Outlook: Newsletter of the Society of Behavioral Medicine

Summer 2022

Translating Science into Impact

Margaret L. Schneider, PhD, SBM President

David E. Conroy, PhD, SBM president
Margaret L. Schneider, PhD
SBM President

 

Summer is here, and I am still buzzing from the in-person 2022 SBM Annual Meeting in Baltimore, MD, this spring. The buzz is but a reverberation of the enthusiasm for our vibrant SBM community that was in evidence in abundance at the meeting. Those of you who were able to join in person bore witness to an explosion of energy the release of which was testament to the long periods of professional isolation that have characterized the last couple of years. If you were not able to attend the meeting, I hope you have been able to connect with colleagues who were there, to hear about the inspiring speakers, the wide-eyed student members attending their first in-person conference, and the boisterous hallway reunions among long-time colleagues too long separated by a persistent pandemic. True to our values, members were diligent about observing safety protocols, and all available evidence suggests that the meeting was a resounding success in terms of scientific communication and public health goals.

SBM 2022 broke new ground in addressing the triple threat of the pandemic, systemic racism, and climate change. As we begin planning for SBM 2023, we will likewise be confronting challenges to health and well-being that may stretch our historical thematic boundaries. Ours is a professional society dedicated to improving health and quality of life through proven behavioral science. This mission is stated right on the homepage of our website. When I first joined SBM 30ish years ago, most of our behavioral science was aligned with lifestyle medicine: promoting exercise, good nutrition, and stress reduction. More recently, SBM has embraced a whole new range of behaviors with profound implications for health at the individual, community and global levels. In his presidential address for the 2022 Annual Meeting, Dr. David Conroy expanded the SBM agenda to tackle “the urgency of adaptation” in the face of institutional, global, and viral threats to health and well-being. As we begin our planning for the 2023 conference, the theme of which will be “Translating Science into Impact,” we are moving into a new normal characterized by a pandemic-turned-endemic, a prolonged military conflict with global implications, ongoing racial and political tensions, and a frightening time of increasing restrictions in women’s reproductive health.

In such a time of multiple and multiplicative challenges to health and quality of life, I am filled with hope by the resourcefulness, passion, and optimism of our SBM community. Our members are exploring new ways of leveraging their expertise in science and communication to ameliorate the mental and physical health consequences emanating from these local, regional, and global events. In addition to reaffirming the power of health behaviors to buffer against the effects of the current threats—yes, exercise, good nutrition and stress reduction do still need and deserve our attention—SBM is taking a more active role in shaping and informing health policy, in harnessing technology for better health, and in placing diversity, equity and inclusion at the center of all we do.

The recently-released SBM position statement supporting policies that protect abortion rights, authored by former SBM president Sherry Pagoto et al. illustrates our members’ determination to advocate for policies that promote better health through proven science. Each of us contributes to this mission by generating the science that informs decision-making, by engaging with members of the community to identify and amplify their priorities, by collaborating with colleagues to ensure that behavioral science is integrated into clinical care policies and practices, and by mentoring successive generations of scientists who will sustain and grow the impact of behavioral medicine. SBM offers multiple avenues for strengthening members’ professional skills, building our community cohesion, and magnifying our impact, including Grand Rounds webinars, Special Interest Groups, the Diversity Institute for Emerging Leaders, the Mid-Career Leadership Institute, the Mentorship program offered through the Student SIG, and of course our Annual Meeting. In the coming year, I invite you to engage with your SBM colleagues as frequently and in as many ways as possible; let that be our pathway from science to impact.

 


Editor's Note

Linda Trinh, PhD; Editor, Outlook


Linda Trinh, PhD

I am excited to be the next Editor-in-Chief for Outlook! Thank you to Dr. Crystal Lumpkins for her leadership serving as the past Editor-in-Chief. I am an Assistant Professor in the Faculty of Kinesiology & Physical Education at the University of Toronto. My research agenda is focused on the development and implementation of theoretically driven physical activity and sedentary behavior interventions in cancer control and survivorship. Prior to this role, I served as the Physical Activity SIG co-chair and was on the advisory board for the past five years.

My vision for Outlook is to engage members in an ongoing commitment to critically reflect on research practices, trainee development, and community engagement to engage in dialogues towards a more diverse and equitable environment. It will serve as a platform for SBM members to share their success stories with research and community partnerships, identifying institutional solutions to advance equity, diversity, and inclusion, adapting and pivoting research during the COVID-19 pandemic, and how to build a race- and ethnicity-sensitive research program, as a few examples. Special topics related to behavioral medicine’s role in climate change, training and development such as teaching strategies, job search preparation, enhancing international collaborations, academic career reflections will also diversify the content of the newsletters. You will see some of these themes reflected in this issue.

In other exciting news, Dr. Michael Diefenbach (SBM Past-President) and I have teamed up to introduce the ‘Climate Change Corner.’ This will be a permanent corner in Outlook where members can share behavioral medicine’s role in research, policy, and advocacy in relation to climate change. This inaugural corner features the Health Equity SIG discussing the compounded vulnerability of energy insecurity, socioeconomic disadvantage, and health in climate change, as well as the Physical Activity SIG highlighting how active transport can benefit your environment and your health. We encourage members to submit content in this area and view your research from a climate change perspective.

Finally, we are always open to new ideas and suggestions from our members. If you have ideas for the newsletter, I encourage you to reach out to Andrew Schmidt at aschmidt@sbm.org or me at linda.trinh@utoronto.ca

 


Introducing the Climate Change Corner: A Look Ahead

Michael A. Diefenbach, PhD; SBM Past-President and Climate Change and Health SIG-in-Formation Chair


Dear Colleagues:

This is the inaugural Outlook column on Climate Change and Behavioral Medicine, a space reserved to discuss behavioral medicine’s role in research, policy, and advocacy related to climate change. In the forthcoming issues of Outlook, we will read how SBM’s special interest groups describe their specific topic areas in relation to climate change. I cannot wait to see the various results and count on the ingenuity and the innovative spirit of our members to apply their specific expertise to this pivotal topic.

In response to the Provocative Questions in Behavioral Medicine initiative, members identified the issue of climate change and behavioral medicine as one of the most important areas to engage. In response, the Society charged me to form a Presidential Working Group (PWG) on Climate Change, Behavior Change and Health. The mission of the working group was to (1) summarize key knowledge and identify key issues to inform a research strategy for transdisciplinary translational research to enhance health and reduce climate change, and (2) to provide recommendations to SBM leadership for engaging the SBM community to advance climate change-related research, as well as for developing policy and advocacy actions. With my co-chair Kara Hall, PhD, from the National Cancer Institute, we identified relevant experts and stakeholders from various disciplines, including environmental and glaciological sciences, health care delivery, political science, and of course the many disciplines with behavioral medicine.

The PWG consisted of five subgroups that were led by a chair and a co-chair, member volunteers, and early career members. The subgroups tackled the following topics (1) climate and behavior change, (2) health-related behavior and climate change, (3) health inequity and climate change, (4) communication, and (5) policy and advocacy. The groups met regularly from the fall of 2020 to the summer of 2021 and then commenced to write their individual reports. These reports were recently published in the April 2022 issue of Translational Behavioral Medicine in a special section of Climate Change and Health. The papers provide a comprehensive overview on behavioral medicine’s position as a discipline regarding theory, intervention efforts and advocacy. I encourage everybody to look at the special issue.

The PWG also made specific recommendations to the society to enhance its policy and advocacy work and the board of directors uniformly approved the working group’s recommendations. Most importantly, climate change and health are now a policy focus for SBM. This designation devotes resources for climate change advocacy and trains members who are willing to serve as climate change policy ambassadors. All members who want to learn more about the role of a climate change policy ambassador or want to assume that role, please contact SBM’s Executive Director Lindsay Bullock (LBullock@sbm.org) or myself (mdiefenbach@northwell.edu). We need as many members as possible to represent all regions of the United States.

