Behavioral Risk Factor Research Articles

Anhedonia Links Sleep Problems and Suicidal Thoughts: An Intensive Longitudinal Study in High-Risk Adolescents.

Growing research indicates that sleep problems are a robust independent risk factor for suicidal thoughts and behaviors among youth. However, relatively little is known about how this risk is conferred. This study used an intensive longitudinal design to investigate anhedonia as a mechanism linking sleep problems and next-day suicidal thoughts in a clinically high-risk sample of adolescents. Adolescents (N = 48; Mage=14.96; 77.1% white, 64.6% female) completed an ecological momentary assessment (EMA) study design for 28 days following discharge from acute psychiatric care for suicide risk. Daily sleep diaries were used to assess prior night total sleep time and sleep onset latency. Ecological momentary assessment was used to assess anhedonia and suicidal thoughts up to six times per day. A series of multi-level structural equation models were used to examine facets of anhedonia as parallel mediators of the association between sleep problems and next-day suicidal thoughts. Significant direct effects were found between sleep problems and consummatory anhedonia, consummatory anhedonia and suicidal thoughts, and anticipatory anhedonia and suicidal thoughts. There were significant indirect (mediated) effects between sleep problems and next-day suicidal thoughts through consummatory anhedonia, but not anticipatory anhedonia. Findings provide initial evidence as to how sleep problems may confer risk for next-day suicidal thoughts- by increasing consummatory anhedonia. Future research is needed to replicate these findings in larger samples and investigate how modifying anhedonia may mitigate suicide risk in youth.

Chronic Joint Pain Disparities for U.S. Transgender Adults: Behavioral Risk Factor Surveillance System, 2020.

Purpose: Several studies have found that sexual minority individuals are at greater risk for chronic pain. However, these studies did not ask about gender identity, and research on chronic pain in transgender populations remains scarce. This present study examined the relationship between transgender status and chronic joint pain disorders among U.S. adults. Methods: Data were obtained from the 2020 Behavioral Risk Factor Surveillance System. We compared odds of chronic joint pain disorders by transgender status (n transgender = 967, cisgender = 217,943, don't know/not sure = 648, refused = 2072) using logistic regression adjusting for age. Results: After adjusting for age, transgender respondents reported greater odds of chronic joint pain disorders (adjusted odds ratio [AOR] = 1.24, 95% confidence interval [CI] = 1.05-1.48), compared with cisgender respondents. Odds for chronic joint pain disorders were lower for the "refused" group (AOR = 0.84, 95% CI = 0.76-0.93) and for those who answered "don't know/not sure" (AOR = 0.73, 95% CI = 0.61-0.88). Conclusion: Consistent with preliminary evidence and with the minority stress model, transgender respondents were at increased odds of chronic joint pain disorders when adjusting for age.

Social prescribing initiatives connecting general practice patients with community-based physical activity: A scoping review with expert interviews.

The World Health Organization states that physical inactivity is one of the leading behavioural risk factors for disability and mortality in Europe. Social prescribing holds promise as a possible solution by connecting patients from general practice to community-based physical activity. Although research within social prescribing exists, the process of connecting general practice patients to community-based physical activity is not well investigated. This scoping review aimed to summarise and synthesise knowledge on social prescribing provided by health professionals in general practice towards community-based physical activity. A systematic search for literature in PubMed, Embase, Scopus, SportsDiscus and other sources was conducted to identify initiatives connecting general practice to community-based physical activity. Semi-structured interviews were then conducted with subject-specific national experts. Finally, preliminary findings from the literature and the interviews were used in a co-creation process with experts to synthesise and finalise the results of a thematic analysis across data sources. Based on 19 records, five expert interviews and subsequent co-creation, we identified three themes: (a) barriers and facilitators, (b) organisational perspectives and (c) value-based considerations. This review illuminates the complex nature of social prescribing programmes that connect general practice patients to community-based physical activity in Denmark. It also presents practical and fundamental considerations when applying social prescribing across different settings.

