American Journal of Health Promotion最新文献

PurposeTo examine the individual and combined effects of modifiable health behaviors-physical activity, healthy diet, smoking, and alcohol consumption-on obesity among U.S. college students.DesignCross-sectional.SettingData from the 2018 American College Health Association-National College Health Assessment surveys.SampleData included 91,535 undergraduate students.MeasuresModifiable health behaviors included self-reported physical activity, diet, smoking, and alcohol use. Weight-related measures included perceived weight status, weight control intentions, weight loss behaviors, and BMI (obesity defined as BMI ≥30).AnalysisWeighted and adjusted logistic regression models estimated associations between individual behaviors, the number of guidelines met, and obesity.ResultsNon-adherence to guidelines for moderate-intensity physical activity, vigorous-intensity physical activity, muscle-strengthening activities, and healthy diet significantly increased obesity odds (OR = 1.14, 1.53, 1.45, and 1.46, respectively). Non-adherence to alcohol guidelines was associated with lower obesity odds (OR = 0.78). Cigarette smoking was not significantly associated with obesity after covariate adjustments. Meeting more guidelines was linked to healthier BMI and weight perceptions. Males were more likely to meet physical activity and alcohol guidelines, whereas females adhered more to dietary and smoking guidelines.ConclusionsInterventions targeting multiple health behaviors are needed to reduce obesity among college students.

PurposePrior research examining place of service and geographic accessibility during the COVID-19 pandemic has largely focused on the operational management of mass vaccination efforts, emphasizing aspects such as vaccine distribution, dose allocation, and user experience and satisfaction, but has paid less attention to the potential impact on mental health outcomes of vaccine seekers. This study examined the effects of different types of vaccination site and driving distance to vaccination sites on anxiety and depression among COVID-19 vaccine seekers.DesignCross-sectional analysis using data from PHQ-4 Covid-19, 2021.SettingSouthern California.SubjectsA total of 13 360 respondents from the dataset.MeasuresKey variables include anxiety, depression, place of service, travel distance, and individual-level and tract-level control variables.AnalysisMultilevel mixed-effect logistic regression models.ResultsThere is a significant positive association between receiving vaccinations at pop-up clinics and anxiety levels (OR = 1.251). Individuals vaccinated at pop-up clinics had a 25% higher likelihood of experiencing anxiety compared to those vaccinated at conventional outpatient clinics. A positive relationship was also observed between driving distance to vaccination sites and anxiety (OR = 1.088).ConclusionThe findings highlight the importance of considering the psychological impact of vaccination site selection and accessibility. To minimize anxiety, public health strategies should prioritize familiar and easily accessible vaccination locations.

PurposeThis randomized investigation tested three different forms of personalized assignment to SMS-based (text messaging) physical activity (PA) advisors to promote PA among midlife and older Latino adults.DesignAn experimental study-within-a-trial (SWAT) from the On the Move randomized clinical trial.SettingSan Francisco Bay Area, California.SampleInsufficiently active midlife and older Latino adults with overweight or obesity (n = 141).InterventionParticipants received SMS-based PA coaching and were randomized to one of three PA advising conditions: Non-Personalized, Sex-Matched, or Choice-of-Sex.MeasuresPA was measured using the validated Community Health Activities Model Program for Seniors (CHAMPS) instrument, which assessed 12-month change in total weekly walking minutes, weekly moderate-to-vigorous physical activity (MVPA) minutes, and total weekly PA minutes.AnalysisRepeated-measures linear regression analyses that employed fully conditional specification intention-to-treat principles were used to examine between-condition PA changes.ResultsSignificant 12-month increases in all PA outcomes were observed across the three SMS conditions (all P < 0.0001). The Non-Personalized (B = -37.34, P < 0.0001) and Choice-of-Sex conditions (B = 20.25, P < 0.01) had greater increases in MVPA minutes than the Sex-Matched condition. In sex-specific subgroup analyses, the increased MVPA minutes for both the Non-Personalized and Choice-of-Sex conditions remained significantly greater than the Sex-Matched condition for men (Non-Personalized: B = -54.01, P = 0.004; Choice-of-Sex: B = 70.11, P < 0.0001), while only the increases in MVPA minutes for the Non-Personalized condition remained significantly greater than the Sex-Matched condition for women (Non-Personalized: B = -33.33, P = 0.0005; Choice-of-Sex: B = 6.62, P = 0.51).ConclusionRandom assignment to either the Non-Personalized or Choice-of-Sex advisors yielded the greatest gains in 12-month MVPA minutes. Simplified digital messaging strategies that are adapted to participant preferences may enhance intervention effectiveness in under-resourced and similar populations with implications for scaling digital PA interventions.

Children's literature is an underutilized but increasingly relevant tool for health promotion practice. Narrative-based approaches embedded in storybooks can support observational learning, normalize preventive behaviors, and promote early health literacy in developmentally appropriate ways. Drawing on Social Cognitive Theory and recent evidence from infectious disease prevention, oral health promotion, and COVID-19 communication, this article argues that children's literature represents a critical emerging trend in health promotion. Integrating storytelling into schools, libraries, and community health settings may strengthen engagement, equity, and sustainability of child-focused health promotion efforts.

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.

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.

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 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.