Health-related Behaviors Research Articles

Improving Communication with Financial Consumers: Insights from a Study of Phone Call Phobia

A phone call phobia is a symptom of avoiding real-time communication that ranges from mild nervousness to a debilitating fear of making or receiving phone calls. The situation of avoidance of real-time communication, including phone call phobia, can potentially influence personal finance, particularly if it limits an individual's ability to communicate effectively with not only family, friends, and employers but also financial service providers. As the COVID-19 pandemic has affected ways of socializing and communicating, it is important to understand the situation and related factors of phone call phobia. This study, therefore, examined factors related to three types of phone call phobia (employer, family, and friends) and six types of communication preferences (face-to-face, phone calls, letters, email, text messaging, and online messaging apps). Using data from an online survey conducted in 2021, this study considered a list of comprehensive factors, including psychological factors, financial-psychological factors, financial status, job-related factors, health-related behavior, and demographic factors, in ordered logistic regression and seemingly unrelated regression estimation models. The findings provide insights to improve communication between financial consumers and financial services providers.

Employee well-being in the digital age: Assessing the impacts of a smartphone application in the workplace

Recently, providing smartphone-based health-improving applications to employees has emerged as a promising strategy for sustaining their well-being. This study estimates the impact of the routine use of an application, introduced in 2020 by a Japanese manufacturing company, on various health-related behaviours and outcomes among employees by exploiting a distinctive large-scale longitudinal dataset and personnel records. The analysis addresses potential selection biases arising from the non-random nature of application usage by employing the instrumental variable approach. Regular application use generates significant positive impacts on health-related habits, including moderate alcohol consumption, regular breakfast intake and refraining from eating two hours before bedtime. Furthermore, regarding physical and psychological stress, noteworthy reductions in physical burden and less frequent experiences of annoyance are observed. Employees also report a lower frequency of dizziness, headaches and palpitations, albeit an increase in the frequency of strained eyes is noted. Additionally, application use is associated with lower systolic and diastolic blood pressure, as well as decreased levels of triglycerides and gamma-GTP.

Prevalence and severity of periodontal disease in the host community and Rohingya refugees living in camps in Bangladesh.

To assess the prevalence and severity of periodontal disease of the Rohingya refugees and host community in Bangladesh. An unpublished pilot was conducted for the sample size calculation. Two-stage cluster sampling method was used to select 50 participants from refugee camps and 50 from the host community. Structured questionnaire and periodontal examination were completed. Composite measures of periodontal disease were based on the World Workshop (WW) and Centers for Disease Control and Prevention-American Academy of Periodontology. Linear regression models, for clinical attachment level and periodontal pocket depth (PPD) and ordered logistic regression models, for composite measures, were fitted to test the association of periodontal measures and refugee status. Compared to the host community, a smaller percentage of refugees reported good oral health-related behaviours. Refugees exhibited lower levels of bleeding on probing but higher PPD, hence a higher proportion had severe stages of periodontitis. As per the WW, prevalence of periodontal disease was 88% and 100% in the host and refugee groups, respectively. In the unadjusted models, refugees were three times more likely to have severe stages of periodontitis; this association was attenuated when adjusted for confounders (sociodemographic variables and oral health-related behaviours). Prevalence of periodontitis was high both in the host community and refugees. The refugees exhibited a more severe disease profile. The oral health of both groups is under-researched impacting the response of the health system. Large-scale research systematically exploring the oral health of both groups will inform the design and delivery of community-based interventions.

