Behavior and Behavior Mechanisms Commons^™

Early Adversity, Impulsivity, And Health Behaviors, Amy Lynn Meadows

Theses and Dissertations--Clinical and Translational Science

Childhood trauma and early adversity are associated with a variety of negative health outcomes, some of which may be mediated by changes to impulsivity as described by the cumulative risk model. The purpose of this project is to provide insight into the effects of cumulative adverse childhood experience on impulsivity in various populations. Three studies examine the effects of early adversity on impulsivity in normal volunteers, parents caring for a child with medical needs, and in patients with diabetes or pre-diabetes with data collected through crowdsourcing. The strongest effects for early adversity on impulsivity were seen in the patients with …

Analysis Of Facilitators Of And Barriers To Enactment Of State Regulation Of Indoor Tanning By Minors, Carolyn J. Heckman, Anna Mitarotondo, David B. Buller, Julia Berteletti, Kevin Schroth, Jerod L. Stapleton, Robert P. Dellavalle

Markey Cancer Center Faculty Publications

Background: Indoor tanning (IT) causes skin cancers, including potentially deadly melanoma. IT often starts during youth, a critical time for deleterious skin damage. About half of the US states have enacted laws banning IT for minors under age 18.

Purpose: This study reports qualitative findings from interviews with key informants (KIs) involved in IT legislative efforts to identify/describe factors influencing law enactment, based on the multiple streams framework.

Methods: Guided by expert advisors and using snowball-sampling, KIs from 16 states with most recently enacted IT laws regulating minor access and states without restrictions were contacted. In virtual interviews, KIs shared …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

The Effects Of Plx 3397 On Fentanyl Escalation In Male And Female Sprague-Dawley Rats, Jakob Shaykin

Theses and Dissertations--Psychology

Purpose: A hallmark characteristic of opioid use disorder (OUD) is a persons’ ‘loss of control’, which leads to the compulsion to seek and obtain opioids, resulting in increased consumption. This phenomenon is known as ‘escalation of drug intake’. Chronic opioid use causes microglial reactivity and subsequent release of proinflammatory cytokines leading to neuroinflammation, weakening one’s executive control over drug taking and ultimately leading to greater use. Previous research in our laboratory has explored heterogeneity of fentanyl intake in extended access (6-hr) sessions and identified distinct endophenotypes of fentanyl intake. Moreover, we have observed a positive correlation between Treml1 expression …

A Review Of The Association Between Dietary Intake And Brain Iron Levels In Older Adults: Preliminary Findings And Future Directions., Valentinos Zachariou, Christopher E. Bauer, Colleen A. Pappas, Brian T. Gold

Behavioral Science Faculty Publications

Background/Objectives: Non-heme iron is essential for critical neuronal functions such as ATP generation, synaptogenesis, neurotransmitter synthesis, and myelin formation. However, as non-heme iron accumulates with age, excessive levels can contribute to oxidative stress, potentially disrupting neuronal integrity and contributing to cognitive decline. Despite growing evidence linking high brain iron with poorer cognitive performance, there are currently no proven methods to reduce brain iron accumulation in aging or to protect cognitive function from iron’s negative effects. Recent studies suggest that nutrition may influence brain iron levels, though the evidence remains limited and mixed. Methods: In this review, we explore recent findings, …

A Mini-Review Of Strategies For Recruiting Older African Americans To Alzheimer's Disease Research., Darlingtina Esiaka, Christina C Yarborough, Bernadette A Fausto, Mark A Gluck

Behavioral Science Faculty Publications

African Americans experience higher incidence and prevalence of Alzheimer's disease (AD). Yet, they continue to be underrepresented in AD research, limiting the ability to generalize findings to the increasingly diverse US population. To reduce AD disparities, targeted efforts are needed to increase the representation of African Americans in AD research. This mini review identified evidence-based strategies that increased research participation among older African Americans. Four recruitment strategies emerged from eight published peer-reviewed studies that directly evaluated the effectiveness of strategies aimed at increasing the number of African American participants in Alzheimer's research. The strategies include community outreach and education, face-to-face …

Extended-Release 7-Day Injectable Buprenorphine For Patients With Minimal To Mild Opioid Withdrawal., Gail D'Onofrio, Andrew A. Herring, Jeanmarie Perrone, Kathryn Hawk, Elizabeth A. Samuels, Ethan Cowan, Erik Anderson, Ryan Mccormack, Kristen Huntley, Patricia Owens, Shara Martel, Mark Schactman, Michelle R. Lofwall, Sharon L. Walsh, James Dziura, David A. Fiellin

Behavioral Science Faculty Publications

IMPORTANCE: Buprenorphine is an effective yet underused treatment for opioid use disorder (OUD).

