American Journal of Health Promotion最新文献

Purpose: The purpose of this study was to (a) examine personal healthcare practices of rural medical providers by issue type (e.g., physical health, social health, or mental health), (b) identify perceived consequences of taking time off and (c) determine whether greater delay in self-care was associated with perceived stress and burnout.

Design: Electronic surveys were sent to 805 medical providers (response rate = 17.8%, n = 143).

Setting: The setting was a rural teaching hospital and affiliated community clinics.

Subjects: Participants included 143 rural medical providers.

Measures: The survey included demographic information, perceived personal health risk, and questions about delaying health care, and perceived consequences of receiving health care.

Results: Medical providers delayed mental health care needs significantly more than physical health needs, t₁₃₁ = 5.13, P < .01, d = .38. Respondents believed that there would be significantly more retaliation against them for taking time off for psychosocial issues, t₁₂₄ = -3.80, P < .001, d = .25. There was a significant negative association between burnout and physical health self-care (r = -.24, P < .01), psychosocial self-care (r = -.20, P = .01), and mental health self-care (r = -.23, P < .01).

Conclusions: Our study identified commonly reported consequences related to taking off work for care seeking behavior. Understanding perceived consequences can help guide health care organizations in dismantling these barriers. This study is limited by the generalizability of its sample.

Objective: To identify environmental features of multi-family housing (MFH) and their surrounding neighborhoods that influence residents' physical activity (PA).

Data source: Articles published between January 2000 and September 2023 were identified from major social science, medical, health, behavioral science, and urban studies databases.

Study inclusion and exclusion criteria: Studies were included if they (a) were empirical studies published in peer-reviewed journals and written in English; (b) focused on the MFH environment or the surrounding neighborhood; and (c) had at least one PA outcome.

Data extraction: Data was extracted regarding the study objective, location, study sample, research design, results related to MFH and neighborhood environment, and limitations.

Data synthesis: Descriptive summary of study characteristics and analysis to identify emerging themes at three spatial scales (i.e., building, site, and neighborhood).

Results: Findings from 35 identified articles revealed factors influencing MFH residents' PA. On the building level, typology (apartment, townhouse) and tenure (public, market rent) showed contrasting correlations with PA in different age groups. On the site level, the presence of PA facilities and safe, walking-friendly environments promoted PA. On the neighborhood level, safety, quality of PA and pedestrian infrastructure, upkeep, air quality, aesthetics, neighborhood satisfaction, street connectivity, walkability, land use mix, density, and public transport promoted PA.

Conclusion: Study findings highlight the importance of the MFH environments in promoting PA, especially in older adults and young children. With increasing housing demand, understanding diverse MFH typologies and the impact of interventions on multi-spatial scales can help promote healthy and activity-friendly communities.

Some have argued that nothing less than truth and freedom is on the ballot in the 2024 election. To be sure, fact checking politicians has become a commonplace element of vetting candidates for public service. This editorial reviews trends in the use of media to influence opinions and practices relating to health promotion and disease prevention. Has society been striking the right balance between protecting free speech while also holding individuals and organizations accountable when disinformation they promulgate causes harm? If we are to protect freedom of speech, one of America's hallmarks to democratic governance, health professionals need to develop more innovative and effective methods for curbing misinformation and for countering the ills created by super spreaders of misinformation.

Purpose: Social participation is vital for the health maintenance of general populations as well as the functional recovery and social ties of clinical patients. To develop a Social Participation Questionnaire (SPQ) to evaluate participation in social activities in an individual's life and to test the reliability and validity of the SPQ.

Design: Cross-sectional study.

Setting: Community and clinic in China.

Subjects: A total of 1419 healthy adults and 486 breast cancer patients.

Measures: The initial items were developed from a theoretical framework, a literature review, and Delphi expert consultation. Item analysis, exploratory (EFA) and confirmatory factor analysis (CFA), criterion validity, construct reliability, and internal consistency reliability were performed to examine the psychometric properties of the SPQ.

Results: The final SPQ was comprised of 11 different types of social activities, falling under the 3 dimensions of activities of daily life, sports and entertainment activities, and social service activities. EFA explained 50.674% of the total item variance contributing to the tool. CFA showed that the SPQ fit well. The total SPQ score was significantly associated with social network, quality of life, and cognitive function (r = |.180∼.466|, P < .001). The internal consistency coefficient was acceptable (range of Cronbach's alpha, .695 to .720).

