American Journal of Health Promotion最新文献

PurposeExplore the causal relationship between sedentary behavior (SB) and the new onset of chronic pain (NOCP) in Americans aged ≥50 years.DesignRetrospective secondary data analysis.Setting/SampleIn a target trial emulation framework, a dataset comprising four consecutive waves (2012, 2014, 2016, and 2018) from the longitudinal Health and Retirement Study was investigated.Measures/AnalysisUnivariable and multivariable analyses were conducted using survey-weighted, mixed-effects Poisson regression models with one-level random intercepts and linearized standard errors. Using the same approach, causal mediation analyses were carried out to examine the potential role of obesity, depression, and sleep disturbances as mediators in the relationship between SB and NOCP. The role of education level, race, and sex as potential effect modifiers was also evaluated.ResultsIn the multivariable analysis, the risk of NOCP in participants who reported not having pain in the 2012 interview increased by 22% in those with SB vs those reporting no SB (95% CI = 1.12, 1.33; P < .001). The mediation effect attributed to obesity and depression was 58.2% (95% CI = 50.5, 71.3; P < .001) and 8.8% (95% CI = 1.6, 14.1; P < .001), respectively. The risk of NOCP in participants reporting SB was increased by 24.8% in women vs men (incidence rate ratio 1.25; 95% CI = 1.02, 1.52; P = .03).ConclusionThere is strong evidence for an association between SB and NOCP in the American subpopulation of women aged $\ge$50 years. This effect seems to be mainly mediated by obesity.

PurposeTo examine physical activity and sleep as predictors of well-being in young adults and explore differences by sex, age, and student status.Design & SettingA cross-sectional, online survey containing validated questionnaires was utilized to measure self-reported physical activity, sleep, and well-being.SampleParticipants were recruited through local and national recruitment efforts and social media. Of 329 survey respondents, 230 adults (69.9%) aged 18-25 years without current injury or physical activity limitations completed the survey between April 2020 and September 2020.MeasuresQuestionnaires utilized included the Godin Leisure Time Exercise Questionnaire for physical activity, the Pittsburgh Sleep Quality Index for sleep, and the Physical Summary Component and Mental Summary Component of the Modified Disablement in the Physically Active Scale for physical and mental well-being.AnalysisLinear regression models, Welch 2 Sample t-tests, Analysis of Variance, Tukey's Honest Significant Difference tests, chi-square tests of independence, F-tests, and stepwise AIC techniques were utilized in data analyses.ResultsSleep quality was the strongest predictor of mental and physical well-being (Estimate = 0.500, P < .001). While no differences in sleep quality or well-being were identified by sex, age, or student status, physical activity was higher among males and younger participants.ConclusionYoung adulthood is a crucial time to establish healthy physical activity and sleep patterns to promote well-being. Collection of data during the COVID pandemic may limit generalizability of results.

PurposeThis scoping review aimed at describing the health promotion initiatives of universities.Data SourcePubMed, Scopus, Embase, Web of Science.Study Inclusion and Exclusion CriteriaStudies were included if they: (a) explicitly referred to higher education or university; (b) focused on improving the health and well-being of the university community; (c) described a specific health promotion intervention or broader university strategies and policies for health promotion without a specific intervention; (d) were available in full text in English or Italian; (e) were published between 01/01/2015 and 02/04/2024.Data ExtractionThe following data were considered: country in which the study was conducted, target population, number of subjects involved, study design, aim of the study, interventions developed, main results.Data SynthesisA narrative synthesis was conducted.ResultsThirty-six studies were included in the final synthesis; they were mostly conducted in Europe (30.6%) and in the Western Pacific Region (25%). Seven studies described multiple interventions as part of the Health Promoting University network. Eleven studies examined health promotion interventions implemented as part of health-promoting strategies defined at the university level. Mental health and psychological well-being represent the most common area of intervention (52.8%).ConclusionAlthough significant progress has been achieved in implementing health-promoting initiatives within universities, challenges remain regarding the full integration of health promotion into the broader university culture.

