Climate Change Harm Perception Among U.S. Adults in the NCI Health Information National Trends Survey, 2022.

PURPOSE: To examine associations between 1) sociodemographics and 2) trust in health information sources with climate change harm perception. METHODS: Weighted adjusted logistic regression models examined correlates of climate change harm perception (harm vs no harm/don't know) among a nationally representative sample of U.S. adults (2022, n = 5585). RESULTS: Sixty-four percent of U.S. adults believed climate change will harm their health. College education (vs high school or less) (AOR 1.7, 95% CI 1.3, 2.2) and having greater trust in doctors (AOR 1.4, 95% CI 1.2, 1.7), scientists (aOR 1.8, 95% CI 1.6, 2.0), and government health agencies (AOR 1.7, 95% CI 1.5, 1.9) for health information were associated with believing climate change harms health. Conversely, greater trust in religious organizations was associated with 16% lower odds of believing climate change harms health (95% CI .74, .94). CONCLUSIONS: Climate change harm perception varied by sociodemographics and trust in health information source. Health communication delivered via alternative and diverse channels could expand the reach of climate and health messaging and ultimately increase public awareness and support for measures to mitigate the health impacts of climate change.

Neuroticism, cancer mortality salience, and physician avoidance in cancer survivors: Proximity of treatment matters.

OBJECTIVE: To examine if the relationship between neuroticism and physician avoidance/physician visit concerns are mediated by perceptions that cancer is associated with death ("cancer mortality salience"; CMS) for cancer survivors to inform public health interventions and tailored health communications. METHODS: Cancer survivors comprised 42.3% of the total sample (n = 525). Participants completed a 4-item neuroticism scale, 4-item cancer perceptions scale, and 4-item physician avoidance and concerns scale. Multiple linear regression models were used to assess relationships among variables for cancer survivors and separately for those without a history of cancer. RESULTS: Neuroticism was positively associated with CMS for cancer survivors, b = 0.26, (p < 0.001), and those without cancer, b = 0.22, (p < 0.001). There was an association between neuroticism and physician avoidance among cancer survivors with temporally distant treatment courses after controlling for CMS, b = 0.56 (p = 0.006), but not for those currently or recently having had undergone treatment (p = 0.949). There was also an indirect relationship between neuroticism and physician visit concerns that was mediated by CMS for cancer survivors, b = 0.07, CI = [0.03, 0.13], but this relationship was again driven by cancer survivors with more distal treatment courses. CONCLUSIONS: High neuroticism in cancer survivors is associated with physician avoidance and physician visit concerns when treatment is temporally distant. Interventions aimed at decoupling the association between cancer and death can help increase the willingness of cancer survivors to attain cancer care follow-ups and healthcare more generally.

Conceptual models for implementing solution-oriented team science in large research consortia.

Large translational research initiatives can strengthen efficiencies and support science with enhanced impact when practical conceptual models guide their design, implementation, and evaluation. The National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) program brings together data from 72 ongoing maternal-child cohort studies - involving more than 50,000 children and over 1200 investigators - to conduct transdisciplinary solution-oriented research that addresses how early environmental exposures influence child health. ECHO uses a multi-team system approach to consortium-wide data collection and analysis to generate original research that informs programs, policies, and practices to enhance children's health. Here, we share two conceptual models informed by ECHO's experiences and the Science of Team Science. The first conceptual model illuminates a system of teams and associated tasks that support collaboration toward shared scientific goals. The second conceptual model provides a framework for designing evaluations for continuous quality improvement of manuscript writing teams. Together, the two conceptual models offer guidance for the design, implementation, and evaluation of translational and transdisciplinary multi-team research initiatives.

Perspective: Time-Restricted Eating Compared with Caloric Restriction: Potential Facilitators and Barriers of Long-Term Weight Loss Maintenance.

A growing body of literature examines the potential benefits of a time-based diet strategy referred to as time-restricted eating (TRE). TRE, a type of intermittent fasting, restricts the time of eating to a window of 4-12 h/d but allows ad libitum intake during eating windows. Although TRE diets do not overtly attempt to reduce energy intake, preliminary evidence from small studies suggests that TRE can lead to concomitant reduction in total energy, improvements in metabolic health, and weight loss. Unique features of the TRE diet strategy may facilitate adherence and long-term weight loss maintenance. In this Perspective, we explore the potential multilevel (i.e., biological, behavioral, psychosocial, environmental) facilitators and barriers of TRE for long-term weight loss maintenance in comparison with the more commonly used diet strategy, caloric restriction (CR). Compared with CR, TRE may facilitate weight loss maintenance by counteracting physiological adaptations to weight loss (biological), allowing for usual dietary preferences to be maintained (behavioral), preserving executive functioning (psychosocial), and enabling individuals to withstand situational pressures to overeat (environmental). However, TRE may also pose unique barriers to weight loss maintenance, particularly for individuals with poor baseline diet quality, internal or social pressures to eat outside selected windows (e.g., grazers), and competing demands that interfere with the scheduling of eating. Future studies of TRE in free-living individuals should consider the multiple levels of influence impacting long-term adherence and weight loss maintenance. Ultimately, TRE could be one strategy in a toolkit of tailored diet strategies to support metabolic health and weight loss maintenance.

