Subjects -> HEALTH AND SAFETY (Total: 1508 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (704 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (385 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (123 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (704 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 3)
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)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 1)
African Health Sciences     Open Access   (Followers: 4)
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: 43)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 6)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access   (Followers: 1)
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: 34)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
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: 29)
American Journal of Public Health     Full-text available via subscription   (Followers: 263)
American Journal of Public Health Research     Open Access   (Followers: 27)
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 Community Medicine and Public 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: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 5)
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: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 12)
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: 12)
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 de Saúde     Open Access  
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 12)
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)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
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 & Salud     Open Access  
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 3)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
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)
Cuaderno de investigaciones: semilleros andina     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)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
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 and Equality in Health and Care     Open Access   (Followers: 9)
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: 23)
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: 8)
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   (Followers: 1)
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  
EUREKA : Health Sciences     Open Access   (Followers: 2)
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: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 14)
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)
Frontiers of Health Services Management     Partially Free   (Followers: 2)
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  
Gestão e Desenvolvimento     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   (Followers: 1)
Global Health Promotion     Hybrid Journal   (Followers: 17)
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   (Followers: 1)
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: 19)
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: 69)
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  

        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: 34  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0890-1171 - ISSN (Online) 2168-6602
Published by Sage Publications Homepage  [1088 journals]
  • In Briefs
    • Pages: 231 - 234
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 231-234, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:18:42Z
      DOI: 10.1177/0890117120906058
      Issue No: Vol. 34, No. 3 (2020)
       
  • Updated Employer Tools Identify Practices Associated With Population
           Health Outcomes
    • Authors: Jessica Grossmeier
      Pages: 316 - 317
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 316-317, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:19:13Z
      DOI: 10.1177/0890117119898026a
      Issue No: Vol. 34, No. 3 (2020)
       
  • American Heart Association’s Workplace Health Achievement Index
    • Authors: Chris Calitz, Kristin Pham
      Pages: 317 - 318
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 317-318, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:19:05Z
      DOI: 10.1177/0890117119898026b
      Issue No: Vol. 34, No. 3 (2020)
       
  • The CDC Worksite Health ScoreCard: An Assessment Tool to Promote Employee
           Health and Well-Being
    • Authors: Jason E. Lang, Amanda Mummert, Enid Chung Roemer, Karen Butcher Kent, Dyann Matson Koffman, Ron Z. Goetzel
      Pages: 319 - 321
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 319-321, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:19:04Z
      DOI: 10.1177/0890117119898026c
      Issue No: Vol. 34, No. 3 (2020)
       
  • The HERO Health and Well-Being Best Practices Scorecard in Collaboration
           With Mercer (HERO Scorecard)
    • Authors: Elissa Rosenbaum, Jessica Grossmeier, Mary Imboden, Steven Noeldner
      Pages: 321 - 323
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 321-323, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:19:13Z
      DOI: 10.1177/0890117119898026d
      Issue No: Vol. 34, No. 3 (2020)
       
  • Measuring a Whole Systems Approach to Wellness With the Well Workplace
           Checklist
    • Authors: Sara Martin, Ryan Picarella, Jennifer S. Pitts
      Pages: 323 - 326
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 323-326, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:19:12Z
      DOI: 10.1177/0890117119898026e
      Issue No: Vol. 34, No. 3 (2020)
       
  • The Evolution of Organizational Health Scorecards and Future Directions
    • Authors: Enid Chung Roemer
      Pages: 326 - 332
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 326-332, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:18:42Z
      DOI: 10.1177/0890117119898026f
      Issue No: Vol. 34, No. 3 (2020)
       
  • Reviewers List 2019
    • Pages: 333 - 335
      Abstract: American Journal of Health Promotion, Volume 34, Issue 3, Page 333-335, March 2020.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-19T11:18:51Z
      DOI: 10.1177/0890117120903582
      Issue No: Vol. 34, No. 3 (2020)
       
  • Implementation Outcomes Following Participation in a Large-Scale Healthy
           Workplace Program Conducted Across Multiple Worksites
    • Authors: Zenobia Talati, Carly Grapes, Emily Davey, Trevor Shilton, Simone Pettigrew
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To measure implementation outcomes of a freely available workplace health promotion program (Healthier Workplace Western Australia [HWWA]) that provides employees with services and supports to make changes in their workplaces.Setting:Western Australian workplaces.Subjects:Employees accessing HWWA services.Intervention:A range of services (training sessions, tailored advice, grant schemes, online resources) were offered relating to nutrition, physical activity, smoking, alcohol consumption, and mental health.Design/Measures:Of the 1627 individuals e-mailed 6 months after participation in HWWA, 345 (21%) individuals who recalled accessing one or more services completed a survey assessing the number and type of changes they had implemented and the perceived barriers to doing so.Analysis:Negative binomial regressions and one-way analysis of variances assessed whether respondent characteristics or number of services used was associated with the number and types of changes made. A qualitative analysis of the perceived barriers was also conducted.Results:The majority of respondents (86%) reported implementing one or more changes. Greater perceived responsibility/authority to make change (β = .56, P < .01), perceived support from coworkers (β = .23, P < .05), and number of HWWA services used (β = .04, P < .05) were positive predictors of the number of changes made. Frequently reported barriers included cost/budget restrictions, lack of management support, and resistance from staff.Conclusion:The HWWA program facilitated implementation of various healthy workplace initiatives across the organizations represented in the evaluation.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-03T09:29:30Z
      DOI: 10.1177/0890117120911504
       
  • Attending After-School Physical Activity Club 2 Days a Week Attenuated an
           Increase in Percentage Body Fat and a Decrease in Fitness Among Adolescent
           Girls at Risk for Obesity
    • Authors: Lorraine B. Robbins, Jiying Ling, Fujun Wen
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To evaluate the effect of a 17-week intervention, including an after-school physical activity (PA) club 3 d/wk, on moderate-to-vigorous physical activity (MVPA), body mass index (BMI) z score, percentage body fat (%BF), and cardiorespiratory fitness (CRF) among fifth to eighth grade girls having a BMI z score ≥0, and explore whether intervention outcomes varied by club attendance (1 vs 2 vs 3 d/wk).Design:Secondary analysis of data from a group randomized controlled trial (N = 1519, 10- to 15-year-old girls: n = 753 intervention; n = 766 control).Setting:Twenty-four Midwestern US schools (n = 12 intervention; n = 12 control).Sample:Subsample (n = 1194 girls) from trial’s intervention (n = 593 girls) and control (n = 601 girls) groups having BMI z scores ≥0.Measures:Moderate-to-vigorous physical activity (min/h), BMI z score, %BF, and CRF ([math]: mL/kg/min) were estimated at baseline and postintervention.Analysis:Linear mixed-effect models.Results:Intervention group gained less %BF (B = −0.35, P = .016), and their CRF decreased less (B = 0.22, P = .010) than the control. Marginally significant findings showed girls attending the club an average of 1 d/wk had greater increases in %BF (B = 0.33, P = .087) and MVPA (B = 0.20, P = .083) and a greater decrease in CRF (B = −0.20, P = .061) than girls attending 3 d/wk. No differences occurred between girls who attended 2 versus 3 d/wk for any outcomes.Conclusions:The intervention attenuated an increase in %BF and a decrease in CRF among girls at risk for obesity from baseline to postintervention. Offering the after-school PA club 2 d/wk may be adequate for achieving outcomes.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-02T09:57:00Z
      DOI: 10.1177/0890117120915679
       
  • Physical Activity, Screen Time, and Sleep Duration Among Youth With
           Chronic Health Conditions in the United States
    • Authors: Sean Healy, John Foley, Justin A. Haegele
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To compare the degree to which youth with and without chronic conditions in the United States met physical activity (PA), screen time, and sleep duration guidelines.Design:A cross-sectional study using data from the 2016 National Survey of Children’s Health.Participants:A total of 24 405 youth (aged 10-17 years) with and without 1 of 19 prevalent chronic health conditions who participated in the 2016 National Survey of Children’s Health.Measures:Parents reported on the time spent by their children in PA, screen time, and sleep.Analysis:Descriptive and bivariate analyses were conducted to estimate and compare health behavior guideline adherence rates among children with and without chronic conditions.Results:Overall, 18.7% of children with chronic conditions did not meet any health behavior guidelines compared to 15.6% of children without chronic conditions. Children with hearing impairments, diabetes, and depression were most likely to not meet any health behavior guidelines (27.9%, 25.4%, and 21.7%, respectively). Of the 3 guidelines, children with and without chronic conditions were least likely to meet the PA guideline (18.6% and 21%, respectively).Conclusions:This study identifies specific groups of children with chronic conditions that are most at risk of not meeting health behavior guidelines. The findings highlight specific behaviors in most need of intervention for children with chronic conditions; PA was identified as the most frequently unmet guideline. Overall findings suggest a need for a more integrated, holistic view of health promotion for children with chronic conditions.
      Citation: American Journal of Health Promotion
      PubDate: 2020-04-01T09:32:38Z
      DOI: 10.1177/0890117120915687
       
