Health Psychology

Interventions involving nudge theory for COVID-19 vaccination: A systematic review and meta-analysis.
Objective: New approaches to mitigate vaccine hesitancy and improve vaccine uptake are urgently needed. Nudging has shown effective results in several health areas. However, the effectiveness of interventions involving nudge theory in increasing COVID-19 vaccination remains unclear. Method: We searched PubMed, Web of Science, and Scopus for randomized controlled trials published before December 31, 2022, to determine whether interventions involving nudge theory improved COVID-19 vaccination behavior and intent. Risk ratio (RR) and a 95% confidence interval (CI) were used as pooled measures to assess vaccination behavior. Intention to vaccinate was reported in a narrative synthesis. Results: Sixteen randomized controlled trials involving 176,125 participants were included. Interventions involving nudge theory weakly boosted the COVID-19 vaccine uptake rate (RR = 1.21, 95% CI [1.07, 1.36], p <.01). Subgroup analysis showed a weak positive effect of social norms (RR = 2.04, 95% CI [1.61, 2.57]), defaults (RR = 1.32, 95% CI [1.03, 1.69]), and salient reminders (RR = 1.19, 95% CI [1.04, 1.36]). Nudge interventions integrating multiple components were more efficacious in increasing vaccination rates compared to nudge alone. The effect of nudging interventions weakened over time (p <.001). Most studies (10 of 11) involving vaccination intention outcomes showed positive or partially positive results. Conclusions: Interventions involving nudge theory can promote COVID-19 vaccination behavior and intentions. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Mortality risk of loneliness: Culture matters.
Objective: Does loneliness predict premature death? Much prior research suggests so, but this evidence draws primarily on populations from individualistic societies, such as North America and Western Europe. Here, we aimed to extend this evidence by testing a hypothesis that loneliness would predict greater mortality risk in collectivistic societies, where social interdependence is normatively sanctioned. Method: Using a harmonized dataset from two individualistic (England and the United States) and two collectivistic (Korea and Mexico) countries (combined N = 41,869), we tested whether cultural contexts moderate the extent to which loneliness predicts 10-year all-cause mortality. Results: After adjustment of demographic variables and health behaviors, loneliness was associated with increased 10-year mortality in all four countries, with hazard ratios (HRs) of 1.13 in England, 1.21 in the United States and Mexico, and 1.51 in Korea. When health conditions were additionally controlled, this association became negligible in two individualistic countries, with HRs of 0.98 for both England and the United States. In contrast, the HR remained highly significant in Korea (HR = 1.27). Curiously, the mortality risk of loneliness in Mexico (HR = 1.03), another collectivistic country, was no different from the risks in England and the United States. Conclusions: When people feel that they are chronically isolated from social networks, this perception can be fatal in Korea, but it is less so in the other three countries. Discussion focuses on other cultural factors, besides the cultural dimension of individualism–collectivism, that may account for the current finding. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Anxiety, depression, and fear of cancer recurrence in head and neck cancer.
Objective: Patients with head and neck cancer (HNC) report some of the highest levels of psychological distress amid managing their disease as well as debilitating and disfiguring treatment side effects. Fear of cancer recurrence (FCR) is a top unmet need and concern of patients with HNC. Prior research suggests elevated symptoms of anxiety and depression are potential antecedents to FCR, but findings have been limited in HNC populations. The aim of the present study was to examine the early level and change in symptoms of anxiety and depression in relation to later change in FCR among patients with HNC. Method: The study is a secondary analysis of data collected from 2011 to 2014 through the Head and Neck 5000 Study in the United Kingdom. A sample of 4,891 patients completed self-report longitudinal assessments of anxiety and depression symptoms at baseline, 4, and 12 months and FCR at 4 and 12 months. Results: Utilizing multiple indicator latent change score modeling, results revealed baseline anxiety and increases in anxiety from baseline to 4 months were both positively associated with increases in FCR from 4 to 12 months. Neither baseline depression nor change in depression from baseline to 4 months were significantly associated with FCR change. Conclusions: Findings indicate that early level and increases in symptoms of anxiety were markers of increased FCR in patients with HNC. Future research may consider anxiety as a unique antecedent and maintaining factor of FCR and targeting anxiety early in the cancer trajectory may have downstream effects on FCR development. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Dyadic coping, resilience, and posttraumatic growth in spinal cord injury patients and their spouses: An actor–partner interdependence mediation model analysis.
Objective: Despite the recognized importance of posttraumatic growth (PTG) in the recovery process, the mechanisms that promote PTG in spinal cord injury (SCI) patients and their spouses, especially the roles of dyadic coping (DC) and resilience, have not been fully explored. This study aimed to assess the PTG of patients with SCI and their spouses and to investigate the interrelationships among DC, resilience, and PTG within the dyadic context. Method: A total of 154 SCI patient–spouse dyads were recruited from a rehabilitation hospital in China. All participants completed questionnaires about DC, resilience, and PTG. Our study was based on the actor–partner interdependence mediation model (APIMeM). Results: SCI patients and their spouses experienced comparable PTG level, M(patients) = 56.05 ± 14.09, M(spouses) = 54.74 ± 15.31. In the APIMeM, the patients’ and their spouses’ DC exerted actor effects on their own resilience, β(patients) = .418, p< .001; β (spouses) = .409, p <.01, and their own resilience also exerted actor effects on their own PTG, β(patients) = .416, p< .001; β (spouses) = .431, p <.001. The mediating effects of resilience on the impact of patients’ and spouses’ own DC on their own PTG were confirmed. Conclusions: Our research offers new insight into the PTG of SCI patients and their spouses at the individual and dyadic levels. Resilience partially mediates the relationship between DC and PTG in couples coping with SCI. Specifically, DC between SCI patient–spouse dyads can not only directly influence the level of PTG but also impact PTG through resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Black men’s health-related quality of life: A qualitative study to understand community-identified perception and needs.
