About

Alexander J. Rothman is a Professor of Psychology at the University of Minnesota, Twin Cities, with affiliations to the Center for Women's Health Research, Healthy Weight Research Center, Life Course Center, and Cancer Prevention and Control. His primary research program focuses on applying social psychological theory to illness prevention and health promotion. This work synthesizes basic research on how individuals process and respond to health information with the development and evaluation of theory-based interventions aimed at promoting healthy behavior. Rothman and his colleagues have addressed a broad range of issues including the evaluation and processing of risk-relevant information, the effectiveness of different health communication strategies, the decision processes underlying the initiation and maintenance of behavior change, and the mechanisms that underlie behavioral interventions. Their theoretical models have informed the design, implementation, and testing of interventions across various behavioral domains such as smoking, diet, physical activity, and cancer screening, as well as exploring implications for environmentally-friendly behaviors. Rothman has served as Associate Editor of Health Psychology Review and as co-editor of special issues in several journals including Annals of Behavioral Medicine, AIDS & Behavior, Self & Identity, and an upcoming issue of Health Psychology. He has played a leadership role in the NCI/NIH-sponsored Advanced Training Institute on Health Behavior Theory since 2004 and currently serves as co-chair of the NCI Cognitive, Affective, and Social Processes in Health Research Group. His research interests include message framing, health communication, health judgment and decision making, initiation and maintenance of behavior change, health behavior theory, mediation and moderation, and interventions to promote healthy behavior. Rothman's work contributes to multiple United Nations Sustainable Development Goals, including Good Health and Well-being, Gender Equality, Reduced Inequalities, Sustainable Cities and Communities, Responsible Consumption and Production, Life on Land, and Peace, Justice and Strong Institutions.

Research topics

• Medicine
• Cardiology
• Internal medicine
• Radiology
• Medical emergency

Selected publications

• AI quantified CT percentage of fibrosis predicts survival in PH-COPD

  2025-09-27

  article

  Pulmonary Hypertension (PH) associated with Chronic Obstructive Pulmonary Disease (PH-COPD) is a heterogenous condition, with a spectrum of predominantly emphysema and some overlapping fibrosis. All patients undergo CT imaging, but it is not used for prognostication. The study <bold>Aim:</bold> is to investigate the prognostic value of AI quantified fibrosis in PH-COPD compared to radiological assessment. Patients with baseline CT between 2001-19 were identified from the ASPIRE registry. A validated PH AI CT model was run and provided the percentage of fibrosis. Scans were scored as none/mild/moderate/severe fibrosis by PH radiologists. Cases with mean pulmonary arterial pressure ≥ 35 mmHg were classified as severe PH-COPD, and fibrosis was grouped with a threshold of 3%. Scaled cox regression and Kaplan Meier survival analysis was performed. 157 patients (113 severe PH-COPD) were included. AI fibrosis % was a significant predictor of mortality (HR 1.46, p<0.001). There was a significant difference (p=0.001) in survival between patients with more and less than 3% fibrosis. 1,3- and 5-year survival was 84%, 57% and 35% resp. in those with <3% fibrosis and 63%, 31% and 18% resp. in those with ≥3% fibrosis. Radiologist scored mild (HR 2.05, p=0.36) and moderate (HR 2.82, p=0.045) fibrosis was a significant predictor, but not severe fibrosis. In severe PH-COPD, radiological scoring was not a significant predictor at any level, but AI fibrosis% was a significant predictor (HR 1.37, p<0.001). <bold>Conclusion:</bold> AI quantified fibrosis predicts survival in PH-COPD and provides additional value over radiological assessment in severe PH-COPD. This is a promising future approach to aid risk-stratification and sub-phenotyping.

