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

{"title":"Effects of the Great Recession on Educational Disparities in Cardiometabolic Health.","authors":"Yanping Jiang,&nbsp;Jennifer Morozink Boylan,&nbsp;Samuele Zilioli","doi":"10.1093/abm/kaab065","DOIUrl":"https://doi.org/10.1093/abm/kaab065","url":null,"abstract":"<p><strong>Background: </strong>Macroeconomic crises can exaggerate existing educational disparities in health. Few studies, however, have examined whether macroeconomic crises get under the skin to affect educational disparities in health-related biological processes.</p><p><strong>Purpose: </strong>This study aimed to examine the effect of the economic recession of 2008 (i.e., Great Recession) on educational disparities in cardiometabolic risk and self-reported psychological distress.</p><p><strong>Methods: </strong>Data were drawn from two subsamples of the Midlife in the United States (MIDUS) study: the second wave of the MIDUS sample (pre-recession cohort, N = 985) and the refresher sample (post-recession cohort, N = 863). Educational attainment was categorized into high school education or less, some college, and bachelor's degree or higher. Outcomes included metabolic syndrome, C-reactive protein, and interleukin-6, as well as self-reported perceived stress, depressive symptoms, and financial distress.</p><p><strong>Results: </strong>Results showed that having a bachelor's degree or higher (compared to having a high school education or less) was more strongly associated with decreased metabolic syndrome symptoms in the post-recession cohort than the pre-recession cohort, above and beyond demographic, health, and behavioral covariates. These findings did not extend to systemic inflammation or psychological distress.</p><p><strong>Conclusions: </strong>Our findings suggest that chronic macroeconomic stressors may widen the educational gap in physical health, particularly cardiometabolic health, by modifying biological and anthropometric risk factors implicated in metabolic syndrome.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"428-441"},"PeriodicalIF":3.8,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116579/pdf/kaab065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39255524","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":"Trajectories of Depressive Symptoms and Incident Diabetes: A Prospective Study.","authors":"Rachel J Burns,&nbsp;Esther Briner,&nbsp;Norbert Schmitz","doi":"10.1093/abm/kaab094","DOIUrl":"https://doi.org/10.1093/abm/kaab094","url":null,"abstract":"<p><strong>Background: </strong>Elevated depressive symptoms are associated with an increased risk for diabetes. Depression is a heterogeneous and chronic condition in which symptoms may remit, emerge, lessen, or intensify over time.</p><p><strong>Purpose: </strong>The purpose of this study was to determine if trajectories of depressive symptoms measured at five time points over 8 years predicted incident diabetes over an 8-year follow-up in middle-aged and older adults. A secondary aim was to determine if trajectories of depressive symptoms predict incident diabetes, above and beyond depressive symptoms measured at a single time point.</p><p><strong>Methods: </strong>Data came from the Health and Retirement Study (n = 9,233). Depressive symptoms were measured biennially from 1998 to 2006. Self-reported incident diabetes was measured during an 8-year follow-up.</p><p><strong>Results: </strong>Five trajectories of depressive symptoms were identified (no depressive symptoms, low depressive symptoms, low-moderate depressive symptoms, moderate depressive symptoms, elevated and increasing depressive symptoms). Compared to the no depressive symptoms trajectory group (referent), all other trajectory groups were at higher risk of developing diabetes after adjusting for covariates. In most cases, trajectory group membership was associated with incident diabetes after controlling for depressive symptoms at a single time point.</p><p><strong>Conclusions: </strong>Patterns of depressive symptoms over time were associated with incident diabetes. Patterns of depressive symptoms may be more predictive of diabetes incidence than depressive symptoms measured at a single time point.