitive adaptation to complex, unpredictable situations across various environments. Human behaviors and decisions reflect an underlying physical variability in the brain and other organs for dealing with unpredictable noises. Choices are not predetermined but reflect the ongoing adaptation processes to dynamic prssu½res. Malfunctions and disease states are characterized by inappropriate variability, reflecting an inability to respond adequately to perturbations. Incorporating CDP-based interventions can overcome malfunctions and disease states and improve decision processes. CDP-based second-generation artificial intelligence platforms improve interventions and are being evaluated to augment personal development, wellness, and health.
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Affiliation(s)
- Yaron Ilan
- Faculty of Medicine, Hebrew University and Department of Medicine, Hadassah Medical Center, Jerusalem, Israel.
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Fritz M, Grimm M, My Hanh HT, Koot JAR, Nguyen GH, Nguyen TPL, Probandari A, Widyaningsih V, Lensink R. Effectiveness of community-based diabetes and hypertension prevention and management programmes in Indonesia and Viet Nam: a quasi-experimental study. BMJ Glob Health 2024; 9:e015053. [PMID: 38777393 PMCID: PMC11116884 DOI: 10.1136/bmjgh-2024-015053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Non-communicable diseases (NCDs) have surpassed infectious diseases as the leading global cause of death, with the Southeast Asian region experiencing a significant rise in NCD prevalence over the past decades. Despite the escalating burden, screening for NCDs remains at very low levels, resulting in undetected cases, premature mortality and high public healthcare costs. We investigate whether community-based NCD prevention and management programmes are an effective solution. METHODS In Indonesia, we compare participants in the community-based NCD screening and management programme Pos Pembinaan Terpadu-Penyakit Tidak Menular with matched non-participants with respect to their uptake of screening activities, health-related behaviour and knowledge and metabolic risk factors. We use statistical matching to redress a possible selection bias (n=1669). In Viet Nam, we compare members of Intergenerational Self-Help Clubs, which were offered similar NCD health services, with members of other community groups, where such services were not offered. We can rely on two waves of data and use a double-difference approach to redress a possible selection bias and to measure the impacts of participation (n=1710). We discuss strengths and weaknesses of the two approaches in Indonesia and Viet Nam. RESULTS In Indonesia, participants have significantly higher uptake of screening for hypertension and diabetes (+13% from a control mean of 88% (95% CI 9% to 17%); +93% from a control mean of 48% (95% CI 79% to 108%)). In both countries, participants show a higher knowledge about risk factors, symptoms and complications of NCDs (Indonesia: +0.29 SD (0.13-0.45), Viet Nam: +0.17 SD (0.03-0.30)). Yet, the improved knowledge is only partly reflected in improved health behaviour (Viet Nam: fruit consumption +0.33 SD (0.15-0.51), vegetable consumption +0.27 SD (0.04-0.50)), body mass index (BMI) (Viet Nam: BMI -0.07 SD (-0.13 to -0.00)) or metabolic risk factors (Indonesia: systolic blood pressure: -0.13 SD (-0.26 to -0.00)). CONCLUSION Community-based NCD programmes are well suited to increase screening and to transmit health knowledge. Due to their extensive outreach within the community, they can serve as a valuable complement to the screening services provided at the primary healthcare level. Yet, limited coverage, insufficient resources and a high staff turnover remain a problem. TRIAL REGISTRATION NUMBER NCT05239572.
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Affiliation(s)
- Manuela Fritz
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
| | - Michael Grimm
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
- IZA Institute of Labor Economics, Bonn, Germany
| | | | - Jaap A R Koot
- Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Thi-Phuong-Lan Nguyen
- Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City, Viet Nam
| | - Ari Probandari
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
| | - Vitri Widyaningsih
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
| | - Robert Lensink
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
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André N, Grousset M, Audiffren M. A Behavioral Perspective for Improving Exercise Adherence. SPORTS MEDICINE - OPEN 2024; 10:56. [PMID: 38763991 PMCID: PMC11102891 DOI: 10.1186/s40798-024-00714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/01/2024] [Indexed: 05/21/2024]
Abstract
Adherence to exercise is a crucial aspect of behavioral changes related to exercise. However, current models fail to predict behavioral change, and exercise programs struggle to foster adherence. In this Current Opinion article, we defined adherence as a process linking behavior and attitude. More specifically, exercise adherence is the process by which people's behaviors conform to their attitudes and vice versa. Behavioral change theories should be able to predict changes, transformations, and modifications of behaviors; however, this is not currently the case. Prediction models of behavior are mainly focused on how to predict behavioral changes by affecting attitudes; however, these models have not considered the target behavior as a facilitator of adherence. Herein, a behavioral perspective is considered in three directions: first, exercise is a therapeutic modality that has the potential to improve motivation; second, chronic exercise helps sustain effort over time and increase executive functions and willpower; and third, exercise is an active behavior that has the potential to facilitate attitude change.
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Affiliation(s)
- Nathalie André
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France.
