American Journal of Health Promotion最新文献

Purpose: College students' academic achievement has crucial implications for their future success. Students' health may be a key determinant of academic performance, but more research is needed to understand this relationship.

Design/setting/subjects: Secondary analysis of the American College Health Association-National College Health Assessment III pre-COVID-19 Spring 2020 dataset. N = 39 146 undergraduates at 75 higher education institutions (14% mean response rate, comparable with other large-scale national college health surveys).

Measures: Self-reported grade point average (GPA) and 33 health behaviors in the categories of dietary behavior, physical activity, sedentary behavior, substance use, sexual risk behavior, violence-related behavior, mental health, and sleep behavior.

Analysis: Weighted cross-tabulations examining the association between GPA and health behaviors; multinomial logistic regressions assessing if behaviors predicted GPA, controlling for year, sex/gender, and race/ethnicity. Individual GPA categories were also compared to a D/F referent group.

Results: There were gradient trends across GPA categories for A through D/F (18 behaviors) or A through C (12 behaviors) (P < .001). Each health behavior predicted GPA differences (P < .001), except heroin use (P = .052). The A GPA group was significantly different from the D/F GPA group for 27 behaviors (P < .001). In general, protective behaviors corresponded with higher GPAs and most risk behaviors were associated with lower GPAs.

Conclusions: There is a link between numerous health behaviors and academic performance. Stakeholders invested in college students' health and academics should engage in mutually beneficial strategies to safeguard students' current and future well-being and success.

Purpose: Increasing the perceived need for CRC screening can facilitate undertaking CRC screening. This study aims to identify factors associated with the need for CRC screening in rural populations.

Design: A cross-sectional online survey.

Setting: The survey was conducted in June - September 2022 in the rural areas of Alaska, Idaho, Oregon, and Washington, US.

Subjects: The subjects of this study were 250 adults (completion rate: 65%) aged 45-75 residing in rural Alaska, Idaho, Oregon, and Washington.

Measures: Perceived need for CRC screening, internet usage for health purposes, demographics, and intrapersonal, interpersonal, community, and environmental characteristics.

Results: Perceived need for CRC screening were negatively associated with patient-provider miscommunication (β = -.23, P < .001) and perceived discrimination (β = -.21, P < .001), cancer fatalism (β = -.16, P < .05), individualism (β = -.15, P < .05), and dependence on community (β = -.11, P < .05), but positively with compliance with social norms (β = .16, P < .05), trust in health care providers (β = .16, P < .05), knowledge about colorectal cancer (β = .12, P < .05).

Conclusions: Our study showed potential individual and situational characteristics that might help increase colorectal cancer screening. Future efforts might consider addressing discrimination in health care settings, improving patient-provider communication, and tailoring messaging to reflect the rural culture.

Purpose: To examine the relative importance of social cognitive predictors (ie, performance accomplishment, vicarious learning, verbal persuasion, affective state) on health promotion self-efficacy among older adults during COVID-19.

Design: Cross-sectional.

Setting: Data collected online from participants in British Columbia (BC), Canada.

Subjects: Seventy-five adults (n = 75) aged ≥65 years.

Measures: Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale. Performance accomplishment was assessed using the health directed behavior subscale of the Health Education Impact Questionnaire; vicarious learning was measured using the positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS); verbal persuasion was assessed using the informational support subscale from the MOS-SSS; and affective state was assessed using the depression subscale from the Depression Anxiety Stress Scale (DASS-21).

Analysis: Multiple linear regression was used to investigate the relative importance of each social cognitive predictor on self-efficacy, after controlling for age.

Results: Our analyses revealed statistically significant associations between self-efficacy and performance accomplishment (health-directed behavior; β = .20), verbal persuasion (informational support; β = .41), and affective state (depressive symptoms; β = -.44) at P < .05. Vicarious learning (β = -.15) did not significantly predict self-efficacy. The model was statistically significant (P < .001) explaining 43% of the self-efficacy variance.

Conclusion: Performance accomplishment experiences, verbal persuasion strategies, and affective states may be the target of interventions to modify health promotion self-efficacy among older adults, in environments that require physical and social distancing.

Purpose: Our study explores cancer care disruption among different demographic subgroups. It also investigates these disruptions' impacts on cancer survivors' mental and physical well-being.

Design: Pooled cross-sectional survey data.

Setting: Health Information Trends Survey for Surveillance Epidemiology and End Results, HINTS-SEER.

Participation: n = 1234 cancer survivors participated in the study and completed the survey.

