IJBM — Interdisciplinary, International, and Outstanding Research on Factors Relevant to Health and Illness

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Abstract

What did we achieve in the 5 years of my term as the Editor-in-Chief of the International Journal of Behavioral Medicine (IJBM)? It has been an interesting and rewarding experience to serve IJBM in this position. In this editorial, I will summarize the major developments during these 5 years and I will assess the current state of IJBM. The profile of IJBM has been defined as “original research and integrative reviews on interactions among behavioral, psychosocial, environmental, genetic, and biomedical factors relevant to health and illness. The scope of IJBM extends from research on biobehavioral mechanisms; clinical studies on diagnosis, treatment, and rehabilitation; to research on public health, including health promotion and prevention” [1]. A thorough understanding of biobehavioral mechanisms contributes to clinical and public health research. Public health research may benefit from insights derived from clinical studies, and vice versa. IJBM brings these differently focused but complementary domains together to integrate and extend knowledge on factors relevant to health and illness. IJBM is preeminently an interdisciplinary journal. I believe IJBM has indeed been successful in publishing high-quality papers in the three major domains of biobehavioral mechanisms, clinical care, and public health. Recent examples in the domain of behavioral mechanisms are The Relationships Between Self-Rated Health and Serum Lipids Across Time [2] and Sleep Duration and Regularity are Associated with Behavioral Problems in 8-year-old Children [3]. Examples in the domain of clinical care include the papers Effects of a Weight Loss Intervention on Body Mass, Fitness, and Inflammatory Biomarkers in Overweight or Obese Breast Cancer Survivor [4] and Parents’ Pain Catastrophizing is Related to Pain Catastrophizing of Their Adult Children [5]. Recent examples in the domain of public health are the review on The Relevance of Fatalism in the Study of Latinas’ Cancer Screening Behavior [6] and the review on Prevention of Type 2 Diabetes and its Complications in Developing Countries [7]. Clinical care and public health have been the most proliferative domains; IJBM could publish somewhat more papers in the field of biobehavioral mechanisms. The International Society of Behavioral Medicine is aiming to strengthen collaboration with more specialized scientific societies in behavioral medicine; this may help to attract more high-quality manuscripts on basic research. The profile emphasizing three major domains brings the risk of lack of focus. Researchers working in a specific field may feel that their audience is “diluted” by readers from the other two fields; they could prefer to submit to a more specialized journal. To counteract this risk, IJBM has put strong emphasis on publishing special series, focusing on a specific theme in behavioral medicine. Examples include the special series on Social Determinants of Health at Different Phases of Life [8]; Psychological Determinants and Outcomes of Sedentary and Physical Activity Behaviours [9]; Psychological Aspects of Cardiovascular Disease [10]; Contemporary Perspectives on Risk Perceptions, Health-Protective Behaviors, and Control of Emerging Infectious Diseases [11]; and Risk Perceptions and Behaviour: Towards Pandemic Control of Emerging Infectious Diseases [12]. These special series bring together research coming from basic science, clinical medicine, and/or public health, all contributing to the specific theme. These special series, frequently prefaced by an editorial describing the context and cohesion of these papers, have been major achievements. The special series have been instrumental in bringing out the very essence of behavioral medicine, i.e., interdisciplinary research on the interactions among behavioral, psychosocial, environmental, genetic, and biomedical factors relevant to health and illness, with contributions from the domains of biobehavioral mechanisms, clinical care, and public health. I also believe that research published in IJBM has contributed to the development of scientific theory in behavioral medicine, either by testing theories or by generating theory based on empirical data. A judicious use of theory is instrumental in developing hypotheses and in interpreting empirical findings. Theories facilitate the interpretation and integration of empirical findings, and a good theory helps to identify the next logical step in research [13]. Papers contributing to the development of theory have been published in the three domains mentioned above. Examples include Predicting Adult Physical Health Outcomes from Childhood Aggression, Social Withdrawal and Likeability: A 30-Year Prospective, Longitudinal Study [14]; Is There a Bidirectional Link Between Insomnia and Burnout? A Prospective Study in the Swedish Workforce [15]; and Risk Perceptions Related to SARS and Avian Influenza: Theoretical Foundations of Current Empirical Research [16]. The number of manuscripts submitted to IJBM is rather stable over the last years. Manuscripts originate from all over the world. In 2010, the distribution of submitted manuscripts over regions was as follows: Africa, 2%; Asia, 28%; Australia/New Zealand, 7%; Europe, 39%; Middle and South America, 2%; and North America, 23%. The number of manuscripts from Asia seems to be increasing, which is a good development. The number of manuscripts from Middle and South America is too low; hopefully, this will improve in the coming years. These manuscripts address issues which are relevant for global health. Not only did manuscripts originate from all over the world, they also address issues related to global health. Examples include behavioral control of emerging infectious diseases, such as influenza A (H1N1) [17]; the cultural adaptation and evaluation of a stress management program in Eastern Europe [18]; prevention of diabetes in developing countries [7]; and the comparison of physical activity in several Asian countries [19] and in several African countries [20]. These examples show that IJBM is a truly international journal. This is a remarkable achievement. It shows that IJBM has its own niche among the journals in the field of behavioral medicine. A major and very positive development has been the transition to Springer Science + Business Media as publisher of IJBM. The transition to Springer has brought many benefits, of which I want to mention three. First, Springer provides free and easy electronic access of IJBM to members of all ISBM member societies. This step is an important contribution to facilitate scientific communication among ISBM members. Second, Springer provides a web-based manuscript submission, review, and tracking system. This has improved the efficiency of submitting and reviewing manuscripts; authors, reviewers, and (associate) editors appreciate this very much. Third, Springer publishes manuscripts Online First. It is a tremendous improvement that manuscripts, instead of waiting in line for publication in print, are now published Online First, soon after being accepted for publication. Publication Online First makes results available for reading and citation, soon after being accepted as scientifically valid and worth publishing. Although its value should not be exaggerated, the impact factor is a reflection of the scientific impact of papers published in the journal. The 2010 impact factor of IJBM is 1.76, and rising. I trust that the growing worldwide interest in behavioral medicine and the continued efforts of the editorial team will boost the scientific impact of research published in IJBM even further. Overall, I conclude that IJBM is in good shape. I want to thank the associate editors for their strong contributions to achieve the present state. Mike Antoni, Wolfgang Hiller, Yvette Miller, Urs Nater, Linda Powell, Katri Raikkonen, Akizumi Tsutsumi, and, previously, Norito Kawakami, and Christina Lee: thank you for handling the review process of so many manuscripts, for your valuable suggestions on how to improve manuscripts, and for your wise decisions and advise. Members of the editorial board and all anonymous outside reviewers: thank you for your constructive and critical comments, which have been extremely helpful in improving the quality of manuscripts; reviewers’ comments do improve the quality of manuscripts. I strongly believe in and have seen empirical evidence for peer review as a system to improve the quality of science. I want to thank authors for submitting their work to IJBM. Only a minority of these manuscripts got accepted. These manuscripts contributed to the advancement of scientific understanding in behavioral medicine. I want to thank the staff at Springer for their highly efficient and very friendly support. Janice Stern, Arlyn Escopete, Tracy Marton and many others behind the scenes: I really appreciated working with you. I will miss these interactions, almost on a daily basis, with you. Finally, I am very pleased that Christina Lee will take over as the next Editor-in-Chief. Her knowledge of behavioral medicine, her experience as Associate Editor, and her managerial skills are critical factors for bringing IJBM at an even higher level. I wish her success and I wish her joy; being editor of IJBM is an interesting and rewarding experience, indeed.

