Social Support for Weight Loss: Online Friends Versus Real Friends

This presentation highlights a project which compares the social support and influence experienced by people who use online social networks to the support and influence they experience from in-person friends and family. This presentation was part of the retreat mini-symposium entitled: Smartphones, Sensors, and Social Networks: The New Tools of Health Behavior Change

Skin Cancer Risk in Gay and Bisexual Men: A Call to Action

Editorial recommending that the significant sexual orientation health disparities among gay and bisexual men in regard to skin cancer and use of indoor tanning must be studied

Weight loss in persons with serious mental illness

Comment on A behavioral weight-loss intervention in persons with serious mental illness. [N Engl J Med. 2013

A Qualitative And Quantitative Review of Behavioral Activation Treatment of Major Depressive Disorder

In the treatment of Major Depressive Disorder (MDD), Behavioral Activation Therapy (BA) has emerged in recent years as an efficacious intervention. Derived from a component analysis of CBT, it offered at once a parsimonious explanation for the active ingredient of CBT, while demonstrating clinical efficacy as a separate treatment. Since the original investigation by Jacobson and colleagues in 1996, several well-controlled studies have been conducted, all of which converge to suggest strong support for BA as a stand-alone therapy for MDD. In this paper we review, evaluate and classify the evidence pertinent to this intervention and provide recommendations concerning its standing as a front line treatment. We conclude that the evidence is strong, the quality of research is generally very good and the effects sizes are compelling. Through both a qualitative and meta-analytic review of this evidence we also suggest the types of future studies that will establish greater confidence in BA as a front line treatment of choice therapy for Major Depressive Disorder

The association between ADHD and eating disorders/pathology in adolescents: A systematic review

Background: Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most common neurodevelopmental conditions of childhood, is associated with high rates of mood and behavioral disorders. Preliminary evidence suggests that ADHD may also be associated with eating disorders (ED) or eating pathology (EP). This systematic review synthesizes the extant published literature on this association among youth ages 12 - 21 years. Methods: Literature searches were performed using Medline, Ovid/Psych Info, Google Scholar, and via manual inspection of bibliographies. Crosssectional, case-control, and prospective studies published in English with sample sizes larger than 50, participant ages 12 - 21 years, and assessed ADHD and ED or EP, were considered for review. Case reports, feeding, and drug studies were excluded. Results: Preliminary searches yielded 337 articles; eight articles met inclusion/exclusion criteria. Two studies documented an association between ADHD and ED, and three studies found an association between ADHD and EP. Youth with ADHD were nearly 3 to 6 times more likely to develop an ED than youth without ADHD, and were also more likely to have higher rates of EP, body dissatisfaction, and desire to lose weight/ drive for thinness. Impulsivity was predictive of EP, and ADHD youth with co-occurring mood/behavioral disorders and punitive parental relationships were at higher risk. Conclusions: Five of eight studies documented an association between ADHD and ED or EP in adolescents. Future research is needed to confirm and refine further these findings. The findings have clinical implications, including the inclusion of ED/EP in screening and anticipatory guidance efforts. Evaluating whether medical management of ADHD may be efficacious in preventing and/or treating ED/EP is also warranted

The US Food and Drug Administration\u27s Proposed Rule to Increase Regulation of Indoor Tanning Devices

Tanning bed use, particularly among teen girls and young adult women, has become a modern-day epidemic in the past 20 years. Numerous studies have established the link between indoor tanning use and skin cancer, including melanoma. Reducing the harms of indoor tanning is one of 5 goals outlined in the 2014 US Surgeon General’s “Call to Action to Prevent Skin Cancer.”Consistent with the Call to Action, on December 22, 2015, the US Food and Drug Administration (FDA) issued a proposed rule with the following restrictions for sunlamp products (ie, indoor tanning beds and booths): (1) to ban their use among individuals younger than 18 years; (2) to require prospective users to sign a risk acknowledgment certification; and (3) to provide user manuals to customers and tanning facility operators on request

The role of attitude, control and intention to explain fruit and vegetable intake among racial/ethnic minority women with low socioeconomic status

OBJECTIVE: Fruit and Vegetable (FV) intake-a modi able risk factor for chronic diseases-is lower among racial/ethnic minorities and low Socio- Economic Status (SES) groups when compared to other populations. The Theory of Planned Behavior (TPB) is one theoretical model studied to explain and in uence individual health behaviors, including FV intake, in middle class populations, but not exclusively in diverse, low SES groups. This cross-sectional study evaluated the utility of select TPB variables to explain intention to consume and intake of FV in this population. DESIGN: Demographics, BMI, select TPB variables, and FV intake were measured via survey. Bivariate analyses were conducted to explore relationships between variables. Hierarchical regression analyses were used to t two models: one to explain intention and one to explain behavior with regard to FV vegetable intake. RESULTS: Participants (n=114) age 25-69 years and were mostly African American/Black and Hispanic (21.9% and 73%, respectively). The TPB variable perceived behavioral control was the only signi cant predictor of intention to consume FV (OR=2.55, 95% CI OR: 1.23, 5.27), and with BMI, FV intake (R2=0.08; F [2,130] =5.72, p=0.0042). CONCLUSION: Perceived behavioral control and BMI are the most signi cant predictors of FV intake but explain only 8% of the variability in intake in our cohort. Our results support prior research which suggests an attenuation of the intention-behavior relationship by SES, and may question the utility of the TPB as it is currently operationalized as a foundational model for future health behavior change research and programs in low SES racial/ethnic minorities

