Self-reported Behavior Research Articles

Happiness depletes me: Seeking happiness impairs limited resources and self-regulation.

People seek happiness when they try to experience as much positive emotion (and as little negative emotion) as possible. A growing body of research suggests that seeking happiness, rather than resulting in yet more happiness, often leads to negative consequences, like less happiness and less available time. Adding to this happiness paradox, the current research examines whether seeking happiness leads to the impairment of self-regulation due to the depletion of regulatory resources. We first demonstrate that trait-level happiness-seeking is associated with worse self-regulation both via self-report (Study 1) and actual behavior (Study 2). This result is corroborated in subsequent experiments that manipulate the pursuit of happiness and find that it, versus a control condition, makes people more vulnerable to lapses in self-control behavior (Study 3) and, versus an accuracy-seeking condition, makes people persist less in a challenging task (Study 4). Our findings suggest that continuous acts of happiness-seeking may cause a chronic depletion of resources, which leads to daily self-regulation failures, a critical component in a cycle of reduced personal happiness and well-being.

Vaccine Literacy and Hesitancy on routine and travelers' vaccines: a preliminary online survey.

The vast amount of conflicting information during the COVID-19 pandemic might have had a detrimental effect on people's opinions about vaccinations, including groups like travelers. This study aimed at assessing Vaccine Literacy in a sample of the general Italian population, together with antecedents of Vaccine Hesitancy, such as confidence, complacency, and convenience, the so-called "3Cs", and their effects on accepting routine and travelers' vaccines. A specifically designed anonymous questionnaire was created by using Google forms and validated through a face validity process. Subsequently, it was employed in an online cross-sectional survey. The assessment Vaccine Literacy scale used in this survey was similar to that employed in earlier surveys. In addition to demographic data and information sources used by participants, the questionnaire was composed, in total, of nine multiple choice questions on Vaccine Literacy, and six questions on the 3Cs. Considered outcomes were self-reported participants' beliefs, attitudes, behaviors and intentions toward recommended routinary adulthoods vaccines and arboviral vaccines for travelers. A section of the questionnaire focused on chikungunya awareness, taken as an example of arboviral disease that has caused outbreaks in Italy, but not yet vaccine-preventable at the time of the investigation. After cleaning the database, 357 responses were suitable for analysis. Vaccine Literacy mean functional score was 2.81 ± 0.74 (lower than in an earlier survey, p = 0.012), while the interactive-critical (score 3.41 ± 0.50) was higher (p<0.001). Vaccine literacy was confirmed to be associated with attitudes and behaviors towards vaccination, with the 3Cs often acting as a mediator. However, interactive Vaccine Literacy was misaligned with respect to functional and critical ones, as if looking for information sources or discussing about vaccination was less relevant than amidst the pandemic. Also, there was an increase in Vaccine Hesitancy, particularly with regard to travel vaccinations, with 10-17% of individuals refusing to be vaccinated if travelling in areas at risk. The main limitation of the study was the unbalance in demographic variables, in particular the education level. The study highlights the risks associated with current travel, including those related to climate change and the spread of vector-borne infections. It underscores the importance of raising awareness about arboviral diseases and the vaccines available to prevent them. As with all online surveys that employ convenience sampling, this study might not have provided a comprehensive representation of the entire population. Nevertheless, a dedicated analysis has been conducted to reduce biases and make data interpretation easier. Despite the need for further research, the findings indicate potential new approaches for assessing Vaccine Literacy and Vaccine Hesitancy, to ease the development of new communication strategies to enhance routine and travel vaccinations.

