AIMS Public Health最新文献

Research suggests experiences of racial discrimination influence blood pressure outcomes among Black women, but little is known about how coping strategies may influence this relationship. Our study aimed to assess the moderating effects of coping strategies on perceived racial discrimination and blood pressure among young Black mothers. We conducted a secondary analysis on data from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study. Eligible participants were African American or Black women aged 21 and older, who did not present with any cognitive disorder that may obscure reporting data, and who had a biological child who was 3-5 years old at the time of study enrollment. In our analysis, systolic and diastolic blood pressure were the primary outcomes, and experiences of discrimination situations and frequency subscales were the primary predictors. We considered the three subscales of the Coping Strategy Indicator (problem-solving, seeking social support, and avoidance) as moderators. Linear regression models were used. Of the 246 female participants (mean age: 31.3 years; SD = 5.8), the mean systolic and diastolic blood pressures were 114 mmHg (SD = 13.8) and 73 mmHg (SD = 10.9), respectively. The frequency of experiences of perceived racial discrimination was significantly associated with higher systolic blood pressure, but this relationship was moderated among participants with greater seeking social support scores (p = 0.01). There were no significant moderation effects in models with diastolic blood pressure as the outcome. Future studies should examine this relationship longitudinally and further investigate specific coping strategies Black women use to manage perceived racial discrimination.

Background: Recent studies have considered the psychological resilience and growth experienced by healthcare professionals, particularly those facing stressors and traumatic events.

Aims: To study post-traumatic growth in healthcare workers caring for patients, determine the internal consistency of the Post-traumatic Growth Inventory (PTGI) and PTGI-Short Form (PTGI-SF) instruments, and carry out confirmatory analyses of their five-factor structures.

Setting: Healthcare workers based in Greece.

Methods: Cross-sectional design. Linear regression analysis with tested independent variables consisting of demographic, professional, health facility, and patient contact data. Confirmatory five-factor analyses of PTGI and PTGI-SF results were performed to validate their associated factors. Unidimensional reliability of the PTGI and PTGI-SF results was calculated.

Results: The final regression model included sex and whether the internet was the source of health-related knowledge (F ₂₁₀₂ = 11.979, p < 0.0001). The confirmatory factor analysis of the PTGI confirmed its five-factor structure (χ² ₁₈₉ = 1233.642, p < 0.0001), root mean square error of approximation (RMSEA = 0.229, p < 0.0001), and internal consistency (Cronbach α = 0.971). Similarly for the PTGI-SF (χ² ₃₅ = 535.965, p < 0.0001; RMSEA = 0.369, p < 0.0001; Cronbach α = 0.935).

Conclusion: Being female and not using the internet as the principal source of information about diseases were each associated with increased post-traumatic growth. The internal consistencies of both the PTGI and the PTGI-SF were confirmed, as were the robustness of the five-factor structure of each instrument.

Objective: This study examined gender differences in the association between recreational walking and indoor and outdoor fall rates among older adults.

Methods: The Healthy Aging and Neighborhood Study is a prospective cohort that included 716 community-dwelling adults aged 65-95 years in central and northeastern Massachusetts, USA (2018-2023). Recreational walking at baseline was measured by the frequency of walking for exercise for at least 10 min in the participants' neighborhood. Falls were reported on monthly falls calendars, and the circumstances for reported falls were collected via subsequent telephone interviews. Mixed effects negative binomial models were used to estimate gender differences in the associations of recreational walking with rates of indoor and outdoor falls, separately. Models were adjusted for sociodemographic variables, physical health, functional status, lifestyle behaviors, mental health, and fear of falling.

Results: There were 394 (55%) female and 322 (45%) male participants enrolled in the study, and the mean (SD) age was 74.08 (6.29). About 61% of participants engaged in recreational walking at least once weekly. Women had lower outdoor fall rates than men (32 vs. 40 per 100 person-years), while indoor fall rates did not significantly differ by gender (31 vs. 34 per 100 person-years). Women engaging in recreational walking at least once weekly had a 62% lower indoor fall rate [IRR (95% CI): 0.38 (0.21, 0.71)] than those who did not. No significant associations were observed between recreational walking and outdoor falls for both women and men.

