American Journal of Health Promotion最新文献

Purpose: Identify variables, including moderating variables, associated with adolescents, young adults, and parents' intention to receive a COVID-19 vaccine in January 2021.

Design: Cross-sectional survey.

Setting: United States Midwestern academic medical center.

Sample: Adolescents (n = 242); young adults (n = 333); parents (n = 563).

Measures: Associations between predictors-participant characteristics, general vaccine hesitancy, COVID-19 and vaccine knowledge, perceptions, and normative beliefs-and intention to receive a COVID-19 vaccine (outcome) were assessed. To determine variables impacting the strength of the relationship between predictors and outcome, moderators included 2020/2021 influenza vaccine receipt, having experienced discrimination, and primary sources of information for COVID-19.

Analysis: Multivariable logistic regression examined associations, including moderating effects, for adolescents, young adults, parents, and parents for child.

Results: With 20,231 email addresses receiving the survey, 1138 participants were included in the analysis. Intention to receive a COVID-19 vaccine was reported by 60.7% adolescents (n = 147), 65.2% young adults (n = 217), and 38.5% parents (n = 217) and 38.2% parents (n = 215) intended to vaccinate their child. Intention was associated with lower general vaccine hesitancy for adolescents (AOR = 1.50), young adults (AOR = 1.39), parents (AOR = 1.18), and parents' intention for their child (AOR = 1.17). Parents citing reputable medical experts as primary source of COVID-19 information positively moderated vaccine perceptions and intention for self (AOR = 8.25) and child (AOR = 6.37).

Conclusion: Clinician training to address vaccine hesitancy may be effective at promoting positive COVID-19 vaccine perceptions.

Objective: To gather and assess current literature on the prevalence and efficacy of lifestyle behavioral interventions (sleep, nutrition, physical activity) for health outcomes, including QOL, psychological well-being, behavioral changes, and seizure frequency, among PWE.

Data source: A review was conducted of English-language articles identified from PubMed, Scopus, and Embase between January 2013 to January 2023.

Study inclusion and exclusion criteria: Inclusion criteria were randomized controlled trials (RCT) with human subjects diagnosed with epilepsy who participated in a lifestyle behavioral intervention.

Data extraction: Two researchers independently completed the title, abstract, and full-text reviews. Information extracted includes study population, duration, type of intervention, findings, and outcomes.

Data synthesis: Data was narratively synthesized to show level of evidence and degree of consistency in findings. Results: 4001 studies identified, 66 full texts reviewed, and 24 included. A majority (n = 16) of studies utilized diet specific RCTs, and some focused on physical activity (n = 7) and sleep (n = 1). Diet-specific RCTs (eg, ketogenic, Modified Atkins) reported reduced seizure frequency with adverse effects, such as gastrointestinal complications. Physical activity-based interventions found that maintained levels of exercise improved QOL and psychological well-being. However, physical activity and diet-based interventions did not have lasting effects after study conclusion. Only the behavioral sleep intervention reported that sleep quality improved significantly and was maintained post-intervention.

Conclusion: Future research is needed to establish the relationship between lifestyle behavioral interventions on QOL and other health outcomes (eg, seizure frequency).

Purpose: To examine associations between 1) sociodemographics and 2) trust in health information sources with climate change harm perception.

Methods: Weighted adjusted logistic regression models examined correlates of climate change harm perception (harm vs no harm/don't know) among a nationally representative sample of U.S. adults (2022, n = 5585).

Results: Sixty-four percent of U.S. adults believed climate change will harm their health. College education (vs high school or less) (AOR 1.7, 95% CI 1.3, 2.2) and having greater trust in doctors (AOR 1.4, 95% CI 1.2, 1.7), scientists (aOR 1.8, 95% CI 1.6, 2.0), and government health agencies (AOR 1.7, 95% CI 1.5, 1.9) for health information were associated with believing climate change harms health. Conversely, greater trust in religious organizations was associated with 16% lower odds of believing climate change harms health (95% CI .74, .94).

Conclusions: Climate change harm perception varied by sociodemographics and trust in health information source. Health communication delivered via alternative and diverse channels could expand the reach of climate and health messaging and ultimately increase public awareness and support for measures to mitigate the health impacts of climate change.

