Annals of Behavioral Medicine最新文献

{"title":"Daily reciprocal relationships between affect, physical activity, and sleep in middle and later life.","authors":"Sun Ah Lee, Zachary Fisher, David M Almeida","doi":"10.1093/abm/kaae072","DOIUrl":"10.1093/abm/kaae072","url":null,"abstract":"<p><strong>Background: </strong>The daily dynamics among affect, physical activity, and sleep are often explored by taking a unidirectional approach. Yet, obtaining a comprehensive understanding of the reciprocal dynamics among affect and health behaviors is crucial for promoting daily well-being.</p><p><strong>Purpose: </strong>This study examined the reciprocal associations among affect, physical activity, and sleep in daily life in a U.S. national sample of mid- and later-life adults.</p><p><strong>Methods: </strong>The study sample included 1,171 participants (mean age = 62.61 years, SD = 10.26 years, 57% female, 82% White) with 9,033 daily interview days from the daily diary project of the third wave of the Midlife in the United States study (MIDUS III). Participants reported their daily experiences across eight consecutive days. Using a dynamic structural equation modeling, we examined day-to-day autoregressive and cross-lagged associations among positive and negative affect, physical activity, and sleep.</p><p><strong>Results: </strong>Results revealed that higher positive affect predicted a greater likelihood of engaging in moderate-to-vigorous physical activity (MVPA) and better sleep quality the following day. Higher sleep quality predicted increased positive affect, reduced negative affect, and a greater likelihood of MVPA engagement the next day. Longer sleep duration predicted lower negative affect the following day. However, MVPA engagement predicted subsequent higher negative affect.</p><p><strong>Conclusions: </strong>Findings underscore the importance of simultaneously considering affect, physical activity, and sleep in studying their day-to-day dynamics, and the protective role of positive affect and sleep quality in daily life. Maintaining high positive affect and managing sleep quality may be important intervention targets for enhancing daily well-being.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing mindsets about methotrexate in the rheumatology clinic to reduce side effects and improve adherence: a randomized controlled trial.","authors":"Rachael Yielder, Kari Leibowitz, Alia J Crum, Paul Manley, Nicola Dalbeth, Keith J Petrie","doi":"10.1093/abm/kaae089","DOIUrl":"10.1093/abm/kaae089","url":null,"abstract":"<p><strong>Background: </strong>Patients' negative expectations about medication can exacerbate side effect burden leading to low adherence and persistence. A novel intervention involves targeting mindsets about non-severe symptoms; reframing them as encouraging signs of medication working.</p><p><strong>Purpose: </strong>This study aimed to assess whether a brief symptom-mindset intervention can improve symptom experience and adherence in patients starting methotrexate to treat an inflammatory rheumatic disease.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted with patients starting methotrexate. Participants were randomly assigned (1:1) to a mindset intervention or standard information control condition. Symptom mindset was assessed after 4 weeks to check intervention efficacy. The primary outcome was symptom experience after 4 weeks. Secondary outcomes were adherence and motivation to take methotrexate (4 weeks), as well as continuation and C-reactive protein (12 weeks).</p><p><strong>Results: </strong>Forty-seven participants were randomly assigned to the intervention (n = 24) or control group (n = 23). All participants completed the study. After 4 weeks, compared to the control group, intervention participants endorsed more positive symptom mindsets, experienced less symptom burden (mean difference -2.70 [95% CI, -4.50, -0.90] P = .005), fewer general symptoms (3.53 [-6.99, .79] P = .045) and a similar number of methotrexate-specific symptoms (-0.79 [-2.29, 0.71] P = .295). The intervention group had better motivation and adherence to methotrexate at 4 weeks and better continuation, and C-reactive protein at 12 weeks than the control group. There was no difference in side effect attribution.</p><p><strong>Conclusions: </strong>In patients starting methotrexate, a mindset intervention reframing the role of non-severe side effects is a promising approach for improving symptom experience and early stage medication persistence.