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Bergum H, Grimsmo J, Anderssen SA, Klemsdal TO. Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care. BMC Cardiovasc Disord 2024; 24:225. [PMID: 38664620 PMCID: PMC11044290 DOI: 10.1186/s12872-024-03892-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme. METHODS A random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein). RESULTS Self-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables. CONCLUSIONS Participation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group. TRIAL REGISTRATION ClinicalTrials.gov (NCT01741428), 04/12/2012.
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Affiliation(s)
- Hilde Bergum
- Department of Cardiac and Pulmonary Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldbergs Hospital, Jessheim, 2051, Norway.
- University of Oslo, Oslo, Norway.
| | - Jostein Grimsmo
- Department of Cardiac and Pulmonary Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldbergs Hospital, Jessheim, 2051, Norway
| | - Sigmund Alfred Anderssen
- Department of Sports Medicine, the Norwegian School of Sports Sciences, Sognsveien 220, 0806, Oslo, Norway
| | - Tor Ole Klemsdal
- Department of Preventive Cardiology, Oslo University Hospital Aker, Trondheimsveien 235, 0586, Oslo, Norway
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Yotsidi V, Nikolatou EK, Kourkoutas E, Kougioumtzis GA. Mental distress and well-being of university students amid COVID-19 pandemic: findings from an online integrative intervention for psychology trainees. Front Psychol 2023; 14:1171225. [PMID: 37519360 PMCID: PMC10374453 DOI: 10.3389/fpsyg.2023.1171225] [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: 02/21/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction University students have been severely affected by the COVID-19 pandemic, as significant changes supervened their academic and social life. To tackle these challenges, several adjustments in the educational methods may be warranted for cultivating a positive environment at higher education institutions. The aim of this study was to investigate the risk and protective factors of students' mental health and well-being as well as their potential for flourishing in an undergraduate clinical psychology course that took place online due to the COVID-19 restrictive measures and incorporated positive psychology exercises as a means to empower young people amid the adverse conditions of the lockdown. Methods In total, 124 students attended the course and completed mental health (i.e., DASS-9, HADS, ERQ) and well-being (i.e., MHC-SF, SWLS, PANAS, GQ-6, BRS) measures at two time points (pre-and-post-test), during the first restrictions in Greece (March-June 2020). Results According to the results, students aged 18-20 years old reported higher levels of stress [χ2 = 14.72, p = 0.002], while students who felt that the quality of their studies had deteriorated [χ2 = 6.57, p = 0.038] reported increased levels of anxiety. High levels of depression were correlated with worse relationships with significant others (z = 7.02, p = 0.030 and χ2 = 11.39, p = 0.003 for family and friends, respectively), while gratitude and resilience were positively correlated with improved relationships with others, both during and after the lockdown. Factors associated with students' well-being were satisfaction with life and gratitude. Discussion These results suggest that well-being enhancement factors may have added value to current educational practices for promoting students' mental health and well-being in times of crisis.
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Affiliation(s)
- Vasiliki Yotsidi
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | | | - Elias Kourkoutas
- Department of Primary Education, Research Center for the Humanities, Social and Education Sciences, University of Crete, Rethymno, Greece
| | - Georgios A. Kougioumtzis
- Department of Turkish Studies, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychology, Neapolis University Pafos, Pafos, Cyprus
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Kubzansky LD, Kim ES, Boehm JK, Davidson RJ, Huffman JC, Loucks EB, Lyubomirsky S, Picard RW, Schueller SM, Trudel-Fitzgerald C, VanderWeele TJ, Warran K, Yeager DS, Yeh CS, Moskowitz JT. Interventions to Modify Psychological Well-Being: Progress, Promises, and an Agenda for Future Research. AFFECTIVE SCIENCE 2023; 4:174-184. [PMID: 37064816 PMCID: PMC9982781 DOI: 10.1007/s42761-022-00167-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/16/2022] [Indexed: 03/06/2023]
Abstract
Psychological well-being, characterized by feelings, cognitions, and strategies that are associated with positive functioning (including hedonic and eudaimonic well-being), has been linked with better physical health and greater longevity. Importantly, psychological well-being can be strengthened with interventions, providing a strategy for improving population health. But are the effects of well-being interventions meaningful, durable, and scalable enough to improve health at a population-level? To assess this possibility, a cross-disciplinary group of scholars convened to review current knowledge and develop a research agenda. Here we summarize and build on the key insights from this convening, which were: (1) existing interventions should continue to be adapted to achieve a large-enough effect to result in downstream improvements in psychological functioning and health, (2) research should determine the durability of interventions needed to drive population-level and lasting changes, (3) a shift from individual-level care and treatment to a public-health model of population-level prevention is needed and will require new infrastructure that can deliver interventions at scale, (4) interventions should be accessible and effective in racially, ethnically, and geographically diverse samples. A discussion examining the key future research questions follows.
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Affiliation(s)
- Laura D. Kubzansky
- Department of Social & Behavioral Sciences, Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA USA
| | - Eric S. Kim
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Julia K. Boehm
- Department of Psychology, Chapman University, One University Drive, Orange, CA USA
| | | | - Jeffrey C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA
- Department of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Eric B. Loucks
- Department of Epidemiology, Mindfulness Center, Brown University School of Public Health, Providence, RI USA
| | - Sonja Lyubomirsky
- Department of Psychology, University of California, Riverside, Riverside, CA USA
| | | | - Stephen M. Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA USA
| | - Claudia Trudel-Fitzgerald
- Department of Psychology, Université du Québec À Trois-Rivières, Trois-Rivières, Canada
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
| | - Tyler J. VanderWeele
- Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA USA
- Human Flourishing Program, Harvard University, Cambridge, MA USA
| | - Katey Warran
- Research Department of Behavioural Science and Health, WHO Collaborating Centre for Arts & Health, University College London, London, UK
| | - David S. Yeager
- Department of Psychology, University of Texas at Austin, Austin, TX USA
| | | | - Judith T. Moskowitz
- Department of Medical Social Sciences, Northwestern University, Chicago, IL USA
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Trajković N, Mitić PM, Barić R, Bogataj Š. Editorial: Effects of physical activity on psychological well-being. Front Psychol 2023; 14:1121976. [PMID: 36743250 PMCID: PMC9890147 DOI: 10.3389/fpsyg.2023.1121976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Affiliation(s)
- Nebojša Trajković
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Petar M. Mitić
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Renata Barić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Špela Bogataj
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia,*Correspondence: Špela Bogataj ✉
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Liebe RA, Adams LM, Hedrick VE, Serrano EL, Porter KJ, Cook NE, Misyak SA. Developing a conceptual framework for the relationship between food security status and mental health among low-income mothers. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2022.1078811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IntroductionBuilding household resiliency is one strategy that may help insulate households from the effects of food system volatility that contributes to in food insecurity. A stronger understanding of the relationship between food security and mental health is needed to identify potential factors for intervention to improve household resiliency to food system stressors. Because mothers often make household food decisions, they are an important population for building household resiliency. The purpose of this study was to develop and test a conceptual framework for the relationship between food security and mental health for low-income mothers and to identify potential targets for intervention.MethodsA conceptual framework was developed based on the existing literature on mental health and food security, as well as factors that impact both constructs. This framework was tested by a path analysis using data from a 2021 cross-sectional survey of low-income Virginia mothers that used validated scales to assess food security status, indicators of mental and physical health, food coping strategies, and social support.Results and discussionThe initial model was systematically adapted to develop the final retained model. The retained model did not include a direct effect of food security on mental health, but highlighted two significant mediators of the relationship, food coping strategies and social support. While the effect of social support was not practically significant, the effects of food coping strategies as a mediator from food security to perceived stress and life satisfaction were small (β = 0.21, 0.14, respectively; p < 0.001). The retained model provides a framework for understanding the relationship between food security and mental health and highlights potential targets for intervention. Notably, reducing the need for mothers to utilize food coping strategies should be targeted on multiple levels to reduce the impact on mental health and ultimately improve resiliency to future food system shocks.
