Cardiorespiratory fitness, regular physical activity, and autonomic nervous system reactivity to laboratory and daily life stress.

The cross-stressor adaptation hypothesis-which posits that adjustment to physical stress as a result of regular physical activity and its effects on fitness crosses over to psychological stress reactivity-has been around for over four decades. However, the literature has been plagued by heterogeneities preventing definitive conclusions. We address these heterogeneity issues in a combined laboratory and daily life study of 116 young adults (M = 22.48 SD = 3.56, 57.76% female). The exposure, i.e., the potential driver of adaptation, was defined in three ways. First, a submaximal test was performed to obtain aerobic fitness measured as the VO2 max (kg/ml/min). Second, leisure time exercise behavior, and third, overall moderate-to-vigorous physical activity (MVPA), were obtained from a structured interview. Outcomes were autonomic nervous system (ANS) reactivity and affective responsiveness to stressors. ANS activity was measured continuously and expressed as inter-beat-interval (IBI), pre-ejection-period (PEP), respiratory sinus arrythmia (RSA), and non-specific Skin Conductance Responses (ns.SCR). Negative and positive affect were recorded after each experimental condition in the laboratory and hourly in daily life with a nine-item digital questionnaire. Linear regressions were performed between the three exposure measures as predictors and the various laboratory and daily life stress measurements as outcomes. Our results support the resting heart rate reducing effect of aerobic fitness and total MVPA in both the laboratory and daily life. We did not find evidence for the cross-stressor adaptation hypothesis, irrespective of ANS or affective outcome measure or whether the exposure was defined as exercise/MVPA or aerobic fitness.

A behavioral approach to annotating sleep in infants: Building on the classic framework.

In infants, monitoring and assessment of sleep can offer valuable insights into sleep problems and neuro-cognitive development. The gold standard for sleep measurements is polysomnography (PSG), but this is rather obtrusive, and unpractical in non-laboratory situations. Behavioral observations constitute a non-obtrusive, infant-friendly alternative. In the current methodological paper, we describe and validate a behavior-based framework for annotating infant sleep states. For development of the framework, we used existing sleep data from an in-home study with an unobtrusive test setup. Participants were 20 infants with a mean age of 180 days. Framework development was based on Prechtl's method. We added rules and guidelines based on discussions and consent among annotators. Key to using our framework is combining data from several modalities, for example, closely observing the frequency, type, and quality of movements, breaths, and sounds an infant makes, while taking the context into account. For a first validation of the framework, we set up a small study with 14 infants (mean age 171 days), in which they took their day-time nap in a laboratory setting. They were continuously monitored by means of PSG, as well as by the test setup from the in-home study. Recordings were annotated based both on PSG and our framework, and then compared. Data showed that for scoring wake vs. active sleep vs. quiet sleep the framework yields results comparable to PSG with a Cohen's Kappa agreement of ≥0.74. Future work with a larger cohort is necessary for further validating this framework, and with clinical populations for determining whether it can be generalized to these populations as well.

Exploring physiologic reactions to persuasive information.

Persuasion aims at changing peoples' motivations and/or behaviors. This study explores how and when physiology reflects persuasion processes and specifically whether individual differences in motivations and behaviors affect psychophysiologic reactions to persuasive information. Participants (N = 70) with medium or high meat consumption patterns watched a persuasive video advocating limited meat consumption, while their electrodermal and cardiovascular physiology was measured. Results indicated that the video increased participants' moral beliefs, perceived behavioral control, and reduction intentions. This study also found an increase in physiologic arousal during the persuasive video and that people with motivations less aligned to the persuasion objective had more physiologic arousal. The findings encourage further psychophysiologic persuasion research, especially as these insights can potentially be used to personalize persuasive messages of behavior change applications.

Integrating technology in mental healthcare practice: A repeated cross-sectional survey study on professionals' adoption of Digital Mental Health before and during COVID-19.