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"311-316"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634021","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":"Caregiver Experiences and Roles in Care Seeking During COPD Exacerbations: A Qualitative Study.","authors":"Madhuvanthi Suresh,&nbsp;Jessica Young,&nbsp;Vincent Fan,&nbsp;Carol Simons,&nbsp;Catherine Battaglia,&nbsp;Tracy L Simpson,&nbsp;John C Fortney,&nbsp;Emily R Locke,&nbsp;Ranak Trivedi","doi":"10.1093/abm/kaab045","DOIUrl":"https://doi.org/10.1093/abm/kaab045","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive, debilitating illness characterized by exacerbations that require timely intervention. COPD patients often rely on informal caregivers-relatives or friends-for assistance with functioning and support. Caregivers perform roles that may be particularly important during acute exacerbations in monitoring symptoms and seeking medical intervention. However, little is known about caregivers' roles and experiences as they support their patients during exacerbations.</p><p><strong>Purpose: </strong>To explore the experiences, roles in care seeking, and needs of caregivers during COPD exacerbations.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 24 caregivers of Veterans with COPD who experienced a recent exacerbation. Interviews were recorded, transcribed, and analyzed using inductive content analysis.</p><p><strong>Results: </strong>Five themes arose: (a) caregivers reported continuously monitoring changes in patients symptom severity to identify exacerbations; (b) caregivers described emotional reactions evoked by exacerbations and constant vigilance; (c) caregivers described disagreements with their patient in interpreting symptoms and determining the need for care seeking; (d) caregivers noted uncertainty regarding their roles and responsibilities in pursuing care and their approaches to promote care varied; and (e) expressed their need for additional information and support. Caregivers of patients with COPD often influence whether and when patients seek care during exacerbations. Discrepancies in symptom evaluations between patients and caregivers paired with the lack of information and support available to caregivers are related to delays in care seeking. Clinical practice should foster self-management support to patient-caregiver dyads to increase caregiver confidence and patient openness to their input during exacerbations.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"257-269"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887575/pdf/kaab045.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39034358","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":"The Cardiovascular Cost of Silence: Relationships Between Self-silencing and Carotid Atherosclerosis in Midlife Women.","authors":"Karen P Jakubowski,&nbsp;Emma Barinas-Mitchell,&nbsp;Yue-Fang Chang,&nbsp;Pauline M Maki,&nbsp;Karen A Matthews,&nbsp;Rebecca C Thurston","doi":"10.1093/abm/kaab046","DOIUrl":"https://doi.org/10.1093/abm/kaab046","url":null,"abstract":"<p><strong>Background: </strong>Individuals engage in a range of behaviors to maintain close relationships. One behavior is self-silencing or inhibiting self-expression to avoid relationship conflict or loss. Self-silencing is related to poor mental health and self-reported physical health in women but has not been examined in relation to cardiovascular health, particularly using direct measures of the vasculature.</p><p><strong>Purpose: </strong>To test associations between self-silencing and carotid atherosclerosis in midlife women; secondary analyses examined moderation by race/ethnicity.</p><p><strong>Methods: </strong>Women (N = 290, ages 40-60) reported on self-silencing in intimate relationships and underwent physical measurements, blood draw, and ultrasound assessment of carotid intima-media thickness (IMT) and plaque. Associations between self-silencing and mean IMT and plaque index (0, 1, ≥2) were tested in linear regression and multinomial logistic regression models, respectively, followed by interaction terms between self-silencing and race, adjusted for demographic factors, CVD risk factors, partner status, depression, physical activity, and diet.</p><p><strong>Results: </strong>Forty-seven percent of women demonstrated carotid plaque. Greater self-silencing was related to increased odds of plaque index ≥2 (e.g., for each additional point, odds ratio [95% confidence interval] = 1.16 [1.03-1.31], p = .012), relative to no plaque). Moderation analyses indicated that self-silencing was related to odds of plaque index ≥2 in non-white women (1.15 [1.05-1.26], p = .004), but there was no significant relationship in white women (1.01 [0.97-1.06], p = .550). No associations emerged for IMT.</p><p><strong>Conclusions: </strong>Among midlife women, self-silencing was associated with carotid plaque, independent of CVD risk factors, depression, and health behaviors. Emotional expression in relationships may be important for women's cardiovascular health.