Health Psychology

Self-help support groups are indigenous community resources designed to help people manage a variety of personal challenges, from alcohol abuse to xeroderma pigmentosum. The social exchanges that occur during group meetings are central to understanding how people benefit from participation. This paper examines the different types of social exchange behaviors that occur during meetings, using two studies to develop empirically distinct scales that reliably measure theoretically important types of exchange. Resource theory informed the initial measurement development efforts. Exploratory factor analyses from the first study led to revisions in the factor structure of the social exchange scales. The revised measure captured the exchange of emotional support, experiential information, humor, unwanted behaviors, and exchanges outside meetings. Confirmatory factor analyses from a follow-up study with a different sample of self-help support groups provided good model fit, suggesting the revised structure accurately represented the data. Further, the scales demonstrated good convergent and discriminant validity with related constructs. Future research can use the scales to identify aspects of social exchange that are most important in improving health outcomes among self-help support group participants. Groups can use the scales in practice to celebrate strengths and address weaknesses in their social exchange dynamics.

Self-help support groups are indigenous community resources designed to help people manage a variety of personal challenges, from alcohol abuse to xeroderma pigmentosum. The social exchanges that occur during group meetings are central to understanding how people benefit from participation. This paper examines the different types of social exchange behaviors that occur during meetings, using two studies to develop empirically distinct scales that reliably measure theoretically important types of exchange. Resource theory informed the initial measurement development efforts. Exploratory factor analyses from the first study led to revisions in the factor structure of the social exchange scales. The revised measure captured the exchange of emotional support, experiential information, humor, unwanted behaviors, and exchanges outside meetings. Confirmatory factor analyses from a follow-up study with a different sample of self-help support groups provided good model fit, suggesting the revised structure accurately represented the data. Further, the scales demonstrated good convergent and discriminant validity with related constructs. Future research can use the scales to identify aspects of social exchange that are most important in improving health outcomes among self-help support group participants. Groups can use the scales in practice to celebrate strengths and address weaknesses in their social exchange dynamics.

HIV/HCV prevention among people who inject drugs (PWID) is of key public health importance. We aimed to assess the impact of COVID-19 and associated response measures on HIV/HCV prevention services and socio-economic status of PWID in high-HIV-risk sites. Sites with recent (2011-2019) HIV outbreaks among PWID in Europe North America and Israel, that had been previously identified, were contacted early May 2020. Out of 17 sites invited to participate, 13 accepted. Semi-structured qualitative site reports were prepared covering data from March to May 2020, analyzed/coded and confirmed with a structured questionnaire, in which all sites explicitly responded to all 103 issues reported in the qualitative reports. Opioid maintenance treatment, needle/syringe programs and antiretroviral treatment /hepatitis C treatment continued, but with important reductions and operational changes. Increases in overdoses, widespread difficulties with food and hygiene needs, disruptions in drug supply, and increased homelessness were reported. Service programs rapidly reformed long established, and politically entrenched, restrictive service delivery policies. Future epidemic control measures should include mitigation of negative side-effects on service provision and socio-economic determinants in PWID. HIV • Hepatitis C • COVID-19 • People who inject drugs (PWID) • Treatment • Prevention • Services • Epidemiology • Social determinants • Outbreaks • Homelessness • Overdose La prevención del VIH/VHC entre las personas que se inyectan drogas (PWID) es de vital importancia para la salud pública. Nuestro objetivo fue evaluar el impacto de COVID-19 y las medidas de respuesta asociadas en los servicios de prevención del VIH/VHC y el estado socioeconómico de las PWID en sitios de alto riesgo de VIH. Se contactó con sitios con brotes recientes (2011-2019) de VIH entre PWID en Europa, América del Norte e Israel, que habían sido previamente identificados, a principios de mayo de 2020. De los 17 sitios invitados a participar, 13 aceptaron. Se prepararon informes cualitativos semiestructurados del sitio que cubrían los datos de marzo a mayo de 2020, analizados/codificados y confirmados con un cuestionario estructurado, en el que todos los sitios respondieron explícitamente a los 103 asuntos reportados en los informes cualitativos. El tratamiento de mantenimiento con opiáceos, los programas de agujas/jeringas y el tratamiento antirretroviral/tratamiento de la hepatitis C continuaron, pero con importantes reducciones y cambios operativos. Se reportaron aumentos en las sobredosis, dificultades generalizadas con las necesidades alimentarias y de higiene, interrupciones en el suministro de medicamentos y aumento de personas sin hogar. Los programas de servicios reformaron rápidamente las políticas restrictivas de prestación de servicios, establecidas desde hace mucho tiempo y políticamente arraigadas. Las futuras medidas de control de epidemias deben incluir la mitigación de los efectos secundarios negativos en la prestación de servicios y los determinantes socioeconómicos en las PWID.