Comparative thinking among university students: an ecological momentary assessment of upward comparisons, stress and learning behavior during exam preparation

Studying for exams can be a stressful time. Uncertainty and stress often reach their peak during exam preparation, as students frequently grapple with feelings of inadequacy and anxiety regarding their academic performance. To assess their exam readiness, students can use social, temporal, criteria-based, and counterfactual comparisons. Engaging in upward comparative thinking during exam preparation may increase students’ stress levels. However, previous studies have not examined whether students’ daily comparisons related to exam preparation are associated with their stress, negative mood, and learning behavior. Therefore, we used Ecological Momentary Assessment (EMA) to capture daily frequency and affective impact of upward comparisons and their influence on stress, negative mood, and self-reported learning behavior among 170 psychology students at a German University. During an eleven-day EMA-phase leading up to exams, participants completed brief surveys three times daily, supplemented by baseline and follow-up assessments. Multilevel models revealed that both between-person and within-person upward comparison frequency correlated positively with stress and negative mood over time. A more negative comparison affective impact mediated the within-person associations of comparison frequency with stress and negative mood. A more negative comparison affective impact also predicted more self-reported avoidant learning behavior, both between-person and within-person. Comparison also influenced depression, test anxiety, and burnout at follow-up. The findings may have implications for designing well-being interventions during periods of performance-related pressure.

Awake Bruxism Is Unrelated to Smoking, Despite the Different Psychological Status: A Pilot Study.

The aim of the present study is to get deeper into the complex interplay that might exist between awake bruxism (AB), tobacco smoking, and anxiety and/or depression symptoms in a group of healthy young adults. The study participants were recruited by advertising the investigation at the University of Siena, Siena, Italy. The inclusion criteria were being in good general health, without systemic diseases or oral diseases. People with ongoing medical or dental treatment and those with a history of systemic disease or temporomandibular disorders were excluded. The participants who were included in the study received a questionnaire containing three sections for the assessment of AB behaviors, anxiety and depression symptoms, and the number of cigarettes smoked. A total of 141 healthy young adults met the inclusion criteria. Different awake masticatory muscle activities showed different strengths of association with anxiety and depression symptoms. However, no relationship was found between the number of smoked cigarettes and the frequency of the various masticatory muscle activities considered. The result of the present study shows no clear-cut association between the frequency of self-reported AB behaviors and smoking in healthy individuals.

A digital intervention to reduce home-office workers’ sedentary behaviour: protocol for the evaluation of the Click2Move programme, a cluster randomised controlled trial

BackgroundA new paradigm of hybrid working exists, with most office workers sharing their work between the office and home office environment. Working from home increases time spent or prolonged sitting, which is associated with an increased risk of chronic disease. Interventions to reduce sitting time, specifically designed for both the office and home-office environments, are required to address this growing public health issue. This study presents a protocol to evaluate the effectiveness of a digital intervention (Click2Move) to reduce sitting time and improve employees’ health and occupational wellbeing among hybrid office workers.MethodsA two-arm cluster randomised controlled trial will be undertaken among hybrid office employees. In total, 200 employees will be recruited across four companies across Europe (The Netherlands, Spain, Ireland, and Slovenia). Participants within each company will be randomly allocated to the intervention or control group at the unit/cluster level. The intervention group will receive the novel multicomponent Click2Move intervention (including environmental, organisational, and individual strategies) for 12 months, and the control groups will maintain their usual work practices. The primary outcome will be occupational sedentary time measured via activPAL3TM at baseline and at 3, 6 and 12 months follow-up. Secondary outcomes will include device-based (activPAL3TM) and self-reported (Global Physical Activity Questionnaire and Workforce Sitting Questionnaire) physical activity and sedentary behaviour; self-reported musculoskeletal disorders (Standardised Nordic Questionnaire) and pain (Numeric Rating Scale); self-reported presenteeism and absenteeism (Health and Work Performance Questionnaire), job satisfaction (Need for Recovery scale) and fatigue (single-item 5-point Likert scale). Focus groups will be conducted with employees post-intervention. Linear mixed models, accounting for covariates, will be employed to determine the effects of the intervention. Additionally, we will perform a full process evaluation analysis.DiscussionThe proposed study will offer a comprehensive evaluation of a digital intervention aimed at reducing sedentary behaviour among hybrid office workers, offering practical solutions to enhance the health, wellbeing and productivity of a growing segment of the workplace.Trial registrationClinicalTrials.gov NCT06247228. Registered 30 January 2024.