Health Behaviors of Cancer Survivors and Population Controls From the National Health Interview Survey (2005-2015).

BACKGROUND: Population-based data from the National Health Interview Survey were examined to provide estimates of a wide range of health behaviors in cancer survivors (ie, physical activity, sun protection, alcohol use, cigarette and e-cigarette use, sleep, and diet) and trends over time. METHODS: Data were collected from 92 257 participants across 3 waves of the National Health Interview Survey. A total of 8050 participants reported having had cancer (2428 in 2005, 2333 in 2010, 3289 in 2015). Weighted and adjusted odds ratios (OR) between cancer survivors and controls were calculated using logistic and multivariable regressions in SPSS, and trend analyses from 2005 to 2015 were conducted. All statistical tests are 2-sided. RESULTS: After adjusting for demographics (2005-2015), cancer survivors, compared with controls, were more likely to wear sunscreen (OR = 1.41, 95% confidence interval [CI] = 1.32 to 1.51) and protect their skin (P < .001) and were less likely to tan indoors (OR = 0.81, 95% CI = 0.69 to 0.95), but reported less sleep (OR = 0.91, 95% CI = 0.85 to 0.98). In adjusted models, no differences were found for physical activity, sunburns, alcohol use, smoking, e-cigarette use, and diet. Smoking rates for cancer survivors decreased from 2005 to 2015 (P < .001) and physical activity increased (P = .02), but physical activity was not statistically significant after adjusting for multiple comparisons. All other health behavior rates for cancer survivors were unchanged from 2005 to 2015 (P > .14). CONCLUSION: After adjusting for covariates, cancer survivors exhibited healthier sun protection, but not sleep behaviors, compared with controls. Cancer survivors (and controls) exhibited decreased smoking rates over time. These results may inform interventions focused on improving cancer control and prevention of other chronic conditions among cancer survivors.

An analysis of online pregnancy message boards: Mother-to-mother advice on medication use.

PROBLEM AND BACKGROUND: Psychotropic medication use is increasingly common among pregnant women. Many women solicit information from other mothers about the safety of these medications for use during pregnancy, yet little is known about the specific advice they receive. AIM: The purpose of the current study was to examine the type of feedback women receive on a popular internet message board about psychotropic medication use during pregnancy. METHODS: A modified Consensual Qualitative Research approach was used to analyze 1728 comments posted by Babycenter.com users about the safety of the use of six common psychotropic medications during pregnancy. Researchers analyzed the comments for overall themes and core ideas. FINDINGS: Results found that comments were comprised of six themes: (1) Personal Anecdotes, (2) Suggesting Alternative Solutions, (3) Directives, (4) Judgement, (5) Social Support, (6) Skepticism & Mistrust, and (7) Risks vs. Benefits. While many comments conveyed emotional support, or encouraged women to seek professional advice, others contained inaccurate and/or contradictory information, or harsh criticism. CONCLUSION: Given that the decision about the use of medication during pregnancy has implications for the health of the mother and fetus, it is important for care providers to be aware of what feedback women may receive from this source. Providers should address questions and concerns that women have about safety of these medications and recognize how the social context of the internet impacts the emotional health of pregnant women faced with these decisions.

Addressing Health Challenges of Women Across the Life Course: Summary of the Women's Health 2018 Preconference Symposium.

Although the United States is often ahead in both research and health care fields, it lags behind peer countries in many population health indicators. To address these complex health problems that often reflect the intersection of many socioeconomic and health issues, it is essential that scientists work collaboratively across distinct disciplines. Women's health is but one area which can benefit from such an approach given the multifaceted and complex issues underlying the different aspects of women's health research. The National Institutes of Health (NIH) Office of Research on Women's Health (ORWH) and the Office of Women's Health of the U.S. Food and Drug Administration (FDA) cosponsored a preconference symposium at the Women's Health 2018 Conference, held in May in Arlington, VA, to highlight interdisciplinary approaches to research, how researchers can work collaboratively, and how to apply multifaceted approaches to complex real-world problems. Three speakers presented information on a range of subjects related to the health of women across the life course, including the distinction between multidisciplinary, interdisciplinary, and transdisciplinary approaches; the science behind Team Science and how its findings apply to working collaboratively; and gender inequalities in the opioid epidemic. This article summarizes the major points of the presentations and the subsequent discussions.

