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This study investigates cross-sectional and longitudinal associations between the diversity of leisure-time sport activities and the frequencies of low back pain (LBP) and neck-shoulder region pain (NSP) in twins, including a cross-sectional within-pair design to adjust for potential familial confounding. Finnish twins born in 1975–79 (FinnTwin16 study) reported participation in leisure-time sport activities at the mean ages of 17 (1992–96) (n = 5096, 54% females) and 34 years (2010−12) (n = 3731, 57% females). Diversity assessed as the number of sport activities was categorized as 1, 2, 3, 4, and ≥ 5, excluding inactive individuals. The frequencies of LBP (n = 3201) and NSP (n = 3207), reported at age 34, were categorized as never/seldom, monthly, or weekly pain. Cross-sectional and longitudinal individual-based associations between the number of sport activities and the frequency of LBP and NSP were investigated with multinomial logistic regression analyses, adjusting for multiple confounders. Cross-sectionally, participation in ≥5 sport activities, compared to 1 sport, was associated with significantly less weekly LBP (OR = 0.63, 95%CI = 0.43–0.90), but not with NSP. Longitudinally, participation in several sport activities in adolescence had no significant association with LBP or NSP in adulthood. Cross-sectional within-pair analyses were conducted among twin pairs discordant for LBP (n = 507) and NSP (n = 579). The associations between monozygotic and dizygotic twin pairs were similar in LBP-discordant pairs but differed within NSP-discordant pairs. Participation in ≥5 sport activities in adulthood may be associated with less weekly LBP, but not with monthly LBP or the frequency of NSP. However, within-pair analyses for NSP suggest confounding due to shared familial factors.

Highlights • Home isolation impacts the dynamics of infection spread via close contacts. • For multiple infections, the dynamic behaviour is interdependent. • The interdependence depends on the epidemiological parameters and symptom severity. • The effect on peak time and final size can be both positive and negative., Behavioral epidemiology, the field aiming to determine the impact of individual behavior on the spread of an epidemic, has gained increased recognition during the last few decades. Behavioral changes due to the development of symptoms have been studied in mono-infections. However, in reality, multiple infections are circulating within the same time period and behavioral changes resulting from contraction of one of the diseases affect the dynamics of the other. The present study aims at assessing the effect of home isolation on the joint dynamics of two infectious diseases, including co-infection, assuming that the two diseases do not confer cross-immunity. We use an age- and time- structured co-infection model based on partial differential equations. Social contact matrices, describing different mixing patterns of symptomatic and asymptomatic individuals are incorporated into the calculation of the age- and time-specific marginal forces of infection. Two scenarios are simulated, assuming that one of the diseases has more severe symptoms than the other. In the first scenario, people stay only at home when having symptoms of the most severe disease. In the second scenario, twice as many people stay at home when having symptoms of the most severe disease than when having symptoms of the other disease. The results show that the impact of home isolation on the joint dynamics of two infectious diseases depends on the epidemiological parameters and properties of the diseases (e.g., basic reproduction number, symptom severity). In case both diseases have a low to moderate basic reproduction number, and there is no home isolation for the less severe disease, the final size of the less severe disease increases with the proportion of symptomatic cases of the most severe disease staying at home, after an initial decrease. This counterintuitive result could be explained by a shift in the peak time of infection of the disease with the most severe symptoms, resulting in a smaller number of people with less contacts at the peak time of the other infection. When twice as many people stay at home when having symptoms of the most severe disease than when having symptoms of the other disease, increasing the proportion staying at home always reduces the final size of both diseases, and the number of co-infections. In conclusion, when providing advise if people should stay at home in the context of two or more co-circulating diseases, one has to take into account epidemiological parameters and symptom severity.

