Research and publications
Publications
ALIVE team members are conducting three reviews in preparation for implementation of the formative research and the pilot trial. These include:
A systematic review of the effects of economic intervention on depression
and anxiety outcomes;
A systematic review of the effects of self-regulation interventions on adolescent depression and anxiety outcomes;
A realist review mapping out the causal mechanisms linking poverty, self-regulation and depression/anxiety.
These will be published as soon as they are available.
Quality in Question: Assessing the Accuracy of Four Heart Rate Wearables and the Implications for Psychophysiological Research
Sinichi, M., Gevonden, M. J., & Krabbendam, L. (2025). Quality in Question: Assessing the accuracy of four heart rate wearables and the implications for psychophysiological research. Psychophysiology,62(2), e70004.
http://dx.doi.org/10.1111/psyp.70004
Summary: Heart rate (HR) and heart rate variability (HRV) are two key measures with significant relevance in psychophysiological studies,and their measurement has become more convenient due to advances in wearable technology. However, photoplethysmogra-phy (PPG)-based wearables pose critical validity concerns. In this study, we validated four PPG wearables: three consumer-grade devices (Kyto2935, Schone Rhythm 24, and HeartMath Inner Balance Bluetooth) and one research-grade device (EmpaticaEmbracePlus, successor to the widely-used but discontinued Empatica E4). All devices were worn simultaneously by 40 healthyparticipants who underwent conditions commonly used in laboratory research (seated rest, arithmetic task, recovery, slow-pacedbreathing, a neuropsychological task, posture manipulation by standing up) and encountered in ambulatory-like settings (slowwalking and stationary biking), compared against a criterion electrocardiography device, the Vrije Universiteit AmbulatoryMonitoring System (VU-AMS). We determined the signal quality, the linear strength through regression analysis, the biasthrough Bland–Altman analysis, and the measurement error through mean arctangent absolute percentage error for each con-dition against the criterion device. We found that the research-grade device did not outperform the consumer-grade devices inlaboratory conditions. It also showed low agreement with the ECG in ambulatory-like conditions. In general, devices capturedHR more accurately than HRV. Finally, conditions that deviated from baseline settings and involved slight to high movement,negatively impacted the agreement between PPG devices and the criterion. We conclude that PPG devices, even those advertisedand designed for research purposes, may pose validity concerns for HRV measurement in conditions other than those similar toresting states.
Strengthening self-regulation and reducing poverty to prevent adolescent depression and anxiety: Rationale, approach and methods of the ALIVE interdisciplinary research collaboration in Colombia, Nepal and South Africa
Lund C, Jordans MJD, Garman E, et al. Strengthening self-regulation and reducing poverty to prevent adolescent depression and anxiety: Rationale, approach and methods of the ALIVE interdisciplinary research collaboration in Colombia, Nepal and South Africa. Epidemiology and Psychiatric Sciences. 2023;32:e69.
Abstract: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the ‘Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)’ study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa.
WearableHRV: A Python package for the validation of heart rate and heart rate variability in wearables
Sinichi et al., (2024). WearableHRV: A Python package for the validation of heart rate and heart rate variability in wearables. Journal of Open Source Software, 9(100), 6240, https://doi.org/10.21105/joss.06240
Summary: Wearable devices that monitor physiology have become ubiquitous, and include smart watches, smart jewellery, and smart textiles. The market for these devices is rapidly expanding with new brands and products. These devices measure a variety of signals, which are translated into a large amount of different features, of which heart rate (HR) and heart rate variability (HRV) are among the most common. These features are particularly interesting, not only for consumers but also for researchers, because they are predictive of mental and physical health outcomes, and easily obtained. However, for manufacturers, there may be a trade-off between user acceptability on the one hand and accuracy on the other, where profit margins typically turn out to be the decisive factor. Therefore, the following question continually comes up: is the cardiac data recorded by this new watch/ring/shirt accurate enough to use in research?
