Little is known about how couples’ social support facilitates the pursuit of important goals in daily life. Using an interpersonal perspective, we examined the effects of support provision and ...receipt on same-day physical activity, and studied the role of partners’ joint engagement in activities. One hundred nineteen heterosexual couples reported on target persons’ received and partners’ provided support across 28 diary days, yielding 2,854 valid days. A dyadic report on couples’ joint engagement was obtained from a subset of 88 couples. Target persons’ daily activity was objectively assessed via accelerometers. On days with high versus low levels of provided support, target persons’ activity was 25 min higher. Support receipt mediated 20% of this effect. Joint engagement accounted for around half of the effects of provided and received support. Support provision is uniquely linked to goal implementation in everyday life. Joint engagement in activities may be one explanation for how support is facilitated.
Planning promotes progress toward goal achievement in a wide range of domains. To date, planning has mostly been studied as an individual process. In couples, however, the partner is likely to play ...an important role in planning. This study tested the effects of individual and dyadic planning on goal progress and goal-related actions. Two samples of couples (N = 76 and N = 87) completed daily diaries over a period of 28 and 21 days. The results indicate that individual and dyadic planning fluctuate on a daily basis and support the idea that dyadic planning is predominantly used as a complementary strategy to individual planning. As expected, individual and dyadic planning were positively associated with higher levels of action control and goal progress. In Sample 2, dyadic planning was only associated with goal progress on days in which individuals felt that they were dependent upon their partners’ behaviors to achieve their goals.
IntroductionFor more than 60 years, contraceptive pills have been prescribed to mostly healthy biological women. An emerging body of research concerning the possible physiological and psychological ...side effects of hormonal contraception has been published over the past two decades. Consequently, discontinuing combined oral contraceptives (COCs) as a conscious decision for reasons other than desired pregnancy has become increasingly common for menstruating individuals. The question remains as to what physical and psychological consequences can be observed after discontinuing COCs. In addition, the consequent healthcare needs and situations of affected individuals in Germany have not been explored. This study aims to gain greater insight into the relationship between discontinuation of COCs and (1) possible health consequences, and (2) to explore the supply situation for affected women within the German healthcare system.Methods and analysisQualitative episodic interviews with women who discontinue COC therapy will explore possible health consequences, and their current healthcare needs and situations in Germany. The interviews will be transcribed verbatim, coded, and in-depth thematic interpretation will be conducted. Subsequently, expert interviews with health professionals who work with women who discontinue COCs will also be conducted. The expert interviews will be analysed according to the documentary method. Overarching themes will represent the perspectives of women and health professionals on the discontinuation of COCs.Ethics and disseminationEthical approval for this study has been granted by the Ethics Review Committee of Martin Luther University, Halle-Wittenberg (Germany), reference number 2021-34. The findings will be disseminated via peer-reviewed publications, posting via social media and presentations at conferences. This study is registered on the OSF platform under the following number: https://doi.org/10.17605/OSF.IO/JYWXM.
Differences in type 2 diabetes risk have been reported for several sociodemographic determinants including sex/gender or socioeconomic status. From an intersectional perspective, it is important to ...not only consider the role of social dimensions individually, but also their intersections. This allows for a deeper understanding of diabetes risk and preventive needs among diverse population groups.
As an intersectionality-informed approach, multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was used in a population-based sample of adults without known diabetes in Germany from the cross-sectional survey "Disease knowledge and information needs- Diabetes mellitus (2017)". Diabetes risk was assessed by the German Diabetes Risk Score (GDRS, range 0-122 points), estimating the individual risk of developing type 2 diabetes within the next 5 years based on established self-reported risk factors. Nesting individuals in 12 intersectional strata defined by combining sex/gender, educational level, and history of migration, we calculated measures to quantify the extent to which individual differences in diabetes risk were explained at strata level, and how much this was due to additive or multiplicative intersectional effects of social determinants.
Drawing on data of 2,253 participants, we found good discriminatory accuracy of intersectional strata (variance partition coefficient = 14.00% in the simple intersectional model). Model-predicted GDRS means varied between 29.97 (corresponding to a "low risk" of < 2%) in women with high educational level and a history of migration, and 52.73 ("still low risk" of 2-5%) in men with low educational level without a history of migration. Variance in GDRS between strata was mainly explained by additive effects of social determinants (proportional change in variance to intersectional interaction model = 77.95%) with being male and having low educational level being associated with higher GDRS. There was no evidence of multiplicative effects in individual strata.
Type 2 diabetes risk differed between intersectional strata and can to some extent be explained at strata level. The role of intersectional effects was minor and needs to be further investigated. Findings suggest a need for specific preventive measures targeted at large groups with increased diabetes risk, such as men and persons with low educational level.
