Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study.

Background: Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements. Methods: We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test. Findings: Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusion: To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.

Distinguishing Dispositional and Cultivated Forms of Mindfulness: Item-Level Factor Analysis of Five-Facet Mindfulness Questionnaire and Construction of Short Inventory of Mindfulness Capability.

The widely used Five-Facet Mindfulness Questionnaire (FFMQ) mixes the dispositional and cultivated forms of mindfulness, thereby resulting in factor issues in previous studies. The present study distinguished the two forms of mindfulness and developed a Short Inventory of Mindfulness Capability at the item level of FFMQ. Three facets of mindfulness, namely, Describing, Acting with Awareness, and Non-judging of Experience, were assessed using community (n = 433) and student (n = 347) samples. Both meditators and non-meditators participated. Exploratory and confirmatory factor analysis (CFA) revealed a three-factor model of mindfulness with 12 items (four items per subscale). Psychometric evaluation demonstrated the solid factor structure of the measurement with high factor loadings, good internal consistency, and convergent validities. Longitudinal analysis indicated that the Acting with Awareness facet was a significant predictor of depression and anxiety symptoms 6 months later. Discussions focused on the roles of mindfulness capability on mental health as well as the relationship between them. A higher-order factor of mindfulness should be used to examine the efficacy of intervention or monitor the changes. Researchers who need to study the specific role or efficacy of each facet should calculate the scores of different facets.