Health Education & Behavior最新文献

Over the past decade, there has been an increased emphasis on tailoring men's health promotion programs. To optimize outcomes, participatory action research that involves and elicits feedback from end-users has been highlighted as important to creating gender-responsive interventions. In this scoping review, we examine (a) how participatory action research has been used to design health promotion interventions for men and (b) what constitutes a gender-responsive intervention design. Following a comprehensive search, 53 articles were included in the review, reporting on 35 men's health promotion programs. Our findings suggest that participatory action methods harness varying degrees of end-user involvement, with a large majority limited to post-intervention evaluations rather than co-design and consumer collaboration. In addition, there are inconsistencies for applying gender-responsive approaches within programs, particularly regarding how interventions are targeted, tailored, and promoted to men. We conclude that participatory action research methods translate to varying degrees of gender responsiveness in men's health promotion programs. That said, involving end-users at various stages of intervention design, implementation, and evaluation may increase the likelihood that programs are more attuned to masculinities and better engage participants in promoting healthy behavior change. Efforts to advance gender-responsive designs can benefit from inductively deriving and incorporating men's masculine values.

Health behaviors such as physical activity (PA) are socially influenced, such that individuals from shared social networks or living environments may exhibit similar habits. This cross-sectional study examined associations of social support, social control, and family member stage of change with moderate-to-vigorous self-reported and objective PA in dyads of adult Hispanic family members. We used the Godin Leisure-Time Physical Activity Questionnaire to assess self-reported PA and accelerometry for objective PA. Validated scales assessed social support, social control, and stage of change. We performed multivariable multilevel analysis using generalized estimating equations (GEE) to account for within-dyad correlations. We conducted multivariable negative binomial regression for Metabolic Equivalent Task minutes (MET-minutes) (self-reported; N = 429) and accelerometer data (N = 356) and logistic regression for meeting PA guidelines (self-reported; N = 429). Most dyads were spouses (41%) or parents and adult children (32%). Individuals with high family support had 81% higher odds of meeting PA guidelines (1.81 adjusted odds ratio (aOR); 95% confidence interval [CI] = [1.06, 3.09]; p = .030) and 58% higher leisure-time MET-minutes of PA per week (1.58 adjusted incidence rate ratio [aIRR], 95% CI = [1.30, 1.91]; p < .0001) than those with low levels of support. Participants reporting medium-to-high family punishment were 98% higher in odds of meeting PA guidelines (1.98 aOR; 95% CI = [1.09, 3.61]; p = .025) and had 70% higher leisure-time MET-minutes of PA (1.7 aIRR; 95% CI = [1.36, 2.13]; p<.0001) compared with those with low scores. Participants with study partners in action or maintenance stages had significantly higher leisure-time MET-minutes of PA per week (aIRR = 1.45, 95% CI = [1.10, 1.91], p = .009 and aIRR = 1.33, 95% CI = [1.01, 1.76], p = .041, respectively) compared with those with partners in other stages. No statistically significant associations were observed for social control with any measure of PA or between psychosocial measures and accelerometer-assessed PA. Our findings demonstrated that interventions should engage social networks and multimodal forms of PA assessment to optimize behavior change in similar populations.

Diffusion of innovations theory can be used to understand how to prevent or slow the spread of harmful behaviors, such as e-cigarette use in adolescent social networks. This study explores how different network intervention strategies could impact diffusion dynamics through network simulations based on observed social norms and e-cigarette use data. Simulations were initialized with baseline network data collected from 10 schools in a prospective cohort study of adolescent social networks and health behaviors in Southern California. Diffusion conditions varied by changes in social norms for intervention nodes (pro-e-cigarette, anti-e-cigarette, or neutral norms) and intervention strategy, where greater pro- and anti-tobacco norms were assigned to 15% of the network based on four intervention seeding conditions: opinion leadership, betweenness centrality, segmentation, and random selection. For each network, simulations were run using the netdiffuseR package in R and multivariate generalized linear models were estimated to examine changes in diffusion dynamics. Diffusion prevalence and rate were greater in denser networks and networks with more initial e-cigarette users. Anti-e-cigarette norms significantly decreased average prevalence across all intervention conditions. Strategically selecting high betweenness centrality nodes and opinion leader nodes significantly decreased the average prevalence of e-cigarette use. The results of this study show that achieving a change in norms for 15% of a network can substantially impact e-cigarette use prevalence. Furthermore, this study enhances our knowledge of how personal and network factors affect diffusion dynamics and demonstrates that targeting social norms through network-based interventions is one avenue for slowing the spread of harmful behaviors.

Collaborative learning is an engaging approach that brings individuals together to achieve common educational goals. This study explores the effectiveness of Dentamatics, an innovative interactive board game, in enhancing oral health knowledge among children. Twelve children participated in the study, playing the game after obtaining consent from the parents. During the sessions, they were encouraged to ask questions and clarify doubts, promoting active learning. Post-game interviews revealed significant improvements in oral health awareness, with children gaining knowledge about topics such as early dental visits and the use of braces for teeth alignment. The game was well-received, with participants expressing enjoyment and a willingness to play again. These findings suggest that Dentamatics is a promising, interactive, and enjoyable tool for educating children about oral health.

