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Abstract: Cost-inclusive research (CIR) uses observations, interviews, self-reports, and archival records to collect data on the types, amounts, and monetary values of resources that make health psychology interventions (HPIs) possible in healthcare and community settings. These resources include time of practitioners, patients, administrators, space in clinics and hospitals, computer hardware, software, telecommunications, and transportation. CIR adopts a societal perspective by including patient resources such as time spent participating in HPIs, income foregone for participation, travel time and transportation to and from HPI sites, patients’ information devices, and child- and eldercare necessitated by HPI participation. This comprehensive approach to HPIs also distinguishes between costs and outcomes of delivery systems, and of techniques used in HPIs. CIR can help justify funding of HPIs by including not only problem-specific outcomes (effectiveness), but also monetary outcomes (benefits) of HPIs, including changes in patient use of services for health and education, patient criminal justice involvement, financial assistance to patients, and changes in patient income. By measuring the types and amounts of resources consumed in specific activities of HPIs, and monetary and nonmonetary outcomes of HPIs, we can better understand, budget for, and disseminate interventions that work and are accessible by most people who need them. Combining effectiveness findings with data on costs and benefits can build a more complete evidence base for optimizing impacts of health psychology, including empirically selected stepwise interventions to deliver the best interventions in health psychology to the most patients for the least amount of necessary societal and healthcare resources. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 02 Mar 2023 00:00:00 GMT DOI: 10.1037/hea0001280
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Abstract: Objective: Self-monitoring and behavioral feedback are widely used to help people monitor progress toward daily physical activity goals. Little information exists about the optimal dosing parameters for these techniques or if they are interchangeable in digital physical activity interventions. This study used a within-person experimental design to evaluate associations between the frequency of two different prompt types (one for each technique) and daily physical activity. Method: Insufficiently active young adults were assigned monthly physical activity goals and wore smartwatches with activity trackers for 3 months. They received zero to six randomly selected and timed watch-based prompts each day, with individual prompts either providing behavioral feedback or prompting the participant to self-monitor. Results: Physical activity increased significantly over the 3-month period (step counts d = 1.03; moderate-to-vigorous physical activity duration d = 0.99). Mixed linear models revealed that daily step counts were positively associated with the frequency of daily self-monitoring prompts up to approximately three prompts/day (d = 0.22) after which additional prompts provided minimal or reduced benefit. Daily step counts were not associated with the frequency of behavioral feedback prompts. Daily moderate-to-vigorous physical activity was not associated with the frequency of either prompt. Conclusions: Self-monitoring and behavioral feedback are not interchangeable behavior change techniques in digital physical activity interventions, and only self-monitoring prompts show signs of a dose-response association with physical activity volume. Activity trackers, such as smartwatches and mobile apps, should provide an option to replace behavioral feedback prompts with self-monitoring prompts to promote physical activity among insufficiently active young adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 02 Mar 2023 00:00:00 GMT DOI: 10.1037/hea0001271
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Abstract: Objective: A novel cognitive-behavioral couple therapy (CBCT) has shown efficacy for treating provoked vestibulodynia (PVD), the most common type of genito-pelvic pain, in comparison to topical lidocaine. However, mechanisms of therapeutic change have not been determined. We examined women's and partners’ pain self-efficacy and pain catastrophizing as mediators of change in CBCT, using topical lidocaine as a control group. Method: 108 couples coping with PVD were randomized to 12-week CBCT or topical lidocaine and assessed at pre-treatment, post-treatment, and six-month follow-up. Dyadic mediation analyses were conducted. Results: CBCT was not more effective in increasing pain self-efficacy than topical lidocaine, so this mediator was discarded. In women, decreases in pain catastrophizing at post-treatment mediated improvement in pain intensity, sexual distress, and sexual function. In partners, decreases in pain catastrophizing at post-treatment mediated improvement in sexual function. Partners’ decreases in pain catastrophizing also mediated reductions in women's sexual distress. Conclusions: Pain catastrophizing may be a mediator specific to CBCT for PVD, explaining improvements in pain and sexuality. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 02 Mar 2023 00:00:00 GMT DOI: 10.1037/hea0001274
