Behavioral MedicinePub Date : 2026-07-01Epub Date: 2026-10-21DOI: 10.1080/08964289.2026.2627895
Jennifer Tsui, Heather Wurtz, Amber Rockson, Emily Dang, Zirui Zhang, Min Qian, Andy Yang, Ruijie Li, Mila Cordero, Junrui Lyu, Lisa E Paddock, Jie Li, Antoinette M Stroup, Lihua Liu, Jason D Wright, X Mona Guo, Goleen Samari, Chanita Hughes-Halbert, Adana A M Llanos
{"title":"Healthcare Inequities and Structural Racism as Determinants of Treatment and Survival among Individuals Recently Diagnosed with Cervical Cancer from Two Diverse Population-Based Cancer Registries: The ACHIEVE Study.","authors":"Jennifer Tsui, Heather Wurtz, Amber Rockson, Emily Dang, Zirui Zhang, Min Qian, Andy Yang, Ruijie Li, Mila Cordero, Junrui Lyu, Lisa E Paddock, Jie Li, Antoinette M Stroup, Lihua Liu, Jason D Wright, X Mona Guo, Goleen Samari, Chanita Hughes-Halbert, Adana A M Llanos","doi":"10.1080/08964289.2026.2627895","DOIUrl":"https://doi.org/10.1080/08964289.2026.2627895","url":null,"abstract":"<p><p>Persistent inequities in cervical cancer burden disproportionately impact marginalized communities and reflect social and structural barriers to high-quality care. Guided by socioecological models, the Assessing Cervical Cancer Healthcare Inequities in Diverse Populations (ACHIEVE) Study examines social and structural influences on cancer treatment among survivors (aged 21-79 years, diagnosed with any stage of cervical cancer between 2021 and 2025, who can complete study surveys in English, Spanish, Chinese, or Haitian Creole) identified through two population-based cancer registries: the New Jersey State Cancer Registry and the Los Angeles Cancer Surveillance Program. Participants were mailed a baseline survey, followed by a request for medical records access and a 12-month follow-up survey. Study activities were significantly halted by NIH's termination of funding from March to July 2025. This analysis reflects baseline survey data collected prior to federal funding disruptions, which includes a socio-demographically diverse study sample of racial and ethnic minorities, immigrants, and individuals with varying insurance coverage and income levels. Treatment delays, experienced by nearly one-third of participants, were more common among survivors diagnosed before age 40, uninsured at diagnosis or having unstable insurance during diagnosis. Survivors with treatment delays more frequently reported difficulty accessing cancer services near home and timely specialist appointments. Participants reported food insecurity, underinsurance, and transportation challenges as barriers to care. Participants reporting discrimination in medical settings were also significantly more likely to experience treatment delays. Regional differences and intersecting social and structural barriers highlight the need for multilevel interventions addressing community-specific and systemic inequities in cervical cancer care.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":"52 3-4","pages":"373-387"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aaron T Berger, Darin J Erickson, Kyla Wahlstrom, Melissa N Laska, Sara Lammert, Rachel Widome
{"title":"Consequences of Delaying School Start Time on Mental Health Among Adolescents: The START Study.","authors":"Aaron T Berger, Darin J Erickson, Kyla Wahlstrom, Melissa N Laska, Sara Lammert, Rachel Widome","doi":"10.1080/08964289.2026.2658525","DOIUrl":"10.1080/08964289.2026.2658525","url":null,"abstract":"<p><p>Depression is common among adolescents and can have severe impacts on their well-being. We aimed to determine if delaying high school start times impacts adolescents' depression risk. Measurement in the START cohort began in Spring 2016 when participants were in 9th grade (baseline, <i>n</i> = 2,134) and all five participating schools started early (7:30 or 7:45 am). Follow-ups 1 and 2 occurred when participants were in 10th and 11th grades by which time two of the schools (\"policy-change schools\") had delayed their start times by roughly one hour. Our outcome was the Kandel-Davies depressed mood scale. Difference-in-differences analyses were employed after missing data were multiply imputed with fully conditional specification. Depressed mood scores increased for students in comparison schools relative to policy-change schools at follow-up 1 and at follow-up 2. These differences were primarily driven by the items in the scale related to fatigue. Implementing school schedule policy that is aligned with adolescent circadian biology has the potential to reduce the prevalence of symptoms of depression among cases where fatigue is a primary presenting symptom.