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Authors:Alexandria G. Bauer, Binoy Shah, Nia Johnson, Natasha Aduloju-Ajijola, Carole Bowe-Thompson, Kelsey Christensen, Jannette Y. Berkley-Patton Abstract: Health Education & Behavior, Ahead of Print. African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings. Citation: Health Education & Behavior PubDate: 2023-11-18T08:16:50Z DOI: 10.1177/10901981231211538
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Authors:Anne Marie Schipani-McLaughlin, Laura F. Salazar, Ruschelle M. Leone, Dori Balser, Kate Hunley, Kelly Quinn-Echevarria Abstract: Health Education & Behavior, Ahead of Print. Acceptability of a sexual violence (SV) risk reduction program called RealConsent designed for first-year female college students was conducted as part of a larger, randomized controlled trial. RealConsent uses web-based and mobile technology to deliver four 45-minute theoretically and empirically derived modules designed to increase knowledge, affect attitudes and normative beliefs, increase bystander and other protective behaviors, and reduce alcohol misuse. Educational entertainment is used throughout the program to achieve these aims. A total of 444 first-year female college students recruited from three Southeastern universities who were eligible and provided informed consent were randomized to RealConsent. Acceptability was ascertained both quantitatively and qualitatively through a survey administered following the completion of each of four modules. Results suggest that overall, RealConsent was viewed as relatable, realistic, and relevant. Most participants rated modules as good/excellent in quality, in organization, and in the conveying of a high degree of knowledge regarding alcohol misuse, consent for sex, sexual communication, defense strategies, protective strategies, and intervening to prevent SV. Suggestions to improve RealConsent centered on having more content inclusive of sexual and gender-minoritized students. Results suggest that RealConsent is an acceptable SV risk reduction program among first-year female college students and may have advantages for dissemination over in-person programs due to its web-based and mobile technology. Citation: Health Education & Behavior PubDate: 2023-11-14T09:25:47Z DOI: 10.1177/10901981231208982
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Authors:Iago Portela-Pino, Alejandro Sal-de-Rellán, Lucía Lomba-Portela Abstract: Health Education & Behavior, Ahead of Print. The ability to work in a team is a skill of special relevance for multiple facets of life, increasing performance and optimizing the process in any task. This work aimed to study whether teamwork skills were related to different health variables. The sample consisted of 671 military personnel from the Spanish Army. The instrument is composed of the Health Literacy Questionnaire—the Teamwork Skills Questionnaire, and Rosenberg’s self-esteem scale. The study concludes that the level of teamwork skills of the military is high, as well as their level of health literacy and their self-perception of health. However, their self-esteem is medium. Teamwork competencies are positively associated with a higher level of health literacy, with a high self-perception of their health, with the level of physical activity and negatively with self-esteem and the number of hospital admissions. Citation: Health Education & Behavior PubDate: 2023-11-03T06:32:29Z DOI: 10.1177/10901981231207079
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Authors:Shawnta L. Lloyd, Kelvin L. Williams, Triad Pastors Network, Allison Caban-Holt, Suzanne Craft, Laura D. Baker, Goldie S. Byrd Abstract: Health Education & Behavior, Ahead of Print. The Black Men’s Health Forum, a 6-week online health education intervention for African American men and accountability partners of African American men, was conducted to increase awareness of health issues that disproportionately affect African American men. In this article, we describe the intervention and report on the immediate benefits of the intervention, including changes in health knowledge and perception of research participation. Participants completed a pre-evaluation prior to participating in the forum and a post-evaluation after each session to capture data on sociodemographic information, medical history, health knowledge, and health behaviors. A total of 60 participants (30 African American men and 30 accountability partners) completed the forum. African American men had a mean age of 61.1 years while accountability partners had a mean age of 57.6 years. Overall health knowledge increased by 6.9 points for African American men and 2.8 points for accountability partners. Before the forum began, nine African American men reported ever participating in a research study. The proportion of African American men who reported that they would definitely participate in research in the next 12 months after participating in the forum increased by 40%. Through culturally tailored programming, the Black Men’s Health Forum increased access to health information as well as African American male medical professionals and health researchers for African American men in the community. Exposure to health information resulted in significant increases in health knowledge and willingness to participate in health research among African American men. Citation: Health Education & Behavior PubDate: 2023-10-31T10:38:51Z DOI: 10.1177/10901981231206074
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Authors:Hollie Bendotti, Sheleigh Lawler, Coral Gartner, David Ireland, Henry M. Marshall Abstract: Health Education & Behavior, Ahead of Print. Telephone-based services are a practical and effective behavioral support for smoking cessation, yet no in-depth analyses of this counseling have been conducted. Understanding the general content of Quitline conversations can help to improve current practices and may inform future interventions. Therefore, we aimed to independently explore conversation themes, topics, and client questions during Quitline counseling sessions with Quitline clients in Queensland, Australia. A purposive sample of 30 recorded counseling sessions, completed between January and March 2019, were de-identified, transcribed, and thematically analyzed. Seven themes, encompassing 35 topics, were derived from 26 initial calls and four follow-up calls: (1) Client details and building rapport; (2) Client history and motivation to quit; (3) Pharmacotherapy; (4) Behavioral aspects of quitting and relationship with smoking; (5) Understanding nicotine dependence and other important considerations; (6) Additional support and smoking cessation resources; and (7) Planning, goal setting and follow-up. Three themes emerged from 18 client questions including (1) Pharmacotherapy safety and contraindications; (2) Pharmacotherapy instructions and mechanism of action; and (3) Physiology of nicotine dependence. This is the first qualitative analysis of the content of Quitline counseling sessions in Australia. Counselors collect and deliver a breadth of information to provide tailored, evidence-based health care, while building rapport and trust. Findings may be translatable into personalized self-help interventions that are more accessible or appealing to people reluctant to contact Quitline. Harnessing educational opportunities regarding pharmacotherapy adherence and misconceptions can improve client confidence in the product and smoking cessation outcomes. Further research will map conversations to motivational interviewing and behavior change techniques. Citation: Health Education & Behavior PubDate: 2023-10-17T12:36:46Z DOI: 10.1177/10901981231206068
