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Article

Amy E. Richardson and Elizabeth Broadbent

Cognitions about illness have been identified as contributors to health-related behavior, psychological well-being, and overall health. Several different theories have been developed to explain how cognitions may exert their impact on health outcomes. This article includes three theories: the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the Common Sense Model (CSM), with the primary focus on the CSM. The HBM posits that cognitions regarding susceptibility to a health threat, the severity of the threat, and the benefits and costs associated with behavior, will determine whether or not a behavior is performed. In the TPB, behavior is thought to be a consequence of intention to act, which is shaped by attitudes regarding a behavior, subjective norms, and perceived behavioral control. The Common Sense Model (CSM) proposes that individuals form cognitive representations of illness (known as illness perceptions) as well as emotional representations, which are key determinants of coping behaviors to manage the illness. Coping behaviors are theorized to have direct relationships with physical and psychological health outcomes. Cognitive representations encompass perceptions regarding the consequences posed by the illness, its timeline, personal ability to control the illness, whether the illness can be cured or controlled by treatment, and the identity of the illness (including its label and symptoms). Emotional representations reflect feelings such as fear, anger, and depression about the illness. The development of illness representations is influenced by a number of factors, including personal experience, the nature of physical symptoms, personality traits, and the social and cultural context. Illness cognitions can vary considerably between patients and health care professionals. There are a number of methods to assess illness-related cognitions, and increasing evidence that modifying negative or inaccurate cognitions can improve health outcomes.

Article

Sara Honn Qualls and Lacey Edwards

Family systems therapy seeks to alter the structure or processes of a family for the purposes of reducing distress in one or more persons and improving the ability of the family to meet members’ needs. Building from a general systems paradigm, family systems therapy recognizes that family structures shift over time as they respond to members’ developmental processes and broader system demands. As members enter and exit or change capacity, and as external stressors arise, the family typically uses adaptive processes to demonstrate resilience. Family systems therapy is useful when the family struggles to adapt, or the adaptation strategy further stresses the family. Multiple models of family systems therapies offer variations in intervention approaches but have common tenets. Major models include Ackerman’s early psychodynamics model, transgenerational models of family therapy, structural family therapy, strategic family therapy, and communications approaches to family therapy. Models vary in their recommended roles for the therapist, strategies for therapist and family, and the salience of immediate versus longer-term goals. Family systems therapies conceptualize family interactions as complex, reciprocal, open, self-organizing, adaptive, social constructionist, and meaning-making. Family systems therapy also can be used with systems larger than families, such as schools or organizations, or to understand cultural phenomena. The field of marriage and family therapy has defined competencies for practice, training requirements, and licensure standards and established national and international professional organizations.

Article

Jennifer McGowan and Lion Shahab

Worldwide, tobacco use is a leading cause of morbidity and mortality. However, the health effects of smoking are reversible, making smoking cessation an important target for public health policy. Tobacco control is a field of public health science dedicated to reducing tobacco use and, thereby, to reducing cigarette-related morbidity and mortality. For tobacco control to be effective, it is necessary for policy makers to understand the personal and interpersonal factors which encourage people to smoke, factors which motivate smokers to quit (e.g., health, social pressure, cost), and the personal and population-level methods that are most effective at encouraging and prolonging attempts to quit. Research has identified that social norms, mental health, and individual personality factors are most associated with smoking uptake, so interventions which reduce social smoking (e.g., smoking bans, plain packaging) would be most effective at preventing uptake. Conversely, the use of cigarettes is maintained by nicotine addiction and attempts to quit are often motivated by health concerns, social pressure and the cost of tobacco products. As such, interventions that address physiological and behavioral addiction inherent in tobacco product use (e.g., nicotine replacement therapy combined with counselling), that create social pressure to stop (e.g., mass media campaigns), or that increase the cost of tobacco products are most likely to be effective at encouraging attempts to quit.

