American Journal of Health Promotion最新文献

Purpose: Though urban-rural disparities in COVID-19 vaccination coverage was documented at a point of time, little is known on the evolution of vaccination uptake over time. This study, using individual level time-to-event data, intend to assess the differences in monthly progression of vaccination uptake among U.S. adults by urban/rural residence.

Design: Survival analysis.

Setting: Urban and rural areas in 29 U.S. states.

Subjects: 135,969 adults aged 18+ years.

Measures: Time (in months) to receive the first dose of COVID-19 vaccine since the U.S. Food and Drug Administration (FDA) Emergency Use Authorization of Pfizer-BioNTech- and Moderna- COVID-19 Vaccine in December 2020.

Analysis: Kaplan-Meier survivor functions and stratified Cox proportional hazard models were estimated for the event of being vaccinated by urban/rural residence for 25 months starting from December 2020. Monthly survival probabilities for urban- and rural- adults were further assessed within certain demographic and socioeconomic groups.

Results: We found a gradual divergence of COVID-19 vaccination uptake in favor of urban adults, which was robust across sex, age groups, race and ethnicity, education, and income levels. In April 2021, after vaccine eligibility was expanded, 42.2% adults in urban and 53.3% adults in rural areas were unvaccinated. While only 19.3% urban adults remained unvaccinated in December 2022, this rate was 32.5% among rural adults. Compared to their urban counterparts, rural adults were 0.77 (95% CI: 0.76 - 0.79) times as likely to receive the first dose of COVID-19 vaccine.

Conclusions: Time-to-event analysis of vaccination against COVID-19 indicated a lower uptake among rural adults, which was persistent across different demographic and socioeconomic groups.

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 Awards, the Editor in Chief Awards, the Michael P. O'Donnell Award and the Dorothy Nyswander Award for the best research and writing published in 2024 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 used 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 enjoyable to read. Awardees in 2024 offered new insights into research methods, the impact of COVID-19 on individuals and groups, brain health and mental health assessment, climate change perceptions and the role of diversity, equity and inclusion in advancing employee health. This "best of 2024 list" featured studies based in health systems, workplaces and communities and includes case studies and qualitative and quantitative research methods that enabled researchers to better explain what amplifies or hampers well-being.

Purpose: Examine the predictors of food security and perceived stress among international students.

Design: Cross-sectional Design.

Settings: A public university in the Southwest United States.

Subjects: Sample size of Seventy-three participants (≥18 years).

Measures: Self-report measures of food insecurity and perceived stress. The U.S. Department of Agriculture (USDA) Adult Food Security Survey Module (AFSSM) to assess food security status, and the Perceived Stress Scale (PSS-10) questionnaire to evaluate stress levels.

Analysis: Logistic regression was performed to identify predictors of food security and perceived stress.

Results: Duration of stay in the U.S. was a predictor of food security status, while gender was a predictor of perceived stress. International students in the U.S. for less than a year had a lower chance of being food secure [OR (95% CI) = 0.22 (0.05 - 0.74)]. Female international students had a lower chance of experiencing low perceived stress [OR (95% CI) = 0.07 (0.00 - 0.51)].

Conclusion: In supporting international students, targeted nutrition and stress management interventions should be emphasized, particularly for females and those who recently moved to the U.S.

Purpose: The aim of this analysis is to investigate physical activity levels amongst e-cigarette users based on their wearable device use.

Design: Cross-sectional secondary data analysis using 2017 Behavioral Risk Factor Surveillance Survey (BRFSS).

Setting: Data from the 2017 BRFSS were used.

Sample: 5,562 U.S. adults (age 18+).

Measures: Self-reported physical activity related variables from U.S. adults (age 18+).

Analysis: Separate unadjusted and adjusted linear regression models were performed for each of the dependent variables using survey analysis.

Results: Non-users of wearable devices and e-cigarettes account for 96.6% (95%CI [95.7, 97.6]) of the sample, whereas users of wearable devices and e-cigarettes account for 3.3% (95%CI [1.2, 5.4]) of the sample. Those who use e-cigarettes participate in almost 50% less vigorous physical activity minutes per week than nonusers, 46 (95%CI [0.43, 91.57]) and 93 (95%CI [80.59, 106.34]) minutes respectively. Individuals who use e-cigarettes and use wearable devices were found to spend significantly more time in total physical activity per week in both the unadjusted and adjusted linear regressions, P = =0.01 and P = =0.04 respectively.

Conclusion: The use of e-cigarettes, wearable devices, or both technologies may influence the physical activity levels of its users. Additional research is needed to better understand the association between physical activity levels and the usage of these technologies.

Purpose: This study explores the relationship between depression and cardiovascular disease (CVD) in the US adult population, focusing on sex differences.

Design: Cross-sectional study.

Setting: National Health and Nutrition Examination Survey data (2013-2018).

Participants: A total of 14 699 community-dwelling adults (≥20 years).

Measure: The Patient Health Questionnaire (PHQ-9) depression screening tool assessed depressive symptoms. CVD events included heart failure, coronary heart disease, angina, heart attack, or stroke.

Analysis: Adjusted prevalence ratios were estimated using a Poisson regression model.

Results: The study finds a positive association between CVD incidents and both mild to moderate depressive symptoms (aPR:1.42, P = .002) and moderately severe to severe depression (aPR:1.72, P = .024). Overall, females exhibit a 47% lower likelihood of CVD incidents compared to males. However, in a subgroup analysis, increased depressive symptoms correlate with higher CVD incidents in females (aPRs range: 2.09 to 3.43, P < .001) compared to males (aPRs range: 1.45 to 1.77, P < .001).

Conclusion: Depression is associated with increased cardiovascular disease (CVD) risk. Females generally have a lower CVD risk than males, but more severe depressive symptoms elevate CVD risk in females. These findings emphasize the significance of considering sex differences. Further research is needed to understand the underlying mechanisms.

