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.

Time-Restricted Eating in Community-Dwelling Adults: Correlates of Adherence and Discontinuation in a Cross-Sectional Online Survey Study.

BACKGROUND: Time-restricted eating (TRE), a type of intermittent fasting in which all daily calories are consumed within a window of ≤12 hours, is hypothesized to promote long-term weight management because of its relative simplicity. OBJECTIVE: This study reports correlates of adherence among community-dwelling adults currently or formerly following a TRE dietary strategy. DESIGN: A 25-minute cross-sectional online survey was developed, including questions about TRE perceptions, behaviors, motivators and drivers, and demographics. The survey was administered in February 2021 via Prolific, an online platform for sample recruitment and survey dissemination. PARTICIPANTS: Eligibility criteria included US adult ages 18+ who currently or formerly (past 3 months) followed TRE (ie, consumed all daily calories within a window of ≤12 hours) for a minimum of 1 week. STATISTICAL ANALYSES: χ2 tests and analysis of covariance (ANCOVA; adjusting for sex and age) compared responses between current and former followers. RESULTS: Current followers (n = 296, mean [SD]: 34.2 ± 12.2y) were older than former followers (n = 295, mean [SD]: 31.1 ± 10.9 y) and practiced TRE for longer (median: 395 vs 90 days, P < 0.001). Current followers reported more success with meeting TRE goals (P ≤ 0.015), were less likely to report TRE concerns (P < 0.001), and more likely to report TRE satisfaction (P < 0.001). Four TRE motivators were more important among current (vs former) followers: weight maintenance, health (not weight), improved sleep, and preventing disease (P ≤ 0.017); weight loss was more important among former (vs current) followers (P = 0.003). Among adherence drivers, ability to work from home and the impact of COVID-19 were reported as more helpful for TRE adherence among current compared with former followers (P ≤ 0.028). CONCLUSIONS: TRE motivators and drivers differed between current and former followers; interventions tailored to individuals' preferences and circumstances may benefit TRE adherence.

Behavioral Medicine Research Council (BMRC) statement papers: A new approach to consensus building in behavioral medicine science.

The BMRC has initiated a new initiative, the Behavioral Medicine Research Council (BMRC) Scientific Statement papers. The statement papers will move the field forward by guiding efforts to improve the quality of behavioral medicine research and practice and facilitate the dissemination and translation of behavioral medicine research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A qualitative exploration of facilitators and barriers of adherence to time-restricted eating.

Time-restricted eating (TRE), a dietary strategy that involves limiting daily energy intake to a window of ≤12 h is appealing for weight management and metabolic health due to its relative simplicity and the ability to consume ad libitum diet during eating windows. Despite the potential utility of TRE for improving health and reducing disease, the feasibility of adherence depends upon a variety of multilevel factors which are largely unexplored. The primary aim of our study was to explore facilitators and barriers of adherence to TRE among community-dwelling individuals. Semi-structured qualitative interviews were conducted among 24 individuals (50% male; M age: 34, range: 18-57; 58% overweight/obese) who currently or formerly practiced TRE. Thematic analysis identified facilitators of and barriers to TRE adherence at multiple levels of influence (i.e., biological, behavioral, psychosocial, environmental). Key facilitators of adherence included improvements in physical health and energy levels, alignment with other aspects of diet, exercise and sleep patterns, self-monitoring and positive psychological impacts, social support, and busy or regular schedules. Key barriers included negative physical health effects, feelings of hunger and sluggishness, difficulty in skipping valued baseline eating routines or inadequate diet quality during the eating window, misalignment of TRE with 24-h activity behaviors, difficulties with self-monitoring, the need to mitigate negative feelings, social situations that discourage TRE, and irregular or idle schedules. Results illustrate that key drivers of adherence differ across individuals and their unique settings and that multiple drivers of behavior should be considered in the successful implementation of TRE. Findings may inform interventions seeking to tailor TRE schedules to fit individuals' diverse behavioral patterns and preferences, thereby optimizing adherence.

Climate change, behavior change and health: a multidisciplinary, translational and multilevel perspective.

