Health Education & Behavior最新文献

Alzheimer's disease (AD)-focused recruitment research registries can help identify eligible participants for AD studies, but registry participation is limited among racial and ethnic groups most at risk for AD. Using the Reasoned Action Approach (RAA), this study is part of a larger project to design theory-based persuasive recruitment messages that would encourage registry enrollment among underrepresented racial and ethnic groups. National survey data were collected in May/June 2021 from adults aged 50-80 years old living in the United States (n = 1,501) with oversamples of non-Hispanic Black (n = 334) and Hispanic (n = 309) adults for group comparisons. Regression analysis was used to estimate the relationship of the attitudes, norms, and perceived behavioral control on intention to sign up for an AD-focused research registry for each racial/ethnic and sex group (i.e., Black women, Black men, Hispanic female, Hispanic men, non-Hispanic White women, and non-Hispanic White men), followed by an audience segmentation analysis based on intender status. Across almost all target groups, attitudes were an important determinant of intention, and norms and capacity were secondary determinants for Black and Hispanic adults, respectively. There was considerable overlap in attitudinal beliefs most salient to the behavior which focused on benefits to society in some way, either generally (i.e., "helping others in the future"; "advancing science") or more specifically (i.e., "helping others like you"). Differences between groups were more apparent regarding norms and capacity. Targeted recruitment messages based on beliefs that were common across the groups could be an efficient way of recruiting people of color into AD research registries.

First-generation Latinx immigrant youth from the Northern Triangle (NT; El Salvador, Guatemala, and Honduras) face unique risks for experiencing stressors across the phases of migration, which could exacerbate their mental health. This study aimed to (a) identify and characterize unique latent profile groups based on response patterns to immigrant minority stress and psychosocial protective factor items and (b) examine the associations of latent profile membership with depression and anxiety symptoms among NT immigrant youth, controlling for study covariates (i.e., postmigration victimization and forced immigration-related family separation). Primary surveys assessing immigrant minority stress and psychosocial protective factors (i.e., ethnic identity importance, and family, peer, and school support) were administered (N = 172, age range = 14-21, 63% female). Latent profile analysis (Aim 1) and multiple linear regression (Aim 2) were conducted to examine the study aims. A three latent profile model was identified: (a) moderate immigrant minority stress and low psychosocial protection (weak resources), (b) moderate immigrant minority stress and moderate psychosocial protection (average resources), and (c) low immigrant minority stress and high psychosocial protection (strong resources) during postmigration. Multiple linear regression demonstrated that latent profile membership was significantly associated with mental health. Protective associations with mental health were consistently present among the strong resources group. Detrimental associations with mental health were consistently present among the weak resources group. The average resources group demonstrated both protective and detrimental associations with mental health. Postmigration victimization and forced immigration-related family separation covariates were significantly associated with mental health. Findings provide a foundation for further mental health prevention research with NT immigrant youth.

Growing research highlights the role of local community contexts in health and well-being. Communities function as central arenas for health promotion as individuals and community spaces interact in daily life. To better communicate the linkages between community and health, we demonstrate the use of a set of geosocial tools for community diagnosis and health promotion, conceptually grounded in the framework of geosocial embeddedness, using data from community surveys and participatory research conducted with local inhabitants to engage their competency. Through a web-based interactive map generated using a geographic information system, we identified public territories in the municipality where greater policy attention is needed to enhance health. Through an intersectional matrix produced using multilevel analysis, we identified precise social groups by intersectional categories that are most at risk of loneliness for targeted intervention. A health radar chart on multidomain indicators illustrated information on group dynamics and longitudinal comparisons for health promotion. Overall, these tools offered not only diagnoses of the most vulnerable social groups for tailored interventions but also insight for policymakers to improve infrastructure and material resources to promote health. We conclude that geosocial tools offer a promising approach toward sharpening health communication and improving health in the community.