  PublisherDOI

• Compendium of Dyadic Behavior Change Techniques v2.0: Results from a Delphi Study

  2025-06-25

  preprintOpen access

  Background: Dyadic interventions involving a close other (e.g., romantic partner) have gained increased awareness and shown initial promise, but a shared language and systematic approach to describing their intervention content (i.e., dyadic behavior change techniques) is lacking. Purpose: This study aimed to further develop a comprehensive and expert-validated Compendium of dyadic behavior change techniques (DBCTs) focused on health behavior change in romantic couples to support intervention development and facilitate intervention reporting.Methods: A two-round Delphi process with international experts was conducted. Experts rated the clarity and comprehensibility of dyadic behavior change techniques, as well as their expected link with the most proximal mechanisms of action. Additionally, experts convened for an online discussion via video conferencing to address key issues and emerging questions.Results: The resulting Compendium of DBCTs v2.0 includes 219 DBCTs that specify who (i.e., execution) does what (i.e., intervention task) for whom (i.e., target). DBCTs are linked to 32 hypothesized most proximal mechanisms of action. An interactive web tool (https://dbctcompendium.com/) was created to facilitate access to and use of the Compendium.Conclusions: The Compendium of DBCTs v2.0 offers a classification of dyadic behavior change techniques validated through expert consensus. It supports systematic development and reporting of dyadic interventions aimed at health behavior change in couples by specifying hypothesized links with underlying mechanisms of action. Future research should focus on identifying the effectiveness of DBCTs under various conditions and the Compendium’s applicability to other dyad types and behavioral domains.Keywords: Dyadic intervention, couples, Compendium, taxonomy, dyadic behavior change techniques, intervention development, intervention reporting, mechanisms of action

  PublisherDOI

• Remote monitoring in pulmonary arterial hypertension

  European Respiratory Society eBooks · 2025-08-28

  book-chapter1st authorCorresponding

  PAH is a progressive chronic condition requiring regular hospital-based assessments to guide therapy. These infrequent snapshot evaluations limit timely intervention and personalised care. Remote monitoring technologies offer real-time, high-frequency collection of key physiological parameters and patient-reported outcomes from patients' homes and have transformed the management of heart failure, diabetes and cardiac arrhythmias. In clinical research, these tools reduce bias, enhance statistical power and support innovative study designs, including small decentralised trials with continuous assessment of therapeutic response. Clinically, remote monitoring supports faster, more informed treatment adjustments and improves engagement between patients and care teams. As infrastructure and data management systems evolve, remote monitoring could become central to both clinical studies and the routine care of patients with PH, enabling earlier intervention and improved outcomes. <bold>Cite as:</bold> Rothman AMK, Benza R, Wilkins MR, <italic>et al.</italic> Remote monitoring in pulmonary arterial hypertension. <italic>In:</italic> Boucly A, Kovacs G, Condliffe R, eds. Pulmonary Hypertension (ERS Monograph). Sheffield, European Respiratory Society, 2025; pp. 77–83 [<ext-link>https://doi.org/10.1183/2312508X.10019524</ext-link>].

  PublisherDOI

• Diffusing capacity of the lung for carbon monoxide, transfer coefficient of the lung for carbon monoxide and forced vital capacity/diffusing capacity of the lung for carbon monoxide in suspected systemic sclerosis-associated pulmonary hypertension: insights from the ASPIRE registry

  ERJ Open Research · 2025-10-09

  articleOpen access

  Objectives There are limited data comparing parameters reflecting gas transfer used to assess the likelihood of pulmonary hypertension (PH) in patients with systemic sclerosis (SSc) and regarding the impact of transitioning to Global Lung Initiative (GLI)-predicted values. Methods 632 patients with suspected SSc-associated PH were identified from the ASPIRE registry. Spirometry and computed tomography reports were reviewed to identify significant lung disease. Receiver operating characteristic curve analysis and correlations of the three markers of gas transfer with pulmonary arterial pressure were performed. Results Correlations of GLI-derived values with mean pulmonary arterial pressure were diffusing capacity of the lung for carbon monoxide ( D LCO )% r= −0.45, transfer coefficient of the lung for carbon monoxide ( K CO )% r= −0.42 and forced vital capacity (FVC)%/ D LCO % r=0.37. Correlations in patients without lung disease were D LCO % r= −0.51, K CO % r= −0.44, FVC%/ D LCO % r=0.38, compared with patients with lung disease: D LCO % r= −0.41, K CO % r= −0.39, FVC%/ D LCO % r=0.39. Area under the curve for the presence of PH in the overall study cohort was significantly superior for D LCO % at 0.84 (optimal threshold 53%), compared with K CO % 0.74 (60%) and FVC%/ D LCO % was 0.74 (1.91), p&lt;0.001 for both. Compared with European Coal and Steel Community-derived data, GLI-derived % predicted lung volumes were lower, D LCO % and K CO % were higher and consequently FVC%/ D LCO % lower (p&lt;0.001, all). Conclusion D LCO performed as least as strongly as K CO or FVC%/ D LCO % in terms of correlations with mean pulmonary arterial pressure and diagnostic utility, regardless of the presence or absence of lung disease. Transitioning to GLI equations led to lower predicted spirometric volumes and higher D LCO %. This should be considered when interpreting changes in values over time and when using screening algorithms.

