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Bueno de Mesquita CP, Vimercati Molano Y, Vimercati L, de Mesquita PJB. Using Evidence-based Scientific Research to Influence Dietary Behavioral Change: Taking a Look in the Mirror. New Solut 2024; 34:10-21. [PMID: 38426812 DOI: 10.1177/10482911241235380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Science can provide accurate information to society to inform decision-making and behavior. One contemporary topic in which the science is very clear, yet behavioral change has lagged, is climate change mitigation. Climate change scientists use evidence-based research to advocate to the public to adopt emission-reducing behaviors in various sectors such as transportation and food. However, scientists themselves often do not change their own behaviors according to the scientific consensus. We present a case study of a group of natural sciences PhD students, who, when presented with evidence and an opportunity for a behavioral change with implications for climate change mitigation, demonstrated defensive reactions that would undoubtedly frustrate these same scientists if they were doing public outreach about their own work. Our goal is to raise awareness that we scientists do not always practice what we preach but could perhaps overcome this by understanding the defense mechanisms that impede meaningful change.
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Affiliation(s)
| | | | - Lara Vimercati
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, CO, USA
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Pinna S, Longo D, Zanobini P, Lorini C, Bonaccorsi G, Baccini M, Cecchi F. How to communicate with older adults about climate change: a systematic review. Front Public Health 2024; 12:1347935. [PMID: 38638477 PMCID: PMC11025664 DOI: 10.3389/fpubh.2024.1347935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction Although older adults are particularly vulnerable to the effects of climate change, they seem to be overall less concerned about it, and less inclined to support climate policies. The study aims to identify the communication strategies that have been evaluated in promoting awareness and/or climate friendly behaviors in older adults. Methods We searched multiple electronic databases for studies that evaluated the effects of any interventions aimed at communicating climate change to older persons (over 65 years) and assessed the results as awareness and /or behavioral changes. We selected quantitative, qualitative and mixed methods studies, and we also included systematic reviews for cross-referencing. Risk of bias of included studies was evaluated using different tools according to the study design. Results From a total of 5,486 articles, only 3 studies were included. One mixed-method study engaged older adults to assess the community vulnerability to climate change and to develop adaptation recommendations based on their perspectives; one qualitative study conducted focus groups to identify the more effective language, values and themes based on participants' responses to narratives; one quantitative study utilized a 360-degree audio-visual platform allowing users to engage with immersive visualizations of sea-level rise scenarios. Discussion Despite the paucity of literature, this review demonstrates the potential for different strategies to increase the awareness of older persons about climate change. The involvement of older adults in the communication process, the identification of their priorities, and the integration of technology in their daily lives are promising approaches but more research, including both quantitative and qualitative studies is recommended on this topic. Systematic review registeration For further details about the protocol, this systematic review has been registered on PROSPERO on July 1, 2023 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023438256).
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Affiliation(s)
- Samuele Pinna
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Fondazione don Carlo Gnocchi, Scientific Institute, Florence, Italy
| | - Diego Longo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Patrizio Zanobini
- Department of Health Science, University of Florence, Florence, Italy
| | - Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy
| | | | - Marco Baccini
- Fondazione don Carlo Gnocchi, Scientific Institute, Florence, Italy
| | - Francesca Cecchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Fondazione don Carlo Gnocchi, Scientific Institute, Florence, Italy
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Lev-Arey D, Gutman T, Levental O. Empowering Movement: Enhancing Young Adults' Physical Activity through Self-Determination Theory and Acceptance and Commitment Therapy-Based Intervention. Behav Sci (Basel) 2024; 14:130. [PMID: 38392483 PMCID: PMC10885898 DOI: 10.3390/bs14020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE This study aims to investigate the effectiveness of a combined Self-Determination Theory (SDT) and Acceptance and Commitment Therapy (ACT) intervention, the "Running Minds" program, in promoting physical activity (PA) among young adults. METHODS The intervention, consisting of eight sessions, targeted motivational and psychological barriers to PA. It intertwined SDT's core components (autonomy, competence, relatedness) with ACT's emphasis on mindfulness and value-driven actions. This study used a qualitative approach, collecting data through semi-structured interviews with twelve participants aged 20-35, conducted post-intervention. RESULTS Our reflexive thematic analysis of the interviews revealed five key themes: alignment with personal values, rewarding experience of the sessions, fulfillment of social connectedness, enhancement of both intrinsic and extrinsic motivation, and observable behavioral changes. These findings highlight the importance of aligning exercise with personal values and the role of supportive social environments in sustaining PA. CONCLUSIONS The integration of SDT and ACT in the "Running Minds" program appears to be a viable approach for enhancing motivation and adherence to PA among young adults. This study offers valuable insights for future PA interventions, underscoring the need for strategies that consider psychological and social dimensions. Limitations and Future Research: Despite the promising results, limitations include potential recall bias and the short duration of the study. Further research, especially focusing on more diverse groups and employing longitudinal designs, is recommended to broaden and substantiate these findings.
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Affiliation(s)
- Dalit Lev-Arey
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Rabenu Yerucham, 2, Tel Avi Yaffo 6816811, Israel
| | - Tomer Gutman
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Rabenu Yerucham, 2, Tel Avi Yaffo 6816811, Israel
| | - Orr Levental
- Department of Physical Education, Tel Hai Academic College, Upper Galilee 1220800, Israel
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Albarracin D, Oyserman D, Schwarz N. Health Communication and Behavioral Change During the COVID-19 Pandemic. Perspect Psychol Sci 2024:17456916231215272. [PMID: 38319808 DOI: 10.1177/17456916231215272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
The COVID-19 pandemic challenged the public health system to respond to an emerging, difficult-to-understand pathogen through demanding behaviors, including staying at home, masking for long periods, and vaccinating multiple times. We discuss key challenges of the pandemic health communication efforts deployed in the United States from 2020 to 2022 and identify research priorities. One priority is communicating about uncertainty in ways that prepare the public for disagreement and likely changes in recommendations as scientific understanding advances: How can changes in understanding and recommendations foster a sense that "science works as intended" rather than "the experts are clueless" and prevent creating a void to be filled by misinformation? A second priority concerns creating a culturally fluent framework for asking people to engage in difficult and novel actions: How can health messages foster the perception that difficulties of behavior change signal that the change is important rather than that the change "is not for people like me?" A third priority entails a shift from communication strategies that focus on knowledge and attitudes to interventions that focus on norms, policy, communication about policy, and channel factors that impair behavior change: How can we move beyond educating and correcting misinformation to achieving desired actions?
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Affiliation(s)
- Dolores Albarracin
- Department of Psychology, School of Arts and Sciences, Annenberg Public Policy Center, Annenberg School for Communication, Department of Family and Community Health, Department of Health Care Management, University of Pennsylvania
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Manskow US, Sagelv EH, Antypas K, Zanaboni P. Adoption, acceptability and sustained use of digital interventions to promote physical activity among inactive adults: a mixed-method study. Front Public Health 2024; 11:1297844. [PMID: 38239801 PMCID: PMC10794730 DOI: 10.3389/fpubh.2023.1297844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Despite the positive effects of physical activity (PA) to prevent lifestyle diseases and improve health and well-being, only one-third of Norwegian adults meet the minimum recommendations on PA. Digital interventions to promote PA in inactive adults may improve health and well-being by being available, personalized and adequate. Knowledge on users' adoption, acceptability and sustainability of digital interventions to promote PA is still limited. Objective To investigate the adoption, acceptability and sustained use of three digital interventions for promoting PA among inactive adults. Design A randomized control trial (ONWARDS) with 183 participants assigned to 3 groups and followed up for 18 months. All participants received a wearable activity tracker with the personalized metric Personal Activity Intelligence (PAI) on a mobile app, two groups received additional access to online training and one group had also access to online social support. Methods A mixed-methods approach was used to address the study objective. Acceptability was evaluated through the System Usability Scale (SUS) (n = 134) at 6 months. Adoption and sustained use were evaluated through a set of questions administered at 12 months (n = 109). Individual interviews were performed at 6 months with a sample of participants (n = 18). Quantitative data were analyzed with descriptive statistics, whereas qualitative data were analyzed using the Framework approach. Results PAI was the most successful intervention, with satisfactory usability and positive effects on motivation and behavior change, contributing to high adoption and sustained use. Online social support had a high acceptability and sustained use, but the intervention was not perceived as motivational to increase PA. Online training had low adoption, usability and sustained use. The qualitative interviews identified five main themes: (1) overall approach to physical activity, (2) motivation, (3) barriers to perform PA, (4) effects of PA, and (5) usability and acceptability of the digital interventions. Conclusion Personalized digital interventions integrating behavior change techniques such as individual feedback and goal setting are more likely to increase acceptability, adoption and sustained use. Future studies should investigate which digital interventions or combinations of different interventions are more successful in promoting PA among inactive adults according to the characteristics and preferences of the users. Trial registration Clinical trial registered at ClinicalTrials.gov: NCT04526444.
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Affiliation(s)
- Unn S. Manskow
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway UiT, Tromsø, Norway
| | - Edvard H. Sagelv
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Konstantinos Antypas
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- SINTEF Digital, Oslo, Norway
| | - Paolo Zanaboni
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Watanabe K. Promoting Physical Activity Among Workers for Better Mental Health: An mHealth Intervention With Deep Learning. J UOEH 2024; 46:119-122. [PMID: 38479866 DOI: 10.7888/juoeh.46.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
There is clear scientific evidence that physical activity helps to prevent depression and anxiety. Utilizing mobile health (mHealth) technologies to enable physical activity is promising, but the evidence of the effectiveness of mHealth interventions on physical activity and mental health is inconsistent. We recently developed a native smartphone app to prevent depression and anxiety by promoting physical activity. One of the app's strengths is that it adopts a deep-learning model and automatically estimates psychological distress from users' physical activity patterns. We conducted a single-arm, 1-month feasibility trial to examine the implementation of the app and its effectiveness in promoting physical activity and improving depression and anxiety. As a result, we did not observe any significant improvement in physical activity or psychological distress. For implementation aspects, the participants used the app less. The conclusion of the presentation is that mHealth interventions are promising for the improvement of physical activity and mental health among workers, but, at this stage, their effectiveness is unclear. There are challenges to be addressed, especially in implementation.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, Japan
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Afrin M, Khan SU, Das SC, Huq KATME, Moriyama M. Effectiveness of a Health Education Program for Patients Who Had a Stroke and Their Caregivers by Controlling Modifiable Risk Factors to Reduce Stroke Recurrence in a Tertiary Hospital in Bangladesh: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e51178. [PMID: 38100172 PMCID: PMC10757230 DOI: 10.2196/51178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Stroke is a significant public health concern that causes severe and long-lasting disability. The recurrence of stroke is increasing due to lack of patients' knowledge and compliance with treatment to control modifiable risk factors and lifestyle changes. Health education can be an effective way to increase knowledge about behavioral changes in patients who had a stroke. OBJECTIVE The aim of this study is to evaluate the effectiveness of a health education program in Bangladesh for patients who had their first stroke and their family caregivers in order to reduce the recurrence of stroke by controlling modifiable risk factors. METHODS This is a parallel, open-label, prospective randomized controlled trial conducted at the National Institute of Neurosciences & Hospital in Dhaka, Bangladesh. We enrolled ≥18-year-old patients of both sexes who had a history of first stroke attack (transient ischemic attack, hemorrhagic stroke, lacunar stroke, atherothrombotic stroke, or cardioembolic stroke). We stratified patients into those aged <65 years and those aged ≥65 years and according to types of strokes for randomization. Our estimated sample size was 432. The intervention group receives face-to-face counseling on lifestyle modifications, blood pressure monitoring, and medication compliance-related health education during enrollment and monthly follow-ups. However, the control group receives only usual care from the hospital. The primary end point of this study is the reduction in the stroke recurrence rates at the end of the 12-month follow-up period. The secondary end points are to (1) assess the occurrence of all adverse events such as other cardiac events and all-cause mortality, (2) evaluate the status of the controlling modifiable risk factors such as blood pressure, glycated hemoglobin, and non-high-density lipoprotein cholesterol, (3) assess the knowledge related to stroke by using the investigator-developed questionnaire, (4) evaluate the lifestyle behavior related to stroke by using the investigator-developed questionnaire, (5) assess medication adherence, and (6) evaluate the quality of life of patients who had a stroke and their family caregivers. The evaluation points will be at baseline, 6 months, and 12 months for both groups. RESULTS Patients' enrollment started on October 2022, and follow-up will be completed in March 2024. A total of 432 participants were included in both the intervention (n=216) and control groups (n=216). This study was approved by the institutional review board and the ethics review board of the National Institute of Neurosciences & Hospital (IRB/NINSH/2022/151) on August 30, 2022. CONCLUSIONS Our health education program is expected to reduce the recurrence of stroke and improve the quality of life of patients who have had the first stroke. The results of this study will provide insights into the importance of health education for (self)-management and prevention of stroke. TRIAL REGISTRATION ClinicalTrials.gov NCT05520034; https://clinicaltrials.gov/ct2/show/NCT05520034. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51178.
