Longitudinal Data Research Articles

Two-Dimensional Latent Physical Activity Self-Efficacy and Its Relationships with Physical Activity: A Secondary Data Analysis

ABSTRACT The purpose of this study was to improve measurement of physical activity self-efficacy (PASE) in adults with obesity by evaluating relationships between responses to a new battery of PASE Scales and physical activity (PA). Specifically, relationships between a recently proposed two-dimensional (shorter and longer durations) latent PASE conceptualization and PA was evaluated across intensities (moderate, vigorous) and domains (work, transport, domestic, leisure) measured by the PASE Scales. Longitudinal secondary data (N = 461) from the Well-Being and Physical Activity (ClinicalTrials.gov, identifier: NCT03194854) study, which deployed the Fun For Wellness (FFW) intervention, were analyzed. A positive direct effect (latent PASE→PA) was observed for the shorter (but not the longer) duration in each domain at both intensities. A positive indirect effect (FFW→latent PASE→PA) was observed for the shorter (but not the longer) duration in each domain at a moderate (but not vigorous) intensity. These results have implications for PA-promotion in this at-risk population.

Elderly vulnerability to temperature-related mortality risks in China.

The elderly face elevated mortality risk due to rising temperature. Previous assessments of temperature-related mortality, however, lack a comprehensive analysis of distinct impacts of temperature change across different timescales and characteristics. Using a longitudinal survey of 27,233 elderly Chinese citizens from 2005 to 2018, we establish connections between rising temperatures, temperature variability, and extreme heat with increased mortality risk, assessed through four annual metrics that combine temperature and humidity. The intensity and prolonged duration of extreme heat are found to have the greatest impact on mortality risk. Furthermore, by identifying heterogeneous impacts based on location, sex, age, obesity, income, and diet, we reveal the pathways through which temperature metrics are likely to influence mortality risk. Our study highlights the compound effects of rising temperatures for elderly populations, and it could be expanded to other countries and regions experiencing similar challenges due to an aging population experiencing warming conditions.

Pre- and postinjury financial hardship among trauma survivors: A national survey study.

National estimates of financial hardship because of injury are lacking, which limits our ability to both define and mitigate the impacts of financial outcomes of trauma care. Furthermore, the absence of preinjury data limits our understanding of the association between injury and financial hardship. We analyzed data from the 2014-2021 Medical Expenditure Panel Survey. We compared injured adults (18-64 years old) to uninjured controls using coarsened-exact matching on age, sex, race/ethnicity, income, payer, survey panel, and comorbidities. Our main outcome of interest was financial hardship, a composite of difficulty paying medical bills, paying medical bills off over time, and delaying medical care because of cost. As a secondary analysis, we evaluated the link between difficulty paying medical bills, delaying care, and poor health. We included a weighted sample of more than 79 million injured patients over the 8-year study period. Difference-in-differences analysis using uninjured, matched controls showed that injured patients experienced an 8.2 percentage point increase in financial hardship (23% relative increase, with 40.6% reporting financial hardship postinjury, p < 0.001) and 4.5 percentage point increase in poor health (20% relative increase, p < 0.001). Injured patients who reported difficulty with medical bills were more likely to report delaying care because of costs (adjusted odds ratio, 3.3; 95% confidence interval, 2.5-4.4), and those who delayed care were more likely to report poor health (adjusted odds ratio, 1.5; 95% confidence interval, 1.2-2.0). In this national analysis of financial hardship before and after injury, 40% of injured patients reported difficulty with medical bills and delayed medical care because of cost. Programs aimed at disrupting the path from injury to financial hardship to poor long-term health have the potential to benefit millions of injury survivors. Retrospective Cohort Study; Level III.