As a consequence of the outbreak of the COVID-19 global pandemic in the spring of 2020, large-scale social distancing measures were implemented, resulting in the forced adoption of online or digital forms of psychological treatment. This sudden transition to digital care offered a unique opportunity to investigate if and how this experience impacted mental healthcare professionals' perceptions and use of Digital Mental Health tools. The current paper presents findings of a repeated cross-sectional study consisting of three iterations of a national online survey in the Netherlands. This survey contained open and closed questions on professionals' adoption readiness, frequency of use, perceived competency, and perceived value of Digital Mental Health collected in 2019 (before the pandemic), in 2020 (after the first wave), and in 2021 (after the second wave). The inclusion of data gathered prior to the COVID-19 pandemic offers a unique window to assess how professionals' adoption has developed through this transition from voluntary to mandatory use of Digital Mental Health tools. Our study also re-assesses the drivers, barriers, and needs of mental healthcare professionals after having gained experience with Digital Mental Health. In total, 1,039 practitioners completed the surveys (Survey 1: n = 432, Survey 2: n = 363, and Survey 3: n = 244). Results indicate that compared to the period before the pandemic, there was a particularly large increase in use, competency, and perceived value regarding videoconferencing. Small differences were also found for some other basic tools that were crucial to ensure the continuation of care, such as e-mail, text messaging, and online screening, but not for more innovative technologies, such as virtual reality and biofeedback. Many practitioners reported to have gained skills regarding Digital Mental Health and experienced several benefits of it. They expressed the intention to continue with a blended approach, using Digital Mental Health tools in combination with face-to-face care, focused on situations in which they found it to have specific added value, such as when clients are unable to travel. Others were less satisfied with the technology-mediated interactions and remained more reluctant to future use of DMH. Implications for broader implementation of Digital Mental Health and future research are discussed.

Assessing Professionals' Adoption Readiness for eMental Health: Development and Validation of the eMental Health Adoption Readiness Scale.

BACKGROUND: The last few decades have witnessed significant advances in the development of digital tools and applications for mental health care. Despite growing evidence for their effectiveness, acceptance and use of these tools in clinical practice remain low. Hence, a validated and easy-to-use instrument for assessing professionals' readiness to adopt eMental health (EMH) is necessary to gain further insights into the process of EMH adoption and facilitate future research on this topic. OBJECTIVE: The aim of this study is to develop and validate an instrument for assessing mental health care professionals' readiness to adopt EMH. METHODS: Item generation was guided by literature and inputs from mental health care professionals and experts in survey development. Exploratory factor analyses were conducted on an initial set of 29 items completed by a sample of mental health care professionals (N=432); thereafter, the scale was reduced to 15 items in an iterative process. The factor structure thus obtained was subsequently tested using a confirmatory factor analysis with a second sample of mental health care professionals (N=363). The internal consistency, convergent validity, and predictive validity of the eMental Health Adoption Readiness (eMHAR) Scale were assessed. RESULTS: Exploratory factor analysis resulted in a 3-factor solution with 15 items. The factors were analyzed and labeled as perceived benefits and applicability of EMH, EMH proactive innovation, and EMH self-efficacy. These factors were confirmed through a confirmatory factor analysis. The total scale and subscales showed a good internal consistency (Cronbach α=.73-.88) along with acceptable convergent and predictive relationships with related constructs. CONCLUSIONS: The constructed eMHAR Scale showed a conceptually interpretable 3-factor structure having satisfactory characteristics and relationships with relevant concepts. Its ease of use allows for quick acquisition of data that can contribute to understanding and facilitating the process of adoption of EMH by clinical professionals.

Mental Health Care Goes Online: Practitioners' Experiences of Providing Mental Health Care During the COVID-19 Pandemic.

The outbreak of the COVID-19 pandemic has necessitated sudden and radical changes in mental health care delivery, as strict social distancing and lockdown measures were imposed in the early phases of the pandemic. Almost overnight, practitioners were forced to transfer their face-to-face care practice to online means. To understand the implications of this drastic change for mental health care, and to improve the online care offerings, an online qualitative survey was held among mental health care professionals in Netherlands (n = 51). Our findings indicate that technological and usability problems pose a significant challenge, as do difficulties to establish rapport with clients. Moreover, not all mental health issues and treatment forms are equally amenable to online interaction. In contrast, in many instances, practitioners were positive about the effectiveness of treatment, and reported flexibility, a lower threshold for contact, and lack of travel time as advantages. Their most prominent needs concern better technological, organizational, and logistical support. It is critical that these needs are acted upon by institutions and governments. In addition, current results inform future research on the improvement of e-mental health technologies.

