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Objective: Psychological stress has long been posited as a potential risk factor for breast cancer. We aimed to examine the relationship between occupational stress and the incidence of invasive breast cancer among postmenopausal women from the Women’s Health Initiative Observational Study. Method: Occupational stress was characterized through linkage of Standard Occupational Classification codes for participants’ jobs to the Occupational Information Network. Following the Karasek job strain model, we cross-categorized demand and control and created four categories of occupational strain. Cox proportional hazards regression models were used to calculate hazard ratios and 95% confidence intervals (CIs). Results: Women with a history of high-strain work (high demand and low control) compared to low-strain work (low demand and high control) were 9% more likely to develop invasive breast cancer during follow-up (hazard ratios = 1.09; 95% CI [1.00, 1.19]) when controlling for age, race/ethnicity, geographical region, education, marital status, and familial history of breast cancer. This weak association between high-strain work and risk of breast cancer was rather consistent across analyses, but CIs included the null value in most models. Conclusions: Our results highlight the potential importance of the occupational domain as a source of stress for women and suggest a possible, but yet tenuous, role in chronic disease etiology. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Objective: Most cancer patients undergoing hematopoietic stem cell transplant report elevated symptoms and reduced health-related quality of life during peritransplant. These concerns can become persistent. A prior randomized controlled trial showed that expressive helping—a low-burden, brief intervention combining expressive writing with a novel peer support writing exercise—reduced psychological distress and physical symptoms in long-term transplant survivors with moderate/high persistent symptoms. The Writing for Insight, Strength, and Ease trial evaluated the use of expressive helping during peritransplant, when symptoms peak and early intervention could prevent the development of persistent symptoms. Method: Three hundred sixty-six adult blood cancer patients (44.3% female, 74.6% White, 13.4% Black, 11.5% Hispanic/Latinx) scheduled for allogeneic (33.9%) or autologous (66.1%) transplant were randomized to complete either expressive helping or a neutral writing task in four writing sessions beginning pretransplant and ending 4 weeks posthospital discharge. Symptom severity (primary outcome), distress (depressive symptoms, generalized and cancer-specific anxiety), health-related quality of life, and fatigue were measured in multiple assessments from prerandomization to 12 months postintervention. Primary endpoints at 3 and 12 months postintervention estimated short- and long-term intervention effects. Moderation analyses explored subgroup differences in intervention efficacy. Results: Mixed models with repeated measures analyses revealed no statistically or clinically significant intervention effects on primary or secondary outcomes. Moderation analyses did not identify subgroups of participants who benefitted from the intervention. Conclusion: Findings do not support use of expressive helping during peritransplant. We recommend that survivors with persistent symptoms complete expressive helping at least 9 months posttransplant, consistent with evidence from a prior trial. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Objective: This field experiment examined the efficacy of a behavioral nudge intervention towards lowering sugar intake in Indonesia. Specifically, two competing hypotheses were tested as to whether behavioral nudge played an additive role (i.e., the Incremental Hypothesis) or contributed to a ceiling effect (i.e., the Saturation Hypothesis) alongside social context and competition in a multimodal intervention program. Method: This field experiment used a three-factorial mixed design involving 403 Indonesian participants based on power statistical analysis: 2 (sugar content nudge: lower sugar tea vs. regular sugar tea default) × 2 (social context: individual vs. group) × 2 (competition: absent vs. present). Results: Nudging was the most powerful intervention in reducing sugar intake, but its effectiveness might be attenuated by social loafing even within Indonesia’s collectivist culture. Competition did not work synergistically with nudging but was effective under the nonnudge condition. Conclusion: Our results are consistent with those of previous research showing that behavioral nudging has a stronger impact on behavioral change than nonnudge strategies. Contrary to some previous research, people in collectivist Indonesia did engage in social loafing: achievement motivation is not necessarily enhanced in a team of people in a collectivist culture. The Nudge × Competition interaction supports the saturation hypothesis in favor of behavioral nudging: using more than one intervention, when a potent strategy such as nudging is present, might result in diminishing returns that could reduce the overall benefit-cost profile of such multimodal intervention programs. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Objective: The effectiveness of behavioral interventions is typically evaluated relative to control conditions using null hypothesis significance testing (i.e., p < .05) or effect sizes. These criteria overlook comparisons with previous interventions and do little to promote a cumulative science of behavior change. We conducted a systematic review of the effectiveness of interventions to promote colorectal cancer screening (CCS) and generated benchmarks via the percentile distribution of ORs, screening rates for intervention and control arms, and differential screening rates (intervention minus control rate) in respective trials. Method: Literature searches identified 187 eligible tests (N = 371,018). Results: Random effects meta-analysis computed a sample-weighted OR = 1.69 (95% CI [1.55, 1.84]) and meta-regression showed that there was no improvement in the effectiveness of CCS interventions between 1996 and 2022. Benchmarking indicated that the median effect size was OR = 1.32, equivalent to a 35.7% screening rate in the intervention arm, and a 5.9% differential screening rate. Benchmarks were also generated for different types of screening (e.g., fecal immunochemical test, colonoscopy), sample characteristics (e.g., race, socioeconomic status), and methodological features (e.g., control conditions). Conclusions: Interventions to promote CCS have a small effect and effectiveness has not increased over time. The percentile values for effect sizes and screening rates reported here can be used to benchmark the effectiveness of future trials. Benchmarking offers a way to evaluate interventions that are grounded in accumulated evidence and can inform judgments about tradeoffs among effectiveness, reach, and cost. