Subjects -> HEALTH AND SAFETY (Total: 1565 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (743 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (390 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (109 journals)
    - PHYSICAL FITNESS AND HYGIENE (133 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (743 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 4)
ACM Transactions on Computing for Healthcare     Hybrid Journal   (Followers: 5)
Acta Informatica Medica     Open Access   (Followers: 3)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 3)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 12)
Advances in Public Health     Open Access   (Followers: 31)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 4)
African Health Sciences     Open Access   (Followers: 6)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 8)
African Journal of Health Professions Education     Open Access   (Followers: 7)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 48)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 7)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 4)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 9)
American Journal of Health Economics     Full-text available via subscription   (Followers: 21)
American Journal of Health Education     Hybrid Journal   (Followers: 39)
American Journal of Health Promotion     Hybrid Journal   (Followers: 35)
American Journal of Health Sciences     Open Access   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 31)
American Journal of Public Health     Full-text available via subscription   (Followers: 296)
American Journal of Public Health Research     Open Access   (Followers: 30)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 9)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 15)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 16)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Ergonomics     Hybrid Journal   (Followers: 18)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 5)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 3)
Archives of Medicine and Health Sciences     Open Access   (Followers: 7)
Archives of Suicide Research     Hybrid Journal   (Followers: 11)
Archivos de Prevención de Riesgos Laborales     Open Access  
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 6)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 15)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 5)
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: 7)
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: 5)
Autism & Developmental Language Impairments     Open Access   (Followers: 16)
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)
Biosafety and Health     Open Access   (Followers: 2)
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: 24)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 13)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 53)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 23)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 16)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 14)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 27)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 2)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 26)
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 and Adolescent Obesity     Open Access   (Followers: 2)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 12)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 3)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 1)
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: 4)
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: 6)
Conflict and Health     Open Access   (Followers: 8)
Contact (CTC)     Open Access  
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 3)
Cuadernos de la Escuela de Salud Pública     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 11)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal  
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 10)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 16)
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: 29)
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: 26)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 10)
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: 6)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 7)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 22)
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: 4)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 7)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 15)
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: 5)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 2)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 10)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
F&S Reports     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: 15)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 15)
FASEB BioAdvances     Open Access  
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 19)
Food Quality and Safety     Open Access   (Followers: 2)
Frontiers in Digital Health     Open Access   (Followers: 3)
Frontiers in Neuroergonomics     Open Access  
Frontiers in Public Health     Open Access   (Followers: 9)
Frontiers of Health Services Management     Partially Free   (Followers: 9)
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   (Followers: 1)
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: 8)
Global Health Annual Review     Open Access   (Followers: 3)
Global Health Journal     Open Access   (Followers: 3)
Global Health Promotion     Hybrid Journal   (Followers: 19)
Global Journal of Health Science     Open Access   (Followers: 12)
Global Journal of Public Health     Open Access   (Followers: 17)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 11)
Global Reproductive Health     Open Access   (Followers: 1)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 9)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 20)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 17)
Health and Human Rights     Open Access   (Followers: 10)

        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: 35  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0890-1171 - ISSN (Online) 2168-6602
Published by Sage Publications Homepage  [1162 journals]
  • In Briefs

    • Free pre-print version: Loading...

      Pages: 755 - 759
      Abstract: American Journal of Health Promotion, Volume 35, Issue 6, Page 755-759, July 2021.

      Citation: American Journal of Health Promotion
      PubDate: 2021-06-14T08:01:18Z
      DOI: 10.1177/08901171211024086
      Issue No: Vol. 35, No. 6 (2021)
       
  • Health Promotion Planning and an Interview With Dr. Lawrence Green

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      Authors: Paul E. Terry
      Pages: 760 - 765
      Abstract: American Journal of Health Promotion, Volume 35, Issue 6, Page 760-765, July 2021.
      “If we are to have more evidence-based practice, we need more practice-based evidence.” This quote has become something of a mantra for the health promotions profession’s most pre-eminent scholar, Dr. Lawrence W. Green. This editorial features an interview with Dr. Green and previews the forthcoming 5th edition of Green and Kreuter’s seminal health promotion planning textbook. The new title will be Health Program Planning, Implementation and Evaluation: Creating Behavioral, Environmental and Policy Change, with the Johns Hopkins University Press as the new publisher. Co-Editors for this new edition are Larry Green, Andrea Gielen, Judith Ottoson Darleen Peterson, and Marshall Kreuter. This edition shows the vital progression from planning and implementation to evaluation and has further refined and simplified the visual representation of the planning model. The “enabling factors” that will spawn more practice based evidence are discussed. To enable practice-based research will mean that end users of a service or intervention must be taught to be leaders and advocates for approaches that are responsive to their needs, preferences and values.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-14T08:00:44Z
      DOI: 10.1177/08901171211022560
      Issue No: Vol. 35, No. 6 (2021)
       
  • Knowing Well, Being Well: well-being born of understanding: Dietary
           Research Done Right: From Je Ne Sais Quoi to Sine Qua Non

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      Authors: David L. Katz, Michael L. Dansinger, Walter C. Willett, Tom Rifai, Lauren Q. Rhee, Christopher D. Gardner, Tushar Mehta, Adam Bernstein, Dina Aronson
      Pages: 874 - 882
      Abstract: American Journal of Health Promotion, Volume 35, Issue 6, Page 874-882, July 2021.