Dissertação de Mestrado realizada sob a orientação da professora Ivone Patrão, apresentada no Instituto Superior de Psicologia Aplicada para obtenção de Grau de Mestre na especialidade de Psicologia Clínica conforme despacho da DGES, n.º 19673/2006 publicado em Diário da Republica 2.ª série de 26 de Setembro, de 2006. Agradecimentos A realização do presente estudo, só foi possível pela colaboração de todos aqueles que contribuíram para a sua concretização. O meu profundo agradecimento à professora Dr.ª Ivone Patrão, pela oportunidade da sua orientação, pela disponibilidade, pelas sugestões, apoio e compreensão demonstrados ao longo do desenvolvimento deste trabalho. A todos os profissionais que possibilitaram o estudo particularmente à Dr.ª Maria de Jesus Lobo Correia responsável pela autorização de recolha dos dados na Maternidade Alfredo da Costa. Agradeço também à Dr.ª Isabel Margarida Mendes e Dr.ª Maria Cristina Canavarro pela cedência das escalas utilizadas nesta investigação e directrizes sugeridas para a realização do trabalho. Às Senhoras enfermeiras das consultas de vigilância pré-natal de todos os serviços onde foi pedido a autorização para a recolha de dados, pela sua preciosa ajuda e solidariedade. Agradeço ao Centro de Educação Jovem da Câmara Municipal de cascais pela facilitação no recrutamento de grande parte das participantes deste estudo. À Dr.ª Ana Eduardo Ribeiro, o meu profundo agradecimento pela sua amizade, incentivo, carinho, disponibilidade e compreensão. Uma palavra de gratidão para todas as grávidas que com a sua participação tornaram possível a realização deste trabalho. Finalmente, à minha família pelo apoio e forma carinhosa como me ajudaram e incentivaram em todos os momentos. RESUMO O objectivo desta investigação foi investigar a possível correlação entre as memórias de infância das práticas educativas parentais e a ligação materno-fetal. Participaram no estudo 60 mulheres grávidas com idades compreendidas entre os 15 e os 38 anos de idade, no 2º ou 3º trimestre de gravidez. A recolha de dados foi realizada por meio da aplicação do Inventory for Assessing Memories of Parental Rearing Behaviour (EMBU) (Perris, Jacobson, Lindstorm, Von Knorring, & Perris, 1980) para as memórias de Infância e da escala de Ligação maternofetal (Cranley, 1980) Por fim, foram encontradas associações estatisticamente significativas entre as memórias de infância para a dimensão suporte emocional face ao pai e a ligação maternofetal e entre o planeamento da gravidez e a ligação materno-fetal. Os resultados foram confrontados com os resultados obtidos na literatura. .

While many facets of loneliness have been explored, research examining the efficacy of loneliness interventions has been overlooked among young adults. The study of loneliness among young adults has become increasingly important considering the current state of isolation and stay-at-home orders issued to prevent the spread of COVID-19. Preliminary reports suggest an increase in loneliness as a result of the current health pandemic, especially among young adults, who have reported feeling lonelier than any other age group. Such findings warrant the study of ways to help reduce loneliness among young adults. The current study examined the efficacy of strategies that might be used to help young adults manage feelings of loneliness. Two hundred and seventy-eight young adults completed the study. Participants read one of four messages: mindfulness, social cognitions, coping behaviors, or a control. Participants in the mindfulness condition felt better equipped to manage future instances ...

Intimate partner violence against women (IPVAW) and femicide (intimate partner femicide, IPF), as a worldwide phenomenon, cannot be explained in a simple way. From an ecological point of view, there are individual factors contemplated. In the current studies, we consider personality as an individual factor to clarify what differentiates a non-lethal IPVAW situation from a femicide. Study 1 was designed to investigate the accuracy with which trained interviewers judged the personality of a group of IPVAW perpetrators during an interview. The target sample of study 1 was composed of 293 males who after being interviewed completed a measure of personality assessing the “Big Three” model of personality. The interviewers performed fairly accurate judgements about the personality of the target participants. Study 2 shows the differences in personality, using Eysenck’s personality model, between the IPF and IPVAW perpetrators and their victims. The total sample study 2 was formed of 551 pa...

The present article reports on a preliminary study exploring the relationships between Dark Triad (narcissism, Machiavellianism, psychopathy) and honesty-humility personality traits and pornography craving and deviant pornography use in a sample of 121 participants (46 men and 75 women) who completed an online survey. Narcissism and psychopathy were positively related to pornography craving and deviant pornography consumption, while honesty-humility appeared to be negatively associated with these pornography-related variables. Furthermore, the data suggested that these relationships were only present in men and not in women. While the current results should be interpreted with caution in the light of a number of limitations (i.e., small sample size, mainly well-educated participants), these results fit with the notion that men are more characterized by anti-social personality traits than women, and hence also have a greater inclination to engage in immoral and sexually deviating actions.

The Cancer Threat Interpretation model proposes that clinically significant fear of cancer recurrence/progression (FCR/P) can occur when people misinterpret ambiguous physical symptoms as a sign of recurrence. The aim of this research was to test whether interpretation biases moderate the relationship between pain and FCR/P in women with breast cancer, as predicted. One hundred and forty-seven women with breast cancer completed questionnaire measures of demographic and medical information, FCR/P, interpretation bias, and symptom burden, as well as other known predictors of FCR/P. Women with clinically significant levels of FCR/P were more likely to interpret ambiguous words as health-related and experienced more pain than women with levels of FCR/P in the non-clinical range. FCR was associated with both pain (r= .40, p < .001) and interpretation bias (r= .45, p < .001). Interpretation bias and pain (r= .31, p < .001) were also associated with each other. Moderation analyses confirmed that interpretation bias moderated the relationship between pain and FCR (F (1, 143) = 5.76; p = 0.01). However, this was not the case with FOP (F (1, 143) = 0.21; p = .65). We found that women with breast cancer with clinically significant FCR/P interpreted ambiguous words as health-related more often and experienced more pain than those with non-clinical FCR/P. Moreover, we found that among those with higher levels of pain, FCR was also higher only amongst those with higher levels of interpretation bias, as the threat interpretation model predicts.

