Search Results (141)

Cancer-related cognitive impairment (CRCI), also known as chemobrain or chemofog, is characterized by subjective and/or objective changes in attention, executive functions, memory, and processing speed in patients with non-CNS cancers, particularly women with breast cancer. This structured narrative review synthesizes current evidence on mechanisms, neuropsychological assessment, neuroimaging correlates, clinical and demographic risk factors, emerging artificial intelligence and machine learning applications, and non-pharmacological approaches to CRCI in breast cancer. A structured literature search was conducted using PubMed/MEDLINE, PsycInfo, and Clinical Key up to May 2026, with emphasis on studies published between 2023 and 2026. Peer-reviewed English-language studies involving adult breast cancer populations and addressing predefined thematic domains of CRCI were considered. Given the heterogeneity of study designs, assessment tools, interventions, and outcomes, the findings were synthesized narratively. Current evidence supports a multifactorial model of CRCI involving neurobiological, treatment-related, psychological, and behavioral mechanisms. Neuroinflammation, endocrine disruption, oxidative stress, glial alterations, and structural or functional brain changes may contribute to cognitive symptoms; however, the strength of evidence varies, and many findings remain correlational or preclinical. Non-pharmacological interventions, including cognitive training, physical activity, mindfulness-based and psychological approaches, and multimodal digital programs, appear promising as supportive strategies. However, evidence remains heterogeneous, with benefits more consistently reported for patient-reported outcomes, fatigue, emotional distress, and quality of life than for objective neuropsychological performance. CRCI in breast cancer should be approached as a heterogeneous condition requiring early recognition, standardized assessment, and multidisciplinary supportive care. Future research should prioritize longitudinal designs, harmonized endpoints, and a clearer distinction between subjective and objective outcomes. Full article

The HORUS project investigates the interface between urban planning and public health, focusing on the reduction in non-communicable diseases through innovative urban planning and technological integration. Using geographic information systems, the project will develop advanced urban mapping and analysis tools to visualize and tackle health inequalities. The participatory approach of technologies will actively engage communities and empower citizens to shape a healthier urban environment. Through multidimensional methodology, including qualitative research and natural experiments, HORUS will align urban planning with public health needs. The project will target modifiable risk factors (physical inactivity, unhealthy diet and substance use) and will promote behavior change and environmental redesign to reduce the prevalence of non-communicable diseases. The integration of digital technologies will not only improve the assessment of urban health but also facilitate evidence-based interventions tailored to vulnerable populations. HORUS will provide practical applications for policy makers and urban planners by providing actionable frameworks for incorporating health-promoting features into urban design. This holistic approach will help create resilient cities that prioritize public health and shape the future urban environment. The project is an example of the transformative potential of aligning technology, policy and community engagement to effectively address the challenges of urbanization, and non-communicable diseases. Full article

Breast cancer survivors frequently experience adverse changes in body composition, cardiometabolic biomarkers, functional capacity and quality of life that may worsen long-term prognosis, yet the comparative effectiveness of lifestyle interventions across delivery formats and supervision levels remains unclear. Background/Objectives: This systematic review assessed the effects of structured diet and exercise interventions on body composition, metabolic and inflammatory biomarkers, functional capacity, dietary habits and quality of life in breast cancer survivors. Methods: Following PRISMA guidelines, Cochrane, PubMed, Scopus and Web of Science were searched for randomized controlled trials and quasi-experimental studies published in English between 2016 and 2026. Risk of bias was assessed with RoB 2 and ROBINS-I and certainty of evidence with GRADE. Results: Of 1413 records, 15 studies (11 RCTs; mean age 46–60 years; mostly overweight or obese post-treatment women) met the inclusion criteria; twelve interventions were supervised and three home-based or web-based. Within the assessed domains, many studies reported significant improvements in body composition, quality of life and metabolic or inflammatory biomarkers. Effects were larger in multimodal supervised programs combining caloric restriction with moderate-to-vigorous aerobic plus resistance training (5–8% weight loss; 19–29% visceral fat reduction; improved insulin, IGF-1, leptin, adiponectin and EORTC QLQ-C30 scores), whereas digital or low-intensity interventions produced smaller, less uniform objective effects despite improving dietary behaviors. GRADE certainty ranged from very low to moderate–high. Conclusions: Multimodal supervised programs offer the most robust benefits; digital formats require additional supervision. Standardized protocols and longer follow-up are needed. Full article

