Courtney J Stevens

• Ph.D.
• Assistant Professsor at Geisel School of Medicine at Dartmouth

Occupational performance challenges are common among breast cancer survivors (BCS). In a recent randomized controlled trial (RCT), our rehabilitation intervention catalyzed significantly greater improvements in occupational performance compared to an education-based control condition. To describe BCS’ activity priorities and examine what short-term...

Background Rural healthcare has unique characteristics that affect the dissemination and implementation of evidence-based interventions. Numerous theories, models, and frameworks have been developed to guide implementation of healthcare interventions, though not specific to rural healthcare. The present scoping review sought to identify the theorie...

Importance Following treatment, breast cancer survivors face challenges participating in valued activities. Objective To determine whether a telephone-based coaching rehabilitation intervention enhances activity participation in the year following breast cancer treatment. Design, Setting, and Participants In this multisite, single-blind randomize...

The purpose of the present study was to conduct a process evaluation of intervention delivery for a randomized controlled trial (RCT) conducted during the COVID-19 pandemic (NCT 03915548). The RCT tested the effects of a telephone-delivered behavioral intervention on changes in breast cancer survivors’ satisfaction with social roles and activities,...

PURPOSE Evidence supporting social media–based recruitment of cancer survivors is limited. This paper describes how we used Facebook during the COVID-19 pandemic to augment our recruitment of breast cancer survivors for our two-site telephone-based randomized clinical trial (RCT) at Dartmouth-Hitchcock Medical Center and the University of Alabama a...

Scalable, transdiagnostic interventions are needed to meet the needs of a growing population of older adults experiencing multimorbidity and functional decline. Behavioral activation (BA) is a pragmatic, empirically-supported treatment for depression that focuses on increasing engagement in values-aligned activities. We propose BA is an ideal trans...

Background: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic etiology of acute coronary syndrome (ACS) that primarily affects younger women with few traditional cardiovascular disease risk factors. The primary objective of this study was to evaluate how younger age impacts the perception of care women receive in the emergency d...

Objectives Lonely and socially isolated homebound older participants of a randomized trial comparing behavioral activation (BA) vs. friendly visiting, both delivered by lay counselors using tele-videoconferencing, were reassessed at one-year to determine whether benefits at 12 weeks were maintained over time. Methods The study reinterviewed 64/89...

Objectives Pre-operative exercise may improve functional outcomes for lung cancer patients, but barriers associated with cost, resources, and burden make it challenging to deliver pre-operative exercise programs. The goal of this proof-of-concept study was to determine level of moderate-vigorous physical activity (MVPA) and change in aerobic capaci...

Rural communities need access to effective interventions that can prevent functional decline among a growing population of older adults. We describe the conceptual framework and rationale for a multicomponent intervention (“Mind, Mood, Mobility”) delivered by Area Agency on Aging staff for rural older adults at risk for functional decline due to ea...

Background Regular exercise is critical for disease prevention, but adherence to public health guidelines is poor. Exercise identity is purported to be associated with exercise behavior maintenance, but the extant literature is largely cross-sectional and of low/modest quality. Purpose To examine change in exercise identity after completion of a s...

The literature on affective determinants of physical activity (PA) is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Frame...

Enhancing health protective behaviors and decreasing health risk behaviors can substantially reduce the risk of chronic diseases while increasing life expectancy and quality. Thus, interventions to change health and risk behaviors are clearly warranted, but designing and conducting such interventions is a complex endeavor. The present work highligh...

Perceptions of the physical and social environment have been shown to be predictive of physical activity (PA) behavior. However, the mechanisms of this association have not been examined. Affective response to PA was examined as a putative mediator of the association between perceptions of the PA environment and subsequent PA behavior. As part of a...

Purpose Few evidence-based strategies are specifically tailored for disparity populations such as rural adults. Two-way video-conferencing using telemedicine can potentially surmount geographic barriers that impede participation in high-intensity treatment programs offering frequent visits to clinic facilities. We aimed to understand barriers and f...

Objective: Consistent with the Science of Behavior Change (SOBC) experimental medicine approach, this early phase intervention development study examines the influence of an intervention strategy (exercise training) on a behavioral health outcome (exercise engagement) in the service of addressing a widespread threat to public health (physical inact...

Objective: To describe our modification of Behavioral Activation to address social isolation and loneliness: Brief Behavioral Activation for Improving Social Connectedness. Our recent randomized clinical trial demonstrated the effectiveness of the intervention, compared to friendly visit, in alleviating loneliness, reducing depressive symptoms, an...