Article

Michael P. Leiter

Engagement has continued to develop as a positive construct in organizational psychology. Initially defined as employees’ identification with their work, work engagement became understood as a configuration of vigor, dedication, and absorption that motivates exceptional work performance. Although generally viewed as a positive construct, engagement may have a dark side in giving work excessive importance in employees’ lives. There has been some debate regarding the specific qualities that define engagement and the extent to which engagement is an enduring trait in contrast to a varying response to situational constraints and opportunities. The concerns are reflected in the measures of engagement, the most widely used is the Utrecht Work Engagement Scale (UWES). The Job Demands/Resources Model has structured much of the research work on engagement in recent years, leading to initiatives to enhance engagement by improving the quality and variety of resources available to employees at work. Within this domain, job crafting appears to provide a means through which individuals or groups may broaden their opportunities to participate in engaging activities while reducing the range of drudgery inherent in their work.

Article

Caring for an older adult who needs help or supervision is in many cases associated with mental and physical health issues, especially if the care recipient has dementia, although positive consequences associated with caregiving have also been reported. Several theoretical models have shown the relevance of psychological variables for understanding variations in the stress process associated with caregiving and how interventions may benefit from psychological techniques and procedures. Since the 1990s it has been witnessed an increment in the number of studies aimed at analyzing caregiver health and developing and testing interventions for decreasing caregiver distress. Several examples of interventions for helping caregivers are considered empirically supported, including interventions for ethnically and culturally diverse caregivers, with psychotherapeutic and psychoeducational interventions showing strong effect sizes. However, efforts are still needed to maintain the results of the interventions in the long term and to make the interventions accessible (e.g., through technological resources) to a large number of caregivers who, because of time-pressure issues associated with caregiving or a lack of support, are not benefiting from them. Making these interventions available in routine healthcare settings would help a large population in need that presents with high levels of psychological suffering.

Article

Healthy aging is accompanied by decrements in episodic memory and working memory. Significant efforts have therefore been made to augment episodic and working memory in healthy older adults. Two principal approaches toward memory rehabilitation adults are restorative approaches and compensatory approaches. Restorative approaches aim to repair the affected memory processes by repeated, adaptive practice (i.e., the trained task becomes more difficult as participants improve), and have focused on recollection training, associative memory training, object-location memory training, and working memory training. The majority of these restorative approaches have been proved to be efficacious, that is, participants improve on the trained task, and there is considerable evidence for maintenance of training effects weeks or months after the intervention is discontinued. Transfer of restorative training approaches has been more elusive and appears limited to other tasks relying on the same domains or processes. Compensatory approaches to memory strive to bypass the impairment by teaching people mnemonic and lifestyle strategies to bolster memory performance. Specific mnemonic strategy training approaches as well as multimodal compensatory approaches that combine strategy training with counseling about other factors that affect memory (e.g., memory self-efficacy, relaxation, exercise, and cognitive and social engagement) have demonstrated that older adults can learn new mnemonics and implement them to the benefit of memory performance, and can adjust their views and expectations about their memory to better cope with the changes that occur during healthy aging. Future work should focus on identifying the personal characteristics that predict who will benefit from training and on developing objective measures of the impact of memory rehabilitation on older adults’ everyday functioning.

Article

Stuart Linke and Elizabeth Murray

Alcohol-use disorders are widespread and associated with a greatly increased risk of health-related and societal harms. The majority of harms associated with consumption are experienced by those who drink above recommended guidelines, rather than those who are alcohol dependent. Brief interventions and treatments based on screening questionnaires and feedback have been developed for this group, which are effective tools for reducing consumption in primary care and in other settings. Most people who drink excessively do not receive help to reduce the risks associated with excessive consumption. Digital versions of brief and extended interventions have the potential to reach populations that might derive benefit from them. Digital interventions utilize the same principles as do traditional face-to-face versions, but they have the advantages of availability, confidentiality, flexibility, low marginal costs, and treatment integrity. The evidence for the feasibility, acceptability, costs, and effectiveness of digital interventions is encouraging, and the evidence for effectiveness is particularly strong in studies of student populations. There are, however, a number of unresolved questions. It is not clear which components of interventions are required to maximize effectiveness, whether digital versions are enhanced by the addition of personal contact from a facilitator or a health professional, or how to increase take up of the offer of a digital intervention and reduce attrition from a program. These questions are common to many online behavior-change interventions and there are opportunities for cross-disciplinary learning between psychologists, health professionals, computer scientists, and e-health researchers.