Empowering leadership in crisis: a natural experiment

ABSTRACT Existing research suggests that empowering leadership enhances employee well-being, but context-specific empirical studies in the public sector remain scarce. We investigated whether this positive impact persists during a public health crisis. To test this, we conducted a natural experiment, utilizing a longitudinal survey of healthcare employees and administrative data on geographical variance in hospitalization rates during a public health crisis. Our findings show that empowering leadership is less effective during a crisis and can even result in adverse effects. The results challenge the notion that empowering leadership universally benefits employee well-being and highlight its potential dark side.

How do Chinese smokers respond to cigarette price? Evidence from a nationwide household survey.

Despite the Chinese government's implementation of tax increases in 2009 and 2015 to curb tobacco use, the anticipated decline in cigarette sales has not materialized. This suggests a need for deeper understanding of smokers' demand behavior. The present study aims to provide a more accurate estimation of the price and income elasticities of cigarettes in China. We utilized Deaton's model to analyze a comprehensive micro-level dataset comprising 10,892 households surveyed in the 2012 wave of China Family Panel Survey, with the aim of estimating the price and income elasticities of cigarette demand, as well as to investigate how these elasticities vary across different income brackets. These resulting elasticities were subsequently integrated into the World Health Organization Tax Simulation Model to simulate the potential impacts of various tax increase scenarios on cigarette consumption and tax revenue. The price elasticity in China hovers around -0.72, with an income elasticity of about 0.23. Heterogeneity analysis indicated that lower-income smokers exhibit greater sensitivity to price changes. Policy simulations suggested that tax increases would substantially reduce consumption while concurrently increasing tax revenue. Chinese smokers exhibited a considerable sensitivity to cigarette prices, underscoring the efficacy of taxation as policy instrument for shaping smoking behavior. As tax reforms continue and cigarette retail prices increase, there lies promising potential for achieving tobacco control goals, generating additional revenue, and improving social equality. A primary contribution of this study is the provision of more reliable estimation of cigarette price and income elasticities in China. These parameters are crucial for assessing the potential impact of tobacco tax increases on cigarette consumption and government revenue. By leveraging a nationally representative survey from 2012 and employing Deaton's identification strategy, we significantly enhanced the data quality and methodological rigor of our analysis, leading to more accurate estimation results compared to previous studies.

Unpacking Organizational Agency in Institutional Change: The role of executives’ political connections and shareholders’ investment horizons

In studies where institutional changes are initiated outside of the organization, two key actors are identified: the institutional entrepreneur, who initiates the change, and the affected organization, which is impacted. This study highlights the crucial role of the affected organization’s agency in adopting new practices in response to normative institutional changes, shifting the focus beyond external initiators. We develop a novel theoretical framework that highlights the interplay between organizational agency and external institutional changes, demonstrating how strategic responses are shaped by both affected organizations and external pressures. Using the Pollution Information Transparency Index (PITI) project as a vehicle for normative institutional change, this study conducts a thorough analysis of its effect on firms’ new practices – environmental innovation – employing longitudinal data (2006–2018) covering 1,988 Chinese listed industrial firms. Our findings reveal that the outcome of normative changes in fostering the adoption of new practices significantly depends on the agency of the affected organizations, moderated by executives’ political connections and shareholders’ investment horizons. Specifically, firms led by executives with weaker political connections or supported by shareholders with long-term investment horizons are more likely to embrace these changes, while those with stronger political connections or a short-term focus tend to resist them. This research not only bridges a significant gap in the literature by highlighting the critical role of affected organizations’ agency but also expands the scope of analysis in institutional change, providing deeper insights into the complex relationship between organizational agency and institutional change.

Existential upheavals: Tracing war’s immediate effect on individual religiosity in Ukraine

This study examines religious changes during Russia’s full-scale invasion of Ukraine through a two-wave panel study of 595 individuals before and during the 2022 war. It explores the relationship between wartime adversity and changes in religiosity. Our findings suggest that greater personal exposure to war does not increase religiosity. At the same time, greater existential insecurity is associated with a greater magnitude of religious change, regardless of its direction. In addition, the research found that individuals who were less religious before the war experienced a greater increase in religiosity. However, the effect of war exposure on the change in religiosity was more pronounced among religious people.