P-499. HIV Risk Perception, Substance Use, and Sexual Practices Among Circuit Party Attendees

Abstract Background Circuit parties are large-scale dance events catering to the LGBTQ+ community. Research suggests high rates of HIV and substance use among participants. This study explores HIV knowledge, awareness of prevention services, perceived and actual HIV risk among attendees of the White Party, a circuit party held in California with an estimated 30,000 participants. Methods Data were gathered from 137 attendees who visited a health booth, where interested individuals completed a self-administered survey on a tablet computer. The survey used the validated Minority AIDS Initiative (MAI) Adult Questionnaire assessing demographics, perceived risk related to substance use and sexual activities, and self-reported risk behaviors in these domains. Following survey completion, participants received a non-monetary incentive (event merchandise). Results The average age of respondents was 38 years, with 26% identifying as Hispanic, 63% as White, 8% as Black, and 17% as Asian. Bivariate and multivariable logistic regression analyses were conducted to explore associations between knowledge of HIV status, awareness of HIV prevention resources, reports of unprotected sex, and the number of sexual partners. Younger participants and those with lower income levels were less likely to know their HIV status. Similarly, Hispanic respondents and those with lower income levels were less likely to know how to access HIV and SUD prevention. A higher perceived risk did not reduce a high incidence (82%) of unprotected sex. Individuals with a history of intimate partner violence (IPV) (18%) were more likely to engage in unprotected sex. Additionally, non-injection substance use was correlated with binge drinking and a higher number of sexual partners. Conclusion This study highlights the need for comprehensive interventions at LGBTQ+ events, addressing substance use and HIV risk simultaneously. Interventions focusing on raising awareness of HIV risks may not be effective in changing behavior. Available interventions should include screening and support for IPV, prioritizing HIV testing among younger attendees, offering culturally tailored outreach in Spanish, and addressing socioeconomic barriers to accessing prevention services. Disclosures All Authors: No reported disclosures

Executive functions in adults born small for gestational age at term: a prospective cohort study

There are mixed findings regarding executive functioning in individuals born small for gestational age (SGA) at term and associations between performance-based and self-reported executive functions have yet to be examined in adults. In a prospective cohort study, 56 SGA and 68 non-SGA control participants were assessed at 32 years using the performance-based Trail Making Test (TMT) and the self-report questionnaire Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A). The SGA group used 1.6 (95% confidence interval [CI] 0.1–3.1) to 3.9 (95% CI 1.2–6.5) seconds more on TMT conditions 1 and 3, indicating more difficulties with visual scanning and letter sequencing than controls. On BRIEF-A, the SGA group scored 1.5 (95% CI 0.2–2.8) points lower on the clinical scale Emotional Control. Correlation coefficients for the association between TMT and BRIEF-A scores ranged from -0.295 (p = 0.065) to 0.345 (p = 0.029) in the SGA group. In conclusion, we found that 32-year-old adults born SGA at term showed poorer performance on some executive function tasks than controls. However, they reported similar executive functioning in everyday life, except for emotional control. The associations between performance-based and self-report assessments of executive functions were weak.

Investigating the longitudinal bi-directional relationship between self-reported restrictive eating behaviours and sleep in UK adolescents within the Millennium Cohort Study.

This study aimed to investigate the longitudinal bi-directional relationship between self-reported restrictive eating behaviours and sleep characteristics within a sample of UK adolescents from the Millennium Cohort Study (MCS). Using a Structural Equation Modelling approach, the present study investigated the prospective associations between individual sleep behaviours (e.g., sleep timing, sleep onset latency, social jetlag) at age 14 and restrictive eating behaviours at age 17. Moreover, the association between restrictive eating behaviours (age 14) and self-reported sleep quality (age 17) was tested. A mediation analysis was conducted to explore the role of depressive symptoms in these relationships. In total, N = 6,041 young people provided self-report data at both timepoints (sweep 6 & 7) and a subsample of N = 2,164 additionally provided diary data on their sleep behaviours over two separate 24h periods. Sleep indicators at age 14 did not significantly predict changes in restrictive eating behaviours across time. However, engagement in restrictive eating behaviours at age 14 significantly predicted poorer self-perceived sleep quality three years later (β = 0.06, SE = 0.01, p <.01). Depressive symptoms fully mediated this relationship (indirect effect: β = 0.05, SE = 0.04, p <.001). The present study provides evidence for a prospective positive association between restrictive eating behaviours and subsequent poorer sleep quality in a large, general population sample. Findings of the mediation analysis suggest mood as a potential target for tertiary prevention when addressing restrictive eating behaviours as an eating disorder risk factor in adolescents.