  • Is Exercise a Useful Intervention in the Treatment of Alcohol Use
           Disorder' Systematic Review and Meta-Analysis
    • Authors: Fatih Gür, Ganime Can Gür
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objectives:This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes.Data Sources:PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases.Study Inclusion and Exclusion Criteria:Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD.Data Extraction:This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines.Data Synthesis:Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week).Results:The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression.Conclusions:Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-26T09:47:14Z
      DOI: 10.1177/0890117120913169
       
  • Correlates of Infrequent Plain Water Intake Among US High School Students:
           National Youth Risk Behavior Survey, 2017
    • Authors: Sohyun Park, Stephen Onufrak, Angie Cradock, Anisha Patel, Christina Hecht, Caitlin Merlo, Heidi M. Blanck
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine factors associated with frequency of plain water (ie, tap, bottled, and unflavored sparkling water) intake among US high school students.Design:Quantitative, cross-sectional study.Setting:The 2017 national Youth Risk Behavior Survey data.Subjects:US high school students with plain water intake data (N = 10 698).Measures:The outcome was plain water intake. Exposure variables were demographics, academic grades, and behavioral characteristics.Analysis:We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for factors associated with infrequent plain water intake (
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-18T10:16:28Z
      DOI: 10.1177/0890117120911885
       
  • Genetic Exceptionalism and Precision Health Promotion
    • Authors: Paul E. Terry
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Are social determinants of health overrated' Is parenting overrated' Will the genetics revolution have the same influence on health behavior as powerful determinants such as culture or the environment' In this editorial, I posit that we will learn that genetic testing will have far greater benefits, and fewer harms, when done in conjunction with well-designed health education and lived experiences. I define precision health promotion as the personalized design of lived experiences that foster improved health and well-being for individuals within the context of their organizations, families, and communities. With the need for education and support to augment genetics information will come the need for unequivocal answers about who should know, and who has no business knowing, about your DNA test results.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-17T10:24:38Z
      DOI: 10.1177/0890117120908806
       
  • Adjudicating Traditional Wellness
    • Authors: Paul E. Terry
      Abstract: American Journal of Health Promotion, Ahead of Print.
      There is no consensus definition for “traditional wellness” but in worksite health promotion, it usually means the wellness program is a health assessment and/or health screening offering followed by some educational programs, usually in the physical health domain. Using the term traditional wellness may belie an unawareness about or lack of appreciation for the quality improvement principles that are as applicable to the health of a profession as they are to the growth of an organization. This editorial examines how the use of the term traditional wellness is a reflection on our professional zeitgeist. Five ideas that attempt to explain misunderstandings about differing approaches to worksite health promotion are offered along with 5 ways we may be able to make peace with traditional wellness.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-13T09:31:22Z
      DOI: 10.1177/0890117120909679
       
  • Development of a Tailored Behavioral Weight Loss Program for Veterans With
           PTSD (MOVE!+UP): A Mixed-Methods Uncontrolled Iterative Pilot Study
    • Authors: Katherine D. Hoerster, Lamont Tanksley, Tracy Simpson, Brian E. Saelens, Jürgen Unützer, Marissa Black, Preston Greene, Nadiyah Sulayman, Gayle Reiber, Karin Nelson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Veterans with post-traumatic stress disorder (PTSD) lose less weight in the Veterans Affairs (VA) weight management program (MOVE!), so we developed MOVE!+UP.Design:Single-arm pre–post pilot to iteratively develop MOVE!+UP (2015-2018).Setting:Veterans Affairs Medical Center.Participants:Overweight Veterans with PTSD (5 cohorts of n = 5-11 [N = 44]; n = 39 received ≥1 MOVE+UP session, with cohorts 1-4 [n = 31] = “Development” and cohort 5 [n = 8] = “Final” MOVE!+UP).Intervention:MOVE!+UP weight management for Veterans with PTSD modified after each cohort. Final MOVE!+UP was coled by a licensed clinical psychologist and Veteran peer counselor in 16 two-hour in-person group sessions and 2 individual dietician visits. Sessions included general weight loss support (eg, behavioral monitoring with facilitator feedback, weekly weighing), cognitive-behavioral skills to address PTSD-specific barriers, and a 30-minute walk to a nearby park.Measures:To inform post-cohort modifications, we assessed weight, PTSD, and treatment targets (eg, physical activity, diet), and conducted qualitative interviews.Analysis:Baseline to 16-week paired t tests and template analysis.Results:Development cohorts suggested improvements (eg, additional sessions and weight loss information, professional involvement) and did not lose weight (mean [M] = 1.8 lbs (standard deviation [SD] = 8.2); P = .29. Conversely, the final cohort reported high satisfaction and showed meaningful weight (M = −14 pounds [SD = 3.7] and 71% lost ≥5% baseline weight) and PTSD (M = −17.9 [SD = 12.2]) improvements, P < .05.Conclusions:The comprehensive, 16-week, in-person, cofacilitated Final MOVE!+UP was acceptable and may improve the health of people with PTSD. Iterative development likely produced a patient-centered intervention, needing further testing.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-12T09:13:49Z
      DOI: 10.1177/0890117120908505
       
  • Interventions to Improve Sexual and Reproductive Health in US Active Duty
           Military Service Members: A Systematic Review
    • Authors: Sara E. Vargas, Colby Norris, Ryan R. Landoll, Baylee Crone, Madison F. Clark, Jeffrey D. Quinlan, Kate M. Guthrie
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:To identify and describe behavioral interventions to promote sexual and reproductive health among US active duty military service members.Data Sources:Systematic searches of PubMed, CINAHL, and PsychINFO (N = 1609 records).Inclusion Criteria:English-language articles published between 1991 and 2018 and retrieved using search terms related to military service, interventions, and sexual and reproductive health.Exclusion Criteria:Articles excluded if not empirically based, not published in peer-reviewed journals, did not sample active duty US military personnel, and did not examine the effectiveness of specified preventive sexual or reproductive health intervention(s).Data Extraction:Teams of paired authors extracted study rationale; aims; design; setting; description of the intervention; measures; sample demographics; clinical, behavioral, and psychosocial outcomes; and conclusions.Data Synthesis:Given the heterogeneity of studies, narrative synthesis was performed.Results:Fifteen articles met inclusion criteria: 10 focused on sexually transmitted infection (STI) acquisition and/or unintended pregnancy and 5 on sexual assault. Studies that assessed clinical outcomes found that interventions were associated with lower rates of STIs and/or unintended pregnancy. Significant effects were found on knowledge-related outcomes, while mixed effects were found on attitudes, intentions, and behaviors.Conclusions:Current evidence on the effectiveness of sexual and reproductive health interventions in the US military is limited in quality and scope. Promoting sexual and reproductive health in this population is critical to maintaining well-being among servicemembers, their families, and the communities surrounding military installations.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-05T10:54:42Z
      DOI: 10.1177/0890117120908511
       
  • Neighborhood Walkability and Overweight/Obese Weight Status Among Latino
           Adults
    • Authors: Rosenda Murillo, Layton M. Reesor-Oyer, Daphne C. Hernandez, Yu Liu, Ezemenari M. Obasi
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine whether aerobic physical activity mediates the association between neighborhood walkability and overweight/obesity weight status among Latino adults and whether the relative contribution of this pathway linking neighborhood walkability and aerobic activity varies by level of neighborhood social cohesion.Design:Cross-sectional.Setting:National Health Interview Survey (NHIS) 2015.Sample:NHIS adult Latino participants ≥18 years of age (n = 4303).Measures:Neighborhood walkability, neighborhood social cohesion, body mass index, and aerobic physical activity.Analysis:To determine whether physical activity mediates the relationship of walkability with overweight/obese weight status, a simple mediation analysis was conducted. Additionally, a moderated mediation analysis was conducted to test whether neighborhood social cohesion had a moderating effect on this relationship.Results:On average, the sample was 41 years old, 51% were male, 34% had less than a high school education, and 57% were foreign-born. Neighborhood walkability was statistically significantly related to overweight/obese weight status (standardized effect= −0.05, standard error [SE] = 0.02, P = .01). The interaction between walkability and neighborhood social cohesion on physical activity was not significant (standardized effect = 0.06, SE = 0.03, P = .09). Thus, the indirect effect of walkability on overweight/obesity weight status through physical activity was not shown to be modified by neighborhood social cohesion.Conclusion:Other neighborhood environment factors may play a role in the contribution of neighborhood walkability to overweight/obese weight status among Latinos.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-05T10:52:42Z
      DOI: 10.1177/0890117120907869
       