Hope Mitigates Depression throughout Adversities: The Immediate and Longitudinal Mediation of Flow

Positive psychology constructs such as hope and flow build resilience against psychological distress in major adversities, but it remains unknown how they interact to exert the protective effects. Taking advantage of the lifting of the “Zero-COVID” policy in December 2022 in mainland China, the current study incorporated a cross-sectional survey (study 1, n = 1185) and a longitudinal survey (n = 296) to investigate the interaction of these two factors in reducing depression during the COVID-lockdown and after the lockdown was finally abandoned. The results showed that hope during COVID-lockdown predicted concomitant flow experience and depression, and proactively predicted depression measured three months after the lockdown was lifted. Moreover, flow experience mediated the cross-sectional and longitudinal hope effects. These findings shed light on the inner dynamics of positive psychology constructs in protecting well-being, and are implicative for mental health intervention in disaster relief.

Correlation between blood pressure control status and cognitive impairment in older adults: A national cross-sectional study.

Hypertension is closely related to cognitive impairment; however, the correlation between blood pressure control and cognitive impairment in the hypertensive population is unclear. We aimed to explore the relationship between blood pressure control and cognitive impairment in older adults with hypertension. Using the cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, 5,860 people with self-reported history of hypertension were divided into the hypotension, intermediate blood pressure, and hypertension groups. Cognitive impairment was defined as a score of < 18 on the Chinese version of the Mini-Mental State Examination. Demographics of the population were also collected. Bivariate Logistic regression analysis and restricted cubic spline (RCS) model were used to analyze the relationship between blood pressure control and cognitive impairment. After adjusting for confounding factors, binary logistic regression analysis showed that the intermediate group was significantly associated with an increased risk of cognitive impairment than the hypotension group, whereas the hypertension group was significantly correlated with a reduced risk of cognitive impairment. No significant correlation was found between blood pressure control and cognitive impairment in patients aged <80 years, with hearing impairment, or with cerebrovascular diseases, whether in the hypotension or hypertension groups. There was a significant correlation between hypotension and cognitive impairment, and no correlation between hypertension and cognitive impairment in people aged ≥ 80 years, Han ethnicity and those who used antihypertensive drugs. Furthermore, RCS model analysis showed that there was a non-linear relationship between systolic blood pressure and cognitive impairment in individuals aged ≥ 80 years and those using antihypertensive drugs. There was a linear relationship between diastolic blood pressure and cognitive impairment. Blood pressure control in the hypertensive group was significantly associated with a lower risk of cognitive impairment.

Bivariate Bayesian joint modeling of CEA and E2 values for female breast cancer patients in Xinjiang

We investigate the comprehensive impact of dynamic changes in CEA (carcinoembryonic antigen) and E2 (estradiol) values on the survival prognosis of breast cancer patients in Xinjiang, as well as predict their long-term mortality probabilities. This work is based on the longitudinal and survival data of female breast cancer patients followed up by the Affiliated Tumor Hospital of Xinjiang Medical University. Firstly, the Boruta algorithm was used to screen the independent prognostic factors that related with the breast cancer patients in Xinjiang. Moreover, a bivariate Bayesian joint model for longitudinal and time-to-event data was constructed to investigate how the dynamical changes of CEA and E2 values collectively affect the survival prognosis of breast cancer patients in Xinjiang. The predictive performance of the model was assessed by using ROC curves and calibration curves. As a result, the variable screen results of the Boruta algorithm indicated that CEA, E2, clinical stage, received neoadjuvant treatment, etc., were identified as independent prognostic factors of breast cancer patients in Xinjiang. In addition, it was shown that the association coefficients of the joint model α1 and α2 were statistically significant. When all other baseline variables were unchanged, patients’ death risk separately increases by approximately 1.577 times (HR=2.577, 95%CI: (1.803,3.563)) and 0.887 times (HR=1.887, 95%CI: (1.472,2.454)) with the one-unit collective increase in the log (CEA) and log (E2). Moreover, the joint model had good discrimination and calibration with an AUC value of 0.778. So the collective increase of CEA and E2 would be associated with the breast cancer patients’ poor survival prognosis. It would be essential to monitor the dynamical changes of CEA and E2 values of breast cancer patients in clinical practice in order to provide more accurate individualized treatment for breast cancer patients.

