American Journal of Health Promotion最新文献

PurposeThis study examined how community violence and perceived stress relate to healthy eating intention.DesignCross-sectional analysis of online survey data.SettingUnited States.Subjects501 Black adults (age 18+).MeasuresRespondents self-reported information on their demographics, exposure to community violence [measured by the Self-Reported Exposure to Community Violence screener (SECV)], perceived stress (measured by the Perceived Stress Scale), and intention to eat healthfully in the next 2 months (measured by the Healthful Eating Belief scale).AnalysisMultivariate logistic regression models were used to analyze associations between SECV, perceived stress, and intention to eat healthfully while controlling for demographics. An interaction term assessed the multiplicative effect of SECV and perceived stress.ResultsIndividuals in the highest quartile of SECV score had lower odds of intending to eat healthy than those in the lowest quartile (aOR:0.54; CI:0.30-0.96). Individuals in the highest perceived stress score tertile had lower odds of intending to eat healthy compared to those in the lowest tertile (aOR:0.53; CI:0.30-0.92). Individuals in the highest quartile of SECV score and highest tertile for perceived stress score had the lowest odds of intending to eat healthy (aOR:0.21; CI:0.08-0.55).ConclusionHigh SECV and perceived stress are associated with reduced odds of intending to eat healthy among Black adults. More research is needed to describe whether these factors influence dietary behavior.

PurposeBreast cancer (BC) is a leading cause of morbidity and mortality worldwide, with its incidence varying significantly across different regions. While individual-level studies have explored the link between diet and BC risk, a comprehensive global assessment using an ecological approach is lacking. The aim of this study is to describe and evaluate the relationship between BC incidence and food and nutrient intake on a global scale.DesignAn ecological study using publicly available country-level data from global sources.SettingCountry-level data were obtained from the Global Cancer Observatory and the Global Dietary Database.SampleThe present study included data of 175 countries, covering a wide range of geographical areas and different food cultures.MeasuresKey measures included country-level data on women's intake of various food and nutrients, alongside age-standardized BC incidence rates. Additional country-level covariates were also considered to account for potential confounding.AnalysesFor initial exploratory assessment, comparisons of median food and nutrient intake were done using the Mann-Whitney U test. Additionally, multiple linear regression was applied to assess the associations between BC incidence and various food and nutrient intake variables, adjusting for potential confounding factors.ResultsThe multivariate analysis, after rigorous adjustment for confounding factors, initially revealed several food and nutrients that appeared to be significantly associated with BC risk. However, after applying the Bonferroni correction, these associations were no longer statistically significant, with the exception of alcohol consumption, which remained positively associated with BC incidence (β = 0.209, P = 0.048).ConclusionThis study suggests that alcohol consumption may be a potential risk factor for BC and highlight the complexity of the relationship between dietary factors and BC risk. The findings of this study could serve as a baseline for future in-depth individual-level research that aims to assess such a relationship.

PurposeTo assess whether caregiving status influenced influenza vaccination uptake during the COVID-19 pandemic and identify key sociodemographic, behavioral, and health-related determinants of vaccine receipt.DesignCross-sectional analysis using multivariable logistic regression models.SettingTwenty-six U.S. states that administered caregiver and marijuana modules in the Behavioral Risk Factor Surveillance System (BRFSS), 2021 and 2022.Sample105 384 adult BRFSS respondents; 21 965 identified as caregivers for individuals with health conditions or limitations.InterventionNot applicable.MeasuresPrimary outcome was self-reported influenza vaccination in the past 12 months. Primary exposure was caregiver status. Covariates included age, sex, race/ethnicity, income, education, healthcare access, and health-related risk behaviors (eg, smoking, binge drinking).AnalysisWeighted multivariable logistic regression assessed associations between caregiver status and vaccination. Interaction terms and caregiver-only models evaluated differential effects.ResultsCaregiver status was not significantly associated with influenza vaccination (AOR ≈ 1.0). Healthcare access (eg, recent check-up) strongly predicted vaccination (AOR ≈ 2.7), while risk behaviors reduced likelihood (AOR ≈ 0.7). Findings were consistent in analyses restricted to caregivers. Disparities were observed by race and sex.ConclusionCaregiver status alone did not predict influenza vaccination. Sociodemographic and behavioral factors, particularly healthcare access and risk behaviors were stronger influences. Interventions addressing structural barriers and behavioral risks may improve caregiver vaccination rates.

