Health Psychology and Behavioral Medicine最新文献

{"title":"The burden of HIV-related stigma on clinical and quality of life outcomes: results from a systematic literature review.","authors":"Irina Kolobova, Natalya Danchenko, Ian Jacob, Dennis Rice, Shannon Jones, Emily Matthews, Patrice Carter, Sanjeev Kumar Bhopal, Michelle Moorhouse","doi":"10.1080/21642850.2026.2672790","DOIUrl":"10.1080/21642850.2026.2672790","url":null,"abstract":"<p><strong>Background: </strong>HIV-related stigma adversely impacts people with HIV. As part of a systematic literature review (SLR) to evaluate 6 research questions on HIV-related stigma among people with HIV, data from studies examining its prevalence and association with clinical and quality of life (QoL) outcomes are presented.</p><p><strong>Methods: </strong>Searches were conducted in MEDLINE® and Embase® via the OVID platform from May 2020 to May 2023 for prevalence and from database inception to May 2023 for the other 5 research questions. Relevant conferences, SLR bibliographies, and websites were searched from January 2021 to June 2023. Records were independently screened by 2 reviewers until ≥90% inter-rater reliability was achieved. Data were extracted by 1 reviewer and validated by another.</p><p><strong>Results: </strong>The reported prevalence of HIV-related stigma was broad across multiple stigma types and geographic regions, ranging from 11% to 94%. Most identified studies reported significant associations between higher HIV-related stigma levels and reduced HIV-specific healthcare engagement and retention (8/11), suboptimal antiretroviral therapy adherence (16/20), unsuppressed viral load (10/14), high levels of substance use (3/4), and suboptimal mental health (28/30). Most identified studies reported significant associations between higher HIV-related stigma levels and poorer QoL (23/27).</p><p><strong>Conclusions: </strong>The substantial evidence identified by this SLR suggests that HIV-related stigma is a significant challenge for people with HIV and negatively impacts QoL, mental health, and clinical outcomes. These findings underscore the importance of integrating stigma considerations into the dialogue between physicians and people with HIV to foster shared decision-making for treatment and support.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2672790"},"PeriodicalIF":2.7,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the process of making health behaviour changes in traditional acupuncture: a longitudinal qualitative study.","authors":"Jonquil Pinto, Katherine Bradbury, Dave Newell, Felicity Bishop","doi":"10.1080/21642850.2026.2709724","DOIUrl":"10.1080/21642850.2026.2709724","url":null,"abstract":"<p><strong>Background: </strong>Health behaviours (e.g. exercise/diet/alcohol/smoking) are a major public health concern and traditional complementary and integrative medicine providers such as traditional acupuncturists could make an important contribution. We explored the support for health behaviour change provided to and experienced by traditional acupuncture patients to understand the ways in which traditional acupuncturists may contribute to their patients making changes to their health behaviours.</p><p><strong>Methods: </strong>Longitudinal qualitative research methods were used to capture experiences as they change over time with nine patient‒practitioner dyads (8 female patients and 1 male, aged 23-55, and 3 female traditional acupuncturists, aged 35-63). Consultations were audio-recorded and in-depth qualitative interviews were conducted with patients (twice) and traditional acupuncturists (once). Experiences were explored with primary focus on the patients; data were coded both deductively and inductively and themes were produced using reflexive thematic analysis.</p><p><strong>Results: </strong>Patients at different stages of readiness to change need different types of support-those overwhelmed by symptoms/stress needed help to gain control, patients more ready to change needed help sustaining motivation. Acceptance of lifestyle/behaviour advice was related to establishing a cycle of trust, in practitioner, explanations and treatment. Decisions to enact behaviour change were based partly on changes in feelings/mood as well as reasoned understanding (e.g. of behavioural contribution to symptoms).</p><p><strong>Conclusions: </strong>Patients' response to behaviour change support in traditional acupuncture may vary according to their symptom control and stress. For some, support for symptoms/stress may need addressing before any behaviour change intervention. Therapeutic trust, coherent explanations and positive feeling from treatments were important in supporting change. These findings link to concepts from the trans-theoretical model and stages of change, social cognitive theory, and the common sense model of self-regulation and dual process theories of behaviour.