Outlook | Newsletter of the Society of Behavioral Medicine

New Articles from Annals of Behavioral Medicine and Translational Behavioral Medicine

SBM's two journals, Annals of Behavioral Medicine and Translational Behavioral Medicine: Practice, Policy, Research (TBM), continuously publish online articles, many of which become available before issues are printed. Three recently published Annals and TBM online articles are listed below.

SBM members who have paid their 2016 membership dues are able to access the full text of all Annals and TBM online articles via the SBM website by following the steps below.

Go to the Members Only section of the SBM website (https://www.sbm.org/membership/members).
Log in with your username and password.
Click on the Journals link (listed third in the list of member benefits).
Click on the title of the journal which you would like to electronically access.

To check if you are a current SBM member, or if you are having trouble accessing the journals online, please contact the SBM national office at info@sbm.org or (414) 918-3156.

Annals of Behavioral Medicine

Genomic Information may Inhibit Weight-Related Behavior Change Inclinations Among Individuals in a Fear State
Authors: Susan Persky, Rebecca A. Ferrer, William M. P. Klein
Abstract: As evidence mounts regarding associations between genetics and body weight, it is essential to understand how to communicate this information, and factors like emotion that could moderate the effectiveness of messages. We assessed influences of emotion on reactions to weight-related genomic information in a virtual clinical setting. An online representative US sample of overweight women was randomized to receive an emotion induction (anger, fear, or neutral) paired with information about genomic or behavioral influences on weight in an interaction with a virtual doctor. Receiving genomic information led to reduced attributions of lifestyle causes for weight and behavioral intentions, but only among individuals in a fear state. The current study is among the first to reinforce the concern that discussing genomic underpinnings of overweight could undercut health behavior, and highlights the importance of identifying factors like emotion that influence interpretation of genomic information.

Theoretical and Behavioral Mediators of a Weight Loss Intervention for Men
Authors: Melissa M. Crane, Dianne S. Ward, Lesley D. Lutes, J. Michael Bowling, Deborah F. Tate
Abstract: Men are currently underrepresented in weight loss trials despite similar obesity rates, which limit our understanding about the most effective elements of treatment for men. The purpose of this study was to test the theoretical (autonomous motivation, self-efficacy, outcome expectancies, and self-regulation) and behavioral (calorie intake, physical activity, self-weighing) mediators of a men-only, Internet-delivered weight loss intervention focused on innovative and tailored treatment elements specifically for men. Data comes from a 6-month randomized trial (N=107) testing the intervention compared to a waitlist control group. Changes in the theoretical mediators between baseline and 3 months were tested as mediators of the intervention effect on weight change at 6 months in both single and multiple mediator models. Changes in behaviors between baseline and 6 months were tested in the same manner. The intervention produced greater weight losses compared to the control group (-5.57 kg±6.6 vs. -0.65 kg±3.3, p <0.001) and significant changes (p's <0.05) in most of the theoretical and behavior mediators. In multiple mediator models, changes in diet-related autonomous motivation, self-efficacy, and self-regulation all significantly mediated the relationship between the intervention and weight loss. The intervention effect was also mediated by changes in dietary intake and self-weighing frequency. By testing the theoretical mediators of this intervention in a multiple mediator context, this study contributes to current knowledge related to the development of weight loss interventions for men and suggests that interventions should target diet-focused constructs.