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Toros E, Maslakçı A, Sürücü L. Fear of COVID-19 and job insecurity among hospitality industry employees: The mediating role of happiness. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2121054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Emete Toros
- Faculty of Economics and Administrative Sciences, University of Kyrenia, Kyrenia North Cyprus
| | - Ahmet Maslakçı
- Faculty of Economics and Administrative Sciences, Cyprus Science University, Northern Cyprus
| | - Lütfi Sürücü
- Faculty of Economics and Administrative Sciences, European Leadership University, North Cyprus
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Clustering of health behaviors among Japanese adults and their association with socio-demographics and happiness. PLoS One 2022; 17:e0266009. [PMID: 35421105 PMCID: PMC9009612 DOI: 10.1371/journal.pone.0266009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 03/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Scholars have associated happiness with health behaviors, which co-occur and exert synergistic effects. Therefore, identifying clusters of health behaviors and their effect on happiness can contribute to the development of strategies for promoting happiness and improving health behaviors.
Aim
This study aimed to examine clusters of health behaviors and their associations with socio-demographics and with happiness among Japanese adults.
Methods
This study used data from the Japanese Household Panel Survey and the Keio Household Panel Survey. Questionnaires were distributed to 4,993 households out of which 1,554 responses were analyzed (participants aged 27−65 years). The survey included health behaviors (alcohol consumption, smoking, vegetable and fruit consumption, breakfast-eating habits, and physical activities), happiness, and socio-demographics. Latent class analysis was conducted to identify the clusters, whereas latent regression was employed to investigate socio-demographics related to the clusters. Logistic regression analysis was conducted to examine the relation between happiness and the clusters.
Results
Two health behavior clusters were identified: Cluster 1 (low substance use and good dietary habit; n = 817; 52.3%) and Cluster 2 (high alcohol, poor nutrition, and inactive; n = 737; 47.7%). Latent regression analysis indicated that all socio-demographics, barring socioeconomic status, were significantly associated with the clusters. The “low substance use and good dietary habit” cluster was significantly related with higher odds of happiness (odds ratio = 1.425, 95% confidence interval = 1.146−1.772, p = 0.001).
Conclusions
This study identified health behavior clusters among Japanese adults and established the association between the “low substance use and good dietary habit” cluster and high levels of happiness. However, the causality of the relationship between health behavior and happiness remains unclear, which highlights the need for further research to elucidate the underlying mechanisms.
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Chang A, Sloan EK, Antoni MH, Knight JM, Telles R, Lutgendorf SK. Biobehavioral Pathways and Cancer Progression: Insights for Improving Well-Being and Cancer Outcomes. Integr Cancer Ther 2022; 21:15347354221096081. [PMID: 35579197 PMCID: PMC9118395 DOI: 10.1177/15347354221096081] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The relationship between psychosocial factors and cancer has intrigued people for centuries. In the last several decades there has been an expansion of mechanistic research that has revealed insights regarding how stress activates neuroendocrine stress-response systems to impact cancer progression. Here, we review emerging mechanistic findings on key pathways implicated in the effect of stress on cancer progression, including the cellular immune response, inflammation, angiogenesis, and metastasis, with a primary focus on the mediating role of the sympathetic nervous system. We discuss converging findings from preclinical and clinical cancer research that describe these pathways and research that reveals how these stress pathways may be targeted via pharmacological and mind-body based interventions. While further research is required, the body of work reviewed here highlights the need for and feasibility of an integrated approach to target stress pathways in cancer patients to achieve comprehensive cancer treatment.
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Affiliation(s)
- Aeson Chang
- Monash Institute of Pharmaceutical Sciences, Drug Discovery Biology, Monash University, Parkville, VIC, Australia
| | - Erica K Sloan
- Monash Institute of Pharmaceutical Sciences, Drug Discovery Biology, Monash University, Parkville, VIC, Australia.,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.,Peter MacCallum Cancer Centre, Division of Surgery, Melbourne, VIC, Australia
| | - Michael H Antoni
- Departments of Psychology, Psychiatry, and Behavioral Sciences, and Cancer Control Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Jennifer M Knight
- Department of Psychiatry and Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rachel Telles
- Departments of Psychological and Brain Sciences, Obstetrics and Gynecology, and Urology, and Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Susan K Lutgendorf
- Departments of Psychological and Brain Sciences, Obstetrics and Gynecology, and Urology, and Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
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Park JW, Dulin AJ, Needham BL, Sims M, Loucks EB, Fava JL, Dionne LA, Scarpaci MM, Eaton CB, Howe CJ. Examining Optimism, Psychosocial Risks, and Cardiovascular Health Using Life's Simple 7 Metrics in the Multi-Ethnic Study of Atherosclerosis and the Jackson Heart Study. Front Cardiovasc Med 2021; 8:788194. [PMID: 34977194 PMCID: PMC8714850 DOI: 10.3389/fcvm.2021.788194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Optimism has been shown to be positively associated with better cardiovascular health (CVH). However, there is a dearth of prospective studies showing the benefits of optimism on CVH, especially in the presence of adversities, i.e., psychosocial risks. This study examines the prospective relationship between optimism and CVH outcomes based on the Life's Simple 7 (LS7) metrics and whether multilevel psychosocial risks modify the aforementioned relationship. Methods: We examined self-reported optimism and CVH using harmonized data from two U.S. cohorts: Multi-Ethnic Study of Atherosclerosis (MESA) and Jackson Heart Study (JHS). Modified Poisson regression models were used to estimate the relationship between optimism and CVH using LS7 among MESA participants (N = 3,520) and to examine the relationship of interest based on four biological LS7 metrics (body mass index, blood pressure, cholesterol, and blood glucose) among JHS and MESA participants (N = 5,541). For all CVH outcomes, we assessed for effect measure modification by psychosocial risk. Results: Among MESA participants, the adjusted risk ratio (aRR) for ideal or intermediate CVH using LS7 comparing participants who reported high or medium optimism to those with the lowest level of optimism was 1.10 [95% Confidence Interval (CI): 1.04-1.16] and 1.05 (95% CI: 0.99-1.11), respectively. Among MESA and JHS participants, the corresponding aRRs for having all ideal or intermediate (vs. no poor) metrics based on the four biological LS7 metrics were 1.05 (0.98-1.12) and 1.04 (0.97-1.11), respectively. The corresponding aRRs for having lower cardiovascular risk (0-1 poor metrics) based on the four biological LS7 metrics were 1.01 (0.98-1.03) and 1.01 (0.98-1.03), respectively. There was some evidence of effect modification by neighborhood deprivation for the LS7 outcome and by chronic stress for the ideal or intermediate (no poor) metrics outcome based on the four biological LS7 metrics. Conclusion: Our findings suggest that greater optimism is positively associated with better CVH based on certain LS7 outcomes among a racially/ethnically diverse study population. This relationship may be effect measure modified by specific psychosocial risks. Optimism shows further promise as a potential area for intervention on CVH. However, additional prospective and intervention studies are needed.
