American Journal of Health Promotion最新文献

PurposeRisk perception for tuberculosis (TB) and previous receipt of a TB test and/or vaccine were assessed to inform TB prevention efforts.DesignCross-sectional.SettingThe 2020, 2021, and 2022 Estilos survey data.Subjects2837 U.S. Hispanic adults (≥18 years).MeasuresSelf-reported receipt of a TB test and/or vaccine, perceived risk for TB, and demographic characteristics.AnalysisWeighted proportions and 95% Confidence Intervals (CIs) were calculated. Associations between demographic characteristics and TB questions were assessed using chi-square tests. Multinomial logistic regression was used to examine perceived risk for TB among those who received a TB test and/or vaccine vs those who did not.ResultsOverall, 7.2% (95%CI [4.8, 10.5]) of U.S. Hispanic adults reported receiving a TB test but not a vaccine, 15.3% (95%CI [12.5, 18.7]) reported receiving a vaccine but not a test, and 28.3% (95%CI [24.7, 32.2]) reported receiving both a TB test and TB vaccine. Respondents who reported previous receipt of a TB test, with or without previous receipt of a TB vaccine, had a significantly higher odds of feeling any risk for TB than those without previous receipt of a TB test or vaccine (aOR = 2.79, 95% CI = 1.19-6.52 for those tested but not vaccinated; aOR = 1.89, 95% CI = 1.11-3.20 for those both tested and vaccinated).ConclusionFindings can help inform education and interventions to raise awareness and encourage TB testing for those at risk for TB.

PurposeDetermine how Farmers Market (FM) shopping is associated with fruit and vegetable (FV) intake and food literacy scores, and to understand knowledge, barriers, and rationale for FM usage among Supplemental Nutrition Assistance Program (SNAP) participants in Oklahoma.DesignCross-sectional study, online and in-person surveys.SettingSNAP-accepting FMs in Oklahoma.SampleSNAP participants in Oklahoma aged 18-64 years of age.MeasuresSurveys captured self-reported FV intake (cups/day), food literacy scores reflecting knowledge, skills, and confidence related to food, and perceived barriers and facilitators to FM shopping. Sociodemographic information was collected to characterize the sample.AnalysisDescriptive summaries presented with counts and frequencies. FV intake and food literacy scores summarized by means and standard deviations. FM awareness scores summarized with medians and IQR.ResultsFM shoppers had a significantly higher intake of FV (19.1 ± 4.2 vs 16.6 ± 4.2; P = 0.0006) and higher food literacy scores (27.7 ± 4.9 vs 25.0 ± 5.5; P = 0.0025) than non-shoppers. FM awareness did not differ between shoppers and non-shoppers. Most prevalent barrier to FM shopping was "I don't know where any markets are" (31.6%) most prevalent facilitator was "fresher produce" (43.3%).ConclusionFM shopping was associated with increased FV intake. Differences in food literacy suggest improving literacy may increase FM shopping among SNAP participants. Study provides new understanding to tailor and positively impact future interventions.

PurposeTo examine the association between the social determinants of health (SDOH) and hypertension, diabetes, heart disease, and anxiety and/or depression among adult US women.DesignCross-sectional survey.Setting2022 Health Information National Trends Survey (HINTS).SampleWomen aged ≥18 years (N = 3535) participated from the U.S.MeasureOutcome variable was diagnosis of diabetes, hypertension, heart disease, and mental illnesses. Covariates included sociodemographic characteristics along with food, housing, and transportation insecurity.AnalysisSeparate weighted bivariate and multivariate logistic regression models were used to examine the unadjusted and adjusted odds ratios (AORs) associations between insecurities and chronic conditions, controlling for sociodemographic characteristics.ResultsHypertension (35.4%) and anxiety/depression (33.4%) were the most reported chronic conditions. Approximately 27% of the sample experienced all three forms of insecurity concurrently. Women with anxiety or depression had elevated levels of food, housing, and transportation insecurity (11.3%, 7.4%, 7.5%) than those with other chronic conditions. Adjusted models indicated that all three types of insecurity were significantly associated with chronic conditions. Food, housing, transportation, and any insecurity nearly doubled the odds of reporting any chronic condition (AOR = 2.15, 2.44, 1.70, and 2.20, respectively).ConclusionFindings highlight a strong association between SDOH and chronic conditions among women, necessitating the implementation of targeted policies and interventions to address sex-related health inequities to improve women's health.

