{"title":"Differential signaling effects of blood glucose on delay discounting in individuals with and without type 1 diabetes.","authors":"Zheng Liu, Noel E Schaeffer, XiaoTian Wang","doi":"10.1007/s10865-024-00500-7","DOIUrl":"10.1007/s10865-024-00500-7","url":null,"abstract":"<p><p>Based on the signaling hypothesis of blood glucose (BG), a rise in BG levels signals a positive energy budget for healthy individuals but cellular starvation for individuals with type 1 diabetes. We examined this novel prediction and its intervention implications in the context of delay discounting, the degree to which delayed rewards are discounted, and the regulatory effects of insulin ingestion. We recruited 44 adults with type 1 diabetes (mean age 30.8 years, diabetes duration 15.4 years) and recorded their BG levels. The delay discounting rate was measured using the intertemporal choice task, where participants were required to choose between sets of smaller-and-sooner (SS) and larger-and-later (LL) rewards. In addition, 82 age-matched healthy participants were recruited to provide a baseline comparison on delay discounting. Random forest analysis showed that among many diagnostic factors, delay discounting was most dominating in differentiating the individuals with type 1 diabetes from the control participants. A hierarchical linear mixed model revealed that participants with type 1 diabetes had a stronger preference for SS rewards (p < .001) after controlling for covariates. Participants who had insulin delivered before the last meal exhibited a stronger preference for LL rewards compared to after-meal delivery. In contrast, subjective measures (e.g., self-reported hunger) failed to predict the participants' actual BG levels and delay discounting rates. In sum, individuals with type 1 diabetes tend to discount future rewards excessively compared to the control participants. Pre-meal insulin ingestion was associated with a higher LL preference for future rewards.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"839-848"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail M Faust, Alexandria Auerbeck, Alexandra M Lee, Ian Kim, David E Conroy
{"title":"Passive sensing of smartphone use, physical activity and sedentary behavior among adolescents and young adults during the COVID-19 pandemic.","authors":"Abigail M Faust, Alexandria Auerbeck, Alexandra M Lee, Ian Kim, David E Conroy","doi":"10.1007/s10865-024-00499-x","DOIUrl":"10.1007/s10865-024-00499-x","url":null,"abstract":"<p><p>The research that links excessive screen time to adverse health outcomes is based on self-reported screen use. Few studies have documented how passively-sensed smartphone and app use relate to health behaviors like activity and sitting. Furthermore, they have not considered that daily fluctuations in smartphone/app use may have different relationships to these behaviors than a person's usual smartphone/app use. This study evaluated whether physical activity or sedentary (sitting) behavior are associated with either smartphone screen time or specific smartphone app use by adolescents and young adults during the COVID-19 pandemic. Adolescents and young adults aged 13-29 years wore activPAL4 micro activity monitors while their smartphones logged daily screen time and app use durations for nine days. Data were collected in 2020-2021 and analyzed in 2022-2023. Participants (N = 125) had a mean (SD) age of 19.7 (4.3) years. Participants' usual smartphone screen time was negatively associated with daily step counts. Daily deviations in smartphone screen time were negatively associated with daily step counts and moderate-vigorous physical activity durations. Time spent on Instagram, YouTube and, to a lesser extent, TikTok were linked with reduced activity levels. Daily sedentary behavior was not associated with usual or daily screen time. Interventions to promote physical activity during the transition into adulthood may benefit from limiting excessive smartphone screen time. Specific intervention targets could include limiting use of apps with infinite scrolling feeds algorithmically tuned to maintain user engagement, such as Instagram, YouTube and TikTok.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"770-781"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zachary M Harvanek, Anastacia Y Kudinova, Samantha A Wong, Ke Xu, Leslie Brick, Teresa E Daniels, Carmen Marsit, Amber Burt, Rajita Sinha, Audrey R Tyrka
{"title":"Childhood adversity, accelerated GrimAge, and associated health consequences.","authors":"Zachary M Harvanek, Anastacia Y Kudinova, Samantha A Wong, Ke Xu, Leslie Brick, Teresa E Daniels, Carmen Marsit, Amber Burt, Rajita Sinha, Audrey R Tyrka","doi":"10.1007/s10865-024-00496-0","DOIUrl":"10.1007/s10865-024-00496-0","url":null,"abstract":"<p><p>Childhood adversity is linked to psychological, behavioral, and physical health problems, including obesity and cardiometabolic disease. Epigenetic alterations are one pathway through which the effects of early life stress and adversity might persist into adulthood. Epigenetic mechanisms have also been proposed to explain why cardiometabolic health can vary greatly between individuals with similar Body Mass Index (BMIs). We evaluated two independent cross-sectional cohorts of adults without known medical illness, one of