American Journal of Health Promotion最新文献

Purpose: Food pantries have provided nutrition education to promote healthy food choices with mixed outcomes. This study assessed the impact of Guided Stars food quality rating system to promote healthy food choices among food pantry clients.

Design: Randomized parallel-group study with balanced randomization.

Setting: A client-choice food pantry in a midwestern city.

Subjects: 613 food pantry clients.

Intervention: Clients were randomly assigned to a one-time treatment group (n = 330) where they received a nutrition information sheet with pantry foods ranked using the Guided Starts rating system, or a control group (n = 299) that did not receive this information.

Measure(s): Healthy food selection; food selection quality measured by a Healthy Index.

Analysis: Multiple linear regression models to estimate the effect of the intervention on the food choices of the food pantry client, accounting for potential confounders.

Results: Results showed a decrease (-.021, P < .05) in the selection of lower nutrition-rated food items, particularly among men.

Conclusion: Food-labeling nutrition education strategies could help promote healthy food choices at food pantries, especially among future-biased clients. However, an information-based intervention alone may not be enough to alter food choices in low-income populations.

Purpose: This study explored the association between diabetes education and self-management during different COVID-19 periods.

Design: Cross-sectional study.

Setting: Korea Community Health Survey (2019, 2021, and 2022) and the data from Korea Centers for Disease Control and Prevention Agency.

Participants: 78, 860 individuals with diabetes who participated in the 2019, 2021, and 2022 KCHS.

Measure: Diabetes education was categorized according to whether individuals received education on how to manage the disease. Diabetes self-management was assessed using self-checking and screening of HbA1c levels.

Analysis: Multiple logistic regression analysis and a subgroup analysis examined the regional impact of COVID-19 on this association.

Results: Participants who received education before and after COVID-19 were more likely to self-manage their diabetes than those without education (pre-COVID-19 aOR = 2.11, post-COVID-19, 2022 aOR = 2.04, and post-COVID-19, 2021 aOR = 1.94). Those in regions with lower COVID-19 incidence had slightly higher self-management rates (pre-COVID-19 aOR = 2.37; post-COVID-19 2022 aOR = 2.33; post-COVID-19 2021 aOR = 2.02) compared to participants in high-incidence regions (pre-COVID-19 aOR = 1.96; post COVID-19 2021 aOR = 1.89 and post COVID-19 2022 aOR = 1.89).

Conclusions: Diabetes education has a positive impact on self-management, which is especially important during public health crises such as the COVID-19 pandemic.

Purpose: Artificially Intelligent (AI) chatbots have the potential to produce information to support shared prostate cancer (PrCA) decision-making. Therefore, our purpose was to evaluate and compare the accuracy, completeness, readability, and credibility of responses from standard and advanced versions of popular chatbots: ChatGPT-3.5, ChatGPT-4.0, Microsoft Copilot, Microsoft Copilot Pro, Google Gemini, and Google Gemini Advanced. We also investigated whether prompting chatbots for low-literacy PrCA information would improve the readability of responses. Lastly, we determined if the responses were appropriate for African-American men, who have the worst PrCA outcomes.

Approach: The study used a cross-sectional approach to examine the quality of responses solicited from chatbots.

Participants: The study did not include human subjects.

Method: Eleven frequently asked PrCA questions, based on resources produced by the Centers for Disease Control and Prevention (CDC) and the American Cancer Society (ACS), were posed to each chatbot twice (once for low literacy populations). A coding/rating form containing questions with key points/answers from the ACS or CDC to facilitate the rating process. Accuracy and completeness were rated dichotomously (i.e., yes/no). Credibility was determined by whether a trustworthy medical or health-related organization was cited. Readability was determined using a Flesch-Kincaid readability score calculator that enabled chatbot responses to be entered individually. Average accuracy, completeness, credibility, and readability percentages or scores were calculated using Excel.

Results: All chatbots were accurate, but the completeness, readability, and credibility of responses varied. Soliciting low-literacy responses significantly improved readability, but sometimes at the detriment of completeness. All chatbots recognized the higher PrCA risk in African-American men and tailored screening recommendations. Microsoft Copilot Pro had the best overall performance on standard screening questions. Microsoft Copilot outperformed other chatbots on responses for low literacy populations.

Conclusions: AI chatbots are useful tools for learning about PrCA screening but should be combined with healthcare provider advice.

Synopsis: Social determinants of health (SDOH), such as food security and healthcare access, are key to maintaining and improving health. Publicly funded safety-net programs, such as Medicaid and the Supplemental Nutrition Assistance Program, address SDOH. Many low-wage employees are program-eligible, but there are substantial participation gaps. Providing information and assistance boosts program participation, and there are third-party organizations ready to aid employers in doing so. In an ideal world, everyone with a job would have the resources to thrive on their pay and benefits, but many do not. Employers could help bridge these gaps via promoting these programs via the workplace.

Purpose: To investigate how media literacy and varied media consumption influenced substance use behavior.