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Authors:Annalynn M. Galvin, Idara N. Akpan, Melissa A. Lewis, Scott T. Walters, Erika L. Thompson Abstract: Health Education & Behavior, Ahead of Print. Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing homelessness. To improve interconception care uptake, this qualitative study aimed to identify barriers and facilitators to reproductive interconception care from the perspectives of women who were recently pregnant and homeless. A semi-structured interview guide and demographic survey were developed based on epidemiological findings, Information-Motivation-Behavioral Skill framework components, and a review by community health workers for content validity. After conducting 12 interviews with women recently pregnant and homeless in a local continuum of care in 2022, audio-recorded interviews were transcribed, iteratively coded using a priori and emerging codes, and thematically analyzed. Key themes were identified to determine implications and next steps to improving reproductive interconception care uptake. Interrelated themes focused on information (e.g., knowledge and misconceptions about pregnancy, birth intervals, contraception), motivation (e.g., attitudes about interconception care experiences, perinatal social influences), behavioral skills (e.g., objective ability to obtain interconception care and perceived self-efficacy related to attending maternal postpartum visits and increasing birth intervals), and macro-level factors (e.g., obtaining housing, contextualizing socioeconomic factors, navigating COVID-19). The findings suggest the need for flexible, streamlined, and personalized interconception care delivery that acknowledges pressing housing and relationship considerations and supports women’s autonomy. Improvements to reproductive interconception care may reduce future unintended pregnancies, increase birth intervals, and improve birth outcomes among women experiencing homelessness. Citation: Health Education & Behavior PubDate: 2023-10-17T11:08:10Z DOI: 10.1177/10901981231204583
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Authors:Jenny L. Olson, David E. Conroy, Scherezade K. Mama, Kathryn H. Schmitz Abstract: Health Education & Behavior, Ahead of Print. Healthy lifestyle behaviors can improve health-related quality of life (HRQOL) in cancer survivors; but the combination of behaviors most important for HRQOL is not known. This study investigated the patterns of lifestyle behaviors among cancer survivors and differences in HRQOL between behavioral classes. Cancer survivors (n = 2,463) were invited to participate in a cross-sectional survey. Participants (N = 591) were predominately female (63%) and non-Hispanic White (90%). Survey items included self-reported physical activity, diet, smoking, sleep, HRQOL, and demographics. Behavioral classes were estimated by latent class analysis. Differences between classes were assessed by latent class regression. Compared with the “healthy lifestyles” class (higher probabilities of meeting aerobic/strength-based activity guidelines, high fruit/vegetable intake, and no sleep problems; 11% of sample), the “sleep and diet problems with inconsistent physical activity” class (higher probabilities of not meeting strength-based guidelines, low fruit/vegetable intake, some sleep problems; marginally higher probability of meeting aerobic guidelines; 41%) had poorer general and physical HRQOL. The “poor physical activity and diet” class (higher probabilities of not meeting aerobic/strength-based guidelines, low fruit/vegetable intake, and some sleep problems; 48%) had poorer general, physical, and mental HRQOL. Few participants exhibited healthy lifestyle patterns associated with HRQOL. The findings provide opportunities to develop differentiated multiple behavior-change interventions, targeted to two common patterns of behavior. A large subgroup of cancer survivors was susceptible to suboptimal physical activity and diet, warranting interventions exclusively targeting these behaviors. Another subgroup was susceptible to suboptimal physical activity, diet, and sleep, indicating interventions for this group should include strategies targeting these three behaviors. Citation: Health Education & Behavior PubDate: 2023-10-13T10:33:28Z DOI: 10.1177/10901981231203978
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Authors:Derek M. Griffith, Emily C. Jaeger, Perri Pepperman, Karen A. Chustz, Deborah Frazier, Amber Wilson, Haywood L. Brown Abstract: Health Education & Behavior, Ahead of Print. There is limited research that specifically explores paternal involvement during pregnancy and childbirth. To address this gap, we completed a series of focus groups with fathers to examine social, cultural, and environmental factors that influence behaviors among new fathers while also providing community perspectives on men’s experiences seeking care pre- and postdelivery. We used a phenomenological thematic approach to analyze data from 10 focus groups from five of the six Alliance for Innovation on Maternal Health-Community Care Initiative pilot sites collected between November 2021 and April 2022. The average age of fathers was 33.9 years (range = 24–61 years). The majority (86.25%) of men were African American, and approximately one sixth of focus group participants (16.25%) were Hispanic or Latino. Four key themes emerged: the importance and meaning of fatherhood, accessibility during pregnancy and childbirth, engagement during pregnancy and childbirth, and responsibility of fathers during pregnancy and childbirth. These fathers not only understood and embraced the awesome responsibility they had for their unborn child, but they also recognized and were invested in being present, accessible, engaged, and responsible to the pregnant woman during the pregnancy. Practitioners and policy makers should work to engage fathers as early in the pregnancy as possible; monitor father’s mental health and financial stress; provide resources to educate fathers on maternal health, pregnancy, and childbirth; and emphasize fathers’ rights, roles, and responsibilities. Citation: Health Education & Behavior PubDate: 2023-10-03T12:17:43Z DOI: 10.1177/10901981231199710
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Authors:Hale M. Thompson, Timothy M. Wang, Ali J. Talan, Kellan E. Baker, Arjee J. Restar Abstract: Health Education & Behavior, Ahead of Print. This article is a call for collective action across health equity researchers and advocates to build a more just world. We attempt to make sense of senseless structural and interpersonal brutality in the context of the current political climate across the United States, whereby the spectrum of gender nonconformity has been and continues to be stigmatized. From drag performance to transgender identities to gender-affirming health care, extremists have instrumentalized primary levers of democracy—the courts, legislatures, and social media—to attempt to outlaw and eradicate gender expansiveness and those who provide forms of support and care, including gender-affirming medical care, to transgender, nonbinary, and gender-expansive (TNBGE) individuals. Citation: Health Education & Behavior PubDate: 2023-09-25T09:01:35Z DOI: 10.1177/10901981231201146