OBJECTIVE: To evaluate the feasibility (acceptability, tolerability, and safety) of 7-day injectable extended-release buprenorphine in patients with minimal to mild opioid withdrawal.

DESIGN, SETTING, AND PARTICIPANTS: This nonrandomized trial comprising 4 emergency departments in the Northeast, mid-Atlantic, and Pacific geographic areas of the US included adults aged 18 years or older with moderate to severe OUD and Clinical Opiate Withdrawal Scale (COWS) scores less than 8 (minimal to mild), in which scores range from 0 to 7, with higher scores indicating increasing withdrawal. Exclusion criteria included methadone-positive …

Effects Of The Communities That Heal (Cth) Intervention On Perceived Opioid-Related Community Stigma In The Healing Communities Study: Results Of A Multi-Site, Community-Level, Cluster-Randomized Trial, Alissa Davis, Hannah K. Knudsen, Daniel M. Walker, Deborah Chassler, Karsten Lunze, Philip M. Westgate, Emmanuel Oga, Sandra Rodriguez, Sylvia Tan, Janae Holloway, Sharon L. Walsh, Carrie B. Oser, R. Craig Lefebvre, Laura C. Fanucchi, Lashawn Glasgow, Ann Scheck Mcalearney, Hilary L. Surratt, Michael W. Konstan, Terry T-K Huang, Patricia Lebaron, Julie Nakayima, Michael D. Stein, Maria Rudorf, Monica Nouvong, Elizabeth N. Kinnard, Nabila El-Bassel, Jess Tilley, Aaron Macoubray, Caroline Savitzky, Amy Farmer, Donna Beers, Pamela Salsberry, Timothy R. Huerta

Behavioral Science Faculty Publications

BACKGROUND: Community stigma against people with opioid use disorder (OUD) and intervention stigma (e.g., toward naloxone) exacerbate the opioid overdose crisis. We examined the effects of the Communities that HEAL (CTH) intervention on perceived opioid-related community stigma by stakeholders in the HEALing Communities Study (HCS).

METHODS: We collected three surveys from community coalition members in 66 communities across four states participating in HCS. Communities were randomized into Intervention (Wave 1) or Wait-list Control (Wave 2) arms. We conducted multilevel linear mixed models to compare changes in primary outcomes of community stigma toward people treated for OUD, naloxone, and medication for …

Processes For Identifying Caregivers And Screening For Caregiver And Patient Distress In Community Oncology: Results From Wf-1803cd., Chandylen L. Nightingale, Anna C. Snavely, Laurie E. Mclouth, Emily V. Dressler, Erin E. Kent, Christian S. Adonizio, Suzanne C. Danhauer, Rachel Cannady, Judith O. Hopkins, Heather Kehn, Kathryn E. Weaver, Katherine R. Sterba

Behavioral Science Faculty Publications

BACKGROUND: Despite their vital roles, informal caregivers of adult cancer patients are commonly overlooked in cancer care. This study describes processes for identifying cancer caregivers and processes for distress screening and management among caregivers and patients in the understudied community oncology setting.

METHODS: Supportive care leaders from the National Cancer Institute Community Oncology Research Program practices completed online survey questions regarding caregiver identification, caregiver and patient distress screening, and distress management strategies. We described practice group characteristics and prevalence of study outcomes. Multivariable logistic regression explored associations between practice group characteristics and caregiver identification in the electronic health record (EHR). …

Get It In Writing: How To Make Medications For Opioid Use Disorder Available During Incarceration, Margaret J. Mcgladrey, Jordan Kelsch, Michelle R. Lofwall, Laura C. Fanucchi, Sharon L. Walsh, Carrie B. Oser

