Subjects -> HEALTH AND SAFETY (Total: 1473 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (676 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (384 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (117 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (676 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 1)
Acta Informatica Medica     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 27)
African Health Sciences     Open Access   (Followers: 3)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 44)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 5)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 18)
American Journal of Health Education     Hybrid Journal   (Followers: 33)
American Journal of Health Promotion     Hybrid Journal   (Followers: 33)
American Journal of Health Sciences     Open Access   (Followers: 10)
American Journal of Health Studies     Full-text available via subscription   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 30)
American Journal of Public Health     Full-text available via subscription   (Followers: 257)
American Journal of Public Health Research     Open Access   (Followers: 29)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 6)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 12)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 14)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 4)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 4)
Archives of Suicide Research     Hybrid Journal   (Followers: 7)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 10)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 11)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 4)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 7)
Autism & Developmental Language Impairments     Open Access   (Followers: 11)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 22)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 11)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 49)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 21)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 11)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 23)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 23)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 1)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 5)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuadernos de la Escuela de Salud Pública     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 5)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 15)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 22)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 22)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 7)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
EsSEX : Revista Científica     Open Access  
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 4)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 13)
Family Medicine and Community Health     Open Access   (Followers: 9)
Family Relations     Partially Free   (Followers: 13)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 17)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access  
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Journal     Open Access  
Global Health Promotion     Hybrid Journal   (Followers: 16)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 13)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access  
Globalization and Health     Open Access   (Followers: 8)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 16)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 13)
Health and Human Rights     Open Access   (Followers: 10)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 10)
Health and Social Work     Hybrid Journal   (Followers: 63)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 16)
Health Equity     Open Access  
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 23)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 45)
Health Policy and Technology     Hybrid Journal   (Followers: 5)
Health Professional Student Journal     Open Access   (Followers: 4)
Health Promotion International     Hybrid Journal   (Followers: 24)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8)
Health Promotion Practice     Hybrid Journal   (Followers: 16)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 55)
Health Psychology Bulletin     Open Access   (Followers: 1)
Health Psychology Research     Open Access   (Followers: 20)
Health Psychology Review     Hybrid Journal   (Followers: 42)

        1 2 3 4 | Last

Similar Journals
Journal Cover
American Journal of Health Promotion
Journal Prestige (SJR): 0.807
Citation Impact (citeScore): 1
Number of Followers: 33  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0890-1171 - ISSN (Online) 2168-6602
Published by Sage Publications Homepage  [1085 journals]
  • In Briefs
    • Pages: 123 - 126
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 123-126, February 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119900051
       
  • The “Best of 2019 List” of Health Promotion Researchers
    • Authors: Paul E. Terry
      Pages: 127 - 131
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 127-131, February 2020.
      Each year, the editorial team of the American Journal of Health Promotion selects our “Best of List” of health promotion science from the prior year. This editorial features the Editor’s picks, the Editor in Chief’s favorites, and other award categories for the research and writing published in 2019 in this journal. Our criteria for selection include such factors as: whether the study addresses a topic of timely importance in health promotion, the research question is clearly stated and the methodologies used are well executed, whether the paper is often cited and downloaded, whether the study findings offer a unique contribution to the literature, and whether the paper is well written and enjoyable to read. Awardees in 2019 shared study findings that demonstrated the vital role of health policies in affecting behaviors and offered new insights into how to engage voices from communities, how intervention dose and reach impact outcomes, and how to better engage the most difficult to reach.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119899249
       
  • The Art of Health Promotion: linking research to practice
    • Authors: Sara S. Johnson, Alexandria Blacker, Stephen Dion, Jessica Grossmeier, Rick Hecht, Elizabeth Markle, Les Meyer, Sarah Monley, Bruce Sherman, Nicole VanderHorst, Emily Wolfe, Michael T. Compton, Ruth S. Shim, Mary Jane Osmick, Marcella Wilson, Kristi Jenkins, Karen Schmidt, Ashley Weigl
      Pages: 206 - 226
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 206-226, February 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119896122
       
  • The Employer’s Role in Addressing Social Determinants of Health
    • Authors: Sara S. Johnson
      Pages: 206 - 207
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 206-207, February 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119896122a
       
  • Social Determinants of Health—an Employer Priority
    • Authors: Alexandria Blacker, Stephen Dion, Jessica Grossmeier, Rick Hecht, Elizabeth Markle, Les Meyer, Sarah Monley, Bruce Sherman, Nicole VanderHorst, Emily Wolfe
      Pages: 207 - 215
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 207-215, February 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119896122b
       
  • Why Employers Must Focus on the Social Determinants of Mental Health
    • Authors: Michael T. Compton, Ruth S. Shim
      Pages: 215 - 219
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 215-219, February 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119896122c
       
  • Social Determinants of Health—Relevant History, A Call to Action, An
           Organization’s Transformational Story, and What Can Employers Do'
    • Authors: Mary Jane Osmick, Marcella Wilson
      Pages: 219 - 224
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 219-224, February 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119896122d
       
  • Addressing Social Determinants of Health—A Large Employer
           Perspective
    • Authors: Kristi Jenkins, Karen Schmidt, Ashley Weigl
      Pages: 224 - 226
      Abstract: American Journal of Health Promotion, Volume 34, Issue 2, Page 224-226, February 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-01T08:00:00Z
      DOI: 10.1177/0890117119896122e
       
  • Sedentary Time and Physical Activity Across Occupational Classifications
    • Authors: Tyler D. Quinn, Kelley Pettee Gabriel, Juned Siddique, David Aaby, Kara M. Whitaker, Abbi Lane-Cordova, Stephen Sidney, Barbara Sternfield, Bethany Barone Gibbs
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine differences in activity patterns across employment and occupational classifications.Design:Cross-sectional.Setting:A 2005-2006 Coronary Artery Risk Development in Young Adults (CARDIA) study.Sample:Participants with valid accelerometry data (n = 2068).Measures:Uniaxial accelerometry data (ActiGraph 7164), accumulated during waking hours, were summarized as mean activity counts (counts/min) and time spent (min/d) in long-bout sedentary (≥30 minutes, SED≥30), short-bout sedentary (
      Citation: American Journal of Health Promotion
      PubDate: 2019-11-15T05:06:09Z
      DOI: 10.1177/0890117119885518
       