Adherence to Physical Activity Recommendations Among Stroke Survivors in the United States.

Physical activity is an effective modifiable behavior for preventing recurrent strokes. This study aims to determine the adherence to physical activity recommendations among stroke survivors in the United States. We further compared our findings with the adherence observed among myocardial infarction (MI) survivors and healthy adults, each assessed against distinct physical activity guidelines specific to their respective populations. We utilized data from the 2011 to 2019 Behavioral Risk Factor Surveillance System, a nationally representative survey. To establish benchmarks for stroke survivors, we referenced 3 different physical activity recommendations outlined in 2011, 2014, and 2021 American Heart Association stroke prevention guidelines. Similarly, for MI survivors and healthy adults, we used the 2011 guidelines for secondary prevention of coronary vascular diseases and the 2020 World Health Organization physical activity guidelines, respectively. Adherence to recommendations was determined by the respondents' self-reported intensity, duration, and frequency of physical activity. Multivariate logistic regression compared adherence in stroke survivors, MI survivors, and healthy adults. Among 48 222 stroke survivors in the United States, the overall adherence rates to 2011, 2014, and 2021 physical activity guidelines were 75.4%, 40.2%, and 69.2%. For independently mobile stroke survivors, the adherence rates increased to 78.1%, 42.1%, and 69.9%. Among MI survivors and healthy adults, the adherence rates were 42.7% and 72%. When 2021 recommendations were used as a benchmark, older (aged ≥65 years) stroke survivors were more likely to adhere to recommendations than younger survivors (71.9% versus 62.3%; P<0.0001). After adjusting for sociodemographic factors and comorbidities, non-Hispanic Black survivors were less likely to adhere to recommendations (adjusted odds ratio, 0.81 [95% CI, 0.7-0.94]), whereas older and higher educated stroke survivors were more likely to adhere to recommendations. Geographically, stroke belt and nonrural residents were less likely to adhere to recommendations ([63.5% versus 67.9%; P<0.0001]; [53.8% versus 58.7%; P<0.0001]). Stroke and MI survivors were less likely to adhere to the latest recommendations than healthy adults (adjusted odds ratio, 0.74 [95% CI, 0.69-0.8]; (adjusted odds ratio, 0.24 [95% CI, 0.22-0.26]). A substantial number of stroke survivors do not meet physical activity recommendations. Tailored interventions should be designed for at-risk populations, for example, non-Hispanic Black survivors and lower educated stroke survivors.

Awareness, perception and behavioral determinants associated with cancer prevention among adults: Results from a cross-sectional study in urban field practice area of a tertiary care hospital, Kolkata

Background: Cancer is emerging as a major public health problem. Two-thirds of cancer patients are in the advanced stage at the time of diagnosis. Public awareness plays a big role in cancer prevention. Aims and Objectives: To assess awareness, perception, and behavioral determinants of cancer prevention of urban adults. Materials and Methods: An observational, cross-sectional study was conducted in the urban slum of Kolkata. Four hundred fifteen respondents were interviewed using a pre-tested questionnaire after having consent. Results: Though majority (72.3%) of respondents had satisfactory awareness but had limited awareness on screening tests (58.6%) and vaccination (1.6%). Half of them had a favorable perception on cancer prevention but the perceived barrier was more. The behavior score was poor among the majority of participants. The main source of information was T.V. (88.2%) and friends and relatives (80.2%). Only one-fourth of participants mentioned of health workers and health camps as sources of information indicating inadequate activities on cancer awareness programs. Age (OR 7.08, 95% CI=1.07–46.74), sex (OR 0.38, 95% CI=0.19–0.76) education (OR 4.81, 95% CI=2.50–9.27) were significant predictors of satisfactory awareness. Higher levels of education, younger age, and female gender were factors that shaped perception. Only education level (OR 0.29, 95% CI=0.15–0.59) had a significant association with cancer preventive behavior. Conclusions: Though awareness on primary preventive measures was satisfactory but behavior was unsatisfactory among study participants. They had more perceived barriers while taking preventive measures. The finding indicates a need to promote health education and motivate people to recognize and modify cancer-related behavioral risk factors.

