Health Promotion Practice最新文献

This study aimed to investigate the current practices of technology use for promoting physical activity in K-12 schools in the United States. A total of 367 registered Active Schools Champions completed the Comprehensive School Physical Activity Program Technology Practice Questionnaire (CSPAP-TPQ). Descriptive statistics identified commonly used technologies, and χ² tests and multiple regression analyses explored associations between personal and school characteristics and technology use. The most frequently used technologies were audio systems in physical education (95.1%), computers in physical activity programming before, during, and after the school day (79%), and email for staff involvement and family and community engagement (79%). The multiple regression model for personal characteristics indicated that race (β = 6.6, p = .004) and certified/licensed teacher status (β = -13.0, p < .001) were significant predictors of individual technology use, R² = .381, F(5,361) = 12.24, p < .001. In contrast, the multiple regression model for school characteristics did not predict school use of technology for physical activity promotion. The widespread adoption of technology to promote physical activity in K-12 schools, which is significantly influenced by personal characteristics such as race and teacher certification, underscores the urgent need for targeted professional development. Future initiatives should focus on the equitable expansion of access and providing dedicated support for diverse school staff in technology integration.

Chronic diseases are prevalent in Canada's aging population (≥65 years), which makes practicing positive health behaviors (e.g., physical activity and healthy diet) critical for the management of chronic diseases (e.g., stroke and heart disease). However, novel coronavirus (COVID-19) prevention strategies of quarantining, social isolation, and physical distancing may compromise one's ability to manage health and engage in daily activities, possibly increasing the risk of adverse health events. The Community Outreach teleheAlth program for Covid education and Health promotion (COACH) program has demonstrated an increase in health-promoting behaviors, but little is known about participants' experiences in participating in the program. The program entailed six telehealth sessions over 2 months that focused on health coaching, behavior change, and COVID education. This study aims to qualitatively describe older adult (≥65 years of age) participants' experiences in the student-delivered COACH program. Twenty-four (n = 24) COACH participants were interviewed one-on-one in 30- to 45-minute audio-recorded, semi-structured interviews through Zoom videoconferencing. Interview recordings were transcribed verbatim and analyzed thematically. The sample's mean age was 73.4 years (58% female) with 75% reporting two or more chronic conditions. Two major themes were identified that described participants' experiences in COACH: (a) "Knowledge: Gaining New and Reinforcing Old" and (b) "Coach: Provider of Motivational Support." COACH supported participants' self-management knowledge, healthy behavior skills, and motivation during COVID-19. COACH acted as an external support strategy for chronic disease management and prevention practices during COVID-19, where student coaches provided motivation and knowledge to support self-management in older adult participants. (ClinicalTrials.gov ID: NCT04492527).

Pride In All Who Served (PRIDE) is the first manualized, evidence-based group intervention developed for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and/or other diverse sexual/gender identities (LGBTQIA+) Veterans. PRIDE has spread to over 70 Veterans Administration Medical Centers (VAMCs) in every region of the country and continues to scale to new sites. In 2023, a PRIDE Manual Revision Team was formed to create a new version of the PRIDE Facilitation Manual (Version 3) that updated information and best practices for the LGBTQIA+ Veteran population and improved ease of facilitation for staff. The purpose of this study was to describe the iterative process used to incorporate input from over 270 Veterans, clinicians, and subject matter experts and to track modifications using the Framework for Reporting Adaptations to Evidence-Based Interventions (FRAME)-a novel application of this framework. Results revealed 76 distinct modifications to improve the feasibility, fit, satisfaction, engagement, and effectiveness of the PRIDE group for LGBTQIA+ Veterans. All modifications occurred during the "Scale-Up" phase of PRIDE, reflecting the program's current progress implementing across the national health care system. This work used a multishareholder modification approach within a large, complex health care setting and provides an example for effectively tracking changes to ensure fidelity of adaptations and promote sustainability in a rapidly expanding field. As additional interventions are disseminated to new settings, systematically tracking modifications can increase understanding of their impact on health outcomes and contribute to successful implementation and sustainment efforts.

