Outlook: Newsletter of the Society of Behavorial Medicine

Summer 2022

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

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

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.

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.

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.

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

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.

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.

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.

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.

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

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.

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).

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.

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.

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.