Status in using wearable devices as surveillance tools in public health research among people with disabilities: preliminary analysis of 2017 BRFSS

Purpose: The study aims to examine the association between disability status and willingness to share wearable devices and mobile apps data for public health research using the 2017 Behavioral risk Factor Surveillance System (BRFSS) through secondary data analysis. Materials and Methods: Current wearable device and mobile apps users at the time of the 2017 BRFSS survey administration from eight states were included in the analysis. Descriptive, chi-square analysis, and multivariable logistic regressions were performed to examine the associations. Subsample analyses were also conducted for individuals with disabilities and different types of disability, including visual impairments, hearing impairments, cognitive disability, independent living disability, self-care disability, and mobility disability on their willingness to share wearable device and mobile app data. Results: Among the 1575 wearable device and mobile app users, 17.8% (95% CI [14.6, 22.0]) were participants with disabilities. Less than half of the participants (43.8%, 95% CI [38.0, 50.0]) were willing to share their data for public health research with no significant differences between those with and without disabilities or among specific disability types. Conclusion: The findings underscore a general reluctance to share information for public health research. To address this reluctance, it is crucial to enhance public awareness of the potential benefits and educate users on how sharing data could contribute to understanding health behaviors and identifying public health needs.

Exploring disparities in post-cancer treatment instructions: an analysis of rural vs. urban breast cancer survivors in Missouri using BRFSS data

BackgroundThere are more than 4 million breast cancer survivors in the United States. With continuing improvements in early detection and treatment, the number of breast cancer survivors will only continue to increase. Breast cancer survivors face a lifetime risk of long-term or late-effects from cancer treatments, thus post-cancer treatment care, referred to as survivorship care, is critical. Social determinants of health, including where a breast cancer survivor lives, may impact cancer survivorship care. Our purpose was to evaluate the relationship between rural/urban status and receipt of cancer survivorship care and instructions for Missouri breast cancer survivors using state-level data from a nationwide telephone survey—the Behavioral Risk Factor Surveillance System (BRFSS).MethodsMissouri included the BRFSS Cancer Survivorship Module in 2014, 2016, 2018, and 2020. Module items ask cancer survivors about receipt of a “post-cancer-treatment summary” and “follow-up instructions.” We hypothesized chances of receipt of both components would differ among four level Rural–Urban Commuting Area (RUCA) Code groups (Rural, Small-Town, Micropolitan, Metropolitan). Data from 430 breast cancer survivors over four survey years were combined and grouped according to RUCA status. Using a logistic model with a multilevel approach (after sampling weights calibration), the relationship between receipt of survivorship instructions and RUCA group was examined.Results46% of Missouri breast cancer survivors reported receipt of complete survivorship instructions. Compared to rural breast cancer survivors, micropolitan breast cancer survivors had 5.9 times higher odds of receiving survivorship instructions (p < 0.0001).ConclusionsLess than half of respondents reported receiving complete post-cancer treatment instructions. More urban respondents were more likely to receive instructions than their rural counterparts which raises questions about the quality of post-treatment care between rural and urban survivors. A sophisticated and purposeful approach to mitigating potential disparities is warranted. Receipt of cancer survivorship care plans may be impacted by rurality/urbanicity. Clinicians caring for cancer survivors living in rural or urban settings must continue to be diligent with providing personalized survivorship care.

Exploring sociodemographic moderators of the association between sleep duration and self-rated health.