Direction of Association Between Depressive Symptoms and Lifestyle Behaviors in Patients with Coronary Heart Disease: the Heart and Soul Study
Authors: Nancy L. Sin, Anupama D. Kumar, Anil K. Gehi, Mary A. Whooley
Abstract: Emerging evidence indicates that the association between depression and subsequent cardiovascular events is largely mediated by health behaviors. However, it is unclear whether depression is the cause or the consequence of poor health behaviors. The purpose of the present study is to examine prospective, bidirectional relationships of depressive symptoms with behavioral and lifestyle factors among patients with coronary heart disease. Depressive symptoms and lifestyle behaviors (physical activity, medication adherence, body mass index, waist to hip ratio, sleep quality, and smoking status) were assessed at baseline and 5 years later among a prospective cohort of 667 patients with stable coronary heart disease. Greater depressive symptoms at baseline predicted poorer lifestyle behaviors 5 years later (less physical activity, lower medication adherence, higher body mass index, higher waist to hip ratio, worse sleep quality, and smoking). After adjustment for demographics, cardiac disease severity, comorbidity, and baseline lifestyle behaviors, depressive symptom severity remained predictive of subsequent worsening of physical activity (beta=-0.08; 95 % confidence interval (CI)=-0.16, -0.01; p=0.03), medication adherence (beta=-0.16; 95 % CI=-0.24, -0.08; p <0.001), and sleep quality (beta=-0.19; 95 % CI=-0.27, -0.11; p<0.001). Baseline lifestyle behaviors also predicted 5-year change in depressive symptoms, although the associations were attenuated after adjustment for baseline depressive symptoms and covariates. Among patients with coronary heart disease, depressive symptoms were linked to a range of lifestyle risk factors and predicted further declines in physical activity, medication adherence, and sleep quality.

Translational Behavioral Medicine

Transforming community prevention systems for sustained impact: embedding active implementation and scaling functions
Authors: William A. AldridgeII, Renée I. Boothroyd, W. Oscar Fleming, Karen Lofts Jarboe, Jane Morrow, Gail F. Ritchie, Joyce Sebian
Abstract: Traditional efforts to translate evidence-based prevention strategies to communities, at scale, have not often produced socially significant outcomes or the local capacity needed to sustain them. A key gap in many efforts is the transformation of community prevention systems to support and sustain local infrastructure for the active implementation, scaling, and continuous improvement of effective prevention strategies. In this paper, we discuss (1) the emergence of applied implementation science as an important type 3-5 translational extension of traditional type 2 translational prevention science, (2) active implementation and scaling functions to support the full and effective use of evidence-based prevention strategies in practice, (3) the organization and alignment of local infrastructure to embed active implementation and scaling functions within community prevention systems, and (4) policy and practice implications for greater social impact and sustainable use of effective prevention strategies.

Statistical methodologies to pool across multiple intervention studies
Authors: Shrikant I. Bangdiwala, Alok Bhargava, Daniel P. O'Connor, Thomas N. Robinson, Susan Michie, David M. Murray, June Stevens, Steven H. Belle, Thomas N. Templin, Charlotte A. Pratt
Abstract: Combining and analyzing data from heterogeneous randomized controlled trials of complex multiple-component intervention studies, or discussing them in a systematic review, is not straightforward. The present article describes certain issues to be considered when combining data across studies, based on discussions in an NIH-sponsored workshop on pooling issues across studies in consortia (see Belle et al. in Psychol Aging, 18(3):396-405, 2003). Several statistical methodologies are described and their advantages and limitations are explored. Whether weighting the different studies data differently, or via employing random effects, one must recognize that different pooling methodologies may yield different results. Pooling can be used for comprehensive exploratory analyses of data from RCTs and should not be viewed as replacing the standard analysis plan for each study. Pooling may help to identify intervention components that may be more effective especially for subsets of participants with certain behavioral characteristics. Pooling, when supported by statistical tests, can allow exploratory investigation of potential hypotheses and for the design of future interventions.

The impact of behavioral and mental health risk assessments on goal setting in primary care
Authors: Alex H. Krist, Russell E. Glasgow, Suzanne Heurtin-Roberts, Roy T. Sabo, Dylan H. Roby, Sherri N. Sheinfeld Gorin, Bijal A. Balasubramanian, Paul A. Estabrooks, Marcia G. Ory, Beth A. Glenn, Siobhan M. Phillips, Rodger Kessler, Sallie Beth Johnson, Catherine L. Rohweder, Maria E. Fernandez
Abstract: Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice patients to be asked about each of eight risks (range of differences 5.3-15.8 %, p <0.001), set goals for six risks (range of differences 3.8-16.6 %, p<0.01), and improve five risks (range of differences 5.4-13.6 %, p<0.01). Compared to controls, intervention patients felt clinicians cared more for them and showed more interest in their concerns. Patient-centered health risk assessments improve screening and goal setting.