The society realizes that we cannot address the issue of climate change alone and need to join forces with other organizations and groups who are advocating for climate change measures. In the past 18 months, the Society has joined the following groups: (1) Lancet Countdown, (2) Medical Society Consortium on Climate and Health, (3) National Academy of Medicine Action Collaborative on Decarbonizing the U.S. Health Sector, and (4) ecoAmerica. Detailed information about SBM’s climate related activities are described here.

Finally, SBM’s Executive Committee also approved the forming of a Climate Change and Health SIG. This is an exciting opportunity for our members to become involved in climate and health behavior work. We are envisioning the Climate Change and Health SIG as a trans-disciplinary forum where members with varied research interests will explore how their expertise can be applied to climate change research and advocacy. Any member who is interested in being part of this new SIG, please email me at mdiefenbach@northwell.edu. We are holding our first inaugural phone call this summer to plan activities for the next year and the annual meeting in 2023. I invite you all to be part of this new initiative.

Our annual meeting with the theme of "The Urgency of Adaptation" highlighted the importance for the Society to engage in pressing issues, such as climate change, diversity, and structural racism. I firmly believe that our research and advocacy have and will continue to make a significant difference in the health and lives of others. I hope you join me in tackling this next and most important challenge in our lives.

 


A Call to Action: Compounded Vulnerability of Energy Insecurity, Socioeconomic Disadvantage, and Health in Climate Change

Lakeshia Cousin, PhD, APRN; Patricia Rodriguez Espinosa, PhD, MPH; Megan Shen, PhD; and Tiffany L. Carson, PhD, MPH; Health Equity SIG


Climate change is currently recognized as the greatest global health threat of the 21st century, with key implications for health equity.1 Low-income communities are often exposed to the threats of energy insecurities, environmental hazards, a higher burden of preexisting health conditions, and are least likely to have resources to address the compounding vulnerabilities that are worsened by climate change.

Energy insecurity, the inability to meet household energy needs, is increasingly becoming a source of hardship for millions around the world.2 It has dire physical, behavioral, and economic consequences.3 Yet, most research on energy-associated economic factors and policy efforts has lacked a structured approach and has not examined the compounded energy, socioeconomic, and health inequities.2 Researchers need to systematically investigate climate injustices using frameworks from health equity research (i.e., examining social inequities and vulnerabilities and understanding how to distribute and provide equitable energy to low-income, marginalized, and underserved households) and develop interventions to achieve equity. We offer key research topics associated with climate change and health equity based on the energy insecurity framework3 (see Figure 1) to raise awareness of a critical planetary health threat that merits attention in behavioral medicine research:
 


Figure 1. Domains from the Energy Insecurity Framework
 

1. Promotion of Energy Efficiency for Energy Justice

Energy insecurity disproportionately affects low-income and racial/ethnic minority households due to the history of structural racism that neglected their socioeconomic opportunities for wealth accumulation, and safe and energy-efficient housing.4 For generations, African Americans have lived in inadequate housing structures and deteriorated energy infrastructure that resulted in adverse outcomes including 1) energy burden and shut-offs, 2) extreme weather and climate impacts, 3) gentrification and displacement and 4) health inequities. Research is needed to understand the multigenerational health impacts from the disproportionate energy burden that affects low-income individuals. In turn, this can help to improve health and social outcomes while also promoting energy efficient programs such as weatherization to enhance energy efficiency and reduce costs.
 

2. Explore Housing Energy Pathways to Stress

Although there is evidence regarding the link between living in poverty and chronic stress among low-income populations, qualitative and quantitative data are needed to understand the associations between housing and energy-related issues and stress. Specifically, what are some of the energy-related pathways to stress that lead to negative health outcomes observed in populations at a socioeconomic disadvantage? A recent study in a South Bronx neighborhood in New York City examined associations between housing and energy-related issues and stress and found energy insecurity to be an important contributor to chronic stress in low-income households.5 Additional pathways to stress that can be examined in future research could include chronic diseases, economic hardship, and health issues.

This unequivocal call for evidence for action and a research agenda for climate solutions related to behavioral health can likely add momentum to move climate change policies faster.
 

Additional Resources on Climate Change and Health Equity

For more information, please visit the Intergovernmental Panel on Climate Change (IPCC) Six Assessment Report: Climate Change 2022: Impacts, Adaptation and Vulnerability at https://www.ipcc.ch/report/ar6/wg2/.

 

References

  1. Romanello M, McGushin A, Di Napoli C, et al. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. Lancet. 2021;398(10311):1619-1662.
  2. Jessel S, Sawyer S, Hernández D. Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature. Front Public Health. 2019;7:357.
  3. Hernández D. Understanding 'energy insecurity' and why it matters to health. Soc Sci Med. 2016;167:1-10.
  4. Lewis J, Hernández D, Geronimus AT. Energy Efficiency as Energy Justice: Addressing Racial Inequities through Investments in People and Places. Energy Effic. 2019;13(3):419-432.
  5. Hernández D, Phillips D, Siegel EL. Exploring the Housing and Household Energy Pathways to Stress: A Mixed Methods Study. Int J Environ Res Public Health. 2016;13(9):916.

 


Slowing Climate Change: How Active Transport Can Benefit Your Environment and Your Health

Nashira I. Brown, MS; Erica A. Schleicher, MS; Kyle I Kershner, MS; Diane K. Ehlers, PhD; Angela J. Fong, PhD; and Dori Pekmezi, PhD; Physical Activity SIG


Benefits of Active Transportation for Climate Change and Public Health

Increasing active transportation (AT; e.g., walking, bicycling, public transit) can reduce the impact humans are having on climate change and improve both individual and public health.1-5 AT has been associated with improved health outcomes (e.g., quality of life, aerobic fitness, decreased risk of chronic diseases, in addition to executive function and cognition),6,7 and increased longevity.3,8 U.S. data indicates that AT is associated with more adults meeting recommended levels of physical activity, 9-12 and lower prevalence of obesity and diabetes.4,7,13,14 AT also benefits the environment by reducing greenhouse gas emissions associated with car-based transit (e.g., dioxide equivalent).3,15 Previous research shows programs promoting AT can help combat climate change by decreasing air pollutants and protecting environmental resources (e.g., less gas consumption).15,16 Thus, AT is uniquely situated to address public health concerns related to both climate change17 and a sedentary lifestyle.18,19
 

Prevalence of Active Transportation (and Challenges)

Despite the environmental and health benefits, AT rates in the U.S. (4-16%) are lower than many other developed nations (34.9- 37.9% in France and the Netherlands), likely due to mixed land use, car-free zones, traffic regulations that support cyclists and pedestrians, and public transportation availability.20 Within the US, there are rural-urban differences,21 with higher AT rates in urban areas where frequented locations such as schools and grocery stores are within close proximity (e.g., 20-minute bicycle ride).22 Conversely, in rural areas, AT infrastructure (e.g., sidewalks, bike lanes, pedestrian crossings) are often lacking,23 and grocery stores, jobs, and schools are typically located more than 20 miles from home.24 Subsequently, “car culture,” or excessive use/reliance on motor vehicles, remains dominant in rural regions25 and likely contributes to existing rural health disparities. Thus, a multi-level approach will be needed to effectively promote AT.
 