This study investigates cross-sectional and longitudinal associations between the diversity of leisure-time sport activities and the frequencies of low back pain (LBP) and neck-shoulder region pain (NSP) in twins, including a cross-sectional within-pair design to adjust for potential familial confounding. Finnish twins born in 1975–79 (FinnTwin16 study) reported participation in leisure-time sport activities at the mean ages of 17 (1992–96) (n = 5096, 54% females) and 34 years (2010−12) (n = 3731, 57% females). Diversity assessed as the number of sport activities was categorized as 1, 2, 3, 4, and ≥ 5, excluding inactive individuals. The frequencies of LBP (n = 3201) and NSP (n = 3207), reported at age 34, were categorized as never/seldom, monthly, or weekly pain. Cross-sectional and longitudinal individual-based associations between the number of sport activities and the frequency of LBP and NSP were investigated with multinomial logistic regression analyses, adjusting for multiple confounders. Cross-sectionally, participation in ≥5 sport activities, compared to 1 sport, was associated with significantly less weekly LBP (OR = 0.63, 95%CI = 0.43–0.90), but not with NSP. Longitudinally, participation in several sport activities in adolescence had no significant association with LBP or NSP in adulthood. Cross-sectional within-pair analyses were conducted among twin pairs discordant for LBP (n = 507) and NSP (n = 579). The associations between monozygotic and dizygotic twin pairs were similar in LBP-discordant pairs but differed within NSP-discordant pairs. Participation in ≥5 sport activities in adulthood may be associated with less weekly LBP, but not with monthly LBP or the frequency of NSP. However, within-pair analyses for NSP suggest confounding due to shared familial factors., Highlights • Participation in more sport activities is associated with less low back pain (LBP). • More sport activities is not associated with neck-shoulder pain (NSP). • Shared familial factors may confound the association between sport activities and NSP. • Number of sport activities in adolescence did not predict LBP or NSP in adulthood.

Backgrounds: Using the self-reported questionnaire to assess the levels of physical activity (PA) and sedentary behavior (SB) has been a widely recognized method in public health and epidemiology research fields. The selected items of the Health Behavior in School-aged (HBSC) Survey Questionnaire have been used globally for measurements and assessments in PA and SB of children and adolescents. However, there are no comprehensive and critical reviews to assess the quality of studies on reliability and validity of selected items for PA and SB measurement and assessment derived from the HBSC. Thus, this review aimed to critically assess the quality of those studies and summary evidence for future recommendations., Methods: A systematic review protocol was used to search potentially eligible studies on assessing reliability and validity of PA and SB measures of the HBSC questionnaire. electronically academic databases were used. The information on the reliability and validity of the PA and SB measures were extracted and evaluated with well-recognized criteria or assessment tools., Results: After a literature search, six studies were included in this review. The reliability of PA measures of the HBSC questionnaire showed a moderate agreement while the reliability of SB measures showed a great variation across the different items in the different subgroups. The validity of the PA measures had acceptable performance, whereas no studies assess the validity of the SB measures. The included studies all had quality weaknesses on reliability or validity analysis., Conclusions: The PA and SB measures of the HBSC questionnaires were reliable in assessing PA and SB among adolescents. However, a little evidence showed that PA measures are partially valid in assessing PA, but no evidence confirmed the validity of SB measures. The included studies all had methodological weaknesses in examining the reliability and validity of the PA and SB measures, which should be addressed in the future. Further studies are encouraged to use a more standardized study design to examine the reliability and validity of the PA and SB measures in more young populations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Su, Zhang, Chen, Hong and Wang.)

The study aimed to describe the prevalence of meeting moderate-to-vigorous-intensity physical activity (MVPA), muscle-strengthening (MS) activities, and television (TV) viewing guidelines, and their association with sociodemographic factors. Data from older adults aged 65 or above were sampled by age and sex to the population aged 65+ years for each area in Taiwan and collected through telephone interviews. The prevalence of meeting MVPA and MS activities, MVPA and MS activities guidelines, and excessive TV viewing were calculated. We also investigated their associations with sociodemographic variables using logistic regression analyses. A total of 1068 older adults (response rate: 32.5%) participated in the present study. 79.4% met the MVPA guidelines (150 min weekly), 25.3% met the MS guidelines (twice a week), 22.4% met both MVPA and MS guidelines, and 53.1% engaged in excessive TV viewing (more than or equal to two hours per day). Overall, in old age, low educational level was associated with lower odds of meeting MVPA and MS activities, and both the MVPA and MS activity guidelines, while living alone and having no full-time job had higher odds of excessive TV viewing. A large number of older adults do not meet the MS recommendations, but are engaged in excessive TV viewing. Our findings may be important for public health interventions to promote MS and avoid excessive TV viewing, especially for at-risk subgroups.

n this work, we propose a new basic mathematical model for Behavioral Epidemiology. It is based in a SIRS epidemiological model and in the Replicator Equations. We use numerical simulations to explore some distinguished characteristics of the model.