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Authors:Elizabeth Valdez, Jazmine Chan, Saharra Dixon, Gray Davidson Carroll, Thupten Phuntsog, Elizabeth Delorme, Justine Egan, Aline Gubrium Abstract: Health Education & Behavior, Ahead of Print. Structural inequities influence young parents’ access to health care, housing, transportation, social support, education, and income. The current study adds to the extant literature by providing data directly obtained in collaboration with young parents to understand how structural violence affects the health and well-being of their families, ultimately resulting in community-driven policy recommendations developed in collaboration with the state health department. We engaged a diverse sample of young people—considered as community researchers in the project—including Black, Latinx, and/or LGBTQ+ pregnant and parenting young parents in a participatory action research (PAR) project in the spring of 2022 to explore their health and material needs while living in Springfield, Massachusetts. Together with young parents, we used participatory arts-based methods to conduct community and identity building, define research questions and photo prompts, conduct data collection (photos), engage in group thematic analysis, and take action at the state policy level. We also conducted individual semi-structured life-history interviews with the young parents. Participatory community-led findings indicate an urgent need for systemic change to increase access to safe and affordable housing; living-wage jobs; safe, high-quality, and affordable child care; and to bolster social support and disabilities services for young parents and their families. This participatory study funded by a state health department demonstrates that participatory community-driven data can have the power to mobilize community members and policy makers for social change if prioritized at the state and local levels. Additional practice-based implications include prioritizing participatory mentorship programs intended to aid young parents in navigating the complex systems that are vital to their survival. Citation: Health Education & Behavior PubDate: 2023-09-25T08:59:36Z DOI: 10.1177/10901981231197397
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Authors:Emily D. Lemon, Kathleen S. Mera Nieto, Luis Yael Serrano Laguna, Yesnely A. Flores, Maria Niño-Suastegui, Jonathan Peraza Campos, Viridiana Fuentes, Kenia Lozada, Audrey Ling, Briana Woods-Jaeger Abstract: Health Education & Behavior, Ahead of Print. Increasingly, immigration policies are understood as structural determinants, rooted in racism, nativism, and ethnocentrism, which raise serious public health concerns for Latinx adolescents’ mental health. Our objective was to examine how immigration policy enforcement affects mental health of Latinx youth raised in a county with an aggressive interior immigration enforcement program. From 2009 to 2021, Gwinnett County, GA, led the nation in deportations under the 287(g) program as a “universal enforcement model,” where local law enforcement were deputized to detain undocumented immigrants, primarily through traffic violations. From June to July 2022, we followed a participatory action research approach with two groups of Latinx youth who grew up in Gwinnett County. In total, 10 youth took photos related to the research question, and engaged in facilitated dialogue using photovoice guide SHOWED/VENCER for four, 2-hour sessions that were audio-recorded and transcribed. Transcripts were analyzed following grounded theory principles to arrive at a conceptual model codeveloped and validated by youth. Youth described how 287(g) led to policing and deportation in their communities, fueling stereotypes, and discrimination that criminalized Latinx immigrants. Youth linked immigration enforcement policies like 287(g) to exclusionary systems that contributed to fear, marginalization, and loss in their communities, bringing experiences of sadness, grief, isolation, hopelessness, and low self-worth. From youth-driven research, we identified mental health implications of the 287(g) program among Latinx youth. The cascading harms of immigration enforcement policies highlight the need to address these policies and identify immediate strategies to promote Latinx youth mental health. Citation: Health Education & Behavior PubDate: 2023-09-07T09:43:31Z DOI: 10.1177/10901981231193695
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Authors:Jemar R. Bather, Debra Furr-Holden, Jesus Ramirez-Valles, Melody S. Goodman Abstract: Health Education & Behavior, Ahead of Print.
Citation: Health Education & Behavior PubDate: 2023-09-05T07:00:04Z DOI: 10.1177/10901981231198785
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Authors:Bo Wang, Lynette Deveaux, Yan Guo, Elizabeth Schieber, Richard Adderley, Stephenie Lemon, Jeroan Allison, Xiaoming Li, Nikkiah Forbes, Sylvie Naar Abstract: Health Education & Behavior, Ahead of Print. BackgroundFew studies have investigated the effects of teacher training and continued support on teachers’ delivery of evidence-based HIV prevention programs. We examined these factors in a national implementation study of an evidence-based HIV risk reduction intervention for adolescents in the sixth grade in the Bahamas.MethodsData were collected from 126 grade 6 teachers and 3,118 students in 58 government elementary schools in the Bahamas in 2019–2021. This is a Hybrid Type III implementation study guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) model. Teachers attended 2-day training workshops. Trained school coordinators and peer mentors provided biweekly monitoring and mentorship. We used mixed-effects models to assess the effects of teacher training and continued support on implementation fidelity.ResultsTeachers who received training in-person or both in-person and online taught the most core activities (27.0 and 27.2 of 35), versus only online training (21.9) and no training (14.9) (F = 15.27, p < .001). Teachers with an “excellent” or “very good” school coordinator taught more core activities than those with a “satisfactory” coordinator or no coordinator (29.2 vs. 27.8 vs. 19.3 vs. 14.8, F = 29.20, p < .001). Teachers with a “very good” mentor taught more core activities and sessions than those with a “satisfactory” mentor or no mentor (30.4 vs. 25.0 vs. 23.1; F = 7.20; p < .01). Teacher training, implementation monitoring, peer mentoring, teachers’ self-efficacy, and school-level support were associated with implementation fidelity, which in turn was associated with improved student outcomes (HIV/AIDS knowledge, preventive reproductive health skills, self-efficacy, and intention to use protection).ConclusionTeachers receiving in-person training and those having higher-rated school coordinator and mentor support taught a larger number of HIV prevention core activities. Effective teacher training, implementation monitoring, and peer mentoring are critical for improving implementation fidelity and student outcomes. Citation: Health Education & Behavior PubDate: 2023-09-02T09:42:17Z DOI: 10.1177/10901981231195881
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Authors:Monica Molino, Valentina Dolce, Claudio Giovanni Cortese, Domenico Sanseverino, Chiara Ghislieri Abstract: Health Education & Behavior, Ahead of Print. During the COVID-19 pandemic, many workers have been forced to work from home. In this situation, the boundaries between work and private life have become particularly blurred, and recovering from work was even more difficult than in traditional times, with negative consequences for workers’ health. Among the psychological experiences that might underlie the recovery process, mastery played a crucial role as people sought new stimuli and challenging situations. However, there are few articles that have explored the role of this specific recovery experience, its antecedents, and the health consequences under conditions of work from home. Therefore, in this multiwave study, we aimed to investigate the role of mastery as a mediator between supervisor support and insomnia problems. The study was conducted during the COVID-19 pandemic in Italy and had a three-wave design. A convenience sample of 130 employees (67% women) completed an online questionnaire. Hypotheses were tested using a three-wave autoregressive cross-lagged panel model. According to the results, supervisor support at Time 1 was positively related to mastery at Time 2, which in turn showed a negative association with insomnia at Time 3. The results demonstrated that mastery experiences have played a crucial role during COVID-19 mandatory work from home, which points to some potential implications for workers’ health in the adoption of teleworking beyond the emergency situation. Citation: Health Education & Behavior PubDate: 2023-08-29T09:48:50Z DOI: 10.1177/10901981231192988
