American Journal of Health Promotion最新文献

PurposeTo investigate the trust levels in health information sources from a United States (U.S.) sample, and to examine the relationships between trust in healthcare professionals (HCPs) and perceptions of modifiability of dementia and stroke risks through maintaining or changing lifestyle habits.DesignCross-sectional.SettingA survey distributed via the vendor platform Prolific to a sample of the U.S. population.ParticipantsData included on U.S. adults (n = 1478) in 2023.MeasuresOutcome variables were perceiving that dementia and stroke risk can be modified through maintaining or changing lifestyle habits. Independent variables were trust levels in HCPs.AnalysisDescriptive analysis was performed to assess levels of trust in information sources. Subsequently, we performed multivariable regression analyses between trust in HCPs and perceptions of risk modifiability in dementia and stroke. A hierarchal cluster analysis was conducted to characterize trust patterns in this cohort.ResultsParticipants with high trust in HCPs compared to those with low trust in HCPs were more likely to perceive that maintaining (adjusted odds ratio [aOR] = 1.57, 95% confidence interval [CI]:1.15-2.12) and changing lifestyle habits (aOR = 1.72, 95% CI: 1.26-2.33) could reduce risk of dementia. Similar associations were found for perceptions of stroke risk reduction through maintaining (aOR = 1.49, 95% CI: 1.07-2.04) and changing (aOR = 2.68, 95% CI: 1.72-4.12) lifestyle habits. Cluster analyses identified three trust patterns amongst the participants: (i) a generally trusting cluster, (ii) a trusting of "official" health sources only cluster, and (iii) a generally not trusting cluster.ConclusionThis study found statistically significant associations between trusting HCPs and the perceptions that maintaining or changing lifestyle habits can modify risks of dementia and stroke, highlighting the importance of trust when developing preventive strategies.

PurposeArtificial intelligence (AI) is increasingly integrated into healthcare, including psychiatric care. This study evaluates ChatGPT-4o's reliability in answering frequently asked antidepressant-related questions by comparing its performance with psychiatrists across four key dimensions: accuracy, conciseness, readability, and clarity.DesignA comparative study analyzing ChatGPT-4o-generated responses and those of psychiatrists with at least five years of clinical experience.SettingParticipants were recruited through institutional and professional networks and provided with standardized questions derived from authoritative treatment guidelines.SubjectsTwenty-six psychiatrists participated, and ChatGPT-4o responses were generated using a standardized prompt for each question.MeasuresTwo independent psychiatrists evaluated accuracy and conciseness using a blinded rating system. Readability was assessed with the Flesch-Kincaid Grade Level test, and clarity was measured with the Writing Clarity Index Calculator.AnalysisThe Shapiro-Wilk test assessed normality. Paired t-tests were used for normally distributed data, and the Wilcoxon signed-rank test for non-normally distributed data. Statistical significance was set at P < .05.ResultsChatGPT-4o showed comparable accuracy to psychiatrists (P = .0645) but was significantly more concise (P = .0019). Readability differences were not statistically significant (P = .0892), while psychiatrists provided clearer responses (P = .0059).ConclusionChatGPT-4o delivers accurate and concise responses, highlighting its potential as a patient education tool. However, psychiatrists offer greater clarity, underscoring the indispensable role of clinical expertise in psychiatric care.

PurposeTo evaluate change in home radon testing after initiation of a public library radon detector lending program (LLP) in four rural counties; and describe the impact of LLP promotions on check-outs.DesignLongitudinal tracking of radon testing and description of LLP promotions.SettingFour rural Kentucky counties.Sample14,697 radon tests pre-LLP (charcoal-based test kits); 12,707 radon tests post-LLP (detector check-outs plus charcoal-based).InterventionLLP and promotional strategies including direct mail, radio, newsletters, social media, and in-library promotions and training.MeasuresRadon detector check-outs (03/2023-11/2024) comparing counties with and without LLP.AnalysisExamined change in radon testing pre- and post-LLP implementation using incidence rate ratios. Evaluated number of check-outs following promotions.ResultsThere was a 2.5-fold increase in the rate of radon testing in the four study counties (RR=2.5, 95% CI: 2.27-2.76; p<.001), while the testing rate fell in non-study counties. Two study counties exceeded their check-out goals multiple months in a row following direct mail campaigns. Social media, in-library signage, and billboards were reported most effective at promoting the program. The proportion of county-level renter-occupied housing fluctuated, potentially affecting differences in library check outs.ConclusionLLPs show promise in maximizing access to population-based radon testing. Mailing postcards to residents had a sustained impact on detector check-outs over 3-5 months in some counties.