The use of insecticide-treated nets (ITNs) is known to be one of the best preventive mechanisms for mosquito-borne human diseases by avoiding infective mosquito bites. However, the effective use of them is affected by human behaviour which is further fueled by the persuasive power of those who object their use. Taking this in to account, we propose a mathematical model for mosquito-borne diseases transmission that considers the effect of information dependent human behaviour in the use of ITNs. The model is mathematically analyzed to determine the basic reproduction number, and to study equilibria and their stability. Moreover, optimal control theory is applied to the model and optimal strategy for implementing health-promotion campaigns is derived. Numerical simulations to the optimal control problem show that as the power of persuasion of the anti-ITNs use group becomes larger than those of the pro-ITNs use group in the population, the burden of the disease becomes more challenging and its control becomes more costly.

In this paper, we consider a SEIR epidemiological model with information--related changes in contact patterns. One of the main features of the model is that it includes an information variable, a negative feedback on the behavior of susceptible subjects, and a function that describes the role played by the infectious size in the information dynamics. Here we focus in the case of delayed information. By using suitable assumptions, we analyze the global stability of the endemic equilibrium point and disease--free equilibrium point. Our approach is applicable to global stability of the endemic equilibrium of the previously defined SIR and SIS models with feedback on behavior of susceptible subjects.

The spread of infectious diseases can be impacted by human behavior, and behavioral decisions often depend implicitly on a planning horizon—the time in the future over which options are weighed. We investigate the effects of planning horizons on epidemic dynamics. We developed an epidemiological agent-based model (along with an ODE analog) to explore the decision-making of self-interested individuals on adopting prophylactic behavior. The decision-making process incorporates prophylaxis efficacy and disease prevalence with the individuals’ payoffs and planning horizon. Our results show that for short and long planning horizons individuals do not consider engaging in prophylactic behavior. In contrast, individuals adopt prophylactic behavior when considering intermediate planning horizons. Such adoption, however, is not always monotonically associated with the prevalence of the disease, depending on the perceived protection efficacy and the disease parameters. Adoption of prophylactic behavior reduces the epidemic peak size while prolonging the epidemic and potentially generates secondary waves of infection. These effects can be made stronger by increasing the behavioral decision frequency or distorting an individual’s perceived risk of infection.

Background: Characterizing HIV infection and associated risk behaviors within military populations is critical for understanding the epidemic and informing prevention activities. However, the prevalence of HIV and related risk behaviors is often unknown. Further, militaries may not have the systems in place or the staff expertise to conduct HIV surveillance and risk behavior studies. Methods: The Department of Defense HIV/AIDS Prevention Program (DHAPP), funded by the President’s Emergency Plan for AIDS Relief and the US Department of Defense, provides technical assistance, management and administrative support for HIV/AIDS prevention, care and treatment for approximately 65 partner militaries. Collaborating with partner militaries in conducting Seroprevalence and Behavioral Epidemiology Risk Surveys (SABERS) and using the data to monitor the epidemic and inform activities is a key component of DHAPP. Conclusion: This paper describes the methodology used to plan, adapt, implement and report SABERS studies.

The study aimed to describe the prevalence of meeting moderate-to-vigorous-intensity physical activity (MVPA), muscle-strengthening (MS) activities, and television (TV) viewing guidelines, and their association with sociodemographic factors. Data from older adults aged 65 or above were sampled by age and sex to the population aged 65+ years for each area in Taiwan and collected through telephone interviews. The prevalence of meeting MVPA and MS activities, MVPA and MS activities guidelines, and excessive TV viewing were calculated. We also investigated their associations with sociodemographic variables using logistic regression analyses. A total of 1068 older adults (response rate: 32.5%) participated in the present study. 79.4% met the MVPA guidelines (150 min weekly), 25.3% met the MS guidelines (twice a week), 22.4% met both MVPA and MS guidelines, and 53.1% engaged in excessive TV viewing (more than or equal to two hours per day). Overall, in old age, low educational level was associated with lower odds of meeting MVPA and MS activities, and both the MVPA and MS activity guidelines; while living alone and having no full-time job had higher odds of excessive TV viewing. A large number of older adults do not meet the MS recommendations, but are engaged in excessive TV viewing. Our findings may be important for public health interventions to promote MS and avoid excessive TV viewing, especially for at-risk subgroups.

