American Journal of Health Promotion最新文献

Purpose: Understanding disease prevalence can inform treatment and resource needs across populations. This study aimed to identify the prevalence of sleep apnea (OSA) among veterans and nonveterans.

Design: The national Comparative Health Assessment Interview Study, cross-sectional survey using probability-based sampling frames.

Setting: Surveys completed by Internet or phone.

Subjects: 15,166 veterans (40% response rate) and 4,654 nonveterans (57% response rate).

Measures: Self-report of healthcare provider-based diagnosis of OSA.

Analysis: Calculation of prevalence of OSA using statistical weighting to allow for direct comparison between veterans and nonveterans. Secondary analyses evaluated OSA by deployment status among veterans and compared average age of OSA diagnosis and differences in OSA prevalence among veterans and nonveterans stratified by gender, marital status, race/ethnicity, and posttraumatic stress disorder diagnosis.

Results: OSA diagnosis was more than twice as prevalent among veterans (21%, 95% CI 20%-22%) than nonveterans (9%, 95% CI 8%-10%; aOR: 2.56, 95% CI 2.22-2.95, P < .001). Deployment was associated with higher odds of OSA among veterans (aOR: 1.64, 95% CI 1.43-18.7, P < 001.) Veterans were diagnosed with OSA on average 5 years earlier than nonveterans.

Conclusion: Veterans have a high prevalence rate of OSA, highlighting the importance of veterans' access to treatment. OSA is likely underdiagnosed in nonveterans, particularly among racial/ethnic minoritized groups. Future research should investigate disparities in access to diagnostic testing for racial/ethnic minority nonveterans and/or risk factors for OSA among racial/ethnic minority veterans. The increased odds of OSA among those with PTSD highlights in the importance of early referral for OSA testing by providers as well as development of trauma-informed strategies to promote OSA treatment adherence. Limitations include a bias toward underestimation of true disease prevalence due to self-report of diagnosis.

Objective: This systematic review and meta-analysis aimed to evaluate the vitamin B12 status and intake of Seventh-day Adventists following a plant-based diet and compare it with omnivore controls to investigate their susceptibility for vitamin B12 deficiency.

Data source: Peer-reviewed articles were identified through a comprehensive search in PubMed, Scopus, and Google Scholar databases from inception up to the year 2024 using specific keywords related to vitamin B12 and Seventh-day Adventists.

Study inclusion and exclusion criteria: Observational studies published in the English language were included if they reported on vitamin B12 status or intake among plant-based Adventists and compared it with omnivore controls who may or may not have been Adventists. Studies that did not present distinguishable results for vegetarian/vegan from omnivore Adventists or only reported on food item intake without specific vitamin B12 data were excluded.

Data extraction: Two independent reviewers extracted data on study characteristics, vitamin B12 intake, and serum levels using a customised data extraction form, resolving discrepancies through consultation with a third reviewer.

Data synthesis: A meta-analysis was conducted using random-effect models due to anticipated heterogeneity, without any subgroup analysis due to the low number of studies. Sensitivity analysis was performed using the 'leave-on-out' method to assess individual study influence on overall effect size and heterogeneity.

Results: Four studies met inclusion criteria, encompassing 1994 participants. Meta-analysis showed no significant differences in serum vitamin B12 levels (MD: -9.85 pmol/L; 95% CI: -45.64 to 25.94 pmol/L; P = 0.54, I² = 50%) or daily intake (MD: 3.31 mcg/d; 95% CI: -4.70 to 11.32 mcg/d; P = 0.42, I² = 90%) between plant-based Adventists and omnivore controls, although there was high heterogeneity between the studies.

Conclusion: Adventists following a vegan or vegetarian diet did not demonstrate increased risk of vitamin B12 deficiency due to the widespread consumption of fortified foods and supplements. The findings underscore the importance of supplementation and the consumption of fortified foods for maintaining adequate B12 status among vegan or vegetarian Adventists but highlight the need for further studies to confirm these observations in diverse geographical areas.

Purpose: To examine user experiences in a moderated Facebook group intervention aimed at Coronavirus disease 2019 (COVID-19) vaccine promotion.

Design: Facebook group members were given 2-3 vaccination posts/day for 28 days (four weeks). Posts were aimed at educating about COVID-19 vaccination, soliciting concerns around COVID-19 vaccination, and engaging members. Participants were surveyed about their experience at four weeks.