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Affiliation(s)
- Mahabuba Afrin
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sharif Uddin Khan
- Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh
| | - Subir Chandra Das
- Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh
| | - K A T M Ehsanul Huq
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michiko Moriyama
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Watanabe K, Okusa S, Sato M, Miura H, Morimoto M, Tsutsumi A. mHealth Intervention to Promote Physical Activity Among Employees Using a Deep Learning Model for Passive Monitoring of Depression and Anxiety: Single-Arm Feasibility Trial. JMIR Form Res 2023; 7:e51334. [PMID: 37976094 PMCID: PMC10692887 DOI: 10.2196/51334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/04/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Physical activity effectively prevents depression and anxiety. Although mobile health (mHealth) technologies offer promising results in promoting physical activity and improving mental health, conflicting evidence exists on their effectiveness, and employees face barriers to using mHealth services. To address these problems, we recently developed a smartphone app named ASHARE to prevent depression and anxiety in the working population; it uses a deep learning model for passive monitoring of depression and anxiety from information about physical activity. OBJECTIVE This study aimed to preliminarily investigate (1) the effectiveness of the developed app in improving physical activity and reducing depression and anxiety and (2) the app's implementation outcomes (ie, its acceptability, appropriateness, feasibility, satisfaction, and potential harm). METHODS We conducted a single-arm interventional study. From March to April 2023, employees aged ≥18 years who were not absent were recruited. The participants were asked to install and use the app for 1 month. The ideal usage of the app was for the participants to take about 5 minutes every day to open the app, check the physical activity patterns and results of an estimated score of psychological distress, and increase their physical activity. Self-reported physical activity (using the Global Physical Activity Questionnaire, version 2) and psychological distress (using the 6-item Kessler Psychological Distress Scale) were measured at baseline and after 1 month. The duration of physical activity was also recorded digitally. Paired t tests (two-tailed) and chi-square tests were performed to evaluate changes in these variables. Implementation Outcome Scales for Digital Mental Health were also measured for acceptability, appropriateness, feasibility, satisfaction, and harm. These average scores were assessed by comparing them with those reported in previous studies. RESULTS This study included 24 employees. On average, the app was used for 12.54 days (44.8% of this study's period). After using the app, no significant change was observed in physical activity (-12.59 metabolic equivalent hours per week, P=.31) or psychological distress (-0.43 metabolic equivalent hours per week, P=.93). However, the number of participants with severe psychological distress decreased significantly (P=.01). The digitally recorded duration of physical activity increased during the intervention period (+0.60 minutes per day, P=.08). The scores for acceptability, appropriateness, and satisfaction were lower than those in previous mHealth studies, whereas those for feasibility and harm were better. CONCLUSIONS The ASHARE app was insufficient in promoting physical activity or improving psychological distress. At this stage, the app has many issues that are to be addressed in terms of both implementation and effectiveness. The main reason for this low effectiveness might be the poor evaluation of the implementation outcomes by app users. Improving acceptability, appropriateness, and satisfaction are identified as key issues to be addressed in future implementation. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry UMIN000050430; https://tinyurl.com/mrx5ntcmrecptno=R000057438.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Mitsuhiro Sato
- Health & Productivity Management Promotion Division, Fujitsu General Limited, Kawasaki, Japan
| | | | | | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
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Winkelmair A, Jansen P. The positive impact of mindfulness interventions on the explicit and implicit affective attitudes toward vegetarian foods. Front Psychol 2023; 14:1158410. [PMID: 37860298 PMCID: PMC10584318 DOI: 10.3389/fpsyg.2023.1158410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/04/2023] [Indexed: 10/21/2023] Open
Abstract
Objectives The main goal of our intervention study was to investigate whether two conceptually different mindfulness interventions positively impacted the explicit and implicit affective evaluations of vegetarian foods. We included possible mediating variables (e.g., wellbeing) and related our results to the stage model of self-regulated behavioral change (SSBC). Methods We implemented a compassion and caring-based mental training (N = 31) and an adapted MBSR course (N = 34) as mindfulness interventions, and a stress-reduction course (N = 26) as the active control group. The curriculums consisted of 12 weekly group sessions á 75 min. All participants were tested pre- and post-intervention and 3 months after the last intervention session, answered questionnaires (mindfulness, compassion, wellbeing, items of the SSBC) and completed an explicit affective evaluation task and an affective priming task. Results There was an improvement in the explicit attitudes toward vegetarian foods regardless of the intervention group. In the SSBC, we found a link between the explicit attitudes toward vegetarian foods and the indicated stage in the model. Multiple regression analysis revealed social and personal norms and a vegetarian/vegan diet as the only significant predictors for goal intention in the SSBC. Conclusion The results of our study suggest that both conceptually different mindfulness interventions, as well as a stress-reduction program, have a positive impact on explicit affective attitudes toward vegetarian foods. We highlight the meaning of inner dimensions and transformation for change processes for a more sustainable diet and the role of social and personal norms.
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Affiliation(s)
- Annica Winkelmair
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
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Fundoiano-Hershcovitz Y, Breuer Asher I, Ritholz MD, Feniger E, Manejwala O, Goldstein P. Specifying the Efficacy of Digital Therapeutic Tools for Depression and Anxiety: Retrospective, 2-Cohort, Real-World Analysis. J Med Internet Res 2023; 25:e47350. [PMID: 37738076 PMCID: PMC10559191 DOI: 10.2196/47350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/01/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Depression and anxiety are the main sources of work and social disabilities as well as health-related problems around the world. Digital therapeutic solutions using cognitive behavioral therapy have demonstrated efficacy in depression and anxiety. A common goal of digital health apps is to increase user digital engagement to improve outcomes. However, there is a limited understanding of the association between digital platform components and clinical outcomes. OBJECTIVE The aim of the study is to investigate the contribution of specific digital engagement tools to mental health conditions. We hypothesized that participation in coaching sessions and breathing exercises would be associated with a reduction in depression and anxiety. METHODS Depression and general anxiety symptoms were evaluated in real-world data cohorts using the digital health platform for digital intervention and monitoring change. This retrospective real-world analysis of users on a mobile platform-based treatment followed two cohorts of people: (1) users who started with moderate levels of depression and completed at least 2 depression assessments (n=519) and (2) users who started with moderate levels of anxiety and completed at least 2 anxiety assessments (n=474). Levels of depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) were tracked throughout the first 16 weeks. A piecewise mixed-effects model was applied to model the trajectories of the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7 mean scores in 2 segments (1-6 weeks and 7-16 weeks). Finally, simple slope analysis was used for the interpretation of the interactions probing the moderators: coaching sessions and breathing exercises in both depression and anxiety cohorts. RESULTS Analysis revealed a significant decrease in depression symptoms (β=-.37, 95% CI -0.46 to 0.28; P≤.001) during the period of weeks 1-6 of app use, which was maintained during the period of 7-16 weeks. Coach interaction significantly moderated the reduction in depression symptoms during the period of weeks 1-6 (β=-.03, 95% CI -0.05 to -0.001; P=.02). A significant decrease in anxiety symptoms (β=-.41, 95% CI -0.50 to -0.33; P≤.001) was revealed during the period of 1-6 weeks, which was maintained during the period of 7-16 weeks. Breathing exercises significantly moderated the reduction in anxiety symptoms during the period of 1-6 weeks (β=-.07, 95% CI -0.14 to -0.01; P=.04). CONCLUSIONS This study demonstrated general improvement followed by a period of stability of depression and anxiety symptoms associated with cognitive behavioral therapy-based digital intervention. Interestingly, engagement with a coaching session but not a breathing exercise was associated with a reduction in depression symptoms. Moreover, breathing exercise but not engagement with a coaching session was associated with a reduction of anxiety symptoms. These findings emphasize the importance of using a personalized approach to behavioral health during digital health interventions.
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Affiliation(s)
| | | | - Marilyn D Ritholz
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States
| | | | | | - Pavel Goldstein
- Integrative Pain Laboratory (iPainLab), School of Public Health, University of Haifa, Haifa, Israel
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Morales-Burton V, Lopez-Ramirez SA. Avoiding SARS-CoV-2 infection in healthcare workers: is behavioral change the answer? Front Public Health 2023; 11:1204878. [PMID: 37794897 PMCID: PMC10546051 DOI: 10.3389/fpubh.2023.1204878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/18/2023] [Indexed: 10/06/2023] Open
Abstract
Background The COVID-19 pandemic has become an important cause of morbimortality, and healthcare workers are at the highest risk of infection. As a result, policies and guidelines have been issued, and behavioral changes have been crucial in hospitals. Among these measures, the implementation of personal protective equipment (PPE) and its appropriate use in the workplace is key to avoiding contagion, as is understanding new measures regarding patient admission, distribution, constant education on virtual platforms, among others, and changing conduct to reduce contagion. However, behavioral change interventions in healthcare workers are challenging as contextual characteristics, attributes of the intervention, and psychological factors are involved. Study objectives The issue under investigation is the impact of COVID-19 on frontline healthcare workers in the emergency department of the Fundación Cardioinfantil (FCI). The objective was to describe their behavioral changes by studying and monitoring SARS-CoV-2 infection and their relationship through the tracing process in 2020. Methods We conducted a case study to identify and relate the SARS-CoV-2 infection rate within the personnel in the department and the response of healthcare workers to the implementation and adherence to the use of PPE through the analysis of the different variables that contributed to behavioral change. Data were collected by a single author and analyzed by two authors using both the individual-level logic model technique and the triangulation of information, with approval from the institutional review board. Discussion Several interventions for behavior change were registered in the data collection process. The data obtained indicated that implementation, embedding, and integration were perceived as collective and individual behavioral processes. This was supported by evidence from healthcare interventions, such as education, incentivization, training, restriction, environmental restructuring, modeling, and enablement. Conclusion Behavioral science should be part of public health responses, as the theoretical basis suggests that change may modify the response to avoid the transmission of infectious diseases. Therefore, individuals at the highest risk appear to adopt guidance with targeted behavior adaptation interventions. Efforts to inform, instruct, and motivate healthcare workers must be continuous, and actions at the community level must be strengthened, as it is human behavior that determines the spread and mortality of infectious diseases, where community compliance to preventive behaviors plays a crucial role.
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Affiliation(s)
- Verónica Morales-Burton
- MSC Health Economics, Policy and Management, The London School of Economics and Political Science, London, United Kingdom
- Department of Pediatrics, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
| | - Sofía A. Lopez-Ramirez
- Department of Pediatrics, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
- Universidad del Rosario, School of Medicine and Health Sciences, Bogotá, Colombia
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Sarasjärvi KK, Chivers P, Bhoyroo R, Codde J. Bouncing back from COVID-19: a Western Australian community perspective. Front Public Health 2023; 11:1216027. [PMID: 37601213 PMCID: PMC10436488 DOI: 10.3389/fpubh.2023.1216027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction This study explored the behavioral profiles of residing Western Australians during a COVID-19 lockdown period and transitions in behavior post-lockdown. Methods A total of 313 participants (76% female, age: M = 50.1, SD = 15.7 years) completed behavioral and mental health questionnaire items ~2 months after a 3-month COVID-19 lockdown in October 2020, using a retrospective recall to assess their experience during the lockdown period. Latent transition analysis (LTA) was used to identify behavioral profiles and transitions. Indicators were identified by assessing during-post-lockdown group differences (Kruskal-Wallis, chi-square tests) and profiles described using qualitative open-ended questions. Results Significant indicators included changes in physical activity, leisure screen time, alcohol intake, psychological distress, and loneliness, but not fast food consumption. The significant indicators were used to form LTA models. The five latent class model showed the best model fit (Log-likelihood = -1301.66, AIC = 426.12, BIC = 609.68). Approximately one in four participants reported a change in their behavior profiles after the lockdown ceased. Key differences between the profiles were age, household income, education, resilience, sense of control, existing mental health issues, and social relations. Washing hands and social distancing were the most recalled and effective health campaigns across the classes, with health campaigns encompassing physical activity/alcohol consumption, or domestic violence having the least attention. Discussion Overall, while most participants recovered relatively well after the lockdown period, LTA did identify subgroups such as those who were inactive and lonely experienced more difficulties than other groups, and engagement with public health campaigns differed. The results provide important insights for future public health campaigns on how these campaigns might be diversified to effectively target more people and particular groups to maximize engagement for maintaining people's mental health with additional focus on physical activity, alcohol consumption, and domestic violence.