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Affiliation(s)
- Jee Won Park
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Epidemiology, Brown University, Providence, RI, United States
| | - Akilah J. Dulin
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Belinda L. Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Eric B. Loucks
- Department of Epidemiology, Brown University, Providence, RI, United States
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Joseph L. Fava
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
| | - Laura A. Dionne
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Matthew M. Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, United States
| | - Charles B. Eaton
- Department of Epidemiology, Brown University, Providence, RI, United States
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Chanelle J. Howe
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Epidemiology, Brown University, Providence, RI, United States
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Stenlund S, Koivumaa-Honkanen H, Sillanmäki L, Lagström H, Rautava P, Suominen S. Subjective well-being predicts health behavior in a population-based 9-years follow-up of working-aged Finns. Prev Med Rep 2021; 24:101635. [PMID: 34976687 PMCID: PMC8684019 DOI: 10.1016/j.pmedr.2021.101635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022] Open
Abstract
Subjective well-being predicts subsequent health behavior in a 9-years of follow-up. Neither direction of influence was stronger as compared to the other one. Enhancing subjective well-being could serve as an additional support for health behavior change.
The cross-sectional association between measures of subjective well-being (SWB) and various health behaviors is well-established. In this 9-year (2003–2012) follow-up study, we explored how a composite indicator of SWB (range 4–20) with four items (interest, happiness, and ease in life, as well as perceived loneliness) predicts a composite health behavior measure (range 0–4) including dietary habits, physical activity, alcohol consumption, and smoking status. Study subjects (n = 10,855) originated from a population-based random sample of working-age Finns in the Health and Social Support study (HeSSup). According to linear regression analysis, better SWB predicted better health behavior sum score with a β = 0.019 (p < 0.001) with a maximum effect of 0.3 points after adjusting for age (p = 0.038), gender (p < 0.001), education (p = 0.55), baseline self-reported diseases (p = 0.020), baseline health behavior (β = 0.49, p < 0.001), and the interaction between SWB and education (p < 0.001). The results suggest that SWB has long-term positive effect on health behavior. Thus, interventions aiming at health behavioral changes could benefit from taking into account SWB and its improvement in the intervention.
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Stenlund S, Junttila N, Koivumaa-Honkanen H, Sillanmäki L, Stenlund D, Suominen S, Lagström H, Rautava P. Longitudinal stability and interrelations between health behavior and subjective well-being in a follow-up of nine years. PLoS One 2021; 16:e0259280. [PMID: 34714864 PMCID: PMC8555827 DOI: 10.1371/journal.pone.0259280] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/16/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The bidirectional relationship between health behavior and subjective well-being has previously been studied sparsely, and mainly for individual health behaviors and regression models. In the present study, we deepen this knowledge focusing on the four principal health behaviors and using structural equation modeling with selected covariates. METHODS The follow-up data (n = 11,804) was derived from a population-based random sample of working-age Finns from two waves (2003 and 2012) of the Health and Social Support (HeSSup) postal survey. Structural equation modeling was used to study the cross-sectional, cross-lagged, and longitudinal relationships between the four principal health behaviors and subjective well-being at baseline and after the nine-year follow-up adjusted for age, gender, education, and self-reported diseases. The included health behaviors were physical activity, dietary habits, alcohol consumption, and smoking status. Subjective well-being was measured through four items comprising happiness, interest, and ease in life, and perceived loneliness. RESULTS Bidirectionally, only health behavior in 2003 predicted subjective well-being in 2012, whereas subjective well-being in 2003 did not predict health behavior in 2012. In addition, the cross-sectional interactions in 2003 and in 2012 between health behavior and subjective well-being were statistically significant. The baseline levels predicted their respective follow-up levels, the effect being stronger in health behavior than in subjective well-being. CONCLUSION The four principal health behaviors together predict subsequent subjective well-being after an extensive follow-up. Although not particularly strong, the results could still be used for motivation for health behavior change, because of the beneficial effects of health behavior on subjective well-being.
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Affiliation(s)
- Säde Stenlund
- Department of Public Health, University of Turku, Turku, Finland
- Research Services, Turku University Hospital, Turku, Finland
| | - Niina Junttila
- Department of Teacher Education, University of Turku, Turku, Finland
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland
- Mental Health and Wellbeing Center, Kuopio University Hospital, Kuopio, Finland
| | - Lauri Sillanmäki
- Department of Public Health, University of Turku, Turku, Finland
- Research Services, Turku University Hospital, Turku, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - David Stenlund
- Faculty of Science and Engineering, Åbo Akademi University, Turku, Finland
| | - Sakari Suominen
- Department of Public Health, University of Turku, Turku, Finland
- Research Services, Turku University Hospital, Turku, Finland
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Hanna Lagström
- Department of Public Health, University of Turku, Turku, Finland
- Research Services, Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Turku, Finland
- Research Services, Turku University Hospital, Turku, Finland
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Kesavayuth D, Shangkhum P, Zikos V. Subjective well-being and healthcare utilization: A mediation analysis. SSM Popul Health 2021; 14:100796. [PMID: 33997245 PMCID: PMC8105663 DOI: 10.1016/j.ssmph.2021.100796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/19/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
Subjective well-being measures are gaining recognition as important determinants of health outcomes. This paper examines whether life satisfaction matters for healthcare usage in the older population and, if so, what might help explain this relationship. To that end, we develop a mediation framework and test whether lifestyle choices and social capital are pathways through which life satisfaction at baseline influences subsequent healthcare usage. Using Heckman's approach to correct for sample selection bias, we find that those high in life satisfaction may need less outpatient care. We also show that this effect is explained by increased physical activity.
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Affiliation(s)
- Dusanee Kesavayuth
- Department of Economics, Faculty of Economics, Kasetsart University, Bangkok, 10900, Thailand
| | - Prompong Shangkhum
- School of Economics, University of the Thai Chamber of Commerce, 126/1 Vibhavadee-Rangsit Road, Dindaeng, Bangkok, 10400, Thailand
| | - Vasileios Zikos
- Faculty of Economics, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand
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Boehm JK. Positive psychological well‐being and cardiovascular disease: Exploring mechanistic and developmental pathways. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2021; 15:e12599. [PMID: 35860033 PMCID: PMC9285725 DOI: 10.1111/spc3.12599] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/15/2021] [Accepted: 03/18/2021] [Indexed: 12/29/2022]
Abstract
Empirical research regarding the health benefits of positive psychological well‐being (e.g., positive emotions, life satisfaction, purpose in life, and optimism) has flourished in recent years, particularly with regard to cardiovascular disease. This paper reviews the state of evidence for well‐being's association with cardiovascular disease in both healthy individuals and those diagnosed with a disease. Prospective studies consistently indicate well‐being reduces cardiovascular events in healthy and, to a lesser extent, patient populations. Potential pathways that link well‐being with cardiovascular disease are discussed (including health behaviors, physiological processes, and stress buffering), although the existing evidence is mostly cross‐sectional which limits conclusions about directionality. Issues related to development across the lifespan are considered and childhood is identified as a crucial period for establishing healthy cardiovascular trajectories. Outstanding questions for future research are provided with recommendations to focus on well‐powered and prospective study designs with rigorous assessment of both well‐being and cardiovascular‐related outcomes.
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Affiliation(s)
- Julia K. Boehm
- Department of Psychology Chapman University Orange California USA
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14
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Zhang L, Bi X, Ding Z. Health lifestyles and Chinese oldest-old's subjective well-being-evidence from a latent class analysis. BMC Geriatr 2021; 21:206. [PMID: 33761879 PMCID: PMC7992951 DOI: 10.1186/s12877-021-02121-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/22/2021] [Indexed: 01/07/2023] Open
Abstract
Background Previous research on the associations between lifestyle behaviors and health has largely focused on morbidity, mortality and disease prevention. More attention should be paid to examining relationships between lifestyle behaviors and positive health outcomes such as well-being. The aim of the study was to classify Chinese oldest-old’s health lifestyles and evaluate the manner in which health lifestyles have impacted Chinese oldest-old’s subjective well-being. Methods Analyzing the 2014 Chinese Longitudinal Healthy Longevity Survey (CLHLS), latent class analysis was applied to identify predominant health lifestyles among Chinese oldest-old aged 85 to 105. Ordinary Least Square (OLS) regression models were used to assess the effects of health lifestyles on Chinese oldest-old’s subjective well-being, adjusting for socio-demographic characteristics. Results Four distinct classes representing health lifestyles emerged. Health lifestyles were found to be strongly associated with Chinese oldest-old’s subjective well-being, even after controlling for demographic features as well as individual and parental socioeconomic disadvantage. Findings showed that healthy lifestyle behaviors stimulated Chinese oldest-old’s positive feelings and led to better evaluative subjective well-being. In contrast, less healthy lifestyle behaviors can be a predictor of negative feelings. Conclusions The regression results highlighted the importance of integrating health lifestyle choices in promoting oldest-old’s psychological well-being. Elders can tackle healthier lifestyle behaviors in their daily lives to reduce the risk of mental health problems. Practicing healthy lifestyles should be integrated in programs for mental health promotion. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02121-0.