Strategies for Encouraging Active Transport

Multi-level approaches promoting AT include individual/interpersonal level behavioral strategies along with policy and environmental changes.2 Interventions targeting interpersonal/organizational levels (e.g., improving AT knowledge and attitudes among office employees) have increased physical activity and decreased car-based transit.26-28 Effective interpersonal/organizational interventions promote AT by creating rich social atmospheres where AT is encouraged through AT-based social events, organization-wide AT marketing, personalized AT plans, and addressing individual barriers for AT.28,29  These efforts can be augmented by government campaigns to increase accessibility/awareness of safe and reliable AT options (e.g., light rail signage30 and street connectivity/housing density1), mixed land-use (e.g., residential developments incorporating spaces for work/shopping/recreation),31 and publicly available AT equipment renting options (e.g., public bike/scooter renting programs).32

Grassroots organizations can add to these interventions by encouraging the use of public transit and creating infrastructure promoting AT.33 For example, Bike Walk Nebraska34 and Heartland Bike Share35 have collaborated with schools to educate families on safe cycling routes to schools, institutions/businesses to offer free bike rentals to employees, and government to add protected bike lanes. Similar programs may include promoting financial incentives/disincentives (e.g., free bike renting or road-use tolls),36 city-wide AT equipment (e.g., bikes, scooters) renting,32 and inserting “greenway systems” connecting urban, suburban, and rural communities via walking/cycling trails.37

Individuals interested in AT should begin by identifying safe routes to walk, bike, or scooter to frequented destinations and seek local renting stations for AT-related equipment (e.g., bike sharing stations). Higher level promotion of AT can be accomplished through appealing to government officials (e.g., urban planners) to affect policy and infrastructure planning, joining local, state, and national organizations (e.g., the Active Transport Alliance,38 Safe Routes Partnership39) If done concomitantly, these policy, environmental, and individual-level interventions have the potential to increase AT and thereby promote reductions in climate change and improved health.
 

Here are some useful resources/websites for those interested in starting their AT journey:

 

References

  1. Young DR, Cradock AL, Eyler AA, et al. Creating Built Environments That Expand Active Transportation and Active Living Across the United States: A Policy Statement From the American Heart Association. Circulation. 2020;142(11):e167-e183.
  2. Nigg C, Nigg CR. It's more than climate change and active transport-physical activity's role in sustainable behavior. Transl Behav Med. 2021;11(4):945-953.
  3. Alessio HM, Bassett DR, Bopp MJ, et al. Climate Change, Air Pollution, and Physical Inactivity: Is Active Transportation Part of the Solution? Med Sci Sports Exerc. 2021;53(6):1170-1178.
  4. Pucher J, Dijkstra L. Promoting safe walking and cycling to improve public health: lessons from The Netherlands and Germany. Am J Public Health. 2003;93(9):1509-1516.
  5. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1435-1445.
  6. Erickson KI, Hillman C, Stillman CM, et al. Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines. Med Sci Sports Exerc. 2019;51(6):1242-1251.
  7. Pucher J, Buehler R, Bassett DR, Dannenberg AL. Walking and cycling to health: a comparative analysis of city, state, and international data. Am J Public Health. 2010;100(10):1986-1992.
  8. Andersen LB, Schnohr P, Schroll M, Hein HO. All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med. 2000;160(11):1621-1628.
  9. Besser LM, Dannenberg AL. Walking to public transit: steps to help meet physical activity recommendations. Am J Prev Med. 2005;29(4):273-280.
  10. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. Jama. 2018;320(19):2020-2028.
  11. Freeland AL, Banerjee SN, Dannenberg AL, Wendel AM. Walking associated with public transit: moving toward increased physical activity in the United States. Am J Public Health. 2013;103(3):536-542.
  12. Yu CY, Wang B. Moving Toward Active Lifestyles: The Change of Transit-Related Walking to Work From 2009 to 2017. J Phys Act Health. 2020;17(2):189-196.
  13. Gordon-Larsen P, Boone-Heinonen J, Sidney S, Sternfeld B, Jacobs DR, Jr., Lewis CE. Active commuting and cardiovascular disease risk: the CARDIA study. Arch Intern Med. 2009;169(13):1216-1223.
  14. Huy C, Becker S, Gomolinsky U, Klein T, Thiel A. Health, medical risk factors, and bicycle use in everyday life in the over-50 population. J Aging Phys Act. 2008;16(4):454-464.
  15. Nigg C, Nigg CR. It’s more than climate change and active transport—physical activity’s role in sustainable behavior. Transl Behav Med. 2021;11(4):945-953.
  16. Kou Z, Wang X, Chiu SF, Cai H. Quantifying greenhouse gas emissions reduction from bike share systems: a model considering real-world trips and transportation mode choice patterns. Resources, Conservation and Recycling. 2020;153:104534.
  17. Environmental Protection Agency. Our Nation’s Air. https://gispub.epa.gov/air/trendsreport/2021 Published 2021. Accessed May 23, 2022.
  18. Wilson DK. Behavior matters: the relevance, impact, and reach of behavioral medicine. Ann Behav Med. 2015;49(1):40-48.
  19. Kim J, Conroy DE, Smyth JM. Bidirectional Associations of Momentary Affect with Physical Activity and Sedentary Behaviors in Working Adults. Ann Behav Med. 2020;54(4):268-279.
  20. Bassett DR, Jr., Pucher J, Buehler R, Thompson DL, Crouter SE. Walking, cycling, and obesity rates in Europe, North America, and Australia. J Phys Act Health. 2008;5(6):795-814.
  21. United States Department of Agriculture. Rural Classifications. https://www.ers.usda.gov/topics/rural-economy-population/rural-classifications/. Published 2021. Accessed May 23, 2022.
  22. Partnership for Active Transportation. Why Active Transportation  https://www.railstotrails.org/partnership-for-active-transportation/why/ Published 2018. Accessed May 23, 2022.
  23. Fan JX, Wen M, Wan N. Built Environment and Active Commuting: Rural-Urban Differences in the U.S. SSM Popul Health. 2017;3:435-441.
  24. Jilcott SB, Liu H, Moore JB, Bethel JW, Wilson J, Ammerman AS. Commute times, food retail gaps, and body mass index in North Carolina counties. Prev Chronic Dis. 2010;7(5):A107.
  25. Lexico. Car Culture. In. Oxford University Press 2022.
  26. Xu H, Wen LM, Rissel C. The relationships between active transport to work or school and cardiovascular health or body weight: a systematic review. Asia Pac J Public Health. 2013;25(4):298-315.
  27. Jones RA, Blackburn NE, Woods C, Byrne M, van Nassau F, Tully MA. Interventions promoting active transport to school in children: A systematic review and meta-analysis. Prev Med. 2019;123:232-241.
  28. Wen LM, Orr N, Bindon J, Rissel C. Promoting active transport in a workplace setting: evaluation of a pilot study in Australia. Health Promot Int. 2005;20(2):123-133.
  29. Brockman R, Fox KR. Physical activity by stealth? The potential health benefits of a workplace transport plan. Public Health. 2011;125(4):210-216.
  30. Lanza K, Oluyomi A, Durand C, et al. Transit environments for physical activity: Relationship between micro-scale built environment features surrounding light rail stations and ridership in Houston, Texas. J Transp Health. 2020;19:100924.
  31. Mumford KG, Contant CK, Weissman J, Wolf J, Glanz K. Changes in physical activity and travel behaviors in residents of a mixed-use development. Am J Prev Med. 2011;41(5):504-507.
  32. Clockston RLM, Rojas-Rueda D. Health impacts of bike-sharing systems in the U.S. Environ Res. 2021;202:111709.
  33. Litman T. Are vehicle travel reduction targets justified. Evaluating Mobility Management Policy Objectives Such As Targets To Reduce VMT And Increase Use Of Alternative Modes' Victoria Transport Policy Institute. 2009.
  34. Nebraska BW. Who We Are : History and Accomplishments. https://www.bikewalknebraska.org/who-we-are/history.html Published 2022. Accessed May 23, 2022.
  35. BCycle. H. In the Community. https://heartland.bcycle.com. Published 2015. Accessed May 23, 2022.
  36. Shill GH. Should law subsidize driving? New York University law review (1950). 2020;95(2):498-579.
  37. Smith M, Hosking J, Woodward A, et al. Systematic literature review of built environment effects on physical activity and active transport – an update and new findings on health equity. International Journal of Behavioral Nutrition and Physical Activity. 2017;14(1):158.
  38. Active Transportation Alliance. Our Work. https://activetrans.org/our-work. Published 2022. Accessed May 23, 2022.
  39. Safe Routes Partnership. Safe Routes to School https://www.saferoutespartnership.org/safe-routes-school. Published 2022. Accessed May 23, 2022.

 


Don’t Take a Donation Vacation!