  • Prevalence of Frequent Mental Distress Among Illinois Adults With Chronic
           Conditions: Estimates From the Behavioral Risk Factor Surveillance System,
           2011 to 2017
    • Authors: Janae D. Price, Nancy L. Amerson, Kamil E. Barbour, Damilola V. Emuze
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The objective of this study was to examine frequent mental distress (FMD) by demographics, chronic conditions, and health risk factors among Illinois adults.Design:Descriptive analyses included χ2 and pairwise t tests to examine how FMD status differed by selected characteristics and Cox proportional hazards regression analysis to examine the association between FMD and chronic conditions and risk factors.Setting:Illinois Behavioral Risk Factor Surveillance System, 2011 to 2017 (n = 37 312).Participants:Adults who self-report FMD (n = 3455) were included.Measures:Prevalence of high blood pressure, coronary heart disease, chronic obstructive pulmonary disease, arthritis, asthma, high blood cholesterol, cancer, kidney disease, stroke, diabetes, weight status, physical activity status, smoking status, and drinking status.Results:A significantly higher FMD prevalence was found among females (11.7%; 95% confidence interval [CI]: 11.1-12.4), non-Hispanic blacks (13.4, 95% CI: 11.9-15.0), adults with less than a high school degree (14.4%; 95% CI: 12.6-16.3), adults with an annual income of less than $15 000 (21.4%; 95% CI: 19.4-23.5), and adults with a disability (23.3%, 95% CI: 21.9-24.7). Adjusted prevalence of FMD was significantly higher among adults for 8 of 10 chronic conditions and 4 of 5 health risk factors studied.Conclusions:Social stigmas related to depression and anxiety may lead to the underreporting of FMD. Chronic disease management programs in Illinois should consider integrating mental health services.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-05T10:51:02Z
      DOI: 10.1177/0890117120906960
       
  • Does Exposure to the Choose Water Campaign Increase Parental Intentions to
           Promote More Water and Less Sugar-Sweetened Beverage Consumption'
    • Authors: Julia I. Caldwell, Brenda Robles, Rachel Tyree, Renee White Fraser, Kelly A. Dumke, Tony Kuo
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To assess if exposure to the Choose Water public health media campaign increased parents’ intentions to promote healthier beverage consumption in their household.Design:A cross-sectional evaluation administered post-campaign.Setting:A 2017 internet panel survey in Los Angeles County, California.Participants:The survey included 499 parents of young children.Intervention:The Choose Water media campaign included digital media and out-of-home advertisements (eg, transit shelters, interiors of buses) in both English and Spanish.Measures:Dichotomous outcome variables were parental intentions to give child(ren) (1) more water and (2) less sugar-sweetened beverage consumption in their households. The independent variable was campaign exposure, categorized as no exposure, exposed but did not discuss visual, and exposed and discussed visual with someone.Analysis:Descriptive, bivariate, and multivariable logistic regressions.Results:Among those who were exposed and discussed a campaign visual, the adjusted odds of intending to promote water consumption were 2.82 times greater than for those who reported no exposure (95% confidence interval [CI]: 1.46-5.46). Similar odds to promote less sugar-sweetened beverage consumption were observed for those who were exposed and discussed a campaign visual (adjusted odds ratio: 3.27, 95% CI: 1.76-6.08). Those with the lowest educational attainment discussed the visual(s) less (10.5%).Conclusion:Word of mouth may enhance health messaging by allowing time for intended audiences to process campaign content within their interpersonal network.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-03T10:04:53Z
      DOI: 10.1177/0890117120908785
       
  • Integration of Mixed Methods in Community-Based Participatory Research:
           Development of a Disease Prevention Intervention for Ultra-Orthodox Jewish
           Women
    • Authors: Elisheva Leiter, Adi Finkelstein, Milka Donchin, Keren L. Greenberg, Osnat Keidar, Sima Wetzler, Sara Siemiatycki, Ronit Calderon-Margalit, Donna R Zwas
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To describe the development of the first disease prevention intervention with ultra-Orthodox Jewish (UOJ) women in Israel using mixed methods and community-based participatory research (CBPR).Design:This collaborative, 7-staged development process used an exploratory sequential mixed methods design integrated into a community-based participatory approach.Setting:The UOJ community in Israel, a high-risk, low socioeconomic, culturally insular minority that practices strict adherence to religious standards, maintains determined seclusion from mainstream culture and preserves traditional practices including extreme modesty and separation between the sexes.Participants:Women from a targeted UOJ community in Israel with distinct geographic, religious, and cultural parameters. These included 5 key informant interviewees, 5 focus groups with 6 to 8 participants in each, a cluster randomized sample of 239 questionnaire respondents (an 87% response rate), and 11 steering committee participants.Method:Qualitative data were analyzed through Interpretative Phenomenological Analysis by 2 researchers. Quantitative data were collected via questionnaire (designed based on qualitative findings) and analyzed utilizing descriptive statistics.Results:Barriers to health behavior engagement and intervention preferences were identified. The final intervention included walking programs, health newsletters, community leader trainings, teacher and student trainings, and health integration into schools.Conclusion:Utilizing mixed methods in CBPR improved cultural tailoring, potentially serving as a model for intervention design in other difficult to access, low socioeconomic, and culturally insular populations.
      Citation: American Journal of Health Promotion
      PubDate: 2020-03-03T09:55:08Z
      DOI: 10.1177/0890117120906965
       
  • Wellness Program Nonparticipation and Its Association With Employee
           Turnover
    • Authors: Kristi Rahrig Jenkins, Bruce W. Sherman
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study examines the association between nonparticipation in wellness activities and employee turnover risk.Design:Retrospective, cross-sectional analysis.Setting:Large university in the Midwestern United States.Participants:Employees with continuous employment during 2016 and complete human resources and wellness program data (n = 34 405).Methods:Demographic, health risk assessment (HRA), and wellness program participation data were collected in 2016 and paired with administratively recorded turnover status from 2017. For the multivariate analyses, logistic regression models were used.Results:There were statistically significant associations between various socioeconomic and demographic characteristics (gender, age, race, wage, union and faculty status, and health score) with turnover status. Also, all 3 participation levels (participated in the HRA only, participated in the HRA and wellness programming, and participated in wellness programming only) had lower odds of experiencing turnover compared to nonparticipants (participated in the HRA only [adjusted odds ratio, AOR: 0.89; confidence interval, CI: 0.80-0.99], participated in wellness program(s) only [AOR: 0.77; CI: 0.62-0.95] and participated in both the HRA and program(s) [AOR: 0.82; CI: 0.74-0.91], respectively).Conclusion:Employee participation in wellness program activities appears to represent a measure of engagement with work. Nonparticipation in these programs is associated with increased risk of employment turnover in the subsequent year.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-27T12:51:00Z
      DOI: 10.1177/0890117120907867
       
  • The Impact of Health Promotion Interventions on Telomere Length: A
           Systematic Review
    • Authors: Shan Qiao, Yanping Jiang, Xiaoming Li
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objectives:The aim of this study was to evaluate the effectiveness of health promotion interventions in delaying telomere shortening (a biomarker for aging).Data Source:PubMed, PsychINFO, EMBASE, CINAHL, and Cochrane Library databases.Study Inclusion and Exclusion Criteria:Inclusion criteria: (1) empirical studies involving human subjects; (2) health promotion intervention studies including both randomized control trials (RCTs) and non-RCTs.; (3) measured telomere length as an intervention outcome; and (4) were written in English. Exclusion criteria: (1) observational studies without any health promotion intervention practices and (2) did not report intervention effects.Data Extraction:Data extraction was performed by two reviewers following the preferred reporting items for systematic reviews and meta-analysis guidelines.Data Synthesis:Substantial heterogeneity in intervention type and study design in the included studies precluded a meta-analysis. We conducted a narrative synthesis instead.Results:Thirty studies were included in the review, of which 16 were RCTs. One-third of the included studies reported significant intervention impacts in delaying telomere shortening, with relatively consistent significant results emerged from weight-loss interventions and interventions involving multiple lifestyle modification components (eg, diet and exercise). Most of supplement intervention studies observed null effects in telomere length.Conclusions:Weight-loss and comprehensive lifestyle intervention strategies show encouraging impacts in delaying telomere shortening. More rigorous studies targeting populations at different age stages through life span are needed.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-27T12:48:33Z
      DOI: 10.1177/0890117120906958
       