      Citation: American Journal of Health Promotion
      PubDate: 2021-06-14T08:07:26Z
      DOI: 10.1177/08901171211016191
      Issue No: Vol. 35, No. 6 (2021)
       
  • Dietary Research Done Right: From Je Ne Sais Quoi to Sine Qua Non

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      Authors: David L. Katz
      Pages: 874 - 875
      Abstract: American Journal of Health Promotion, Volume 35, Issue 6, Page 874-875, July 2021.

      Citation: American Journal of Health Promotion
      PubDate: 2021-06-14T08:01:20Z
      DOI: 10.1177/08901171211016191a
      Issue No: Vol. 35, No. 6 (2021)
       
  • The Study of Dietary Patterns: Righting the Remedies

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      Authors: David L. Katz, Michael L. Dansinger, Walter C. Willett
      Pages: 875 - 878
      Abstract: American Journal of Health Promotion, Volume 35, Issue 6, Page 875-878, July 2021.

      Citation: American Journal of Health Promotion
      PubDate: 2021-06-14T08:01:19Z
      DOI: 10.1177/08901171211016191b
      Issue No: Vol. 35, No. 6 (2021)
       
  • On Energy Balance and Weight Control— Is a Calorie a Calorie'

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      Authors: Tom Rifai, Lauren Q. Rhee
      Pages: 878 - 880
      Abstract: American Journal of Health Promotion, Volume 35, Issue 6, Page 878-880, July 2021.

      Citation: American Journal of Health Promotion
      PubDate: 2021-06-14T08:02:31Z
      DOI: 10.1177/08901171211016191c
      Issue No: Vol. 35, No. 6 (2021)
       
  • Three Factors That Need to be Addressed More Consistently in Nutrition
           Studies: “Instead of What'”, “In What Context'”, and
           “For What'”

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      Authors: Christopher D. Gardner, Tushar Mehta, Adam Bernstein, Dina Aronson
      Pages: 881 - 882
      Abstract: American Journal of Health Promotion, Volume 35, Issue 6, Page 881-882, July 2021.

      Citation: American Journal of Health Promotion
      PubDate: 2021-06-14T08:01:58Z
      DOI: 10.1177/08901171211016191d
      Issue No: Vol. 35, No. 6 (2021)
       
  • Preferences Toward COVID-19 Diagnostic Testing Features: Results From a
           National Cross-Sectional Survey

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      Authors: Bhagyashree Katare, Shuoli Zhao, Joel Cuffey, Maria I. Marshall, Corinne Valdivia
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Describe preferences toward COVID-19 testing features (method, location, hypothetical monetary incentive) and simulate the effect of monetary incentives on willingness to test.Design:Online cross-sectional survey administered in July 2020.Subjects:1,505 nationally representative U.S. respondents.Measures:Choice of preferred COVID-19 testing options in discrete choice experiment. Options differed by method (nasal-swab, saliva), location (hospital/clinic, drive-through, at-home), and monetary incentive ($0, $10, $20).Analysis:Latent class conditional logit model to classify preferences, mixed logit model to simulate incentive effectiveness.Results:Preferences were categorized into 4 groups: 34% (n = 517) considered testing comfort (saliva versus nasal swab) most important, 27% (n = 408) were willing to trade comfort for monetary incentives, 19% (n = 287) would only test at convenient locations, 20% (n = 293) avoided testing altogether. Relative to no monetary incentives, incentives of $100 increased the percent of testing avoiders (16%) and convenience seekers (70%) that were willing to test.Conclusion:Preferences toward different COVID-19 testing features vary, highlighting the need to match testing features with individuals to monitor the spread of COVID-19.
      Citation: American Journal of Health Promotion
      PubDate: 2021-07-21T08:57:56Z
      DOI: 10.1177/08901171211034093
       
  • Weight, Weight Perceptions, and Health and Well-Being Among Canadian
           

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      Authors: Lei Chai, Jia Xue
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The present study examines the extent to which (mis)matched weight and weight perceptions predict adolescents’ self-rated health, mental health, and life satisfaction.Design:Quantitative, cross-sectional study.Setting:Data from the 2017-2018 Canadian Community Health Survey (CCHS)—a nationally representative sample collected by Statistics Canada.Participants:Canadian adolescents aged between 12 and 17 (n = 8,081).Measures:The dependent variables are self-rated health, mental health, and life satisfaction. The independent variable is (mis)matched weight and weight perceptions.Analysis:We perform a series of ordinary least squares (OLS) regression models.Results:Overweight adolescents with overweight perceptions are associated with poorer self-rated health (b = −.546, p < .001 for boys; b = −.476, p < .001 for girls), mental health (b = −.278, p < .001 for boys; b = −.433, p < .001 for girls), and life satisfaction (b = −.544, p < .001 for boys; b = −.617, p < .001 for girls) compared to their counterparts with normal weight and normal weight perceptions. Similar patterns have also been observed among normal weight adolescents with overweight perceptions (e.g., normal weight adolescents with overweight perceptions are associated with poorer self-rated health (b = −.541, p < .01 for boys; b = −.447, p < .001 for girls)).Conclusion:Normal weight adolescents are not immune to adverse self-rated health, mental health, and life satisfaction because their weight perceptions are also a contributing factor to health and well-being consequences.
      Citation: American Journal of Health Promotion
      PubDate: 2021-07-20T09:10:50Z
      DOI: 10.1177/08901171211031064
       