Objective The purpose of this study was to explore the feasibility, acceptability and perceived utility of the provision of a wearable fitness device and an exercise prescription from a surgeon, prior to surgery for lung cancer. Methods A single‐arm, pre–post feasibility study was conducted with 30 participants scheduled for surgery to treat stage...

This article describes the psychotherapy practice of physician John G. Gehring and places it in historical context. Forgotten today, Gehring was a highly sought‐after therapist from the 1890s to the 1920s by prominent figures in the arts, sciences, business, and law. He practiced a combination of work therapy, suggestion, and autosuggestion that ha...

Objective To test the acceptability and effectiveness of a lay-coach-facilitated, videoconferenced, short-term behavioral activation (Tele-BA) intervention for improving social connectedness among homebound older adults. Methods We employed a two-site, participant-randomized controlled trial (RCT) with 89 older adults (averaging 74 years old) who...

Introduction Many breast cancer survivors report an inability to fully participate in activities of daily living after completing cancer treatment. Reduced activity participation is linked to negative consequences for individuals (eg, depression, reduced quality of life) and society (reduced workforce participation). There is currently a lack of ev...

Objective: A 5% change in weight is a significant predictor for frailty and obesity. We ascertained how self-reported weight change over the lifespan impacts rates of frailty in older adults. Methods: We identified 4,984 subjects ≥60 years with body composition measures from the National Health and Nutrition Examination Survey. An adapted versio...

Background: Self-reported weight change may lead to adverse outcomes. We evaluated weight change with cutpoints of low lean mass (LLM) in older adults. Methods: Of 4984 subjects ≥60 years from NHANES 1999-2004, we applied LLM cutoffs of appendicular lean mass (ALM):body mass index (BMI) males<0.789, females<0.512. Self-reported weight was assess...

Background: The public health crisis of obesity leads to increasing morbidity that are even more profound in certain populations such as rural adults. Live, two-way video-conferencing is a modality that can potentially surmount geographic barriers and staffing shortages. Methods: Patients from the Dartmouth-Hitchcock Weight and Wellness Center w...

Evidence supporting the incorporation of affective constructs, such as affective attitudes and anticipated regret, into theoretical models of health behavior has been mounting in recent years; however, the role of positive anticipated affective reactions (e.g., pride) has been largely unexplored. The purpose of the present investigation was to asse...

Purpose: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic type of acute myocardial infarction that primarily affects young, healthy women without typical risk factors for heart disease. Few investigations have examined psychosocial variables in this population and none have looked at patient perceptions of the experience and s...

Objective: Anticipated affect may influence exercise behavior via experienced affective responses and intentions. Cognitive manipulations of anticipated affect may inform exercise intervention design. The purpose of this study was to experimentally test the effects of an expectation-based manipulation of affective responses to exercise on anticipa...

Objective: To test the extent to which participants exposed to an uncommon versus common exercise stimulus would result in more favourable affect at post task. Design: Experimental design. Participants, (N = 120) American women aged 18-45 years, were randomly assigned to complete 30-minutes of either the uncommon (HOOP; n = 58) or common (WALK;...

A comprehensive review of research examining intermediary mechanisms to understand the link between genetic variation and addiction liability. Although there is scientific consensus that genetic factors play a substantial role in an individual's vulnerability to drug or alcohol addiction, specific genetic variables linked to risk or resilience rema...

Chronic alcohol abuse is related to numerous deleterious neurobiological consequences, including loss of gray matter, damage to white matter (WM), and impairment of cognitive and motor functions. Aerobic exercise has been demonstrated to slow cognitive decline and decrease the negative neural changes resulting from normal aging and from several dis...

Historically, the approach of promoting exercise by emphasizing its effects on long-term health has predominated. Despite this tradition, there is no strong empirical support for such an approach. Recent work has argued that exercise suffers from a “branding problem” and efforts to promote exercise may be better served by switching the focus from t...

Objective. To determine whether genetic variants suggested by the literature to be associated with physiology and fitness phenotypes predicted differential physiological and subjective responses to a bout of aerobic exercise among inactive but otherwise healthy adults. Method. Participants completed a 30-minute submaximal aerobic exercise session....

Reviews the book, Asylum: Inside the closed world of state mental hospitals by Christopher Payne and Oliver Sacks (see record 2009-07529-000 ). For much of the 20th century, state psychiatric hospitals were overcrowded warehouses for the indigent mentally ill. The hospitals evoked fear in those likely to be sent there and a combination of alarm and...