Article

Well-being is a core concept for both individuals, groups and societies. Greater understanding of trajectories of well-being in later life may contribute to the achievement and maintenance of well-being for as many as possible. This article reviews two main approaches to well-being: hedonic and eudaimonic well-being, and shows that it is not chronological age per se, but various factors related to age that underlie trajectories of well-being at older ages. Next to the role of genes, heritability and personality traits, well-being is determined to a substantial extent by external circumstances and resources (e.g., health and social relationships), and to malleable individual behaviors and beliefs (e.g., self-regulatory ability and control beliefs). Although many determinants have been identified, it remains difficult to decide which of them are most important. Moreover, the role of some determinants varies for different indicators of well-being, such as positive affect and life satisfaction. Several prominent goal- and need-based models of well-being in later life are discussed, which explicate mechanisms underlying trajectories of well-being at older ages. These are the model of Selection, Optimization, and Compensation, the Motivational Theory of Lifespan Development, Socio-emotional Selectivity Theory, Ryff’s model of Psychological Well-Being, Self-Determination Theory, and Self-Management of Well-being theory. Also, interventions based on these models are reviewed, although not all of them address older adults. It is concluded that the literature on well-being in later life is enormous, and, together with various conceptual models, offers many important insights. Still, the field would benefit from more theoretical integration, and from more attention to the development and testing of theory-based interventions. This remains a challenge for the science of well-being in later life, and could be an important contribution to the well-being of a still growing proportion of the population.

Article

Individuals with mild cognitive impairment (MCI) experience cognitive difficulties and many find themselves in a transitional stage between aging and dementia, making this population a suitable target for cognitive intervention. In MCI, not all cognitive functions are impaired and preserved functions can thus be recruited to compensate for the impact of cognitive impairment. Improving cognition may have a tremendous impact on quality of life and help delay the loss of autonomy that comes with dementia. Several studies have reported evidence of cognitive benefits following cognitive intervention in individuals with MCI. Studies that relied on training memory and attentional control have provided the most consistent evidence for cognitive gains. A few studies have investigated the neurophysiological processes by which these training effects occur. More research is needed to draw clear conclusions on the type of brain processes that are engaged in cognitive training and there are insufficient findings regarding transfer to activities of daily life. Results from recent studies using new technologies such as virtual reality provide encouraging evidence of transfer effects to real-life situations.

Article

There is no doubt that exercise, a vital health-promoting activity, regardless of health status, produces numerous well-established physical, functional, and mental health benefits. Many people, however, do not adhere to medical recommendations to exercise consistently, especially if they have chronic illnesses. Put forth to explain this conundrum are numerous potential explanatory factors. Among these are mental health correlates such as anxiety, fear, fatigue, pain, motivation, and depression, as well as various self-efficacy perceptions related to exercise behaviors, which may be important factors to identify and intervene upon in the context of promoting adherence to physical activity recommendations along with efforts to reduce the cumulative health and economic burden of exercise non-adherence among the chronically ill and those at risk for chronic illnesses.