  • Perceptions of Arguments in Support of Policies to Reduce Sugary Drink
           Consumption Among Low-Income White, Black and Latinx Parents of Young
           Children

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      Authors: Julie S. Cannon, Elizabeth K. Farkouh, Liana B. Winett, Lori Dorfman, A. Susana Ramírez, Spencer Lazar, Jeff Niederdeppe
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To test for racial/ethnic differences in perceived argument strength in favor of structural interventions to curb childhood obesity among lower-income parents of young children.Design:Cross-sectional, self-report.Setting:Online research panel, national sample of 1485 US adults in Fall 2019.Participants:Parents of children (age 0-5 years) with an annual income
      Citation: American Journal of Health Promotion
      PubDate: 2021-07-16T09:19:32Z
      DOI: 10.1177/08901171211030849
       
  • Unique Predictors of Intended Uptake of a COVID-19 Vaccine in Adults
           Living in a Rural College Town in the United States

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      Authors: Robert P. Lennon, Meg L. Small, Rachel A. Smith, Lauren J. Van Scoy, Jessica G. Myrick, Molly A. Martin, Data4 Action Research Group
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To explore public confidence in a COVID-19 vaccine.Design:Cross-sectional survey.Setting:A rural college town in central Pennsylvania.Subjects:Adult residents without minor children.Measures:The primary outcome was COVID-19 vaccination intention. Secondary measures included vaccination attitudes, norms, efficacy, past behavior, trust in the vaccination process, and sociodemographic variables of education, financial standing, political viewpoint, and religiosity.Analysis:Descriptive statistics were used to describe quantitative data. Multivariate ordinal regression was used to model predictors of vaccine intention.Results:Of 950 respondents, 55% were “very likely” and 20% “somewhat likely” to take a coronavirus vaccine, even though 70% had taken the flu vaccine since September 2019. The strongest predictors of vaccine acceptance were trust in the system evaluating vaccines and perceptions of local COVID-19 vaccination norms. The strongest predictors of negative vaccine intentions were worries about unknown side-effects and positive attitudes toward natural infection. Sociodemographic factors, political views, and religiosity did not predict vaccine intentions.Conclusion:Fewer adults intend to take a coronavirus vaccine than currently take the flu vaccine. Traditional sociodemographic factors may not be effective predictors of COVID-19 vaccine uptake. Although based on a small sample, the study adds to our limited understanding of COVID-19-specific vaccine confidence among some rural Americans and suggests that traditional public health vaccination campaigns based on sociodemographic characteristics may not be effective.
      Citation: American Journal of Health Promotion
      PubDate: 2021-07-16T09:10:14Z
      DOI: 10.1177/08901171211026132
       
  • “A Bowl of Vegetables With Someone You Love”: Faith, Health
           and Workplace Well-Being

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      Authors: Paul E. Terry
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Worksite health and well-being initiatives will ideally be integrated with employers’ efforts to address diversity, equity and inclusion issues. Social Determinants of Health (SDOH) include race, class, community health, income and other variables that companies can play a role in ameliorating. As much as spirituality is commonly espoused as a component of a holistic approach to health promotion, making space to discuss faith and health remains an uncommon strategy in the workplace wellness movement. Recognizing the value on investment (VOI) in wellness has eclipsed a return on investment as a driver of an employer’s well-being strategy. This editorial argues that making space for learning about faith and health will intersect in vital ways with anti-racism work, diversity programs and similar efforts to eliminate health inequities, address SDOH and bolster the VOI of worksite well-being initiatives. A fictional dialogue between executives is used to review these issues and related literature.
      Citation: American Journal of Health Promotion
      PubDate: 2021-07-12T08:54:30Z
      DOI: 10.1177/08901171211030141
       
  • Examination of Sleep and Obesity in Children and Adolescents in the United
           States

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      Authors: Puneet Kaur Chehal, Livvy Shafer, Solveig Argeseanu Cunningham
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US.Design:Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children’s Health.Setting:US, national.Subjects:Children ages 10-17 years (n = 34,640)Measures:Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts.Analysis:Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics.Results:An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time.Conclusion:Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.
      Citation: American Journal of Health Promotion
      PubDate: 2021-07-12T08:53:57Z
      DOI: 10.1177/08901171211029189
       
  • Reliability and Validity of the American Heart Association’s Workplace
           Health Achievement Index

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      Authors: Enid Chung Roemer, Karen B. Kent, Ron Z. Goetzel, Chris Calitz, Drew Mills
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:To test the validity and reliability of the American Heart Association’s (AHA) updated Workplace Health Achievement Index (WHAI).Methods:We piloted the updated WHAI with respondent pairs at 94 organizations, and examined the inter-rater reliability (percent agreement) for each item on the survey. To evaluate face and content validity, we conducted preliminary focus groups pre-survey, and follow-up cognitive interviews post-survey administration.Results:Respondents found the updated WHAI to be comprehensive and useful in identifying gaps and opportunities for improving their health and wellbeing programs. The mean percent agreement on all items was 73.1%. Only 9% (or 14 items out of 146) had poor inter-rater reliability (below 61 percent agreement), but through follow-up cognitive interviews we determined that most were due to artifacts of the study design or were resolved through minor revisions to the survey question, instructions, and/or adding examples for clarity. Only 1 question was deleted due to lack of relevance.Conclusion:The updated WHAI is a valid and reliable tool for employers to assess how well they promote the health and wellbeing of their employees.
      Citation: American Journal of Health Promotion
      PubDate: 2021-07-06T09:02:50Z
      DOI: 10.1177/08901171211022925
       