Healthy Food Incentive (HFI) programs, also known as Nutrition Incentive programs, enhance access to nutrient-dense, low-calorie foods like fruits and vegetables by increasing consumers' purchasing power and improving dietary quality for participants, especially for those with limited resources. This study aimed to explore the facilitators and barriers to implementing an electronic redemption system among farmers' markets, farm stands, and community-supported agriculture involved in an HFI program, while also demonstrating the evaluation process using a theoretical framework. Qualitative semi-structured interviews were conducted with staff members at the participating HFI sites. The analysis of the interview transcripts was guided by Greenhalgh's diffusion of innovations model, adapted for a non-health-care, community setting. The evaluation highlighted the necessity of localizing the dissemination of technology. Six facilitators, such as streamlined electronic program reports, and ten barriers were identified through the interviews. Challenges included a cumbersome registration process, technological difficulties, the risk of losing customers, and insufficient capacity. To address these barriers, suggestions included pre-registration before the market season, assigning a dedicated person from the HFI program to each site for support, and collaborating with the state-level nutrition program. The findings underscore the importance of timely evaluation to tailor the dissemination process and enhance sustainability. Utilizing theoretical frameworks during the evaluation can effectively optimize health promotion practices.

Transgender and gender-diverse (trans) people report disordered eating behaviors at disproportionately high rates compared to their cisgender peers. Although disordered eating can drastically reduce quality of life and lead to early mortality, trans-affirming primary care providers are not typically taught to identify disordered eating behaviors or provide support for eating disorder recovery. A scarcity of trans-competent eating disorder treatment for trans people combined with a lack of training and capacity in trans-affirming primary care leads to substantial barriers to accessing care for disordered eating. Engaging a structural competency approach, we employ two theoretical case vignettes to integrate insights from our clinical experience with existing research and practice. We use these cases to illustrate the application of our recommendations for prevention and early detection of disordered eating in trans-affirming primary care settings, offer suggestions for future research, and explain policy-level implications.

Issue: As a result of structural health inequities, Black, Hispanic, and other people of color and people with low income experience higher rates of diabetes and prediabetes, leading to greater barriers to participating in the Centers for Disease Control and Prevention National Diabetes Prevention Program (National DPP) lifestyle change program. This is especially true for men. The COVID-19 pandemic exacerbated health inequities and severely affected New York City (NYC) particularly the Bronx. These circumstances led the New York State Department of Health (NYSDOH) to create, implement, and evaluate a prediabetes media campaign specifically for Black and Hispanic men with low income.

Methods: NYSDOH conducted a cross-sectional, post-campaign online survey in NYC. Black and Hispanic men with low income were recruited using social media and an online survey panel. The survey, completed by 477 respondents, assessed campaign awareness, perceived message effectiveness, and campaign-related outcomes. We conducted descriptive, bivariate, and logistic regression analyses.

Results: Nearly half the participants were aware of the campaign and ads were well-received. Campaign awareness was significantly associated with awareness of the National DPP lifestyle change program, and all intended behavioral outcomes.

Implications for practice: These results show promise and build upon public health media campaigns literature, focusing on a prediabetes media campaign that is tailored for Black and Hispanic men. Implications for diabetes prevention practice include developing and implementing similar campaign strategies to increase awareness of prediabetes and the National DPP lifestyle change program and encourage key diabetes prevention behaviors among populations experiencing diabetes health inequities.

Through an adaptation of photo-based methods, which we call artifact creation, we wanted to understand the risks and strategies of young South African people regarding intimate-partner violence and HIV exposure. We worked with 17 young men and women (ages 18-24 years) from urban informal settlements and a rural village in KwaZulu-Natal, South Africa, to understand the everyday lives of young people. This article reflects on the strengths and limitations of the artifact-creation process. The artifact creation highlighted the advantages and disadvantages of using visual methods as a method and WhatsApp as a collection tool. This included the ease of sending artifacts deemed appropriate by young people and the rich stories that were shared based on these artifacts. The cost and connectivity of cellular data hampered this ease of sending artifacts at times, especially in rural areas. Overall, the artifact creation provided valuable lessons in furthering nontraditional qualitative methods. We argue that visual methods and tools such as WhatsApp can be beneficial when working with young people. However, there are apparent limitations as to what research can effectively be achieved through social media platforms.

