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 2018 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.

1. Go to the Members Only section of the SBM website.
2. Log in with your username and password.
3. Click on the Journals link.
4. 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

Organizational Religious Activity, Hypertension, and Sexual Orientation: Results From a Nationally Representative Sample

Kalina M Lamb, Kelsey A Nogg, Benjamin M Rooney, Aaron J Blashill

Background
Hypertension is a major public health concern, given prevalence and morbidity. Among the general population, greater religious attendance is associated with lower blood pressure (BP). However, no known studies have examined the association between religious attendance and BP among sexual minorities.
Purpose
To examine the association between BP/hypertension and organizational religious activity as a function of sexual orientation.
Methods
Data were utilized from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a publicly available, U.S. nationally representative data set. Of the 4,874 individuals included in analyses, 366 participants were identified as a sexual minority. An organizational religious activity variable was created by summing responses of two separate items. BP was measured as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Increasing levels of clinical severity of hypertension were also examined. Relevant covariates were controlled for in two separate models. Significant interactions between religious attendance and sexual orientation were explored in simple slope analyses.
Results
Overall, results indicated that sexual orientation moderated the association between organizational religious activity, and BP/hypertension. Crossover interactions were present for the dependent variables SBP, DBP, and prehypertension and higher (prehypertension, and hypertension 1 and 2). Generally, a negative association between organizational religious activity and hypertension was revealed among the heterosexual group, whereas a positive association was found among the sexual minority group.
Conclusions
Organizational religious activity is differentially associated with BP/hypertension among sexual minority versus heterosexual individuals. Organizational religious activity may represent a risk factor for hypertension among sexual minority individuals.

The Influence of University Students’ Stress Mindsets on Health and Performance Outcomes

Jacob J Keech, Martin S Hagger, Frances V O’Callaghan, Kyra Hamilton

Background
Emerging evidence indicates that holding particular stress mindsets has favorable implications for peoples’ health and performance under stress.
Purpose
The aim of the current study was to examine the processes by which implicit and explicit stress mindsets relate to health- and performance-related outcomes. Specifically, we propose a stress beliefs model in which somatic responses to stress and coping behaviors mediate the effect of stress mindsets on outcomes.
Methods
Undergraduate university students (N = 218, n = 144 females) aged 17– 25 years completed measures of stress mindset, physical and psychological wellbeing, perceived stress, perceived somatic responses to stress, proactive behaviors under stress, and an implicit association test assessing an implicit stress mindset. At the end of the semester, students’ academic performance was collected from university records.
Results
Path analysis indicated significant indirect effects of stress mindset on psychological wellbeing and perceived stress through proactive coping behaviors and perceived somatic symptoms. Stress mindset directly predicted perceived stress and physical wellbeing, and physical wellbeing and academic performance were predicted by stress mindset through perceived somatic symptoms. Implicit stress mindset did not predict proactive behavior as anticipated.
Conclusions
Current findings indicate that behaviors with the goal of proactively meeting demands under stress and perceived somatic symptoms are important mediators of the effect of stress mindset on health- and performance-related outcomes. The findings from this study provide formative data that can inform the development of future interventions aiming to encourage more adaptive responses to stress.

Perseverative Cognitions and Stress Exposure: Comparing Relationships With Psychological Health Across a Diverse Adult Sample

Matthew J Zawadzki, Martin J Sliwinski, Joshua M Smyth, PhD

Background
Both exposure to stress and perseverative cognitions (PCs)—repetitive cognitive representations of real or imagined stressors—are linked with poor psychological health. Yet, stress exposure and PCs are correlated, thus potentially obscuring any unique effects.
Purpose
The purpose of this paper is to concurrently test associations between stress exposure and PCs and psychological health to examine the independent relationship of each with psychological health. Moreover, we examined whether these relationships are similar across sex, age, and race.
Methods
An adult community sample (n = 302) completed a measure of stress exposure, three PCs scales, and questionnaires assessing self-reported psychological health, including emotional well-being, vitality, social functioning, role limitations due to personal problems, subjective well-being, depressive symptoms, and poor sleep quality.
Results
Structural equation modeling was used to test a model in which both stress exposure and PCs predict psychological health. PCs consistently predicted all the psychological health outcomes, but stress was largely unrelated to the outcomes despite bivariate correlations suggesting a relationship. A follow-up model identified indirect effects of stress exposure on psychological health via PCs. Results were fairly consistent regardless of one’s sex, age, or race.
Conclusions
PCs robustly predicted all of the psychological health outcomes, intimating PCs as a common pathway to poor psychological health. Results have implications for stress interventions, including the need to address PCs after experiencing stress.