Engagement in preventive health behaviors (PHBs; i.e., healthy eating, sleep, and physical activity) during adolescence is associated with reduced risks for chronic conditions, such as diabetes, in adulthood. Although several interventions seek to improve adolescents' engagement in health promoting behaviors, racial- and income-based disparities across PHBs persist and may be even more pronounced for adolescents with multiple minoritized identities (e.g., Black adolescents in low-income communities). Therefore, targeted interventions that better meet the needs of minoritized adolescents are critical. The design of such interventions should include: (1) adolescent involvement, (2) cultural tailoring, (3) developmental theory, and (4) consideration of the social determinants of health. This article describes how these elements have been successfully incorporated into adolescent preventive health interventions and used to design #DoubleTap4Health, a community-based social media health intervention for Black adolescents from a low-income community. The results of a feasibility pilot of #DoubleTap4Health suggest that (1) attention to these elements in the intervention design process is feasible and advantageous to ensuring that the intervention components are appropriate and well received by adolescents, and (2) the intervention demonstrated promise as adolescents showed improved engagement in PHBs and media literacy skills. Lessons learned and next steps for intervention development are discussed. Including the above four elements in the design of preventive health interventions for adolescents from minoritized communities is critical to promoting health equity.

While 10% of the U.S. population are afflicted with a rare disease, patients with a rare disease can have a difficult time finding a provider or useful information. Patients with rare diseases are often frustrated by lack of knowledge from their provider, lack of satisfaction with their provider, and lack of available time with their provider. Social connections and networks can be a useful tool for patients with rare diseases to seek and maintain support and information. For this study, a specific rare disease's (Ehlers-Danlos syndrome) support groups in a moderately sized metropolitan area were surveyed about their social interactions with others around their rare disease. The survey was distributed through online support groups on Facebook and was open over a 3-month period. For the 102 respondents that completed the social networking portion of the survey, there were 448 connections. The main modality of networking was in-person, with discussions about their rare disease occurring daily. Providers can utilize these social networks, after engaging with patients, to disseminate educational information and request feedback from patients. The social networks patients create can help them feel a sense of connectedness they might not otherwise feel due to their rare disease.

Third- and fourth-year U.S. medical students applying to residency were surveyed between August 6 and October 22, 2022, to assess the impact of Dobbs v. Jackson Women's Health Organization (Dobbs) on medical student residency application location choices. Across all medical specialties, most respondents were unlikely or very unlikely to apply to one or more residency programs located in a state with abortion restrictions (57.9%) and were considering changes in state abortion access when choosing the location of residencies to apply to (77.0%). Respondents in states with no abortion restrictions were less likely to apply to a program in a state with abortion restrictions (2 [1, 3] p < .001). The Dobbs decision significantly impacts residency application decisions for medical students in all specialties. Students are choosing to avoid or target states with restrictive abortion legislation based on their personal views.

This study aimed to describe barriers athletic trainers (ATs) face to implementing expert recommendations for improving athletes' concussion care-seeking behavior. We distributed an electronic survey through the National Athletic Trainers' Association to 9,997 ATs working in secondary schools or collegiate institutions and received 365 complete responses. We quantitatively measured their barriers using a validated survey based on the Capability, Opportunity, Motivation, Behavior (COM-B) behavior system containing six Likert-type items with a scale of 0 to 10 (labeled Strongly Disagree-Strongly Agree). We performed three analyses: (a) descriptive analysis of COM-B responses, (b) separate ordinal regression analyses to determine if gender, years certified, percent of employment hours spent at their school, or setting (e.g., secondary school or college/university) predict COM-B responses, and (c) group comparisons within types of secondary schools and collegiate institutions. Athletic trainers reported the highest barriers in the opportunity-related constructs followed by capability-related and motivation-related constructs. Practicing in a secondary school, rather than college/university, setting predicted stronger barriers in psychological capability, social opportunity, physical opportunity, and automatic motivation. Athletic trainers at National Collegiate Athletic Association (NCAA) affiliated colleges/universities had higher physical and psychological capability, compared to ATs at non-NCAA-affiliated colleges/universities. Athletic trainers feel motivated and capable of employing practices to improve athlete care-seeking after a concussion, but they face barriers. Organizations should support ATs by providing opportunities to deliver concussion education. Secondary schools and non-NCAA institutions may benefit from resources to reduce barriers to providing concussion education, like toolkits to help deliver concussion education and protected time to providing this education.