The WearableHRV Python package offers a comprehensive pipeline for validating the accuracy of HR and HRV measurements. It allows for advanced statistical analyses on device agreement from beat-to-beat cardiac data. The package’s graphical user interface (GUI) facilitates pre-processing, visualization, and data analysis at both individual and group levels. As input, a user of WearableHRV should use a criterion device (i.e., a gold standard), referably an electrocardiograph (ECG). Simultaneously acquired data from the device(s) of interest can then be compared against the criterion. The only required inputs for the pipeline are the inter-beat intervals (IBIs) and timestamps for each device; the rest is fully handled by the WearableHRV package.
Publications relevant to ALIVE
Self-regulation interventions for Children and Adolescents: Systematic Review
Reference: Pandey, A., Hale, D., Das, S., Goddings, A. L., Blakemore, S. J., & Viner, R. M. (2018). Effectiveness of universal self-regulation–based interventions in children and adolescents: A systematic review and meta-analysis. JAMA pediatrics, 172(6), 566-575.
Abstract: This systematic review and meta-analysis of 49 randomized clinical trials evaluating 50 self-regulation interventions found that these interventions were effective in children and adolescents. Positive outcomes on health and social measures such as academic achievement, social skills, mental health, behavioral problems, conduct disorders, school suspensions, and substance abuse was also reported.
Reducing crime and violence
Reference: Blattman, C., Jamison, J. C., & Sheridan, M. (2017). Reducing crime and violence: Experimental evidence from cognitive behavioral therapy in Liberia. American Economic Review, 107(4), 1165-1206.
Abstract: We show that a number of noncognitive skills and preferences, including patience and identity, are malleable in adults, and that investments in them reduce crime and violence. We recruited criminally engaged men and randomized one-half to eight weeks of cognitive behavioral therapy designed to foster self-regulation, patience, and a noncriminal identity and lifestyle. We also randomized $200 grants. Cash alone and therapy alone initially reduced crime and violence, but effects dissipated over time. When cash followed therapy, crime and violence decreased dramatically for at least a year. We hypothesize that cash reinforced therapy’s impacts by prolonging learning-by-doing, lifestyle changes, and self-investment.
Ever failed, try again, succeed better
Reference: Alan, S., Boneva, T., & Ertac, S. (2019). Ever failed, try again, succeed better: Results from a randomized educational intervention on grit. The Quarterly Journal of Economics, 134(3), 1121-1162.
Abstract: We show that grit, a skill that has been shown to be highly predictive of achievement, is malleable in childhood and can be fostered in the classroom environment. We evaluate a randomized educational intervention implemented in two independent elementary school samples. Outcomes are measured via a novel incentivized real-effort task and performance in standardized tests. We find that treated students are more likely to exert effort to accumulate task-specific ability and hence more likely to succeed. In a follow up 2.5 years after the intervention, we estimate an effect of about 0.2 standard deviations on a standardized math test.
Poverty and self-regulation
Reference: Palacios-Barrios EE, Hanson JL. Poverty and self-regulation: Connecting psychosocial processes, neurobiology, and the risk for psychopathology. Comprehensive psychiatry. 2019 Apr 1;90:52-64.
Abstract: In the United States, over 40% of youth under the age of 18 live at or near the federal poverty line. Several decades of research have established clear links between exposure to child poverty and the development of psychopathology, yet the mechanisms that convey this risk remain unclear. We review research in developmental science and other allied disciplines that identify self-regulation as a critical factor that may influence the development of psychopathology after exposure to poverty. We then connect this work with neurobiological research in an effort to further inform these associations. We propose a starting framework focused on the neural correlates of self-regulation, and discuss recent work relating poverty to alterations in brain regions related to self-regulation. We close this review by highlighting important considerations for future research on poverty/socioeconomic status, neurobiology, self-regulation, and the risks related to the development of negative mental health outcomes.
