Danielle Arigo

Psychiatric comorbidities in women with Celiac Disease

Objective: Although the physical consequences of Celiac Disease are well studied, less is known about co-occurring psychiatric symptoms. This study examines psychiatric risk and comorbidities of women with Celiac Disease, who may be at increased risk for psychiatric symptoms (e.g. depression, and disordered eating behaviours). Methods: Women (Nu2009=u2009177) with Celiac Disease responded to an extensive web-mediated survey assessing dietary compliance, illness symptoms, psychiatric functioning, and disordered eating. Results: Despite high reported dietary compliance, patients reported marked illness symptoms and impaired quality of life. A substantial minority endorsed symptoms that met criteria for the diagnosis of psychiatric disorders: 37% (nu2009=u200965) met the threshold suggesting depression, and 22% (nu2009=u200939) for disordered eating. Participants whose symptoms exceeded these clinical thresholds reported greater perceived stress and reduced overall mental health, relative to women below the clinical cutoffs. Conclusions: Despite largely adhering to a gluten-free diet, a substantial subset of women with Celiac Disease report clinically relevant symptoms of depression and disordered eating; such symptoms are associated with increased psychosocial distress in other domains. These results suggest potential to improve the patient well-being through attention to psychosocial care, in addition to existing dietary recommendations for individuals with Celiac Disease.

Promoting physical activity among women using wearable technology and online social connectivity: a feasibility study

Wearable physical activity (PA) tracking technology, which has the capacity to connect users’ PA data to online social networks, could address the need for cost-effective, scalable PA programs for women. It is not yet clear how to use wearable devices to maximize the effectiveness of evidence-based PA promotion techniques. There also is need to examine time-sensitive, within-person relationships between aspects of social networking and PA progress. The present study tested the feasibility, acceptability, and effectiveness of an online PA program that employed wearable technology, an associated social network, and the assignment of program partners. Sedentary women (nu2009=u200920, MAgeu2009=u200950, MBMIu2009=u200930.9u2005kg/m2) used wearable devices and attended one face-to-face session that introduced evidence-based PA promotion skills (e.g. goal setting). The remainder of the six-week program emphasized online communication with PA partners and other group members. Participants completed online surveys about their social contact at the end of every week. The recruitment target (set at 20) was reached after three weeks, and retention over six weeks was 100%. Objectively verified daily device wear was high (97%) and participant program ratings were favorable (e.g. Mu2009=u20093.85 of 5, SDu2009=u20091.04 for “effectiveness”). Participants showed large increases in daily steps (from 3796 [SEu2009=u2009478] to 8190 [SEu2009=u2009516]) and daily minutes of moderate-to-vigorous PA (from 12.68 [SEu2009=u20093.15] to 24.05 [SEu2009=u20093.48]). Multilevel models revealed meaningful within-person relationships between PA and social contact (psu2009<u2009.02); PA was highest at times when social contact was higher than a participants average level. Findings support the feasibility, acceptability, and effectiveness of incorporating wearable technology and online social networking into an online PA program for women, and provide time-sensitive evidence that social networking is beneficial for PA. Consequently, larger, randomized trials of this approach are warranted.

Perceptions of similarity and response to selected comparison targets in type 2 diabetes

Objective: Social comparisons (i.e. self-evaluations relative to others) may affect motivation for diabetes self-care behaviours. Comparisons can have either positive or negative effects, but it is not clear what differentiates these responses. This study tested the effect of a patient’s perceived similarity to a comparison target on motivation for self-care. Design: Individuals with type 2 diabetes (n = 180, MA1c = 7.59%) selected to read one of four brief descriptions of a patient with diabetes. Main outcome measures: Participants rated their motivation for self-care behaviours prior and subsequent to reading and reported the extent to which they focused on similarities between the self and the selected patient while reading. Results: Perceived similarity moderated the effect of selection on motivation for self-care (p = .01, η2u2009=u2009.06). Increased motivation was observed if participants focused on similarities with patients ‘doing better’ (i.e. high coping effectiveness/low symptom severity) and decreased motivation if they focused on similarities with patients ‘doing worse’ (low coping effectiveness/high symptom severity). Conclusions: Providing social comparison information in diabetes management (and perhaps other chronic diseases) may improve motivation for self-care among some patients. A subset of patients, however, may benefit from guidance to focus on similarities with certain targets.

