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Ding S, Ru Y, Wang J, Yang H, Xu Y, Zhou Q, Pan H, Wang M. Effects of episodic future thinking in health behaviors for weight loss: A systematic review and meta-analysis. Int J Nurs Stud 2024; 152:104667. [PMID: 38244405 DOI: 10.1016/j.ijnurstu.2023.104667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/15/2023] [Accepted: 11/30/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Obesity and related diseases have become one of the leading causes of death worldwide, which has been linked to biopsychosocial effects such as type 2 diabetes, cardiovascular disease, various cancers, depression, and weight stigma. Episodic future thinking (EFT) has been found to support the development of changes in health behaviors. However, the effectiveness of EFT in enhancing weight loss behavior and health outcomes is not well supported. OBJECTIVE To establish implementation options for the EFT intervention, and critically synthesize the data that assesses the impact of EFT on weight loss behavior and health outcomes. METHODS Searches were performed across 5 Chinese and 9 English databases systematically from inception to March 2023. Randomized controlled trials, written in English or Chinese were included. Two independent reviewers evaluated all relevant studies, who also assessed the risk of bias, and extracted the data. Meta-analyses were conducted using Review Manager 5.4.1. The quantity of evidence's certainty was assessed using the Risk bias assessment tool RoB2 (revised version 2019). This study was registered in PROSPERO. RESULTS A total of 1740 participants were included, and 18 studies were eligible for inclusion. Meta-analysis reported a statistically significant effect size favoring EFT on delay discounting (AUC) (MD = 0.1, 95 % CI: [0.02, 0.17], P = 0.01; I2 = 73 %), delay discounting (K) (MD = -0.85, 95 % CI: [-1.44, -0.26], P = 0.005; I2 = 77 %), energy intake (MD = -107.59, 95 % CI: [-192.21, -22.97], P = 0.01; I2 = 57 %), grocery purchased (SMD: -0.91, 95 % CI:[-1.48, -0.34], P = 0.002; I2 = 63 %), and BMI (MD = -2.73, 95 % CI: [-5.13, -0.32], P = 0.03; I2 = 0 %, two studies). CONCLUSIONS EFT was found to have favorable effects on delay discounting, energy intake, grocery purchased, and BMI of individuals. The presence of high heterogeneity is evident in most of the outcomes. The modalities of EFT intervention are still in the exploratory phase, there is no consensus on the valence, context type, longest delay time, and practice strategy, and it needs to be further explored for different populations. It is anticipated that additional well-designed studies will continue developing high-quality evidence in this field.
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Affiliation(s)
- Shanni Ding
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Yifan Ru
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jinrui Wang
- Zhejiang University, Hangzhou, Zhejiang, China
| | - Haili Yang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yihong Xu
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qianya Zhou
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hongying Pan
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Manjun Wang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Ferrante MJ, McGovern L, Epstein LH, Hollis-Hansen K, Leone LA, Anzman-Frasca S. Optimal Defaults in Online Grocery Shopping: A Secondary Analysis to Explore Impacts in Multiresident Households and Families. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00007-1. [PMID: 38416095 DOI: 10.1016/j.jneb.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To examine whether household type (eg, families with children) moderated the effects of an optimal defaults grocery intervention and examine intervention effects on grocery purchases to be consumed by the participant vs others in the household. METHODS Participants (n = 65) diagnosed with or at risk for type 2 diabetes were recruited and randomized into an optimal default online grocery intervention or an online or in-person control group. Grocery receipt data were coded into Dietary Approaches to Stop Hypertension nutritional quality scores, and energy, carbohydrate, and sugar content were calculated. Repeated measures analysis of variance examined household types (eg, single vs multi-resident) as moderators of intervention effects. Parallel models explored foods purchased for the participant and foods purchased for other household members separately. RESULTS Household type was not a significant moderator of intervention effects on nutritional quality or other nutrients of interest (P > 0.10). The default intervention significantly increased the nutritional quality of groceries purchased across household types and for other household members besides the participant (P < 0.05). CONCLUSIONS AND IMPLICATIONS Optimal defaults may improve grocery purchases across different household types and extend to others in the household, supporting use across household types.
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Affiliation(s)
- Mackenzie J Ferrante
- Department of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ
| | - Lily McGovern
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY
| | - Kelseanna Hollis-Hansen
- Peter O'Donnell Jr, School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX
| | - Lucia A Leone
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY; Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY.
