Feasibility and preliminary effects of the Fit2ThriveMB pilot physical activity promotion intervention on physical activity and patient reported outcomes in individuals with metastatic breast cancer.

PURPOSE: Physical activity research among patients with metastatic breast cancer (MBC) is limited. This study examined the feasibility and potential benefits of Fit2ThriveMB, a tailored mHealth intervention. METHODS: Insufficiently active individuals with MBC (n = 49) were randomized 1:1 to Fit2ThriveMB (Fit2ThriveMB app, Fitbit, and weekly coaching calls) or Healthy Lifestyle attention control (Cancer.Net app and weekly calls) for 12 weeks. Fit2ThriveMB aimed to increase daily steps via an algorithm tailored to daily symptom rating and step goal attainment. The primary outcome was feasibility defined as ≥ 80% completion rate. Secondary feasibility metrics included meeting daily step goal and wearing the Fitbit ≥ 70% of study days, fidelity, adherence to intervention features and safety. Secondary outcomes included physical activity, sedentary time, patient reported outcomes (PROs), health-related quality of life (QOL) and social cognitive theory constructs. A subsample (n = 25) completed functional performance tests via video conferencing. RESULTS: The completion rate was 98% (n = 1 died). No related adverse events were reported. Fit2ThriveMB participants (n = 24) wore the Fitbit 92.7%, met their step goal 53.1%, set a step goal 84.6% and used the app 94.1% of 84 study days. Intent-to-treat analyses indicated trends toward improvements in activity, QOL, and some PROs, social cognitive theory constructs, and functional performance tests favoring the Fit2ThriveMB group. Significant effects favoring Fit2ThriveMB were observed for self-efficacy and goal-setting. However, some PROs and functional performance improvements favored the control group (p-values > 0.05). CONCLUSIONS: Fit2ThriveMB is feasible and safe for patients with MBC and warrants further evaluation in randomized controlled trials with larger sample sizes. Registration Clinicaltrials.gov NCT04129346, https://clinicaltrials.gov/ct2/show/NCT04129346.

Day-level associations of physical activity and sedentary time in mother-child dyads across three years: a multi-wave longitudinal study using accelerometers.

Understanding associations between mothers' and children's physical activity and sedentary behavior on more fine-grained timescales can provide insights into real-time intervention opportunities. This study examined the extent to which mothers' and their children's device-measured moderate-to-vigorous physical activity (MVPA) and sedentary time (SDT) were associated at the day level during non-school time. Mother-child dyads (N = 193; baseline Mean ages = 40.69 ± 6.11 [mother] and 9.57 ± 0.89 [child] years) provided 3,135 paired days of accelerometry data from six bi-annual waves across three years. Controlling for covariates, multilevel models revealed that mothers' and their children's MVPA and SDT were positively associated at the day level during non-school time, both on weekdays and weekends. During weekdays, the day-level association for SDT was stronger for older than younger children, and the day-level association for MVPA was stronger for boys than girls. Designing family-based interventions targeting school-age children and their mothers during non-school time across the week may be useful for promoting active lifestyles.

Bi-Directional Associations Between Real-Time Affect and Physical Activity in Weight-Discordant Siblings.

Pediatric obesity confers increased risk for a host of negative psychological and physical health consequences and is reliably linked to low levels of physical activity. Affective antecedents and consequences of physical activity are thought to be important for the development and maintenance of such behavior, though research examining these associations in youth across the weight spectrum remains limited. OBJECTIVE: This study examined bi-directional associations between affect and physical activity (i.e., moderate-to-vigorous physical activity [MVPA] and total activity counts), and the extent to which weight (body mass index z-score [z-BMI]) moderated these associations. METHODS: Participants were drawn from a prior study of siblings (N = 77; mean age = 15.4 ± 1.4 years) discordant for weight status (39 nonoverweight siblings, 38 siblings with overweight/obesity) who completed ecological momentary assessment (EMA) with accelerometer-assessed physical activity. RESULTS: Generalized linear mixed models indicated z-BMI moderated trait-level and momentary associations. When adolescents with higher z-BMI reported momentary negative affect, they evidenced less MVPA within the next hour. Across the sample, greater overall activity was associated with lower negative affect. However, at the momentary level, when adolescents with higher (but not lower) z-BMI evidenced greater activity, they reported decreases in negative affect. CONCLUSIONS: Findings indicate affective experiences surrounding physical activity differ according to z-BMI. Specifically, momentary negative affect may impede momentary MVPA among youth with higher z-BMI. Further research is warranted to elucidate factors influencing these momentary associations and the extent to which these momentary associations prospectively predict weight change.