Pilot Test of an Acceptance-Based Behavioral Intervention to Promote Physical Activity During Weight Loss Maintenance

ABSTRACT Behavioral interventions for obesity reliably facilitate short-term weight loss, but weight regain is normative. A high level of aerobic exercise may promote weight loss maintenance. However, adopting and maintaining a high level of exercise is challenging, and experiential acceptance may be important. The aim of this study was to pilot test the feasibility and efficacy of an acceptance-based behavioral treatment to promote moderate-to-vigorous physical activity (MVPA) among individuals who had recently lost weight. Adults (n = 16) who had recently lost ≥ 5% of weight were provided with a 12-week, group-based treatment. At 12 weeks, complete analyses indicated that participants had increased activity 69% (completing an average of 198.27 minutes/week of bouted MVPA, i.e., episodes of at least 10 minutes in duration). Medium-to-large effect sizes were observed for changes in process measures, including experiential acceptance. Future research to test this approach using an experimental design, a larger sample, and a longer period of observation is warranted.

Understanding physical activity lapses among women: responses to lapses and the potential buffering effect of social support

Many women fail to meet recommended levels of physical activity (PA). Limited research has examined women’s barriers to PA adoption during attempts to increase PA—in particular, how often they experience PA lapses (i.e., failure to meet PA goals), their cognitive–affective responses to lapses, and the role of social support in preventing or responding to lapses. The present study assessed weekly variability in PA lapses, cognitive–affective responses to lapses, and social support related to PA among women participating in a partner-based PA program (nxa0=xa020). Multilevel modeling showed that greater PA self-efficacy and more frequent partner communication predicted fewer lapses during the concurrent or subsequent week (psxa0<xa00.02). Interestingly, greater self-forgiveness for lapsing also predicted more lapses the subsequent week (pxa0=xa00.04), though greater perceived partner support appeared to buffer the negative effect of self-forgiveness on future lapses (pxa0=xa00.04). These findings demonstrate the importance of cognitive–affective responses to PA lapses for future PA, as well as the potential benefit of social support for preventing PA lapses among women.

Smartphone apps providing social comparison for health behavior change: a need for better tailoring to person and context

Smartphone apps that support health behavior change efforts often provide opportunities for users to compare their behaviors and progress to that of other users (i.e., social comparison). At present, however, available literature on features of these apps has two main limitations: (I) it shows little consistency in its application of the term social comparison, and (II) it does not take into account key aspects and consequences of social comparison that could improve user engagement and behavioral outcomes. In this piece, we provide examples to illustrate the problems in each domain of limitation, and we identify critical aspects of the broader social comparison literature that could inform the tailoring of social comparison features to individual users and contexts.

Social comparisons in adults with type 2 diabetes: Patients’ reasons for target selection

Objective: To examine reasons for selecting a social comparison target (i.e. a specific other for relative self-evaluation), and their influence on affect and motivation for self-care, in type 2 diabetes (T2DM). Design: Adults with T2DM (n = 180, MA1c = 7.6%) chose to read about one of four targets. Participants rated five reasons for their choice (strongly disagree – strongly agree), and rated affect and self-care motivation before and after reading. Results: To boost confidence in my ability to manage diabetes was rated highest overall (ps < 0.01), though choosing worse-off (vs. better-off) targets was associated with to gain useful information about how to improve (p = 0.04, = 0.05). Selection in order to feel better worked for those who chose better-off targets; choosing worse-off targets for this purpose worsened mood and stress (ps < 0.04, s = 0.02). Choosing worse-off targets to learn about similar others reduced self-care motivation (p < 0.01, = 0.05). Selection in order to boost confidence showed increased motivation only among those who chose better-off targets (p = 0.01). Conclusions: Patients’ reasons for a particular comparison are associated with short-term changes in affect and self-care motivation, and warrant greater empirical and clinical attention.