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Persson DR, Bardram JE, Bækgaard P. Perceptions and effectiveness of episodic future thinking as digital micro-interventions based on mobile health technology. Digit Health 2024; 10:20552076241245583. [PMID: 38577315 PMCID: PMC10993675 DOI: 10.1177/20552076241245583] [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] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Abstract
Objective Delay discounting denotes the tendency for humans to favor short-term immediate benefits over long-term future benefits. Episodic future thinking (EFT) is an intervention that addresses this tendency by having a person mentally "pre-experience" a future event to increase the perceived value of future benefits. This study explores the feasibility of using mobile health (mHealth) technology to deliver EFT micro-interventions. Micro-interventions are small, focused interventions aiming to achieve goals while matching users' often limited willingness or capacity to engage with interventions. We aim to explore whether EFT delivered as digital micro-interventions can reduce delay discounting, the users' perceptions, and if there are differences between regular EFT and goal-oriented EFT (gEFT), a variant where goals are embedded into future events. Method A randomized study was conducted with 208 participants allocated to either gEFT, EFT, or a control group for a 21-day study. Results Results indicate intervention groups when combined achieved a significant reduction of Δ log k = - .80 in delay discounting (p = .017 ) compared to the control. When split into gEFT and EFT separately only the reduction of Δ log k = .96 in EFT delay discounting was significant (p = .045 ). We further explore and discuss thematic user perceptions. Conclusions Overall, user perceptions indicate gEFT may be slightly better for use in micro-interventions. However, perceptions also indicate that audio-based EFT micro-interventions were not always preferable to users, with findings suggesting that future EFT micro-interventions should be delivered using different forms of multimedia based on user preference and context and supported by other micro-interventions to maintain interest.
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Affiliation(s)
- Dan Roland Persson
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Denmark
| | - Jakob E. Bardram
- Department of Health Technology, Technical University of Denmark, Denmark
| | - Per Bækgaard
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Denmark
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Brown JM, Bickel WK, Epstein LH, Stein JS. Episodic future thinking in type 2 diabetes: Further development and validation of the Health Information Thinking control for clinical trials. PLoS One 2023; 18:e0289478. [PMID: 37535609 PMCID: PMC10399790 DOI: 10.1371/journal.pone.0289478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/19/2023] [Indexed: 08/05/2023] Open
Abstract
Episodic Future Thinking (EFT) reduces delay discounting and may have the potential as a clinical tool to increase the likelihood of health-promoting behaviors. However, evaluations of EFT in clinical settings require control conditions that match the effort and frequency of cue generation, as well as participants' expectations of improvement. The Health Information Thinking (HIT) control addresses these issues, but how this control affects delay discounting in individuals with diabetes and obesity when utilizing diabetes-management specific health-information vignettes is unknown. Moreover, little research has explored whether EFT reduces delay discounting in individuals with type 2 diabetes. To this end, we examined the impact of EFT, HIT, and a secondary no-cue control condition (NCC; assessments as usual) on delay discounting in 434 adults with self-reported type 2 diabetes and obesity recruited using Amazon Mechanical Turk. After completing an initial screening questionnaire, eligible participants reported demographics, then were randomized to EFT, HIT, or NCC conditions. Following the generation of seven EFT or HIT cues, participants assigned to EFT or HIT conditions completed a delay discounting task while imagining EFT or HIT cues; no-cue participants completed the task without cues. EFT participants demonstrated significantly lower delay discounting levels than HIT or NCC participants; no differences in delay discounting between HIT and NCC participants were observed. These results suggest that engaging in EFT, but not diabetes-specific HIT, results in lower delay discounting in adults with type 2 diabetes and obesity. This provides further evidence for the appropriateness of the HIT control for clinical trials examining the effect of EFT on delay discounting in adults with self-reported type 2 diabetes.
