The obesity epidemic continues largely unabated, affecting more than one-third of the US population and disproportionately burdening individuals from socioeconomically disadvantaged populations. Numerous factors contribute to the high prevalence of obesity, including socioeconomic and structural barriers impeding primordial and primary prevention efforts. Despite broad recognition that social determinants of health are key drivers of obesity, the importance of socioeconomic and structural factors as contemporary barriers to individual-, community-, and population-level obesity prevention and intervention efforts remains underappreciated. This scientific statement highlights multilevel barriers to obesity prevention and management, with an emphasis on social determinants of health, societal culture, and shared biases that may interfere with the success of healthy weight management programs. The assessment includes a comprehensive review of policy and community-level strategies used to address the obesity epidemic and identifies key areas for future research.

A systematic review was conducted to evaluate the efficacy of mindfulness-based interventions (MBIs) to reduce stress and related outcomes in Latinx college students. Despite decades of research, less is known about the efficacy of MBIs in reducing stress among this population, given their negligible representation in previous studies. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature search was conducted across six databases through June 2023. Eligible studies measured stress and related outcomes, had baseline and follow-up assessments, and included Latinx college students. Excluded studies lacked an intervention, targeted medical or nursing students, did not report stress measures, were conducted outside of the U.S., and did not report including Latinx students. A total of 15 studies were identified. Findings indicate that most MBIs resulted in significant changes in stress reduction, mindfulness, anxiety, and improved GPAs. Among these studies, two “focal studies” reported samples of 50

Loneliness is known to be an important contributor to cardiovascular disease (CVD). However, little is known about the impact of loneliness on endothelial barrier integrity, a crucial hallmark of CVD development and progression. In this study, we aimed to investigate how loneliness might impact the endothelium. We found greater perceived loneliness associated with the product of circulating epinephrine and TNFα (E/T), which, in turn, associated with lower VE-cadherin on endothelial cells in an ex vivo experiment. Additionally, circulating plasma levels of soluble VE-cadherin were associated significantly with subclinical CVD. To explore the mechanistic aspects of these associations, we measured the effects of E/T on endothelial barrier function in vitro. E/T treatment decreased endothelial VE-cadherin expression and dampened endothelial barrier integrity, involving at least partial JAK/Stat signaling, highlighting a potential additive effect of epinephrine and TNFα on endothelial dysfunction, potentially accelerating CVD development and progression in individuals experiencing loneliness-related chronic stress.

The coronavirus pandemic posed a major challenge to mental health. Existing evidence shows that COVID-19 is related to poor emotional well-being, particularly among women. However, most work on the subject uses single-country samples, limiting the ability to generalize the disparity or explain it as a function of societal variables. The present study investigates the expression of positive and negative emotions during the pandemic as a function of gender and across 24 countries (N = 49,637). Strong gender differences emerged across countries, with women reporting more negative emotions (anxious, depressed, nervous, exhausted) and less positive emotions (calm, content, relaxed, energetic) than men. The gender gap in positive emotions was significantly wider in countries higher in individualism and narrower in countries higher in power distance. For instance, differences in emotions were larger in Western countries high in individualism, such as the USA, the UK, Italy, and France, and smaller in countries with higher collectivism and power distance, such as China, Malaysia, and South Korea, with a few exceptions like Japan and Brazil. These gender differences across countries were not explained by country-level gender inequalities indicators (GGGI and GII). Interestingly, the national severity of the pandemic, an epidemiological factor, reduced gender differences in positive emotions. These results underscore the importance of considering cultural and national factors when assessing gender differences in well-being.

