Health Promotion Practice最新文献

Background. Lack of physical activity (PA) causes over 5.3 million deaths every year and causes more deaths than smoking worldwide. Prolonged periods of sitting contributes to chronic diseases, which are among the leading causes of deaths, illnesses, and health care costs worldwide. Over 133 million Americans are currently affected by chronic diseases and associated health care costs the United States an estimated $3.5 trillion annually. Working adults spend an average of 7.6 hours per day at work and office-based employees spend 75% of their time sitting. Prolonged periods of sitting also causes stress, and stress is the leading cause of 75%-90% of all doctor visits. Purpose. The purpose of this study was to determine facilitators and barriers of workplace PA to relieve stress at a Florida Department of Health (FDOH) site. Methods. Mixed-methods data were collected in an anonymous Qualtrics survey. Sample included employees ≥ 18 years old with sedentary or active occupations who completed or not completed recommended PA at FDOH site. Results. A total of 336 responses were recorded and produced an 84% response rate. Lack of time was the most commonly reported barrier. Discussion. Too much sitting has become a global epidemic. Completing 30 minutes of daily PA can reverse 10 hours of sitting, relieve stress, improve health outcomes, and ultimately save lives. Workplace PA facilitators/barriers and stress relief behaviors were identified and provided practical methods to improve overall workforce health outcomes. Implementing fun, inclusive and healthy interventions in policy and practice, can encourage happier and healthier workforces and communities worldwide.

In 2021, the Centers for Disease Control and Prevention's (CDC) National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) funded community health workers (CHWs) for COVID Response and Resilient Communities (CCR). CCR is a 3-year, $350 million initiative to implement CHW strategies aimed at reducing COVID-19 impacts, building resilience, and improving health equity by addressing health-related social needs. This paper describes the CCR initiative and experiences to date, underscoring CHWs' critical role in CDC's pandemic response. CCR funds 67 recipients to reach communities who are disproportionately affected by long-standing health disparities (hereafter, priority populations). CCR aims to decrease the impact of COVID-19 and increase community resilience to respond to COVID-19 and future public health emergencies. Recipients implement three strategies: train CHWs to support the COVID-19 response, increase the workforce of CHWs to manage the spread of the disease, and improve utilization of community and clinical resources to engage CHWs to help strengthen communities' resilience to mitigate the impact of COVID-19. We funded three additional organizations to provide technical assistance to CCR recipients and collaborate with us on a national evaluation of the program. CCR recipients hired about 950 CHWs and integrated these CHWs into over 1,000 organizations and care teams. At the end of the second program year, CHWs made over 250,000 referrals to social services and over 150,000 referrals to address specific health conditions. CCR demonstrates that CHWs can be quickly mobilized to participate in a public health emergency and reach those most affected by COVID-19.

Food insecurity is a household-level economic and social condition characterized by limited access to nutritious food. This study explored dental practitioners' views on food insecurity screening and its impact on oral health. A five-question survey ("Quick Poll") was conducted through the National Dental Practice-Based Research Network (PBRN) in the United States. A total of 332 dental practitioners responded. Preferences for food insecurity screening in dental practice settings showed substantial variability: 30% in favor, 39% neutral, and 29% against. When identifying the primary oral health issue influenced by food insecurity, 68% pinpointed dental caries. Over half (53%) expressed comfort in directing patients experiencing food insecurity to relevant resources. Notably, 61% of respondents expressed interest in being involved in future food insecurity clinical studies. This preliminary study underscores the relevance of food insecurity in the professional dental setting and suggests that the clinical setting may be well suited for educational programs designed to improve the oral health of patients experiencing food insecurity. Future research may achieve this goal, including a PBRN clinical study of interventions to improve oral health among patients experiencing food insecurity.

In 2022, over 38,000 new HIV infections were diagnosed in the United States disproportionately affecting non-dominant racial and ethnic populations and Southern United States. While pre-exposure prophylaxis (PrEP) is 99% effective, uptake of this regimen remains low, mainly owing to structural barriers, stigma, and perceived and actual discomfort among providers. This problem presents the PrEP/HIV Toolkit (see www.grlgbtqhealthcareconsortium.org/toolkit) as a novel, equity-focused solution for scaling up HIV prevention. The toolkit was designed with a "two-door" approach, with each "door" tailored to health care providers and community members information needs, facilitating a two-way exchange of information, and empowerment. By integrating evidence-based resource decision-support tools, and stigma-reducing messaging, the toolkit achieves its goal to dismantle barriers to PrEP access. It also leverages QR code-sharing functionality to optimize accessibility and fill information gaps between parties. Since its launch on September 28, 2024, the toolkit has demonstrated international reach, with users in 97 countries and all 50 U.S. states represented. Future directions include refining accessibility features, intensifying partnerships with health care payers and policymakers, and integrating best-practice alerts for use in any electronic health record software. This toolkit is an actionable, scalable solution to improve PrEP uptake and reduce new HIV infections by promoting informed, stigma-free discussions in both clinical and community environments.