which explicitly recruited individuals with early life stress (ELS) and control participants (n = 195), and the other a general community sample (n = 477). In these cohorts, we examine associations between childhood adversity, epigenetic aging, and metabolic health. Childhood adversity was associated with increased GrimAge Acceleration (GAA) in both cohorts, both utilizing a dichotomous yes/no classification (both p < 0.01) as well as a continuous measure using the Childhood Trauma Questionnaire (CTQ) (both p < 0.05). Further investigation demonstrated that CTQ subscales for physical and sexual abuse (both p < 0.05) were associated with increased GAA in both cohorts, whereas physical and emotional neglect were not. In both cohorts, higher CTQ was also associated with higher BMI and increased insulin resistance (both p < 0.05). Finally, we demonstrate a moderating effect of BMI on the relationship between GAA and insulin resistance where GAA correlated with insulin resistance specifically at higher BMIs. These results, which were largely replicated between two independent cohorts, suggest that interactions between epigenetics, obesity, and metabolic health may be important mechanisms through which childhood adversity contributes to long-term physical and metabolic health effects.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"913-926"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Abdelaziz, Abdelrahman H Hafez, Merna Raafat Roshdy, Mohamed Abdelaziz, Moemen A Eltobgy, Hanaa Elsayed, Youssef El-Sherif, Mohamed Atef, Abdullah Ashraf Hamad, Hany Atwan, Rama Jamal Eddin Haboush, Nada Ibrahim Hendi, Alyaa Hefny, Hazem S Ghaith
{"title":"Cognitive behavioral therapy for the treatment of insomnia in patients with cardiovascular diseases: a meta-analysis with GRADE analysis.","authors":"Ahmed Abdelaziz, Abdelrahman H Hafez, Merna Raafat Roshdy, Mohamed Abdelaziz, Moemen A Eltobgy, Hanaa Elsayed, Youssef El-Sherif, Mohamed Atef, Abdullah Ashraf Hamad, Hany Atwan, Rama Jamal Eddin Haboush, Nada Ibrahim Hendi, Alyaa Hefny, Hazem S Ghaith","doi":"10.1007/s10865-024-00490-6","DOIUrl":"10.1007/s10865-024-00490-6","url":null,"abstract":"<p><p>Insomnia, as a difficulty in initiating and maintaining sleep, coupled with cardiovascular diseases (CVDs) increase the risk of aggravate daytime symptoms, mortality, and morbidity. Cognitive behavioral therapy (CBT) is thought to have a significant impact on insomnia treatment, but in patients with CVDs, there is a paucity of data. To provide a comprehensive appraisal on the impact of CBT on the treatment of insomnia in patients with CVDs. We searched Ovid, Scopus, Web of science, and Cochrane central, to randomized controlled trials (RCTs) from inception till November 2022. Outcomes of interest were insomnia severity index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep efficiency (SE), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), and sleep disorders questionnaire (SDQ). Pooled data were analyzed using mean difference (MD) with its 95% confidence interval (CI) in a random effect model using STATA 17 for Mac. Nine RCTs comprising 365 patients were included in the analysis. CBT significantly reduced scores of ISI (MD = - 3.22, 95% CI - 4.46 to - 1.98, p < 0.001), PSQI (MD = - 2.33, 95% CI - 3.23 to - 1.44, p < 0.001), DBAS (MD = - 0.94, 95% CI - 1.3 to - 0.58, p < 0.001), SDQ (MD = - 0.38, 95% CI - 0.56 to - 0.2, p < 0.001). Also, it increased the score of SE (MD = 6.65, 95% CI 2.54 to 10.77, p < 0.001). However, there was no difference in terms of ESS. CBT is an easy and feasible intervention with clinically significant improvement in insomnia symptoms. Further large-volume studies are needed to assess sustained efficacy.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"819-827"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bryce K Clausen, Anna Yaggi, Jafar Bakhshaie, Ava A Jones, Michael J Zvolensky
{"title":"Anxiety sensitivity in relation to smoking dependence motives among Latinx persons who smoke.","authors":"Bryce K Clausen, Anna Yaggi, Jafar Bakhshaie, Ava A Jones, Michael J Zvolensky","doi":"10.1007/s10865-024-00504-3","DOIUrl":"10.1007/s10865-024-00504-3","url":null,"abstract":"<p><p>Hispanic/Latinx (hereafter Latinx) persons are an established tobacco disparities population in the United States (US). Past work has suggested that individual differences in anxiety sensitivity, or the fear of arousal-based sensations, is one important cognitive construct for smoking maintenance and relapse among Latinx persons who smoke. However, previous research has not examined if anxiety sensitivity is associated with motivational facets of smoking dependence among this tobacco disparities population. In the current study, anxiety sensitivity was explored in terms of smoking motives for primary, secondary, and overall cigarette dependence. Participants included 336 English-speaking Latinx adults in the US who smoked cigarettes daily (M<sub>age</sub> = 35.53, SD = 8.65, 37.3% Female). Results indicated that anxiety sensitivity was statistically significantly and positively related to higher primary and secondary dependence motives and marginally statistically significant to cigarette dependence; findings were evident after adjusting for numerous theoretically relevant variables (e.g., depression). Overall, the current study is the first to document linkages between anxiety sensitivity and numerous motivational bases of tobacco dependence among Latinx persons who smoke from the US.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"864-873"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L Alison Phillips, Kimberly R More, Daniel Russell, Hyun Seon Kim
