Health-promotion interventions targeting multiple behaviors: A meta-analytic review of general and behavior-specific processes of change.

Although health-promotion interventions that recommend changes across multiple behavioral domains are a newer alternative to single-behavior interventions, their general efficacy and their mechanisms of change have not been fully ascertained. This comprehensive meta-analysis (6,878 effect sizes from 803 independent samples from 364 research reports, N = 186,729 participants) examined the association between the number of behavioral recommendations in multiple-behavior interventions and behavioral and clinical change across eight domains (i.e., diet, smoking, exercise, HIV [Human Immunodeficiency Virus] prevention, HIV testing, HIV treatment, alcohol use, and substance use). Results showed a positive, linear effect of the number of behavioral recommendations associated with behavioral and clinical change across all domains, although approximately 87% of the samples included between 0 and 4 behavioral recommendations. This linear relation was mediated by improvements in the psychological well-being of intervention recipients and, in several domains (i.e., HIV, alcohol use, and drug use), suggested behavioral cuing. However, changes in information, motivation, and behavioral skills did not mediate the impact of the number of recommendations on behavioral and clinical change. The implications of these findings for theory and future intervention design are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

T(H)1, T(H)2, and T(H)17 cells instruct monocytes to differentiate into specialized dendritic cell subsets.

Monocytes and T helper (T(H)) cells rapidly infiltrate inflamed tissues where monocytes differentiate into inflammatory dendritic cells (DCs) through undefined mechanisms. Our studies indicate that T(H) cells frequently interact with monocytes in inflamed skin and elicit the differentiation of specialized DC subsets characteristic of these lesions. In psoriasis lesions, T(H)1 and T(H)17 cells interact with monocytes and instruct these cells to differentiate into T(H)1- and T(H)17-promoting DCs, respectively. Correspondingly, in acute atopic dermatitis, T(H)2 cells interact with monocytes and elicit the formation of T(H)2-promoting DCs. DC formation requires GM-CSF and cell contact, whereas T(H) subset specific cytokines dictate DC function and the expression of DC subset specific surface molecules. Moreover, the phenotypes of T cell-induced DC subsets are maintained after subsequent stimulation with a panel of TLR agonists, suggesting that T(H)-derived signals outweigh downstream TLR signals in their influence on DC function. These findings indicate that T(H) cells govern the formation and function of specialized DC subsets.

Social Distancing and Adolescent Psychological Well-Being: The Role of Practical Knowledge and Exercise.

BACKGROUND AND OBJECTIVES: This intensive longitudinal study investigated 1) the extent to which engaging in social distancing predicted adolescents' same- and next-day stress and positive affect and 2) whether COVID-19-related knowledge and exercise moderated these links during statewide stay-at-home orders that mandated schools and nonessential businesses to close during the coronavirus pandemic. METHODS: Over the course of 28 days at the onset of the COVID-19 pandemic, a nationwide sample of 349 adolescents (Mean age = 15.0; 40% male; 44% Black, 39% White, 9% Latinx, 6% Asian American, 2% Native American) completed daily surveys about their social distancing behaviors, knowledge about the coronavirus, and exercise habits. Analysis was conducted on a total of 9372 assessments using longitudinal multilevel modeling approaches. RESULTS: Daily engagement in social distancing predicted increases in adolescents' stress and decreases in their positive affect. Practical knowledge about COVID-19 and daily exercise moderated these links. Specifically, practical knowledge and exercise weakened the positive link between social distancing and stress as well as the negative link between social distancing and positive affect. CONCLUSIONS: Adolescents' practical knowledge and exercise have the potential to buffer against the adverse effects of social distancing on stress and positive affect. However, it is critical for health care providers to recognize that youth are experiencing significant stress due to the disruption of developmentally normal patterns of social interaction. Pediatricians should focus on explaining the rationale behind social distancing while encouraging exercise as an adaptive coping mechanism that has benefits for psychological well-being.

The roles of stress, coping, and parental support in adolescent psychological well-being in the context of COVID-19: A daily-diary study.