This article discusses the importance of accessibility in health education evaluation. The authors describe the process of adapting components of an existing evaluation and the informed consent process of a research project to maximize accessibility for individuals with intellectual and/or developmental disabilities. Adaptations were made through the application of principles of accessibility and universal design, and by working directly with people with lived experience of disability throughout the adaptation process to identify specific ways to increase accessibility of the materials. Contributions from people with lived experience of disability were crucial to the process. Implications for practice include broadening the involvement of people with disabilities in evaluation design and implementation and increasing practitioner knowledge of accessibility and universal design principles. Implications for policy include ensuring that funding mechanisms actively support inclusion of people with disabilities and the consideration that meaningful engagement of individuals with lived experience is a worthwhile process.

This practice note describes a community-driven needs assessment conducted in Early Head Start (EHS) programs in Orleans Parish, Louisiana (LA), using the fit-to-context (F2C) framework to guide program planning and future sustainability. Rooted in participatory action principles, the project engaged EHS educators and the Louisiana State University Health Sciences Center's (LSUHSC) Early Childhood Initiative team from the outset to co-identify barriers, strengths, and opportunities related to developmental monitoring (DM) practices in southeast LA's EHS programs. Through iterative collaboration during the F2C framework's conceptualization and design phases, the team developed mixed-method tools to assess local DM needs, current practices, and contextual factors influencing early identification of developmental concerns. Findings revealed key challenges, including limited educator planning time, inconsistent training, and gaps in family engagement. The process also highlighted strengths such as strong educator commitment and openness to capacity-building. This article offers actionable guidance for practitioners and program planners seeking to use F2C in early childhood settings. It illustrates how early-phase engagement fosters shared ownership and increases the relevance and potential for sustainability of interventions, particularly in underserved communities. Implications for practice and research focus on extending this approach to implementation, dissemination, and evaluation of tailored, scalable strategies to advance equitable developmental outcomes for young children.

Mental Health First Aid (MHFA) is an evidence-based program that equips participants with the knowledge and skills to respond to a person experiencing mental health or substance-use-related challenges. Prior evaluations of MFHA have focused on in-person delivery and effects at the participant level, largely overlooking aspects of the implementation process. This paper presents findings of the evaluation of virtual Adult MHFA using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, using instructor reflection, the plan-do-study-act (PDSA) quality improvement tool, and a pretraining and 30-day posttraining survey. Between September 2020 and August 2022, 406 people participated in virtual MHFA training, with 96 (23.6% response rate) participating in the pre- and 30-day survey. Generally, respondents reported increased awareness of the signs and symptoms associated with mental health challenges and increased confidence in identifying the signs of mental health distress and engaging in helping behaviors. However, there were no meaningful changes to mental-health-related stigma or helping behaviors. Adoption of MHFA training was significantly higher (p = .04) among community-based organization (CBO) initiated settings compared with non-CBO-initiated settings. Instructor reflection indicated high fidelity to the MHFA curriculum, while PDSA cycles helped indicate improved survey participation through reminder e-mails. Generally, results from our evaluation indicate that virtual MHFA performs similarly to in-person MHFA, regarding effects at the participant level. Our findings highlight unique challenges encountered through the virtual curriculum, offering considerations for practitioners. Finally, the use of the RE-AIM framework provided a comprehensive lens for examining the implementation across multiple dimensions.

