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Behavioral and Psychological Intervention for Long Term Health Conditions

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A special issue of Behavioral Sciences (ISSN 2076-328X). This special issue belongs to the section "Health Psychology".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 25378

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Special Issue Editor

Dr. Aikaterini Kassavou

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Guest Editor

1. Department of Public Health and Primary Care, The University of Cambridge, Cambridge CB2 0SR, UK
2. Warwick Businness School, The University of Warwick, Coventry CV4 7AL, UK
Interests: behavior sciences; tailored interventions; digital health; health care professionals; process for clinical effectiveness

Special Issue Information

Dear Colleagues,

Health behaviors underpin long-term health conditions and direct their trajectory. However, only a minority of patients who receive treatment experience clinically meaningful and sustained health effects. Health care providers have an important role in supporting changes in patients’ health behavior; however, their time is limited and expensive. Current interventions are complex, including those delivered or received (a) at different levels, e.g., the patients, health care professionals, dyads, or groups; (b) via in-person communication or in combination with digital technology, e.g., smartphone apps, telemedicine; (c) across health care sectors, e.g., community, primary case, policy making.

Currently, there is limited evidence regarding the components and mechanisms of effective psychological and behavioral interventions, and their impact on long-term health conditions.

This Special Issue aims to address this gap in the literature and advance the understanding of behavior change interventions for people with long-term health conditions. We are seeking articles that will enhance knowledge across the intersections of behavior change interventions, from the development, implementation, evaluation, and evidence to their translation in policy and practice. This Special Issue will provide a comprehensive library of research evidence that will advance our current understanding and knowledge of replicable ways to improve health behavior change interventions. It will also provide a description of the factors and the mechanisms of behavioral and psychological interventions that underpin and impact outcomes related to long-term health conditions.

Dr. Aikaterini Kassavou
Guest Editor

Manuscript Submission Information

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Keywords

behavioral science
behavior change interventions
components
mechanisms
health care providers
digital health

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Published Papers (9 papers)

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Research

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36 pages, 4105 KiB

Open AccessArticle

Patients’ UX Impact on Medication Adherence in Czech Pilot Study for Chronically Ill

by Ondrej Gergely, Romana Mazalová, Michal Štýbnar, Antonín Hlavinka, Nicola Goodfellow, Michael Scott, Glenda Fleming, Leona Jochmannová and Ladislav Stanke

Behav. Sci. 2024, 14(6), 489; https://doi.org/10.3390/bs14060489 - 9 Jun 2024

Viewed by 1722

Abstract

This article presents a comprehensive and multistage approach to the development of the user experience (UX) for an mHealth application targeting older adult patients with chronic diseases, specifically chronic heart failure and chronic obstructive pulmonary disease. The study adopts a mixed methods approach, incorporating both quantitative and qualitative components. The underlying hypothesis posits that baseline medicine adherence knowledge (measured by the MARS questionnaire), beliefs about medicines (measured by the BMQ questionnaire), and level of user experience (measured by the SUS and UEQ questionnaires) act as predictors of adherence change after a period of usage of the mHealth application. However, contrary to our expectations, the results did not demonstrate the anticipated relationship between the variables examined. Nevertheless, the qualitative component of the research revealed that patients, in general, expressed satisfaction with the application. It is important to note that the pilot testing phase revealed a notable prevalence of technical issues, which may have influenced participants’ perception of the overall UX. These findings contribute to the understanding of UX development in the context of mHealth applications for older adults with chronic diseases and emphasise the importance of addressing technical challenges to enhance user satisfaction and engagement. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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21 pages, 520 KiB

Open AccessArticle

A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders

by Cristiana-Manuela Cojocaru, Cosmin Octavian Popa, Alina Schenk, Zsolt Jakab, Bogdan Andrei Suciu, Peter Olah, Horațiu Popoviciu and Simona Szasz