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Risk Perceptions Related to SARS and Avian Influenza: Theoretical Foundations of Current Empirical Research

Anja Leppin, Arja Aro (2009)

Background The outbreak of severe acute respiratory syndrome in 2003 and the subsequent emergence of the H5N1 virus have highlighted the threat of a global pandemic influenza outbreak. Planning effective public health control measures for such a case will be highly dependent on sound theory-based research on how people perceive the risks involved in such an event. Purpose The present article aims to review theoretical models and concepts underlying current empirical research on pandemic influenza risk perception. Method A review was conducted based on 28 empirical studies from 30 articles which were published between 2003 and 2007. Results Concepts of risk perception mostly seemed more pragmatic than theory-based and were highly heterogeneous, for instance, in terms of conceptualizing risk perception as an exclusively cognitive or as a cognitive and emotional phenomenon or whether the concept was dominated by expectancy or expectancy and value components. Similarly, the majority of studies investigating risk perceptions and protective behaviors were not model-based. Conclusions The current body of knowledge can only provide preliminary insights. Unlike the reviewed studies, which were mostly launched as a rapid response to outbreak situations, future research will have to invest more strongly into theoretical work to provide sounder evidence.

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Risk Perceptions and Behaviour: Towards Pandemic Control of Emerging Infectious Diseases

Johannes Brug, Arja Aro, Jan Richardus (2009)