  • Coaction Between Physical Activity and Fruit and Vegetable Intake in
           Racially Diverse, Obese Adults
    • Authors: Natalia I. Heredia, Maria E. Fernandez, Alexandra E. van den Berg, Casey P. Durand, Harold W. Kohl, Belinda M. Reininger, Kevin O. Hwang, Lorna H. McNeill
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:There is minimal understanding of the potential for coaction, defined as action on one behavior increasing the likelihood of taking action on another behavior, between physical activity (PA) and fruit and vegetable (FV) intake. The purpose of this study was to assess the bidirectional coaction between FV intake and PA, as well as self-efficacy for these behaviors, in a racially diverse sample of obese adults.Design:This is a secondary analysis using data collected from the Path to Health study, a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03674229.Sample:Obese adults who completed baseline and 6-month follow-up assessments.Measures:For this study, data on FV intake, leisure time PA, and 7-day accelerometer data were analyzed at baseline and 6-month follow-up.Analysis:We interchanged modeling the FV intake and PA change variables as the independent and dependent variables. We conducted multiple imputation and both linear and multinomial regression.Results:The sample (n = 168) was 59% female and mainly split between white (42%) and African American (42%). Change in self-efficacy for PA was predictive of change in self-efficacy for FV intake and vice versa. When compared with participants with no change in FV intake, someone with a positive change in FV intake was more likely to have a positive change in self-reported PA (adjusted risk ratio [RR] = 6.72, 95% confidence interval [CI] = 1.69-26.68). Likewise, when compared with no change, participants with a positive change in self-reported PA were more likely to report a positive change in FV intake (adjusted RR = 6.79, 95% CI = 1.70-27.17).Conclusion:Findings suggest coaction between self-efficacy for FV intake and PA as well as between FV intake and PA. Coaction could be capitalized on to more effectively promote both energy-balance behaviors.
      Citation: American Journal of Health Promotion
      PubDate: 2019-11-14T03:52:01Z
      DOI: 10.1177/0890117119884479
       
  • “I Don’t Feel Like the Odd One”: Utilizing Content Analysis to
           Compare the Effects of Social Media Use on Well-Being Among Sexual
           Minority and Nonminority US Young Adults
    • Authors: César Escobar-Viera, Ariel Shensa, Megan Hamm, Eleanna M. Melcher, Daniel I. Rzewnicki, James E. Egan, Jaime E. Sidani, Brian A. Primack
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Although there is evidence of associations between social media (SM) use and mental well-being among the general population, these associations among lesbian, gay, and bisexual (LGB) persons are poorly understood. This study compared the influence of SM experiences on mental well-being between LGB and non-LGB persons.Design and Setting:Online cross-sectional survey.Participants:National sample of 2408 US adults aged 18 to 30 years.Method:We asked participants to provide examples of when SM affected their well-being separately in good and bad ways. We coded, summed, and used rate ratios (RRs) to compare responses of LGB and non-LGB individuals. Thematically similar codes were described and grouped into categories.Results:Most responses described positive SM effects. However, of 6 codes that were significantly more frequent among LGB respondents, only social capital (RR = 1.58, 95% confidence interval [CI], 1.17-2.12) described a positive effect. Five codes described negative effects of SM for LGB users: negative emotional contagion (RR = 1.28, 95% CI, 1.04-1.58), comparison with others (RR = 1.28, 95% CI, 1.01-1.62), real-life repercussions (RR = 1.86, 95% CI, 1.18-2.94), envy (RR = 2.49, 95% CI, 1.48-4.19), and need for profile management (RR = 2.32, 95% CI, 1.07-5.03).Conclusion:These findings suggest that, for LGB persons, gaining social capital from SM is valuable for establishing and maintaining connections. Increased negative SM experiences may pose a risk for the mental well-being of LGB individuals.
      Citation: American Journal of Health Promotion
      PubDate: 2019-11-08T03:56:17Z
      DOI: 10.1177/0890117119885517
       
  • Associations of Tobacco Advertising Appeal With Intentions to Use
           Alternative Tobacco Products Among Young Tobacco Users Experiencing
           Homelessness
    • Authors: William G. Shadel, Joan S. Tucker, Rachana Seelam, Daniela Golinelli, Daniel Siconolfi
      First page: 132
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Virtually nothing is known about the potential effects of tobacco advertising on tobacco use among youth experiencing homelessness, a vulnerable population with high tobacco use rates. This study examines associations between the appeal of advertising for 5 classes of tobacco product (electronic cigarettes, hookah, cigars, cigarillos, and smokeless tobacco) and future intentions to use those products again among homeless youth who had indicated any level of lifetime use.Design:A cross-sectional design was used.Setting:Settings were 25 service and street sites in Los Angeles County.Participants:A probability sample of 469 young tobacco users experiencing homelessness (mean age = 22; 71% male; 29% non-Hispanic White) was recruited.Measures:Assessments included product-specific tobacco advertising appeal and future intentions to use the product again, as well as a range of covariate controls (eg, demographics, homelessness severity, current tobacco use, general advertising exposure).Analysis:Linear regression tested for associations between the appeal of advertising for a specific tobacco product and intentions to use that product again in the future, controlling for myriad covariates.Results:Advertising appeal was positively associated with future intentions to use again for electronic cigarettes (P = .006) and hookah (P = .001), but not cigars (P = .486), cigarillos (P = .126), or smokeless tobacco (P = .109).Conclusion:Results suggest that advertising appeal may increase use of certain tobacco products among youth experiencing homelessness. However, differences in themes emphasized by advertising for specific tobacco products could differentially influence use in this population.
      Citation: American Journal of Health Promotion
      PubDate: 2019-10-04T04:17:33Z
      DOI: 10.1177/0890117119878350
       
  • Tracking Changes in US Organizations’ Workplace Health Promotion
           Initiatives: A Longitudinal Analysis of Performance Against Quality
           Benchmarks
    • Authors: GracieLee M. Weaver, Daniel L. Bibeau, Kelly Rulison, Jeremy Bray, William N. Dudley, Nilay Unsal
      First page: 142
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine changes in organizations’ workplace health promotion (WHP) initiatives over time associated with repeated self-assessment using the Well Workplace Checklist (WWC).Design:Well Workplace Checklist data include a convenience sample of US organizations that selected to assess their performance against quality WHP benchmarks.Setting:Workplaces.Subjects:In total, 577 US organizations completed the WWC in 2 or more years from 2008 to 2015.Measures:The WWC is a 100-item organizational assessment that measures performance against the original set of quality benchmarks that were established by the Wellness Council of America (WELCOA).Analysis:This study examined changes in overall WWC scores as well as 7 separate benchmark scores. Multilevel modeling was used to examine changes in scores associated with repeated assessments, controlling for the year of assessment and organizational characteristics.Results:There were significant increases in overall WWC scores (β = 2.93, P < .001) associated with the repeated WWC assessments, after controlling for organizational characteristics. All 7 benchmark scores had significant increases associated with reassessment. Compared to other benchmarks, operating plan (β = 6.18, P < .001) and evaluation (β = 4.91, P < .001) scores increased more with each reassessment.Conclusion:Continued reassessment may represent more commitment to and investment in WHP initiatives which could lead to improved quality. Other factors that may positively influence changes in performance against benchmarks include company size, access to outside resources for WHP, and a history with implementing WHP.
      Citation: American Journal of Health Promotion
      PubDate: 2019-10-24T04:47:52Z
      DOI: 10.1177/0890117119883581
       