The climate crisis provides a critical new lens through which health and health behaviors need to be viewed. This paper has three goals. First, it provides background on the climate crisis, the role of human behavior in creating this crisis, and the health impacts of climate change. Second, it proposes a multilevel, translational approach to investigating health behavior change in the context of the climate crisis. Third, it identifies specific challenges and opportunities for increasing the rigor of behavioral medicine research in the context of the climate crisis. The paper closes with a call for behavioral medicine to be responsive to the climate crisis.

Behavioral Research in Cancer Prevention and Control: Emerging Challenges and Opportunities.

It is estimated that behaviors such as poor diet, alcohol consumption, tobacco use, sedentary behavior, and excessive ultraviolet exposure account for nearly one-half of all cancer morbidity and mortality. Accordingly, the behavioral, social, and communication sciences have been important contributors to cancer prevention and control research, with methodological advances and implementation science helping to produce optimally effective interventions. To sustain these contributions, it is vital to adapt to the contemporary context. Efforts must consider ancillary effects of the 2019 coronavirus disease pandemic, profound changes in the information environment and public understanding of and trust in science, renewed attention to structural racism and social determinants of health, and the rapidly increasing population of cancer survivors. Within this context, it is essential to accelerate reductions in tobacco use across all population subgroups; consider new models of energy balance (diet, physical activity, sedentary behavior); increase awareness of alcohol as a risk factor for cancer; and identify better communication practices in the context of cancer-related decisions such as screening and genetic testing. Successful integration of behavioral research and cancer prevention depends on working globally and seamlessly across disciplines, taking a multilevel approach where possible. Methodological and analytic approaches should be emphasized in research training programs and should use new and underused data sources and technologies. As the leadership core of the National Cancer Institute's Behavioral Research Program, we reflect on these challenges and opportunities and consider implications for the next phase of behavioral research in cancer prevention and control.

Circadian timing of eating and BMI among adults in the American Time Use Survey.

BACKGROUND/OBJECTIVES: Experimental studies of time-restricted eating suggest that limiting the daily eating window, shifting intake to the biological morning, and avoiding eating close to the biological night may promote metabolic health and prevent weight gain. SUBJECTS/METHODS: We used the Eating & Health Module of the 2006-2008 and 2014-2016 American Time Use Survey to examine cross-sectional associations of timing of eating in relation to sleep/wake times as a proxy for circadian timing with body mass index (BMI). The analytical sample included 38 302 respondents (18-64 years; BMI 18.5-50.0 kg/m2). A single 24-hour time use diary was used to calculate circadian timing of eating variables: eating window (time between first and last eating activity); morning fast (time between end of sleep and start of eating window); and evening fast (time between end of eating window and start of sleep). Multinomial logistic regression and predictive margins were used to estimate adjusted population prevalences (AP) by BMI categories and changes in prevalences associated with a one-hour change in circadian timing of eating, controlling for sociodemographic and temporal characteristics. RESULTS: A one-hour increase in eating window was associated with lower adjusted prevalence of obesity (AP = 27.1%, SE = 0.1%). Conversely, a one-hour increase in morning fast (AP = 28.7%, SE = 0.1%) and evening fast (AP = 28.5%, SE = 0.1%) were each associated with higher prevalence of obesity; interactions revealed differing patterns of association by combination of eating window with morning/evening fast (p < 0.0001). CONCLUSIONS: Contrary to hypotheses, longer eating windows were associated with a lower adjusted prevalence of obesity and longer evening fasts were associated with a higher prevalence of obesity. However, as expected, longer morning fast was associated with a higher adjusted prevalence of obesity. Studies are needed to disentangle the contributions of diet quality/quantity and social desirability bias in the relationship between circadian timing of eating and BMI.

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.

Prevención transfronteriza de la obesidad infantil: comentario de los National Institutes of Health.