Discussion: Among community-dwelling older women, but not men, a higher frequency of recreational walking was associated with lower rates of indoor falls, while no changes were seen with outdoor falls. Increasing recreational walking may be a viable focus for fall prevention programs in the community, especially for older women.

Objective: To examine the impact of the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program on the reversal of one or more metabolic syndrome (MetS) criteria among community members with MetS and define the significant predictors of upholding individual MetS criterion from 2020 to 2023.

Methods: The program enrolled 278 community members with/or at risk of MetS. Participants followed regular physical activity and a Mediterranean diet for 12 months with the assistance of a registered dietitian and a kinesiologist. A licensed practical nurse and/or registered nurse measured participants' weight, height, waist circumference, and blood pressure and withdrew blood samples for laboratory investigations. Physical activity, physical fitness, Mediterranean diet score (MDS), anthropometric measurements, and laboratory investigations were assessed at the baseline and every three months. Descriptive statistics were calculated, and binary logistic regression analysis was performed to define the significant predictors of upholding each criterion of the MetS.

Results: Participants' mean age was 60.5 ± 11.7 years, and 74.8% were females. Participants with MetS decreased by 5.04% by the end of the program. The percentage of participants with each MetS criterion showed a significant decrease at the end of the study, except for low HDL, which remained with no change. Moreover, the mean of physical activity, physical fitness tests, and MDS scores showed a significant increase after the 12 months of study. Compared to baseline, daily sedentary and screen times showed a significant decrease at the end of the program (8.6 vs. 7.2 and 3.2 vs. 2.6 hours, respectively). Logistic regression analysis revealed that age, female gender, low educational attainment, physical activity, physical fitness, and screen time were significant predictors for upholding one or more MetS criteria.

Conclusion: MetS criteria can be reversed following the CHANGE program. Sociodemographic and lifestyle features are significant predictors for upholding MetS criteria. The program is cost-effective considering its low cost and could lead to significant savings on healthcare costs. Further studies among different communities are recommended to confirm the generalizability of the results.

The extensive impact of social media on communication of public health information is a growing concern. This is particularly worrying in the context of vaccination. Thus, we investigated the quality of TikTok videos regarding vaccination in Arabic, with examination of the association of video source and content type with the information quality and video engagement metrics. The final sample comprised a total of 129 TikTok videos in Arabic posted between January 2021 and July 2024. Videos were categorized based on the source [healthcare professional (HCPs), lay individuals, media], and content type (COVID-19 vaccination, childhood vaccination, general vaccination, others). We utilized a miniaturized version of the DISCERN instrument (mini-DISCERN) scale to evaluate information quality by two independent raters and assessed video engagement metrics (Likes, Comments, Shares, and Saves). The results indicated a statistically significant discrepancy in information quality, with videos from HCPs and media outlets scoring higher on the mini-DISCERN scale compared to those from lay individuals [mean: (4.818 ± 0.726) vs. (4.053 ± 1.441) vs. (2.003 ± 1.640), P < 0.001]. The highest information quality was found for videos on childhood vaccination, whereas content on COVID-19 vaccination was rated significantly lower on mini-DISCERN [mean: (4.510 ± 1.269) vs. (2.542 ± 1.827), P < 0.001]. Videos with higher engagement metrics, particularly those from lay individuals, were negatively correlated with information quality. Linear regression analysis confirmed the significant influence of the creator background (β = -0.618, P < 0.001) and video topic (β = 0.179, P = 0.009) on information quality. This study highlights the critical role of content creator background and topic on the quality of vaccination-related information on TikTok in Arabic. We emphasize the need for stringent verification of TikTok content, especially from lay individuals, as videos with higher engagement metrics often contained lower-quality information regarding vaccination. We recommend enhanced support for content from HCPs and targeted digital literacy programs to combat vaccine misinformation on TikTok effectively.