  • Online Pro-Tobacco Marketing Exposure Is Associated With Dual Tobacco
           Product Use Among Underage US Students
    • Authors: Hunter Marion, William Garner, Alex Estrada, Christopher Moorer, Ixel Acosta-Velazquez
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To understand the effect of pro-tobacco marketing on electronic cigarette and combustible cigarette dual use among US middle and high school students under 18 years of age.Design:Data were derived from the 2018 National Youth Tobacco Survey, an annual self-administered school-based cross-sectional survey.Setting:The survey was administered in public and private middle and high schools across the United States.Participants:The probability sample size was 15 238 middle and high school students with complete responses who were under 18 years of age during the study period.Measures:The study measured self-reported exposure to online combustible and electronic cigarette advertisements, dual use of combustible and electronic cigarettes during the past 30 days, exposure to the Real Cost antitobacco campaign advertisements, and other sociodemographic factors (eg, race/ethnicity, gender, and grade).Analysis:Logistic regressions were used to measure pro-tobacco marketing exposure and dual use as a function of pro-tobacco marketing exposure.Results:Descriptive analyses show that 59.0% of respondents were exposed to pro-tobacco online marketing, and 2.9% were dual users. Dual users (odds ratio [OR] = 1.73) and high school students (OR = 1.43) were more likely to report exposure to online pro-tobacco marketing.Conclusions:Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-25T11:55:15Z
      DOI: 10.1177/0890117120905231
       
  • Reply to Dr Goetzel
    • Authors: Damon Jones, David Molitor, Julian Reif
      Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-24T09:25:29Z
      DOI: 10.1177/0890117120906661
       
  • Nurses’ Perspectives on the Dismissal of Vaccine-Refusing Families From
           Pediatric and Family Care Practices
    • Authors: Michael J. Deem, Rebecca A. Kronk, Vincent S. Staggs, Denise Lucas
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Dismissal of families who refuse mandated childhood vaccines from pediatric practices has become more common among US pediatricians over the past 2 decades. While nurses (registered nurses [RNs] and advanced practice registered nurses [APRNs]) often are the first health-care professional to encounter parents’ vaccine hesitancy and serve as a primary source of information, there are no published data on nurses’ perspectives on dismissal as a response to vaccine refusal. This study examined nurses’ perspectives on dismissal of vaccine-refusing families from primary care practices.Design:Cross-sectional survey administered electronically from February to September 2018. Data analysis was conducted from November 2018 to March 2019.Setting:Data were collected electronically from a national sample of nurses.Subjects:A convenience sample of 488 primary care nurses (74% APRNs) was recruited and enrolled in the study through collaboration with 4 professional nursing associations.Measure and Analysis:A cross-sectional survey was conducted from February to September 2018. We explored correlates of nurses’ (n = 488) attitudes toward dismissal by modeling attitude scores as a function of practice and respondent characteristics. We also modeled odds of encountering vaccine refusal and odds of reporting dismissal of a vaccine-refusing family in the last 12 months, each as a function of respondents’ practice characteristics.Results:Eighty-four percent of respondents encountered vaccine refusal in the previous 12 months, and 22% reported that their practice had dismissed a vaccine-refusing family within the previous 12 months. Twenty-eight percent agreed/strongly agreed that they would dismiss or support a decision to dismiss families who refuse all vaccines, and 12% supported dismissal of families for refusal of some but not all vaccines. Thirty-nine percent of respondents disagreed/strongly disagreed with dismissing families who refuse all vaccines, and 50% disagreed/strongly disagreed with dismissal for refusal of some but not all.Conclusion:Almost all nurses working in primary care encounter vaccine refusal, and most consider all Centers for Disease Control and Prevention–recommended childhood vaccines to be important to public health. There is significant polarization of nurses’ attitudes toward the appropriateness of dismissal as a response to vaccine refusal. We recommend the development of professional nursing guidelines for responding to vaccine refusal. However, because there are no data on the community health impact of dismissal policies, we recommend further research on outcomes of dismissal policies to inform such guidelines.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:12:34Z
      DOI: 10.1177/0890117120906971
       
  • Development of a Wellness Committee Implementation Index for Workplace
           Health Promotion Programs in Small Businesses
    • Authors: Meagan C. Brown, Jeffrey R. Harris, Kristen Hammerback, Marlana J. Kohn, Amanda T. Parrish, Gary K. Chan, India J. Ornelas, Christian D. Helfrich, Peggy A. Hannon
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To construct a wellness committee (WC) implementation index and determine whether this index was associated with evidence-based intervention implementation in a workplace health promotion program.Design:Secondary data analysis of the HealthLinks randomized controlled trial.Setting:Small businesses assigned to the HealthLinks plus WC study arm.Sample:Small businesses (20-200 employees, n = 23) from 6 low-wage industries in King County, Washington.Measures:Wellness committee implementation index (0%-100%) and evidence-based intervention implementation (0%-100%).Analysis:We used descriptive and bivariate statistics to describe worksites’ organizational characteristics. For the primary analyses, we used generalized estimating equations with robust standard errors to assess the association between WC implementation index and evidence-based intervention implementation over time.Results:Average WC implementation index scores were 60% at 15 months and 38% at 24 months. Evidence-based intervention scores among worksites with WCs were 27% points higher at 15 months (64% vs 37%, P < .001) and 36% points higher at 24 months (55% vs 18%, P < .001). Higher WC implementation index scores were positively associated with evidence-based intervention implementation scores over time (P < .001).Conclusion:Wellness committees may play an essential role in supporting evidence-based intervention implementation among small businesses. Furthermore, the degree to which these WCs are engaged and have leadership support, a set plan or goals, and multilevel participation may influence evidence-based intervention implementation and maintenance over time.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:11:14Z
      DOI: 10.1177/0890117120906967
       
  • Commentary on the Study: “What Do Workplace Wellness Programs Do'
           Evidence From the Illinois Workplace Wellness Study”
    • Authors: Ron Z. Goetzel
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Recently, several high-profile randomized clinical trials conducted with employees at the University of Illinois and BJ’s Wholesale Club have questioned the value of workplace health and well-being programs. This commentary focuses on the latest research published in The Quarterly Journal of Economics by authors Jones, Molitor, and Reif who evaluated the iThrive wellness program. The commentary challenges the study’s main finding that wellness programs (in general) do not work. Several perspectives are explored including whether the evaluated programs are well-designed, sufficiently potent, and appropriate candidates for randomized trials. The article also asks what role employers can or should play in improving the health and well-being of Americans given recent troubling statistics showing a decline in life expectancy and an increase in health risks.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:09:34Z
      DOI: 10.1177/0890117120906664
       
  • Effects of Intervention Characteristics on Willingness to Initiate a
           Weight Gain Prevention Program
    • Authors: Megan A. McVay, Marissa L. Donahue, JeeWon Cheong, Joseph Bacon, Michael G. Perri, Kathryn M. Ross
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine characteristics of weight gain prevention programs that facilitate engagement.Design:Randomized factorial experiment (5 × 2).Setting:Recruited nationally online.Participants:Adults aged 18 to 75 with body mass index ≥25 who decline a behavioral weight loss intervention (n = 498).Measures:Participants were randomly presented with one of 10 possible descriptions of hypothetical, free weight gain prevention programs that were all low dose and technology-based but differed in regard to 5 behavior change targets (self-weighing only; diet only; physical activity only; combined diet, physical activity, and self-weighing; or choice between diet, physical activity, and self-weighing targets) crossed with 2 financial incentive conditions (presence or absence of incentives for self-monitoring). Participants reported willingness to join the programs, perceived program effectiveness, and reasons for declining enrollment.Analysis:Logistic regression and linear regression to test effects of program characteristics offered on willingness to initiate programs and programs’ perceived effectiveness, respectively. Content analyses for open-ended text responses.Results:Participants offered the self-weighing-only programs were more willing to initiate than those offered the programs targeting all 3 behaviors combined (50% vs 36%; odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.01-3.13). Participants offered the programs with financial incentives were more willing to initiate (50% vs 33%; OR = 2.08; 95% CI, 1.44-2.99) and anticipated greater intervention effectiveness (β = .34, P = .02) than those offered no financial incentives. Reasons for declining to initiate included specific program features, behavior targets, social aspects, and benefits.Conclusion:Targeting self-weighing and providing financial incentives for self-monitoring may result in greater uptake of weight gain prevention programs.Study Preregistration: https://osf.io/b9zfh, June 19, 2018.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:08:14Z
      DOI: 10.1177/0890117120905709
       