En respuesta al aumento de las tasas de obesidad infantil, Estados Unidos y algunos países de Latinoamérica han financiado numerosos estudios que analizan estrategias e intervenciones innovadoras. A pesar de ello, los avances han sido lentos, irregulares y esporádicos, lo cual demuestra la necesidad de intensificar el intercambio de conocimientos y la colaboración en la investigación para acelerar la adaptación e implementación de intervenciones prometedoras en el campo de la obesidad infantil. Con la intención de compartir resultados de estudios, problemas y estrategias de intervención de probada eficacia entre los investigadores latinoamericanos y estadounidenses (especialmente los que trabajan con poblaciones latinas y latinoamericanas), los National Institutes of Health (NIH) reunieron a investigadores de Estados Unidos y Latinoamérica para destacar las sinergias entre los estudios de Latinoamérica y los realizados en poblaciones latinas de Estados Unidos. El fin último de esta iniciativa fue catalizar nuevas relaciones e identificar preguntas y estrategias comunes para la investigación. Este artículo se centra en la investigación y las prioridades de los NIH en materia de prevención de la obesidad infantil, así como en las áreas para futuras acciones, incluidos los planes generales de los NIH y las inversiones de sus institutos, centros y oficinas en áreas concretas relacionadas con la prevención de la obesidad infantil en Latinoamérica y en las poblaciones latinas de Estados Unidos.

Single case designs for early phase behavioral translational research in health psychology.

OBJECTIVE: The biomedical research community has long recognized that much of the basic research being conducted, whether in the biological, behavioral or social sciences, is not readily translated into clinical and public health applications. This translational gap is due in part to challenges inherent in moving research findings from basic or discovery research to applied research that addresses clinical or public health problems. In the behavioral and social sciences, research designs typically used in the early phases of translational research are small, underpowered "pilot" studies that may lack sufficient statistical power to test the research question of interest. While this approach is discouraged, these studies are often employed to estimate effect sizes before embarking on a larger trial with adequate statistical power to test the research hypothesis. The goal of this paper is to provide an alternative approach to early phase studies using single case designs (SCDs). METHOD: Review basic principles of SCDs; provide a series of hypothetical SCD replication experiments to illustrate (1) how data from SCDs can be analyzed to test the effects of an intervention on behavioral and biological outcomes and (2) how sample sizes can be derived for larger randomized controlled trials (RCTs) based on clinically meaningful effects from SCDs; and review feedback between SCDs and RCTs. RESULTS: The paper illustrates the use of SCD reversal and multiple baseline designs for early phase translational research. CONCLUSION: SCDs provide a flexible and efficient platform for the use of experimental methods in early phase translational research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Childhood obesity prevention across borders: A National Institutes of Health commentary.

In response to the increasing rates of childhood obesity, the United States and countries across Latin America have invested in research that tests innovative strategies and interventions. Despite this, progress has been slow, uneven, and sporadic, calling for increased knowledge exchange and research collaboration that accelerate the adaptation and implementation of promising childhood obesity interventions. To share research results, challenges, and proven intervention strategies among Latin American and US researchers, particularly those working with Latino and Latin American populations, the National Institutes of Health (NIH) convened researchers from the United States and Latin America to highlight synergies between research conducted in Latin America and among Latino populations in the United States with the goal of catalyzing new relationships and identifying common research questions and strategies. This article highlights the NIH's research and priorities in childhood obesity prevention as well as areas for future direction, including overarching NIH plans and NIH institutes, centers, and offices investments in specific areas related to childhood obesity prevention in Latin America and/or among Latino populations in the United States.

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.

An introduction to the special issue: From ideas to efficacy in health psychology.

The impetus for the special issue, "From Ideas to Efficacy" was the perceived need to stimulate and support a more vibrant research base that translates basic behavioral and social science research (bBSSR) discoveries to clinical and public health interventions. This special issue presents novel research that advances translational behavioral science, focusing primarily on the early phases of behavioral translation that are not as well recognized as later-phase translational science (e.g., dissemination and implementation research). The special issue includes a series of empirical, conceptual, and methodological papers, and a shining example of translational research that has had important clinical implications for the treatment of obesity and prevention of people with prediabetes from transitioning to Type II diabetes. In this introduction we will first set the context of the special issue and briefly comment on the papers. We end with several ideas in the areas of funding, training and publication of early phase translational behavioral science that can accelerate the process through which new ideas from our deepening understanding of human behavior can be more rapidly and fully brought to bear on the pressing health problems facing our nation and our world. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

From ideas to interventions: A review and comparison of frameworks used in early phase behavioral translation research.