The COMET study: Examining the effects of COVID-19-related perceived stress on Los Angeles Mothers' dysregulated eating behaviors, child feeding practices, and body mass index.

The COVID-19 pandemic and associated restrictions and mandates have had pronounced implications on the well-being of individuals. This study conducted exploratory analyses of the relationship between COVID-19-related life changes and COVID-19-related perceived stress and associations between COVID-19-related perceived stress and dysregulated maternal eating behaviors, child feeding practices, and body mass index (BMI) in Los Angeles mothers. Mothers (Mage = 37.6 ± 6.9) of children aged 5-11 (N = 197, response rate 92.5%) completed an online questionnaire assessing COVID-19-related life changes, COVID-19-related perceived stress, mechanisms used to cope with COVID-19, child feeding practices, their own eating behavior, demographics, and height and weight. The highest proportion of participants reported changes to work, disruptions due to childcare challenges, and increased home responsibilities. Higher COVID-19-related perceived stress was experienced by those who reported loss of work hours (29%), loss of job (15.2%), reduced ability to afford childcare (18.8%), and reduced ability to afford rent/mortgage (19.8%) (ps < 0.05) than those who did not. The most common strategy that mothers indicated using to cope with COVID-19 related stress was eating comfort foods (e.g., candy and chips) (58.7%). COVID-19-related perceived stress was positively associated with mother's BMI and emotional eating (ps < 0.05). Rewarding their child's eating and behavior with food were both positively associated with the number of COVID-19 related life changes (ps < 0.05). This study yields new knowledge of the effects of the COVID-19 pandemic on mothers' dysregulated eating behaviors and child feeding practices. The results highlight the importance of conducting further research to confirm these findings and understand the nature of associations between COVID-19-related perceived stress and health. This is crucial in order to explore ways in which lasting impacts of the pandemic on mental and physical health can be prevented.

Examining the day-level impact of physical activity on affect during the early months of the COVID-19 pandemic: An ecological momentary assessment study.

Engaging in physical activity (PA) may be a promising approach to mitigate the effects of the COVID-19 pandemic and related restrictions on daily affect. The study used ecological momentary assessment (EMA) to examine the within-subject associations of day-level PA with same-day evening affect. Interactions between daily PA and overall stress related to COVID-19 predicting evening affect were also examined. Adults living in the U.S. (N = 157, M age = 31.7, 84.1% female) participated in a 28-day smartphone-based EMA study during the early months of the pandemic (April - June 2020). Evening EMA surveys assessed daily PA minutes, momentary positive activated and deactivated affect, and momentary negative activated and deactivated affect. An online questionnaire assessed demographics. Multi-level linear regression models assessed day-level associations between PA and evening affect, controlling for age, sex, income, body mass index, employment status, and morning affect. There were N = 2,409 person-days in the analysis. Baseline COVID-19 stress was not associated with daily PA minutes (p = .09) or positive-activated affect (p = .14), but was associated with lower positive-deactivated affect (p < .001) and greater negative-activated and negative-deactivated affect (ps < .001) in the evenings. On days when individuals reported more PA than usual, they reported greater positive-activated and positive-deactivated affect, and lower negative-activated and negative-deactivated affect in the evening (ps < .001). The interaction of day-level PA and COVID-19 stress predicting evening positive-activated, positive-deactivated, negative-activated, and negative-deactivated affect was not significant (ps > .05). During the early months of the pandemic, adults experienced improved evening affect on days when they engaged in more PA. However, data did not show that PA counteracts detrimental effects of the COVID-19 pandemic on evening affect. Public health efforts should strategically promote and address barriers to PA during the pandemic.

Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the U.S.

BACKGROUND: COVID-19 restrictions such as the closure of schools and parks, and the cancellation of youth sports and activity classes around the United States may prevent children from achieving recommended levels of physical activity (PA). This study examined the effects of the COVID-19 pandemic on PA and sedentary behavior (SB) in U.S. children. METHOD: Parents and legal guardians of U.S. children (ages 5-13) were recruited through convenience sampling and completed an online survey between April 25-May 16, 2020. Measures included an assessment of their child's previous day PA and SB by indicating time spent in 11 common types of PA and 12 common types of SB for children. Parents also reported perceived changes in levels of PA and SB between the pre-COVID-19 (February 2020) and early-COVID-19 (April-May 2020) periods. Additionally, parents reported locations (e.g., home/garage, parks/trails, gyms/fitness centers) where their children had performed PA and their children's use of remote/streaming services for PA. RESULTS: From parent reports, children (N = 211) (53% female, 13% Hispanic, Mage = 8.73 [SD = 2.58] years) represented 35 states and the District of Columbia. The most common physical activities during the early-COVID-19 period were free play/unstructured activity (e.g., running around, tag) (90% of children) and going for a walk (55% of children). Children engaged in about 90 min of school-related sitting and over 8 h of leisure-related sitting a day. Parents of older children (ages 9-13) vs. younger children (ages 5-8) perceived greater decreases in PA and greater increases in SB from the pre- to early-COVID-19 periods. Children were more likely to perform PA at home indoors or on neighborhood streets during the early- vs. pre-COVID-19 periods. About a third of children used remote/streaming services for activity classes and lessons during the early-COVID-19 period. CONCLUSION: Short-term changes in PA and SB in reaction to COVID-19 may become permanently entrenched, leading to increased risk of obesity, diabetes, and cardiovascular disease in children. Programmatic and policy strategies should be geared towards promoting PA and reducing SB over the next 12 months.

Associations between naturalistically assessed physical activity patterns, affect, and eating in youth with overweight and obesity.

Insufficient physical activity (PA) and excessive stationary behavior (SB) are contributors to pediatric obesity, though antecedents and consequences of these behaviors in this population are relatively unknown. This pilot study examined affect, loss of control eating (LOCE), overeating, and hunger surrounding PA and SB in 17 youth with overweight/obesity. Participants completed a 14-day ecological momentary assessment (EMA) wearing accelerometers. At the momentary level, higher negative affect and lower positive affect predicted SB increases and PA decreases following EMA prompts; higher PA and lower SB also predicted increases in positive affect. Higher LOCE predicted SB increases and PA decreases, while increases in PA and decreases in SB predicted short-term increases in LOCE and overeating. At the individual level, higher SB and lower PA were related to lower positive affect and higher negative affect, LOCE, overeating, and hunger. Findings suggest affect is a relevant antecedent and consequence of PA/SB, and dysregulated eating may acutely impact PA/SB.

Ecological momentary assessment of eating and dietary intake behaviors in children and adolescents: A systematic review of the literature.

The objective of this review was to summarize associations between ecological momentary assessment (EMA)-measured contextual factors and eating and dietary intake behaviors in children and adolescents. The inclusion criteria were availability of the study in English and use of EMA to study eating and dietary intake behaviors among children and/or adolescents (ages<18). Literature searches were conducted in PsycInfo and PubMed databases across all dates until December 2018. A modified Checklist for Reporting EMA Studies was used to assess quality of studies. Eighteen articles from 15 independent studies were included in the systematic review. Contextual factors examined in relation to children's eating in studies included affect and stress; cognitive factors; social and environment factors; behavioral factors; and caregiver-related factors. Studies suggested there is strong evidence that cognitive and social factors have an effect on eating and dietary intake behaviors while the association between affect and eating and dietary intake behaviors remains mixed. Future studies should consider timing of effects, measure choice, individual difference and contextual factors, and developmental context.