Winter 2016	Return to Outlook main page »
New Articles from Annals of Behavioral Medicine and Translational Behavioral Medicine SBM's two journals, Annals of Behavioral Medicine and Translational Behavioral Medicine: Practice, Policy, Research (TBM), continuously publish online articles, many of which become available before issues are printed. Three recently published Annals and TBM online articles are listed below. SBM members who have paid their 2016 membership dues are able to access the full text of all Annals and TBM online articles via the SBM website by following the steps below. Go to the Members Only section of the SBM website (https://www.sbm.org/membership/members). Log in with your username and password. Click on the Journals link (listed third in the list of member benefits). Click on the title of the journal which you would like to electronically access. To check if you are a current SBM member, or if you are having trouble accessing the journals online, please contact the SBM national office at info@sbm.org or (414) 918-3156. Annals of Behavioral Medicine Genomic Information may Inhibit Weight-Related Behavior Change Inclinations Among Individuals in a Fear State Authors: Susan Persky, Rebecca A. Ferrer, William M. P. Klein Abstract: As evidence mounts regarding associations between genetics and body weight, it is essential to understand how to communicate this information, and factors like emotion that could moderate the effectiveness of messages. We assessed influences of emotion on reactions to weight-related genomic information in a virtual clinical setting. An online representative US sample of overweight women was randomized to receive an emotion induction (anger, fear, or neutral) paired with information about genomic or behavioral influences on weight in an interaction with a virtual doctor. Receiving genomic information led to reduced attributions of lifestyle causes for weight and behavioral intentions, but only among individuals in a fear state. The current study is among the first to reinforce the concern that discussing genomic underpinnings of overweight could undercut health behavior, and highlights the importance of identifying factors like emotion that influence interpretation of genomic information. Theoretical and Behavioral Mediators of a Weight Loss Intervention for Men Authors: Melissa M. Crane, Dianne S. Ward, Lesley D. Lutes, J. Michael Bowling, Deborah F. Tate Abstract: Men are currently underrepresented in weight loss trials despite similar obesity rates, which limit our understanding about the most effective elements of treatment for men. The purpose of this study was to test the theoretical (autonomous motivation, self-efficacy, outcome expectancies, and self-regulation) and behavioral (calorie intake, physical activity, self-weighing) mediators of a men-only, Internet-delivered weight loss intervention focused on innovative and tailored treatment elements specifically for men. Data comes from a 6-month randomized trial (N=107) testing the intervention compared to a waitlist control group. Changes in the theoretical mediators between baseline and 3 months were tested as mediators of the intervention effect on weight change at 6 months in both single and multiple mediator models. Changes in behaviors between baseline and 6 months were tested in the same manner. The intervention produced greater weight losses compared to the control group (-5.57 kg±6.6 vs. -0.65 kg±3.3, p <0.001) and significant changes (p's <0.05) in most of the theoretical and behavior mediators. In multiple mediator models, changes in diet-related autonomous motivation, self-efficacy, and self-regulation all significantly mediated the relationship between the intervention and weight loss. The intervention effect was also mediated by changes in dietary intake and self-weighing frequency. By testing the theoretical mediators of this intervention in a multiple mediator context, this study contributes to current knowledge related to the development of weight loss interventions for men and suggests that interventions should target diet-focused constructs. Direction of Association Between Depressive Symptoms and Lifestyle Behaviors in Patients with Coronary Heart Disease: the Heart and Soul Study Authors: Nancy L. Sin, Anupama D. Kumar, Anil K. Gehi, Mary A. Whooley Abstract: Emerging evidence indicates that the association between depression and subsequent cardiovascular events is largely mediated by health behaviors. However, it is unclear whether depression is the cause or the consequence of poor health behaviors. The purpose of the present study is to examine prospective, bidirectional relationships of depressive symptoms with behavioral and lifestyle factors among patients with coronary heart disease. Depressive symptoms and lifestyle behaviors (physical activity, medication