  • Socioeconomic Differences in Access to Neighborhood and Network Social
           Capital and Associations With Body Mass Index Among Black Americans
    • Authors: Stephanie T. Child, Andrew T. Kaczynski, Katrina M. Walsemann, Nancy Fleischer, Alexander McLain, Spencer Moore
      First page: 150
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine associations between socioeconomic status and two forms of social capital, namely, neighborhood and network measures, and how these distinct forms of capital are associated with body mass index (BMI) among Black residents of low-income communities.Design:Respondent-driven sampling was used to engage residents in a household survey to collect data on the respondents’ personal network, perceptions about their neighborhood environment, and health.Setting:Eight special emphasis neighborhoods in Greenville, South Carolina.Participants:N = 337 black/African American older adults, nearly half of whom have a household income of less than $15 000 and a high school education, were included.Measures:Neighborhood capital was assessed via three scales on social cohesion, collective efficacy, and social support from neighbors. Network capital was calculated via a position generator, common in egocentric network surveys. Body mass index was calculated with self-reported height and weight.Analysis:Multilevel linear regression models were used to examine the association between neighborhood and network capital and obesity among respondents within sampling chains.Results:Higher household income was associated with greater neighborhood capital, whereas higher educational attainment was associated with greater network capital. Social cohesion was negatively associated with BMI (b = −1.25, 95% confidence interval [CI]: −2.39 to −0.11); network diversity was positively associated with BMI (b = 0.31, 95% CI: 0.08 to 0.55).Conclusion:The findings shed light on how social capital may be patterned by socioeconomic status and, further, how distinct forms of capital may be differentially associated with health among black Americans.
      Citation: American Journal of Health Promotion
      PubDate: 2019-10-31T03:50:07Z
      DOI: 10.1177/0890117119883583
       
  • Make Your Move Experience: A Worksite Wellness Pilot in South Texas
    • Authors: Anna V. Wilkinson, Amanda Davé, Elif Ozdemir, Limairy Rodriquez, Belinda M. Reininger
      First page: 161
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To describe the implementation of Make Your Move Experience (MYME) between 2015 and 2017.Design:Cross-sectional.Setting:Make Your Move Experience is a culturally sensitive worksite wellness program in South Texas designed to encourage sedentary workers to engage in physical activity.Participants:In total, 681 individuals from 19 different organizations.Intervention:UTHealth School of Public Health in Brownsville staff recruited individuals within local organizations to join MYME. At the end of the 3 months, organizations in which employees met MYME goals earned an incentive—bike rack or hydration station—selected to be permanent features of the local environment and facilitate physical activity.Measures:Participant self-reported gender, physical activity level prior to joining MYME (beginner or experienced), and weekly miles of biking, walking, or running completed.Analysis:Mean number of miles biked, walked, and ran each month were compared between (1) beginners and experienced, (2) men and women, and (3) in fall 2016 and spring 2017 using t tests.Results:Beginners initiated physical activity by walking. Men biked more miles than women did (P < .05 all 3 years). Bike riders cycled fewer miles (20.2 miles vs 44.9 miles; P = .03) and walkers covered fewer miles (195.4 miles vs 266.7 miles; P = .04) in fall 2016 compared to spring 2017.Conclusions:Participation in MYME, a culturally appropriate intervention delivered at the worksite, facilitated an increase in physical activity levels among sedentary individuals.
      Citation: American Journal of Health Promotion
      PubDate: 2019-11-15T05:05:21Z
      DOI: 10.1177/0890117119885874
       
  • Racial/Ethnic Differences in Diet Quality and Eating Habits Among WIC
           Pregnant Women: Implications for Policy and Practice
    • Authors: Alla M. Hill, Danielle L. Nunnery, Alice Ammerman, Jigna M. Dharod
      First page: 169
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:One of the major federal food assistance programs, the Special Supplemental Program for Women, Infants, and Children (WIC), serves approximately 1.5 million low-income pregnant women per year; however, limited information is available on their dietary habits. This is critical because low-income women are at higher risk of gaining excess weight during pregnancy. Thus, the study objectives were to (1) determine the overall diet quality of WIC pregnant women and (2) examine diet quality and eating behaviors by race/ethnicity and other sociodemographics.Design:This was a cross-sectional study.Setting:One of the 3 WIC offices in a north-central county in North Carolina, USA.Sample:Pregnant women (n = 198) in the second trimester.Measures:Interviews included sociodemographics, food security, diet, and eating behaviors. Diet quality was assessed by the Healthy Eating Index (HEI) 2010 scores.Analysis:Descriptives, bivariate analysis, and multivariate analysis.Results:Average participant age was 26 years, and the mean HEI-2010 score was 56 of maximum score of 100. Specifically, African American women consumed significantly lower servings of whole grains (β = −1.71; 95% CI: −3.10 to −0.32; P < .05) and dairy (β = −1.42; 95% CI: −2.51 to −0.33; P < .05) compared with non-Hispanic white women. Hispanic women scored higher in daily intake of fruits (β = 0.98; 95% CI: 0.17-1.79; P < .05) and for consuming empty calories in moderation (β = 1.57; 95% CI: 0.06-3.09; P < .05). Frequency of intake of fast foods/outside meals was higher among African American women (57%, P = .025).Conclusion:Efforts are warranted to promote optimal nutrition among WIC pregnant women. Specifically, African American women are highly vulnerable to poor dietary habits during pregnancy. Further investigation of barriers/facilitators for healthy eating is necessary to address nutrition disparities among WIC pregnant women.
      Citation: American Journal of Health Promotion
      PubDate: 2019-10-29T03:02:20Z
      DOI: 10.1177/0890117119883584
       