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Authors:Gabrielle Garon-Carrier, Arya Ansari, Rachel Margolis, Caroline Fitzpatrick Abstract: Health Education & Behavior, Ahead of Print. Separation anxiety symptoms are frequent among preschool-aged children, but it is also a possible gateway for diagnosis of separation anxiety disorder. Early maternal employment after childbirth can increase the risk for the development of separation anxiety symptoms. From an economic perspective, however, securing employment is one effective strategy to ensure child well-being. This study investigated how mothers’ participation in the labor force (vs. maternal leave) and the financial state of families when the child was 5 months old was prospectively associated with separation anxiety symptoms. This study is based on 1,295 Canadian families with children assessed longitudinally from 17 months to age 6 on their levels of separation anxiety. Separation anxiety was measured during face-to-face interviews with the mothers. Maternal labor force participation, financial status, and risk factors were measured at 5 months. Results adjusted for propensity scores and for sample weight revealed that children of working mothers, despite having sufficient income (n = 245, 18.9%), were at higher risk of separation anxiety during early childhood. In contrast, maternity leave was most beneficial for children’s separation anxiety, whether they were in a family with sufficient income (n = 950, 73.4%) or temporary low income (n = 100, 7.7%). Children of mothers in maternity leave were at risk of heightened separation anxiety only if they experienced chronic economic hardship. Therefore, maternity leave uptake could help prevent the development of separation anxiety. Providing families with opportunity to care for the baby as their main occupation during this sensitive developmental period could help improve children’s mental health. Citation: Health Education & Behavior PubDate: 2023-07-31T12:23:20Z DOI: 10.1177/10901981231188137
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Authors:Lorien C. Abroms, Donald Koban, Nandita Krishnan, Melissa Napolitano, Samuel Simmens, Brendan Caskey, Tien-Chin Wu, David A. Broniatowski Abstract: Health Education & Behavior, Ahead of Print. BackgroundVaccine misinformation has been widely spread on social media, but attempts to combat it have not taken advantage of the attributes of social media platforms for health education.MethodsThe objective was to test the efficacy of moderated social media discussions about COVID-19 vaccines in private Facebook groups. Unvaccinated U.S. adults were recruited using Amazon’s Mechanical Turk and randomized. In the intervention group, moderators posted two informational posts per day for 4 weeks and engaged in relationship-building interactions with group members. In the control group, participants received a referral to Facebook’s COVID-19 Information Center. Follow-up surveys with participants (N = 478) were conducted 6 weeks post-enrollment.ResultsAt 6 weeks follow-up, no differences were found in vaccination rates. Intervention participants were more likely to show improvements in their COVID-19 vaccination intentions (vs. stay same or decline) compared with control (p = .03). They also improved more in their intentions to encourage others to vaccinate for COVID-19. There were no differences in COVID-19 vaccine confidence or intentions between groups. General vaccine and responsibility to vaccinate were higher in the intervention compared with control. Most participants in the intervention group reported high levels of satisfaction. Participants engaged with content (e.g., commented, reacted) 11.8 times on average over the course of 4 weeks.ConclusionsEngaging with vaccine-hesitant individuals in private Facebook groups improved some COVID-19 vaccine-related beliefs and represents a promising strategy. Citation: Health Education & Behavior PubDate: 2023-07-31T05:57:41Z DOI: 10.1177/10901981231188313
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Authors:BoAe Im, HyunSoo Oh, SooHyun Kim, HyeSun Jeong, WhaSook Seo Abstract: Health Education & Behavior, Ahead of Print. Rheumatic diseases are known to be associated with the development of metabolic syndrome, which increases mortality rates due to cardiovascular complications. Although a variety of self-management programs for rheumatic diseases have been developed, few have concentrated on metabolic syndrome. This study aimed to develop and verify a blended (a mixture of telephone and online interventions) metabolic syndrome self-management program. The program was developed in four stages: analysis to identify program contents, website design, website development, and validity testing. A quasi-experimental nonequivalent control group, pretest–posttest design was adopted to verify the program effectiveness in 54 patients with rheumatic disease. The program was initially implemented via telephone for 4 weeks and then self-administered via a web-based platform for 20 weeks. Indices of metabolic syndrome and self-management and quality of life scores were measured as outcome variables. Data were collected three times: before intervention, after 4 weeks of telephone interventions, and after 20 weeks of online self-interventions. The devised program had a significant overall effect on metabolic syndrome indices, metabolic syndrome-related self-management behaviors, and quality of life. Detailed analysis showed the program effectively reduced body mass index, waist circumference, systolic blood pressure, and blood glucose levels and improved metabolic syndrome self-management behaviors. Based on our findings, it can be expected that the use of this program may retard or prevent the progression of metabolic syndrome by improving some metabolic syndrome indices and metabolic syndrome-related self-management behaviors, which are key components of care in rheumatic disease patients with metabolic syndrome. This web-based program appears to be beneficial in public health care settings because it is cost-effective, readily available, and may provide long-term support. Citation: Health Education & Behavior PubDate: 2023-07-31T05:50:29Z DOI: 10.1177/10901981231188136
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Authors:Heena Parveen, Shagufta Nasir, Md Ghazi Shahnawaz, Fatema Husain, Juweria Baig, Anand Shankar Abstract: Health Education & Behavior, Ahead of Print. COVID-19 is yet not completely over; however, many people are hesitant to take COVID-19 vaccines despite their availability. Vaccine hesitancy is a major roadblock to attaining normalcy and controlling the spread of the COVID-19 virus. The present research used a multitheoretical framework (Health Belief Model, 3Cs framework, fatalism, and religious fatalism) to comprehend the complexity of vaccine hesitancy. Thus, the present study aimed at exploring vaccine hesitancy in India by using key components of the Health Belief Model, 3Cs framework, fatalism, religious fatalism, and some demographics as predictors. Data were collected electronically with the help of Google Forms from 639 Indian adults following snowballing and convenience sampling techniques with standardized measures (albeit some modifications to suit the context of the study). Descriptive analysis and hierarchical regression analysis were run in SPSS (V-22) to analyze the data. Results revealed that participants of the present study scored relatively high on vaccine hesitancy. Muslims as compared with Hindus and vaccination status emerged as significant predictors of vaccine hesitancy out of the demographic factors. Fear of COVID-19, vaccine convenience, and religious fatalism also significantly predicted vaccine hesitancy. Thus, a comprehensive approach is needed to strategically use these predictors to control vaccine hesitancy. Citation: Health Education & Behavior PubDate: 2023-07-04T12:10:16Z DOI: 10.1177/10901981231179503
