The objective of this study was to identify physical, social, and intrapersonal cues that were associated with the consumption of sweetened beverages and sweet and salty snacks among adolescents from lower SES neighborhoods. Students were recruited from high schools with a minimum level of 25% free or reduced cost lunches. Using Ecological Momentary Assessment, participants (N=158) were trained to answer brief questionnaires on handheld PDA devices: (a) each time they ate or drank, (b) when prompted randomly, and (c) once each evening. Data were collected over 7 days for each participant. Participants reported their location (e.g., school grounds, home), mood, social environment, activities (e.g., watching TV, texting), cravings, food cues (e.g., saw a snack), and food choices. Results showed that having unhealthy snacks or sweet drinks among adolescents was associated with being at school, being with friends, feeling lonely or bored, craving a drink or snack, and being exposed to food cues. Surprisingly, sweet drink consumption was associated with exercising. Watching TV was associated with consuming sweet snacks but not with salty snacks or sweet drinks. These findings identify important environmental and intrapersonal cues to poor snacking choices that may be applied to interventions designed to disrupt these food-related, cue-behavior linked habits.

Inhibitory control and sensitivity to reward are relevant to the food choices individuals make frequently. An imbalance of these systems can lead to deficits in decision-making that are relevant to food ingestion. This study evaluated the relationship between dietary behaviors – binge eating and consumption of sweetened beverages and snacks - and behavioral control processes, among 198 ethnically diverse adolescents, ranging in age from 14 to 17, in Southern California. Neurocognitive control processes were assessed with the Iowa Gambling Task, a generic Go/No-Go task, and a food-specific Go/No-Go task. The food-specific Go/No-Go task directly ties the task to food cues that trigger responses, addressing an integral link between cue-habit processes. Dietary measures were assessed with self-administered food frequency and binge eating questionnaires. Results of latent variable models revealed marked gender differences. Inhibitory problems on the food-specific and generic Go/No-Go tasks were significantly correlated with binge eating only in females, whereas inhibitory problems measured with these tasks were the strongest correlates of sweet snack consumption in males. Higher BMI percentile and sedentary behavior also predicted binge eating in females and sweet snack consumption in males. Inhibitory problems on the generic Go/No-Go, poorer affective decision-making, assessed with the Iowa Gambling Task, and sedentary behavior were associated with sweetened beverage consumption in males, but not females. The food-specific Go/No-Go was not predictive in models evaluating sweetened beverage consumption, providing some initial discriminant validity for the task, which consisted of sweet/fatty snacks as no-go signals and no sugar-sweetened beverage signals. This research extends other study findings, revealing gender differences in inhibitory function relevant to behavioral control. Further, the findings contribute to research implicating the relevance of cues in habitual behaviors and their relationship to snack food consumption in an understudied population of diverse adolescents not receiving treatment for obesity or eating disorders.

BackgroundCounselor behaviors that mediate the efficacy of motivational interviewing (MI) are not well understood, especially when applied to health behavior promotion. We hypothesized that client change talk mediates the relationship between counselor variables and subsequent client behavior change.MethodsPurposeful sampling identified individuals from a prospective randomized worksite trial using an MI intervention to promote firefighters’ healthy diet and regular exercise that increased dietary intake of fruits and vegetables (n = 21) or did not increase intake of fruits and vegetables (n = 22). MI interactions were coded using the Motivational Interviewing Skill Code (MISC 2.1) to categorize counselor and firefighter verbal utterances. Both Bayesian and frequentist mediation analyses were used to investigate whether client change talk mediated the relationship between counselor skills and behavior change.ResultsCounselors’ global spirit, empathy, and direction and MI-consistent behavioral counts (e.g., reflections, open questions, affirmations, emphasize control) significantly correlated with firefighters’ total client change talk utterances (rs = 0.42, 0.40, 0.30, and 0.61, respectively), which correlated significantly with their fruit and vegetable intake increase (r = 0.33). Both Bayesian and frequentist mediation analyses demonstrated that findings were consistent with hypotheses, such that total client change talk mediated the relationship between counselor’s skills—MI-consistent behaviors [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .02, .12] and MI spirit [Bayesian mediated effect: αβ = .06 (.03), 95% CI = .01, .13]—and increased fruit and vegetable consumption.ConclusionMotivational interviewing is a resource- and time-intensive intervention, and is currently being applied in many arenas. Previous research has identified the importance of counselor behaviors and client change talk in the treatment of substance use disorders. Our results indicate that similar mechanisms may underlie the effects of MI for dietary change. These results inform MI training and application by identifying those processes critical for MI success in health promotion domains.