  • Risk Exposures, Risk Perceptions, Negative Attitudes Toward General
           Vaccination, and COVID-19 Vaccine Acceptance Among College Students in
           south Carolina

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      Authors: Shan Qiao, Cheuk Chi Tam, Xiaoming Li
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The current study investigated how risk exposures, risk perceptions of COVID-19, and negative attitudes toward general vaccination were related to COVID vaccine acceptance among college students.Design:Cross-sectional study.Setting:Data was collected by online survey using RedCap among college students in South Carolina between September 2020 and October 2020.Sample:1062 college students in South Carolina.Measures:risk exposures to COVID-19, perceived severity of COVID-19, perceived susceptibility of COVID-19, negative attitude toward general vaccination, vaccine acceptance of COVID-19.Analysis:Hierarchical linear regression was used to examine the association of these factors with COVID-19 vaccine acceptance controlling for key demographics.Results:Perceived severity of COVID-19 was positively associated with vaccine acceptance (ß = 0.19, p < 0.001). Higher level of risk exposures (ß = −0.08, p = 0.007) and negative attitude toward general vaccination (ß = −0.38, p < 0.001) were associated with low vaccine acceptance.Conclusion:We need tailored education messages for college students to emphasize the severity of COVID-19, address the concerns of side effects of general vaccines by dispelling the misconception, and target the most vulnerable subgroups who reported high level of risk exposures while showed low intention to take the vaccine.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-24T09:01:57Z
      DOI: 10.1177/08901171211028407
       
  • Association of Weight Loss With Type 2 Diabetes Remission Among Adults in
           Medically Underserved Areas: A Retrospective Cohort Study

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      Authors: Ming Chen, Satya Surbhi, James E. Bailey
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine the association between weight loss and type 2 diabetes remission among vulnerable populations living in medically underserved areas of the Mid-Southern United States.Design:Quantitative, retrospective cohort study.Setting:114 ambulatory sites and 5 adults’ hospitals in the Mid-South participating in a regional diabetes registry.Participants:9,900 adult patients with type 2 diabetes, stratified by remission status, with 1 year of baseline electronic medical record data, and 1 year of follow-up data for the 2015-2018 study period.Measures:The outcomes were diabetes remissions, categorized as any remission, partial remission, and complete remission based on the guidelines of the American Diabetes Association. The exposure was weight loss, calculated by the change in the Body Mass Index (BMI) as a proxy measure.Analysis:χ2 tests, Fisher’s exact tests, and the Mann-Whitney U-test were used to examine the differences in patient characteristics by remission status across the 3 remission categories, as appropriate. Multiple multivariable logistic regressions adjusting for confounders were performed to estimate the adjusted odds ratios (aORs) for the associations between weight loss and diabetes remission.Results:Among 9,900 patients identified, a reduction of 0.3 kg/m2 (standard deviation: 2.5) in the average BMI from the baseline to the follow-up was observed. 10.8% achieved any type of remission, with 9.8% for partial and 1.0% for complete remissions. Greater weight loss was significantly associated with an increased likelihood of any (aOR = 1.07, 95% confidence interval (CI), 1.06-1.08), partial (aOR 1.06, 95% CI, 1.04-1.07), and complete diabetes remission (aOR 1.10, 95% CI, 1.07-1.13).Conclusions:Weight loss is significantly associated with diabetes remission among patients living in medically underserved areas, but complete remission is rare.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-15T10:05:45Z
      DOI: 10.1177/08901171211024426
       
  • Supporting Employee Health at Work: How Perceptions Differ Across Wage
           Category

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      Authors: Kristi Rahrig Jenkins, Emily Stiehl, Bruce W. Sherman, Susan L. Bales
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study examines the association between sources of stress and perceptions of organizational and supervisor support for health and well-being.Design:Retrospective, cross-sectional analysis.Setting:Large university in the mid-western United States.Sample:This study focused on university employees with complete data for all variables (organizational support/N = 19,536; supervisor support/N = 20,287).Measures:2019 socioeconomic and demographic characteristics, count of chronic conditions, sources of stress and perceptions of organizational and supervisor support.Analysis:For the multivariate analyzes, linear regression models were analyzed separately by wage bands (low ≤$46,100; middle>$46,100-$62,800; high>$62,800).Results:For all employees, workplace stressors, including problematic relationships at work and heavy job responsibilities, were negatively associated with perceptions of supervisor and organizational support. In comparison, the most salient home-based stressors were negatively associated with perceptions of supervisor support for the lowest-wage band (the death of a loved one, b = −0.13) and middle-wage band (personal illness or injury, b = −0.09), while the one for the highest-wage band (illness or injury of a loved one, b = 0.07) was positively associated with perceptions of supervisor support.Conclusion:Stressful job responsibilities and work relationships are associated with lower perceptions of supervisor and organizational support for health and well-being across all wage bands. Favorable perceived support for personal stressors only among high wage earning employees may suggest a need for improved equity of perceived support for these stressors among lower wage workers.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-15T09:47:04Z
      DOI: 10.1177/08901171211024416
       