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Affiliation(s)
- Kiira Karoliina Sarasjärvi
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Paola Chivers
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ranila Bhoyroo
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Jim Codde
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
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Klein DH, Mohamoud I, Olanisa OO, Parab P, Chaudhary P, Mukhtar S, Moradi A, Kodali A, Okoye C, Arcia Franchini AP. Impact of School-Based Interventions on Pediatric Obesity: A Systematic Review. Cureus 2023; 15:e43153. [PMID: 37692730 PMCID: PMC10484325 DOI: 10.7759/cureus.43153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Childhood obesity is a global public health problem with significant implications for the health and well-being of children. The prevalence of childhood obesity is increasing every decade, making it a recognized public health concern. This systematic review aims to explore and evaluate the impact of school-based interventions on reducing pediatric obesity among school-aged children. A systematic review of literature according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 was conducted. Google Scholar, PubMed, and Cochrane were the databases used. After screening for bias, inclusion and exclusion criteria, and quality, 27 studies were included in the systematic review, and data were synthesized. The results show that physical activity reduces obesity and improves cardiovascular health. The nutritional change reduces the risk of obesity more than physical activity alone. When blended, the two provide the most benefits for participants. Motivation, self-efficacy, and behavioral change could help maintain the improvements. Schools should adopt a blend of physical activity and nutritional change to reduce prevent, reduce, and manage obesity.
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Affiliation(s)
- Dhadon H Klein
- Internal Medicine, Saint James School of Medicine, Park Ridge, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Iman Mohamoud
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Olawale O Olanisa
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Panah Parab
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Priti Chaudhary
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sonia Mukhtar
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ali Moradi
- Medicine, Semmelweis University, Budapest, HUN
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Athri Kodali
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Chiugo Okoye
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ana P Arcia Franchini
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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14
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Volpato E, Banfi P, Verkleij M. Editorial: The psychological challenges of respiratory disease. Front Psychol 2023; 14:1213963. [PMID: 37292508 PMCID: PMC10245553 DOI: 10.3389/fpsyg.2023.1213963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 06/10/2023] Open
Affiliation(s)
- Eleonora Volpato
- Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Marieke Verkleij
- Department of Paediatric Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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15
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Tran DMT, Martinez I, Cross CL, Earley YF. MOBILE Intervention Pilot Study in College Students With Elevated Blood Pressure. J Cardiovasc Nurs 2023; 38:256-261. [PMID: 37027130 PMCID: PMC9579215 DOI: 10.1097/jcn.0000000000000917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hypertension is typically recognized in middle-aged and older adults but often overlooked in younger populations. OBJECTIVE We evaluated a mobile intervention for reducing blood pressure (BP) in college-age students for 28 days. METHODS Students with elevated BP or undiagnosed hypertension were assigned to an intervention or control group. All subjects completed baseline questionnaires and attended an educational session. For 28 days, intervention subjects sent their BP and motivation levels to the research team and completed assigned BP-reducing tasks. After 28 days, all subjects completed an exit interview. RESULTS We found a statistically significant decrease in BP in the intervention group only ( P = .001) but no statistical difference in sodium intake for either group. Mean hypertension knowledge increased in both groups but was only significant for the control group ( P = .001). CONCLUSIONS The results provide preliminary data on BP reduction with greater impact on the intervention group.
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Affiliation(s)
- Dieu-My T. Tran
- University of Nevada, Las Vegas – School of Nursing, Las Vegas, Nevada, USA
| | - Iris Martinez
- University of Nevada, Las Vegas – School of Nursing, Las Vegas, Nevada, USA
| | - Chad L. Cross
- University of Nevada, Las Vegas – School of Public Health, Las Vegas, Nevada, USA
| | - Yumei Feng Earley
- University of Nevada, Reno – School of Medicine, Reno, Nevada, USA
- University of Nevada, Reno – Center for Molecular and Cellular Signal Transduction in the Cardiovascular System, Reno, Nevada, USA
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16
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Eker S, Mastrucci A, Pachauri S, van Ruijven B. Social media data shed light on air-conditioning interest of heat-vulnerable regions and sociodemographic groups. One Earth 2023; 6:428-440. [PMID: 37128238 PMCID: PMC10140935 DOI: 10.1016/j.oneear.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/30/2022] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
Cooling homes with air conditioners is a vital adaptation approach, but the wider adoption of air conditioners can increase hydrofluorocarbon emissions that have high global warming potential and carbon emissions as a result of more fossil energy consumption. The scale and scope of future cooling demand worldwide are, however, uncertain because the extent and drivers of air-conditioning adoption remain unclear. Here, using 2021 and 2022 Facebook and Instagram data from 113 countries, we investigate the usability of social media advertising data to address these data gaps in relation to the drivers of air-conditioning adoption. We find that social media data might represent air-conditioning purchasing trends. Globally, parents of small children and middle-aged, highly educated married or cohabiting males tend to express greater interest in air-conditioning adoption. In regions with high heat vulnerability yet little empirical data on cooling demand (e.g., the Middle East and North Africa), these sociodemographic factors play a more prominent role. These findings can strengthen our understanding of future cooling demand for more sustainable cooling management.
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Affiliation(s)
- Sibel Eker
- Nijmegen School of Management, Radboud University, Nijmegen, the Netherlands
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
- Corresponding author
| | - Alessio Mastrucci
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Shonali Pachauri
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Bas van Ruijven
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
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17
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Yuan X, Chen K, Yuan J, Chu Q, Hu S, Gao Y, Yu F, Diao X, Chen X, Li Y, Sun H, Shu C, Wang W, Pan X, Zhao W, Hu S. Evaluation of the Effectiveness and Safety of a Multifaceted Computerized Antimicrobial Stewardship Intervention in Surgical Settings: A Single-center Cluster-randomized Controlled Trial. Int J Antimicrob Agents 2023; 61:106787. [PMID: 36935089 DOI: 10.1016/j.ijantimicag.2023.106787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Inappropriate antimicrobial use is common for patients undergoing surgery. Whether a multifaceted computerized antimicrobial stewardship program is effective and safe in reducing inappropriate antimicrobial use in surgical settings is unclear. METHODS We developed a multifaceted computerized antimicrobial stewardship intervention system, and conducted an open-label, cluster-randomized, controlled trial among 18 surgical teams that enrolled 2470 patients with open-chest cardiovascular surgery. The surgical teams were randomly divided into intervention and control groups at a ratio of 1:1. The primary endpoints were days of therapy (DOT)/1000 patient-days, DDDs (measured by defined daily dose)/1000 patient-days, and length of therapy (LOT)/1000 patient-days. RESULTS The means of DOT, DDDs, and LOT per 1000 patient-days in the intervention group were significantly lower than those in the control group (472.2 versus 539.8, 459.5 versus 553.8, and 438.4 versus 488.7, p<0.05), with a 14.2% (95% CI, 11.8% to 16.7%), 18.7% (95% CI, 15.9% to 21.4%), and 11.9% (95% CI, 9.6% to 14.1%) reduction, respectively. The daily risk of inappropriate antimicrobial use after the intensive care unit decreased by 23.9% (95% CI, 15.5% to 31.5% [incidence risk ratio 0.76, 95% CI 0.69 to 0.85]) in the intervention group. There was no significant difference in rates of infection or surgical-related complications between the groups. The median (IQR) antimicrobial costs were significantly lower in the intervention group (873.4 [684.5-1,255.4] RMB versus 1,178.7 [869.1-1,814.5] RMB, p<0.001). CONCLUSIONS The multifaceted computerized antimicrobial stewardship interventions safely reduced inappropriate antimicrobial use. TRIAL REGISTRATION Clinicaltrials.gov: NCT04328090.
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Affiliation(s)
- Xin Yuan
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Yuan
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Chu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Hu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Gao
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Yu
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaolin Diao
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xingwei Chen
- Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yandong Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hansong Sun
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chang Shu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangbin Pan
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Zhao
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shengshou Hu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Velázquez-Jurado H, Flores-Torres A, Pérez-Peralta L, Salinas-Rivera E, Valle-Nava MD, Arcila-Martinez D, Hernández-Jiménez S. Cognitive behavioral treatment to improve psychological adjustment in people recently diagnosed with type 2 diabetes: Psychological treatment in type 2 diabetes. Health Psychol Behav Med 2023; 11:2179058. [PMID: 36846199 PMCID: PMC9946322 DOI: 10.1080/21642850.2023.2179058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic disease that affects a person's general well-being. Current evidence sets an association between psychological well-being and controlled metabolic parameters. People newly diagnosed with T2DM show higher prevalence of depression and anxiety symptoms. Cognitive behavioral therapy (CBT) has effectively improved psychological adjustment, but most studies do not specifically address recently diagnosed people nor usually include long-term follow-up measures. Objective We sought to assess changes in psychological variables in people with newly diagnosed diabetes who received a cognitive-behavioral intervention, within a comprehensive care program. Method 1208 adults with T2DM (≤5 years) who attended a national health institute in Mexico received a cognitive-behavioral intervention aimed at improving quality of life and reducing emotional distress that often interferes with diabetes control, as well as evaluating cognitive and emotional resources and social support. Measures of quality of life, diabetes-related distress, anxiety and depression questionnaires were compared at pre-test, post-test and follow up using Friedman's ANOVAs. Multiple logistic regression models evaluated glycosylated hemoglobin (HbA1c) and triglycerides control at post-test and follow up. Results Questionnaire measures and metabolic variables significantly decreased symptomatology at post-test and these changes maintained at follow-up. Significant associations were found between quality-of-life scores and HbA1c and triglycerides levels in post-test and follow-up. Diabetes-related distress scores increased the odds of having adequate HbA1c control at post-test. Conclusion This study contributes to the evidence on the importance of considering psychological factors as part of comprehensive diabetes care to improve quality of life and emotional burden and facilitate the achievement of metabolic goals.
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Affiliation(s)
- Héctor Velázquez-Jurado
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico,Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico, Héctor Velázquez-Jurado Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico; National Autonomous University of Mexico, Mexico City, Mexico; Av. Vasco de Quiroga #15, Col. Belisario Dominguez, Sección XVI, Alc. Tlalpan, C.P. 14080, Ciudad de Mexico
| | - Athena Flores-Torres
- Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Liliana Pérez-Peralta
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Edgar Salinas-Rivera
- Department of Educational Psychology, National Pedagogic University (UPN), Mexico City, Mexico
| | - Marianne Daniela Valle-Nava
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico,Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Denise Arcila-Martinez
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Sergio Hernández-Jiménez
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - for the CAIPaDi Study Group
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
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Voss C, Liu J, Chang A, Kosmas JA, Biehl A, Flynn RL, Kruzan KP, Wildes JE, Graham AK. Weight Loss Expectations of Adults With Binge Eating: Cross-sectional Study With a Human-Centered Design Approach. JMIR Form Res 2023; 7:e40506. [PMID: 36853750 PMCID: PMC10015344 DOI: 10.2196/40506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/17/2022] [Accepted: 01/03/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND People tend to overestimate their expectations for weight loss relative to what is achievable in a typical evidence-based behavioral weight management program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people who have overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight and shape concerns and often presents to treatment with the goal of losing weight. OBJECTIVE The aim of the study is to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting for a digital intervention, given that engagement and dropout are notable problems for digital behavior change interventions. We tested the hypotheses that (1) people who endorsed some or recurrent binge eating would expect to lose more weight than those who did not endorse binge eating and (2) people who endorsed a more severe versus a low or moderate overvaluation of weight and shape would have higher weight loss expectations. METHODS A total of 760 adults (n=504, 66% female; n=441, 58% non-Hispanic White) completed a web-based screening questionnaire. One-way ANOVAs were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight. RESULTS Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight or shape expected to lose the most weight compared to those with low or moderate levels of overvaluation of weight and shape. CONCLUSIONS In the sample, people interested in a study to inform a digital intervention for binge eating and weight management overestimated their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals' intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.
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Affiliation(s)
- Claire Voss
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jianyi Liu
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jacqueline A Kosmas
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Abigail Biehl
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Rebecca L Flynn
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kaylee P Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Andrea K Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Alkhaldi O, McMillan B, Maddah N, Ainsworth J. Interventions Aimed at Enhancing Health Care Providers' Behavior Toward the Prescription of Mobile Health Apps: Systematic Review. JMIR Mhealth Uhealth 2023; 11:e43561. [PMID: 36848202 PMCID: PMC10012012 DOI: 10.2196/43561] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) apps have great potential to support the management of chronic conditions. Despite widespread acceptance of mHealth apps by the public, health care providers (HCPs) are reluctant to prescribe or recommend such apps to their patients. OBJECTIVE This study aimed to classify and evaluate interventions aimed at encouraging HCPs to prescribe mHealth apps. METHODS A systematic literature search was conducted to identify studies published from January 1, 2008, to August 5, 2022, using 4 electronic databases: MEDLINE, Scopus, CINAHL, and PsycINFO. We included studies that evaluated interventions encouraging HCPs to prescribe mHealth apps. Two review authors independently assessed the eligibility of the studies. The "National Institute of Health's quality assessment tool for before-and-after (pretest-posttest design) studies with no control group" and "the mixed methods appraisal tool (MMAT)" were used to assess the methodological quality. Owing to high levels of heterogeneity between interventions, measures of practice change, specialties of HCPs, and modes of delivery, we conducted a qualitative analysis. We adopted the behavior change wheel as a framework for classifying the included interventions according to intervention functions. RESULTS In total, 11 studies were included in this review. Most of the studies reported positive findings, with improvements in a number of outcomes, including increased knowledge of mHealth apps among clinicians, improved self-efficacy or confidence in prescribing, and an increased number of mHealth app prescriptions. On the basis of the behavior change wheel, 9 studies reported elements of environmental restructuring such as providing HCPs with lists of apps, technological systems, time, and resources. Furthermore, 9 studies included elements of education, particularly workshops, class lectures, individual sessions with HCPs, videos, or toolkits. Furthermore, training was incorporated in 8 studies using case studies or scenarios or app appraisal tools. Coercion and restriction were not reported in any of the interventions included. The quality of the studies was high in relation to the clarity of aims, interventions, and outcomes but weaker in terms of sample size, power calculations, and duration of follow-up. CONCLUSIONS This study identified interventions to encourage app prescriptions by HCPs. Recommendations for future research should consider previously unexplored intervention functions such as restrictions and coercion. The findings of this review can help inform mHealth providers and policy makers regarding the key intervention strategies impacting mHealth prescriptions and assist them in making informed decisions to encourage this adoption.
