American Journal of Health Promotion最新文献

COVID-19 was the first pandemic of the internet age. Beginning at a time of great societal division in the United States (and globally), pandemic responses were further beleaguered by the viral proliferation of information, disinformation, and propaganda-collectively, an "infodemic." Polarized, blinkered views of the crisis precluded a balanced consideration of objectives, opportunities, and ineluctable trade-offs between the risks of actions and corresponding inactions. The results were lapses in both directions, greatly amplifying the pandemic toll. Persistence of this costly fractiousness is now spawning monocular critiques of the pandemic response, with neglect of essential nuance. There is a better pandemic that might have been, and the chance for far better responses to the next- but only if the follies of this history are lessons learned and applied. Failing that, the risk looms that having been amply forewarned of our liabilities, we will fail to be forearmed.

Purpose: As pandemic-related mistrust of public health recommendations in rural communities may compound gaps in pediatric immunizations, our team explored parents' perceptions of trustworthiness in messaging.

Design: Qualitative study using 4 virtual focus groups.

Setting: Rural Wisconsin.

Participants: Participants (n = 25) were parents or guardians of children recruited through our contacts with community-based organizations serving rural communities.

Methods: Researchers used task-oriented elicitation techniques to initiate discussion on the trustworthiness of messengers and messages providing health recommendations. Participants were asked to (1) review existing public health messaging on a range of topics and from a range of sponsors; and (2) rank a list of potential messengers in terms of trustworthiness (eg, local health department, Centers for Disease Control). Discussions were recorded, and audio files transcribed, to facilitate a team-based, thematic analysis.

Results: Competency in medical knowledge and parenting experience contributed to estimations of trustworthiness. Participants also responded well to messages and messengers that were able to project recognition of their children's uniqueness and their experience as parents. Participants distrusted messengers who were seen as biased or "one-sided" in their perspectives.

Conclusions: For successful health promotion for rural-living parents, messengers must be recognized as "competent" to provide pediatric health advice and to avoid blanket recommendations that may undermine parents' experience and feelings of being "understood" and affect perceptions of trustworthiness.

Purpose: To examine adolescents' perspectives regarding external and internal influences of the e-cigarette initiation process.

Design: Semi-structured, in-depth qualitative interviews.

Setting: California, remote videoconference.

Participants: Adolescents ages 13-17 who currently or previously used e-cigarettes (n = 47).

Method: Interviews occurred from May 2020-February 2021. Two researchers coded transcripts based on a codebook developed inductively. Coded excerpts were reviewed to identify encompassing themes related to adolescent e-cigarette initiation.

Results: Adolescents were often near e-cigarette use by peers, family members, and others, creating ample opportunities to try e-cigarettes in response to curiosity, peer pressure, and desires to cope with stress or belong to a group. Adverse first experiences were common (eg, throat irritation, nausea), but many adolescents vaped again or continued to use regularly in attempts to cement friendships or alleviate symptoms of stress and anxiety. Specific characteristics of e-cigarette devices, including low-cost, concealability, and variety in designs and flavors facilitated initiation, continued use, and nicotine dependence.

Conclusions: Adolescents progress to e-cigarette use via a multistage process, starting where social expectations and opportunity converge. While individual circumstances vary, many continue to vape as a perceived coping tool for emotional issues, to gain social belonging, or influenced by e-cigarette characteristics that contribute to ongoing use and dependence. Efforts to deter use should address the devices themselves and the social forces driving youth interest in them.

As Pride marches are celebrated globally in June, stigma and discriminatory laws against LGBTQ+ individuals remain prevalent in over a third of countries, potentially worsening health disparities among this population. Despite these challenges, notable progress has been made in Asia. Several countries have seen court rulings favoring LGBTQ+ rights, while the National Medical Commission of India has committed to ending conversion therapy, a harmful healthcare practice. As Asian nations advance and draw inspiration from their neighbors' successes, health practitioners, researchers, organizations, and institutions in the region can advocate for LGBTQ+ rights, offer targeted health services, and promote inclusive healthcare practices.