  • The Neighborhood Environment and Hispanic/Latino Health

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      Authors: Natalia I. Heredia, Tianlin Xu, MinJae Lee, Lorna H. McNeill, Belinda M. Reininger
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Hispanic/Latino adults on the Texas-Mexico border have high rates of chronic disease. Neighborhoods can influence health, though there is a limited research on neighborhood environment and health in Hispanics/Latinos. The purpose of this study was to assess the relation of neighborhood environment with health variables in Hispanic/Latino adults, including physical activity [PA], depression, anxiety, and lab-assessed conditions (type 2 diabetes, metabolic syndrome, and chronic inflammation).Methods:Participants were randomly-selected from a Hispanic/Latino cohort on the Texas-Mexico border. Neighborhood environment, self-reported PA, anxiety, and depression were assessed through questionnaires. Laboratory values determined Type 2 diabetes, metabolic syndrome, and C-reactive protein (CRP). We conducted multivariable linear and logistic regression analyses to assess the associations of neighborhood environment and health variables, controlling for covariates.Results:Participants (n = 495) were mostly females, without insurance. After controlling for covariates, crime (Adjusted Odds Ratio [AOR] = 1.59 (95%CI 1.06-2.38), no streetlights (AOR = 1.65, 95%CI 1.06-2.57), and traffic (AOR = 1.74, 95%CI 1.16-2.62) were all significantly associated with anxiety. Only traffic was significantly associated with depression (AOR = 1.61, 95%CI1.05-2.47). A lack of nearby shops (AOR = 0.57, 95%CI 0.38-0.84) and no one out doing PA (AOR = 0.53, 95% CI 0.34-0.83) were both significantly associated with lower odds of meeting PA guidelines. A lack of nearby shops was associated with a 26% increase in the CRP value (β = 0.26, 95%CI 0.04-0.47).Discussion:Several neighborhood environment variables were significantly associated with mental health, PA and CRP, though estimates were small. The neighborhood environment is a meaningful contextual variable to consider for health-related interventions in Hispanic/Latino adults, though more study is needed regarding the magnitude of the estimates.Trial registration:NCT01168765.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-15T09:12:24Z
      DOI: 10.1177/08901171211022677
       
  • Examining Disparities in Food Access Between Historically Black Colleges
           and Universities and Non-Historically Black Colleges and Universities

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      Authors: Mariah Kornbluh, Shirelle Hallum, Marilyn Wende, Joseph Ray, Zachary Herrnstadt, Andrew T. Kaczynski
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Examine if Historically Black Colleges and Universities (HBCUs) are more likely to be located in low food access area (LFA) census tracts compared to public non-HBCUs.Design:ArcGIS Pro was utilized to capture food environments and census tract sociodemographic data.Setting:The sample included 98 HBCUs and 777 public non-HBCUs within the United States. 28.9% of study census tracts were classified as LFA tracts.Measures:University data were gathered from the National Center for Education Statistics. Census tract-level LFA classification was informed by the United States Department of Agriculture’s Food Access Research Atlas. Covariates included population density and neighborhood socioeconomic status of census tracts containing subject universities.Analysis:Multilevel logistic regression was employed to examine the relationship between university type and LFA classification.Results:A higher percentage of HBCUs (46.9%) than public non-HBCUs (26.6%) were located in LFAs. After adjusting for population density and neighborhood socioeconomic status, university type was significantly associated with food access classification (B=0.71;p=.0036). The odds of an HBCU being located in LFA tracts were 104% greater than for a public non-HBCU (OR=2.04;95% CI=1.26,3.29).Conclusion:Findings underscore the need for policy interventions tailored to HBCU students to promote food security, environmental justice, and public health.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-09T09:34:39Z
      DOI: 10.1177/08901171211024412
       
  • Associations Between Occupational and Leisure-Time Physical Activity With
           

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      Authors: Marilyn Batan Wolff, Patrick J. O’Connor, Mark G. Wilson, Jennifer L. Gay
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Examine the associations of occupational and leisure-time physical activity with job stress, burnout, and well-being among healthcare industry workers.Design:Quantitative; cross-sectional.Setting:Healthcare Industry.Sample:US Amazon Mechanical Turk participants (n = 550) employed in the healthcare industry, worked 35 hours or more per week, had ≥ 1 supervisor and ≥ 1 co-worker, and were ≥ 18 years old.Measures:Self-reported measures of occupational physical activity (OPA) and leisure-time physical activity (LTPA), employee well-being, job stress, and burnout operationalized as exhaustion and disengagement.Analysis:Associations between OPA and LTPA with employee well-being, job stress, exhaustion and disengagement were assessed with separate multiple linear regression models.Results:OPA had positive significant associations with job stress (β = 0.10, P value = .003) and exhaustion (β = 0.21, P value < .0001). No significant associations were found between OPA with other psychological outcomes. A significant inverse association was found between LTPA and exhaustion (β = −0.04, P value = .007).Conclusion:In a sample of U.S. health care workers, and consistent with prior epidemiological studies, greater LTPA was associated with lower feelings of exhaustion. In contrast, health care workers with greater OPA reported higher perceptions of job stress and exhaustion. The findings underscore the need for more research aimed at understanding relationships between OPA and psychological health among healthcare workers.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-09T09:12:01Z
      DOI: 10.1177/08901171211011372
       