A Real-World Study on the Quality of Life of Consumers with Dentine Hypersensitivity and the Benefits of Hypersensitivity Toothpaste Use

Dentine hypersensitivity (DH) causes pain from exposed dentine, triggered by external stimuli. Limited evidence exists on its impact on quality of life (QoL), the effectiveness of hypersensitivity toothpaste (HT) and the dental behaviors of DH sufferers. This study therefore aimed to generate evidence to address these evidence gaps and validate the existing science behind the effectiveness of HT. An observational retrospective cross-sectional survey was conducted in Indonesia, which included the Dentine Hypersensitivity Experience Questionnaire-15 (DHEQ-15), items related to the perceived effectiveness of HT and self-reported dental health behaviors. A total of 511 respondents completed the survey. The mean (standard deviation) DHEQ score of participants was 82.44 (14.41), showing the substantial impact of DH on QoL. Nearly all HT users (97.7%) reported relief from DH, with additional benefits like long-lasting fresh breath (96.4%) and cleaner teeth (97.1%), with regular HT users experiencing greater benefits such as improvements in DH (R-HT users [4.65 (0.55)] vs. E-HT users [4.46 (0.65)], p &lt; 0.01). Compared to HT users, mainstream toothpaste (MT) users were significantly less likely to brush their teeth at least three times a day (HT users [41.9%], MT users [18.7%], p &lt; 0.05) and to have had a dental check-up within the past year (HT users [82.5%], MT users [47.3%], p &lt; 0.05). This study found that DH significantly impacts QoL, and that HT effectively relieves DH symptoms, particularly for regular users, who also show better dental health behaviors than users of mainstream toothpaste. The preliminary results indicate that educating users about dental products, like hypersensitivity toothpaste, can improve oral health behaviors and outcomes.

Depression symptom severity and behavioral impairment in school-going adolescents in Uganda

BackgroundDuring adolescence, a critical developmental phase, cognitive, psychological, and social states interact with the environment to influence behaviors like decision-making and social interactions. Depressive symptoms are more prevalent in adolescents than in other age groups which may affect socio-emotional and behavioral development including academic achievement. Here, we determined the association between depression symptom severity and behavioral impairment among adolescents enrolled in secondary schools of Eastern and Central Uganda.MethodsThis cross-sectional study was conducted among 1,669 adolescents enrolled in secondary schools in Eastern and Central Uganda. Our outcome variable was behavioral impairment defined as self-reported behavior that interferes with an individuals’ ability to do schoolwork (school performance) or get along with others (peer interaction) (yes/no). The key independent variable was depression symptom severity assessed using the Child and Adolescent Symptom Inventory-5 (CASI-5), a behavior rating scale for symptoms of DSM-5 emotional and behavioral disorders. Modified Poisson regression models tested the independent association between depressive symptom severity and behavioral impairment. Prevalence Rate Ratios (PRR) and 95% confidence intervals (95%CI) were reported.ResultsParticipants’ mean age was 15.3 years (SD = 1.8), 58.5% were female, 86.8% witnessed domestic violence, 47.4% had behavioral impairment, and 2.8% had mild depression symptoms. School-going adolescents with mild depression symptoms had two times higher risk of behavioral impairment when compared to those with no or slight depression symptoms, after controlling for potential confounders. Other factors independently associated with higher risk for behavioral impairment were female sex (Adj. PRR 1.27, 95%CI 1.12, 1.43) compared to males, taking alcohol (Adj. PRR 1.42, 95%CI 1.25, 1.61) compared to not taking alcohol, boarding school enrollees (Adj. PRR 1.62, 95%CI 1.33, 1.98), and day school enrollees (Adj. PRR 1.46, 95%CI 1.21, 1.76) compared to mixed (day and boarding) school enrollees respectively, advanced level enrolment (Adj. PRR 1.25, 95%CI 1.05, 1.48) compared to ordinary level enrolment, and attending urban schools (Adj. PRR 1.27, 95%CI 1.11, 1.45) compared to rural secondary school attendance.ConclusionsBehavioral impairments are widespread among Ugandan secondary students. Mild depression symptoms adversely affect adolescents' academic and social lives, potentially leading to long-term consequences. Where feasible, early detection of depressive symptoms and treatment may mitigate their negative effects on student school performance ability and peer/social interaction. Future research should examine school-level factors influencing academic performance by depression status. Policymakers in education and gender sectors should prioritize mental health programs in secondary schools.

