American Journal of Health Promotion最新文献

Artificial intelligence (AI) is reshaping employer-sponsored mental health and well-being initiatives, offering new opportunities for personalized support, early detection, and scalable interventions. Yet the rapid expansion of AI tools raises critical concerns regarding clinical effectiveness, data privacy, equity, and responsible use. This editorial synthesizes insights from the Spring 2025 Health Enhancement Research Organization (HERO) Think Tank, which convened experts in mental health, AI, ethics, and workplace well-being to identify guardrails for safe and equitable implementation. Key recommendations include establishing rigorous clinical validation standards, ensuring human oversight and transparent communication, conducting regular bias and fairness audits, strengthening data privacy and consent practices, and countering AI-generated misinformation through digital literacy efforts. Employers are encouraged to adopt governance structures, pilot and evaluate AI tools, and develop ethical procurement practices. By proactively shaping policy and organizational practices, employers can harness AI's potential while protecting trust, human dignity, and workforce well-being.

PurposeGraphic warning labels (GWLs) are widely employed to communicate smoking-related health risks. Most GWLs elicit a high level of emotional reaction (ER). Our recent study showed poorer efficacy of high-ER GWLs vs low-ER ones during a month-long naturalistic exposure. Here, we aimed to examine whether GWL effects persist after discontinuing the exposure.DesignA secondary analysis investigated the delayed GWL effects on smoking severity.SettingPhiladelphia Metropolitan Area, United States.Subjects96 adult smokers who completed a month-long exposure to high-ER or low-ER GWLs.MeasuresThe number of cigarettes smoked per day (CPD) was measured immediately and 4 weeks after the end of GWL exposure. Participants also indicated their subjective feeling of being relieved from having to see the GWLs.AnalysisGeneralized estimating equations examined the change in CPD across time and its association with sense of relief.ResultsWe found a significant reduction in CPD from the immediate to the 4-week post-exposure timepoint (11.69 vs 10.30, P = 0.001). There was no difference between the high-ER and low-ER groups in CPD reduction (P = 0.74). Higher sense of relief was associated with greater CPD reduction in the high-ER group (z = -2.14, P = 0.033).ConclusionOur study suggests lasting impact of GWLs on smoking behavior. The findings may be particularly important to high-ER GWLs, which appear less effective in reducing smoking during active exposure.

PurposeThis study examines whether loneliness mediates the association between food insecurity and multiple sleep problems.DesignQuantitative, cross-sectional.SettingData were drawn from the 2021/22 wave of the UK Household Longitudinal Study, which-for the first time in the main survey-included a validated measure of food insecurity.SubjectsThe analytic sample included 21,650 individuals aged 18 and older.MeasuresSleep problems were assessed across six dimensions using items from the Pittsburgh Sleep Quality Index. Loneliness was measured using the UCLA three-Item Loneliness Scale. Food insecurity was assessed using the Food Insecurity Experience Scale. Sociodemographic variables were included as covariates.AnalysisOrdinary Least Squares and logistic regression models were used to examine associations between food insecurity and sleep outcomes. The Karlson-Holm-Breen method was employed to assess mediation by loneliness.ResultsIndividuals experiencing food insecurity reported worse outcomes across all sleep problems compared to those without food insecurity (from b = .154, P < .001 for greater daytime dysfunction to b = .470, P < .001 for longer sleep latency; OR = 2.531, P < .001 for short sleep duration). Loneliness mediated all associations, explaining between 14.75% and 27.24% of the total effect.ConclusionPublic health interventions that address both food insecurity and loneliness may help improve sleep health.

PurposeDescribe the Perspectives of Psychiatry approach and how it was integrated into an employer-based mental health engagement program.DesignRetrospective cohort study.SettingWorkplace-based.Sample913 employees.InterventionThe Johns Hopkins Balance program is a novel, employer-initiated mental health engagement program. The Balance program integrates the Perspectives of Psychiatry (Perspectives) ideology for mental health care and takes a population health and psychoeducational approach to screening and care connection.MeasuresUtilization and engagement rates, algorithm-based mental health symptom risk, Perspectives-based risk.AnalysisChi squared tests for risk categorization associations, odds ratio high risk categorization, frequency and percentage of referral types.Results94% (860/913) of participants who registered completed the Balance assessment and 14% (130/913) completed a care concierge visit. Referrals were placed for 69% (90/130) of employees who completed a care concierge visit. A person identified as high risk by the standardized assessments had 6.74 (4.38, 10.71) times the odds of endorsing a concern on at least one of the Perspectives. An additional 28 participants were identified as high risk based on their own concern after scoring low risk on the standardized assessment. Of the 117 referrals placed, 96.6% (113/117) were in individuals scoring high risk on the assessment.ConclusionA population health and psychoeducational approach to employer-based mental health engagement can successfully identify risk and connect employees to care.