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Abstract: Objective: To understand the association between psychosocial stressors and cardiovascular health by evaluating: (a) lifespan patterns of childhood and adulthood stressors in relation to hemodynamic acute stress reactivity and recovery and (b) the role of optimism in these associations. Method: Participants (n = 1,092, 56% women, 21% racial/ethnic minority, Mage = 56.2) were from the Midlife in the United States Study II Biomarker Project. Lifespan profiles of psychosocial stressor exposure (low lifespan exposure, high childhood only, high adulthood only, persistent exposure) were constructed from responses to the Childhood Trauma Questionnaire and a life events inventory. Optimism was measured with the Life Orientation Test-Revised. Hemodynamic acute stress reactivity to and recovery from cognitive stressors were assessed using a standardized laboratory protocol involving continuous measurements of systolic and diastolic blood pressure (BP) and baroreflex sensitivity (BRS). Results: Compared with the low lifespan exposure group, the high childhood- and persistent-exposure groups showed lower BP reactivity, and to a lesser extent, slower BP recovery. Persistent exposure was also associated with slower BRS recovery. Optimism did not modify the association between stressor exposure and any hemodynamic acute stress responses. However, in exploratory analyses, greater stressor exposure across all developmental periods was indirectly associated with reduced BP acute stress reactivity and slower recovery via lower optimism levels. Conclusions: Findings support childhood as a unique developmental period wherein high adversity exposure may exert an enduring influence on adulthood cardiovascular health by limiting individuals’ capacity to cultivate psychosocial resources and altering hemodynamic responses to acute stressors. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 02 Mar 2023 00:00:00 GMT DOI: 10.1037/hea0001276
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Abstract: Objective: Most fear of cancer recurrence (FCR) interventions have small effects, and few target FCR. This randomized controlled trial (RCT) with breast and gynecological cancer survivors evaluated the efficacy of a cognitive-existential fear of recurrence therapy (FORT) compared to an attention placebo control group (living well with cancer [LWWC]) on FCR. Method: One hundred and sixty-four women with clinical levels of FCR and cancer distress were randomly assigned to 6-weekly, 120 min FORT (n = 80) or LWWC (n = 84) group sessions. They completed questionnaires at baseline (T1), posttreatment (T2; primary endpoint), 3 (T3), and 6 months (T4) posttreatment. Generalized linear models were used to compare group differences in the fear of cancer recurrence inventory (FCRI) total score and secondary outcomes. Results: FORT participants experienced greater reductions from T1 to T2 on FCRI total with a between-group difference of −9.48 points (p = .0393), resulting in a medium effect of −0.530, with a maintained effect at T3 (p = .0330) but not at T4. For the secondary outcomes, improvements were in favor of FORT, including FCRI triggers (p = .0208), FCRI coping (p = .0351), cognitive avoidance (p = .0155), need for reassurance from physicians (p = .0117), and quality of life (mental health; p = .0147). Conclusions: This RCT demonstrated that FORT, compared to an attention placebo control group, resulted in a greater reduction in FCR posttreatment and at 3 months posttreatment in women with breast and gynecological cancer, indicating its potential as a new treatment strategy. We recommend a booster session to sustain gains. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 02 Mar 2023 00:00:00 GMT DOI: 10.1037/hea0001253
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Abstract: Objective: Adult vaccination rates in the United States fall short of national goals, and rates are particularly low for Black Americans. We tested a provider-focused vaccination uptake intervention: a modified electronic health record clinical reminder that bundled together three adult vaccination reminders, presented patient vaccination history, and included talking points for providers to address vaccine hesitancy. Method: Primary care teams at the Atlanta Veterans Affairs Medical Center, who saw 28,941 patients during this period, were randomly assigned to receive either the modified clinical reminder (N = 44 teams) or the status quo (N = 40 teams). Results: Uptake of influenza and other adult vaccinations was 1.6 percentage points higher in the intervention group, which was not statistically significant (confidence interval, CI [−1.3, 4.4], p = .28). The intervention had similar effects on Black and White patients and did not reduce the disparity in vaccination rates between these groups. Conclusion: Provider-focused interventions are a promising way to address vaccine hesitancy, but they may need to be more intensive than a modified clinical reminder to have appreciable effects on vaccination uptake. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Thu, 13 Oct 2022 00:00:00 GMT DOI: 10.1037/hea0001218
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Abstract: Objectives: To understand the role of personal experience, religious and political beliefs as well as conspiracy theory beliefs on the acceptance of COVID-19 vaccination. Method: Just under 400 adults completed online questionnaires assessing to what extent they endorsed conspiracy theories (CTs) and an evidenced measure of personality disorders (PDs). One month later, they were asked about having the COVID-19 vaccine. We examined the relationship between demographic (age, sex, education), ideology (political and religious beliefs), general beliefs in CTs, PDs and attitudes toward vaccination. Results: We found, as anticipated, conservative political orientation, religiosity, Cluster A PDs, and conspiracy thinking correlated negatively with vaccine acceptance. Analysis of variance (ANOVA) showed that the group of vaccine accepting individuals differed from the group of individuals either hesitant or resistant to the vaccine with respect to education, personal ideology, general conspiracy theory adherence, and cluster A PDs. Multinomial logistic regression indicates that religiosity, conspiracy thinking, and lower levels of education predict vaccine hesitancy or rejection. Conclusion: Implications for “rolling out” the vaccine are discussed in terms of who to target and how to address misbeliefs about vaccination. (PsycInfo Database Record (c) 2023 APA, all rights reserved) PubDate: Mon, 05 Sep 2022 00:00:00 GMT DOI: 10.1037/hea0001222
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