The Translational Behavioral Oncology Postdoctoral Training Program at Moffitt Cancer Center, funded by the National Cancer Institute (T32CA090314), prepares postdoctoral fellows to excel in highly interdisciplinary and collaborative cancer research environments. This program leverages Moffitt's robust faculty expertise and institutional resources, and draws from various disciplines engaged in cancer research, including behavioral science, population science, health communication, nursing, and medicine. Over the past 20 years, this program has recruited a talented and diverse pool of postdoctoral trainees (n = 47) who have acquired the requisite knowledge, skills, and experience to become successful independent investigators in behavioral oncology. In this paper, the training components and outcomes over the past two decades are reported with a particular focus on trainee and mentor evaluations of core components from the 2019-2024 cycle. These findings provide insights for developing and optimizing postdoctoral training in cancer prevention and control, serving as a model for advancing the careers of the next generation of cancer researchers.

The selection of appropriate statistical models is essential for accurately interpreting the analysis of count data, especially in behavioral medicine. Traditionally, Poisson and Negative Binomial models have been commonly employed, but they may not always be the most optimal choices, particularly when dealing with data with an abundance of zeroes, which can be effectively modeled using zero-inflated and zero-altered (hurdle) models. Additionally, U-shaped distributions where the data are clustered around both ends-low and high counts-with fewer occurrences in the middle, cannot be adequately captured by traditional approaches and further complicate the analysis. This paper critically examines the widespread use of zero-inflated Poisson (ZIP) and zero-inflated negative binomial (ZINB) models in the context of adolescent substance use data, identifying their potential limitations.Using a dataset from a smoking study of 1263 adolescents who reported smoking behavior across eight waves, we analyzed the sparse count outcome "Days Smoked in the Past Month," with covariates such as sex, age, and GPA recorded at each wave. Through a comprehensive evaluation of smoking behavior count outcomes-employing model identification via the Kolmogorov-Smirnov (KS) test, validation through confirmation studies, and regression analysis guided by Akaike Information Criterion (AIC). The range of models covered includes: ZIP, Poisson hurdle (PH), ZINB, negative binomial hurdle (NBH), zero-inflated negative binomial with fixedr(ZINB-r), negative binomial hurdle with fixedr(NBH-r), zero-inflated beta-binomial (ZIBB), beta-binomial hurdle (BBH), zero-inflated beta-binomial with fixed n (ZIBB-n), beta-binomial hurdle with fixedn(BBH-n), zero-inflated beta-binomial with fixedalphaandbeta(ZIBB-ab), beta-binomial hurdle with fixed alpha and beta (BBH-ab), zero-inflated beta negative binomial (ZIBNB), and beta negative binomial hurdle (BNBH). Our study demonstrates the superior model fitting and regression analysis capabilities of the ZIBB and BBH models. Notably, our findings reveal the effectiveness of the ZIBB model in capturing the U-shaped distribution observed in real-world data. This underscores the importance of exploring a wider range of models beyond ZIP and ZINB for count data analysis. This study advocates for the broader application of these more sophisticated models in behavioral medicine, with the goal to enhance the accuracy and reliability of research outcomes.

Pharmacists' barriers and enablers to delivering health behaviour recommendations for patients with behavioural determinants of disease: Application of the COM-B model.