Virus mitigation behavior has been and still is a powerful means to fight the COVID-19 pandemic irrespective of the availability of pharmaceutical means (e.g., vaccines). We drew on health behavior theories to predict health-protective (coping-specific) responses and hope (coping non-specific response) from health-related cognitions (vulnerability, severity, self-assessed knowledge, efficacy). In an extension of this model, we proposed orientation to internal (problem-focused coping) and external (country capability) coping resources as antecedents of health protection and hope; health-related cognitions were assumed as mediators of this link. We tested these predictions in a large multi-national multi-wave study with a cross-sectional panel at T1 (Baseline, March-April 2020; N = 57,631 in 113 countries) and a panel subsample at two later time points, T2 (November 2020; N = 3097) and T3 (April 2021; N = 2628). Multilevel models showed that health-related cognitions predicted health-protective responses and hope. Problem-focused coping was mainly linked to health-protective behaviors (T1-T3), whereas country capability was mainly linked to hope (T1-T3). These relationships were partially mediated by health-related cognitions. We conceptually replicated predictions of health behavior theories within a real health threat, further suggesting how different coping resources are associated with qualitatively distinct outcomes. Both patterns were consistent across countries and time.

The onset of the COVID-19 pandemic saw a shift toward a more traditional division of labor–one where women took greater responsibility for household tasks and childcare than men. We tested whether this regressive shift was more acutely perceived and experienced by women in countries with greater gender equality. Cross-cultural longitudinal survey data for women and men (N = 10,238) was collected weekly during the first few months of the pandemic. Multilevel modelling analyses, based on seven waves of data collection, indicated that a regressive shift was broadly perceived but not uniformly felt. Women and men alike perceived a shift toward a more traditional division of household labor during the first few weeks of the pandemic. However, this perception only undermined women’s satisfaction with their personal relationships and subjective mental health if they lived in countries with higher levels of economic gender equality. Among women in countries with lower levels of economic gender equality, the perceived shift predicted higher relationship satisfaction and mental health. There were no such effects among men. Taken together, our results suggest that subjective perceptions of disempowerment, and the gender role norms that underpin them, should be considered when examining the gendered impact of global crisis.

Some public officials have expressed concern that policies mandating collective public health behaviors (e.g., national/regional "lockdown ") may result in behavioral fatigue that ultimately renders such policies ineffective. Boredom, specifically, has been singled out as one potential risk factor for noncompliance. We examined whether there was empirical evidence to support this concern during the COVID-19 pandemic in a large cross-national sample of 63,336 community respondents from 116 countries. Although boredom was higher in countries with more COVID-19 cases and in countries that instituted more stringent lockdowns, such boredom did not predict longitudinal within-person decreases in social distancing behavior (or vice versa; n = 8,031) in early spring and summer of 2020. Overall, we found little evidence that changes in boredom predict individual public health behaviors (handwashing, staying home, self-quarantining, and avoiding crowds) over time, or that such behaviors had any reliable longitudinal effects on boredom itself. In summary, contrary to concerns, we found little evidence that boredom posed a public health risk during lockdown and quarantine.

ABSTRACT The American Psychosomatic Society (APS) is an international professional society that aims to advance the scientific study of biological, behavioral, and social factors in health among educators, clinicians, and researchers. In pledging to be an antiracist organization in 2020, APS formed the Antiracism Task Force to identify different manifestations of systemic racism within the society and to make recommendations for building a more inclusive and equitable professional organization. The goal of this paper was to be maximally transparent to membership about our activities and lessons learned, as well as offer a case study to other organizations striving toward antiracism. We describe the inaugural year of activities of the APS Antiracism Task Force, which included proposing amendments to the society’s bylaws, collecting data on member attitudes toward diversity, and consulting on other member efforts to implement antiracism activities (e.g., increasing access to early career awards). In addition to reflecting on task force and society-specific factors that were facilitative in our first year, we describe future plans and potential challenges we may face as we support sustained commitment to APS’s antiracism efforts.

Psychological research on the predictors of conspiracy theorizing-explaining important social and political events or circumstances as secret plots by malevolent groups-has flourished in recent years. However, research has typically examined only a small number of predictors in one, or a small number of, national contexts. Such approaches make it difficult to examine the relative importance of predictors, and risk overlooking some potentially relevant variables altogether. To overcome this limitation, the present study used machine learning to rank-order the importance of 115 individual- and country-level variables in predicting conspiracy theorizing. Data were collected from 56,072 respondents across 28 countries during the early weeks of the COVID-19 pandemic. Echoing previous findings, important predictors at the individual level included societal discontent, paranoia, and personal struggle. Contrary to prior research, important country-level predictors included indicators of political stability and effective government COVID response, which suggests that conspiracy theorizing may thrive in relatively well-functioning democracies.

