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SIGNIFICANCE/BACKGROUND:Although research and evidence-based practice are widely regarded as foundational to high quality patient care, little is known about the evidence-based practice and research competencies of ambulatory care nurses. AIMS:The aim of this study was to measure the self-perceived evidence-based practice and research competencies and learning needs of ambulatory care nurses. METHODS:In 2024, a national sample of 2790 ambulatory care nurses participated in an online cross-sectional structured survey measuring evidence-based practice and research competencies. Respondents rated their competency using the EBP Capability Beliefs Scale and the Application of Knowledge and Skills subscale from the Research Competencies Assessment Instrument for Nurses (RCAIN). Results were compared across practice settings, job roles, and subspecialties. RESULTS/FINDINGS:Higher education levels correlated with higher scores in both evidence-based practice and research competencies. After controlling for education level, nurses from specialty or procedural areas scored higher in evidence-based practice competencies than nurses from all other work environments. Direct care nurses scored lower than nurses in all other roles in research competencies. Statistically significant correlations were also found between evidence-based practice competencies and the type of organization where a nurse worked. LINKING EVIDENCE TO ACTION:Findings indicate EBP and research competencies must be increased among ambulatory care nurses. Leadership support and resource allocation are critical for EBP development. Among ambulatory care nurses, those in direct care roles may have the greatest opportunities to develop EBP and research competencies. Nurses with limited exposure to EBP and research should be encouraged to engage in professional development activities on these topics. Education and EBP mentorship for ambulatory care nurses should be tailored to the ambulatory care environment where possible, to make it relatable to learners.
BACKGROUND:Stressful life events are commonly associated with the experience of depressive symptoms. However, more nuanced questions about how specific experiences of stress are associated with individual symptoms, while accounting for latent depression severity, referred to as pathoplastic effects, have not been extensively examined but may provide leverage for personalized interventions. Moreover, there are few multi-wave longitudinal studies that examine whether fluctuations in life events are associated with corresponding changes in specific depressive symptoms. METHODS:We relied on self-report measures of depression and perceived stressful life events, coded into twelve dimensions (e.g., loss, dependent, independent life events), that were assessed on up to seven annual assessments (total observations = 7967; N = 1414; age range = 18.9-31.7 years). We examined both within- and between-person associations involving self-reported stressful life events and symptoms. RESULTS:There were few within- and between-person pathoplastic effects found at the level of specific symptoms, and some of these effects may be accounted for by mechanisms unrelated to depression. By contrast, we found consistent, robust associations between all dimensions of perceived stressful life events and overall depression severity at both within- and between-person levels. CONCLUSIONS:The results suggest that stressful events play a role in the experience of depression by influencing overall symptom severity, both within- and between-person, rather than influencing the specific symptomatic expression of the syndrome.
OBJECTIVE:This systematic review evaluated the feasibility, efficacy, adherence, and methodological quality of ecological momentary intervention (EMI)-based treatments for individuals with diagnosed eating disorders (EDs) and/or obesity. METHOD:Eight electronic databases were systematically searched from inception to January 2026. Randomized, non-randomized, and uncontrolled studies evaluating EMI-based treatments for individuals with diagnosed EDs and/or obesity were included. Data on intervention characteristics, clinical and behavioral outcomes, feasibility, acceptability, and adherence were extracted. Risk of bias was assessed using RoB 2 and ROBINS-I, and findings were synthesized narratively. RESULTS:Fourteen studies met inclusion criteria (eight obesity-focused, six ED-focused), including nine randomized controlled trials. In ED studies, EMI-augmented interventions were associated with significant within-group reductions in binge-eating frequency and ED psychopathology. However, superiority over active cognitive-behavioral therapy-based controls was inconsistent and primarily observed during maintenance phases. Obesity-focused trials demonstrated small to moderate within-group improvements in weight-related outcomes, with generally small and non-sustained between-group effects. Feasibility and acceptability were generally high, although retention and engagement varied across studies. Risk of bias was low in most randomized trials but higher in non-randomized studies. DISCUSSION:EMIs appear to be a feasible and acceptable approach for extending evidence-based treatments for EDs and obesity into daily life. Current evidence suggests that EMIs may exert a beneficial adjunctive effect by enhancing engagement and improving short-term behavioral outcomes. However, their impact on long-term clinical outcomes remains limited and inconsistent, underscoring the necessity for conducting rigorously designed clinical trials with extended follow-up periods.
A common problem for assessing psychiatric screening tools is that initial diagnostic accuracy estimates are conducted on cross-sectional data and later found to be lower than expected when longitudinal analyses are conducted. This article uses prevalence estimates to identify potentially missed cases and adjust diagnostic accuracy metrics. To display this approach, we meta-analyze and assess 27 population-level autism screening studies identified via an umbrella review and contrast four population adjustments (none, national, U.S.-centric, and world prevalence). Studies with no positive screen adjustments displayed adequate sensitivity (.75), but poor sensitivity resulted when applying national (.52), world (.50), and U.S.-centric (.33) population adjustments. We also address missing positive screen cases due to the common problem of attrition (Sheldrick et al., 2023). Positive screen adjustments suggested a range of sensitivity impacts ranging from very poor (.32) to good (.89). Across analyses, positive predictive value estimates also ranged from .20 to .73 depending on population and missed case assumptions. The strengths and benefits of blending epidemiology and psychometric perspectives to identify screening tools that are weaker than expected are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
OBJECTIVE:We aimed to determine if the high co-occurrence rates between food addiction (FA) and binge-spectrum eating disorders (BSEDs) are partially due to their respective measures assessing similar symptoms. Specifically, we aimed to clarify whether the Yale Food Addiction Scale 2.0 (YFAS 2.0) assesses a distinct symptom profile from common BSED measures (e.g., measures of binge-eating disorder (BED) or bulimia nervosa). Because FA does not include compensatory behaviors, our comparison focused specifically on FA and binge-related features of BSEDs. METHOD:We conducted a content analysis on the YFAS 2.0 and five of the most cited BSED measures. Five trained coders inductively assigned symptom codes to every item from each measure. Because FA does not include compensatory behaviors, we removed compensatory-behavior items from the BSED measures prior to coding to focus on binge-related content. We then calculated Jaccard similarity coefficients to quantify symptom overlap between measures. RESULTS:The YFAS 2.0 showed very low symptom overlap with the BSED measures (Jaccard range = 0.08-0.19). However, nearly half (47%) of its symptoms were captured by at least one BSED measure. The symptoms assessed by the YFAS 2.0 and not the BSED measures tended to focus on the impairment and consequences of eating behavior, whereas the BSED measures focused more on the cognitive features of eating behavior. DISCUSSION:This comparison revealed both differences and similarities between FA and BSED measures. Although the YFAS 2.0 showed limited overlap with any single BSED measure, about half of its symptoms were represented in at least one BSED measure, indicating partial shared content. The FA and BSED measures also reflect different theoretical emphases, with FA focusing on impairment and BSEDs emphasizing cognitive and behavioral features. Further clarifying how FA and BED relate will require integrating measurement patterns with evidence on mechanisms and clinical course.