Marian Fitzgibbon, PhD; SBM Past-President and Development Council Chair


It’s finally summertime across the U.S.! While many of you are off enjoying the warm sun and time away from the office or lab, SBM continues to stay active all 52 weeks out of the year. We are over half way through the year now and have already accomplished so much through the Proven Science—Better Health Giving Campaign.
 

February

The launch of the Kenneth A. Wallston Leadership Development Honor Fund. This is an excellent opportunity to show gratitude for a prominent and founding SBM member who has paved the way for many generations of leaders and helped transform SBM into the thriving organization it is today. Every gift to Dr. Wallston’s honor fund assists with Leadership Institute & Diversity Institute tuition to help emerging professionals from diverse backgrounds cultivate their skills through year-long mentorship and coaching. Give to the Ken Wallston Leadership Development Honor Fund today.

 

March

In the debut of SBM’s Policy Advocacy Month, we highlighted the critical policy advocacy work that we’ve accomplished in our three key policy priority areas: child nutrition, non-pharmacological pain management/opioid misuse, and rural health. With the help of our dedicated Advocacy Council, Position Statements Committee, and other volunteers, we’ve increased our efforts to make public health policies evidence-based and more impactful. Your contribution to the Policy Advocacy Fund supports the important work that our health policy ambassadors are doing to create impact on a national level by bringing behavioral medicine research directly to lawmakers. Invest in SBM’s policy ambassador program by contributing to the Policy Advocacy Fund here.
 

April

Of course, April was a busy month for the Giving Campaign with the Annual Meeting in Baltimore. We saw the Health Equity SIG take home the win for the Battle of the SIGs competition by contributing over $1,600 in 2021-22. SBM Past President Sherry Pagoto, PhD, took on plank challengers during the Planking Palooza to match $650 in gifts to the Science Communication Fund to support SBM’s new scicomm toolkit. We held our first Stride for Science Run/Walk where SBMers ran or walked their way around the Baltimore NFL and MLB stadiums to raise money for the General Fund. Every registration fee was donated to keep membership dues low for our student members to enhance their careers, keep them engaged in the field, and ensure a strong future for behavioral medicine. Join us next year for the 2nd Annual Stride for Science Run/Walk in Phoenix!
 

May

The Sustaining Donor Club gains new members! The Sustaining Donor Club was created to help support the next generation of behavioral medicine researchers, share evidence with policymakers on the federal level, and reach patients who can benefit from our science. You have the power to do more for the behavioral medicine community with a monthly subscription that truly creates an impact. Your monthly gift of $25 becomes $300 in just one year. Each gift, no matter the size, makes a difference. Join the Sustaining Donor Club today.
 

June

Applications for the first Bridging the Gap Research Award opened in June! This is an $8,000 annual award that will provide resources to help one postdoctoral student prepare a competitive grant proposal by using the funds for equipment and supplies, consultants, data collection, professional development, and more. The awardee will also be paired up with a mentor who has experience in the specific research topic area. This award would not be possible without the support of Sharon Manne, PhD. Applications close on July 26. Learn more about the award and applicant eligibility here.

 

Save the Date for Upcoming 2022 Giving Campaign Events

August 17 – National Nonprofit Day
September 12-16 – Thank Your Mentor Week
November – Stride for Science Run/Walk Registration Opens
November 10 – World Science Day Panel
November 29 - GivingTuesday
 

Spring, summer, fall, or winter – SBM’s Proven Science—Better Health Giving Campaign is active all year long to advance the field of behavioral medicine and provide resources and opportunities to help you thrive in your research or career. We can’t do this alone though. We need members like you to invest in the future of behavioral medicine by making a contribution to the General Fund, Leadership Development Fund, Policy Advocacy Fund, or Science Communication Fund today at www.sbm.org/donate.

 


Promoting Health Policy with your State Representatives: A Q&A with Dr. Allyson Hughes

Caroline Cummings, PhD; Cassandra Gonzalez, MA; Shuyuan Huang, PhD, MPH, RN; Allyson Hughes, PhD; Caroline Presley, MD MPH; and Jennifer Warnick, PhD; Diabetes SIG


Allyson Hughes, PhD


Communicating with representatives of national and state government is an important part of advocacy efforts to increase the reach of evidence-based behavioral interventions. Unfortunately, policy and advocacy are often overlooked in the curricula of graduate programs, leaving trainees and professionals with unanswered questions about how to incorporate advocacy efforts in their professional endeavors. Dr. Allyson Hughes is an assistant professor at Ohio University Heritage College of Osteopathic Medicine and past chair of the Diabetes SIG. She recently met with representatives to discuss the need to expand coverage for telehealth services, diabetes self-management training for people with diabetes, and virtual Diabetes Prevention Program (DPP) training. We interviewed Dr. Hughes so that she could share her experience with SBM members.
 

Who did you meet with and what was the format of the meeting?

I met with staffers of varying levels of seniority at four legislative offices who were assigned based on their expertise whether it be healthcare, gun reform, education, or something else. In this case, the people I met with were all “local” to me, so I only met with staffers for my state legislators. The meetings were over Zoom and lasted between 20 and 40 minutes.
 

How did you prepare for the meeting?

I prepared for meeting with legislators and staff by attending a training program offered by the Association of Diabetes Care and Education Specialists (ADCES). Each year they host a Capitol Hill Day where they set up legislative meetings for members. ADCES provides specific bills to discuss, and at the end of the meetings there may be a few minutes where we have time to talk about other healthcare topics. This is when I speak about the cost of insulin and what I have learned from my diabetes health policy research.
 

What types of questions or feedback did you receive from legislators or staff?

Some staff members and legislators are very aware of current diabetes bills while others need more explanation. It is important to be prepared to explain specific diabetes terms in a simplistic manner. Staff appreciate follow- up emails with the specific title and bill number. This helps them to accurately pass the message onto the rest of the staff and the legislator they support.

These meetings are not always strictly business. At the end of the day, we are all humans in back-to-back meetings s. So sometimes it is nice to break up the conversation by talking about the best restaurants in your state or sharing pictures of your pets.
 

What was the experience like for you?

Overall, it was a very positive experience. At times you will meet with individuals who do not see eye to eye with you. This is why it is important to know the talking points for each bill. It can help you bridge the gap between each side of the aisle. Importantly, in the last meeting, the legislative director asked how the other advocacy meetings went and if other offices were supporting the bills. The response led her to making meetings with other offices to see if there was enough support across legislators to move the bills forward.
 

What lessons did you learn from the experience?

1)    Know your “talking points” for each bill. Examples: What will the bill achieve? Is it bipartisan? Who is endorsing this bill?
2)    Have a few personal stories ready so that you can leave a lasting impression. Sharing personal stories has been shown to increase the likelihood of change when someone is stuck on one side of an argument. I always talk about how due to the cost of diabetes treatment, many people must seek out supplies online (Facebook, Twitter, and others).
 

What advice would you give to other SBM members about getting involved with advocacy?

I encourage you to find what you are passionate about in health policy and pursue it. It is very fulfilling and leads to making an important difference not only at the state level but also nationally.
 

If you are interested in learning more about speaking to state or national representatives or other advocacy work, check out these resources:

 

References

  1. Alexander, A. A., & Allo, H. (2021). Building a climate for advocacy training in professional psychology. The Counseling Psychologist, 49(7), 1070-1089. https://doi.org/10.1177/00110000211027973
  2. Buscemi, J., Bennett, G. G., Gorin, S. S., Pagoto, S. L., Sallis, J. F., Wilson, D. K., & Fitzgibbon, M. L. (2017). A 6-year update of the health policy and advocacy priorities of the Society of Behavioral Medicine. Translational behavioral medicine, 7(4), 903–911. https://doi.org/10.1007/s13142-017-0507-z
  3. Cullerton, K., Donnet, T., Lee, A. et al. Effective advocacy strategies for influencing government nutrition policy: a conceptual model. Int J Behav Nutr Phys Act 15, 83 (2018). https://doi.org/10.1186/s12966-018-0716-y

 


Social Determinants of Health, Social Risks, and Social Needs: What’s the Difference and How Do You Measure Them?