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in daily stress reactivity and changes in physical health across 18 years of adulthood.","authors":"Jonathan Rush, Susan T Charles, Emily C Willroth, Eric S Cerino, Jennifer R Piazza, David M Almeida","doi":"10.1093/abm/kaae086","DOIUrl":"10.1093/abm/kaae086","url":null,"abstract":"<p><strong>Background: </strong>Stress plays a pivotal role in physical health. Although many studies have linked stress reactivity (daily within-person associations between stress exposure and negative affect) to physical health outcomes, we know surprisingly little about how changes in stress reactivity are related to changes in physical health.</p><p><strong>Purpose: </strong>The current study examines how change in stress reactivity over 18 years is related to changes in functional health and chronic health conditions.</p><p><strong>Methods: </strong>Three measurement bursts from the National Study of Daily Experiences (N = 2880; 55% female) each included daily measures of stressor exposure and negative affect across 8 consecutive days, yielding 33 944 days of data across 18 years of adulthood. At each wave, participants reported their functional health limitations (ie, basic activities of daily living [ADL] and instrumental activities of daily living [IADL]) and chronic health conditions. Multilevel structural equation models simultaneously modeled stress reactivity at Level 1, longitudinal changes in stress reactivity at Level 2, and the association between changes in stress reactivity and changes in functional limitations and chronic conditions at Level 3.</p><p><strong>Results: </strong>Higher levels of stress reactivity at baseline were associated with more functional health limitations 18 years later (ADLs: Est. = 0.90, P = .001; IADLs: Est. = 1.78, P < .001). Furthermore, individuals who increased more in their stress reactivity across the 18-year period also showed greater increases in their functional health limitations (ADLs: Est. = 4.02, P = .017; IADLs: Est. = 5.74, P < .001) and chronic conditions (Est. = 11.17, P = .008).</p><p><strong>Conclusions: </strong>These findings highlight the strong connection between health and stress in daily life, and how they travel together across adulthood.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dulce Digital-Me: results of a randomized comparative trial of static versus adaptive digital interventions for Latine adults with diabetes.","authors":"Athena Philis-Tsimikas, Addie L Fortmann, Taylor Clark, Samantha R Spierling Bagsic, Emilia Farcas, Scott C Roesch, James Schultz, Todd P Gilmer, Job G Godino, Kimberly L Savin, Mariya Chichmarenko, Jennifer A Jones, Haley Sandoval, Linda C Gallo","doi":"10.1093/abm/kaae077","DOIUrl":"10.1093/abm/kaae077","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of a static, text-based diabetes education and support intervention (Dulce Digital, DD) versus a dynamic approach with personalized feedback and goal setting (Dulce Digital-Me, DD-Me) in improving diabetes outcomes.</p><p><strong>Design and methods: </strong>Comparative effectiveness trial in 310 Latine adults with poorly managed type 2 diabetes in a Federally Qualified Health Center in Southern California, randomized to DD, DD-Me-Auto (algorithm-driven text-based personalized feedback), or DD-Me-Tel (coach delivered personalized feedback). Changes in HbA1c (primary outcome), low-density lipoprotein-cholesterol, systolic blood pressure, and patient-reported outcomes were examined across 6 and 12 months, with the primary comparison being DD versus DD-Me (combined automated and telephonic).</p><p><strong>Results: </strong>Participants were 52.1 (±10.2) years old, 69.7% female, with HbA1c 9.3% (±1.6) at baseline. Across groups, there was a statistically significant improvement in HbA1c at 6 months (mean∆ per month = -0.17, 95% CI -0.20, -0.14; P < .001) and 12 months (mean∆ per month = -0.07, 95% CI -0.09, -0.05; P < .001). However, there were no time-by-group interaction effects indicating group differences in clinical outcomes across 6 or 12 months. The DD-Me groups showed greater improvements across time than the DD group for diabetes self-management behaviors.</p><p><strong>Conclusions: </strong>Static and adaptive digital interventions for Latine adults with type 2 diabetes had similar and clinically significant effects on HbA1c across 12 months. Simple digital approaches can be integrated within primary care-based chronic care models to reduce diabetes disparities.