 

Translational Behavioral Medicine

How to empower patients? A systematic review and meta-analysis

Amber Werbrouck, Eva Swinnen, Eric Kerckhofs, Ronald Buyl, David Beckwée, Liesbet De Wit

Abstract
Patient empowerment, a concept focused on patient-centeredness and patients autonomy, is a well-discussed topic in health literature. However, translating theory into practice is a challenge. The purpose of this study was to assess the effectiveness of interventions on patient empowerment and to identify and compare the modalities of these interventions. For this systematic review including meta-analysis, eligibility criteria were as follows: (i) adult participants with one or more chronic somatic diseases, (ii) “patient empowerment” was explicitly measured (i.e., outcome or measuring instrument), (iii) randomized controlled designs, and (iv) written in English, French, Dutch, or German. A systematic search strategy was applied in five online databases (last search: March 29, 2017). Thirty-two studies were included in this review, of which 23 studies could be included in the meta-analysis. Overall effect estimate was significant in favor of the intervention; however, heterogeneity was high. Subgroup analyses revealed that the effect estimate was higher in studies with interventions that comprised individual sessions. The most recurrent behavioral change technique identified in our review was “knowledge”, though this is not sufficient to empower. “Goal setting” and “action planning” were more likely to be applied in successful interventions. “Knowledge” could be combined with “goal setting” and “action planning” to empower. Thorough understanding of the concept of patient empowerment remains necessary. Future research should focus on somatic chronic diseases other than diabetes, a consensus definition for patient empowerment, and clinimetric properties of instruments.

Behavior change is not one size fits all: psychosocial phenotypes of childhood obesity prevention intervention participants

Marissa Burgermaster, Isobel Contento, Pamela Koch, Lena Mamykina

Abstract
Variability in individuals’ responses to interventions may contribute to small average treatment effects of childhood obesity prevention interventions. But, neither the causes of this individual variability nor the mechanism by which it influences behavior are clear. We used qualitative methods to characterize variability in students’ responses to participating in a childhood obesity prevention intervention and psychosocial characteristics related to the behavior change process. We interviewed 18 students participating in a school-based curriculum and policy behavior change intervention. Descriptive coding, summary, and case-ordered descriptive meta-matrices were used to group participants by their psychosocial responses to the intervention and associated behavior changes. Four psychosocial phenotypes of responses emerged: (a) Activated—successful behavior-changers with strong internal supports; (b) Inspired—motivated, but not fully successful behavior-changers with some internal supports, whose taste preferences and food environment overwhelmed their motivation; (c) Reinforced—already practiced target behaviors, were motivated, and had strong family support; and (d) Indifferent—uninterested in behavior change and only did target behaviors if family insisted. Our findings contribute to the field of behavioral medicine by suggesting the presence of specific subgroups of participants who respond differently to behavior change interventions and salient psychosocial characteristics that differentiate among these phenotypes. Future research should examine the utility of prospectively identifying psychosocial phenotypes for improving the tailoring of nutrition behavior change interventions.

Posts, pics, or polls? Which post type generates the greatest engagement in a Facebook physical activity intervention?

Sarah Edney, Jemma Looyestyn, Jillian Ryan, Jocelyn Kernot, Carol Maher

Abstract
Social networking websites have attracted considerable attention as a delivery platform for physical activity interventions. Current evidence highlights a need to enhance user engagement with these interventions to actualize their potential. The purpose of this study was to determine which post type generates the most engagement from participants and whether engagement was related to change in physical activity in an intervention delivered via Facebook. Subgroup analysis of the intervention condition of a randomized controlled trial was conducted. The group moderator posted a new message to the private Facebook group each day of the program. The Facebook posts (n = 118) were categorized into the following types: moderator-initiated running program, multimedia, motivational, opinion polls, or discussion question and participant-initiated experience shares, or questions. Four metrics were used to measure volume of engagement with each post type, “likes,” “comments,” “poll votes,” and “photo uploads.” One-way ANOVA was used to determine whether engagement differed by post type and an independent samples t-test to determine differences in engagement between moderator and participant-initiated posts. Pearson correlation was used to examine associations between total engagement and change in physical activity. Engagement varied by post type. Polls elicited the greatest engagement (p ≤ .01). The most common form of engagement was “likes,” and engagement was higher for moderator-initiated rather than participant-initiated posts (mean = 8.0 [SD 6.8] vs. 5.3 [SD 3.2]; p ≤ .01). Total engagement with the Facebook group was not directly associated with change in physical activity (r = −.13, p = .47). However, engagement was associated with compliance with the running program (r = .37, p = .04) and there was a nonsignificant positive association between compliance and change in physical activity (r = .32, p = .08). Posts requiring a simple response generated the most engagement. Intervention moderators should facilitate familiarity between participants at the intervention outset, to encourage engagement between participants. Engagement was related to change in physical activity, and these recommendations should be incorporated to enhance engagement and efficacy of interventions.