Positive and negative forms of social control are commonly used to regulate another person's health-related behaviors, especially in couples. Social control efforts have been shown to result in ...desirable, but also undesirable effects on different outcomes. Little is known for which outcomes, when, and under which contextual conditions these different effects unfold in people's everyday lives. Using the dual-effects model of health-related social control, we predicted that same-day and previous-day positive social control would result in desirable effects on target behavior, and same-day positive control on affect. Same-day and previous-day negative control was assumed to result in undesirable effects on reactant responses (i.e., doing the opposite of what the partner wanted and hiding the unhealthy behavior), and same-day negative control on affect. Further, we explored whether it makes a difference if one or both partners intend to change their health behavior. Three daily diary studies addressed these questions for smoking (Studies 1 and 2), and physical activity (Study 3). Receiving more positive control related to more desirable target behavior, and feeling better; more negative control was associated with more reactant responses and feeling worse. Social control unfolded its effects within 1 day, but hardly across days, indicating that control and its reactions to it are fast-acting processes in daily life. The pattern of results were the same for couples with one and both partners intending to change their behavior. Further, results replicated when using partner-reported provided control. Based on these results, social control cannot be unanimously recommended as a behavior change strategy in couples. Future studies should follow up on dyadic and temporal dynamics of social control in couples' everyday lives in different contexts.
Recent evidence suggests that text messaging may help to reduce problem drinking as an extension to in-person services, but very little is known about the effectiveness of remote messaging on problem ...drinking as a stand-alone intervention, or how different types of messages may improve drinking outcomes in those seeking to moderate their alcohol consumption.
We conducted an exploratory, single-blind randomized controlled pilot study comparing four different types of alcohol reduction-themed text messages sent daily to weekly drink self-tracking texts in order to determine their impact on drinking outcomes over a 12-week period in 152 participants (≈ 30 per group) seeking to reduce their drinking on the internet. Messaging interventions included: weekly drink self-tracking mobile assessment texts (MA), loss-framed texts (LF), gain-framed texts (GF), static tailored texts (ST), and adaptive tailored texts (TA). Poisson and least squares regressions were used to compare differences between each active messaging group and the MA control.
When adjusting for baseline drinking, participants in all messaging groups except GF significantly reduced the number of drinks consumed per week and the number of heavy drinking days compared to MA. Only the TA and GF groups were significantly different from MA in reducing the number of drinking days. While the TA group yielded the largest effect sizes on all outcome measures, there were no significant differences between active messaging groups on any outcome measure. 79.6% of individuals enrolled in the study wanted to continue receiving messages for an additional 12 weeks at the end of the study.
Results of this pilot study indicate that remote automated text messages delivered daily can help adult problem drinkers reduce drinking frequency and quantity significantly more than once-a-week self-tracking messages only, and that tailored adaptive texts yield the largest effect sizes across outcomes compared to MA. Larger samples are needed to understand differences between messaging interventions and to target their mechanisms of efficacy.
Social support plays an important role for health outcomes. Support for those living with chronic conditions may be particularly important for their health, and even for their survival. The role of ...support for the survival of cancer patients after receiving an allogeneic hematopoietic cell transplant (alloHCT) is understudied. To better understand the link between survival and support, as well as different sources and functions of support, we conducted two studies in alloHCT patients. First, we examined whether social support is related to survival (Study 1). Second, we examined who provides which support and which specific support-related functions and tasks are fulfilled by lay caregivers and healthcare professionals (Study 2).
In Study 1, we conducted a retrospective chart review of alloHCT patients (
= 173, 42.8% female, age:
= 49.88) and registered availability of a dedicated lay caregiver and survival. In Study 2, we prospectively followed patients after alloHCT (
= 28, 46.4% female, age:
= 53.97, 46.4% ethnic minority) from the same hospital, partly overlapping from Study 1, who shared their experiences of support from lay caregivers and healthcare providers in semi-structured in-depth interviews 3 to 6 months after their first hospital discharge.
Patients with a dedicated caregiver had a higher probability of surviving to 100 days (86.7%) than patients without a caregiver (69.6%), OR = 2.84,
= 0.042. Study 2 demonstrated the importance of post-transplant support due to patients' emotional needs and complex self-care regimen. The role of lay caregivers extended to many areas of patients' daily lives, including support for attending doctor's appointments, managing medications and financial tasks, physical distancing, and maintaining strict dietary requirements. Healthcare providers mainly fulfilled medical needs and provided informational support, while lay caregivers were the main source of emotional and practical support.