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Authors:Danielle Boucher, Dominique Beaulieu, Dominic Simard Abstract: Health Education & Behavior, Ahead of Print. Cooking at home is associated with health benefits, and 10- and 11-year-old children are capable of participating in meal preparation. However, opportunities for children to cook at home have declined. This study aimed to identify determinants of the frequency and the intention to cook at home in fifth graders using the Theory of Planned Behavior as a framework with quantitative methodology. A total of 241 participants across five elementary schools of the Chaudière-Appalaches region (Quebec, Canada) took part in this correlational study. Data were collected via a self-administered questionnaire based on the Theory of Planned Behavior. Regression analyses led to the identification of determinants of frequency and intention to cook at home. More than two-thirds of participants (69%) declared having cooked at home in the past 7 days. Intention was the only significant variable explaining 18% of the variance for frequency. Intention was determined by perceived behavioral control, attitude, descriptive norms, subjective norms, perceived barriers, being a girl, and normative beliefs, which explain 74% of the variance. Whereas other studies aiming at better understanding children’s involvement in meal preparation at home focused on self-efficacy for cooking, this study highlights other behavioral determinants. For example, support from parents appears to be crucial to promote this behavior in this age group. Future research and interventions should be oriented toward determinants such as subjective norms and normative beliefs, and focus on children’s autonomy. Citation: Health Education & Behavior PubDate: 2023-06-28T09:45:07Z DOI: 10.1177/10901981231179504
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Authors:Sadie Chen, Galya Walt, Alison Aldrich, Ann Scheck McAlearney, Benjamin Linas, Brenda Amuchi, Darcy A. Freedman, Dawn Goddard-Eckrich, Erin Gibson, Jeanie Hartman; MS, Julie Bosak, Karsten Lunze, Latasha Jones, Mia Christopher, Pamela Salsberry, Rebecca Jackson, Sandi Back, Mari-Lynn Drainoni, Daniel M. Walker Abstract: Health Education & Behavior, Ahead of Print. Opioid overdose deaths are dramatically increasing in the United States and disproportionately affecting minority communities, with the increasing presence of fentanyl exacerbating this crisis. Developing community coalitions is a long-standing strategy used to address public health issues. However, there is a limited understanding of how coalitions operate amid a serious public health crisis. To address this gap, we leveraged data from the HEALing Communities Study (HCS)—a multisite implementation study aiming to reduce opioid overdose deaths in 67 communities. Researchers analyzed transcripts of 321 qualitative interviews conducted with members of 56 coalitions in the four states participating in the HCS. There were no a priori interests in themes, and emergent themes were identified through inductive thematic analysis and then mapped to the constructs of the Community Coalition Action Theory (CCAT). Themes emerged related to coalition development and highlighted the role of health equity in the inner workings of coalitions addressing the opioid epidemic. Coalition members reported seeing the lack of racial and ethnic diversity within their coalitions as a barrier to their work. However, when coalitions focused on health equity, they noted that their effectiveness and ability to tailor their initiatives to their communities’ needs were strengthened. Based on our findings, we suggest two additions to enhance the CCAT: (a) incorporating health equity as an overarching construct that affects all stages of development, and (b) ensuring that data about individuals served are included within the pooled resource construct to enable monitoring of health equity. Citation: Health Education & Behavior PubDate: 2023-06-28T09:06:03Z DOI: 10.1177/10901981231179755
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Authors:Guillermo M. Wippold, Kaylyn A. Garcia, Sarah Grace Frary, Derek M. Griffith Abstract: Health Education & Behavior, Ahead of Print. IntroductionCommunity health workers (CHWs) are health promotion specialists who are trusted members of the community served and have a close understanding of the community’s needs and values. CHWs are a cost-effective and scalable workforce to promote health among men through tailored approaches. The purpose of the present review was to use the RE-AIM Framework to assess design, implementation, and outcomes of CHW-implemented health promotion efforts tailored for men to provide recommendations for future efforts.MethodsThe protocol was pre-registered with PROSPERO. The primary inclusion criteria were that the interventions were (a) implemented at least partially by CHWs, (b) conducted only among men, and (c) designed to improve a health-related outcome. PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Global Index Medicus were searched using a librarian-generated search strategy. In all, 1,437 articles were uploaded to Rayyan and two reviewers blindly reviewed each article for inclusion. A total of 24 articles met the inclusion criteria.ResultsMost interventions (a) targeted men under 50 years, (b) were conducted among a subset of underserved men, (c) improved health outcomes, (d) community-based and informed, (e) atheoretical, and (f) had satisfactory retention rates. The roles and responsibilities of CHWs were varied. Attention was given to training of CHWs, but limited attention was given to how/if the CHWs were supervised.DiscussionCHW-implemented interventions can improve health outcomes among men. Opportunities exist to build on past interventions, such as addressing mental health and incorporating prosocial aspects of masculinity. The results have implications for designing similar interventions. Citation: Health Education & Behavior PubDate: 2023-06-23T08:10:08Z DOI: 10.1177/10901981231179498
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Authors:Olatokunbo Osibogun, Olufemi Erinoso, Wei Li, Mohammad Ebrahimi Kalan, Zoran Bursac, Akin Osibogun Abstract: Health Education & Behavior, Ahead of Print. ObjectiveAdverse childhood experiences (ACEs), which refer to childhood traumatic events, have been identified as risk factors for tobacco use in adulthood. However, studies are limited on the effect of sex on the association of ACEs with e-cigarettes and dual use of e-cigarettes and cigarettes. This study explored sex differences in the association of ACEs with e-cigarettes, cigarettes, and dual use of e-cigarettes and cigarettes among adults in the United States.MethodsThis was a cross-sectional analysis of data from adults aged ≥18 years in the 2020 Behavioral Risk Factor Surveillance System (N = 62,768). ACEs, the independent variable, was a composite score assessed from 11 questions (with responses yes—1 or no/never—0) related to childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction and categorized as 0 (reference), 1, 2, 3, or ≥4. The dependent variable, tobacco use patterns, included nonuse (reference), e-cigarette only, cigarette only, and dual use of e-cigarettes and cigarettes. Multinomial logistic regression was performed to test the interaction between sex and ACEs while controlling for potential confounders.ResultsAlthough we found no statistically significant interaction by sex, a greater number of ACEs were associated with higher odds of the different tobacco use patterns among females and males, with varying strengths of associations. Specifically, females who reported ≥4 ACEs compared with none had higher odds of e-cigarette (aOR [95% CI]: 3.58 [1.49–8.63]), cigarette (2.57 [1.72–3.83]) and dual use (3.25 [1.79–5.91]) relative to nonuse. Males with ≥4 ACEs had higher odds of cigarette (1.75 [1.15–2.65]) and dual use (7.64 [3.95–14.79]).ConclusionOur findings underscore the importance of developing appropriate, tailored trauma-informed intervention strategies for females and males. It is also important to consider ACEs in designing tobacco-specific preventive programs to curb initiation and promote cessation among U.S. adults. Citation: Health Education & Behavior PubDate: 2023-06-17T11:41:58Z DOI: 10.1177/10901981231178696