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2709724"},"PeriodicalIF":2.7,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using behavioural theory to explore barriers and facilitators to physical activity in haemodialysis patients: an updated systematic review of qualitative evidence.","authors":"Sarah Jasat, Roseanne E Billany, Courtney J Lightfoot, Amirah Essop-Adam, James O Burton, Matthew P M Graham-Brown","doi":"10.1080/21642850.2026.2707668","DOIUrl":"10.1080/21642850.2026.2707668","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) improves health indicators for people receiving haemodialysis; however, participation remains low, and PA provision in routine care is inconsistent, despite recommendations from clinical practice guidelines. This review updates and integrates existing evidence on the attitudes towards PA and applies behaviour change theory to move beyond feasibility and identify components that support sustainable integration into routine clinical care.</p><p><strong>Methods: </strong>Five databases were systematically searched for studies reporting qualitative data on barriers and/or facilitators to PA (or its delivery) for adults undergoing maintenance haemodialysis and staff facilitating and observing. The findings were mapped to the Theoretical Domains Framework (TDF) and linked Capability, Opportunity, Motivation (COM-B) components, with candidate intervention functions identified through the Behaviour Change Wheel. A frequency analysis identified prominent domains from staff and patient data, and inductive thematic analysis within TDF domains identified barrier and facilitator themes.</p><p><strong>Results: </strong>Seventeen papers met the inclusion criteria. There were similarities in prominent TDF domains and themes between patient and staff data, and all areas of the COM-B were implicated as relevant. While all nine Behaviour Change Wheel intervention functions were identified, the APEASE-based assessment highlighted training, environmental restructuring, education, modelling, and enablement as the most feasible and relevant, with illustrative behaviour change techniques provided to support translation into practice.</p><p><strong>Conclusion: </strong>These findings identify areas of congruence in perceptions of barriers and facilitators across staff and patient groups, as well as key areas to consider when developing future interventions. Addressing these areas through the proposed intervention functions may enhance participation in PA and support sustained behaviour change.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2707668"},"PeriodicalIF":2.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13410551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test anxiety predictors inventory (tapi): development and initial validation of a predictor-oriented instrument for medical students.","authors":"Dang Thanh Hong, Nguyen Thi Hong Duy, To Thi Kim Quyen","doi":"10.1080/21642850.2026.2687929","DOIUrl":"10.1080/21642850.2026.2687929","url":null,"abstract":"<p><strong>Background: </strong>Test anxiety (TA) is common among medical students and may adversely affect mental well-being and academic performance. However, existing instruments such as the Test Anxiety Inventory (TAI) predominantly quantify the severity and manifestations of anxiety (outcomes) rather than identifying modifiable, intervention-relevant antecedents (predictors). This study aimed to develop and validate the Test Anxiety Predictors Inventory (TAPI) to support concurrent identification of at-risk students and to inform domain-specific, targeted interventions in resource-constrained medical training settings.</p><p><strong>Methods: </strong>A cross-sectional census survey was conducted at Can Tho University of Medicine and Pharmacy (Dec 2024-Mar 2025; 382/389 valid responses, 98.2%). A 30-item pool was piloted in 71 students, then refined through iterative EFA (3 rounds; ML extraction, Direct Oblimin) and CFA (ML and DWLS estimators). Internal consistency, convergent and discriminant validity, correlation with TAI, and concurrent classification performance (multivariable logistic regression; ROC-AUC) were assessed. Because census sampling yielded one dataset, EFA/CFA reflect internal testing pending external validation; 'prediction' denotes concurrent classification, not temporal forecasting.</p><p><strong>Results: </strong>TA prevalence (TAI ≥ 48) was 67.0% (95% CI 62.15-71.54). The final 14-item TAPI loaded on three factors-EAS (7), AMF (4), SRP (3)-explaining 77.99% of variance (KMO = 0.935). The correlated three-factor CFA showed good fit (CFI = 0.957; RMSEA = 0.083). The second-order DWLS model showed excellent fit but produced a Heywood warning with negative latent variance for EAS; the correlated three-factor model is therefore the more defensible representation. Reliability was high (α/ω = 0.89-0.95; CR = 0.92-0.96; AVE = 0.74-0.82; HTMT < 0.85). TAPI-TAI correlation was r = 0.576; classification model AUC = 0.804, sensitivity = 0.938, specificity = 0.452.