American Journal of Health Promotion最新文献

PurposeExamined how moderate-to-vigorous physical activity (MVPA) and weight status during physical education (PE) class was related to peer MVPA and weight status.DesignData collected during the first and last weeks of a semester-long PE class.SettingHouston, Texas charter school.ParticipantsAdolescents (n = 156; 13.51 ± 1.45 years old; 52.6% female; 85.4% Hispanic, 14.1% African American, 0.5% Asian) nominated up to 3 female and 3 male students they felt closest to in PE.MeasuresMVPA during PE was assessed by heart rate throughout the semester. Body mass index (BMI) z-score was calculated from height and weight measured at the beginning and end of the semester.AnalysisExponential random graph models explored friendship existence, formation, and maintenance in these networks. Separable temporal exponential random graph models examined how MVPA impacted friendships forming or maintaining over the semester.ResultsStudents with higher MVPA were more likely to receive a new nomination from a student throughout the semester (E = 0.007, P < .03), but not to send a new nomination themselves. Students with higher BMI z-scores were significantly less likely to send a nomination at baseline (E = -0.11, P = .04); however, this effect was not significant at semester's end.ConclusionsMVPA opportunities during PE may be a mechanism for youth to establish friendships, making PE important for adolescent social and physical health. Larger scale research is warranted.

PurposeIn young women with obesity, we sought to explore their: (1) psychosocial health; (2) perceptions of their and engagement in current health behaviors; (2) motivation to change their health behaviors; and (3) desired characteristics of a health behavior intervention.ApproachConvergent-parallel mixed methods study.SettingFocus groups were conducted over zoom.Participants34 young women with obesity (M ± SD; age = 23.79 ± 4.22 years; BMI = 35.66 ± 5.56 kg/m²; 41.2% non-Hispanic White).MethodQuantitative data were collected via Qualtrics prior to focus groups. We conducted 8 semi-structured focus groups (2-7 participants per group; 32-93 minutes) to address the pre-specified objectives.ResultsParticipants reported poor psychosocial health, with 100% meeting the cut-point indicative of significant depressive symptoms and 79.4% for clinically meaningful anxiety. Participants expressed the interconnectedness of their physical and mental health and desire to improve consistency in their eating and physical activity behaviors. However, participants did not want to emphasize weight loss as the primary focus of a health behavior intervention. Preferences for the characteristics of a health behavior intervention were in support of a hybrid format, with in-person meetings focusing on active engagement (e.g., cooking classes).ConclusionsOur findings support shifting the focus from a weight-normative to a weight inclusive approach to health behavior interventions to meet the needs and preferences of young women with obesity.

PurposeOf the 88 million American adults with prediabetes, 1.5 million transition to type 2 diabetes annually. Lifestyle changes could delay progression to type 2 diabetes development. Glycemic Excursion Minimization/Glucose Everyday Matters (GEM) is a self-guided intervention that empowers individuals via a guide paired with a continuous glucose monitor and activity monitor to understand how dietary and activity choices impact their blood glucose excursions. This qualitative study aimed to explore participant perspectives and experiences of GEM.DesignSemi-structured qualitative interviews.SettingThe study was conducted at an urban medical center. Interviews took place via HIPAA compliant Zoom.ParticipantsParticipants from a larger clinical trial who completed the GEM intervention for prediabetes (n = 16).MethodInterviews were audio-recorded and transcribed. Using two coders, iterative cycles of inductive thematic analysis was performed to yield overarching themes related to the GEM guide and intervention.ResultsAnalysis of 16 interviews revealed five major themes which highlighted the positive outcomes in health status, disease insight and support experienced during the GEM trial.ConclusionKey findings included increased knowledge on the relationship between lifestyle choices and glucose excursions, and positive insight on the GEM intervention and its components. Feedback from this study will be incorporated into further adoption of the GEM intervention for a prediabetes population.

PurposeTo develop a cross-cultural adaptation and analyze evidence of content validity of the 2019 CDC Worksite Health ScoreCard (WHSC) for use in Brazil.DesignPsychometric study conducted according to international guidelines for cross-cultural adaptation and evidences of validity.SettingBrazil, November to December 2023.SampleFive independent bilingual reviewers evaluated linguistic equivalence; 18 experts in occupational health or psychometrics assessed content validity (response rate 52.9%); 10 occupational health and safety professionals participated in cognitive testing with gender parity.MeasuresSemantic, idiomatic, conceptual, and experiential equivalences; clarity, practical and theoretical relevance, and dimensionality of items.AnalysisContent Validity Ratio (CVR) was applied, with critical values ranging from 0.44 to 0.50; qualitative thematic analysis was performed on cognitive testing.ResultsInitial evaluations identified items with CVR <0.99 due to clarity issues, which were revised. In content validity assessment, CVR values ranged from 0.80 to 1.00 across all items, confirming acceptable agreement among experts. Cognitive testing confirmed comprehension and cultural adequacy, with participants suggesting inclusion of diversity-related items in future versions.ConclusionsThe Brazilian Portuguese version of the WHSC demonstrated strong linguistic quality and evidence of content validity with adequate clarity and cultural relevance for electronic administration. Limitations include reliance on a convenience sample of experts and the need for further evaluation of additional psychometric properties, such as internal structure and reliability.