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Authors:Elizabeth M. Rojo, Kelly D. Taylor, Willi McFarland Abstract: Health Education & Behavior, Ahead of Print. Despite widespread availability of human papillomavirus (HPV) vaccines and recommendations for routine use, awareness and uptake of HPV vaccination are not universal. We assessed self-reported history of HPV vaccination in a sample of low-income men and women recruited from the community using respondent-driven sampling as part of the National HIV Behavioral Surveillance (NHBS) survey in San Francisco. Of the 384 respondents, a minority (12.5%) reported they had received the HPV vaccine. In multivariate analysis, independent associations with HPV vaccination history were female sex (adjusted odds ratio [AOR] = 3.76, 95% confidence interval [CI] = [1.73, 8.17]), younger age (AOR = 0.89 per year, 95% CI = [0.86, 0.92]), and education above high school (AOR = 2.84, 95% CI = [1.37, 5.90]). Missed opportunities for HPV vaccination were evident in 84.4% of respondents having visited a health care provider in the last year, including 40.1% tested for a sexually transmitted infection, and entry into higher education programs (33.4%). Citation: Health Education & Behavior PubDate: 2023-06-17T11:26:38Z DOI: 10.1177/10901981231179938
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Authors:Shannon L. Edmed, M. Mamun Huda, Cassandra L. Pattinson, Kalina R. Rossa, Simon S. Smith Abstract: Health Education & Behavior, Ahead of Print. BackgroundPoor sleep can contribute to poorer health and socioemotional outcomes. Sleep health can be influenced by a range of individual and other socioecological factors. Perceptions of neighborhood physical and social characteristics reflect broader social-level factors that may influence sleep, which have not been well studied in the Australian context. This study examined the association between perceived neighborhood characteristics and sleep in a large sample of Australians.MethodsData were from 9,792 people aged 16 years or older, from Waves 16 and 17 of the nationally representative Household, Income and Labour Dynamics in Australia Survey. Associations between perceived neighborhood characteristics (neighborly interaction and support, environmental noise, physical condition, and insecurity) and self-reported sleep duration, sleep disturbance, and napping were examined using multiple logistic regression models.Results“Neighborhood interaction and support” and “neighborhood physical condition” were not significantly associated with any sleep outcomes after adjusting for relevant covariates. However, “environmental noise” and “neighborhood insecurity” remained significantly associated with sleep duration and sleep disturbance. None of the neighborhood characteristics were associated with napping. Furthermore, associations did not significantly vary by gender.ConclusionsThis study highlights the potential benefit of public health policies to address noise and safety in neighborhoods to improve sleep. Citation: Health Education & Behavior PubDate: 2023-06-12T08:56:07Z DOI: 10.1177/10901981231177687
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Authors:Wei Peng, Jocelyn McKinnon-Crowley, Qian Huang, Bingjing Mao Abstract: Health Education & Behavior, Ahead of Print. BackgroundAvoidance of colonoscopy is often associated with fear, embarrassment, and disgust aroused in screening procedures. However, each emotion can be linked to different challenges faced by patients. More research is needed to evaluate and address the causes of these respective emotions.AimThe purpose of this study was to develop and assess the scales of three negative emotions (i.e., fear, embarrassment, and disgust) caused by specific issues in colonoscopy screening.MethodThe measurement items were developed based on multiple common barriers in colonoscopy screening procedures. An online sample of 232 adults aged 45-75 was recruited from Amazon Mechanical Turk to test the scales. Explorative and confirmatory factor analyses were conducted to validate the measurement models.ResultsPsychometric evidence demonstrated the factor structures of three negative emotions. Each emotional factor was caused by unique combinations of barriers in the preparation, screening, and recovery stages of colonoscopy. Most of the emotional factors were associated with attitudes and screening intention.ConclusionThis study showed different dimensions of negative emotions and their underlying causes in colonoscopy. These findings will help assess specific causes of negative emotions in colonoscopy and develop effective interventions to improve screening uptake. Citation: Health Education & Behavior PubDate: 2023-06-09T09:21:45Z DOI: 10.1177/10901981231177075
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Authors:Anderson Martins da Silva, Daniela Pereira Valentim, Adriana Leite Martins, Rosimeire Simprini Padula Abstract: Health Education & Behavior, Ahead of Print. BackgroundThe use of measurement instruments to assess the use of Evidence-Based Practice by health professionals has been frequently reported in studies.AimsThis systematic review aimed to summarize, describe, and evaluate the measurement properties of the instruments that evaluate the use of Evidence-Based Practice in health professionals.MethodsThe search was carried out in four databases considering three groups of search terms: evidence-based practice, evaluation, and measurement proprieties. Studies were included that described the use of instruments to assess Evidence-Based Practice in health professionals, with the full-text publication, which analyzed the measurement properties, in English. The methodological quality of the studies was evaluated using COnsensus-based Standards for the selection of health Measurement INstruments.ResultsIn total, 6,429 were found and only 92 were eligible for data analysis. Forty new instruments were identified most were developed for nursing and physical therapist. The investigators performed at least 1 type of validity test on 73% of the instruments. Reliability was tested at 90%, through internal consistency. Responsiveness was tested on less than half of the instruments (30%). Most of the instruments identified are reliable and valid to measure evidence-based practice in health professionals.ConclusionAlthough the Fresno Test remains the most complete instrument, and adequate for use. The COnsensus-based Standards for the selection of health Measurement INstruments checklist classified 7 (seven) instruments as suitable for the target audience. Citation: Health Education & Behavior PubDate: 2023-06-02T04:34:17Z DOI: 10.1177/10901981231170154
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Authors:Devin Miller, Dayna DeHerrera-Smith, Teresa A. Sharp, Elizabeth D. Gilbert Abstract: Health Education & Behavior, Ahead of Print. A revised way of thinking is essential for promoting harm reduction strategies and reducing the negative implications of injection drug use (IDU). Despite the growth of harm reduction approaches in the United States, there is limited guidance for designing and implementing multi-sector efforts that address the external determinants that promote and facilitate IDU. Current frameworks fail to acknowledge the individual’s role and influence in multi-sector change. To address the multifaceted nature of IDU, we must address the complex relationship between people who inject drugs (PWID) and their external environment. As part of a community–academic partnership, a framework was developed to address the gaps in current theoretical models and community practice. Our Harm Reduction Collaboration Framework (HRCF) accepts PWID as key stakeholders and presents a practical framework in which PWID and community organizations partner in decision making to influence policy, systems, and environmental change. We provide examples of two organizations that have made substantive changes in implementing harm reduction strategies in their communities by utilizing the HRCF. Citation: Health Education & Behavior PubDate: 2023-05-02T12:15:06Z DOI: 10.1177/10901981231165338