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors Associated with Healthcare Providers' Lifestyle Information Provision to Adult Patients in Oncology: A Systematic Literature Review.","authors":"Gwenn Beets, Nadine Bol, Rachel Drbohlav Ollerton, Frans Folkvord, Martijn Stuiver, Gráinne Deasy, Emiel Krahmer","doi":"10.1080/08964289.2026.2677133","DOIUrl":"10.1080/08964289.2026.2677133","url":null,"abstract":"<p><p>Given the importance of a healthy lifestyle for cancer patients' health outcomes and quality of life, this study aimed to synthesize the literature on factors (perceived as) hindering or facilitating healthcare providers' provision of lifestyle information in oncology. Based on this synthesis, we additionally derived recommendations to improve this practice, which were independently validated by experts. A systematic literature review was conducted. PubMed, Web of Science, CINAHL Ultimate, and PsycINFO were searched. We screened titles and abstracts, aided by ASReview, and full texts. Peer-reviewed articles published from 2007-2022 were included, reporting non-interventional studies on factors that HCPs associated with lifestyle information provision to adult cancer patients. We identified 20,176 unique articles, of which 108 articles were included. Most articles studied factors related to information provision about physical activity, smoking, or a combination of lifestyle behaviors. Factors associated with lifestyle information provision fell into four main groups; factors related to the (1) HCP (e.g., knowledge), (2) patient (e.g., interest), (3) relationships between HCPs, patients, and stakeholders (e.g., support), and (4) organization (e.g., resources). The factors were linked to whether, how, and when information is provided. The review provides an overview of factors associated with communication about different lifestyle behaviors across HCPs and cancer types. Based on the findings, we formulated recommendations for future research and for clinical practice, which were validated via interviews with nine oncology HCPs, confirming feasibility with minor adjustments. Overall, lifestyle information provision as a whole and associated factors deserve more attention in clinical practice and scientific research.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-22"},"PeriodicalIF":1.2,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dennis Miezah, Michelle D S Boakye, Ashley K Parks, Laura L Hayman, Julie E Volkman, Julie A Wright
{"title":"Black Women's Perspectives on Seeking Social Support for Physical Activity: A Qualitative Study.","authors":"Dennis Miezah, Michelle D S Boakye, Ashley K Parks, Laura L Hayman, Julie E Volkman, Julie A Wright","doi":"10.1080/08964289.2026.2684654","DOIUrl":"https://doi.org/10.1080/08964289.2026.2684654","url":null,"abstract":"<p><p>Black and African American (Black) women in the US experience disproportionately high rates of hypertension (HTN) and low levels of physical activity (PA). Social support (SS) is recognized as an important component of PA promotion, yet less is known about how Black women get SS for PA. This study explored Black women's perspectives on seeking SS for PA and their confidence in doing so. Semi-structured, in-depth interviews were conducted with adults aged 40-65 years who self-identified as Black women with HTN. A purposive sampling strategy was used to recruit a balance of physically active and inactive women. Interviews were conducted by phone, transcribed verbatim and coded by three researchers. Emergent themes were identified using Thematic Analysis. Twenty-three women were on average 56 years old; 44% were inactive and 44% low income, completed interviews. Two themes emerged: 1) Pathways to building SS for PA with subthemes of building connections with like-minded individuals, utilizing support resources, creating a safe space and taking responsibility and planning ahead, and 2) Varied willingness to seek social support for PA with subthemes reflecting strong willingness to seek support, context-dependent willingness, and hesitation in seeking SS for PA. Participants valued trustworthy, inclusive, and encouraging forms of support, but many described hesitations in seeking support. Future studies should explore the best strategies for building trust, developing peer relationships, and enhancing communication for getting the kind of SS that is important to initiate and maintain PA for Black women with HTN.