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Affiliation(s)
- Ohoud Alkhaldi
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, The University of Manchester, Manchester, United Kingdom
| | - Noha Maddah
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Health Services and Hospitals Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
| | - John Ainsworth
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Chan CCK, Chan AK, Chu C, Tsang YC. Theory-based behavioral change interventions to improve periodontal health. Front Oral Health 2023; 4:1067092. [PMID: 36762002 PMCID: PMC9905735 DOI: 10.3389/froh.2023.1067092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
Periodontal disease is a significant global health burden affecting half of the world's population. Given that plaque and inflammation control are essential to the attainment of periodontal health, recent trends in preventive dentistry have focused on the use of behavioral models to understand patient psychology and promote self-care and treatment compliance. In addition to their uses in classifying, explaining and predicting oral hygiene practices, behavioral models have been adopted in the design of oral hygiene interventions from individual to population levels. Despite the growing focus on behavioral modification in dentistry, the currently available evidence in the field of periodontology is scarce, and interventions have primarily measured changes in patient beliefs or performance in oral hygiene behaviors. Few studies have measured their impact on clinical outcomes, such as plaque levels, gingival bleeding and periodontal pocket reduction, which serve as indicators of the patient's disease status and quality of oral self-care. The present narrative review aims to summarize selected literature on the use of behavioral models to improve periodontal outcomes. A search was performed on existing behavioral models used to guide dental interventions to identify their use in interventions measuring periodontal parameters. The main models were identified and subsequently grouped by their underlying theoretical area of focus: patient beliefs (health belief model and cognitive behavioral principles); stages of readiness to change (precaution adoption process model and transtheoretical model); planning behavioral change (health action process approach model, theory of planned behavior and client self-care commitment model); and self-monitoring (self-regulation theory). Key constructs of each model and the findings of associated interventions were described. The COM-B model, a newer behavioral change system that has been increasingly used to guide interventions and policy changes, is discussed with reference to its use in oral health settings. Within the limitations of the available evidence, interventions addressing patient beliefs, motivation, intention and self-regulation could lead to improved outcomes in periodontal health. Direct comparisons between interventions could not be made due to differences in protocol design, research populations and follow-up periods. The conclusions of this review assist clinicians with implementing psychological interventions for oral hygiene promotion and highlight the need for additional studies on the clinical effects of behavioral model-based interventions.
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Helbach A, Dumm M, Moll K, Böttrich T, Leineweber CG, Mueller W, Matthes J, Polidori MC. Improvement of Dietary Habits among German Medical Students by Attending a Nationwide Online Lecture Series on Nutrition and Planetary Health ( "Eat This!"). Nutrients 2023; 15:nu15030580. [PMID: 36771284 PMCID: PMC9920441 DOI: 10.3390/nu15030580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Nutrition is a major influential factor in optimizing human health and environmental sustainability. Medical students often do not follow national dietary guideline recommendations. Raising awareness of a healthy lifestyle is important as physicians with healthy lifestyle behaviors are more likely to counsel on nutrition. Our study aims to evaluate a Germany-wide online lecture series on nutritional medicine, "Eat This!". Before and after the course, 520 medical students who participated and 64 who did not participate in the course (comparison group) filled out an online survey. To assess the students' dietary habits, a validated FFQ was used. According to this questionnaire, only 31% of the lecture participants consumed enough fruits and 24% consumed enough vegetables, while almost half of the students exceeded the recommended maximum amount of crisps and sweets. After attending the lecture series, guideline adherence with respect to fruits and vegetables showed a significant increase, as did awareness of healthy nutrition and percentage of students with low-risk lifestyle habits. Our results show that low-threshold approaches, such as "Eat This!", can positively influence the dietary behaviors and lifestyle habits of medical students. This can help future doctors fulfill their role in the fight against the global burden of non-communicable diseases.
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Affiliation(s)
- Anna Helbach
- Department II of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
- Institute of General Practice, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Moritz Dumm
- Center of Pharmacology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50931 Cologne, Germany
| | - Katharina Moll
- Faculty of Medicine, University Clinic Hamburg Eppendorf, 20251 Hamburg, Germany
| | - Tim Böttrich
- Faculty of Medicine, University of Gießen, 35392 Gießen, Germany
| | - Can Gero Leineweber
- Medical Department B of Internal Medicine, Brandenburg Medical School, University Hospital Ruppin-Brandenburg, 16816 Neuruppin, Germany
| | - Wiebke Mueller
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Jan Matthes
- Center of Pharmacology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50931 Cologne, Germany
| | - Maria Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
- Correspondence:
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Dukelow T, Lawrence EG, Jacobson L, Vassilev P, Koychev I, Muhammed K, Kennelly SP. Modifiable risk factors for dementia, and awareness of brain health behaviors: Results from the Five Lives Brain Health Ireland Survey (FLBHIS). Front Psychol 2023; 13:1070259. [PMID: 36710802 PMCID: PMC9879702 DOI: 10.3389/fpsyg.2022.1070259] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/13/2022] [Indexed: 01/13/2023] Open
Abstract
Up to 40% of dementias globally are attributable to modifiable risk factors. Many existing studies examining attitudes to brain health are limited by a failure to consider a range of pertinent risk factors and associated barriers to protective behaviors. In Ireland, self-reported knowledge of dementia is poor compared to other conditions. In this context, the current study aimed to explore exposure to and awareness of specific modifiable risk factors for dementia. We also aimed to investigate whether exposure to these risk factors is associated with demographic and socioeconomic factors. A cross-sectional survey was administered to 555 voluntary participants in February 2022. The survey captured the following information: (1) Sociodemographic factors; (2) Exposure to, as well as knowledge of modifiable risk factors for dementia, namely diet, social interaction, exercise, hypertension, sleep, depression, smoking, alcohol consumption, cognitive stimulation, hearing impairment, diabetes, air pollution, and head injury. The study population comprised 551 participants (50.3% male; 49.6% female). Mean age was 59.7 years. Modifiable risk factors for dementia were prevalent. Relative to females, male gender was significantly associated with multiple risk factors. Whilst 65.6% of participants believed that lifestyle improvements can decrease a person's risk of developing dementia, only 31.4% believed that dementia could be prevented. Head injury (90.9%, n = 500), low mental stimulation (85.3%, n = 469), and alcohol consumption (77.8%, n = 428) were the three most commonly recognized risk factors. Awareness was significantly greater in both university groups (undergraduate and postgraduate) for multiple risk factors. Our findings demonstrate that the distribution of exposure to modifiable risk factors for dementia is unequal across gender and age groups, and that awareness levels vary across risk factors. These findings highlight that focus surrounding dementia prevention should shift toward individual risk profiling and should be tailored toward an individual's specific needs.
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Affiliation(s)
- Tim Dukelow
- Cork University Hospital (CUH), Cork, Ireland,*Correspondence: Tim Dukelow,
| | - Erin Grace Lawrence
- Unit of Psychological Medicine, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom,Five Lives SAS, Tours, France
| | | | | | - Ivan Koychev
- Five Lives SAS, Tours, France,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Kinan Muhammed
- Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Sean P. Kennelly
- Tallaght University Hospital, Dublin, Ireland,Trinity College Dublin, Dublin, Ireland
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Westervelt K, Rose GL, Avery S, Celley A, Cho J, Donoghue R, Goodrich B. Employee Group Coaching Program for University and Hospital Employees During COVID-19: A Feasibility Study. Glob Adv Integr Med Health 2023; 12:27536130231207856. [PMID: 37868691 PMCID: PMC10588399 DOI: 10.1177/27536130231207856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 09/18/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023]
Abstract
Background Workplace wellbeing programs can be beneficial but range widely in approach. A group coaching model offers numerous benefits. Objective To evaluate feasibility of group coaching for employees during COVID-19. Methods Employees (n = 29) at a university and university hospital underwent a 12-week group coaching program. Measurements of feasibility -- including enrollment, attendance at sessions goal attainment and satisfaction -- and exploratory outcomes including perceived physical and mental health and stress were administered at beginning, middle, and end of the program, plus 2 follow-ups. Results Twenty-six of the 29 program enrollees (96% women; 65% university employees) opted to complete surveys at 1 or more time points, and 9 individuals completed surveys at all 5 time points. Median attendance was 9 sessions. Participants opted to focus on movement, nutrition and mind/body goals and all participants reported making progress toward their goal during the program. Exploratory wellness outcomes showed meaningful improvements in perceived physical and mental health and reduced stress during the program, with return to near baseline 12 weeks after program completion. Perceptions of workplace wellness culture varied by employer. Conclusion Despite pandemic-related disruptions to life, work, and health, online group coaching is feasible and acceptable to participants. The program should be replicated to evaluate whether the improvements in exploratory wellness outcomes observed during the program are statistically significant. The apparent return to baseline levels by 24 weeks suggests that post-program maintenance support may be helpful.
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Affiliation(s)
- Karen Westervelt
- Osher Center for Integrative Health, University of Vermont, Burlington, VT, USA
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Gail L. Rose
- Osher Center for Integrative Health, University of Vermont, Burlington, VT, USA
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Scott Avery
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Alisha Celley
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Josh Cho
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Rory Donoghue
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Brennan Goodrich
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
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Muacevic A, Adler JR, Jumaah O, Abubakar M, Landau D. Important Clues for the Diagnosis of Anti-LGI1-Antibody Autoimmune Encephalitis: A Case Report. Cureus 2023; 15:e34222. [PMID: 36852369 PMCID: PMC9960044 DOI: 10.7759/cureus.34222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 01/27/2023] Open
Abstract
Anti-leucine-rich-glioma-inactivated 1 (LGI1) antibody autoimmune encephalitis is a rare autoimmune encephalitis. We present a 68-year-old female patient who initially presented with episodic confusion, hallucinations, behavioral changes, and unexplained hyponatremia. History was also remarkable for intermittent abnormal movement affecting the left upper extremity and face. She was initially thought to be suffering from dementia and was discharged home. However, progressive symptoms led to her second admission, where evidence of autonomic dysfunction with episodic bradycardia and persistent symptomatic orthostatic hypotension were evident. Generalized cortical hyperexcitability and subclinical seizures were seen. Diagnosis of LGI1 encephalitis was confirmed with a positive Anti-LGI1 antibody in the cerebrospinal fluid, and treatment with intravenous immunoglobulin and steroids improved her cognitive function. This case helps to highlight important features that should raise early clinical suspicion of LGI1 encephalitis, including unexplained progressive hyponatremia, autonomic dysfunction, and frequent refractory seizures. This can lead to earlier recognition of this condition, where earlier implementation of immunosuppressive therapy is linked to better clinical outcomes and brain structural preservation.
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26
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Hibino Y, Matsumoto S, Nagase H, Nakamura T, Kato Y, Isomura T, Hori M. Exploring Changes in Attitudes, Behaviors, and Self-Measured Health Data Through Lifestyle Modification Support by Community Pharmacists: Suito-Ogaki Selfcare (SOS) Trial. Integr Pharm Res Pract 2023; 12:87-99. [PMID: 37124706 PMCID: PMC10143748 DOI: 10.2147/iprp.s408813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose Contributing to public health by supporting people's health is the social mission of community pharmacists. This multicenter, prospective case series study aimed to evaluate changes in people's behavior and health states through community pharmacists' self-care support for healthy lifestyles. Methods The participants were recruited from voluntary adults aged ≥20 years who agreed to participate in the study, at community pharmacies in Gifu, Japan, between June and September 2021. Participants self-managed their lifestyles for six months while recording their health data, including blood pressure (BP), daily using devices (home BP monitor, body composition monitor, and activity meter) and a diet-recording app. They received lifestyle modification support at pharmacies at least once per month. Participants' subjective health status, attitudes, and behavioral changes were evaluated using self-report questionnaires. Due to the exploratory nature of this study, data were primarily analyzed descriptively. Results Fifty-four participants aged 20 to 77 (mean age: 49.6 years; female participant proportion: 55.6%) participated in this study. Their mean weekly BP shifted almost horizontally from baseline to week 24 (systolic BP: 118.8 to 121.5 mmHg; diastolic BP: 76.1 to 77.5 mmHg). At six months, 38.9% and 35.2% of the participants reported better overall health and mental health, respectively, than at baseline. Over 85% of the participants became more proactive in improving their lifestyles regarding salt intake, diet, weight loss, and exercise, although drinking and smoking habits were more challenging to change. All the participants reported that they intended to continue to improve their lifestyle. Conclusion The participants' responses suggested that community pharmacists' support helped increase participants' health awareness and promote their health-enhancing behaviors. However, its impact on health parameters should be further examined in future studies. More vigorous, tailored self-care support may be worth considering in developing a more effective, community-fitted health/well-being support system in Japan.