  • Sustained Long-Term Effectiveness of an Energy Management Training Course
           on Employee Vitality and Purpose in Life
    • Authors: Sai Krupa Das, Shawn T. Mason, Taylor A. Vail, Caroline M. Blanchard, Meghan K. Chin, Gail T. Rogers, Kara A. Livingston, Jennifer L. Turgiss
      First page: 177
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Programs designed to sustainably improve employee well-being are urgently needed but insufficiently researched. This study evaluates the long-term effectiveness of a commercial well-being intervention in a worksite setting.Design:A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months.Setting:Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8).Participants:One hundred sixty-three employees with a mean age of 47 (11) years (57% female).Intervention:A 2.5-day group-based behavioral program emphasizing vitality and purpose in life (PiL).Measures:Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality (primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale, Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18 months.Analysis:General linear models with repeated measures for mean values at baseline and follow-up.Results:At 18-month follow-up, sustained improvements were observed for vitality, general health, and mental health domains of SF-36 and PiL (P < .001 for all measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved at 18 months (P < .05 for all measures).Conclusions:An intensive 2.5-day intervention showed sustained improvement in employee quality of life, PiL, and other measures of well-being over 18 months.
      Citation: American Journal of Health Promotion
      PubDate: 2019-11-08T03:55:57Z
      DOI: 10.1177/0890117119883585
       
  • Addressing Health and Well-Being Through State Policy: Understanding
           Barriers and Opportunities for Policy-Making to Prevent Adverse Childhood
           Experiences (ACEs) in South Carolina
    • Authors: Aditi Srivastav, Mindi Spencer, James F. Thrasher, Melissa Strompolis, Elizabeth Crouch, Rachel E. Davis
      First page: 189
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:As adverse childhood experiences (ACEs) become increasingly recognized as a root cause of unhealthy behaviors, researchers, practitioners, and legislators seek to understand policy strategies to prevent and mitigate its effects. Given the high prevalence of ACEs, policies that address ACEs can meaningfully prevent disease in adulthood and improve population health. We sought to understand barriers and opportunities for policies to prevent and mitigate ACEs by exploring state legislator perspectives.Setting and Participants:Twenty-four current state legislators in South Carolina.Design:In 2018, we conducted semistructured interviews with 24 state legislators. Participants were recruited using maximum variation sampling. The researchers individually analyzed each interview transcript using focused coding qualitative techniques. A high inter-rater agreement was demonstrated (κ = .76 to .87), and discrepancies were resolved through discussion.Method:The data collection and analysis were guided by Multiple Streams Theory, which identifies 3 key components (attention to the problem, decisions about policy options, and the impact of political landscape) that can lead windows of opportunity for passing policies.Results:Legislators identified several factors that can influence the passage of legislation on ACEs: awareness of ACEs; gaps in understanding about what can be done about ACEs; the use of data and stories that contextualize the problem of ACEs; capitalizing on the bipartisanship of children’s issues; and linking to current ACEs-related issues on the policy agenda, such as school safety and violence prevention and the opioid epidemic.Conclusion:Public health researchers and practitioners should focus on the factors identified to advocate for policies that prevent ACEs and/or address their health consequences.
      Citation: American Journal of Health Promotion
      PubDate: 2019-10-10T05:21:27Z
      DOI: 10.1177/0890117119878068
       
  • Cooperative Extension Gets Moving, but How' Exploration of Extension
           Health Educators’ Sources and Channels for Information-Seeking Practices
           
    • Authors: Thomas E. Strayer, Lauren E. Kennedy, Laura E. Balis, NithyaPriya S. Ramalingam, Meghan L. Wilson, Samantha M. Harden
      First page: 198
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The Cooperative Extension System (Extension) has implemented concerted efforts toward health promotion in communities across the nation by acting as an intermediary between communities and universities. Little is known about how these intermediaries communicate and learn about existing evidence-based programming. This study serves to explore this gap by learning about information sources and channels used within Extension.Design:Sequential explanatory mixed methods approach.Setting:National Cooperative Extension System.Participants:Extension community-based health educators.Methods:A nationally distributed survey with follow-up semistructured interviews. Survey results were analyzed using a Kruskal-Wallis 1-way analysis of variance test paired with Bonferroni post hoc. Transcripts were analyzed by conventional content analysis.Results:One hundred twenty-one Extension educators from 33 states responded to the survey, and 18 of 20 invited participants completed the interviews. Educators’ information seeking existed in 2 forms: (1) information sources for learning about programming and (2) channels by which this information is communicated. Extension educators reported contacting health specialists and other educators. Extension educators also reported using technological means of communication such as e-mail and Internet to reach information sources such as peers, specialists, academic journals, and so on.Conclusion:Extension state specialists were preferred as primary sources for intervention information, and technology was acknowledged as an easy contact channel. This study identifies county-based health educators’ information structures and justifies the need for future research on the role of specialists in communication efforts for educators.
      Citation: American Journal of Health Promotion
      PubDate: 2019-10-04T04:18:33Z
      DOI: 10.1177/0890117119879606
       
  • Physical Activity Surveillance Using Wearable Activity Monitors: Are US
           Adults Willing to Share Their Data'
    • Authors: Eric T. Hyde, John D. Omura, Janet E. Fulton, Andre Weldy, Susan A. Carlson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Wearable activity monitors (wearables) have generated interest for national physical activity (PA) surveillance; however, concerns exist related to estimates obtained from current users willing to share data. We examined how limiting data to current users who are willing to share data associated with PA estimates in a nationwide sample.Design:Cross-sectional web-based survey.Setting:US adults.Subjects:In total, 942 respondents.Measures:The 2018 Government & Academic Omnibus Survey assessing current wearable use, willingness to share data with various people or organizations, and PA levels.Analysis:Estimated the prevalence of current wearable use; current users’ willingness to share data with various people or organizations; and PA levels overall, among current users, and among current users willing to share their data.Results:Overall, 21.7% (95% confidence interval [CI]: 19.1-24.5) of US adults reported currently using a wearable. Among current users, willingness to share ranged from 40.1% with a public health agency to 76.3% with their health-care provider. Overall, 62.2% (95% CI: 58.9-65.3) of adults were physically active. These levels were similar between current users (75.0%, 95% CI: 68.3-80.7) and current users willing to share their data (75.3%, 95% CI: 67.9-81.5).Conclusion:Our findings suggest that using data from wearable users may overestimate PA levels, although reported willingness to share the data may not compound this issue.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119900587
       