Stephanie L. Fitzpatrick, PhD; SBM Member Delegate and 2023 Annual Meeting Program Chair


Despite advances in medicine, racial, ethnic, and socioeconomic disparities in chronic disease prevention and management persist. In the health care sector, social determinants of health have increasingly become part of the conversation around reducing health disparities. This makes sense given that social determinants account for 50% of health outcomes whereas medical care only accounts for 20% (health behaviors account for 30%).1 Multi-level, multi-sector, and multi-system efforts are needed to address health inequities. Behavioral medicine can help inform these efforts. However, as behavioral medicine researchers and practitioners, we must: 1) understand the nuances in the different terminology that is used related to social health as it has implications for study design and level of impact; and 2) do a better job at incorporating social health-related measures in behavioral medicine research. The goals of this article are to explain the difference between social determinants of health, social risk factors, and social needs as well as provide a brief overview of available measures that can be used to assess these constructs in future research.
 

Social Determinants of Health

The Office of Disease Prevention and Health Promotion defines social determinants of health as “conditions in which people are born, live, learn, work, play, worship, and age that affect health [physical and mental], functioning, and quality of life.2 Social determinants can impact health positively or negatively and are shaped by policies, systems, and social norms that determine the distribution of money, power, and resources.3,4 Unfortunately, these policies and systems are marred by historical injustices and racism leading to subpar education, poor access to health care, and unacceptable living conditions for certain groups of society and an overabundance of resources for others, for example. Thus, social determinants are upstream factors such as policies and systems that play a role in health and health inequities.
 

Social Risks and Social Needs

Social determinants affect everyone, not just the socially and economically disadvantaged. On the other hand, social risk factors are specific adverse conditions at the individual or family level that are associated with poor health and can exacerbate health inequities.4 Examples of social risk factors include:

  • Food insecurity
  • Housing instability
  • Social isolation
  • Intimate partner violence
  • Lack of transportation
  • Financial strain

Social needs (also sometimes referred to as health-related social needs, non-medical factors, material need insecurities, or unmet needs) are the social risks an individual seeks assistance with immediately.4 Although a person may indicate the presence of several social risk factors, they may only need help with one of those at the time of screening. In other words, social needs take into account the individual and/or family’s preferences and priorities, and thus requires a person-centered approach when intervening.
 

Social Health Measures

Because social determinants of health are shaped by policies, systems, and social norms, it is in fact these upstream factors that need to be assessed in future behavioral medicine studies. Here are just a few ideas:

  • Conducting a community environmental scan
  • Qualitative interviews with various political, community, and other systems level stakeholders to understand the history of certain policies and the impact on certain communities
  • Examining zoning laws and other built environment agendas and the impact on health
  • Utilizing geographic information systems (GIS) to understand the impact of certain policies at the neighborhood, city, county, or state level and linking with electronic health record or other available public health databases

There are numerous social risk factor measures available for use in behavioral medicine research. Some commonly used tools include the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) assessment tool,5 the Centers for Medicare & Medicaid Services Accountable Health Communities Health-Related Social Needs Screening Tool,6 and the 2-item Hunger Vital Sign.7 Refer to Henrikson et al. 2019 for a systematic review of the psychometric and pragmatic properties of 21 unique social risk screening tools.8
 

In summary, social determinants of health, social risk factors, and social needs are related, but distinct concepts. As behavioral medicine researchers and practitioners, it is important to understand this distinction to appropriately design our studies and interventions as well as incorporate measurement of these concepts to advance health equity.   

 

Suggested readings:

  1. Green K, Zook M. "When Talking About Social Determinants, Precision Matters", Health Affairs Blog, October 29, 2019. DOI: 10.1377/hblog20191025.776011
  2. Bailey ZD, Krieger N, Agenor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453-1463.
  3. Bailey ZD, Feldman JM, Bassett MT. How Structural Racism Works - Racist Policies as a Root Cause of U.S. Racial Health Inequities. N Engl J Med. 2021;384(8):768-773.

 

References

  1. Magnan, S. 2017. Social Determinants of Health 101 for Health Care: Five Plus Five. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. https://doi.org/10.31478/201710c
  2. Office of Disease Prevention and Health Promotion. Healthy People 2030: Social Determinants of Health. https://health.gov/healthypeople/priority-areas/social-determinants-health. Accessed May 31, 2022.
  3. World Health Organization. Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1. Last Updated 2022. Accessed May 31, 2022.
  4. Alderwick H, Gottlieb LM. Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems. Milbank Q. 2019;97(2):407-419.
  5. National Association of Community Health Centers. Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE). https://www.nachc.org/research-and-data/prapare/prapare_one_pager_sept_2016-2/. Published 2020. Accessed March 31, 2022.
  6. Alley DE, Asomugha CN, Conway PH, Sanghavi DM. Accountable Health Communities--Addressing Social Needs through Medicare and Medicaid. N Engl J Med. 2016;374(1):8-11.
  7. Hager ER, Quigg AM, Black MM, et al. Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics. 2010;126(1):e26-32.
  8. Henrikson NB, Blasi PR, Dorsey CN, et al. Psychometric and Pragmatic Properties of Social Risk Screening Tools: A Systematic Review. Am J Prev Med. 2019;57(6 Suppl 1):S13-S24.

 


Shaping the Future of Integrated Primary Care: An Interview with Dr. Stacy Ogbeide

Philip Fizur, PsyD and Stacy A. Ogbeide, PsyD; Integrated Primary Care SIG


Stacy A. Ogbeide, PsyD


Like many specialties within Behavioral Medicine, the pace of research and clinical work within Integrated Primary Care (IPC) is exceedingly fast. When working in such fast-paced areas it is wise to frequently check in with the experts as to remain up-to-date with the current state of affairs while also having one eye on the future. As such, the IPC SIG recently sat down with Dr. Stacy Ogbeide, an expert helping to shape the future of integrated primary care. She shared with us her thoughts on the importance of high-quality mentorship at all professional levels, the different pathways to engaging in IPC work, the importance of active involvement in advocacy, and much more.
 

Cultivating Different Pathways to IPC Clinical Work and Research

Behavioral Medicine is setting more and more training programs offer specialty tracks and concentrations geared toward primary care. But while some graduate programs and mentors help create a path to primary care, Dr. Ogbeide notes that “for some time now, people who are trained in traditional mental health are coming back into primary care and having to relearn things, which is not a bad thing at all. It's just a different path.” For those interested, she shared the following resources:

Mentorship as a Means of Shaping Future IPC Researchers and Clinicians

Dr. Ogbeide highlighted the role mentorship can play and highlighting the value integrated care brings to the table, and how good mentorship is helping to shape the future of this approach to service delivery. “I definitely was not planning to be in primary care, and I am some people have similar stories. I had originally planned to work in behavioral cardiology.” This was her plan throughout her undergraduate education, but upon beginning her doctoral studies she met one of her mentors, Dr. Chris Neumann, who asked “given your interests, are you familiar with integrated primary care?” From there, she learned of her program’s primary care track and was mentored in this specialty throughout the rest of her training.

Dr. Ogbeide has continued to emphasize the importance of mentorship as her career has progressed. Two years ago, the Society of Teachers of Family Medicine launched a program for mentoring underrepresented faculty in academic family medicine, focusing both on “not only offering mentorship for faculty, but training mentors, especially mentors who may not be the same from underrepresented or marginalized group as the mentee, in the nuances of this role. So if you're if you're a white female, what your black female mentee is going through is very different to your experience.” Recognizing this, and providing training on how to handle this, Dr. Ogbeide feels is an important part of training the next generation of IPC clinicians and researchers.

When asked to summarize the importance of mentorship and how it integrated with her other work, Dr. Ogbeide shared that she thinks “mentoring can sometimes be seen as something only for those who are wanting to be in academic medicine, which is definitely not the case. So many of our masters’ students who are coming into the program, they want to be on the ground clinicians in a community health center or a federally qualified health center. I want to let them know that they still definitely will benefit from mentorship.”
 

