New Articles from Annals of Behavioral Medicine and Translational Behavioral Medicine

Psychological and Biological Pathways Linking Perceived Neighborhood Characteristics and Body Mass Index

Diana A Chirinos, Luz M Garcini, Annina Seiler, Kyle W Murdock, Kristen Peek, Raymond P Stowe, Christopher Fagundes

Background
Perceived neighborhood characteristics are linked to obesity, however, the mechanisms linking these two factors remain unknown.
Purpose
This study aimed to examine associations between perceived neighborhood characteristics and body mass index (BMI), establish whether indirect pathways through psychological distress and inflammation are important, and determine whether these associations vary by race/ethnicity.
Methods
Participants were 1,112 adults enrolled in the Texas City Stress and Health Study. Perceived neighborhood characteristics were measured using the Perceived Neighborhood Scale. Psychological distress was measured with the Center for Epidemiological Studies Depression Scale, Perceived Stress Scale and mental health subscale of the Short Form Health Survey-36. Markers of inflammation included C-reactive protein, interleukin-6, and tumor necrosis factor receptor-1. Associations were examined with Structural Equation Modeling.
Results
A model linking neighborhood characteristics with BMI through direct and indirect (i.e., psychological distress and inflammation) paths demonstrated good fit with the data. Less favorable perceived neighborhood characteristics were associated with greater psychological distress (B = −0.87, β = −0.31, p < .001) and inflammation (B = −0.02, β = −0.10, p = .035). Psychological distress and inflammation were also significantly associated with BMI (Bdistress = 0.06, β = 0.08, p = .006; Binflammation = 4.65, β = 0.41, p < .001). Indirect paths from neighborhood characteristics to BMI via psychological distress (B = −0.05, β = −0.03, p = .004) and inflammation (B = −0.08, β = −0.04, p = .045) were significant. In multiple group analysis, a model with parameters constrained equal across race/ethnicity showed adequate fit suggesting associations were comparable across groups.
Conclusion
Our study extends the literature by demonstrating the importance of neighborhood perceptions as correlates of BMI across race/ethnicity, and highlights the role of psychological and physiological pathways.

Executive Functioning as a Predictor of Weight Loss and Physical Activity Outcomes

Meghan L Butryn, Mary K Martinelli, Jocelyn E Remmert, Savannah R Roberts, Fengqing Zhang,  Evan M Forman, Stephanie M Manasse

Background
Executive functioning, which is fundamental for carrying out goal-directed behaviors, may be an underappreciated predictor of outcomes in lifestyle modification programs for adults with obesity.
Purpose
This study tested the hypotheses that higher levels of baseline executive functioning would predict greater weight loss and physical activity after 6 months of behavioral treatment.
Methods
Participants (N = 320) were recruited from the community and provided with 16 treatment sessions. Executive functioning was measured with the tower task component of the Delis-Kaplan Executive Function System (D-KEFS). At months 0 and 6, weight was measured in the clinic and physical activity was measured with tri-axial accelerometers.
Results
Baseline D-KEFS achievement score, rule violations, and completion time significantly predicted weight loss at 6 months. For example, among participants without any rule violations (n = 162), weight loss averaged 11.0%, while those with rule violations (n = 158) averaged 8.7% weight loss. Rule violations also significantly predicted physical activity at 6 months. Among participants without any rule violations, physical activity at 6 months averaged 169.8 min/week, versus 127.2 min/week among those with rule violations.
Conclusions
Particular aspects of executive functioning may predict the relative ease or difficulty of changing eating and exercise-related behaviors, albeit with small effect sizes. This study is the first to our knowledge to detect a predictive relationship between components of executive functioning and objectively measured physical activity in adult lifestyle modification, and one of the first to predict weight loss in adults using an objective measure of executive functioning.