Scientists are experiencing unprecedented challenges to the time honored conventions that usually guide consensus building and health communications. This editorial offers a primer on this journal's peer review process and argues that professional societies, the private sector and non-governmental organizations need to fill the void being created by disinvestments in our federal and state public health infrastructure. The process that guides our peer reviewers and composite reviewers is described. The vital importance of peer reviewers sharing their expertise with fellow scientists via narrative feedback on studies is emphasized. An interview with an exemplary composite reviewer, our Associate Editor in Chief, Dr Kerry Redican, is offered as a way to underscore the rigor needed to preserve the integrity of the scientific method at a time when science is being threatened by ideological clashes.

PurposeClinical firearm safety counseling can help prevent firearm injuries, yet many clinicians have not adopted this practice. We collected practical tips from physicians who do such counseling to help others interested in conducting such counseling while perhaps feeling insecure about how to implement it.DesignQualitative interview study.Setting/ParticipantsSixteen physicians who had made clinical firearm safety counseling part of their practice.MethodsAn interview guide included questions about how, when, and with whom participants were undertaking firearm safety counseling, motivations, experiences with the counseling, patient reactions, and barriers and facilitators. The interviews were analyzed using inductive thematic analysis.ResultsMost (11 out of 16) physicians were in primary care/family medicine or pediatrics; 54% worked in urban, 27% in rural/small town, and 20% in suburban settings. Three takeaways were reported by virtually every participant: firearm safety counseling is not difficult; almost all patients react positively, and occasional skeptical reactions are easily defused; and this counseling does not take much time. Participants kept conversations nonjudgmental and focused on safety, not on firearm ownership itself. Participants' strong convictions that it was their responsibility to address firearm safety helped them overcome barriers such as lack of time, training, and guidelines.ConclusionParticipants shared actionable ideas on how to facilitate firearm safety counseling, exemplifying ways to encourage firearm safety behaviors.

PurposeExplore the causal relationship between sedentary behavior (SB) and the new onset of chronic pain (NOCP) in Americans aged ≥50 years.DesignRetrospective secondary data analysis.Setting/SampleIn a target trial emulation framework, a dataset comprising four consecutive waves (2012, 2014, 2016, and 2018) from the longitudinal Health and Retirement Study was investigated.Measures/AnalysisUnivariable and multivariable analyses were conducted using survey-weighted, mixed-effects Poisson regression models with one-level random intercepts and linearized standard errors. Using the same approach, causal mediation analyses were carried out to examine the potential role of obesity, depression, and sleep disturbances as mediators in the relationship between SB and NOCP. The role of education level, race, and sex as potential effect modifiers was also evaluated.ResultsIn the multivariable analysis, the risk of NOCP in participants who reported not having pain in the 2012 interview increased by 22% in those with SB vs those reporting no SB (95% CI = 1.12, 1.33; P < .001). The mediation effect attributed to obesity and depression was 58.2% (95% CI = 50.5, 71.3; P < .001) and 8.8% (95% CI = 1.6, 14.1; P < .001), respectively. The risk of NOCP in participants reporting SB was increased by 24.8% in women vs men (incidence rate ratio 1.25; 95% CI = 1.02, 1.52; P = .03).ConclusionThere is strong evidence for an association between SB and NOCP in the American subpopulation of women aged $\ge$50 years. This effect seems to be mainly mediated by obesity.

PurposeTo examine physical activity and sleep as predictors of well-being in young adults and explore differences by sex, age, and student status.Design & SettingA cross-sectional, online survey containing validated questionnaires was utilized to measure self-reported physical activity, sleep, and well-being.SampleParticipants were recruited through local and national recruitment efforts and social media. Of 329 survey respondents, 230 adults (69.9%) aged 18-25 years without current injury or physical activity limitations completed the survey between April 2020 and September 2020.MeasuresQuestionnaires utilized included the Godin Leisure Time Exercise Questionnaire for physical activity, the Pittsburgh Sleep Quality Index for sleep, and the Physical Summary Component and Mental Summary Component of the Modified Disablement in the Physically Active Scale for physical and mental well-being.AnalysisLinear regression models, Welch 2 Sample t-tests, Analysis of Variance, Tukey's Honest Significant Difference tests, chi-square tests of independence, F-tests, and stepwise AIC techniques were utilized in data analyses.ResultsSleep quality was the strongest predictor of mental and physical well-being (Estimate = 0.500, P < .001). While no differences in sleep quality or well-being were identified by sex, age, or student status, physical activity was higher among males and younger participants.ConclusionYoung adulthood is a crucial time to establish healthy physical activity and sleep patterns to promote well-being. Collection of data during the COVID pandemic may limit generalizability of results.