Academic institutions face increasing challenges in grant writing due to evolving federal and state policies that restrict the use of specific language. Manual review processes are labor-intensive and may delay submissions, highlighting the need for scalable, secure solutions that ensure compliance without compromising scientific integrity. This study aimed to develop a secure, artificial intelligence-powered tool that assists researchers in writing grants consistent with evolving state and federal policy requirements. GrantCheck (University of Massachusetts Chan Medical School) was built on a private Amazon Web Services virtual private cloud, integrating a rule-based natural language processing engine with large language models accessed via Amazon Bedrock. A hybrid pipeline detects flagged terms and generates alternative phrasing, with validation steps to prevent hallucinations. A secure web-based front end enables document upload and report retrieval. Usability was assessed using the System Usability Scale. GrantCheck achieved high performance in detecting and recommending alternatives for sensitive terms, with a precision of 1.00, recall of 0.73, and an F1-score of 0.84-outperforming general-purpose models including GPT-4o (OpenAI; F1=0.43), Deepseek R1 (High-Flyer; F1=0.40), Llama 3.1 (Meta AI; F1=0.27), Gemini 2.5 Flash (Google; F1=0.58), and even Gemini 2.5 Pro (Google; F1=0.72). Usability testing among 25 faculty and staff yielded a mean System Usability Scale score of 85.9 (SD 13.4), indicating high user satisfaction and strong workflow integration. GrantCheck demonstrates the feasibility of deploying institutionally hosted, artificial intelligence-driven systems to support compliant and researcher-friendly grant writing. Beyond administrative efficiency, such systems can indirectly safeguard public health research continuity by minimizing grant delays and funding losses caused by language-related policy changes. By maintaining compliance without suppressing scientific rigor or inclusivity, GrantCheck helps protect the pipeline of research that advances biomedical discovery, health equity, and patient outcomes. This capability is particularly relevant for proposals in sensitive domains-such as social determinants of health, behavioral medicine, and community-based research-that are most vulnerable to evolving policy restrictions. As a proof-of-concept development study, our implementation is tailored to one institution's policy environment and security infrastructure, and findings should be interpreted as preliminary rather than universally generalizable.

Health psychology, also known as clinical psychology or behavioral medicine, is a field that studies Physiological, Social and Biological There are several elements that influence health and how they affect, prevent, and encourage sickness. It's a habit that motivates people to make health-conscious choices like working out, Cultural ideas, family ties, and social support networks are examples of model factors. Eating well and being more active can help prevent disease. Biological variables include things like inherited personality traits and genetic illnesses. Psychological influences include things like lifestyle, personality traits, and stress levels. Primary care is psychological patients and families for common physical and mental health problems will experience the full application of knowledge and principles their lives. Research significance: Research in health care for psychopathology is essential for advancing mental health care, improving treatment strategies, promoting early intervention, and reducing societal stigma surrounding mental illness. It lies in its ability to improve Quality of life. Significance of this study that individual’s burden on healthcare systems, and foster a greater understanding of mental health in society. Many individuals with mental health disorders also suffer from physical health problems, and understanding the connections between mental and physical health can lead to better, integrated care approaches. Methodology: A method used for ranking and selection. EDAS (Estimation Alternatives in decision making problems involving multiple conflicting criteria. The process involves evaluating each alternative (treatment or intervention, in the context of psychopathology) based on its performance relative to other alternatives, and then determining which one best meets the desired criteria. Alternative: QH1, QH2, QH3, QH4, QH5 refers to an approach that combines medication and therapy to address mental illness for individuals diagnosed with mood disorders such as depression or bipolar disorder. For example, using antidepressants such as sertraline or fluoxetine along with cognitive-behavioral therapy (CBT) allows for a comprehensive treatment plan. Medication targets neurochemical imbalances, while therapy helps individuals understand and challenge negative thought patterns that contribute to their symptoms. This integrated approach has been shown to be effective in improving patients’ emotional and psychological well-being, helping them manage symptoms, and achieving long-term stability. The combination Especially pharmacological and therapeutic treatments beneficial for people experiencing moderate to severe symptoms, as they address both biological and cognitive aspects mental illness. This holistic treatment approach can provide patients with better symptom management and improved quality of life, especially for those who do not respond to holistic treatments. Ongoing monitoring of both medication doses and treatment progress is important for optimal outcomes. Evaluation preference: The parameters of tolerability, Energy efficiency, flexibility and real-time predictability, reliability, integrity, management provide a comprehensive framework for assessing its effectiveness. Tolerability reflects the patient’s ability to handle the treatment without major side effects, while predictability assesses the sustained relief of symptoms. It ensures that benefits are maintained over the long term, while integrity ensures that the treatment focuses on key goals. Energy efficiency assesses the balance between treatment intensity and benefit, and flexibility allows for meeting the needs of the individual patient. Finally, real-time management helps patients manage immediate symptoms and provides ongoing support. If all of these factors are assessed positively, a treatment approach such as can be considered a very effective, well-rounded solution for managing mood disorders. Results: QH5 represents the most effective treatment approach, offering consistent results, long-term benefits, and personalized care that caters to individual patient needs. QH4, however, is considered less effective and has limitations in terms of predictability, tolerance, and long-term results, making it less suitable for patients with more severe symptoms. The ranking highlights the critical importance of selecting the most appropriate treatment option tailored to the patient’s needs, ensuring the best outcomes for their mental health and overall well-being.