PurposeTo evaluate the real-world effectiveness of a longstanding community-based National Diabetes Prevention Program (DPP) on participation and weight-loss for Latino(a) adults.DesignRetrospective cohort analysis.SettingThe yearlong program was delivered in an urban area of Colorado by a team of Latino(a) community health workers in partnership with a safety-net healthcare organization.SubjectsNational DPP participants between January 2014 and December 2023.MeasuresOutcome measures included National DPP sessions attended and achievement of ≥5% weight loss. Covariates included demographics, body mass index, self-reported physical activity, and health status.AnalysisDescriptive statistics and multivariable logistic regression analyses evaluated associations between demographic and program-related characteristics with program attendance and ≥5% weight loss.Results2377 participants were included; median age 44 years (IQR 37, 52), 86.1% female, 89.8% Latino(a), and 82.0% Spanish speakers. Among 1988 participants who attended ≥8 of 20 sessions within 6 months and had 2 or more weight values, 31.6% achieved ≥5% weight loss. Weight loss of ≥5% was associated with male sex, attendance of ≥16 of 26 sessions, participation in later cohorts, ≥20% sessions with ≥150 minutes per week physical activity, and high self-reported health status.ConclusionCommunity-based National DPP programs can be an effective strategy for increasing program participation and supporting weight loss among Latino(a) adults. Ongoing efforts to engage Latino men in such programs are needed.

PurposeNutrition plays an important role in overall health, yet little is known about how perceived nutritional status relates to health outcomes among older Korean Americans.DesignCross-sectional survey design.SettingSurveys were conducted at six subsidized senior housing facilities in Los Angeles between April and June 2023.SampleThe sample included 318 Korean American adults aged 65 and older.MeasuresParticipants rated their nutritional status, as well as physical, mental, and oral health on a 5-point scale. Responses were grouped into two categories: excellent/very good/good = 0, fair/poor = 1.AnalysisLogistic regression models examined the health risks associated with perceived nutrition, adjusting for demographic and health-related covariates.ResultsHalf of participants (50.5%) rated their nutritional status as fair or poor. These individuals had significantly higher odds of reporting poor physical health (OR = 6.44, 95% CI = 3.53, 11.7), mental health (OR = 4.48, 95% CI = 2.43, 8.27), and oral health (OR = 2.97, 95% CI = 1.64, 5.37) compared to those with better perceived nutrition (all P < .001).ConclusionFindings underscore the value of self-perceived nutrition as an indicator of well-being and highlight the need for culturally informed approaches to improving nutritional status and health. This study contributes to the growing evidence on the interconnectedness of nutrition with various domains of health in older immigrants.

PurposeTo analyze the effects of a 6-week multidomain walking training program (MWTP) with mHealth technology on health status, cognitive performance, and physical function in older adults.DesignControlled longitudinal intervention study with pre- and post-intervention assessments.SettingCommunity-based, autonomous outdoor environments.SampleForty-nine sedentary older adults (mean age 69.9 ± 3.7 years) allocated to an experimental (n = 21) or control group (n = 28).InterventionThe experimental group followed a 6-week mHealth-supported MWTP combining endurance, strength, and dual-task cognitive exercises, with progressive intensity and volume. The control group maintained usual routines.MeasuresPhysical fitness (lower limb strength, walking speed, cardiorespiratory capacity), cognitive function (executive function), and health variables (anthropometric and psychosocial) were assessed using standardized tests.AnalysisData were analyzed using SPSS v.19.0. Descriptive statistics, normality and homogeneity tests, and appropriate parametric (2 × 2 repeated-measures ANOVA, ANCOVA) and non-parametric (Mann-Whitney U, Wilcoxon) tests were applied (α < 0.05).ResultsThe experimental group showed significant improvements in lower limb strength, walking speed, and cardiorespiratory capacity. Executive function was preserved in the experimental group but declined in the control group. No significant changes were found in anthropometric or psychosocial measures.ConclusionThe MWTP enhances physical fitness and preserves executive function in older adults. Its autonomous, mHealth-supported format offers a scalable and cost-effective strategy for promoting healthy aging.

