More remains unknown than known about how to optimize multiple health behaviour change.
After reviewing the prevalence and comorbidities among major chronic disease risk behaviours for adults and ...youth, we consider the origins and applicability of high-risk and population strategies to foster multiple health behaviour change.
Findings indicate that health risk behaviours are prevalent, increase with age and co-occur as risk behaviour clusters or bundles.
We conclude that both population and high-risk strategies for health behaviour intervention are warranted, potentially synergistic and need intervention design that accounts for substitute and complementary relationships among bundled health behaviours. To maximize positive public health impact, a pressing need exists for bodies of basic and translational science that explain health behaviour bundling. Also needed is applied science that elucidates the following: (1) the optimal number of behaviours to intervene upon; (2) how target behaviours are best selected (e.g. greatest health impact; patient preference or positive effect on bundled behaviours); (3) whether to increase healthy or decrease unhealthy behaviours; (4) whether to intervene on health behaviours simultaneously or sequentially and (5) how to achieve positive synergies across individual-, group- and population-level intervention approaches.
Background: Body shape concern (BSC; preoccupation with body shape) has been linked to variable weight loss in standard behavioral weight loss treatment (SBT) and degree of BSC may impact response to ...weight loss programs modified to enhance treatment outcomes. This secondary analysis examined the association of BSC with weight loss among women in a pilot study randomly assigned to 12-week Internet-delivered SBT, SBT modified to focus on negative consequences of unhealthy behaviors (PREVENT), or SBT modified to focus on positive consequences of healthy behaviors (PROMOTE). Methods: Women (n=82, 80% WHITE; BMI=33.3, SD=5.0) completed the Body Shape Questionnaire before randomization and were categorized based on established BSC clinical cutoffs (No BSC (20%), Low BSC (33%), Moderate BSC (32%), or High BSC (15%)). Percent weight loss (PWL) was calculated from baseline to 12-week (baseline carried forward). Due to the small sample descriptive analysis was used to evaluate mean values for PWL for each of the BSC levels by treatment conditions. Results: Women with No BSC had greater weight loss in PREVENT (-6.7%) than in SBT (-2.5%) or PROMOTE(-4.5%), as did those with Low BSC (PREVENT: -4.9% SBT:-2.8% PROMOTE: -2.9%) or Moderate BSC (PREVENT: -6.7%, SBT=-4.3% PROMOTE=-3.9%). However, women with High BSC did not experience enhanced weight loss in any of the conditions (PREVENT: -3.7%, SBT: -3.2%, PROMOTE: -3.9%). Conclusions: SBT modified to focus on the negative consequences of unhealthy behaviors (PREVENT) was associated with greater weight loss for women with No, Low, or Moderate BSC; with average PWL in PREVENT that approached or exceeded 5% which is widely accepted as clinically significant change. Women with High BSC did not exhibit improved PWL or reach the 5% clinical target in any condition. Consistent with precision medicine, BSC may have implications for treatment matching in SBT programs that have been modified to enhance the saliency of positive or negative effects of health behaviors.
Background: The transition from adolescence to adulthood is widely assumed to be a critical window for laying a foundation for healthful behavior patterns, yet few studies have empirically tested ...whether behaviors in this life stage track with later adult outcomes. Methods: From 1998-2007, incoming undergraduates (n = 4,641) at a northeast US university completed baseline health surveys prior to matriculation. A 2018 survey assessed self-reported weight 11-21 years later among the same individuals as adult alumni. Latent class analysis was used to identify baseline classes of health behaviors including diet (fruit, vegetables, dairy, red meat), physical activity, TV time, sleep, and supplement use. Analysis of covariance was used to test for differences in mean change in body weight and BMI from pre-college age to later adulthood by baseline latent class, controlling for baseline weight/BMI, sex, smoking, race-ethnicity, and time. Results: Complete baseline and alumni survey data were obtained for 23% (n = 1052) of the original cohort, with the following baseline characteristics: mean age 18 (0.50) years, 62% female, 76% white, and 81% with normal weight. Baseline latent classes were defined as healthful (27% of the sample), moderately healthful (49%), and unhealthful (25%). There were statistically significant differences in mean baselineto-adulthood weight change by baseline latent class (p = 0.03), with the healthful group having less gain in body weight (4.3 7.3 kg) compared with the moderately healthful (6.1 8.5 kg) and unhealthful (6.5 9.1 kg) groups, after adjustment for covariates. There were similar differences in BMI change, with smaller mean increases in the healthful group (1.4 2.5 kg/m2) compared with the moderately healthful (2.0 2.9 kg/m2) and unhealthful (2.1 3.1 kg/m2) groups (p = 0.03). Conclusions: Behavioral patterns prior to college enrollment have implications for weight-related outcomes 11-21 years later. Intervening early in life is critical to long-term health.