  • Changes in Health Behaviors Associated With Weight Gain by Weight
           Classification During the COVID-19 Pandemic

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      Authors: Kristie Rupp, Ciarán P. Friel
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine whether perceived changes (i.e. perception of engagement during the pandemic relative to pre-pandemic) in specific health behaviors differ by weight status (i.e. healthy weight, overweight, obese).Design:Cross-sectional. Recruitment took place between June-August 2020, via social media posts and Qualtrics online panels.Setting:Participants completed the survey online through the Qualtrics platform.Sample:Analyses included N = 502 participants (≥18 years); 45.2% healthy weight (n = 227), 28.5% overweight (n = 143), and 26.3% obese (n = 132).Measures:Study-specific survey items included questions about demographics and perceived changes in health behaviors.Analysis:Logistic regression models, adjusted for age, race, ethnicity, gender, education, and COVID-19 diagnosis, assessed the odds of perceiving changes in health behaviors considered a risk for weight gain.Results:Participants with obesity, but not overweight, were significantly more likely to report deleterious changes to health behaviors compared to healthy weight peers, including: (1) decreased fruit/vegetable consumption [adjusted odds ratio (AOR) = 1.92; 95% confidence interval (CI): (1.13, 3.26)]; (2) increased processed food consumption [AOR = 1.85; 95%CI: (1.15, 3.00)]; (3) increased caloric intake [AOR = 1.66; 95% CI: (1.06, 2.61)]; (4) decreased physical activity [AOR = 2.07; 95%CI: (1.31, 3.28)]; and (5) deterioration in sleep quality [AOR = 2.07; 95%CI: (1.32, 3.25)].Conclusion:Our findings suggest that adults with obesity may be at greater risk for unhealthy behaviors during a period of prolonged social distancing, potentially exacerbating the obesity epidemic.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-08T08:59:29Z
      DOI: 10.1177/08901171211022958
       
  • Using the CDC Worksite Health ScoreCard to Promote Organizational Change

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      Authors: Richard Scott Safeer, Meg Mia Lucik, Katherine Claire Christel
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To measure the impact of tying adoption of evidence-based worksite health promotion (WHP) interventions to annual organizational strategic objectives, as measured by the Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard (ScoreCard).Design:A prospective cohort study following Johns Hopkins Medicine (JHM) affiliates against industry-specific and large employer benchmarks from 2016-2020.Settings:JHM, the largest private employer in Maryland with facilities in Florida and the District of Columbia.Subjects:Twelve JHM affiliates representing over 40,000 employees.Intervention:A strategic objective was established annually based on the ScoreCard and organizational priorities.Measures:JHM affiliates measured their WHP efforts annually using the ScoreCard. CDC industry-specific and large employer benchmarks were collected for comparison.Analysis:ScoreCard data was assessed annually to measure deviations from CDC benchmarks, determine whether strategic objectives were met, and inform additional annual objectives.Results:JHM demonstrated improvement from 8.9 percentage points above industry-specific and 3.4 percentage points below large employer benchmarks in 2016, to 26.4 percentage points above industry-specific and 21.8 percentage points above large employer benchmarks in 2020.Conclusion:Large employers face unique challenges in implementing WHP programs. Our study suggests embedding health promotion in annual strategic objectives may alleviate these challenges by prioritizing the goal and ensuring adequate resources to be successful. There are however, some limitations on using benchmarking data for comparison.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-07T09:31:46Z
      DOI: 10.1177/08901171211012948
       
  • COVID-19 Experiences and Social Distancing: Insights From the Theory of
           Planned Behavior

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      Authors: Rochelle L. Frounfelker, Tara Santavicca, Zhi Yin Li, Diana Miconi, Vivek Venkatesh, Cecile Rousseau
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The objective of this study is to identify the relationship between COVID-19 experiences, perceived COVID-19 behavioral control, social norms and attitudes, and future intention to follow social distancing guidelines.Design:This is a cross-sectional study.Setting:Participants responded to an on-line survey in June 2020.Subjects:The study included 3,183 residents within Quebec, Canada aged 18 and over.Measures:Measures include perceived COVID-19 related discrimination, fear of COVID-19 infection, prior exposure to COVID-19, and prior social distancing behavior. Participants self-reported attitudes, perceived behavioral control, and perceived norms related to social distancing. Finally, we measured social distancing behavioral intention.Analysis:We evaluated a theory of planned behavior (TPB) measurement model of social distancing using confirmatory factor analysis (CFA). The association between COVID-19 perceived discrimination, fear of infection, previous social distancing behavior, exposure to COVID-19, TPB constructs and behavioral intentions to social distance were estimated using SEM path analysis.Results:TPB constructs were positively associated with intention to follow social distancing guidelines. Fear of COVID-19 infection and prior social distancing behavior were positively associated with behavioral intentions. In contrast, perceived discrimination was negatively associated with the outcome. Associations between fear of COVID-19, perceived COVID-19 discrimination and behavioral intentions were partially mediated by constructs of TPB.Conclusions:COVID-19 prevention efforts designed to emphasize positive attitudes, perceived control, and social norms around social distancing should carefully balance campaigns that heighten fear of infection along with anti- discrimination messaging.
      Citation: American Journal of Health Promotion
      PubDate: 2021-06-02T08:58:02Z
      DOI: 10.1177/08901171211020997
       