Objective: Health-related quality of life (HRQoL) is a multidimensional indicator of overall health associated with premature mortality. Black men score low on measures of HRQoL, but it is unclear how Black men conceptualize HRQoL and whether there have been efforts to promote HRQoL among these men. The present qualitative study to understand Black men’s conceptualization of HRQoL and strategies to improve HRQoL was based in community-based participatory research and the social–ecological model of health. Method: A community advisory board (CAB) was established, and the need for an effort to promote HRQoL promotion among Black men was assessed and supported. A focus group protocol was developed in conjunction with the CAB and a group of barbers. Seven focus groups were conducted consisting of 56 Black men in the Southeastern United States. The mean age of participants was 45 years. Two reviewers coded each focus group. Reliability ranged from 71% to 76%. A thematic analysis was conducted, and the findings were confirmed with the CAB. Results: Three themes emerged: (a) a holistic conceptualization of health that includes spiritual functioning among Black men; (b) a state of HRQoL among Black men predominately marked by mental health concerns, in addition to physical and social health concerns; and (c) multilevel determinants of HRQoL among Black men. This last theme consisted of three subthemes related to community-level, interpersonal, and intrapersonal determinants of HRQoL. Conclusions: Findings from this study can help inform the development of strategies to improve HRQoL and reduce health disparities among Black men. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Longitudinal associations in dementia family caregivers of ambivalent feelings and disruptive behaviors with C-reactive protein, interleukin-6, and D-dimer.
Objective: Caregivers’ ambivalent feelings toward the care recipient have been found to be associated with depression and anxiety. There is no research linking caregivers’ ambivalent feelings and cardiovascular risk. This study was aimed to analyze longitudinally the effect of ambivalence on caregivers’ cardiovascular risk, defined by circulating levels of high-sensitivity C-reactive protein, interleukin-6 (IL-6), and D-dimer. Method: Participants were 121 dementia family caregivers who were assessed three times during a 2-year period. Sociodemographic and health variables, behavioral and psychological symptoms of dementia (BPSD), ambivalent feelings, and C-reactive protein (CRP), IL-6, and D-dimer values were assessed. Mixed linear models were used to analyze the association between variables, including testing whether ambivalent feelings moderated the links between BPSD and biomarkers. Results: Increases over time in D-dimer were associated with increases in ambivalence, older age, female gender, and body mass index (BMI). Increases over time in CRP were associated with increases in BMI, older age, female gender, and the interaction of BPSD with caregivers’ ambivalent feelings. The moderation analysis showed that increased BPSD was significantly associated with increased CRP when caregivers experienced high levels of ambivalence (p = .006). In contrast, BPSD were not significantly associated with CRP when caregivers experienced low levels of ambivalence (p = .73). Increases in IL-6 were associated with female gender and BMI. The tested model explained 42.85%, 33.15%, and 5.36% of longitudinal variance in CRP, D-dimer, and IL-6 levels, respectively. Conclusion: The findings suggest that high ambivalent feelings are relevant for understanding cardiovascular vulnerability in dementia caregivers. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Training physicians in motivational communication: An integrated knowledge transfer study protocol.
Objective: While behavior change counseling (BCC) targeting health risk behaviors has shown efficacy for improving patient health outcomes, barriers to knowledge translation have resulted in poor uptake among health care providers (HCPs). This article outlines the development of a new BCC training framework for HCPs, from inception to readiness for efficacy testing. It provides an example of integrated knowledge translation (iKT) used in alignment with the obesity-related behavioral intervention trials model. Method: (a) A modified Delphi process identified essential BCC skills for HCPs; (b) a survey assessed HCP attitudes and training needs; (c) an online competency assessment tool was developed using iKT mixed methods; (d) a training program was developed and refined using a logic model; and (e) the program was optimized using iterative rounds of participant feedback. A future proof-of-concept trial (f) will determine the program’s readiness for full efficacy testing. Results: A Delphi panel (n = 46) identified 11 core BCC competencies for HCPs, defining “motivational communication.” The HCP survey (n = 80) showed willingness to devote 4 hr to introductory training in BCC. The Motivational Communication Competency Assessment Test (MC-CAT: an online, interactive evaluation tool) and a motivational communication training program (MOTIVATOR: accredited for continuing education by the Royal College of Physicians and Surgeons of Canada) were collaboratively developed with knowledge users. The optimization process (n = 11) provided key feedback, with minor changes being made to the program. Conclusions: In developing a new BCC framework, obstacles to BCC implementation were addressed through an iterative iKT process. This should improve eventual intervention uptake. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Health Psychology - Vol 43, Iss 11