American Journal of Health Promotion最新文献

Purpose: The use of cannabis is an important public health concern in the United States. The connection between perceived risk and cannabis use has been documented in the substance use literature for youth and adults.

Design: Examine how past 30-day cannabis use is influenced by the interaction between perceived risk and age.

Subjects: Nationally representative sample of individuals ages 12 and older in the United States.

Measures: Secondary data analysis of the 2021 National Survey on Drug Use and Health (N = 58, 034).

Analysis: Binary logistic regression that included the complex sampling elements of the survey.

Results: Support was found for an interaction between age and perceived risk. Most notably, the sharpest increase in the probability of cannabis use occurred between the 12-17 and 18-25 year-old age groups for no/low risk perception.

Conclusion: Addressing the perceived risk of cannabis use at younger ages - specifically adolescence - may be an important prevention strategy for later cannabis use. Results directly inform preventive interventions regarding by indicating the age groups that at are at a higher probability for using cannabis based on perceived risk levels. This study adds to the literature by directly testing an interaction between perceived risk and age on the probability of using cannabis in the past 30-days at the population level.

Purpose: Examining the associations between sleep duration and lifestyle risk factors and assessed whether sex modify such associations among U.S. adolescents.

Design: Cross-sectional study among high school students from the 2015-19 national Youth Risk Behavior Survey.

Setting: US, national.

Subjects: High school students grade 9-12 (n = 31 871).

Measures: Students reported hours of sleep on an average school night categorized into "less than 6 hours", "6 to 7 hours" and "8 hours and more". Lifestyle risk factors including physical inactivity, insufficient breakfast consumption, current tobacco use, and current binge drinking were self-reported and dichotomized.

Analysis: Multivariable logistic regression models were used to estimate associations between sleep duration and lifestyle risk factors, adjusting for confounders.

Results: Compared to students with 8 hours and more of sleep, students with 6 to 7 hours and less than 6 hours of sleep had 79% and 228% (P < .01) increased odds of insufficient breakfast consumption; and had 22% (P = 0.0014) and 74% (P < .01) increased odds of binge drinking, respectively. There is a significant interaction between sleep duration and sex (P < .05) for physical inactivity and current tobacco use.

Conclusion: Insufficient sleep is common among US adolescents and is associated with increased risks of multiple lifestyle risk factors, which suggests great needs for multilevel interventions to address sleep deprivation and promote good sleep hygiene among adolescents.

Purpose: This study estimated mandated physical education (PE) and physical activity (PA) time stipulated by state laws in public schools across the 50 States and the District of Columbia, and compared these times between states with and without specified mandates across education levels.

Design: Descriptive research.

Sample: State PE and PA regulation across 50 States and the District of Columbia.

Measures: Regulations were sourced from School Health Policy Database developed by the National Association of State Boards of Education State, Nexis Uni academic research database, Casetext, and state government websites.

Analysis: Frequency analysis and two-way analysis of variance were used to compare estimated PE and PA time between states with and without specific mandates.

Results: Across education levels, only 25.5% of the states mandated specific PA/recess time, 74.5% did not. About 51.0% mandated specific PE time, 45.1% mandated PE without specifying time, and 3.9% did not mandate PE. States with specified mandated PE and PA time averaged 76.54 and 131.41 minutes per week, respectively, showing significantly higher estimated PE and PA (P < 0.001) time compared to states without such mandates.

Conclusion: Many states mandate specific PA or PE times, but the average mandated time is significantly below the recommended 60 minutes of daily PA for school-aged children. This highlights the need to reassess current legislation to align with established recommendations.

Purpose: The purpose of this study was to (a) examine personal healthcare practices of rural medical providers by issue type (e.g., physical health, social health, or mental health), (b) identify perceived consequences of taking time off and (c) determine whether greater delay in self-care was associated with perceived stress and burnout.

Design: Electronic surveys were sent to 805 medical providers (response rate = 17.8%, n = 143).

Setting: The setting was a rural teaching hospital and affiliated community clinics.

Subjects: Participants included 143 rural medical providers.

Measures: The survey included demographic information, perceived personal health risk, and questions about delaying health care, and perceived consequences of receiving health care.

Results: Medical providers delayed mental health care needs significantly more than physical health needs, t₁₃₁ = 5.13, P < .01, d = .38. Respondents believed that there would be significantly more retaliation against them for taking time off for psychosocial issues, t₁₂₄ = -3.80, P < .001, d = .25. There was a significant negative association between burnout and physical health self-care (r = -.24, P < .01), psychosocial self-care (r = -.20, P = .01), and mental health self-care (r = -.23, P < .01).