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Add-on Yoga-Based Intervention on Schizophrenia: A Randomized Controlled Trial.","authors":"Thrinath Mullapudi, Shivarama Varambally, Moinak Banerjee, Ramajayam Govindaraj, Praveen Raj, Paranthaman V Kavya, Samartha Daddaladka Krishnayya, Saranya Haribabu, Kaushik Kadiwal, Girikematha S Ravi, Monojit Debnath","doi":"10.1080/08964289.2026.2669678","DOIUrl":"https://doi.org/10.1080/08964289.2026.2669678","url":null,"abstract":"<p><p>Schizophrenia is a complex, highly heterogenous, and multifactorial psychiatric disorder. Antipsychotic medications which are the mainstay pharmacological therapy of Schizophrenia, have significant limitations in improving negative and cognitive symptoms and are frequently associated with adverse effects. Yoga, as an adjunctive intervention, has shown benefits in clinical outcomes, particularly in negative and cognitive symptoms. This study explored the impact of add-on yoga-based intervention on clinical outcomes, DNA methylation pattern, protein and mRNA expressions of immune molecules like cytokines and complement proteins in schizophrenia patients. Sixty-six patients were randomized to yoga therapy (YT, <i>n</i> = 33) and treatment-as-usual (TAU, <i>n</i> = 33) groups, of whom 30 patients in the YT group and 29 in TAU group completed three-month intervention period. Collection of blood samples to analyze plasma levels, lymphocyte gene expression, promoter DNA methylation pattern of interleukin-1β (IL-1β), IL-6, IL-10, IL-17A, and complement components (C3, C4, and C5) and clinical assessments were carried out at baseline and post-intervention. Patients of YT group demonstrated significant improvements in clinical outcomes, reductions in the levels of plasma IL-1β, expression of <i>Il1b</i> and <i>Il6</i> genes, increased expression of <i>C4</i> gene, hypermethylation of <i>Il1b</i> gene, hypomethylation of <i>Il6</i>, <i>Il10</i> and <i>C4</i> genes compared to TAU group post-intervention. These findings suggest that yoga-based intervention is associated with improvements in clinical outcomes, with concurrent changes in the expressions and DNA methylation patterns of a few immune markers. This study highlights the beneficial attributes of yoga-based intervention in schizophrenia and suggests that immunomodulation could be one of the mediating effects of yoga in Schizophrenia.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naomi Deokule, Alexandra Roy, Margaret H Bublitz, Judson Brewer
{"title":"Enhancing Interoceptive Awareness Through a Digital Mindfulness Intervention: Evidence from a Real-World Population.","authors":"Naomi Deokule, Alexandra Roy, Margaret H Bublitz, Judson Brewer","doi":"10.1080/08964289.2026.2658522","DOIUrl":"https://doi.org/10.1080/08964289.2026.2658522","url":null,"abstract":"<p><p>Disordered, emotional, and craving-related eating are major contributors to obesity. Mindfulness-based interventions (MBIs) show promise in reducing these behaviors by enhancing awareness of internal bodily cues. The <i>Eat Right Now</i> (ERN) app is a digital MBI targeting craving-related eating through mindfulness training. While ERN has previously been shown to reduce craving-related eating, the mechanisms underlying its effects, particularly the role of interoceptive awareness-the conscious perception of internal bodily signals such as hunger, satiety, and muscular tension, and the capacity to use these signals to guide behavior-remain understudied. Interoceptive awareness is the ability to identify, understand, and respond to internal bodily signals. To examine whether engagement with the ERN app is associated with changes in interoceptive awareness in a real-world sample, a total of 3,469 users completed three subscales of the Multidimensional Assessment of Interoceptive Awareness (MAIA), a self-report measure of interoceptive awareness, every 7 days throughout app usage, including the capacity to attend to uncomfortable bodily sensations without avoidance (Not Distracting), to actively listen to bodily signals (Body Listening), and to trust the body as a source of reliable information (Trusting). App usage metrics were extracted, including core module completion, mindfulness exercises, tool use, community engagement, and latency between assessments. Tobit regression models and two-part models were utilized to assess the relationship between app engagement and follow-up MAIA scores. Engagement with ERN app was associated with greater interoceptive awareness across subscales. Increased latency between assessments was negatively associated with Not Distracting. App community engagement was not significantly associated with interoception. These findings suggest that interoceptive awareness may be a mechanism through which digital mindfulness interventions support healthier eating behaviors.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tamara M Williamson, Tavis S Campbell, Sydney Seidel, Kathryn King-Shier, Stephen B Wilton, Lianne Tomfohr-Madsen, Sandeep G Aggarwal, Ross Arena, Codie R Rouleau