Healthcare professionals’ promotion of physical activity to people living with and beyond head and neck cancer: a cross-sectional survey

PurposePhysical activity (PA) can improve health-related outcomes for head and neck cancer (HaNC) patients, and PA guidance from healthcare professionals’ can increase patients’ PA levels. However, less than 9% of HaNC patients are physically active. This study explored healthcare professionals’ promotion of PA across the National Health Service (NHS) in North West England and North Wales, to HaNC patients.MethodsA cross-sectional online survey exploring healthcare professionals’ promotion of PA in HaNC. The International Physical Activity Questionnaire–Short Form was used to estimate healthcare professionals’ PA levels. Quantitative data were analyzed using descriptive or inferential statistics and qualitative data were analyzed using reflexive thematic analysis. Data were synthesized drawing on the capability-opportunity-motivation-behavior model and theoretical domains framework.ResultsEighty-one professionals participated. Fifty-three percent self-reported high levels of PA. Seventy-five percent considered PA promotion as part of their role; however, only 39% discussed PA with their patients (reflective motivation and social/professional role and identity). Only 38% felt confident initiating PA discussions and 76% reported needing further training. Training on the benefits of PA for HaNC patients and how to encourage health-related behavior change were identified as beneficial (psychological capability and knowledge).ConclusionHealthcare professionals are influential in enabling patients to adopt health-related behavior change; however, PA promotion was not routine practice for professionals involved in the care of HaNC patients. Training should be provided to professionals on PA promotion, with a focus on behavior change techniques. Future research should explore how behavior change techniques can be implemented into clinical practice to improve health-related outcomes in HaNC.

Oral Health Status of Korean Students and Associated Fasting Plasma Glucose in Overweight/Obese Individuals

This study aimed to evaluate the current oral health status of Korean children and adolescents and investigate the correlation between fasting plasma glucose levels and oral health in individuals with overweight and obesity. A total of 121,682 participants were selected from the Survey of School Health Examination data provided by the Ministry of Education over the last 5 years to assess recent oral health status and related factors. Among them, 18,105 students with overweight or obesity who had their fasting plasma glucose levels measured were assessed for blood glucose-related analysis. Based on fasting blood glucose levels, the participants were categorized into normal, impaired fasting glucose, and diabetes groups. The associations of these groups with dental caries, oral hygiene, and periodontal diseases were investigated. There were significant associations between demographic factors, health-related behaviors, and blood glucose levels with oral health. Increased fasting blood glucose levels were associated with poor oral health. These results suggest that glycemic management is important in enhancing the oral health of overweight and obese children and adolescents.

The role of motivational interviewing in the management of obesity in adults

Introduction: The last 50 years have seen a significant global increase in the obesity rate. The prevalence of excess weight gain has doubled worldwide since 2000 and approximately one-third of the world's population is obese or overweight. Purpose: To identify the role of motivational interviewing in the management of obesity in adults. Methodology: This narrative review was based on the bibliographic search of reviews and research studies drawn from international databases. The exclusion criterion of the articles was the language other than English and Greek. Results: There is evidence for the effectiveness of family-based behavioral treatment for controlling weight and improving health outcomes. Obesity-related health risks have been documented such as metabolic syndrome. The importance of dietary prevention is also a major modifiable factor in cardiovascular disease and diabetes mellitus. One of the most prevalent health-related behavior modification models is Motivational Interviewing which is a patient-centered communication style that uses specific methods such as reflective listening, autonomy support, shared decision-making, and eliciting change talk. Conclusion: Recent studies support the use of motivational Interviewing for weight loss in primary care.

The influence of parents’ oral health literacy and behavior on oral health of preschool children aged 3–6 years- evidence from China