Conclusions: The SPQ has robust properties, wide application, and provides a culturally relevant tool to evaluate the social participation of individuals, thus facilitating rigorous clinical and population-based research.

Purpose: To inform food retail interventions, this study explored food shopping strategies employed by people constrained by limited budgets but residing in an urban environment offering numerous retail options.

Approach: Qualitative study incorporating semi-structured interviews and shop-alongs.

Setting: East Harlem, New York City.

Participants: 37 East Harlem residents participated in interviews, of whom 15 participated in shop-alongs.

Methods: Interviews and shop-alongs were conducted in English, Spanish, and Mandarin Chinese. Interview transcripts were analyzed using a grounded theory approach. Data from shop-alongs were used to supplement interview findings.

Results: Participants shopped 1-2 times at an average of 4 retail locations per week. Two key themes emerged: (1) planning trips and choosing venues; and (2) shopping experiences and perceptions of stores. Price was the primary driver of store choice, followed by product quality and variety. Substantial time was invested in shopping. Most English- and Spanish-speaking participants shopped in East Harlem. Chinese American participants shopped in Chinatown due to language concordance, availability of culturally-preferred foods, and proximity to other services.

Conclusion: East Harlem residents invested substantial planning, time and effort in food shopping to acquire sufficient food for their households on limited budgets. These findings offer insight into how residents interact with food environments and key drivers of decision-making about food shopping that affect decisions about where to shop and what to purchase.

What sense does it make to say that a new program implemented in a community with roots as old as evolution caused an observed health benefit? Evaluation of community approaches has often sought to isolate the causal roles of interventions. Central to this is the assumption that there are causes to be proven and isolated. Benedict Spinoza (1632-1677) dismissed the concept of cause, arguing that all things, "substances," are not caused but simply are. Actions of things in nature can influence each other, e.g., erosion of a mountain, but their substance, the mountains simply are. For Spinoza, satisfaction in life comes from realizing and acting in accord with our substance, but this requires communities that support such realization and action. Thus, communities and the vast influences they contain are central to human welfare. Interventions within them do not cause benefits but join with the history, culture, and numerous other features of the community in becoming part of how the community influences its members. Implications include a) expanding the social ecological model fully to embrace multiple influences - including innovative programs - and interactions among them, and c) varied research methods to identify practical lessons about how communities may adopt and incorporate innovations to engender change, rather than a catalogue of interventions that are supposed to change them.

Purpose: To describe the well-being supports provided to health care workers (HCWs) during the COVID-19 pandemic in health centers and hospitals.

Design: Cross-sectional qualitative interviews before and after implementation of a peer-based support intervention.

Setting: Purposively sampled hospitals and health centers across the US.

Participants: 28 site leaders and 56 HCWs sampled from 16 hospitals and 12 health centers.

Method: Site leaders and HCWs were asked to describe supports available to HCWs during the COVID-19 pandemic. Thematic and content coding and analysis of interview responses were conducted using Dedoose.

Results: Both site leaders and HCWs identified a range of support resources available. Communication resources were the most frequently cited in both groups. Health care workers reported bi-directional communication, while one-way communication was emphasized by site leaders. Hospitals highlighted counseling support, particularly Employee Assistance Programs (EAP), while health centers prioritized community support. Wellness activities were more prevalent in hospital settings, while health centers offered specific workplace-provided training for HCWs. Health care workers encountered barriers when accessing support, including limited time, fear of stigma, and disruptions to their existing support networks attributable to the pandemic.

Conclusion: While there are resources for HCWs, the available supports may not align with their needs and barriers to access may limit the effectiveness of these supports. Continued engagement between leaders and HCWs could help better align resources with needs.

Purpose: To examine user experiences in a moderated Facebook group intervention aimed at Coronavirus disease 2019 (COVID-19) vaccine promotion.

Design: Facebook group members were given 2-3 vaccination posts/day for 28 days (four weeks). Posts were aimed at educating about COVID-19 vaccination, soliciting concerns around COVID-19 vaccination, and engaging members. Participants were surveyed about their experience at four weeks.

Setting: Moderated Facebook group.

Participants: Unvaccinated individuals who were randomized to the intervention group and completed four week follow-up (N = 216, 82.1%).

Method: After four weeks, participants rated their experience in the Facebook group (eg, program satisfaction) and provided open-text responses about their satisfaction with the group. Free-text responses were dual coded and emergent themes were examined.