Implementation and Utilization of Mobile Technology In Adolescent Bariatric Surgery Patients

Obesity is the most prevalent chronic disease of childhood. Obese adolescents are likely to become obese adults with significant associated co-morbidities and early mortality. In Massachusetts, 30% of children ages 10-17 are overweight or obese. It is projected that 48% of Massachusetts’ adults will be obese by 2030. In March of 2015, the Good Fit Adolescent Weight and Wellness Center opened, with a goal of addressing this issue with a proven multidisciplinary approach. Mobile technology continues to develop at a rapid pace. Adolescent access to mobile technology on smart phones and tablets continues to increase. Mobile fitness tracker applications are numerous and easy to use for today’s tech savvy teens. Successful weight loss and health maintenance is variable and has been difficult to validate with this technology so far. The purpose of this study is to evaluate existing mobile applications to be used by adolescent patients in the Good Fit Center. Our aim is to determine whether adolescent patients will be compliant with diet and exercise challenges sent through a mobile application and social media platform. We will work closely with dietitians, physicians and surgeons to evaluate feasibility and compliance within the first year of this project. In the second year, we will then test the functionality of this mobile application as it relates to patient success in the Good Fit program. The proposed research is a novel multimodal study combining behavioral sciences research, clinical outcomes research, and mobile technology to help to better understand the fitness management of adolescents struggling with morbid obesity. The findings of our research may have a number of important implications. These include the refinement of existing fitness strategies, as well as the development of a new useful piece of technology to combat obesity and improve the health and clinical outcomes of our nation’s children

Pilot and feasibility test of an implementation intention intervention to improve fruit and vegetable intake among women with low socioeconomic status

Fruit and vegetable intake (FVI), a modifiable risk factor for chronic diseases, is lower in low socioeconomic status (SES) populations. Implementation intentions (a specific type of planning that extends the Theory of Planned Behavior) has been studied to improve FVI, but not exclusively with low SES groups. Using mixed methods, we evaluated the feasibility, acceptability, and preliminary efficacy of an implementation intention intervention (versus a general plan) to increase FVI in women with low SES. For the pilot randomized controlled trial, demographics, body mass index, attitude, perceived behavioral control, goal intention strength, and FVI were measured at baseline and FVI again 1-month following the intervention. Feasibility data were collected for recruitment, randomization, retention, and assessment procedures and compared to predetermined targets. Semi-structured interview data was analyzed for emergent themes regarding acceptability of the trial. Preliminary efficacy of the intervention to improve FVI was analyzed descriptively. Feasibility targets were met for randomization (100% vs. ≥80% target), retention (93.5% vs. ≥70% target) and the assessment metrics missing data points (2% vs. ≤10% target) and days from intervention to follow up (mean=69.2, sd=42.6 vs.days). Targets for recruitment were not met with the exception of participants giving informed consent (100% vs. ≥70% target). Participants described the intervention as enjoyable and reported behavioral constructs outside of those measured as important to improve FVI. Limited efficacy analysis suggested that both groups increased their FVI (experimental: +0.17 servings per day, 95% CI: -0.85, 1.20; control: +0.50 servings per day, 95% CI: -0.56, 1.58). Further research which examines interventions based upon behavior change models to improve dietary health behaviors in marginalized groups is needed

A Systematic Review of Electronic Portal Usage Among Patients with Diabetes

The objectives of this review were (1) to examine characteristics associated with enrollment and utilization of portals among patients with diabetes and (2) to identify barriers and facilitators of electronic patient portal enrollment and utilization. PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were systematically searched for papers reporting original research using quantitative or qualitative methods on characteristics, barriers, and facilitators associated with portal enrollment and utilization among patients with diabetes in the United States. The search was limited to articles published between February 1, 2005 (the date of the national symposium on personal health records) and January 1, 2014. Sixteen articles were identified. Of these, nine were quantitative, three were qualitative, and four used mixed-methods. Several demographic characteristics, having better-controlled diabetes, and providers who engaged in and encouraged portal use were associated with increased portal enrollment and utilization. Barriers to portal enrollment included a lack of patient (1) capacity, (2) desire, and (3) awareness of portal/portal functions. Barriers to portal utilization included (1) patient capacity, (2) lack of provider and patient buy-in to portal benefits, and (3) negative patient experiences using portals. Facilitators of portal enrollment and utilization were providers and family members recommending and engaging in portal use. Improved usability, increased access, educating patients how to use and benefit from portals, and greater endorsement by providers and family members might increase portal enrollment and utilization. As more providers and hospitals offer portals, addressing barriers and leveraging facilitators may help patients with diabetes achieve potential benefits