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Affiliation(s)
| | | | - Hisamitsu Nagase
- Faculty of Pharmacy, Gifu University of Medical Science, Gifu, Japan
| | - Takamasa Nakamura
- Japan Selfcare Promotion Association, Tokyo, Japan
- Clinical Study Support, Inc, Nagoya, Japan
| | - Yoshihito Kato
- Japan Selfcare Promotion Association, Tokyo, Japan
- Kowa Company, Ltd, Nagoya, Japan
| | - Tatsuya Isomura
- Japan Selfcare Promotion Association, Tokyo, Japan
- Clinical Study Support, Inc, Nagoya, Japan
- Correspondence: Tatsuya Isomura, Japan Selfcare Promotion Association, Showayakubou Bldg. 5F, 3-4-18 Nihonbashi-honcho, Chuo-ku, Tokyo, 103-0023, Japan, Tel +81-3-6271-8941, Fax +81-3-6271-8942, Email
| | - Michiko Hori
- Japan Selfcare Promotion Association, Tokyo, Japan
- SIC Co., Ltd, Tokyo, Japan
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Kanngiesser P, Serko D, Woike JK. Promises on the go: A field study on keeping one's word. Front Psychol 2023; 14:1097239. [PMID: 36949911 PMCID: PMC10025327 DOI: 10.3389/fpsyg.2023.1097239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Promises are voluntary commitments to perform a future action and are often thought to be powerful levers for behavioral change. Here we studied the effectiveness of promises in two preregistered, incentivized field experiments with German students (N = 406) on the premises of a cafeteria. In Experiment 1, the majority of participants (63%) kept their promise to pay back at least half of a € 4-endowment, even though there was no foreseeable cost of breaking the promise, reputational or otherwise. Significantly fewer participants (22%) paid back money in a control group that faced a simple decision to return money or not. In Experiment 2, the majority of participants (54%) kept their promise to add a provided stamp to a postcard and mail it back (anonymously) within a week. We found similar return rates (52%) for a second group for which the word "promise" was omitted from the commitment. Our findings show that participants kept their word outside the laboratory while pursuing everyday activities even when there were no foreseeable negative consequences for breaking them, demonstrating that promises are effective levers for behavioral change.
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Affiliation(s)
- Patricia Kanngiesser
- Faculty of Education and Psychology, Freie Universität Berlin, Berlin, Germany
- School of Psychology, University of Plymouth, Plymouth, United Kingdom
- *Correspondence: Patricia Kanngiesser
| | - Daniil Serko
- Max Planck Research Group iSearch, Max Planck Institute for Human Development, Berlin, Germany
| | - Jan K. Woike
- School of Psychology, University of Plymouth, Plymouth, United Kingdom
- Center for Adaptive Rationality (ARC), Max Planck Institute for Human Development, Berlin, Germany
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28
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Okada I, Yanagi I, Kubo Y, Kikuchi H. Descriptive, injunctive, or the synergy of both? Experimenting normative information on behavioral changes under the COVID-19 pandemic. Front Psychol 2022; 13:1015742. [PMID: 36643703 PMCID: PMC9838221 DOI: 10.3389/fpsyg.2022.1015742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
Backgrounds The effectiveness of citizens' behavioral changes to prevent the spread of SARS-CoV-2, such as avoiding large social events, relies on science communication from policymakers and collective action among peer citizens. Extant studies recognize the potential effects of information stimuli on citizens' behavioral changes, including what epidemiological experts request (injunctive information) and what surrounding people behave (descriptive information). Yet, they have insufficiently assessed the co-occurrence and possible interaction of multiple information stimuli. Methods 1,819 Japanese citizens aged 18 or over were recruited for an experimental survey during March 1-3, 2021 and asked their views on a hypothetical wedding attendance in Japan while being exposed to randomly assigned normative information stimuli. Their willingness to attend a wedding asked before and after the intervention was measured. Infection risk perception was also asked as a mediating variable. Results Findings suggest the constant supremacy of descriptive information and no synergistic effects in the interaction of multiple information stimuli. We also report that the effects of injunctive and descriptive information vary according to participants' risk perception, age, and trust in experts. Conclusion Our experimental test enables a systematic assessment of multiple normative information and confirms the primacy of descriptive information as the main driver of behavioral change. Communication by medical experts has limitations but is still effective in specific categories of the population.
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Affiliation(s)
- Isamu Okada
- Graduate School of International Development, Nagoya University, Nagoya, Japan,*Correspondence: Isamu Okada,
| | - Itaru Yanagi
- School of Law, Ritsumeikan University, Kyoto, Japan
| | - Yoshiaki Kubo
- Department of Urban Studies, School of Policy Studies, Kwansei Gakuin University, Sanda, Hyogo, Japan,Department of Law, Politics, and International Relations, Faculty of Humanities and Social Sciences, University of the Ryukyus, Nishihara, Okinawa, Japan,Research Institute for Humanity and Nature, Kyoto, Japan,Department of East Asian Languages and Cultures, Hamilton Lugar School of Global and International Studies, Indiana University, Bloomington, IN, USA,Program on U.S.-Japan Relations, Weatherhead Center for International Affairs, Harvard University, Harvard University, Cambridge, USA
| | - Hirokazu Kikuchi
- Area Studies Center, Institute of Developing Economies, Japan External Trade Organization, Chiba, Japan
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29
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Aisyah DN, Manikam L, Kiasatina T, Naman M, Adisasmito W, Kozlakidis Z. The Use of a Health Compliance Monitoring System During the COVID-19 Pandemic in Indonesia: Evaluation Study. JMIR Public Health Surveill 2022; 8:e40089. [PMID: 36219836 PMCID: PMC9683531 DOI: 10.2196/40089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/31/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND COVID-19 cases are soaring in Asia. Indonesia, Southeast Asia's most populous country, is now ranked second in the number of cases and deaths in Asia, after India. The compliance toward mask wearing, social distancing, and hand washing needs to be monitored to assess public behavioral changes that can reduce transmission. OBJECTIVE This study aimed to evaluate this compliance in Indonesia between October 2020 and May 2021 and demonstrate the use of the Bersatu Lawan COVID-19 (BLC) mobile app in monitoring this compliance. METHODS Data were collected in real time by the BLC app from reports submitted by personnel of military services, police officers, and behavioral change ambassadors. Subsequently, the data were analyzed automatically by the system managed by the Indonesia National Task Force for the Acceleration of COVID-19 Mitigation. RESULTS Between October 1, 2020, and May 2, 2021, the BLC app generated more than 165 million reports, with 469 million people monitored and 124,315,568 locations under observation in 514 districts/cities in 34 provinces in Indonesia. This paper grouped them into 4 colored zones, based on the degree of compliance, and analyzed variations among regions and locations. CONCLUSIONS Compliance rates vary among the 34 provinces and among the districts and cities of those provinces. However, compliance to mask wearing seems slightly higher than social distancing. This finding suggests that policy makers need to promote higher compliance in other measures, including social distancing and hand washing, whose efficacies have been proven to break the chain of transmission when combined with masks wearing.
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Affiliation(s)
- Dewi Nur Aisyah
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
- Indonesia One Health University Network, Depok, Indonesia
| | - Logan Manikam
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
- Aceso Global Health Consultants Pte Limited, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | | | - Maryan Naman
- Aceso Global Health Consultants Pte Limited, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Wiku Adisasmito
- Indonesia One Health University Network, Depok, Indonesia
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Fichtner UA, Armbruster C, Bischoff M, Maiwald P, Sehlbrede M, Tinsel I, Brame J, Kohl J, König D, Fuchs R, Wurst R, Farin-Glattacker E. Evaluation of an Interactive Web-Based Health Program for Weight Loss-A Randomized Controlled Trial. Int J Environ Res Public Health 2022; 19:15157. [PMID: 36429876 PMCID: PMC9690889 DOI: 10.3390/ijerph192215157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
Personal behavior patterns, such as unhealthy diet and lack of physical activity, lead to the development of overweight and obesity. These are associated with other comorbidities, reduced quality of life, premature frailty and increased mortality. Personalized web-based interventions are promising in inducing behavioral change leading to effective reductions in body weight at relatively low costs. However, the long-term effects have not been thoroughly investigated. This work evaluates the effectiveness of web-based interactive weight loss coaching and compares it to a non-interactive web-based health program. Therefore, a randomized controlled trial (RCT) was implemented, measuring primary and secondary outcomes at four time points (program start; end of the 12-week-program; 6 months after program end, 12 months after program end). The net sample covered 1499 subjects in the intervention group and 1492 in the control group. On average, the IG was 43 years old (±13.6), 80.1% male, and had 86.4 kg body weight (±16.1) at baseline. The CG was 42.7 years old (±13.9), 79.5% male and had a mean body weight of 86.1 (±15.7). Multilevel analyses with fixed effects were carried out both from the perspective of an intention-to-treat (ITT) and a complete cases approach (CCA). In sum, our adjusted models suggest a weight loss of 0.4 kg per time point. At the end of the program, significant differences in weight loss in % to baseline (delta M = 1.8 in the CCA) were observed in favor of the intervention group. From a long-term perspective, no superiority of the intervention group in comparison to the control group could be found. More intensive use of the program was not statistically associated with higher weight loss.
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Affiliation(s)
- Urs Alexander Fichtner
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Christoph Armbruster
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Martina Bischoff
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Phillip Maiwald
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Matthias Sehlbrede
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Iris Tinsel
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
| | - Judith Brame
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Jan Kohl
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Daniel König
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
- Department of Sport Science, Institute for Nutrition, Sports and Health, University of Vienna, 1150 Vienna, Austria
- Department of Nutritional Sciences, Institute for Nutrition, Sports and Health, University of Vienna, 1090 Vienna, Austria
| | - Reinhard Fuchs
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Ramona Wurst
- Department of Sport and Sport Science, University of Freiburg, 79117 Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, 79106 Freiburg, Germany
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Rababah J, Al-Hammouri MM. Effect of a modified motivational interviewing intervention on university students' psychological, cognitive, and nutritional health: A randomized controlled trial. Nurs Forum 2022; 57:1424-1433. [PMID: 36380519 DOI: 10.1111/nuf.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/10/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Motivational interviewing is a set of interviewing techniques that are employed to promote behavioral change. However, motivational interviewing is a costly intervention that requires training, and its effectiveness relies greatly on the skills and training of specialists. To overcome these limitations, this study developed and implemented a modified version of motivational interviewing. AIM This study was conducted to investigate the effect of a modified motivational interviewing (MMI) intervention on university students' psychological, cognitive, and nutritional health indicators. METHODS This randomized controlled trial study was conducted using an experimental, repeated-measures, two-group design. The authors developed a modified version of motivational interviewing, and its effect was investigated among university students. The final sample size in this study was 94 university students (intervention = 48 and control = 46). Psychological, cognitive, and nutritional health indicators were measured at baseline and 1 month postrandomization and 3 months postrandomization. Repeated-measures multivariate analysis of variance was used to analyze the data. RESULTS The results of the multivariate analysis revealed a significant effect of the MMI intervention on the linear combination of the dependent variables: Pillai's trace = 0.28, F (9, 84) = 3.59, p = .001. The univariate analysis showed that the effect of the MMI intervention was significant on four dependent variables (namely, uncontrolled eating, emotional eating, perceived stress, and mindfulness). CONCLUSION The MMI intervention improved university students' perceived stress, uncontrolled eating, emotional eating, and mindfulness. Further research should be conducted to validate the results reported in this article.
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Affiliation(s)
- Jehad Rababah
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Kim B, Thomsen MR, Nayga RM, Fang D, Goudie A. Impact of Weight Status Reporting on Childhood Body Mass Index. Child Obes 2022; 18:485-493. [PMID: 35196146 PMCID: PMC9529310 DOI: 10.1089/chi.2021.0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Many states have adopted school-based BMI screening or surveillance programs in an effort to address high rates of childhood obesity, some of which involve provision of confidential BMI reports to parents. While there is evidence that parents are attuned to information in the reports, there is less evidence showing that the reports are effective in preventing excess childhood weight gain. Methods: Data from Arkansas, the state with the nation's first and longest running and BMI screening program, were used to measure the impact of BMI reports. This was done through a regression discontinuity design that compared future BMI z-scores among children falling within a narrow band around the obese and overweight thresholds. We derived the effects of BMI reports by comparing students who received different types of reports around the relevant threshold. Results: While we are unable to detect any differences in BMI z-scores between the children who received the overweight report and the children who received the healthy weight report, we detected some differences between children who received the obese report and children who received the overweight report. These findings hold across subsamples by age, minority status, and school meal status. Conclusions: Based on these data, overweight or obese reports to do not meaningfully impact future BMI z-scores. This may be due, in part, to the format of parental reports, which may dampen the surprise element of an overweight or obese report.
