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.

PurposeThis study aimed to explore the role of bilingual provider preferences in mediating healthcare anxiety and cross-border healthcare access.DesignA multi-channel sampling was employed to recruit participants from Brownsville, Texas from March to September 2024.SettingThe research team distributed bilingual (English/Spanish) survey links through partners and community events and promoted the survey via city broadcasts and social media.SampleThe final analytic sample comprised 144 adult residents of Brownsville.MeasuresThe survey items included measures of healthcare anxiety related to providers, preference for bilingual providers, and access to cross-border healthcare, with socio demographics included as covariates.AnalysisStructural equation modeling examined the relationships between provider-related healthcare anxiety, bilingual provider preferences, and cross-border healthcare access, using path analysis to assess direct and indirect effects.ResultsThe analysis revealed a significant positive relationship between provider-related healthcare anxiety and bilingual provider preferences (β = 0.20, P = 0.018). Additionally, bilingual provider preferences were strongly associated with cross-border healthcare access (β = 0.47, P < 0.001). A mediation effect was observed, where bilingual provider preferences mediated the relationship between healthcare anxiety and cross-border healthcare access (β = 0.10, P = 0.04).ConclusionBilingual provider preferences significantly mediate the relationship between provider-related healthcare anxiety and cross-border healthcare access in U.S.-Mexico border communities. These findings emphasize the importance of language concordance in reducing healthcare anxiety and enhancing access to care.

PurposeTo explore the bidirectional relationship between food insecurity and cigarette smoking.DesignSecondary data analysis.SettingLarge U.S. cities.SampleMothers from the Future of Families and Child Wellbeing Study (FFCWS) Waves 3 and 4 (N = 2394) cohort.MeasuresFood insecurity (USDA 18-item Household Food Security Survey Module) and smoking (past-month cigarette use).AnalysisUnadjusted and adjusted cross-lagged panel analyses were conducted to examine bidirectional relationships between baseline (Wave 3) food insecurity and follow-up (Wave 4) smoking, and baseline smoking and follow-up food insecurity. Post-hoc exploratory models tested each covariate separately.ResultsThe unadjusted model showed significant bidirectional relationships between smoking and food insecurity (food insecurity to smoking: β = 0.045, p = .021; smoking to food insecurity: β = 0.073, p = .010). In the adjusted model, these relationships became non-significant. Exploratory models yielded mixed findings. When controlling for race alone, relationships remained significant (p = .012 and p = .008) but were non-significant when controlling for poverty or mental health.ConclusionFindings suggest complex interrelationships between food insecurity, smoking, poverty, and mental health. Bidirectional relationships between food insecurity and smoking may be explained by poverty and mental health, warranting consideration of contextual factors. Policies and interventions addressing food insecurity and smoking should integrate strategies that also address poverty and mental health.

PurposeTo understand variables involved in COVID-19 vaccine hesitancy in women, including sociodemographics and concerns regarding the vaccine's effects on reproductive health.DesignCross-sectional survey.Subjects617 adult females.MeasuresDemographics; adult Vaccine Hesitancy Scale (VHS); time between COVID-19 vaccination eligibility and vaccination; medical conditions; gynecologic history; menstrual cycle changes related to COVID-19 vaccination, infection, and stress; levels of worry regarding effects of the vaccine on reproductive health.AnalysisWilcoxon rank-sum, Kruskal-Wallis, Chi-square or Fisher's exact tests, linear regression.ResultsWomen without a college degree had higher VHS scores (P < 0.002) and waited longer to get vaccinated once becoming eligible (P < 0.001). There were no significant differences in vaccine hesitancy between women of reproductive age and older women. VHS scores were significantly higher for women worried about adverse effects of the vaccine on reproductive health (P < 0.001). Women not using hormonal contraception were more likely to report late onset of their cycle after receiving the vaccine compared to those using hormonal contraception (P = 0.018).ConclusionGreater vaccine hesitancy was associated with concerns around the vaccine's effects on reproductive health and lower levels of total education achieved. This study highlights specific concerns women have related to COVID-19 vaccination, emphasizing the importance of prioritizing reproductive health information in the development and dissemination of novel vaccines.