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Affiliation(s)
- Jeremiah M. Brown
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, United States of America
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, United States of America
| | - Warren K. Bickel
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, United States of America
| | - Leonard H. Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America
| | - Jeffrey S. Stein
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, United States of America
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, United States of America
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Kakoschke N, Cox DN, Ryan J, Gwilt I, Davis A, Jansons P, de Courten B, Brinkworth G. Disrupting future discounting: a commentary on an underutilised psychological approach for improving adherence to diet and physical activity interventions. Public Health Nutr 2023; 26:1088-1093. [PMID: 36786324 PMCID: PMC10346014 DOI: 10.1017/s136898002200252x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/09/2022] [Accepted: 11/21/2022] [Indexed: 02/15/2023]
Abstract
Non-communicable diseases (NCD) such as CVD and type 2 diabetes mellitus are major contributors to the burden of disease. NCD are largely driven by modifiable lifestyle factors including poor diet and insufficient physical activity, and consequently, prevention is a public health priority. Although diet and physical activity levels can be improved via lifestyle interventions, long-term adherence to such interventions remains low, which limits their effectiveness. Thus, it is critical to identify the underlying mechanisms that challenge uptake and adherence to such interventions. The current commentary discusses an important, but underexplored, psychological driver of poor adherence to lifestyle interventions, namely, future discounting, which describes the tendency to prefer smaller, short-term rewards over larger, long-term rewards. For example, in the nutrition domain, future discounting refers to valuing the immediate reward of excessive intake of energy-dense, nutrient-poor, discretionary foods high in salt, sugar, and saturated fat, and insufficient intake of low-energy, nutrient-dense, whole foods such as vegetables. Prominent theoretical models propose that excessive future discounting is a major contributor to the development of unhealthy lifestyle behaviours. Furthermore, a vast body of evidence suggests that future discounting plays a key role in risk of NCD. Thus, the evidence to date supports the idea that future discounting is an important multi-behaviour target for supporting lifestyle behaviour change; however, this approach has been largely neglected in preventive health efforts. Furthermore, this commentary discusses promising techniques (e.g. Episodic Future Thinking) for disrupting future discounting to promote improved adherence to lifestyle interventions aimed at reducing NCD risk.
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Affiliation(s)
- Naomi Kakoschke
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
| | - David N Cox
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
| | - Jillian Ryan
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
- BVA BDRC, Sydney, Australia
| | - Ian Gwilt
- UniSA Creative, The University of South Australia, Adelaide, Australia
| | - Aaron Davis
- UniSA Creative, The University of South Australia, Adelaide, Australia
| | - Paul Jansons
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | | | - Grant Brinkworth
- Human Health, CSIRO Health & Biosecurity, SAHMRI, North Terrace, Adelaide5000, Australia
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Brown JM, Stein JS. Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors. Front Public Health 2022; 10:1020171. [PMID: 36408004 PMCID: PMC9669959 DOI: 10.3389/fpubh.2022.1020171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
In recent years, episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors; however, considerable methodological heterogeneity in methods for eliciting engagement in EFT has been observed in prior research. In this narrative review, we briefly describe methods for generating EFT cues, the content of EFT cues, common control conditions for experiments utilizing EFT, and considerations for cue delivery and implementation. Where possible, we make suggestions for current best practices in each category while identifying gaps in knowledge and potential areas of future research. Finally, we conclude by using the NIH Stage model to better frame the current state of the literature on EFT and propose gaps to be addressed if EFT is to be both an efficacious and effective behavioral intervention.
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Affiliation(s)
- Jeremiah Michael Brown
- Fralin Biomedical Research Institute, Virginia Tech Carilion, Roanoke, VA, United States
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA, United States
| | - Jeffrey Scott Stein
- Fralin Biomedical Research Institute, Virginia Tech Carilion, Roanoke, VA, United States
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA, United States
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Baldwin AS, Lamb CL, Geary BA, Mitchell AD, Kouros CD, Levens S, Martin LE. Testing and Optimizing Guided Thinking Tasks to Promote Physical Activity: Protocol for a Randomized Factorial Trial (Preprint). JMIR Res Protoc 2022; 11:e40908. [PMID: 36074550 PMCID: PMC9501674 DOI: 10.2196/40908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration International Registered Report Identifier (IRRID)
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Affiliation(s)
- Austin S Baldwin
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Colin L Lamb
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Bree A Geary
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Alexis D Mitchell
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Chrystyna D Kouros
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Sara Levens
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Laura E Martin
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