  PublisherDOI

• Inflammation and obesity correlate in pulmonary hypertension but associate with diverging outcomes

  2025-09-27

  article

  <bold>Background:</bold> Inflammation is associated with all types of Pulmonary Hypertension (PH) both as a known cause and/or a putative confounder. The most common marker of inflammation, C-reactive protein (CRP), has not been widely studied in PH. This study set out to clarify if CRP informed clinical endotyping. <bold>Methods:</bold> Time-series clustering of longitudinal CRP levels was employed. Clinical differences between clusters were validated in three independent UK/International cohorts (n=10,301; UK-cohort, ASPIRE and FDA cohort). Associations were analysed with functional and mortality outcomes by linear and Cox regression models including all-causes of PH (groups 1-5). Multi-omics were interrogated from associated previously published arrays. <bold>Results:</bold> Patients segregated into two stable CRP clusters, with strong associations with body mass index (BMI). Increased CRP and BMI associated with worse exercise capacity. Inflammation associated with worse survival, more comorbidities, higher pulmonary vascular resistance (PVR), and smoking status. No relationship was observed between CRP and circulating autoantibodies, but CRP and BMI were associated with differing inflammatory profiles in proteomic and transcriptomic analyses. Despite the relationship with CRP, higher BMI associated with improved survival and lower PVR and did not negatively affect treatment response. <bold>Conclusions:</bold> We establish a strong relationship between CRP and BMI across all cause PH. Despite this relationship, CRP and BMI associated with diverging clinical outcomes. Inflammation and obesity are relevant phenotypes for consideration in clinical trial design. Understanding their impacts on outcomes is important for clinical practice.

  PublisherDOI

• Abstract 4367586: Safety Profile of the CardioMEMS HF System in Pulmonary Arterial Hypertension: A Pooled Adverse Event Analysis from Three Clinical Studies

  Circulation · 2025-11-03

  article

  Introduction: Pulmonary arterial hypertension (PAH) is a progressive disease. Continuous hemodynamic monitoring may help manage more severe PAH. The CardioMEMS HF System, an implantable pulmonary artery pressure (PAP) monitoring device, has shown promise in PAH management. However, its safety in patients with PAH remains undefined. Hypothesis: The use of the CardioMEMS is associated with an acceptable safety profile in patients with PAH. Methods: Adverse event data were combined from the completed CS1-003 (NCT05224531), on-going ARTISAN (NCT05203510), and on-going FIT_PH (NCT04078243) studies. Baseline assessments included demographics, hemodynamics, N-terminal pro B-type natriuretic peptide (NT-proBNP), 6-minute walk test (6MWT), and WHO Functional Class. Safety data were collected throughout each study. Results: At the time of analysis, 129 patients had received a CardioMEMS implant across the CS1-003 (n=25), ARTISAN (n=49), and FIT_PH (n=55) studies. All patients were diagnosed with PAH, with idiopathic, heritable, or drug/toxin-induced etiologies accounting for 81.4% of the cases, and connective tissue disease for 14.7%. The mean age was 54.6 years (range: 19-84), with 73.6% female patients. Most patients (77.5%) were classified as WHO Functional Class III or IV. The pooled means of baseline hemodynamic parameters were as follows: mean PAP of 47.9 mmHg (range: 23–81), mean right atrial pressure of 8.2 mmHg (range: 1–25), pulmonary artery wedge pressure of 10.0 mmHg (range: 1– 16), the cardiac output (CO) of 5.1 L/min (range: 1.3–10.9), and pulmonary vascular resistance of 8.4 Wood Units (range: 2–21). The average of baseline 6MWT was 336 meters (range: 10–930) and mean NT-proBNP was 978.6 ng/L (range: 18-11006). Based on the REVEAL 2.0 or Lite 2 risk scores (mean: 7, range: 2–14), the cohort was categorized at intermediate risk. A total of 71 (55%) patients completed at least 12 months of follow-up. Only five adverse events were reported as possibly related to the CardioMEMS implant procedure, including one serious adverse event. No unexpected adverse events, CardioMEMS device- or system-related adverse events, or sensor failures were reported by study sites throughout each study. Conclusions: The use of CardioMEMS in this combined PAH cohort has demonstrated a favorable safety profile, with few procedure-related adverse events and no enduring consequences. Future studies are warranted to investigate its long-term safety and efficacy in this population.