Long-term non-progression in children living with HIV: estimates from international cohort data.

To estimate the probability of long-term nonprogression (LTNP) in the absence of antiretroviral treatment (ART) in children with perinatally acquired HIV, and the impact of LTNP definitions on these estimates. Analysis of longitudinal routine care data (follow-up to 2016) collected through a collaboration of cohorts of children in routine HIV care across Europe and Thailand. LTNP was defined as reaching age 8 years without disease progression (defined as an AIDS diagnosis or immunosuppression based on WHO immunosuppression-for-age thresholds, age-adjusted CD4+z-scores or CD4+ counts). ART initiation was treated as a competing risk (children initiating ART before age 8 were not considered to have LTNP). We included children born domestically in six national HIV cohorts (n = 2481). Additional analyses included domestic-born children enrolled in national cohorts in infancy (aged <12 months, n = 1144, six cohorts), or all domestic-born children in national and nonnational cohorts (n = 4542, 18 cohorts). Results were stratified by birth year. Among children born domestically in national cohorts in 2004-2007, the probability [95% confidence interval (CI)] of LTNP at age 8 years was 10% (6-15%) based on WHO immunosuppression-for-age criteria. This was lower for children born earlier when ART use was less frequent. Results were similar using other immunosuppression thresholds. Estimates were lower when restricted to domestic-born children in national cohorts enrolled in infancy, and higher when including all domestic-born children. Up to 10% of children born during 2004-2007 had LTNP at age 8. Our findings may help identify participants with LTNP for research into posttreatment control and HIV cure.

Impoundments facilitate upstream invasion and introgression: Case studies of fluvial black basses (Micropterus spp.) in the southeastern USA

Impoundment construction has resulted in the alternation and loss of fluvial habitats, threatening the persistence of many native fishes. Compounding this threat, non-native species stocked into impoundments often invade interconnected fluvial habitats, where they may negatively affect native species. Black basses (genus Micropterus) are popular sportfishes with divergent ecologies: some taxa are tolerant of impoundments and widely stocked to create fishing opportunities, whereas others are endemic fluvial specialists that are threatened by introgression with non-native congeneric taxa. We investigated whether impoundments facilitate non-native invasion and introgression in two case study systems: Lake Lanier, Georgia, and Lake Tenkiller, Oklahoma. In both case studies, native fluvial taxa inhabited upstream tributaries and a non-native was established within the downstream impoundment. Results from longitudinal surveys of upstream tributaries provided clear evidence that non-natives invaded upstream from impoundments, and in some cases, extensive introgression with native taxa also occurred. Variation in spatial trends of invasion and directionalities of introgression across case studies provided insights into eco-evolutionary drivers. Within the riverscapes studied, proximity to impoundment appeared to influence invasion and introgression dynamics, and in one case, stream size was also influential. Introgression rates also varied markedly across the species pairs studied–from very little introgression to the onset of hybrid swarming–illustrating the importance of underlying eco-evolutionary mechanisms such as habitat alteration, propagule pressure, and reproductive isolation. Our results underscore the need to consider the upstream influences of impoundments, and the non-natives that invade from them, to create more holistic riverscape conservation plans for fluvial fishes, including native black basses.