Community science as a potential tool to monitor animal demography and human-animal interactions

Community science can provide crucial insights into population dynamics and demography. To date, its effectiveness for understanding human-wildlife interactions has not been tested. This is vital for designing effective wildlife management plans. We used a case study of an individually marked population of mute swans Cygnus olor, to test the reliability of community scientist data for quantifying self-reported interactions. We compared 5,251 community scientist sightings of individually marked birds with 317 observations recorded through systematic recording methods, to test the reliability of sightings, and of self-reported human-swan interactions. 98.86% of ring readings were correctly reported; sighting reliability increased with experience and was higher when the observer fed the birds. Community scientist observations were reliable for quantifying family group size, but not clutch size. Self-reported data for assessing feeding interactions with wildlife were not comparable with systematic recording methods. 22% of standardised observations recorded supplementary feeding of swans by people. This is the first systematic quantification of the frequency of interaction of wild waterfowl with humans through supplementary feeding in the Northern hemisphere; we highlight potential impacts of this common human-wildlife interaction for both birds and people. We provide new insights into using community science methods as potential alternatives to more time-consuming systematic methods. Community science methods may be useful across a range of systems where humans and wildlife interact, but we highlight the need for validation of the reliability of community scientist data, particularly self-reported behaviours, before being used to inform management and conservation practices.

A comparison of objective and subjective measures of physical activity, sedentary and sleep behaviors between persons with and without depressive symptoms.

Major Depressive Disorder (MDD) is characterized by negative recall biases, which may impact how individuals with depressive symptoms report physical activity (PA), sedentary, and sleep behaviors. Additionally, there are discrepancies between subjective and objective behaviors in MDD. Thus, the current study investigated whether individuals with depressive symptoms differ in their subjective and objective PA, sedentary, and sleep behaviors, and whether the magnitude of these discrepancies differ from those in individuals without depressive symptoms. Participants from the 2011-2014 National Health and Nutrition Examination Survey (N = 8367; Ndepressed = 762) with one-week of passively-collected, wrist worn actigraphy data and self-reported questionnaires assessing PA, sedentary, and sleep behaviors were analyzed. Three negative binomial models investigated the effects of group, measurement type, and their interaction on PA, sedentary, and sleep behaviors. Individuals with depressive symptoms exhibited lower PA and sleep than individuals without depressive symptoms but did not differ in sedentary behaviors. Measurement type differed across all models: self-reported PA and sleep were lower, and self-reported sedentary behaviors were greater, than objective measurements. The interaction was significant only for PA; whereas objective PA was greater than subjective measurements for all individuals, the difference was far greater for individuals with depressive symptoms. The absence of a clinically depressed sample and current manner of assessing subjective and objective measures may limit our generalizability and conclusions. Our study highlights discrepancies in objective and subjective reports across domains and emphasizes the importance of incorporating objective measurements to improve psychopathology assessment.

Effectiveness of E-Learning Method on Exodontia for Dental Students: A Theoretical Domain Framework Study.