</p><p><strong>Clinicaltrials.gov registration: </strong>NCT03130699, Initial Release 04/24/2017, https://clinicaltrials.gov/ct2/show/NCT03130699?term=NCT03130699&draw=2&rank=1.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the Let's Move It multi-level vocational school-based intervention on physical activity and sedentary behavior: a cluster randomized trial.","authors":"Nelli Hankonen, Ari Haukkala, Minttu Palsola, Matti Toivo Juhani Heino, Reijo Sund, Kari Tokola, Pilvikki Absetz, Vera Araújo-Soares, Falko F Sniehotta, Katja Borodulin, Antti Uutela, Taru Lintunen, Tommi Vasankari","doi":"10.1093/abm/kaaf023","DOIUrl":"10.1093/abm/kaaf023","url":null,"abstract":"<p><strong>Background: </strong>Low levels of physical activity (PA), more prevalent among those with low education, require effective interventions. Fewer trials have tested interventions to decrease sedentary behavior (SB). No school-based interventions have shown lasting effects on PA or SB in vocational schools.</p><p><strong>Purpose: </strong>To examine whether the Let's Move It intervention has effects on behavioral and clinical outcomes among vocational students after 2 and 14 months.</p><p><strong>Methods: </strong>A cluster randomized trial in 6 school units in vocational education in Finland (N = 1112) (mean age 18.5 years, range 15-46). The multi-component intervention targeted in-class activity opportunities (eg, teacher-led activity breaks, equipment in classrooms), and students' motivation and self-regulation (eg, 6 group sessions, à 45-60 min, during the intensive intervention period of 2 months). Valid (≥ 4 days, ≥ 10 h/day) accelerometer data were obtained from 741 students at baseline, 521 (70.3%) at 2 months, and 406 (54.8%) at 14 months.</p><p><strong>Results: </strong>No evidence of a significant intervention effect on the co-primary outcomes (moderate-to-vigorous PA, SB, breaks in SB) was found. Participants in the intervention arm reduced their total daily SB time by 32 min (95% CI, -43.2 to -20.8) on weekdays, compared with the control arm's reduction of 8.6 (95% CI, -19.5 to 2.3) and engaged in more accelerometer-measured light PA during school time. Few differences were found in secondary outcomes. The fidelity of intervention delivery was relatively good.</p><p><strong>Conclusions: </strong>This school-based intervention did not affect leisure-time activity. Despite a positive outcome on school-time light PA, more comprehensive or intensive environmental changes may be needed to meaningfully improve vocational students' total activity.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"59 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yes I can! Exploring the impact of self-efficacy in a digital weight loss intervention.","authors":"Angel E Cleare, Christopher D Gardner, Abby C King, Michele L Patel","doi":"10.1093/abm/kaae085","DOIUrl":"10.1093/abm/kaae085","url":null,"abstract":"<p><strong>Background: </strong>Self-efficacy is a modifiable intervention target in behavioral weight loss interventions. However, its role in the context of digital interventions is less clear.</p><p><strong>Purpose: </strong>To determine change in self-efficacy in a digital weight loss intervention, and whether self-efficacy is associated with engagement in self-monitoring diet or weight loss.</p><p><strong>Methods: </strong>This is a secondary analysis of the GoalTracker study among 100 adults with overweight or obesity enrolled in a 12-week standalone digital weight loss intervention emphasizing daily self-monitoring. At baseline, 1 month, and 3 months, we assessed self-efficacy for controlling eating (via the Weight Efficacy Lifestyle Questionnaire; WELQ) and self-efficacy for tracking diet. Dietary self-monitoring engagement data were collected from the MyFitnessPal app. Weight was collected in person on a calibrated scale. Analyses included participants with complete data (N range: 72-99).</p><p><strong>Results: </strong>Positive change from baseline to 1 month in self-efficacy for controlling eating was associated with higher dietary self-monitoring engagement (r = 0.21, P = .008) but not with 3-month weight change (r = -0.20, P = .052). Meanwhile, positive change from baseline to 1 month in self-efficacy for tracking diet was associated in a beneficial direction with both outcomes (r = 0.57, P < .001; r = -0.35, P < .001, respectively). However, on average, self-efficacy for controlling eating did not change over time while self-efficacy for tracking diet decreased (P < .001).