Design: A cross-sectional survey was conducted.

Setting: Online survey was conducted June 22-July 18, 2020, with quality checks.

Subjects: The study recruited U.S. residents aged 18 and older who were proficient in English (N = 1264). Panel sampling using quotas reflecting U.S. census was employed as an alternative to random digit dialing sampling.

Measures: Substance use behavior, media literacy for news, liberal media use, conservative media use, social media use, and demographics were assessed.

Results: Hierarchical multiple regression analysis was conducted. Media literacy for news was negatively associated with substance use (β = -.15, SE = .08, P < 0.01, [95% CI: -.36, .06]) and interaction effect between social media use and media literacy for news on substance use behavior was significant (β = .47, SE = .05, P = 0.02, [95% CI: .02, .20]) in the final model (F(12, 1207) = 33.21, R² = 25%).

Conclusions: Media literacy for news has a negative association with substance use behavior. Social media use, specifically, diminishes the effect of media literacy skills on substance use behavior. The prediction is based on correlational data. Further investigations are required to examine how individuals' specific patterns of media use impact substance use behavior as part of media literacy intervention efforts.

PurposeSocial support, particularly from family, is crucial for physical activity (PA) among youth. This study examined the association between father support and moderate-to-vigorous physical activity (MVPA) in Latina pre-teens and explored the moderating role of body mass index (BMI).DesignCross-sectional analysis.SettingBaseline data from a pilot randomized controlled trial in San Diego County. SubjectsSixty Latina pre-teen girls aged 8-11 years.MeasuresGirls' MVPA was measured via accelerometry. An exploratory factor analysis created a composite measure of father support, reported by mothers.AnalysisHierarchical linear regression models, adjusting for covariates, assessed the relationship between father support and MVPA. Interaction models tested the moderating effect of BMI z-score (zBMI).ResultsFather support was significantly associated with MVPA (b-range = 0.07 to 0.08, 95%CI = 0.02, 0.13) after adjusting for age, income, acculturation, and maternal support. However, this association became non-significant with the inclusion of zBMI (b = 0.06, 95%CI: -0.01, 0.11). The interaction model showed a significant positive association between father support and MVPA among girls with a healthy weight (b = 0.27, 95%CI: 0.27, 2.68) but not among those with overweight/obesity (b = 0.95, 95%CI: -0.38, 2.28).ConclusionOur findings indicate a potential association between father support and daughters' MVPA among girls with a healthy weight. Further research is needed to understand why this association is not observed in girls with overweight/obesity.

Purpose: To examine associations between identified factors to accessing Food and Drug Administration-approved quit medication (FDAQM) and use among a sample of tobacco users.

Design: Cross-sectional, online survey.

Setting: County in Central California.

Subjects: Current adult tobacco users (n = 76).

Measures: Demographics self-reported likelihood of quitting in the next month, contacting a healthcare provider about quitting, time since last healthcare visit, provider asking about tobacco/nicotine use, provider advice to quit, provider FDAQM prescription and FDAQM use in the past year.

Analysis: Logistic regression.

Results: Those with a higher likelihood of quitting had a lower odds of FDAQM use (OR = 0.15, 95% CI = 0.03, 0.73) while those who had contacted a healthcare provider had a higher odds (OR = 15.39, 95% CI = 2.72, 87.05).

Conclusion: While the sample was limited, this research provides evidence in an understudied tobacco cessation area. More work is needed to understand the generalizability of these results and develop interventions that address these factors.

Purpose: Examine whether baseline participant characteristics predict engagement in a movement-based RCT for chronic low back pain (CLBP).

Design: Longitudinal study within an RCT.

Setting: Online.

Subjects: 138 individuals with CLBP (18-79 years).

Intervention: Participants were randomized to a 12-week intervention of twice-weekly synchronous online yoga OR stretching/strengthening classes, and received 20-min pre-recorded home videos to complete daily.

Measures: Baseline questionnaires assessed sociodemographic, psychosocial, and pain factors (100% response rate). Engagement was operationalized as minutes of class attended + minutes of home videos completed.

Results: Bivariate correlations were computed between baseline variables and engagement. Three multivariate negative binomial generalized linear models (GLMs) were constructed to simultaneously examine predictors of engagement in the domains of sociodemographic, psychosocial, and pain-related factors. Greater engagement was significantly associated with greater baseline age, educational attainment, energy, and emotional well-being, and less emotion regulation difficulties, cannabis use problems, and pain interference (|rs| = .19-.33). In the domain specific GLMs, education (B = .491, P = .017) and cannabis use problems (B = -.048, P = .027) were the only significant predictors in the sociodemographic and psychosocial models, respectively. Neither pain interference nor pain severity were significant in the pain model.

Conclusion: Factors identified can inform strategies to increase engagement in movement-based CLBP interventions, potentially improving research validity and outcomes. Limitations include lack of racial diversity and not testing how engagement fluctuates throughout the intervention.

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.