Article

Loredana A. Marchica and Jeffrey L. Derevensky

With the gambling market continuously shifting and evolving, one form of gambling has uninterruptedly remained a staple in most cultures. Sports wagering has been and remains one of the most popular forms of gambling, especially among males. With the increase in the gambling market, sports wagering has also grown into the online gambling and fantasy sports wagering markets. These escalations in popularity have brought substantial revenue to sports wagering operators and have influenced government officials, policymakers, legislation researchers, the media, and the general public. There are two major groups of issues that surround sports wagering: sports wagering as an economic and tax-generating entity and the integrity of the game. More recently, a concern over problem gambling from a public health perspective has evolved. It is equally important that these issues be considered when creating or changing legislation around sports wagering.

Article

Rebecca A. Zakrajsek and Jedediah E. Blanton

It is important for sport and exercise psychology (SEP) professionals to demonstrate that the interventions they employ make a difference. Assessing the degree of an intervention’s effectiveness depends first and foremost on the nature and scope of the intervention (i.e., the objective of the intervention) and its targeted group. Traditionally, interventions have been quite varied between the fields of sport psychology and exercise psychology; a common thread however, can be seen as an enhancement of the sport or exercise experience, along with an attempt to help the individual better self-regulate engagement with the targeted behavior or mindset. The central aim of enhancing the experience and increased self-regulation is oriented toward performance enhancement within sport psychology interventions, whereas within exercise psychology interventions the orientation is toward physical-activity adoption and better exercise program adherence. Although the two fields may have different objectives, it can be argued that sport psychology interventions—specifically psychological skills training (PST) interventions—can inform SEP professionals’ research and applied practices with both the sport and exercise populations. Psychological skills training includes the strategies and techniques used to develop psychological skills, enhance sport performance, and facilitate a positive approach to competition. Since the early 1980s, a growing body of evidence has supported that the PST interventions SEP professionals employ do make a difference. In particular, evidence from research in sport contexts supports the use of a multimodal approach to PST interventions—combining different types of psychological strategies (e.g., goal-setting, self-talk, imagery, relaxation)—because a multimodal approach has demonstrated positive effects on both psychological skills and sport performance. The research investigating the effectiveness of PST interventions in enhancing performance has primarily centered on adult athletes who compete at competitive or elite levels. Elite athletes are certainly important consumers of SEP services; however, SEP professionals have rightfully challenged researchers and practitioners to target other consumers of SEP services who they argue are as deserving of PST as elite athletes. For example, young athletes and coaches are two populations that have traditionally been overlooked in the PST research. PST interventions targeting young athletes can help them to develop (at the start of their sporting careers) the type of psychological skills that facilitate a positive approach to competition and better abilities to self-regulate their emotional responses to stressful competitive situations. Coaches are also performers with unique needs who could benefit from PST interventions. Researchers have begun to target these two populations and the results might be considered the most intriguing aspects of the current PST literature. Future research related to PST interventions should target exercise populations. Exercise professionals often operate as coaches in healthy behavior change (e.g., strength and conditioning coaches, personal trainers, etc.) and as such should also employ, and monitor responses to, PST. To facilitate further development and growth of PST intervention research in both sport and exercise settings, SEP professionals are encouraged to include a comprehensive evaluation of program effectiveness. In particular, four major areas to consider when evaluating PST programs are (a) the quality of the PST service delivery (e.g., the knowledge, delivery style, and characteristics of the SEP professional); (b) assessment of the sport psychological strategies participants used as a result of the PST program; (c) participants’ perceptions of the influence of the PST program on their psychological skills, performance, and enjoyment; and (d) measurement of participants psychological skills, performance, and enjoyment as a result of the PST program.

