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Medication adherence plays an important role in optimizing the outcomes of many treatment and preventive regimens in chronic illness. Self-report is the most common method for assessing adherence behavior in research and clinical care, but there are questions about its validity and precision. The NIH Adherence Network assembled a panel of adherence research experts working across various chronic illnesses to review self-report medication adherence measures and research on their validity. Self-report medication adherence measures vary substantially in their question phrasing, recall periods, and response items. Self-reports tend to overestimate adherence behavior compared with other assessment methods and generally have high specificity but low sensitivity. Most evidence indicates that self-report adherence measures show moderate correspondence to other adherence measures and can significantly predict clinical outcomes. The quality of self-report adherence measures may be enhanced through efforts to use validated scales, assess the proper construct, improve estimation, facilitate recall, reduce social desirability bias, and employ technologic delivery. Self-report medication adherence measures can provide actionable information despite their limitations. They are preferred when speed, efficiency, and low-cost measures are required, as is often the case in clinical care.

OBJECTIVES: Working outside the workplace and ordinary work hours has become common for a larger part of the working population. The objective of the current study was to examine the relationship between working after-hours and employee burnout, musculoskeletal pain, detachment and work–home conflict, delineating the independent effect of four different types of after-hours work, and the moderating role of work-time control. METHODS: The data comprised longitudinal questionnaire data from 1465 full-time employees in Norway across four waves (2021–2022). We examined the link between four types of after-hours work: (i) long daily work hours (>10 hours); (ii) late evening work (after 21:00 hours); (iii) quick returns (<11 hours continued rest); and (iv) long weekly work hours (>40 hours a week) and employee health and wellbeing (ie, work–home conflict, detachment, burnout, and musculoskeletal pain), in fixed effects models. We stratified the analyses by working-time control. RESULTS: The results support a link between late evening work, long daily and weekly work, and higher work–home conflict and lower detachment as well as between weekly work hours and higher burnout. The findings yielded limited support for work-time control as a moderating factor; the link between quick returns and burnout was only evident for employees with below-average work-time control. CONCLUSIONS: The four types of after-hours work were all independently related to at least one employee outcome, although the link with quick returns was only evident when work-time control was below average. The results are important for practitioners aiming to implement family-friendly and healthy practices.

Remote work is fundamentally changing the organization of work, replacing the physical work environment of the office and creating a spatial distance between colleagues. This article investigates the relationship between remote work frequency and three aspects of the psychosocial work environment (quantitative job demands, control, and social support) and to which extent the relationship is mediated by the frequency of contact with supervisors and co-workers. The Norlife Remote Work - Longitudinal Study (NorRemo-LS) of Norwegian employees (n = 2553) across four waves between February 2021 and September 2022 is analyzed using general structural equation modeling (GSEM). The results show that the extent of remote work is associated with increased schedule control. Remote work may diminish employee control and increase quantitative job demands if employees have less frequent contact with their supervisor. Less frequent contact with co-workers not only entails lower job control and less social support but also lower quantitative demands.

Mobile technologies are being used to deliver health behavior interventions. The study aims to determine how health behavior theories are applied to mobile interventions. This is a review of the theoretical basis and interactivity of mobile health behavior interventions. Many of the mobile health behavior interventions reviewed were predominately one way (i.e., mostly data input or informational output), but some have leveraged mobile technologies to provide just-in-time, interactive, and adaptive interventions. Most smoking and weight loss studies reported a theoretical basis for the mobile intervention, but most of the adherence and disease management studies did not. Mobile health behavior intervention development could benefit from greater application of health behavior theories. Current theories, however, appear inadequate to inform mobile intervention development as these interventions become more interactive and adaptive. Dynamic feedback system theories of health behavior can be developed utilizing longitudinal data from mobile devices and control systems engineering models.

Adverse and suboptimal health behaviors and habits are responsible for approximately 40 % of preventable deaths, in addition to their unfavorable effects on quality of life and economics. Our current understanding of human behavior is largely based on static “snapshots” of human behavior, rather than ongoing, dynamic feedback loops of behavior in response to ever-changing biological, social, personal, and environmental states. This paper first discusses how new technologies (i.e., mobile sensors, smartphones, ubiquitous computing, and cloud-enabled processing/computing) and emerging systems modeling techniques enable the development of new, dynamic, and empirical models of human behavior that could facilitate just-in-time adaptive, scalable interventions. The paper then describes concrete steps to the creation of robust dynamic mathematical models of behavior including: (1) establishing “gold standard” measures, (2) the creation of a behavioral ontology for shared language and understanding tools that both enable dynamic theorizing across disciplines, (3) the development of data sharing resources, and (4) facilitating improved sharing of mathematical models and tools to support rapid aggregation of the models. We conclude with the discussion of what might be incorporated into a “knowledge commons,” which could help to bring together these disparate activities into a unified system and structure for organizing knowledge about behavior.