261 ISSN 1758-1907 10.2217/DMT.12.36 © 2012 Future Medicine Ltd Diabetes Manage. (2012) 2(4), 261–263 The importance of physical activity as a powerful therapeutic agent in the treatment and prevention of Type 2 diabetes has been recognized for many years. However, once-accepted dogmas around the definition and utility of physical activity have been challenged in recent years by the emergence of a new separate paradigm: sedentary behavior. This may appear to be just the simple inverse of physical activity but this is not the case. Sedentary behavior refers to “any waking behavior characterized by an energy expenditure ≤1.5 METs while in a sitting or reclining posture” [1]. Typical examples include TV viewing, computer use, sitting in meetings and car travel. Conversely, any standing behavior can be thought of as nonsedentary. Thus it is possible to meet the national recommended levels of physical activity (30 min per day for adults), and therefore be classified as ‘active’, whilst at the same time indulging in high levels of sedentary behavior – the two behaviors may coexist; indeed it is thought that where these behaviors do coexist, being physically active may not fully ameliorate the deleterious impact of high levels of sedentary behavior. The behavioral epidemiology framework, proposed by Sallis and Owen, specifies that in the early stages of researching a new topic, such as sedentary behavior, we need to establish that we can measure the behavior of interest and the behavior leads to meaningful health outcomes [2]. Once these have been at least partially satisfied, we need to identify the correlates of sedentary behavior and test how to reduce sedentary behavior through interventions. In this editorial, we will highlight the links between sedentary behavior and poor health and comment on current evidence concerning interventions to change sedentary behavior.

The aim of this Grand Rounds column is to present a “real life” clinical case and invite selected authors and noted clinicians to make comment and provide insights into how they would conceptualize and treat the presented case. In this column I've asked for commentary from Dr. Thorana Nelson, Director of the Marriage and Family Therapy Program at Utah State University, Dr. Garrett McAuliffe, Graduate Program Director of Counseling at Old Dominion University, and Dr. Cindy Corey, Project Coordinator and Clinical Director at the Center for Behavioral Epidemiology and Community Health, San Diego State University.

Background and objectives Differences in sociodemographic attributes and healthcare access may explain differences in regional sexually transmitted disease rates but don't fully explain why syphilis persists disproportionately in certain populations. Goal of this study To understand the behavioral epidemiology of syphilis, we conducted a social network analysis of persons with syphilis and their contacts and developed and applied a definition of core transmitters. Study design We interviewed 10 index persons with primary or secondary untreated syphilis and 80 of their named sexual and social contacts. Results Fourteen (16%) of 90 interviewed persons met the definition of core transmitters, 9 of whom had past or current syphilis. The other interviewed persons had only moderately risky behaviors. Seventy-eight (42%) of the network sexual contacts were connected directly or indirectly to a core transmitter. Conclusion This analysis suggests that syphilis transmission is maintained by a community with a small percentage of high-risk persons centrally placed amidst a larger group with moderately risky behavior.

The focus of the growing discipline of behavioral epidemiology (BE) of infectious diseases is on individual behavior as a key determinant of infection trajectories. This overview departs from the central, but static, role of human behavior in traditional mathematical models of infection to motivate the importance of including behavior into epidemiological models. Our aim is threefold. First, we attempt to motivate the historical and cultural background underpinning the BE revolution, focusing on the issue of rational opposition to vaccines as a natural endpoint of the changed relation between man and disease in modern industrialized countries. Second, we review those contributions, from both mathematical epidemiology and economics, that forerun the current “epidemic” of studies on BE. Last, we offer a more detailed overview of the current epidemic phase of BE studies and, still motivated by the issue of immunization choices, introduce some baseline ideas and models.

Three behavioral-epidemic models (i.e. epidemic systems including feedbacks that the information about an infectious disease has on its spreading) are introduced. Two relevant feedbacks are explicitly considered: the pseudo-rational exemption to vaccination and the information--related changes in contact patterns by healthy subjects. The global stability analysis of the endemic states is performed by means of the geometric approach to stability, with particular focus on a model of vaccination of adult susceptible subjects. Biological implications of the results are discussed.

Physical activity is a key behavior in modern public health and is a topic of great concern to governments and health agencies. Psychologists can contribute to a better understanding of physical activity behavior by studying and explaining factors associated with participation in physical activity and interventions to change such behaviors. This chapter outlines the evidence on correlates for physical activity across the age span, what mediators might be important for behavior change, and what current evidence on interventions is available to guide thinking on behavior change.

The idea behind adaptive behavioral epidemiology is that groups and individuals respond to the knowledge of a disease threat by changing their habits to avoid interactions with those who are contagious. Network-based models take this adaptive behavior into account by allowing the network to "rewire" its connections.

One of the key analytic problems in behavioral epidemiology research is related to determining most important factors among those that influence the behavior of interest. The present paper offers a brief review of the method designed to estimate relative importance of predictor variables described by J. W. Johnson. Examples are discussed that illustrate the use of relative importance analysis to examine and compare impacts of determinants of sexual risk behavior.