Ten Lessons for Good Practice for the INHERIT Triple Win: Health, Equity, and Environmental Sustainability.

The world's challenges of climate change, damage to ecosystems, and social and health inequalities require changes in human behaviours at every level of organisation, among governments, business, communities, and individuals. An important question is how behaviour change can be enabled and supported at the scale and speed required. The research reported in this paper describes important lessons for good practice in changing contexts to modify behaviours for a triple win for health, equity and environmental sustainability. Authors synthesised learning from qualitative, quantitative and cost benefit evaluations of 15 case studies conducted in 12 countries in Europe. The case studies address ways of living (green spaces and energy efficient housing), moving (active transport) and consuming (healthy and sustainable diets) that support the triple win. Ten lessons for good practice were identified. These include bringing a triple win mindset to policy and practice in planning interventions, with potential to improve environmental sustainability, health and equity at the same time. The lessons for good practice are intended to support governmental and non-governmental actors, practitioners and researchers planning to work across sectors to achieve mutual benefits for health and environmental sustainability and in particular to benefit poorer and more socio-economically disadvantaged groups.

Lifestyle E-Coaching for Physical Activity Level Improvement: Short-Term and Long-Term Effectivity in Low Socioeconomic Status Groups.

E-coaching applications can improve people's lifestyles; however, their impact on people from a lower socioeconomic status (low SES) is unknown. This study investigated the effectiveness of a lifestyle e-coaching application in encouraging people facing low SES disadvantages to engage in a more active lifestyle over a course of 19 weeks. In this bicountry study, 95 people with low activity level (GR: 50, NL: 45) used a mobile application linked to a wearable activity tracker. At the start and after 6 and 19 weeks, self-reported physical activity levels, attitudes, and intention towards increasing activity levels, perceived behavioral control, and wellbeing were measured. Results indicated that participants using the lifestyle e-coaching application reported significantly more often an increase in activity levels than a parallel control group. Additionally, the people using the application also more often reported increased levels of wellbeing and perceived behavioral control. Therefore, lifestyle e-coaching applications could be a cost-effective solution for promoting healthier lifestyles in low-SES populations.

Evaluation of an activity monitor for use in pregnancy to help reduce excessive gestational weight gain.

BACKGROUND: Excessive weight gain during pregnancy increases the risk for negative effects on mother and child during pregnancy, delivery, and also postnatally. Excessive weight gain can be partially compensated by being sufficiently physically active, which can be measured using activity trackers. Modern activity trackers often use accelerometer data as well as heart rate data to estimate energy expenditure. Because pregnancy affects the metabolism and cardiac output, it is not evident that activity trackers that are calibrated to the general population can be reliably used during pregnancy. We evaluated whether an activity monitor designed for the general population is sufficiently accurate for estimating energy expenditure in pregnant women. METHODS: Forty pregnant women (age: 30.8 ± 4.7 years, BMI: 25.0 ± 4.0) from all three trimesters performed a 1-h protocol including paced and self-paced exercise activities as well as household activities. We tracked reference energy expenditure using indirect calorimetry and used equivalence testing to determine whether the estimated energy expenditure from the activity monitor was within the limits of equivalence. RESULTS: Overall we found an averaged underestimation of 10 kcal (estimated energy expenditure was 97% of the reference measurement). The 90% CI for the cumulative total energy expenditure was 94-100%. The activities of self-paced cycling, household activities, stair-walking, and yoga had one of their equivalence boundaries outside a 80-125% range of equivalence; for exercise on a cross-trainer, for self-paced and fixed-pace walking, fixed-paced cycling, and resting, the estimations were within the limits of equivalence. CONCLUSIONS: We conclude that the activity monitor is sufficiently accurate for every-day use during pregnancy. The observed deviations can be accounted for and are acceptable from a statistical and an applied perspective because the positive and negative deviations that we observed cancel out to an accurate average energy expenditure over a day, and estimations during exercise are sufficiently accurate to enable coaching on physical activity. The positive and negative deviations themselves were relatively small. Therefore, the activity monitor can be used to help in preventing excessive weight gain during pregnancy by accurately tracking physical activity.