PurposeThis study aimed to demonstrate how ParkIndex values can be used to examine issues related to composite park access, and to investigate whether ParkIndex scores for block groups were significantly different by income, race/ethnicity, and population density.DesignCross-sectional, environmental justice analysis of spatial disparities.SettingGreenville County, South Carolina, and Raleigh, North Carolina.SubjectsPark access and quality data were collected for a total of 507 block groups across the study setting.MeasuresFor all study block groups, we empirically derived a multi-dimensional park access metric called ParkIndex representing the probability of park use based on three park availability and quality indicators. Block group median household income, race/ethnicity, and population density were obtained from the US Census Bureau's American Community Survey.AnalysisChoropleth maps were used to juxtapose ParkIndex values and neighborhood sociodemographic attributes. Analysis of variance was conducted to examine differences in ParkIndex values by multiple sociodemographic variables.ResultsNo significant differences in ParkIndex values were found by median household income (F = 0.15,P = .86), percent non-Hispanic White race/ethnicity (F = 0.22,P = .80), or population density (F = 0.70,P = .50).ConclusionThe current study contributes to the fast-growing body of literature examining whether access to quality parks is equitably distributed in diverse locations. Future research can investigate the utility and generalizability of this composite metric to identify and mitigate potential environmental injustices and health disparities.

PurposeUnhealthy diets contribute to hypertension. Culinary medicine (CM) combines cooking skills with medical science to improve eating behavior. This study assessed the feasibility of an electronic CM education program emphasizing herbs/spices to improve diet and health among adults with hypertension.Design/SubjectsSeventeen individuals with hypertension completed a 6-week, randomized, controlled, feasibility study, assigned to an eCulinary medicine (e-group) or control (c-group).Intervention/MeasuresThe e-group received CM and nutrition education videos focusing on herbs/spices to enhance vegetable consumption. Dietary intake, weight, and blood pressure were measured at baseline, every two weeks for six weeks, and one-month follow-up.Analysis/ResultsAt one month, the e-group showed significantly lower sodium (P = .008), caloric (P = .02), and fat intake (P = .005) compared to the c-group. Within the e-group, fiber intake (P = .01) and diastolic blood pressure (P = .003) improved significantly between baseline and one-month follow-up.ConclusionThis study suggests that a 6-week virtual CM program emphasizing herbs/spices was feasible and led to modest improvements in dietary behaviors and health outcomes in adults with hypertension.

PurposeThis study aimed to assess the prevalence of hypertension and diabetes among laundromat users in San Antonio, Texas, and explore laundromats as a novel setting for health interventions regarding these 2 conditions.DesignThis descriptive, cross-sectional study involved demographic, blood pressure and HbA1c screenings to assess the health status of laundromat users.SettingThe study took place in 7 laundromats in low-income areas of San Antonio.SubjectsA total of 150 adults aged 18 and older who regularly used the laundromats and spoke either English or Spanish were eligible to participate.MeasuresHypertension was defined as a systolic BP ≥130 mmHg and/or diastolic BP ≥80 mmHg. Diabetes was defined as an HbA1c level ≥6.5%. A survey collected demographic and healthcare access data.Results61.1% (95% CI: 53.0%-68.6%) of participants screened positive for hypertension, significantly higher than county (31.1%), state (32.3%), and national (32.7%) rates (P < .001). The prevalence of diabetes was 14.1% (95% CI: 8.7%-21.1%), slightly higher than Bexar County (10.2%) and national (8.4%) rates, though not statistically significant. Gender and the number of children in the household were significantly associated with hypertension and diabetes, respectively.ConclusionLaundromats can effectively serve as sites for health screening and interventions for hypertension and diabetes, offering a unique opportunity to reach underserved populations and address health disparities.

PurposeTo assess the maintenance of fat mass loss and increases in exercise self-control and self-compassion at 8-months follow-up to the Mindless to Mindful (M2M) program.DesignThis was a single-group follow-up case study.SampleFor the analysis, 79 of the original 195 M2M participants (n = 40.51%) participated.InterventionThe eight-week M2M program provided goal-setting, group exercise, and goal monitoring to promote fat mass loss.MeasuresParticipants completed measures of body fat, the brief self-control scale, and the self-compassion scale-short form.AnalysisPaired sample t-tests were used to determine differences within and between groups (P-value < .05).ResultsThere was a significant increase in fat mass from post-test to follow-up (t(78) = 3.105, P = .001, d = .349), but participants did not revert to baseline. There was a significant decrease in self-control (t(78) = -3.381, P < .001, d = -.380) and self-compassion (t(78) = -2.670, P = .005, d = -.300). Further, team participants gained significantly more fat mass (M = 3.46, SD = 7.41), had diminished self-control (M= -2.87, SD =5.83), and decreased self-compassion (M= 0.16, SD= 0.38) when compared to individual participants.ConclusionParticipants maintained some fat mass loss at eight-month follow-up.