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"282-290"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887577/pdf/kaab046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39110820","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":"BestFIT Sequential Multiple Assignment Randomized Trial Results: A SMART Approach to Developing Individualized Weight Loss Treatment Sequences.","authors":"Nancy E Sherwood,&nbsp;A Lauren Crain,&nbsp;Elisabeth M Seburg,&nbsp;Meghan L Butryn,&nbsp;Evan M Forman,&nbsp;Melissa M Crane,&nbsp;Rona L Levy,&nbsp;Alicia S Kunin-Batson,&nbsp;Robert W Jeffery","doi":"10.1093/abm/kaab061","DOIUrl":"https://doi.org/10.1093/abm/kaab061","url":null,"abstract":"<p><strong>Background: </strong>State-of-the-art behavioral weight loss treatment (SBT) can lead to clinically meaningful weight loss, but only 30-60% achieve this goal. Developing adaptive interventions that change based on individual progress could increase the number of people who benefit.</p><p><strong>Purpose: </strong>Conduct a Sequential Multiple Assignment Randomized Trial (SMART) to determine the optimal time to identify SBT suboptimal responders and whether it is better to switch to portion-controlled meals (PCM) or acceptance-based treatment (ABT).</p><p><strong>Method: </strong>The BestFIT trial enrolled 468 adults with obesity who started SBT and were randomized to treatment response assessment at Session 3 (Early TRA) or 7 (Late TRA). Suboptimal responders were re-randomized to PCM or ABT. Responders continued SBT. Primary outcomes were weight change at 6 and 18 months.</p><p><strong>Results: </strong>PCM participants lost more weight at 6 months (-18.4 lbs, 95% CI -20.5, -16.2) than ABT participants (-15.7 lbs, 95% CI: -18.0, -13.4), but this difference was not statistically significant (-2.7 lbs, 95% CI: -5.8, 0.5, p = .09). PCM and ABT participant 18 month weight loss did not differ. Early and Late TRA participants had similar weight losses (p = .96), however, Early TRA PCM participants lost more weight than Late TRA PCM participants (p = .03).</p><p><strong>Conclusions: </strong>Results suggest adaptive intervention sequences that warrant further research (e.g., identify suboptimal responders at Session 3, use PCMs as second-stage treatment). Utilizing the SMART methodology to develop an adaptive weight loss intervention that would outperform gold standard SBT in a randomized controlled trial is an important next step, but may require additional optimization work.</p><p><strong>Clinical trial information: </strong>ClinicalTrials.gov identifier; NCT02368002.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"291-304"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887581/pdf/kaab061.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39329314","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":"Role of Yoga and Its Plausible Mechanism in the Mitigation of DNA Damage in Type-2 Diabetes: A Randomized Clinical Trial.","authors":"Rajesh G Nair,&nbsp;Mithila M Vasudev,&nbsp;Ramesh Mavathur","doi":"10.1093/abm/kaab043","DOIUrl":"https://doi.org/10.1093/abm/kaab043","url":null,"abstract":"<p><strong>Background: </strong>Although yoga is found to be beneficial in the management of type 2 diabetes (T2D), its mechanism of action is poorly understood. T2D is also known to be associated with increased oxidative stress (OS) and DNA damage.</p><p><strong>Purpose: </strong>This study examines how yoga modulates OS-induced DNA damage and the efficiency of DNA repair in T2D conditions.</p><p><strong>Methods: </strong>In this assessor-masked randomized clinical trial, T2D subjects (n = 61), aged (Mean ± SD, 50.3 ± 4.2) were randomly allocated into Yoga group (31) that received 10 weeks of yoga intervention and Control (30) with routine exercises. Molecular and biochemical assessments were done before and after the intervention period. Structural Equation Modeling using \"R\" was used for mediation analysis.</p><p><strong>Results: </strong>At the end of the 10th week, Yoga group showed significant reduction in DNA damage indicators like Tail Moment (-5.88[95%CI: -10.47 to -1.30]; P = .013) and Olive Tail Moment (-2.93[95%CI: -4.87 to -1.00]; P < .01), oxidative DNA damage marker 8-OHdG (-60.39[95%CI: -92.55 to -28.23]; P < .001) and Fasting Blood Sugar (-22.58[95%CI: -44.33 to -0.83]; P = .042) compared to Control. OGG1 protein expression indicating DNA repair, improved significantly (17.55[95%CI:1.37 to 33.73]; P = .034) whereas Total Antioxidant Capacity did not (5.80[95%CI: -0.86 to 12.47]; P = 0.086). Mediation analysis indicated that improvements in oxidative DNA damage and DNA repair together played a major mediatory role (97.4%) in carrying the effect of yoga.