14. Outpatient GI Behavioral Medicine: An Analysis of Psychiatric Referrals in Gastroenterology—Patient Characteristics, Diagnoses, and Preliminary Health Outcomes

Simple SummaryEquine gastric ulcer syndrome refers to a collection of stomach diseases in horses. Diseases of the lining of the stomach can be painful in affected horses. This in part explains why equine gastric ulcer syndrome continues to receive substantial attention in the equine medical, welfare and equitation research sectors. There is a complex interplay between EGUS and a variety of physical and psychological stressors. Affected horses are often presented to veterinarians with a history of problem behaviors, some of which resolve following treatment for gastric ulcers. However, problem behaviors persist in other cases, despite apparent (videoendoscopic) resolution of gastric ulcers. Some of these horses can have pain-related learnt, anticipatory behavior, even after the original source of pain has resolved. A behavioral medicine approach can benefit such cases, as well as chronic or refractory gastric ulcer cases. This includes the management of underlying disease(s), environmental modification, behavior modification, and, in select cases, behavior-modifying medication. This commentary, based on the authors’ clinical experiences and current literature, will explore how behavioral medicine can be integrated with traditional pharmacologic, nutraceutical, and husbandry strategies for the multi-modal management of gastric ulcers in horses, with a focus on managing the horse’s experience to improve case outcome.Equine gastric ulcer syndrome (EGUS) refers to mucosal gastric disease in horses, including equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD), which present as two distinct disease entities differing in pathophysiology and approach to disease management. Both diseases are a source of pain in affected horses, partly explaining why EGUS continues to receive substantial attention in the equine medical, welfare and equitation research sectors. There is a complex interplay between EGUS and a variety of physical and psychological stressors. Horses with EGUS are often presented to veterinarians with a history of problem behaviors, some of which resolve following gastroprotectant therapy. However, problem behaviors persist in some cases, despite gastroscopic resolution of disease. Some of these horses have pain-related learnt, anticipatory behavior, even after the original source of pain has resolved. Such cases, as well as chronic or refractory EGUS cases, can benefit from a behavioral medicine approach. This includes the management of any underlying diseases, environmental modification, behavior modification, and, in select cases, behavior-modifying medication. This commentary, based on the authors’ clinical experiences and current literature, explores how behavioral medicine can be integrated with traditional pharmacologic, nutraceutical, and husbandry strategies for the multi-modal management of EGUS, with a focus on managing the horse’s experience to improve case outcome.

Dick Vet's new residency in veterinary behavioural medicine

Cultural competence is essential in delivering high-quality, patient-centered care, especially in increasingly diverse clinical environments. Despite its importance, cultural competency training in health professions education remains inconsistent and often inadequate. This quantitative study examined the impact of a 3-month behavioral medicine course on first-year physician assistant (PA) students' cultural intelligence and preparedness to provide culturally competent care. A presurvey and postsurvey design was used to assess changes in cultural sensitivity using a validated assessment tool, the Cultural Sensitivity Questionnaire.6 A priori power analysis (effect size = 0.5, power = 0.8) determined a minimum sample size of 34. Paired samples t-test analyzed differences between precourse (group A) and postcourse (group B) scores. A total of 44 participants completed both surveys. Postintervention scores showed a statistically significant improvement in cultural sensitivity awareness (group A: M = 4.863, standard deviation [SD] = 0.732; group B: M = 5.548, SD = 0.794; t(39) = 4.279, P < .001). Findings support the integration of structured behavioral medicine curricula that incorporate cultural competency tools in PA education. Enhancing cultural intelligence among PA students may improve clinical communication and mitigate health disparities across diverse populations.