In Sync: The Effect of Physiology Feedback on the Match between Heart Rate and Self-Reported Stress.

Over the past years self-tracking of physiological parameters has become increasingly common: more and more people are keeping track of aspects of their physiological state (e.g., heart rate, blood sugar, and blood pressure). To shed light on the possible effects of self-tracking of physiology, a study was conducted to test whether physiology feedback has acute effects on self-reported stress and the extent to which self-reported stress corresponds to physiological stress. In this study, participants executed several short tasks, while they were either shown visual feedback about their heart rate or not. Results show that self-reported stress is more in sync with heart rate for participants who received physiology feedback. Interactions between two personality factors (neuroticism and anxiety sensitivity) and feedback on the level of self-reported stress were found, indicating that while physiology feedback may be beneficial for individuals high in neuroticism, it may be detrimental for those high in anxiety sensitivity. Additional work is needed to establish how the results of this study may extend beyond immediate effects in a controlled lab setting, but our results do provide a first indication of how self-tracking of physiology may lead to better body awareness and how personality characteristics can help us predict which individuals are most likely to benefit from self-tracking of physiology.

Effects of mood induction via music on cardiovascular measures of negative emotion during simulated driving.

A study was conducted to investigate the potential of mood induction via music to influence cardiovascular correlates of negative emotions experience during driving behaviour. One hundred participants were randomly assigned to one of five groups, four of whom experienced different categories of music: High activation/positive valence (HA/PV), high activation/negative valence (HA/NV), low activation/positive valence (LA/PV) and low activation/negative valence (LA/NV). Following exposure to their respective categories of music, participants were required to complete a simulated driving journey with a fixed time schedule. Negative emotion was induced via exposure to stationary traffic during the simulated route. Cardiovascular reactivity was measured via blood pressure, heart rate and cardiovascular impedance. Subjective self-assessment of anger and mood was also recorded. Results indicated that low activation music, regardless of valence, reduced systolic reactivity during the simulated journey relative to HA/NV music and the control (no music) condition. Self-reported data indicated that participants were not consciously aware of any influence of music on their subjective mood. It is concluded that cardiovascular reactivity to negative mood may be mediated by the emotional properties of music.

Respiratory sinus arrhythmia responses to cognitive tasks: effects of task factors and RSA indices.

Many studies show that respiratory sinus arrhythmia (RSA) decreases while performing cognitive tasks. However, there is uncertainty about the role of contaminating factors such as physical activity and stress-inducing task variables. Different methods to quantify RSA may also contribute to variable results. In 83 healthy subjects, we studied RSA responses to a working memory task requiring varying levels of cognitive control and a perceptual attention task not requiring strong cognitive control. RSA responses were quantified in the time and frequency domain and were additionally corrected for differences in mean interbeat interval and respiration rate, resulting in eight different RSA indices. The two tasks were clearly differentiated by heart rate and facial EMG reference measures. Cognitive control induced inhibition of RSA whereas perceptual attention generally did not. However, the results show several differences between different RSA indices, emphasizing the importance of methodological variables. Age and sex did not influence the results.

Using music to change mood while driving.

This study investigated whether gradual or abrupt music change towards more calming music is most effective in calming drivers during high-demand driving situations. Twenty-eight participants were subjected to two types of music change (gradual, abrupt) in a within-subject design. First, a relatively happy mood was induced with personally selected music during an eight-minute simulated high-demand drive. The drive then continued and the mood was changed either gradually or abruptly. Subjective results showed successful music mood induction irrespective of gradual or abrupt changes. The results further showed lower skin conductance (less arousal) and more facial corrugator muscle tension (more sadness) during the abrupt music change. Fewer accidents occurred during the abrupt music mood change. To conclude, the results support the abrupt way of changing music type to down-regulate one's mood: during high-demand driving, abrupt changes in music led to more physiological calmness and improved driving performance, and were thus safer and more effective. PRACTITIONER SUMMARY: The current study shows that during high-demand drives, drivers are calmed more effectively using abrupt music changes compared to gradual music changes. This is illustrated by reductions in physiological arousal and improved driving behaviour. Hence, in-car music presentation can be used as a tool to improve driver's mood and behaviour.

