American Journal of Health Promotion最新文献

PurposeOf the 88 million American adults with prediabetes, 1.5 million transition to type 2 diabetes annually. Lifestyle changes could delay progression to type 2 diabetes development. Glycemic Excursion Minimization/Glucose Everyday Matters (GEM) is a self-guided intervention that empowers individuals via a guide paired with a continuous glucose monitor and activity monitor to understand how dietary and activity choices impact their blood glucose excursions. This qualitative study aimed to explore participant perspectives and experiences of GEM.DesignSemi-structured qualitative interviews.SettingThe study was conducted at an urban medical center. Interviews took place via HIPAA compliant Zoom.ParticipantsParticipants from a larger clinical trial who completed the GEM intervention for prediabetes (n = 16).MethodInterviews were audio-recorded and transcribed. Using two coders, iterative cycles of inductive thematic analysis was performed to yield overarching themes related to the GEM guide and intervention.ResultsAnalysis of 16 interviews revealed five major themes which highlighted the positive outcomes in health status, disease insight and support experienced during the GEM trial.ConclusionKey findings included increased knowledge on the relationship between lifestyle choices and glucose excursions, and positive insight on the GEM intervention and its components. Feedback from this study will be incorporated into further adoption of the GEM intervention for a prediabetes population.

PurposeTo develop a cross-cultural adaptation and analyze evidence of content validity of the 2019 CDC Worksite Health ScoreCard (WHSC) for use in Brazil.DesignPsychometric study conducted according to international guidelines for cross-cultural adaptation and evidences of validity.SettingBrazil, November to December 2023.SampleFive independent bilingual reviewers evaluated linguistic equivalence; 18 experts in occupational health or psychometrics assessed content validity (response rate 52.9%); 10 occupational health and safety professionals participated in cognitive testing with gender parity.MeasuresSemantic, idiomatic, conceptual, and experiential equivalences; clarity, practical and theoretical relevance, and dimensionality of items.AnalysisContent Validity Ratio (CVR) was applied, with critical values ranging from 0.44 to 0.50; qualitative thematic analysis was performed on cognitive testing.ResultsInitial evaluations identified items with CVR <0.99 due to clarity issues, which were revised. In content validity assessment, CVR values ranged from 0.80 to 1.00 across all items, confirming acceptable agreement among experts. Cognitive testing confirmed comprehension and cultural adequacy, with participants suggesting inclusion of diversity-related items in future versions.ConclusionsThe Brazilian Portuguese version of the WHSC demonstrated strong linguistic quality and evidence of content validity with adequate clarity and cultural relevance for electronic administration. Limitations include reliance on a convenience sample of experts and the need for further evaluation of additional psychometric properties, such as internal structure and reliability.

PurposeTo examine demographic, socioeconomic, and family characteristics associated with elevated depression and anxiety symptoms and frequent loneliness among US adults with children.DesignCross-sectional survey.SettingUS Census Household Pulse Survey (July-September 2024).SubjectsUS adults with 1 or more children (0-17 years) in their household (N = 31 063, representing approximately 87 million US adults with children).MeasuresParticipants completed the Patient Health Questionnaire for Depression and Anxiety (PHQ-4); scores of 3+ out of 6 indicated elevated depression and anxiety symptoms, respectively. Participants reported how often they feel lonely. Frequent loneliness was indicated by responses of "always" or "usually" (versus "sometimes", "rarely", or "never"). Participants reported several demographic, socioeconomic, and family characteristics.AnalysisWe used unadjusted logistic regression models to compare the proportion of US adults with children experiencing elevated depression symptoms, elevated anxiety symptoms, or frequent loneliness by demographic, socioeconomic, and family characteristics. Analyses were weighted to represent US adults living with children.ResultsAmong US adults with children, 14.2% (SE: 0.4%) reported elevated depression symptoms, 19.2% (SE: 0.5%) reported elevated anxiety symptoms, and 13.5% (SE: 0.4%) reported usually or always feeling lonely; prevalences differed by several demographic, socioeconomic, and family characteristics.ConclusionsCollecting nationally-representative data about families is critical to inform efforts to support the mental and physical health of US parents and other adults who care for children.