Translational Behavioral Medicine

Exercise effects on quality of life, mood, and self-worth in overweight children: the SMART randomized controlled trial

Kaile M Ross, Emma C Gilchrist, Stephen P Melek, Patrick D Gordon, Sandra L Ruland, Benjamin F Miller

Abstract
Overweight children are at risk for poor quality of life (QOL), depression, self-worth, and behavior problems. Exercise trials with children have shown improved mood and self-worth. Few studies utilized an attention control condition, QOL outcomes, or a follow-up evaluation after the intervention ends. The purpose is to test effects of an exercise program versus sedentary program on psychological factors in overweight children. One hundred seventy-five overweight children (87% black, 61% female, age 9.7 ± 0.9 years, 73% obese) were randomized to an 8 month aerobic exercise or sedentary after-school program. Depressive symptoms, anger expression, self-worth, and QOL were measured at baseline and post-test. Depressive symptoms and QOL were also measured at follow-up. Intent-to-treat mixed models evaluated intervention effects, including sex differences. At post-test, QOL, depression, and self-worth improved; no group by time or sex by group by time interaction was detected for QOL or self-worth. Boys’ depressive symptoms improved more and anger control decreased in the sedentary intervention relative to the exercise intervention at post-test. At follow-up, depressive symptoms in boys in the sedentary group decreased more than other groups. Exercise provided benefits to QOL, depressive symptoms, and self-worth comparable to a sedentary program. Sedentary programs with games and artistic activities, interaction with adults and peers, and behavioral structure may be more beneficial to boys’ mood than exercise. Some benefits of exercise in prior studies are probably attributable to program elements such as attention from adults.

Trending on Pinterest: an examination of pins about skin tanning

Smita C Banerjee, Vivian M Rodríguez, Kathryn Greene, Jennifer L Hay

Abstract
Rates of melanoma and nonmelanoma skin cancers are on the rise in the USA with data revealing disproportionate increase in female young adults. The popularity of intentional skin tanning among U.S. adolescents is attributed to several factors, including prioritization of physical appearance, media images of tanned celebrities, ease of availability of artificial tanning facilities, and more recently, the prevalence and celebration of tanned skin on social media. Pinterest, as the third most popular social media platform, was searched for “pins” about skin tanning. The resultant “pins” were examined to understand the extent and characteristics of skin tanning portrayed on Pinterest. We analyzed pins on Pinterest about skin tanning (n = 501) through a quantitative content analysis. Overall, results indicated an overwhelmingly protanning characteristic of pins about skin tanning on Pinterest, with over 85% of pins promoting tanning behavior. The pins were generally characterized by the portrayal of a female subject (61%) and provided positive reinforcement for tanning (49%). Use of tanning for enhancing appearance was the main positive outcome expectancy portrayed in the pins (35%), and nudity or exposure of skin on arms (32%) and legs (31%) was evident in about a third of pins. With overwhelmingly positive pins promoting tanning, use of female subjects, exhibiting nudity, and appearance enhancement, there seems be to a consistent targeting of female users to accept tanning as a socially acceptable and popular behavior. The findings indicate a need for developing sun protection messages and the leveraging of social media for dissemination of skin cancer prevention and detection messages.

The “House of Quality for Behavioral Science”—a user-centered tool to design behavioral interventions

Sarah L Mullane, Dana R Epstein, Matthew P Buman

Abstract
Within the behavioral field, a plethora of conceptual frameworks and tools have been developed to improve transition from efficacy to effectiveness trials; however, they are limited in their ability to support new, iterative intervention design decision-making methodologies beyond traditional randomized controlled trial design. Emerging theories suggest that researchers should employ engineering based user-centered design (UCD) methods to support more iterative intervention design decision-making in the behavioral field. We present, an adaptation of a UCD tool used in the engineering field—the Quality Function Deployment “House of Quality” correlation matrix, to support iterative intervention design decision-making and documentation for multicomponent behavioral interventions and factorial trial designs. We provide a detailed description of the adapted tool—“House of Quality for Behavioral Science”, and a step-by-step use-case scenario to demonstrate the early identification of intervention flaws and prioritization of requirements. Four intervention design flaws were identified via the tool application. Completion of the relationship correlation matrix increased requirement ranking variance for the researcher (σ2 = 0.47 to 7.19) and participant (σ2 = 0.56 to 3.89) perspective. Requirement prioritization (ranking) was facilitated by factoring in the strength of the correlation between each perspective and corresponding importance. A correlational matrix tool such as the “House of Quality for Behavioral Science” may provide a structured, UCD approach that balances researcher and participant needs and identifies design flaws for pragmatic behavioral intervention design. This tool may support iterative design decision-making for multicomponent and factorial trial designs.