Background/Objectives: Understanding the microstructure of ingestive behavior (IB) is critically important to the development and success of interventions to change eating rates and produce more optimal food energy intake outcomes. Detailed measurement of IB microstructure is needed to guide development of real-time sensing approaches that can support such interventions. This article summarizes novel measurement and inference strategies around both digital video and inertial motion sensors in a structured laboratory protocol. Methods: Digital video footage was annotated for chews and bites and analyzed with generalized additive models to assess differences in IB for each of four meal courses varying by food texture. Results: Significant differences were revealed in IB microstructure in the form of nonlinear patterns of annotated video footage and initial sensing tests, indicating an optimal sensor location over the jaw’s condyle bone. Conclusions: Findings of an intensive longitudinal multicourse full meal protocol reflect important differences in nonlinear trends of eating behavior for diverse texture foods. These differences inform further development of technology-aided measurement strategies, provide an experimental protocol for fieldwide IB inquiry, and reveal expected fundamental differences in ingestion rates. Further inquiry into the underlying causes of nonlinearities for high UPF foods, along with sensor measurements, is warranted. Full article

The perinatal period is a critical window of susceptibility for fetal development and awareness for women’s health. Pregnant women are highly motivated to reduce environmental health risks, yet often lack personalized, actionable guidance on mitigating endocrine-disrupting chemicals and other household hazards. Grounded in Motivational Interviewing theory, a digital assessment was developed to empower parents to identify and reduce exposures. The tool screens for home-based and environmental risks across several domains: air quality, lead, tobacco, cleaning agents, pesticides, and plastics (BPA/phthalates). Based on user inputs, a defined algorithm generates a positive index score paired with prioritized, low-cost behavioral recommendations designed to shift users from risk awareness to active mitigation. Since its launch in Spring 2024, the tool has had over 1900 views. Preliminary analytics suggest promising engagement, and feedback more so suggests that the motivational-interview-based framing, which emphasizes empowerment over fear, facilitates immediate behavioral changes, such as switching to safer personal care products and improving indoor ventilation. Digital health interventions that translate complex environmental data into a single, manageable score can bridge the gap between clinical knowledge and household practice. This article details the score’s calculation methodology and underlying datasets, and reports usage analytics and user feedback, discussing how digital screening can scale environmental health literacy and improve maternal and child health outcomes. Full article

Background: Schools are widely recognized as key settings for promoting healthy eating behaviors and supporting childhood obesity prevention. In recent years, increasing attention has been devoted to experiential and interactive nutrition education strategies designed to actively engage children and adolescents in food-related learning processes. These approaches move beyond traditional didactic teaching and include practical and participatory formats, such as cooking activities, school gardening, digital or app-based learning tools, workshops and educational camps, and game-based learning interventions. Objective: This narrative review aims to provide an overview of experiential school-based nutrition education interventions, describing the main types of programs implemented in school settings and summarizing their reported effects on nutrition knowledge, attitudes, and eating behaviors among children and adolescents. Results: Across intervention studies and systematic reviews, hands-on and interactive educational models, including cooking classes, gardening programs, digital learning tools, workshops or camps, and board game-based interventions, frequently report improvements in nutrition knowledge, attitudes toward food, food-related skills, and self-efficacy. These programs seek to strengthen food literacy by combining experiential learning with educational content delivered within the school environment. Evidence regarding changes in dietary intake, diet quality, and anthropometric outcomes is more heterogeneous, with some studies reporting improvements in eating behaviors and others showing more modest or short-term effects. Program outcomes appear to be influenced by several contextual factors, including intervention duration, curriculum integration, teacher involvement, and the availability of resources supporting implementation. Conclusions: Experiential and interactive approaches represent an increasingly adopted strategy in school-based nutrition education. Their effectiveness appears to depend on the quality of implementation, the degree of integration within the school curriculum, and the broader educational context. Future research should further explore how different experiential formats can be optimally integrated into school systems to support the development of food literacy and sustainable healthy eating behaviors among children and adolescents. Full article