</p><p><strong>Conclusions: </strong>TAPI shows promising internal structure and concurrent classification performance. High sensitivity supports first-stage screening, while modest specificity indicates it should complement, not replace, formal diagnostic procedures.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2687929"},"PeriodicalIF":2.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative investigation of experiences of care and illness perceptions related to self-management behaviors in chronic kidney disease.","authors":"Malin Ekholm, Henna Hämäläinen, Virpi Rauta, Keegan Knittle","doi":"10.1080/21642850.2026.2699481","DOIUrl":"10.1080/21642850.2026.2699481","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) requires active self-management to slow progression, yet adherence is often low. To inform intervention development, this qualitative study explored CKD patients' illness perceptions and care experiences, and examined how these factors may interact to shape self-management.</p><p><strong>Methods: </strong>Eighteen adults with CKD stages 2-5 were recruited from a nephrology clinic and interviewed immediately after routine care encounters. Semi-structured interviews were analyzed using both inductive and deductive reflexive thematic analysis (informed by the Common-Sense Model of Self-Regulation).</p><p><strong>Results: </strong>Patients generally perceived CKD as chronic but controllable, with few noticeable symptoms and limited immediate consequences. Low symptom burden often reduced the perceived importance of self-management in daily life, whereas understanding the reasons for treatment and lifestyle changes increased motivation. Patients described treatment and control beliefs as moderate, but patients struggled to perceive the effects of dietary changes. Access to clear information, continuity of care, and trust in healthcare and practitioners were highlighted as important for coherence and confidence in self-management. Emotional responses were often alleviated through increased knowledge and supportive interactions with healthcare staff.</p><p><strong>Conclusion: </strong>Mapping experiences to illness perceptions revealed multiple pathways through which care processes may support or hinder CKD self-management.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2699481"},"PeriodicalIF":2.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User experiences of the mobile stress autism mate (SAM) application: a qualitative study among autistic adults not receiving mental health care.","authors":"Alvin van Asselt, Yvette Roke, Kirsten Hoeberichts, Sander Begeer, Anke Scheeren","doi":"10.1080/21642850.2026.2684373","DOIUrl":"10.1080/21642850.2026.2684373","url":null,"abstract":"<p><strong>Background: </strong>Autistic adults typically experience greater daily stress than their non-autistic counterparts, but professional mental health care is not always accessible or fitting. This qualitative study explored the user experiences of the Stress Autism Mate (SAM), a free co-created mobile application designed to reduce stress, among autistic adults not receiving mental health care.</p><p><strong>Methods: </strong>A total of 15 autistic users (8 satisfied, 7 dissatisfied; aged 27-70; 4 men, 10 women, 1 non-binary) were recruited through a prior SAM trial database and autism-related social media groups for semi-structured online interviews. Interview questions were informed by the User Experience Technology Acceptance Model (UX-TAM), whereas themes were developed inductively through thematic analysis.</p><p><strong>Results: </strong>Participants generally appreciated the SAM app's focus on enhancing stress recognition and its non-coercive, intuitive, and minimalist interface. Nevertheless, they found the app's stress tips insufficiently tailored to their context and the repeated login requirement frustrating. Satisfied users expressed a stronger need for stress-reducing support and greater trust in the app's developers and its scientific foundations. Dissatisfied users perceived the app's features as superficial and reported greater strain from attempting to adhere to its demands.</p><p><strong>Conclusions: </strong>Despite the diverse user experiences, the findings highlight various avenues to improve the SAM app and similar standalone mHealth tools for autistic adults. Future adaptations should carefully balance the provision of structure and support with the risk of inducing technostress.