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Objective: Sleep deprivation and reduced sleep quality are common in adolescents and negatively impact their physical and mental wellbeing. This study evaluates the effect of a participatory-developed school-based healthy sleep intervention for adolescents. Method: A 16-week long intervention, cocreated with adolescents, was conducted with two schools with four schools serving as measurement-only controls. Intervention elements included a kickoff event, posters, Instagram posts, an application, and class activities. Data on sleep parameters, sleep hygiene, and psychosocial factors were collected before, immediately after, and 6 months after implementation (N = 1,176; 15.2 ± 0.7 years; 37.9% girls). Sleep duration was objectively measured with activity trackers in a subsample (n = 133). Generalized linear mixed models were applied to analyze the intervention effect in RStudio. Results: Participants in the intervention group demonstrated significant increases in sleep knowledge and larger decreases in supportive peer and parental factors compared to the control group. At 6 months, the intervention group displayed increased self-reported weekend sleep duration and objectively measured week sleep duration. There was a significantly smaller increase in the use of screens in bed and barriers toward screen use in bed in the intervention group compared to the control group. Finally, a significant decrease in peer modeling and mental support of parents was observed in the intervention group (versus significant increase and no significant change in the control group, respectively). Conclusion: Researchers developing healthy sleep interventions should consider combining a participatory approach with a theory-based protocol including the use of active parental components. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Objective: To examine the rates as well as the interdependence of depressive symptoms and sleep problems in patients with cancer and their intimate partner family caregivers. Method: Patients diagnosed with cancer (69.3 years old, 56.9% male) and their intimate family caregivers (63.8 years old, 30.7% male) were enrolled in the study (n = 188 dyads). Both patients and intimate partner family caregivers completed the Center for Epidemiological Studies-Depression and the Pittsburgh Sleep Quality Index. Descriptive statistics and Actor–Partner Interdependence Modeling were used to test the hypotheses. Results: The rates of depressive symptoms in the clinical range were 39% for patients and 33% in intimate partner family caregivers. A mean of 6.3 (SD = 1.9) and 6.5 (SD = 1.5) hours of sleep was reported by patients with cancer and intimate partner family caregivers. The mean sleep efficiency (76.6% and 81.3%) and sleep quality (8.25 and 7.2) were poor for both partners. After covarying for age, sex, body mass index, smoking status, pain, and cancer stage, patients’ depressive symptoms were associated with their own shorter sleep duration. Patient depressive symptoms were associated with their own and their partners‘ f poorer sleep efficiency and poorer sleep quality. Caregivers’ depressive symptoms were also associated with their own poorer sleep quality. Conclusions: The mood of both partners affect on sleep, and potentially health, was underscored by the findings. The development of dyadic interventions is warranted to improve both mood and sleep in both the patient and caregivers in the context of cancer. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Objective: This study aimed to examine asthma disparities at the intersection of four sociodemographic characteristics, inhaled substance use, and bias-based bullying as metrics of stigma. We hypothesized that high prevalence groups for asthma would be those with marginalized social positions and those reporting bullying experiences, independent of inhaled substance use. Method: The analytic sample (N = 90,367) included eighth, ninth, and 11th grade students who participated in the 2022 Minnesota Student Survey. Exhaustive Chi-square Automatic Interaction Detection tested all combinations of sociodemographic characteristics (gender identity, sexual orientation, racial/ethnic identity, and access to resources), inhaled substance use (none vs. any), and bias-based bullying about sexuality, gender identity/expression, racial identity, and weight/size to predict mutually exclusive groups of youth based on self-reported asthma diagnosis. Results: Approximately 15% of the sample reported asthma. Sexually, gender, and racially/ethnically diverse youth reported higher rates of asthma relative to their heterosexual, cisgender, and White counterparts. High prevalence groups for asthma (rates between 24% and 41%) were characterized by having multiple marginalized identities, experiencing bias-based bullying, and engaging in inhaled substance use. Three of the 10 intersectional groups with a high prevalence of asthma were not inhaled substance users. Conclusions: These findings suggest that stigma may help explain the asthma disparities among marginalized youth. Efforts to reduce asthma disparities in marginalized youth should move beyond pathologizing the individual through overfocusing on health behaviors and attend to root causes, like experiences of stigma. Future studies should examine systemic inflammation as the potential connection between stigma and asthma. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
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Mon, 16 Dec 2024 00:00:00 GMT