Respiratory sinus arrhythmia responses to induced emotional states: effects of RSA indices, emotion induction method, age, and sex.

The literature shows large inconsistencies in respiratory sinus arrhythmia (RSA) responses to induced emotional states. This may be caused by differences in emotion induction methods, RSA quantification, and non-emotional demands of the situation. In 83 healthy subjects, we studied RSA responses to pictures and film fragments eliciting six different discrete emotions relative to neutral baseline stimuli. RSA responses were quantified in the time and frequency domain and were additionally corrected for differences in mean heart rate and respiration rate, resulting in eight different RSA response measures. Subjective ratings of emotional stimuli and facial electromyographic responses indicated that pictures and film fragments elicited the intended emotions. Although RSA measures showed various emotional effects, responses were quite heterogeneous and frequently nonsignificant. They were substantially influenced by methodological factors, in particular time vs. frequency domain response measures, correction for changes in respiration rate, use of pictures vs. film fragments, and sex of participants.

The influence of music on mood and performance while driving.

Mood can influence our everyday behaviour and people often seek to reinforce, or to alter their mood, for example by turning on music. Music listening while driving is a popular activity. However, little is known about the impact of music listening while driving on physiological state and driving performance. In the present experiment, it was investigated whether individually selected music can induce mood and maintain moods during a simulated drive. In addition, effects of positive, negative, and no music on driving behaviour and physiological measures were assessed for normal and high cognitive demanding rides. Subjective mood ratings indicated that music successfully maintained mood while driving. Narrow lane width drives increased task demand as shown in effort ratings and increased swerving. Furthermore, respiration rate was lower during music listening compared to rides without music, while no effects of music were found on heart rate. Overall, the current study demonstrates that music listening in car influences the experienced mood while driving, which in turn can impact driving behaviour. PRACTITIONERS SUMMARY: Even though it is a popular activity, little is known about the impact of music while driving on physiological state and performance. We examined whether music can induce moods during high and low simulated drives. The current study demonstrates that in car music listening influences mood which in turn can impact driving behaviour. The current study shows that listening to music can positively impact mood while driving, which can be used to affect state and safe behaviour. Additionally, driving performance in high demand situations is not negatively affected by music.

Considerations for emotion-aware consumer products.

Emotion-aware consumer products require reliable, short-term emotion assessment (i.e., unobtrusive, robust, and lacking calibration). To explore the feasibility of this, an experiment was conducted where the galvanic skin response (GSR) and three electromyography (EMG) signals (frontalis, corrugator supercilii, and zygomaticus major) were recorded on 24 participants who watched eight 2-min emotion inducing film fragments. The unfiltered psychophysiological signals were processed and six statistical parameters (i.e., mean, absolute deviation, standard deviation, variance, skewness, and kurtosis) were derived for each 10-s interval of the film fragment. For each physiological signal, skewness and kurtosis discriminated among affective states, accompanied by other parameters, depending on the signal. The skewness parameter also showed to indicate mixed emotions. Moreover, a mapping of events in the fragments on the signals showed the importance of short-term emotion assessment. Hence, this research identified generic features, denoted important considerations, and illustrated the feasibility of emotion-aware consumer products.

The smoothness of shaven beards: the relation between stubble length distribution and skin parameters and tactile smoothness.

In this report we describe how the tactile smoothness of shaven beards depends on the distribution of the stubble lengths remaining after shaving and on various skin parameters like coarseness and scaliness. To this end, we set up two experiments on perceived smoothness with blinded human judges. In the first experiment we used artificial beards with various stubble length distributions and stubble densities as stimuli. In the second experiment we presented freshly shaven human beards, for which a wide range of objective skin and stubble parameters had been measured, as stimuli. The results of the two experiments are mostly in line with each other. We can conclude that there are individual differences between judges in the aspects they pay attention to when judging tactile smoothness. Nevertheless, a general line is discernable, and we can identify three parameters that influence the impression of tactile smoothness: the orientation of the stubble, the density of the stubble, and the length of the hairs in the stubble length distribution. We have also established the relative importance of the latter two effects.