Lower total and regional grey matter brain volumes in youth with perinatally-acquired HIV infection: Associations with HIV disease severity, substance use, and cognition.

Despite improved survival due to combination antiretroviral therapy (cART), youth with perinatally-acquired HIV (PHIV) show cognitive deficits and developmental delay at increased rates. HIV affects the brain during critical periods of development, and the brain may be a persistent reservoir for HIV due to suboptimal blood brain barrier penetration of cART. We conducted structural magnetic resonance imaging (sMRI) and cognitive testing in 40 PHIV youth (mean age=16.7years) recruited from the NIH Pediatric HIV/AIDS Cohort Study (PHACS) who are part of the first generation of PHIV youth surviving into adulthood. Historical and current HIV disease severity and substance use measures were also collected. Total and regional cortical grey matter brain volumes were compared to a group of 334 typically-developing, HIV-unexposed and uninfected youth (frequency-matched for age and sex) from the Pediatric Imaging, Neurocognition, and Genetics (PING) study (mean age=16.1years). PHIV youth had smaller (2.8-5.1%) total and regional grey matter volumes than HIV-unexposed and uninfected youth, with smallest volumes seen among PHIV youth with higher past peak viral load (VL) and recent unsuppressed VL. In PHIV youth, worse cognitive performance correlated with smaller volumes. This pattern of smaller grey matter volumes suggests that PHIV infection may influence brain development and underlie cognitive dysfunction seen in this population. Among PHIV youth, smaller volumes were also linked to substance use (alcohol use: 9.0-13.4%; marijuana use: 10.1-16.0%). In this study, collection of substance use information was limited to the PHIV cohort; future studies should also collect substance use information in controls to further address interactions between HIV and substance use on brain volume.

Burden and Inattentive Responding in a 12-Month Intensive Longitudinal Study: Interview Study Among Young Adults.

BACKGROUND: Intensive longitudinal data (ILD) collection methods have gained popularity in social and behavioral research as a tool to better understand behavior and experiences over time with reduced recall bias. Engaging participants in these studies over multiple months and ensuring high data quality are crucial but challenging due to the potential burden of repeated measurements. It is suspected that participants may engage in inattentive responding (IR) behavior to combat burden, but the processes underlying this behavior are unclear as previous studies have focused on the barriers to compliance rather than the barriers to providing high-quality data. OBJECTIVE: This study aims to broaden researchers' knowledge about IR during ILD studies using qualitative analysis and uncover the underlying IR processes to aid future hypothesis generation. METHODS: We explored the process of IR by conducting semistructured qualitative exit interviews with 31 young adult participants (aged 18-29 years) who completed a 12-month ILD health behavior study with daily evening smartphone-based ecological momentary assessment (EMA) surveys and 4-day waves of hourly EMA surveys. The interviews assessed participants' motivations, the impact of time-varying contexts, changes in motivation and response patterns over time, and perceptions of attention check questions (ACQs) to understand participants' response patterns and potential factors leading to IR. RESULTS: Thematic analysis revealed 5 overarching themes on factors that influence participant engagement: (1) friends and family also had to tolerate the frequent surveys, (2) participants tried to respond to surveys quickly, (3) the repetitive nature of surveys led to neutral responses, (4) ACQs within the surveys helped to combat overly consistent response patterns, and (5) different motivations for answering the surveys may have led to different levels of data quality. CONCLUSIONS: This study aimed to examine participants' perceptions of the quality of data provided in an ILD study to contribute to the field's understanding of engagement. These findings provide insights into the complex process of IR and participant engagement in ILD studies with EMA. The study identified 5 factors influencing IR that could guide future research to improve EMA survey design. The identified themes offer practical implications for researchers and study designers, including the importance of considering social context, the consideration of dynamic motivations, and the potential benefit of including ACQs as a technique to reduce IR and leveraging the intrinsic motivators of participants. By incorporating these insights, researchers might maximize the scientific value of their multimonth ILD studies through better data collection protocols. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/36666.

Long-term effects of the COVID-19 pandemic on children's physical activity and sedentary behavior.