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Horgan OZ, Crane NT, Forman EM, Milliron BJ, Simone NL, Zhang F, Butryn ML. Optimizing an mHealth Intervention to Change Food Purchasing Behaviors for Cancer Prevention: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e39669. [PMID: 35749216 PMCID: PMC9270710 DOI: 10.2196/39669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dietary intake is a powerful modifiable factor that influences cancer risk; however, most US adults do not adhere to dietary guidelines for cancer prevention. One promising pathway for improving dietary adherence is targeting grocery shopping habits. Interventions might facilitate healthy grocery choices, with a combination of mHealth and traditional methods, by promoting the salience of dietary goals while shopping, enhancing motivation to make dietary changes, and increasing household support for healthy food purchasing. OBJECTIVE This pilot study will assess feasibility and acceptability of intervention components designed to improve adherence to dietary guidelines for cancer prevention (preliminary aim). The primary aim of the study is to quantify the effect of each intervention component, individually and in combination, on dietary intake (primary aim) and grocery store food purchases (exploratory aim). Mediation analyses will be conducted to understand the mechanisms of action (goal salience, motivation, and household support-secondary aims). The overarching goal is to optimize an mHealth intervention to be tested in a future fully powered clinical trial. METHODS The study enrolled adults (N=62) with low adherence to dietary recommendations for cancer prevention. In a 20-week program, all participants attend a nutrition education workshop and receive weekly educational messages through an app. A factorial design is used to test 4 intervention components: (1) location-triggered messages: educational messages are delivered when arriving at grocery stores; (2) reflections on the benefits of change: content is added to messages to encourage reflection on anticipated benefits of healthy eating, and participants attend an additional workshop session and 3 coach calls on this topic; (3) coach monitoring: food purchases are monitored digitally by a coach who sends personalized weekly app messages and conducts 3 coaching calls that focus on feedback about purchases; and (4) household support: another adult in the household receives messages designed to elicit support for healthy food purchasing, and support is addressed in 3 coach calls and an extra workshop session attended by the index participant and household member. Assessments are completed at weeks 0, 10, and 20 using self-report measures, as well as objective capture of grocery data from the point of purchase using store loyalty accounts. RESULTS The National Cancer Institute funded this study (R21CA252933) on July 7, 2020. Participant recruitment began in the spring of 2021 and concluded with the successful enrollment of 62 participants. Data collection is expected to be completed in the summer of 2022, and results are expected to be disseminated in the summer of 2023. CONCLUSIONS The results of this study will inform the development of scalable interventions to lower cancer risk via changes in dietary intake. TRIAL REGISTRATION ClinicalTrials.gov NCT04947150; https://clinicaltrials.gov/ct2/show/NCT04947150. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39669.
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Affiliation(s)
- Olivia Z Horgan
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Nicole T Crane
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, United States
| | - Nicole L Simone
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
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Sukumar JS, Vaughn JE, Tegge A, Sardesai S, Lustberg M, Stein J. Delay Discounting as a Potential Therapeutic Target for Weight Loss in Breast Cancer Survivors. Cancers (Basel) 2022; 14:cancers14051134. [PMID: 35267441 PMCID: PMC8909266 DOI: 10.3390/cancers14051134] [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: 01/03/2022] [Revised: 02/10/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity in breast cancer (BC) survivors is associated with increased mortality. Delay discounting (DD) is a behavioral economic measure of how individuals value future outcomes. Higher DD correlates with obesity in the general population. Valuation of the future may be associated with obesity differently in cancer survivors. This study evaluated the relationship between DD and obesity in BC survivors. We report an exploratory analysis assessing cross-sectional associations between DD, BMI, and lifestyle behaviors (vegetable and fruit consumption, exercise) related to obesity in 89 women with hormone receptor positive non-metastatic BC. Multivariate linear regression analysis examined demographic and lifestyle behavior variables associated with both BMI and DD. Greater willingness to wait for larger, delayed rewards (lower DD) was significantly associated with lower BMI (standardized beta = −0.32; p < 0.01), independent of age, race, income, time since diagnosis, and menopausal status. There was no significant association between DD and fruit consumption or exercise frequency. Vegetable consumption was significantly associated with lower DD (standardized beta = 0.24; p < 0.05). Higher DD is associated with obesity and decreased frequency of vegetable consumption in BC survivors. Future studies should investigate DD as a therapeutic target for behavioral interventions to facilitate weight loss and promote longevity in this population.
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Affiliation(s)
- Jasmine S. Sukumar
- Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43221, USA; (J.S.S.); (S.S.)
- Stefanie Spielman Comprehensive Breast Center, The Ohio State University, Columbus, OH 43212, USA
| | - Jennifer E. Vaughn
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
- Correspondence: ; Tel.: +1-614-293-5655
| | - Allison Tegge
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA 24016, USA; (A.T.); (J.S.)
- Department of Statistics, Virginia Tech, Roanoke, VA 24060, USA
| | - Sagar Sardesai
- Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43221, USA; (J.S.S.); (S.S.)
- Stefanie Spielman Comprehensive Breast Center, The Ohio State University, Columbus, OH 43212, USA
| | - Maryam Lustberg
- Division of Medical Oncology, Yale Comprehensive Cancer Center, New Haven, CT 06510, USA;
| | - Jeffrey Stein
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at VTC, Virginia Tech, Roanoke, VA 24016, USA; (A.T.); (J.S.)