BackgroundDirect and indirect associations have been identified among health literacy, health behavior, and health status. Thus, we aimed to investigate the influence of oral health literacy and behaviors in parents on their children's oral health status. Moreover, we aimed to analyze the mentioned mediating effects through oral health behavior management.MethodsOral health information of 1,102 preschool children aged 3 to 6 years was collected from five primary schools in Jinjiang District, Chengdu City, Sichuan Province, China. The decay-missing-filled teeth (DMFT) index and soft scale plaque index (PI) were used by professional dentists aided by school teachers to assess caries and periodontal health among the children. Simultaneously, we conducted a questionnaire-based survey among the parents to determine their oral health literacy and health behavior and their children's oral health behavior. The probit model, instrumental variables, and mediation effect model were used to evaluate the association of parents' oral health literacy and behavior with their children's oral health status.ResultsThe DFMT index was 1.58 among the children, with zero caries in 646 (58.6%) children. The PI was 0.68, with zero gum disease in 517 (46.9%). The univariate analysis suggested that the parents' health literacy and behavior were correlated with their children's oral health status (P < 0.01). Parents' oral health behavior significantly affected their children's oral health status. Simultaneously, a stronger correlation was observed upon using parents' health literacy as an instrumental variable to assess the endogeneity, indicating endogeneity problems. Parents' health-related behaviors exerted a mediating effect on children's oral health, with parents helping children brush their teeth demonstrating the strongest effect.ConclusionParents' oral health-related behaviors can affect their children's oral health status. We recommend enhancing parents' oral health literacy to improve children's oral health status.

Communication Experiences of Conscious Indonesian Patients Who Underwent Mechanical Breathing in an Intensive Care Unit: A Phenomenological Approach

Background: Mechanical ventilation is equipment used by patients in ICU. These patients may experience stress due to inadequate communication, including psycho-emotional pressure with a tendency to depression, anxiety, and frustration. It is important to facilitate effective communication during mechanical ventilation to monitor these patients. Nursing staff need to understand patients regarding their inability to communicate. The installation of mechanical ventilation is a barrier to nurse-patient communication. The culture in which a person lives has an impact on their health-related attitudes and behaviors. Thus, this study aims to determine the experience of the communication needs of conscious patients with experience of mechanical ventilation in ICU. Methods: The research method uses qualitative research with a phenomenological approach. The population in this study were former ICU patients with experience mechanical ventilation who were conscious. The sampling of informants was carried out using a purposive method. This study involved three research informants of various ages. This research was conducted in Yogyakarta, a province of Indonesia. Data collection used in-depth interviews. Data analysis in this study used the Colaizzi method to generate themes. Results: The themes obtained in this study were experience of discomfort disturbance in mechanically ventilated conscious patients; mechanically ventilated patients' communication perceptions; the need for social interaction when mechanically ventilated; and the beliefs experienced by patients while unconscious in ICU. We found a new insight that trusting something the patient has experienced is something that needs to be respected. When patients were unconscious, all participants experienced a spiritual journey that brought them into a state of belief about the dying phase. Conclusion: Communication between patients and nurses is beneficial in providing better nursing care following patient needs. This communication is also needed for patients with mechanical ventilation in ICU. It shows the importance of communication between mechanically ventilated patients and nurses in ICU.

Health-Related Behaviors and Risk of Common Age-Related Brain Diseases Across Severities of Genetic Risk.

The 21-point Brain Care Score (BCS) is an index that ranks behaviors and clinical measurements with the aim of encouraging lifestyle adjustments to lower the incidence of age-related brain disease, including stroke, late-life depression (LLD), and dementia. A higher BCS at baseline is associated with a lower risk of these outcomes. We aimed to investigate whether the associations between BCS and stroke, LLD, and dementia risks are independent of genetic predisposition for these conditions and quantify the effect of healthy lifestyle across genetic risk distributions for these outcomes. Using the UK Biobank (UKB) prospective cohort study, we computed baseline BCSs and polygenic scores to estimate genetic predisposition for stroke and LLD and APOE ε allele status to stratify dementia risk. As for outcomes again in UKB, we measured incidence of stroke, LLD, and dementia. We used multivariate Cox proportional hazard models to assess associations between BCS, genetic predisposition, and these outcomes. We also conducted stratified and interaction analyses to estimate the incidence of these outcomes across quartiles of genetic risk and BCS. We included 368,340 UKB participants (median age 58 years (interquartile range 51-63 years), 46.3% male). Independent of genetic risk, a 5-point increase in BCS corresponded to lowered hazards of stroke (hazard ratio [HR] 0.70, 95% CI 0.68-0.73), LLD (HR 0.65, 95% CI 0.63-0.67), and dementia (HR 0.82, 95% CI 0.78-0.85). Incidences of all 3 outcomes were higher among participants with high genetic risk of these outcomes. However, these increased risks were offset for individuals with a higher BCS (incidence rates per 1,000 person-years were 2.76 vs 1.19 for stroke, 7.34 vs 4.46 for LLD, and 3.64 vs 2.05 for dementia, when comparing low and high BCS). Across different genetic predispositions for stroke, LLD, and dementia, healthier lifestyle behaviors are protective for brain health, demonstrating the nondeterminism of genetic risk. Furthermore, differences in BCS behave as aggregate risk estimators of all 3 outcomes. Further work is needed to prospectively investigate the utility and performance of the BCS as a targeted intervention in populations at elevated genetic risk of age-related brain disease.