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2684373"},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical EFT for individuals with visual impairment: effects on psychological wellbeing and subjective visual functioning.","authors":"Peta Stapleton, Christine Roil","doi":"10.1080/21642850.2026.2699488","DOIUrl":"10.1080/21642850.2026.2699488","url":null,"abstract":"<p><strong>Background: </strong>Visual impairment (VI) affects over 2.2 billion people globally and is often associated with heightened levels of anxiety and depression, adversely impacting quality of life. Despite increasing prevalence and associated psychosocial burden, effective psychosocial interventions in this population remains limited. This study examines the efficacy of an eight-week online Clinical Emotional Freedom Techniques (EFT) program in improving psychological wellbeing (anger, anxiety and depression) and perceived subjective visual functioning in individuals with self-reported VI.</p><p><strong>Method: </strong>Employing a randomised controlled trial design, 588 participants were assigned to either an EFT intervention (<i>n</i> = 321) or waitlist control group (<i>n</i> = 267). Outcomes were assessed at baseline, post-intervention and three- and six-month follow up.</p><p><strong>Results: </strong>Per-protocol results indicated significant improvements in the EFT group compared to the waitlist control group across psychological outcomes and vision functioning. Repeated measures ANOVA revealed significant Time × Allocation interactions for anger, anxiety, depression, and vision functioning (all <i>p</i> < .001), indicating differential change over time between groups. Within the EFT group, significant reductions in anger, anxiety, and depression were observed from pre- to post-intervention, with these improvements maintained at three- and six-month follow-ups (all <i>p</i> < .05). In contrast, the waitlist group showed no comparable improvements over the same period. Vision functioning significantly improved in the EFT group relative to the waitlist group, with a significant interaction effect (<i>p</i> < .001), although no overall main effect of time was observed. Intention-to-treat analyses using mixed-effects models confirmed the primary findings, with significant improvements in anxiety, depression, anger, and vision functioning relative to the waitlist control condition (all <i>p</i> < .001), and treatment gains were maintained at 3- and 6-month follow-up.</p><p><strong>Conclusions: </strong>These findings suggest that the online Clinical EFT intervention was associated with sustained improvements in psychological distress and vision-related functioning compared to waitlist control. Limitations and future directions are discussed.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2699488"},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting breastfeeding through digital communication: a longitudinal randomized controlled trial.","authors":"Margherita Guidetti, Giulia Scaglioni, Nicoletta Cavazza, Rossana Reggiani, Ramona Infante, Maria Teresa Molinazzi, Isabella Neri","doi":"10.1080/21642850.2026.2685914","DOIUrl":"10.1080/21642850.2026.2685914","url":null,"abstract":"<p><strong>Introduction: </strong>Breastfeeding is a key early-life primary prevention behavior; yet, despite consistent recommendations and recent improvements, exclusive breastfeeding rates remain well below target levels. This preregistered longitudinal randomized controlled trial (RCT) tested the effectiveness of two resource-efficient digital communication interventions.</p><p><strong>Methods: </strong>Women in the 36th week of pregnancy (<i>N</i> = 467) were randomly assigned to one of six conditions in a 2 × 3 between-participants design. The first intervention consisted of informational messages targeting components of the extended Theory of Planned Behavior (TPB). The second intervention was a drip communication campaign delivered via mobile phone messages: participants in the <i>tips</i> condition received messages aimed at increasing practical breastfeeding knowledge and skills, whereas participants in the <i>implementation intentions</i> condition were additionally prompted to formulate specific if-then plans. Control groups received messages related to healthy eating and physical activity. Participants were followed up until 5 months postpartum.</p><p><strong>Results: </strong>The TPB-based intervention exerted indirect effects on both full and any breastfeeding duration by increasing breastfeeding self-efficacy and perceived behavioral control, which in turn enhanced exclusive breastfeeding intentions. For full breastfeeding only, the intention-behavior relationship-and thus the indirect effect of the TPB intervention-was strengthened by both the tips and implementation intentions interventions. Higher levels of self-objectification indirectly reduced breastfeeding duration through weaker identification as a breastfeeding mother and lower intentions.</p><p><strong>Discussion: </strong>Delivering simple, resource-efficient digital communication interventions that empower mothers and support the translation of intentions into sustained behavior represents a scalable strategy to promote exclusive breastfeeding.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2685914"},"PeriodicalIF":2.