This study examined the association of sleep duration with self-rated health (SRH) and if age, sex, and race/ethnicity modifies this association. This was a cross-sectional analysis of 396,455 adults who were aged ≥ 18years in the 2020 Behavioral Risk Factor Surveillance System. Sleep duration was categorized into three: short (< 7h), normal (7-9h; reference), and long (> 9h). SRH was dichotomized into suboptimal (fair/poor; reference) and optimal (excellent/very good/good). Logistic regression models were employed to investigate the association and assess interactions of age, sex, and race/ethnicity with sleep duration. Short (adjusted odds ratio: 0.70 [95% confidence interval 0.66-0.74]) and long (0.65 [0.58-0.73]) sleep duration was associated with decreased odds of optimal SRH. There was a significant interaction between age and sleep duration (p = 0.029). The association between short sleep duration and SRH was strongest in the youngest age (18-24; 0.59 [0.47-0.74]), while 35-44 (0.57 [0.39-0.82] had the strongest association for long sleep duration with SRH. No significant interactions were found for sex (p = 0.314) or race/ethnicity (p = 0.930). Short and long sleep duration are associated with decreased odds of optimal SRH among US adults. Prioritizing sleep hygiene across all ages may improve SRH.

Long COVID and financial hardship: A disaggregated analysis at income and education levels.

To examine how long COVID is associated with financial hardship (food insecurity, inability to pay bills, or threat of losing service) across income and education levels, and to assess the role of employment loss or reduced work hours in this hardship. We used nationally representative data on 271,076 adults from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). We used multivariable binomial logistic regression models to estimate the average marginal effect of long COVID on financial hardships across multiple income and education groups. In general, we found a significant positive association between long COVID and the three measures of financial hardships across income and education groups (1-11 percentage points increase, 95% CI 0.00-0.02 and 0.07-0.14, respectively). Mediation analysis showed that lost or reduced hours of employment accounted for a significant portion (6%-20%) of the changes in financial distress. Long COVID has affected the economic wellbeing of people from all socioeconomic statuses, although at a higher rate for lower income groups. Policy attention is needed to address its economic impacts across income and education levels.

“Prevalence And Risk Factors Of Cardiovascular Diseases Among Adults Of Selected Rural Community At Siliguri, West Bengal.”

Background: Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions. More than four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely. Since there are not many studies on these rural communities to identify the prevalence rate and associated risk factors, so the investigators have selected this study for proper risk identification, assessing the prevalence rate and educating and motivating adults on appropriate screening, prevention, and treatment. Materials and Methods: A descriptive cross sectional study was conducted in a rural community in West Bengal, India. Total 100 numbers of adults were selected for the study. The prevalence rate and risk factors of cardiovascular diseases were assessed using the structured interview schedule and physical measurements. Results: The result reveals that regarding behavioural risk factors of Cardiovascular diseases, among the 100 participants, 60(60%) consume Tobacco products and 81 (81%) consume Alcohol, Adequate consumption of Fruits and vegetables is only 10(10%) i.e. more than 5 times in a week, 19(19%) perform sufficient physical activity/exercise i.e more than 150 minutes/week. Regarding physical assessments, the overweight was 19(19%) and obesity was 9(9%), the abdominal obesity in males was 31(31%), and in females was 35 (35%). The prevalence rate of Hypertension was 23(23%), Stroke was 2(2%), Coronary Heart Disease was 7(7%), High blood cholesterol was 2(2%), and Diabetes Mellitus was 11(11%). Conclusion: The study demonstrated the high burden of fatal CVDs and identified the impact of CVDs risk factors such as hypertension, self-reported diabetes, high cholesterol, smoking, alcohol, and abdominal obesity. The significant incidence of CVDs risk factors in the rural communities, particularly among those who are overweight or obese, necessitates early clinical identification, referral and appropriate management of clients in primary health care settings