Article

Sharon Glazer and Cong Liu

Work stress refers to the process of job stressors, or stimuli in the workplace, leading to strains, or negative responses or reactions. Organizational development refers to a process in which problems or opportunities in the work environment are identified, plans are made to remediate or capitalize on the stimuli, action is taken, and subsequently the results of the plans and actions are evaluated. When organizational development strategies are used to assess work stress in the workplace, the actions employed are various stress management interventions. Two key factors tying work stress and organizational development are the role of the person and the role of the environment. In order to cope with work-related stressors and manage strains, organizations must be able to identify and differentiate between factors in the environment that are potential sources of stressors and how individuals perceive those factors. Primary stress management interventions focus on preventing stressors from even presenting, such as by clearly articulating workers’ roles and providing necessary resources for employees to perform their job. Secondary stress management interventions focus on a person’s appraisal of job stressors as a threat or challenge, and the person’s ability to cope with the stressors (presuming sufficient internal resources, such as a sense of meaningfulness in life, or external resources, such as social support from a supervisor). When coping is not successful, strains may develop. Tertiary stress management interventions attempt to remediate strains, by addressing the consequence itself (e.g., diabetes management) and/or the source of the strain (e.g., reducing workload). The person and/or the organization may be the targets of the intervention. The ultimate goal of stress management interventions is to minimize problems in the work environment, intensify aspects of the work environment that create a sense of a quality work context, enable people to cope with stressors that might arise, and provide tools for employees and organizations to manage strains that might develop despite all best efforts to create a healthy workplace.

Article

Jiaying Zhao and Brandon M. Tomm

Scarcity is the condition of having insufficient resources to cope with demands. This condition presents significant challenges to the human cognitive system. For example, having limited financial resources requires the meticulous calculation of expenses with respect to a budget. Likewise, having limited time requires the stringent management of schedules with respect to a deadline. As such, scarcity consumes cognitive resources such as attention, working memory, and executive control and elicits a range of systematic and even counter-productive cognitive and behavioral responses as a result. Specifically, scarcity induces an attentional focus on the problem at hand, which facilitates performance by enhancing cognitive processing of information relevant to the problem, increasing the efficiency of resource use, and stabilizing the perception of value. Such prioritization of the problem at hand may seem advantageous, but it can produce undesirable consequences. For example, scarcity causes myopic and impulsive behavior, prioritizing short-term gains over long-term gains. Ironically, scarcity can also result in a failure to notice beneficial information in the environment that alleviates the condition of scarcity. More detrimentally, scarcity directly impairs cognitive function, which can lead to suboptimal decisions and choices that exacerbate the condition of scarcity. Thus, scarcity means not only a shortage of physical resources (e.g., money or time) but also a deficit of cognitive resources (e.g., attention, executive control). The cognitive deficits under scarcity are particularly problematic because they impair performance and lead to counter-productive behaviors that deepen the cycle of scarcity. In addition, people under financial scarcity suffer from stigmas and stereotypes associated with poverty. These social perceptions of poverty further burden the mind by consuming cognitive resources, weakening performance in the poor. Understanding the cognitive and behavioral responses to scarcity provides new insights into why the poor remain poor, identifying the psychological causes of scarcity, and illuminating potential interventions to stop the cycle of scarcity. These insights have important implications for the design and the implementation of policies and services targeting the populations under scarcity.

Article

Vindhya Undurti

There is no explicitly defined field as feminist psychology(ies) in India. It is therefore necessary to look beyond the discipline of psychology and examine the scholarship available in other disciplines as well as in activist efforts to illumine questions that are of concern to feminist psychology(ies)—questions of how inequitable access to resources, disproportionate burden of care giving and gender stereotypical identities impact on gender relations and on women’s well-being and identity. From the interface of psychology with feminisms, three thematic areas emerge against the backdrop of past and contemporary socio-political developments in the country that have directly or indirectly influenced and informed the content and direction of research in these thematic areas. The three key themes are (a) mental health and well-being and the influence of the interlinked perspectives of gender, public health, human rights and social justice on this field, (b) gender-based violence and the evolution of psychosocial interventions for reduction and prevention of violence, and (c) the socio-historical construction of identities and the construction of masculinities in particular and that of the “modern Indian woman” in the conundrum of tradition and modernity. First, the literature on gender and mental health emphasizes the need to connect mental health with social determinants, demonstrates the existence of gender bias in access to mental health services, shows that women are represented more in common mental disorders whose aetiology is associated with the social position of women, and highlights the relationship of gender-specific risk factors such as domestic violence to the occurrence of depression in women. Second, the body of work on interventions for reducing and preventing gender-based violence shows services such as one-stop centers hinged on a psychosocial intervention model; and women’s collectives for alternate dispute resolution based loosely on feminist principles, serving as a platform for voicing and recognition of violence and connecting survivors to institutional services. Third, the socio-historical context of identity construction reveals masculinity as a product of interplay of the colonizing and colonized cultures in the nationalist period of pre-independence India, the subsequent turn to “aggressive Hindu communalism” as a model for masculinity and the construction of femininity in the conundrum of tradition and modernity. Thus, despite e some influence and infusion of perspectives on each other, feminisms and psychology in India continue to run parallel to each other, and feminist psychology(ies) in India remains an indistinct field as yet.