PurposeWe sought to explore perceived barriers to engaging in weight-related health behavior change among parent child dyads.DesignThis is a secondary analysis of data from a cluster-randomized controlled trial investigating the effectiveness of Fitline telephonic coaching vs Fitline workbook at improving weight-related health behaviors and body mass index for children 8-12 years old with overweight and obesity.SettingThe trial which the present data comes from was conducted within 20 pediatric primary care practices in Central Massachusetts.SampleData from 499 parent-child dyads were included.MeasuresBarriers to weight-related health behavior changes were assessed via 10 survey items answered by parents and the enrolled child at baseline, 6- and 12-month.AnalysisWe used frequencies to describe the distribution of parent and child reported behavior-change barriers as well as McNemar's and Bowker's tests to compare distributions of behavior-change barriers at baseline and change in report of behavior-change barriers at 6-month.ResultsWe found that barriers to weight-related health behavior change varied within parent child dyads with up to 30% of dyads disagreeing on behavior-change barrier perception at baseline. Additionally, up to 37% of dyads were not aligned on reported change in barriers to health behavior change at 6-month.ConclusionOur findings support the potential benefit of integrating behavior-change barrier assessment from both the parent and child perspectives into intervention delivery when developing and tailoring family-centered interventions.

PurposeTo examine demographic, socioeconomic, and family characteristics associated with elevated depression and anxiety symptoms and frequent loneliness among US adults with children.DesignCross-sectional survey.SettingUS Census Household Pulse Survey (July-September 2024).SubjectsUS adults with 1 or more children (0-17 years) in their household (N = 31 063, representing approximately 87 million US adults with children).MeasuresParticipants completed the Patient Health Questionnaire for Depression and Anxiety (PHQ-4); scores of 3+ out of 6 indicated elevated depression and anxiety symptoms, respectively. Participants reported how often they feel lonely. Frequent loneliness was indicated by responses of "always" or "usually" (versus "sometimes", "rarely", or "never"). Participants reported several demographic, socioeconomic, and family characteristics.AnalysisWe used unadjusted logistic regression models to compare the proportion of US adults with children experiencing elevated depression symptoms, elevated anxiety symptoms, or frequent loneliness by demographic, socioeconomic, and family characteristics. Analyses were weighted to represent US adults living with children.ResultsAmong US adults with children, 14.2% (SE: 0.4%) reported elevated depression symptoms, 19.2% (SE: 0.5%) reported elevated anxiety symptoms, and 13.5% (SE: 0.4%) reported usually or always feeling lonely; prevalences differed by several demographic, socioeconomic, and family characteristics.ConclusionsCollecting nationally-representative data about families is critical to inform efforts to support the mental and physical health of US parents and other adults who care for children.

PurposeDescribe perceived impact of a 6-week community-based physical activity (PA) intervention on adult participants' PA knowledge and behaviors.DesignQualitative Case Study.SettingUnder-resourced Michigan communities.ParticipantsAdults (n = 26) aged 18-85 years represented urban (n = 11), suburban (n = 7), and rural (n = 6) environments, and diverse identities by race (n = 3 did not respond) White (46%, n = 11), African American (38%, n = 9), American Indian/Native American (4%, n = 1) and by intellectual or developmental disability (n = 7).InterventionRec-Connect™: A Physical Activity Demonstration Playbook.MethodSemi-structured focus groups (n = 3, n = 26 participants). Surveys measured knowledge and behavioral outcomes.Data CollectionFocus groups were conducted in person (n = 2) or over telephone (n = 1). Surveys were disseminated pre-post completion of at least 6 lessons of the intervention series; pre-post participant surveys were matched with focus group participants (n = 12).AnalysisHybrid analysis was used to generate themes from transcripts. Descriptive statistics were summarized from surveys.ResultsAnalysts generated 3 primary themes which demonstrated Rec-Connect's impact on PA behavior changes: 1) leveraged connections promoted PA outside of class, 2) educators are key to attitudes on PA and time spent in PA, and 3) multi-level (ie, socio-emotional-physical) behavior change impacts were achieved.ConclusionThis community-based PA intervention had multi-level impacts on adult participants. The socio-emotional connections made during Rec-Connect between educators and peers positively influenced time in and attitudes towards PA.