  • Parents’ Perceptions and Engagement Regarding School-Based Physical
           Activity Promotion

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      Authors: Collin A. Webster, Gabriella McLoughlin, Angie Starrett, Jillian Papa, Heather Erwin, Julian A. Reed, Russell L. Carson, Charlene Burgeson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study examined parents’ perceived importance of, and engagement in, school-based physical activity (PA) promotion.Design:A cross-sectional, quantitative survey design was employed.Setting:The survey was conducted in the United States.Subjects:Using a probability-based panel (AmeriSpeak®), a national sample of 3599 parents was randomly recruited to participate in the survey and 1015 participants (28.2%) completed it. Parents or legal guardians of children enrolled in K-12 during the 2017-2018 school year were eligible to participate.Measures:The survey was developed and distributed by a national collaborative for active schools with the support of a national research center.Analysis:Data were analyzed using structural equation modeling and path analysis.Results:The data supported a 6-factor solution encompassing perceived importance of PA before, during, and after school, communication with administrators, and volunteering and participating in school-based PA (CFI = .974, RMSEA = .034, SRMR = .056). Path coefficients from perceived importance of PA before/after school to current (β = .43; 95%CI[.25, .61]) and future communication with administrators (β = .40; 95%CI[.23, .55]) were statistically significant, as were coefficients from perceived importance of PA before/after school to past (β = .60; 95%CI[.35, .83]) and current volunteering/participating in school-based PA (β = .63; 95%CI[.42, .85]).Conclusion:Parents’ perceived importance of school-based PA opportunities before and after school warrants emphasis in future research and advocacy.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-28T09:08:46Z
      DOI: 10.1177/08901171211020987
       
  • Sexual Orientation Identity and Its Implication in the Disparities in
           Psychological Health-Related Quality of Life

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      Authors: Hui Xie, Yannan Li, Cailtin Turner
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine disparities in psychological health-related quality of life (HRQoL) among sexual minority women within racial/ethnic subgroups.Design:A secondary analysis of the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS).Setting:United States.Subjects:Noninstitutionalized, cisgender, adult women in the U.S (unweighted n = 81,947).Measures:Socioeconomics, health behaviors, and healthcare access as risk factors, whereas 1 item measures psychological HRQoL as an outcome.Analysis:Weighted multivariable logistic regressions to estimate the odds of having adversely psychological HRQoL in relation to sexual orientation and other correlates within a racial/ethnic subgroup independently.Results:The prevalence of adverse psychological HRQoL was greater in bisexual and “other” sexual orientation women. Both bisexual (adjusted odds ratio [aOR] = 1.58; 95% confidence interval [CI] = 1.26-2.00) and “other” sexual orientation (Aor = 1.93; 95%CI = 1.26-2.96) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in non-Hispanic White women. Bisexual women (aOR = 3.42; 95%CI = 1.98-5.88) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in Latinas. No similar pattern was observed in non-Hispanic Black women.Conclusion:Disparities in psychological HRQoL varied by sexual orientation identities within different racial/ethnic subgroups. The magnitude of the association for Latina bisexual women was strong. Implications for bisexual health among people with intersecting identities are discussed.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-25T09:09:52Z
      DOI: 10.1177/08901171211019898
       
  • Socioeconomic Factors Influence Health Information Seeking and Trust Over
           Time: Evidence From a Cross-Sectional, Pooled Analyses of HINTS Data

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      Authors: Naleef Fareed, Pallavi Jonnalagadda, Christine M. Swoboda, Pranav Samineni, Tyler Griesenbrock, Timothy Huerta
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Assessed socioeconomic factors in health information seeking behavior and trust of information sources from 2007 to 2017.Design:Pooled cross-sectional survey data.Setting:Health Information National Trends Survey.Participation:Data included 6 iterations of U.S. adults (Pooled: N = 19,496; 2007: N = 3,593; 2011: N = 3,959; 2013: N = 3,185; FDA 2015: N = 3,738; 2017: N = 3,285; and FDA 2017: N = 1,736).Measures:Outcome variables were health information seeking, high confidence, and high trust of health information from several sources. Independent variables were education and income group, controlling for other sociodemographic variables.Analysis:Weighted descriptive and multivariate logistic regression for the pooled sample assessed associations by education and income. Fully interacted models with education/income-survey year interactions compared differences in outcomes between years.Results:We found information seeking, confidence, and trust were associated with income and education, which supported previously reported findings. Additionally, our findings indicated low-and medium-income groups had significantly lower odds of seeking health information compared to those in a high-income group. Regarding trust of information, a high school education was associated with higher odds of trust in family and friends. We also found that, over time, information seeking, confidence, and trust behavior differed by income and education, with some differences persisting.Conclusion:Disparities by income and education in trust of information sources remained across time. Understanding optimal information sources, their reach, and their credibility among groups could enable more targeted interventions and health messaging. We also describe the implications for our findings in the context of COVID-19.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-19T09:05:12Z
      DOI: 10.1177/08901171211018135
       