  • Prevalence of Workplace Health Practices and Policies in Hospitals:
           Results From the Workplace Health in America Study
    • Authors: Laura Mulder, Brook Belay, Qaiser Mukhtar, Jason E. Lang, Diane Harris, Stephen Onufrak
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To provide a nationally representative description on the prevalences of policies, practices, programs, and supports relating to worksite wellness in US hospitals.Design:Cross-sectional, self-report of hospitals participating in Workplace Health in America (WHA) survey from November 2016 through September 2017.Setting:Hospitals across the United States.Participants:Random sample of 338 eligible hospitals participating in the WHA survey.Measures:We used previous items from the 2004 National Worksite Health Promotion survey. Key measures included presence of Worksite Health Promotion programs, evidence-based strategies, health screenings, disease management programs, incentives, work-life policies, barriers to health promotion program implementation, and occupational safety and health.Analysis:Independent variables included hospital characteristics (eg, size). Dependent characteristics included worksite health promotion components. Descriptive statistics and χ2 analyses were used.Results:Eighty-two percent of hospitals offered a wellness programs during the previous year with larger hospitals more likely than smaller hospitals to offer programs (P < .01). Among hospitals with wellness programs, 69% offered nutrition programs, 74% offered physical activity (PA) programs, and 84% had a policy to restrict all tobacco use. Among those with cafeterias or vending machines, 40% had a policy for healthier foods. Only 47% and 25% of hospitals offered lactation support or healthy sleep programs, respectively.Conclusion:Most hospitals offer wellness programs. However, there remain hospitals that do not offer wellness programs. Among those that have wellness programs, most offer supports for nutrition, PA, and tobacco control. Few hospitals offered programs on healthy sleep or lactation support.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:06:34Z
      DOI: 10.1177/0890117120905232
       
  • Join the Commune: A Controlled Study of Social Branding Influencers to
           Decrease Smoking Among Young Adult Hipsters
    • Authors: Pamela M. Ling, Nadra E. Lisha, Torsten B. Neilands, Jeffrey W. Jordan
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To evaluate the impact of a Social Branding intervention in bars and nightclubs on smoking behavior.Design:Quasi-experimental controlled study.Setting:Bars and nightclubs in San Diego and San Francisco (intervention) and Los Angeles (control).Participants:“Hipster” young adults (age 18-26) attending bars and nightclubs.Intervention:Anti-tobacco messages delivered through monthly anti-tobacco music/social events, opinion leaders, original art, direct mail, promotional activities, and online media.Measures:A total of 7240 surveys were collected in 3 cities using randomized time location sampling at baseline (2012-2013) and follow-up (2015-2016); data were analyzed in 2018. The primary outcome was current smoking.Analysis:Multivariable logistic regression assessed correlates of smoking, adjusting for covariates including electronic cigarette use; differences between cities were evaluated using location-by-time interactions.Results:Smoking in San Francisco decreased at a significantly faster rate (51.1%-44.1%) than Los Angeles (45.2%-44.5%) (P = .034). Smoking in San Diego (mean: 39.6%) was significantly lower than Los Angeles (44.8%, P < .001) at both time points with no difference in rate of change. Brand recall was not associated with smoking behavior, but recall was associated with anti-tobacco attitudes that were associated with smoking.Conclusion:This is the first controlled study of Social Branding interventions. Intervention implementation was accompanied by decreases in smoking (San Francisco) and sustained lower smoking (San Diego) among young adult bar patrons over 3 years.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-20T01:05:14Z
      DOI: 10.1177/0890117120904917
       
  • Corrigendum
    • Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      PubDate: 2020-02-17T11:40:16Z
      DOI: 10.1177/0890117120907448
       
  • Economic Evaluation of a Sun Protection Promotion Program in California
           Elementary Schools
    • Authors: Richard T. Meenan, Kim D. Reynolds, David B. Buller, Kim Massie, Julia Berteletti, Mary K. Buller, Jeff Ashley, Xia Liu
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Background:An economic evaluation of Sun Safe Schools intervention designed to aid California elementary schools with implementing sun safety practices consistent with local board–approved policy.Design:Program cost analysis: intervention delivery and practice implementation.Setting:California elementary schools (58 interventions and 60 controls). Principals at 52 intervention and 53 control schools provided complete implementation data.Participants:Principals completing pre-/postintervention surveys assessing practice implementation.Intervention:Phone-based 45-minute session with a project coach on practice implementation, follow-up e-mails/phone contacts, $500 mini-grant. Schools chose from a list of 10 practices for implementation: ultraviolet monitoring, clothing, hats, and/or sunscreen recommendations, outdoor shade, class education, staff training and/or modeling, parent outreach, and resource allocation. The duration of intervention was 20 months. Rolling recruitment/intervention: February 2014 to December 2017.Measures:Intervention delivery and practice implementation costs. Correlations of school demographics and administrator beliefs with costs.Analysis:Intervention delivery activities micro-costed. Implemented practices assessed using costing template.Results:Intervention schools: 234 implemented practices, control schools: 157. Twenty-month delivery costs: $29 310; $16 653 (per school: $320) for project staff, mostly mini-grants and coaching time. Administrator costs: $12 657 (per school: $243). Per-student delivery costs: $1.01. Costs of implemented practices: $641 843 for intervention schools (per-school mean: $12 343, median: $6 969); $496 365 for controls (per-school mean: $9365, median: $3123). Delivery costs correlated with implemented practices (0.37, P < .01) and total practice costs (0.37, P < .05). Implemented practices correlated with principal beliefs about the importance of skin cancer prevention to student health (0.46, P < .001) and parents (0.45, P < .001).Conclusion:Coaching of elementary school personnel can stimulate sun safety practice implementation at a reasonable cost. Findings can assist schools in implementing appropriate sun safety practices.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-14T01:46:57Z
      DOI: 10.1177/0890117120905217
       
  • Applying a Medical Wellness Group Visit Model to a Community Setting
           Yielding Weight Loss and Improved Laboratory Results
    • Authors: Kimberly R. Dong, Lila Flavin, Kerri Hawkins, Wayne Altman
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine the feasibility of applying a medical wellness group (WG) model to a community setting to improve cardiometabolic health.Design:This quasi-experiment was designed to compare individuals participating in the WG to participants in the control group who received general lectures on nutrition, physical activity, and sleep.Setting:A suburb north of Boston, Massachusetts.Participants:Forty-five adults were in the WG and 10 in the control group.Intervention:Fourteen weekly 90-minute sessions, led by a physician and dietitian, focusing on nutrition, physical activity, and sleep, compared to controls receiving two 30-minute general wellness lectures provided within 3 months.Measures:Pre- and postweight, waist circumference, hemoglobin A1C (HbA1c), and serum lipids; a survey measuring beliefs, attitudes, and intentions related to behavioral change.Analysis: T tests examined the mean change in biometric measurements. The Wilcoxon test was used to compare the ordinal questions in baseline and final survey results. The Mann-Whitney test was used to compare final survey results between groups.Results:The WG demonstrated desirable difference-in-difference between groups in weight (P < .001), waist circumference (P < .001), and total cholesterol (P = .03) compared to the control group. Mean change of HbA1c and triglycerides was not different between groups. Survey results showed that attitudes, perceived behavioral control, and feeling supported about wellness behaviors significantly improved from baseline to final visit in the WG (P = .002; P = .019, P = .006, respectively), but not among controls.Conclusion:Wellness groups are feasible and provide high levels of support and accountability that empower people to make behavioral changes to improve health.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-12T03:23:19Z
      DOI: 10.1177/0890117120905241
       
  • Does Adherence to Mediterranean Diet Mediate the Association Between Food
           Environment and Obesity Among Non-Hispanic Black and White Older US
           Adults' A Path Analysis
    • Authors: Meifang Chen, Virginia Howard, Kathy F. Harrington, Thomas Creger, Suzanne E. Judd, Kevin R. Fontaine
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study aims to test the hypothesis that in addition to a direct effect of food environment on obesity, food environment is indirectly associated with obesity through consuming Mediterranean diet (MD).Design:Cross-sectional secondary data analysis.Setting:Nationwide community-dwelling residency.Sample:A total of 20 897 non-Hispanic black and white adults aged ≥45 years who participated in the REasons for Geographic and Racial Differences in Stroke study and completed baseline assessment during January 2003 and October 2007.Measures:The Modified Retail Food Environment Index (mRFEI; 0-100) was used as food environment indicator. The MD score (0-9) was calculated to indicate the dietary pattern adherence. Body mass index (BMI; kg/m2) was used to estimate obesity.Analysis:Path analysis was used to quantify the pathways between food environment, MD adherence, and obesity. Proper data transformation was made using Box–Cox power transformation to meet certain analysis assumptions.Results:The participants were from 49 states of the United States, with the majority (64.42%) residing in the South. Most of the participants were retired, female, white, married, having less than college graduate education, having annual household income ≤75 000, and having health insurance. The means of mRFEI was 10.92 (standard deviation [SD] = 10.19), MD score was 4.36 (SD = 1.70), and the BMI was 28.96 kg/m2 (SD = 5.90). Access to healthy food outlets (β = .04, P < .0001) and MD adherence (β = .08, P < .0001) had significant and inverse relationships with BMI, respectively. Mediterranean diet adherence mediated the relationship between food environment and obesity among a subpopulation who had an annual household income of
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-12T03:21:59Z
      DOI: 10.1177/0890117120905240
       