PurposeAssess obesity and cardiometabolic disease risk factors among a high-risk pediatric population.DesignObservational, cross-sectional study using electronic medical records (EMR).SettingThe only academic medical center in Mississippi.SampleData were extracted for children and adolescents aged 2 through 19 years treated in primary care from 2013-2023.MeasuresMeasures of height, weight, blood pressure, lipid profiles, and hemoglobin A1c were categorized to determine the prevalence of obesity, hypertension, hyperlipidemia, and hyperglycemia.AnalysesMultivariable regression models were used to establish the association between age- and sex-adjusted body mass index z-score (zBMI) and demographic characteristics. Outcomes were explored by race/ethnicity, sex, age, insurance type, visit year, and rurality.ResultsThe study sample included 38 275 participants (M age = 8.9 years, SD = 5.3; 48.7% female; 45.4% non-Hispanic Black [NHB]). Half of NHB females aged 12 through 19 were either overweight (19.0 %), obese (15.9%), or severely obese (14.9%). Age was positively associated with BMI z-score (P < 0.001). Nearly 40% of all participants with a blood pressure (BP) reading had a measure consistent with elevated BP (17.1%) or hypertension (22.1%). NHB males with severe obesity had the highest prevalence of stage II hypertension (12.3%).ConclusionsThe distribution of mean zBMI values greater than zero indicated that this pediatric population contained a larger proportion of individuals with obesity than the age- and sex-matched reference population. Intervention in NHB females aged 2 through 9 with severe obesity may present the best opportunity for the prevention of severe obesity and hypertension.

PurposeTo synthesize evidence on the incidence of COVID-19 vaccine-related adverse events across countries by income level.DesignSystematic review and meta-analysis of randomized trials.SettingStudies published 2020-2025, retrieved from EMBASE, PubMed/MEDLINE, and Scopus.SampleEleven trials with 7841 participants; seven from high-income and four from upper-middle-income countries.MeasuresIncidence per 100 vaccinated. Countries by income: low (≤$1145), lower-middle ($1146-4515), upper-middle ($4516-14,005), high (>$14,005). Inter-reviewer agreement assessed by kappa (0.684). Risk of bias evaluated with Cochrane RoB 2.AnalysisMantel-Haenszel random-effects models estimated relative risks (RR) with 95% confidence intervals. Heterogeneity assessed by I². Subgroup analyses by income and dose.ResultsAEFI incidence was consistently higher in high-income vs upper-middle-income countries, especially after dose 2. Injection-site pain (68.1 vs 26.3 per 100), headache (45.7 vs 14.1), myalgia (42.5 vs 9.2), and fatigue (33.8 vs 11.4) were most common. Meta-analyses showed higher pooled RR in high-income settings: any AEFI after dose 1, RR = 1.83 (95% CI: 1.39-2.42); local, RR = 3.15; systemic, RR = 2.05. After dose 2, overall RR reached 2.94; local, 4.37; systemic, 2.48. All subgroup differences were significant.ConclusionHigher-income countries showed a greater incidence of mostly mild adverse events, particularly after the second dose. mRNA vaccines had the highest rates. Findings reveal income-based disparities and inform equitable post-vaccination monitoring.

PurposeTo assess the acceptability and feasibility of the Phoenix smoking cessation smartphone app in people who smoke and are not yet ready to quit.Approach/DesignPost-intervention telephone interview.SettingOklahoma and Texas.ParticipantsAdults who were not ready to quit smoking at baseline (71% female, 76% White, mean age 52.6 years).InterventionThis 26-week 3-arm randomized controlled trial examined the utility of the Phoenix app which encouraged and provided support for smoking cessation attempts through twice-daily messages and weekly surveys.MethodsParticipants (100/152) completed an audio-recorded interview that assessed app engagement including benefits, barriers, most useful features, and suggested app modifications. Transcribed interviews were coded and analyzed for themes.ResultsAdults who were not ready to quit smoking experienced few barriers to using Phoenix app content, and reported increased self-reflection, awareness of smoking behaviors, and motivation to quit smoking in response to the tailored messages and weekly assessments. Participants with less control over daily schedules wanted more access to missed messages and surveys. Messages and surveys were helpful, but participants suggested increasing the variety of message and survey content.ConclusionAdults not yet ready to quit smoking are receptive to using mHealth smoking cessation apps to reduce/quit smoking. mHealth applications can increase access to evidence-based smoking cessation interventions and may be an effective tool for reducing smoking disparities.