PurposeThis scoping review aimed at describing the health promotion initiatives of universities.Data SourcePubMed, Scopus, Embase, Web of Science.Study Inclusion and Exclusion CriteriaStudies were included if they: (a) explicitly referred to higher education or university; (b) focused on improving the health and well-being of the university community; (c) described a specific health promotion intervention or broader university strategies and policies for health promotion without a specific intervention; (d) were available in full text in English or Italian; (e) were published between 01/01/2015 and 02/04/2024.Data ExtractionThe following data were considered: country in which the study was conducted, target population, number of subjects involved, study design, aim of the study, interventions developed, main results.Data SynthesisA narrative synthesis was conducted.ResultsThirty-six studies were included in the final synthesis; they were mostly conducted in Europe (30.6%) and in the Western Pacific Region (25%). Seven studies described multiple interventions as part of the Health Promoting University network. Eleven studies examined health promotion interventions implemented as part of health-promoting strategies defined at the university level. Mental health and psychological well-being represent the most common area of intervention (52.8%).ConclusionAlthough significant progress has been achieved in implementing health-promoting initiatives within universities, challenges remain regarding the full integration of health promotion into the broader university culture.

PurposeThis study examined preferences to consider low-calorie, no sugar substitution options for sugar-sweetened beverage (SSB) among US adults. This could help develop tailored public health strategies to reduce SSB consumption and related health risks.DesignQuantitative, cross-sectional study.SettingUnited States.SampleThis study used 2021 SummerStyles survey data for 2552 US adults recruited from an online panel of approximately 60 000 non-institutionalized adults.MeasuresThe outcome measure was considering a non-sugar SSB substitute (Yes or no) for six different beverage options among individuals consuming SSBs who would consider a substitute. Exposure measures were sociodemographic characteristics and frequency of SSB consumption.AnalysisLogistic regression models were used to estimate adjusted odds ratios (ORs) for preference to consider each substitution option.ResultsPlain water was considered by 71% of respondents as a substitute; 36% considered flavored water, 27% sparkling water, 25% herbal tea, 19% diet drinks, and 18% unsweetened coffee. Preferences varied by demographic characteristics. Individuals reporting an annual household income of <$35 000 had 0.6 (95% confidence interval (CI): 0.4, 0.9) times lower odds to consider plain water than those with income ≥$100 000, and individuals with obesity had 1.9 (95% CI: 1.4, 2.6) times greater odds of considering diet drinks compared to those with healthy weight or underweight.ConclusionPopulation subgroups of regular SSB-consuming adults exhibit varying preferences for SSB substitutes, which can inform tailored public health messaging and interventions.

PurposeThis study examined nativity differences in social and structural correlates of single and polytobacco product use among United States (U.S.) Black young adults (YA).DesignOnline cross-sectional study.SettingUnited States.SampleU.S.-born and foreign-born Black YA ages 18-25 years (N = 484) living in the U.S.MeasuresSelf-reported past 30-day tobacco product use, safety concerns, and food and housing insecurity measured with the Accountable Health Communities Health-Related Social Needs Screening Tool; experience of racist events measured with the schedule of racist events scale.AnalysisStratified adjusted multinomial logistic regression analyses were conducted. Separate models were constructed for overall sample, U.S.-born YA, and foreign-born YA. All models adjusted for demographic characteristics. Models for foreign-born YA adjusted for length of stay in the U.S.ResultsOverall, 18.8% (CI = 15.6-22.5) and 17.4% (CI = 14.2-21.0) of participants reported single tobacco use and polytobacco use respectively. Among foreign-born participants, exposure to racist events (aOR = 1.06, 95%CI = 1.02-1.11) and housing insecurity (aOR = 1.95, 95%CI = 1.05-3.63) were associated with higher odds of polytobacco use. Among U.S.-born participants, exposure to racist events (aOR = 1.02, 95%CI = 1.001-1.05) and safety concerns (aOR = 3.19, 95%CI = 1.51-6.73) were associated with higher odds of polytobacco use.ConclusionExperience of racist events was associated with polytobacco use among both U.S.-born and foreign-born Black YA. However, different structural determinants were associated with polytobacco use among both groups. Results suggest need for tailored tobacco prevention efforts among Black young adults in the U.S.