Introduction: The COVID-19 pandemic disproportionately impacted ethnic minority and other underserved communities, prompting the federal government to fund community-led health literacy initiatives. This evaluation shares challenges and lessons learned, and identifies best practices from community-based organizations (CBOs) partnering with academia and local government to support health literacy programming.

Methods: In 2023, 20 representatives from 12 CBOs in Southern California responded to an interviewer-administered survey, including open-ended questions about lessons learned. We analyze text data to identify key themes.

Results: CBOs expressed a need for additional financial resources and technical assistance, including grantsmanship training, access to in-language resources, support to build and use in-house evaluation systems, and greater university oversight for student collaborators. Respondents highlighted the importance of community engagement efforts to build trust and enhance the uptake of programming. They also stressed the need for specialized training of community health workers engaged in health programs and the utilization of population sub-group data to inform policy and funding development to better serve communities' needs.

Conclusion: CBOs are eager to partner with government and academia and acknowledge the need for targeted support and resources that can be facilitated through multisectoral partnerships. We offer recommendations and actionable strategies for funders and academia to create and improve equitable partnerships with CBOs. Partnerships that address the needs and systemic barriers experienced by ethnic minority communities will support local public health goals while fostering resilience and health equity.

Little is known about how distance learning impacts delivery of the National Diabetes Prevention Program (DPP) despite a rapid shift to this platform during the coronavirus disease 2019 (COVID-19) public health emergency. We explored how a workplace DPP, delivered via distance learning, impacted knowledge, motivation, and behavioral skills of participants throughout the program. We conducted repeated qualitative interviews with distance learning participants at baseline, 6 months, and 12 months from September 2020 to July 2022. Three study team members coded interview data using individual responses as the unit of analysis. We used a thematic approach, using the information-motivation-behavioral skills framework, to analyze responses and generate understanding of the program's impact. The 27 individuals who participated in the interviews (89% women, mean age 56 years) reported the distance learning platform was effective in changing their behavior. The program's focus on food logging and setting limits on specific types of caloric intake was perceived as essential. Education on ideal levels of fat and sugar consumption, lessons on how to read food labels, and dissemination of recipes with healthy food substitutions allowed participants to initiate and sustain healthy decision-making. Strategies to increase physical activity, including breaking up exercise throughout the day, made reaching their goals more feasible. Participants reported food logging and weight reporting, as well as group support during sessions, either sustained or increased their motivation to adhere to the program over time. A workplace DPP delivered via distance learning successfully prompted improvements in the knowledge, motivation, and behavioral skills necessary to increase healthy eating and physical activity among participants.

Background: For older Latinos, some benefits of leisure-time physical activity (LTPA) include enhanced cognitive functioning, decreased loneliness, and reduced premature mortality. Despite LTPA benefits, adults ≥50 years are one of the most inactive age groups in the United States.

Methods: This qualitative study aimed to add to the limited evidence of LTPA in older Latino adults by exploring the barriers and facilitators for fitness class uptake and park use. Guided by a Social-Ecological Model of Health and Social Determinants of Health theoretical and a phenomenological research design, qualitative research data were collected via 27 personal interviews with Latino adults using a semistructured interview guide. Participants were recruited using purposive sampling strategies in collaboration with community partners. Bicultural data collectors conducted the semistructured interviews over Zoom. Thematic analysis was performed using Dedoose, following an inductive and deductive approach.

Results: The main barriers to fitness class attendance and park use were family and/or work commitments, perceived safety, and perceived discrimination. Conversely, the critical facilitators for participation were socialization into a group, social connectedness with group members, fitness instructor characteristics, and exercise history.

Conclusions: Findings from this study hold important implications for the design of fitness programming and park-based recreation, including the need to increase the cultural diversity of recreation staff and culturally relevant programming. Future research is needed on time poverty related to family/work commitments and whether discriminatory practices at fitness centers, like ageism and race/ethnicity, influence physical activity behavior.