Nursing handover is essential in clinical practice across various healthcare settings and can significantly impact nurses' mental health. This scoping review aimed to explore and map these implications using the JBI methodology and PRISMA ScR Checklist. It included 11 studies published between 1988 and 2022 from the UK, Australia, USA, South Korea, and Hong Kong, involving over 122 nurses in acute care settings. The findings reveal three major themes: source of psychological discomfort, coping resource, and peer support and cohesion. Negative emotions such as stress, anxiety, dissatisfaction, and tension are linked to handovers, particularly bedside handovers, which raise confidentiality issues and induce scrutiny among nurses. The lack of standardized training and consistent procedures also contributes to stress, especially for newly graduated and less experienced nurses. Conversely, handovers function as structured rituals providing peer support and a sense of control, helping nurses manage psychological demands. To mitigate negative impacts, implementing standardized handover procedures and comprehensive training programs for new nurses is essential. Encouraging open communication and fostering a supportive environment can enhance team cohesion and reduce stress. Future research should measure the impact of different handover practices on nurses' mental health and explore their supportive, social, protective, and restorative functions. This review highlights the critical role of nursing handovers in supporting nurses' mental health and underscores the need for standardized practices to improve the well-being of nursing professionals and the quality of patient care.

Background: Hispanic ethnicity is associated with an increased risk for severe disease in children with COVID-19. Identifying underlying contributors to this disparity can lead to improved health care utilization and prevention strategies.

Methods: This is a retrospective cohort study of children 2-20 years of age with positive SARS-CoV-2 testing from March-October 2020. Univariable and multivariable logistic regression models were fitted to identify demographic, comorbid health conditions, and social vulnerabilities as predictors of severe COVID-19 (need for hospital admission or respiratory support).

Results: We included 1572 children with COVID-19, of whom 45% identified as Hispanic. Compared to non-Hispanic children, patients who identified as Hispanic were more often obese (28% vs. 14%, p < 0.0001), preferred a non-English language (31% vs. 3%, p < 0.0001), and had Medicaid or no insurance (79% vs. 33%, p < 0.0001). In univariable analyses, children who identified as Hispanic were more likely to require hospital admission (OR 2.4, CI: 1.57-3.80) and respiratory support (OR 2.4, CI: 1.38-4.14). In multivariable analyses, hospital admission was associated with obesity (OR 1.9, CI: 1.15-3.08), non-English language (OR 2.4, CI: 1.35-4.23), and Medicaid insurance (OR 2.0, CI: 1.10-3.71), but ethnicity was not a significant predictor of severe disease.

Conclusions and relevance: The high rates of severe COVID-19 observed in Hispanic children early in the pandemic appeared to be secondary to underlying co-morbidities and social vulnerabilities that may have influenced access to care, such as language and insurance status. Pediatric providers and public health officials should tailor resource allocation to better target this underserved patient population.

Objectives: Healthcare workers, most notably nursing professionals, face high levels of recurrent stress that lead to symptoms of burnout and other negative mental health outcomes. This indicates the need for greater individual and organizational health system support, including implementation of effective, evidence-based interventions for burnout reduction in this population. Organizationally supported mindfulness-based interventions can be used to build individual resilience, buffering the detrimental effects of occupational stress and enhance professional well-being. Our aim was to evaluate the effect of an evidence-based mindfulness intervention on perceived stress, burnout, resilience, and work engagement in nursing professionals.

Methods: A non-randomized single arm, pre/post design was used for this study. Healthcare workers (n = 631), including Registered Nurses and Advanced Practice Nurses (n = 128), physicians (n = 105), social workers (n = 21), pharmacists (n = 8), chaplains (n = 30), physician and occupational therapists (n = 39), patient care assistants (n = 13), other clinical staff (n = 26), non-clinical staff (n = 229), and 32 others participated in Mindfulness in Motion, an 8-week evidence-based worksite mindfulness intervention. Validated self-report measures assessing burnout (Maslach Burnout Inventory), perceived stress (Perceived Stress Scale), resilience (Connor Davidson Resiliency Scale), and work engagement (Utrecht Work Engagement Score) were given pre and post program. Total burnout was determined by scores on the subscales of emotional exhaustion, depersonalization, and personal accomplishment of the Maslach Burnout Inventory: Emotional exhaustion >27 or depersonalization >13 or personal accomplishment <31.