We assessed individual and collective responses to HIV pre-exposure prophylaxis ('PrEP') among a network of male sex workers and clients. From 2011 to May 2017, keyword searches on an online discussion forum identified 668 posts that referenced PrEP. We conducted four analyses: (i) discourse analysis identifying reactions to PrEP, (ii) thematic analysis constructing rhetorical strategies, (iii) content analysis comparing discursive positions and rhetorical strategies, and (iv) longitudinal analyses assessing trends over time. Forum posts adopted one of three discursive positions (reluctance, interest, advocacy), drawing upon four non-exclusive strategies (deference to experts and evidence, acknowledging personal and shared experiences, establishing philosophical arguments, engaging in speculation). Posts from sex workers were more likely than clients to be supportive of PrEP (96% vs. 42%; χ 2 = 18.46, p < 0.001) while over time this network moved from being predominantly reluctant about PrEP (61% of posts in 2012) to advocating for its use (65% of posts in 2017; Z = 5.01, p < 0.001). Evaluamos las respuestas individuales y colectivas a la profilaxis pre-exposición para el VIH (el "PrEP" en Inglés) entre una red de trabajadores sexuales masculinos y de clientes. Desde 2011 hasta mayo de 2017, las búsquedas de palabras claves en un foro de discusión en línea identificaron 668 publicaciones que se refirieron al PrEP. Realizamos cuatro análisis: (i) análisis del discurso identificando las reacciones al PrEP, (ii) análisis temático construyendo estrategias retóricas, (iii) análisis de * James MacGibbon

We conducted a pre-post feasibility trial of Healthy Eating for Life, a theory-based, multimedia English as a second language curriculum that integrates content about healthy nutrition into an English language learning program to decrease cancer health disparities. Teachers in 20 English as a second language classrooms delivered Healthy Eating for Life to 286 adult English as a second language students over one semester. Postintervention data are available for 227 students. The results indicated that Healthy Eating for Life is effective for increasing fruit and vegetable intake as well as knowledge, action planning, and coping planning related to healthy eating. Participants also achieved higher reading scores compared to the state average. The National Cancer Institute (NCI) defines cancer health disparities as "adverse differences in cancer incidence (new cases), cancer prevalence (all existing cases), cancer death (mortality), cancer survivorship, and burden of cancer or related health conditions that exist among specific population groups in the United States" (NCI, 2010b). Individuals susceptible to these health disparities have a higher chance of being diagnosed and dying from preventable and/or generally curable cancers. They tend not to engage in cancer screening behaviors and are diagnosed at later stages of the disease, receive inadequate or no treatment, and suffer from cancer without palliative care (US Department of Health and Human Services (USDHHS), 2004). Modifiable cancer risk factors, such as smoking, leisure time physical inactivity, and obesity, tend to vary by race/ethnicity and socioeconomic status such that minority and medically underserved individuals are more likely to engage in unhealthy lifestyle behaviors . Although the two primary factors that contribute to cancer health disparities in the United States are lack of health-care coverage and low socioeconomic status, cancer health disparities may be further explained by limitations in health literacy among individuals from the most marginalized populations. Health literacy is defined as "the degree to which

Colorectal cancer (CRC) is the third leading cause of cancer mortality among women. Screening can prevent the development of CRC or diagnose early disease when it can effectively be cured, however existing screening methods are underutilized. In this study, we examined the utility of an updated Health Belief Model to explain CRC screening adherence. The present study included 280 older

Integrasi pangan dan gizi dalam pembangunan merupakan hal yang sangat penting, terutama dalam konteks pembangunan nasional dan kesejahteraan masyarakat. Pangan dan gizi memiliki hubungan yang erat dan saling mempengaruhi, karena kualitas gizi seseorang sangat bergantung pada ketersediaan, akses, dan konsumsi pangan yang bergizi. Dalam upaya mewujudkan pembangunan yang inklusif dan berkelanjutan, integrasi pangan dan gizi menjadi elemen yang tidak bisa dipisahkan. Pentingnya Pangan dan Gizi untuk Kesehatan yaitu tetersediaan pangan yang bergizi sangat mempengaruhi kualitas kesehatan masyarakat. Kekurangan atau ketidakseimbangan gizi dapat menyebabkan masalah kesehatan serius seperti malnutrisi, stunting (pendeknya tinggi badan anak akibat kekurangan gizi), dan penyakit tidak menular (seperti obesitas, diabetes, dan hipertensi).

The impact of COVID-19 across health services, including treatment services for people who use drugs, is emerging but likely to have a high impact. Treatment services for people who use drugs provide essential treatment services including opiate agonist treatment and needle syringe programmes alongside other important treatment programmes across all substance types including withdrawal and counselling services. Drug and alcohol hospital consultation-liaison clinicians support emergency departments and other services provided in hospital settings in efficiently managing patients who use drugs and present with other health problems. COVID-19 will impact on staff availability for work due to illness. Patients may require home isolation and quarantine periods. Ensuring ongoing supply of opiate treatment during these periods will require significant changes to how treatment is provided. The use of monthly depot buprenorphine as well as moving from a framework of supervised dosing will be required for patients on sublingual buprenorphine and methadone. Ensuring ready access to take-home naloxone for patients is crucial to reduce overdose risks. Delivery of methadone and buprenorphine to the homes of people with confirmed COVID-19 infections is likely to need to occur to support home isolation. People who use drugs are likely to be more vulnerable during the COVID-19 epidemic, due to poorer health literacy and stigma and discrimination towards this group. People who use drugs may prioritise drug use above other health concerns. Adequate supply of clean injecting equipment is important to prevent outbreaks of blood-borne viruses. Opiate users may misinterpret SARS-CoV2 symptoms as opiate withdrawal and manage this by using opioids. Ensuring people who use drugs have access to drug treatment as well as access to screening and testing for SARS-CoV2 where this is indicated is important.

Objective-Evidence suggests interdependence between cancer patients' and their caregivers' physical and mental health. However, the extent to which caregivers' health relates to their patients' recovery, or patients' health affects their caregivers' outcomes, is largely unknown. This dyadic investigation reports the relations between cancer patients' and their caregivers' physical and mental health trajectories during the year following diagnosis. Design-Ninety-two colorectal cancer patient-caregiver dyads completed questionnaires at two, six, and twelve months post-diagnosis. Outcome Measures-Self-reported physical and mental health using the Medical Outcomes Study Short Form Health Survey-12. Results-Patients reported improved physical health over the year following their diagnosis, whereas caregivers reported declining physical health. Patients with lower mental health at diagnosis had stagnated physical health recovery. Caregivers' physical health declined most noticeably among those reporting low mental health at diagnosis and whose patients reported low physical health at diagnosis. reporting poor mental health at diagnosis may mitigate their long-term physical morbidity. Limited evidence of dyadic interdependence between patients' and caregivers' physical and mental health trajectories suggests future studies are warranted to identify psychosocial and medical characteristics moderating the relations between patients' and caregivers' health.