The ecology of multilevel intervention research.

Behavior change research to promote health and prevent disease increasingly relies on a complex set of interacting characteristics across levels of influence such as biological, psychological, behavioral, interpersonal, and environmental. How to best develop health-related interventions that incorporate the individual, the macro-environment, and their interactions remains a challenge. This article considers a set of key dimensions that constitute what we refer to as the ecology of research across a broad context of multilevel research (MLR), spanning fundamental multilevel research (FMLR), multilevel intervention research (MLIR), and multilevel implementation science (MIS). With the goal of promoting improvements in MLIR, we describe the inherent interdependencies among aspects of research and consider how the growth and development of evidence and resources influence the cross-talk among researchers from different perspectives (e.g., disciplines and domains). We propose a framework that highlights opportunities to reduce barriers and address gaps in areas critical to generating an evidence base through MLR, MLIR, and MIS. Overall, we aim to support strategic decisions that can accelerate our understanding of ML health outcomes and interactions among factors within and across levels, with the goal of strengthening the effectiveness of ML interventions across health-related outcomes.

The science of team science: A review of the empirical evidence and research gaps on collaboration in science.

Collaborations among researchers and across disciplinary, organizational, and cultural boundaries are vital to address increasingly complex challenges and opportunities in science and society. In addition, unprecedented technological advances create new opportunities to capitalize on a broader range of expertise and information in scientific collaborations. Yet rapid increases in the demand for scientific collaborations have outpaced changes in the factors needed to support teams in science, such as institutional structures and policies, scientific culture, and funding opportunities. The Science of Team Science (SciTS) field arose with the goal of empirically addressing questions from funding agencies, administrators, and scientists regarding the value of team science (TS) and strategies for successfully leading, engaging in, facilitating, and supporting science teams. Closely related fields have rich histories studying teams, groups, organizations, and management and have built a body of evidence for effective teaming in contexts such as industry and the military. Yet few studies had focused on science teams. Unique contextual factors within the scientific enterprise create an imperative to study these teams in context, and provide opportunities to advance understanding of other complex forms of collaboration. This review summarizes the empirical findings from the SciTS literature, which center around five key themes: the value of TS, team composition and its influence on TS performance, formation of science teams, team processes central to effective team functioning, and institutional influences on TS. Cross-cutting issues are discussed in the context of new research opportunities to further advance SciTS evidence and better inform policies and practices for effective TS. (PsycINFO Database Record

Integrating knowledge across domains to advance the science of health behavior: overcoming challenges and facilitating success.

Health behaviors often co-occur and have common determinants at multiple levels (e.g., individual, relational, environmental). Nevertheless, research programs often examine single health behaviors without a systematic attempt to integrate knowledge across behaviors. This paper highlights the significant potential of cross-cutting behavioral research to advance our understanding of the mechanisms and causal factors that shape health behaviors. It also offers suggestions for how researchers could develop more effective interventions. We highlight barriers to such an integrative science along with potential steps that can be taken to address these barriers. With a more nuanced understanding of health behavior, redundancies in research can be minimized, and a stronger evidence base for the development of health behavior interventions can be realized.

Transdisciplinary translational behavioral (TDTB) research: opportunities, barriers, and innovations.

The translation of basic behavioral science discoveries into practical strategies represents a promising approach to developing more effective preventive interventions to improve health. Since translational research inevitably involves making use of diverse perspectives from multiple disciplines, it is best conducted as a transdisciplinary enterprise. In this paper, we discuss current strategies used by NIH to support transdisciplinary translational behavioral (TDTB) research, summarize successful efforts, and highlight challenges encountered in conducting such work (ranging from conceptual to organizational to methodological). Using examples from NIH-funded projects we illustrate the potential benefits of, and barriers to, pursuing this type of research and discuss next steps and potential future directions for NIH-supported TDTB research.

Use of Health Behavior Theory in Funded Grant Proposals: Cancer Screening Interventions as a Case Study.