  • Student Tobacco Use Behaviors on College Campuses by Strength of Tobacco
           Campus Policies
    • Authors: Melinda J. Ickes, Amanda T. Wiggins, Mary Kay Rayens, Ellen J. Hahn
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine the association between strength of policy and self-reported tobacco use behavior, controlling for demographic characteristics, polytobacco use, knowledge of campus tobacco policy, and perceived policy compliance by others.Design:Cross-sectional, online survey.Setting:Ten participating State University of New York (SUNY) campuses; 5 with designated smoking/tobacco use areas and 5 with 100% tobacco-free policies.Subjects:Convenience sample of students from SUNY campuses: only tobacco users (N = 576 students) included for analysis.Measures:Items assessing tobacco use behaviors on campus, policy knowledge, and observation of others using tobacco on campus.Analysis: T tests and chi-square tests of association used to compare responses between tobacco users across campuses. Generalized estimating equations modeling used to evaluate predictors of tobacco use on campus; model estimated with students nested within campus.Results:Those on campuses without a comprehensive policy were more likely to report (in the past week) having seen others smoke on campus (98% vs 69%, P < .001), having personally smoked on campus (65% vs 36%, P < .001), and seeing others use tobacco products on campus (88% vs 67%, P < .001), compared to those on tobacco-free campuses.Conclusion:Tobacco-free campus policies provide numerous protective factors for tobacco users and nonusers. However, compliance strategies are imperative for intended policy success.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-12T03:20:39Z
      DOI: 10.1177/0890117120904015
       
  • Impact of Physician Referral to Health Coaching on Patient Engagement and
           Health Risks: An Observational Study of UPMC’s Prescription for Wellness
           
    • Authors: Michael D. Parkinson, Tracy Hammonds, Donna J. Keyser, Jennie R. Wheeler, Pamela B. Peele
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Evaluate impact of physician referral to health coaching on patient engagement and health risk reduction.Design:Four-year retrospective, observational cohort study with propensity-matched pair comparisons.Setting:Integrated delivery and finance system in Pittsburgh, Pennsylvania.Sample:10 457 adult insured members referred to health coaching by their physician; 37 864 other members identified for health coaching through insurer-initiated outreach.Intervention:Practice-based, technology-supported workflow and process for physician prescribing of health coaching during regular office visit, with follow-up on patient’s progress and implementation supports.Measures:Patient engagement based on completion of pre-enrollment assessment, formal enrollment in health coaching, completion of required sessions, health risk levels, and number of health risks pre- and post-health coaching referral.Analysis:Difference-in-difference analysis to assess change in health risk levels and number of health risks pre- and post-health coaching and probability weighting to control for potential confounding between groups.Results:Members referred by a physician were significantly more likely to enroll in a health coaching program (21.0% vs 6.0%, P < .001) and complete the program requirements (8.5% vs 2.7%, P < .001) than when referred by insurer-initiated outreach; significant within group improvement in health risk levels from baseline (P < .001) was observed for both the groups.Conclusions:Patients are significantly more likely to engage in health coaching when a referral is made by a physician; engagement in health coaching significantly improves health risk levels.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-12T03:10:57Z
      DOI: 10.1177/0890117119900588
       
  • Race/Ethnic Variations in Predictors of Health Consciousness Within the
           Cancer Prevention Context
    • Authors: Lucinda Nevarez, Shelly R. Hovick, Kimberly R. Enard, Stacy M. Lloyd, Lee Ann Kahlor
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Although the literature establishes a link between health consciousness (HC) and prevention behavior, less explored are the individual, social, and health characteristics that are associated with increased HC. Similarly, underexamined is the influence of race and ethnicity on the relationship of these characteristics to higher levels of HC.Design:This cross-sectional study aims to identify and assess the relative importance of factors associated with higher levels of HC, highlighting the role of race and ethnicity.Participants:Participants came from a national research panel survey (N = 1007).Measures:Participants completed a 4-item scale capturing key concepts of HC as well as questionnaires capturing demographic profiles, social support, social networking activities, and health status.Analysis:A stepwise multiple regression was used to identify significant predictors of HC.Results:Female and more educated participants report higher levels of HC. African American and Hispanic participants report higher levels of HC compared to white participants. Findings indicate social support, social network participation, education, cancer survivorship, and health status were positively associated with higher HC for the collective sample. However, results revealed variations in factors associated with higher HC when stratified by race/ethnicity.Conclusion:Findings suggest that interventions aiming to motivate cancer prevention behaviors within at-risk communities may find more success by incorporating factors that are aligned with increased HC among culturally diverse populations.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-10T10:39:50Z
      DOI: 10.1177/0890117120904000
       
  • Stronger State School Nutrition Laws Are Associated With Healthier Eating
           Behaviors and Optimal Weight Status in US Adolescents
    • Authors: Namrata Sanjeevi, Leah M. Lipsky, Tonja R. Nansel, Denise Haynie, Aiyi Liu, Bruce Simons-Morton
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To investigate relationships of farm-to-school, school meal, and competitive food state laws with eating behaviors and weight status and to examine interaction between different types of state laws.Design:Observational cohort study.Settings:US adolescents.Participants:The NEXT study is a nationally representative sample of adolescents assessed annually for 7 years. Data (N = 2751) from students attending public schools from the first (W1) and third (W3) assessment waves (2010 and 2012), occurring during grades 10 and 12, respectively, of the NEXT study were included.Measures:Eating behaviors and weight status of adolescents were linked with Classification of Laws Associated with School Students scoring for state laws.Analysis:Regression analyses examined associations of laws with intake and weight status, accounting for complex survey design and school-level clustering.Results:Adolescents in states with strong farm-to-school laws had greater W1 whole fruit, lower soda, and snack intakes versus those in states with no laws. Strong school meal laws were associated with lower W1 soda intake. Adolescents in states with strong competitive food laws had lower soda intake and overweight/obesity odds than those in states with no laws in W3. Strong farm-to-school laws were inversely associated with W3 overweight/obesity odds only in states with strong competitive food laws.Conclusions:Stronger laws governing school nutrition were related to healthier eating behaviors and optimal weight status in this nationally representative sample of adolescents. Further, farm-to-school laws may be more effective in reducing obesity when combined with strong competitive food legislation.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-10T09:56:40Z
      DOI: 10.1177/0890117120902346
       
  • Community Program Activities Predict Local Tobacco Policy Adoption in
           Florida Counties
    • Authors: Lauren E. Grattan, Carol L. Schmitt, Lauren Porter
      Abstract: American Journal of Health Promotion, Ahead of Print.
      The Bureau of Tobacco Free Florida’s community program funds county-level grantees who promote local policy change through activities that educate the public, policy-makers, and decision-makers. There is robust literature linking tobacco control policies such as smoke-free air laws and tax increases to reductions in tobacco use. There is less evidence documenting the local activities programs conduct to achieve local policy change. In the current study, we used a quantitative model to assess the relationship between community tobacco control activities and local tobacco policy adoption. Grantee activities and policy adoption for each county are recorded in a database. To evaluate the community program, we compiled inputs and used a fixed-effects negative binomial regression to examine the relationship between grantee activities and policy adoption across all 67 community-based programs in Florida from 2010 to 2017 and analyzed the data in 2018. Measures included categories of policies (organization policies and jurisdiction policies) and community-based activities associated with tobacco control programs. Organization policy (school and business policy) and jurisdiction policy (county or city ordinances, proclamations, and resolutions) were dependent on partner meetings (incident rate ratio [IRR] = 1.03, confidence interval [CI] = 1.00-1.07 and IRR = 1.04, CI = 1.01-1.07, respectively) and local decision-maker communication (IRR = 1.01, CI = 1.00-1.03 and IRR = 1.05, CI = 1.03-1.07, respectively). Jurisdiction policy was also dependent on media advocacy (IRR = 1.07, CI = 1.02-1.12) and state policy-maker education (IRR = 1.16, CI = 1.06-1.26. Community outreach was negatively associated with jurisdiction policy (IRR = 0.97, CI = 0.94-0.99), and data collection was negatively associated with organization and jurisdiction policy (IRR = 0.97, CI = 0.95-1.00 and IRR = 0.97, CI = 0.95-1.00, respectively). Results from the study demonstrate that the type and timing of community grantee activities may influence local tobacco control policy adoption.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-07T12:02:48Z
      DOI: 10.1177/0890117120904005
       