PurposeDescribe perceived impact of a 6-week community-based physical activity (PA) intervention on adult participants' PA knowledge and behaviors.DesignQualitative Case Study.SettingUnder-resourced Michigan communities.ParticipantsAdults (n = 26) aged 18-85 years represented urban (n = 11), suburban (n = 7), and rural (n = 6) environments, and diverse identities by race (n = 3 did not respond) White (46%, n = 11), African American (38%, n = 9), American Indian/Native American (4%, n = 1) and by intellectual or developmental disability (n = 7).InterventionRec-Connect™: A Physical Activity Demonstration Playbook.MethodSemi-structured focus groups (n = 3, n = 26 participants). Surveys measured knowledge and behavioral outcomes.Data CollectionFocus groups were conducted in person (n = 2) or over telephone (n = 1). Surveys were disseminated pre-post completion of at least 6 lessons of the intervention series; pre-post participant surveys were matched with focus group participants (n = 12).AnalysisHybrid analysis was used to generate themes from transcripts. Descriptive statistics were summarized from surveys.ResultsAnalysts generated 3 primary themes which demonstrated Rec-Connect's impact on PA behavior changes: 1) leveraged connections promoted PA outside of class, 2) educators are key to attitudes on PA and time spent in PA, and 3) multi-level (ie, socio-emotional-physical) behavior change impacts were achieved.ConclusionThis community-based PA intervention had multi-level impacts on adult participants. The socio-emotional connections made during Rec-Connect between educators and peers positively influenced time in and attitudes towards PA.

PurposeTo compare correlates of mental distress among non-professional caregivers vs non-caregivers and evaluate trends in non-professional caregivers' mental distress pre-vs COVID-onward.DesignCross-sectional study.SettingWe used nationally representative data from multiple cycles of the Health Information National Trends Survey (HINTS) from 2018 to 2022.Subjects15 318 participants age 18 and older were included, comprising non-professional caregivers (n = 1387) and non-caregivers (n = 13 931). Professional caregivers and caregivers of child (ren) were excluded from this study.MeasuresThe outcome (mental distress) was categorized based on the Patient Health Questionnaire-4 (PHQ-4) score. Caregivers were identified as those indicating that they provide care or make health care decisions for someone in a non-professional way.AnalysisWe analyzed the association between caregiving status and mental distress pre-COVID and COVID-onward and examined correlates of caregivers' mental distress pre-COVID and COVID-onward through logistic regression models.ResultsCaregivers reported a higher mean PHQ-4 score than non-caregivers overall (|t| = 4.81, P < .001). Caregiving status was significantly associated with mental distress pre-COVID (OR = 1.47; 95% CI = 1.13-1.92; P < .01) and COVID-onward (OR = 1.51; 95% CI = 1.01-2.26; P < .05). Being in fair or poor health status was associated with a higher likelihood of mental distress pre-COVID (OR = 2.58, 95% CI = 1.31-5.09, P < .01), while having a college education or higher was associated with a lower likelihood of mental distress COVID-onward (OR = 0.46, 95% CI = 0.21-0.99, P < .05).ConclusionCaregiving continues to present significant risks for mental distress. The COVID-19 pandemic may continue to present risks to caregivers' mental well-being, requiring policies and programs to improve caregiver mental health.

The internet has been a powerful tool in democratizing information, but its omnipresence has all but assured its omnipotence. This editorial challenges health promotion professionals to consider how their use of social media is, or is not, advancing quality and professional development in our discipline. Leading health promotion experts contributed recommendations of media sites they consider relevant, credible and worthy of the ever-shrinking time professionals have available for learning, networking and personal renewal.