</p><p><strong>Conclusion: </strong>The beneficial effect of yoga on DNA damage in T2D subjects was found to be mediated by mitigation of oxidative DNA damage and enhancement of DNA repair.</p><p><strong>Clinical trial information: </strong>(www.ctri.nic.in) CTRI/2018/07/014825.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"235-244"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39135671","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":"Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health.","authors":"Lukoye Atwoli,&nbsp;Abdullah H Baqui,&nbsp;Thomas Benfield,&nbsp;Raffaella Bosurgi,&nbsp;Fiona Godlee,&nbsp;Stephen Hancocks,&nbsp;Richard Horton,&nbsp;Laurie Laybourn-Langton,&nbsp;Carlos Augusto Monteiro,&nbsp;Ian Norman,&nbsp;Kirsten Patrick,&nbsp;Nigel Praities,&nbsp;Marcel G M Olde Rikkert,&nbsp;Eric J Rubin,&nbsp;Peush Sahni,&nbsp;Richard Smith,&nbsp;Nick Talley,&nbsp;Sue Turale,&nbsp;Damián Vázquez","doi":"10.1093/abm/kaab084","DOIUrl":"https://doi.org/10.1093/abm/kaab084","url":null,"abstract":"This is an editorial on climate change that is being published simultaneously by 100+ health care journal to marshal collective action to tackle the global environmental crisis. We—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C and halt the destruction of nature.","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"317-319"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39388296","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":"Applying the RISE Model of Resilience in Partners Post-Stroke: A Qualitative Analysis.","authors":"Miranda A Anderson,&nbsp;Corinne Buffo,&nbsp;Dana Ketcher,&nbsp;Hop Nguyen,&nbsp;Justin J MacKenzie,&nbsp;Maija Reblin,&nbsp;Alexandra L Terrill","doi":"10.1093/abm/kaab053","DOIUrl":"https://doi.org/10.1093/abm/kaab053","url":null,"abstract":"<p><strong>Background: </strong>Resilience is dynamic and influenced by internal and external factors. In persons with chronic illness and/or disability, resilience is viewed as the ability to adapt to new life circumstances. Existing models of resilience typically focus on the absence of deficit and pathology in the individual, overlooking resources, well-being, and broader social impacts. Our proposed novel Relational, Intrapersonal, Social and Environmental (RISE) Model of resilience incorporates and describes the interconnection and influence of constructs that impact resilience and affect the quality of life.</p><p><strong>Purpose: </strong>The purpose of this study is to examine the fit of the RISE Model against original interview data obtained from persons with stroke and their partners.</p><p><strong>Methods: </strong>This study is a secondary analysis of qualitative data collected from post-intervention interviews that were part of an intervention pilot study designed to promote resilience in couples coping with stroke. Interviews were coded to examine relationships between RISE Model constructs.</p><p><strong>Results: </strong>The study included 36 interviews from 18 cohabitating couples; mean participant age was 53.33 years (SD ±14.70). Examples of each construct within the RISE Model appeared in transcribed interviews and common patterns of co-occurring constructs were identified.</p><p><strong>Conclusion: </strong>The constructs within the RISE Model were supported by the interviews. The impact of disability does not remain confined to a single individual and instead branches out into the broader social context, including close interpersonal relationships. A deeper understanding of resilience and its relationship with intrapersonal, interpersonal and socio-ecological constructs would add value to our understanding and fostering of resilience in persons with disabilities and/or chronic illness.</p><p><strong>Clinical trial information: </strong>NCT03335358.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"270-281"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887576/pdf/kaab053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39074238","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":"Intra-individual Associations of Perceived Stress, Affective Valence, and Affective Arousal with Momentary Cortisol in a Sample of Working Adults.","authors":"Jillian A Johnson,&nbsp;Matthew J Zawadzki,&nbsp;Dusti R Jones,&nbsp;Julia Reichenberger,&nbsp;Joshua M Smyth","doi":"10.1093/abm/kaab049","DOIUrl":"https://doi.org/10.1093/abm/kaab049","url":null,"abstract":"<p><strong>Background: </strong>Research pairing ecological momentary assessment (EMA) methodology and ambulatory cortisol during daily life is still rare, as is careful testing of the within-person associations between stress, affect, and cortisol. Using a circumplex approach, we considered both valence and arousal components of affect.