BackgroundFailures in communicating risks associated with consumer products, including pharmaceuticals, foods, and medical devices, have repeatedly contributed to preventable morbidity and mortality and have undermined public trust in product safety.PurposeTo argue that the prevailing consumer product risk communication paradigm is structurally inadequate and to propose an integrated framework that shifts risk communication from a reactive to a proactive public health function.Research DesignConceptual and policy analysis informed by lessons from major safety crises and established principles of risk communication and risk perception science.Study SampleNot applicable (no human participants or clinical dataset).Data Collection and/or AnalysisWe synthesize recurring system-level vulnerabilities in consumer product oversight (eg, fragmented regulation, reliance on industry self-reporting, misaligned corporate incentives, and limited incorporation of risk perception science) and integrate these insights with evidence-based communication principles to derive a proposed framework emphasizing transparency, clarity, independent validation, and accountability.ResultsWe identify persistent, predictable failure points that enable delayed recognition and disclosure of risk, inconsistent public messaging, and inadequate accountability, collectively fostering a reactive posture that permits avoidable harm. We propose an integrated framework with four pillars: (1) proactive transparency across the product lifecycle, (2) evidence-based communication clarity tailored to how individuals perceive and act on risk information, (3) independent validation to reduce conflicts of interest and improve credibility, and (4) systemic accountability mechanisms that align corporate behavior with public health goals.ConclusionsIncremental refinements to current regulations are unlikely to resolve the recurring, structural drivers of risk communication failure. An integrated, proactive framework is an urgent public health imperative to prevent harm, better equip clinicians and consumers to make informed decisions, and restore confidence in the safety of consumer goods.

PurposeLocal food service guidelines (FSG) policies can affect the foods sold or served to support local businesses and human health. This study identified FSG policies enacted between 2017 and 2023 and used an FSG Classification Tool to quantify alignment of policy attributes.DesignQuantitative content analysis.SettingLocal jurisdictions.SampleTwenty most populous U.S. cities in 2022.MeasuresFrequency of FSG policies and percent alignment to coding tool.AnalysisUsing municipal legal code databases and city clerk websites, enacted FSG policies were identified. Content analysis determined policy attributes across 3 FSG domains: (1) nutrition standards; (2) behavioral design; (3) facility efficiency; and the construct of implementation supports.ResultsFrom 2017 to 2023, 7 policies across 6 cities met inclusion criteria. Alignment to the tool ranged from 6% to 71%, with 2 policies scoring higher than 51%. Nutrition domain scores ranged from 0% to 100%, with 3 policies scoring >70%. Behavioral design and facility efficiency domain attributes were less frequent. All policies included at least 1 implementation supports provision, with scores ranging from 14% to 61%.ConclusionFrom 2017 to 2023, 7 FSG policies were enacted by 6 of the 20 most populous cities in the U.S. These policies can serve as models for other jurisdictions. To maximize impact, FSG policies can include additional FSG standards to improve food environments.

Background: Nutrition Incentive (NI) programs increase fruit and vegetable (FV) purchasing and consumption among Supplemental Nutrition Assistance Program (SNAP) participants by providing financial incentives at the point of sale. Through supported and sustained Farm Bill investment and bipartisan backing, NI programs operate in diverse retail settings. Discussion: Evidence indicates that NI programs generate benefits at multiple levels. At the individual and household level, they are associated with improved diet quality and enhanced food security. At the community and systems level, NI programs contribute to local economic activity by increasing FV sales in grocery and farm direct settings, supporting farmers, and reinforcing retailer participation in healthy food initiatives. This "triple-win" is dynamic, benefiting consumers, retailers, and producers and positions NI programs as a strategic mechanism for aligning public health and economic development goals. Conclusions: As a proven and scalable intervention, NI programs represent a cross-sector solution that advancas public health, strengthens local food systems, and promotes community resilience. Continued policy support and investment are critical to sustaining and expanding their impact nationwide.