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Affiliation(s)
- Li Zhang
- School of Sociology, China University of Political Science and Law, Beijing, 102249, China
| | - Xiangyang Bi
- School of Ethnology and Sociology, Minzu University of China, No. 27, Zhongguancunnan Street, Haidian District, Beijing, 100081, China
| | - Zhihong Ding
- School of Sociology and Psychology, Central University of Finance and Economics, Beijing, 100081, China.
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15
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de Vries LP, Baselmans BML, Bartels M. Smartphone-Based Ecological Momentary Assessment of Well-Being: A Systematic Review and Recommendations for Future Studies. JOURNAL OF HAPPINESS STUDIES 2021; 22:2361-2408. [PMID: 34720691 PMCID: PMC8550316 DOI: 10.1007/s10902-020-00324-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 05/07/2023]
Abstract
Feelings of well-being and happiness fluctuate over time and contexts. Ecological Momentary Assessment (EMA) studies can capture fluctuations in momentary behavior, and experiences by assessing these multiple times per day. Traditionally, EMA was performed using pen and paper. Recently, due to technological advances EMA studies can be conducted more easily with smartphones, a device ubiquitous in our society. The goal of this review was to evaluate the literature on smartphone-based EMA in well-being research in healthy subjects. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searching PubMed and Web of Science, we identified 53 studies using smartphone-based EMA of well-being. Studies were heterogeneous in designs, context, and measures. The average study duration was 12.8 days, with well-being assessed 2-12 times per day. Half of the studies included objective data (e.g. location). Only 47.2% reported compliance, indicating a mean of 71.6%. Well-being fluctuated daily and weekly, with higher well-being in evenings and weekends. These fluctuations disappeared when location and activity were accounted for. On average, being in nature and physical activity relates to higher well-being. Working relates to lower well-being, but workplace and company do influence well-being. The important advantages of using smartphones instead of other devices to collect EMAs are the easier data collection and flexible designs. Smartphone-based EMA reach far larger maximum sample sizes and more easily add objective data to their designs than palm-top/PDA studies. Smartphone-based EMA research is feasible to gain insight in well-being fluctuations and its determinants and offers the opportunity for parallel objective data collection. Most studies currently focus on group comparisons, while studies on individual differences in well-being patterns and fluctuations are lacking. We provide recommendations for future smartphone-based EMA research regarding measures, objective data and analyses.
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Affiliation(s)
- Lianne P. de Vries
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Bart M. L. Baselmans
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD Australia
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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16
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Nurse-Led Positive Psychology Intervention Is Feasible in Patients With Heart Failure. J Cardiovasc Nurs 2020; 36:131-135. [PMID: 33109921 DOI: 10.1097/jcn.0000000000000758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Negative psychological states have been linked with poor cardiovascular outcomes, including heart failure (HF). Positive psychological states have been associated with superior outcomes, with little focus on interventions designed to increase positive psychological states in patients with HF. OBJECTIVE The aim of this study was to test the acceptability and feasibility of a nurse-led positive psychology intervention. METHODS A convenience sample of patients with HF was enrolled at a single academic medical center. The participants were coached in the Best Possible Self intervention by a trained nurse. Participants were then contacted by telephone to determine continued practice and satisfaction with the intervention. RESULTS Eighty-seven patients were approached to enroll 60 patients with a yield rate of 69%. The intervention was feasible and acceptable as 80% continued the intervention until study completion. CONCLUSION Patients with HF are willing to participate and accept a nurse-led positive psychology intervention.
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17
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Optimism and Social Support Predict Healthier Adult Behaviors Despite Socially Disadvantaged Childhoods. Int J Behav Med 2020; 27:200-212. [PMID: 31933126 DOI: 10.1007/s12529-020-09849-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Studies have shown adverse effects of a disadvantaged childhood on adult health-promoting behaviors and related outcomes. Optimism and social support have been linked to greater likelihood of engaging in healthy behavior, but it is unclear whether these positive psychosocial factors may buffer harmful effects of early adversity. This study aims to determine if optimism and social support in adulthood can modify effects of childhood disadvantage on health behavior-related outcomes. METHODS Longitudinal data were analyzed from a subset of participants in a US birth cohort established in 1959-1966 (ns of 681-840, per outcome). An index of childhood social disadvantage was derived from adverse socioeconomic and family stability factors reported by mothers at child's birth and age 7 years. Health behavior-related outcomes were self-reported when participants were of mean age 47 years. Multivariable adjusted robust Poisson regressions were performed. RESULTS Regardless of level of childhood social disadvantage, we found higher levels of optimism and social support were both associated with higher probabilities of being a non-smoker (relative risk [RR]optimism = 1.17, 95% confidence interval [CI] = 1.09-1.26; RRsocial support = 1.24, 95%CI = 1.11-1.39), having a healthy diet (RRoptimism = 1.25, 95%CI = 1.10-1.43; RRsocial support = 1.27, 95%CI = 1.04-1.56), and a healthy body mass index (RRoptimism = 1.18, 95%CI = 1.00-1.40; RRsocial support = 1.29, 95%CI = 1.00-1.66). Interactions link higher optimism or social support with lower risk of smoking among those with moderate childhood disadvantage. CONCLUSIONS Overall, these findings are consistent with the possibility that positive psychosocial resources contribute to maintaining a healthy lifestyle in mid-adulthood and may buffer effects of childhood social disadvantage.
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18
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Throuvala MA, Griffiths MD, Rennoldson M, Kuss DJ. Mind over Matter: Testing the Efficacy of an Online Randomized Controlled Trial to Reduce Distraction from Smartphone Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4842. [PMID: 32635650 PMCID: PMC7369880 DOI: 10.3390/ijerph17134842] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 02/07/2023]
Abstract
Evidence suggests a growing call for the prevention of excessive smartphone and social media use and the ensuing distraction that arises affecting academic achievement and productivity. A ten-day online randomized controlled trial with the use of smartphone apps, engaging participants in mindfulness exercises, self-monitoring and mood tracking, was implemented amongst UK university students (n = 143). Participants were asked to complete online pre- and post-intervention assessments. Results indicated high effect sizes in reduction of smartphone distraction and improvement scores on a number of self-reported secondary psychological outcomes. The intervention was not effective in reducing habitual behaviours, nomophobia, or time spent on social media. Mediation analyses demonstrated that: (i) emotional self-awareness but not mindful attention mediated the relationship between intervention effects and smartphone distraction, and (ii) online vigilance mediated the relationship between smartphone distraction and problematic social media use. The present study provides preliminary evidence of the efficacy of an intervention for decreased smartphone distraction and highlights psychological processes involved in this emergent phenomenon in the smartphone literature. Online interventions may serve as complementary strategies to reduce distraction levels and promote insight into online engagement. More research is required to elucidate the mechanisms of digital distraction and assess its implications in problematic use.