Purpose: Gathering contextual information (i.e., location and purpose) about active and sedentary behaviors is an advantage of self-report tools such as previous day recalls (PDR). However, the validity of PDR’s for measuring context has not been empirically tested. The purpose of this paper was to compare PDR estimates of location and purpose to direct observation (DO). Methods: Fifteen adult (18–75 y) and 15 adolescent (12–17 y) participants were directly observed during at least one segment of the day (i.e., morning, afternoon or evening). Participants completed their normal daily routine while trained observers recorded the location (i.e., home, community, work/school), purpose (e.g., leisure, transportation) and whether the behavior was sedentary or active. The day following the observation, participants completed an unannounced PDR. Estimates of time in each context were compared between PDR and DO. Intra-class correlations (ICC), percent agreement and Kappa statistics were calculated. Results: For adults, percent agreement was 85% or greater for each location and ICC values ranged from 0.71 to 0.96. The PDR-reported purpose of adults’ behaviors were highly correlated with DO for household activities and work (ICCs of 0.84 and 0.88, respectively). Transportation was not significantly correlated with DO (ICC = �0.08). For adolescents, reported classification of activity location was 80.8% or greater. The ICCs for purpose of adolescents’ behaviors ranged from 0.46 to 0.78. Participants were most accurate in classifying the location and purpose of the behaviors in which they spent the most time. Conclusions: This study suggests that adults and adolescents can accurately report where and why they spend time in behaviors using a PDR. This information on behavioral context is essential for translating the evidence for specific behavior-disease associations to health interventions and public policy.

Hypertension is a major cause of stroke in the African-American community, and lack of control of hypertension appears to be common. Improving compliance to antihypertensive therapy in African-American stroke patients could have a significant impact on recurrent stroke rates. Little is known about factors affecting compliance in this community and which interventions would be effective in improving compliance. Health behavior models which assess the patient’s perception of stroke and hypertension, barriers to the desired behavior, perception of ability to perform the behavior, perception of others’ acceptance of the behavior and the patient’s behavioral stage could be used to tailor interventions to improve compliance. A plan to improve compliance should take into account the target population’s baseline rates of compliance, perception of need for intervention and risk factors for noncompliance.

The primary objective of this chapter is to suggest ideas that may be helpful for integrating the literatures of behavioral and psychosocial epidemiology, in the broader context of the study of health-related behaviors in older adulthood. The chapter is organized into four sections. The first section discusses the importance of understanding the health-related behaviors of older persons. The section reviews studies from the domain of behavioral epidemiology, which link lifestyle habits with the outcomes of mortality and morbidity. The topic of patterns among, and correlates of, health behaviors is also discussed.

This article describes the use of social area analytic techniques in the study of the looting which occurred during the Con Edison power failure of July 13 and 14, 1977. Detailed procedures are outlined of the systematic collection and analysis of data which were developed from available data. Analyses contrasting competing explanatory theoretical models for blackout looting are presented. The central dependent variable is ratio of looted to retail stores. Both the numerator and denominator are aggregated to the census tract level.

The research and clinical enterprise of behavior therapy has prospered, having become the mainstream of psychotherapy research and a central aspect of clinical practice. The percentage of controlled clinical studies published in Behavior Therapy has steadily increased over the years, and studies now have a longer duration of follow-up. Despite this progress, a theme of discontent has been sounded in the literature. One source of discontent has been sown by the claim that all therapies are equal. Such a claim leads to a theoretical and therapeutic deadend. Rather, it is necessary to identify the active ingredients of all therapies that have been demonstrated to work in particular conditions. Amongst the challenges and opportunities facing behavior therapy in the near term, are the facilitation of behavior change in the real world, a vigorous exploitation of the interaction between behavioral and pharmacologic therapies, and the development of a behavioral epidemiology focusing upon understanding the etiology of the conditions that we treat.

Behavioral toxicology treats the whole organism as an assay system. Certain features of such an approach are exceedingly resistant to simplification, and it is doubtful that we will ever have the luxury of something approaching in vitro testing in convenience and clarity. Three aspects of behavioral assessment are especially difficult to simplify in reasonable ways. Psychophysics is the discipline that allows us to determine sensory capacity. With animals, complex, lengthy procedures are often the only alternative by which to assess subtle questions of sensory dysfunction. Measures of aversiveness and attractiveness are also definable only by behavioral techniques, yet constitute critical data for environmental standards. Behavioral epidemiology is the most obvious enemy of simplification since it deals with how people feel and function.