PurposeTo identify multimorbidity patterns among U.S adults entering their 40s.DesignCross-sectional analysis of cohort data.Setting and SampleData are from the National Longitudinal Study of Youth 1979, a nationally representative cohort born between 1957-1964 (n = 8104) who were followed from adolescence into adulthood; this analysis used data collected when participants entered their 40s (1998-2006).Measures and AnalysisParticipants self-reported whether they had ever been diagnosed with each of 7 chronic conditions: hypertension, diabetes, non-skin cancers, chronic lung disease, heart disease, mental disorders, and arthritis or rheumatism. We used latent class analysis to identify multimorbidity patterns. Multimorbidity was defined as ≥2 diagnosed conditions and obesity as body mass index ≥30 kg/m² from self-reported height and weight. We used multinomial survey-adjusted logistic regressions to examine associations between obesity and disease clusters.ResultsAt mean age of 41y, 10.8% of adults in the U.S. had multimorbidity; 26.3% had obesity. Three patterns emerged: healthy (≤1 disease), an arthritis-mental health conditions-dominated cluster (5.6%) and a hypertension-diabetes-dominated cluster (2.4%). People with obesity had 5 times higher odds of having a hypertension-diabetes-dominated cluster (OR = 5.2, 95%CI: 3.2-8.5) and double the odds of having an arthritis-mental health conditions-dominated cluster (1.7, 1.2-2.2) compared to normal-weight individuals.ConclusionAmong U.S. adults in their 40s, multimorbidity clusters were dominated by arthritis-mental health and hypertension-diabetes; both disproportionately affected individuals with obesity.

PurposeYoung individuals are increasingly turning to platforms like TikTok for health-related information, driven by its popularity and widespread acceptance. This study aimed to investigate the key contributors behind sexual assault education on TikTok.DesignExploratory content analysis.SettingVideos tagged #sexualassaultawareness or #sexualharassmentawareness published via public accounts before February 2024 were collected from the platform using Apify.SubjectsAmong 1042 videos collected in our metadata, we examined 203 TikTok posts focused on sexual assault education to determine the types of creators behind the content.MeasuresEducational videos were categorized into non-professionals, small businesses, organizations, and professionals.Analysis100 random videos were coded to identify themes and categories, leading to the development of a codebook with distinct definitions and examples. Using Microsoft Excel, two independent reviewers coded the educational videos, and inter-rater reliability was tested using SPSS.Results203 (30.4%) were classified as educational content. 166 (81.8%) videos were posted by non-professionals/lay TikTok users, 12 (5.9%) by small businesses, 5 (2.5%) by organizations, and 22 (10.8%) by professionals, such as therapists.ConclusionsNone of the users who shared this information self-identified as health education professionals, such as those holding a health education certification. This presents an opportunity for health professionals to share science-based, timely health education online, thus meeting the needs of users seeking reliable information.

PurposeMicro-influencers (10,000 -100,000 followers) promote e-cigarettes in various contexts on social media. We assessed how e-cigarette promotion alongside fitness-oriented, healthy-lifestyle activities affects adolescent perceptions of e-cigarettes and micro-influencers.DesignRandomized experiment.SettingOnline survey.SampleCalifornia adolescents (N = 664, Mean age = 15) recruited in 2024.MeasuresAfter viewing each of 10 influencer videos, participants rated perceived influencer credibility (eg, honesty). After all videos, participants reported perceived harm, appeal, and susceptibility to use e-cigarettes.AnalysisParticipants were randomized to view 10 Instagram/TikTok posts of micro-influencers promoting e-cigarettes alongside fitness-oriented activities (treatment condition) vs micro-influencers promoting e-cigarettes without fitness-oriented imagery (control). Outcomes were compared between groups (treatment vs control) and between participants who perceived influencers as credible vs non-credible, using Cumulative Link Mixed Models.ResultsParticipants in the treatment condition were more likely to report lower e-cigarette harm perceptions (AOR = 1.15; 95% CI = 1.03-1.27), higher social appeal (AOR = 1.13; 95% CI = 1.02-1.25) and attractiveness (AOR = 1.21; 95% CI = 1.09-1.34) of e-cigarette use. Among those who perceived influencers as credible, participants in the treatment condition were more likely to report lower harm perceptions and higher social appeal, attractiveness, and fun of e-cigarette use.ConclusionMicro-influencer e-cigarette promotion alongside fitness-oriented activities, and perceptions of micro-influencers as credible, contributes to lower harm perceptions and higher appeal of e-cigarettes among adolescents.