In the beginning of 2003, the world was alarmed by the emergence of a new and apparently fatal infectious disease. The disease was labelled SARS. Thanks to enormous efforts made by national and international organisations, the epidemic was brought under control by the summer of that year. In recent years, the world has also been confronted with outbreaks or threats of outbreaks of other emerging infectious diseases such as avian influenza. To control new infectious diseases, the identification of the organisms, the infectivity, development of vaccines and therapies, contact tracing, isolation and screening may all be important. Many of these issues are partly dependent on human behaviours. For example, the success of prevention of infectivity (e.g. engaging in precautionary behaviours such as wearing masks, hand hygiene, isolation etc.), vaccination, contact tracing and population screening are all more or less dependent on whether people at risk comply with behavioural recommendations. Especially in the early phases of a possible epidemic, compliance to precautionary behaviours among the populations at risk is often the only means of prevention of a further spread of the disease. However, very little research has been conducted to explore the determinants of behavioural responses to infectious disease outbreaks [1, 2]. The present special series of the International Journal of Behavioral Medicine is dedicated to such research. One of the six papers, i.e. by Vartti et al. [3], in this special series originated from international collaboration of behavioural scientists to study risk perceptions around SARS during the SARS outbreak. The Aro et al. [4] paper represents early work related to risk perceptions among travellers during the avian influenza outbreak. Three papers [5–7] were the result of a European Commission funded project, called SARS-Control that was partly dedicated to exploring risk perceptions and risk communications related to SARS and other emerging infectious diseases. The SARS Epidemic and other Emerging Infectious Diseases Severe acute respiratory syndrome (SARS) was a new infectious disease due to an infection with a novel coronavirus, which was provisionally termed SARS-associated coronavirus (SARS-CoV) [8–10]. The earliest cases of SARS are known to have occurred in mid-November 2002 in Guangdong Province, China. SARS was first recognised in late February 2003, when cases of an atypical pneumonia of unknown cause began appearing among staff at hospitals in Guangdong, China and Hanoi, Vietnam [11]. Within 2 weeks, similar outbreaks occurred in various hospitals in Hong Kong, Singapore and Toronto, and the number of worldwide cases exceeded 4,000 within 2 months, and 7,000 a few weeks later, with cases being reported from 30 countries. During the peak of the global outbreak, near the start of May 2003, more than 200 new cases were being reported each day. More than 900 people died from SARS [12]. China was hit hardest, with over 5,000 patients and approximately 350 deaths. After July, SARS appeared to be under control. Although SARS did not have the disastrous health impact that many at first feared, the panic caused by SARS had an enormous economic impact in many countries because of the health fears and related control measures. The global travel, tourism and related industries in particular faced a significant downturn in income, although mostly temporary. The global macroeconomic impact has been estimated at 30 to 100 billion US dollars. Although the European Union was not afflicted heavily by the SARS epidemic in terms of patient numbers, there was a large public concern related to the disease. While the dissemination of SARS has been prevented in Europe and controlled in all affected areas within a few months, this may not be the case for other emerging infectious diseases. For instance, the West Nile virus was introduced in North America in 1999 and has been widely diffused since then despite very aggressive control efforts. In the USA in 2002, 4,156 cases were notified among whom 284 died [13]. Severe infection can emerge in Europe too. The H7N7 influenza episode among workers of the Dutch poultry industry in 2003 [14] has shown that the potential for pandemic influenza to start within Europe is there. Circulation of a human strain at the same time as the zoonotic strains (H7N7) were circulating in the poultry worker population could have precipitated the emergence of a new strain adapted to humans with fast secondary diffusion. International Research Projects Already in April 2003, an international Psychosocial SARS Research Consortium was formed initiated by professor George Bishop at Singapore University, which developed a survey instrument in several languages to probe awareness, knowledge, risk perceptions and precautionary behaviours related to SARS. In 2004, a European Union sponsored 3-year research programme SARSControl was started with collaborators from Europe and China (partly building on the methods of the Psychosocial SARS Research Consortium) with the title “Effective and Acceptable Strategies for the Control of SARS and New Emerging Infections in China and Europe”; SARSControl. Risk perception and risk communication were themes in two out of nine work packages of the SARSControl project. The Importance of Risk Perception Effective management of new epidemic infectious disease risks in the phase that no treatment or vaccination is yet possible is largely dependent on precautionary behaviour of the population. Implementation of precautionary behaviour is largely dependent on effective risk communication, i.e. communication that induces realistic risk perceptions, correct knowledge and skills to promote and enable precautionary practices. Scientific knowledge about these topics in the area of infectious disease control is scarce. Neither is there knowledge if the theories and measures developed for risk perception research on, for example chronic diseases, can be applied in the area of infectious diseases. However, such knowledge is vital for effective control of newly emerging infectious diseases, because our ability to promote health protective behavioural change depends on our knowledge of important determinants of such behaviour [15]. For people to voluntarily engage in precautionary actions, they first of all need to be aware of the risk. Risk perception is a central feature in many health behaviour theories. According to the Protection Motivation Theory, for example [16], protection motivation is the