Results: Significant reductions in burnout (p < 0.00001), perceived stress (p < 0.00001), with significant increases in resilience (p < 0.00001), and work engagement (p < 0.00001) were observed among Registered and Advanced Practice Nurses comparing pre-post measures. Notably, the number of nursing professionals who no longer qualified as burned out was 10% higher than the other participants.

Conclusion: Our results suggest that nursing professionals could greatly benefit from organizationally supported mindfulness-based interventions such as Mindfulness in Motion and may benefit them most compared to other health system employees.

Despite federal legislation intended to increase the prescribing of buprenorphine as medication for opioid use disorder (MOUD), such as the Drug Addiction Treatment Act (DATA) of 2000, most providers have continued to prescribe to some patients or to not prescribe at all. We aimed to determine the continuing barriers and supports needed for expanding buprenorphine prescribing and compared barriers experienced by emergency department (ED) physicians with those in other practice settings, given the unique aspects of the ED practice setting. We obtained survey data from August through November 2021 from 412 X-waivered Illinois physicians licensed to prescribe buprenorphine as MOUD, 95 (23.1%) of whom worked primarily in a hospital-based ED. Survey questions included: 1) Professional background, practice characteristics, and prescribing practices; 2) barriers to prescribing buprenorphine; 3) barriers to expanding prescribing; and 4) training/additional supports needed to facilitate buprenorphine prescribing. We used bivariate crosstabulations and multivariable OLS and binary logistic regressions to compare the responses of physicians practicing in the ED versus other practice settings and to compare physicians who prescribed buprenorphine in the past year with those who had not. There were few statistically significant differences among the examined subgroups indicating general agreement regardless of practice setting and prescribing status. The most frequently perceived barrier was having an inadequate community-based behavioral health treatment system to which OUD patients could be referred. Insurance reimbursement, difficulties building practice- and community-based systems to support buprenorphine prescribing, and challenges knowing where and how to refer patients for follow-up and ongoing support services were also prominent concerns. Based on study findings, efforts to expand buprenorphine for OUD might focus on providing support to make and manage treatment referrals and expanding the availability of community-based behavioral healthcare services. Building networks of care could potentially have a greater impact on MOUD availability than increasing the number of practitioners trained to prescribe buprenorphine.

Sleep duration and quality have been increasingly recognized as critical determinants of childhood obesity risk, with insufficient sleep linked to disruptions in appetite-regulating hormones and unhealthy weight gain trajectories. Emotional intelligence, which involves recognizing, understanding, and managing one's own emotions as well as those of others, has garnered attention for its potential impact on VARIOUS aspects of health and well-being, including weight management. Moreover, childhood obesity remains a significant public health concern worldwide, with multifaceted factors contributing to its prevalence and persistence. Research is starting to reveal how sleep patterns and emotional intelligence (ΕΙ) influence children's weight status. This study aims to investigate the relationship between childhood sleep patterns, EI, and body mass index (BMI) in school-aged children. Utilizing a sample of 614 children, aged 8-12 years (mean age 10.0 y), data on emotional intelligence scores, sleep duration and quality, and BMI measurements were collected and analyzed. The results reveal significant correlations among these variables, indicating that emotional intelligence may play a crucial role in both sleep patterns and BMI outcomes in children (Mean = 3.53, SD = 0.51 in total sample; Mean = 3.53, SD = 0.51 in overweight/obese). Specifically, higher emotional intelligence scores are associated with better sleep quality and duration, as well as healthier BMI levels (p ≤ 0.001). These findings underscore the importance of considering emotional well-being and sleep hygiene in the context of childhood obesity prevention and intervention efforts. Further research is needed to elucidate the underlying mechanisms driving these relationships and to develop targeted strategies for promoting emotional intelligence and healthy sleep habits in school-aged children.