PurposeUnderstanding reactions to health communication campaigns is essential to designing effective messaging. Multi-year campaigns through The Helping to End Addiction Long-term^® Initiative (HEALing) Communities Study (HCS) were implemented from April 2020 - June 2022. Responses to HCS campaign messages and statewide campaign messages were evaluated.DesignCross-sectional, self-reported surveys of different respondents at 3 timepoints.SettingN = 33 communities across Kentucky, Ohio, Massachusetts, and New York.SubjectsN = 2368 respondents recruited from Facebook/Instagram.MeasuresMessage acceptability survey items assessed attention, understandability, and visuals/text match. Message influence items assessed whether the message made the respondent want to carry naloxone, learn more about medications for opioid use disorder (MOUD), or seek help for OUD. Items were scaled from 1 (strongly disagree) to 5 (strongly agree).AnalysisAll outcomes were analyzed using linear mixed models adjusted for community as a random effect.ResultsAmong naloxone campaigns, HCS message acceptability was higher than statewide messages (3.98, 95% CI = 3.94-4.02 vs 3.93, 95% CI = 3.89-3.97, P = 0.002). HCS message influence was also higher than those of statewide messages (3.44, 95% CI = 3.38-3.50 vs 3.40, 95% CI = 3.34-3.46, P = 0.034). Among HCS campaigns, naloxone messaging had the highest acceptability (3.96, 95% CI = 3.92-4.00), followed by MOUD stigma (3.73, 95% CI = 3.70-3.77) and MOUD awareness (3.71, 95% CI = 3.68-3.75, P < 0.001). The HCS naloxone campaign was also highest rated in terms of influence (3.47, 95% CI = 3.43-3.51, P < 0.001).ConclusionThis analysis provides insight into acceptability and potential influence of locally-tailored, opioid-related health campaign messaging.This work was performed under the HEALing Communities Study, ClinicalTrials.gov Identifier: NCT04111939, https://clinicaltrials.gov/study/NCT04111939.

Synopsis: Peer support can promote friendships and social connections for the one in 8 American men for whom loneliness is a barrier to health and well-being. Community-funded for more than 10 years, Face It Foundation has supported, without fees, more than 1600 men with nearly 125 000 hours of peer-led support. Approximately 70% of the men are referred by a mental health professional. Face It also produces a monthly men's breakfast, ongoing classes, a retreat center, podcasts, and crisis intervention. At scale, this peer-support model could meet a need that complements psychotherapy services by promoting the development of friendships and social connections.

Much has been written about the well-being of healthcare employees; the COVID-19 pandemic brought these issues into acute focus. Literature supports that partnerships among professional organizations, healthcare systems, governments, and universities can enhance healthcare worker and trainee well-being and retention. The author continues to follow the progress of a healthcare system dealing with the stress, guilt, grief, and burnout stemming from effects of a pandemic. This article discusses participation in two national initiatives that foster clinician resilience and well-being.

PurposeThe South Carolina Choose Well contraceptive access initiative launched a statewide media campaign, No Drama, in 2018. We evaluated the reach and effectiveness of No Drama and provided recommendations for future campaigns.DesignA convergent mixed methods design triangulated data collected between 2018 and 2021 from (1) surveys of women of reproductive age seeking care at Choose Well-participating clinics in South Carolina (n = 908); (2) interviews with clinic staff (n = 100); and (3) metrics about statewide utilization of the campaign.SettingCommunity - No Drama was implemented in communities across South Carolina. Clinical - Research data were collected at family planning (health department and federally qualified health center) clinics.MeasuresExposure to and reported effectiveness of the campaign in encouraging contraceptive appointments and contraceptive use were examined. Clinic staff perceptions of campaign strengths and areas for improvement were also explored.AnalysisModified Poisson regression models with Generalized Estimating Equations, and inductive coding with content analysis, were used to analyze survey and interview data, respectively. Contraceptive appointments requested through No Drama were examined.ResultsNo Drama produced nearly 22 000 contraceptive appointment requests between 2018 and 2021. One-third of reproductive-age patients at Choose Well-participating clinics reported exposure to the campaign. Exposure differed by race/ethnicity and educational attainment of patients. Nearly half (46%) of exposed patients found the campaign very effective at encouraging contraceptive appointments. Perceiving the campaign as very effective in encouraging contraceptive counseling appointments and encouraging contraceptive use was associated with the frequency of exposure. Clinic staff reported that the campaign had widespread visibility and connected patients to clinics.ConclusionNo Drama reached a portion of its intended audience and facilitated access to contraceptive care among exposed people. Future campaigns may consider increasing the rate of advertisements, ensuring clear messaging, involving community partners in campaign design, and diversifying campaign materials and locations.