Background: Pediatric obesity (PO) is a chronic disease requiring multidisciplinary management. Recent clinical guidelines emphasize the need for accessible, patient-centered solutions, positioning mHealth interventions as vital “clinical extenders” in modern practice. Objective: This systematic review and meta-analysis evaluate the efficacy and evolution of mHealth interventions for PO management between 2020 and 2026. Methods: A systematic search of electronic databases identified randomized controlled trials (RCTs) investigating mHealth for PO. Quality was assessed using the Cochrane RoB 2 tool, and a meta-analysis was performed on a subset of studies reporting zBMI data. Results: Twenty-three RCTs met the inclusion criteria, of which six were included in the quantitative synthesis. The meta-analysis demonstrated a statistically significant reduction in BMI z-score (MD = −0.20; 95% CI: −0.36 to −0.04; p = 0.02), with moderate heterogeneity (I² = 60%; Q = 13.5, p = 0.019). Beyond anthropometric outcomes, mHealth interventions consistently improved behavioral parameters, including dietary quality and sedentary time. However, engagement declined over time in standalone digital interventions (“mHealth fade-out”), whereas hybrid models integrating human support demonstrated improved retention and sustained effects. Anthropometric and behavioral outcomes showed partially divergent trajectories, with behavioral improvements often preceding measurable changes in BMI, and data on body composition were rarely reported, limiting a more precise understanding of changes in adiposity beyond BMI. Conclusions: mHealth is an effective catalyst for obesity management when integrated into a multidisciplinary framework. Future protocols must prioritize developmental tailoring—targeting parental empowerment in early childhood and encouraging adolescent autonomy—to ensure sustained engagement and a clinical focus that looks beyond BMI. Full article

Background: Adolescence is a critical period for the development of beverage-related behaviors; however, the role of digital interventions in addressing sugar-sweetened beverage and energy drink consumption remains insufficiently characterized. Methods: This study examined the literature on digital interventions aimed at modifying beverage-related behaviors among adolescents through a structured search in Scopus, PubMed, and Web of Science. Eligible studies were analyzed descriptively and classified according to intervention focus, digital delivery mode, behavior change strategy, ecological level of delivery, and beverage outcome specificity. Results: Twenty-two studies were included. Most studies have focused on sugar-sweetened beverage outcomes, whereas energy drink consumption has rarely been addressed directly. The identified interventions were predominantly mobile- or web-based and were often embedded within broader multicomponent, school-based, or lifestyle-oriented approaches. Beverage-related outcomes varied substantially across studies. Conclusions: Digital interventions targeting beverage-related behaviors in adolescents represent a promising but fragmented field. These findings offer a structured analytical foundation for designing and implementing future digital interventions targeting beverage consumption in adolescents. Full article

Background: Obesity is a major public health concern associated with adverse physical and psychological outcomes, including body shame (BS) and reduced self-esteem (SE). Lifestyle interventions incorporating dietary and exercise components, such as time-restricted eating (TRE), mindful eating, and structured physical activity, have shown promise; however, evidence on their combined effects within scalable, web-based formats remains limited. Objective: This study aimed to evaluate the effectiveness of a multi-component, web-based lifestyle intervention integrating TRE, mindful eating, and structured online exercise on body composition and psychological outcomes in young adults. Methods: In this pilot randomized controlled trial, 42 healthy young adults (age: 20.4 ± 1.6 years) were allocated to either an intervention group (n = 28) or a control group (n = 14). The intervention group followed an integrated program combining TRE, mindful eating principles, and guided online exercise sessions, while the control group received standard dietary and physical activity recommendations. Outcomes included body composition, anthropometric measures, BS (Weight- and Body-Related Shame and Guilt Scale), SE (Rosenberg Self-Esteem Scale), and eating behavior (Three-Factor Eating Questionnaire). Results: Significant group × time interactions were observed for body fat percentage (p < 0.001), fat mass (p = 0.001), and body mass (p = 0.025), with the intervention group demonstrating greater reductions compared with controls. BS scores significantly decreased in the intervention group, whereas no significant between-group differences were observed for SE (p > 0.05). Dietary adherence appeared higher than exercise adherence over the intervention period. Conclusions: A multi-component, web-based lifestyle intervention integrating TRE, mindful eating, and structured exercise may improve body composition and reduce BS in young adults. However, changes in SE were not observed over the short term. These findings support the feasibility of scalable digital lifestyle interventions, while highlighting the need for longer-term studies to clarify psychological outcomes. Full article

Physical activity apps offer significant potential to promote physical activity and active aging; however, their acceptance among older adults remains limited, often due to insufficient digital literacy. This study aimed to examine whether targeted, app-specific digital literacy training can improve eHealth literacy, acceptance of physical activity apps, and behavioral intentions among older women, drawing on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) extended with a personal innovativeness construct. A total of 63 older women (M = 67.0, SD = 4.6) were randomly assigned to an experimental (n = 32) or control group (n = 31). The experimental group participated in a nine-week digital literacy training focused on practical use of physical activity apps. Measures were collected before and after the intervention. Data were analyzed using repeated-measures MANOVA and ANOVAs. A significant Group × Time interaction was observed for technology acceptance (Wilks’ Λ = 0.41, F (7, 54) = 11.14, p < 0.001, η_p² = 0.59). The experimental group showed significant improvements across all measured constructs. The largest effects were found for eHealth literacy (η_p² = 0.39) and intention to use physical activity apps (η_p² = 0.24). App-specific digital literacy training can enhance technology acceptance and support physical activity–related intentions among older women, highlighting its potential to reduce digital barriers and promote active aging. The findings reflect short-term, self-reported changes in technology acceptance and behavioral intentions. Full article