Food insecurity has been identified as an understudied risk factor for weight-based stigma and discrimination. This study leverages data from 1,904 working-age adults to examine the food insecurity-weight-based discrimination relationship, as well as tests gender differences for this association. Logistic regression models revealed that food insecurity was significantly associated with higher odds of reporting weight-based discrimination in both unadjusted and adjusted models. Importantly, this association was only significant in the female sample. Contrary to expectations, body mass index (BMI) did not moderate this relationship among women. These findings highlight the gendered nature of the food insecurity-weight discrimination link, underscoring the need for targeted interventions and policies addressing food insecurity and weight stigma, particularly among women. Specifically, public health practitioners should consider screening for both food insecurity and experiences of weight discrimination, especially when working with female patients. Furthermore, policymakers should consider the interconnected nature of food insecurity and weight discrimination when designing programs to address either issue. Finally, future research should explore the mechanisms underlying these associations and investigate potential interventions to mitigate the negative impacts of food insecurity and weight discrimination on health and well-being.

This study explored sexual orientation and gender identity as predictors of health literacy among adolescents attending New York City (NYC) public high schools. Many studies have demonstrated disparities in sexual health among sexual and gender minority (SGM) adolescents. However, little is known about their health literacy. Health literacy, defined as the capacity to acquire, understand, appraise, and apply health information, especially in health decision-making, is a known predictor of health. Data came from a quantitative cross-sectional survey (N = 1,438) collected at 15 high schools in the Bronx, NYC. Four aspects of health literacy were explored: (1) knowledge of sexually transmitted infections (STIs), (2) knowledge of sexual health rights in New York State, (3) health access literacy and self-efficacy, and (4) health communication. Linear regression analysis was used to test predictors of health literacy. Contrary to our hypothesis, SGM adolescents did not score significantly lower on the health literacy variables compared with cisgender heterosexual adolescents. SGM adolescents scored significantly higher on knowledge of STIs and knowledge of health rights compared with cisgender heterosexual young men. Adolescents who were questioning their sexual identity scored significantly lower compared with both SGM and cisgender heterosexual adolescents on all four health literacy scales. Interventions are needed to ensure that in-school curricula are inclusive and address health literacy among questioning adolescents and cisgender heterosexual young men. Addressing the health needs of questioning adolescents is particularly important because adolescence is a critical time of decision-making around sexuality and health.

Optimism bias is common across health risk assessments, including firearm injury risk, and can have behavioral consequences. Using data from the 2018 California Safety and Wellbeing Survey, we examine whether optimism bias influences firearm injury prevention practices and policy support by comparing the characteristics, behaviors, and opinions of gun owners who believed having a gun at home is comparatively safer for themselves than for similar others (Optimism Bias group) with (1) those who unequivocally believe guns increase safety for themselves and others (Always Safer group), and (2) those who said they "don't know" or "it depends" in both the self and other scenarios (Uncertain group). Weighted multinomial logistic regression results indicated that gun owners in the Optimism Bias group were more often female, members of minoritized racial or ethnic groups, and new gun owners than the Always Safer and Uncertain groups; they also demonstrated greater support for 4 of 5 firearm injury prevention policies/interventions. Despite similar prevalence of owning a gun for protection, gun owners in the Optimism Bias group less often carried a loaded firearm or stored a gun in an unsecure way compared with the Always Safer group. Findings suggest that gun owners characterized by optimism bias, who acknowledged some risk associated with firearms, even if only or more so for others than for themselves, may represent a "movable middle" that is more receptive to firearm injury prevention efforts. Public health messages emphasizing other-oriented (vs. personal) risk and collective responsibility may be perceived as less threatening to the symbolic significance of guns to individual identity, thus enhancing effectiveness.

Mobile phone interventions are evidence-based methods for preventing obesity among Latino adults and school-aged children; however, few such interventions exist to improve the obesogenic behaviors of children in the developmentally critical preschool years (ages 2-5). Focusing on this age group is important since over one-quarter of 2- to 5-year-old Latino children are overweight or obese. Moreover, most documented interventions target mothers exclusively, ignoring the influence that other caregivers such as fathers and grandparents have on the environment and the child's behaviors. We describe the development and refinement of a theory-informed mobile phone intervention using an iterative, user-centered approach that supports healthy weight-related behaviors in preschool-aged Latino children by engaging mothers, fathers, and grandparents. The resulting intervention, Familias Unidas, Niños Sanos (FUNS), is a culturally centered bilingual (Spanish/English), 12-week, web-based mobile phone intervention grounded in family systems theory. Through three to four weekly text messages and links to web-based interactive multi-media content, caregivers of 2- to 5-year-old Latino children learn evidence-based practices to support specific child behaviors in three domains: healthy eating, media viewing, and physical activity. Development of specific messages is grounded in social cognitive theory. Participants can connect with a virtual coach and other participants. The prototype received high levels of acceptability and usability among members of the target audience and is ready for feasibility testing. The systematic process of development and refinement of the intervention can serve as a model for other mHealth interventions, addressing the ongoing critique of the general lack of theoretical application in such intervention work.