</p><p><strong>Conclusion: </strong>Improvements in self-efficacy-particularly for tracking diet-early on in a digital weight loss intervention served as a mechanism of greater engagement and weight loss, highlighting the need for strengthening intervention strategies that promote early self-efficacy within a digital context.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty years of intervention optimization.","authors":"Linda M Collins","doi":"10.1093/abm/kaae076","DOIUrl":"10.1093/abm/kaae076","url":null,"abstract":"<p><p>In the classical paradigm for intervention research, the components that are to make up an intervention are identified, pilot tested, and then immediately assembled into a treatment package and subjected to an evaluation randomized controlled trial (RCT) to assess the performance of the entire package. Intervention optimization, which adapts ideas from technological fields to intervention science in order to hasten scientific progress, is an alternative to the classical paradigm. The first article introducing intervention optimization via the multiphase optimization strategy (MOST) was published in Annals of Behavioral Medicine in 2005. In this commentary, I reflect on the evolution of intervention optimization from that first publication to today, and on what the future could hold if the intervention science field continues to adopt the optimization paradigm. I propose that if intervention optimization became standard operating procedure, the field would accumulate a coherent base of knowledge about what specific intervention strategies work, for whom, under which circumstances, and why; every intervention produced would contain only components that contribute enough to justify their resource requirements; interventions would be readily implementable; and as the knowledge base grew, interventions would be improved continually.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of empirical research on firearms and firearm violence among sexual and gender minority populations in the United States.","authors":"Wesley M Correll-King, Cassandra Crifasi, Kristi E Gamarel","doi":"10.1093/abm/kaae094","DOIUrl":"10.1093/abm/kaae094","url":null,"abstract":"<p><strong>Background: </strong>Firearms-related health sciences research has documented disparities in fatal and nonfatal firearm injury impacting populations in the United States defined by race and ethnicity, age, gender, and geography. Recent reports from research and advocacy organizations have highlighted a need for this research to include sexual and gender minority (ie, lesbian, gay, bisexual, transgender, and queer [LGBTQ+]) populations to guide public health efforts to prevent homicide, suicide, and injury.</p><p><strong>Purpose: </strong>The current review examines and summarizes existing research related to firearms and LGBTQ+ populations in the United States.</p><p><strong>Methods: </strong>A search of PubMed, Embase, CINAHL, PsycInfo, LGBT Life, and Scopus was conducted in May 2024 using search strings related to LGBTQ+ populations, firearms, and suicide. Articles were included in this review if they were peer-reviewed, empirical studies assessing any construct related to firearms among LGBTQ+ people in the United States.</p><p><strong>Results: </strong>Ultimately, 35 studies were included. Constructs examined in included studies were suicide (n = 6), homicide (n = 4), responses to the Pulse nightclub shooting (n = 9), nonfatal interpersonal violence (n = 4), and firearm access and ownership (n = 12).</p><p><strong>Conclusions: </strong>Findings identified substantial gaps in the literature, underscoring an urgent need for LGBTQ+ health researchers and firearm injury prevention researchers to collaboratively extend and improve the evidence base on firearms among LGBTQ+ populations. Key recommendations include improving Sexual Orientation and Gender Identity data collection in firearms research, collecting original data to address LGBTQ+-specific and LGBTQ+-inclusive research questions regarding firearms, broadening the scope of firearms constructs assessed among LGTBQ+ populations, and using intersectionality to guide future research.