Background/Objectives: Digital health ecosystems increasingly integrate content, behavioral interventions, and commercial offerings across multiple platforms. While design consistency is established as critical for trust in commercial contexts, its associations with health behavior change and objective health outcomes remain underexplored. This study examined how cross-platform design consistency and aesthetic experience are associated with behavioral adoption through psychological pathways and investigated relationships between design-driven adoption and objective health outcomes. Methods: A convergent mixed-method design comprised five integrated studies: systematic content analysis of short-form videos (N = 200), expert evaluation and user testing (N = 33), a cross-sectional survey (N = 186), semi-structured interviews (N = 15), and a 3-month longitudinal health outcome analysis (N = 143). Structural equation modeling tested pathways from design features through psychological mediators and COM-B components (capability, opportunity, motivation) to behavioral adoption and health outcomes. Results: Design consistency was significantly associated with trust (β = 0.52), perceived value (β = 0.68), and reduced perceived risk (β = −0.41; all p < 0.001). Aesthetic experience predicted emotional resonance (β = 0.71, p < 0.001) and moderated design–trust associations. COM-B components mediated 75% of the intention-to-adoption pathway (total indirect effect = 0.51, p < 0.001). High-adoption users showed clinically meaningful improvements in weight (−2.8 kg, d = 0.89), HbA1c (−0.7%, d = 0.65), fasting glucose (−0.9 mmol/L, d = 0.72), and LDL-C (−0.4 mmol/L, d = 0.51) over three months. Conclusions: Within a single, influencer-centered Chinese digital health ecosystem, design consistency and aesthetic experience were significantly associated with trust, psychological readiness, and behavioral adoption. These findings are observational; randomized controlled trials and multi-site replication are required to establish causal mechanisms and assess generalizability. Full article

Physical inactivity is a major preventable cause of non-communicable disease and premature mortality. Mobile health interventions can promote physical activity, but their effectiveness depends on the ability to adapt to user’s context and motivation. Reinforcement learning (RL), particularly contextual bandits (CBs), offers a promising framework for such adaptive personalization. However, in practice, RL-based models face the cold start problem (CSP), due to the lack of initial training data. This study examines whether theory-driven simulated data can mitigate the CSP in training RL systems for personalized physical activity recommendations. A scoping review of 18 empirical studies on the Integrated Behavioral Change Model (IBC) provided population parameters for key constructs, used to simulate 2000 virtual users via multivariate modeling and structural equation calibration. A CB algorithm with an ε-greedy policy was trained with this dataset and compared with data from real world pilot using the Apptivate mHealth web-app (n = 588). Results showed close alignment between simulated and real behaviors. Our findings demonstrate that behaviorally informed synthetic data can effectively be used to train RL algorithms, offering an interpretable, sustainable, scalable, and privacy-safe solution to the CSP in personalized digital health interventions. Full article

Background: Exercise is safe and beneficial for managing symptoms, preventing progression, and enhancing the physical and mental well-being of people with multiple sclerosis (MS). Such evidence has supported prescriptive guidelines delivered alongside behavioral interventions to promote and sustain exercise behavior. Evidence-based exercise training interventions now exist for people with MS, such as Project GEMS, a home-based program grounded in MS-specific exercise training guidelines and supported by principles of behavior change based on social–cognitive theory. The field is now ready for the process of translating evidence-based programs from research settings into clinical or community contexts for greater reach and accessibility, but dissemination and implementation remain significant challenges. Objectives: The current paper presents a conceptual roadmap for implementing a validated home-based exercise training intervention for people with MS, originally tested in controlled research environments, within the broader community context. This is guided by the PRACTIS framework for scaling up physical activity/exercise interventions. Roadmap: Our paper presents a conceptual example along with details regarding strategic adaptations for tailoring the remote GEMS program for a diverse and wide MS population, integrating input from community stakeholders and ensuring long-term sustainability through collaborative researcher–stakeholder partnerships. Such an initiative may bridge the gap between research and practice in the domains of exercise training and behavioral interventions for people with MS and further serve as a scalable model for promoting exercise behavior in other neurological conditions by expanding accessibility for effective digital resources. Conclusion: The design of the exercise intervention discussed in this paper offers one example and conceptual pathway for expanding access for evidence-based exercise programs at the wider level. Full article