331 Background: Hepatocellular carcinoma (HCC) is a common cause of cancer and cancer-related mortality and is attributable to liver cirrhosis in ~80% of cases. Patients with HCC struggle with high levels of psychological distress and quality of life (QOL) impairments due to difficulty managing cancer- and liver disease-related symptoms, uncertainty stemming from gradual tumor progression and unpredictable episodes of liver decompensation, and stigma related to liver disease’s association with substance use and sexually transmitted infections. We aimed to develop and refine a novel supportive care intervention to reduce psychological distress and improve QOL in this population. Methods: We integrated stakeholder input from 4 patients, 1 caregiver, and 7 clinicians in oncology, hepatology, and behavioral medicine with principles of chronic disease self-management, cognitive behavioral therapy, and positive psychology to develop “HARMONY.” We conducted an open pilot study of adult patients diagnosed with any stage of HCC in the last 6 months who had concomitant cirrhosis. All participants received HARMONY and were asked to rate each session on a 1-10 scale (higher scores indicated higher acceptability) and the overall intervention using the Client Satisfaction Scale-8 (CSQ-8, scores ≥20 on an 8-32 scale defined as acceptable). At study completion or withdrawal, patients were invited to participate in exit interviews to provide feedback on HARMONY, which we used to refine the intervention. Results: Our stakeholder- and theory-informed approach led to the development of a 5-session virtual coaching program focused on 1) disease education to enhance self-efficacy for managing concomitant serious illnesses, 2) psychosocial skills to reduce prognostic distress, and 3) self-compassion to reduce internalized stigma. We enrolled 10 participants (median age 70 years, 7 men, 6 non-Hispanic White), of whom 6 completed ≥3 and 4 completed all 5 sessions. Reasons for withdrawal included scheduling conflicts (n = 3) and lack of interest (n = 1); 2 participants were lost to follow-up due to hepatic decompensation. All 4 participants who completed HARMONY reported mean acceptability scores &gt; 9 for each session and CSQ-8 scores ≥20 for the overall intervention. In qualitative interviews (n = 5), participants reported feeling well supported by the study clinician and enjoying the psychosocial skill-building exercises, but the disease education content was less relevant to those with low physical symptom burden. Conclusions: HARMONY is a novel intervention tailored to the unique needs of patients with HCC. We have since condensed HARMONY into 3 sessions to enhance engagement and modified the intervention structure to more flexibly address participants’ most salient needs. A pilot randomized controlled trial is planned to assess the feasibility and acceptability of HARMONY in a larger cohort of patients.

The epigenetic recognizes our predisposition to obesity as the key assumption of the mismatch between the human genome molded over millions of generations (thrifty genotype) evolved for efficient food collection and fat deposition to survive periods of famine, now frugally coping with the modern dietary and physical environments of energy dense foods and/or sedentary lifestyle. Having fat as major energy-yielding substrate, the thriftiness to effectively detect, metabolize, and store fats likely provided tremendous selective advantages “(meat-adaptive genes)” to our ancestors. Among adipocytes, white-fat cells are specialized for the storage of chemical energy as triglycerides, a neutral non-toxic fat. Under excess of energy, adipocytes become enlarged and their secreted growth factors led neo-adipocyte to differentiate resulting hyperplasia. Leaked or broken open (hypertrophied) adipocytes are phagocytosed by resident and embed macrophages. Then, obesity-derived inflammatory stress is a systemic orchestrated metabolic network triggered by the chronic accumulation of lipids into adipose tissue. The resident macrophages amplify the inflammatory signal which is enhanced by the cross talk among endothelial cells (adhesion molecules), adipocytes (leptin), and resident macrophages, which together contribute to the production of pro-inflammatory cytokines resulting in the elevated circulating levels of insulin, leptin that accompany obesity. Differently from treating low-level targets by drugs (homeostatic model), the allostasis model has a more rational goal of intervention, the basis of Behavioral Medicine. As a model of Behavioral Medicine, our community-based ongoing epidemiological study, “Moving for Health Program” (1991 to 2019) with lifestyle re-education with supervised physical exercises and diet-counseling program, had promoted proactively, alternatively to homeostatic model, eutrophy and significant reductions of overweight-related NCDs with considerable economic impact on Health Care.