Setting: Moderated Facebook group.

Participants: Unvaccinated individuals who were randomized to the intervention group and completed four week follow-up (N = 216, 82.1%).

Method: After four weeks, participants rated their experience in the Facebook group (eg, program satisfaction) and provided open-text responses about their satisfaction with the group. Free-text responses were dual coded and emergent themes were examined.

Results: On average, participants were 37.0 years old (SD = 10.3), majority female (70.9%), and white (79.7%). The majority of participants were satisfied with the group (76.7%), agreed that other people were friendly (M = 5.58/7), and felt safe discussing health information (M = 3.96/5). Open-text responses revealed that participants liked the program because they thought the information was useful (27.7%), other members were friendly (16.1%), and the group was a safe place (13.8%). While many responded that there was nothing they did not like about the program (37.6%), nearly one-third (31.9%) reported disliking the program because it appeared to be too much in favor of vaccination and because other members came across as rude (7.1%). Those with conservative political views were less likely to be satisfied with the group (P = .04).

Conclusion: Facebook groups represent an acceptable way to engage participants to improve vaccination against COVID-19. Some aspects of the Facebook group could be improved for future iterations.

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.

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.

Objective: The purpose of this scoping review is to identify strategies from existing literature, for school-based professionals to share with parents, that may be used on a family-level to help the recovery from the effects of the COVID-19 pandemic on pediatric mental health.

Data source: This scoping review consists of a comprehensive PubMed, CINAHL, and Google Scholar database search.

Study inclusion and exclusion criteria: Studies published between 2020 and 2023 that were written in English, originated in the United States, and evaluated pediatric mental health in the context of the COVID-19 pandemic were considered for inclusion in the scoping review.

Data extraction and data synthesis: One researcher independently conducted the PubMed, CINAHL, and Google Scholar literature search. Subsequently, results were reviewed independently by two additional researchers.

Results: Title and abstract review were conducted for 2563 articles. After excluding studies not written in English, studies with international origin, and studies which were not relevant to this scoping review, 101 studies remained for full-text review. After full-text review, 32 studies (31.68%) were deemed relevant and concordant with the inclusion criteria and were included in this scoping review. We identified five prominent themes: 1) maintaining daily life and routines, 2) the importance of physical activity and the pandemic's effect on student athletes' mental health, 3) the use of screen time, 4) the effect of parent and caregiver stress on their children's mental health, and 5) the effect of pandemic-related health disparities and racism on pediatric mental health.

Discussion: This scoping review focused on interventions and practices which can be implemented at the family level to help children and adolescents recover from the effects of the COVID-19 pandemic on their mental health.

Objective: Understand parental perceptions of beverages and factors influencing the beverage choices they make for their children.

Data source: A literature search was conducted using PubMed, Scopus, and CINAHL.

Study inclusion and exclusion criteria: Included studies contained qualitative data examining parents' perceptions of beverages or factors that influence their child's beverage consumption, were conducted in the United States between 2000 and 2022, written in English, and enrolled parents of children aged 18 years or younger.

Data extraction: Authors, titles, study aims, methods, qualitative results, and representative quotations were extracted using Covidence.

Data synthesis: Qualitative findings were independently coded by two coders. Codes were compared and discrepancies resolved through discussion with a third team member. Themes and sub-themes were identified, and representative quotations selected.

Results: 13 studies met inclusion criteria. Five major themes emerged: 1) factors that influence parents' provision of beverages to their children, 2) parents' concerns about sugar-sweetened beverages (SSBs), 3) barriers to limiting children's SSB consumption, 4) strategies to lower children's SSB consumption, and 5) parents' perceptions of beverage healthfulness.

Conclusion: Though most parents are aware of unfavorable health effects of frequent SSB intake, environmental and sociocultural factors pose barriers to limiting their child's SSB consumption. Changes to policy and the food environment are needed to initiate and sustain reductions in SSB intake, along with continued nutrition education efforts.

Purpose: There is a need to gain a deeper understanding of facilitators and barriers involving lifestyle behaviors among newly diagnosed breast cancer patients. Design: Research team explored influences (e.g., social, cultural, environmental) for healthy lifestyle behaviors (nutrition, physical activity (PA), and self-care).

Method: One researcher conducted semi-structured interviews. Qualitative data were analyzed through content analysis. Demographic data were collected via survey, and descriptive statistics were generated.