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Affiliation(s)
- Melina A. Throuvala
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
| | - Mike Rennoldson
- Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Daria J. Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
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19
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Kushlev K, Heintzelman SJ, Lutes LD, Wirtz D, Kanippayoor JM, Leitner D, Diener E. Does Happiness Improve Health? Evidence From a Randomized Controlled Trial. Psychol Sci 2020; 31:807-821. [DOI: 10.1177/0956797620919673] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Happier people are healthier, but does becoming happier lead to better health? In the current study, we deployed a comprehensive, 3-month positive psychological intervention as an experimental tool to examine the effects of increasing subjective well-being on physical health in a nonclinical population. In a 6-month randomized controlled trial with 155 community adults, we found effects of treatment on self-reported physical health—the number of days in the previous month that participants felt healthy or sick, as assessed by questions from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System Questionnaire. In a subsample of 100 participants, we also found evidence that improvements in subjective well-being over the course of the program predicted subsequent decreases in the number of sick days. Combining experimental and longitudinal methodologies, this work provides some evidence for a causal effect of subjective well-being on self-reported physical health.
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Affiliation(s)
| | | | | | - Derrick Wirtz
- Department of Psychology, University of British Columbia
| | | | - Damian Leitner
- Department of Psychology, University of British Columbia
| | - Ed Diener
- Department of Psychology, University of Virginia
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20
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Martín-María N, Caballero FF, Moreno-Agostino D, Olaya B, Haro JM, Ayuso-Mateos JL, Miret M. Relationship between subjective well-being and healthy lifestyle behaviours in older adults: a longitudinal study. Aging Ment Health 2020; 24:611-619. [PMID: 30590962 DOI: 10.1080/13607863.2018.1548567] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: People who report better subjective well-being tend to be healthier in their daily behaviours. The objective of this study is to assess whether different components of subjective well-being are prospectively associated with different healthy lifestyle behaviours and to assess whether these associations differ by age.Method: A total of 1,892 participants aged 50+ living in Spain were interviewed in 2011-12 and 2014-15. Life satisfaction was measured with the Cantril Self-Anchoring Striving Scale. Positive and negative affect were assessed using the Day Reconstruction Method. Physical activity was assessed with the Global Physical Activity Questionnaire version 2. The remaining healthy lifestyle behaviours were self-reported. Generalised Estimating Equations (GEE) models were run.Results: Not having a heavy episodic alcohol drinking was the healthy lifestyle behaviour most fulfilled (97.97%), whereas the intake of five or more fruits and vegetables was the least followed (33.12%). GEE models conducted over the 50-64 and the 65+ age groups showed that a higher life satisfaction was significantly related to a higher physical activity in both groups. Relationships between a higher negative affect and presenting a lower level of physical activity, and a higher positive affect and following the right consumption of fruits and vegetables and being a non-daily smoker, were only found in the older group.Conclusion: The relationship between subjective well-being and healthy lifestyle behaviours was found fundamentally in those aged 65+ years. Interventions focused on incrementing subjective well-being would have an impact on keeping a healthy lifestyle and, therefore, on reducing morbidity and mortality.
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Affiliation(s)
- Natalia Martín-María
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública. CIBERESP, Madrid, Spain
| | - Darío Moreno-Agostino
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Beatriz Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Josep Maria Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Marta Miret
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
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21
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Kimiecik J, Horn T, Newman TJ, Kimiecik CM. Moving adolescents for a lifetime of physical activity: shifting to interventions aligned with the third health revolution. Health Psychol Rev 2019; 14:486-503. [PMID: 31814512 DOI: 10.1080/17437199.2019.1700820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Public health advocates have been calling for an intensified focus on early, middle, and late adolescence health behaviours due to both the short- and long-term health consequences. Hence, both the health-risk (e.g., alcohol consumption) and health-promoting (e.g., physical activity) behaviours of adolescents have been widely studied to better understand the underlying causes or determinants with an eye towards implementing more effective interventions. The success of these interventions, typically grounded in a risk-reduction/prevention-oriented intervention approach has been modest, especially those focused on health-promoting behaviours, such as physical activity. The purposes of this paper are to (1) conduct a conceptual critique of the risk-reduction/prevention-oriented approach underlying traditional adolescent physical activity interventions, and (2) examine the potential usefulness of an emerging person-based, development-oriented (PBDO) approach for enhancing the motivation and sustainability of adolescent physical activity. Within this PBDO perspective, emphasis is on adolescent growth and development as the starting point for initiating and sustaining physical activity. Implications of the PBDO approach for adolescent physical activity interventions are presented.
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Affiliation(s)
- Jay Kimiecik
- Department of Kinesiology and Health, Miami University, Oxford, OH, USA
| | - Thelma Horn
- Department of Kinesiology and Health, Miami University, Oxford, OH, USA
| | | | - Carlyn M Kimiecik
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
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22
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Kushlev K, Drummond DM, Diener E. Subjective Well‐Being and Health Behaviors in 2.5 Million Americans. Appl Psychol Health Well Being 2019; 12:166-187. [DOI: 10.1111/aphw.12178] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Ed Diener
- University of Utah USA
- University of Virginia USA
- Gallup Organization USA
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23
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Kushlev K, Drummond DM, Heintzelman SJ, Diener E. Do happy people care about society’s problems? JOURNAL OF POSITIVE PSYCHOLOGY 2019. [DOI: 10.1080/17439760.2019.1639797] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kostadin Kushlev
- Department of Psychology, Georgetown University, Washington, DC, USA
| | | | | | - Ed Diener
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
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24
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Roy B, Riley C, Sinha R. Emotion regulation moderates the association between chronic stress and cardiovascular disease risk in humans: a cross-sectional study. Stress 2018; 21:548-555. [PMID: 30084712 PMCID: PMC6367063 DOI: 10.1080/10253890.2018.1490724] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Chronic stress is a risk factor for incident cardiovascular (CV) disease. Emotion regulation is the ability to modulate one's state or behavior in response to a given situation or stressor, and may mitigate the effect of chronic stress on CV disease risk. Data from a cohort of 754 community-dwelling young to middle-aged adults who were assessed between 2007 and 2012 on stress, emotion regulation, and CV risk measures were used to test the hypothesis that emotion regulation mitigates the effect of chronic stress on CV risk. Emotion regulation was measured using the Difficulties in Emotion Regulation Scale (DERS). We created a composite stress score using data from the Cumulative Adversity Interview and the Perceived Stress Scale. Our outcomes included blood pressure, body mass index, and insulin resistance separately and combined into a composite CV risk score. Covariates included age, sex, race, years of education, and smoking status. We used multivariable logistic regression to evaluate associations between stress measures and CV risk among participants and the impact of emotion regulation (DERS scores) on this association. We found that composite stress interacted significantly with the DERS score to affect CV risk (p = .007). A median split of the DERS scores indicated that CV risk was associated with the composite stress score in the fully adjusted model (ß = 0.206; p = .005) among participants with low emotion regulation, but not among those with high emotion regulation (ß = 0.048; p = .59). Chronic stress was associated with CV risk only among participants with poor emotion regulation. Emotion regulation is a teachable skill, and may play a role in preventing CV disease.Lay summaryEmotion regulation is the ability to modify one's reaction to a negative or stressful event, and is a teachable skill. Effective emotion regulation dampens the negative effect of chronic stress on the body, which may reduce risk for cardiovascular disease.
