American Journal of Health Promotion最新文献

Objective: The concept of self-efficacy is a determining factor in many behaviours related to health promotion and health education. Several pilot studies have been conducted in different parts of the world on different populations regarding the impact of training based on the Pender Health Promotion Model on self-efficacy, yielding conflicting results. Therefore, the present systematic review and meta-analysis were conducted with the aim of evaluating and summarizing the results of studies on the impact of training based on the Pender Health Promotion Model on self-efficacy.

Data source: MagIran, SID, PubMed, Embase, Web of Science (WoS), Scopus and Google Scholar.

Study inclusion and exclusion criteria: Original scientific research articles; Interventional studies; Studies investigating the effects of education based on the Pender Health Promotion Model on self-efficacy; Studies irrelevant to the objective; Cross-sectional studies; case reports; and papers presented in conferences; letters to the editor; systematic and meta-analysis studies.

Data extraction: Two independent reviewers extracted data and assessed the quality of the 18 included studies using a pre-prepared checklist for the systematic review and meta-analysis process.

Data synthesis: We conducted meta-analyses and reported the characteristics, outcomes, and risk of bias of studies.

Methods: The present study was conducted according to PRISMA guidelines until December 2022. The quality assessment of the included articles for meta-analysis was performed using the JBI checklist. Heterogeneity of the studies was calculated using the I² statistics, and Egger's regression intercept was used to assess publication bias.

Results: In the initial search, 13,943 studies were found, and after excluding studies irrelevant to the research objective, a total of 18 articles were included in the meta-analysis. These articles represented a sample size of 1015 individuals in the intervention group and 999 individuals in the control group. The combined results of the studies showed a significant increase in self-efficacy in the intervention group when compared to the control group (1.788 ± .267; CI: 95%, P < .001). With an increase in the year of study and the quality assessment score of the articles, the effect of the intervention decreased (P < .001).

Conclusion: The results of this study indicated that training based on the Pender Health Promotion Model significantly increased self-efficacy. Therefore, it seems that training based on this model can have positive effects on individuals' self-efficacy.

Purpose: Examine trust in sources of COVID-19 information and vaccination status.

Design: Cross-sectional.

Setting: Chicago, Illinois.

Subjects: Convenience sample of 538 Black adults surveyed between September 2021 and March 2022.

Measures: Trust in sources of COVID-19 information, COVID-19 vaccination.

Analysis: Using latent class analysis, we identified classes of trust in sources of COVID-19 information. We considered predictors of class membership using multinomial logistic regression and examined unadjusted and adjusted associations between trust class membership and COVID-19 vaccination while accounting for uncertainty in class assignment.

Results: Our analytic sample (n = 522) was predominantly aged 18-34 (52%) and female (71%). Results suggested a four-class solution: (1) low trust, (2) high trust in all sources, (3) high trust in doctor and government, and (4) high trust in doctor, faith leader, and family. Unadjusted odds of vaccination were greater in the high trust in all sources (OR 2.0, 95% CI 1.2-3.2), high trust in doctor and government (OR 2.7, 95% CI 1.4-5.3), and high trust in doctor, faith leader, and family classes (OR 2.1, 95% CI 1.2, 3.9) than the low trust class. However, these associations were not significant after adjustment for sociodemographic and health status factors.

Conclusion: Although COVID-19 vaccination varied across trust classes, our adjusted findings do not suggest a direct association between trust and vaccination, reflecting complexities in the vaccine decision-making process.

Purpose: To describe healthcare experiences and health outcomes among rural LGBTQ + individuals.

Design: 2022 cross-sectional survey.

Setting: Southern Illinois.

Sample: 85 individuals.

Measures: Demographics, sexual orientation and gender identity, healthcare experiences, health outcomes.

Analysis: Experiences and outcomes were assessed vs orientation and identity. Distribution comparison was by t-test and chi-square, risk prediction by logistic regression, and significance assumed at P < .050.

Results: By orientation, participants were: 35.3% gay, 16.5% lesbian, and 45.8% bisexual plus; and by identity they were: 49.4% cisgender, 25.9% transgender, and 24.8% other identity. Survey item responses ranged from 95%-99%. Compared to gay men, lesbians and bisexual plus individuals more frequently reported medical bill payment difficulty (58.3% and 57.9% vs 25.0%; P = .020) and more past month days of poor mental health (19.4 and 15.8 vs 10.6; P = .018). Compared to heterosexual and other identity, transgender individuals less frequently reported having a routine medical provider (72.7% vs 92.7% and 95.0%; P = .037) and more frequently reported past healthcare denial (45.5% vs 17.5% and 18.8%; P = .042). Current health was associated with medical bill payment ability (OR = .33, 95% CI = .13-.86) and respectful treatment by healthcare administrators (OR = 3.90, 95% CI = 1.34-11.35) and clinicians (OR = 3.82, 95% CI = 1.39-10.47). Significance of some findings likely limited due to sample size.

Conclusions: Our data describes healthcare experience and health outcome disparities among rural lesbian, gay, bisexual, transgender, queer and other sexual and gender minority individuals, and indicate that clinical experiences directly influence health outcomes.

