Annals of behavioral medicine : a publication of the Society of Behavioral Medicine最新文献

{"title":"Gynecological cancer survivors with higher levels of physical and psychological symptoms consume less fruits and vegetables.","authors":"Joann Kiebach, Sandra Beijer, Belle H de Rooij, Johanna M A Pijnenborg, M Caroline Vos, Dorry Boll, Roy F P M Kruitwagen, Nicole P M Ezendam","doi":"10.1093/abm/kaaf008","DOIUrl":"10.1093/abm/kaaf008","url":null,"abstract":"<p><strong>Background: </strong>Low fruit and vegetable consumption among gynecological cancer survivors is associated with worse health outcomes, but this association could be bidirectional.</p><p><strong>Purpose: </strong>To investigate the association between physical and psychological symptoms and fruit and vegetable consumption, alongside a potential mediation by behavioral constructs of the theory of planned behavior (TPB).</p><p><strong>Methods: </strong>Self-reported data from a Dutch cohort of endometrial and ovarian cancer survivors (n = 227) was used. Physical and psychological symptoms were assessed at 12 months, TPB constructs, fruit and vegetable consumption at 18 months posttreatment. Associations of these symptoms with daily fruit (pieces) and vegetable (grams) consumption, and the role of intention as TPB construct were evaluated using mediation analyses. If mediation was present, successive regression analyses assessed possible involvements of distal TPB constructs (attitude, subjective norm, perceived behavioral control (PBC)).</p><p><strong>Results: </strong>About 53% and 32% of the survivors met the fruit or vegetable guidelines, respectively. Higher anxiety and depressive symptoms were directly associated with lower fruit consumption (P = .02). There were direct associations between higher fatigue or depressive symptoms and lower vegetable consumption (P < .05), partly mediated by intention (P = .01, P < .05, respectively). Of all distal TPB constructs, PBC was a possible mediator. More gastrointestinal symptoms showed a total association with lower vegetable consumption (P = .02).</p><p><strong>Conclusions: </strong>Gynecological cancer survivors with more physical and psychological symptoms consumed less fruits and/or vegetables. For vegetables, this was partly mediated by decreased intention and PBC. Dietary advice focusing on increasing intention and diminishing perceived barriers may empower survivors to integrate fruits and vegetables in their diet.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140267","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":"Sleep disturbance trajectories in cancer survivors during the transition to survivorship: a prospective examination of modifiable predictors and physical health outcomes.","authors":"Mariel Emrich, Katherine E Gnall, Zachary E Magin, Keith M Bellizzi, Crystal L Park, Tara Sanft","doi":"10.1093/abm/kaag055","DOIUrl":"https://doi.org/10.1093/abm/kaag055","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbance is common among cancer survivors, but more research is needed to understand individual differences and predictors during the transition from primary treatment to early survivorship.</p><p><strong>Purpose: </strong>This study aimed to: (1) model sleep disturbance trajectories among cancer survivors from post-primary treatment into early survivorship, (2) examine the relationships of general (i.e., anxiety, depression, emotion dysregulation) and cancer-specific (i.e., illness beliefs, fear of cancer recurrence) factors with sleep disturbance trajectories, and (3) examine the association between sleep disturbance trajectories and changes in physical health.</p><p><strong>Methods: </strong>A total of 501 breast, colorectal, and prostate cancer survivors (24-80 years old, 69.9% female, 84.6% White) completed self-report measures at baseline (approximately 3 months post-primary cancer treatment) and 3-, 6-, 9-, and 12-month follow-ups. Latent class linear mixed modeling identified distinct trajectories of sleep disturbance. Psychosocial correlates of trajectory membership were examined using multinomial logistic regression. A linear regression tested whether sleep trajectory class was associated with changes in physical health over one year.</p><p><strong>Results: </strong>Three sleep disturbance trajectories were identified: low and slightly improving (44.3%), average and slightly improving (32.9%), and high and slightly improving (22.8%). Individually, higher emotion dysregulation, anxiety, depression, fear of cancer recurrence, and illness beliefs significantly differentiated the high sleep disturbance group from the low and average groups. In the combined model, only anxiety and depression symptoms remained significant. The high sleep disturbance group had significantly less improvement in physical health over one year compared to the low group.