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Affiliation(s)
- Brita Roy
- Assistant Professor, Section of General Internal Medicine, Yale School of Medicine, 367 Cedar St., ESH-A, Suite 406A, New Haven, CT 06510; (203) 785-5564;
- Corresponding author
| | - Carley Riley
- Assistant Professor, Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267
- Attending Physician, Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229; (312) 208-0767;
| | - Rajita Sinha
- Yale Stress Center and Departments of Psychiatry, Neuroscience and Child Study, Yale School of Medicine, 2 Church Street S, New Haven, CT 06519; (203) 737-5805;
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25
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Psychological well-being and restorative biological processes: HDL-C in older English adults. Soc Sci Med 2018; 209:59-66. [PMID: 29800769 PMCID: PMC9901326 DOI: 10.1016/j.socscimed.2018.05.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/03/2018] [Accepted: 05/12/2018] [Indexed: 02/08/2023]
Abstract
RATIONALE Psychological well-being is associated with better cardiovascular health, but the underlying mechanisms are unclear. OBJECTIVE This study investigates one possible mechanism by examining psychological well-being's prospective association with lipid levels, focusing on high-density lipoprotein cholesterol (HDL-C). METHODS Participants were 4757 healthy men and women ages ≥50 from the English Longitudinal Study of Ageing with clinical data from three times, three to five years apart. Psychological well-being was assessed at baseline using the Control, Autonomy, Satisfaction, and Pleasure scale; HDL-C, triglycerides, and total cholesterol were assayed from blood samples. Descriptive statistics and linear mixed models were used to examine associations between psychological well-being and lipid levels over time; the latter controlled for confounders and health behaviours. RESULTS In descriptive analyses, HDL-C levels were initially higher in people with greater psychological well-being. Among those who met recommended levels of HDL-C at baseline, fewer individuals with higher versus lower psychological well-being dropped below HDL-C recommendations over time. Mixed models indicated that HDL-C increased over time (β = 0.64; 95% CI = 0.58 to 0.69) and higher baseline psychological well-being was associated with higher baseline HDL-C (β = 0.51; 95% CI = 0.03 to 0.99). A significant well-being by time interaction indicated individuals with higher versus lower well-being exhibited a more rapid rate of increase in HDL-C over follow-up. Higher psychological well-being was also significantly associated with lower triglycerides, but main effects for both HDL-C and triglycerides were attenuated after accounting for health behaviours. CONCLUSION Higher psychological well-being is associated with healthier HDL-C levels; these effects may compound over time. This protective effect may be partly explained by health behaviours.
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26
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Diener E, Lucas RE, Oishi S. Advances and Open Questions in the Science of Subjective Well-Being. COLLABRA. PSYCHOLOGY 2018; 4:15. [PMID: 30637366 PMCID: PMC6329388 DOI: 10.1525/collabra.115] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Subjective well-being (SWB) is an extremely active area of research with about 170,000 articles and books published on the topic in the past 15 years. Methodological and theoretical advances have been notable in this period of time, with the increasing use of longitudinal and experimental designs allowing for a greater understanding of the predictors and outcomes that relate to SWB, along with the process that underlie these associations. In addition, theories about these processes have become more intricate, as findings reveal that many associations with SWB depend on people's culture and values and the context in which they live. This review provides an overview of many major areas of research, including the measurement of SWB, the demographic and personality-based predictors of SWB, and process-oriented accounts of individual differences in SWB. In addition, because a major new focus in recent years has been the development of national accounts of subjective well-being, we also review attempts to use SWB measures to guide policy decisions.
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Affiliation(s)
- Ed Diener
- Department of Psychology, University of Virginia, Charlottesville, VA and Department of Psychology, University of Utah, Salt Lake City, UT
| | - Richard E Lucas
- Department of Psychology, Michigan State University, East Lansing, MI
| | - Shigehiro Oishi
- Department of Psychology, University of Virginia, Charlottesville, VA
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27
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Boehm JK, Chen Y, Koga H, Mathur MB, Vie LL, Kubzansky LD. Is Optimism Associated With Healthier Cardiovascular-Related Behavior? Circ Res 2018; 122:1119-1134. [DOI: 10.1161/circresaha.117.310828] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Julia K. Boehm
- From the Department of Psychology, Chapman University, Orange, CA (J.K.B.); Department of Social and Behavioral Sciences (Y.C., H.K., L.D.K.) and Department of Biostatistics (M.B.M.), Harvard T.H. Chan School of Public Health, Boston, MA; and Department of Psychology, University of Pennsylvania, Philadelphia (L.L.V.)
| | - Ying Chen
- From the Department of Psychology, Chapman University, Orange, CA (J.K.B.); Department of Social and Behavioral Sciences (Y.C., H.K., L.D.K.) and Department of Biostatistics (M.B.M.), Harvard T.H. Chan School of Public Health, Boston, MA; and Department of Psychology, University of Pennsylvania, Philadelphia (L.L.V.)
| | - Hayami Koga
- From the Department of Psychology, Chapman University, Orange, CA (J.K.B.); Department of Social and Behavioral Sciences (Y.C., H.K., L.D.K.) and Department of Biostatistics (M.B.M.), Harvard T.H. Chan School of Public Health, Boston, MA; and Department of Psychology, University of Pennsylvania, Philadelphia (L.L.V.)
| | - Maya B. Mathur
- From the Department of Psychology, Chapman University, Orange, CA (J.K.B.); Department of Social and Behavioral Sciences (Y.C., H.K., L.D.K.) and Department of Biostatistics (M.B.M.), Harvard T.H. Chan School of Public Health, Boston, MA; and Department of Psychology, University of Pennsylvania, Philadelphia (L.L.V.)
| | - Loryana L. Vie
- From the Department of Psychology, Chapman University, Orange, CA (J.K.B.); Department of Social and Behavioral Sciences (Y.C., H.K., L.D.K.) and Department of Biostatistics (M.B.M.), Harvard T.H. Chan School of Public Health, Boston, MA; and Department of Psychology, University of Pennsylvania, Philadelphia (L.L.V.)
| | - Laura D. Kubzansky
- From the Department of Psychology, Chapman University, Orange, CA (J.K.B.); Department of Social and Behavioral Sciences (Y.C., H.K., L.D.K.) and Department of Biostatistics (M.B.M.), Harvard T.H. Chan School of Public Health, Boston, MA; and Department of Psychology, University of Pennsylvania, Philadelphia (L.L.V.)
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Boehm JK, Soo J, Chen Y, Zevon ES, Hernandez R, Lloyd-Jones D, Kubzansky LD. Psychological Well-being's Link with Cardiovascular Health in Older Adults. Am J Prev Med 2017; 53:791-798. [PMID: 28844346 PMCID: PMC5833990 DOI: 10.1016/j.amepre.2017.06.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/22/2017] [Accepted: 06/27/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Favorable cardiovascular health (FCH) is associated with healthy longevity and reduced cardiovascular mortality risk. However, limited work has investigated the distribution of FCH in older age or considered the antecedents of FCH. Based on prior work linking psychological well-being with cardiovascular endpoints, higher psychological well-being was hypothesized to be associated with increased likelihood of maintaining FCH over time. METHODS Data were from the English Longitudinal Study of Ageing. The first study wave (2002-2003) included men and women aged ≥50 years. The analytic sample (N=4,925) was restricted to individuals without baseline cardiovascular disease and with clinical data from three follow-ups through 2013. Psychological well-being was assessed with 17 items from the Control, Autonomy, Satisfaction, and Pleasure scale. FCH was defined as being a non-smoker, diabetes-free, and having healthy levels of blood pressure, cholesterol, and BMI (FCH scores ranged from 0-5). Statistical analyses conducted in 2016-2017 used linear mixed models to examine associations between psychological well-being and FCH scores over time. Secondary analyses examined cardiovascular-related mortality. RESULTS Only 1% of participants had achieved complete FCH at study baseline. Adjusting for sociodemographic factors and depression, greater psychological well-being was associated with higher FCH scores across time (β=0.05, 95% CI=0.02, 0.08), but not rate of change in FCH. Psychological well-being was also associated with a 29% reduced risk of cardiovascular-related mortality in multivariable-adjusted models. CONCLUSIONS Findings suggest that psychological well-being is associated with having FCH at older ages, and add to knowledge of assets that may increase likelihood of healthy aging.