Association between oral health-related behaviors and quality of life of adolescents among three provinces in Northwest China

ObjectiveTo assess the oral health-related quality of life (OHRQoL) of adolescents in Northwest China, and to explore the relationship between sociodemographic characteristics, oral health-related behaviors and OHRQoL.MethodsA cross-sectional survey of adolescents aged 12–15 years in Shaanxi, Gansu province and Ningxia Hui Autonomous Region of Northwest China was conducted by stratified cluster random sampling. Oral examinations were performed with World Health Organization (WHO) standards, and the condition of crowns and periodontal was recorded. Adolescents' oral health-related behaviors and OHRQoL were collected by questionnaire. Chi-square test and binary logistic regression analysis were used to examine the relationship.ResultsA total of 7,648 subjects were included. The prevalence of low OHRQoL which defined as a score higher than 0, was 83.8%. A low OHRQoL was most prevalent in Gansu Province and least prevalent in Shaanxi Province. Younger (OR = 0.73, CI = 0.60–0.87), female (OR = 1.27, CI = 1.11–1.44), rural (OR = 1.44, CI = 1.21–1.72), and mother with less education (OR = 0.69, CI = 0.60–0.81) all showed statistically significant influence on teenagers' OHRQoL. From a behavior perspective, teens' OHRQoL was correlated with their frequency of sugar consumption (OR = 1.72, CI = 1.41–2.10), dental appointment rate (OR = 1.29, CI = 1.064–1.57), self-assessment of oral health (OR = 3.09, CI = 2.29–4.19), DMFT index (OR = 1.19, CI = 1.04–1.37), number of teeth calculus (OR = 1.20, CI = 1.01–1.43), and dental trauma (OR = 0.47, CI = 0.39–0.57) over the previous year; however, brushing their teeth was not statistically significant.ConclusionsGenerally speaking, oral health-related behaviors—such as eating more sugary foods and scheduling dental appointments within the last year—have a significant negative impact on the quality of life of adolescents in Northwest China. Female, and adolescents from families with low educational backgrounds are more likely to be affected by such behaviors in their daily lives.

Dental Caries and Extrinsic Black Tooth Stain in Children With Primary, Mixed and Permanent Dentitions: A Cross-Sectional Study.

Dental caries and extrinsic black tooth stain (EBS) are prevalent among children, with current evidence suggesting a negative correlation between them. It is unclear whether the factors contributing to developing or preventing dental caries and EBS are connected or aligned. To investigate the prevalence and associated factors of caries and EBS among children with primary, mixed and permanent dentitions. This was designed as a cross-sectional study. Probability proportionate to size sampling and simple random sampling methods were used to recruit children aged 5, 9 and 12. Three calibrated paediatric dentists conducted intra-oral examinations. Nutritional supplements, oral health-related behaviours and family background were collected. Bivariate analysis, negative binomial and binary logistic regression were performed. Caries and EBS prevalence were 83.7% and 4.7%, respectively. A decreasing trend in caries and an increasing trend in EBS prevalence were observed across three dentitions. Caries were associated with EBS, oral hygiene, vitamin intake, gender, food-pocketing habits, toothbrushing duration, dental attendance and socioeconomic status. EBS was more likely to occur in caries-free children (OR = 4.42, 95% CI 2.97,6.58, p < 0.001) and children without vitamin consumption (OR = 1.59, 95% CI 1.07, 2.36, p = 0.021). The occurrence of caries and EBS varied across different dentition stages. Their risk and protective factors were not significantly aligned.

