The HEALthy Brain and Child Development Study (HBCD): NIH collaboration to understand the impacts of prenatal and early life experiences on brain development.

The human brain undergoes rapid development during the first years of life. Beginning in utero, a wide array of biological, social, and environmental factors can have lasting impacts on brain structure and function. To understand how prenatal and early life experiences alter neurodevelopmental trajectories and shape health outcomes, several NIH Institutes, Centers, and Offices collaborated to support and launch the HEALthy Brain and Child Development (HBCD) Study.

Intentions to share exome sequencing results with family members: exploring spousal beliefs and attitudes.

Given familial implications of genetic information, it is important to understand intentions to share carrier results with family members. To our knowledge, no studies among individuals undergoing exome sequencing have used dyadic data analysis to examine the effect of spousal perceptions and beliefs. Survey responses from 136 individuals (68 couples) undergoing exome sequencing in a research study were analyzed using dyadic analysis (the actor-partner interdependence model).

Self-affirmation increases defensiveness toward health risk information among those experiencing negative emotions: Results from two national samples.

Objective: Self-affirmation can promote health behavior change and yield long-term improvements in health via its effect on receptiveness to risk information in behavior change interventions. Across 2 studies, we examined whether the emotional state of the person presented with health risk information moderates self-affirmation effectiveness.

Method: Data were collected from 2 U.

Engagement with Genetic Information and Uptake of Genetic Testing: the Role of Trust and Personal Cancer History.

We used national survey data to (1) determine the extent to which individuals trust the sources from which they are most likely to receive information about cancer-related genetic tests (BRCA1/2, Lynch syndrome), (2) examine how level of trust for sources of genetic information might be related to cancer-related genetic testing uptake, and (3) determine whether key factors, such as cancer history and numeracy, moderate the latter association. We used cross-sectional data from the Health Information National Trends Survey. Our study sample included individuals who responded that they had heard or read about genetic tests (n = 1117).

Lay Awareness of the Relationship between Age and Cancer Risk.

Background: Cross-sectional studies suggest many people are unaware that cancer risk increases with age, but this misbelief has rarely been studied prospectively, nor are its moderators known.

Purpose: To assess whether people recognize that cancer risk increases with age and whether beliefs differ according to gender, education, smoking status, and family history of cancer.

Methods: First, items from the cross-sectional Health Information National Trends Survey (n = 2069) were analyzed to examine the association of age and perceived cancer risk.

The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: A meta-analysis.

Objective: Several health behavior theories converge on the hypothesis that attitudes, norms, and self-efficacy are important determinants of intentions and behavior. However, inferences regarding the relation between these cognitions and intention or behavior rest largely on correlational data that preclude causal inferences. To determine whether changing attitudes, norms, or self-efficacy leads to changes in intentions and behavior, investigators need to randomly assign participants to a treatment that significantly increases the respective cognition relative to a control condition, and test for differences in subsequent intentions or behavior.

Advancing Cancer Prevention and Behavior Theory in the Era of Big Data.

The era of "Big Data" presents opportunities to substantively address cancer prevention and control issues by improving health behaviors and refining theoretical models designed to understand and intervene in those behaviors. Yet, the terms "model" and "Big Data" have been used rather loosely, and clarification of these terms is required to advance the science in this area. The objectives of this paper are to discuss conceptual definitions of the terms "model" and "Big Data", as well as examine the promises and challenges of Big Data to advance cancer prevention and control research using behavioral theories.

Health Behavior Change: Moving from Observation to Intervention.

How can progress in research on health behavior change be accelerated? Experimental medicine (EM) offers an approach that can help investigators specify the research questions that need to be addressed and the evidence needed to test those questions. Whereas current research draws predominantly on multiple overlapping theories resting largely on correlational evidence, the EM approach emphasizes experimental tests of targets or mechanisms of change and programmatic research on which targets change health behaviors and which techniques change those targets. There is evidence that engaging particular targets promotes behavior change; however, systematic studies are needed to identify and validate targets and to discover when and how targets are best engaged.