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Roanoke, VA 24061, USA
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August KJ, Novak JR, Peak T, Gast J, Miyairi M. Examining foodwork and eating behaviors among heterosexual and gay male couples. Appetite 2022; 172:105953. [PMID: 35121054 DOI: 10.1016/j.appet.2022.105953] [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: 12/08/2021] [Revised: 01/14/2022] [Accepted: 01/29/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Spouses play an important role in their partner's eating behaviors, including both promoting and impeding healthy eating. The division of foodwork in the relationship (i.e., if there is individual or shared responsibility for food roles) may vary as a function of gender or sexual orientation and may be important in understanding eating behaviors. METHOD Using cross-sectional, dyadic data from 462 heterosexual and gay married couples (N = 921 individuals) residing in the United States, we accordingly sought to examine which partner was most responsible for two food roles, food shopping and meal preparation (Aim 1); whether these roles differed by gender (Aim 1a) and sexual orientation (Aim 1b); whether these food roles were related to the frequency of eating healthy and unhealthy foods (Aim 2); and whether these associations differed by gender (Aim 2a) and sexual orientation (Aim 2b). RESULTS We found that one individual was responsible for these roles in a majority of couples, although meal preparation was more likely to be shared in gay than in heterosexual couples. We also found that, in general, the person responsible for these food roles ate healthy more frequently compared to when their partner was responsible; findings for shared responsibility were more equivocal. These associations did not differ, however as a function of gender or sexual orientation. CONCLUSION Our findings contribute to a further understanding of food dynamics among heterosexual and gay male couples and have important implications for health promotion and intervention efforts.
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Affiliation(s)
- Kristin J August
- Department of Psychology and Health Sciences Center, Rutgers University, Camden, 311 N. Fifth Street, Camden, NJ, 08102, USA.
| | - Josh R Novak
- Department of Human Development and Family Science, Auburn University, 312 Quad Drive, Auburn, AL, 36849, USA.
| | - Terry Peak
- Department of Social Work, Utah State University, Old Main 239, 0730 Old Main Hill, Logan, UT, 85322, USA.
| | - Julie Gast
- Department of Kinesiology and Health Science, Utah State University, 7000 Old Main Hill, Logan, UT, 84322, USA.
| | - Maya Miyairi
- Department of Kinesiology and Health Science, Utah State University, 989 S. Main Street, Brigham City, UT, 84302, USA.
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Effects of 6-month episodic future thinking training on delay discounting, weight loss and HbA1c changes in individuals with prediabetes. J Behav Med 2022; 45:227-239. [PMID: 35006500 PMCID: PMC8744570 DOI: 10.1007/s10865-021-00278-y] [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] [Received: 06/02/2021] [Accepted: 12/22/2021] [Indexed: 12/22/2022]
Abstract
People with prediabetes are at risk for type 2 diabetes. They may discount the future delay discounting (DD), and not engage in preventive health behaviors. Episodic future thinking (EFT) can reduce DD when future scenarios are cued, but research is needed to assess long-term effects of EFT and when EFT is not cued. This study tested EFT training compared to control for people with prediabetes enrolled in a 6-month weight loss program on DD, weight, HbA1c, and physical activity. Results showed a reliable EFT effect on reducing DD in cued (p = 0.0035), and uncued DD tasks (p = 0.048), and significant overall changes in weight (p < 0.001), HbA1c (p, 0.001) and physical activity (p = 0.003), but no significant differences in these outcomes by group (p’s > 0.05). Sixty-eight percent of the sample ended below the prediabetes HbA1c range. These results suggest that DD can be modified over extended periods, and the effects of EFT can be observed without EFT cues. However, these data do not suggest that changes in weight, HbA1c or physical activity were due to EFT training. The study was initiated before the COVID-19 pandemic which provided the opportunity to compare differences for people treated in-person or remotely. Analyses showed no differences in DD, weight, HBA1c or physical activity outcomes were observed between in-person and remote treatment, suggesting telehealth is a scalable approach to treating prediabetes.