Purpose: This study investigated the relationships among exercise engagement, psychosocial factors, and social participation for adults aging with physical disabilities (AAwPD).

Design: A cross-sectional study within a community-based cohort study of participation among AAwPD was conducted.

Setting: A comprehensive survey was administered online or via telephone.

Participants: Participants were 474 individuals between the ages of 45-65, primarily living in the Midwestern United States, who reported living with a physical disability for at least 5 years.

Method: Survey questions created based on prior consolidation of activity domains assessed exercise engagement. Psychosocial health and social participation were measured using the Patient Reported Outcomes Measurement Information System. Chi-square tests, t-tests, and a general linear model were used to examine differences between exercisers and non-exercisers.

Results: Participants who exercised reported less pain (P < .001), fatigue (P < .001), and depression (P < .001) and greater self-efficacy for management of chronic conditions (P = .002), satisfaction with participation in social roles and activities (P < .001), and ability to participate in social roles and activities (P < .001) compared with non-exercising participants.

Conclusions: AAwPD who exercised reported fewer secondary conditions and greater social participation. Although causal relationships cannot be drawn, and the frequency, duration, and intensity of exercise were not examined, this study lays important groundwork for future research to determine the health and participation benefits of exercise for AAwPD. Future studies should also focus on the development of exercise interventions to support successful aging with disability.

Purpose: Identify the effects of engagement with different intervention delivery channels on physical activity (PA), and the participant subgroups engaging with the different channels, among Women's Health Initiative Strong and Healthy (WHISH) PA trial participants.

Design: Secondary analysis of data from WHISH, a pragmatic trial that used passive randomized consent.

Setting: United States (remote intervention in all 50 states).

Sample: 18,080 U.S. women, aged 68-99 years, assigned to the WHISH PA intervention arm.

Measures: 6 dichotomous variables operationalized engagement: Engagement with Targeted Inserts, Email (opened), Email (clicked links), Website (logging in), Website (tracking), Interactive Voice Response (IVR). PA was measured using the CHAMPS PA questionnaire.

Analysis: Linear regressions evaluated effects of engagement on PA. Conditional Inference Trees identified subgroups of participants engaging with different channels based on demographic and psychosocial variables.

Results: Engagement with each channel, except IVR, was associated with significantly more hours/week of PA (square root coefficients .29 - .13, P values <.001). Consistently across channels, features that identified subgroups of participants with higher engagement included younger age, and higher levels of PA and physical function. Subgroups with the highest engagement differed from those with the lowest in most participant characteristics.

Conclusions: For equitable population-level impact via large-scale remotely-delivered PA programs, it may be necessary to identify strategies to engage and target harder to reach subgroups more precisely.

Clinical trial registration: The WHISH trial is registered at ClinicalTrials.gov (No. NCT02425345).

Story telling is one of the most time honored methods for conveying ideas, inspiring action and offering insights into the foibles and ferment of the human condition. This editorial offers a glimpse into what is sparking the imaginations and passions of health promotion professionals by simply asking them 'what are you reading?' Those who shared the books currently sitting alongside their reading chairs were not asked to select books that were related to improving health and well-being. Still, it came as no surprise that contributors to this article uniformly described plots, characters and narratives that illuminate how life circumstances can accost health and jeopardize well-being. What's more, you will see that in fiction, non-fiction and fanciful fables alike, health promotion professionals extract inspiration from these books and find ways to apply the moral of these stories toward the improvement of our profession.

Purpose: Various forms of exercise have proven health benefits for people with Parkinson's (pwPD) yet high intensity functional training (HIFT) has yet to be studied. The purpose of this study was to examine the feasibility, physical and psychosocial impacts of a HIFT program for pwPD and their care partners (CPs).

Design: A single group, pre-post design with assessments before, in the middle (13 weeks), and after the 25-week intervention.

Setting: Community fitness facility.

Participants: Fourteen pwPD (10 at Hoehn Yahr Stage ≤2, 4 females) and 10 CPs (5 females) were included (mean age = 71.5 (6.1)).

Intervention: A 25-week HIFT program (≤49 exercise sessions, ≤75 min long).