Integrating knowledge across domains to advance the science of health behavior: overcoming challenges and facilitating success.

Health behaviors often co-occur and have common determinants at multiple levels (e.g., individual, relational, environmental).

Attentional effects of self-affirmation in response to graphic antismoking images.

Objective: Self-affirmation has been shown to reduce defensive responding to threatening information. However, little is known about the cognitive and attentional processes underlying these effects. In the current eye-movement study, the authors explored whether self-affirmation affects attention allocation (i.

A Pilot Test of Self-Affirmations to Promote Smoking Cessation in a National Smoking Cessation Text Messaging Program.

Background: Although effective smoking cessation treatments, including mHealth interventions, have been empirically validated and are widely available, smoking relapse is likely. Self-affirmation, a process through which individuals focus on their strengths and behaviors, has been shown to reduce negative effects of self-threats and to promote engagement in healthier behavior.

Objective: To assess the feasibility of incorporating self-affirmations into an existing text messaging-based smoking cessation program (Smokefree TXT) and to determine whether self-affirmation led to greater engagement and higher cessation rates than the standard intervention.

Spontaneous self-affirmation is associated with psychological well-being: Evidence from a US national adult survey sample.

Emerging evidence suggests that individuals spontaneously self-affirm, by reflecting on values and strengths, in response to daily threats. We examined the prevalence and demographic and well-being correlates of spontaneous self-affirmation in the general population. Participants ( n = 3185) completed the cross-sectional, nationally representative 2013 Health Information National Trends Survey (HINTS 4, Cycle 3), and answered questions about spontaneous self-affirmation, demographic factors, well-being, and affect.

Nonverbal and paraverbal behavior in (simulated) medical visits related to genomics and weight: a role for emotion and race.

It is crucial to examine patient reactions to genomics-informed approaches to weight management within a clinical context, and understand the influence of patient characteristics (here, emotion and race). Examining nonverbal reactions offers a window into patients' implicit cognitive, attitudinal and affective processes related to clinical encounters. We simulated a weight management clinical interaction with a virtual reality-based physician, and experimentally manipulated patient emotional state (anger/fear) and whether the physician made genomic or personal behavior attributions for weight.

The role of conviction in personal disease risk perceptions: What can we learn from research on attitude strength?

Perceived risk for disease is included as a predictor of intentions and behavior in many health behavior theories. However, perceived risk is not always a strong predictor of intentions and behaviors. One reason may be suboptimal conceptualization and measurement of risk perceptions; in particular, research may not capture the conviction and certainty with which a risk perception is held.

The Tripartite Model of Risk Perception (TRIRISK): Distinguishing Deliberative, Affective, and Experiential Components of Perceived Risk.

Background: Although risk perception is a key predictor in health behavior theories, current conceptions of risk comprise only one (deliberative) or two (deliberative vs. affective/experiential) dimensions.

Purpose: This research tested a tripartite model that distinguishes among deliberative, affective, and experiential components of risk perception.

Dispositional optimism and therapeutic expectations in early-phase oncology trials.

Background: Prior research has identified unrealistic optimism as a bias that might impair informed consent among patient-subjects in early-phase oncology trials. However, optimism is not a unitary construct; it also can be defined as a general disposition, or what is called dispositional optimism. The authors assessed whether dispositional optimism would be related to high expectations for personal therapeutic benefit reported by patient-subjects in these trials but not to the therapeutic misconception.

Genomic Information may Inhibit Weight-Related Behavior Change Inclinations Among Individuals in a Fear State.

Background: As evidence mounts regarding associations between genetics and body weight, it is essential to understand how to communicate this information, and factors like emotion that could moderate the effectiveness of messages.

Purpose: We assessed influences of emotion on reactions to weight-related genomic information in a virtual clinical setting.