Understanding the determinants of COVID-19 vaccine uptake is important to inform policy decisions and plan vaccination campaigns. The aims of this research were to: (1) explore the individual- and country-level determinants of intentions to be vaccinated against SARS-CoV-2, and (2) examine worldwide variation in vaccination intentions. This cross-sectional online survey was conducted during the first wave of the pandemic, involving 6697 respondents across 20 countries. Results showed that 72.9% of participants reported positive intentions to be vaccinated against COVID-19, whereas 16.8% were undecided, and 10.3% reported they would not be vaccinated. At the individual level, prosociality was a significant positive predictor of vaccination intentions, whereas generic beliefs in conspiracy theories and religiosity were negative predictors. Country-level determinants, including cultural dimensions of individualism/collectivism and power distance, were not significant predictors of vaccination intentions. Altogether, this study identifies individual-level predictors that are common across multiple countries, provides further evidence on the importance of combating conspiracy theories, involving religious institutions in vaccination campaigns, and stimulating prosocial motives to encourage vaccine uptake.

Behavioral medicine research and practice have not traditionally acknowledged the detrimental effects of anti-Black racism (and other forms of systemic oppression) on health, interventions, or research. This commentary describes four ways that behavioral medicine researchers and clinicians can address the past to envision the future of behavioral medicine to promote equitable health for all: 1) name anti-Black racism, 2) ensure interventions address structural inequities, 3) advocate for systemic change, and 4) change expectations for publications.

Before vaccines for coronavirus disease 2019 (COVID-19) became available, a set of infection-prevention behaviors constituted the primary means to mitigate the virus spread. Our study aimed to identify important predictors of this set of behaviors. Whereas social and health psychological theories suggest a limited set of predictors, machine-learning analyses can identify correlates from a larger pool of candidate predictors. We used random forests to rank 115 candidate correlates of infection-prevention behavior in 56,072 participants across 28 countries, administered in March to May 2020. The machine-learning model predicted 52% of the variance in infection-prevention behavior in a separate test sample-exceeding the performance of psychological models of health behavior. Results indicated the two most important predictors related to individual-level injunctive norms. Illustrating how data-driven methods can complement theory, some of the most important predictors were not derived from theories of health behavior-and some theoretically derived predictors were relatively unimportant.

BACKGROUND:Sickle cell disease (SCD) is a heritable chronic health condition characterized by pain symptoms throughout the life course that are routinely treated with opioids.OBJECTIVE:This study examined differences in substance use disorders in Black American adults with SCD compared to those with other chronic conditions or with no chronic conditions.DESIGN:Data from a population-representative sample of Black Americans with SCD, other chronic conditions, and no chronic conditions were obtained from the National Survey of American Life (NSAL) database. Diagnosis of substance use disorder was determined by structured clinical interview. Hierarchical models controlling for covariates (demographics, socioeconomic status, self-rated health, and mood disorders) compared odds of diagnosis between the three groups.PARTICIPANTS:The sample included 4238 African-American and Black Caribbean participants from the NSAL study who were 18 years of age or older.MAIN MEASURES:Measures included age, sex, income, education, marital status, employment, possession of health insurance, health conditions, and substance use disorders diagnosed by structured clinical interview.KEY RESULTS:Controlling for age, sex, and socioeconomic status, there were no differences in odds of a drug use disorder when comparing individuals with SCD to Black adults with other chronic conditions (OR = 1.12; p = 0.804) or no chronic condition (OR = 2.09; p = 0.102). SCD was, however, associated with greater odds of alcohol use disorders when compared to the groups with other chronic conditions (OR = 2.15; p = 0.01) and no chronic conditions (OR = 5.11; p < 0.001). This effect was not better accounted for by socioeconomic status, marital status, self-rated physical health, or the presence of a mood disorder.CONCLUSIONS:SCD was not a risk factor for drug use disorders. Further data will be needed to understand the factors contributing to increased risk of alcohol use disorders in SCD and the role uncontrolled pain symptoms may have in driving substance use.