Assessing the impact of COVID-19 on outpatient psychiatric population well-being and symptomology utilizing COVID-19 Events Checklist (CEC) and Measurement Based Care

BackgroundThis study examines the impact of SARS-CoV-2 (i.e., coronavirus, COVID, COVID-19) using data from a measurement-based care (MBC) system utilized in an outpatient psychiatric clinic providing telemedicine care. A novel Patient Rated Outcome Measure (PROM), the COVID-19 Events Checklist (CEC) was administered in a hospital system based ambulatory clinic beginning April 2020 to track COVID-19-19’s impact on patients’ mental, emotional, and health-related behaviors during the pandemic. The study (1) provides descriptive CEC data, and (2) compares CEC results with PROMs evaluating anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire; PHQ-9), and psychological distress (Brief Adjustment Scale-6; BASE-6).MethodsThis retrospective observational study included patient intake data collected from April 2020 to March 2021. Patient (N = 842) reports on the CEC’s five domain questions were aggregated to calculate average reports of COVID-19 related impacts at intake over the initial 12 months of the pandemic. Trends in COVID-19 related impacts were examined, and non-aggregated scores on the PHQ-9, GAD-7, and BASE-6 were compared to primary dichotomous (yes/no) CEC survey questions via Wilcoxon rand sum testing.ResultsResults capture the relationship between COVID-19 exposure, COVID-19- related sequelae and behaviors, and psychological symptom severity. Specifically, Wilcoxon rank-sum tests indicate that social determinants of health (SDOH), negative mental health impacts, and positive coping skill use were significantly associated with psychological symptomatology including overall psychological functioning via the BASE-6, anxiety via the GAD-7, and depressive symptoms via the PHQ-9. Results regarding SDOH were as follows: BASE-6 (w = 44,005, p < 0.001), GAD-7 (w = 44,116, p < 0.001), and PHQ-9 (w = 43,299, p < 0.001). Regarding negative mental health outcomes, the results were: BASE-6 (w = 38,374, p < 0.001), GAD-7 (w = 39,511, p < 0.001), and PHQ-9 (w = 40,154, p < 0.001). As the initial year of the pandemic elapsed, incoming patients demonstrated increased rates of suspected or confirmed exposure to COVID-19, (+2.29%, t = 3.19, p = 0.01), reported fewer negative impacts of COVID-19 on SDOH (−3.53%, t= −2.45, p = 0.034), and less engagement in positive coping strategies (−1.47%, t = −3.14, p = 0.010).ConclusionsPsychosocial factors related to COVID-19 are discussed, as well as opportunities for further research on the relationship between psychological symptomatology and the impact of COVID-19 on health-related behaviors.

The prevalence and changes of alcohol consumption across three trimesters of pregnancy assessed by ethyl glucuronide concentration in maternal hair and self-reports: a cross-sectional study.