Purpose: Healthcare professionals experience stressors that begin during training and persist into their careers that adversely impact their well-being. This study aims to identify students' and professionals' stress levels, satisfaction with wellness domains, barriers to wellness, and stress management practices.

Design: This study was a cross-sectional self-reported survey study.

Settings and sample: The study included students (N = 242) and professionals (N = 237) from medicine, nursing, pharmacy, physical therapy, social work, and counseling/psychology.

Measures: The Managing Health & Wellness in Health Professions Training and Practice survey was used to capture wellness practices and barriers among participants. Results: Students reported significantly higher perceived stress compared to professionals (P < 0.001). Total wellness is significantly higher among professionals compared to students (P < 0.001). A higher stress rate is significantly related to being female, having a lower wellness score, and facing more barriers (P < 0.001). Intellectual health is the most valuable wellness domain for providers (M = 3.71, SD = 0.9) and students (M = 3.43, SD = 0.85), followed by spiritual health for providers (M = 3.4, SD = 1.1), and work/learning environment for students (M = 3.33, SD = 0.93). Professionals and students are least satisfied with their physical and financial health. Barriers include fatigue, workload/productivity in clinical practice, work hours, and burnout.

Conclusions: Healthcare professionals exhibit a variety of stress management practices, encounter barriers, and prioritize different wellness domains. Healthcare systems should incorporate self-care education into their curricula and implement systemic changes to foster a thriving healthcare workforce.

Purpose: State and local public health departments (LHDs) are encouraged to collaborate with community-based organizations (CBOs) to enhance communication and promote protective practices with communities made vulnerable during emergencies, but there is little evidence-based understanding of practical approaches to fostering collaboration in this context. This research focuses on how collaboration enhances LHD capacity for effective communication for people with limited English proficiency (LEP) during infectious disease outbreaks specifically and strategies to facilitate productive LHD-CBO collaboration.

Design: Qualitative, telephone interviews, conducted March-October 2021.

Setting: Rural and urban jurisdictions with Chinese-speaking or Spanish-speaking populations across the United States.

Participants: 36 LHD and 31 CBO staff working on outreach to Chinese and Spanish speakers during COVID-19.

Method: Interviews were audio-recorded, transcribed verbatim, and analyzed using a team-based, codebook approach to thematic analysis.

Results: During COVID-19, CBOs extended LHD capacity to develop and disseminate effective communication, meaning communication that is rapidly in-language, culturally resonant, locally relevant, and trusted. Practical strategies to enable and sustain effective collaboration were needed to address operational dimensions (eg, material and administrative) and relational dimensions (eg, promoting trust and respect).

Conclusion: Policies and financing to support LHD-CBO collaborations are critical to improving communication with people with LEP and addressing long-standing inequities in outcomes during outbreaks.

Objective: We conducted a systematic review of the literature on online health memes to (a) detect and describe the available research, (b) identify key findings, and (c) delineate future research needs/opportunities.

Data source: Databases, communication and public health journals, and ancestry search.

Study inclusion and exclusion criteria: Empirical studies, in English, published in peer-reviewed academic journals, and focused on memes to discuss health-related topics.

Data extraction: We scrutinized 357 empirical articles and included 35.

Data synthesis: Descriptive summary of the locations where studies were conducted, the health topics addressed, theories and methods used, features of memes analyzed, study outcomes, and researchers' challenges.

Results: Most studies were conducted in the USA (n = 14); focused on COVID-19 (n = 15); were a-theoretical (n = 19); and quantitative (n = 19). Most explored the themes and use of the memes available online (n = 19); compared meme variations (n = 12) by health issue, content, or participants' group; examined meme' effects on health outcomes (n = 1); or evaluated memes as part of a health campaign (n = 3). We summarized the studies' limitations and key findings.

Conclusions: Memes are a promising message strategy for health promotion and education, but more research is necessary. Considering the information retrieved, we provide five specific recommendations for future research directions when studying health memes, including suggestions on the multiple health issues to address and promising theories to adopt and expand.

Purpose: To inform food retail interventions, this study explored food shopping strategies employed by people constrained by limited budgets but residing in an urban environment offering numerous retail options.