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Affiliation(s)
- Julia K Boehm
- Department of Psychology, Chapman University, Orange, California.
| | - Jackie Soo
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily S Zevon
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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The Appraisal of Self-Care Agency Scale - Revised (ASA-R): Adaptation and Validation in a Sample of Spanish Older Adults. SPANISH JOURNAL OF PSYCHOLOGY 2017; 20:E48. [PMID: 29056098 DOI: 10.1017/sjp.2017.52] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Self-care agency is an important determinant of healthy aging. The Appraisal of Self-care Agency Scale (ASA-R) (Sousa et al., 2010) is one of the main instrument to assess self-care capacity. The objectives of the study were: 1) to adapt and validate ASA-R scale for use in Spanish population; 2) to examine the dimensionality, validity and reliability; 3) and to establish the convergent validity of ASA-R using a self-reported health measure. The ASA-R Scale and the 12-item Short Form Health Survey (SF-12) were administered to 488 Spanish seniors aged 65 and over. Confirmatory Factor Analysis (CFA) was used to analyze the dimensionality, validity and reliability. Convergent validity was tested by correlating the ASA-R factors with the SF-12 subscales; correlations were significant (p 0.05 (0.436), RMSEA closer to 0 (0.006), SRMR 0.95 (0.996 and 0.995). The results also demonstrated that ASA-R is a reliable and valid instrument. The ASA-R has demonstrated to be a reliable (CR indices > 0.7) and valid (AVE > 0.5) instrument in measuring self-care agency among Spanish older population.
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Sin NL. The Protective Role of Positive Well-Being in Cardiovascular Disease: Review of Current Evidence, Mechanisms, and Clinical Implications. Curr Cardiol Rep 2017; 18:106. [PMID: 27612475 DOI: 10.1007/s11886-016-0792-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Positive psychological aspects of well-being-including positive emotions, optimism, and life satisfaction-are increasingly considered to have protective roles for cardiovascular disease (CVD) and longevity. A rapidly-growing body of literature has linked positive well-being with better cardiovascular health, lower incidence of CVD in healthy populations, and reduced risk of adverse outcomes in patients with existing CVD. This review first examines evidence on the associations of positive well-being with CVD and mortality, focusing on recent epidemiological research as well as inconsistent findings. Next, an overview is provided of putative biological, behavioral, and stress-buffering mechanisms that may underlie the relationship between positive well-being and cardiovascular health. Key areas for future inquiry are discussed, in addition to emerging developments that capitalize on technological and methodological advancements. Promising initial results from randomized controlled trials suggest that efforts to target positive well-being may serve as valuable components of broader CVD management programs.
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Affiliation(s)
- Nancy L Sin
- Center for Healthy Aging and the Department of Biobehavioral Health, The Pennsylvania State University, 422 Biobehavioral Health Building, University Park, PA, 16802, USA.
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Johnson SS. The Art of Health Promotion. Am J Health Promot 2017. [DOI: 10.1177/0890117117715321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Neumeier LM, Brook L, Ditchburn G, Sckopke P. Delivering your daily dose of well-being to the workplace: a randomized controlled trial of an online well-being programme for employees. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2017. [DOI: 10.1080/1359432x.2017.1320281] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Libby Brook
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia
| | - Graeme Ditchburn
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia
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van Montfort E, Denollet J, Widdershoven J, Kupper N. Interrelation and independence of positive and negative psychological constructs in predicting general treatment adherence in coronary artery patients - Results from the THORESCI study. J Psychosom Res 2016; 88:1-7. [PMID: 27521644 DOI: 10.1016/j.jpsychores.2016.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 06/14/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND In cardiac patients, positive psychological factors have been associated with improved medical and psychological outcomes. The current study examined the interrelation between and independence of multiple positive and negative psychological constructs. Furthermore, the potential added predictive value of positive psychological functioning regarding the prediction of patients' treatment adherence and participation in cardiac rehabilitation (CR) was investigated. METHOD 409 percutaneous coronary intervention (PCI) patients were included (mean age = 65.6 ± 9.5; 78% male). Self-report questionnaires were administered one month post-PCI. Positive psychological constructs included positive affect (GMS) and optimism (LOT-R); negative constructs were depression (PHQ-9, BDI), anxiety (GAD-7) and negative affect (GMS). Six months post-PCI self-reported general adherence (MOS) and CR participation were determined. RESULTS Factor Analysis (Oblimin rotation) revealed two components (r = − 0.56), reflecting positive and negative psychological constructs. Linear regression analyses showed that in unadjusted analyses both optimism and positive affect were associated with better general treatment adherence at six months (p < 0.05). In adjusted analyses, optimism's predictive values remained, independent of sex, age, PCI indication, depression and anxiety. Univariate logistic regression analysis showed that in patients with a cardiac history, positive affect was significantly associated with CR participation. After controlling for multiple covariates, this relation was no longer significant. CONCLUSIONS Positive and negative constructs should be considered as two distinct dimensions. Positive psychological constructs (i.e. optimism) may be of incremental value to negative psychological constructs in predicting patients' treatment adherence. A more complete view of a patients' psychological functioning will open new avenues for treatment. Additional research is needed to investigate the relationship between positive psychological factors and other cardiac outcomes, such as cardiac events and mortality.
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Affiliation(s)
- Eveline van Montfort
- Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, the Netherlands
| | - Johan Denollet
- Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, the Netherlands
| | - Jos Widdershoven
- Elisabeth Tweesteden hospital, Tilburg, the Netherlands and Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, the Netherlands
| | - Nina Kupper
- Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, the Netherlands.
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Positive Cardiovascular Health. J Am Coll Cardiol 2016; 68:860-7. [DOI: 10.1016/j.jacc.2016.03.608] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 02/26/2016] [Accepted: 03/25/2016] [Indexed: 11/23/2022]
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Sanjuán P, Montalbetti T, Pérez-García AM, Bermúdez J, Arranz H, Castro A. A Randomised Trial of a Positive Intervention to Promote Well-Being in Cardiac Patients. Appl Psychol Health Well Being 2016; 8:64-84. [PMID: 26876425 DOI: 10.1111/aphw.12062] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Negative emotions are linked to the onset and development of coronary heart diseases (CHD), whereas positive emotions are associated with better health and lower mortality rates among patients with these diseases. The objective of this randomised trial was to improve cardiac patients' emotional states using a Programme to Improve Well-being (PIW) based exclusively on positive interventions (those that promote intentional behaviours and thoughts to improve well-being). METHODS Cardiac patients (n = 108) were randomly assigned to two parallel groups. In the control group, they participated in only a Cardiac Rehabilitation Programme (CRP group), whereas the intervention group also participated in the PIW (CRP+PIW group). Physical functional capacity, depressive symptoms, hostility, and negative and positive affect were assessed at T1 (baseline) and T2 (8 weeks later). RESULTS At T2, after controlling for functional capacity, the CRP+PIW group reported a significantly less negative affect than the CRP group. Moreover, the CRP group did not change from T1 to T2, whereas the CRP+PIW group reported more positive emotions and fewer negative emotions and hostility at T2 than at T1. CONCLUSIONS Positive interventions effectively improve the emotional state of cardiac patients. We suggest that specific modules should be included in the CRP to improve well-being.