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Abstract
Context Online grocery services are an emerging component of the food system with the potential to address disparities in access to healthy food. Objective We assessed the barriers and facilitators of equitable access to healthy foods in the online grocery environment, and the psychosocial, purchasing, and dietary behaviors related to its use among low-income, diverse populations. Data Sources Four electronic databases were searched to identify relevant literature; 16 studies were identified. Results Barriers to equitable access to healthy food included cost and limited availability of online grocery services in food deserts and rural areas. The expansion of online grocery services and the ability to use nutrition assistance benefits online were equity-promoting factors. Perceived low control over food selection was a psychosocial factor that discouraged online grocery use, whereas convenience and lower perceived stress were facilitators. Findings were mixed regarding healthfulness of foods purchased online. Although few studies assessed diet, healthy food consumption was associated with online grocery use. Conclusion Researchers should assess the impact of online grocery shopping on low-income families’ food purchases and diet. Systematic Review Registration PROSPERO registration no. CRD: 42021240277
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Affiliation(s)
- Angela C B Trude
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- A.C.B. Trude, 411 Lafayette St, New York, NY 10003, USA. E-mail:
| | - Caitlin M Lowery
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, New York, USA
| | - Gabriela M Vedovato
- Institute of Health and Society, Federal University of Sao Paulo, Santos, Sao Paulo, Brazil
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13
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Stein JS, Madden GJ. Choice bundling, unpacked: Observed and predicted effects on intertemporal choice in an additive model of hyperbolic delay discounting. PLoS One 2021; 16:e0259830. [PMID: 34767599 PMCID: PMC8589209 DOI: 10.1371/journal.pone.0259830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 10/27/2021] [Indexed: 11/18/2022] Open
Abstract
One method known to increase preference for larger, later rewards (LLRs) over smaller, sooner rewards (SSRs) is choice bundling, in which a single choice produces a series of repeating consequences over time. The present study examined whether effects of choice bundling on preference for LLRs: (1) increase with the number of rewards in the bundle (i.e., bundle size); (2) are independent of differences in reward magnitude between conditions; and (3) accord with predictions of an additive model of hyperbolic delay discounting, in which the value of a bundle of rewards can be expressed as the summed discounted value of all rewards in that bundle. Participants (N = 252) completed a choice task to assess valuation of monetary LLRs at bundle sizes of 1 (control), 3, and 9 rewards per choice (ascending/descending order counterbalanced). To control for the magnitude effect, the total reward amounts were held constant across conditions. Choice bundling significantly increased LLR preference (p < .001), with the largest effect observed at the largest bundle size. The descending bundle-size order produced significantly greater LLR preference than the ascending order (p < .05), although order did not significantly interact with bundle size. Difference scores between observed measures and those predicted by an additive model of hyperbolic discounting were small and not significantly different than zero, but were not equivalent to zero. Future research should investigate the clinical utility of choice bundling for reducing the maladaptive health behavior (e.g., substance use) with which delay discounting is associated.
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Affiliation(s)
- Jeffrey S. Stein
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, United States of America
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, United States of America
- * E-mail:
| | - Gregory J. Madden
- Department of Psychology, Utah State University, Logan, Utah, United States of America
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Epstein LH, Jimenez-Knight T, Honan AM, Biondolillo MJ, Paluch RA, Bickel WK. A story to tell: the role of narratives in reducing delay discounting for people who strongly discount the future. Memory 2021; 29:708-718. [PMID: 34080492 PMCID: PMC8461562 DOI: 10.1080/09658211.2021.1936560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
Delay Discounting (DD) or devaluing a future, larger reward in favour of a smaller, more immediate reward, has been linked to negative health behaviours. One intervention that reduces DD is Episodic Future Thinking (EFT). EFT has participants generate cues representing positive future events that correspond to temporal windows during the DD task. The current study examined if incorporating EFT cues into narratives would strengthen effects on DD. One hundred and sixty adults were recruited from Amazon Mechanical Turk and were randomised to traditional or narrative EFT. Results showed that participants in narrative EFT discounted the future less (p = 0.034) than participants who engaged in traditional EFT. This novel approach to EFT is well grounded in research and theory on the power of narratives to influence behaviour and can open a new window into ways to reduce DD to strengthen engagement in positive choices.