Results: On average, participants were 37.0 years old (SD = 10.3), majority female (70.9%), and white (79.7%). The majority of participants were satisfied with the group (76.7%), agreed that other people were friendly (M = 5.58/7), and felt safe discussing health information (M = 3.96/5). Open-text responses revealed that participants liked the program because they thought the information was useful (27.7%), other members were friendly (16.1%), and the group was a safe place (13.8%). While many responded that there was nothing they did not like about the program (37.6%), nearly one-third (31.9%) reported disliking the program because it appeared to be too much in favor of vaccination and because other members came across as rude (7.1%). Those with conservative political views were less likely to be satisfied with the group (P = .04).

Conclusion: Facebook groups represent an acceptable way to engage participants to improve vaccination against COVID-19. Some aspects of the Facebook group could be improved for future iterations.

Objective: This systematic review and meta-analysis aimed to evaluate the vitamin B12 status and intake of Seventh-day Adventists following a plant-based diet and compare it with omnivore controls to investigate their susceptibility for vitamin B12 deficiency.

Data source: Peer-reviewed articles were identified through a comprehensive search in PubMed, Scopus, and Google Scholar databases from inception up to the year 2024 using specific keywords related to vitamin B12 and Seventh-day Adventists.

Study inclusion and exclusion criteria: Observational studies published in the English language were included if they reported on vitamin B12 status or intake among plant-based Adventists and compared it with omnivore controls who may or may not have been Adventists. Studies that did not present distinguishable results for vegetarian/vegan from omnivore Adventists or only reported on food item intake without specific vitamin B12 data were excluded.

Data extraction: Two independent reviewers extracted data on study characteristics, vitamin B12 intake, and serum levels using a customised data extraction form, resolving discrepancies through consultation with a third reviewer.

Data synthesis: A meta-analysis was conducted using random-effect models due to anticipated heterogeneity, without any subgroup analysis due to the low number of studies. Sensitivity analysis was performed using the 'leave-on-out' method to assess individual study influence on overall effect size and heterogeneity.

Results: Four studies met inclusion criteria, encompassing 1994 participants. Meta-analysis showed no significant differences in serum vitamin B12 levels (MD: -9.85 pmol/L; 95% CI: -45.64 to 25.94 pmol/L; P = 0.54, I² = 50%) or daily intake (MD: 3.31 mcg/d; 95% CI: -4.70 to 11.32 mcg/d; P = 0.42, I² = 90%) between plant-based Adventists and omnivore controls, although there was high heterogeneity between the studies.

Conclusion: Adventists following a vegan or vegetarian diet did not demonstrate increased risk of vitamin B12 deficiency due to the widespread consumption of fortified foods and supplements. The findings underscore the importance of supplementation and the consumption of fortified foods for maintaining adequate B12 status among vegan or vegetarian Adventists but highlight the need for further studies to confirm these observations in diverse geographical areas.

Purpose: Many universities maintain pouring rights contracts (PRCs) with beverage companies wherein one company exchanges sponsorship payments for exclusive beverage marketing rights. Separately, universities may have healthy beverage initiatives (HBIs) to encourage healthier choices on campus. This study aimed to assess how and how frequently PRCs included provisions related to health and nutrition to examine how PRCs may support or undermine HBIs.

Design: Cross-sectional.

Setting: U.S. public universities with >20,000 students.

Sample: 131 PRCs obtained from 124 of 143 universities in 2019-2020.

Measures: Primary outcomes were the presence of provisions that could encourage or discourage promotion of healthy beverages (water, diet soda, unsweetened coffee or tea, and 100% juice), and any other provisions explicitly or implicitly referencing health or nutrition.

Analysis: Descriptive statistics.

Results: Twelve contracts (9%) had explicit commitments from the company or university to promote healthy beverages or adhere to nutrition standards, including five committing to support HBIs, four committing to healthy vending policies, and three describing activities to promote healthy beverage brands. Ten (8%) had provisions explicitly inhibiting water promotion and 55 (42%) had provisions that could be interpreted that way. Eleven (8%) included other health and nutrition provisions, such as funding for unspecified wellness activities.

Conclusion: Most university beverage contracts did not expressly aim to support healthy choices, and more than half had provisions potentially limiting universities' ability to implement HBIs. When present, nutrition standards were weak.