• From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases.

    Objective: Given the critical role of behavior in preventing and treating chronic diseases, it is important to accelerate the development of behavioral treatments that can improve chronic disease prevention and outcomes. Findings from basic behavioral and social sciences research hold great promise for addressing behaviorally based clinical health problems, yet there is currently no established pathway for translating fundamental behavioral science discoveries into health-related treatments ready for Phase III efficacy testing. This article provides a systematic framework for developing behavioral treatments for preventing and treating chronic diseases. Method: The Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral treatment development features a flexible and progressive process, prespecified clinically significant milestones for forward movement, and return to earlier stages for refinement and optimization. Results: This article presents the background and rationale for the ORBIT model, a summary of key questions for each phase, a selection of study designs and methodologies well-suited to answering these questions, and prespecified milestones for forward or backward movement across phases. Conclusions: The ORBIT model provides a progressive, clinically relevant approach to increasing the number of evidence-based behavioral treatments available to prevent and treat chronic diseases. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
  • Insomnia and self-reported infections in cancer patients: An 18-month longitudinal study.

    Objective: This study, conducted in cancer patients, aimed to evaluate longitudinally whether the presence of insomnia is associated with the occurrence of self-reported infections. Method: Patients scheduled to receive a curative surgery for a first diagnosis of nonmetastatic cancer were solicited on the day of their preoperative visit. In total, 962 cancer patients completed the Insomnia Interview Schedule and a clinical interview to assess infectious symptoms at 6 time points: at the perioperative phase (baseline), as well as 2, 6, 10, 14, and 18 months later. At each assessment, patients were categorized into the following 3 groups: insomnia syndrome (SYN), insomnia symptoms (SX), and good sleepers (GS). Results: The analyses revealed that SYN patients at 1 time point were at a significantly higher risk of reporting at least 1 infectious episode at the subsequent assessment (OR = 1.31, p = .04), whereas SX patients were at a marginally significant higher risk of reporting such episodes (OR = 1.19, p = .08), as compared with GS. Conclusions: Although these results need replication and the causality needs to be established, they suggest that insomnia may potentiate the risk of experiencing infections during the cancer care trajectory. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
  • Smoker identity and its potential role in young adults’ smoking behavior: A meta-ethnography.

    Objective: Identity is an important influence on behavior. To identify potential targets for smoking cessation interventions in young adults, we synthesized findings from qualitative studies on smoker identity and potential influences on smoking and smoking cessation. Methods: A systematic search of 4 electronic databases up to September 19, 2013, was conducted to identify qualitative studies on smoker identity in smokers and ex-smokers aged 16–34. Key concepts were extracted from individual studies and synthesized into higher-order interpretations by following the principles of meta-ethnography. Results: Seventeen relevant papers were identified. At the highest level of interpretation, we identified 4 types of findings: (a) contributory factors to identity, (b) identity in relation to smoking, (c) contextual and temporal patterning, and (d) behavior in relation to smoking. Contributory factors included the desire to establish aspirational individual and social identities, enact a smoker identity appropriate to the momentary social context, and alter personal nonsmoking rules when consuming alcohol. Smoker identity was multifaceted and incorporated individuals’ defensive rationalizations, and both positive and negative feelings attached to it. Smoker identities took time to develop, were subject to change, and were context dependent. Identity was found to play a role in quit attempts. Conclusions: Qualitative research into the identity of young adult smokers has established it as a multifaceted phenomenon serving important functions but also involving conflict and defensive rationalizations. It develops over time and contextual factors influence its expression. The nature of a smoker’s identity can play an important role in smoking cessation. (PsycINFO Database Record (c) 2015 APA, all rights reserved)