Health Promotion Perspectives最新文献

Background: Hypertension is a prevalent medical condition associated with cardiovascular and kidney diseases, leading to premature death and disability. Despite medication use, hypertension continues to rise due to unhealthy lifestyles. Self-care strategies play crucial roles in effectively treating hypertension. We aimed to evaluate the effectiveness of interventions based on the transtheoretical model (TTM) in improving self-care, self-efficacy, and health-related quality of life (HRQOL) in hypertensive adults.

Methods: A comprehensive search was performed in multiple databases using appropriate search strategies. Two independent reviewers screened articles, and assessed their adherence to the inclusion and exclusion criteria. The risk of bias in randomized controlled trials was assessed by the Cochrane Collaboration tool and quasi-experimental studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies.

Results: The review included 24 studies with a total of 6553 participants. Most interventions aimed to encourage a healthier lifestyle and improve diet and physical activity. The message was delivered through various methods such as slide/tape messages, individual education/counseling sessions, telephone-delivered interventions, and multimedia training software based on the TTM. Control groups received physician visits or attended lifestyle lectures but did not receive specific behavior change programs like the intervention groups.

Conclusion: Our results indicated that the TTM and stage of change model can be an appropriate framework for delivering educational messages to patients.

Background: Online home exercises represent opportunities to increase physical activity levels. However, high dropout rates are commonly reported in such programmes. This study aimed to investigate the predictors of dropping out from an online home exercise programme.

Methods: A total of 760 individuals from nine countries participated in this 8-week prospective cohort study derived from a randomised controlled trial. The participants were randomised into "4-week live-streamed exercise ->4-week recorded exercise" or "4-week no intervention ->4-week recorded exercise" group. Repeated measurements using weekly questionnaires were performed. Pain intensity, disability, mental well-being score, exercise motivation, sleep quality, impulsiveness/anxiety, and physical activity level were analysed.

Results: A total of 53.8% (95% confidence interval [CI] 50.3%-57.3%) participants dropped out from the programme. The identified predictors of dropping out from the programme were: well-being (odds ratio [OR] 0.94, 95% CI 0.91-0.97) and disability (OR 1.02, 95% CI 1.002-1.04) at baseline considering the first 4 weeks; age (0.98; 95% CI 0.96-1.00) and baseline well-being (0.93; 95% CI 0.89-0.97) considering the entire follow-up (8 weeks); exercise motivation (0.92; 95% CI 0.87 to 0.97) and general impulsiveness/anxiety (1.04; 95% CI 1.01-1.07) repeated measured over time.

Conclusion: About half of the participants dropped out from the online home exercise programme. Higher baseline scores in mental well-being and age predicted a reduction in dropping out. Higher baseline disability predicted an increase in dropping out. During the follow-up, higher exercise motivation was associated with a reduction in dropping out, and higher impulsiveness and anxiety were associated with an increase in dropping out.

Background: Understanding the factors associated with the propensity for drug dependence might be helpful in providing the best strategies for substance use prevention among youth. The present study was conducted to examine the association between childhood maltreatment (CM) and susceptibility to substance use disorders (SUDs), taking into account the mediating role of psychological safety.

Methods: In this cross-sectional study, multistage cluster sampling was employed to recruit 400 male students from the three universities of Tabriz in 2019. Research instruments included the valid and reliable scales of substance abuse, childhood trauma, and mental safety. Data were analyzed using Pearson correlation, and structural equation modeling.

Results: The results showed positive significant relationships between vulnerability to SUDs, CM, and low levels of psychological safety. The evaluation of our hypothetical research model using fit indices showed that the model fits well the measurement model (CFI=0.97, GFI=0.95, RMSEA=0.058).

Conclusion: Our proposed theoretical model suggested psychological security as a mediator between CM and SUDs. CM explained addiction in college students through reducing psychological security. Investigating these interactive processes seems to be detrimental, considering that they may enhance our understanding of the ways to reduce the risk.

Background: The utilization of a theoretical framework is vital in health promotion research, particularly when endeavoring to modify health behaviors. This systematic review aimed at evaluating and synthesizing evidence through studies conducted using the fourth-generation multi-theory model (MTM) of health behavior change for its effectiveness.

