Objective: We aimed to document the use of transparent reporting of hypotheses and analyses in behavioral medicine journals in 2018 and 2008. Design: We examined a randomly selected portion of articles published in 2018 and 2008 by behavioral medicine journals with the highest impact factor, excluding manuscripts that were reviews or purely descriptive. Main Outcome Measures: We coded whether articles explicitly stated if the hypotheses/outcomes/analyses were primary or secondary; if study was registered/pre-registered; if 'exploratory' or a related term was used to describe analyses/aims; and if power analyses were reported. Results: We coded 162 manuscripts published in 2018 (87% observational and 12% experimental). Sixteen percent were explicit in describing hypotheses/outcomes/analyses as primary or secondary, 51% appeared to report secondary hypotheses/ outcomes/analyses but did not use term 'secondary,' and 33% were unclear. Registration occurred in 14% of studies, but 91% did not report which analyses were registered. 'Exploratory' or related term was used in 31% of studies. Power analyses were reported in 8% of studies. Compared to 2008 (n = 120), studies published in 2018 were more likely to be registered and less likely to be unclear if outcomes were primary or secondary. Conclusions: Behavioral medicine stakeholders should consider strategies to increase clarity of reporting, and particularly details that will inform readers if analyses were pre-planned or post-hoc. Study registration: https://osf.io/39ztn ARTICLE HISTORY

Objective: Free online tools show potential for promoting weight loss at a low cost, but there is limited evidence about how to effectively engage patients with them. To address this, a low-dose, flexible intervention was developed that aims to enhance weight-related discussions with primary care providers (PCPs) and engage patients with an organic (i.e., not researcher-created) weight loss-focused social media community and online self-monitoring tool. Feasibility and acceptability of the intervention was evaluated in a single-arm, 12-week pilot.Methods: PCPs were recruited at two clinics, then PCP's patients with upcoming appointments were identified and recruited. Patients received an interactive online kickoff before their scheduled primary care appointment, then 8 follow-up messages over 12 weeks via email or their electronic health record patient portal. Patients completed assessments at baseline, post-appointment, and week 12. Primary care providers and patients completed semi-structured interviews.Results: All PCPs approached enrolled (n = 6); patient recruitment was on track to meet the study goal prior to COVID-19 restrictions, and n = 27 patients enrolled.Patient satisfaction with the pre-appointment kickoff was high. Twenty-four patients reported discussing weight-related topics at their primary care appointment and all were satisfied with the discussion. Twenty-two patients completed 12-week assessments. Of these, 15 reported engaging with the self-monitoring tool and 9 with the social media community. Patient interviews revealed reasons for low social media community engagement, including perceived lack of fit. On average, patients with available data (n = 21) lost 2.4 � 4.1% of baseline weight, and 28.6% of these patients lost ≥3% of baseline weight. Primary care providers reported high intervention satisfaction. Conclusions:The intervention and trial design show potential, although additional strategies are needed to promote tool engagement.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Given the broad benefits of physical activity (PA) but low PA levels among breast cancer survivors (i.e., women who have received a breast cancer diagnosis), innovative and evidence-based techniques are needed to motivate and support exercise. This study systematically reviews the use of behavior change techniques (BCTs) in digital PA interventions for breast cancer survivors. Studies were retrieved from five electronic databases and were included if they (i) sampled exclusively female breast cancer survivors aged >18 years, (ii) involved a digital intervention with the primary purpose of increasing PA, (iii) included a BCT component, (iv) used a randomized or quasi-randomized design, and (v) were published from January 2000 to May 2022. Two coders independently extracted data. Twenty primary studies met the inclusion criteria and were included in this review. All interventions used at least one BCT (mean 4 ± 1, range 2–13); self-monitoring (85%) and goal setting (79%) were the most common BCTs. Twelve of 20 (60%) studies reported improvements in PA behavior in the intervention vs. control group, and self-monitoring and goal setting were the most commonly used BCTs in these studies. Of the 93 total BCTs, 66 were not used in any interventions in the review, including critical constructs for PA behavior change (e.g., biofeedback). BCTs, important facilitators of PA behavior change, are being underutilized in digital PA interventions for breast cancer survivors. Future research should incorporate more diverse BCTs to explore if they can add to the effectiveness of digital interventions for this population.

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