Article

Steve A. Nida

The brutal 1964 murder of Kitty Genovese sparked widespread public interest, primarily because it was reported to have taken place in view of some 38 witnesses, most of whom had seen the incident through the windows of their apartments in a high-rise building directly across the street. (Investigative work conducted some 50 years later suggests that there were not that many actual witnesses—more likely as few as seven or eight.) The ensuing analyses provided by newspaper columnists and others tended to focus on the callous indifference that had been demonstrated by those who had chosen not to intervene in the emergency, a state of affairs that came to be known, at least for a while, as “bystander apathy.” (It soon became clear, however, that bystanders in such events are rarely apathetic or indifferent.) Intrigued by the internal and interpersonal dynamics that might be involved, two social psychologists, Bibb Latané and John Darley, began a program of research that led to the conclusion that any notion of “safety in numbers” is illusory. In fact, it is the very presence of other people that may discourage helping in such circumstances. More specifically, other unresponsive bystanders may provide cues suggesting that the event is not serious and that inaction is the appropriate response. In addition, knowing that others are available to help allows the individual bystander to shift some of the responsibility for intervening to the others present, a process that Latané and Darley termed “diffusion of responsibility”; that is, the greater the number of others present, the easier it is for any one individual to assume that someone else will help. Subsequent research has demonstrated that this tendency for the individual to be less likely to help when part of a group than when alone—now known as the “bystander effect”—is a remarkably robust phenomenon. Even though social psychology has developed a thorough understanding of the mechanisms that drive this phenomenon, applying this knowledge is difficult, and significant incidents involving the bystander effect continue to occur.

Article

Stephen J. Bright

In the 21st century, we have seen a significant increase in the use of alcohol and other drugs (AODs) among older adults in most first world countries. In addition, people are living longer. Consequently, the number of older adults at risk of experiencing alcohol-related harm and substance use disorders (SUDs) is rising. Between 1992 and 2010, men in the United Kingdom aged 65 years or older had increased their drinking from an average 77.6 grams to 97.6 grams per week. Data from Australia show a 17% increase in risky drinking among those 60–69 between 2007 and 2016. Among Australians aged 60 or older, there was a 280% increase in recent cannabis use from 2001 to 2016. In the United States, rates of older people seeking treatment for cocaine, heroin, and methamphetamine have doubled in the past 10 years. This trend is expected to continue. Despite these alarming statistics, this population has been deemed “hidden,” as older adults often do not present to treatment with the SUD as a primary concern, and many healthcare professionals do not adequately screen for AOD use. With age, changes in physiology impact the way we metabolize alcohol and increase the subjective effects of alcohol. In addition, older adults are prone to increased use of medications and medical comorbidities. As such, drinking patterns that previously would have not been considered hazardous can become dangerous without any increase in alcohol consumption. This highlights the need for age-specific screening of all older patients within all healthcare settings. The etiology of AOD-related issues among older adults can be different from that of younger adults. For example, as a result of issues more common as one ages (e.g., loss and grief, identity crisis, and boredom), there is a distinct cohort of older adults who develop SUDs later in life despite no history of previous problematic AOD use. For some older adults who might have experimented with drugs in their youth, these age-specific issues precipitate the onset of a SUD. Meanwhile, there is a larger cohort of older adults with an extensive history of SUDs. Consequently, assessments need to be tailored to explore the issues that are unique to older adults who use AODs and can inform the development of age-specific formulations and treatment plans. In doing so, individualized treatments can be delivered to meet the needs of older adults. Such treatments must be tailored to address issues associated with aging (e.g., reduced mobility) and may require multidisciplinary input from medical practitioners and occupational therapists.