Shaping the Future Through Advocacy and Policy Work

Dr. Ogbeide also feels that everyone’s involvement in advocacy is key the future of IPC, including advocating for what billing, coding, and insurance coverage as well as assuring fair and equitable reimbursement rates and more. She recalls when completing her fellowship, she attended a lecture on policy by Dr. Ben Miller. “He is a policy rock star within integrated care, and has been for a number of years. He was giving a didactic to us on policy as fellows in terms of how to get involved with whatever state we were going to for after fellowship was complete, and I remember speaking to him after that and saying, ‘I'm moving to Texas who should I talk to about grassroots on the ground work with primary care?’ He gave me this group, Mental Health America of Greater Houston. They have an integrated care initiative where they work throughout the state, not just in Houston on anything and everything related to primary care." She points to how her work in these organizations led her to her involvement in shaping and advocating for an integrated care bill currently before congress right now. This is one of many examples of how she and others are using their knowledge as Behavioral Medicine experts to affect change locally and beyond.
 

Closing Thoughts

We spent the rest of our time with Dr. Ogbeide asking her about what she sees as the greatest challenges and most exciting things coming down the pike for IPC in the next five to ten years. As far as challenges, she feels that once people understand the purpose and function of different models of integrated care, it will lead to asking the right questions and having the right conversations to improving care. “I think the biggest challenge is resolving the misunderstanding of different ways to do integrated primary care.” She highlights the relationships among the Collaborative Care (CoCM) and The Primary Care Behavioral Health (PCBH) and how understanding these can improve clinical and policy work.

Dr. Ogbeide also shared that she is excited about a few things. These include ongoing evolution of competency in primary care-focused graduate programs, and offering competencies for supervisors already working in the field, in addition to workforce training in the coming years. “I'm seeing so many programs develop (strong IPC training) through HRSA grants and other avenues, and so I am really excited that our current workforce, a lot of them are getting trained before they're licensed. And so their trajectory may look a lot different than working in the field and coming back later. So I'm very excited for our future of primary care that we're having individuals trained intentionally. They are being trained intentionally, on purpose” in programs designed with IPC mind to help you function as a member of the primary care team.

 


How Understanding Identity Can Improve the Effectiveness of Dietary Interventions: A Conversation with Suzannah Gerber

Jennifer A. Emond, PhD, MS; Evidence-Based Behavioral Medicine SIG


Suzannah Gerber, MA


Healthy dietary patterns are important for positive physical and mental health across the lifespan.  Unfortunately, most Americans consume a diet of poor nutritional quality. Dietary changes are challenging, as poor habits can be difficult to revise once they are established.  Evidence-based behavioral medicine is crucial to help individuals make positive dietary changes and stick with those changes over time. However, there are many gaps in our understanding for what will work for whom and when.

Suzannah Gerber is a dedicated behavior change scholar, chef, and advocate whose work aims to elucidate the importance of identity in shaping our dietary behaviors. Understanding how identity shapes behavioral differences not only across individuals, but within individuals over time, will enable the design of more tailored dietary interventions and thus holds promise for increasing the sustainability of dietary changes. I talked with Ms. Gerber in May and here are a few key takeaways from that interview.
 

What do we mean when we talk about identity?

Identity is usually talked about as demographics in most areas of health sciences. That could be sex, race, ethnicity, or religion. Identity becomes a more complex and robust construct when we look to fields such as psychology or anthropology, where identity is more about how someone internally understands themselves. That can mean self-, social- or group-identity, for some ontological examples. My research shows that people hold multiple “identities,” which can change over the lifespan, or even during a single day, often in response to specific cues, their environment, and the people around them.
 

Why is it important to consider one’s identity when we consider eating behaviors?

Cues in our environment and the internal states we experience because of those cues affect what we value in the moment. This in turn may influence what foods and drinks we choose if we want our choices to align with those salient values. Your response to what you would like to have for lunch may be very different if you are with your co-workers versus with your kids, for example. Thus, we need to understand the importance of identity as a lens from which individuals act and make dietary choices.
 

Why is acknowledging identity important from a research perspective specifically?

Even simply asking individuals first about how much they identify with a certain environment can improve the reporting of their eating behaviors in that environment, perhaps because identity in that context becomes more salient.  It is also critical to understand how identity can impact long-term dietary change. For example, an individual may choose to consume foods and drinks they normally would not because they are in an environment where it is important to adhere to shared social or cultural norms. The individual thus experiences an internal shift and dissonance between their dietary goals and their identity. That dissonance then becomes the new obstacle to overcome if we want to support sustained dietary changes.
 

Is there a closing comment about identity you would like Outlook readers to know?

It is important to appreciate identity as a self-defined experience. Even when members of a group share the same race or ethnicity, for example, there is enormous heterogeneity within these groups, and those internal difference could influence behaviors and commitments. Interventions that acknowledge the richness of one’s internal identities is better able to fully honor the individual, and thus may increase the relevancy of behavior change intentions.
 

A video explaining Ms. Gerber’s recent research with Dr. Sara Folta of Tufts University, You Are What You Eat…but Do You Eat What You Are? The Role of Identity in Eating Behavior, can be found here.
 

Suzannah Gerber is an executive chef, cookbook author, advocate, and scholar with a passion for plant-based dietary interventions and public health. She is a PhD student at the Friedman School of Nutrition Science and Policy at Tufts University. Ms. Gerber was awarded the Silver Award for Outstanding Student Abstract in the Theories and Techniques of Behavior Change SIG award at the 2022 SBM annual meeting.


Considerations for Enhanced Alcohol and Substance Use Assessment as Veterans Affairs (VA) Prepares for Increased Substance Treatment Services in Primary Care Settings

Katherine Buckheit, PhD; Julie Gass, PhD; Jennifer Funderburk, PhD; and Tanya Bowen, PhD; Military and Veterans' Health and Integrated Primary Care SIGs


Alcohol/substance use are prevalent among service members and Veterans. The Veterans Health Administration (VHA) Strategic Plan has prioritized access to substance treatment via integrated behavioral health providers (BHPs) in primary care (PC). As service provision for alcohol/substance use evolves, so should its assessment. Assessment of substance use and related problems using standardized measures is largely absent in PC other than annual administration of the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C), which only assesses alcohol consumption and may not be adequately sensitive to change to monitor treatment progress. The purpose of this article is to highlight validated measures of alcohol and substance use for screening/monitoring alcohol and substance treatment progress in PC. The particular measures selected were intended to provide a comprehensive and complementary range of assessment options that is highly feasible in primary care settings.

CAGE-AID (Brown et al., 1998) is a four-item measure that assesses alcohol/substance-related problems that correspond to DSM-5 symptoms of alcohol and substance use disorder (AUD/SUD) (i.e., have you ever felt the need to cut down on your drinking/drug use; have people annoyed you by criticizing your drinking/drug use; have you ever felt guilty about your drinking/drug use; have you ever felt you needed a drink/drug first thing in the morning (eye-opener)). The CAGE-AID complements the assessment of consumption (i.e., the AUDIT-C), while its brevity and ease of administration and scoring render it feasible for PC. However, a disadvantage of the CAGE-AID is that it may be overly broad due to its timeframe (lifetime use), particularly for monitoring treatment progress over time. The CAGE-AID is available from the US Health Services and Research Administration.

Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST; Humeniuk et al., 2010) is an 8-item measure assessing lifetime and current use of substances and substance-related problems that correspond to DSM-5 symptoms of AUD/SUD. The ASSIST yields an overall risk score which maps directly onto a targeted intervention strategy in the ASSIST manual. Advantages of the ASSIST include its consolidation of assessment and intervention into one comprehensive package which is likely to facilitate implementation into PC settings. However, a disadvantage of the ASSIST is that it assesses lifetime and current use for 10 classes of substances, which may render it less feasible for patients using multiple substances within the time constraints of integrated PC settings. The ASSIST is available from the World Health Organization.