PurposeThis study examined preferences to consider low-calorie, no sugar substitution options for sugar-sweetened beverage (SSB) among US adults. This could help develop tailored public health strategies to reduce SSB consumption and related health risks.DesignQuantitative, cross-sectional study.SettingUnited States.SampleThis study used 2021 SummerStyles survey data for 2552 US adults recruited from an online panel of approximately 60 000 non-institutionalized adults.MeasuresThe outcome measure was considering a non-sugar SSB substitute (Yes or no) for six different beverage options among individuals consuming SSBs who would consider a substitute. Exposure measures were sociodemographic characteristics and frequency of SSB consumption.AnalysisLogistic regression models were used to estimate adjusted odds ratios (ORs) for preference to consider each substitution option.ResultsPlain water was considered by 71% of respondents as a substitute; 36% considered flavored water, 27% sparkling water, 25% herbal tea, 19% diet drinks, and 18% unsweetened coffee. Preferences varied by demographic characteristics. Individuals reporting an annual household income of <$35 000 had 0.6 (95% confidence interval (CI): 0.4, 0.9) times lower odds to consider plain water than those with income ≥$100 000, and individuals with obesity had 1.9 (95% CI: 1.4, 2.6) times greater odds of considering diet drinks compared to those with healthy weight or underweight.ConclusionPopulation subgroups of regular SSB-consuming adults exhibit varying preferences for SSB substitutes, which can inform tailored public health messaging and interventions.

PurposeThis study examined nativity differences in social and structural correlates of single and polytobacco product use among United States (U.S.) Black young adults (YA).DesignOnline cross-sectional study.SettingUnited States.SampleU.S.-born and foreign-born Black YA ages 18-25 years (N = 484) living in the U.S.MeasuresSelf-reported past 30-day tobacco product use, safety concerns, and food and housing insecurity measured with the Accountable Health Communities Health-Related Social Needs Screening Tool; experience of racist events measured with the schedule of racist events scale.AnalysisStratified adjusted multinomial logistic regression analyses were conducted. Separate models were constructed for overall sample, U.S.-born YA, and foreign-born YA. All models adjusted for demographic characteristics. Models for foreign-born YA adjusted for length of stay in the U.S.ResultsOverall, 18.8% (CI = 15.6-22.5) and 17.4% (CI = 14.2-21.0) of participants reported single tobacco use and polytobacco use respectively. Among foreign-born participants, exposure to racist events (aOR = 1.06, 95%CI = 1.02-1.11) and housing insecurity (aOR = 1.95, 95%CI = 1.05-3.63) were associated with higher odds of polytobacco use. Among U.S.-born participants, exposure to racist events (aOR = 1.02, 95%CI = 1.001-1.05) and safety concerns (aOR = 3.19, 95%CI = 1.51-6.73) were associated with higher odds of polytobacco use.ConclusionExperience of racist events was associated with polytobacco use among both U.S.-born and foreign-born Black YA. However, different structural determinants were associated with polytobacco use among both groups. Results suggest need for tailored tobacco prevention efforts among Black young adults in the U.S.

PurposeAssess how modifications from community partners changed usability and feasibility (U/F) of a pilot physical activity (PA) intervention.DesignMixed-Methods.SettingMichigan communities that are under-resourced.SubjectsPartners from 13 community-based organizations (n = 7 key informant interviews (KII); n = 12 organization survey responses).InterventionRec-Connect™: A Physical Activity Demonstration Playbook, a community-based PA intervention.MeasuresKIIs (2021) and surveys (2023) assessed what ways and/or to what extent modifications to the PA pilot (e.g., guidance, materials, curriculum, partnerships, PA-based policy, systems, and environmental changes (PSE)) improved implementation.AnalysisContent analysis was applied to KII; descriptive statistics were generated from surveys.ResultsThree primary themes were derived from KIIs which explained how modifications improved U/F: (1) effective communication across and within socio-ecologic spheres transformed U/F and illuminated best practices, (2) explicit community engagement guidance made implementation more responsive to PA needs, and (3) stronger and increased collaborations reduced deterrents to PA. Survey results supported themes and explicated modification benefits, which increased communications with entities (44%), identification of community champions (35%), new partnerships (43%), and new PSE changes to address (43%).ConclusionIncorporating partner modifications improved intervention U/F, enhanced facilitation and engagement practices, and strengthened implementation with organizations and champions. Including partner input resulted in a more transformative PA intervention exemplified by increased partnerships and collaborations to address PSE changes.