This study examined how stress from cancer affects fruit and vegetable consumption (FVC) in cancer patients and their family caregivers during the year following diagnosis. Colorectal cancer patients and their caregivers (92 dyads) completed questionnaires at two (T1), six (T2), and 12 months post-diagnosis (T3). Individuals reported perceived cancer-related stress (CRS) at T1 and days of adequate FVC at T1 through T3. Both patients and caregivers reported inadequate FVC during the first year post-diagnosis. Latent growth modeling with actor-partner interdependence modeling revealed that, at T1, one's own greater CRS was associated with one's partner having fewer concurrent days of adequate FVC (ps=.01). Patients' greater CRS predicted their own more pronounced rebound pattern in FVC (p=.01); both patients' and caregivers' CRS marginally predicted their partners' change in FVC (p=.09). Findings suggest that perceived stress from cancer hinders FVC around the diagnosis, but motivates positive dietary changes by the end of the first year.

Diabetes melitus (DM) merupakan suatu kelompok peyakit metabolik yang ditandai dengan karakteristik hiperglikemia atau peningkatan kadar glukosa darah yang terjadi karena kelainan sekresi insulin, kerja insulin atau karena keduanya [11]. Hasil Riskesdas 2018 menunjukkan bahwa prevalensi diabetes di Indonesia berdasarkan diagnosis dokter pada umur ≥ 15 tahun sebesar 2%. Angka ini menunjukkan adanya peningkatan dibandingkan prevalensi diabetes melitus pada pendududuk ≥ 15 tahun pada hasil Riskesdas 2013 sebesar 1,5%. Akan tetapi prevalensi diabetes melitus menurut hasil pemeriksaan gula darah meningkat dari yang semula 6,9% pada tahun 2013, menjadi 8,5% di tahun 2018. Angka ini menunjukkan bahwa baru sekitar 25% penderita diabetes mengetahui bahwa dirinya sedang menderita penyakit tersebut [8].

Prior research finds that sex ratio, defined as the proportion of males and females in a given context, is related to engagement in risk-taking behaviors. However, most research operationalizes sex ratio at a local context (e.g., regional or county), which fails to reflect with precision the sex ratios contexts of individuals at a closer level. Furthermore, the relationship between sex ratio and risk-taking behaviors may be affected by individuals’ life history strategy, with previous studies showing fast life history strategies linked to risk-taking behaviors, compared to slow life history strategies. The present study analyzes the relationship between classroom sex ratio and risk-taking behaviors and the interaction between classroom sex ratio and life history strategy in adolescents. The sample comprised 1214 participants nested in 57 classrooms, 49.75% females, 91.5% Spanish and a mean age of 16.15 years (SD = 1.23, range 14–21). Results from multilevel modeling showed a negativ...

The existing literature on parental control and children's diets is confusing. The present paper reports two studies to explore an expanded conceptualisation of parental control with a focus on overt control which 'can be detected by the child' and covert control which 'cannot be detected by the child'. In study 1, 297 parents of children aged between 4 and 11 completed a measure of overt control and covert control alongside ratings of their child's snacking behaviour as a means to assess who uses either overt or covert control and how these aspects of parental control relate to a child's snacking behaviour. The results showed that lighter parents and those with children perceived as heavier were more likely to use covert control and those from a higher social class were more likely to use overt control. Further, whilst greater covert control predicted a decreased intake of unhealthy snacks, greater overt control predicted an increased intake of healthy snacks. In study 2, 61 parents completed the same measure of overt and covert control alongside the three control subscales of the Child Feeding Questionnaire to assess degrees of overlap between these measures. The results showed that although these five measures of control were all positively correlated, the correlations between the new and existing measures indicated a maximum of 21% shared variance suggesting that covert and overt control are conceptually and statistically separate from existing measures of control. To conclude, overt and covert control may be a useful expansion of existing ways to measure and conceptualise parental control. Further, these constructs may differentially relate to snacking behaviour which may help to explain some of the confusion in the literature.

A 5-day course designed to train psychiatric hospital staff verbal and physical methods of preventing violence and injury when dealing with upset patients was taught to 89 staff from maximum and less secure wards. Compared to no-treatment controls, experimental subjects improved significantly on four tests of crisis-related tests and knowledge. Questionnaire and self-report measures from staff and patients on the training wards also indicated positive course effects. Assault frequencies decreased immediately after the course and staff injuries on experimental wards were reduced after the course relative to control wards.

This article provides an account of a 10-year collaborative documentation of community leadership in an African American community on the South side of Chicago. The stories are oriented to several critical incidents in the life course of the collaboration. They are told from the perspectives of one university professor, four graduate students, and one community leader. Together they provide an account of how this research was shaped by the interactions of the research team with members of the community, how research questions emerged, methodologies were developed, ways of gathering data were tried and tested, and interpretations of data unfolded. Special attention is given to the ways in which the process and products of this research contributed to the community's own process of leadership development. The stories also discuss the various roles participants in this collaboration played both in the academic arena and in the community, and how they experienced gender, race, nationality, and social status.

This study extended the literature by examining whether three profiles of depression predicted breast cancer status. In 1076 women of the Baltimore Epidemiologic Catchment Area study, depression status and hopelessness were measured at baseline and breast cancer status was ascertained 24 years later. Double depression, but not major depression or dysthymia, was associated with breast cancer. Hopelessness predicted fewer new cases of breast cancer. When double depression and hopelessness were simultaneously entered as predictors, the regression weights of both predictors increased. The role of severe and extended duration depression as well as possible explanations for unexpected findings are discussed.