PurposeA case example describing a teen-led council convened by an integrated health system. We seek to share the approach and impact of this work with the broader health services and promotion field.Approach or DesignA stakeholder-informed formative evaluation.SettingIntegrated health system in Upper Midwest.ParticipantsProgram staff, a program alumna, external program partners, subject matter experts, and current council members.MethodThis evaluation was informed by a literature review, data previously collected by the program, key informant conversations, and a participatory data collection activity with current council members. Rapid qualitative analysis was used to describe council framework and stakeholder-identified outcomes.ResultsInformed by best practices in authentic youth engagement and youth-adult partnership, this council has had a positive impact on participants, the convening health system, and the community served by the health system, in service of adolescent health and well-being.ConclusionThis formative evaluation demonstrates how youth are able to take on a leadership role and have a positive impact on adolescent care delivery and health promotion.

PurposeScreening for chronic conditions such as diabetes, high blood pressure and high cholesterol during a voluntary wellness program visit.DesignObservational study based on secondary data collected between 2000 and 2017.Setting and sampleData included 4876 visits from 2309 unique participants, all employees of an academic institution in United States.MeasuresWe leverage clinical guidelines to define criteria for classifying a patient as susceptible, or not, to a chronic disease.AnalysisWe perform descriptive statistics and logistic regression to quantify the association between patient characteristics and their susceptibility to chronic conditions.ResultsThe prevalence of susceptibility for diabetes is 17.03% (18.29%) for one-time (frequent) participants, for high blood pressure is 44.76% (48.27%), and for high cholesterol is 8.97% (7.33%). The risks of diabetes and high blood pressure increase with age, and all three risks increase with BMI. Being female is associated with a lower risk of diabetes and high blood pressure. Race is generally not associated with a higher risk of chronic conditions, except for high blood pressure. We also find that each of the three risks is positively and strongly associated with the other two.ConclusionOur study provides evidence that wellness program checks can serve as viable screening opportunities for alerting participants when their health exhibits concerning signs associated with chronic diseases.

PurposeTo identify food decision-making profiles for adults with T2DM and overweight/obesity based on nutritional health and decision process, and to explore differences in health outcomes among profiles.DesignCross-sectional.SettingPrimary healthcare settings.Subject105 adults with T2DM and overweight/obesity (90.52% retention).MeasuresNutritional health and decision process were assessed through the Food Choice Task, indicated by healthy decision rate and reaction time respectively. Health outcomes included clinical (HbA1C, fasting blood glucose, BMI) and psychological (diabetes management self-efficacy, food choice motives) measures.AnalysisHierarchical cluster analysis was used to identify profiles according to nutritional health and decision process. Welch's ANOVA were used to test their differences in health outcomes.ResultsFive profiles were identified: Cautious (healthy choice + slow reaction, 42.86%), Moderate (moderate healthy choice/reaction time, 28.57%), Well-Habit (healthy choice + fast reaction, 11.43%), Strained (unhealthy choice + slow reaction, 7.62%) and Impulsive (unhealthy choice + fast reaction, 9.52%). The Well-Habit Profile exhibited the best outcomes, including lower BMI, higher self-efficacy and healthier food choice motives. The Cautious Profile showed healthy choices but suboptimal self-efficacy. The Impulsive Profile presented a good self-efficacy, but the highest BMI and inadequate healthy choice motives.ConclusionThis study identified five food decision-making profiles for adults with T2DM and overweight/obesity, providing insights of considering both nutritional health and decision process as food choice features when conducting dietary interventions. Limitation included the small sample size and limited settings.

Objective: This commentary critically evaluates a recent scoping review on differences in COVID-19 vaccine intentions and uptake in the United States (U.S.) by gender or sex.Data Source: The reference articles in the scoping review titled "A Scoping Review on Gender/Sex Differences in COVID-19 Vaccine Intentions and Uptake in the United States" and other published articles on the subject.Study inclusion and exclusion criteria: Peer-reviewed articles in the English language that studied COVID-19 vaccine uptake in the U.S. population and evaluated sex/gender differences in vaccination were included. Studies that only assessed COVID-19 vaccine intentions in the U.S. population were excluded.Data extraction: Not applicable to this study.Data synthesis: Not applicable to this study.Results: The commentary findings on gender/sex differences are drawn from limited evidence, many with particular subpopulations (e.g., healthcare workers and military personnel) and an unbalanced gender/sex mix. Additionally, several studies use data from small surveys. By contrast, analyses using immunization registry data and large nationally representative surveys consistently find a higher COVID-19 vaccine uptake among women than men overall and in most age groups.Conclusion: This commentary argues for the inclusion of higher-quality, population-representative data sources within reviews to illustrate gender/sex differences in vaccine coverage more accurately.

Each year the editorial team of the American Journal of Health Promotion selects our "Best of the Year List" of health promotion studies from the prior year. This editorial features the Editor's Picks Award, the Editor in Chief Award, the Michael P. O'Donnell Award and the Dorothy Nyswander Award for the best research and writing published in 2025 in this journal. Our criteria for selection includes: whether the study addresses a topic of timely importance in health promotion, the research question is clearly stated and the study methods are well executed; whether the paper is often cited and downloaded; if the study findings offer a unique contribution to the literature; and if the paper is well-written and engaging. Awardees in 2025 offered new insights into health literacy, gun violence, social determinants and youth fitness, the effectiveness of health coaching in weight management and factors that affect access to GLP-1's. This "best of 2025 list" featured studies based in health systems, workplaces and communities and includes case studies and qualitative and quantitative research methods that enable researchers to better explain what amplifies or hampers well-being.