Dynamic Relations Between Negative News Media Experiences and Mental Distress? Examining Transactional Effects During Times of Health Crises

ABSTRACT The current study concentrates on individual’s media experiences during public health crises – especially media experiences of fear and issue fatigue regarding COVID-19 news media coverage – and their relationship to mental distress. Specifically, we aim to examine potential transactional effects and ask whether media experiences are only a cause or also a consequence of mental distress throughout a health crisis. Utilizing a three-wave panel survey of German citizens (n = 856), the study employs two random intercept cross-lagged panel models (RI-CLPMs). RI-CLPMs distinguish stable between-person differences from temporal within-person changes, facilitating a nuanced understanding of transactional dynamics. Our study shows distinct relationships between media experiences and mental distress. While the respondents’ experiences of issue fatigue led to subsequent changes in their depressive symptoms, which, in turn, influenced subsequent changes in their issue fatigue at the within-person level, media-related fear experience was strongly associated with depressive symptoms only at the between-person level. Thus, our findings demonstrate a causal transactional relationship between media experiences of issue fatigue and mental distress that evolves over time. Media experiences of fear, however, appear to be a consequence of trait-like differences between individuals rather than a result of intraindividual change.

Spouses’ personalities and marital satisfaction in Chinese families

IntroductionConsidering the traditional Confucian values prevalent in Chinese society, we study the effects of the spouses’ personalities and household sociodemographic circumstances on the marital satisfaction of marriage partners.MethodsWe evaluate the factors that contribute to marital satisfaction, using the 2018 wave of the Chinese Family Panel Survey, including 6,603 households. We use information on both spouses’ Big-Five personality traits, and marital satisfaction. In addition, the effects of the household’s sociodemographic factors on the spouses’ marital satisfaction are estimated. We employ the Actor–Partner Interdependence Model to estimate the effects, using simultaneous equation modeling.ResultsWe find significant actor effects of personality, i.e., agreeableness, openness, conscientiousness, and extroversion, but few partner effects on marital satisfaction. In addition to other socioeconomic effects, we find strong actor effects of subjective social status on marital satisfaction for both spouses. The wife’s level of education had a negative effect on her marital satisfaction.DiscussionThe effects of the spouses’ personalities and sociodemographic circumstances on their marital satisfaction fit the Confucian values fostered in China. The wife’s double burden of having a job and taking care of household duties, negatively affecting her marital satisfaction, may be alleviated by proper government policies.

The impacts of climate and the extreme drought in 2018 on population growth in Swedish moth species

Abstract Insects are pivotal to ecosystem diversity and functionality, yet they face increasing threats from anthropogenic climate change impacts. A growing body of studies reports the effects of changing temperature and precipitation patterns, but relatively few studies focus on the consequences for insect populations because of extreme weather events. Here, we examine population growth responses to temperature, precipitation and the extreme summer drought in Sweden in 2018. For this purpose, we used longitudinal data for 54 moth species collected between 2005 and 2023 using light traps at three sites in southeastern Sweden. We found a positive relationship between temperature and population growth rates across all study sites, while precipitation showed a positive relationship at two sites and no effect at the third. The results indicated a negative time‐lag effect on population growth, at two of the sites, of precipitation the previous year, while there were no significant effects of temperature the previous year. Despite the extreme drought in 2018, moth populations remained resilient, with no dramatic decline in population growth between 2018 and 2019. Our results contrast earlier studies reporting severe declines in population growth in response to extreme drought events. The discrepancy may reflect a combination of region‐specific effects of extreme weather events and that selected species in this study predominantly consist of range‐expanding and migratory species, better able to withstand adverse conditions due to a higher climatic tolerance and being habitat and food plant generalists. Our findings underscore the importance of an increased knowledge of site‐specific responses and effects of extreme weather events such as droughts when outlining conservation efforts.