</p><p><strong>Conclusions: </strong>Both general and cancer-specific psychosocial factors appear to play a key role in identifying individuals at risk for persistent sleep disturbance following cancer treatment. Sleep disturbance trajectories were also associated with changes in physical health over one year, underscoring the importance of early intervention.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivational interviewing increases physical activity for adults with low back pain: a systematic review and meta-analysis.","authors":"Stephen Barrett, Ashley R Dunford, Tara Bewley, Liz Riddell, Gabrielle Barrett, Kane Rodda, Paul O'Halloran, Jeff Breckon, Sarah Hardcastle, Michael Kingsley","doi":"10.1093/abm/kaag040","DOIUrl":"10.1093/abm/kaag040","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is the leading cause of disability globally and contributes substantially to healthcare costs and lost productivity. Physical activity (PA) is recommended for managing LBP, nevertheless, many individuals with LBP remain insufficiently physically active, and strategies to support behavior change are needed. Motivational interviewing (MI) may support behavior change by enhancing intrinsic motivation and self-efficacy.</p><p><strong>Purpose: </strong>To synthesize evidence on the effects of MI interventions targeting PA behavior in adults with LBP.</p><p><strong>Methods: </strong>Six databases (MEDLINE, Embase, CINAHL, Web of Science, CENTRAL, PsycINFO) and clinical trial registries were searched from inception to February 2026. Eligible trials evaluated MI-based interventions targeting PA in adults with acute, subacute, or chronic LBP. Random-effects meta-analyses were conducted to calculate standardized mean differences (SMD; Hedges' g) and 95% confidence intervals (CI). The primary outcome was change in PA; secondary outcomes included pain and disability-related outcomes. Risk of bias was assessed using the Cochrane tool, and certainty of evidence was evaluated using GRADE.</p><p><strong>Results: </strong>Motivational interviewing-based interventions were associated with a statistically significant increase in PA compared with control conditions (SMD: 0.57; 95% CI, 0.10-1.03; P = .02), representing a moderate effect. No statistically significant effects were observed for pain (SMD: 0.04; 95% CI, -0.27 to 0.36; P = .76) or disability (SMD: 0.08; 95% CI, -0.25 to 0.40; P = .60). Certainty of evidence was low for PA and very low for pain and disability outcomes.</p><p><strong>Conclusions: </strong>Motivational interviewing interventions were associated with increased PA in adults with LBP but did not demonstrate significant effects on pain or disability. MI may serve as a client-centered support strategy within broader rehabilitation models. Further high-quality trials with fidelity assessment and longer follow-up are warranted.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140364","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":"Supporting Black breast cancer survivors and their informal caregivers: a qualitative dyadic analysis of intervention preferences.","authors":"Tess Thompson, Emani Sargent, Judith M Mwobobia, Christi M Lero, LaShaune P Johnson, Naitra Ramchander, Serena Xiong, Aimee S James","doi":"10.1093/abm/kaag052","DOIUrl":"10.1093/abm/kaag052","url":null,"abstract":"<p><strong>Background: </strong>Cancer affects not only patients but also their informal caregivers. Dyadic interventions hold promise but are rarely integrated into clinical care, and few have been developed for Black women in particular.</p><p><strong>Purpose: </strong>We centered the voices of Black breast cancer survivors and female caregivers to understand their experiences with cancer and their preferences for psychosocial intervention.</p><p><strong>Methods: </strong>Twenty survivors and their female, nonpartner caregivers (10 dyads) participated in semistructured Zoom interviews. Interviews were transcribed, coded, and analyzed to examine themes related to psychosocial intervention preferences.</p><p><strong>Results: </strong>Five themes emerged: (1) \"Being able to have that combination would be awesome\": Desiring an intervention that helps survivors and caregivers both separately and together, (2) \"Whatever their preference is\": Tradeoffs to teleconferencing vs in-person interventions, (3) \"Therapy scares people sometimes\": Pros and cons to terminology, (4) \"I would just like to have more knowledge\": Proposed intervention topics and characteristics, and (5) \"Cancer's not a Black thing\" vs \"we really see things different\": A range of opinions about a service/program for Black women in particular. One overarching theme involved taking a dyadic perspective on intervention by considering the needs and preferences of both members of a pair.