Methods: A comprehensive article search was performed across MEDLINE, CINAHL, and Academic Search Premier. The search focused on studies utilizing MTM from 2016 to December 2023, following the PRISMA guidelines for systemic reviews.

Results: An initial pool of 7583 articles was narrowed down through screening of titles, abstracts, and full texts. A total of 69 articles met the inclusion criteria. These studies, encompassing a global range of diverse target groups and health behaviors, were categorized as qualitative, cross-sectional, or experimental. The six qualitative studies revealed MTM themes for diverse health behaviors. The fifty-six cross-sectional studies showed MTM constructs effectively predicting behavior change, albeit with varying statistical significance. The seven experiments demonstrated MTM's role in initiating and sustaining change. For the initiation model, operationalized by 49 studies, the mean adjusted R² was 38.4% (SD=16.4%). For the sustenance model, operationalized by 45 studies, the mean adjusted R² was 38.9% (SD=15.5%).

Conclusion: This systematic review corroborates the MTM as a potent framework for understanding, predicting, and facilitating health behavior changes. Its universal applicability and effectiveness underscore the model's potential as a foundational tool in designing future health promotion strategies and interventions aimed at positive and enduring behavior modifications.

Background: Atherosclerotic cardiovascular disease (ASCVD) is considered a worldwide health problem associated with high morbidity, mortality, and cost of care. In the present study, we examined risk-enhancing factors for ASCVD in healthcare workers of the AZAR cohort population.

Methods: Data from a total of 500 participants were used for this cross-sectional study. Demographic characteristics, anthropometric indices, biochemical factors, and blood pressure were assessed. To evaluate the associations of ASCVD with the parameters mentioned above, univariate and multivariate logistic regression analyses were conducted.

Results: The total frequency of subjects with severe (≥7.5) and low (<7.5) ASCVD was 7.6% (95% CI: 5.4-10.3), and 90.6% (95% CI: 87.7-93.0), respectively. The top strongest links were found between ASCVD and atherogenic index of plasma (AIP) (odds ratio [OR]: 12.8, 95% CI: 3.2-49.9), diabetes (OR: 7.6, 95% CI: 2.8-25), and daily smoking (OR: 7.0, 95% CI: 2.8-20). Based on a multivariate logistic regression model, low-density lipoprotein cholesterol (LDL-C)/apolipoprotein B (Apo b), diabetes, hematocrit, age, Triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C), systolic blood pressure, HDL-C, apolipoprotein A-I (Apo A-I), hemoglobin, and Apo B/Apo A-I have significant associations with ASCVD severity.

Conclusion: In conclusion, the present study showed significant associations between the severity of ASCVD with some parameters among healthcare workers of AZAR cohort study.

Background: Faced with a deemed mediocre quality of life (QoL) in people with multiple sclerosis (pwMS), the effectiveness of therapeutic education (TPE) programs is called into question. This systematic review is conducted to examine the impact of the TPE programs on the QoL of pwMS.

Methods: A search was performed in three databases (PubMed, Web of Science and Scopus) to identify relevant studies published between 2007 and 2022. The review followed the PRISMA guidelines. Two reviewers independently extracted data on the study and program characteristics. These data were presented in tables for detailed synthesis and descriptive analyses. The selected studies underwent assessment using recommended evaluation tools.

Results: Of the 21 studies included in the review, 13 found a significant improvement in QoL, which was maintained during follow-up testing in 42% of the studies. TPE programs that focused on patients' individual needs and aimed to develop their skills in a personalized manner appeared to promote QoL. Interaction formats (individual, group, remote), session duration [range=1.5-28] and number of sessions [range=1-18] varied between the studies reviewed.

Conclusion: Thoughtful, structured design of educational programs requires a match between the educational aspects specific to each individual and the appropriate choice of content, delivery modalities of the interventions and evaluation protocol, as well as a reasonable follow-up time. The conclusions drawn could serve as guidelines to direct future research towards optimal educational interventions.

Systematic review registration: PROSPERO CRD42022338651.

Background: Predictive equations have been considered as a practical approach for estimating resting energy expenditure (REE) across multiple populations, but their accuracy for each community remains to be determined. Thus, the purposes of this study were to determine the validity of REE predictive equations and to develop a new REE predictive equation in adults living in Tehran.