Article

Brian C. Focht and Ciaran M. Fairman

Health-related quality of life (HRQL) is a multidimensional subcomponent of quality of life involving subjective appraisal of various dimensions of one’s life that can be affected by health or health-related interventions. There is considerable evidence demonstrating that exercise consistently results in meaningful improvements in an array of HRQL outcomes. Advances in the conceptualization of HRQL and recent evidence identifying select moderators and mediators of the effects of upon HRQL outcomes have important implications for the design and delivery of exercise interventions. Taken collectively, contemporary findings support the utility of adopting a hierarchical, bottom-up approach to the investigation of the effects of exercise upon HRQL.

Article

Aleksandra Kudlicka and Linda Clare

The number of people living with dementia is growing, and with limited pharmacological treatment options the importance of psychosocial interventions is increasingly recognized. Cognitive rehabilitation is particularly well placed to address the needs of people living with mild and moderate dementia and their family supporters, as it offers a range of tools to tackle the complexity of the condition. It utilizes powerful approaches of problem solving and goal setting combined with evidence-based rehabilitative techniques for managing cognitive impairments. It also incorporates strategies to address emotional and motivational aspects of dementia that may affect a person’s well-being. It is provided on an individual basis, usually in people’s homes, making it directly applicable to everyday life. It is also genuinely person-centered and flexible as the therapy goals are agreed in a collaborative process between the therapist, person with dementia, and family members. Cognitive rehabilitation does not claim to address underlying pathology, but instead focuses on a person’s functional ability and enjoyment of life. Evidence for effectiveness of cognitive rehabilitation in the context of mild and moderate dementia, mostly Alzheimer’s disease (AD), is gradually accumulating with a number of randomized control trials demonstrating that people with mild and moderate dementia can significantly improve their functioning in targeted areas. For example, the GREAT trial with 475 people with mild to moderate Alzheimer’s, vascular, and mixed dementia completed in 2017 in the United Kingdom demonstrated that cognitive rehabilitation improves everyday functioning in relation to individual therapy goals. There is a growing interest in cognitive rehabilitation and the focus shifts to extending evidence to less-common forms of dementia, particularly in people with non-amnestic presentation. Future efforts need to concentrate on promoting the approach and optimizing application in real-life settings with the aim of maximizing benefits for people living with dementia and their families.

Article

Ildiko Tombor and Susan Michie

People’s behavior influences health, for example, in the prevention, early detection, and treatment of disease, the management of illness, and the optimization of healthcare professionals’ behaviors. Behaviors are part of a system of behaviors within and between people in that any one behavior is influenced by others. Methods for changing behavior may be aimed at individuals, organizations, communities, and/or populations and at changing different influences on behavior, e.g., motivation, capability, and the environment. A framework that encapsulates these influences is the Behavior Change Wheel, which links an understanding of behavior in its context with methods to change behavior. Within this framework, methods are conceptualized at three levels: policies that represent high-level societal and organizational decisions, interventions that are more direct methods to change behavior, and behavior change techniques that are the smallest components that on their own have the potential to change behavior. In order to provide intervention designers with a systematic method to select the policies, interventions, and/or techniques relevant for their context, a set of criteria can be used to help select intervention methods that are likely to be implemented and effective. One such set is the “APEASE” criteria: affordability, practicability, effectiveness, acceptability, safety, and equity.