PurposeTo compare correlates of mental distress among non-professional caregivers vs non-caregivers and evaluate trends in non-professional caregivers' mental distress pre-vs COVID-onward.DesignCross-sectional study.SettingWe used nationally representative data from multiple cycles of the Health Information National Trends Survey (HINTS) from 2018 to 2022.Subjects15 318 participants age 18 and older were included, comprising non-professional caregivers (n = 1387) and non-caregivers (n = 13 931). Professional caregivers and caregivers of child (ren) were excluded from this study.MeasuresThe outcome (mental distress) was categorized based on the Patient Health Questionnaire-4 (PHQ-4) score. Caregivers were identified as those indicating that they provide care or make health care decisions for someone in a non-professional way.AnalysisWe analyzed the association between caregiving status and mental distress pre-COVID and COVID-onward and examined correlates of caregivers' mental distress pre-COVID and COVID-onward through logistic regression models.ResultsCaregivers reported a higher mean PHQ-4 score than non-caregivers overall (|t| = 4.81, P < .001). Caregiving status was significantly associated with mental distress pre-COVID (OR = 1.47; 95% CI = 1.13-1.92; P < .01) and COVID-onward (OR = 1.51; 95% CI = 1.01-2.26; P < .05). Being in fair or poor health status was associated with a higher likelihood of mental distress pre-COVID (OR = 2.58, 95% CI = 1.31-5.09, P < .01), while having a college education or higher was associated with a lower likelihood of mental distress COVID-onward (OR = 0.46, 95% CI = 0.21-0.99, P < .05).ConclusionCaregiving continues to present significant risks for mental distress. The COVID-19 pandemic may continue to present risks to caregivers' mental well-being, requiring policies and programs to improve caregiver mental health.

PurposeUnderstanding reactions to health communication campaigns is essential to designing effective messaging. Multi-year campaigns through The Helping to End Addiction Long-term^® Initiative (HEALing) Communities Study (HCS) were implemented from April 2020 - June 2022. Responses to HCS campaign messages and statewide campaign messages were evaluated.DesignCross-sectional, self-reported surveys of different respondents at 3 timepoints.SettingN = 33 communities across Kentucky, Ohio, Massachusetts, and New York.SubjectsN = 2368 respondents recruited from Facebook/Instagram.MeasuresMessage acceptability survey items assessed attention, understandability, and visuals/text match. Message influence items assessed whether the message made the respondent want to carry naloxone, learn more about medications for opioid use disorder (MOUD), or seek help for OUD. Items were scaled from 1 (strongly disagree) to 5 (strongly agree).AnalysisAll outcomes were analyzed using linear mixed models adjusted for community as a random effect.ResultsAmong naloxone campaigns, HCS message acceptability was higher than statewide messages (3.98, 95% CI = 3.94-4.02 vs 3.93, 95% CI = 3.89-3.97, P = 0.002). HCS message influence was also higher than those of statewide messages (3.44, 95% CI = 3.38-3.50 vs 3.40, 95% CI = 3.34-3.46, P = 0.034). Among HCS campaigns, naloxone messaging had the highest acceptability (3.96, 95% CI = 3.92-4.00), followed by MOUD stigma (3.73, 95% CI = 3.70-3.77) and MOUD awareness (3.71, 95% CI = 3.68-3.75, P < 0.001). The HCS naloxone campaign was also highest rated in terms of influence (3.47, 95% CI = 3.43-3.51, P < 0.001).ConclusionThis analysis provides insight into acceptability and potential influence of locally-tailored, opioid-related health campaign messaging.This work was performed under the HEALing Communities Study, ClinicalTrials.gov Identifier: NCT04111939, https://clinicaltrials.gov/study/NCT04111939.

Synopsis: Peer support can promote friendships and social connections for the one in 8 American men for whom loneliness is a barrier to health and well-being. Community-funded for more than 10 years, Face It Foundation has supported, without fees, more than 1600 men with nearly 125 000 hours of peer-led support. Approximately 70% of the men are referred by a mental health professional. Face It also produces a monthly men's breakfast, ongoing classes, a retreat center, podcasts, and crisis intervention. At scale, this peer-support model could meet a need that complements psychotherapy services by promoting the development of friendships and social connections.