  • Health-Promoting Effects of a Concurrent Workplace Training Program in
           Inactive Office Workers (HealPWorkers): A Randomized Controlled Study
    • Authors: Konstantina Karatrantou, Vassilis Gerodimos, Nikolaos Manouras, Theodora Vasilopoulou, Anastasia Melissopoulou, Apostolos Filippos Mesiakaris, Yiannis Theodorakis
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To the best of our knowledge, no previous study has examined the health-promoting effects of a daily supervised concurrent workplace training program in inactive office workers. The main objective of this study was to examine the effectiveness of a 6-month workplace training program on health indices, musculoskeletal pains, functional capacity, and physical fitness in office workers.Design:Randomized controlled study.Setting:Four workplaces in the Region of Thessaly, Greece.Participants:A total of 36 office workers (≥6 hours/d, 5 days/wk) were randomly assigned to either a training group (TG; n = 18) or a control group (CG; n = 18).Intervention:The TG participated, every working day, in a 6-month supervised concurrent (flexibility, strength, balance, aerobic) training program (120 training sessions, 2 workouts/d of 15-20 minutes) that was implemented, in small groups, at the workplace during the work shift. The CG did not participate in any training.Measures:Health indices (body composition, blood pressure, respiratory function), musculoskeletal pains, functional capacity (flexibility, balance), and physical fitness (maximal strength, cardiorespiratory fitness) were measured before and after the completion of the program. After the completion of the program, participants’ enjoyment was assessed.Analysis:Two-way analysis of variance (group × time) with repeated measures on the “time” factor.Results:The statistical power, for all parameters, ranged from 0.85 to 0.94. Training group significantly increased lean body mass (3.81%); respiratory function (4.20%-4.53%); cervical, handgrip, back, and leg maximal strength (8.75%-26.55%); and functional capacity (19.71%-188.20%; P < .001-.01; Cohen’s effect size: 0.80-7.21), while significant reductions were observed on body fat (7.58%), blood pressure (4.99%-8.05%), heart rate (12.80%), and musculoskeletal pains (33.33%-100%; P < .001; Cohen’s effect size: 0.81-6.21). In CG, all the above variables did not change. Furthermore, a great percentage of workers (94.4%) reported high levels of enjoyment.Conclusion:The program “HealPWorkers” is an enjoyable exercise modality that may be safely and effectively used, to work settings, for the improvement of worker’s health, overall fitness, and functional capacity.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119899781
       
  • Sexual and Reproductive Health Web Sites: An Analysis of Content for
           Sexual and Gender Minority Youth
    • Authors: Jack Andrzejewski, Catherine N. Rasberry, Brian Mustanski, Riley J. Steiner
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Sexual and gender minority (SGM) youth face risks for negative sexual and reproductive health (SRH) outcomes; it is critical to provide these populations with health education that is both inclusive of and specific to their needs. We sought to characterize the strengths and weaknesses of SGM-related messages from web sites that address SRH for young people. We considered who is included, what topics are discussed, and how messages are framed.Methods:A systematic Google search and screening process was used to identify health promotion web sites with SRH content for adolescents and young adults. Using MAXQDA, we thematically coded and analyzed SGM content qualitatively.Results:Of 32 SRH web sites identified, 23 (71.9%) contained SGM content. Collectively, the sites included 318 unique SGM codes flagging this content. Approximately two-thirds of codes included messages that discussed SGM youth in aggregate (eg, lesbian, gay, bisexual, and transgender)—specific content about the diverse subpopulations within this umbrella term (eg, transgender youth) was more limited. In addition to SRH topics, most web sites had messages that addressed a broad array of other health issues including violence, mental health, and substance use (n = 17, 73.9%) and SGM-specific topics, for example coming out (n = 21, 91.3%). The former were often risk-framed, yet affirmational messages were common. Most web sites (n = 16; 69.6%) presented information for SGM youth both in stand-alone sections and integrated into broader content. Yet, integrated information was slightly more common (56.6% of all codes) than stand-alone content.Conclusions:Challenges of developing SRH content related to SGM youth include: (1) aggregate terms, which may not represent the nuances of sexual orientation and gender, (2) balancing risk versus affirmational messages, and (3) balancing stand-alone versus integrated content. However, SGM-related content also offers an opportunity to address diverse topics that can help meet the needs of these populations.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119899217
       
  • Cannabis Enthusiasts’ Knowledge of Medical Treatment Effectiveness and
           Increased Risks From Cannabis Use
    • Authors: Daniel J. Kruger, Jessica S. Kruger, R. Lorraine Collins
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To compare cannabis enthusiasts’ knowledge about cannabis risks and effectiveness in treating medical conditions with existing empirical evidence.Design:A brief survey assessed cannabis use, information sources, and knowledge about risks and effectiveness.Setting:A cannabis advocacy event in April 2019 in a state with legal medical and recreational cannabis.Participants:Demographically diverse adults (N = 472) who frequently used cannabis; 85% used cannabis for health or medical purposes.Measures:Participants reported the sources of their cannabis information, health conditions they thought cannabis was effective in treating (n = 10), and health risks increased by cannabis (n = 6). Conditions and risks were based on ratings of evidence (ie, from substantial to insufficient) for therapeutic effects and risks identified in a review by The National Academies of Sciences, Engineering, and Medicine (NASEM, 2017).Analyses:Chi-square tests examined the correspondence between participants’ knowledge and NASEM conclusions.Results:Most participants’ (95% confidence interval [CI]: 74%-81%) knowledge of cannabis was from their own experiences; 18% (95% CI: 14%-21%) received information from primary care providers. On average, participants’ beliefs matched NASEM conclusions for half of effectiveness (95% CI: 50%-53%) and risk items (95% CI: 55%-57%). Many (95% CI: 38%-42%) thought that cannabis use did not increase any risk. Contrary to NASEM conclusions, many thought cannabis was effective in treating cancer (76%), depressive symptoms (72%), and epilepsy (68%). Those who received cannabis information from their primary care providers had better knowledge of medical effectiveness. Medicinal cannabis use frequency inversely predicted knowledge of medical effectiveness and increased risks of adverse events.Conclusion:There were considerable discrepancies between cannabis users’ knowledge and available evidence, highlighting the need for more research and education (by physicians, caregivers, and dispensaries) on effectiveness and health risks, especially for users with specific health issues such as pregnant women and people with depression.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119899218
       