BACKGROUND: Interventions using theory should change behavior and identify both mechanisms of effect and necessary conditions. To date, inconsistent description of "use of theory" has limited understanding of how theory improves intervention impact. PURPOSE: The purpose of this study was to describe the use of theory in health behavior intervention development by coding grant proposals. METHODS: We developed an abstraction tool to characterize investigators, interventions, and theory use and identified seven core elements describing both how and how much theory was used. We used the tool to review and code NCI's funded cancer screening intervention R01 proposals, 1998-2009. RESULTS: Of 116 proposals, 38 met criteria; all but one described a conceptual model unique to the proposed research. Few proposals included plans to identify mechanisms of effect or conditions necessary for intervention effectiveness. CONCLUSIONS: Cancer screening intervention grant proposals rarely use theory in ways that advance behavioral or theoretical sciences. Proposed core elements may classify and synthesize the use of theory in behavioral intervention research.

Haptic control of a pneumatic muscle actuator to provide resistance for simulated isokinetic exercise; part II: control development and testing.

Pneumatic muscle actuators (PMAs) have a high power to weight ratio and possess unique characteristics which make them ideal actuators for applications involving human interaction. PMAs are difficult to control due to nonlinear dynamics, presenting challenges in system implementation. Despite these challenges, PMAs have great potential as a source of resistance for strength training and rehabilitation. The objective of this work was to control a PMA for use in isokinetic exercise, potentially benefiting anyone in need of optimal strength training through a joint's range of motion. The controller, based on an inverse three-element phenomenological model and adaptive nonlinear control, allows the system to operate as a type of haptic device. A human quadriceps dynamic simulator was developed (as described in Part I of this work) so that control effectiveness and accommodation could be tested prior to human implementation. Tracking error results indicate that the control system is effective at producing PMA displacement and resistance necessary for a scaled, simulated neuromuscular actuator to maintain low-velocity isokinetic movement during simulated concentric and eccentric knee extension.

Advancing Transdisciplinary Research: The Transdisciplinary Research on Energetics and Cancer Initiative.

Strategies for constructing and maintaining cross-disciplinary teams are in their infancy. We outline strategies to support one form, transdisciplinary research, in a major initiative of the National Cancer Institute, the Transdisciplinary Research in Energetics and Cancer 2 (TREC2) initiative. Discussion of the TREC2 sites' experiences with transdisciplinarity is structured around a conceptual model that identifies four iterative phases of transdisciplinary research. An active coordination center, regular face-to-face meetings, and input from external advisors were instrumental in moving TREC2 to the translation phase. The possibilities for advancements in the science of energetics and cancer increased as investigator ties became denser. TREC2 can be seen as a flagship effort in transdisciplinary science that provides lessons on moving ideas from development to translation.

Future directions for postdoctoral training in cancer prevention: insights from a panel of experts.

Cancer prevention postdoctoral fellowships have existed since the 1970s. The National Cancer Institute facilitated a meeting by a panel of experts in April 2013 to consider four important topics for future directions for cancer prevention postdoctoral training programs: (i) future research needs; (ii) underrepresented disciplines; (iii) curriculum; and (iv) career preparation. Panelists proffered several areas needing more research or emphasis, ranging from computational science to culture. Health care providers, along with persons from nontraditional disciplines in scientific training programs such as engineers and lawyers, were among those recognized as being underrepresented in training programs. Curriculum suggestions were that fellows receive training in topics such as leadership and human relations, in addition to learning the principles of epidemiology, cancer biologic mechanisms, and behavioral science. For career preparation, there was a clear recognition of the diversity of employment options available besides academic positions, and that program leaders should do more to help fellows identify and prepare for different career paths. The major topics and strategies covered at this meeting can help form the basis for cancer prevention training program leaders to consider modifications or new directions, and keep them updated with the changing scientific and employment climate for doctoral degree recipients and postdoctoral fellows.

Haptic control of a pneumatic muscle actuator to provide resistance for simulated isokinetic exercise: Part I--dynamic test station and human quadriceps dynamic simulator.

Pneumatic muscle actuators (PMAs) have a high power to weight ratio and possess unique characteristics which make them ideal actuators for applications involving human interaction. PMAs are difficult to control due to nonlinear dynamics, presenting challenges in system implementation. Despite these challenges, PMAs have great potential as a source of resistance for strength training and rehabilitation. The objective of this work was to control a PMA for use in isokinetic exercise, potentially benefiting anyone in need of optimal strength training through a joint's range of motion. A human quadriceps dynamic simulator (HQDS) was developed so that control effectiveness and accommodation could be tested prior to human implementation. The experimental set-up and HQDS are discussed in Part I of this work. The development of a PMA haptic controller and its interaction with the HQDS are discussed in Part II.