</p><p><strong>Conclusions: </strong>Participants expressed support for dyadic interventions, especially those that would address survivors and caregivers both as individuals and as a pair, and they described how caregivers in particular may have unmet needs for emotional support. Findings provide rich information about participants' preferences and highlight the value and challenges of taking a dyadic approach to intervention.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140264","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":"Health literacy as a moderator of menu labeling effects on fast-food ordering: an online randomized controlled trial.","authors":"Yiqing Skylar Yu, Alyssa Leib, Laura L Bellows, Christopher Berry, Dan J Graham, Danielle M Krobath, Megan P Mueller","doi":"10.1093/abm/kaag049","DOIUrl":"10.1093/abm/kaag049","url":null,"abstract":"<p><strong>Objectives: </strong>To examine whether functional health literacy moderates the effects of menu labeling formats on fast-food ordering behavior.</p><p><strong>Methods: </strong>A total of 2829 US adults completed an online randomized controlled survey in 2022. Participants viewed 1 of 8 menus in a 2 × 2 × 2 factorial design varying calorie labels (present/absent), sodium stoplight icons (present/absent), and \"all-natural\" claims (present/absent), then selected an entrée, side, beverage, and optional dessert. Linear regression models tested main and interaction effects of labeling formats and functional health literacy on total calories and sodium ordered, adjusting for sociodemographic characteristics, fast-food consumption frequency, and typical ordering patterns.</p><p><strong>Results: </strong>In covariate-adjusted within-literacy comparisons, several labeling experimental conditions were associated with lower-calorie and lower-sodium selections among participants with moderate functional health literacy, whereas no significant differences were observed among participants with low or high literacy. Significant differences among moderate-literacy participants ranged from 90 to 135 fewer calories and 123 to 154 mg less sodium compared with the control condition (nominal P < .05).</p><p><strong>Conclusion: </strong>Menu labeling effects were not uniform in this online fast-food ordering experiment. Their impact depends on consumers' ability to interpret basic nutrition information. Designing more intuitive labels may improve the equity and effectiveness of restaurant nutrition policies.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140244","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":"Moderators of adaptive interventions for physical activity outcomes in the Working Women Walking program: a sequential multiple assignment randomized trial design.","authors":"Manju Daniel, Susan Weber Buchholz, Michael E Schoeny, Spyros Kitsiou, Shannon Halloway, Tricia Johnson, Sachin Vispute, Joellen Wilbur","doi":"10.1093/abm/kaag010","DOIUrl":"10.1093/abm/kaag010","url":null,"abstract":"<p><strong>Background: </strong>Sequential physical activity interventions hold promise in developing effective interventions when adapted to participants' physical activity. Adaptive interventions can be further strengthened by understanding the moderators of their effects on physical activity outcomes.</p><p><strong>Purpose: </strong>To determine whether baseline personal characteristics moderated the impact of adaptive interventions on physical activity in the Working Women Walking trial.</p><p><strong>Methods: </strong>This study analyzed data from a sequential multiple assignment randomized trial (SMART) targeting 18- to 70-year-old women employed at an urban medical center who self-reported low physical activity (N = 301). Four adaptive interventions included combinations of Initial Treatments (Fitbit or Fitbit + Text Messages) and Augmented Treatments for nonresponders (Motivational Calls or Group Meetings). Personal characteristics, including demographics, health status, self-reported physical activity, and neighborhood walkability, were measured at baseline. Moderation of intervention effects was tested across ActiGraph-assessed physical activity at baseline, 9-10 weeks (end of Initial Phase), 35-36 weeks (end of Augmented Phase), and 49-50 weeks (end of Maintenance).</p><p><strong>Results: </strong>There was no evidence that personal characteristics moderated the differential impact of the Initial or Augmented Treatments on device-assessed steps or moderate-to-vigorous physical activity. Independent of the Initial Treatment, Black race, higher baseline body mass index, and higher baseline self-reported moderate-to-vigorous physical activity were associated with lower increases in physical activity (P < .05) during the Initial Phase. Lower neighborhood walkability was associated with relative decreases in physical activity during the Maintenance Phase.</p><p><strong>Conclusions: </strong>Although personal characteristics may have altered the degree to which participants increased their physical activity, they did not alter the differential impact of the adaptive interventions.