  • An Observational Assessment of Physical Activity Levels and Social
           Behavior During Residential Summer Camp Unstructured Time
    • Authors: Zachary Wahl-Alexander, Craig A. Morehead
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To evaluate children’s physical activity (PA) levels, social play behavior, activity time, and social interactions during unstructured time.Approach:Systematic observation tool to record child’s PA level, social group size, activity type, and social interaction during play.Setting:Northeast US residential summer camp, pseudonym Forest Hills Camp.Participants:Fifty-nine third-grade campers (27 males and 32 females).Method:Observational data were obtained using the System for Observing Children’s Activity and Relationships during Play (SOCARP). Data were analyzed using independent samples t tests (with Bonferroni adjustment) to assess statistical differences between boys and girls SOCARP categories.Results:Both boys and girls spend over 50% of their time in moderate-to-vigorous physical activity (MVPA). Statistically significant differences between genders were observed: activity level—(a) girls sat more than boys, and (2) boys engaged in more vigorous activity; activity type—(1) boys engaged in more sport activity, girls engaged in more locomotion activity, and girls were more sedentary; and social interactions—(1) boys had more physical conflict, and (2) boys had more verbal conflict.Conclusion:Contrary to previous research suggesting that summer campers have increased sedentary behavior during unstructured time, our results indicate that third-grade campers engaged in MVPA over 50% of their unstructured time. This suggests that unstructured time in outdoor camp settings may provide valuable opportunities for adolescent children to choose PA.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119897191
       
  • The Association Between Hours Spent at Work and Obesity Status: Results
           From NHANES 2015 to 2016
    • Authors: Caitlin Doerrmann, S. Cristina Oancea, Arielle Selya
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine whether weekly hours worked is associated with obesity among employed adults in the United States.Design:Data from the 2015 to 2016 National Health and Nutrition Examination Survey were used for this study. National Health and Nutrition Examination Survey is a cross-sectional study.Setting:National Health and Nutrition Examination Survey is conducted annually by the National Center for Health Statistics designed to assess the health and nutritional status of citizens in the United States.Participants:The final study sample size was 2,581.Measures:The outcome was obesity status (yes/no) and the exposure was the number of hours worked per week (40 h/wk). Covariates of interest included in the analyses were income, age, education level, race, leisure-time physical activity, and gender.Analysis:A weighted and adjusted logistic regression model was conducted in order to investigate the association between the number of hours worked at a job per week and obesity status. Descriptive statistics and weighted and adjusted odds ratios were produced with 95% confidence intervals (CI).Results:After controlling for the covariates of interest, people working 40 or 40+ hours a week had 1.403 (95% CI: 1.06-1.85) and 1.409 (95% CI: 1.03-1.93) times significantly greater odds of obesity than those who work
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119897189
       
  • They Came, But Will They Come Back' An Observational Study of
           Re-Enrollment Predictors for the Oklahoma Tobacco Helpline
    • Authors: Laura A. Beebe, Lindsay M. Boeckman, Paola G. Klein, Jessie E. Saul, Stephen R. Gillaspy
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Although quitlines reach 1% to 2% of tobacco users annually, additional efforts are needed to increase their impact. We hypothesized that offering less intensive services would increase the rate of re-enrollment in any service, as well as re-enrollment in more intensive services. This study describes the enrollment patterns and identifies re-enrollment predictors for Oklahoma Tobacco Helpline (OTH) participants.Design:This study used a comparative observational design.Setting:The setting for this study was the OTH, a telephone-based cessation program funded by the Oklahoma Tobacco Settlement Endowment Trust. The OTH participants could select either a multicall telephone-based cessation program (MC) or one or more individual services (IS), including a 2-week nicotine replacement therapy (NRT) starter kit, e-mail or text-based support, and a printed quit guide.Participants:A total of 35 648 first-time adult OTH participants eligible for the multicall program from October 2015 through September 2018 were included.Measures:Demographic and tobacco use variables and initial quitline service selection were collected at intake. Additional service utilization was tracked for 6 months following initial registration.Analysis:Pearson chi-square and t tests were used to test for significant differences between groups. Multinomial logistic regression was used to examine predictors of re-enrollment.Results:Individual services were more frequently selected (n = 17 266) than MC (n = 14 326), despite all users being eligible for MC. A much higher proportion of IS registrants re-enrolled than MC registrants (16% vs 3%, P < .0001) Among the IS cohort, those who received an NRT follow-up call were 14.7 times more likely to re-enroll in IS, and 7.8 times more likely to re-enroll in MC, than those who were not reached by phone.Conclusions:Access to free NRT without a telephone-coaching requirement is a draw for tobacco users, especially those with lower income and the uninsured. The results suggest the value of increasing use of nonphone services in an effort to increase interest in quitting and reach.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119890789
       
  • Patient Phenotypes Help Explain Variation in Response to a Social
           Gamification Weight Loss Intervention
    • Authors: Jeffrey Lienert, Mitesh Patel
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study aims to determine latent classes of study participants using baseline characteristics, explore the patterns within the groups, and determine whether the intervention had differential effects on weight loss across the groups.Design:Secondary analysis of a completed randomized clinical trial.Setting:Participants in a gamification intervention with social incentives who were recruited as pairs and given an intervention for 24 weeks. Participants were randomized to control, gamification, or gamification with primary care physician sharing arms.Participants:All 196 participants in the Lose It trial (recruited as 98 pairs).Measures:Outcome variable—participants’ weight change after 24 and 36 weeks. Factors—intervention arm and latent class.Analysis:Latent class analysis on both participants’ and teams’ characteristics. This was followed by 1-sample t tests of weight at 24 and 36 weeks, stratified by latent class.Results:Three groups of participants were identified: “Kin teams,” “Distant teams,” and “Married teams.” “Kin teams” lost more weight after the intervention in the gamification and gamification with PCP sharing arms. The “Distant teams” lost similar amounts of weight in all 3 arms but did not keep it off during maintenance. The “Married teams” lost the most weight across all 3 arms and kept it off following the intervention.Conclusions:Patient phenotypes can identify variations in response to a gamification weight loss intervention. Future intervention studies may benefit from leveraging this during participant recruitment and allocation.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119892776
       
  • Perceived Motivators, Barriers and Intervention Strategies Related to
           Weight Loss After Childbirth Among WIC Participants in Southern California
           
    • Authors: Maria Koleilat, Loan P. Kim, Brittany Cortes, Gergana Damianova Kodjebacheva
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To explore perceived motivators and barriers to weight loss after childbirth and ideas for postpartum weight loss interventions among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).Approach:Four (2 with English-speaking and 2 with Spanish-speaking participants) focus groups were conducted.Setting:A WIC clinic in Southern California.Participants:Of 22 participants, the majority were Hispanic/Latina. The mean age of the mothers’ infants was 6.18 months.Measures:A structured focus group guide was used.Analysis:Audio-recordings were transcribed verbatim. The Spanish transcriptions were reviewed for discrepancies by a bilingual coinvestigator and translated into English for analysis. Transcriptions of the focus group audio-recordings were organized in ATLAS.ti version 8.0. and analyzed using content analysis.Results:Participants had a mean age of 30.5 and a mean prepregnancy body mass index of 32.4. Motivators for weight loss after childbirth included modeling healthy behavior for children and a fear of developing chronic illness. Barriers to weight loss included lack of knowledge, self-efficacy, time, child care and support, postpartum depression, the 40-day rule, and having a c-section. Intervention ideas included providing accountability and peer support for weight loss, providing nutrition/exercise weight loss strategies, and integrating mobile phone technologies into weight loss programs.Conclusions:Weight loss strategies for postpartum WIC participants should provide knowledge, support, accountability, and preferably integrate technology.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119895948
       