Reported Influences on Restaurant-Type Food Selection Decision Making in a Grocery Store Chain

Objective: To examine food decision‐making priorities for restaurant‐type foods at grocery stores and determine whether adding calorie information, as required by federal menu labeling laws, affected decision‐making priorities. Design: Natural experiment: intervention and control groups with baseline and follow‐up. Setting: Regional grocery store chain with 9 locations. Participants: Participants (n = 393; mean age, 54.8 ± 15.1 years) were primarily women (71%) and Caucasian (95%). Intervention: Data were collected before and after calorie information was added to restaurant‐type foods at 4 intervention locations. Main Outcome Measure(s): Primary influencers of food selection decision making for restaurant‐type foods and frequency of use of nutrition information. Analysis: Quantitative analysis examined the top 3 influencers of food selections and chi‐square goodness of fit test determined whether the calorie labeling intervention changed food decision‐making priorities. Qualitative data were used to describe responses. Results: Taste, cost, and convenience were the most frequently reported influencers of restaurant‐type food selections; 20% of participants rated calories as influential. Calorie labeling did not affect food selection decision making; 16% of participants in intervention stores noticed calorie labels. Qualitative explanations confirmed these findings. Conclusions and Implications: Menu labeling laws increase access to calorie information; however, use of this information is limited. Additional interventions are needed to encourage healthier restaurant‐type food selections in grocery stores.

Mediators of two selective prevention interventions targeting both obesity and eating disorders

The present study tested hypothesized mechanisms underlying the effects of two selective prevention interventions targeting both obesity and eating disorders (Healthy Weight and the newly developed Project Health), relative to video control. Tests examined mediation for the significant weight gain prevention and eating disorder symptom prevention effects previously reported. College students (Nu202f=u202f364; 72% women) with weight concerns were randomized to condition and assessed for 2-years post-intervention. Project Health participants had significant improvements in 2 of the 7 proposed mediators relative to comparisons (i.e., cognitive dissonance, the unhealthy Western dietary pattern) but change in these variables did not mediate its effect on long-term BMI change. Two variables emerged as full mediators of the eating disorder prevention effects for both experimental interventions: body dissatisfaction and negative affect. Analyses failed to support the exploratory hypothesis that change in eating disorder symptoms mediated the effects of condition on BMI gain. This report is the among the first to examine mediation for programs aimed at preventing both weight gain and eating disorders, particularly in mixed-gender groups. Mediational analyses are essential in identifying the mechanism of intervention action, which can inform improvements to prevention programs.

Subjective Life Expectancy Among College Students

ABSTRACT Establishing healthy habits in college is important for long-term health. Despite existing health promotion efforts, many college students fail to meet recommendations for behaviors such as healthy eating and exercise, which may be due to low perceived risk for health problems. The goals of this study were to examine: (1) the accuracy of life expectancy predictions, (2) potential individual differences in accuracy (i.e., gender and conscientiousness), and (3) potential change in accuracy after inducing awareness of current health behaviors. College students from a small northeastern university completed an electronic survey, including demographics, initial predictions of their life expectancy, and their recent health behaviors. At the end of the survey, participants were asked to predict their life expectancy a second time. Their health data were then submitted to a validated online algorithm to generate calculated life expectancy. Participants significantly overestimated their initial life expectancy, and neither gender nor conscientiousness was related to the accuracy of these predictions. Further, subjective life expectancy decreased from initial to final predictions. These findings suggest that life expectancy perceptions present a unique—and potentially modifiable—psychological process that could influence college students self-care.