Measures: Outcome variables were treatment disruption in cancer care, mental health and physical health perceptions, age, race, education, income, and sexual orientation.

Analysis: Multiple imputations were used to address missing data. Descriptive statistics were conducted to understand the perceptions of care disruption. Partial least squares structural equation models were employed for data analysis, adjusted for socio-demographics.

Results: COVID-19 impacted cancer treatment and follow-up appointments (69.45%), routine cancer screening (60.70%), and treatment plans (73.58%), especially among elderly patients. It changed the interactions with health care providers (HCP) for 28.03% of the participants. Older adults were 2.33 times more likely to experience treatment appointment disruptions. People who thought their contact with their doctors changed during COVID-19 were more likely to be older adults (65 or more) (OR = 3.85, P = .011), white (OR >1, P = .002), and with higher income (OR = 1.81, P = .002). The changes to cancer treatment and follow-up medical appointments negatively impacted the well-being of the patients (mental: β = -.006, P = .043; physical: β = -.001, P = .006), routine screening and preventative care visits (mental: β = -.029, P = .031; physical: β = -.003, P = .008), and cancer treatment plans (mental: β = -.044, P = .024; physical: β = -.021, P = .040).

Conclusions: Our findings underscore the crucial requirement for implementing focused interventions aimed at alleviating the discrepancies in the accessibility of cancer care across diverse demographic groups, particularly during times of emergency, in order to mitigate any potential disruptions in care.

Purpose: Community members and non-academic partners ("affected groups") were asked to identify factors that can influence public support, impede adoption, and mitigate challenges related to adopting local smoke-free multi-unit housing policies.

Approach: A series of key informant interviews were conducted with affected groups from a large U.S. metropolitan area.

Setting: 20 cities in Los Angeles County without a smoke-free multi-unit housing ordinance.

Participants: Interviewees were recruited from affected groups with knowledge about their community's civic and political landscape (n = 63).

Method: Data were collected and analyzed using thematic analysis to identify, code and compare themes.

Results: Most interviewees indicated civic groups, those who do not smoke, and/or groups who are educated about the negative health effects of secondhand smoke exposure would be more likely to support smoke-free multi-unit housing policies. Interviewees reported several challenges to policy adoption, including competing city priorities, public disengagement, and the cost and social burden of enforcing these ordinances. To overcome them, interviewees recommended working synergistically with local governments to build diverse coalitions, educate the public, and develop clear enforcement plans.

Conclusion: Insights and recommendations from affected groups in 20 U.S. cities suggest that communicating with the public and priming impacted communities to support smoke-free multi-unit housing policies are promising interventions for protecting at-risk families from secondhand smoke exposure in their homes.

Objective: Identify commercial tobacco cessation interventions for American Indian and Alaska Native (AI/AN) communities, focusing on strategies used to advance health equity, including strategies to address social determinants of health (SDOH), community engagement, and cultural tailoring.

Data source: We searched Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, ProQuest Central, Academic Search Complete, JSTOR, and Indigenous/Tribal health-related journals and databases.

Study inclusion and exclusion criteria: We included peer-reviewed studies on commercial tobacco cessation for AI/AN persons published January 1998-April 2023 that reported quit rates/attempts. We excluded studies that only used pharmaceutical interventions.

Data extraction: Two reviewers independently assessed each study against our inclusion/exclusion criteria. A reviewer extracted data, and another checked for completeness.

Data synthesis: Synthesis focused on reported intervention effectiveness and strategies used for addressing SDOH, community engagement, and cultural tailoring. We used a synthesis matrix which allowed for comparison across studies.

Results: We screened 1116 articles and included 12 for synthesis. Of the 12, five engaged community health workers; four included SDOH elements; and six were reported effective. Of these six, five included early-stage community engagement and four were culturally tailored.

Conclusions: There are few commercial tobacco cessation interventions for AI/AN populations. Building capacity, including tribal capacity, to develop and test multi-level, culturally grounded cessation interventions that address relevant SDOH may advance commercial tobacco cessation efforts in these populations.

Purpose: This study examined the use of behavioral design strategies to improve healthier food sales.

Design: A quasi-experimental, one-group, repeated measures design examined changes in food sales following behavioral design adjustments.

Setting: United States military base hospital dining facility.

Subjects: U.S. military service members, retirees, and civilian employees.

Intervention: Behavioral design changes included placement, layout, messaging, default healthy bundling, a stoplight rating system, strategic positioning of healthy items on menu boards, and an increase in healthier snacks.

Measures: Food sales were assessed by point-of-sales data.