Behav. Sci. 2024, 14(4), 327; https://doi.org/10.3390/bs14040327 - 15 Apr 2024

Cited by 3 | Viewed by 2260

Abstract

Background and Objectives: Defined by chronic pain, rheumatic diseases are often co-occurring with anxiety and depression. Among the available psychological interventions, cognitive-behavioral therapies have an already-proven efficiency in these cases. However, the need to adjust their structure became ubiquitous during the post-pandemic period. Hence, the objective of this study was to investigate the impact of a single-session, process-based cognitive-behavioral intervention for patients with rheumatic conditions within an in-patient setting. Materials and Methods: A total of 31 participants (mean age 58.9 years) completed the single-session intervention. Assessments were conducted prior to the intervention, post-intervention and after one month. Results: Pearson’s correlations, paired samples T tests and a covariance analysis based on the Linear Mixed Model were performed for exploring the relations between baseline variables and evaluating the impact of the SSI intervention. Immediately after the intervention, a significant reduction in cognitive fusion (p = 0.001, d = 1.78), experiential avoidance (p = 0.001, d = 1.4) and dysfunctional behavioral processes was observed. At the one-month evaluation, participants reported decreased pain (p = 0.001, d = 1.11), anxiety (p = 0.004, d = 0.55) and depression (p = 0.001, d = 0.72). Conclusions: The single-session, process-based approach represents a promising intervention in healthcare contexts, as an integrative part of a multimodal rehabilitation treatment in patients with rheumatic conditions. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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22 pages, 992 KiB

Open AccessArticle

Exploring the Influence of YouTube on Digital Health Literacy and Health Exercise Intentions: The Role of Parasocial Relationships

by Jongho Kim, Heeok Youm, Sujin Kim, Hongjun Choi, Dohee Kim, Sungeun Shin and Jinwook Chung

Behav. Sci. 2024, 14(4), 282; https://doi.org/10.3390/bs14040282 - 28 Mar 2024

Cited by 1 | Viewed by 2117

Abstract

The purpose of this study was to analyze the mediating role of digital health literacy and the moderating effect of parasocial relationships on the relationship between the viewing experience of health exercise-related YouTube content and the intention for health exercise behavior. Based on the health action process approach, this study established a foundational theoretical model to analyze how digital health literacy mediates the impact of media viewing experience on health exercise behavior intention. Additionally, this study examined the moderating effect of parasocial relationships with YouTube creators. For empirical analysis, variables were measured using a self-administration method among 409 randomly sampled consumers of YouTube health exercise content. The collected data were analyzed using a structural equation model incorporating mediation parameters, and a multigroup model analysis was conducted to understand differences based on parasocial relationships. The results revealed that increased YouTube viewing experience enhanced cognitive, skill, and evaluative components of digital health literacy, which were significant factors in increasing health exercise behavior intention. Notably, the mediating effect of cognition played a crucial role, and the strengthening effect of parasocial relationships on this relationship was confirmed. These findings can be utilized as practical foundational data for designing digital health communication strategies, particularly in developing motivational mechanisms that encourage consumers to engage voluntarily and consistently in health behaviors based on online health information. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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14 pages, 689 KiB

Open AccessArticle

The Influence of Emotional Intelligence on Quality of Life in Patients Undergoing Chronic Hemodialysis Focused on Age and Gender

by Afra Masià-Plana, Miquel Sitjar-Suñer, Susana Mantas-Jiménez and Rosa Suñer-Soler

Behav. Sci. 2024, 14(3), 220; https://doi.org/10.3390/bs14030220 - 8 Mar 2024

Cited by 1 | Viewed by 1874

Abstract

Emotional intelligence is a health predictor as it has an effect on quality of life, given that it affects a person’s capacity to use and regulate emotions and consequently has an influence on their physical and mental condition. The aim of this study is to analyze emotional intelligence, quality of life, and associated correlation factors in patients undergoing chronic hemodialysis, differentiating age and gender differences. A multicenter study of one hundred and thirty-eight hemodialysis patients was conducted using a quantitative, observational, and cross-sectional design. A battery of questionnaires, including Trait Meta-Mood Scale (TMMS-24), Kidney Disease Quality of Life—Short Form (KDQOL-SF), and an ad hoc sociodemographic questionnaire, were administered. The Chi-squared test, the Student’s t-test, and one-way ANOVA were used to compare categorical, independent, and continuous variables, respectively. A linear regression model was used to compare variables associated with quality of life. Gender differences existed when assessing the three dimensions of emotional intelligence: ranked by order, the highest scores in males were in clarity, repair, and attention. However, in females, the highest scores were in repair, clarity, and attention. Males had higher scores than females in emotional roles (p = 0.045). Younger participants had better scores in all physical functions (p = 0.001) and vitality (p = 0.038). Participants who had a higher level of education presented better physical function (p = 0.027) and higher scores in emotional wellbeing (p = 0.036). Finally, in females, emotional attention (p = 0.046) and repair (p = 0.000) were strongly associated with general health perception. The assessment of emotional intelligence considering gender differences in patients undergoing chronic hemodialysis can be an indicator of quality of life, including for use in health interventions. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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11 pages, 704 KiB

