Health Education & Behavior最新文献

Growing up in socioeconomic disadvantage increases risk of peer bullying at school. Both socioeconomic status and involvement in bullying are predictive of a range of adverse developmental outcomes. However, neither (a) the mechanisms whereby disadvantage increases bullying risk nor (b) the developmental outcomes for which bullying may mediate disadvantage are clear. This review scoped the literature on the relationships between socioeconomic disadvantage, bullying, and health and developmental outcomes for school-aged children and adolescents. Four databases were searched up to June 3, 2023 with 565 studies retrieved, of which 17 met criteria. Most studies were cross-sectional, and studies varied greatly in their definition and measurement of both bullying involvement and disadvantage. No intervention studies were found. Mediators of the disadvantage-bullying association ranged from individual level (e.g., depression) to the national level (e.g., homicide rate); only two studies examined bully-victim status. Of studies where bullying was a mediator, none examined bullying perpetration; the range of outcomes examined was narrowly focused on mental health, failing to capture the full range of developmental outcomes associated with either socioeconomic disadvantage or bullying involvement. This review highlights that future research is needed on identifying and understanding the mediators of the association between disadvantage and bullying victimization, and on the developmental outcomes mediated by bullying perpetration for disadvantaged children. These insights are critical to increase the effectiveness of community- and school-based bullying prevention, particularly in communities with high proportions of socioeconomically disadvantaged families.

Even though multiple states have approved legal recreational use of cannabis, the expansion of recreational cannabis legalization has led to public health concerns in the United States. Young adults (18-25 years old) have the highest percentage of cannabis use disorder compared to all other age groups. The purpose of this study is to compare cognitive and emotional responses of young adults who use cannabis and non-users to two anti-cannabis media campaigns that employed different message strategies. In total, 50 people (25 people who use cannabis and 25 non-users) participated in the study-a 2 (cannabis use status: people who currently use cannabis/non-users) × 2 (Public Service Advertising [PSA] campaign: Don't be a Lab Rat-Informational/Stoner Sloth-Narrative) × 3 (message replication) experiment. Participants viewed six messages based on the combinations of each of the three message replications within two campaigns. Participants' facial emotional responses were recorded during message exposure. Self-report questions were asked after viewing each message. Self-report indices showed no differences between the two campaigns for participants who use cannabis and non-users. However, after controlling for individual differences, participants who use cannabis displayed more negative emotional responses to the Don't be a Lab Rat messages than to the Stoner Sloth messages. Conversely, cannabis users experienced more positive emotional responses to the Stoner Sloth messages than to the Don't be a Lab Rat messages. The study provides insights for message design in public health campaigns addressing cannabis use, suggesting that psychophysiological measures can be helpful in providing insights into responses not detected by traditional self-report measures.

South Asians have become a sizable ethnic minority in Hong Kong with unique health and social needs often being overlooked. Elevated obesity risk among South Asians has been highlighted in high-income Western settings; however, relevant local evidence is scarce. This cross-sectional study aims to explore the obesity prevalence and related risk factors among South Asians in Hong Kong. Between June 2022 and February 2023, 535 South Asian adults were recruited via territory-wide health outreach services, and completed a survey and anthropometric measurements on height, weight, and waist circumference. In our female-dominated sample (84.1% female; mean age = 41.0 ± 12.3 years), the observed prevalence of general obesity (body mass index [BMI] ≥ 27.5 kg/m² for South Asians) and abdominal obesity (waist-to-height ratio [WHtR] > 50%) were 60.2% and 89.4%, respectively. Results from multivariable linear regressions showed that mean BMI and WHtR were significantly higher among women and Pakistani individuals (and Nepalese individuals for BMI only) but lower among better educated and employed respondents. Apart from age, household size, and marital status as common risk factors, having a healthier diet and higher physical activity level were also associated with lower WHtR. Notably, the associations of female gender and Pakistani ethnicity were attenuated after adjustments for socioeconomic and lifestyle factors. In conclusion, there was a high prevalence of obesity in South Asian participants in this study. The identified risk and protective factors could inform targeted services and community-based weight management programs to mitigate obesity and its associated cardiometabolic risks in this fast-growing but vulnerable community.

Adolescent relationship abuse (ARA) has significant sequelae and is more prevalent among sexual and gender-diverse youth (SGDY). Increased parental involvement and communication has been linked to decreased prevalence of ARA and associated health risks. Parents of SGDY may have unique needs and experiences regarding communicating with their children about ARA, yet little research has examined this area. This study explored caregivers' current practices around supporting their SGDY in healthy relationship formation and ARA prevention; caregivers' perceptions about ARA among SGDY; and their recommendations for developing ARA prevention-focused interventions for caregivers of SGDY. We conducted 24 semi-structured interviews with caregivers of SGDY aged 12 to 19. Transcripts were analyzed using thematic analysis. Some participants reported having positive, open communication with their SGDY about dating, while others struggled to understand and respond to the unique risks of ARA experienced by their adolescent. Caregivers discussed ways systemic discrimination affects SGDY experiences of relationships and ARA, and distinct dating challenges for gender-diverse youth. When considering caregiver-focused ARA prevention, participants supported a program including ARA education, communication skills building, and caregiver affirmation. Participants encouraged the use of digital and in-person mediums, experienced and relatable facilitators, and SGDY involvement. Caregivers of SGDY had significant strengths and challenges when engaging and communicating with their child around dating and ARA prevention. Caregivers at varying stages of acceptance and understanding believed they could benefit from a comprehensive and inclusive education program on SGDY ARA experiences and how they can support their child in preventing ARA.