ObjectiveTo examine storytelling interventions as health promotion tools in underserved populations across disease states, including hypertension, diabetes, overall chronic disease, obstetric care, and preventative health to assess intervention design and cultural tailoring and analyze reported quantitative and qualitative health outcomes.Data SourceA comprehensive literature search was performed in PUBMED.Study Inclusion and Exclusion CriteriaStudies were included if they implemented a storytelling intervention to promote health knowledge, behavior change, or health-related outcomes. Excluded studies lacked an evaluated intervention or reported outcomes. Reviews, commentaries, editorials, protocols without outcome data, and duplicate publications without novel findings were excluded. Only English-language studies were included due to reviewer fluency.Data ExtractionTwenty-five studies were included and categorized based on disease focus.Data SynthesisA narrative synthesis and inductive content analysis was performed. Studies were grouped by disease state and analyzed for population demographics, intervention development and delivery, cultural tailoring, storytelling theory, and measured outcomes.ResultsStorytelling, in digital and oral formats, improved health knowledge, self-efficacy, and preventive behaviors. Several methods were employed to culturally tailor interventions. Interventions were based on multiple behavioral theories.ConclusionsWhen culturally tailored and rooted in theory, regardless of delivery format, storytelling can foster behavior change across diverse health conditions.

PurposeTo explore associations between adolescent's concern for their body weight/shape/size and engagement in unhealthy weight control behaviors (UWCBs).DesignSecondary data analysis.Setting2022 National Survey of Children's Health.SubjectsAnalyses included 23 357 (51.8% male) adolescents, ages 10-17 years (mean 13.8 ± 2.3 years).MeasuresReported concern for body weight/shape/size, and UWCBs including skipping meals/ fasting; low interest in food; picky eating; binge eating, purging; diet pills; and over-exercising.AnalysisLogistic regression models assessed the odds of engaging in UWCBs by reported concern for body weight/shape/size.ResultsEngagement in UCWBs was low with 21.1% reporting picky eating, 13.5% fasting, 11.7% low interest in food, 5.3% binge eating, and <2% purging, over-exercising, or using diet pills. Compared to adolescents who were not at all concerned about their body weight/shape/size, adolescents who were somewhat or very much concerned had significantly higher odds (P's < 0.05) of engaging in all UCWB outcomes except for using diet pills or laxatives, which was only significant for adolescents who reported being very concerned (OR = 12.74; CI: [19.16, 36.94]). Further, after stratification by gender and age, there was a significant p-for trend (P's < 0.05), in engagement in UWCBs by concern for body weight/shape/size except for using diet pills or laxatives in 10-11- and 12-14-year-olds.ConclusionExpressing concern for body weight/image/size is associated with an increased likelihood of engaging in UCWB in adolescents, regardless of gender or stage of adolescence.

PurposeStudents can serve as key advocates for healthier environments in their schools. This study employs the Youth Advocacy for Obesity Prevention Framework to investigate associations between advocacy skills for environmental and policy change and both self-efficacy and health behaviors, and explores applications of advocacy skills for health among 9-15 year-old elementary and middle schoolers.DesignConvergent, nested mixed-methods approach.SettingElementary and middle schools in a mid-Atlantic U.S. state.Subjects457 low-income elementary and middle students.MeasuresValidated questionnaires were administered to 457 students attending 33 elementary or middle schools serving low-income communities in 5 school districts, assessing self-efficacy for physical activity (PA) and healthy eating (HE), PA and HE behaviors, and advocacy skills. Semi-structured interviews with a subset of 199 students explored advocacy applications.AnalysisHierarchical linear regressions assessed associations between students' self-efficacy for PA and HE, PA and HE behaviors, and advocacy scores, accounting for school-level clustering and controlling for student factors (eg, gender, race, and BMI category). Integrated analysis of quantitative and qualitative data explored conceptualizations of advocacy skills.ResultsSelf-efficacy for PA (b = .24; P < .001), self-efficacy for HE (b = .39; P < .001), and engagement in PA (b = .10; P < .001) were associated with higher advocacy scores. Mixed methods findings further operationalized advocacy skills including leadership participation and history, self-efficacy for health promotion, and assertiveness in advocacy.ConclusionPromoting youth self-efficacy for health behaviors may enhance advocacy efforts for healthier school environments. Future research should further explore methods to foster youth advocacy and assess its impact on promoting healthier school environments.