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Authors:Javier I. Rosado, Jessica M. Costero, Yuxia Wang Abstract: Health Education & Behavior, Ahead of Print. Amid the COVID-19 pandemic, vaccine hesitancy is believed to be among the top global health threats. U.S. Latinos have disproportionately been affected by the pandemic and have higher COVID-19 vaccine hesitancy. This study applied the Vaccine Hesitancy Determinants Matrix to understand COVID-19 vaccine hesitancy in a Latino agricultural community. Surveys were conducted with 180 adults from a Migrant Community Health Center to measure pandemic experiences and hesitancy factors across three categories: individual and group factors, vaccine/vaccination-specific factors, and contextual factors. Approximately 16% of participants reported having tested positive for COVID-19, 90% endorsed loss of income, and 47% reported their mental health was affected. Only 46% received a COVID-19 vaccine. Common individual vaccine hesitancy factors included worry about side effects, worry that vaccines cause infection, and concern that side effects would be worse than the virus. Vaccine/vaccination-specific factors included concern about how quickly COVID-19 vaccines were developed and concern about there being insufficient research on their effectiveness, potential risks, and side effects. Common contextual factors included religious beliefs and political mistrust. Logistic regression results indicated that subjects who tested positive for COVID-19, or had a coworker who tested positive were more likely to get vaccinated. The odds ratio of being vaccinated increased with age. Subjects who endorsed concern that vaccine side effects were worse than the virus were less likely to be vaccinated. Results highlight that there are health literacy gaps among Latino communities such as interpretation of vaccine efficacy and safety to gain a more accurate understanding of side effects. Citation: Health Education & Behavior PubDate: 2023-04-29T06:33:20Z DOI: 10.1177/10901981231167893
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Authors:Clare Barrington, Dirk A. Davis, Gustavo Angeles, Angela Yolanda Pajarito Rompich, Renato Santa Luce, Victoria Shelus, Sanny Northbrook Abstract: Health Education & Behavior, Ahead of Print. Globally, gay, bisexual, and other men who have sex with men (GBMSM) are disproportionately affected by HIV, but few interventions address mental health and HIV outcomes among GBMSM living with HIV. The purpose of this study was to pilot a multicomponent intervention, integrating emotional well-being (EW) and health navigation for GBMSM living with HIV in Guatemala City. We implemented a 12-month intervention, including a four-session EW component and a health navigation component among newly diagnosed and reengaged GBMSM with HIV (n = 112). We conducted socio-behavioral surveys at baseline and endline to measure patient characteristics and HIV, and mental health outcomes as well as viral load testing. We documented participation in EW sessions and used a smartphone application to track navigation mode, frequency, and content. Using first-difference estimation modeling, we assessed associations between participation in EW and navigation and mental health (depression and anxiety symptoms) and HIV outcomes (HIV treatment adherence, viral suppression). Acceptability was high for EW (86%) and navigation (99%). During the intervention, viral suppression increased significantly and anxiety and depression decreased significantly. Participation in EW sessions and greater navigation frequency and duration were associated with being suppressed, whereas higher emotional navigator support was associated with being unsuppressed. Participation in EW sessions was associated with reduced anxiety. Findings suggest that multicomponent interventions integrating individual counseling and navigation may promote EW and sustained viral suppression. Future intervention research is needed to confirm whether HIV and mental health outcomes are attributable to the intervention and to assess mechanisms of influence. Citation: Health Education & Behavior PubDate: 2023-04-24T05:29:29Z DOI: 10.1177/10901981231164598
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Authors:Xiao Wei, Mengfan Xu, Li Yang, Zihan Gao, Jinke Kuang, Kexin Zhou Abstract: Health Education & Behavior, Ahead of Print. BackgroundHealth-promoting behaviors and positive lifestyle changes are crucial for effective stroke prevention. However, individuals at high risk of stroke exhibit poor health behavior due to a deficiency of individual motivation. Moreover, there are only a few studies on health-promoting behaviors that have applied behavior change theories in individuals at high risk of stroke.ObjectiveThis study aimed to use the theory of the planned behavior (TPB) model to investigate determinants of health-promoting behaviors for stroke prevention and control.MethodIn this cross-sectional study, 263 participants were recruited from five community health centers in Qingdao. Confirmatory factor analysis was performed to assess the reliability and validity of the constructs, and structural equation modeling was used to analyze the proposed relationships between the TPB-related variables.ResultsThe attitudes, subjective norms, and perceptions of behavioral control positively influenced behavioral intention. The behavioral intention had a positive effect on health-promoting behaviors. Attitudes, subjective norms, and perceived behavioral control were influenced primarily by the mediating variable behavioral intention to affect health-promoting behaviors. Stroke knowledge was an influential facilitator of behavioral attitudes, subjective norms, and perceived behavior control.ConclusionThe TPB-based model is suitable for explaining health-promoting behaviors in individuals at risk of stroke and for guiding the development of effective health management programs. A comprehensive person-centered motivation behavior strategy that is based on health education and complemented by social support and health resource optimization is critical in promoting health behavior motivation and health promotion behaviors in stroke high-risk groups. Citation: Health Education & Behavior PubDate: 2023-03-24T08:59:51Z DOI: 10.1177/10901981231160149
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Authors:Meng Chen, Laramie D. Taylor, Robert A. Bell Abstract: Health Education & Behavior, Ahead of Print. Narratives have been widely acknowledged as a powerful persuasion tool in health promotion and education. Recently, great efforts have been devoted to identifying message components and causal pathways that maximize a narrative’s persuasion power. Specifically, we investigated how narrator point of view and readers’ subjective relative risk moderate the effects of protagonist competence on intentions to adopt osteoporosis-prevention behaviors, and proposed identification with the protagonist, self-referencing, and fear arousal as three mediators explaining the effect. Women aged 35 to 55, still young enough to reduce osteoporosis risk, read a narrative in which the 60-year-old female character reflects on either taking actions to prevent osteoporosis (competent protagonist) or failing to do so, resulting in osteoporosis (incompetent protagonist) (N = 563). The narratives were told from either the first- or third-person point of view. We found that women who perceived themselves to be at lower risk for developing osteoporosis relative to their peers identified more with the competent protagonist. For women at higher perceived risk, the competent and incompetent protagonists elicited similar levels of identification. Identification was higher when the protagonist’s story was told from the first-person perspective, but only for the incompetent protagonist narrative. Identification, self-referencing, and fear arousal played important mediating roles. Implications for theory development and practice are examined. Citation: Health Education & Behavior PubDate: 2023-03-21T06:06:01Z DOI: 10.1177/10901981231158412