Heavy drinking is a major public health concern, particularly among young adults who often experience fear of being stigmatized when seeking help for alcohol-related problems. To address drinking concerns outside clinical settings, we tested the feasibility of a novel imagery-based behavior change strategy led by student lay interventionists in a college setting. Participants were adults recruited on a college campus and were randomized to either learn the four steps of WOOP (Wish, Outcome, Obstacle, and Plan) or to learn a format-matched Sham WOOP (Wish, Outcome, "Outcome," and Plan). Both WOOP and Sham WOOP interventions were taught by student lay interventionist. We found that the WOOP intervention group reported fewer heavy drinking days (≥ 5 drinks for men or ≥ 4 drinks for women, measured using the Alcohol Timeline Follow-Back Method) compared to the Sham group at the 1-month and 2-month follow-ups. WOOP, when taught by student lay interventionists in a single session, demonstrated the feasibility of reducing heavy drinking. WOOP shows promise as a low-cost and scalable intervention for reducing heavy drinking in nonclinical settings.

Background: Equitable access to health care services for Hispanic and Latine populations requires that systems go beyond working to increase enrollment in health insurance but also addressing health insurance literacy-the knowledge, ability, and confidence to find and use health insurance.

Methods: In collaboration with a local health policy organization, individual interviews were conducted with Hispanic and Latine community members. Group engagement sessions were conducted with key professionals. Interviews and engagement sessions focused on the adaptation of an existing health insurance education program (HIEP) to Spanish-speaking Hispanic and Latine individuals. An outline of the proposed HIEP content was provided prior to each interview or engagement session. Qualitative content was analyzed using an inductive thematic analysis guided by the intervention adaptation literature.

Results: A total of N = 20 professionals participated in an engagement session, while N = 21 community members took part in an interview. Professionals worked in both health care systems (55%) and community organizations (45%). Community members were on average 41 years of age (SD = 13), 81% female, and 100% Hispanic or Latine. Qualitative analysis revealed that participants overwhelmingly supported the adaptation of the HIEP and approved of the proposed topics. Participants also provided recommendations to improve the intervention content and characteristics including a focus on controlling costs, tailoring to the population, ensuring accessibility of content, and specifics regarding the HIEP delivery and facilitator.

Conclusions: Overall participants were supportive of the proposed HIEP adaptation and provided a variety of recommendations. Health insurance literacy was perceived as an important next step to enrollment in health insurance.

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.

Misinformation hinders the impact of public health initiatives. Efforts to counter misinformation likely do not consider the full range of factors known to affect how individuals make decisions and act on them. Implementation science tools and concepts can facilitate the development of more effective interventions against health misinformation by leveraging advances in behavior specification, uptake of evidence, and theory-guided development and evaluation of complex interventions. We conducted a scoping review of misinformation literature reviews to document whether and how important concepts from implementation science have already informed the study of misinformation. Of 90 included reviews, the most frequently identified implementation science concepts were consideration of mechanisms driving misinformation (78%) and ways to intervene on, reduce, avoid, or circumvent it (71%). Other implementation science concepts were discussed much less frequently, such as tailoring strategies to the relevant context (9%) or public involvement in intervention development (9%). Less than half of reviews (47%) were guided by any theory, model, or framework. Among the 26 reviews that cited existing theories, most used theory narratively (62%) or only mentioned/cited the theory (19%), rather than using theory explicitly to interpret results (15%) or to inform data extraction (12%). Despite considerable research and many summaries of how to intervene against health misinformation, there has been relatively little consideration of many important advances in the science of health care implementation. This review identifies key areas from implementation science that might be useful to support future research into designing effective misinformation interventions.

Hazardous/harmful drinking among college students is increasingly becoming a global health concern. Previous studies have mostly paid more attention to the prevalence and risk factors of alcohol use disorder based on the public health approach, and less is understood about psychological mechanisms and protective factors of problem drinking behavior. Grounded in the framework of developmental assets, this study explored the predictive effect of external assets (i.e., social connectedness) and internal assets (i.e., self-concept clarity and drinking refusal self-efficacy) on hazardous/harmful drinking among Chinese college students. Participants were 598 college students with a mean age of 19.41 (SD = 1.21) years. The results of structural equation modeling showed that social connectedness negatively predicted college students' hazardous/harmful drinking. Moreover, our path analyses revealed a serial mediation among these variables: students with high social connectedness tended to report high self-concept clarity, which in turn increased drinking refusal self-efficacy, and consequently decreased the level of hazardous/harmful drinking. This study revealed the mechanisms underlying how external and internal assets predict risky drinking among college students. These findings made significant contributions to prevention and precision interventions for college-aged youth with drinking problems.

This article discusses Earth's Rights as an environmental justice mechanism of reparation, protection, and justice for indigenous communities, environmental defenders, and other populations in Latin America. We argue that Earth's rights encompass and include the right to health and can be integrated into international human rights frameworks to protect all forms of life, responding to colonial legacies of discrimination and violence. We respond to the scarcity of literature discussing Earth's rights in relation to situations where human rights and Earth's rights are violated. We ground our argument in the theoretical conceptualization of Latin American proposals of Earth's rights and its potential for actionable policy approaches that include human health as inevitably interconnected to our planet's well-being. We address the environmental injustices that affect the right to health and argue that an Earth's rights framework can support reparations for historically marginalized communities.