Background: During the early months of the COVID-19 pandemic, decreases in physical activity (PA) and increases in sedentary behavior (SB) were reported among children in the United States (U.S.). This follow-up analysis examines 13-month effects of the COVID-19 pandemic on children's PA and SB one year into the pandemic. Methods: Parents of 5-13-year-old children in the U.S. (N = 71) reported on their child's PA and SB during the early COVID-19 period (April-May 2020) and again 12-14 months later (June-July 2021). Results: Paired t-tests showed significant within-subject reductions in SB minutes per day (M diff = -86.20, t = 3.26, p < 0.01) but no changes in PA minutes per day. Separate mixed-model repeated-measures analysis of covariance procedures found that within-subject changes in PA and SB did not differ by child sex or age. Conclusion: As COVID-19 restrictions lessened, there were more opportunities for children to reduce SB, but there were still barriers to engage in PA.

Interactive associations between abstinence plans and romantic partner conflict and support with cigarette smoking.

BACKGROUND: While most individuals who smoke cigarettes desire to quit, quit motivation can change daily and sustained abstinence is rarely achieved in quit attempts. Assessment of psychosocial factors that moderate associations between daily abstinence intentions and smoking behavior is necessary to inform effective cessation efforts. METHODS: A secondary analysis was conducted using data from a 28-day ecological momentary assessment study among individuals who smoke and who were not actively planning a long-term quit attempt (N = 81 individuals; N = 1585 days). We examined main effect and interaction associations between primary predictors (daily abstinence plans and within- and between-person estimates of perceived romantic relationship conflict and support) and daily number of cigarettes smoked, as well as baseline emotion regulation difficulties as a moderator of these associations. RESULTS: Smoking was reduced on days with an abstinence plan (ß=-0.57,p<.001), especially among individuals with lower average levels of conflict (plan × between-person conflict interaction: ß=0.98, p < .001), and higher average levels of support (plan × between-person support interaction: ß=0.26, p < .001). Additionally, smoking was increased on days when participants had higher levels of conflict than usual (ß=0.07, p < .01), but only on days when participants did not have a plan (plan × within-person conflict interaction:ß=-0.10, p < .05). Emotion regulation difficulties did not moderate any associations. CONCLUSION: This study adds to the literature on the influence of negative aspects of social experience on smoking behavior. Further, the present study underlines the importance of assessing the influence of both positive and negative aspects of - and within- and between-person differences in - social experiences.

Emotion regulation expectancies and smoking cessation factors: A daily diary study of California adults who smoke cigarettes during a practice quit attempt.

SIGNIFICANCE: Cross-sectional studies have shown that greater cigarette smoking-related emotion regulation expectancies were associated with retrospectively reported withdrawal during prior quit attempts and greater barriers to cessation. Few studies have investigated the relationship of within-person daily emotion regulation expectancies to factors related to initiating and maintaining a brief quit attempt. METHODS: People living in California who smoked cigarettes daily (n = 220, 50 % female; 48.5 % white, 14.6 % Hispanic, 16.7 % Black or African American, 9.6 % Asian, 7.6 % Multi-race, 3.0 % other race; mean age=43.71 years old) completed a practice quit attempt and 28-days of daily diary surveys. In the morning, participants reported non-smoking and smoking emotion regulation expectancies based on the Affective Processing Questionnaire, daily abstinence plan, abstinence self-efficacy, and cigarettes smoked. Successful abstinence plans were calculated as days with an abstinence plan and no cigarettes smoked. Multilevel models investigated whether within-person emotion regulation expectancies were associated with abstinence plan, self-efficacy, and successful abstinence plan. RESULTS: Greater within-person non-smoking emotion regulation expectancies were associated with increased odds of having an abstinence plan, higher self-efficacy, and a successful abstinence plan on a given day (ps < .05). Greater within-person smoking emotion regulation expectancies were associated with lower odds of having an abstinence plan and lower self-efficacy (ps < .001) but did not significantly associate with a successful abstinence plan. CONCLUSIONS: These findings show that within-person levels of expectations in emotion regulation abilities may contribute to factors relevant to initiating and achieving daily abstinence during a practice attempt.