Estimating statistical power is essential for designing behavioral medicine studies efficiently and conserving finite resources. Sometimes behavioral medicine researchers are interested in calculating power for 1-sided z-tests of individual parameters (e.g., slopes) in complex models such as multilevel structural equation models or multilevel mixture regression models. For such models, calculating power for 1-sided z-tests is cumbersome because: (a) online z-test power calculator tools are inapplicable, (b) commonly-used power analysis software provides power only for 2-sided z-tests and does not allow changing alpha, and (c) published power tables typically provide power results only for 2-sided z-tests. Hence, here we introduce straightforward and resource-efficient conversion formulas to estimate the power of 1-sided z-tests of individual parameters in any model by using direct power conversions from the corresponding 2-sided tests. We then implement these conversion formulas in accessible R and Excel software. This brief report thus provides behavioral medicine researchers with a convenient and practical solution for power calculation that minimizes the time, financial, and computational resources typically needed for power estimation.

Latent profile analysis (LPA) is in the finite mixture model analysis family and identifies subgroups by participants' responses to continuous variables (i.e., indicators); participants' probable membership in each subgroup is based on the similarity between the subgroup's prototypical responses and the person's unique responses. Compared to latent class analysis (LCA) with categorical data, LPA is a better fit for many variables and theories in behavioral medicine, because LPA can have continuous item, sub-scale, or scale scores as indicators, which can enable identifying and examining subgroups defined by responses representing complex, multidimensional concepts (e.g., orientations, motivations, well-being, ill-being, physical activity engagement) and biomarkers of diseases and disorders. Recently, the use of LPA has increased and as it continues to evolve, it is important researchers know best practice recommendations and explanations for both conducting as well as reading/reviewing LPA models. With this paper we: 1) discuss the strengths and weaknesses of LPA and the questions it is most appropriate to answer, 2) introduce LPA conceptually, 3) illustrate an LPA conducted with exercise psychology variables following current best practice recommendations, and 4) juxtapose resulting models from the LPA approach to a typical approach with the same data. We also share the data and syntax files used to conduct the basic steps of the LPA analyses as supplemental appendix files in addition to including the tables and figures for reporting LPA results following best practices.

This study investigated the effects of low-dose 1cp-LSD, a prodrug of LSD, on canine anxiety, while exploring the influence of owner psychopathology on treatment outcomes. Seven dogs exhibiting anxiety-related behaviors were recruited and received 2.5, 5, or 10 µg of 1cp-LSD orally every three days for 30 days. One additional dog, which did not meet clinical criteria for anxiety but whose owner perceived it as anxious, received a placebo (saccharin) as an observational case. Anxiety levels were assessed using validated scales at baseline, post-treatment, and one month after treatment cessation. Owners' neuroticism and psychopathological dimensions were evaluated using the IPIP and SA-45 scales. Linear regression analyses examined associations between anxiety reduction, administered dose, and owner psychological traits. A significant reduction in separation anxiety scores was observed post-treatment (mean: 11.3 ± 3.0, p = 0.023). Higher 1cp-LSD doses correlated with greater anxiety reduction (B = -1.15, 95% CI = [-2.29, -0.003], p = 0.050). Additionally, higher owner psychoticism scores were associated with smaller improvements in canine anxiety (p = 0.035). Anxiety levels remained low one month after treatment, with significant associations between canine anxiety and the owners' hostility, interpersonal sensitivity, and paranoid ideation. These findings support the potential role of low-dose serotonergic psychedelics in managing canine anxiety and suggest an association between caregiver psychological traits and treatment outcomes. The sustained reduction in anxiety behaviors also suggests a meaningful and lasting improvement in animal welfare. However, significant results should be interpreted cautiously due to the small sample size. Further blinded, controlled studies are needed to validate these preliminary observations and assess broader applications in veterinary behavioral medicine.