Developing and testing more effective health-related behavioral interventions is critical to making progress in improving disease prevention and treatment. One way to achieve this goal is to use a systematic and progressive framework that outlines the steps needed to translate theories, findings, and basic understandings about human behavior into risk factor and disease management or mitigation strategies. Although several frameworks and process models have been designed to inform the development and optimization of health-related behavioral interventions, little guidance is available to compare key aspects of these models, clarify their common and unique features, and aid in selecting the best approach for a specific research question. This article describes the major frameworks that focus on early phase translation-that is, approaches that address the design and optimization of behavioral interventions before testing in Phase III efficacy trials. Differences between and common features of these models are described, opportunities for combining frameworks to maximize their impact are noted, and guidance is provided to enable investigators to choose the most useful model(s) when designing and optimizing health-related behavioral interventions. The goal of this article is to promote the consistent use of frameworks that encourage a systematic, progressive approach to behavioral intervention development and testing as one way to encourage the creation of well-characterized, optimized, and potentially more effective health-related behavioral interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.

BACKGROUND: Building capacity in research funding organizations to support the conduct of pragmatic clinical trials is an essential component of advancing biomedical and public health research. To date, efforts to increase the ability to design and carry out pragmatic trials have largely focused on training researchers. To complement these efforts, we developed an interactive workshop tailored to meet the roles and responsibilities of program scientists at the National Cancer Institute-the leading cancer research funding agency in the USA. The objectives of the workshop were to improve the understanding of pragmatic trials and enhance the capacity to distinguish between elements that make a trial more pragmatic or more explanatory among key programmatic staff. To our knowledge, this is the first reported description of such a workshop. MAIN BODY: The workshop was developed to meet the needs of program scientists as researchers and stewards of research funds, which often includes promoting scientific initiatives, advising prospective applicants, collaborating with grantees, and creating training programs. The workshop consisted of presentations from researchers with expertise in the design and interpretation of trials across the explanatory-pragmatic continuum. Presentations were followed by interactive, small-group exercises to solidify participants' understanding of the purpose and conduct of these trials, which were tailored to attendees' areas of expertise across the cancer control continuum and designed to reflect their scope of work as program scientists at NCI. A total of 29 program scientists from the Division of Cancer Control and Population Sciences and the Division of Cancer Prevention participated; 19 completed a post-workshop evaluation. Attendees were very enthusiastic about the workshop: they reported improved knowledge, significant relevance of the material to their work, and increased interest in pragmatic trials across the cancer control continuum. CONCLUSION: Training program scientists at major biomedical research agencies who are responsible for developing funding opportunities and advising grantees is essential for increasing the quality and quantity of pragmatic trials. Together with workshops for other target audiences (e.g., academic researchers), this approach has the potential to shape the future of pragmatic trials and continue to generate more and better actionable evidence to guide decisions that are of critical importance to health care practitioners, policymakers, and patients.

The selection of comparators for randomized controlled trials of health-related behavioral interventions: recommendations of an NIH expert panel.

OBJECTIVES: To provide recommendations for the selection of comparators for randomized controlled trials of health-related behavioral interventions. STUDY DESIGN AND SETTING: The National Institutes of Health Office of Behavioral and Social Science Research convened an expert panel to critically review the literature on control or comparison groups for behavioral trials and to develop strategies for improving comparator choices and for resolving controversies and disagreements about comparators. RESULTS: The panel developed a Pragmatic Model for Comparator Selection in Health-Related Behavioral Trials. The model indicates that the optimal comparator is the one that best serves the primary purpose of the trial but that the optimal comparator's limitations and barriers to its use must also be taken into account. CONCLUSION: We developed best practice recommendations for the selection of comparators for health-related behavioral trials. Use of the Pragmatic Model for Comparator Selection in Health-Related Behavioral Trials can improve the comparator selection process and help resolve disagreements about comparator choices.