Legislation has Changed But Issues Remain: Provider Perceptions of Caring for People Who Use Cannabis During Pregnancy in Safety Net Health Settings, a Qualitative Pilot Study.

Objective: To identify perceptions of cannabis use and risk among maternal health providers who provide care for people who use cannabis during pregnancy in safety-net health settings. Methods: Using qualitative, constructivist ground theory methods, we conducted semistructured remote interviews with 10 providers (2 midwives, 6 OB/GYN physicians, and 2 OB/GYN residents) in Southern California, United States, between March 15, 2022, and April 6, 2022. We selected participants through selective sampling using a convenience sample and snowball approach. Providers were eligible for the study if they self-reported via survey to being a maternal health provider (e.g., physician, doula, midwife, and so on) providing care in a safety-net health setting and had cared for people who used cannabis during pregnancy in the last year. Analysis drew upon grounded theory methods to document the socio-structural contexts that contribute to provider perceptions about cannabis. This study was approved by the University of Southern California Institutional Review Board (UP-21-00282-AM009). Results: We identified three categories of provider perceptions of cannabis use and risk during pregnancy: (1) Relying on self-education, (2) Taking a case-by-case approach, and (3) Avoiding cannabis discussions to maintain an alliance with patients. Findings indicate that provider reluctance to counsel patients about cannabis in favor of preserving a therapeutic relationship can overlook the lack of resources and access to health care alternatives available to low-income patients that can shape self-medicating. Conclusions: Nonpunitive policies and training on cannabis use are critical steps for supporting providers to counsel patients who use cannabis during pregnancy, alongside a harm reduction approach that acknowledges the broader socio-structural contexts and barriers facing patients who disclose use.

Motivational Profile as a Predictor of Physical Activity Among US Adults During the Early Months of the COVID-19 Pandemic: A Daily Diary Study.

This study used a daily diary approach to examine associations between day-level physical activity (PA) behavior, PA-specific motivational profile, and days since the COVID-19 national emergency declaration during the early months (April-June 2020) of the pandemic. A total of 468 US adults (Mage = 34.8 y, 79% female) participated in a 28-day smartphone-based daily diary study assessing PA. A baseline survey assessed PA and motivation for PA using the Behavioral Regulation in Exercise Questionnaire. Multilevel linear regression models examined the main effects and interactions of motivational profile and time (days since the US March 13, 2020, COVID-19 national emergency declaration) on daily PA minutes. Latent profile analysis identified 4 distinct motivational profiles for PA among this sample: profile 1: high amotivation (n = 100, 21%); profile 2: low controlled motivation (n = 55, 12%); profile 3: high external regulation (n = 47, 10%); and profile 4: moderate autonomous motivation (n = 266, 57%). After controlling for baseline PA, there were significant interactions between profile and time on daily PA (-0.21, P < .01). Profile 2 showed greater decreases in daily PA minutes over time than profile 1 (b = -0.29, P < .01). Profiles 3 and 4 did not indicate significant decreases in PA compared with profile 1 (b = 0.14, P = .31 and b = -0.16, P = .05, respectively). Contrary to previous research, individuals with lower controlled or moderate autonomous motivation demonstrated the largest decreases in PA over time, whereas individuals with higher amotivation or external regulation demonstrated smaller decreases over time. These findings suggest that external motivation may have provided short-term protection against declines in PA observed during early months of the COVID-19 pandemic.

Accelerometer-Based Physical Activity and Shape and Weight Concerns Among Youth With Overweight and Obesity: A Pilot Exploratory Ecological Momentary Assessment Study.