  PublisherDOI

• <scp>NT</scp> ‐ <scp>proBNP</scp> and <scp>BNP</scp> Testing in Pulmonary Arterial Hypertension: Point‐of‐Care and Remote Monitoring

  Respirology · 2025-07-03 · 2 citations

  articleOpen access

  BACKGROUND AND OBJECTIVES: Brain natriuretic peptide (BNP) and N-terminal prohormone of BNP (NT-proBNP) are important biomarkers in pulmonary arterial hypertension (PAH). However, results are rarely available at the time of clinical assessment. The reliability of NT-proBNP/BNP point-of-care tests (POCT) in PAH patients and the stability of NT-proBNP in posted blood samples, to simulate remote monitoring, was investigated. METHODS: Group 1 PAH patients were prospectively recruited. A sample of 40 was required to demonstrate an intraclass correlation coefficient (ICC) of 0.94 with a 95% confidence interval width of < 0.1 for agreement between POCT and the laboratory standard. Blood samples were taken at two time-points for laboratory and POCT NT-proBNP/BNP. Separate samples were returned to the laboratory by post and some samples were assessed pre- and post-exercise assessing the impact of exercise. RESULTS: Forty-one patients were enrolled with 56 study visits. NT-proBNP laboratory and POCT (n = 50) provided equivalent test results (Passing-Bablok slope = 1.08, CI = 0.97-1.19, intercept = 18.22, CI = -41.6 to 4.5) and ICC = 0.97. However, laboratory and POCT BNP (n = 49), showed non-equivalence (Passing-Bablok slope = 1.24, CI 1.11-1.31, intercept = -5.11, CI = -9.4 to -0.46), ICC = 0.96. POCT NT-proBNP/BNP correctly classified 92% and 86% of cases, respectively against COMPERA 2.0 4-risk-strata thresholds. NT-proBNP postal laboratory samples and immediately processed NT-proBNP laboratory samples showed good agreement and exercise had no clinically significant effect on NT-proBNP/BNP results. Laboratory BNP identified fewer patients as high risk compared to NT-proBNP. BNP and NT-proBNP risk status agreed at only 57% of visits (p < 0.0009). CONCLUSIONS: These data support the use of POCT NT-proBNP as a rapidly accessible and reliable alternative in clinical settings and highlight the potential of NT-proBNP for remote monitoring via posted samples. TRIAL REGISTRATION: ClinicalTrials.gov registration: NCT05421949.

  PublisherOA PDFDOI

• Comparability, acceptability and longitudinal adherence with digital emPHasis-10 in pulmonary arterial hypertension

  European Respiratory Journal · 2025-05-22 · 1 citations

  letterOpen access

  <title>Extract</title> Pulmonary hypertension (PH) affects 1% of the global population and significantly impacts health-related quality of life (HRQoL) [1, 2]. Patient reported outcome measures (PROMs) are standardised tools used in clinical practice and research to assess health outcomes from the patient's perspective. Routine measurement of HRQoL is supported by clinical guidelines, recommending disease-specific PROMs [1]. EmPHasis-10 is a widely used ten-item PROM developed for patients in any World Health Organisation (WHO) PH group [2, 3]. Available in numerous languages, it has strengths in both its psychometric properties and feasibility [2, 4]. However, it is currently only available in a paper-based format.

