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Background: Women with a low socioeconomic status often have a vulnerable health status due to an accumulation of health-deteriorating factors such as poor lifestyle behaviors, including inadequate nutrition, mental stressors, and impaired health literacy and agency, which puts them at an unnecessary high risk of adverse pregnancy outcomes. Adequately preparing for pregnancy through preconception care (PCC) uptake and lifestyle improvement can improve these outcomes. We hypothesize that nudging is a successful way of encouraging engagement in PCC. A nudge is a behavioral intervention that changes choice behavior through influencing incentives. The mobile health (mHealth) app-based loyalty program Pregnant Faster aims to reward women in an ethically justified way and nudges to engage in pregnancy preparation by visiting a PCC consultation., Objective: Here, we first describe the process of the cocreation of the mHealth app Pregnant Faster that aims to increase engagement in pregnancy preparation by women with a vulnerable health status. Second, we describe the cohort study design to assess the feasibility of Pregnant Faster., Methods: The content of the app is based on the eHealth lifestyle coaching program Smarter Pregnancy, which has proven to be effective in ameliorating preconceptional lifestyle behaviors (folic acid, vegetables, fruits, smoking, and alcohol) and an interview study pertaining to the preferences of the target group with regard to an mHealth app stimulating PCC uptake. For moral guidance on the design, an ethical framework was developed based on the bioethical principles of Beauchamp and Childress. The app was further developed through iterative cocreation with the target group and health care providers. For 4 weeks, participants will engage with Pregnant Faster, during which opportunities will arise to earn coins such as reading informative blogs and registering for a PCC consultation. Coins can be spent on small fun rewards, such as folic acid, fruits, and mascara. Pregnant Faster's feasibility will be tested in a study including 40 women aged 18 to 45 years, who are preconceptional or <8 weeks pregnant, with a low educational level, and living in a deprived neighborhood. The latter 2 factors will serve as a proxy of a low socioeconomic status. Recruitment will take place through flyers, social media, and health care practices. After finalization, participants will evaluate the app through the "mHealth App Usability Questionnaire" and additional interviews or questionnaires., Results: Results are expected to be published by December 2023., Conclusions: Pregnant Faster has been designed through iterative cocreation with the target group and health care professionals. With the designed study, we will test Pregnant Faster's feasibility. If overall user satisfaction and PCC uptake is achieved, the app will be further developed and the cohort will be continued with an additional 400 inclusions to establish effectiveness., International Registered Report Identifier (irrid): DERR1-10.2196/45293., (©Sharissa M Smith, Babette Bais, Hafez Ismaili M'hamdi, Maartje H N Schermer, Regine P M Steegers-Theunissen. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 09.08.2023.)

Introduction Qi-gong, a mind–body practice combining meditation, physical movement and controlled breathing, is reported to improve psychological well-being and physical function in older adults. However, the effects of Qi-gong on hypothalamic–pituitary–adrenal (HPA) axis activity and reactivity to stress in older people are elusive. An uncontrolled, before-and-after study in a group of healthy older adults was conducted to investigate the possible benefits of 12-week Qi-gong training on self-rated distress symptoms and cortisol secretion under basal and stimulated conditions. Methods Before (T0) and after (Tf) Qi-gong training, participants ( n = 28), men and women, mean age 65 years;(smokers, obese subjects, persons with chronic diseases and oral pathologies, and subjects reporting major stressful events in their recent past were excluded) answered the PSS-10 questionnaire. Salivary samples were collected for cortisol detection at various times of the day during a challenging mental task. Results Qi-gong training reduced basal cortisol output across the day, notably in the morning. In subjects who responded to the stressor at T0 ( n = 16, baseline-to-peak increment >1.5 nmol/l), cortisol response to cognitive challenge was markedly blunted after training, accompanied by a decreasing trend of PSS-10 score. Conclusion Qi-gong practice in elderly people appears to improve control on HPA axis activity, reducing daytime cortisol levels and attenuating cortisol responses to mental stress. Ameliorating the profile of basal and stimulated HPA activity, may reflect better adaptation to stress, and may favor successful aging and positive health outcomes. Present findings encourage the implementation of programs aimed at further disseminating Qi-gong practice among the older population. [ABSTRACT FROM AUTHOR]

Abstract: Objective: In the following study we tested the stress response dampening (SRD) model which postulates that stress responses are more likely to be attenuated by alcohol in individuals at risk for alcohol dependence than in persons without that risk. In a laboratory experiment we examined a) if SRD effects exist for both sons and healthy daughters of alcohol dependent fathers, and b) if SRD effects exist for siblings of alcohol dependent males. Methods: We recruited 104 subjects at risk and 51 matched control subjects. In a laboratory experiment, study subjects received alcohol in one of two laboratory sessions and a stress paradigm served to elicit heart rate stress responses. Results: Heart rate stress responses were attenuated by alcohol in female family history positive (FHP) and female family history negative (FHN) subjects, however not in males. A multiple regression analysis revealed “Heart Rate Stress Response in the Non-Alcohol Condition” and “Blood Alcohol Level” as significant predictors of SRD. Conclusions: According to our findings, females carry a distinct risk for developing alcohol dependence, regardless of their family history and regardless of their degree of familial relationship. This is an important issue for devising models concerning the development and maintenance of alcohol dependence in females. The study extends the current research literature, which mainly focuses on male subjects at risk, by including female subjects at risk, as well as siblings at risk of both genders. [Copyright &y& Elsevier]