result of the threat appraisal and coping appraisal. Threat appraisal consists of estimates of the chance of contracting a disease (perceived vulnerability or susceptibility) and estimates of seriousness of a disease (perceived severity). Risk perceptions thus are important for precautionary actions, but risk perceptions are often biased [17]. Unrealistic optimism about health risks is often observed related to familiar risks that are perceived to be largely under volitional control. Such optimism may result in lack of precautions and false feelings of security. A pessimistic bias is more likely for new, unfamiliar risks that are perceived as uncontrollable. Such unwarranted high-risk perceptions may lead to unnecessary mass scares, and are often combined with stigmatisation of specific risk groups. Perceptions of risk are a necessary but often not sufficient condition for engagement is such behaviours. Therefore, higher risk perceptions may only predict protective behaviour when people believe that effective protective actions are available (response efficacy) and when they are confident that they have the abilities to engage in such protective actions (self-efficacy). Preliminary research on SARS as well as avian influenza risk perceptions support these theorised associations and show inverse associations between risk perceptions and efficacy beliefs [2, 18]. Furthermore, risk perceptions as well as efficacy beliefs in the early stages of a possible pandemic are dependent on communications with and between the members of the groups at risk. Risk communication messages that are not comprehended by the public at risk, or communication of conflicting risk messages will result in lack of precautionary actions. Communications that are perceived as coming from a non-trustworthy source may have the same results. However, risk communication messages are sometimes very quickly adopted by the media, possibly leading to an ‘amplification’ of risk information that may lead to unnecessary mass scares and unnecessary or ineffective precautionary actions. This Special Series In the first paper of this special series, Leppin and Aro [19] provide an overview of the theoretical frameworks on which risk perception and infectious disease research is founded. Leppin and Aro first of all make a distinction between a more sociological and a primarily psychological approach to risk perception research. They conclude that the current risk perception research in infectious disease epidemics is seldom theory based or conceptually clear. This is understandable when doing first surveys in the early phases of new emerging epidemics, but there certainly is a need to do consolidate the theoretical and methodological research base. We also need to find out empirically if the theories and methods developed mostly for chronic diseases under volitional control of individuals can be directly applied in emerging epidemics. Four of the papers present empirical mostly explorative original research on risk perceptions, knowledge, beliefs and other issues related to SARS during or after the SARS outbreak in 2003. De Zwart and colleagues, in their eight-country survey in 2005, almost 2 years after the SARS outbreak, found out that perceived threat of SARS in case of an outbreak in the country was higher than that of other diseases [7]. Perceived vulnerability of SARS was at an intermediate level compared to other diseases while perceived severity was high. Perceived threat for SARS varied between countries in Europe and Asia, but these differences did not appear to be associated with the proximity of the SARS 2003 outbreak. Vartti et al. [3] in their study during the SARS outbreak found that despite the fact that both Finland and the Netherlands were unaffected by the outbreak the Finns were more likely to be knowledgeable and worried about SARS as well as to have low perceived comparative SARS risk and poor personal efficacy beliefs to prevent SARS. The Finns were also more likely to have high confidence in physicians in the SARS issues and less likely to have received information from the internet and have confidence in the internet information than the Dutch. Voeten et al. [5] and Jiang et al. [6] studied the Chinese communities in the Netherlands and the UK because of their close communication and travel contacts with China, where the outbreak was the most severe. Jiang and colleagues, in their qualitative study, revealed that information from affected Asia influenced the perceived threat form SARS and protective behaviour among the Chinese in Europe when more relevant local information was absent. When a high perceived threat was combined with low efficacy regarding precautionary measures, avoidance-based precautionary action appeared to dominate responses to SARS. These actions may have contributed to the adverse impact of SARS on the community. The Voeten et al. [5] study results indicate that the Chinese community members relied more on information from friends and Chinese media and had less confidence in their doctor, government agencies and consumer interest groups. While their knowledge of SARS was high, they reported a lower perceived threat and higher self-efficacy than general populations with regard to SARS and avian flu, due to a lower perceived severity. The Aro et al. [4] study, from the early phase of the avian influenza outbreak, found out that younger travellers and those on holidays are willing to take more health risks than those older or on business trips. The overall results indicate that people across Europe and East Asia do regard recently emerging infectious diseases as serious potential health threats, based on information they receive from a range of different sources, with clear differences between countries and regions. These differences appear not to be necessarily associated with proximity of an outbreak. It remains unclear if cultural differences or experience with an outbreak may explain these differences in risk perceptions and beliefs. Given the clear and present danger of newly emerging infectious disease outbreaks in the near future and the importance of the public response and precautionary actions to control the spread, additional research on risk perceptions and other behavioural determinants is warranted. The present series of papers present a first qualitative and social–epidemiological exploration. More theory-driven and stronger designed longitudinal and experimental studies are needed to test some of the hypotheses touched upon in this issue.