Conclusions: Our study identified commonly reported consequences related to taking off work for care seeking behavior. Understanding perceived consequences can help guide health care organizations in dismantling these barriers. This study is limited by the generalizability of its sample.

Objective: To identify environmental features of multi-family housing (MFH) and their surrounding neighborhoods that influence residents' physical activity (PA).

Data source: Articles published between January 2000 and September 2023 were identified from major social science, medical, health, behavioral science, and urban studies databases.

Study inclusion and exclusion criteria: Studies were included if they (a) were empirical studies published in peer-reviewed journals and written in English; (b) focused on the MFH environment or the surrounding neighborhood; and (c) had at least one PA outcome.

Data extraction: Data was extracted regarding the study objective, location, study sample, research design, results related to MFH and neighborhood environment, and limitations.

Data synthesis: Descriptive summary of study characteristics and analysis to identify emerging themes at three spatial scales (i.e., building, site, and neighborhood).

Results: Findings from 35 identified articles revealed factors influencing MFH residents' PA. On the building level, typology (apartment, townhouse) and tenure (public, market rent) showed contrasting correlations with PA in different age groups. On the site level, the presence of PA facilities and safe, walking-friendly environments promoted PA. On the neighborhood level, safety, quality of PA and pedestrian infrastructure, upkeep, air quality, aesthetics, neighborhood satisfaction, street connectivity, walkability, land use mix, density, and public transport promoted PA.

Conclusion: Study findings highlight the importance of the MFH environments in promoting PA, especially in older adults and young children. With increasing housing demand, understanding diverse MFH typologies and the impact of interventions on multi-spatial scales can help promote healthy and activity-friendly communities.

Some have argued that nothing less than truth and freedom is on the ballot in the 2024 election. To be sure, fact checking politicians has become a commonplace element of vetting candidates for public service. This editorial reviews trends in the use of media to influence opinions and practices relating to health promotion and disease prevention. Has society been striking the right balance between protecting free speech while also holding individuals and organizations accountable when disinformation they promulgate causes harm? If we are to protect freedom of speech, one of America's hallmarks to democratic governance, health professionals need to develop more innovative and effective methods for curbing misinformation and for countering the ills created by super spreaders of misinformation.

Purpose: Social participation is vital for the health maintenance of general populations as well as the functional recovery and social ties of clinical patients. To develop a Social Participation Questionnaire (SPQ) to evaluate participation in social activities in an individual's life and to test the reliability and validity of the SPQ.

Design: Cross-sectional study.

Setting: Community and clinic in China.

Subjects: A total of 1419 healthy adults and 486 breast cancer patients.

Measures: The initial items were developed from a theoretical framework, a literature review, and Delphi expert consultation. Item analysis, exploratory (EFA) and confirmatory factor analysis (CFA), criterion validity, construct reliability, and internal consistency reliability were performed to examine the psychometric properties of the SPQ.

Results: The final SPQ was comprised of 11 different types of social activities, falling under the 3 dimensions of activities of daily life, sports and entertainment activities, and social service activities. EFA explained 50.674% of the total item variance contributing to the tool. CFA showed that the SPQ fit well. The total SPQ score was significantly associated with social network, quality of life, and cognitive function (r = |.180∼.466|, P < .001). The internal consistency coefficient was acceptable (range of Cronbach's alpha, .695 to .720).

Conclusions: The SPQ has robust properties, wide application, and provides a culturally relevant tool to evaluate the social participation of individuals, thus facilitating rigorous clinical and population-based research.

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.

What sense does it make to say that a new program implemented in a community with roots as old as evolution caused an observed health benefit? Evaluation of community approaches has often sought to isolate the causal roles of interventions. Central to this is the assumption that there are causes to be proven and isolated. Benedict Spinoza (1632-1677) dismissed the concept of cause, arguing that all things, "substances," are not caused but simply are. Actions of things in nature can influence each other, e.g., erosion of a mountain, but their substance, the mountains simply are. For Spinoza, satisfaction in life comes from realizing and acting in accord with our substance, but this requires communities that support such realization and action. Thus, communities and the vast influences they contain are central to human welfare. Interventions within them do not cause benefits but join with the history, culture, and numerous other features of the community in becoming part of how the community influences its members. Implications include a) expanding the social ecological model fully to embrace multiple influences - including innovative programs - and interactions among them, and c) varied research methods to identify practical lessons about how communities may adopt and incorporate innovations to engender change, rather than a catalogue of interventions that are supposed to change them.

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.