Methods: An online representative US sample of overweight women was randomized to receive an emotion induction (anger, fear, or neutral) paired with information about genomic or behavioral influences on weight in an interaction with a virtual doctor.

Patient's lung cancer diagnosis as a cue for relatives' smoking cessation: evaluating the constructs of the teachable moment.

Background: To understand whether patient-reported experiences with lung cancer may create teachable moments (TM) for their relatives as evidenced by shifts in their risk perceptions, affective response, and self-image and in turn, motivation to quit smoking.

Methods: Patients at a comprehensive cancer center (n = 152) completed a survey within 6 months of lung cancer diagnosis to assess their cancer-related symptoms and openness and enumerated relatives who were smokers. Relative smokers (n = 218) then completed a survey assessing their risk perceptions, affective response, and self-image as a smoker related to the patient's diagnosis (TM mechanisms), and their motivation to quit smoking.

Optimism and Spontaneous Self-affirmation are Associated with Lower Likelihood of Cognitive Impairment and Greater Positive Affect among Cancer Survivors.

Background: Optimism and self-affirmation promote adaptive coping, goal achievement, and better health.

Purpose: The aim of this study is to examine the associations of optimism and spontaneous self-affirmation (SSA) with physical, mental, and cognitive health and information seeking among cancer survivors.

Methods: Cancer survivors (n = 326) completed the Health Information National Trends Survey 2013, a national survey of US adults.

Effects of perceived weight discrimination on willingness to adopt unhealthy behaviours: influence of genomic information.

Objective: Weight-based discrimination negatively influences health, potentially via increased willingness to engage in unhealthful behaviours. This study examines whether the provision of genomic obesity information in a clinical context can lead to less willingness to engage in unhealthy eating and alcohol consumption through a mediated process including reduced perceptions of blame and discrimination.

Design: A total of 201 overweight or obese women aged 20-50 interacted with a virtual physician in a simulated clinical primary care environment, which included physician-delivered information that emphasised either genomic or behavioural underpinnings of weight and weight loss.

Associations of spontaneous self-affirmation with health care experiences and health information seeking in a national survey of US adults.

Objective: Self-affirming--such as by reflecting on one's strengths and values--reduces defensiveness to threatening information, reduces negative effects of stereotype threat and promotes prosociality. These outcomes may promote physical health, highlighting a need to examine the role of self-affirmation in medical and health contexts.

Design: Data were collected as part of the nationally representative, cross-sectional, 2013 Health Information National Trends Survey.

Risk perceptions and health behavior.

Risk perceptions - or an individual's perceived susceptibility to a threat - are a key component of many health behavior change theories. Risk perceptions are often targeted in health behavior change interventions, and recent meta-analytic evidence suggests that interventions that successfully engage and change risk perceptions produce subsequent increases in health behaviors. Here, we review recent literature on risk perceptions and health behavior, including research on the formation of risk perceptions, types of risk perceptions (including deliberative, affective, and experiential), accuracy of risk perceptions, and associations and interactions among types of risk perceptions.

Smoke-free air laws and quit attempts: Evidence for a moderating role of spontaneous self-affirmation.

Background: In addition to their primary goal of protecting nonsmokers from secondhand smoke, smoke-free air laws may also encourage intentions to quit smoking, quit attempts, and cessation among smokers. However, laws may not encourage quitting if smokers feel threatened by them and react defensively.

Objective: This study examined whether spontaneous self-affirmation - the extent to which people think about their values or strengths when they feel threatened - may reduce smokers' reactance to smoke-free laws, enhancing the ability of the laws to encourage quitting.

Characterizing Participants in the ClinSeq Genome Sequencing Cohort as Early Adopters of a New Health Technology.

Genome sequencing is a novel clinical tool that has the potential to identify genetic origins of disease. However, the complexities of this new technology are significant and little is known about its integration into clinical care, and its potential adoption by patients. Expectations of its promise for personalized medicine are high and it is important to properly match expectations to the realities of the test.