Still Waters Run Deep: How Employee Silence Affects Instigated Workplace Incivility Over Time

Abstract Research has shown that employees who remain silent about important issues at work are likely to experience negative personal consequences (e.g., burnout, reduced job satisfaction). Less clear is whether silence, over time, could also lead to negative interpersonal consequences. Drawing on social identity theory, we propose that involuntary forms of silence (acquiescent and quiescent silence) lead to decreased organizational identification, which, in turn, leads to increased instigated incivility over time. We tested our model at the within-person level using five waves of longitudinal data across four months from N = 1156 employees working in different industries. In line with predictions, results of random-intercept cross-lagged panel modeling (RI-CLPM) showed that higher acquiescent silence at the within-person level predicted subsequent decreases in organizational identification, which, in turn, predicted subsequent increases in instigated incivility. Contrary to expectations, there was no significant effect of quiescent silence on organizational identification. Supplemental analyses also revealed non-significant indirect effects for voluntary forms of silence (prosocial and opportunistic silence). Overall, these findings suggest that acquiescent silence may not only impair employees’ own well-being, but can also result in interpersonal harm.

Development of item banks to assess financial hardship in cancer survivors using item response theory

BackgroundFinancial hardship is common after a cancer diagnosis. Current financial hardship measures have advanced the field, but assessing the dimensions of financial hardship remains challenging. We created item banks to assess four financial hardship dimensions using item response theory (IRT). IRT-based item banks can be tailored to each context and used in computerized adaptive testing (CAT) to reduce participant burden.MethodsCancer survivors (n = 459) were recruited from a survivorship program and online survey panel to complete an online or paper survey. Four item banks were developed based on previous studies, expert feedback, and patient interviews: financial coping: 41 items, financial consequences: 21 items, financial depression: 15 items, and financial worry: 21 items. We used the two-parameter logistic and graded response models for analysis.ResultsThe IRT model fit well for all four item banks: financial coping root mean square error of approximation (RMSEA) = 0.06, financial consequences RMSEA = 0.03; financial depression RMSEA = 0.05; and financial worry RMSEA = 0.03. The accuracy parameters ranged from 1.01 to 6.53, indicating good reliability for each item. The severity parameters showed each item bank assessed financial hardship across two to three standard deviations, supporting content validity. Short forms were developed for financial consequences, depression, and worry.ConclusionThe item banks can be used to create brief screening measures and, using CAT, efficiently screen for each dimension of financial hardship while minimizing burden. Future research is required to assess the clinical utility of using the item banks to screen for financial hardship.

The Safety of Social Media Instigated Visitation to National Parks in New South Wales, Australia: Insights From a Population Representative Sample.

The integration of social media, smartphone technology and the widespread sharing of images has reshaped tourism, sparking new trends such as selfie-tourism and social media-driven travel. National parks, offering scenic and pristine landscapes, have become prime destinations for these pursuits. The popularity of platforms like Instagram and Facebook, combined with the influence of travel-focused social media personalities, has inspired a wave of visitors seeking "selfie-worthy" locations. However, this shift in visitation motives has raised environmental and safety concerns: visitors venture off-trail, engage in risky photography practices and disrupt natural habitats, increasing the risk of injury and fatalities in hazardous coastal and cliff areas. National parks face growing challenges, with social media's allure prompting a variety of visitors who may lack awareness of responsible tourism practices. This trend imposes costs on park management, emergency services and local ecosystems, necessitating new strategies to balance tourism promotion with ecological protection and public safety. This cross-sectional survey involved New South Wales (NSW) residents aged 18+ who had previously visited a coastal national park in NSW. Conducted online from 18 to 25 August 2023, the survey recruited a demographically representative sample through Dynata, an established survey panel provider. Demographic data included age, gender, education, country of birth, years in Australia, main language spoken at home and language proficiency. The survey examined park visitation behaviours and safety perceptions, with specific questions assessing social media's influence on visitation motivations. A total of 1009 NSW residents completed the survey, with 51.5% identifying as female and 75.4% born in Australia. Social media influenced 32% of respondents to visit coastal national parks, with Instagram being the most popular platform, followed by Facebook and TikTok. Younger age groups (18-34) were significantly more likely to visit parks because of social media compared to older adults (55+; χ2 = 252.07, p < 0.05), though no significant difference was found by gender. Social media platform preferences differed by age, with younger respondents favouring Instagram and TikTok and older respondents favouring Facebook (χ2 = 316.18; p < 0.001). Of those who visited due to social media, 65% took photos and 36% engaged in risky photography (e.g., cliff edges), though no significant age difference was found for risky photo behaviour. Although 56.8% considered park infrastructure safe for social media photos, 43.1% did not, with respondents suggesting improvements in barriers, signage and individual responsibility. The study findings underscore the need for a stronger focus on visitor safety related to photography in NSW national parks, with acknowledgement of visitation instigated by social media. Risky behaviours associated with photography are prevalent and pose significant safety challenges. Public health initiatives should prioritise educational campaigns and safety infrastructure improvements that address risky photography behaviours, independent of social media influences. SO WHAT?: Park management should highlight personal responsibility and consider educational campaigns about the potential dangers of photography in these settings. Nevertheless, social media companies have a role to play in controlling dangerous content that is published on their platforms which is leading to risky behaviours in the real world.