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Affiliation(s)
- Leonard H Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Tatiana Jimenez-Knight
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Anna M Honan
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Mathew J Biondolillo
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Rocco A Paluch
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
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15
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Carr KA, Hollis-Hansen K, Austin K, Epstein LH. Written or drawn episodic future thinking cues improves delay discounting in adults. LEARNING AND MOTIVATION 2021; 74. [DOI: 10.1016/j.lmot.2021.101727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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16
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Athamneh LN, Stein MD, Lin EH, Stein JS, Mellis AM, Gatchalian KM, Epstein LH, Bickel WK. Setting a goal could help you control: Comparing the effect of health goal versus general episodic future thinking on health behaviors among cigarette smokers and obese individuals. Exp Clin Psychopharmacol 2021; 29:59-72. [PMID: 32191071 PMCID: PMC7501169 DOI: 10.1037/pha0000351] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Episodic Future Thinking (EFT) reduces delay discounting (DD; preference for smaller, immediate rewards) and various maladaptive behaviors. Exploring potential personalization of EFT to optimize its ability to alter DD and demand for unhealthy reinforcers is important for the development of interventions targeting long-term improvement and maintenance of health. In this investigation, using 2 separate studies, we examined the effects of EFT with and without a health goal on rates of discounting, demand, and craving for cigarettes and fast food among cigarette smokers and obese individuals, respectively. Using data collected from Amazon Mechanical Turk (mTurk), Study 1 (N = 189) examined the effect of EFT on DD and measures of cigarette demand and craving in cigarette smokers who were randomly assigned to 1 of 3 conditions: EFT-health goal, EFT-general, or Episodic Recent Thinking (ERT)-general. Study 2 (N = 255), using a 2x2 factorial design, examined the effects of health goals and general EFT on DD and measures of fast food demand and craving in obese individuals who were randomly assigned to 1 of 4 conditions: EFT-health goal, EFT-general, ERT-health goal or ERT-general. Health goal EFT was not more effective than general EFT in reducing monetary discounting. However, the addition of a health goal to general EFT was significantly associated with higher effect on intensity and elasticity of demand for cigarettes and fast food compared to EFT without a health goal. These findings suggest that the amplification of future thinking through the inclusion of a health goal may promote healthy decisions and result in positive behavior changes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Elysia H Lin
- Center for Transformative Research on Health Behaviors
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17
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Bauer KW, Hilliard ME, Albright D, Lo SL, Fredericks EM, Miller AL. The Role of Parent Self-Regulation in Youth Type 1 Diabetes Management. Curr Diab Rep 2020; 20:37. [PMID: 32638126 PMCID: PMC8018188 DOI: 10.1007/s11892-020-01321-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Youth with strong self-regulation (SR), or the ability to manage thoughts, emotions, and behaviors, engage in more effective type 1 diabetes (T1D) management. However, while parent support and engagement are critical to ensuring positive youth T1D outcomes, it is rarely considered that parents' SR may also influence youth T1D management. If this is the case, novel interventions to improve parents' SR or ensure adequate support for parents with SR challenges offer great potential to improve family functioning and youth T1D management. RECENT FINDINGS Theoretical and preliminary empirical evidence suggests that parental SR impacts family processes that support youth T1D treatment regimen adherence. Furthermore, parent and youth SR likely interact, with high parent SR enhancing the positive effects of high youth SR or compensating for low youth SR. Continued research is needed to better understand the ways in which parent SR matters to youth T1D management and identify how to support improvements in T1D management among families of parents with low SR.
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Affiliation(s)
- Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, 3854 SPH I, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Dana Albright
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sharon L Lo
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Emily M Fredericks
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
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18
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Hollis-Hansen K, Seidman J, O'Donnell S, Epstein LH. Mothers' DASH diet adherence and food purchases after week-long episodic future thinking intervention. Appetite 2020; 154:104757. [PMID: 32522591 DOI: 10.1016/j.appet.2020.104757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/29/2020] [Accepted: 06/03/2020] [Indexed: 12/22/2022]
Abstract
Prospection has helped participants forego the temptation to buy and eat higher calorie nutrient poor foods in favor of buying and eating fewer calories and healthier macronutrient profiles in laboratory tasks and brief field studies. This pilot study examines whether episodic future thinking (EFT) improves mothers' dietary behavior and food purchasing over a longer 7-10-day period. The study utilized a 2 × 2 factorial design with mothers (N = 60) randomized to EFT or standardized episodic thinking (SET) crossed with dietary approaches to stop hypertension (DASH) diet education or a food safety education control. Participants listened to their cues (e.g., recordings of themselves imagining a future event or recalling a past episode) using a mobile ecological momentary intervention (EMI) tool and returned to complete a follow-up dietary recall and submit food receipts. Results showed diets of mothers in the EFT groups became more concordant with the DASH diet (ηp2 = 0.08, p < .05) than mothers in the SET group. When considering food purchases for the family, there was an EFT effect on milligrams of sodium purchased (ηp2 = 0.07, p < .05) and a trend towards a decrease in grams of fat purchased (ηp2 = 0.06, p = .06), however, these findings were no longer significant after correcting for multiple comparisons. There were no DASH education effects and no DASH by EFT interactions observed. The dietary intake and food purchasing results should be replicated in larger more representative samples.