  • Sociodemographic Correlates of Food Insecurity Among New York City Tobacco
           Users
    • Authors: Christina N. Wysota, Scott E. Sherman, Elizabeth Vargas, Erin S. Rogers
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To identify rates and sociodemographic correlates of food insecurity among low-income smokers.Design:Cross-sectional analysis of baseline survey data from a randomized controlled trial (N = 403) testing a smoking cessation intervention for low-income smokers.Setting:Two safety-net hospitals in New York City.Sample:Current smokers with annual household income
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-07T12:01:05Z
      DOI: 10.1177/0890117120904002
       
  • Use of Patient Portals of Electronic Health Records Remains Low From 2014
           to 2018: Results From a National Survey and Policy Implications
    • Authors: Y. Alicia Hong, Shaohai Jiang, Piper Liping Liu
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To investigate the trend of patient portal use in the general population and the barriers to adoption.Participants:We analyzed 3 iterations of the Health Information National Trends Survey (HINTS) collected in 2014, 2017, and 2018.Measures:Patient portal use, high-speed Internet access, data safety confidence, prior experience of online patient provider communication (OPPC), and demographic variables.Analysis:Logistic regression analyses were conducted separately for the 3 iterations of HINTS.Results:The use of patient portals increased from 25.6% in 2014 to 30.5% in 2017, and 31.4% in 2018. These users were more likely to be white female with higher levels of education or income. Meanwhile, high-speed Internet access, prior experience of OPPC, and data safety confidence were positive predictors of patient portal use in all 3 iterations.Conclusion:The use of patient portals in the general public remains low and a significant digital divide persists, presenting a major challenge on meaningful use of electronic health record. We call for more effective interventions to address these gaps. Such interventions should target people of low socioeconomic status and focus on improving eHealth literacy and patients’ confidence in data safety.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-07T11:44:10Z
      DOI: 10.1177/0890117119900591
       
  • Breakfast Positively Impacts Cognitive Function in College Students With
           and Without ADHD
    • Authors: Elizabeth T. Brandley, Kathleen F. Holton
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To compare the effects of a nutritionally balanced breakfast on cognitive function in college students with and without attention-deficit/hyperactivity disorder (ADHD).Design:Pre–post dietary intervention.Setting:University.Sample:College students aged 18 to 25 years with (n = 19) and without (n = 27) ADHD.Intervention:Participants completed computerized cognitive assessment after an overnight fast and again 1 hour after consuming a nutritionally balanced breakfast shake.Measure:CNS Vital Signs computerized cognitive testing.Analysis:Chi-square tests were used to compare categorical variables, and nonparametric Wilcoxon rank sum and signed rank tests were used to compare continuous data between and within groups (respectively). Multivariable logistic regression was used to estimate the likelihood of ADHD based on cognitive improvement from breakfast consumption, after adjusting for age, sex, GPA, and year in school.Results:A significant proportion of those with and without ADHD (47% and 33%, respectively) reported not typically eating breakfast at baseline. One hour after consuming a balanced breakfast shake, both groups demonstrated improvements in 4 cognitive function domains. Those with ADHD were more likely to improve in reaction time than those without ADHD (odds ratio [95% confidence interval] = 1.07 [1.00-1.15], P = .04).Conclusions:The results of this pilot study suggest that college students with and without ADHD may benefit cognitively from a balanced breakfast. More research is needed to confirm these findings.
      Citation: American Journal of Health Promotion
      PubDate: 2020-02-04T10:53:04Z
      DOI: 10.1177/0890117120903235
       
  • Exploring the Relationship Between MyPlate Knowledge, Perceived Diet
           Quality, and Healthy Eating Behaviors Among Adolescents
    • Authors: Miranda Westfall, Sarah E. Roth, Monique Gill, Alec M. Chan-Golston, Lindsay N. Rice, Catherine M. Crespi, Michael L. Prelip
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:MyPlate is the current dietary guidance icon meant to communicate healthy eating patterns. The purpose of this study is to evaluate knowledge of MyPlate nutrition education messages among middle school students and its association with dietary intake and perceived diet quality.Design:Secondary analysis of cross-sectional data.Settings:Survey of eighth-grade students from 16 middle schools in California.Subjects:A total of 3521 eighth-grade students.Measures:MyPlate knowledge was assessed with 3 questions asking how much of the plate in a typical meal should be (1) fruits and vegetables, (2) grains, and (3) proteins. A brief food frequency questionnaire measured intake of fruits, vegetables, sweets, salty snacks, fast-food, and sugar-sweetened beverages (SSBs) over the past 7 days. Students self-rated their diet quality as poor, fair, good, or excellent.Analysis:Hierarchical logistic regression models controlling for gender, ethnicity, and socioeconomic status.Results:Only 11% of students answered all MyPlate questions correctly. MyPlate knowledge was associated with 65% higher odds of not consuming SSBs, but 46% lower odds of not consuming sweets. MyPlate knowledge was not associated with adolescents’ perceived diet quality or intake of salty snacks, fruits, or vegetables.Conclusion:Knowledge of nutrition education messages communicated by the MyPlate dietary guidance icon is limited among adolescents. The association between MyPlate knowledge and lower consumption of SSBs is encouraging, given the strong association between SSBs and childhood obesity.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-31T09:17:16Z
      DOI: 10.1177/0890117120901430
       
  • Development and Evaluation of a Cancer Literacy Intervention to Promote
           Mammography Screening Among Navajo Women: A Pilot Study
    • Authors: Pamela S. Sinicrope, Mark C. Bauer, Christi A. Patten, Martha Austin-Garrison, Linda Garcia, Christine A. Hughes, Martha J. Bock, Paul A. Decker, Kathleen J. Yost, Wesley O. Petersen, Lydia P. Buki, Edward R. Garrison
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Develop and evaluate a mammography intervention that provides hope about cancer prevention and treatment.Design:Pilot randomized controlled trial.Setting:Two communities on the Navajo Nation.Participants:Navajo women and support persons.Intervention:Both groups received standard care: one home visit discussing mammography pros/cons and barriers. The treatment group received an intervention based on Navajo language via an additional home visit with health education materials (written and oral) in English and Navajo, including a Navajo Cancer Glossary with a new descriptive phrase for cancer.Analysis:Between control and intervention conditions, we compared baseline sociodemographics; changes from baseline to 3 months on mammography completion and breast cancer literacy scores.Measures:(1) intervention feasibility; (2) self- and clinic-reported mammography screening completion; (3) breast cancer literacy.Results:A total of 25 participants were randomly assigned (13 treatment, 12 control), with 7 support persons in each arm. Mean age was 53 years, 90% had a high school degree or higher, 86% spoke Navajo and English. At 3 months, 44% had a clinically verified mammogram. Mammography completion was 57% among those with a support person and 27% among those without (P = .14). Intervention women reported more breast cancer beliefs consistent with mammography (P = .015).Conclusions:Increases in breast cancer beliefs consistent with mammography show promise. Findings highlight a need to tailor education materials to Navajo culture/language and focus on enhancing support.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-28T02:00:25Z
      DOI: 10.1177/0890117119900592
       
  • Implementation of Healthy Eating Interventions in Center-Based Childcare:
           The Selection, Application, and Reporting of Theories, Models, and
           Frameworks
    • Authors: Marjorie Rafaela Lima do Vale, Anna Farmer, Geoff D. C. Ball, Rebecca Gokiert, Katerina Maximova, Jessica Thorlakson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To explore the selection, use, and reporting of theories, models, and frameworks (TMFs) in implementation studies that promoted healthy eating in center-based childcare.Data Source:We searched 11 databases for articles published between January 1990 and October 2018. We also conducted a hand search of studies and consulted subject matter experts.Study Inclusion and Exclusion Criteria:We included studies in center-based settings for preschoolers that addressed the development, delivery, or evaluation of interventions or implementation strategies related to healthy eating and related subjects and that explicitly used TMF. Exclusion criteria include not peer reviewed or abstracts and not in English, French, German, and Korean.Data Extraction:The first author extracted the data using extraction forms. A second reviewer verified data extraction.Data Synthesis:Direct content analysis and narrative synthesis.Results:We identified 8222 references. We retained 38 studies. Study designs included quasi-experimental, randomized controlled trials, surveys, case studies, and others. The criteria used most often for selecting TMFs were description of a change process (n = 12; 23%) or process guidance (n = 8; 15%). Theories, models, and frameworks used targeted different socioecological levels and purposes. The application of TMF constructs (e.g., factors, steps, outcomes) was reported 69% (n = 34) of times.Conclusion:Reliance on TMFs focused on individual-level, poor TMF selection, and application and reporting for the development of implementation strategies could limit TMF utility.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-27T08:00:59Z
      DOI: 10.1177/0890117119895951
       