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Authors:David M. Stoff, Lisa Bowleg, Ana María del Río-González, Carlos E. Rodriguez-Diaz, Maria Cecilia Zea Abstract: Health Education & Behavior, Ahead of Print. HIV-related comorbidities in underrepresented minority populations are reframed to include the co-occurring problems of systemic and structural barriers, within the mentoring context as a buffer and as action-oriented. This framework is discussed to improve racial and ethnic minority diversity in the research workforce from the perspectives of HIV comorbidities and mentoring. An integrated and coordinated approach to HIV-related comorbidities and inequities may be helpful when combined with research on the social-structural contributions as drivers to diversify the research workforce. We emphasize how these key research issues (a) provide a platform for training and retraining a highly motivated, diverse workforce and (b) facilitate the empowerment of these trained individuals to conduct rigorous scientific research on social-structural factors to mitigate the effects of these comorbidities. We conclude that a diverse research workforce is necessary but insufficient for improving training-related outcomes or reducing comorbidity effects. Additional considerations are warranted that include systemic approaches and changes at the structural and institutional levels. Citation: Health Education & Behavior PubDate: 2023-03-16T09:18:33Z DOI: 10.1177/10901981231157795
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Authors:Ann Marie Cheney, Evelyn Vázquez, Julie Chobdee Abstract: Health Education & Behavior, Ahead of Print. This article reports on a 3-year longitudinal study focused on the impact of cross-sector, collective impact approaches to creating cultures of campus health. The study sought to understand the integration of health and well-being concepts into university operations, including business practices and policies, as well as the contribution of public health initiatives focused on health-promoting universities to creating cultures of campus health for students, staff, and faculty. Research was carried out from spring 2018 to spring 2020 via focus group data collection and rapid qualitative analysis involving template and matrix analysis. A total of 18 focus groups were conducted across the 3-year study, six with students, eight with staff, and four with faculty. The initial cohort included 70 participants: 26 students, 31 staff, and 13 faculty. Qualitative analysis findings indicate a general pattern of change over time from a primary focus on well-being characterized by programs and services (e.g., fitness classes) to policy and structural-level interventions (e.g., stairwell beautification and hydration stations) promoting well-being for all. Grass-top and grassroots leadership and action were instrumental to changes in working and learning environments, policies, and campus environment/infrastructure. This work contributes to the growing literature on health-promoting universities and colleges and demonstrates the critical role of both top-down and ground-up approaches and leadership efforts to create more equitable and sustainable cultures of campus health and well-being. Citation: Health Education & Behavior PubDate: 2023-02-16T12:25:14Z DOI: 10.1177/10901981231151628
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Authors:Ariadne Ribeiro, Denis Gomes Alves Pinto, Alisson Paulino Trevisol, Vitor Tardelli, Felipe Arcadepani, Rogério Adriano Bosso, Marcelo Ribeiro, Thiago Marques Fidalgo Abstract: Health Education & Behavior, Ahead of Print. Drug misuse among people living with HIV (human immunodeficiency virus) is associated with higher mortality. It is a frequently observed reason for treatment abandonment, with people who misuse drugs showing a 10 to 25 times higher risk of HIV than the general population. The authors conducted a systematic review and meta-analysis to assess the efficacy of contingency management (CM) to improve adherence to antiretroviral therapy in people living with HIV and substance use disorder (SUD). The inclusion criteria consisted of studies written in English, Italian, Spanish, German, and French; studies conducted with humans; and clinical trials that combined SUD treatment with CM for people living with HIV. Two hundred twenty-two articles were identified, five met all inclusion criteria, and three provided enough data to perform the meta-analysis. We considered treatment adherence by measuring the increase in the CD4 count as our primary outcome. We found a significant increase in treatment adherence in the patient group compared with the control groups during the intervention phase. Positive findings did not persist after the cessation of the incentives. The meta-analysis showed that the intervention improved patient adherence by 2.69 (95% confidence interval: [0.08, 0.51]; p = .007) compared with the control group during the intervention period. All short-term CM studies converged on a positive result for adherence to antiretroviral therapy. Citation: Health Education & Behavior PubDate: 2023-02-06T12:36:29Z DOI: 10.1177/10901981221148966
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Authors:Tessa Kohler, Jeanine P. D. Guidry, Paul Perrin, Linnea Laestadius Abstract: Health Education & Behavior, Ahead of Print. Background:Social media platforms have become a popular source for health information despite concerns about the quality of content shared. We examined how oral contraceptive pills and intrauterine devices are framed on the platform Pinterest using the Health Belief Model (HBM), as well as how fertility awareness methods are portrayed as an alternative to hormonal contraception.Methods:We collected pins in February 2021 using searches for birth control, oral contraceptives, and intrauterine devices. After excluding paid ads and pins not relevant to contraceptive use, we conducted a content analysis of 404 pins using a coding framework grounded in the HBM. We carried out descriptive statistics for all variables in the final sample.Results:Following coding, we found that 54.7% of pins mentioned oral contraceptive pills, 41.58% mentioned intrauterine devices, and 11.63% mentioned fertility awareness methods. Fertility awareness pins had the highest percentage of benefits conveyed (70.21%), followed by intrauterine devices (44.05%), then oral contraceptive pills (38.91%). Pill pins had the highest percentage of barriers conveyed (52.94%) and fertility awareness had the least (25.53%). Side effects were the most mentioned barrier among pill (37.10%) and intrauterine device pins (23.21%). Very few pins were made by (2.48%) or originated with medical institutions (5.45%).Conclusions:Oral contraceptive pills are often negatively framed on Pinterest, whereas intrauterine devices and fertility awareness methods are more positively framed. This suggests a need for clear communication from clinicians regarding all contraceptive options and their relative merits and risks. Citation: Health Education & Behavior PubDate: 2023-02-03T11:00:49Z DOI: 10.1177/10901981231152238
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