Open AccessArticle

Effects of Myofascial Release Technique along with Cognitive Behavior Therapy in University Students with Chronic Neck Pain and Forward Head Posture: A Randomized Clinical Trial

by Sahreen Anwar, Junaid Zahid, Cristina Ioana Alexe, Abdullah Ghazi, Gabriel Mareș, Zainab Sheraz, Rubén Sanchez-Gomez, Wajida Perveen, Dan Iulian Alexe and Qais Gasibat

Behav. Sci. 2024, 14(3), 205; https://doi.org/10.3390/bs14030205 - 4 Mar 2024

Cited by 2 | Viewed by 2725

Abstract

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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18 pages, 561 KiB

Open AccessArticle

Factors Influencing the Purchase Intention for Online Health Popular Science Information Based on the Health Belief Model

by Jingfang Liu and Shiqi Wang

Behav. Sci. 2023, 13(8), 693; https://doi.org/10.3390/bs13080693 - 20 Aug 2023

Cited by 4 | Viewed by 2159

Abstract

There is a growing demand for health popular science information from the public. Online paid health popular science information provides a new channel for the public to obtain health popular science information and can meet users’ demands for high-quality health popular science information. In order to improve the popularity of online paid health popular science information, it is urgent to investigate the factors influencing users’ intention to pay for online health popular science information. Paid online health popular science information can provide users with higher-quality health knowledge, while monetary compensation can incentivize publishers to create and promote the sustainability of social media platforms. Therefore, paid online health popular science information is important for readers, creators, and platforms. Therefore, this study investigates the factors influencing users’ intentions to purchase online health popular science information based on the health belief model (HBM). Our research data were obtained by a questionnaire and empirically analyzed by SmartPLS structural equation modeling. The results of this study indicate that the greater the perceived susceptibility, severity, and irreplaceability of health problems, the greater the intention of users to purchase health information when they read the summary portion of paid online health popular science information. And the higher the perceived risk and the more unreasonable the price of the online health popular science information, the lower the intention to purchase. Moreover, both the perceived susceptibility and perceived severity significantly attenuated the negative impacts of perceived health popular science information risk and perceived price unreasonableness on users’ intentions to purchase online health popular science information. This study not only enriches and extends the application of the health belief model, but also has important positive implications for the development of online paid health popular science information. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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18 pages, 2912 KiB

Open AccessArticle

Public Health Safety in Community Living Circles Based on a Behavioral Motivation Perspective: Theoretical Framework and Evaluation System

by Qikang Zhong, Bo Li, Yue Chen and Jiawei Zhu

Behav. Sci. 2023, 13(1), 26; https://doi.org/10.3390/bs13010026 - 27 Dec 2022

Cited by 1 | Viewed by 4050

Abstract

Public health problems, such as the spread of COVID-19 and chronic diseases, are mainly caused by the daily life activities of community residents. Therefore, there is a need to build a healthy and safe community living circle through the evaluation of health behaviors in daily life. This paper proposes a theoretical framework and evaluation system for public health safety in community living circles, from a behavioral motivation perspective. Firstly, based on the behavioral motivation theory, a theoretical framework for the study of public health safety in community living circles is constructed from the perspective of the “project–activity–health” coupling relationship network, regarding community residents’ daily life activities. Then, a public health safety evaluation system for community living circles is proposed based on this framework, which includes the following: (1) identifying the scope of community living circles based on Spatio-temporal Activities Analysis; (2) Based on the theory of protection motivation, a health behavior evaluation model based on the three elements of “spatial and temporal geographical environment–daily life activities–public health safety” is established; (3) Based on the hierarchy of public health problems, a public health safety evaluation model of the community living circle is established. The behavioral motivation-based evaluation system explores a new approach and research paradigm for community-scale public health safety theory; this will help to achieve the goal of “healthy communities” when further empirical evidence is available. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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Review