Background Causal inference continues to be a critical aspect of evaluation research. Recent research in causal inference for statistical mediation has focused on addressing the sequential ignorability assumption; specifically, that there is no confounding between the mediator and the outcome variable. Objectives This article compares and contrasts three different methods for assessing sensitivity to confounding and describes the graphical depiction of these methods. Design Two types of data were used to fully examine the plots for sensitivity analysis. The first type was generated data from a single mediator model with a confounder influencing both the mediator and the outcome variable. The second was data from an actual intervention study. With both types of data, situations are examined where confounding has a large effect and a small effect. Subjects The nonsimulated data were from a large intervention study to decrease intentions to use steroids among high school football players. We demonstrate one situation where confounding is likely and another situation where confounding is unlikely. Conclusions We discuss how these methods could be implemented in future mediation studies as well as the limitations and future directions for these methods.

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This study compares the analysis of covariance (ANCOVA), difference score, and residual change score methods in testing the group effect for pretest–posttest data in terms of statistical power and Type I error rates using a Monte Carlo simulation. Previous research has mathematically shown the effect of stability of individual scores from pretest to posttest, reliability, and nonrandomization (i.e., pretest imbalance) on the performance of the ANCOVA, difference score, and residual change score methods. However, related power issues have not been adequately addressed. The authors examined the impact of stability of measurement over time, reliability of covariate and criterion, nonrandomization, sample size, and treatment effect size on statistical power of the three methods. Across conditions, ANCOVA and residual change score methods had similar power rates. When reliability was less than perfect, ANCOVA had more power than the difference score method when there was an increase from pretest to posttest and a positive baseline imbalance (i.e., treatment group had higher pretest scores than the control group), or when there was a decrease from pretest to posttest and a negative baseline imbalance, and vice versa. In case of perfect reliability, the statistical power of ANCOVA did not differ from the difference score method. For the difference score method, when reliability was low, there was no effect of stability on power, whereas when reliability was high or perfect, power increased as stability increased for medium and large effect sizes. Difference scores may be preferred over ANCOVA under certain circumstances.

Objective To determine the relationship between lifestyle variables including body mass index (BMI) and filing a worker’s compensation claim due to firefighter injury. Methods A cross-sectional evaluation of firefighter injury related worker compensation claims occurring 5 years after the original PHLAME study intervention. Results Logistic regression analysis for variables predicting filing a worker’s compensation claim due to an injury were performed. with a total of 433 participants. The odds of filing a compensation claim were almost three times higher for firefighters with a BMI >30 compared to firefighters with normal BMI (odds ratio=2.89, p<.05). Conclusions This study addresses a high priority area of reducing firefighter injuries and worker’s compensation claims. Maintaining a healthy body weight is important to reduce injury and worker’s compensation claims among firefighters.

The issue of Americans' levels of narcissism is subject to lively debate. The focus of the present research is on the perception of national character (PNC) of Americans as a group. In Study 1, American adults (N = 100) rated Americans as significantly more narcissistic than they perceived themselves and acquaintances. In Study 2, this finding was replicated with American college students (N = 322). PNC ratings of personality traits and externalizing behaviors revealed that Americans were perceived as disagreeable and antisocial as well. In Study 3, we examined the broader characteristics associated with PNC ratings (N = 183). Americans rated the typical American as average on a variety of characteristics (e.g., wealth, education, health, likability) and PNC ratings of narcissism were largely unrelated to these ratings. In Study 4 (N = 1,202) Americans rated PNCs for different prespecified groups of Americans; as expected, PNC ratings of narcissism differed by gender, age, and occupational status such that American males, younger Americans, and Americans working in high-visibility and status occupations were seen as more narcissistic. In Study 5 (N = 733), citizens of 4 other world regions (Basque Country, China, England, Turkey) rated members of their own region as more narcissistic than they perceived themselves, but the effect sizes were smaller than those found in the case of Americans' perceptions of Americans. Additionally, members of these other regions rated Americans as more narcissistic than members of their own region. Finally, in Study 6, participants from around the world (N = 377) rated Americans as more narcissistic, extraverted, and antagonistic than members of their own countries. We discuss the role that America's position as a global economic and military power, paired with a culture that creates and reifies celebrity figures, may play in leading to perceptions of Americans as considerably narcissistic.