PurposeResearch demonstrates that cardiorespiratory fitness (CRF) mitigates age-related cognitive decline, but its specific effects across different stages of aging remain unclear. This study aimed to examine the association between CRF and global cognition in older adults, identifying the age ranges during which cognitive differences between older adults with higher and lower CRF levels were most pronounced.DesignCross-sectional.SettingData from the National Health and Nutrition Examination Survey 2011-2014.SampleA total of 2311 U.S. older adults aged 60 to 79 years.MeasuresCRF was estimated using a validated non-exercise regression equation, and participants were categorized into above- and below-median CRF groups. Global cognition was assessed using composite z-scores derived from 3 cognitive tests: CERAD Word Learning subtest, Animal Fluency Test, and Digit Symbol Substitution Test.AnalysisWeighted time-varying effect modeling was employed to examine age-related trends in the association between CRF and global cognition throughout late adulthood. Separate analyses were conducted for older adults with higher and lower CRF levels to explore differences in cognitive trajectories between these groups.ResultsParticipants with higher CRF demonstrated significantly better global cognition than those with lower CRF, particularly between the ages of 61 and 66. The largest difference was observed at age 62, where individuals with higher CRF had a mean composite score of 0.40 (95% CI = [0.27, 0.53]), compared to 0.03 (95% CI = [-0.10, 0.16]) for those with lower CRF.ConclusionPromoting improvements in CRF during key aging periods may serve as an effective strategy to delay age-related cognitive decline.

PurposeExamined how moderate-to-vigorous physical activity (MVPA) and weight status during physical education (PE) class was related to peer MVPA and weight status.DesignData collected during the first and last weeks of a semester-long PE class.SettingHouston, Texas charter school.ParticipantsAdolescents (n = 156; 13.51 ± 1.45 years old; 52.6% female; 85.4% Hispanic, 14.1% African American, 0.5% Asian) nominated up to 3 female and 3 male students they felt closest to in PE.MeasuresMVPA during PE was assessed by heart rate throughout the semester. Body mass index (BMI) z-score was calculated from height and weight measured at the beginning and end of the semester.AnalysisExponential random graph models explored friendship existence, formation, and maintenance in these networks. Separable temporal exponential random graph models examined how MVPA impacted friendships forming or maintaining over the semester.ResultsStudents with higher MVPA were more likely to receive a new nomination from a student throughout the semester (E = 0.007, P < .03), but not to send a new nomination themselves. Students with higher BMI z-scores were significantly less likely to send a nomination at baseline (E = -0.11, P = .04); however, this effect was not significant at semester's end.ConclusionsMVPA opportunities during PE may be a mechanism for youth to establish friendships, making PE important for adolescent social and physical health. Larger scale research is warranted.

PurposeIn young women with obesity, we sought to explore their: (1) psychosocial health; (2) perceptions of their and engagement in current health behaviors; (2) motivation to change their health behaviors; and (3) desired characteristics of a health behavior intervention.ApproachConvergent-parallel mixed methods study.SettingFocus groups were conducted over zoom.Participants34 young women with obesity (M ± SD; age = 23.79 ± 4.22 years; BMI = 35.66 ± 5.56 kg/m²; 41.2% non-Hispanic White).MethodQuantitative data were collected via Qualtrics prior to focus groups. We conducted 8 semi-structured focus groups (2-7 participants per group; 32-93 minutes) to address the pre-specified objectives.ResultsParticipants reported poor psychosocial health, with 100% meeting the cut-point indicative of significant depressive symptoms and 79.4% for clinically meaningful anxiety. Participants expressed the interconnectedness of their physical and mental health and desire to improve consistency in their eating and physical activity behaviors. However, participants did not want to emphasize weight loss as the primary focus of a health behavior intervention. Preferences for the characteristics of a health behavior intervention were in support of a hybrid format, with in-person meetings focusing on active engagement (e.g., cooking classes).ConclusionsOur findings support shifting the focus from a weight-normative to a weight inclusive approach to health behavior interventions to meet the needs and preferences of young women with obesity.

PurposeWe sought to explore perceived barriers to engaging in weight-related health behavior change among parent child dyads.DesignThis is a secondary analysis of data from a cluster-randomized controlled trial investigating the effectiveness of Fitline telephonic coaching vs Fitline workbook at improving weight-related health behaviors and body mass index for children 8-12 years old with overweight and obesity.SettingThe trial which the present data comes from was conducted within 20 pediatric primary care practices in Central Massachusetts.SampleData from 499 parent-child dyads were included.MeasuresBarriers to weight-related health behavior changes were assessed via 10 survey items answered by parents and the enrolled child at baseline, 6- and 12-month.AnalysisWe used frequencies to describe the distribution of parent and child reported behavior-change barriers as well as McNemar's and Bowker's tests to compare distributions of behavior-change barriers at baseline and change in report of behavior-change barriers at 6-month.ResultsWe found that barriers to weight-related health behavior change varied within parent child dyads with up to 30% of dyads disagreeing on behavior-change barrier perception at baseline. Additionally, up to 37% of dyads were not aligned on reported change in barriers to health behavior change at 6-month.ConclusionOur findings support the potential benefit of integrating behavior-change barrier assessment from both the parent and child perspectives into intervention delivery when developing and tailoring family-centered interventions.