The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to ...lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting.
This study investigates the possible association between social media usage and the mental health toll from the coronavirus at the peak of Wuhan's COVID-19 outbreak. Informed by the Crisis and ...Emergency Risk Communication Model and Health Belief Model, it proposes a conceptual model to study how people in Wuhan – the first epicenter of the global COVID-19 pandemic – used social media and its effects on users' mental health conditions and health behavior change. The results show that social media usage was related to both depression and secondary trauma, which also predicted health behavior change. But no relation was detected between health behavior change and mental health conditions. As the virus struck, social media usage was rewarding to Wuhan people who gained informational, emotional, and peer support from the health information shared on social media. An excessive use of social media, however, led to mental health issues. The results imply that taking a social media break may promote well-being during the pandemic, which is crucial to mitigating mental health harm inflicted by the pandemic.
•This study reveals mental health toll at the peak of Wuhan's COVID-19 outbreak.•Social media usage predicted both depression and secondary trauma in Wuhan residents.•Social media usage predicted health behavior change during the public health crisis.•Social media usage offered users vital informational, emotional, and peer support.•Social media are not the culprit for mental health issues detected in the pandemic.
We study partisan differences in Americans' response to the COVID-19 pandemic. Political leaders and media outlets on the right and left have sent divergent messages about the severity of the crisis, ...which could impact the extent to which Republicans and Democrats engage in social distancing and other efforts to reduce disease transmission. We develop a simple model of a pandemic response with heterogeneous agents that clarifies the causes and consequences of heterogeneous responses. We use location data from a large sample of smartphones to show that areas with more Republicans engaged in less social distancing, controlling for other factors including public policies, population density, and local COVID cases and deaths. We then present new survey evidence of significant gaps at the individual level between Republicans and Democrats in self-reported social distancing, beliefs about personal COVID risk, and beliefs about the future severity of the pandemic.
Recent popular press authors have proposed that men are less likely to wear face masks during the COVID-19 pandemic. We investigate this notion in the current article by analyzing three extant ...datasets. We also assess the mediating effect of eight different face mask perceptions in the relation between gender and face mask wearing via the Face Mask Perceptions Scale. Across the three datasets, the sample-size weighted meta-analytic correlation between gender and face mask wearing was not statistically significant, and no face mask perception was a consistent mediator of this effect. Gender did have significant relations with two face mask perceptions, however. Men were more likely to perceive face masks as infringing on their independence, whereas women were more likely to perceive face masks as uncomfortable. Therefore, although gender does not relate to whether a person wears a face mask, it does relate to face mask perceptions. We offer several suggestions for research and practice from these results, such as the positioning of face mask wearing alongside passive health behaviors, the broader study of face mask perceptions' outcomes beyond face mask wearing, as well as the creation of interventions to target differing face mask perceptions across genders.
The cumulative science linking stress to negative health outcomes is vast. Stress can affect health directly, through autonomic and neuroendocrine responses, but also indirectly, through changes in ...health behaviors. In this review, we present a brief overview of (
a
) why we should be interested in stress in the context of health; (
b
) the stress response and allostatic load; (
c
) some of the key biological mechanisms through which stress impacts health, such as by influencing hypothalamic-pituitary-adrenal axis regulation and cortisol dynamics, the autonomic nervous system, and gene expression; and (
d
) evidence of the clinical relevance of stress, exemplified through the risk of infectious diseases. The studies reviewed in this article confirm that stress has an impact on multiple biological systems. Future work ought to consider further the importance of early-life adversity and continue to explore how different biological systems interact in the context of stress and health processes.
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