  • Workplace Well-Being Factors That Predict Employee Participation, Health
           and Medical Cost Impact, and Perceived Support
    • Authors: Jessica Grossmeier, Patricia H. Castle, Jennifer S. Pitts, Colleen Saringer, Kristi Rahrig Jenkins, Mary T. Imboden, David J. Mangen, Sara S. Johnson, Steven P. Noeldner, Shawn T. Mason
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study tested relationships between health and well-being best practices and 3 types of outcomes.Design:A cross-sectional design used data from the HERO Scorecard Benchmark Database.Setting:Data were voluntarily provided by employers who submitted web-based survey responses.Sample:Analyses were limited to 812 organizations that completed the HERO Scorecard between January 12, 2015 and October 2, 2017.Measures:Independent variables included organizational and leadership support, program comprehensiveness, program integration, and incentives. Dependent variables included participation rates, health and medical cost impact, and perceptions of organizational support.Analysis:Three structural equation models were developed to investigate the relationships among study variables.Results:Model sample size varied based on organizationally reported outcomes. All models fit the data well (comparative fit index> 0.96). Organizational and leadership support was the strongest predictor (P < .05) of participation (n = 276 organizations), impact (n = 160 organizations), and perceived organizational support (n = 143 organizations). Incentives predicted participation in health assessment and biometric screening (P < .05). Program comprehensiveness and program integration were not significant predictors (P> .05) in any of the models.Conclusion:Organizational and leadership support practices are essential to produce participation, health and medical cost impact, and perceptions of organizational support. While incentives influence participation, they are likely insufficient to yield downstream outcomes. The overall study design limits the ability to make causal inferences from the data.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-27T08:00:57Z
      DOI: 10.1177/0890117119898613
       
  • Job-Related Characteristics and Obesity in Australian Employees: Evidence
           From a Longitudinal Nationally Representative Sample
    • Authors: Syed Afroz Keramat, Khorshed Alam, Jeff Gow, Stuart J. H. Biddle
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:This study aimed to examine the longitudinal association between 9 job-related characteristics and obesity among Australian employees using a nationally representative sample.Design:Longitudinal research design.Setting:Workplace.Participants:This study was conducted by pooling 2 cross-sectional surveys of nationally representative longitudinal data collected across 2-time points in 2013 and 2017. This study limited the sample to current employees aged 15 to 64 years. The total number of observation included in the analysis is 16 980 of 11 521 employees.Measures:The outcome variable is weight status and the main exposure variables are 9 job-related characteristics (work hours per week, work schedule, job type, employment contract type, firm size, supervisory responsibility, paid sick leave, self-perceived job stress, and self-perceived job insecurity). Generalized estimating equation logistic regression was employed to explore the association between job-related characteristics and obesity.Results:This study found that 59% of Australian employees were either overweight or obese. Employees working more than 40 hours per week were 1.11 times (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.03-1.21) and 1.07 times (OR: 1.07, 95% CI: 1.01-1.13) more prone to become overweight and obese, respectively, compared to their counterparts who work 31 to 40 hours per week. The study also revealed that self-perceived job insecurity was positively associated with obesity (OR: 1.03, 95% CI: 1.02-1.04). However, this study did not find evidence that work schedule, job type, employment contract, firm size, supervisory role, paid sick leave, and self-perceived job stress were associated with obesity.Conclusions:Working more than 40 hours per week and self-perceived job insecurity were significantly associated with obesity among Australian employees. A better understanding of why prolonged work hours and self-perceived job insecurity are associated with obesity may help policy makers to implement workplace wellness policies and for employers to take measures to tackle the obesity problem of their employees.
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-27T08:00:57Z
      DOI: 10.1177/0890117119901093
       
  • 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
      PubDate: 2020-01-20T10:06:21Z
      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
      PubDate: 2020-01-17T11:17:05Z
      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
      PubDate: 2020-01-13T09:47:42Z
      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
      PubDate: 2020-01-09T01:39:03Z
      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
      PubDate: 2020-01-06T09:36:07Z
      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
      PubDate: 2020-01-03T10:31:04Z
      DOI: 10.1177/0890117119897189
       
  • Introducing “Precision Health Promotion”: The Convergence of Genomics,
           Health Education, and Lived Experience
    • Authors: Paul E. Terry
      First page: 235
      Abstract: American Journal of Health Promotion, Ahead of Print.
      The prospect that modifying just 1 mutated letter in a genomic sequence could save millions of lives has spawned a growing discipline called personalized medicine (PM). Where PM focuses on bringing greater precision to individual treatments, the genetics revolution also invites questions about how genetics testing and genetics reference panels can be applied in a public health context. Some voice concerns that the growth of PM will shift us back to an emphasis on the medical model for health advancement with undue focus and investment on individual rather than societal solutions. This editorial introduces precision health promotion and defines it as “the personalized design of lived experiences that foster improved health and well-being for individuals within the context of their families, organizations and communities.”
      Citation: American Journal of Health Promotion
      PubDate: 2020-01-30T07:09:31Z
      DOI: 10.1177/0890117120903129
       
  • The Art of Health Promotion: linking research to practice
    • Authors: Jessica Grossmeier, Chris Calitz, Kristin Pham, Jason E. Lang, Amanda Mummert, Enid Chung Roemer, Karen Butcher Kent, Dyann Matson Koffman, Ron Z. Goetzel, Elissa Rosenbaum, Mary Imboden, Steven Noeldner, Sara Martin, Ryan Picarella, Jennifer S. Pitts
      First page: 316
      Abstract: American Journal of Health Promotion, Ahead of Print.

      Citation: American Journal of Health Promotion
      PubDate: 2020-01-30T10:17:18Z
      DOI: 10.1177/0890117119898026
       
  • 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
      PubDate: 2019-12-23T12:10:24Z
      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
      PubDate: 2019-12-20T10:56:17Z
      DOI: 10.1177/0890117119895204
       
  • 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
      First page: 238
      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
       
  • 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
      First page: 247
      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
       
  • Employee Perceptions of Wellness Programs and Incentives
    • Authors: Jennifer Fink, Barbara Zabawa, Sarah Chopp
      First page: 257
      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
      PubDate: 2019-12-26T10:26:30Z
      DOI: 10.1177/0890117119887687
       
  • 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
      First page: 261
      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
      PubDate: 2019-12-27T09:55:01Z
      DOI: 10.1177/0890117119890789
       
  • A Randomized Trial to Encourage Healthy Eating Through Workplace Delivery
           of Fresh Food
    • Authors: Rachel Feuerstein-Simon, Roxanne Dupuis, Ryan Schumacher, Carolyn C. Cannuscio
      First page: 269
      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
      PubDate: 2019-12-16T10:16:08Z
      DOI: 10.1177/0890117119890804
       
  • Patient Phenotypes Help Explain Variation in Response to a Social
           Gamification Weight Loss Intervention
    • Authors: Jeffrey Lienert, Mitesh Patel
      First page: 277
      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
      PubDate: 2019-12-26T10:30:30Z
      DOI: 10.1177/0890117119892776
       
  • “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
      First page: 285
      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
       
  • 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
      First page: 294
      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
      PubDate: 2019-12-26T10:28:50Z
      DOI: 10.1177/0890117119895948
       
  • Maternal Educational Attainment and Child Health in the United States
    • Authors: Elizabeth M. Lawrence, Richard G. Rogers, Robert A. Hummer
      First page: 303
      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
      PubDate: 2019-12-13T10:08:01Z
      DOI: 10.1177/0890117119890799
       
  • 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
      First page: 307
      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
      PubDate: 2019-12-19T10:10:43Z
      DOI: 10.1177/0890117119892765
       
  • Physical Activity Support Predicts Safety-Net Patients’ Digital
           Health-Care Engagement: Implications for Patient Care Delivery
    • Authors: Sharon S. Laing, Ryan Sterling, Carlota Ocampo
      First page: 311
      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
      PubDate: 2019-12-20T10:54:26Z
      DOI: 10.1177/0890117119894508
       
 
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