Purpose: Presenting a chain mediation model to investigate whether mobile phone dependence results in a reduction in health-related quality of life (HRQoL) among Chinese college students, through the mediating effect of chronotype and sleep quality.

Design and setting: A cross-sectional survey was conducted on students from a Chinese university using a validated structured questionnaire.

Sample: 2014 freshmen.

Measures: The study measured the students' level of mobile phone dependence using the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use. Chronotype and sleep quality were measured by the Chinese version of the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI), respectively. HRQoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L), including a descriptive system and a visual analog scale (VAS).

Analysis: Descriptive statistical analysis, correlation analysis, and mediation analysis.

Results: Mobile phone dependence had a significant negative effect on HRQoL as indicated by both the EQ-5D-5L index score and EQ-VAS score (P < .001 for both). Additionally, it was found to significantly predict chronotype (MEQ score) (β = -.546, P < .001) and sleep quality (PSQI score) (β = .163, P < .001). Chronotype negatively predict sleep quality (β = -.058, P < .001), and sleep quality was a significant negative predictor of HRQoL (EQ-5D-5L index score, β = -.008, P < .001; EQ-VAS score, β = -1.576, P < .001).

Conclusion: Mobile phone dependence negatively impacts students' HRQoL through chronotype and sleep quality, and there is a chain mediating effect. Students should consider making lifestyle changes to improve their HRQoL and promote health.

Purpose: To explore whether school poverty level and funding modified the effectiveness of an evidence-based Comprehensive School Physical Activity Program called Health Empowers You! implemented in elementary schools in Georgia.

Design: Secondary data analysis of a multi-level, cluster-randomized controlled trial.

Setting: 40 elementary schools in Georgia in 2018-2019.

Subjects: 4^th grade students in Georgia.

Measures: Intervention schools implemented the Health Empowers You! program to increase school-day physical activity. The outcome was average daily moderate-to-vigorous physical activity, school free-reduced price lunch (FRPL) percentage and per pupil expenditures were effect modifiers.

Analysis: Separate linear mixed regression models estimated the effect of the intervention on average daily moderate-to-vigorous physical activity, with interaction terms between intervention status and (1) school FRPL percentage or (2) per pupil expenditures.

Results: The effect of the intervention was significantly higher in schools with higher FRPL percentage (intervention*school % FRPL β (95% CI): .06 (.01, .12)), and was modestly, but not statistically significantly, higher in schools with lower per pupil expenditures.

Conclusion: Findings support the use of the Health Empowers You! intervention, which was effective in lower income schools, and may potentially reduce disparities in students' physical activity levels.

Purpose: While the value of art therapy is well-established and arts are increasingly leveraged to promote health and wellbeing more broadly, little is known about the impacts of non-clinical arts programs. In this preliminary investigation, we sought to fill this gap by exploring diverse stakeholders' perspectives on the impacts of non-clinical arts programming on Veterans receiving care at the Veterans Health Administration (VA).

Design: Semi-structured qualitative interviews with Veterans, VA staff, and community partners.

Setting: Interviewees were recruited from 7 VA medical centers that have recently implemented non-clinical arts programming to promote Veterans' health and wellbeing, some of them in partnership with community organizations.

Participants: 33 individuals were interviewed, including 9 Veterans, 14 VA staff, and 10 community partners involved in non-clinical arts program implementation.

Method: Interview transcripts were analyzed using iterative rounds of qualitative content analysis.

Results: The following impacts on Veterans were described: (1) mental health improvements, (2) renewed sense of purpose; (3) increased social connectedness, (4) improved self-esteem, and (5) self-driven engagement in art activities.

Conclusion: Non-clinical arts programming was perceived by diverse stakeholders to offer important benefits for Veterans' health and well-being. Offering non-clinical arts programming inside and outside healthcare facilities' walls is a promising direction for the field of public health undergoing a shift towards holistic approaches to improving individual and population health outcomes.

Purpose: To investigate the associations among self-compassion, resilience and mental health of community residents.

Design: Cross-sectional study.

Setting: Voluntary survey of web-based, posters-based platform.

Participants: 453 community residents.

Methods: Participants living in Kaohsiung, Taiwan were recruited from posters, online advertisements based platforms and were assessed with the self-compassion scale (SCS), Connor-Davidson Resilience Scale (CD-RISC-25), Center for Epidemiological Studies Depression Scale (CES-D), The Satisfaction with Life Scale (SWLS) and The Positive Mental Health Scale (PMH-scale) measures during the period from March 1 to October 31, 2023.

Results: After adjusting for age, gender and education, stepwise regression analysis revealed that isolation, self-judgment, and control accounted for 14% of the variance in depressive symptoms (CES-D) (adjusted R² = .149, P < .05). Over-identification, self-kindness and control accounted for 26% of the variance in satisfaction with life (SWLS) (adjusted R² = .263, P < .001). Over-identification, self-kindness, isolation, control and personal competence and tenacity accounted for 37% of the variance in positive mental health (PMH-scale) (adjusted R² = .375, P < .05).

Conclusions: Findings suggested that components of self-compassion and resilience may be important factors that promote positive mental health and provide potential interventions for professionals to increase the well-being of community residents.

In part one of this editorial covering fifty observations about the history and evolution of the health promotion discipline I shared twenty five observations relating to societal trends, definitional nuances and seminal studies and resources that have contributed to the trajectory of the field. In this, part two of the editorial, I list an additional twenty five observations focused on polemics and controversies and on the importance of effective teaching, research and writing. I reflect on the different approaches used by public sector and private sector health promotion experts respectively. I also share inspirational quotes that I consider closely aligned with the vision and mission of our profession.