{"title":"Evaluating the impact of individuals' morningness-eveningness on the effectiveness of a habit-formation intervention for a simple and a complex behavior.","authors":"L Alison Phillips, Kimberly R More, Daniel Russell, Hyun Seon Kim","doi":"10.1007/s10865-024-00503-4","DOIUrl":"10.1007/s10865-024-00503-4","url":null,"abstract":"<p><p>Planning-based interventions are often used to help individuals form habits. Existing literature suggests a one-size-fits all approach to habit formation, but planning interventions may be optimized if tailored to individual differences and/or behavioral complexity. We test the hypothesis that planning to do a relatively complex behaviour (exercise) at a time that matches an individuals' diurnal preference will facilitate behavioral engagement; whereas for a simpler behaviour (calcium supplementation), the optimal time-of-day for a new behavior will occur in the morning. Young, women volunteers (N = 317) were randomly assigned to take calcium supplements or to exercise for 4 weeks and to control (no planning) or to one of three planning interventions (morning plan; evening plan; unassigned-time plan). Participants reported diurnal preference at baseline and habit strength and behavioral frequency weekly. Fitbit Zips and Medication Event Monitoring System Caps (MEMS) were used to objectively assess behavioral engagement. Multilevel modelling found that calcium-supplementation was greatest for morning-types in the morning-cue condition, whereas exercise was greatest for morning-types with morning cues and evening-types with evening cues. Habit-formation strategies may depend on diurnal preference and behavioral complexity. Future research can evaluate the role of other individual differences.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"804-818"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael J Zvolensky, Justin M Shepherd, Bryce K Clausen, Jillian Robison, Miguel Ángel Cano, Marcel de Dios, Virmarie Correa-Fernández
{"title":"Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke.","authors":"Michael J Zvolensky, Justin M Shepherd, Bryce K Clausen, Jillian Robison, Miguel Ángel Cano, Marcel de Dios, Virmarie Correa-Fernández","doi":"10.1007/s10865-024-00480-8","DOIUrl":"10.1007/s10865-024-00480-8","url":null,"abstract":"<p><p>There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, M<sub>age</sub>= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"581-594"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Colby Kipp, Dawn K Wilson, Asia Brown, Mary Quattlebaum, Haylee Loncar, Allison M Sweeney, Demetrius A Abshire
{"title":"Compounding effects of stress on diet, physical activity, and wellbeing among African American parents: a qualitative study to inform the LEADS health promotion trial.","authors":"Colby Kipp, Dawn K Wilson, Asia Brown, Mary Quattlebaum, Haylee Loncar, Allison M Sweeney, Demetrius A Abshire","doi":"10.1007/s10865-024-00477-3","DOIUrl":"10.1007/s10865-024-00477-3","url":null,"abstract":"<p><p>The purpose of the study was to conduct in-depth qualitative interviews to understand the lived experiences of African American parents of overweight adolescents who had previously participated in a family-based weight loss program and to utilize these insights to inform the essential elements of the LEADS trial, an integrated resilience stress management and health promotion intervention. Participants (N = 30) were African American parents and/or caregivers (96.7% female; M<sub>age</sub> = 49.73, SD = 10.88; M<sub>BMI</sub> = 37.63, SD = 8.21) of adolescents with overweight and/or obesity. Interviews were transcribed and coded using inductive and deductive approaches for themes by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. Prominent stress themes included caregiver responsibilities, work, interpersonal family conflict, and physical and emotional consequences of chronic stress. Participants also noted decreases in physical activity and poor food choices due to stress. Coping mechanisms included prayer/meditation, church social support, and talking with family/partner. Results highlight the importance of mitigating stress among African American parents through stress management and cultural/familial resilience approaches to increase the likelihood of engagement in behavioral strategies in health promotion programs. Future studies should assess the utility of incorporating stress management components and health promotion techniques to improve health outcomes among African American families.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"647-661"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander Haussmann, Nadine Ungar, Angeliki Tsiouris, Laura I Schmidt, Jana Müller, Jost von Hardenberg, Joachim Wiskemann, Karen Steindorf, Monika Sieverding