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Affiliation(s)
- Bongkyun Kim
- Department of Economics, Kangwon National University, Chuncheon-si, Gangwon-Do, Korea
| | - Michael R. Thomsen
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Rodolfo M. Nayga
- Department of Agricultural Economics, Texas A&M University, College Station, TX, USA
| | - Di Fang
- Food and Resource Economics Department, University of Florida, Gainesville, FL, USA
| | - Anthony Goudie
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Center for Health Improvement, Little Rock, AR, USA; Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Gal LB, Bruck M, Tal R, Baum S, Ali JM, Weldegabriel LL, Sabar G, Golan R, Bentwich Z. Sustainable Elimination of Schistosomiasis in Ethiopia-A Five-Year Follow-Up Study. Trop Med Infect Dis 2022; 7:tropicalmed7090218. [PMID: 36136629 PMCID: PMC9501490 DOI: 10.3390/tropicalmed7090218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/21/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
In 2009, Mekele, the capital of the Tigray Region in Ethiopia, presented a mean prevalence of 44.7% of schistosomiasis (S. mansoni) in school children. Termed a public health problem, NALA, an international public health non-governmental organization, and their partners implemented a novel model of intervention, which aimed to compliment mass drug administration (MDA) campaigns with behavioral change (BC) and improved sanitation to achieve sustained elimination of schistosomiasis. The four-year intervention (2009−2012) covered 38 primary schools. The objective of this study was to examine factors associated with control or resurgence of the disease, and the association between the behavioral change program and disease prevalence, ten years after initiation. Eleven primary schools were selected for this follow-up study. All students provided a stool sample and filled in a knowledge, attitude and practice (KAP) questionnaire. In seven out of eleven schools (63.6%) the prevalence of schistosomiasis was maintained below 2% ten years after the initiation of the intervention. In four schools, prevalence returned to pre-intervention levels, defining them as persistent hot spots (PHS). Students from PHS schools scored lower on KAP questionnaires compared to students from responder schools; 3.9 ± 0.9 vs. 4.2 ± 0.9 (p-value < 0.001) for practice questions and 4.4 ± 1.4 vs. 4.6 ± 1.5 (p-value = 0.03) for attitude questions. The prevalence of schistosomiasis correlated positively with age, (p-value = 0.049), sex (relative risk = 1.7, p-value < 0.001), and location. Semi-urban locations (n = 382) had higher disease prevalence than urban locations (n = 242), (22.7% vs. 5.5%, p-value < 0.001). Students residing in semi-urban areas and close to a river (<500 m) were at higher risk of contracting schistosomiasis than those living in urban areas far from the river (RR = 5.95, p-value < 0.001). Finally, a correlation between prevalence and proximity of schools to rivers was found (semi-urban areas; RR = −0.91, p-value = 0.001 vs. urban areas; RR = −0.51, p-value = 0.001). Soil-transmitted-helminths prevalence in 2009 was 8.1% and declined during the intervention years to 0.5%. Prevalence in 2018 was found to be stable at 0.8%. These results demonstrate the long-term success of NALAs’ comprehensive model of intervention for elimination of schistosomiasis in school children, combining behavioral change and improved sanitation with MDA.
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Affiliation(s)
| | - Michal Bruck
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Robyn Tal
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Sarit Baum
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Jemal Mahdi Ali
- Department of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | | | - Galia Sabar
- The Department of Middle Eastern and African History, Tel Aviv University, Tel Aviv-Yafo P.O. Box 39040, Israel
| | - Rachel Golan
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer Sheva P.O. Box 653, Israel
| | - Zvi Bentwich
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
- Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev, Beer Sheva P.O. Box 653, Israel
- Correspondence: ; Tel.: +972-522440060
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Shigematsu J, Kobayashi R. Relationship between emotion regulation strategies and total conviction in promoting behavior change. Front Psychol 2022; 13:941404. [PMID: 36092109 PMCID: PMC9450947 DOI: 10.3389/fpsyg.2022.941404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/22/2022] [Indexed: 11/24/2022] Open
Abstract
Research conducted in the recent past have proposed total conviction as a factor associated with cognitive reappraisal that may produce changes in emotion and behavior. However, the factors that influence total conviction are not yet clearly identified. In this study, we focused on daily emotion regulation strategies and examined the relationship between emotion regulation strategies and total conviction. A total of 42 undergraduate and graduate students participated in this study. They measured their tendency toward daily emotion regulation strategies and then engaged in the cold pressor task (CPT) which is a distress tolerance task. Participants were then presented with information that encouraged them to engage in the task while enduring distress, creating a context for cognitive reappraisal of the task. Thereafter, they engaged in a second CPT. Finally, the degree of total conviction to the information that prompted reappraisal was measured. The results showed that total conviction in the experimental situation predicted behavior change. We found that the tendency to use routine cognitive reappraisal was not associated with total conviction, while the tendency to use expressive suppression would have a negative effect on total conviction. Furthermore, the expressive suppression tendency was found to moderate the relationship between total conviction and behavior change. These results indicate that the occurrence of total conviction in cognitive reappraisal leads to behavior change, though the tendency toward daily cognitive reappraisal is not related to the occurrence of total conviction in the experimental setting. The results also suggest that daily expressive suppression inhibits total conviction, particularly in situations where cognitive reappraisal is required.
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Affiliation(s)
- Jun Shigematsu
- Department of Psychology, Faculty of Humanities, University of Toyama, Toyama, Japan
- Department of Psychology, Graduate School of Education, Hiroshima University, Hiroshima, Japan
| | - Ryota Kobayashi
- Department of Psychology, Graduate School of Education, Hiroshima University, Hiroshima, Japan
- Department of Human Development and Education, School of Human and Social Sciences, Fukuoka Prefectural University, Fukuoka, Japan
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Hristov H, Millard J, Pravst I, Janssen M. European household spending and socio-economic impacts on food behavior during the first wave of COVID-19. Front Nutr 2022; 9:869091. [PMID: 35990318 PMCID: PMC9382126 DOI: 10.3389/fnut.2022.869091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
This paper provides a European-level analysis using a large-scale survey of 13 countries to examine the power of relevant economic and socio-demographic characteristics to account for changes in food consumption and purchasing behavior during COVID-19. This was done by focusing on a two-level analysis of subject-related predictors highlighted in many existing country-level studies to test the generality of their significance. The Level 1 predictors relate to the individual households participating in the survey consisting of household composition, education, and location, as well as three types of perceived COVID-19 risks of infection, severity, and anxiety. Level 2 relates to the national level, and especially to the financial situation measured by the mean national Actual Individual Consumption (AIC) per capita in PPP, of the countries, in which the households reside. In terms of changes in food consumption, results show that household composition, education, and the household's perceived risk of both being infected by COVID-19 and being severely infected are significant predictors, although there are some differences between the two levels. Some possible explanations are as follows: putting food into one's body in the context of the pandemic is related to a household's financial situation, its composition, especially the presence or absence of children and older people, and its educational attainment, and through all these aforementioned to the perception of COVID-19 infection and its severity risks. Changes in food purchasing react significantly to the same predictors, but additionally, to all other predictors at both household and AIC levels. The household's location and perceived COVID-19 anxiety risks are thus also significant. Food purchasing depends much more on factors operating both at the individual household level and the AIC level together; for example, households' access to food is affected by both national and local lockdown restrictions that vary according to the location of the household.
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Affiliation(s)
- Hristo Hristov
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
| | - Jeremy Millard
- Third Millennium Governance, Ry, Denmark
- International Center, Danish Technological Institute, Taastrup, Denmark
| | - Igor Pravst
- Nutrition Institute, Nutrition and Public Health Research Group, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Ljubljana, Slovenia
| | - Meike Janssen
- Consumer and Behavioral Insights Group, Copenhagen Business School, Frederiksberg, Denmark
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Kuo CY, Lin CF, Chung SY, Lin YL, Chu WM, Chen CC, Tsan YT. Biomonitoring of Urinary Nickel Successfully Protects Employees and Introduces Effective Interventions. Int J Environ Res Public Health 2022; 19:4887. [PMID: 35457753 DOI: 10.3390/ijerph19084887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 02/01/2023]
Abstract
Nickel is a heavy metal used in many industries. Nickel exposure can induce respiratory diseases and allergic reactions, and increase cancer risk. This study evaluated the introduction of a grinding and polishing system to prevent injuries from nickel toxicity in workers. We performed a controlled, interventional, before-and-after study from January 2018 to December 2019 at a faucet component industrial manufacturing site. Results from workplace environmental monitoring, questionnaire responses, and biomonitoring were collected before and after the intervention. Thirty-seven workers (100% men) aged 25.0 (interquartile range (IQR): 22.0–33.5) years were categorized into two groups, those with and without nickel exposure. In the exposed group, the median exposure time was 18.0 months (IQR 14.0–20.0 months). Urinary nickel concentration was lower in the exposed group than in the non-exposed group (13.8 (IQR 1.7–20.7); 23.1 (IQR 11.3–32.8) μg/g creatinine, respectively; p = 0.047). The median urinary nickel concentration was lower in the second year than in the first year (17.4 (IQR 2.2–27.4), 7.7 (IQR 4.3–18.5) μg/g creatinine, respectively; p = 0.022). Significant reductions in urinary nickel concentration were observed following the intervention and educational program. Thus, biomonitoring of urinary nickel concentration can successfully reflect the effectiveness of interventions and their relationship to nickel exposure.
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Mi RZ, Kornfield R, Shah DV, Maus A, Gustafson DH. Intraindividual, Dyadic, and Network Communication in a Digital Health Intervention: Distinguishing Message Exposure from Message Production. Health Commun 2022; 37:397-408. [PMID: 33238732 PMCID: PMC8144230 DOI: 10.1080/10410236.2020.1846273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Communicating within digital health interventions involves a range of behaviors that may contribute to the management of chronic illnesses in different ways. This study examines whether communication within a smartphone-based application for addiction recovery produces distinct effects depending on 1) the "level" of communication, defined as intraindividual communication (e.g., journal entries to oneself); dyadic communication (e.g., private messaging to other individuals); or network communication (e.g., discussion forum posts to all group members), and 2) whether individuals produce or are exposed to messages. We operationalize these communication levels and behaviors based on system use logs as the number of clicks dedicated to each activity and assess how each category of system use relates to changes in group bonding and substance use after 6 months with the mobile intervention. Our findings show that (1) intraindividual exposure to one's own past posts marginally predicts decreased drug use; (2) dyadic production predicts greater perceived bonding; while dyadic exposure marginally predicts reduced drug use; (3) network production predicts decreased risky drinking. Implications for digital health interventions are discussed.
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Affiliation(s)
- Ranran Z Mi
- School of Journalism and Mass Communication, University of Wisconsin-Madison
| | - Rachel Kornfield
- Preventive Medicine, Feinberg School of Medicine, Northwestern University
| | - Dhavan V Shah
- School of Journalism and Mass Communication, University of Wisconsin-Madison
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison
| | - Adam Maus
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison
| | - David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison
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Castela Forte J, Folkertsma P, Gannamani R, Kumaraswamy S, van Dam S, Hoogsteen J. Effect of a Digitally-Enabled, Preventive Health Program on Blood Pressure in an Adult, Dutch General Population Cohort: An Observational Pilot Study. Int J Environ Res Public Health 2022; 19:ijerph19074171. [PMID: 35409854 PMCID: PMC8998845 DOI: 10.3390/ijerph19074171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023]
Abstract
Worldwide, it is estimated that at least one in four adults suffers from hypertension, and this number is expected to increase as populations grow and age. Blood pressure (BP) possesses substantial heritability, but is also heavily modulated by lifestyle factors. As such, digital, lifestyle-based interventions are a promising alternative to standard care for hypertension prevention and management. In this study, we assessed the prevalence of elevated and high BP in a Dutch general population cohort undergoing a health screening, and observed the effects of a subsequent self-initiated, digitally-enabled lifestyle program on BP regulation. Baseline data were available for 348 participants, of which 56 had partaken in a BP-focused lifestyle program and got remeasured 10 months after the intervention. Participants with elevated SBP and DBP at baseline showed a mean decrease of 7.2 mmHg and 5.4 mmHg, respectively. Additionally, 70% and 72.5% of participants showed an improvement in systolic and diastolic BP at remeasurement. These improvements in BP are superior to those seen in other recent studies. The long-term sustainability and the efficacy of this and similar digital lifestyle interventions will need to be established in additional, larger studies.
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Affiliation(s)
- José Castela Forte
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, 9711 LM Groningen, The Netherlands
- Ancora Health B.V., 9711 LM Groningen, The Netherlands; (P.F.); (R.G.); (S.K.); (S.v.D.); (J.H.)