</p><p><strong>Purpose: </strong>To examine the within-person covariation of momentary cortisol with momentary perceived stress, affective valence, and affective arousal in everyday life.</p><p><strong>Methods: </strong>115 working adults (Mage = 41.2; 76% women; 76% white) completed six EMA surveys per day over 3 days. Each assessment included reports of perceived stress and affect (used to construct indicators of affective valence and arousal), followed by a saliva sample (from which cortisol was assessed). Multi-level models were used to examine the momentary associations between perceived stress, affective valence, affective arousal, and cortisol.</p><p><strong>Results: </strong>Moments characterized by higher perceived stress were associated with higher cortisol (p = .036). Affective valence covaried with cortisol (p = .003) such that more positive valence was associated with lower cortisol and more negative valence with higher cortisol. Momentary affective arousal was not related to cortisol (p = .131). When all predictors were tested in the same model, only valence remained a significant predictor of cortisol (p = .047).</p><p><strong>Conclusion: </strong>Momentary perceived stress and affective valence, but not affective arousal, were associated with naturalistic cortisol. Cortisol was more robustly associated with affective valence than perceived stress or affective arousal. These findings extend our understanding of how moments of stress and particular characteristics of affective states (i.e., valence but not arousal) may \"get under the skin\" in daily life.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"305-310"},"PeriodicalIF":3.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39096354","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":"Peer-delivered Cognitive Behavioral Therapy-based Intervention Reduced Depression and Stress in Community Dwelling Adults With Diabetes and Chronic Pain: A Cluster Randomized Trial.","authors":"Susan J Andreae,&nbsp;Lynn J Andreae,&nbsp;Joshua S Richman,&nbsp;Andrea L Cherrington,&nbsp;Monika M Safford","doi":"10.1093/abm/kaab034","DOIUrl":"https://doi.org/10.1093/abm/kaab034","url":null,"abstract":"<p><strong>Background: </strong>Finding effective, accessible treatment options such as professional-delivered cognitive behavioral therapy (CBT) for medically complex individuals is challenging in rural communities.</p><p><strong>Purpose: </strong>We examined whether a CBT-based program intended to increase physical activity despite chronic pain in patients with diabetes delivered by community members trained as peer coaches also improved depressive symptoms and perceived stress.</p><p><strong>Methods: </strong>Participants in a cluster-randomized controlled trial received a 3-month telephonic lifestyle modification program with integrated CBT elements. Peer coaches assisted participants in developing skills related to adaptive coping, diabetes self-management goal-setting, stress reduction, and cognitive restructuring. Attention controls received general health advice with an equal number of contacts but no CBT elements. Depressive symptoms and stress were assessed using the Centers for Epidemiologic Studies Depression and Perceived Stress scales. Assessments occurred at baseline, 3 months, and 1 year.</p><p><strong>Results: </strong>Of 177 participants with follow-up data, 96% were African Americans, 79% women, and 74% reported annual income <$20,000. There was a significant reduction in perceived stress in intervention compared to control participants at 3-months (β = -2.79, p = .002 [95% CI -4.52, -1.07]) and 1 year (β = -2.59, p < .0001 [95% CI -3.30, -1.87]). Similarly, intervention participants reported significant decreases in depressive symptoms at 3-months (β = -2.48, p < .0001 [95% CI -2.48, -2.02]) and at 1 year (β = -1.62, p < .0001 [95% CI -2.37, -0.86]).</p><p><strong>Conclusions: </strong>This peer-delivered CBT-based program improved depressive symptoms and stress in individuals with diabetes and chronic pain. Training community members may be a feasible strategy for offering CBT-based interventions in rural and under-resourced communities.</p><p><strong>Clinical trial registration: </strong>NCT02538055.</p>","PeriodicalId":520558,"journal":{"name":"Annals of behavioral medicine : a publication of the Society of Behavioral Medicine","volume":" ","pages":"970-980"},"PeriodicalIF":3.8,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/abm/kaab034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38885837","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}