  PublisherDOI

• Reply to Ding <i>et al.</i> : Imatinib: A Promising Therapeutic Shining Light on Pulmonary Arterial Hypertension Treatment

  American Journal of Respiratory and Critical Care Medicine · 2025-06-13 · 1 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Understanding Longitudinal Ecological Momentary Assessment Completion: Results From 12 Months of Burst Sampling in the TIME Study

  JMIR mhealth and uhealth · 2025-10-22 · 2 citations

  articleOpen access

  BACKGROUND: Ecological momentary assessment (EMA) is a valuable method for capturing real-time data on behaviors and experiences in naturalistic settings. However, maintaining participant engagement in longitudinal (ie, multiburst) EMA studies remains challenging, particularly when collecting intensive data over extended periods. Understanding factors affecting completion rates is essential for designing more effective EMA protocols and interpreting results accurately. OBJECTIVE: This study investigated factors influencing EMA completion rates in a 12-month intensive longitudinal study among young adults in the United States, examining both time-varying factors and stable individual characteristics. METHODS: Young adults (N=246, ages 18-29 years) participated in the Temporal Influences on Movement and Exercise (TIME) study, responding to smartphone-based EMA prompts during biweekly measurement bursts (4-day periods of intensive sampling), with continuous passive data collection via smartwatches. Each burst included signal-contingent prompts delivered approximately once per hour during waking hours, resulting in an average of 12.1 (SD 1.3) prompts per day. Multilevel logistic regression models examined the effects of time-varying temporal factors (time of day, day of week, season, and time in study), contextual factors (phone screen status, phone usage, and location), behavioral factors (sleep duration, physical activity levels, and travel status), and psychological factors (momentary affect and stress) on prompt completion. Models also included time-invariant demographic characteristics (sex, race, ethnicity, education, and employment) and tested interactions between time in study and other predictors. RESULTS: Mean completion rate was 77% (SD 13%). Hispanic participants showed lower odds of completion compared to non-Hispanic participants (odds ratio [OR] 0.79, 95% CI 0.63-0.99; P=.04) and employed participants were less likely to complete prompts than unemployed participants (OR 0.75, 95% CI 0.61-0.92; P<.01). Having the phone screen on at prompt delivery substantially increased completion odds (OR 3.39, 95% CI 2.81-4.09; P<.001), while being away from home reduced completion likelihood, with particularly low odds when at sports facilities (OR 0.58, 95% CI 0.47-0.74; P<.001) or restaurants and shops (OR 0.61, 95% CI 0.51-0.72; P<.001). Short sleep duration the previous night (OR 0.92, 95% CI 0.87-0.99; P=.02) and traveling status (OR 0.78, 95% CI 0.75-0.82; P<.001) were associated with lower completion odds. Higher momentary stress levels predicted lower completion of subsequent prompts (OR 0.85, 95% CI 0.78-0.93; P<.001). Completion odds declined over the 12-month study (OR 0.95, 95% CI 0.94-0.96; P<.001), with significant interactions between time in study and various predictors, indicating changing patterns of engagement over time. CONCLUSIONS: Findings highlight the dynamic nature of EMA engagement in longitudinal multiburst studies and underscore the importance of considering time-varying and time-invariant factors in study design and analysis. This study provides valuable insights for researchers designing intensive longitudinal studies in behavioral science and digital health. Potential strategies for optimizing EMA protocols could include tailoring prompt schedules to individual contexts and developing adaptive sampling techniques.

  PublisherDOI

Frequent coauthors

• David G. Kiely

  University of Sheffield

  254 shared

• Robin Condliffe

  184 shared

• Andrew J. Swift

  155 shared

• A. A. Roger Thompson

  University of Sheffield

  142 shared

• Jim M. Wild

  127 shared

• Charlie Elliot

  University of Sheffield

  123 shared

• Athanasios Charalampopoulos

  Sheffield Teaching Hospitals NHS Foundation Trust

  117 shared

• Jennifer T Middleton

  Sheffield Teaching Hospitals NHS Foundation Trust

  110 shared

Education

• PhD

  University of Sheffield

  2015

• MSc Clinical Research (Distinction), ScHARR

  University of Sheffield

  2012

• MRCP

  Royal College of Physicians

  2009

• Clinical Medicine

  University of Oxford

  2005

• Natural Sciences

  University of Cambridge

  2002

Awards & honors

• APA 2002 Distinguished Scientific Award for Early Career Con…
• Outstanding Contributions to Graduate and Professional Educa…
• Induction into the Academy of Distinguished Teachers (2018)
• Distinguished University Teaching Professor (2018)
• Master Lecture, Society of Behavioral Medicine (2020)