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"59 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Health Benefits of Everyday Physical Activity in a Diverse Sample of Middle-Aged Adults.","authors":"Jonathan G Hakun, Lizbeth Benson, Tian Qiu, Daniel B Elbich, Mindy Katz, Pamela A Shaw, Martin J Sliwinski, Yasmin Mossavar-Rahmani","doi":"10.1093/abm/kaae059","DOIUrl":"10.1093/abm/kaae059","url":null,"abstract":"<p><strong>Background: </strong>Physical activity has been associated with a wide range of health benefits including long-term benefits for cognitive and brain health. Whether episodes of everyday physical activity are associated with immediate cognitive benefits remains unknown.</p><p><strong>Purpose: </strong>The purpose of the current study was to examine whether episodes of physical activity, occurring over the course of participants' daily lives, are associated with short-term improvements in cognitive health.</p><p><strong>Methods: </strong>Participants completed a 9-day ecological momentary assessment protocol involving 5 daily assessments of self-reported physical activity and ambulatory cognitive assessments of processing speed and visuospatial working memory. Data were analyzed in a multilevel modeling framework to explore changes in performance on each task associated with physical activity during the period leading up to the assessment as well as individual differences in average frequency of physical activity.</p><p><strong>Results: </strong>Results of MLMs indicated that engaging in physical activity during the period (~3.5 hr) leading up to an assessment was associated with improvements in processing speed equivalent to 4 years of cognitive aging. Such improvements were observed for both light and moderate-to-vigorous physical activity levels. No association was observed for visuospatial working memory accuracy; however, response time during the working memory task reliably mirrored the association observed for processing speed. The short-term benefits were observed, particularly, for individuals with an overall higher frequency of reported physical activity.</p><p><strong>Conclusions: </strong>Our findings suggest that engaging in everyday physical activity of any intensity level may have short-term, acute benefits for cognitive health and point to new potential targets for intervention.</p><p><strong>Clinical trial information: </strong>NCT03240406.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and Psychosocial Dynamics in Diabetes Management: A Path Analysis to Examine the Influence of Acculturation in Arab Immigrant Communities.","authors":"Hamzah Alzubaidi, Vitor H Oliveira, Ward Saidawi, Raya Aljobowry, Jonathan E Shaw, Catarina Samorinha","doi":"10.1093/abm/kaae062","DOIUrl":"10.1093/abm/kaae062","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) prevalence is rising globally. Arab immigrants with T2DM, one of the least studied ethnic minorities, have a higher diabetes prevalence and more prominent management-related challenges compared with mainstream host societies. Acculturation's impact on self-care activities and diabetes distress (DD) is understudied globally.</p><p><strong>Purpose: </strong>To examine how acculturation affects self-care practices and DD in first-generation Arab immigrants with T2DM and how health literacy, illness perceptions, and self-efficacy mediate these associations.</p><p><strong>Methods: </strong>This multicenter cross-sectional study was conducted in Victoria, Australia. Eligible patients were invited while waiting for their appointments. The questionnaire included validated tools to assess DD, self-care activities, health literacy, self-efficacy, and acculturation. We tested mediation hypothesis using path analysis, with a maximum likelihood estimation to calculate total, direct, and indirect effects and bias-corrected accelerated 95% CI.</p><p><strong>Results: </strong>Overall, 382 Arab immigrants with T2DM participated, with an average age of 57.9 years (SD = 8.0). Half were males, most had low education, and were married. Participants lived in Australia for a mean of 19.1 years (SD = 8.3) and had diabetes for 7.1 years (SD =4.7). Higher acculturation was directly associated with decreased DD. Illness perceptions (p = .002) and self-efficacy (p = .001) mediated the association of acculturation with self-care activities, while health literacy did not. Additionally, self-efficacy fully mediated the relationship between acculturation and DD (p = .001).</p><p><strong>Conclusions: </strong>This research provided valuable insights into the complex interplay between acculturation, diabetes management, and psychosocial factors. Interventions targeting self-efficacy and illness perceptions may improve self-care activities and reduce DD among Arab immigrants with T2DM.</p>","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}