Memorializes Irving B. (Irv) Weiner (1933-2024), a clinical and forensic psychologist recognized for shaping contemporary psychological assessment practice. Over 5 decades, he held academic and administrative roles at Case Western Reserve University, the University of Denver, Fairleigh Dickinson University, and his final appointment as professor of psychiatry and behavioral medicine and director of psychological services at the University of South Florida Psychiatry Center. Irv's scholarship spans 6 decades and includes over 35 books and 300 articles. His 1966 masterpiece, Psychodiagnosis in Schizophrenia, provided a framework for assessing disordered thinking. He served on the APA Council of Representatives and played a role in advancing the visibility of assessment psychology within APA governance structures. Irv will be remembered for the clarity of his thought and writing. His work remains central to the professional literature and training infrastructure for future assessment and clinical psychologists. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Temporomandibular disorders (TMDs) and migraine are highly prevalent, overlapping pain conditions that cause considerable burden in the population. These two disorders are of different etiology and pathophysiology, but both are mediated by the trigeminal system. Due to the interrelated anatomy and physiology of the craniofacial and cervical structures, shared molecular links and mutual feedback, there is an inherent potential for exacerbation of symptomatology, perpetuation and progression; however, on a positive note, there is good potential for developing integrated, mutually beneficial management protocols when migraine and TMDs are comorbid. Currently, there are no established protocols of management, and the literature is limited in studies exploring dual therapeutic protocols. So, the question is, how can management be optimized with the evidence available? We should start by recognizing the need for multidisciplinary management to improve patient outcomes and we must highlight the importance of the dialogue between headache medicine and dentistry. The meeting point is where the dental discipline and the specialty of orofacial pain reside. The underlying pathophysiology of this comorbidity points to the need to decrease mutual exacerbation inputs. Therefore, it is fundamental to identify contributing factors of potential sensitization, such as the presence of parafunctional behaviors, cervical spine contributors, the presence of other comorbidities and headache hygiene. Current evidence supports management recommendations that should be developed by a multidisciplinary team as an integrated plan with combination therapy including both pharmacological and non-pharmacological approaches to optimize management. This multidisciplinary team should include the medical provider (neurologist/headache medicine expertise), the dentist specialized in orofacial pain, the physical therapist and the behavioral medicine specialist. Research is needed to support evidence-based integrated protocols for the management of comorbid migraine and TMDs. Evidence has shown that calcitonin gene-related peptide (CGRP) is also involved in TMDs. CGRP-targeting therapies may hold future opportunities for pharmacological monotherapy addressing this comorbidity.

2025 International Conference on Mental Health and Behavioral Medicine.

Patient-reported outcomes (PROs) and caregiver-reported outcomes (CROs) are tools for evaluating behavioral medicine interventions and for bringing the patient voice into observational research. This study aimed to identify barriers to using PROs/CROs in behavioral cancer research and to equitably address those barriers. Forty-nine members of a cancer special interest group from a research society completed surveys in early 2023 about needs related to the use of PROs and CROs. Descriptive statistics were used to summarize results. Most participants used PROs (n = 34, 69%) but few frequently used CROs (n = 12, 24%). More than 80% of the sample were familiar with common PRO/CRO properties such as reliability and validity. Participants reported considering a wide variety of population characteristics when using PROs and CROs, including language (n = 31, 70%) and education level (n = 31, 70%). The most common barriers to using PROs/CROs in research were time, funding, and technology with many reflecting potential reasons for inequitable representation of certain groups in research. Webinars were the most preferred educational format (n = 38, 78%) for resources related to PROs/CROs. Many participants encountered barriers to using PROs in research. Creation and dissemination of educational resources to promote equitable use of PROs/CROs across underrepresented groups and overcome common barriers to use of these measurement tools are warranted.

Special Issue: The 3rd International Conference on Mental Health and Behavioral Medicine (MHBM 2025), June 27-28, 2025, Kuala Lumpur, Malaysia.

Plain Language SummaryAccess to behavioral therapies for headache is limited. The Veterans Administration trained 233 providers across the country in a specialized headache‐focused behavioral therapy and introduced a biofeedback program. Early results show that trained providers were satisfied with their training and are using these techniques in practice, and this may pave the way for broader access to non‐medication headache treatments.