Health Education & Behavior最新文献

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.

This study aimed to look into the effectiveness of a 6-month health coaching intervention on kidney function in treating patients with type 2 diabetes and early-stage chronic kidney disease (CKD). It was conducted via a two-armed, randomized-controlled trial involving 92 diabetic patients who were regularly followed under the shared care system at a medical center in Taiwan. The intervention group had health coaching and usual care, while the control group had usual care only. During the 6 months, there was a significant improvement in kidney function in those patients who experienced significant worsening of eGFR prior to enrollment. The intervention group significantly improved their eGFR up to 7.92 (SD = 8.32, p = .003) and 7.63 mL/min/1.73 m² (SD = 9.71, P < .001) within the 3-month and 6-month coaching, respectively, and the control group, neither eGFR nor urinary albumin/creatinine ratio (UACR) changed significantly during the trial. In addition, concurrent use of nutrition supplements at baseline is an essential factor in the effectiveness of intervention in this study. Based on the results of this study, health coaching may help protect kidney function for some patients with type 2 diabetes with early-stage CKD. It should raise awareness and attention to early-stage CKD and public education on the proper use of healthy nutrition supplements. Further studies on this issue with higher-quality evidence and a larger sample size are needed.

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.

BackgroundEquitable 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.MethodsIn 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.ResultsA 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.ConclusionsOverall 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.

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.

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.

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.