Background: A bidirectional association between shape and weight concerns (SWC) and physical activity (PA) has been previously documented. This relationship may be particularly salient among youth with overweight/obesity, given that social marginalization of larger bodies has been associated with elevated SWC and barriers to PA. This pilot study explores reciprocal relationships between momentary SWC and accelerometer-assessed PA behavior. Methods: Youth with overweight/obesity (N = 17) participated in a 14-day ecological momentary assessment protocol, during which they were prompted to respond to questions about SWC several times per day. They also continuously wore Actiwatch 2 accelerometers to capture light and moderate-to-vigorous PA behavior. Results: Hierarchical linear modeling revealed a unidirectional association between SWC and PA, whereby after engaging in a higher duration of PA, participants reported lower SWC. SWC did not predict subsequent PA. Conclusion: The findings support a negative temporal relationship between PA and SWC. While further work is needed to replicate and extend these preliminary findings, they may suggest that PA acutely benefits SWC among youth with overweight and obesity.

Interactions between daily abstinence plans and approach/avoidance motivation on cigarette smoking in pre-quit smokers.

Enhancing motivation to quit among smokers who are not ready for cessation is a key component of several interventions. However, there is a dearth of empirical data about motivational factors and smoking behavior among pre-quit smokers. Here, we examined interactions between approach/avoidance goal motivations and daily abstinence plan (i.e., plans to either continue or abstain from smoking) on daily cigarette use. Current smokers (n = 82; M = 11.4 cigs/day; 46% Female) completed a baseline assessment, including a measure of approach/avoidance motivation [Behavioral Inhibition and Behavioral Activation Scales (BIS/BAS)], followed by 28-days of Ecological Momentary Assessment (EMA). EMA included a morning assessment of abstinence plan, and evening assessment of cigarettes smoked. Multilevel linear models tested interactions between BIS/BAS and abstinence plan on cigarette smoking (defined as percent change from within-subject mean). There was a significant abstinence plan × BIS interaction, F(1, 637) = 6.567, p = .011, and abstinence plan × BAS interaction, F(1, 637) = 6.553, p = .011, on cigarette smoking. High BIS and low BAS were each associated with reduced smoking on abstinence days and increased smoking on non-abstinence days. Modest rates of smoking cessation may be due to the unassisted, spontaneous nature of most quit attempts. Among pre-quit smokers, high behavioral inhibition and low behavioral activation may underlie the ability to intentionally vary smoking levels according to individuals' daily abstinence plans. Future studies should examine how motivational factors during the pre-quit stage may predict long-term smoking cessation in the future. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Intensive Longitudinal Data Collection Using Microinteraction Ecological Momentary Assessment: Pilot and Preliminary Results.

BACKGROUND: Ecological momentary assessment (EMA) uses mobile technology to enable in situ self-report data collection on behaviors and states. In a typical EMA study, participants are prompted several times a day to answer sets of multiple-choice questions. Although the repeated nature of EMA reduces recall bias, it may induce participation burden. There is a need to explore complementary approaches to collecting in situ self-report data that are less burdensome yet provide comprehensive information on an individual's behaviors and states. A new approach, microinteraction EMA (µEMA), restricts EMA items to single, cognitively simple questions answered on a smartwatch with single-tap assessments using a quick, glanceable microinteraction. However, the viability of using µEMA to capture behaviors and states in a large-scale longitudinal study has not yet been demonstrated. OBJECTIVE: This paper describes the µEMA protocol currently used in the Temporal Influences on Movement & Exercise (TIME) Study conducted with young adults, the interface of the µEMA app used to gather self-report responses on a smartwatch, qualitative feedback from participants after a pilot study of the µEMA app, changes made to the main TIME Study µEMA protocol and app based on the pilot feedback, and preliminary µEMA results from a subset of active participants in the TIME Study. METHODS: The TIME Study involves data collection on behaviors and states from 246 individuals; measurements include passive sensing from a smartwatch and smartphone and intensive smartphone-based hourly EMA, with 4-day EMA bursts every 2 weeks. Every day, participants also answer a nightly EMA survey. On non-EMA burst days, participants answer µEMA questions on the smartwatch, assessing momentary states such as physical activity, sedentary behavior, and affect. At the end of the study, participants describe their experience with EMA and µEMA in a semistructured interview. A pilot study was used to test and refine the µEMA protocol before the main study. RESULTS: Changes made to the µEMA study protocol based on pilot feedback included adjusting the single-question selection method and smartwatch vibrotactile prompting. We also added sensor-triggered questions for physical activity and sedentary behavior. As of June 2021, a total of 81 participants had completed at least 6 months of data collection in the main study. For 662,397 µEMA questions delivered, the compliance rate was 67.6% (SD 24.4%) and the completion rate was 79% (SD 22.2%). CONCLUSIONS: The TIME Study provides opportunities to explore a novel approach for collecting temporally dense intensive longitudinal self-report data in a sustainable manner. Data suggest that µEMA may be valuable for understanding behaviors and states at the individual level, thus possibly supporting future longitudinal interventions that require within-day, temporally dense self-report data as people go about their lives.