Center on Drug and Alcohol Research Faculty Publications

In a case example from the Kentucky HEALing Communities Study, extensive resources were deployed to address structural barriers and facilitate the provision of medication for opioid use disorder (OUD) in an urban county jail. However, implementation was unsuccessful, and this case example emphasizes the importance of including evidence-based medication for OUD (MOUD) treatment in the scope of work of jails’ contracted medical providers. The privatization of correctional health care services allows local governments with opioid abatement funds to incorporate requirements into medical provider contracts to screen all people entering jails for OUD and to offer MOUD at intake, throughout incarceration, …

Perceived Versus Actual Hiv Risk Among Prep Indicated Persons With Criminal Legal Involvement, Taylor Krajewski, Katherine H. Lemasters, Carrie B. Oser, Lauren Brinkley-Rubinstein

Behavioral Science Faculty Publications

Individuals involved with community supervision experience multi-level obstacles impacting health outcomes. This is a high-risk period for HIV acquisition due to potential reengagement in unprotected sex and/or unsafe injection drug practices. This study aimed to assess the congruence between actual and perceived HIV risk and the degree to which individual, social, and behavioral factors impact risk perception among individuals on community supervision. While all participants were clinically indicated for PrEP, most participants (81.5%) did not consider themselves at risk for HIV (69.5%) or were not sure of their risk (12.0%). Among those with no or unsure perceived risk, 94% engaged …

Screening Incarcerated Women For Opioid Use Disorder, Michele Staton, Martha Tillson, Mary M. Levi, Matthew Webster, Carrie B. Oser, Carl Leukefeld

Behavioral Science Faculty Publications

The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree …

Trends In Youth Opinions About Police Agencies In The United States, 2017–2021, Delvon T. Mattingly, Nancy L. Fleischer

Behavioral Science Faculty Publications

Introduction: As civil unrest about policing in the United States (US) continue, research on changing opinions about police agencies is needed, especially among younger populations. These opinions may be associated with distress and other health outcomes that come with public health implications.

Methods: We aggregated and used yearly 2017 to 2021 data on 12th-grade youth living in the US from the Monitoring the Future cross-sectional study (n = 7132). We categorized opinions about police agency job per- formance into 1) very poor/poor (hereafter: poor), 2) fair/good/very good, and 3) no opinion. To examine trends in policy agency opinions over time, …

A Social History Of Opioids’ Crimedical Cycle, Jerel M. Ezell, Alex Rains, Babatunde Patrick Ajayi, Kyle Miller, Erin Augustine, Dawn Goddard-Eckrich, Elizabeth N. Kinnard, Michelle R. Lofwall

Behavioral Science Faculty Publications

Historically, public and political discourse around people who nonmedically use opioids has largely been rendered via a deficits-oriented lens, presenting this population as weak, disinterested, and deviant,and thus undesirable and ill-positioned for wellness and communal integration. These narratives, and subsequent policies used to engage people who use opioids, are intermittently formed and disrupted by geopolitical changes, as public and institutional attitudes, often driven by racial and class-related considerations, shift. As part of what we term the crimedical cycle, a population’s behaviors fluctuate between periods of medicalization and criminalization. Strengths-based theory, an offshoot of ‘positive psychology’ that helps contextualize the crimedical …

Extended-Release Injection Vs Sublingual Buprenorphine For Opioid Use Disorder With Fentanyl Use, Edward V. Nunes, Sandra D. Comer, Michelle R. Lofwall, Sharon L. Walsh, Stefan Peterson, Fredrik Tiberg, Peter Hjelmstrom, Natalie R. Budilovsky-Kelley

Behavioral Science Faculty Publications

Importance: Fentanyl has exacerbated the opioid use disorder (OUD) and opioid overdose epidemic. Data on the effectiveness of medications for OUD among patients using fentanyl are limited.

Objective: To assess the effectiveness of sublingual or extended-release injection formulations of buprenorphine for the treatment of OUD among patients with and without fentanyl use.