The teratogenic effect of alcohol is well known, but its prevalence is usually underestimated. This study presents the findings of a cross-sectional study conducted in Poland, which aimed to assess the prevalence and changes in alcohol consumption during pregnancy. The study utilized ethyl glucuronide concentration in maternal hair and self-reports as measures to evaluate alcohol intake across the three trimesters of pregnancy. The study involved postpartum women (n=150) and their babies. Hair samples from 135 participants allowed segmental analysis (separately for the three trimesters) and hair from 15 were analysed for the entire 9 moths by gas chromatography tandem mass spectrometry. Survey data included self-reports of health related behaviours and socio-demographic characteristics; medical records - information on the course of a pregnancy and newborns health. Standard medical interview revealed no cases of alcohol use during pregnancy. The analysis of EtG indicated 50.3% women had been drinking alcohol at any time during pregnancy, including 10% with excessive alcohol consumption. Most participants maintained the same level of alcohol consumption throughout the pregnancy but 8.7% women decreased and 20.7% increased the amount of alcohol consumed between 1st and 2nd or 2nd and 3rd trimester. Gestational consumption of alcohol was not related to sociodemographic characteristics, course of pregnancy and self-reported health behaviours but babies of women who drunk alcohol during pregnancy were more often small for gestation age than babies of abstainers (OR=6.008), with the highest risk observed in case of increased alcohol consumption (OR=12,348). Maternal hair analysis is useful in detecting pregnancy alcohol use and allows retrospective analysis over a longer period than other biological samples, providing a more comprehensive pattern of use throughout pregnancy. However, there is a need to improve routine methods of interviewing patients about alcohol use and to implement effective preventive strategies regarding alcohol consumption during pregnancy in Poland.

Which behavioral regulations predict physical activity and sedentary behavior in people with mental illness?

Moderate-to-vigorous physical activity (MVPA) is beneficial for health, and reducing sedentary behavior (SB) is recommended in international guidelines. People with mental illnesses are at higher risk of preventable diseases than the general population, partly attributable to lower MVPA and higher SB. Self-determination theory provides a framework for understanding how motivation regulates behavior. This study aimed to evaluate the contribution of different forms of motivation for physical activity (amotivation, controlled, autonomous) to MVPA and SB in people with mental illnesses. Cross-sectional self-reported and accelerometer-derived MVPA and SB in people with a range of mental illnesses across four countries were pooled for analysis (Australia, Belgium, England, Uganda). Motivation for physical activity was measured using the Behavioural Regulation in Exercise Questionnaire (BREQ). Regression analyses were used to investigate the association of MVPA and SB with amotivation, controlled, autonomous motivations, controlling for mental health and demographic variables. Autonomous motivation was associated with 31% higher self-reported MVPA, and amotivation and controlled motivation were associated with 18% and 11% lower self-reported MVPA, respectively (n = 654). In contrast, controlled motivation was positively associated with SB (n = 189). Having physical comorbidities or an alcohol use disorder was associated with lower MVPA (n = 318). Sub-analyses with accelerometer-derived MVPA and SB (n = 139 and n = 145) did not reveal any associations with motivational forms. Findings with an international sample support the universal relevance of motivation in promoting health-related behavior. Strategies for facilitating autonomous motivation should be utilized by health professionals seeking to support people with mental illnesses to become physically active.

Clustering of diet and physical activity behaviours in adolescents across home and school area-level deprivation in Cameroon, South Africa, and Jamaica

BackgroundAdolescence is a crucial period for establishing healthy behaviours that can reduce the risk of noncommunicable diseases. However, limited data exist on the clustering of health-related behaviours, in adolescents from low- and middle-income countries (LMICs). This study examined how diet and physical activity behaviours cluster and how they are influenced by home and school area-level deprivation.MethodsThe study surveyed 527 adolescents in Yaoundé (Cameroon), Kingston (Jamaica), and Cape Town (South Africa) and grouped them into three categories according to the socioeconomic status (SES) of their homes and school areas (low-low, low-high, and high-high). A k-median algorithm defined three clusters and measured dietary attributes including Dietary Habit Score (DHS), Healthy Food Score (HFS), Nutritional Knowledge Questionnaire (NKQ), moderate-to-vigorous physical activity (MVPA), and sedentary time using validated questionnaires. The clusters were ranked based on their physical activity levels and compared them within each city using statistical tests.ResultsThe scores on the NKQ and HFS indicated a poor level of both nutritional knowledge and healthy food consumption across sites. Cluster analysis revealed a consistent pattern of high screen time clustering with lower (less healthy) dietary scores across sites. This pattern was consistent regardless of SES in Kingston, and SES and school socioeconomic areas in Cape Town and Yaoundé.ConclusionAn inverse clustering of sedentary behaviour duration and eating habits remained consistent across different strata for at least two sites, suggesting that interventions to reduce sedentary time could have a ripple effect on multiple NCD risk factors in adolescence.