{"title":"A Qualitative Investigation of Barriers, Facilitators, and Preferences Regarding a Cardiac Rehabilitation-Based Behavioral Weight Loss Program in Adults with Atrial Fibrillation and Obesity.","authors":"Tamara M Williamson, Tavis S Campbell, Sydney Seidel, Kathryn King-Shier, Stephen B Wilton, Lianne Tomfohr-Madsen, Sandeep G Aggarwal, Ross Arena, Codie R Rouleau","doi":"10.1080/08964289.2026.2641456","DOIUrl":"https://doi.org/10.1080/08964289.2026.2641456","url":null,"abstract":"<p><p>Up to one-third of patients with atrial fibrillation (AF) live with obesity and stand to experience improvements in AF symptom burden through moderate weight loss. Cardiac rehabilitation (CR) programs are ideal settings to manage AF risk factors, however few programs offer targeted behavioral weight loss treatment (BWLT). The aim of this study was to investigate perceived barriers and facilitators of participating in BWLT + CR to inform the development of a BWLT for patients with AF and obesity using a qualitative descriptive approach. Purposive sampling was used to recruit patients with AF and BMI <math><mrow><mo>≥</mo></mrow></math> 30 kg/m<sup>2</sup> from an AF specialty clinic in Canada. Patients participated in semi-structured interviews regarding perceived barriers, facilitators, and preferences to a proposed BWLT+ CR program consisting of 12 wk of supervised CR exercise with weekly, virtual, group-based BWLT sessions followed by bi-weekly follow up support for 12 wk. Interviews were recorded and transcribed verbatim. Conventional content analysis was used to analyze the qualitative data. Twenty patients (9 women; 100% white) participated in the interviews. Data were categorized to describe barriers (e.g., time constraints), facilitators (e.g., accountability) and preferences (e.g., virtual participation options). Four overarching themes emerged: 1) gender differences in prior weight loss attempts; 2) AF symptoms are manageable; 3) need for more AF patient education; and 4) a desire for flexibility. In conclusion, patients unanimously reported that a BWLT+ CR program was desirable and had few barriers to participating. Results informed modifications to a BWLT+ CR program which is currently being tested in a randomized clinical trial.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Devon Ziminski, Daniel C Semenza, John Fuqua, Melissa Fox
{"title":"Community Violence Intervention (CVI) in a Semi-Rural Region: Implementation and Operation Considerations.","authors":"Devon Ziminski, Daniel C Semenza, John Fuqua, Melissa Fox","doi":"10.1080/08964289.2026.2653519","DOIUrl":"https://doi.org/10.1080/08964289.2026.2653519","url":null,"abstract":"<p><p>Community Violence Intervention (CVI) programs work to reduce community and firearm-related violence in local areas. Research to date has predominantly focused on the operations and effectiveness of CVI programs in urban settings, leaving a gap in research on CVI programs in semi-rural and rural areas. This study focuses on the contextual determinants and operating challenges and opportunities of Life Worth Living (LWL), a CVI program spanning a three-county rural-suburban region in a Northeast state. The study utilizes qualitative data collected from LWL and partner staff to highlight considerations for semi-rural and rural CVI programs. Five themes related to the research questions include prioritizing the depth and breadth of reliable partnerships, proactive program nimbleness and hot spot rotation, working with varying group dynamics influenced by physical distance and social media, supporting infrastructure needs and the co-location of services, and supporting multi-sector funding models. Coordinating services across the three counties required extensive logistical planning, resource pooling, and relationship management, underscoring the critical nature of partnerships in less resource-dense geographic areas. Findings also noted a working relationship between local law enforcement and LWL, reflecting varied outlooks and approaches on law enforcement involvement in CVI work. Implications from this study support co-locating social services and healthcare in semi-rural and rural locations, creating pathways for joint funding applications and grants, and formalizing partnerships across multiple sectors to support quality service delivery.