Design, Setting, and Participants: Post hoc analysis of a 24-week, randomized, double-blind clinical trial conducted at 35 outpatient sites in the US from December 2015 to November 2016 of sublingual buprenorphine-naloxone vs extended-release subcutaneous injection buprenorphine (CAM2038) for patients with OUD subgrouped by presence vs absence of fentanyl …

Repolarizing Tumor-Associated Macrophages In Ovarian Cancer: A Novel Immunotherapeutic Approach, David Schweer

Theses and Dissertations--Clinical and Translational Science

Ovarian cancer, recognized for its high lethality and resistance to conventional immunotherapies, mandates innovative strategies to confront its intricate challenges. The tumor microenvironment (TME), orchestrated by tumor-associated macrophages (TAMs), assumes a pivotal role in disease progression, rendering TAMs an appealing therapeutic target. This study endeavors to explore the prospect of repolarizing TAMs from a protumor M2 phenotype to an antitumor M1 state, employing M1 macrophage-derived vesicles (MEVs) as a groundbreaking immunotherapeutic approach.

The primary objective is to investigate the capacity of M1 MEVs to repolarize M2 macrophages in vitro towards an anti-tumor M1-like phenotype. By inducing human macrophages to adopt …

Receipt Of Follow‑Up Care Plans On Colorectal Cancer Screening Among Breast, Prostate, And Lung Cancer Survivors, Meng-Han Tsai, Malcolm S. Bevel, Sydney E. Andrzejak, Justin X. Moore

Behavioral Science Faculty Publications

Purpose Our study aimed to examine whether receipt of follow-up care plans is associated with greater guideline-concordant CRC screening stratified by breast, prostate, and lung cancer survivors.

Methods We used data from years 2016, 2018, and 2020 of the Behavioral Risk Factor Surveillance System on 3339 eligible treatment-utilizing cancer survivors with complete treatment. We performed descriptive statistics and multivariable logistic regression to examine the mentioned association.

Results We observed that 83.9% of breast and 88.2% of prostate cancer survivors with follow-care plans received CRC screening (p-value < 0.001). The lowest CRC screening use was observed among lung cancer (70.8%). In multivariable analysis, receipt of follow-up care plans was strongly associated with greater odds of receiving CRC screening in breast (OR, 2.67; 95% CI: 1.71–4.16) and prostate (OR, 3.81; 95% CI: 2.30–6.31) cancer survivors. Regardless of provider type, 84 to 88% reduced likelihood of receipt of CRC screening when they received follow-up care plans among lung cancer survivors. Among those without follow-up care plans, breast (OR, 0.29; 95% CI: 0.09–0.92) and lung (OR, 0.05; 95% CI: 0.01–0.25) cancer survivors who received care from general practices were less likely to receive CRC screening compared to those who received care from non-general practices.

Conclusions Receipt of follow-up care plans was associated with greater CRC screening use in …

Establishing The Feasibility Of Crowdsourcing To Study Value-Based Decision-Making In Substance Use Disorders, Thomas Shellenberg

Theses and Dissertations--Psychology

Substance use disorders (SUDs) are characterized by repeated choices to use drugs despite adverse consequences. Value-based decision-making theory posits that choices are guided by predicted values of available options which are updated based on outcomes. Computational modeling of reinforcement learning (RL) during choice tasks has shown promise for uncovering latent mechanisms of decision-making. Recruiting people with SUD is difficult, but crowdsourcing offers an alternative for accelerating data collection. However, the validity of computational modeling using online choice task data has not been well-established. This thesis aimed to use the online crowdsourcing platform Prolific to 1) compare online and in-person choice …

Naltrexone-Bupropion Combinations Do Not Affect Cocaine Self-Administration In Humans, Sean D. Regnier, William W. Stoops, Joshua A. Lile, Joseph L. Alcorn Iii, B. Levi Bolin, Anna R. Reynolds, Lon R. Hays, Abner O. Rayapati, Craig R. Rush

Behavioral Science Faculty Publications

The FDA has not yet approved a pharmacotherapy for cocaine use disorder despite nearly four decades of research. This study determined the initial efficacy, safety, and tolerability of naltrexone-bupropion combinations as a putative pharmacotherapy for cocaine use disorder.