</p><p><strong>Clinical trial registration number: </strong>ClinicalTrials.gov identifier: NCT03558828.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13174382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140339","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":"Integrating coaching into digital behavioral interventions: a scalable training model and fidelity evaluation.","authors":"Susan M Breitenstein, Michelle M Greene, Grace Miller, Shea Smoske, Sara Alqasem, Jillian Harrington, Jennifer Filipkowski, Mason J Moser, Michael Schoeny","doi":"10.1093/abm/kaag014","DOIUrl":"10.1093/abm/kaag014","url":null,"abstract":"<p><strong>Background: </strong>Digital interventions offer scalable solutions for program accessibility but face challenges with engagement and adherence. Hybrid delivery models integrating human support through coaching may enhance engagement outcomes, which can improve intervention or clinical outcomes.</p><p><strong>Purpose: </strong>This study describes a structured, intervention-agnostic coaching model and associated training procedures designed to reinforce digital intervention content without requiring specialist expertise. It evaluates the feasibility, fidelity, and acceptability of the coaching model, including participant satisfaction.</p><p><strong>Methods: </strong>Parents of toddlers born very preterm (n = 113) received digital parent training or health education paired with weekly coaching calls. Eleven coaches from diverse educational backgrounds completed a standardized training protocol. Feasibility was assessed via observations and coach self-report of adherence and competence. Acceptability was evaluated through parent satisfaction surveys. Descriptive analyses summarized fidelity, engagement, and program completion.</p><p><strong>Results: </strong>Coaches demonstrated high adherence (M = 94.9%) and competence (M = 88.9%) across 266 observed calls, with minimal variance. Parent call engagement was rated high (M = 2.70; 3-point scale). Most parents (75%) attended ≥6 of 11 coaching calls, and 64% completed all 6 digital program modules. Satisfaction was strong, with 93.6% of parents reporting being satisfied or very satisfied, and over 70% felt connected to their coach. Calls were brief (M = 12.9 minutes), supporting feasibility for busy families.</p><p><strong>Conclusions: </strong>An intervention-agnostic coaching model delivered by non-specialists was feasible and acceptable for parent participants. Development of a standardized coaching manual and testing across additional digital interventions are planned to enhance scalability and replication.</p><p><strong>Clinical trial identification number: </strong>NCT05217615; ClinicalTrials.gov.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140342","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":"Neighborhood built environment and leukocyte telomere length among African American adults in the Jackson Heart Study.","authors":"Mohammad Moniruzzaman, Yangyang Deng, Lauren A Reid, Allana T Forde, Priya Palta, Mario Sims, Kosuke Tamura","doi":"10.1093/abm/kaag016","DOIUrl":"10.1093/abm/kaag016","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the relationship between the built environment and leukocyte telomere length (LTL), a biomarker of cellular aging, is limited and inconsistent, with intermediary factors and the moderating role of sex remaining understudied.</p><p><strong>Purpose: </strong>This study examined the direct associations between built environment factors and LTL and evaluated whether these associations were mediated by physical activity (PA) and diet and varied by sex.</p><p><strong>Methods: </strong>Cross-sectional data came from the Jackson Heart Study (baseline, 2000-04; n = 2174; mean age = 54.7 years; 55.2% females). LTL was measured from blood using Southern blot analysis. Built environment measures included unfavorable food stores, population density, PA facilities, and popular walking destinations. Total PA and healthy eating diet scores were tested as mediators. Linear regression was used to examine the direct and indirect associations between each built environment factor and LTL adjusted for covariates. All analyses were stratified by sex.</p><p><strong>Results: </strong>Unfavorable food stores, population density, PA facilities, and popular walking destinations were directly associated with LTL (β = -.05, 95% confidence interval [CI] = -0.08 to -0.01; β = -.06, 95% CI = -0.09 to -0.02; β = -.04, 95% CI = -0.07 to -0.01; and β = -.05, 95% CI = -0.08 to -0.02, respectively). When stratified by sex, similar associations were observed in females but not in males. No statistically significant mediation through PA or diet was observed in overall or sex-stratified analyses.