American Journal of Health Promotion最新文献

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.

PurposeGrowing evidence suggests a bidirectional relationship between depression and obesity. This study examined the association between A Body Shape Index (ABSI) and depressive symptoms among U.S. adults and explored the mediating role of the triglyceride-glucose (TyG) index.DesignCross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES, 2005-2018).SettingUnited States, utilizing NHANES data collected between 2005 and 2018.Participants15200 non-institutionalized U.S. adults aged >=20 years with complete data on ABSI, depression (assessed by PHQ-9), and TyG index.MethodsMultivariate logistic regression, smooth curve fitting, subgroup/interaction analysis, and sensitivity analyses assessed the ABSI-depression link. Mediation analysis quantified the TyG index's role.ResultsAfter adjusting for potential confounders, a significant positive association was observed between ABSI and depressive symptoms. Participants in the highest ABSI quartile (Q4) had higher odds of depression compared to those in the lowest quartile (Q1). Subgroup and sensitivity analyses confirmed the robustness and independence of this association. Mediation analysis revealed that the TyG index partially mediated the relationship between ABSI and depression, with a mediation effect accounting for 5.31% of the total association.ConclusionThis large cross-sectional study highlights a significant association between higher ABSI and depressive symptoms among U.S. adults. These findings highlight the need for further research to explore underlying mechanisms and potential clinical implications.

ObjectiveTo provide a comprehensive overview of the global prevalence of Advance Care Planning (ACP) and its moderating factors through a systematic review and meta-analysis.Data SourcePubMed, Scopus, and Cochrane Library databases were searched for studies reporting ACP prevalence up to December 31, 2023.Study Inclusion and Exclusion CriteriaEligible studies included prospective and retrospective cohort studies, cross-sectional surveys, and randomized controlled trials (RCTs). Only English-language studies were considered. RCTs reporting prevalence in control or pre-intervention arms were included.Data ExtractionTwo reviewers independently evaluated studies using Rayyan software. Data extracted included article characteristics, population characteristics, ACP prevalence, and potential moderating factors.Data SynthesisA random-effects meta-analysis model estimated ACP prevalence. Univariate meta-regressions and multimodel inference explored potential moderators. Subgroup analyses were conducted based on populations and settings.Results92 studies involving 7 839 271 individuals were included. The overall meta-analytic estimate of ACP prevalence was 0.39 (95% CI: 0.32-0.46), adjusted to 0.09 after accounting for publication bias. Significant moderators included the proportion of oncologic patients and white ethnicity. ACP prevalence was lower in acute disease populations compared to chronic disease and general populations.ConclusionACP prevalence is low and stationary over time, potentially overestimated in chronic disease contexts. Facilitators such as supportive policies, public and professional education, and adaptive ACPs should be investigated to enhance ACP adoption.

PurposeTo examine the association between sociodemographic determinants and parent-reported up-to-date childhood vaccination status in Tennessee.DesignCross-sectional statewide survey.SettingAll 95 Tennessee counties, July 2022 to May 2024. Surveys were distributed at community outreach events (health fairs, Head Start programs, community baby showers), and community organizations (schools, daycares, and preschools).SampleParents or caregivers of children aged 18 years and younger (N = 8954).MeasuresThe primary outcome was parent-reported up-to-date childhood vaccination status. Covariates included child's age, health insurance status, parental race/ethnicity and education, household income, and rural/urban residency.AnalysisDescriptive statistics and log-binomial regression models were used to assess associations between sociodemographic factors and vaccination status. Stratified analyses were conducted by rural and urban status. Adjusted prevalence (aP) and 95% confidence intervals (CIs) with robust estimates were reported.ResultsOverall, 96.5% reported that their children were up-to-date on vaccinations. The lowest vaccination rates were observed among children of multiracial (86.4%), and Asian/Native Hawaiian/Pacific Islander (90.3%) parents. Children without health insurance had a significantly higher prevalence of under-vaccination (aP = 0.104; 95% CI, 0.079-0.137) compared to insured children (aP = 0.029; 95% CI, 0.025-0.033). Across both rural and urban areas, under-vaccination was significantly associated with insurance, race, and child age, while parental education was significant only in urban areas and household income only in rural areas.ConclusionsFindings highlight critical gaps in vaccine coverage tied to insurance, race, and age. Targeted outreach to underserved and low-education communities is needed to promote equity in childhood vaccination.

PurposeTo investigate the frequency of physical activity behavior among adolescents between the ages of 14-18 and to explain their physical activity behavior within a mixed theory of planned behavior and social cognitive theory model (TPB/SCT) with structural equation modeling.DesignWe investigated the causality of physical activity behavior in adolescents with classical epidemiological regressions models and structural equation models.SettingThe data were stratified by student grade, school type (public/private), and education type (vocational/other).SubjectsThe analyses included data from 1003 students from 31 high schools.Measures & AnalysisFor the "classical epidemiological approach" descriptive, univariate, and multivariate (logistic regression) analyses were presented. For the "structural approach", based on the mixed model of TPB/SCT, 10 structural equation models were established, with stratum of gender and socioeconomic status of the participants.ResultsOur results confirm the hypothesis that attitudes of adolescents - except in poor male adolescents - (β min-max: 0.39-0.46) and perceived behavioral control (β min-max: 0.27-0.39) predicts "intention," while intention (β min-max: 0.39-0.46) predicts physical activity "behavior." The barriers significantly reduce physical activity, especially in wealthy male adolescents (β: -0.12), and peer support significantly increases physical activity in all models (β min-max: 0.21-0.28) except for poor female adolescents. Our models explained approximately 60.0% of physical activity intention variance and approximately 45.0% of physical activity behavior variance. In addition, the lowest values of these two variance percentages were calculated (54.0% and 28.0%) among poor female adolescents.ConclusionOur model could be applied to understand physical activity behavior in adolescents, and still three out of every four adolescents are not physically active at recommended levels. Psychological theories have not yet been able to adequately explain the physical activity behavior of poor female students. According to structural equation modeling, peer social support was found to be twice as effective as parental social support.

ObjectiveReview studies targeting obesity/overweight among older rural adults to: (1) summarize obesity prevalence and identify high-risk groups in epidemiological studies, and (2) describe the types of obesity interventions and outcomes examined in this population.Data SourceCINAHL Ultimate, PubMed, Google Scholar, MEDLINE.Study Inclusion/Exclusion CriteriaInclusion criteria: peer-reviewed intervention/epidemiological studies in English, adults aged 50+ with overweight/obesity who were rural dwellers. Exclusion criteria: review/meta-analysis articles, child/adolescent obesity, youth or adults aged <50, examining obesity with other chronic conditions, published before the year 2000.Data ExtractionStudy population/design/methodology/results, publication year (2000-2024), type of intervention, methodology of epidemiological studies.Data SynthesisStudy characteristics and outcomes were summarized in the assessment/intervention matrix tables.ResultsSeventeen articles met the inclusion criteria: 6 epidemiological studies (US = 3, overseas = 3), 7 community-based interventions, 3 remote interventions, and 1 hybrid intervention. Epidemiological studies showed that the obesity/overweight prevalence ranged from 11.2%-64.6%. Women were consistently more likely to be obese/overweight than men. While one US study found significant associations between lower educational attainment and higher obesity rates, one non-US study reported no association between educational attainment and obesity. Community-based interventions with nutrition/exercise sessions and remote/hybrid interventions were reported to support weight and/or insulin resistance management.ConclusionFuture interventions should prioritize high-risk subgroups, such as American Indians/Alaska Natives, older women, and individuals with lower educational attainment.