American Journal of Health Promotion最新文献

Purpose: This study evaluates the impact of interventions in the Omaha System and HeartScore®-based program to reduce impaired-risk perception.

Design: and setting: This study utilized a one-group pre-test-post-test design.

Subjects: The program was conducted among participants aged over 50 years from different social settings.

Intervention: The program had three parts: a briefing on HeartScore® recommendations, Omaha System interventions, and referral to a doctor.

Measures: HeartScore® determined cardiovascular disease (CVD) risk, body mass index (BMI) was calculated from height and weight, and the International PA Questionnaire evaluated physical activity (PA) levels. Self-assessment was used to perceived CVD risk, BMI, and PA.

Analysis: We used the Wilcoxon signed-rank test to compare the pre-test and post-test scores of the Omaha System, the problem rating scale (PRS) subscales and McNemar test to measure changes in CVD risk perception, BMI, and PA level.

Results: 310 high-risk individuals out of 522 had impaired perception of their CVD risk. Only 201 responded to follow-up phone calls. Interventions based on HeartScore® and Omaha System improved CVD risk and PA perceptions (P < .001) but not BMI. The program significantly increased knowledge, status, and behavior scores (P < .001). After participating, 39% saw a cardiologist, and 57.2% saw a family physician within six months to reduce impaired risk perception. CVD risk perception increased to the actual level after the intervention, mostly in the group with low education level.

Conclusions: The program using the Omaha System and HeartScore® can help middle-aged individuals better understand their risk of cardiovascular disease.

Purpose: Type 2 diabetes mellitus (T2DM) self-management is a comprehensive approach that individuals with T2DM employ to manage and control their condition. Patients' activation, "an individual's knowledge, skill, and confidence for managing their health and health care", has been used as a major driver of self-management. This study aimed to assess the relationship of patient activation with T2DM self-management and clinical outcomes.

Design: A cross-sectional study.

Subjects: Patients with type T2DM who age 18-years and older.

Setting: The primary care centers in Saudi Arabia.

Measures: Patient activation measure (PAM) and the Summary of Diabetes Self-Care Activities (SDSCA).

Analysis: Descriptive statistic, T-test, One-way ANOVA test, Chi-square test, and linear and logistic regressions were performed.

Results: A total of 398 patients, mostly male (54.9%) with a mean age of 53.2 (±10.7) years old participated in the study. The participants' mean of Hemoglobin A1c (HbA1c) was 8.4% (±1.7%) and most of them (74.5%) had an uncontrolled HbA1c level (>7% %). The mean patient activation score was 55.9 (±13.5). 24.4% were at [PA1], 26.7% at [PA2], 37.4% at [PA3], and 11.5% at [PA4]. Patient activation level was positively associated with better glycemic control and self-management behaviors including diet, physical activity, blood glucose self-testing, foot care, and smoking (P < .05) but not with adherence to medication.

Conclusions: Our findings reveal a positive association between patient activation level and enhanced glycemic control and self-management behaviors and suggest that patient activation-informed self-management interventions are more likely to yield promising health outcomes.

Purpose: Weight concern is a barrier to smoking cessation. We examined the impact of weight concern on post-cessation weight gain, abstinence and program engagement.

Design: Randomized-controlled trial.

Setting: Telephone-based and group-based intervention sessions.

Subjects: 305 participants were randomized and analyzed.

Intervention: Participants were randomized to receive a self-guided intervention, a weight loss intervention, or a weight stability intervention prior to all receiving the same smoking cessation intervention.

Measures: Level of weight concern on three measures, point-prevalence abstinence, weight change, and session attendance at 12 months.

Analysis: Continuous and discrete outcomes were compared between weight-concerned and non-weight-concerned participants using two-sample t-tests and chi-square tests respectively.

Results: There were no significant differences in weight change (range: +1.77, -1.91 kg) when comparing weight-concerned and non-weight-concerned participants. Point-prevalence abstinence ranged from 36% to 64%, with no differences by condition based on level of weight concern. There were no significant differences in session attendance by weight concern (Weight sessions: 50-70%, Smoking cessation sessions: 41-56%, Booster sessions: 28-45%). Weight concern, on all measures, significantly decreased between screening and 2 months (after the weight management intervention), for most of the comparisons made overall and by condition.