{"title":"Determinants of physical activity during cancer treatment: a longitudinal exploration of psycho-cognitive variables and physician counseling.","authors":"Alexander Haussmann, Nadine Ungar, Angeliki Tsiouris, Laura I Schmidt, Jana Müller, Jost von Hardenberg, Joachim Wiskemann, Karen Steindorf, Monika Sieverding","doi":"10.1007/s10865-023-00458-y","DOIUrl":"10.1007/s10865-023-00458-y","url":null,"abstract":"<p><p>Individuals with cancer are recommended to engage in regular physical activity (PA) even during cancer therapy. The aim of this study was to explore how patient-reported physician PA counseling influences their PA intention and behavior in addition to psycho-cognitive determinants derived from the theory of planned behavior (TPB). A longitudinal study during cancer treatment was conducted among N = 115 patients with breast, prostate, or colorectal cancer (M<sub>age</sub> = 58.0, SD = 11.5; 55.7% female). The median time since diagnosis was 2 months, and 19.1% were diagnosed with metastases. Participants provided information on PA counseling by their physicians and on psycho-cognitive variables of the TPB at three measurement points. Additionally, they wore accelerometers for seven days at baseline and three months later. Nearly half of participants (48%) reported basic PA counseling and 30% reported in-depth PA counseling. Patients in poorer health and with lower education reported significantly less in-depth counseling. In addition to patient self-efficacy in performing PA, only in-depth physician PA counseling, but not basic physician counseling, predicted intention for PA four weeks later. Patients' PA three months after baseline was predicted by patients' PA at baseline and their intention for PA. Overall, the PA level at baseline was identified as the most important predictor of PA three months later. Nevertheless, physicians seem to have the ability to increase their cancer patients' intention for PA by in-depth counseling.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"566-580"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11291613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patricia B Pedreira, Sara E Fleszar-Pavlović, Emily A Walsh, Blanca Noriega Esquives, Patricia I Moreno, Dolores Perdomo, Aaron S Heller, Michael H Antoni, Frank J Penedo
{"title":"Familism, family cohesion, and health-related quality of life in Hispanic prostate cancer survivors.","authors":"Patricia B Pedreira, Sara E Fleszar-Pavlović, Emily A Walsh, Blanca Noriega Esquives, Patricia I Moreno, Dolores Perdomo, Aaron S Heller, Michael H Antoni, Frank J Penedo","doi":"10.1007/s10865-024-00479-1","DOIUrl":"10.1007/s10865-024-00479-1","url":null,"abstract":"<p><strong>Background: </strong>Familism, the cultural value that emphasizes feelings of loyalty and dedication to one's family, has been related to both positive and negative outcomes in Hispanic cancer survivors. One potential source of observed inconsistencies may be limited attention to the family environment, as familism may be protective in a cohesive family whereas it can exacerbate distress in a conflictive family.</p><p><strong>Purpose: </strong>The current study explored the associations of familism with general and disease-specific health-related quality of life (HRQoL) in Hispanic men who completed prostate cancer (PC) treatment, and whether family cohesion may help explain these relationships.</p><p><strong>Methods: </strong>Hispanic men treated for localized PC (e.g., radiation, surgery) were enrolled in a randomized controlled stress management trial and assessed prior to randomization. Familism (familial obligation) was assessed using Sabogal's Familism Scale and family cohesion was measured using the Family Environment Scale (ranging from high to low). The sexual, urinary incontinence, and urinary obstructive/irritative domains of the Expanded Prostate Cancer Index Composite - Short Form measured disease-specific HRQoL. The physical, emotional, and functional well-being subscales of the Functional Assessment of Cancer Therapy - General captured general HRQoL. Hierarchical linear regression and the SPSS PROCESS macro were used to conduct moderation analyses, while controlling for relevant covariates.</p><p><strong>Results: </strong>Participants were 202 older men on average 65.7 years of age (SD = 8.0) who had been diagnosed with PC an average of 22 months prior to enrollment. Familism was not directly associated with general and disease-specific HRQoL. Moderation analyses revealed that greater familism was related to poorer urinary functioning in the incontinence (p = .03) and irritative/obstructive domains (p = .01), and lower emotional well-being (p = .02), particularly when family cohesion was low.</p><p><strong>Conclusions: </strong>These findings underscore the importance of considering contextual factors, such as family cohesion, in understanding the influence of familism on general and disease-specific HRQoL among Hispanic PC patients. The combined influence of familism and family cohesion predicts clinically meaningful differences in urinary functioning and emotional well-being during the posttreatment phase. Culturally sensitive psychosocial interventions to boost family cohesion and leverage the positive impact of familistic attitudes are needed to enhance HRQoL outcomes in this population.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"595-608"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}