Thirty-one (31) non-treatment seeking participants with cocaine use disorder completed a mixed-design human laboratory study. Participants were randomly assigned to the naltrexone conditions (i.e., 0, 50 mg/ day; between-subject factor) and maintained on escalating doses of bupropion (i.e., 0, 100, 200, 400 mg/day; within-subject factor) for at least four days prior to the conduct of experimental sessions. Cocaine self-administration (IN, 0, 40, …

Cannabinoid Poisoning-Related Emergency Department Visits And Inpatient Hospitalizations In Kentucky, 2017 To 2019, Stevie C. Britch, Sharon L. Walsh, Rachel Vickers-Smith, Shanna Babalonis, Svetla Slavova

Center on Drug and Alcohol Research Faculty Publications

Background and objectives: Cannabis is the most used federally illicit substance. Due to widespread medicinal use and state-level legalization, public perceptions of cannabis have shifted toward the assumption that cannabis is safe. However, cannabinoids can cause adverse medical complications that may lead people to seek treatment. This study characterized cannabinoid poisoning-related medical encounters, poisoning involving cannabinoids and other psychoactive substances, and cannabinoid poisoning-related cardiac complications. Methods: Administrative billing data for emergency department visits and inpatient hospitalizations in acute care facilities with a discharge date from January 1, 2017 to December 31, 2019 were used to characterize cannabinoid poisoning events in …

Developing Ecologically Valid Clinical Tools For Persons With Tbi: Understanding The Role And Impact Of Distractions, Deanna Pinnow

Theses and Dissertations--Rehabilitation Sciences

There is a critical need for the development of ecologically valid clinical tools to assess real-life cognitive functioning in persons impacted by traumatic brain injury (TBI). Chronic cognitive impairments that are exacerbated by distractions are one of the core factors contributing to poor home and community re-integration post injury. Simulation-based digital platforms (i.e., virtual reality, augmented reality, and mixed reality) have become potential solutions for eliciting real-world cognitive performance in clinical settings. Yet, there is a paucity of research investigating the role and impact of distractions on cognition. As a result, there is no clear framework of measuring distractions to …

Cumulative Risk For Children’S Behavior Problems And Child Abuse Potential Among Mothers Receiving Substance Use Treatment: The Unique Role Of Parenting Stress, Stephanie Gusler, Angela Moreland

Psychiatry Faculty Publications

There is a high prevalence of children whose parents suffer with a substance use disorder (SUD), which is associated with negative outcomes for children such as behavior problems and parents’ child abuse potential. To understand negative consequences for children, it is important to consider a cumulative risk model, examining the impact of multiple co-occurring risks, as well as examine unique singular risk factors, such as parenting stress, which may have a direct effect on outcomes as well as mediate an association between cumulative risk and outcomes. Data came from 99 mothers with SUD, engaged in a substance treatment program. Results …

Cannabidiol And Delta-9-Tetrahydrocannabinol Interactions In Male And Female Rats With Persistent Inflammatory Pain, Stevie C. Britch, Rebecca M. Craft

Behavioral Science Faculty Publications

Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), 2 of the primary constituents of cannabis, are used by some individuals to self-treat chronic pain. It is unclear whether the painrelieving effects of CBD alone and in combination with THC are consistent across genders and among types of pain. The present study compared the effects of CBD and THC given alone and in combination in male and female rats with Complete Freund’s adjuvant-induced inflammatory pain. After induction of hindpaw inflammation, vehicle, CBD (0.05−2.5 mg/kg), THC (0.05−2.0 mg/kg), or a CBD: THC combination (3:1, 1:1, or 1:3 dose ratio) was administered i.p. twice daily for …

The Endowment Effect And Temporal Discounting Of Drug And Non-Drug Commodities, Sean D. Regnier, Mark J. Rzeszutek, Justin C. Strickland, Thomas Shellenberg, William W. Stoops

Behavioral Science Faculty Publications

Objectives: Despite a rich history of behavioral economic research on substance use there remains a need for further exploration of behavioral mechanisms that may underlie the etiology or persistence of substance use disorder. The purpose of this study was to measure the association between delay discounting and the endowment effect in people who smoke cigarettes, use cocaine, and controls, using online crowdsourcing. Methods: Participants were categorized to a cocaine group (n = 36), cigarette group (n = 48), or control group (n = 47) based on recent reported drug use. Based on group, participants completed up to three delay discounting …

The Moderating Effect Of Physical Activity On The Relationship Between Bullying And Mental Health Among Sexual And Gender Minority Youth, Sally J. Kirklewski, Ryan J. Watson, Carolyn Lauckner

Behavioral Science Faculty Publications

Background: Sexual and gender minority youth frequently experience bullying, which often contributes to higher depressive symptoms and lower self-esteem. Given that physical activity (PA) can mitigate depressive symptoms and improve self-esteem, we examined the moderating effect of PA on the relationship between bullying and mental health among sexual and gender minority youth.