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Different Forms of Parent-Child Interactions Shape Healthy Aging: Evidence from over 100,000 Parent-Child Relationships on Lifestyle Behaviors Among Chinese Older Adults (2011-2020).","authors":"Shahmir H Ali, Yuxuan Gu","doi":"10.1080/08964289.2026.2641451","DOIUrl":"https://doi.org/10.1080/08964289.2026.2641451","url":null,"abstract":"<p><p>As family structures evolve in China, adult children's engagement with aging parents has become increasingly complex, yet little is known about how distinct forms of interaction shape older adults' health behaviors. This study examined how visitation, interaction frequency, co-residence, and financial support relate to four lifestyle behavior domains: total and leisure physical activity, smoking, alcohol use, and sleep. Data were drawn from 22,114 older adults and 138,243 parent-child dyads in the China Health and Retirement Longitudinal Study (2011 to 2020) and analyzed using multivariable mixed-effects models that accounted for repeated observations and clustering at both the respondent and child levels. Weekly interaction increased from 86.0% to 89.1%, while in-person visitation declined from 60.4% to 55.2%. Interaction was more common with healthier, more highly educated, and female children; male children were more likely to co-reside. Weekly interaction was associated with lower odds of low total physical activity, low leisure activity, and drinking. Co-residence reduced odds of drinking, and increased odds of low total activity, low leisure activity, and smoking. Financial support predicted lower odds of low total activity and low leisure activity, while weekly interaction was linked to lower odds of suboptimal sleep. Even as face-to-face contact declines, interaction continues to grow, likely through digital platforms, and distinctly shapes lifestyle behaviors. This study lays important groundwork for more intensive mixed methods research to explore mechanisms underlying how different engagement patterns influence health behaviors in aging populations.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Behavioral MedicinePub Date : 2026-04-01Epub Date: 2025-08-27DOI: 10.1080/08964289.2025.2543265
Katherine M Knauft, Angela J Jacques-Tiura, April Idalski Carcone, Meredyth A Evans, Jill Weissberg-Benchell, Colleen Buggs-Saxton, Claudia Boucher-Berry, Jennifer L Miller, Tina Drossos, M Bassem Dekelbab, Deborah Ellis
{"title":"Blood Glucose Levels and Diabetes Family Conflict in Black Adolescents with Type 1 Diabetes During the COVID-19 Pandemic.","authors":"Katherine M Knauft, Angela J Jacques-Tiura, April Idalski Carcone, Meredyth A Evans, Jill Weissberg-Benchell, Colleen Buggs-Saxton, Claudia Boucher-Berry, Jennifer L Miller, Tina Drossos, M Bassem Dekelbab, Deborah Ellis","doi":"10.1080/08964289.2025.2543265","DOIUrl":"10.1080/08964289.2025.2543265","url":null,"abstract":"<p><p>The coronavirus 2019 (COVID-19) pandemic escalated family stress and prompted interruptions of regular healthcare visits. Such pandemic-related disruptions may be particularly deleterious among Black youth with chronic health conditions, such as type 1 diabetes. The present study leveraged longitudinal data from a multi-center randomized clinical trial (Clinicaltrials.gov [NCT03168867]) and a follow-up ancillary study focused on effects of COVID-19 to examine blood glucose trajectories and diabetes family conflict among Black adolescents with type 1 diabetes and their caregivers. Throughout the primary and ancillary studies, both adolescents and caregivers reported on their experience of diabetes family conflict across seven study visits. At each of these visits, the adolescent's hemoglobin A1c (HbA1c) was measured as an indicator of their blood glucose levels; further, HbA1c data during the study window was also extracted from the electronic medical record. Results demonstrated that HbA1c among the sample was linearly improving prior to the pandemic, but improvement halted following the onset of COVID-19. Following COVID-19 onset, average HbA1c remained stable, but higher than the recommended level. Higher mean levels of diabetes family conflict across the study were associated with higher HbA1c on average. However, diabetes family conflict did not predict changes in HbA1c trajectories pre- or post-pandemic onset. These findings highlight the potential stagnation of improving health-related outcomes during the COVID-19 pandemic for Black adolescents with type 1 diabetes and the need for further longitudinal work examining the familial and systemic factors contributing to the negative health consequences of the COVID-19 pandemic.</p>","PeriodicalId":55395,"journal":{"name":"Behavioral Medicine","volume":" ","pages":"135-149"},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}