The opioid crisis has increased risks for injection drug use-associated HIV outbreaks in rural communities throughout the United States. Existing research has examined pre-exposure prophylaxis (PrEP) utilization among people who inject drugs (PWID); however, no studies have been conducted to explore barriers and facilitators of PrEP use among rural PWID in Appalachia. We conducted qualitative interviews with PWID (n = 48) in two rural counties in West Virginia to explore barriers and facilitators of PrEP use. Among our participants, the majority (68.8%) had never heard of PrEP. Upon learning about PrEP, most participants expressed willingness to use it. Rural PWID described several factors that may impede PrEP utilization (e.g., housing instability, forgetting to take PrEP). Participants also identified practical strategies to support sustained PrEP utilization, such as integrating PrEP services into venues PWID access. This research provides important insights into the barriers and facilitators of PrEP utilization among rural PWID.

Background The opioid overdose crisis in the USA has called for expanding access to evidence-based substance use treatment programs, yet many barriers limit the ability of people who inject drugs (PWID) to engage in these programs. Predominantly rural states have been disproportionately affected by the opioid overdose crisis while simultaneously facing diminished access to drug treatment services. The purpose of this study is to explore barriers and facilitators to engagement in drug treatment among PWID residing in a rural county in West Virginia. Methods From June to July 2018, in-depth interviews (n = 21) that explored drug treatment experiences among PWID were conducted in Cabell County, West Virginia. Participants were recruited from locations frequented by PWID such as local service providers and public parks. An iterative, modified constant comparison approach was used to code and synthesize interview data. Participants reported experiencing a variety of barriers to engaging in drug treatment, including low thresholds for dismissal, a lack of comprehensive support services, financial barriers, and inadequate management of withdrawal symptoms. However, participants also described several facilitators of treatment engagement and sustained recovery. These included the use of medications for opioid use disorder and supportive health care workers/program staff. Conclusions Our findings suggest that a range of barriers exist that may limit the abilities of rural PWID to successfully access and remain engaged in drug treatment in West Virginia. Improving the public health of rural PWID populations will require expanding access to evidence-based drug treatment programs that are tailored to participants' individual needs.

Background: Syringe services programs (SSPs) are evidence-based interventions that are associated with decreases in prevalence and incidence rates of HIV and viral hepatitis among people who inject drugs (PWID). SSPs are also effective conduits to deliver overdose prevention resources among PWID. In December 2015, the Kanawha-Charleston Health Department (KCHD) in West Virginia implemented a SSP; however, the program was indefinitely suspended in early 2018 following policy changes that would have forced the program to operate in ways that conflicted with established best practices. The purpose of this research is to explore the public health implications of the suspension of the KCHD SSP among rural PWID. Methods: We conducted semi-structured interviews with 27 PWID (59.3% male, 88.9% White) to explore access to sterile injection equipment and overdose prevention resources, high-risk injection practices, and HIV risk perceptions following the KCHD SSP suspension. Participants were recruited from street locations frequented by PWID. Interviews were audio-recorded and transcribed verbatim. We employed an iterative, modified constant comparison approach to systematically code and synthesize textual interview data. Results: Participants described the KCHD SSP as providing a variety of harm reduction services to PWID and being able to speak honestly with SSP staff about their drug use without fear of stigmatization. The suspension of the KCHD SSP fundamentally changed the public health landscape for PWID, ushering in a new era of increased risks for acquiring bloodborne infections and overdose. PWID described more frequently injecting with used syringes and engaging in a range of high-risk injection practices after the SSP was suspended. PWID also discussed having decreased access to naloxone and being less likely to get routinely tested for HIV following the KCHD SSP suspension. Conclusions: This research demonstrates that the suspension of a SSP in rural West Virginia increased risks for HIV/HCV acquisition and overdose among PWID. The suspension of the SSP led to community-wide decreases in access to sterile injection equipment and naloxone among PWID. The suspension of the KCHD SSP should be viewed as a call to action for sustaining evidence-based interventions in the face of sociopolitical forces that attempt to subvert public health.

The Stability-Cordiality Theory of Success is a behaviorist-based framework that seeks to advance existing theories of personality development by offering a comprehensive model for understanding human success. Success, in this context, is defined as a state of fulfillment, happiness, safety, health, and love—concepts aligned with Seligman’s notion of flourishing and Csikszentmihalyi’s theory of flow. This theory explains the dynamic processes underlying human actions, leadership, personal growth, and societal behaviour.
The theory posits that individuals progress toward success through nine cardinal steps: self-motivation, spirituality, perspicacity, cognitive assonance, authenticity, cognitive flexibility, technical literacy, social-cognitive skills, and identity achievement. Each step represents a crucial component of stability that fosters long-term success. Conversely, individuals may fall into failure when negative cardinal steps—such as gullibility, lethargy, cognitive dissonance, and identity confusion—dominate their development. However, transitions between these paths are possible through significant life experiences or guided interventions. By integrating cognitive, social, and technical dimensions, the Stability-Cordiality Theory of Success provides a structured approach to personal and professional growth. It highlights how individual differences, environmental influences, and self-awareness contribute to achieving a stable and fulfilling life. The theory also introduces the Stability-Cordiality Model, which illustrates how individuals can navigate from negative to positive cardinal steps with effort, guidance, and self-realization. This theory offers valuable insights for personal development, leadership training, and psychological well-being, making it a versatile tool for understanding human behaviour and success.

Better understanding of compliance with BZD taper is warranted. Compliance with a taper program and perceived self-efficacy (SE) in being able to comply with hypnotic reduction goals was monitored weekly in 52 older adults (mean age: 63.0 years) with chronic insomnia (average duration: 21.9 years) who underwent a 10-week physician-supervised medication tapering. One group received cognitive-behavior therapy for insomnia during discontinuation, whereas the other did not. Compliant patients showed higher SE ratings at Weeks 6, 8, 9, and 10. Medication-free patients at the end of the treatment also reported higher mean SE ratings at those 4 weeks. Differences remained significant when withdrawal symptoms and sleep efficiency were controlled for. These results have important clinical implications because SE may indicate key time points when patients are experiencing more difficulty during discontinuation.