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The Influence of Social-Cognitive Factors on Personal Hygiene Practices to Protect Against Influenzas: Using Modelling to Compare Avian A/H5N1 and 2009 Pandemic A/H1N1 Influenzas in Hong Kong

Qiuyan Liao, Benjamin Cowling, Wendy Wing Tak Lam … (2010)

Background Understanding population responses to influenza helps optimize public health interventions. Relevant theoretical frameworks remain nascent. Purpose To model associations between trust in information, perceived hygiene effectiveness, knowledge about the causes of influenza, perceived susceptibility and worry, and personal hygiene practices (PHPs) associated with influenza. Methods Cross-sectional household telephone surveys on avian influenza A/H5N1 (2006) and pandemic influenza A/H1N1 (2009) gathered comparable data on trust in formal and informal sources of influenza information, influenza-related knowledge, perceived hygiene effectiveness, worry, perceived susceptibility, and PHPs. Exploratory factor analysis confirmed domain content while confirmatory factor analysis was used to evaluate the extracted factors. The hypothesized model, compiled from different theoretical frameworks, was optimized with structural equation modelling using the A/H5N1 data. The optimized model was then tested against the A/H1N1 dataset. Results The model was robust across datasets though corresponding path weights differed. Trust in formal information was positively associated with perceived hygiene effectiveness which was positively associated with PHPs in both datasets. Trust in formal information was positively associated with influenza worry in A/H5N1 data, and with knowledge of influenza cause in A/H1N1 data, both variables being positively associated with PHPs. Trust in informal information was positively associated with influenza worry in both datasets. Independent of information trust, perceived influenza susceptibility associated with influenza worry. Worry associated with PHPs in A/H5N1 data only. Conclusions Knowledge of influenza cause and perceived PHP effectiveness were associated with PHPs. Improving trust in formal information should increase PHPs. Worry was significantly associated with PHPs in A/H5N1.

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: j.dekker@vumc.nl

Journal

Journal ID (nlm-ta): Int J Behav Med

Title: International Journal of Behavioral Medicine

Publisher: Springer US (Boston )

ISSN (Print): 1070-5503

ISSN (Electronic): 1532-7558

Publication date (Electronic): 28 August 2011

Publication date PMC-release: 28 August 2011

Publication date (Print): December 2011

Volume: 18

Issue: 4

Pages: 285-287

Affiliations

Department of Rehabilitation Medicine and Department of Psychiatry, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, Netherlands

Article

Publisher ID: 9189

DOI: 10.1007/s12529-011-9189-y

PMC ID: 3212672

PubMed ID: 21874401

SO-VID: 1741206b-6260-4a74-aee1-cfabe3996737

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IJBM — Interdisciplinary, International, and Outstanding Research on Factors Relevant to Health and Illness

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Most cited references 14

Risk Perceptions Related to SARS and Avian Influenza: Theoretical Foundations of Current Empirical Research

Risk Perceptions and Behaviour: Towards Pandemic Control of Emerging Infectious Diseases

The Influence of Social-Cognitive Factors on Personal Hygiene Practices to Protect Against Influenzas: Using Modelling to Compare Avian A/H5N1 and 2009 Pandemic A/H1N1 Influenzas in Hong Kong

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