Background: The BEST study investigated the effectiveness of a 12-week digital treatment program for male LUTS. Here, we report on the long-term outcomes of the patients involved in this trial. Methods: The randomized controlled BEST trial enrolled 237 patients (intervention group, IG: n = 112, hereafter referred to as the direct intervention group [DIG]; control group, CG: n = 125, hereafter referred to as the postponed intervention group [PIG]). The intervention consisted of pelvic floor muscle training, behavioral training, completion of a micturition diary, bladder training, urge suppression techniques, fluid and dietary management, and structured educational content. Patients in the DIG received the intervention immediately, Patients in the PIG after a 12-week waiting period. Patients in both groups were offered the option to complete additional treatment cycles at their discretion. The primary endpoint was change from baseline in the International Prostate Symptom Score (IPSS). Secondary endpoints included the symptom severity (OAB-q SF1) and quality-of-life (OAB-q SF2) subscales of the Overactive Bladder Questionnaire, among others. Long-term follow-up assessments at 24, 36, and 48 weeks for participants in both study arms were prospectively specified in the study protocol. Results: Baseline data from 236 patients were available for the follow-up analyses. In a linear mixed-effects model, the fixed effect of time on IPSS was found to be statistically significant (F(4, 515.245) = 89.77, p < 0.001), indicating differences across measurement time points. Compared with the baseline, IPSS scores were lower at all subsequent follow-up assessments. The mean difference between the baseline and 12 weeks after was −6.32 points (95% CI: −7.60 to −5.04; p < 0.001). Differences between the baseline and 24 weeks (−7.81 points; 95% CI: −9.37 to −6.25; p < 0.001), baseline and 36 weeks (−8.62 points; 95% CI: −10.46 to −6.79; p < 0.001), and baseline and 48 weeks (−9.56 points; 95% CI: −12.66 to −6.46; p < 0.001) were also statistically significant. Comparable patterns of improvement were observed for both subscales of the OAB-q Short Form questionnaire. In a separate linear mixed-effects model, the fixed effect of time on IPSS after the discontinuation of app usage was not statistically significant (F(2, 19.750) = 0.01, p = 0.992), suggesting stable effects after discontinuation. Conclusions: Long-term outcomes of the structured app-based therapeutic program demonstrated that a multimodal digital intervention for male LUTS induces a rapid and clinically meaningful symptom reduction within the first 12 weeks, with consolidating and sustaining benefits over up to 48 weeks. Full article

Background: Nudging has become a prominent approach for influencing secure digital behavior, yet its theoretical coherence and long-term effectiveness remain unclear. Objectives: This systematic review examines how the “nudging paradigm” is interpreted and operationalized in cybersecurity research and evaluates the short-term effectiveness and durability of nudging interventions on user behavior. Methods: Following PRISMA 2020 guidelines, we searched Scopus, APA PsycInfo, IEEE Xplore, and the ACM Digital Library using the query “(cybersecurity OR security) AND nudg*”. We included peer-reviewed empirical studies that explicitly self-identified their intervention as a “nudge” within a digital security context. Two reviewers independently screened records and extracted data. Studies were classified by cybersecurity domain, nudge type, and functional mechanism. Risk of bias was assessed descriptively using a behavior-analytic quality lens focusing on ecological validity, outcome type, and temporal scope. Results were synthesized narratively and descriptively at the study level. Results: Sixty-five studies (2012–December 2025) met inclusion criteria. Most focused on password security and privacy/data security. Informational/feedback nudges predominated, followed by default/design, framing, and social nudges. Many studies reported significant short-term behavioral effects, particularly when interventions embedded response-contingent feedback or altered response effort via protective defaults. Effects were most consistent for direct behavioral outcomes (e.g., password strength, clicks, configuration choices). Only one study met the criterion of post-withdrawal follow-up (≥2 weeks), and it did not demonstrate sustained maintenance of secure behavior once prompts and interface support were fully removed. Limitations: Evidence is constrained by heterogeneous designs, frequent reliance on short online experiments, limited ecological validity, and the near absence of post-withdrawal follow-ups. Interpretation: Nudging in cybersecurity reliably produces short-term improvements when interventions modify immediate contingencies of action. However, the literature does not currently provide empirical tests of durable behavior change under full withdrawal conditions. Future research should integrate consequence-based design, assess maintenance after withdrawal, and test generalization across contexts. Full article