The study aimed to assess the impact of e-learning tools using teaching videos on dental extraction for dental students. Teaching videos on dental extraction were sent to each participating dental students. The theoretical domain framework (TDF) was used to assess dental students' self-reported behavior on dental extraction. The response rate was 77%. Male students found teaching videos support their practice significantly in dental extraction by their skills, beliefs about capabilities, optimism, environment context and resources, social influences, and emotion (p-value <0.001 and <0.05). T-Test showed that male students reported significant improvement in the overall TDF compared to female students (male = 130.26 ± 21.4 vs. female = 115.09 ± 26.8, p-value = 0.007). Results showed that there are positive correlations between skills (r = 0.419), beliefs about capabilities (r = 0.511), optimism (r = 0.414), emotion (r = 0.411), beliefs about consequences (r = 0.314), reinforcement (r = 0.396), intentions (r = 0.322), goals (r = 0.329), memory, attention and decision process (r = 0.356), environment context and resources (r = 0.318), and social influences (r = 0.367) with students' satisfaction rate when practicing dental extraction after watching the teaching videos (p-value <0.001 and <0.05). The one-way analysis of variance (ANOVA) test showed that students at higher levels have higher scores on the theoretical framework's domains as measured by the means on 10 domains out of 13 (p-value < 0.001). Incorporating video-based teaching materials into the dental curriculum can be valuable in improving students' skills and proficiency in performing dental extractions.

Early Reinitiation of Obesity Pharmacotherapy Post Laparoscopic Sleeve Gastrectomy in Youth: A Retrospective Cohort Study.

Bariatric surgery is the most effective intervention for severe pediatric obesity, but a subset of youth experience suboptimal weight loss and/or recurrent weight gain. Early re-initiation ofobesity pharmacotherapy postoperatively may improve outcomes, though this has not been evaluated in pediatric populations. A retrospective cohort study at a tertiary care children's hospital evaluated the safety and efficacy of reintroducing obesity pharmacotherapy within six weeks afterlaparoscopic sleeve gastrectomy (LSG). Youth were offered obesity pharmacotherapy reinitiation at their 2-week postoperative visit. The study compared outcomes between 25 youth who chose early obesity pharmacotherapy reinitiation and 21 who received standard care without restarting medication. Primary outcomes included weight trajectory, eating behaviors, complications, readmissions, and reoperation rates, analyzed using independent t-tests, Chi-squared tests, and logistic regressions. Between November 2023 and July 2024, 53 youth had surgical consults, and 46 (86% conversion rate; mean age 16.5 ± 1.9years, mean BMI 53 ± 9.7kg/m2; 70% (32/46) female, 80% (37/46) Hispanic, 87% (40/46) publicly insured) underwent LSG, with 93% (43/46) using obesity pharmacotherapy preoperatively. Mixed-effects multivariate regression, adjusting for baseline BMI, age, and sex, revealed that early reinitiation (5.1weeks [IQR 3.7, 8.4]) significantly reduced BMI, percent BMI, percent total weight loss (TWL), and percent excess weight loss (EWL) at 3 and 6months compared to standard care, with no significant differences in complications or readmissions. At 6months, the mean differences were: %BMI: -6.5% (95% CI: -9.13, -3.86), p < 0.001; %TWL: -5.9% (95% CI: -8.52, -3.25), p < 0.001; %EWL: Reinitiators: -45.5% vs. standard care: -39.4%; meandifference: -8.2% (95% CI: -14.69, -1.63), p < 0.001. Early reinitiation also resulted in a significant reduction in emotional overeating at 3 and 6months compared to standard care, with mean differences of -2.5points (95% CI: -3.29, -1.76), p < 0.001, and -3.5points (95% CI: -4.38, -2.69), p < 0.001, respectivelyon self-reported eating behavior questionnaires. Early obesity pharmacotherapy reinitiation after LSG was safe and well tolerated, improving weight outcomes without negatively impacting complication or readmission rates.

Oral Health and Quality of Life in Type 2 Diabetic Patients: Key Findings from a Romanian Study.