adherence, body mass index, waist to hip ratio, sleep quality, and smoking status) were assessed at baseline and 5 years later among a prospective cohort of 667 patients with stable coronary heart disease. Greater depressive symptoms at baseline predicted poorer lifestyle behaviors 5 years later (less physical activity, lower medication adherence, higher body mass index, higher waist to hip ratio, worse sleep quality, and smoking). After adjustment for demographics, cardiac disease severity, comorbidity, and baseline lifestyle behaviors, depressive symptom severity remained predictive of subsequent worsening of physical activity (beta=-0.08; 95 % confidence interval (CI)=-0.16, -0.01; p=0.03), medication adherence (beta=-0.16; 95 % CI=-0.24, -0.08; p <0.001), and sleep quality (beta=-0.19; 95 % CI=-0.27, -0.11; p<0.001). Baseline lifestyle behaviors also predicted 5-year change in depressive symptoms, although the associations were attenuated after adjustment for baseline depressive symptoms and covariates. Among patients with coronary heart disease, depressive symptoms were linked to a range of lifestyle risk factors and predicted further declines in physical activity, medication adherence, and sleep quality. Translational Behavioral Medicine Transforming community prevention systems for sustained impact: embedding active implementation and scaling functions Authors: William A. AldridgeII, Renée I. Boothroyd, W. Oscar Fleming, Karen Lofts Jarboe, Jane Morrow, Gail F. Ritchie, Joyce Sebian Abstract: Traditional efforts to translate evidence-based prevention strategies to communities, at scale, have not often produced socially significant outcomes or the local capacity needed to sustain them. A key gap in many efforts is the transformation of community prevention systems to support and sustain local infrastructure for the active implementation, scaling, and continuous improvement of effective prevention strategies. In this paper, we discuss (1) the emergence of applied implementation science as an important type 3-5 translational extension of traditional type 2 translational prevention science, (2) active implementation and scaling functions to support the full and effective use of evidence-based prevention strategies in practice, (3) the organization and alignment of local infrastructure to embed active implementation and scaling functions within community prevention systems, and (4) policy and practice implications for greater social impact and sustainable use of effective prevention strategies. Statistical methodologies to pool across multiple intervention studies Authors: Shrikant I. Bangdiwala, Alok Bhargava, Daniel P. O'Connor, Thomas N. Robinson, Susan Michie, David M. Murray, June Stevens, Steven H. Belle, Thomas N. Templin, Charlotte A. Pratt Abstract: Combining and analyzing data from heterogeneous randomized controlled trials of complex multiple-component intervention studies, or discussing them in a systematic review, is not straightforward. The present article describes certain issues to be considered when combining data across studies, based on discussions in an NIH-sponsored workshop on pooling issues across studies in consortia (see Belle et al. in Psychol Aging, 18(3):396-405, 2003). Several statistical methodologies are described and their advantages and limitations are explored. Whether weighting the different studies data differently, or via employing random effects, one must recognize that different pooling methodologies may yield different results. Pooling can be used for comprehensive exploratory analyses of data from RCTs and should not be viewed as replacing the standard analysis plan for each study. Pooling may help to identify intervention components that may be more effective especially for subsets of participants with certain behavioral characteristics. Pooling, when supported by statistical tests, can allow exploratory investigation of potential hypotheses and for the design of future interventions. The impact of behavioral and mental health risk assessments on goal setting in primary care Authors: Alex H. Krist, Russell E. Glasgow, Suzanne Heurtin-Roberts, Roy T. Sabo, Dylan H. Roby, Sherri N. Sheinfeld Gorin, Bijal A. Balasubramanian, Paul A. Estabrooks, Marcia G. Ory, Beth A. Glenn, Siobhan M. Phillips, Rodger Kessler, Sallie Beth Johnson, Catherine L. Rohweder, Maria E. Fernandez Abstract: Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice patients to be asked about each of eight risks (range of differences 5.3-15.8 %, p <0.001), set goals for six risks (range of differences 3.8-16.6 %, p<0.01), and improve five risks (range of differences 5.4-13.6 %, p<0.01). Compared to controls, intervention patients felt clinicians cared more for them and showed more interest in their concerns. Patient-centered health risk assessments improve screening and goal setting.