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15 pages, 3222 KiB

Open AccessReview

Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis

by Yan Yee Cherizza Choi, Micah Fineberg and Aikaterini Kassavou

Behav. Sci. 2023, 13(3), 246; https://doi.org/10.3390/bs13030246 - 11 Mar 2023

Cited by 3 | Viewed by 2893

Abstract

Background: Stroke affects more than 30 million people every year, but only two-thirds of patients comply with prescribed medication, leading to high stroke recurrence rates. Digital technologies can facilitate interventions to support treatment adherence. Purpose: This study evaluates the effectiveness of remote interventions and their mechanisms of action in supporting medication adherence after stroke. Methods: PubMed, MEDLINE via Ovid, Cochrane CENTRAL, the Web of Science, SCOPUS, and PsycINFO were searched, and meta-analysis was performed using the Review Manager Tool. Intervention content analysis was conducted based on the COM-B model. Results: Ten eligible studies were included in the review and meta-analysis. The evidence suggested that patients who received remote interventions had significantly better medication adherence (SMD 0.49, 95% CI [0.04, 0.93], and p = 0.03) compared to those who received the usual care. The adherence ratio also indicated the interventions’ effectiveness (odds ratio 1.30, 95% CI [0.55, 3.10], and p = 0.55). The systolic and diastolic blood pressure (MD −3.73 and 95% CI [−5.35, −2.10])/(MD −2.16 and 95% CI [−3.09, −1.22]) and cholesterol levels (MD −0.36 and 95% CI [−0.52, −0.20]) were significantly improved in the intervention group compared to the control. Further behavioural analysis demonstrated that enhancing the capability within the COM-B model had the largest impact in supporting improvements in adherence behaviour and relevant clinical outcomes. Patients’ satisfaction and the interventions’ usability were both high, suggesting the interventions’ acceptability. Conclusion: Telemedicine and mHealth interventions are effective in improving medication adherence and clinical indicators in stroke patients. Future studies could usefully investigate the effectiveness and cost-effectiveness of theory-based and remotely delivered interventions as an adjunct to stroke rehabilitation programmers. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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21 pages, 3822 KiB

Open AccessReview

Digital Health Behavioural Interventions to Support Physical Activity and Sedentary Behaviour in Adults after Stroke: A Systematic Literature Review with Meta-Analysis of Controlled Trials

by Serena Caitlin Yen Wang and Aikaterini Kassavou

Behav. Sci. 2023, 13(1), 62; https://doi.org/10.3390/bs13010062 - 10 Jan 2023

Cited by 4 | Viewed by 3917

Abstract

Background: As the global prevalence of stroke continues to rise, it becomes increasingly pressing to investigate digital health behaviour change interventions that promote physical activity and reduce sedentary behaviour for stroke patients to support active lifestyles. Purpose: The primary aim of this study is to investigate the effectiveness of digital health interventions in promoting physical activity and reducing sedentary behaviour for stroke patients. The secondary aim is to investigate the intervention components that explain intervention effectiveness to further inform intervention development and policy making. Methods: A systematic search of the literature was conducted in four databases (Scopus, MEDLINE (PubMed), Web of Science, and PsychINFO) to identify the most robust evidence in the form of randomised controlled trials of digital interventions for patients with stroke. A random-effects meta-analysis were utilized to quantify the intervention effects on behaviour change, and subgroup analyses to characterise intervention effective components. Results: In total, 16 RCTs were deemed eligible and included in the systematic review. Meta-analyses suggested significant improvements in physical activity (SMD = 0.39, 95% CI 0.17, 0.61, N = 326, p < 0.001, I₂ = 0%), and reductions in time of sedentary behaviour (SMD= −0.45, 95% CI −0.76, -0.14, N = 167, p = 0.00, I₂ = 0%) after stroke. The 10 m walk test for physical activity, and the timed up and go test for sedentary behaviour, were the objective outcome measures in the most effective behavioural change interventions. Subgroup analyses found that most effective interventions were underpinned by theories of self-regulation and utilised interactive functions to engage patients with the processes of behaviour change. Conclusions: Digital self-monitoring behavioural interventions are effective in promoting physical activity for stroke patients in adjunct to usual care clinical practice and rehabilitation programmes. Rigorous studies are required to provide evidence to disentangle the most effective intervention components for preventative practices and rehabilitation programs and to inform policymaking for stroke treatment. Full article

(This article belongs to the Special Issue Behavioral and Psychological Intervention for Long Term Health Conditions)

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