Background: Diabetes mellitus is associated with various oral health complications that can negatively impact quality of life. Despite evidence of the relationship between diabetes and oral health issues, limited research exists on the perceptions, behaviors, and oral health-related quality of life (OHRQoL) of diabetic patients in Romania. This study aims to evaluate self-reported oral health, knowledge, behaviors, and OHRQoL among diabetic patients in western Romania. Methods: A cross-sectional study was conducted in early 2024 at Pius Brinzeu County Emergency Hospital, Timisoara, involving 121 patients with type 2 diabetes. Data were collected using self-administered questionnaires that assessed oral health status, behaviors, and OHRQoL, with the OHIP-14 instrument employed for quality-of-life measurement. Statistical analyses included descriptive statistics, multiple linear regression, and correlation analyses to identify the predictors of oral health knowledge and OHRQoL. Results: Participants (mean age: 63.24 years; 52.1% female; 60.5% urban residents) reported significant oral health challenges. Over half (56.2%) did not visit a dentist regularly, with financial constraints identified as the primary barrier (23.5%). Oral hygiene practices were suboptimal: only 38.0% brushed twice daily, while 78.5% used fluoride toothpaste. Auxiliary hygiene tools, such as mouthwash and toothpicks, were rarely used (13.22% and 11.57%, respectively). Regression analyses identified the significant predictors of oral health knowledge, including tooth mobility (β = 0.33, p < 0.01) and brushing frequency (β = -0.18, p < 0.05). The mean OHIP-14 score (0.55) indicated a moderate impact on OHRQoL, with domains such as psychological discomfort and social disability revealing nuanced challenges. Conclusions: Diabetic patients in Romania face oral health challenges and care barriers, emphasizing the need for preventive strategies, oral health education, and integrated diabetes care. Addressing these gaps can improve oral health outcomes and overall quality of life in this vulnerable population.

HIV Vulnerability Typologies Among Adolescent Girls and Young Women in Lesotho: A Population-Based, Cross-Sectional, Latent Class Analysis.

Adolescent girls and young women ages 15-29 years (AGYW) living in Lesotho experience a disproportionate HIV burden. Using a household-based national survey in Lesotho, we conducted a three-step latent class analysis to identify typologies of AGYW most vulnerable to HIV infection. We first classified AGYW into HIV vulnerability groups based on self-reported sexual behaviors, then identified associations between typology and HIV diagnosis. HIV vulnerability behaviors included early sexual debut, condomless sex, multiple sexual partners in the past year, sex with partners they do not know the status of or are living with HIV, age disparate sex, use of contraceptives, and having children. Across all age groups, we found that HIV vulnerability typologies could be described as low vulnerability, high vulnerability, and parous. As AGYW age, they engage in more types of higher vulnerability sexual behaviors; interventions to reduce this risk should start at a younger age. Our findings emphasize the importance of implementing and scaling up biomedical strategies such as pre-exposure prophylaxis.

Providing Physical Activity Access Through Health Care: The PA2TH Pilot Study

Despite nurse practitioners’ (NPs’) and other health care providers’ (HCPs’) understanding of the advantages of physical activity (PA), only one-third of patients receive PA counseling from their HCP. Physical inactivity remains a significant health problem in the United States. Use of health care visits for PA discussions as part of usual care may improve patients’ PA behaviors, which are especially important for patients with chronic diseases, such as diabetes. The purpose of this study was to determine whether PA discussions guided by the Exercise is Medicine initiative would improve (1) PA discussions with patients at each visit, (2) self-reported patient PA behaviors, and (3) patient hemoglobin A1c (HbA1c) levels. We enrolled 20 patients and 7 HCP participants and conducted a 12-week pre-post study with 3 phases (baseline assessments, intervention implementation, and intervention evaluation) to determine whether the PA intervention would improve PA behaviors. Patients’ post-HbA1c levels (8.5% [SD, 1.6%]) were reduced from prestudy levels (10.8% [SD, 2.4%]; P = .001), with an average decrease of 2.3 (SD, 2.8; Cohen d = 0.9, large effect). HCPs’ primary perceived barrier to PA discussions was time constraints. Findings may motivate HCPs to include PA discussions during health care visits as a nonpharmaceutic method to improve HbA1c levels and lessen the consequences of physical inactivity among vulnerable patients with diabetes. HCPs should actively encourage PA during each health care visit as a powerful tool to enhance overall well-being and manage chronic health conditions, including diabetes.

Measuring implicit associations with behaviours to improve resident mood: development of implicit association tasks for nursing home care providers.