Conclusion: It may not be necessary to screen for weight concerns in smoking cessation and/or post-cessation weight management programs, as the trial interventions were beneficial regardless of weight concern.

Purpose: This study aims to identify whether adverse childhood experiences (ACEs) influence health lifestyles throughout adulthood and examine how ACEs influence dimensions of health lifestyles.

Design: The data was collected cross-sectionally through an online questionnaire.

Setting: Individuals were invited to participate in an online survey for a larger brain health study as a pre-screening measure.

Subjects: Women in the Midwest between 18-25 and 65-85 who reported either no ACEs or 3 or more ACEs completed the survey, with 233 women answering all questionnaires.

Measures: Demographic indicators, the 10-item ACEs questionnaire, and the Health Promoting Lifestyle Profile (HPLP-II).

Analysis: Independent sample t-tests revealed significantly lower scores for ACEs group on the HPLP-II and the 6 subcategories (heath responsibility, interpersonal relationships, nutrition, physical activity, spiritual growth, and stress management). A structural equation model using the 3 ACE categories (abuse, neglect, and household dysfunction) and 6 health domains showed substantial differences in the variance captured for each health behavior.

Results: Findings indicate that abuse predicts physical activity, stress management, and spiritual growth (β = -.21, -.23, -.20); neglect predicts interpersonal relationships and spiritual growth (β = -.17, -.18); and household dysfunction predicts health responsibility, nutrition, stress management, and interpersonal relations (β = -.20, -.22, -.10, -.17).

Conclusion: The present investigation extends research in displaying that ACEs play a significant role in future health behaviors, with household dysfunction being the greatest predictor.

Purpose: To pilot a novel approach investigating the interplay of social and institutional determinants influencing university undergraduate student sleep patterns.

Design: A two-part, three-phase mixed-methods approach.

Setting: A mid-size US university conducted in spring and fall 2020.

Participants: 191 undergraduate students (69 first-years, 43 second-years, 48 third-years, 31 fourth-years).

Method: For Part A, participants texted their activities and emotions in real time, producing a data-rich, weeklong diary of comprehensive activity logs, emoticons, multimedia submissions, and juxtapositions of ideal vs real schedules. Semi-structured contextual interviews were also conducted. For Part B, a one-time survey examined Part A insights across all class years. These diverse datasets were triangulated using thematic, comparative, and content analyses through MAXQDA software and visual mapping methods.

Results: Three preliminary themes were identified as encouraging an irregular sleep schedule: a prevailing academic ethos emphasizing busyness, time management challenges, and the rhythm of institutional schedules and deadlines. An overarching theme suggests that perceptions of peer sleep habits and academic prioritization above all else could be influential across factors.

Conclusion: This pilot study indicates that sleep regularity among undergraduates is potentially shaped by individual choices combined with broader institutional paradigms. While it is limited by its exploratory nature, timing, and small sample size, the results highlight the promise of this methodology for more extensive studies and suggest that future interventions should emphasize systemic changes that prioritize sleep.

Purpose: To examine changes in obesity prevalence among US adults after the COVID-19 pandemic by level of stay-at-home order and sociodemographic characteristics.

Design: Quasi-experimental study using repeated cross-sectional data.

Setting: Behavioral Risk Factor Surveillance System (BRFSS).

Sample: Pooled data for US adults ages ≥26 years (n = 1,107,673) from BRFSS (2018-2021).

Measures: States/territories were classified into three levels of stay-at-home order: none, advisory/only for persons at risk, or mandatory for all. Individual-level sociodemographic characteristics were self-reported.

Analysis: The difference-in-differences method was conducted with weighted multiple logistic regression analysis to examine obesity (body mass index ≥30 kg/m²) prevalence by stay-at-home order level and sociodemographic characteristics before/after the COVID-19 pandemic (January 2018-February 2020 vs March 2020-February 2022).

Results: After adjusting for a secular trend and multiple covariates, adults in states/territories with mandatory stay-at-home orders experienced a larger increase in obesity prevalence (adjusted odds ratio: 1.05; 95% confidence interval: 1.01, 1.11) than adults in states/territories with no stay-at-home order. Younger adults (vs ≥65 years) and individuals with

Conclusion: Increases in obesity prevalence were perpetuated 2 years after implementation of stay-at-home orders, indicating that longer-term health implications are co-occurring during the pandemic recovery period. Future research should focus on successful methods for staying active and healthy during social distancing and beyond.