Impact of modifiable healthy lifestyles on mortality in Chinese older adults

In China, unhealthy lifestyles, including smoking, alcohol consumption, a lack of exercise, and irrational diets, are relatively common among the elderly population. The objective of this study was to examine the specific associations between poor health-related behaviours and all-cause and cause-specific mortality in older adults. This study involved 5,015 subjects ≥ 60 years of age from the CHARLS database over a 10-year follow-up period. The average age was (67.96 ± 6.39) years. We examined whether lifestyle groups, based on adherence to non-smoking, no-alcohol, moderate exercise, and 18.5 kg/m2 ≤ BMI< 24 kg/m2, were linked with subsequent mortality. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence intervals for all-cause and cause-specific mortality of maintaining a healthy lifestyle. In multivariate adjustment model, the risk of all-cause mortality was reduced by 59.2% [HR 0.408 (95% CI 0.333, 0.499)] in the moderate group compared with the unfavorable group. In addition, the risk of all-cause mortality was reduced to 80.5% [HR 0.195 (95% CI 0.150, 0.253)] in the favorable group. The risks of cardiovascular and cerebrovascular diseases, chronic respiratory disease, cancers, and diabetes increased with similar dose-response patterns. The combination of all four healthy lifestyles provided the greatest protection, reducing mortality by 84.5%. In the elderly population, adherence to a healthy lifestyle is associated with a significant reduction in the risk of all-cause and cause-specific mortality.

Pre-diagnosis blood DNA methylation profiling of twin pairs discordant for breast cancer points to the importance of environmental risk factors

BackgroundAssessment of breast cancer (BC) risk generally relies on mammography, family history, reproductive history, and genotyping of major mutations. However, assessing the impact of environmental factors, such as lifestyle, health-related behavior, or external exposures, is still challenging. DNA methylation (DNAm), capturing both genetic and environmental effects, presents a promising opportunity. Previous studies have identified associations and predicted the risk of BC using DNAm in blood; however, these studies did not distinguish between genetic and environmental contributions to these DNAm sites. In this study, associations between DNAm and BC are assessed using paired twin models, which control for shared genetic and environmental effects, allowing testing for associations between DNAm and non-shared environmental exposures and behavior.ResultsPre-diagnosis blood samples of 32 monozygotic (MZ) and 76 dizygotic (DZ) female twin pairs discordant for BC were collected at the mean age of 56.0 years, with the mean age at diagnosis 66.8 years and censoring 75.2 years. We identified 212 CpGs (p < 6.4*10–8) and 15 DMRs associated with BC risk across all pairs using paired Cox proportional hazard models. All but one of the BC risks associated with CpGs were hypomethylated, and 198/212 CpGs had their DNAm associated with BC risk independent of genetic effects. According to previous literature, at least five of the top CpGs were related to estrogen signaling. Following a comprehensive two-sample Mendelian randomization analysis, we found evidence supporting a dual causal impact of DNAm at cg20145695 (gene body of NXN, rs480351) with increased risk for estrogen receptor positive BC and decreased risk for estrogen receptor negative BC.ConclusionWhile causal effects of DNAm on BC risk are rare, most of the identified CpGs associated with the risk of BC appear to be independent of genetic effects. This suggests that DNAm could serve as a valuable biomarker for environmental risk factors for BC, and may offer potential benefits as a complementary tool to current risk assessment procedures.