Methods: Data from the Lesbian, Gay, Bisexual, Transgender, and Queer National Teen Survey (n = 9890) were analyzed. Hierarchical regression analyses examined the influence of history and frequency of being bullied, PA, and the interaction of these variables on depressive symptoms and self-esteem. Simple slopes analyses were used …

Sensory Marketing For Consumer Wellbeing, Josh Lundberg

Theses and Dissertations--Marketing and Supply Chain

Chapter 1. Many consumer decisions – from trying a new brand to trying a new recipe – involve some risk. However, although consumers’ appetite for risk has received over fifty years of investigation, the impact of situational variables (e.g., atmospherics) on consumer decision making involving risk remains relatively unexplored. To address this gap, the current work examines the influence of temperature, a ubiquitous situational influence, on consumers’ inclination toward risk. Across four studies, we find evidence for a positive relationship between temperature and risk taking, using multiple manipulations of temperature and measurements of risk. Evidence suggests that this effect is …

Effects Of Social Isolation And Adolescent Ethanol Exposure On Adult Drinking And Nicotine Co-Use, Jakob Shaykin

Theses and Dissertations--Psychology

Alcohol use often begins in adolescence and can lead to increased susceptibility to AUD in adulthood. Stress in the form of social isolation during adolescence can also prompt substance use disorders later in adulthood. This thesis determined if exposure to ethanol (EtOH) during adolescence and social isolation alters the trajectory of alcohol and nicotine intake during adulthood. In Experiment 1, adolescent male and female Sprague-Dawley rats were administered intermittent injections of EtOH (2g/kg 20% EtOH, IP) or saline (PND 28-41). EtOH consumption was measured in adulthood (PND 49-55) using a 2-bottle choice procedure where one bottle contained a 0.2% saccharin/15% …

Prenatal Ethanol Exposure Impairs Performance On Spatial And Tactile Sequential Discrimination Task In Juvenile Rats, Caleb S. Bailey

Theses and Dissertations--Psychology

Fetal alcohol spectrum disorders (FASDs) are a set of cognitive and behavioral abnormalities that arise in ~5% of children who have been prenatally-exposed to alcohol. Prenatal alcohol exposure (PAE) can cause impairments in learning acquisition, working memory, response inhibition, and attentional-set shifting that result in exaggerated deficits in executive function and impairments in goal-seeking behavior. There are standard procedures used in rodent research to address some components of these deficits, but few procedures are sensitive enough to comprehensively assess such deficits. To address this issue in FASDs research techniques, we developed a procedure that requires prolonged executive function in a …

Adaptation And Study Protocol Of The Evidence-Based Make Better Choices (Mbc2) Multiple Diet And Activity Change Intervention For A Rural Appalachian Population, Nancy E. Schoenberg, Deanna Sherman, Angela Fidler Pfammatter, Michelle K. Roberts, Ming-Yuan Chih, Sarah Cornelia Vos, Bonnie Spring

Behavioral Science Faculty Publications

Background: Rural Appalachian residents experience among the highest prevalence of chronic disease, premature mortality, and decreased life expectancy in the nation. Addressing these growing inequities while avoiding dupli‑ cating existing programming necessitates the development of appropriate adaptations of evidence-based lifestyle interventions. Yet few published articles explicate how to accomplish such contextual and cultural adaptation.

Methods: In this paper, we describe the process of adapting the Make Better Choices 2 (MBC2) mHealth diet and activity randomized trial and the revised protocol for intervention implementation in rural Appalachia. Deploying the NIH’s Cultural Framework on Health and Aaron’s Adaptation framework, the …

Editorial: Individual Differences In Cognition And Affects In The Era Of Pandemic And Machine Learning, Andrea Vranic, Yang Jiang, Xiaopeng Zhao

Behavioral Science Faculty Publications

No abstract provided.