Gaps in food and nutrition security prompted farm to family innovations in Michigan to increase the number of community-supported agriculture (CSA) sites accepting Supplemental Nutrition Assistance Program (SNAP) along with financial incentives. In addition, there was a need for Supplemental Nutrition Assistance Program Education (SNAP-Ed) nutrition education. The Michigan Fitness Foundation, (MFF), recruited SNAP-Ed staff from key organizations to inform resource development framed in a community-involved process. MFF staff followed the community-involved process to promote collaboration and learn how to best meet nutrition education needs for shoppers at Michigan Farm to Family: CSA (MF2FCSA) sites. The methods used in the community-involved process included a listening session with SNAP-Ed staff, a brainstorming session with MFF staff, and a survey with shoppers at MF2FCSA sites. From this, lessons were learned. First, educators should have autonomy to choose the nutrition education activities that fit the needs of their local context. Another lesson learned was the importance of developing strong relationships between nutrition educators and CSA staff to support effective communication, and ultimately, the delivery of nutrition education. These lessons learned informed the development of a resource, called the CSA Food Navigator Playbook. The playbook includes program guidance and a suite of flexible and feasible nutrition education activities designed specifically to meet the needs of shoppers at MF2FCSA sites. Multiple feedback loops and collaboration strategies informed the community-involved process which were key for formative program development.

Pap smear rates have been declining in recent years, highlighting the need for effective public health messaging to encourage regular screenings. This study examines how Pap smears and cervical cancer screenings are discussed on TikTok, a key focus of public health messaging efforts. Using the Extended Parallel Process Model (EPPM), we analyzed threat and efficacy messages in 155 TikTok videos tagged with #PapSmear and #FirstPapSmear. Our sample included content from health care professionals and non-health care creators, with diverse racial and ethnic representation. Findings reveal a low prevalence of threat messaging, with only 3.2% of videos addressing the susceptibility to or severity of cervical cancer. In contrast, efficacy messaging was more common: 12.3% of videos provided strategies to make Pap smears more comfortable, and 18.1% discussed the diagnostic benefits of Pap smears. Black creators were more likely to share negative experiences and promote Pap smear importance compared to all other creators, whereas White creators emphasized the diagnostic value of the Pap smear. Hispanic creators most frequently mentioned preparatory strategies, and messages from Asian creators did not include self-efficacy messages. Health sources were more likely than non-health sources to offer preparation tips for Pap smears and emphasize their diagnostic value. Engagement data analyses showed that videos highlighting diagnostic benefits received more likes, while those offering Pap smear preparation tips garnered more likes, comments, and saves. Addressing racial and ethnic differences in the creation of Pap smear content may improve public health education.

This study examines cross-sectional relationships between sugar-sweetened beverage (SSB) consumption and sleep in early adolescents using rigorous assessments and accounting for caffeine consumption. It was hypothesized that greater SSB consumption would be associated with shorter sleep duration, greater sleepiness, lower sleep quality, and later bedtimes and waketimes on weekdays and weekends. The sample included 288 middle school students (M_age = 12.09 years; 54% female; 48% Black; 37% White; 10% Hispanic/Latino; and 5% other racial-ethnic groups) recruited from 15 public middle schools in the Birmingham metropolitan area. Sleep duration, as well as wake and bedtimes, were calculated from 7-day actigraphy. During the same 7 days, SSB and caffeine consumption were measured with daily assisted 24-hour food recalls. Multiple regression analyses showed that after controlling for sociodemographics, physical activity, energy intake, and caffeine consumption, greater SSB consumption was associated with shorter weekday sleep duration (β = -.19; CI = [-.28, -.05]). Furthermore, higher SSB consumption was linked to later bedtimes (β = .19; CI = [.05, .33]). Results suggest that youth who drink more SSBs have disruptions in sleep timing on weekdays and weekends that may contribute to shorter sleep duration. To improve adolescent sleep, continued efforts are needed to reduce overall SSB consumption through nutrition education in schools and communities.