</p><p><strong>Conclusions: </strong>Built environment appears to be directly associated with shorter LTL in African American females, suggesting an increased disease risk. Similar studies could be extended to other racial and/or ethnic groups to determine the generalizability of the current findings.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140348","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":"Experimental designs with repeated randomizations for optimizing adaptive interventions: guidelines and practical considerations.","authors":"Shiyu Zhang, John J Dziak, Devin C Tomlinson, Inbal Nahum-Shani","doi":"10.1093/abm/kaag006","DOIUrl":"10.1093/abm/kaag006","url":null,"abstract":"<p><strong>Background: </strong>In adaptive interventions, dynamic information about individuals is used to determine whether and how to intervene. Depending on the nature of the intervention (eg, human-delivered vs digitally delivered), adaptations may need to occur slowly or rapidly (eg, after a month vs daily). The optimization of adaptive interventions has been powered by 2 experimental designs, both employing sequential randomizations but on different timescales: the sequential multiple assignment randomized trial (SMART) on a slow timescale for standard adaptive interventions and the microrandomized trial (MRT) on a fast timescale for just-in-time adaptive interventions.</p><p><strong>Purpose: </strong>This paper intends to help investigators who have research questions about the delivery and adaptation of intervention options at more than 1 time point, select and plan a trial design with the right form of sequential randomizations, on the appropriate timescale.</p><p><strong>Methods: </strong>This is a conceptual paper discussing considerations related to designing trials with sequential randomizations.</p><p><strong>Results: </strong>We clarify the differences and similarities between the SMART and the MRT, outline the types of questions that can be answered by the 2 experimental designs, and provide guidelines for selecting and planning the appropriate form of trial design based on the questions that need answers.</p><p><strong>Conclusions: </strong>When designing a trial with sequential randomizations, it is essential to consider the need for sequential randomizations, the appropriate timescale for randomizations, whether to impose restrictions on randomizations, whether to randomize upfront or sequentially, the timing for measuring the primary outcome, and sample size planning.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140300","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":"Communicating the health implications of global environmental change: a mixed-methods systematic review of health framing in environmental messaging.","authors":"Frederick H F Chan, Rachel W S Koh, Steve H L Yim, Benjamin P Horton, Konstadina Griva","doi":"10.1093/abm/kaag002","DOIUrl":"10.1093/abm/kaag002","url":null,"abstract":"<p><strong>Background: </strong>Global environmental change poses a significant threat to human health, necessitating effective communication strategies to raise public awareness and motivate mitigation and adaptation actions. Previous studies have examined whether framing climate change and other environmental issues as health problems can increase public engagement, with mixed results.</p><p><strong>Purpose: </strong>This mixed-methods systematic review synthesizes existing evidence on the effectiveness of health framing in text-based environmental communication interventions.</p><p><strong>Methods: </strong>We searched 5 electronic databases (Web of Science, Scopus, PubMed, PsycINFO, and Communication and Mass Media Complete) from inception to May 9, 2025, and identified 46 relevant articles (54 studies). The Mixed Methods Appraisal Tool was used to assess study quality, and qualitative narrative synthesis was performed.</p><p><strong>Results: </strong>Most studies were randomized controlled trials conducted among the general public in high-income, English-speaking countries. Key findings indicate that health-framed environmental messages are generally perceived as clear and helpful, particularly when employing a gain frame and emphasizing mitigation benefits. Health framing also effectively increases threat perception, policy support, and health-protective intentions, although its impacts on sustainable lifestyle changes and advocacy behaviors are less consistent.</p><p><strong>Conclusions: </strong>Future research should incorporate rigorous designs and diverse populations and focus on long-term, real-world outcomes to obtain a clearer understanding of effective communication strategies at the intersection of global environmental change and health.</p><p><strong>Registration: </strong>The systematic review protocol was registered within the PROSPERO database (CRD420251050978).</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":"60 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140323","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}