Setting: Patients were recruited, and interviews conducted via Zoom or phone.

Participants: Twenty-eight newly diagnosed, treatment naïve breast cancer patients were interviewed, a majority were non-Hispanic White women (n=23; 82%) with invasive (n=14; 50%) breast cancer.

Results: Themes related to nutrition, PA, and self-care emerged, including influences (e.g., environmental, cultural, social), barriers, facilitators, and lived experiences. Most patients stressed the importance of maintaining healthy eating habits (n=23), and some were interested in understanding the relationship between nutrition and cancer (n=7). Sixteen reported sustaining their PA levels, while others (n=11) explained barriers, such as time, distance, and pain. All patients reported utilizing self-care strategies, and most reported increased engagement in self-care since being diagnosed (n=14).

Conclusion: This study sheds light on factors influencing and hindering the adoption of healthy eating, PA, and self-care strategies among newly diagnosed breast cancer patients. The findings reflect the importance of healthy lifestyle behaviors as critical areas for upstream intervention.

Purpose: Examine the prevalence of and characteristics related to COVID-19 vaccine uptake.

Design: Quantitative and qualitative data collected at two-time points via phone interviews.

Setting: Rural Midwestern communities.

Sample: 109 Latina mothers with incomes < 185% FPL, at least one child < age 12 recruited from a Midwestern state based on two previous studies.

Measures: Mothers responded to the following variables through a survey: Vaccine uptake measured by responses to, Have you received a vaccination shot for COVID-19. Tested predictors of vaccine uptake included: income, gender, education, immigration status, confidence in vaccine, belief the pandemic is over). Mothers' perspectives regarding the vaccine explored via responses to Why haven't you received COVID-19 vaccine?.

Analysis: Binary logistic regression analysis was conducted. Demographic variables and attitudes toward the vaccine served as predictors of mothers' vaccine uptake. Qualitative data were analyzed to shed light on mothers' perspectives on receiving the vaccine.

Results: Mother's confidence in the vaccine predicted vaccine uptake in 2021 (aOR=1.332, 95% CI: 1.07-1.65) and 2022 (aOR=1.48, 95%CI: 1.11-1.97). In 2021, income also predicted vaccine uptake (aOR=1; 95% CI: 1-1.002). Overarching themes: "vaccination is not necessary","mistrust of the vaccine", and "vaccine as protector".

Conclusion: Vaccinated mothers viewed the vaccine as a protection from being infected or gravely ill. For unvaccinated mothers, messages are needed that communicate the vaccine can protect them from virus transmission from household members who unknowingly are infected, as well as from different virus strains.

Purpose: This study aimed to explore associations of sociodemographic factors with difficulties in three health literacy (HL) skills and the severity of low HL skills.

Design: Cross-sectional secondary data analysis. Subjects: Data came from 17,834 adults who responded to the HL module with a response rate of 47% in the 2016 Behavioral Risk Factor Surveillance System.

Measures: Independent variables included sex, age, race/ethnicity, education, employment and income. Dependent variables are three HL skills: obtaining, understanding oral, and understanding written health information.

Analysis: We conducted weighted Chi-square tests and multinominal logistic regressions.

Results: Cancer survivors younger than 65 (aged 18-39: AOR = 4.46, P < .001; aged 40-64: AOR = 2.29, P < .001), Hispanic (AOR = 2.17, CI = 1.61-2.50, P < .01) had higher odds of difficulty obtaining health information. Female cancer survivors had lower odds of difficulty comprehending oral (AOR = .69, CI = .55-.87, P < .01) and written (AOR = .58, CI = .46-.74, P < .001) information. The relative risk ratio of having difficulties in three HL tasks was higher for those who were younger than 65 (aged 18-39: RRR = 10.18, CI = 2.41-4.3, P < .01; aged 40-64: RRR = 4.01, CI = 2.09-7.69, P < .001), Hispanic (RRR = 3.24, CI = 1.66-11.34, P < .01), unemployed (RRR = 6.1, CI = 2.88-12.76, P < .001), education levels lower than some college (some high school: RRR = 4.34, P < .01; high school: RRR = 2.62, P < .05) and household income under $25,000 (RRR = 6.99, CI = 2.8-17.5, P < .001).

Conclusion: Intervention and communication materials need to be tailored for patients with different HL skills considering age, gender, socioeconomic status and cultural backgrounds.