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Affiliation(s)
- Kelseanna Hollis-Hansen
- Department of Population Health, University of Texas at Austin, Dell Medical School, Austin, TX, USA; University of Texas at Austin, Steve Hicks School of Social Work, Austin, TX, USA.
| | - Jennifer Seidman
- Department of Pediatrics, Division of Behavioral Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Sara O'Donnell
- Department of Pediatrics, Division of Behavioral Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Leonard H Epstein
- Department of Pediatrics, Division of Behavioral Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
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Hollis-Hansen K, Seidman J, O'Donnell S, Wedderburn A, Stanar S, Brande S, Epstein LH. An ecological momentary episodic future thinking intervention on mother's weekly food purchases. Health Psychol 2019; 39:159-167. [PMID: 31682147 DOI: 10.1037/hea0000817] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Imagining one's own future (episodic future thinking, EFT) has helped mothers with overweight purchase healthier groceries during an online shopping task in the laboratory. The present study explored whether delivering an EFT intervention to participants' devices via an ecological momentary intervention (EMI) tool would help mothers purchase healthier food at brick-and-mortar stores. METHOD Participants (N = 43, mothers 31-52 years of age, BMI ≥ 24.9 kg/m2) were randomized to EFT or standardized episodic thinking (SET). EFT cues include a positive and vivid description of future events while SET cues focus on the recent experience of playing games in the laboratory. Cues were uploaded to participant profiles on an EMI site. Participants were trained on how to read and listen to cues as well as how to detail purchases. Participants received text reminders to listen to cues before shopping and returned with receipts the following day. Receipt data was analyzed to derive dependent variables, calories, and nutrients purchased per person. Correlations were used to analyze associations between study variables of interest, and ANOVAs were conducted to compare dietary variables by group. RESULTS Participants in the EFT group purchased fewer calories, fewer grams of fat, fewer grams of saturated fat, and fewer miligrams of sodium than participants in the SET control group. CONCLUSION Delivering EFT cues to participant devices may be a promising way to improve the calorie and nutrient content of food purchases. Future research should include a longer follow-up and analyze calorie changes over time. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Kelseanna Hollis-Hansen
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Jennifer Seidman
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Sara O'Donnell
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Amber Wedderburn
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Sanja Stanar
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Spencer Brande
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
| | - Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo
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20
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Hollis-Hansen K, O’Donnell SE, Seidman JS, Brande SJ, Epstein LH. Improvements in episodic future thinking methodology: Establishing a standardized episodic thinking control. PLoS One 2019; 14:e0214397. [PMID: 30921384 PMCID: PMC6438451 DOI: 10.1371/journal.pone.0214397] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 03/12/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Delay discounting (DD) is the choice of a smaller immediate reward over a larger delayed reward, which has been associated with a number of maladaptive behaviors. Episodic future thinking (EFT), the ability to project oneself into the future, is an intervention designed to reduce DD. EFT has reliable effects on DD, but the size of the effect varies, which could be due in part to the use of different control groups. Episodic recent thinking (ERT) serves as a common control for many EFT studies, but the temporal window of "recent" cues ranges from 24 hours ago to 12 days past. Since prior research has shown that retrospection can lead to prospection, it may be important to ensure that EFT controls do not inadvertently lead to prospection for some participants thereby increasing the variability of the control condition. The present study sought to develop a comparison group that standardizes the time frame and experiences that are the basis for the recent thinking control. METHODS Participants (n = 53, 18-45) were randomized to one of three conditions: EFT, ERT, or standardized episodic thinking (SET). Participants attended a laboratory appointment where they played mobile application games, created cues, and completed a DD task. RESULTS There was a significant difference between groups (p<0.05), with EFT reducing discounting more than either control (p<0.05), and no differences between ERT and SET (p>0.05). CONCLUSION This study established that SET provides an alternative control in EFT studies and provides the advantage of standardizing the participant's recent experience without changing the relationship between EFT and recent thinking controls.
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Affiliation(s)
- Kelseanna Hollis-Hansen
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, New York, United States of America
| | - Sara E. O’Donnell
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America
| | - Jennifer S. Seidman
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America
| | - Spencer J. Brande
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America
| | - Leonard H. Epstein
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America
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Role of delay discounting in predicting change in HBA1c for individuals with prediabetes. J Behav Med 2019; 42:851-859. [PMID: 30903441 DOI: 10.1007/s10865-019-00026-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/09/2019] [Indexed: 01/09/2023]
Abstract
The majority of people with prediabetes transition to type 2 diabetes. Weight gain is a known predictor of increasing the risk of diabetes, but another reason may be a focus on immediate rewards and discounting of the future. Delay discounting (DD: devaluation of future consequences) is related to obesity and poor glycemic control in persons with type 2 diabetes. This study was designed to assess whether changes in DD are associated with HbA1c change beyond BMI change in individuals with prediabetes. Hierarchical regression showed changes in BMI (p = 0.008) and the $1000 DD task (p = 0.04) were associated with HbA1c change beyond demographic characteristics, with the full model accounting for 25.8% of the variance. Those with greater BMI increases and greater increases in discounting of the future showed the greatest increases in HbA1c. DD represents a novel target to prevent progression from prediabetes to type 2 diabetes.
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