  • Employee Perceptions of Wellness Programs and Incentives
    • Authors: Jennifer Fink, Barbara Zabawa, Sarah Chopp
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To explore, by income level, employee perceptions of an employer offered wellness incentive program.Design:Qualitative and quantitative study that includes a survey with close-ended and open-ended questions.Setting:The study setting was a hospital in Wisconsin.Participants:Participants (n = 105).Measures and Analysis:Quantitative responses were analyzed using descriptive statistics in Qualtrics and logistic regression in Statistical Analysis System.Results:Sixty-three percent participated in the wellness incentivized program because their employer offers them a reward; 52% said they would participate without a reward; 48% feel like they must participate in this year’s program; and 34% feel like they would have to disclose information about their health at or below the current reward level.Conclusion:Income does not have a significant effect on whether employees feel they must participate or disclose health information. However, income has a significant effect on employee’s beliefs about whether or not employers should play an active role in improving the health of their employees.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119887687
       
  • Rethinking Urban Female Adolescents’ Safety Net: The Role of Family,
           Peers, and Sexual Partners in Social Support
    • Authors: Camille A. Robinson, Maria Trent, Jonathan M. Ellen, Pamela A. Matson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine how interpersonal factors are associated with family, peer, and partner social support among urban female adolescents in sexual relationships.Design:Secondary data analysis of cross-sectional data.Setting:Two urban health clinics and community sites in Baltimore, Maryland.Participants:One hundred sixteen female adolescents (ages 16-19) with 131 heterosexual relationships from the Perceived Risk of Sexually Transmitted Diseases cohort.Measures:Interpersonal factors included parental monitoring, friend–partner connectedness, and feelings of intimacy for partner. Social support was measured using the Multidimensional Scale of Perceived Social Support with family, peer, and partner subdomains.Analysis:Multivariable linear regression models using baseline data and accounting for clustering of partners.Results:Adolescents perceived high levels of family, peer, and partner support, with the greatest coming from partners (range: 1-5; family mean: 4.0 [95% confidence interval, CI: 3.83-4.18]; peer mean: 4.2 [95% CI: 4.05-4.33]; partner mean: 4.5 [95% CI: 4.36-4.60]). Parental monitoring and friend–partner connectedness were significantly associated with greater family (b = 0.11, standard error [SE] = 0.03, P = 0.001; b = 0.15, SE = 0.06, P = .02) and peer support (b = 0.06, SE = 0.02, P = .01; b = 0.29, SE = 0.07, P < .001). Feelings of intimacy for partner was significantly associated with greater partner support (b = 0.08, SE = 0.03, P = .02).Conclusion:Feeling connected to one’s social network and having a connected network is an important contribution to social support for urban female adolescents in sexual relationships. Future research targeting interpersonal factors is warranted, as it may result in increased social support and promote positive sexual health behaviors in an urban female adolescent population.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119896194
       
  • Changing the Physical Activity Behavior of Adults With Fitness Trackers: A
           Systematic Review and Meta-Analysis
    • Authors: Chris Lynch, Stephen Bird, Noel Lythgo, Isaac Selva-Raj
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:To examine whether a fitness tracker (FT) intervention changes physical activity (PA) behavior compared to a control condition or compared to an alternative intervention.Data Source:Searches between January 01, 2010, and January 01, 2019, were conducted in PubMed, CINAHL, Cochrane CENTRAL, EMBASE, and PsycINFO.Inclusion/Exclusion Criteria:Randomized clinical trials of adults using an FT to change PA behavior were included. Nonclinical trials, studies that included the delivery of structured exercise, and/or studies that only used the FT to assess PA were excluded.Data Extraction:Extracted features included characteristics of the study population, intervention components, PA outcomes, and results.Data Synthesis:Papers were pooled in a statistical meta-analysis using a fixed effects model. Where statistical pooling was not possible, standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Findings were presented in a narrative form and tables.Results:Of 2076 articles found, 21 were included in the review. A small yet significant positive effect (SMD = 0.25, 95% CI = 0.17-0.32; P < .01; I2 = 56.9%; P = .03) was found in step count for interventions compared to control. A small yet significant negative effect (SMD = −0.11, 95% CI = −0.20 to −0.02; P = .02; I2 = 58.2%; P = 0.03) was found in moderate-to-vigorous PA for interventions compared to an alternative intervention.Conclusion:Trackers may enhance PA interventions, as a general positive effect is found in step count compared to a control. However, there is no evidence of a positive effect when interventions are compared to an alternative intervention. It is unknown whether results are due to other intervention components and/or clinical heterogeneity.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119895204
       
  • Physical Activity Support Predicts Safety-Net Patients’ Digital
           Health-Care Engagement: Implications for Patient Care Delivery
    • Authors: Sharon S. Laing, Ryan Sterling, Carlota Ocampo
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Assess relationship among health services received and patients’ digital health-care engagement.Design:Quantitative cross-sectional survey study.Setting:Community health centers in Washington state and DC.Sample:N = 164 adult safety-net patients.Intervention:Not applicableMeasures:Outcomes were knowledge and use of health apps. Predictors were health service access (access to specialists and health information); health service delivery (healthy eating and physical activity counsel); health service satisfaction; and perceived service value.Analysis:Descriptive and multivariate regression analyses. Odds ratios (OR) reported for 95% confidence interval (CI).Results:Response rate was 35%. Of all, 71% were knowledgeable of smartphone use for wellness and 48% used health apps. Physical activity (PA) counseling predicted knowledge and health apps use. Respondents receiving PA counseling were 2.61 times more likely to be knowledgeable about using smartphones for health promotion (OR = 2.61; P = .047; 95% CI: 1.01-6.73). Respondents receiving PA counseling were 2.89 times more likely to use health apps (OR = 2.89; P = .022; 95% CI: 1.17-7.17). Health information access predicted health apps use; respondents with easy access to general health information were 0.29 times as likely to use health apps (OR = 0.29; P = .043; 95% CI: 0.09-0.96).Conclusion:Targeted preventive care support encourages digital health-care engagement. mHealth may supplement health-care needs outside clinics.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119894508
       