Balancing Knowledge and Health: A Comparative Analysis of Students and Healthcare Workers Nutrition Related Health Behaviors, a Cross-Sectional Study.

The study aimed to investigate nutrition-related health behaviors among nursing and medical students compared to healthcare workers (HCWs), including nurses and physicians. A cross-sectional survey was conducted between May and November 2022, using the I-MEDAS and lifestyle-related behavior questionnaires. The participants included nursing and medical students, nurses, and physicians, with a total of 384 participants: 16.9% physicians, 23.17% nurses, and 59.9% students, 93% of whom were nursing students. The average I-MEDAS score (out of 17) was 7 for physicians, 8 for nurses, and 8 for students, with no significant differences in lifestyle behavior scores between the groups (p = 0.11), although nurses tended to score lower. Nurses also had a significantly higher BMI compared to physicians and students (p < 0.001). Physicians and nurses reported lower engagement in leisure activities and household chores, fewer sleep hours, and poorer sleep quality. The findings highlight a decline in healthy lifestyle behaviors and poor adherence to the Mediterranean diet among HCWs and students, particularly nurses, emphasizing the need for interventions to promote healthier habits in these groups.

Family formation and health-related behavior: The case of meal skipping

Using four rounds of nationally representative U.S. panel survey data (NLSY97) and fixed-effects models, this study examines whether and how transitions to marriage/cohabitation/parenthood are associated with gender-specific changes in meal-skipping patterns. Two theoretical perspectives, social control and time scarcity, provide different explanations of how family formation relates to meal skipping. However, empirical research examining the association using a nationally representative sample is scarce. Results indicate that the transitions to romantic relationships (either marriage or cohabitation) are associated with less frequent meal skipping, consistent with social control theory, but in ways that differ by gender. The transition to marriage is associated with reduced meal skipping only for men, whereas the transition to cohabitation is associated with reduced meal skipping to some extent for women. The transition to parenthood has distinctive consequences for women’s meal patterns. Specifically, having two or more children at home is associated with increased meal skipping only for women, which can be explained by the time scarcity perspective. This study reveals that the consequences of family formation on health-related behaviors are gender specific and not universally positive, highlighting women’s persistent role as the primary caregiver for the family.

Personalized interventions for behaviour change: A scoping review of just-in-time adaptive interventions.

Examine the development, implementation and evaluation of just-in-time adaptive interventions (JITAIs) in behaviour change and evaluate the quality of intervention reporting. A scoping review of JITAIs incorporating mobile health (mHealth) technologies to improve health-related behaviours in adults. We searched MEDLINE, Embase and PsycINFO using terms related to JITAIs, mHealth, behaviour change and intervention methodology. Narrative analysis assessed theoretical foundations, real-time data capturing and processing methods, outcome evaluation and summarized JITAI efficacy. Quality of intervention reporting was assessed using the template for intervention description and replication (TIDieR) checklist. Sixty-two JITAIs across physical activity, sedentary behaviour, dietary behaviour, substance use, sexual behaviour, fluid intake, treatment adherence, social skills, gambling behaviour and self-management skills were included. The majority (71%) aimed to evaluate feasibility, acceptability and/or usability. Supporting evidence for JITAI development was identified in 46 studies, with 67% applying this to develop tailored intervention content. Over half (55%) relied solely on self-reported data for tailoring, and 13 studies used only passive monitoring data. While data processing methods were commonly reported, 44% did not specify their techniques. 89% of JITAI designs achieved full marks on the TIDieR checklist and provided sufficient details on JITAI components. Overall, JITAIs proved to be feasible, acceptable and user-friendly across behaviours and settings. Randomized trials showed tailored interventions were efficacious, though outcomes varied by behaviour. JITAIs offer a promising approach to developing personalized interventions, with their potential effects continuously growing. The recommended checklist emphasizes the importance of reporting transparency in establishing robust intervention designs.