Analysis: T-tests examined total sales of each food adjusted weekly between baseline and intervention and intervention and post-intervention. 16 food items targeted by the intervention were examined. Weekly food sales were calculated for the 18-week baseline, 18-week intervention, and 9-week post-intervention. Further, analysis estimated negative binomial models for food item sales.

Results: The hospital dining facility served 600 to 900 meals per day. Weekly foods sales decreased during the intervention for desserts, cooked starches, hummus, and yogurt (P < 0.01). Sales increased during the intervention for fruit cups, cooked vegetables, vegetable and turkey burgers, grilled chicken, packaged salads, French fries, hamburgers, and hot dogs (P < 0.02).

Conclusion: This study demonstrates that a mixture of behavioral design strategies can be operationalized with reasonable fidelity and can lead to increases in the sales of some healthy foods in military worksites.

Purpose: This study examined whether the relationship between adverse childhood experiences (ACEs) and self-rated health among adults in a nationally representative population is modified by age, sex, or race/ethnicity.

Design: Cross-sectional study.

Setting: United States.

Sample: Data from the 2020 and 2021 Behavioral Risk Factor Surveillance System were obtained from 185 731 (weighted N = 47 862 016) persons 18 years or older.

Measures: The ACE cumulative score (range: 0-11) was calculated using 11 questions about childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction before age 18 and classified as 0 (reference), 1, 2, 3, or ≥4. Self-rated health was divided into (excellent/very good/good [reference]) and suboptimal (fair/poor) categories.

Analysis: Multivariable-adjusted logistic regression was conducted to test for the interaction with age, sex, and race/ethnicity with ACEs. After adjustment for potential confounders, an increasing number of ACEs had statistically significantly higher odds of suboptimal self-rated health in a graded manner except for 1 ACE (1 ACE: aOR:1.09; 95% CI: 1.00-1.20, 2 ACEs: 1.16; 1.03-1.30, 3 ACEs: 1.17; 1.03-1.32 and ≥4 ACEs: 1.39; 1.26-1.53). There was a significant interaction between ACEs and age. Younger age (18-24 years) had the strongest association for ≥4 ACEs compared to the older age groups. There was no effect modification by sex or race.

Conclusion: ACEs should be considered when creating health-promoting interventions to improve health.

Importance: To examine the associations of basic demographics (age, race, and gender identity) on alcohol consumption among college students at a mid-sized university.

Objective: To evaluate the drinking habits of students using the survey tool that will measure basic demographics to collect data.

Design: A cross-sectional study that included college students ages 17-21 at Columbus State University in the fall of 2021.

Setting: Columbus, Georgia.

Participants: University students (n = 260, mean age 20.5 ± 3.8).

Analysis: One-way ANOVA and independent t-tests were used to test differences in age on alcohol consumption and binge drinking. Chi-Square tests and Fisher's Exact were used to estimate differences in proportions of binge drinking for race and gender.

Results: Underage students (57.7%) reported having consumed alcohol in the past. Frequency of alcohol consumption increased with age (P = 0.004). Caucasian students reported drinking most frequently, with 14.8% (n = 12) drinking at least once a week, compared to 0 African American students reporting they drank at least once per week (P < 0.001). There were no significant findings when examining differences in binge drinking for demographics assessed in this sample (P > 0.05).

Conclusion: and Relevance: In this cross-sectional research study, the prevalence of underage drinking among college-aged students, there is a need for targeted prevention methods to reduce adverse health outcomes among this vulnerable population.

Purpose: To evaluate the impact of the Mindless to Mindful intervention on fat mass loss in adults.

Design: This was a single-group case study.

Setting: A fitness center delivered by certified fitness professionals.

Subjects: 222 adults who participated in M2M as a team or as individuals, and 195 completed the entire intervention (attrition rate = 12.16%).

Intervention: M2M was an 8-week behavior change intervention with tailored coaching, group moderate-to-vigorous exercise (MVE) and self-regulation techniques.

Measures: Participants completed a demographic questionnaire, the Jackson-Pollock 4-site body fat measure, brief self-control scale, self-compassion scale, and a daily exercise log.

Analysis: Paired sample t-tests were used to determine differences within groups and a one-way ANOVA was used to determine the differences between groups (P-value <.05).

Results: Participants engaged in an average of 4.88 h (SD = 2.04) of MVE per week. There was a significant decrease in fat mass (M = £7.65; P < .001) and increase in self-control (t = 6.248, P < .001, d = .300) and self-compassion (t = 4.314, P < .001, d = .165).

Conclusion: Self-monitoring, group exercise, and individualized coaching can promote self-regulation and fat mass loss.