Measures: Recruitment, retention, attendance, safety and exercise intensity (measured via session-Rating of Perceived Exertion (RPE)) was assessed in addition to cardiovascular endurance, lower extremity strength, walking speed, balance, exercise self-efficacy, balance confidence, social support for exercise and health-related quality of life.

Analysis: Descriptive data was used to describe feasibility measures. Wilcoxon signed-rank test was used to compare pre- and post-program data. Effect size, r, was calculated.

Results: Recruitment rates were ≥40% for pwPD and CPs and retention rates were 80% for pwPD and 62.5% for CPs. Average session attendance was 71.2% with 15 adverse events reported, including 7 non-injurious falls. Median session-RPE was 5 (IQR = 1) out of 10. PwPD demonstrated significant improvements in cardiovascular endurance, self-selected and fast walking speeds, balance and social support for exercise. CPs demonstrated significant improvements in cardiovascular endurance and lower extremity strength. Exercise self-efficacy, balance confidence and health-related quality of life did not significantly change for pwPD or CPs.

Conclusion: High intensity functional training appears feasible for pwPD and their CPs and may lead to health benefits. Healthcare providers should consider HIFT as another option to engage pwPD in community-based exercise.

Purpose: Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD.

Design: Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data.

Sample: 114 164 respondents, representing approximately 59 million US adults aged ≥45.

Measures: SCD was indicated if the respondent reported confusion or memory loss during the past 12 months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week).

Analysis: Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C.

Results: US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0).

Conclusion: Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.

Purpose: People aging with disability may be limited in their ability to engage in healthy behaviors to maintain cardiometabolic health. We investigated the role of health promoting features in the neighborhood environment for incident cardiometabolic disease in adults aging with physical disability in the United States.

Design: Retrospective cohort study.

Setting: Optum's Clinformatics® Data Mart Database (2007-2018) of administrative health claims.

Subjects: ICD-9-CM codes were used to identify 15 467 individuals with a diagnosis of Cerebral Palsy, Spina Bifida, Multiple Sclerosis, or Spinal Cord Injury.

Measures: Cardiometabolic disease was identified using ICD-9-CM/ICD-10-CM codes over 3 years of follow-up. Measures of the neighborhood environment came from the National Neighborhood Data Archive and linked to individual residential ZIP codes over time. Covariates included age, sex, and comorbid health conditions.

Analysis: Cox regression models estimated hazard ratios (HR) for incident cardiometabolic disease. Using a 1-year lookback period, individuals with pre-existing cardiometabolic disease were excluded from the analysis.

Results: Net of individual risk factors, residing in neighborhoods with a greater density of broadband Internet connections (HR = .88, 95% CI: .81, .97), public transit stops (HR = .89, 95% CI: .83, .95), recreational establishments (HR = .89, 95% CI: .83, .96), and parks (HR = .88, 95% CI: .82, .94), was associated with reduced risk of 3-year incident cardiometabolic disease.

Conclusion: Findings identify health-promoting resources that may mitigate health disparities in adults aging with disability.

Purpose: We examined if civic engagement during emerging adulthood positively impacted a broad array of outcomes in middle adulthood, and if associations varied based on race, gender, age, and urban-rural status.

Design: Prospective design used to determine if civic engagement during emerging adulthood (M age = 21.81) predicted outcomes 15 years later.

Setting: Restricted data from the National Longitudinal Study of Adolescent to Adult Health.

Subjects: Wave 1 participants who completed surveys 7 years (77% follow-up rate), 14 years (80% follow-up rate), and 22 years later (follow-up rate 72%) and who had valid sampling weight to ensure national representativeness (n = 9349).

Measures: Predictor - civic engagement; Outcomes-mental health, substance use, criminal behaviors, and healthy behavior.

Analysis: Linear regression using MPLUS 7.2.

Results: Civic engagement predicted lower levels of depressive symptoms (b = -1.05, SE = .28), criminal behaviors (b = -.47, SE = .12), and substance use (b = -.66, SE = .13), and higher levels of healthy behaviors (b = 1.26, SE = .19), after controlling for demographics, family, peer, neighborhood, and school-related background variables. Moderation analyses revealed that civic engagement benefited females and white participants more.

Conclusion: Civic engagement during emerging adulthood has a positive impact on a broad array of outcomes in middle adulthood. Implications and future research recommendations will be discussed.