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight stigma and engagement in physical health behaviours among young adults in India.","authors":"Ankita Sehrawat, Susan M Sherman, Nicola J Buckland, Chantelle Wood","doi":"10.1080/21642850.2026.2687229","DOIUrl":"10.1080/21642850.2026.2687229","url":null,"abstract":"<p><strong>Background: </strong>Weight stigma - bias, prejudice, and discrimination based on weight - affects engagement in physical health behaviours in Western populations. Effects on individuals from South Asia, particularly India, are less well understood.</p><p><strong>Objective: </strong>This study examined whether weight stigma is associated with young Indian adults' engagement in physical health behaviours and explored potential moderators and mediators.</p><p><strong>Methods: </strong>781 adults (18-26 years) completed an online survey. Multiple regression analyses assessed whether experienced (EWS), anticipated (AWS), and internalised (IWS) weight stigma is associated with engagement in physical health behaviours while controlling for self-reported BMI, gender, age, and income, whether effects were mediated by stress and self-esteem, and moderated by perceived weight status and BMI.</p><p><strong>Results: </strong>EWS, AWS and IWS were significantly associated with greater engagement in unhealthy and extremely unhealthy weight control behaviours, alcohol consumption, and binge eating with and without loss of control. EWS was also associated with greater cigarette use. AWS and EWS were associated with lower physical activity. While stress more consistently mediated the relationship between weight stigma and health behaviour, self-esteem emerged as a novel mediator. Perceived weight status was a more consistent moderator than BMI.</p><p><strong>Discussion: </strong>This is the first study to provide evidence that weight stigma is associated with greater engagement in unhealthy behaviours and less engagement in healthy behaviours in young Indian adults. Mediation by stress supports COBWEBS and the Weight-Based Social Identity Threat Model, while self-esteem emerged as a novel mediator. These findings offer insights into mechanisms linking weight stigma to physical health behaviours and the impacts of weight stigma within a non-Western setting.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2687229"},"PeriodicalIF":2.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle behavior clusters and their associations with depressive symptoms among Chinese adolescents: during and after COVID-19 period.","authors":"Zeng-Bao Hu, Ke-Qin Ding, Stuart McDonald, Qing-Hai Gong, Yi Lin","doi":"10.1080/21642850.2026.2677983","DOIUrl":"10.1080/21642850.2026.2677983","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of depressive symptoms among adolescents presents a significant public health challenge. However, little is known about the influence of lifestyle changes on depressive symptoms among adolescents after the cancellation of the zero-COVID policy in China. This study aims to examine the associations between clusters of lifestyle behaviors and depressive symptoms among Chinese adolescents during and after the zero-COVID policy period.</p><p><strong>Methods: </strong>A school-based 2-year longitudinal study was conducted from September 2022 to October 2023 in Ningbo, Zhejiang Province, China. Depressive symptoms were assessed using the 20-item Center for Epidemiological Studies Depression Scale. Two-step cluster analysis was used to identify clusters based on adolescents' levels of moderate-to-vigorous physical activities, screen-based sedentary time, sleep duration, and consumption of sugar-sweetened beverages and deep-fried food in each period. A binary generalized linear model (GLM) regression was used to estimate and examine associations between lifestyle clusters and depressive symptoms.</p><p><strong>Results: </strong>A total of 2705 adolescents aged between 10 and 19 years were included in the analysis. The prevalence of depressive symptoms in the zero-COVID policy period was lower than that in the post-zero-COVID policy period (20.00% vs. 25.21%, <i>p</i> < 0.01). Five lifestyle clusters were recognized in each time period.</p><p><strong>Conclusions: </strong>In general, unhealthy lifestyle clusters were associated with a higher likelihood of depressive symptoms, with the association being stronger and more significant in the post-zero-COVID policy period. Effective interventions for adolescents' lifestyle behaviors, such as health education programs, are needed to reduce long-term negative effects on their mental health in the post-pandemic period and potential future pandemics.</p>","PeriodicalId":12891,"journal":{"name":"Health Psychology and Behavioral Medicine","volume":"14 1","pages":"2677983"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13228188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}