Dyadic Effects of Pokémon GO on Physical Activity and Sedentary Behavior in Mothers and Children.

Family-based mobile health applications may be an opportunity to increase children's physical activity (PA) levels. Researchers have highlighted Pokémon GO as a potential model for future PA interventions as it integrates PA with social gamification. This study provides descriptive data on Pokémon GO usage among mothers and their children and examines differences in moderate to vigorous PA (MVPA) over time among individuals playing Pokémon GO compared to non-players using a dyadic subsample from a three-year longitudinal study. After the release of Pokémon Go in July 2016, 156 mother-child dyads completed questionnaires about Pokémon Go usage and wore accelerometers continuously for seven days at baseline (Sep 2016), six months, and twelve months. Independent sample t-tests and chi-square tests were used to investigate differences in demographics and daily MVPA by player status cross-sectionally at each time point. At baseline, six mothers and 21 children reported playing Pokémon Go. Baseline demographic characteristics were not associated with player status. Across time, mothers engaged in an average of 21.12 minutes of daily MVPA (SD = 19.7) and children in 29.35 minutes (SD = 18.88). Children's daily MVPA did not differ by player status, but mothers who reported playing engaged in higher daily MVPA (M = 46.84, SD = 38.07) compared to non-players (M = 21.40, SD = 23.31). This naturalistic study lacked power to further analyze changes in MVPA after the release of the game due to lack of engagement with Pokémon GO. Understanding how to design a family-oriented game to bring together gamification, physical activity, and family-based interventions will be important for future public health efforts.

Investigating Microtemporal Processes Underlying Health Behavior Adoption and Maintenance: Protocol for an Intensive Longitudinal Observational Study.

BACKGROUND: Young adulthood (ages 18-29 years) is marked by substantial weight gain, leading to increased lifetime risks of chronic diseases. Engaging in sufficient levels of physical activity and sleep, and limiting sedentary time are important contributors to the prevention of weight gain. Dual-process models of decision-making and behavior that delineate reflective (ie, deliberative, slow) and reactive (ie, automatic, fast) processes shed light on different mechanisms underlying the adoption versus maintenance of these energy-balance behaviors. However, reflective and reactive processes may unfold at different time scales and vary across people. OBJECTIVE: This paper describes the study design, recruitment, and data collection procedures for the Temporal Influences on Movement and Exercise (TIME) study, a 12-month intensive longitudinal data collection study to examine real-time microtemporal influences underlying the adoption and maintenance of physical activity, sedentary behavior, and sleep. METHODS: Intermittent ecological momentary assessment (eg, intentions, self-control) and continuous, sensor-based passive monitoring (eg, location, phone/app use, activity levels) occur using smartwatches and smartphones. Data analyses will combine idiographic (person-specific, data-driven) and nomothetic (generalizable, theory-driven) approaches to build models that may predict within-subject variation in the likelihood of behavior "episodes" (eg, ≥10 minutes of physical activity, ≥120 minutes of sedentary time, ≥7 hours sleep) and "lapses" (ie, not attaining recommended levels for ≥7 days) as a function of reflective and reactive factors. RESULTS: The study recruited young adults across the United States (N=246). Rolling recruitment began in March 2020 and ended August 2021. Data collection will continue until August 2022. CONCLUSIONS: Results from the TIME study will be used to build more predictive health behavior theories, and inform personalized behavior interventions to reduce obesity and improve public health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36666.