Krista Wilke Ranby

Dual-smoker couples exhibit highly interdependent smoking behaviors, less frequent quit attempts, higher risk of relapse, and lower cessation rates. Financial incentive treatments are a promising form of intervention that lead to abstinence and can be adapted to address the motivational and relationship obstacles that dual-smoker couples face. We enrolled 95 dual-smoker couples (total n = 190) in a randomized controlled trial (National Clinical Trials 04832360) to investigate the potential mechanisms by which two versions of partner-involved financial incentive treatments (combined in analyses) might facilitate quitting relative to a no-incentive control. Dyadic structural equation modeling tested whether the dyadic interventions impacted the likelihood of individual and couple-level cessation and whether these effects were mediated by individual (i.e., motivation) and relationship (i.e., partner support) processes. The results suggest that self-directed and partner-directed motivation changed in response to partner-involved financial incentive treatments. Change in self-directed motivation mediated the effect of the intervention on individual and joint abstinence at follow-up; partner-directed motivation also mediated the effect of the intervention on joint abstinence at follow-up. Our findings highlight the benefits of dyadic adaptations of treatments for dual-smoker couples and point to potential motivational mechanisms of behavior change. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Relationship partners’ impacts on health are not fully captured by existing measures. A measure that applies to a prevention context and accounts for both partners’ perspectives is needed. This wor...

Physical activity (PA) and exercise, a subset of PA that is a planned and structured movement for the purpose of maintaining physical fitness or health, are some of the most studied health behaviors. In contrast, sedentary behavior is not just the absence of movement but is distinct from PA and exercise, and typically is defined as time spent sitting. Notably, routine PA is related to numerous psychosocial and health benefits as well as salutary effects for chronic disease management and increased longevity, whereas sedentary behavior is associated with increased morbidity and all-cause mortality ^{[1, 2]}. Despite the well-documented guidelines for PA, many people worldwide engage in excessive sedentary behavior or do not participate regularly in PA, resulting in a substantial increased risk for chronic illness and premature mortality ^[3]. Data suggest that although insufficient PA is a concern across all age ranges, adolescence/emerging...

Background: Younger breast cancer survivors face unique challenges, and research is needed to better understand how to optimize their quality of life (QoL) and satisfaction with life (SwL). Objective: The aim of this study was to examine a biopsychosocial model of QoL and SwL in young breast cancer survivors. Biological, psychological, and social/practical factors were hypothesized to be associated with both distressing and adaptive reactions during survivorship, which in turn were hypothesized to be associated with QoL and SwL. Methods: Young (age = 19-45 years at diagnosis) breast cancer survivors (N = 284) completed an online survey assessing demographic and biopsychosocial factors, QoL, and SwL. Latent variables were created for adaptive and distressing reactions, and structural equation modeling was used to test the hypothesized relationships. Results: The model fit the data (χ²(100) = 332.92, P < .001, comparative fit index = 0.86, root mean square error of approximation = 0.09, standardized root mean square residual = 0.05) and accounted for large proportions of variance in QoL (R ² = 0.86) and SwL (R ² = 0.62). Social support, parenting concerns, and fertility concerns each significantly predicted adjustment. Adaptive reactions positively predicted SwL (β = 0.58, P < .001) but not QoL. Distressing reactions negatively predicted SwL (β = −0.26, P < .01) and QoL (β = −0.87, P < .001). Conclusions: Adjustment in survivorship mediated the association of social support, parenting concerns, and fertility concerns on QoL and SwL in young breast cancer survivors. Implications for Practice: To support the psychological adjustment of young breast cancer survivors, attention should be given to survivors' social context including survivors' available social support and their concerns about fertility and parenting.

Objective: Prostate cancer (PC) and its treatment often result in chronic, negative side‐effects that affect both patients and their romantic partners. Illness uncertainty is a chronic stressor that impacts PC patients and their partners and, if left unmanaged, predicts decreased interpersonal functioning and quality of life (QOL) after treatment is complete. This study explored associations among psychosocial constructs, measured from both partners during the first year following a PC diagnosis, to better understand both partners' experiences and identify potential intervention targets for improving QOL.Methods: Couples (N = 165) in which one partner was undergoing treatment for PC were recruited from the Duke University Medical Center of Urology. Patients and their partners were surveyed at four time points: diagnosis and 1‐, 6‐, and 12‐months post treatment. An Actor‐Partner Interdependence Model (APIM) framework was used to examine associations among perceived partner support, nonsupportive behaviors, illness uncertainty, relationship satisfaction, and physical and mental QOL.Results: Partners feeling more supported at diagnosis was related to patients feeling more supported at 6 months. When patients' illness uncertainty decreased between diagnosis and 1 month, partners reported feeling more supported and engaging in fewer nonsupportive behaviors at 6‐months post‐treatment. Finally, partners' reports of support at 6 months predicted patients' 12‐month ratings of physical and mental QOL and relationship satisfaction.Conclusions: Findings highlight psychological interdependence between PC patients and their partners. Future interventions to improve long‐term QOL in couples facing PC may benefit by targeting both partner support and illness uncertainty.

Background: Patients with repeated hospitalizations represent a group with potentially avoidable utilization. Recent publications have begun to highlight the heterogeneity of this group. Latent class analysis provides a novel methodological approach to utilizing administrative data to identify clinically meaningful subgroups of patients to inform tailored intervention efforts. Objective: The objective of the study was to identify clinically distinct subgroups of adult superutilizers. Research Design: Retrospective cohort analysis. Subjects: Adult patients who had an admission at an urban safety-net hospital in 2014 and 2 or more admissions within the preceding 12 months. Measures: Patient-level medical, mental health (MH) and substance use diagnoses, social characteristics, demographics, utilization and charges were obtained from administrative data. Latent class analyses were used to determine the number and characteristics of latent subgroups that best represented these data. Results: In this cohort (N=1515), a 5-class model was preferred based on model fit indices, clinical interpretability and class size: class 1 (16%) characterized by alcohol use disorder and homelessness; class 2 (14%) characterized by medical conditions, MH/substance use disorders and homelessness; class 3 (25%) characterized primarily by medical conditions; class 4 (13%) characterized by more serious MH disorders, drug use disorder and homelessness; and class 5 (32%) characterized by medical conditions with some MH and substance use. Patient demographics, utilization, charges and mortality also varied by class. Conclusions: The overall cohort had high rates of multiple chronic medical conditions, MH, substance use disorders, and homelessness. However, the patterns of these conditions were different between subgroups, providing important information for tailoring interventions.