Methods: The study included 284 subjects (158 females) aged 18-60 years old from two cross-sectional studies conducted in Tehrani populations. Anthropometric measurements were assessed using standard protocols. REE was measured using indirect calorimetry (IC) and was estimated using preexisting equations. A new equation was also developed based on the REE from IC and variables such as age, sex, height, and weight. Measured REE was compared to new equation and preexisting predictive equations via correlation, linear regression, and Bland-Altman tests.

Results: The new equation and the equations by Mifflin-St. Jeor, Livingston, Frankenfield, Nichols, Müller, and Ganpule demonstrated the best predictive value at a group level (mean percentage error=-2.2 to 2.4 %). At an individual level, the new equation and the equations by Mara, Frankenfield, Roza, Nikooyeh, and Harris & Benedict showed the greatest accuracies compared to measured REE (accuracy prediction=50-53%).

Conclusion: This study highlights the importance of considering race when predicting REE. It also demonstrates that the newly developed equation is more appropriate in a clinical setting at group but not individual level. Thus, further research is needed to examine the new equation in an independent sample.

Background: Current evidence suggests that health literacy (HL) impacts self-care behaviors and quality of life (QOL) in patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the impact of a short-time health literacy promotion program (HeLPP) on self-care behaviors and QOL in rural patients with type 2 diabetes.

Methods: Conducted from 2018 to 2019 in Chaldoran county, Iran, this randomized controlled trial followed the Solomon four-group design. Participants included 160 rural individuals with T2DM, who were divided into two intervention (A and C) and two control (B and D) groups. Pre-tests were conducted for intervention group A and control group B, with post-tests administered to all groups at three and six months. Interventions, consisting of five training sessions lasting 45 to 55 minutes, were planned and executed based on pre-test analyses. Primary outcomes were QOL and self-care behaviors, and secondary outcomes were glycated hemoglobin (HbA1c), HL and patients' awareness of the disease.

Results: Prior to the intervention, there was no significant difference in awareness, HL, self-care behaviors, HbA1c, and QOL between intervention group A and control group B (P>0.05). However, at three and six months after the educational program, intervention group A exhibited significantly increased average scores in awareness, HL, self-care behaviors, and QOL, along with reduced HbA1c levels (P<0.05) compared to control group B. No interaction was detected between the pre-test and the primary and secondary outcome scores after intervention.

Conclusion: Implementing intervention programs like HeLPP focusing on enhancing practical HL and empowering T2DM patients seems to be promising in improving patients' self-care behaviors and QOL, while reducing their HbA1c levels.

Trial registration: Identifier: IRCT20131116015422N7; https://irct.behdasht.gov.ir/trial/35569.

Background: Roughly 10% of children aged 3 -17 in the USA are diagnosed with attention-deficit hyperactivity disorder (ADHD), and minorities are less likely to initiate common pharmacologic treatment. We conducted a review of the literature to examine meditation as a safe, effective, and low-cost alternative.

Methods: We searched PubMed and other journals using "meditation," "mindfulness," "minority," related keywords, and relevant MeSH terms. Eligible studies involved racial/ethnic minorities in the USA, reported quantitative psychosocial outcomes, and were published in a peer-reviewed, English-language journal.

Results: Out of 119 "hits," 111 were eliminated as duplicates or were not relevant. A full-text review of the remaining eight revealed that none fully met our eligibility criteria. Besides the obvious lack of studies, those reviewed reported incomplete demographic and clinical data. They also employed different and inconsistent research methodologies, interventions and modalities, and statistical analyses. This hindered understanding exactly which populations may benefit from meditation, and for which specific symptoms.

Conclusion: We recommend a socio-ecological model in examining intervention modalities, especially in the context of intrapersonal, interpersonal, organizational, environmental, and policy domains. We also suggest the possible inclusion of research older than 10 years, conducted outside of the USA, on minority and non-minority populations, for supplementary and confirmatory data. We advocate for consistency in study design and data collection, which would help align research conducted in different countries. Searches should also include variations of meditation such as "mindfulness" and "guided imagery," and associated symptoms and comorbidities of ADHD, including "learning disorder" and "behavioral problems."

[This corrects the article DOI: 10.34172/hpp.2021.06.].