Purpose: The Sustainable Culturally Adapted Nutrition Program (SCAN) is a novel adaptation to the National Diabetes Prevention Program (NDPP) that aims to improve attendance and effectiveness. This paper presents its feasibility and impact through the initial 6-month outcomes.

Design: A pragmatic quasi-experimental pilot study with intervention (DPP plus SCAN) and control (DPP only) groups.

Samples and inclusion criteria: Sustainable Culturally Adapted Nutrition Program participants were recruited from federally qualified health center (FQHC) clinic patients enrolled in a NDPP in Houston, Texas. Participants needed to be (1) ≥18 years old, (2) body mass index >25, (3) no prior diagnosis of diabetes, and (4) not pregnant.

Intervention: Sustainable Culturally Adapted Nutrition Program cooking classes were designed to teach skills to prepare fresh produce, and utilized Motivational Interviewing (MI) techniques to encourage participants to adapt these skills for foods that were culturally important to them.

Outcome measures: (1) National Diabetes Prevention Program attendance, (2) BMI and (3) percent weight loss.

Analysis: We used linear mixed models to test the association between weights and NDPP attendance.

Results: 22 intervention and 15 control participants completed the program to the 6-month point. Intervention participants had increased DPP attendance over controls (7.14 vs 6.87 session). Intervention participants also demonstrated on average, 1.5% weight loss for each additional SCAN class attended (P = .144).

Conclusions: The SCAN adaptation shows promising results for effectively increasing both NDPP attendance and weight loss.

Purpose: This study examines the pathways through which e-cigarette users' awareness of the truth® campaign influences e-cigarette use frequency over time.

Design and setting: Data included four waves (2020-2023) of the Truth Longitudinal Cohort, a probability-based, nationally representative survey.

Participants: The analytic sample was 15-24-year-olds who reported current e-cigarette use at baseline (N = 718). Wave-by-wave retention rates were 64% to 69%.

Measures: Respondents' cumulative awareness of truth® ads was calculated (Waves 1-2). Strength of agreement with campaign-targeted attitudes was measured on five-point scales (Wave 2). The outcome was change in the 4-level frequency of e-cigarette use (Waves 2-4).

Analysis: Latent growth structural equation modeling examined the pathway from cumulative ad awareness to the frequency of e-cigarette use via campaign-targeted attitudes.

Results: Model fit estimates identified a three-step pathway by which awareness of the campaign reduced e-cigarette use. Ad awareness was significantly associated with stronger campaign-targeted attitudes: perceived risk (β = .20, P < .0001); anti-vape industry (β = .13, P = .003); independence from addiction (β = .13, P = .004); and affinity with groups that reject vaping (β = .18, P < .0001). Each attitude was significantly associated with stronger perceived norms against e-cigarette use (respectively: β = .25, P < .0001; β = .15, P < .0001; β = .12, P = .018; β = .27, P < .0001). Perceived norms against e-cigarette use had a significant negative relationship with growth in e-cigarette use frequency over time (β = -.23, P < .0001).

Conclusion: Greater truth® anti-vaping ad awareness strengthens campaign-targeted attitudes among current users, increasing perceived norms against e-cigarette use and reducing use over time.

Purpose: Evidence suggests that sedentary behavior is increased among those with mobility impairment, but the evidence examining the impact of social support networks (SSN) on this relationship remains limited. This study examines the relationship between SSN and sedentary behavior among adults with and without mobility impairment.

Design: Cross-sectional.

Setting: National Health and Nutrition Examination Survey (NHANES) 2007-2008.

Subjects: U.S. adults (≥40 years of age) with (n = 962) and without (n = 1393) mobility impairment.

Measures: The Social Support Network (SSN) score was created using self-reported emotional, financial, church, friends, and marital support/status. The dependent variable in this study was the upper quartile of sedentary time in minutes.

Results: Both higher SSN score (AOR .43; 95% CI 0.25-.76, P = .045) and poverty to income ratio (PIR) (AOR 2.60; 95% CI 1.40-4.82, P = .01) were significant predictors of increased sedentary time among adults with mobility impairment. Among adults without mobility impairment, higher PIR was the only significant predictor of increased sedentary time (OR 3.59; 95% Cl 1.80-7.15, P < .0001).

Conclusion: Higher SSN score was associated with significantly lower odds of increased sedentary time among adults with mobility impairment. A similar relationship was not revealed among adults without mobility impairment. Higher PIR was associated with significantly higher odds of increased sedentary time among adults with and without mobility impairment.

In observance of having worked for going on five decades in the health promotion profession, this editorial shares fifty observations about the state of our field. In part one, I offer these first twenty five observations that focus on societal trends that have shifted how we frame our work and the movement from wellness to well-being. I reflect on why the wellness term fell out of favor, the roots of the well-being term and attendant definitions of health promotion. Seminal professional text books, popular readership books and key studies that have informed the health promotion discipline are reviewed. I summarize several conundrums that need solving for and conclude with calls to action for health promotion professionals.