Better understanding of compliance with BZD taper is warranted. Compliance with a taper program and perceived self-efficacy (SE) in being able to comply with hypnotic reduction goals was monitored weekly in 52 older adults (mean age: 63.0 years) with chronic insomnia (average duration: 21.9 years) who underwent a 10-week physician-supervised medication tapering. One group received cognitive-behavior therapy for insomnia during discontinuation, whereas the other did not. Compliant patients showed higher SE ratings at Weeks 6, 8, 9, and 10. Medication-free patients at the end of the treatment also reported higher mean SE ratings at those 4 weeks. Differences remained significant when withdrawal symptoms and sleep efficiency were controlled for. These results have important clinical implications because SE may indicate key time points when patients are experiencing more difficulty during discontinuation.

It is challenging to collect accurate and complete data on sensitive issues such as sexual behaviors. Our objective was to explore experience and perceptions regarding the use of a locally programmed color-coded audio computer-assisted self interview (C-ACASI) system among men and women in a semi-rural setting in south India. We conducted a mixed-methods cross-sectional survey using semi-structured interviews among 89 truck drivers and 101 truck driver wives who had participated earlier in the C-ACASI survey across a predominantly rural district in Tamil Nadu. To assess the color-coded format used, descriptive quantitative analysis was coupled with thematic content analysis of qualitative data. Only 10 % of participants had ever used a computer before. Nearly 75 % did not report any problem in using C-ACASI. The length of the C-ACASI survey was acceptable to 98 % of participants. Overall, 87 % of wives and 73 % of truck drivers stated that C-ACASI was user-friendly and felt comfortable in responding to the sensitive questions. Nearly all (97 %) participants reported that using C-ACASI encouraged them to respond honestly compared to face-to-face personal interviews. Both the drivers and wives expressed that C-ACASI provided confidentiality, privacy, anonymity, and an easy mechanism for responding truthfully to potentially embarrassing questions about their personal sexual relationships. It is feasible and acceptable to use C-ACASI for collecting sensitive data from poorly computer-literate, non-English-speaking, predominantly rural populations of women and men. Our findings support the implementation of effective and culturally sensitive C-ACASI for data collection, albeit with additional validation.

Guided by vested interest theory, the impact of educating potential organ donors about the beneficial experiences afforded to families of deceased donors was assessed. Participants were informed about these benefits by taking a survey that asked them to indicate both their awareness, and the appeal, of numerous existing benefits (e.g. grief services). We employed a double-sided mixed design. Both the true experimental design and the quasi-experimental repeated assessment indicated increased registration intentions. Only the quasi-experimental design indicated significant attitude change. This study provides evidence supporting the potential utility of focusing interventions on the benefits afforded to donor families.

Integrating mobile technology into health promotion strategies has the potential to support healthy behaviors. A new theory-informed app was designed to augment an intervention promoting wellness motivation in older adults with fall risk and low levels of physical activity. The app content was evaluated for clarity, homogeneity, and validity of motivational messages; both the app and device were evaluated for acceptability and usability. The initial evaluation included nine adults (mean age, 75); four of whom also assessed the app's sensing abilities in the field. As part of an intervention feasibility study, 14 older adults (mean age, 84) also provided a follow-up evaluation of app usability. Evaluation participants assessed the app as valid, usable, acceptable, and able to sense most reported free-living activities, and provided feedback for improving the app. Design processes illustrate methodologic and interpretive efforts to operationalize motivational content in a theory-informed app promoting change in physical activity behavior.

Objective: Despite evidence that goal setting is valuable for physical activity promotion, recent studies highlighted a potential over oversimplification in the application of this behavior change technique. While more difficult performance goals might trigger higher physical activity levels, higher performance goals might concurrently be more difficult to achieve, which could reduce long-term motivation. This study examined i) the association between performance goal difficulty and physical activity and ii) the association between performance goal difficulty and goal achievement. Methods: This study used data from an e-Health intervention among inactive overweight adults (n = 20). The study duration included a 2-week baseline period and an intervention phase of 80 days. During the intervention, participants received a daily step goal experimentally manipulated by taking participants’ baseline physical activity median (i.e., number of steps) multiplied by a pseudo-random factor rang...

Adaptive interventions are an emerging class of behavioral interventions that allow for individualized tailoring of intervention components over time to a person's evolving needs. The purpose of this study was to evaluate an adaptive step goal + reward intervention, grounded in Social Cognitive Theory delivered via a smartphone application (Just Walk), using a mixed modeling approach. Participants (N = 20) were overweight (mean BMI = 33.8 ± 6.82 kg/m 2 ), sedentary adults (90% female) interested in participating in a 14-week walking intervention. All participants received a Fitbit Zip that automatically synced with Just Walk to track daily steps. Step goals and expected points were delivered through the app every morning and were designed using a pseudo-random multisine algorithm that was a function of each participant's median baseline steps. Self-report measures were also collected each morning and evening via daily surveys administered through the app. The linear mixed effects model showed that, on average, participants significantly increased their daily steps by 2650 (t = 8.25, p \ 0.01) from baseline to intervention completion. A non-linear model with a quadratic time variable indicated an inflection point for increasing steps near the midpoint of the intervention and this effect was significant (t 2 = -247, t = -5.01, p \ 0.001). An adaptive step goal + rewards intervention using a smartphone app appears to be a feasible approach for increasing walking behavior in overweight adults. App satisfaction was high and participants enjoyed receiving variable goals each day. Future mHealth studies should consider the use of adaptive step goals + rewards in conjunction with other intervention components for increasing physical activity.