  • Food Purchasing Behaviors of WIC Participants: What Non-WIC Eligible Foods
           Items Are Being Purchased
    • Authors: Samantha M. Rex, Jillian Trabulsi, Sandra Baker, Barry Bodt, Shannon M. Robson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To describe items purchased during a shopping trip by families enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).Design:Cross-sectional, quantitative, observational study.Setting:Grocery stores in the Newark, Delaware area.Participants:A convenience sample of mothers (n = 35) were recruited from a local WIC Clinic waiting room.Measures:The number of items categorized into 12 food groups, (baby food, beverages, dairy, fats/oils, fruit, vegetables, grains, protein, preprepared, seasonings, sweets, and other) extracted from grocery receipts.Analysis:Means and frequencies were used to analyze continuous and categorical data, respectively, for receipt data and demographics.Results:The most common foods purchased not included as part of the WIC food package included protein (1.0 [standard deviation, SD 3.0]), preprepared foods (0.9 [SD 2.0]), and other foods (1.0 [SD 1.9]). The most frequent foods purchased included as part of the WIC food package included fruit (2.3 [SD 1.5]), grains (1.7 [SD 1.6]), and dairy (1.5 [SD 0.8]).Conclusions:Further investigation of foods purchased that were not part of the WIC food package is warranted, as understanding food purchases particularly among low-income mothers may inform nutrition education practices.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119892765
       
  • A Randomized Trial to Encourage Healthy Eating Through Workplace Delivery
           of Fresh Food
    • Authors: Rachel Feuerstein-Simon, Roxanne Dupuis, Ryan Schumacher, Carolyn C. Cannuscio
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study aimed to increase the consumption of home-cooked meals among employees at a large urban worksite through a fully subsidized Community Supported Agriculture (CSA) program.Design:Randomized trial.Setting:Worksite in a large northeast city.Participants:Employees were recruited through flyers, e-mail listservs, and outreach from departmental administrators (n = 60).Intervention:Intervention participants received 8 biweekly fresh food deliveries through a CSA program. They also received cooking education and support. Control participants received usual employee benefits.Measures:Consumption of meals prepared at home was the primary end point. Increased consumption of fresh fruits and vegetables was the secondary end point, and food insecurity was an exploratory end point.Analysis:Poisson regression was used to assess mean differences in weekly consumption of home-cooked meals. To assess differences in fruit and vegetable consumption and food insecurity, binary logistic regression was used to estimate odds ratios.Results:Compared to the control group, intervention participants consumed 29% more home-cooked meals per week (P < .01). Fruit and vegetable consumption also increased among intervention participants. The odds of at least twice-daily fruit consumption were 3.8 times higher among intervention participants than among controls, and the odds of at least twice-daily vegetable consumption were 6.2 times higher among intervention participants than among controls. Compared to control participants, intervention participants experienced a statistically significant 89% reduction in the odds of reporting food insecurity at follow-up, when controlling for baseline food insecurity. Participants reported perceived intervention benefits, including the opportunity to experiment with new, healthful foods without financial risk, as well as the social value of sharing recipes, food, and related conversation with colleagues.Conclusion:The study demonstrated the feasibility and potential positive effects of a subsidized workplace CSA program, augmented with cooking education and support.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119890804
       
  • Maternal Educational Attainment and Child Health in the United States
    • Authors: Elizabeth M. Lawrence, Richard G. Rogers, Robert A. Hummer
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To identify how child health status differs by mother’s educational attainment for the overall US population and by race/ethnicity and to assess whether these disparities have changed from 2000 to 2017.Design:Repeated cross-sectional data from the 2000-2017 National Health Interview Survey (NHIS).Setting:United States.Participants:Children aged 1 to 17 years from a nationally representative sample of the noninstitutionalized US population (N = 199 427).Measures:Reported child health status, mother’s educational attainment, child’s race/ethnicity, and control variables were measured using the NHIS.Analysis:Using logistic regression models, we assessed the relationship between maternal education and child health. Missing data were imputed.Results:Children whose mothers had less than a high school education (odds ratio [OR] = 3.84, 95% confidence interval [CI]: 3.62-4.07), high school diploma or equivalent (OR = 2.57, 95% CI: 2.44-2.70), or some college (OR = 1.90, 95% CI: 1.80-2.00) had worse reported health status compared to children whose mothers graduated college. These associations were strongest among non-Hispanic white children, with significantly (P < .05) smaller associations observed for non-Hispanic black, Mexican origin, and other Hispanic children. The associations were smaller but persisted with inclusion of controls. From 2000 to 2017, child health disparities slightly narrowed or remained stagnant among white, non-Hispanic black, and other Hispanic children but widened for Mexican origin children (P < .05).Conclusion:Maternal education disparities in child health are wide and have persisted.
      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117119890799
       
  • The Nation’s Disaffected and Workplace Health Promotion
    • Authors: Paul E. Terry
      Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      DOI: 10.1177/0890117117688822
       
  • Effects of Exercise-Based Interventions on Neonatal Outcomes: A
           Meta-Analysis of Randomized Controlled Trials
    • Authors: Gema Sanabria-Martínez, Antonio García-Hermoso, Raquel Poyatos-León, Alberto González-García, Mairena Sánchez-López, Vicente Martínez-Vizcaíno
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective.The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled clinical trials (RCTs) assessing the influence of physical exercise interventions during pregnancy on some neonatal outcomes.Data Source.Key words were used to conduct a computerized search in six databases: Cochrane Library Plus, Science Direct, EMBASE, PubMed, Web of Science, and ClinicalTrials.gov.Study Inclusion and Exclusion Criteria.RCTs that included an exercise program for healthy pregnant women who were sedentary or had low levels of physical activity were selected.Data Extraction.Two independent reviewers extracted data and assessed the quality of the studies included. Of 4296 articles retrieved, 14 RCTs (3044 pregnant women) met the inclusion criteria.Data Synthesis.Pooled effect sizes (ESs) were calculated using a fixed model.Results.Overall, physical exercise programs during pregnancy produced a small reduction in neonatal birth weight (ES = −.10; p = .04). The Apgar score at 1 minute was also weakly increased with combined exercise (aerobic, strength, and flexibility) (ES = .09; p = .048) and no differences between groups were observed in gestational age at delivery and Apgar score at 5 minutes.Conclusion.Structured physical exercise programs during pregnancy appear to be safe for the neonate, mainly favoring a lower birth weight within normal range. However, more studies are needed to establish recommendations.
      Citation: American Journal of Health Promotion
      DOI: 10.4278/ajhp.140718-LIT-351
       
 
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