Brief Addiction Monitor (BAM; Cacciola et al., 2013) and its revision (BAM-R; Hallinan et al., 2021) include 17 items that assess alcohol/substance consumption, risk factors, and protective factors. The BAM has been adopted by many VA substance use clinics to monitor treatment progress. An advantage of the BAM is that it is the most comprehensive of the included measures in its assessment of substance use and related factors (i.e., risk and protective factors). However, this can also be a disadvantage in primary care settings. The BAM is longer than most measures used in PC, however it may be appropriate during behavioral health treatment in PC. Online/mobile platforms to support measurement-based care (MBC) (i.e., VHA’s Mental Health Checkup) allow patients to complete measures at home in advance of a session. Additionally, although use of the aggregate and subscale scores is recommended, the BAM also screens for health, mood, substance use, craving, income, social support, and treatment satisfaction based on single items. The BAM is available from the VA Center for Integrated Healthcare.

This article offers suggestions for enhanced assessment of alcohol and substance use in PC for consideration by both VHA and non-VA providers.  The CAGE-AID, ASSIST, and BAM offer three alternatives to assess alcohol/substance use and monitor treatment progress in PC with complementary strengths and weaknesses. Factors such as time (i.e., a warm handoff versus follow-up) and patient characteristics (e.g., polysubstance vs. monosubstance use; comfort with technology) should be taken into consideration as providers choose among these measures. As the VHA strives for alcohol and substance use services in PC settings, assessment of outcomes may need adaptations. MBC is crucial to integrated PC settings to inform clinical care via reliable, validated measures administered at consistent intervals. MBC facilitates shared-decision making, ongoing treatment monitoring and treatment planning, may reduce stigma, and can improve outcomes, yet has not been widely adopted in the practice of treating alcohol/substance use problems. Providers should strive to incorporate MBC via reliable, validated measures such as those presented in this article when providing treatment for substance use in primary care.

 

References

  • Brown, R. L., Leonard, T., Saunders, L. A., & Papasouliotis, O. (1998). The prevalence and detection of substance use disorders among inpatients ages 18 to 49: An opportunity for prevention. Preventive Medicine, 27(1), 101-110. https://doi.org/10.1006/pmed.1997.0250
  • Cacciola, J. S., Alterman, A. I., DePhilippis, D., Drapkin, M. L., Valadez Jr, C., Fala, N. C., Oslin, D., & McKay, J. R. (2013). Development and initial evaluation of the Brief Addiction Monitor (BAM). Journal of Substance Abuse Treatment, 44(3), 256-263. https://doi.org/10.1016/j.jsat.2012.07.013
  • Hallinan, S., Gaddy, M., Ghosh, A., & Burgen, E. (2021). Factor structure and measurement invariance of the Revised Brief Addiction Monitor. Psychological Assessment, 33(3), 273-278. https://doi.org/10.1037/pas0000973
  • Humeniuk, R., Henry-Edwards, S., Ali, R., Poznyak, V., & Monteiro, M. G. (2010). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): manual for use in primary care. (9522727083). Geneva, Switzerland: World Health Organization

 


New Articles from Annals of Behavioral Medicine and Translational Behavioral Medicine

SBM's two journals, Annals of Behavioral Medicine and Translational Behavioral Medicine: Practice, Policy, Research (TBM), continuously publish online articles, many of which become available before issues are printed. Three recently published Annals and TBM articles are listed below.

SBM members who have paid their 2022 membership dues are able to access the full text of all Annals and TBM online articles via the SBM website by following the steps below.

  1. Go to the Members Only section of the SBM website.
  2. Log in with your username and password.
  3. Click on the Journals link.
  4. Click on the title of the journal which you would like to electronically access.

To check your membership status, or if you are having trouble accessing the journals online, please contact the SBM national office at info@sbm.org or (414) 918-3156.


Annals of Behavioral Medicine
 

Psychosocial Determinants of COVID-19 Vaccination Intention Among White, Black, and Hispanic Adults in the US

 Amy Bleakley, PhD, MPH, Michael Hennessy, PhD, MPH, Erin Maloney, PhD, Dannagal G Young, PhD, John Crowley, PhD, Kami Silk, PhD, Jessica B Langbaum, PhD

Background
COVID-19 vaccine uptake is an urgent public health priority.

Purpose
To identify psychosocial determinants (attitudes, normative pressure, and perceived behavioral control) of COVID-19 vaccination intentions for U.S. White, Black, and Hispanic adults, and how COVID-19 misperceptions, beliefs about the value of science, and perceived media bias relate to these determinants.

Methods
Longitudinal online survey using two national samples (18–49 years old/50 years and older), each stratified by racial/ethnic group (n = 3,190). Data were collected in October/November 2020 and were weighted by race group to be representative.

Results
Path analyses showed that more positive attitudes about getting vaccinated predict intention across age and racial/ethnic groups, but normative pressure is relevant among older adults only. Belief in the value of science was positively associated with most determinants across all groups, however the association of COVID-19 misperceptions and perceived media bias with the determinants varied by age group.

Conclusions
Messages that emphasize attitudes toward vaccination can be targeted to all age and racial/ethnic groups, and positive attitudes are universally related to a belief in the value of science. The varying role of normative pressure poses messages design challenges to increase vaccination acceptance.

 

Adherence to Recommended Preventive Behaviors During the COVID-19 Pandemic: The Role of Empathy and Perceived Health Threat

Talia Morstead, BA, Jason Zheng, MA, Nancy L Sin, PhD, David B King, PhD, Anita DeLongis, PhD

Background
Coping via empathic responding may play a role in preventive behavior engagement during the COVID-19 pandemic, and unlike trait empathy, is a potentially alterable target for changing health behavior.

Purpose
Our goal was to examine the role of empathic responding in preventive behavior engagement during the COVID-19 pandemic, independent of trait empathy and perceived threat of COVID-19.

Methods
Participants (N = 2,841) completed a baseline survey early in the pandemic, and a follow-up survey approximately 2 weeks later (M = 13.50 days, SD = 5.61). Preventive health behaviors, including physical distancing and hygiene practices, were assessed at both timepoints. Hierarchical linear regression examined the contributions of trait empathy, perceived threat of COVID-19, and empathic responding at baseline to preventive behaviors at follow-up.

Results
Controlling for baseline levels of preventive behaviors and demographic covariates, trait empathy and threat of COVID-19 at baseline were each independently associated with preventive behaviors at follow-up. An interaction between perceived threat and empathic responding indicated that those perceiving high threat of COVID-19 at baseline tended to report engaging in preventive behaviors at follow-up regardless of their levels of empathic responding, whereas for those reporting low levels of perceived threat, higher levels of empathic responding were associated with higher engagement in preventive behavior.

Conclusions
When perceived threat of COVID-19 was low, higher empathic responding was associated with increased engagement in preventive behaviors regardless of trait empathy, suggesting that empathic responding can serve as an actionable target for intervention to promote preventive behavior during the pandemic.

 

Psychological Predictors of Self-reported COVID-19 Outcomes: Results From a Prospective Cohort Study

 Kieran Ayling, PhD, Ru Jia, MSc, Carol Coupland, PhD, Trudie Chalder, PhD, Adam Massey, PhD, Elizabeth Broadbent, PhD, Kavita Vedhara, PhD

Background
Previous research has shown that psychological factors, such as stress and social support, are associated with greater susceptibility to viral respiratory illnesses and more severe symptoms. During the COVID-19 pandemic there has been a well-documented deterioration in psychological well-being and increased social isolation. This raises questions as to whether those experiencing psychological adversity during the pandemic are more at risk of contracting and/or experiencing COVID-19 symptoms.

Purpose
To examine the relationship between psychological factors and the risk of COVID-19 self-reported infection and the symptomatic experience of SARS-CoV-2 (indicated by the number and severity of symptoms).

Methods
As part of a longitudinal prospective observational cohort study, 1,087 adults completed validated measures of psychological well-being during April 2020 and self-reported incidence of COVID-19 infection and symptom experience across the pandemic through to December 2020. Regression models were used to explore these relationships controlling for demographic and occupational factors.

Results
Greater psychological distress during the early phase of the pandemic was significantly associated with subsequent self-reported SARS-CoV-2 infection as well as the experience of a greater number and more severe symptoms.