A central goal of behavioral medicine is the creation of evidence-based interventions for promoting behavior change. Scientific knowledge about behavior change could be more effectively accumulated using &quot;ontologies.&quot; In information science, an ontology is a systematic method for articulating a &quot;controlled vocabulary&quot; of agreed-upon terms and their inter-relationships. It involves three core elements: (1) a controlled vocabulary specifying and defining existing classes; (2) specification of the inter-relationships between classes; and (3) codification in a computer-readable format to enable knowledge generation, organization, reuse, integration, and analysis. This paper introduces ontologies, provides a review of current efforts to create ontologies related to behavior change interventions and suggests future work. This paper was written by behavioral medicine and information science experts and was developed in partnership between the Society of Behavioral Medic...

Advances in wireless devices and mobile technology offer many opportunities for delivering just-in-time adaptive interventions (JITAIs)-suites of interventions that adapt over time to an individual&#39;s changing status and circumstances with the goal to address the individual&#39;s need for support, whenever this need arises. A major challenge confronting behavioral scientists aiming to develop a JITAI concerns the selection and integration of existing empirical, theoretical and practical evidence into a scientific model that can inform the construction of a JITAI and help identify scientific gaps. The purpose of this paper is to establish a pragmatic framework that can be used to organize existing evidence into a useful model for JITAI construction. This framework involves clarifying the conceptual purpose of a JITAI, namely, the provision of just-in-time support via adaptation, as well as describing the components of a JITAI and articulating a list of concrete questions to guide ...

Lifestyle behaviors across the 24-h spectrum (i.e., sleep, sedentary, and active behaviors) drive metabolic risk. We describe the development and process evaluation of BeWell24, a multicomponent smartphone application (or "app") that targets behavior change in these interdependent behaviors. A community-embedded iterative design framework was used to develop the app. An 8-week multiphase optimization strategy design study was used to test the initial efficacy of the sleep, sedentary, and exercise components of the app. Process evaluation outcomes included objectively measured app usage statistics (e.g., minutes of usage, self-monitoring patterns), user experience interviews, and satisfaction ratings. Participants (N=26) logged approximately 60 % of their sleep, sedentary, and exercise behaviors, which took 3-4 min/day to complete. Usage of the sleep and sedentary components peaked at week 2 and remained high throughout the intervention. Exercise component use was low. User experiences were mixed, and overall satisfaction was modest.

To test the effect of exposure to the US Food and Drug Administration&#39;s proposed graphic images with text warning statements for cigarette packages on implicit and explicit attitudes towards smoking. A two-session web-based study was conducted with 2192 young adults 18-25-years-old. During session one, demographics, smoking behaviour, and baseline implicit and explicit attitudes were assessed. Session two, completed on average 18 days later, contained random assignment to viewing one of three sets of cigarette packages, graphic images with text warnings, text warnings only, or current US Surgeon General&#39;s text warnings. Participants then completed post-exposure measures of implicit and explicit attitudes. ANCOVAs tested the effect of condition on the outcomes, controlling for baseline attitudes. Smokers who viewed packages with graphic images plus text warnings demonstrated more negative implicit attitudes compared to smokers in the other conditions (p = .004). For the entir...

Implicit attitudes have been shown to predict smoking behaviors. Therefore, an important goal is the development of interventions to change these attitudes. This study assessed the effects of a web-based intervention on implicit attitudes toward smoking and receptivity to smoking-related information. Smokers (N=284) were recruited to a two-session web-based study. In the first session, baseline data were collected. Session two contained the intervention, which consisted of assignment to the experimental or control version of an approach-avoidance task and assignment to an anti-smoking or control public service announcement (PSA), and post-intervention measures. Among smokers with less education and with plans to quit, implicit attitudes were more negative for those who completed the approach-avoidance task. Smokers with more education who viewed the anti-smoking PSA and completed the approach-avoidance task spent more time reading smoking-related information. An approach-avoidance task is a potentially feasible strategy for changing implicit attitudes toward smoking and increasing receptivity to smoking-related information.

Previous literature suggests that the adolescent at risk to engage in substance use and other negative health-related behaviors is deviant in a negative sense (i.e., rebellious, antisocial, and alienated from traditional institutions). However, some researchers have distinguished between two types of deviance-a true autonomy and independence that is more positive and constructive, and a reactant "anticonformity" that is more negative and destructive. The current study assessed the roles of both constructive and destructive deviance in adolescent cigarette smoking and positive health-related behaviors. Adolescents who were constructively deviant engaged in higher levels of health-protective behaviors. Moreover, constructive deviance was an independent predictor of both cigarette smoking and positive health behaviors over and above the effects of traditional negative deviance indicators. These data suggest that constructive deviance is not a competing model to more traditional notions, but that it is an additional possible pathway into adolescent positive and negative health behaviors.

Objective: To investigate the relation between developmental phenotypes of parental smoking (trajectories of smoking from adolescence to adulthood) and the intergenerational transmission of smoking to their adolescent children. Design: A longitudinal, multigenerational study of a midwestern community sample followed individuals from adolescence into adulthood and was combined with Web-based assessment of participants' spouses and adolescent children. Mixture modeling identified multiple trajectories of smoking, and path analyses related these trajectories to adolescents' smoking (beyond both parents' current smoking). Potential mediations were parental education and adolescents' personality characteristics. Main Outcome Measure: The outcome measure was adolescent smoking. Results: A parent's smoking trajectory had a unique effect on their adolescent's smoking, beyond both parents' current smoking and the parent's educational attainment. However, although adolescents' personality characteristics were related both to adolescent smoking and to their parents' smoking, these characteristics could not explain the effects of the parent's smoking trajectory. Conclusion: Parents whose smoking had an early onset, steep acceleration, high levels of smoking, and persistence over time had the highest risk for intergenerational transmission of smoking to their adolescent children.