Intersectional trends in poor mental health and health inequities across the US

Though mental distress poses a large and growing threat to population health, our understanding of how its social distribution has changed over time and what these changes imply for mental health equity is limited. To address this, we use data from the Behavioral Risk Factor Surveillance System to non-parametrically describe how age-standardized prevalence of frequent mental distress (FMD) and social inequities in FMD have changed in the United States between 1993 and 2019 for intersectional social groups defined by ethnicity, race, sex, educational attainment, and household poverty status. We find that age-standardized FMD prevalence has increased for almost all social groups, that health inequities between more and less privileged groups have mostly widened in absolute terms but narrowed relatively, and that relying solely on common group FMD summaries masks substantial heterogeneity across intersectional subgroups. Our findings show an urgent need to address the sociopolitical determinants of mental distress, prioritizing policies which would address the growing inequitable burden experienced by those less privileged.

Feature importance and model performance for prediabetes prediction: A comparative study

ObjectivesPrediabetes is a significant health condition that elevates the risk of developing type 2 diabetes and other associated complications. This study aims to (1) explore the potential of machine learning models to improve the prediction of prediabetes, (2) compare the performance of various machine learning models with traditional regression methods, and (3) identify the most influential demographic, socioeconomic, and health-related factors associated with prediabetes. MethodsThis study utilized data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) and employed comprehensive data preprocessing techniques. Logistic regression analysis was conducted to assess correlations between features and prediabetes risk. Feature importance was quantified using Adjusted Mutual Information values. Multiple machine learning models, including Random Forest, K Nearest Neighbors (KNN), Extreme Gradient Boosting (XGBoost), Neural Network, and Logistic Regression, were used for prediction. The best model was selected and validated through cross-validation to ensure robustness. ResultsSignificant associations were observed between prediabetes and key predictors such as cholesterol levels, BMI categories, hypertension status, age groups, and income categories. Among the models tested, Random Forest demonstrated the highest accuracy and robustness, outperforming traditional regression models. ConclusionsThis study highlights the potential of machine learning to enhance prediabetes prediction and underscores the importance of identifying high-risk individuals for early intervention. The findings contribute to population health strategies by integrating advanced analytical methods with public health data.

Drug Use among a Moroccan Sample of College Students

Introduction: the pressures that college students face and the sensitivity of their age put them at a significant risk of developing drug use-related problems. Objective: this study aims to evaluate some of the associated factors with drug use behavior among a sample of Moroccan college students. Method: the study included 1147 students (703 females and 444 males) with a mean age of 20 (SD = 2.6) who completed a sociodemographic questionnaire and the Arabic version of the Drug Use Disorders Identification Test (DUDIT). Results: the results demonstrated that it identifies gender, alcohol consumption, smoking, gambling, and medication for depression, anxiety, and sleep problems as potential risk factors of drug use behavior. Discussion and conclusions: more research is required on college students' drug use, and intervention strategies must be developed.

Life satisfaction and risk of dementia over 18years: an analysis of the National Alzheimer's Coordinating Center dataset.

Life satisfaction predicts lower risk of adverse health outcomes, including morbidity and mortality. Research on life satisfaction and risk of dementia has been limited by a lack of comprehensive clinical assessments of dementia. This study builds on previous research examining life satisfaction and clinically ascertained cognitive impairment and dementia. Participants (N = 23070; Meanage = 71.83, SD = 8.80) from the National Alzheimer's Coordinating Center reported their satisfaction with life at baseline. Incident dementia was ascertained through clinical assessment over up to 18years. Life satisfaction was associated with about 72% lower risk of all-cause of dementia, an association that remained significant accounting for demographic (age, sex, race, ethnicity, education, marital and living status), psychological (depression), clinical (obesity, diabetes, hypertension), behavioral (current and formersmoking), and genetic risk (APOEϵ4) factors. The association was not moderated by demographics, depression, andAPOEε4 status groups. The association was similar when cases occurring in the first five years were excluded, reducing the likelihood of reverse causality. Life satisfaction was also linked to specific causes of dementia, with a reduced risk ranging from about 60% to 90% for Alzheimer's disease and vascular dementia to > 2-fold lower risk of Lewy Body and frontotemporal dementia. Older adults who were satisfied with their lives were also at 61% lower risk of incident mild cognitive impairment and at 22% lower risk of converting from mild cognitive impairment to dementia. Being satisfied with one's life is associated with a lower risk of dementia. Improving life satisfaction could promote better cognitive health and protect against dementia.