The use and subjective experience of sleep apps and their relationship with personality characteristics among young adults

IntroductionSleep app use has become widespread in recent years. Still, understanding of characteristics of users and the impact of sleep app usage remains limited.MethodsA sample of 940 young adults (18–30 years) living in the UK were recruited from Prolific (online research platform offering researchers access to survey panels) and invited to participate in a survey on the use and experience with sleep apps. Both sleep app users and non-users were invited. The survey included questions about demographics, morningness (Horne–Östberg Morningness–Eveningness Questionnaire-reduced scale), insomnia symptoms (Bergen Insomnia Scale), personality (HEXACO: Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, and Openness to Experience), in addition to sleep app usage and how such use is experienced. A logistic regression analysis was conducted to identify characteristics of sleep app users. Factor analysis was used to elucidate dimensions of sleep app use experiences. Scores on the items making up each factor were then regressed on demographic variables, morningness, insomnia symptoms and personality.ResultsIn all, 36.8% of the participants reported using or having used sleep apps. Use was positively associated with age, insomnia symptoms, and conscientiousness. The factor analysis revealed three factors coined: trust/objectification (trust in sleep app results), negative (e.g., becoming stressed) and positive (e.g., prioritize sleep more) perceived effects. Trust/objectification was positively associated with age and agreeableness, and inversely related to high education and openness to experience. Insomnia symptoms and emotionality were associated with perceived negative effects. Morningness and male gender were associated with perceived positive effects whereas high education had an inverse relationship with perceived positive effects.DiscussionThe use of sleep apps was widespread. Different responses to sleep app usage were observed and linked to various individual variables. The findings suggest that perceived effects of sleep apps usage should be considered in light of individual differences. Research on sleep apps is still in its early stages, and several suggestions (recommendations) for future studies are outlined.

Impact of Modifiable Factors Associated with Physical Frailty and Cognitive Impairment Trajectory of Older Adults: Using the Korean Longitudinal Study of Aging 2006–2018

Background/Objectives: To identify joint trajectories of physical frailty and cognitive impairment among community-dwelling older adults and to determine modifiable factors for each trajectory. Methods: Data were utilized from the Korean Longitudinal Study of Aging, which was conducted between 2006 and 2018. Physical frailty was assessed using the Fried phenotype, and cognitive impairment was evaluated using the Korean version of the Mini-Mental State Examination. Group-based trajectory modeling and logistic regression were employed for the analyses. Results: Based on longitudinal data, 415 participants averaging 72.2 years of age were analyzed. Three trajectories of physical frailty were identified: mild physical frailty, moderate physical frailty, and improving frailty. Two trajectories of cognitive impairment were identified: stable cognitive impairment and improving cognitive impairment. Factors influencing physical frailty trajectories included the number of medications taken, being overweight or obese, and depression. Education level was found to be associated with cognitive impairment trajectories. Conclusions: This study provides evidence for the distinct identification of joint trajectories of physical frailty and cognitive impairment, which can inform the target groups for intervention. It offers a basis for including modifiable physical and mental factors in intervention components for physical frailty trajectories.