Assessed the magnitude of risk that adolescent cigarette smoking carries for adult smoking. Using a longitudinal, prospective design, results indicate that even infrequent experimentation in adolescence significantly raises the risk for adult smoking and that regular (at least monthly) adolescent smoking raises the risk for adult smoking by a factor of 16 compared to nonsmoking adolescents. Relative risk was also increased by an early onset of smoking and by a stable, uninterrupted course from experimentation to regular smoking. Relative risk did not significantly vary by age or sex. The continuity of smoking behavior between adolescence and adulthood supports the importance of primary prevention programs directed at adolescent populations.

Background: Self-care behavior is crucial for patients with heart failure to have positive outcomes, and it also serves as a predictor of wellbeing. The self-care tasks that these patients are required to carry out include managing their symptoms, sticking to numerous pharmaceutical regimens, following dietary salt restrictions, and self-monitoring weight. In many cases, a crucial aspect of heart failure treatment is still challenging. Objective: To determine the self-care practices of patients with heart failure at Hasan Sadikin General Hospital in Bandung, Indonesia. Methods: The study used a descriptive study with a consecutive sampling of 196 patients with heart failure in the clinic. Results: the demographic characteristics were mean of age (in year) 56.26±12.49, majority were male 144 respondents (73.57%), above the senior high school 128 respondents (65.3%),

Given the current status of HIV infection in youth in India, developing and implementing HIV education and prevention interventions is critical. The goal for School-based Teenage Education Program (STEP) was to demonstrate that a HIV/AIDS and alcohol abuse educational program built with specific cultural, linguistic, and community-specific characteristics could be effective. Utilizing the Train-the-Trainer model, the instructors (17-21 years) were trained to present the 10 session manualized program to primarily rural and tribal youth aged 13-16 years in 23 schools (N = 1,421) in the northern state of Himachal Pradesh in India. The intervention had a greater impact on girls; girls evidenced greater communication skills and a trend towards greater self efficacy and reduced risk taking behavior. The STEP has been successfully adapted by the community organizations that were involved in coordinating the program at the local level. Their intention to continue STEP beyond extra funding shows that utilizing the local community in designing, implementing and evaluating programs promotes ownership and sustainability.

Objective: This study tested the differential effects of several cognitive and psychological variables on children's perception of asthma symptoms by use of an Asthma Risk Grid. Children's subjective and objective assessments of PEFR (peak expiratory flow rate) were characterized as representing perceptual accuracy, symptom magnification, and/or underestimation of asthma symptoms. Design: Two hundred and seventy children with asthma (ages 7-17) and their primary caregivers completed measures assessing cognitive and psychological factors and a 5-6 week symptom perception assessment. Children's symptom perception scores by use of the Asthma Risk Grid. Results: Children's attentional abilities had more of a bearing on their symptom monitoring abilities than their IQ estimates and psychological symptoms. The more time children took on Trails and Cancellation Tasks and the fewer errors they made on these tasks, the more likely they were to perceive their asthma symptoms accurately. More time on these tasks were associated with more symptom magnification scores, and fewer errors were related with fewer symptom magnification scores. More errors and higher total scores on the Continuous Performance Task were associated with a greater proportion of scores in the danger zone. Statistical support was provided for the utility of attentional-based instruments for identifying children who may have problems with perceptual accuracy, and who are at risk for asthma morbidity.

Invocación de DIOS Lamento comenzar este mensaje con tal "advertencia", pero las cosas deben ser claras y directas. Ahora, ya me conoces, no soy el tipo de persona que se anda por las ramas. Este ritual de contacto, como todo lo que transmito aquí, y a priori desde que empiezo de nuevo los mensajes en mi sitio web, está dirigido a personas de mente abierta pero EQUILIBRADAS. Todos aquellos que deambulan de un dios a otro, un día budista, el siguiente raeliano, antes de convertirse en el evangelista el tercero, no tienen absolutamente nada que hacer en este lugar y menos aún los rituales y meditaciones que se dan. Estos serán ineficaces: nunca DIOS ni ningún otro dios VERDADERO perderá su tiempo con los tontos, porque están ocupados salvando a la Tierra de futuros desastres. Además, una práctica errática de rituales y meditaciones atrae a los "insectos astrales" que están muy contentos de venir y alimentar su feo vientre con usted. Cualquier ritual es un acto de magia. Cualquier acto mágico SIEMPRE tiene consecuencias. Así que sé muy claro contigo mismo. No se permite ningún "turismo" espiritual aquí, solo por tu seguridad. Por lo tanto, si realizas rituales en todas partes, wicca aquí, vudú allí y ahora "un poco de DIOS", gradualmente transformarás tu aura en una pila de energía,

Objective: This study tested whether an intervention that combined information with self-regulation strategies had a better effect on eating fruits and vegetables than an information-only intervention. Desigll: Women between age 30 and 50 (N 255) participated in a 24-month randomized controlled trial comparing two brief interventions: All participants received the same information intervention; participants in the information plus self-regulation group additionally learned a self-regulation technique that integrates mental contrasting with implementation intentions. Maill outcome measures: Participants reported in daily diaries how many servings of fruits and vegetables they ate per day during I week at baseline, and in the first week, I, 2, 4, and 24 months after intervention. Results: Participants in both groups ate more fruits and vegetables (0.47 to 1.00 daily servings) than at baseline during the first 4 months after intervention. Two years later, participants in the information plus self-regulation group maintained the higher intake, whereas participants in the information group returned to baseline levels. COllclusioll: Adding self-regulation training to an information intervention increased its effectiveness for long-term behavior change.

This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally suppressed (OR 0.96, 95 % CI 0.91-1.00 and OR 0.50, 95 % CI 0.25-1.02, respectively). Concerns about public attitudes toward HIV were positively related to medication adherence (OR 2.18, 95 % CI 1.20-3.94) and psychological distress (OR 5.02, 95 % CI 1.54-16.34). The various domains of HIV stigma differentiall...