The findings highlight the importance of studying support from lay caregivers as well as healthcare providers, to better understand how they work together to support patients' adherence to recommended self-care and survival.
Background
During adolescence, young women and men frequently show low physical activity and elevated depressed affect. This study aimed to examine the within‐person link between moderate‐to‐vigorous ...physical activity (MVPA) and depressed affect in everyday life.
Methods
Within an intensive longitudinal approach, adolescents (N = 72; 37% young women; M age = 17.36 years; age range: 12–26 years; mid‐90% age range: 13–22 years) wore accelerometers to assess their daily MVPA and reported next‐morning and same‐evening depressed affect in diaries over eight consecutive days. The within‐person link between MVPA and depressed affect on the next morning (time‐lagged prediction) and the same evening (same‐day link) was analyzed with mixed‐effects models.
Results
More‐than‐usual MVPA significantly predicted less next‐morning depressed affect on weekdays in young women, to the extent that a 60‐min increase in MVPA over the person mean significantly predicted 50 per cent lower next‐morning depressed affect.
Conclusions
This study encourages the development of individually tailored physical activity interventions that could help adolescents enhance their daily amount of unstructured, self‐initiated MVPA to reduce depressed affect. This approach may be particularly suitable for young women who have the highest risk for an inactive lifestyle and elevated depressed affect.
IntroductionThe prevalence of at-risk drinking is far higher among those in contact with the criminal justice system (73%) than the general population (35%). However, there is little evidence on the ...effectiveness of alcohol brief interventions (ABIs) in reducing risky drinking among those in the criminal justice system, including the prison system and, in particular, those on remand. Building on earlier work, A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE) is a pilot study designed to assess the feasibility and acceptability of an ABI, delivered to male prisoners on remand. The findings of APPRAISE should provide the information required to design a future definitive randomised controlled trial (RCT).Methods and analysisAPPRAISE will use mixed methods, with two linked phases, across two prisons in the UK, recruiting 180 adult men on remand: 90 from Scotland and 90 from England. Phase I will involve a two-arm, parallel-group, individually randomised pilot study. The pilot evaluation will provide data on the likely impact of A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE), which will be used to inform a future definitive multicentre RCT. Phase II will be a process evaluation assessing how the ABI has been implemented to explore the change mechanisms underpinning the ABI (figure 1) and to assess the context within which the ABI is delivered.Ethics and disseminationThe APPRAISE protocol has been approved by the East of Scotland Research Ethics Committee (19/ES/0068), National Offender Management System (2019-240), Health Board Research and Development (2019/0268), Scottish Prison Service research and ethics committee, and by the University of Edinburgh’s internal ethics department. The findings will be disseminated via peer-reviewed journal publications, presentations at local, national and international conferences, infographics and shared with relevant stakeholders through meetings and events.Trial registration numberISRCTN27417180.
Percutaneous left atrial appendage closure (LAAC) has emerged as a non-pharmacological alternative for stroke prevention in patients with atrial fibrillation (AF) not suitable for anticoagulation ...therapy. Real-world data on peri-procedural outcomes are limited. The aim of this study was to analyze outcomes of peri-procedural safety and healthcare resource utilization in 11,240 adult patients undergoing LAAC in the United States between 2016 and 2019. Primary outcomes (safety) were in-hospital ischemic stroke or systemic embolism (SE), pericardial effusion (PE), major bleeding, device embolization and mortality. Secondary outcomes (resource utilization) were adverse discharge disposition, hospital length of stay (LOS) and costs. Logistic and Poisson regression models were used to analyze outcomes by adjusting for 10 confounders. SE decreased by 97% between 2016 and 2019 95% Confidence Interval (CI) 0-0.24 (
= 0.003), while a trend to lower numbers of other peri-procedural complications was determined. In-hospital mortality (0.14%) remained stable. Hospital LOS decreased by 17% (0.78-0.87,
< 0.001) and adverse discharge rate by 41% (95% CI 0.41-0.86,
= 0.005) between 2016 and 2019, while hospital costs did not significantly change (
= 0.2). Female patients had a higher risk of PE (OR 2.86 95% CI 2.41-6.39) and SE (OR 5.0 95% CI 1.28-43.6) while multi-morbid patients had higher risks of major bleeding (
< 0.001) and mortality (
= 0.031), longer hospital LOS (
< 0.001) and increased treatment costs (
= 0.073). Significant differences in all outcomes were observed between male and female patients across US regions. In conclusion, LAAC has become a safer and more efficient procedure. Significant sex differences existed across US regions. Careful considerations should be taken when performing LAAC in female and comorbid patients.
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