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Affiliation(s)
- Pilar Sanjuán
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | | | - José Bermúdez
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Kubzansky LD, Boehm JK, Segerstrom SC. Positive Psychological Functioning and the Biology of Health. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2015. [DOI: 10.1111/spc3.12224] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sin NL, Moskowitz JT, Whooley MA. Positive Affect and Health Behaviors Across 5 Years in Patients With Coronary Heart Disease: The Heart and Soul Study. Psychosom Med 2015; 77:1058-66. [PMID: 26428445 PMCID: PMC4643380 DOI: 10.1097/psy.0000000000000238] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Positive psychological states are linked to superior health and longevity, possibly due to behavioral factors. We evaluated cross-sectional and 5-year associations between positive affect and health behaviors in patients with coronary heart disease (CHD). METHODS Outpatients with CHD reported positive affect, physical activity, sleep quality, medication adherence, cigarette smoking, and alcohol use at baseline (n = 1022) and 5 years later (n = 662). Covariates in regression analyses included demographics, cardiac disease severity, and depressive symptoms. RESULTS At baseline, higher positive affect (per 1 standard deviation) was associated with better health behaviors: physical activity (odds ratio [OR] = 1.52, 95% 95% confidence interval [CI] = 1.30-1.77, p < .001), sleep quality (OR = 1.24, 95% CI = 1.04-1.48, p = .015), medication adherence (OR = 1.46, 95% CI = 1.12-1.90, p = .005), and nonsmoking (OR = 1.29, 95% CI = 1.06-1.57, p = .012), but was unrelated to alcohol use. Baseline positive affect did not predict health behaviors at follow-up, accounting for baseline behaviors. However, increases in positive affect across 5 years co-occurred with improvements in physical activity (B = 0.023, standard error [SE] = 0.008, p = .002), sleep quality (B = 0.011, SE = 0.005, p = .039), and medication adherence (B = 0.014, SE = 0.004, p < .001), but not smoking status (OR = 1.07, 95% CI = 0.73-1.55, p = .74). CONCLUSIONS Positive affect was associated with health behaviors among patients with CHD. Efforts to sustain or enhance positive affect may be promising for promoting better health behaviors.
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Affiliation(s)
- Nancy L. Sin
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
| | - Judith Tedlie Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Mary A. Whooley
- Department of Medicine, University of California, San Francisco, CA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA
- Veterans Affairs Medical Center, San Francisco, CA
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Taking the tension out of hypertension: a prospective study of psychological well being and hypertension. J Hypertens 2015; 32:1222-8. [PMID: 24786293 DOI: 10.1097/hjh.0000000000000175] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous studies have shown that psychological well being is associated with reduced risk of cardiovascular disease. However, whether well being might be specifically associated with reduced risk of hypertension has not been rigorously investigated in prospective studies. OBJECTIVE This study examined the prospective association between two measures of psychological well being and incident hypertension. METHODS Participants were 6384 healthy British civil servants aged 39-63 from the Whitehall II cohort. Psychological well being (emotional vitality and optimism) and cardiovascular risk factors (demographic characteristics, health status, health behaviors, psychological ill being) were assessed during the 1991-1994 baseline. Incident hypertension was defined by clinical measures of SBP or DBP at least 140/90 mmHg, self-reported physician-diagnosed hypertension, or treatment for hypertension. Follow-up assessments of hypertension took place approximately every 3 years through 2002-2004. Cox proportional hazards regression models estimated hazard ratios. RESULTS There were 2304 cases of incident hypertension during the follow-up period. High versus low emotional vitality was associated with a significantly reduced risk of hypertension in an age-adjusted model (hazard ratio = 0.89; 95% confidence interval 0.80-0.98). This association was maintained after controlling for demographic characteristics and health status, but was slightly attenuated after adjusting for health behaviors and ill being. Optimism was not significantly associated with hypertension. CONCLUSION High emotional vitality was associated with reduced hypertension risk; favorable health behaviors explained only part of the relationship. Associations did not differ by age, were similar for men and women, and were maintained after accounting for ill being.
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Evers KE, Castle PH, Prochaska JO, Prochaska JM. Examining Relationships between Multiple Health Risk Behaviors, Well-Being, and Productivity. Psychol Rep 2014; 114:843-53. [DOI: 10.2466/13.01.pr0.114k25w4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Traditionally, the concept of health promotion has emphasized the reduction of health risk behaviors to reduce disease and impairment. Well-being research expands this focus to include positive constructs such as thriving, productivity, life-evaluation, and emotional and physical health. The objective of the present study was to examine the relationships between health risk behaviors and specific measures of individual well-being. Participants ( N = 790) from 49 states completed a one-time online assessment that included the Life-Evaluation Index, Emotional and Physical Health Ladders, the Health Risk Intervention Assessment, and the Work Productivity and Activity Improvement Questionnaire for General Health. Life Evaluation and physical and emotional health were all inversely related to the number of health risk behaviors, with higher well-being scores associated with lower number of risk behaviors. Across the three Life Evaluation categories (Suffering, Struggling, and Thriving) the number of health risk behaviors decreased, productivity loss decreased, and emotional and physical health increased. The results add to previous research on how reducing multiple health risk behaviors can be combined with well-being, i.e., an emphasis on increasing life-evaluation, emotional and physical health, better functioning, and productivity.
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Affiliation(s)
- Alan Rozanski
- From the Division of Cardiology, Department of Medicine, Mt. Sinai St. Lukes Roosevelt Hospital Center, New York, NY; and the Icahn School of Medicine at Mount Sinai, New York, NY
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Kim ES, Smith J, Kubzansky LD. Prospective study of the association between dispositional optimism and incident heart failure. Circ Heart Fail 2014; 7:394-400. [PMID: 24647117 DOI: 10.1161/circheartfailure.113.000644] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although higher optimism has been linked with an array of positive health behaviors, biological processes, and cardiovascular outcomes, the relationship between optimism and heart failure has not been examined. In the United States, 80% of heart failures occur in adults aged 65+ years. Therefore, we examined whether higher optimism was linked with a reduced incidence of heart failure among older adults. METHODS AND RESULTS Prospective data were from the Health and Retirement Study, a nationally representative study of older US adults. Our sample included 6808 participants who were followed for 4 years. Multiple logistic regression models were used to assess whether optimism was independently associated with incident heart failure. We adjusted for sociodemographic, behavioral, biological, and psychological covariates. Higher optimism was associated with a lower risk of incident heart failure during the follow-up period. In a model that adjusted for sociodemographic factors, each SD increase in optimism had an odds ratio of 0.74 (95% confidence interval, 0.63-0.85) for heart failure. Effects of optimism persisted even after adjusting for a wide range of covariates. There was also evidence of a dose-response relationship. As optimism increased, risk of developing heart failure decreased monotonically, with a 48% reduced odds among people with the highest versus lowest optimism. CONCLUSIONS This is the first study to suggest that optimism is associated with a lower risk of heart failure. If future studies confirm these findings, they may be used to inform new strategies for preventing or delaying the onset of heart failure.
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Affiliation(s)
- Eric S Kim
- From the Department of Psychology (E.S.K., J.S.) and Institute for Social Research (J.S.), University of Michigan, Ann Arbor; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K.).
| | - Jacqui Smith
- From the Department of Psychology (E.S.K., J.S.) and Institute for Social Research (J.S.), University of Michigan, Ann Arbor; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K.)
| | - Laura D Kubzansky
- From the Department of Psychology (E.S.K., J.S.) and Institute for Social Research (J.S.), University of Michigan, Ann Arbor; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K.)
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Abstract
OBJECTIVE Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high-quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information about the association between life satisfaction and health care use is available. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. METHODS Participants were 6379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults older than 50 years. Participants were tracked for 4 years. We analyzed the data using a generalized linear model with a gamma distribution and log link. RESULTS Higher life satisfaction was associated with fewer doctor visits. On a 6-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits--after adjusting for sociodemographic factors (relative risk = 0.89, 95% confidence interval = 0.86-0.93). The most satisfied respondents (n = 1121; 17.58%) made 44% fewer doctor visits than did the least satisfied (n = 182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (relative risk = 0.96, 95% confidence interval = 0.93-0.99). CONCLUSIONS Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs.
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