- Correspondence:
| | - Pytrik Folkertsma
- Ancora Health B.V., 9711 LM Groningen, The Netherlands; (P.F.); (R.G.); (S.K.); (S.v.D.); (J.H.)
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, 9711 LM Groningen, The Netherlands
| | - Rahul Gannamani
- Ancora Health B.V., 9711 LM Groningen, The Netherlands; (P.F.); (R.G.); (S.K.); (S.v.D.); (J.H.)
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9711 LM Groningen, The Netherlands
| | - Sridhar Kumaraswamy
- Ancora Health B.V., 9711 LM Groningen, The Netherlands; (P.F.); (R.G.); (S.K.); (S.v.D.); (J.H.)
| | - Sipko van Dam
- Ancora Health B.V., 9711 LM Groningen, The Netherlands; (P.F.); (R.G.); (S.K.); (S.v.D.); (J.H.)
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, 9711 LM Groningen, The Netherlands
| | - Jan Hoogsteen
- Ancora Health B.V., 9711 LM Groningen, The Netherlands; (P.F.); (R.G.); (S.K.); (S.v.D.); (J.H.)
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Miao Y, Wang M, Cai X, Zhu Q, Mao L. Leucine rich alpha-2-glycoprotein 1 (Lrg1) silencing protects against sepsis-mediated brain injury by inhibiting transforming growth factor beta1 (TGFβ1)/SMAD signaling pathway. Bioengineered 2022; 13:7316-7327. [PMID: 35264055 PMCID: PMC8973760 DOI: 10.1080/21655979.2022.2048775] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Sepsis-associated encephalopathy (SAE) is key manifestation of sepsis which is responsible for increased morbidity and mortality. Leucine rich alpha-2-glycoprotein 1 (Lrg1) is a secreted protein implicated in a variety of diseases. We aimed to explore the effects and potential mechanism of Lrg1 on sepsis-mediated brain injury. A sepsis-induced brain damage mice model was established. Then, ELISA was utilized to detect the levels of inflammatory factors in brain tissues. Behavioral performance, spatial learning and memory of mice were evaluated by open field test and Morris water maze test. The number of neurons was tested by H&E staining. Lrg1 expression was evaluated by RT-qPCR and western blot. In vitro, mouse hippocampal neuronal cell line (HT22) was stimulated by lipopolysaccharide (LPS). After Lrg1 silencing, cell viability was determined using CCK-8 and cell apoptosis was assessed by TUNEL. The levels of inflammatory factors were detected by ELISA. Moreover, western blot was applied to analyze the expression of proteins in transforming growth factor beta1 (TGFβ1)/SMAD signaling. Results revealed that mice in the model group showed obvious behavioral changes. Lrg1 was highly expressed in the brain tissues of model mice. Besides, Lrg1 knockdown suppressed the inflammation and apoptosis of LPS-induced HT22 cells. Moreover, Lrg1 silencing caused the inactivation of TGFβ1/SMAD signaling. Rescue assays confirmed that TGFβ1 overexpression reversed the impacts of Lrg1 deletion on the inflammation and apoptosis in LPS-induced HT22 cells. Collectively, Lrg1 silencing alleviates brain injury in SAE via inhibiting TGFβ1/SMAD signaling, implying that Lrg1 might serve as a promising target for SAE treatment.
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Affiliation(s)
- Youhan Miao
- Department of Infectious Diseases, The Third People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Meihua Wang
- Department of Infectious Diseases, The Third People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Xiaojuan Cai
- Department of Infectious Diseases, The Third People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Qiqi Zhu
- Department of Infectious Diseases, The Third People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Liping Mao
- Department of Infectious Diseases, The Third People's Hospital of Nantong, Nantong, Jiangsu, China
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Vincenzo JL, Patton SK, Lefler LL, McElfish PA, Wei J, Curran GM. Older Adults' Perceptions and Recommendations Regarding a Falls Prevention Self-Management Plan Template Based on the Health Belief Model: A Mixed-Methods Study. Int J Environ Res Public Health 2022; 19:ijerph19041938. [PMID: 35206125 PMCID: PMC8871905 DOI: 10.3390/ijerph19041938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 12/10/2022]
Abstract
Falls are the leading cause of fatal and non-fatal injuries among older adults. Self-management plans have been used in different contexts to promote healthy behaviors, but older adults’ perceptions of a falls prevention self-management plan template have not been investigated. Using mixed methods, we investigated older adults’ perceptions and recommendations of a falls prevention self-management plan template aligned with the Health Belief Model. Four focus groups (n = 27, average age 78 years) were conducted using semi-structured interview guides. Participants also ranked the written plan on paper with respect to each item by the level of importance, where item 1 was the most important, and 10 was the least important. Focus groups were transcribed and analyzed. Descriptive statistics were calculated for item rankings. Older adults felt that the plan would raise awareness and help them to engage in falls prevention behaviors. Participants recommended adding graphics and using red to highlight the risk of falling. Participants opined that ranking the items by level of importance was challenging because they felt all items were important. ‘What might happen to me if I fall’ was ranked as the most important item (average 2.6), while ‘How will I monitor progress’ was the least important (average = 6.6). Considering that older adults need support to engage in falls prevention, future research should investigate the impact of implementing an individually tailored falls prevention self-management plan on older adults’ engagement in falls prevention behaviors and outcomes of falls and injuries.
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Affiliation(s)
- Jennifer L. Vincenzo
- Department of Physical Therapy, College of Health Professions, University of Arkansas for Medical Sciences, Fayetteville, AR 72703, USA
- Correspondence:
| | - Susan K. Patton
- Department of Nursing, College of Education and Health Professions, University of Arkansas, Fayetteville, AR 72703, USA;
| | - Leanne L. Lefler
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Pearl A. McElfish
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Fayetteville, AR 72703, USA;
| | - Jeanne Wei
- Department of Geriatrics, Reynolds Institute on Aging, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Geoffrey M. Curran
- Departments of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114, USA
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Lie HC, Juvet LK, Street RL, Gulbrandsen P, Mellblom AV, Brembo EA, Eide H, Heyn L, Saltveit KH, Strømme H, Sundling V, Turk E, Menichetti J. Effects of Physicians' Information Giving on Patient Outcomes: a Systematic Review. J Gen Intern Med 2022; 37:651-663. [PMID: 34355348 PMCID: PMC8858343 DOI: 10.1007/s11606-021-07044-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Providing diagnostic and treatment information to patients is a core clinical skill, but evidence for the effectiveness of different information-giving strategies is inconsistent. This systematic review aimed to investigate the reported effects of empirically tested communication strategies for providing information on patient-related outcomes: information recall and (health-related) behaviors. METHODS The databases MEDLINE, Embase, PsycINFO (Ovid), Cochrane Central Register of Controlled Trials, and relevant bibliographies were systematically searched from the inception to April 24, 2020, without restrictions, for articles testing information-giving strategies for physicians (PROSPERO ID: CRD42019115791). Pairs of independent reviewers identified randomized controlled studies with a low risk of selection bias as from the Cochrane risk of bias 2 tool. Main outcomes were grouped into patient information recall and behavioral outcomes (e.g., alcohol consumption, weight loss, participation in screening). Due to high heterogeneity in the data on effects of interventions, these outcomes were descriptively reported, together with studies', interventions', and information-giving strategies' characteristics. PRISMA guidelines were followed. RESULTS Seventeen of 9423 articles were included. Eight studies, reporting 10 interventions, assessed patient information recall: mostly conducted in experimental settings and testing a single information-giving strategy. Four of the ten interventions reported significant increase in recall. Nine studies assessed behavioral outcomes, mostly in real-life clinical settings and testing multiple information-giving strategies simultaneously. The heterogeneity in this group of studies was high. Eight of the nine interventions reported a significant positive effect on objectively and subjectively measured patients' behavioral outcomes. DISCUSSION Using specific framing strategies for achieving specific communication goals when providing information to patients appears to have positive effects on information recall and patient health-related behaviors. The heterogeneity observed in this group of studies testifies the need for a more consistent methodological and conceptual agenda when testing medical information-giving strategies. TRIAL REGISTRATION PROSPERO registration number: CRD42019115791.
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Affiliation(s)
- Hanne C Lie
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lene K Juvet
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.,Norvegian Institute of Public Health, Oslo, Norway
| | - Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, USA
| | - Pål Gulbrandsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Health Services Research (HØKH) Centre, Akershus University Hospital, Lørenskog, Norway
| | - Anneli V Mellblom
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lena Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Kristina H Saltveit
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Oslo, Norway
| | - Vibeke Sundling
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.,Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Eva Turk
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.,Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Julia Menichetti
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway. .,Health Services Research (HØKH) Centre, Akershus University Hospital, Lørenskog, Norway.
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42
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Lamb JJ, Stone M, D’Adamo CR, Volkov A, Metti D, Aronica L, Minich D, Leary M, Class M, Carullo M, Ryan JJ, Larson IA, Lundquist E, Contractor N, Eck B, Ordovas JM, Bland JS. Personalized Lifestyle Intervention and Functional Evaluation Health Outcomes SurvEy: Presentation of the LIFEHOUSE Study Using N-of-One Tent-Umbrella-Bucket Design. J Pers Med 2022; 12:115. [PMID: 35055430 PMCID: PMC8779079 DOI: 10.3390/jpm12010115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/31/2021] [Accepted: 01/11/2022] [Indexed: 12/20/2022] Open
Abstract
The working definition of health is often the simple absence of diagnosed disease. This common standard is limiting given that changes in functional health status represent early warning signs of impending health declines. Longitudinal assessment of functional health status may foster prevention of disease occurrence and modify disease progression. The LIFEHOUSE (Lifestyle Intervention and Functional Evaluation-Health Outcomes SurvEy) longitudinal research project explores the impact of personalized lifestyle medicine approaches on functional health determinants. Utilizing an adaptive tent-umbrella-bucket design, the LIFEHOUSE study follows the functional health outcomes of adult participants recruited from a self-insured employee population. Participants were each allocated to the tent of an all-inclusive N-of-one case series. After assessing medical history, nutritional physical exam, baseline functional status (utilizing validated tools to measure metabolic, physical, cognitive, emotional and behavioral functional capacity), serum biomarkers, and genomic and microbiome markers, participants were assigned to applicable umbrellas and buckets. Personalized health programs were developed and implemented using systems biology formalism and functional medicine clinical approaches. The comprehensive database (currently 369 analyzable participants) will yield novel interdisciplinary big-health data and facilitate topological analyses focusing on the interactome among each participant's genomics, microbiome, diet, lifestyle and environment.
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Affiliation(s)
- Joseph J. Lamb
- Personalized Lifestyle Medicine Center, Gig Harbor, WA 98332, USA; (M.S.); (D.M.)
| | - Michael Stone
- Personalized Lifestyle Medicine Center, Gig Harbor, WA 98332, USA; (M.S.); (D.M.)
- Office of Personalized Health and Well-Being, Medical College of Georgia, AU/UGA Medical Partnership, Athens, GA 30606, USA
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
| | - Christopher R. D’Adamo
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
- Center for Integrative Medicine, University of Maryland, Baltimore, MD 21201, USA
| | | | - Dina Metti
- Personalized Lifestyle Medicine Center, Gig Harbor, WA 98332, USA; (M.S.); (D.M.)
| | - Lucia Aronica
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA 94305, USA
| | - Deanna Minich
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
- Human Nutrition and Functional Medicine, University of Western States, Portland, OR 97213, USA
| | | | - Monique Class
- Institute for Functional Medicine, Federal Way, WA 98003, USA; (C.R.D.); (D.M.); (M.C.)
- The Center for Functional Medicine, Stamford, CT 06905, USA
| | - Malisa Carullo
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Jennifer J. Ryan
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA;
| | - Ilona A. Larson
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Erik Lundquist
- Personalized Lifestyle Medicine Center, Aliso Viejo, CA 92656, USA;
| | - Nikhat Contractor
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Brent Eck
- Metagenics, Inc., Aliso Viejo, CA 92656, USA; (L.A.); (M.C.); (I.A.L.); (N.C.); (B.E.)
| | - Jose M. Ordovas
- Jean Meyer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111, USA;
| | - Jeffrey S. Bland
- Personalized Lifestyle Medicine Institute, Bainbridge Island, WA 98110, USA;
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43
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Xu H, Liu L, Zhao L, Takashi E, Kitayama A, Zou Y. Psychological Impact and Compliance with Staying at Home of the Public to COVID-19 Outbreak during Chinese Spring Festival. Int J Environ Res Public Health 2022; 19:916. [PMID: 35055736 DOI: 10.3390/ijerph19020916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/27/2021] [Accepted: 01/11/2022] [Indexed: 11/25/2022]
Abstract
In December 2019, COVID-19 was reported in Wuhan, China. Most of the studies related to the psychological impact and compliance with staying at home due to COVID-19 focused on ten days or one month after the initial “stay-at-home” phase of the COVID-19 pandemic. The early psychological impact and behavior change to COVID-19 during the Chinese Spring Festival (the start time for recommendations to stay at home) is uncertain. In this study, people from 23 provinces in China were recruited to participate in an online survey, using Credamo. Psychological impact and compliance with staying at home were evaluated by a self-designed and validated questionnaire. The results indicated that anxiety was the most often reported feeling (mean: 3.69), followed by sadness (mean: 3.63). Participants employed in foreign-owned companies were most likely to express anxiety and sadness. Overall, 61.8% of participants reported hardly going out, whereas 2.4% said they frequently went out during the initial “stay-at-home” phase of the COVID-19 pandemic. Participants with higher levels of anxiety and sadness were most likely to stay at home against the spread of COVID-19, as were female gender. This survey is an important study of the first reaction to staying at home during the initial “stay-at-home” phase coinciding with Chinese Spring Festival. Our findings identified factors associated with higher level of psychological impact and better compliance with staying at home recommendations during Chinese Spring Festival. The findings can be used to formulate precaution interventions to improve the mental health of vulnerable groups and high uptake of policy during the COVID-19 epidemic.