To develop and evaluate instruments for measuring implicit associations of nursing home care providers with behaviours aimed at improving resident mood. Study 1 (N = 41) followed an iterative approach to develop two implicit association tasks measuring implicit attitude (positive versus negative valence) and motivation (wanting versus not wanting) regarding mood-improving behaviours, followed by an evaluation of the content validity for target stimuli representing these behaviours. In Study 2 (N = 230), the tasks were assessed for stimulus classification ease (accuracy and speed) and internal consistency. A subsample (n = 111) completed additional questionnaires to evaluate convergent validity (with self-reported attitudes towards depression, altruism, and mood-improving behaviours), and discriminant validity (against social desirability), and repeated the tasks after 2 weeks to assess test-retest reliability. Content validity indexes for target stimuli were satisfactory. Error rates were acceptable for attribute stimuli, but exceeded the 10 % limit for target stimuli. Response times for all stimuli exceeded the 800-millisecond threshold. Both tasks demonstrated good internal consistency but poor test-retest reliability. Regarding convergent validity, both tasks significantly correlated with altruism, the implicit attitude task associated with self-reported mood-improving behaviours, and the implicit motivation task correlated with the behavioural scale of attitudes towards depression. Discriminant validity was supported as neither task was significantly associated with social desirability. The implicit association tasks show potential for measuring implicit associations with mood-improving behaviours of care providers, offering an innovative pathway for exploring processes influencing caregiving behaviours. However, limitations in psychometric properties were identified, aligning with challenges observed in similar measures.

Self-reported physical activity and sedentary behaviour amongst UK university students: a cross-sectional case study

ABSTRACT Background This cross-sectional study investigated self-reported physical activity (PA) and sedentary behaviour amongst UK university students. Methods An online survey was completed by 590 students at a higher education institution in the UK to obtain both quantitative and qualitative data on PA levels and experiences, knowledge and adherence to PA guidelines, and sitting time. Results Considerable numbers (37%) were estimated to not meet the 150-min moderate-vigorous intensity weekly PA guideline and 56% did not meet strength-based activity guidelines. Just under half (48%) reported experiencing barriers to PA at university, with females, sexual minority students, white ethnicity students, those reporting lower levels of PA, and undergraduate students being more likely to report experiencing barriers. Respondents reported financial reasons, time and stress being the most influential barriers to PA, regardless of demographics. Average reported sitting time on weekdays was 8 h. Conclusions The results indicate that a large proportion of our sample of UK university students did not meet PA guidelines, experience barriers to engaging in PA, and demonstrate sedentary behaviour that has been associated with negative health outcomes. The article discusses these findings and practical considerations are offered for personnel working within universities as well as directions for future research.

Medication adherence feedback with older adults with cognitive impairment: a mixed Methods study

Objective: Older adults with cognitive impairment are at risk of medication-taking errors. This study assessed the impact of providing medication adherence feedback to cognitively impaired older adults. Methods: Forty participants with mild cognitive impairment or mild dementia had their medication adherence electronically monitored for 8 weeks. They were provided with verbal and visual feedback about their adherence results. Initial participant reactions were elicited using a Motivational Interviewing approach, and self-reported behavior changes were assessed during a follow-up interview. Quantitative analyses assessed relationships among electronically monitored and self-rated adherence, initial reactions to adherence feedback, and subsequently reported medication self-management changes. Thematic analysis determined facilitators and barriers to making self-management changes. Results: Although self-rated adherence was high, electronic monitoring revealed that 20% of the sample had suboptimal adherence (took the recommended dose on <80% of monitored days). Fifty-three percent of the sample reported feeling surprised by their adherence results, and 45% endorsed initial motivation to change self-management behaviors. Motivated participants demonstrated worse electronically monitored adherence than unmotivated peers, and those who were surprised by their medication-taking errors expressed greater initial motivation to change. At follow-up, 50% reported having made changes, and 82.4% of them indicated that this study played a role. Facilitators of making changes included awareness of medication-taking errors and cognitive impairment, whereas barriers included lack of perceived difficulty/need. Conclusions: Adherence monitoring with feedback is feasible and impactful in cognitively impaired older adults. Increasing awareness of medication-taking errors fosters motivation to improve medication self-management and results in participant-reported behavior change.