Background Depression and anxiety are the most common mental health problems among women, with various negative impacts both for the women concerned and their families. Greater understanding of developmental trajectories of maternal symptoms of depression and anxiety over the child rearing period would have significant benefits for public health, informing prevention and treatment approaches. The aim of the current study was to examine whether stressors related to child rearing and living conditions, social support, and maternal temperament, predicted mothers’ membership in groups with different trajectories of symptoms of depression and anxiety during 13 years of the child rearing phase. Methods The data were from a prospective, longitudinal study of 913 mothers in Norway followed from when their children were 18 months old (time 1) until they were 14.5 years (time 6) (the TOPP study). Multinomial logistic regression analyses were used to test whether child related stressors, stressors related to the living conditions, social support and maternal temperament at time 1 predicted membership in groups based on maternal symptoms of depression and anxiety over the subsequent 13 years. Results Temperamental distress, followed by child related stressors, were the strongest predictors of membership in a group with high symptoms of depression and anxiety over time. Stressors related to living conditions, and social support from partner and friends/family were also significant predictors. No interaction effects among predictors were found. Conclusions This study indicates that factors present early in the child rearing phase may provide substantial prediction of the variance in maternal symptoms of depression and anxiety over the following 13 years. Temperamental distress and child related stressors were the strongest predictors of membership in different depression and anxiety symptom trajectory groups.

ObjectiveThere is growing interest in the relationship between sedentary behaviour and mental distress among adolescents, but the majority of studies to date have relied on self-reported measures with poor validity. Consequently, current knowledge may be affected by various biases. The aim of this study was to investigate the cross-sectional and longitudinal association between (1) objectively measured sedentary time and (2) self-reported screen time with mental distress among adolescents participating in The Tromsø Study: Fit Futures, in order to see if the association is dependent on mode of measurement of sedentary behaviour.DesignProspective study.SettingSample drawn from upper secondary school students (mean age 16.3 years at baseline) from two municipalities in Northern Norway participating in The Tromsø Study: Fit Futures 1 and 2.Participants686 adolescents (54.5% female), with complete self-reported and accelerometer data after multiple imputation.Primary outcome measuresMental distress assessed via the Hopkins Symptom Checklist-10 (HSCL-10).ResultsMinutes in sedentary behaviour measured by accelerometer showed no significant relationship with mental distress in neither crude, partly adjusted nor multiple adjusted hierarchic linear regression analyses. Self-reported screen time was positively associated with mental distress in all analyses (multiple adjusted, B=0.038, p=0.008, 95% CI 0.010 to 0.066). However, the effect was small.ConclusionsSelf-reported screen time was associated with slightly elevated mental distress 2 years later, whereas objectively measured minutes in sedentary behaviour was not, indicating a discrepancy in the results depending on measurement methods.

Background Social skills might play an important role for the relationship between maternal psychological distress and subsequent development of depressive symptoms. The majority perspective is that social skills is adaptive and protective, but there is a need to also highlight the potential maladaptive effect of social skills in some settings or for some sub groups. The current study examined the longitudinal interplay between maternal-reported psychological distress in early childhood (age 1.5), and offspring reports on social skills and depressive symptoms in early (age 12.5) and middle adolescence (age 14.5). Methods We used data from the Tracking Opportunities and Problems Study (TOPP), a community-based longitudinal study following Norwegian families to examine direct links and interactions between early maternal distress (measured with the Hopkins Symptom Checklist) and early adolescent offspring social skills (measured with the Social Skills Rating System) and middle adolescent depressive symptoms (measured with the Moods and Feelings Questionnaire) in 370 families (in total 740 mothers and adolescents). Results Exposure to childhood maternal distress predicted offspring depressive symptoms in middle adolescence. Higher social skills in early adolescence predicted lower levels of depressive symptoms for girls, but not for boys, in middle adolescence. An interaction effect was found in which adolescents exposed to early maternal distress who reported high social skills in early adolescence had the highest level of depressive symptoms in middle adolescence. Conclusions The findings highlight the nuances in the role of social skills for adolescent depressive symptoms – having the potential to be both adaptive as well as maladaptive for some subgroups (those experiencing maternal psychological distress). This has important implications for social skill programs.

Background Parental chronic pain has been associated with adverse outcomes in offspring. However, knowledge on individual and family resilience factors in adolescent offspring of chronic pain sufferers is scarce. This study thus aimed to investigate the associations between parental chronic pain and self-esteem, social competence, and family cohesion levels reported by adolescent girls and boys. Methods Based on cross-sectional surveys from the Nord Trøndelag Health Study (the HUNT 3 study), the study used independent self-reports from adolescents aged 13 to 18 years ( n  = 3227) and their parents and conducted separate linear regression analyses for girls and boys. Results Concurrent maternal and paternal chronic pain was associated with reduced self-esteem, social competence, and family cohesion in girls. Moreover, maternal chronic pain was associated with higher social competence in boys and reduced self-esteem in girls. The majority of the observed associations were significantly different between girls and boys. Paternal chronic pain was not found to be associated with child outcomes. Conclusions The findings indicate that the presence of both maternal and paternal chronic pain could be a potential risk factor for lower levels of individual and family resilience factors reported by girls. Further research on the relationship between parental pain and sex-specific offspring characteristics, including positive resilience factors, is warranted. The study demonstrates the importance of targeting the entire family in chronic pain care.