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Adachi S, Fukumura S, Kato S, Mikami T, Tsugawa T. Transient personality changes with bilateral thalamic infarction in a 12-year-old girl. Pediatr Int 2022; 64:e15352. [PMID: 36410724 DOI: 10.1111/ped.15352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Shuhei Adachi
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shinobu Fukumura
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shinsuke Kato
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeshi Mikami
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeshi Tsugawa
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
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45
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Nguyen-Phuong-Mai M. What Bias Management Can Learn From Change Management? Utilizing Change Framework to Review and Explore Bias Strategies. Front Psychol 2021; 12:644145. [PMID: 34975601 PMCID: PMC8714784 DOI: 10.3389/fpsyg.2021.644145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
This paper conducted a preliminary study of reviewing and exploring bias strategies using a framework of a different discipline: change management. The hypothesis here is: If the major problem of implicit bias strategies is that they do not translate into actual changes in behaviors, then it could be helpful to learn from studies that have contributed to successful change interventions such as reward management, social neuroscience, health behavioral change, and cognitive behavioral therapy. The result of this integrated approach is: (1) current bias strategies can be improved and new ones can be developed with insight from adjunct study fields in change management; (2) it could be more sustainable to invest in a holistic and proactive bias strategy approach that targets the social environment, eliminating the very condition under which biases arise; and (3) while implicit biases are automatic, future studies should invest more on strategies that empower people as "change agents" who can act proactively to regulate the very environment that gives rise to their biased thoughts and behaviors.
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46
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Ochi S, So M, Hashimoto S, Denda K, Sekizawa Y. Behavioral Factors Associated with COVID-19 Risk: A Cross-Sectional Survey in Japan. Int J Environ Res Public Health 2021; 18:ijerph182212184. [PMID: 34831940 PMCID: PMC8625679 DOI: 10.3390/ijerph182212184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Behaviors to avoid infection are key to minimizing casualties of the COVID-19 pandemic, as well as to avoid excessive interventions that are less effective. This study aims to identify behavioral patterns associated with SARS-CoV-2 infection in the real world. METHODS A questionnaire-based cross-sectional study was conducted targeting a research panel of NTTCom Online Marketing Solutions Corporation or its affiliates. Data were extracted so that their demographic composition ratios matched the population estimates. Individuals who answered with consistency to have been diagnosed with SARS-CoV-2 at a medical facility were categorized into a SARS-CoV-2 group. Differences in lifestyles were compared using multiple regression and inverse probability weighing. RESULTS In total 13,277 participants were included, of whom 44 (0.33%) were categorized as the SARS-CoV-2 group. Diagnosis of SARS-CoV-2 was negatively correlated with crowd avoidance, mask wearing, and hand-washing behavior. On the contrary, the diagnosis was positively correlated with some behaviors that appear to be preventive actions against the infection, such as changing clothes frequently, sanitizing belongings, and remote working. CONCLUSIONS It is important to conduct evidence-based intervention on people's behaviors and to avoid excessive interventions that are less effective, so that people can minimize the indirect harm, such as exhaustion and economic loss.
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Affiliation(s)
- Sae Ochi
- Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo 105-0003, Japan
- Correspondence:
| | - Mirai So
- Department of Psychiatry, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Sora Hashimoto
- United Health Communication Co., Ltd., Tokyo 103-0006, Japan;
| | - Kenzo Denda
- Hiramatsu Memorial Hospital, Sapporo 064-8536, Japan;
| | - Yoichi Sekizawa
- Research Department, Research Institute of Economy, Trade and Industry, Tokyo 100-8901, Japan;
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47
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Bishop CJ. Homonegativity Scores in Response to Static Same-Sex Imagery versus Observable Behavioral Change in Response to an Interactive Gay Male Target. J Homosex 2021; 68:2301-2321. [PMID: 32154767 DOI: 10.1080/00918369.2020.1736431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Homonegativity research tends to focus on the identities of gay men and lesbian women through inauthentic means such as vignettes and signifiers like t-shirts with pro-gay slogans. Such research also tends to neglect sexual behavior. These issues were addressed in the present mixed-methods study. Heterosexual male (n = 196) and female (n = 219) participants were asked to complete measures of old-fashioned and modern homonegativity toward gay men and lesbian women after viewing a set of stimuli depicting gay male, lesbian female, or heterosexual couples. Participants also completed an interview with the researcher where he self-identified as a gay male and observed any changes in behavior following his disclosure. Findings indicated that male participants showed higher levels of modern homonegativity than female participants, regardless of the images viewed, and had higher odds of exhibiting negative behavioral change in response to the researcher's self-disclosure. Also, participants who viewed images of lesbian couples kissing or embracing had lower odds of showing negative behavioral change.
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Affiliation(s)
- C J Bishop
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
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48
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Carey A, Yang Q, DeLuca L, Toro-Ramos T, Kim Y, Michaelides A. The Relationship Between Weight Loss Outcomes and Engagement in a Mobile Behavioral Change Intervention: Retrospective Analysis. JMIR Mhealth Uhealth 2021; 9:e30622. [PMID: 34747706 PMCID: PMC8663454 DOI: 10.2196/30622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/02/2021] [Accepted: 09/19/2021] [Indexed: 01/11/2023] Open
Abstract
Background There is large variance in weight loss outcomes of digital behavior change interventions (DBCIs). It has been suggested that different patterns of engagement in the program could be responsible for this variance in outcomes. Previous studies have found that the amount of engagement on DBCIs, such as the number of meals logged or articles read, is positively associated with weight loss. Objective This retrospective study extends previous research by observing how important weight loss outcomes (high weight loss: 10% or greater body weight loss; moderate weight loss: between 5% to 10%; stable weight: 0 plus or minus 1%) are associated with engagement on a publicly available mobile DBCI (Noom) from 9 to 52 weeks. Methods Engagement and weight data for eligible participants (N=11,252) were extracted from the Noom database. Engagement measures included the number of articles read, meals logged, steps recorded, messages to coach, exercise logged, weigh-ins, and days with 1 meal logged per week. Weight was self-reported on the program. Multiple linear regressions examined how weight loss outcome (moderate and high vs stable) was associated with each engagement measure across 3 study time periods: 9-16 weeks, 17-32 weeks, and 33-52 weeks. Results At 9-16 weeks, among the 11,252 participants, 2594 (23.05%) had stable weight, 6440 (57.23%) had moderate weight loss, and 2218 (19.71%) had high weight loss. By 33-52 weeks, 525 (18.21%) had stable weight, 1214 (42.11%) had moderate weight loss, and 1144 (39.68%) had high weight loss. Regression results showed that moderate weight loss and high weight loss outcomes were associated with all engagement measures to a significantly greater degree than was stable weight (all P values <.001). These differences held across all time periods with the exception of exercise for the moderate weight loss category at 1 time period of 33-52 weeks. Exercise logging increased from 9 to 52 weeks regardless of the weight loss group. Conclusions Our results suggest that these clinically important weight loss outcomes are related to the number of articles read, meals logged, steps recorded, messages to coach, exercise logged, weigh-ins, and days with 1 meal logged per week both in the short-term and long-term (ie, 1 year) on Noom. This provides valuable data on engagement patterns over time on a self-directed mobile DBCI, can help inform how interventions tailor recommendations for engagement depending on how much weight individuals have lost, and raises important questions for future research on engagement in DBCIs.
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Affiliation(s)
- Alissa Carey
- Academic Research, Noom Inc, New York, NY, United States
| | - Qiuchen Yang
- Academic Research, Noom Inc, New York, NY, United States
| | - Laura DeLuca
- Academic Research, Noom Inc, New York, NY, United States.,Department of Clinical Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Tatiana Toro-Ramos
- Academic Research, Noom Inc, New York, NY, United States.,Amgen, Thousand Oaks, CA, United States
| | - Youngin Kim
- Academic Research, Noom Inc, New York, NY, United States.,Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Vanderplanck M, Lapeyre B, Lucas S, Proffit M. Ozone Induces Distress Behaviors in Fig Wasps with a Reduced Chance of Recovery. Insects 2021; 12:995. [PMID: 34821795 DOI: 10.3390/insects12110995] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary Ecological interactions among organisms underpin the stability of ecological networks, which are responsible for species biodiversity in ecosystems. These interactions are currently threatened by environmental risks, mainly due to human activities, such as air pollution. Among air pollutants, tropospheric ozone (O3) is known to disrupt chemical communication between plants and their pollinators. Alarmingly, its concentration is likely to increase by two–four-fold in the next two decades. However, the direct effects of O3 on the behavior of pollinators themselves have not been investigated so far, even though insect behavior is key to their ecological interactions. In this study, we evaluated the potential effects of O3 at different field-realistic concentrations on the behavior of the fig wasp Blastophaga psenes, the exclusive pollinator of the Mediterranean fig species Ficus carica. We found that O3, even at low concentrations, induced abnormal motility in fig wasps, and that exposed individuals might only have a reduced chance of recovery. Overall, our findings indicate that O3 can affect pollinator behavior, which may have detrimental implications for pollination systems. Abstract Among anthropogenic environmental risks, air pollution has the potential to impact animal and plant physiology, as well as their interactions and the long-term survival of populations, which could threaten the functioning of ecosystems. What is especially alarming is that the concentration of tropospheric ozone (O3) has dramatically increased since pre-industrial times. However, the direct effects of O3 on the behavior of pollinators themselves have not been investigated so far even though insect behavior is key to their ecological interactions, which underpin the stability of ecological networks responsible for species biodiversity in ecosystems. In this study, we aim to determine the potential effects of O3 episodes at different field-realistic concentrations (0, 40, 80, 120, and 200 ppb for 60 min) on the behavior of the fig wasp Blastophaga psenes by monitoring exposed individuals hourly for 5 h after exposure. We found that ozone episodes induced major changes in insect behavior, which were already significant at 80 ppb with individuals displaying abnormal motility. The tracking over time clearly showed that exposed individuals might only have a reduced chance of recovery, with a decreasing proportion of active fig wasps despite the cessation of an O3 episode. These findings illustrate that O3 episodes can affect pollinator behavior, which may have detrimental implications for pollination systems. It is, therefore, of importance to assess the effects of O3 on insect behavior in order to predict how it could modify ecological interactions and species biodiversity in ecosystems.
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Tsiouris KM, Tsakanikas VD, Gatsios D, Fotiadis DI. A Review of Virtual Coaching Systems in Healthcare: Closing the Loop With Real-Time Feedback. Front Digit Health 2021; 2:567502. [PMID: 34713040 PMCID: PMC8522109 DOI: 10.3389/fdgth.2020.567502] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/28/2020] [Indexed: 12/04/2022] Open
Abstract
This review focuses on virtual coaching systems that were designed to enhance healthcare interventions, combining the available sensing and system-user interaction technologies. In total, more than 1,200 research papers have been retrieved and evaluated for the purposes of this review, which were obtained from three online databases (i.e.,PubMed, Scopus and IEEE Xplore) using an extensive set of search keywords. After applying exclusion criteria, the remaining 41 research papers were used to evaluate the status of virtual coaching systems over the past 10 years and assess current and future trends in this field. The results suggest that in home coaching systems were mainly focused in promoting physical activity and a healthier lifestyle, while a wider range of medical domains was considered in systems that were evaluated in lab environment. In home patient monitoring with IoT devices and sensors was mostly limited to activity trackers, pedometers and heart rate monitoring. Real-time evaluations and personalized patient feedback was also found to be rather lacking in home coaching systems and this is the most alarming find of this analysis. Feasibility studies in controlled environment and an ongoing active research on Horizon 2020 funded projects, show that the future trends in this field are aiming to close the loop with automated patient monitoring, real-time evaluations and more precise interventions.
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Affiliation(s)
- Kostas M Tsiouris
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.,Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Vassilios D Tsakanikas
- Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Dimitrios Gatsios
- Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece.,Department of Neurology, Medical School, University of Ioannina, Ioannina, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Material Science and Engineering, University of Ioannina, Ioannina, Greece.,Department of Biomedical Research, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology - Hellas, Ioannina, Greece
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