The COVID-19 pandemic caused unprecedented disruption of social networks and negatively impacted social determinants of health (SDoH, e.g., economic stability, mental health, health care access) among African Americans. The FAITH! (Fostering African-American Improvement in Total Health!) Program, an academic-community partnership with African American churches, pivoted to pandemic-related impacts on health behaviors of African Americans. This exploratory, cross-sectional study examined associations between multilevel factors influencing difficulty maintaining a healthy lifestyle during the early pandemic phase, including mental/emotional health and COVID-19 hardships (e.g., job/food/housing insecurity, paying utilities). An online survey was distributed via FAITH!-affiliated churches and social media. Logistic regression (odds ratios [ORs], adjusted for age/gender) and associated 95% confidence intervals [CIs]) examined associations between difficulty maintaining a healthy lifestyle and multilevel factors. Greater than half of respondents reported difficulty maintaining a healthy lifestyle (N = 169, 54% [91/169]). Adjusted odds of having difficulty maintaining a healthy lifestyle were greater for those reporting mental/emotional health issues (high-stress OR 4.0; 95% CI [1.9,8.9], p < .001); occasional symptoms of depression (OR 3.7; 95% CI [01.9,7.7]; p < .001); anger (OR 2.5; 95% CI [1.2,5.4]; p = .044), and anxiety (OR 2.8; 95% CI [1.4,6.0]; p = .008)). COVID-19 hardships of job insecurity (OR 1.4.; 95% CI [0.7, 2,8]; p = .015), difficulty paying rent (OR 4.4; 95% CI [2.1,9.9]; p < .001) or difficulty paying for food/utilities (OR 5.4; 95% CI [2.6,11.7]; p < .001) were associated with difficulty maintaining a healthy lifestyle. Our study revealed the negative impact of mental/emotional health and COVID-19 hardships on maintaining a healthy lifestyle among African Americans. This could inform SDoH-focused lifestyle interventions during future public health crises.

It has been previously reported that 79.6% of adults in Malaysia are still unaware of the Malaysian Healthy Plate. Therefore, this study aims to assess changes in undergraduates' knowledge of the Malaysian Healthy Plate following a peer-led educational intervention. Fifteen active Bachelor's in Nutrition students, also known as nutrition buddies, were required to conduct a 30-minute workshop covering three topics: the key messages of the Malaysian Healthy Plate, practical guidelines for portioning food groups according to the Malaysian Healthy Plate, and estimating portion sizes using hand measures. A total of 194 undergraduates participated in this workshop. They were asked to self-report their gender, age, ethnicity, study stream, study year, and awareness of the Malaysian Healthy Plate before the workshop began. To assess the change in knowledge resulting from the peer-led educational intervention, all participants were asked to complete nine multiple-choice questions before (pre-intervention) and after (post-intervention) the intervention. The current findings indicate that the mean knowledge score on the Malaysian Healthy Plate significantly improved (t = -8.003, p < .001), rising from 5.25 ± 2.58 at pre-intervention to 6.75 ± 2.30 at post-intervention. It is also worth highlighting that pre-intervention knowledge scores differed significantly by gender, age, study stream, and awareness of the Malaysian Healthy Plate. In contrast, post-intervention knowledge scores showed significant differences only by gender and study stream. In conclusion, incorporating nutrition buddies into a peer-led educational intervention may be cost-effective in raising awareness and potentially fostering behavioral change related to nutrition-related issues among undergraduates.

ObjectiveThis study sought to identify factors associated with (1) situational awareness (i.e., daily recognition of situations to make choices to act in the best interest of one's health) and (2) the self-care gap (i.e., not acting in one's best interest despite having recognized at least one opportunity to perform healthful behaviors).MethodsData from 1,761 non-Hispanic Black (58.4%) and Hispanic (41.6%) men aged 40 years or older with chronic conditions were collected using an internet-delivered questionnaire. Two linear regression models were fitted to assess factors associated with situational awareness and the self-care gap, respectively. Regression models were adjusted for sociodemographics, disease symptomatology, preventive screening activity, health behaviors, and health-related perceptions.ResultsSituational awareness levels were lower for older individuals (B = -.03, p < .001). Men who had higher fatigue (B = .11, p = .002), more stress (B = .07, p = .032), utilized more prevention screenings (B = .13, p = .001), adhered to physical activity guidelines (B = .36, p = .044), and received more social support (B = .89, p < .001) reported higher situational awareness. The self-care gap was more pronounced among non-Hispanic Black men (B = -.32, p = .026). Men who reported higher fatigue (B = .06, p = .041), clinical depression (B = .39, p = .039), more barriers to self-care (B = .11, p < .001), and higher frustrations with health care (B = .12, p < .001) were associated with greater self-care gaps.ConclusionsMen's recognition of healthful opportunities was largely driven by their disease symptomatology, greater engagement in preventive screenings, and receiving social support. However, the self-care gap was seemingly driven by mental health and challenges with disease self-management and health care interactions. Efforts are needed to narrow disparities in the self-care gap between non-Hispanic Black and Hispanic men.