BACKGROUND: COVID-19 has introduced novel stressors into American adolescents' lives. Studies have shown that adolescents adopt an array of coping mechanisms and social supports when contending with stress. It is unclear, though, which strategies are most effective in mitigating daily pandemic-related stress, as few micro-longitudinal studies have explored adolescents' daily affect during COVID-19. Parental support may also be a critical component of adolescents' pandemic-related coping, as adolescents' peer networks have been limited by public health measures. METHODS: This longitudinal study examined links between stress, coping, parental support, and affect across 14 consecutive days and 6216 assessments from a national sample of adolescents (N=444; Mage=15.0; 60% female; 44% Black/African American, 39% White/Europen American, 9% Latinx, 6% Asian American, 2% Native American) during school closures and state-mandated stay-at-home orders between April 8 and April 21, 2021. RESULTS: Adolescents' health and financial stress predicted increases in same-day (health stress' effect size = .16; financial stress' effect size = .11) and next-day negative affect (health stress' effect size = .05; financial stress' effect size = .08). Adolescents' secondary control engagement coping predicted increases in same-day (effect size = .10) and next-day (effect size = .04) positive affect and moderated the link between health stress and negative affect. Parental social support predicted increases in same-day (effect size = .26) and next-day (effect size = .06) positive affect and decreases in same-day (effect size = .17) negative affect and moderated the link between financial stress and negative affect. LIMITATIONS: Results are indicative of conditions at the immediate onset of COVID-19 and should be interpreted as such. CONCLUSIONS: Findings provide information as to how health providers and parents can help adolescents mitigate the impact of COVID-19-related health and economic stressors on their psychological well-being. It remains critical to monitor the psychosocial impact of the pandemic on adolescents' affect while continuing to identify personal and environmental protective factors for reducing harm and maximizing resilience.

Qa-1(b)-dependent modulation of dendritic cell and NK cell cross-talk in vivo.

Dendritic cells (DC) trigger activation and IFN-gamma release by NK cells in lymphoid tissues, a process important for the polarization of Th1 responses. Little is known about the molecular signals that regulate DC-induced NK cell IFN-gamma synthesis. In this study, we analyzed whether the interaction between Qa-1(b) expressed on DC and its CD94/NKG2A receptor on NK cells affects this process. Activation of DC using CpG-oligodeoxynucleotides in Qa-1(b)-deficient mice, or transfer of CpG-oligodeoxynucleotide-activated Qa-1(b)-deficient DC into wild-type mice, resulted in dramatically increased IFN-gamma production by NK cells, as compared with that induced by Qa-1(b)-expressing DC. Masking the CD94/NKG2A inhibitory receptor on NK cells in wild-type mice similarly enhanced the IFN-gamma response of these cells to Qa-1(b)-expressing DC. Furthermore, NK cells from CD94/NKG2A-deficient mice displayed higher IFN-gamma production upon DC stimulation. These results demonstrate that Qa-1(b) is critically involved in regulating IFN-gamma synthesis by NK cells in vivo through its interaction with CD94/NKG2A inhibitory receptors. This receptor-ligand interaction may be essential to prevent unabated cytokine production by NK cells during an inflammatory response.

Natural killer cells trigger differentiation of monocytes into dendritic cells.

Circulating monocytes can differentiate into dendritic cells (moDCs), which are potent inducers of adaptive immune responses. Previous reports show that granulocyte macrophage-colony-stimulating factor (GM-CSF) and interleukin-4 induce monocyte differentiation into moDCs in vitro, but little is known about the physiological requirements that initiate moDC differentiation in vivo. Here we show that a unique natural killer (NK) cell subset (CD3(-)CD56(bright)) that accumulates in lymph nodes and chronically inflamed tissues triggers CD14(+) monocytes to differentiate into potent T-helper-1 (T(H)1) promoting DC. This process requires direct contact of monocytes with NK cells and is mediated by GM-CSF and CD154 derived from NK cells. It is noteworthy that synovial fluid (SF) from patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA), but not osteoarthritis (OA), induces monocytes to differentiate into DC. However, this process occurs only in the presence of NK cells. We propose that NK cells play a role in the maintenance of T(H)1-mediated inflammatory diseases such as RA by providing a local milieu for monocytes to differentiate into DC.