Conclusions
COVID-19 infection and symptoms may be more common among those experiencing elevated psychological distress. Further research to elucidate the mechanisms underlying these associations is needed.

 

 

Translational Behavioral Medicine
 

Recommendations from LGBTQ+ adults for increased inclusion within physical activity: a qualitative content analysis

 Shannon S C Herrick, Tyler Baum, Lindsay R Duncan

For decades, physical activity contexts have been inherently exclusionary toward LGBTQ+ participation through their perpetuation of practices and systems that support sexuality- and gender-based discrimination. Progress toward LGBTQ+ inclusivity within physical activity has been severely limited by a lack of actionable and practical suggestions. The purpose of this study was to garner an extensive account of suggestions for inclusivity from LGBTQ+ adults. Using an online cross-sectional survey, LGBTQ+ adults (N = 766) were asked the following open-ended question, “in what ways do you think physical activity could be altered to be more inclusive of LGBTQ+ participation?” The resulting texts were coded using inductive qualitative content analysis. All coding was subject to critical peer review. Participants’ suggestions have been organized and presented under two overarching points of improvement: (a) creation of safe(r) spaces and (b) challenging the gender binary. Participants (n = 558; 72.8%) outlined several components integral to the creation and maintenance of safe(r) spaces such as: (i) LGBTQ+ memberships, (ii) inclusivity training for fitness facility staff, (iii) informative advertisement of LGBTQ+ inclusion, (iv) antidiscrimination policies, and (v) diverse representation. Suggestions for challenging the gender binary (n = 483; 63.1%) called for the creation of single stalls or gender-neutral locker rooms, as well as for the questioning of gender-based stereotypes and binary divisions of gender within physical activity (e.g., using skill level and experience to divide sports teams as opposed to gender). The findings of this study represent a multitude of practical suggestions for LGBTQ+ inclusivity that can be applied to a myriad of physical activity contexts.

 

Scenario planning: a framework for mitigating uncertainty in implementing strategic behavioral medicine initiatives during the COVID-19 pandemic

 Michael Hoerger, Sarah Alonzi, Brenna Mossman

Behavioral medicine investigators can adapt their research priorities, objectives, and methods to respond more effectively to the changing circumstances of the COVID-19 pandemic. Despite progress in understanding COVID-19, nonpharmaceutical interventions, vaccines, and treatments, there remains “the unsettling realization that we have little confidence in predicting how the pandemic will unfold.”

 

Feedback on Instagram posts for a gestational weight gain intervention

 Molly E Waring, Sherry L Pagoto, Tiffany A Moore Simas, Grace Heersping, Lauren R Rudin, Kaylei Arcangel

Lifestyle interventions can facilitate healthy gestational weight gain but attending in-person meetings can be challenging. High rates of use and the popularity of pregnancy content suggests Instagram as a possible platform for delivering gestational weight gain interventions. We assessed the logistics and acceptability of creating a private Instagram group and to obtain feedback on intervention posts. We conducted a 2-week study with pregnant women with pre-pregnancy overweight or obesity who use Instagram daily. Participants created a private Instagram account and followed other participants and a moderator who shared twice-daily posts about physical activity and healthy eating during pregnancy. Participants provided feedback through a follow-up survey and focus group/interviews. Engagement data was abstracted from Instagram. Participants (N = 11) were on average 26.3 (SD: 7.4) weeks gestation and 54% had obesity pre-pregnancy. All participants followed the moderator’s account, 73% followed all other participants, participants engaged with 100% of study posts, 82% felt comfortable sharing in the group, and 73% would participate in a similar group if pregnant in the future. While participants felt the posts were visually attractive and included helpful information, they wanted more personalized content and felt reluctant to post photos they felt were not “Instagram worthy.” Moderators should foster an environment in which participants feel comfortable posting unedited, authentic photos of their lives, perhaps by sharing personal photos that are relatable and represent their own imperfect lives. Results will inform further development and testing of an Instagram-delivered gestational weight gain intervention.

 

 

Honors and Awards

Congratulations to the following Society of Behavioral Medicine (SBM) members who recently received awards or were otherwise honored. To have your honor or award featured in the next issue of Outlook, please email aschmidt@sbm.org.
 

Amy L. Ai, PhD
Dr. Ai was recently named a Florida State University Distinguished Research Professor.

John P. Allegrante, PhD
Dr. Allegrante was named the inaugural Charles Irwin Lambert Endowed Professor of Health Behavior and Education at Teachers College, Columbia University.

Sara Bybee, PhD, LCSW
Dr. Bybee was awarded the Outstanding Dissertation Award from the University of Utah College of Nursing during May 2022 convocation from the PhD program.

Alan M. Delamater, PhD
The American Diabetes Association selected Dr. Delamater for the 2022 Richard R. Rubin Award.

Allison Marziliano, PhD
NIA granted Dr. Marziliano a K01 career development award for her project “Increasing Meaning to Reduce Loneliness in Care Partners of Persons with Alzheimer’s Disease (AD) and AD-related dementias (AD/ADRD)”.

Susan Michie, DPhil
Dr. Michie was elected as a Fellow of the British Academy.

William E. Rosa, PhD
Dr. Rosa was recently selected for the International Association for Hospice & Palliative Care Individual Recognition Award, the Loretta C. Ford Award for Advancement of the Nurse Practitioner Role in Health Care Fellows of the American Association of Nurse Practitioners, and the Excellence in Oncology Nursing Health Policy and Advocacy Award from the Oncology Nursing Society.

 

 


Members in the News

The following SBM members and their research were recently featured in news articles, videos, or journals. To have your news spot featured in the next issue of Outlook, please email aschmidt@sbm.org.
 

Nicole A. Arrato, MA
Ms. Arrato's dissertation project, "Stress and immunity in lung cancer patients: Pilot test of A Biobehavioral/Cognitive (ABC) treatment for stress, depression, and anxiety" was featured in a segment broadcast on Cincinnati's Local 12 News in April.

Michelle Cardel, PhD, MS, RD
Dr. Cardel was quoted in "Childcare crowdfunding campaigns aim to keep mums on the academic track" in Nature.

Michelle Segar, PhD, MPH, MS
Dr. Segar's book The Joy Choice was recently selected as a Next Big Idea Club nominee and featured on NPR KPCW, Thrive Global, and Forbes.

Sara M. St. George, PhD
The Miami Herald featured Dr. St. George in an article entitled "Put down the pastelitos. New app aims to get Hispanic families on healthy track."

Various Members
SBM members Heather Cole-Lewis, PhD; Linda M. Collins, PhD; Nnamdi P. Ezeanochie, MD, DrPH; Eric J. Daza, DrPH, MPS; Sherry L. Pagoto, PhD; Kate Wolin, ScD; Ashleigh S. Golden, PsyD; and Madalina Sucala, PhD were included on a Forbes list of "16 Healthcare Innovators That You Should Know."

 


CLASSIFIEDS

UMass Chan Medical School - Faculty Position in Health Informatics and Implementation Science


The Department of Population and Quantitative Health Sciences (PQHS) at the University of Massachusetts (UMass) Chan Medical School (UMass Chan) in Worcester, MA is recruiting two faculty members in Health Informatics and/or Implementation Science. We welcome applications from established researchers as well as junior faculty (Assistant, Associate, or Full Professor rank).

We are a collaborative team conducting cutting-edge research in digital health, clinical informatics, machine learning, behavior change, and implementation science. These positions include an opportunity for a joint appointment at the Veterans Administration Center of Innovation in Health Services Research at the VA Bedford Healthcare System.

As an equal opportunity and affirmative action employer, UMass Chan recognizes the added value of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds. We are especially eager to consider applicants who will support and elevate the UMass Chan commitment to diversity, equity and inclusion, and foster an environment of inclusive collaborative excellence where all faculty can thrive.

More information and applications are available:

Health Informatics - https://academicjobsonline.org/ajo/jobs/21478
Implementation Science - https://academicjobsonline.org/ajo/jobs/21479

Inquiries, but not application materials, may be directed to PQHS.faculty.search@umassmed.edu