- Maison des Sciences de l'Homme et de la Société, CNRS, University of Poitiers, Poitiers, France.
| | - Marine Grousset
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France
- Richelieu Centre, French Red Cross Association, La Rochelle, France
| | - Michel Audiffren
- Research Centre on Cognition and Learning, CNRS, University of Poitiers, Poitiers, France
- Maison des Sciences de l'Homme et de la Société, CNRS, University of Poitiers, Poitiers, France
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Choudry M, Ganti L. Exploration of the Motivational Factors that Influence the Maintenance of Health. Health Psychol Res 2024; 12:115356. [PMID: 38533343 PMCID: PMC10963256 DOI: 10.52965/001c.115356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Objective This study aims to identify motivators influencing individuals' commitment to maintaining positive health trajectories across different demographics. The primary objective is to leverage this knowledge to enhance patient-physician relationships and improve the quality of care. Methods A web-based survey collected data from 204 randomly selected participants aged 16 and older. The survey assessed participants' self-rated health, health-related habits, and motivators for a healthy lifestyle. Open-ended responses were included. Results Participants had a mean self-rated health score of 6.24 (scale: one to ten). Motivation scores for health-related factors averaged 3.25 (scale: one to five), with caregiving responsibility scoring 3.07 (scale: one to five), mainly among women. Motivators related to personal productivity and values scored 3.44 (scale: one to five), while cultural or religious beliefs scored lowest at 2.89 (scale: one to five). Common themes from free responses included longevity, quality of life, personal well-being, family, independence, prevention of complications, health goals, finances, and faith, listed by frequency. Among participants, only 30% had chronic diseases, but 80% of those with chronic conditions were motivated to improve their health. Conclusion This survey gathered valuable data on motivators for maintaining positive health trajectories. The findings have implications for improving patient-physician relationships and healthcare delivery. Understanding individuals' motivators can inform tailored interventions and personalized care approaches.
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Ge Y, Zheng C, Wang X, Liu T. Psychometric properties of the Chinese version of the health behavior motivation scale: a translation and validation study. Front Psychol 2024; 15:1279816. [PMID: 38298519 PMCID: PMC10827909 DOI: 10.3389/fpsyg.2024.1279816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
Objective This study's objectives were to translate the Health Behavior Motivation Scale (HBMS) into Chinese and verify the scale's validity and reliability among Chinese healthy adults. Method The HBMS scales were translated into Chinese based on Brislin's principles. The Chinese version of HBMS is created through translation, back translation, and cross-cultural adaptation. This investigation implemented the convenience sampling method to conduct a survey on 781 healthy respondents, utilizing the Chinese version of the HBMS and a general demographic questionnaire. We used AMOS (v28.0) and SPSS (v26.0) for statistical analysis. We employed test-retest reliability, split-half reliability, and internal consistency to assess the reliability of the translation questionnaire. Structure validity and content validity were used to assess validity. Results The Chinese version of the Health Behavior Motivation Scale (HBMS) had a Cronbach's alpha coefficient of 0.885, and the range of Cronbach's alpha values for each dimension was 0.820-0.885. The scale's test-retest reliability was 0.824, and its split-half reliability was 0.906. Five public factors with a cumulative variance contribution of 56.527% were retrieved from the exploratory factor analysis. Moreover, the factor loading value for each item exceeded 0.4.In confirmatory factor analysis, the indicators were reported as follows: χ2/df = 1.567, GFI = 0.900, CFI = 0.952, IFI = 0.952, TLI = 0.946, AGFI = 0.881, PGFI = 0.757, PNFI = 0.789, RMSEA = 0.039, and the results of the model fit metrics were within the reference range. Conclusion The Chinese version of the HBMS exhibits strong discrimination, validity, and reliability. The tool effectively identifies the motivation of healthy people to engage in healthy behaviors. It can be used by healthcare practitioners to assist in the development of follow-up interventions to reduce the prevalence of chronic disease in older people and the incidence of chronic disease in populations of young and middle-aged people.
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Affiliation(s)
- Yuanhui Ge
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Chen Zheng
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Xin Wang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
- Nursing Department of Huaian Hospital of Huaian City, Huaian, China
| | - Tao Liu
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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Dresp-Langley B. From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context. Biomedicines 2023; 11:2469. [PMID: 37760910 PMCID: PMC10525914 DOI: 10.3390/biomedicines11092469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
When "hijacked" by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in the dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain correlate of mental health, dopamine has a central functional role in behavioral regulation from healthy reward-seeking to pathological adaptation to stress in response to adversity. This narrative review offers a spotlight view of the transition from healthy reward function, under the control of dopamine, to the progressive deregulation of this function in interactions with other brain centers and circuits, producing what may be called an anti-reward brain state. How such deregulation is linked to specific health-relevant behaviors is then explained and linked to pandemic-related adversities and the stresses they engendered. The long lockdown periods where people in social isolation had to rely on drink, food, and digital rewards via the internet may be seen as the major triggers of changes in motivation and reward-seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain is discussed. It is argued that, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior changes and mental health is affected, depending on individual vulnerabilities. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.
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Affiliation(s)
- Birgitta Dresp-Langley
- Centre National de la Recherche Scientifique, UMR 7357 ICube CNRS, Université de Strasbourg Hôpitaux Universitaires Faculté de Médecine, Pavillon Clovis Vincent, 4 Rue Kirschleger, CEDEX, 67085 Strasbourg, France
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