Social Determinants of Health and Health-Related Social Needs Among Adults With Chronic Diseases in the United States, Behavioral Risk Factor Surveillance System, 2022.

The relationship between social determinants of health (SDOH) and health-related social needs (HRSN) and some chronic diseases at the population level is not well known. We sought to determine relationships between SDOH/HRSN and major chronic diseases among US adults by using data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). We used data from the new Social Determinants and Health Equity (SD/HE) module, conducted in 39 states, the District of Columbia, and 2 territories as part of the 2022 BRFSS. These data yielded a sample of 324,631 adult participants (aged ≥18 y). We examined 12 indicators of SDOH/HRSN and 9 chronic diseases. We calculated weighted prevalence estimates for each SDOH/HRSN measure for each chronic disease and associations between each SDOH/HRSN and each chronic disease. Two-thirds of participants (66.3%) had 1 or more chronic diseases, and 59.4% reported 1 or more adverse SDOH/HRSN. Prevalence estimates for individual SDOH/HRSN measures were generally higher among participants with chronic diseases (except cancer). The more chronic diseases reported, the more likely participants were to have SDOH/HRSN (P < .05 for linear trend). The leading SDOH/HRSN measures associated with each chronic disease varied; however, the most common were mental stress, receiving food stamps or participating in the Supplemental Nutrition Assistance Program, cost as a barrier for needed medical care, and life dissatisfaction. From a treatment and prevention perspective, health care providers should consider the influence of SDOH/HRSN on people with or at risk for chronic diseases. Additionally, human service and public health systems in communities with high rates of chronic disease should consider these findings as they plan to mitigate adverse SDOH.

Were COVID and the Great Recession well-being reducing?

Using micro-data on six surveys-the Gallup World Poll 2005-2023, the U.S. Behavioral Risk Factor Surveillance System, 1993-2022, Eurobarometer 1991-2022, the UK Covid Social Survey Panel, 2020-2022, the European Social Survey 2002-2020 and the IPSOS Happiness Survey 2018-2023 -we show individuals' reports of subjective wellbeing in Europe declined in the Great Recession of 2008/9 and during the Covid pandemic of 2020-2021 on most measures. They also declined in four countries bordering Ukraine after the Russian invasion in 2022. However, the movements are not large and are not apparent everywhere. We also used data from the European Commission's Business and Consumer Surveys on people's expectations of life in general, their financial situation and the economic and employment situation in the country. All of these dropped markedly in the Great Recession and during Covid, but bounced back quickly, as did firms' expectations of the economy and the labor market. Neither the annual data from the United Nation's Human Development Index (HDI) nor data used in the World Happiness Report from the Gallup World Poll shifted much in response to negative shocks. The HDI has been rising in the last decade reflecting overall improvements in economic and social wellbeing, captured in part by real earnings growth, although it fell slightly after 2020 as life expectancy dipped. This secular improvement is mirrored in life satisfaction which has been rising in the last decade. However, so too have negative affect in Europe and despair in the United States.

Partnering RemoTe monitoring of Implanted Cardiac devices with Intelligent PATient Engagement – PARTICIPATE trial: a protocol for a randomised controlled trial

IntroductionCardiac implantable electronic devices (CIED) can transfer data to the healthcare team, remotely. National and international cardiac organisations recommend all patients use this technology, however patient engagement is suboptimal. Previously,...