Approach: Qualitative study incorporating semi-structured interviews and shop-alongs.

Setting: East Harlem, New York City.

Participants: 37 East Harlem residents participated in interviews, of whom 15 participated in shop-alongs.

Methods: Interviews and shop-alongs were conducted in English, Spanish, and Mandarin Chinese. Interview transcripts were analyzed using a grounded theory approach. Data from shop-alongs were used to supplement interview findings.

Results: Participants shopped 1-2 times at an average of 4 retail locations per week. Two key themes emerged: (1) planning trips and choosing venues; and (2) shopping experiences and perceptions of stores. Price was the primary driver of store choice, followed by product quality and variety. Substantial time was invested in shopping. Most English- and Spanish-speaking participants shopped in East Harlem. Chinese American participants shopped in Chinatown due to language concordance, availability of culturally-preferred foods, and proximity to other services.

Conclusion: East Harlem residents invested substantial planning, time and effort in food shopping to acquire sufficient food for their households on limited budgets. These findings offer insight into how residents interact with food environments and key drivers of decision-making about food shopping that affect decisions about where to shop and what to purchase.

Purpose: Many universities maintain pouring rights contracts (PRCs) with beverage companies wherein one company exchanges sponsorship payments for exclusive beverage marketing rights. Separately, universities may have healthy beverage initiatives (HBIs) to encourage healthier choices on campus. This study aimed to assess how and how frequently PRCs included provisions related to health and nutrition to examine how PRCs may support or undermine HBIs.

Design: Cross-sectional.

Setting: U.S. public universities with >20,000 students.

Sample: 131 PRCs obtained from 124 of 143 universities in 2019-2020.

Measures: Primary outcomes were the presence of provisions that could encourage or discourage promotion of healthy beverages (water, diet soda, unsweetened coffee or tea, and 100% juice), and any other provisions explicitly or implicitly referencing health or nutrition.

Analysis: Descriptive statistics.

Results: Twelve contracts (9%) had explicit commitments from the company or university to promote healthy beverages or adhere to nutrition standards, including five committing to support HBIs, four committing to healthy vending policies, and three describing activities to promote healthy beverage brands. Ten (8%) had provisions explicitly inhibiting water promotion and 55 (42%) had provisions that could be interpreted that way. Eleven (8%) included other health and nutrition provisions, such as funding for unspecified wellness activities.

Conclusion: Most university beverage contracts did not expressly aim to support healthy choices, and more than half had provisions potentially limiting universities' ability to implement HBIs. When present, nutrition standards were weak.

Purpose: To investigate whether changes in volunteering from adolescence to young adulthood are associated with subsequent health and well-being outcomes in adulthood.

Design: Longitudinal cohort study.

Setting: National Longitudinal Study of Adolescent to Adult Health.

Subjects: U.S. adults from Wave IV (2008/2009; N = 12,234) and Wave V (2016-2018; N = 9,971).

Measures: Any volunteering and nine types of volunteering (independent variables) and 41 health and well-being outcomes (dependent variables) using an outcome-wide approach with multiple linear-, logistic-, and generalized linear regressions.

Results: Volunteering in young adulthood was associated with better health behaviors (e.g., 34% decreased risk of binge drinking, 95% CI [0.54, 0.81]) and improved psychosocial and civic outcomes (e.g., lower depressive symptoms (β = -0.08, 95% CI [-0.14, -0.02]) in adulthood. Volunteering showed little evidence of associations with other health and well-being outcomes (e.g., loneliness, (β = -0.04, 95% CI [-0.09, 0.01])). Assessing volunteering by organization types showed a range of positive and negative outcomes. For example, volunteering in hospitals/nursing homes was associated with a 36% increased risk of high cholesterol (95% CI [1.06, 1.73]) and volunteering with political clubs was associated with a 52% increased risk of an anxiety diagnosis (95% CI [1.13, 2.05]).

Conclusion: Our findings suggest more work is needed to determine the conditions under which volunteering is health promoting and to minimize potential adverse effects associated with some types of volunteering.