Multiple pathways to suicide: A network analysis based on three components of psychological pain

BackgroundPsychological pain is a multidimensional structure that has long been recognized as an important risk factor for suicidal ideation and behavior. The roles of interactions among psychological pain subfactors at different stages of suicidality remain unclear. MethodsA relatively large sample of outpatients with major depressive disorder (N = 501) was recruited to complete the Three-Dimensional Psychological Pain Scale (TDPPS). Exploratory graphical analysis (EGA) was conducted to explore the factor structure of TDPPS, thereby ensuring that the psychological pain subfactor was measured accurately. Network analysis included all TDPPS items, depression, passive suicidal ideation (PSI), active suicidal ideation (ASI), and history of suicidal action (SA) to identify key loops of suicidality. ResultsEGA disclosed a three-factor structure of TDPPS comprising cognitive, affective, and motivational factors. Network analysis revealed that items of motivational factors, but none of the items of cognitive and affective factors, were directly linked to PSI, ASI, and SA. Furthermore, three communities were identified by a “walktrap” algorithm. Depression and cognitive factor coalesced into a ‘cognitive’ community, affective factor constituted an ‘affective’ community, and motivational factor, PSI, ASI, and SA comprised a ‘suicidal’ community. LimitationsThis study used a cross-sectional design that cannot provide information on causal relationships among variables in the network. ConclusionsPsychological pain avoidance may be a direct driver of suicidality, and therefore its assessment and intervention in clinical practice is necessary.

Procrastination and preventive health-care in the older U.S. population

ObjectiveMaintaining health preventive behaviours in later life reduces the risk of non-communicable diseases. However, these behaviours often require effort and discipline to adopt and may be prone to procrastination. This study examined whether procrastination affected engagement in health preventive behaviours among older adults. MethodsWe applied generalised additive models to data from the 2020 wave of the United States Health and Retirement Study. Our analytic sample consisted of adults aged 50+ (n = 1338; mean = 68.24; range = 50–95). Our analysis focused on six health preventive behaviours: prostate exams, mammograms, cholesterol screenings, pap smears, flu shots, and dental visits. ResultsProcrastination was associated with less frequent engagement in mammograms and cholesterol screenings among women, though it had no significant association with pap smears or flu shots. Additionally, procrastination interacted with depression reducing the likelihood of prostate exams in men and dental visits in both men and women, such that individuals with high procrastination and low depression were associated with less frequent engagement in both preventive health behaviours. ConclusionsProcrastination may be a behavioral risk factor for maintaining optimal health in older adults. Given that procrastination is a potentially modifiable behaviour, interventions aimed at reducing procrastination, such as simplifying tasks or providing default appointment, could improve engagement in critical health preventive behaviours.

Cumulative Interpersonal Risk, Non-Suicidal Self-Injury, and Suicide Attempts in Early Adolescence: Between-Person Differences and within-Person Effects.

Poor interpersonal relationships are one of the risk factors for non-suicidal self-injury (NSSI) and suicidal behaviors among adolescents. Previous studies have mostly focused on a single interpersonal perspective, and it remains uncertain how the cumulative interpersonal risk across time and domains interacts with NSSI and suicide. The current study employed cross-lagged panel models (CLPM) and random intercept cross-lagged panel models (RI-CLPM) to investigate the interaction among cumulative interpersonal risk, NSSI, and suicide attempts at both the between-person and within-person levels, while examining sex differences in these relationships. A total of 1038 Chinese adolescents (47.0% girls; baseline Mage = 12.35 years, SD = 0.52) participated in a four-wave longitudinal survey with 6-months intervals. The results showed that at the between-person level, there were reciprocal predictive relationships between cumulative interpersonal risk, NSSI and suicide attempts. At the within-person level, changes in NSSI affected changes in cumulative interpersonal risk, and suicide attempts exhibited a reciprocal relationship with cumulative interpersonal risk and NSSI, with significant sex differences observed. These findings underscore the stable and trait-like associations between cumulative interpersonal risk, NSSI and suicide attempts. Given these findings, to reduce the occurrence of suicide among adolescents, it is essential to target interventions aimed tat enhancing their interpersonal adaptability.