  • Social Support Networks and Foreign-Birth Status Associated With Obesity,
           Hypertension and Diabetes Prevalence Among 21-30 and 50-70 Year Old Adults
           Living in the San Francisco Bay Area

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      Authors: Leslie E. Cofie, Jacqueline M. Hirth, Joseph G. L. Lee
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine whether social network characteristics of US-and foreign-born individuals are related to hypertension, diabetes and obesity prevalence.Design:Cross-sectional.Setting:Six San Francisco Bay Area counties.Participants:N = 1153 cohorts of young and older adults (21-30 and 50-70 years).Measures:Network structure and support measures were calculated using name elicitation and interpreter questions common in egocentric surveys. Hypertension and diabetes were self-reported, and overweight/obesity was determined using body mass index calculations. Foreign-birth status was based on country of birth.Analysis:Adjusted and unadjusted logistic regression models were used to examine associations between network characteristics and hypertension, diabetes and overweight/obesity. These relationships were tested for moderation by foreign-birth status, age and gender.Results:Higher percentages of family members (AOR = 4.16, CI: 1.61-10.76) and same-sex individuals (AOR = 3.41, CI: 1.25-9.35) in the composition of respondents’ networks were associated with overweight/obesity. Higher composition of family members (AOR = 3.54, CI: 1.09-11.48) was associated with hypertension. Respondents whose networks composed of higher numbers of advice individuals (AOR = 0.88, CI: 0.77-0.99), female respondents (AOR = 0.52, CI: 0.35-0.77) and foreign-born respondents (AOR = 0.54, CI: 0.32-0.92) were less likely to report overweight/obesity. Diabetes was associated with higher composition of individuals living within 5-minutes to respondents (AOR = 5.13, CI: 1.04-25.21).Conclusion:Family and network support members such as advice individuals could be potential targets for chronic disease prevention, particularly among older adults and immigrants.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-18T08:54:54Z
      DOI: 10.1177/08901171211016320
       
  • Effectiveness of Workplace Exercise Interventions on Body Composition: A
           Systematic Review and Meta-Analysis

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      Authors: Guillermo García Pérez de Sevilla, Fernando Cobo Vicente-Arche, Israel John Thuissard, Olga Barcelo, Margarita Perez-Ruiz
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:The aim of this review was to analyze the effectiveness of workplace exercise interventions on body composition (BC).Data Source:Studies published in PubMed, Scopus, SPORTDiscus, Web of Science, CINAHL and PsycINFO, from the earliest time point until 8 July 2020.Study Inclusion and Exclusion Criteria:Inclusion criteria were worksite interventions, in adults, Randomized Controlled Trials (RCTs), real exercise practice, and measuring BC outcomes. Exclusion criteria were full-text non-available, abstract not in English, and exercise protocol missing.Data Extraction:157 studies were retrieved and assessed for inclusion by 2 independent reviewers, who also used the Cochrane’s Collaboration Tool to assess study quality and risk of bias.Data Synthesis:We performed a meta-analysis to determine the effect size of the interventions on BC outcomes reported in at least 5 studies.Results:Twelve RCTs were included (n = 1270, 66% women), quality of studies being low to high (25% moderate, 67% high). Interventions achieved a statistically significant decrease in waist circumference (SMD = 0.24; 95% confidence interval (CI): 0.06 to 0.41; p = 0.008), total mass fat (SMD = 0.21; 95%CI: 0.00 to 0.41; p = 0.047), and body adiposity index (SMD = 0.20; 95%CI: 0.00 to 0.41; p = 0.049). No changes were observed in body weight (SMD = 0.08 95%CI: −0.02 to 0.18; p = 0.128). Additionally, muscle mass increased in interventions that included strength training. There were no adverse events reported.Conclusion:The most effective workplace exercise interventions to improve BC combined supervised, moderate-intensity aerobic and strength training, for at least 4 months.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-18T08:40:11Z
      DOI: 10.1177/08901171211014726
       
  • Association of Behavioral Phenotypes With Changes in Sleep During a
           Workplace Wellness Program

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      Authors: Kimberly J. Waddell, Sujatha Changolkar, Gregory Szwartz, Sarah Godby, Mitesh S. Patel
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Examine changes in sleep duration by 3 behavioral phenotypes during a workplace wellness program with overweight and obese adults.Design:Secondary analysis of a randomized clinical trialSetting:Remotely monitored intervention conducted across the United StatesSubjects:553 participants with a body mass index ≥25Intervention:Participants were randomized to 1 of 4 study arms: control, gamification with support, gamification with collaboration, and gamification with competition to increase their physical activity. All participants were issued a wrist-worn wearable device to record their daily physical activity and sleep duration.Measures:The primary outcome was change in daily sleep duration from baseline during the 24 week intervention and follow-up period by study arm within behavioral phenotype class.Analysis:Linear mixed effects regression.Results:Participants who had a phenotype of less physically active and less social at baseline, in the gamification with collaboration arm, significantly increased their sleep duration during the intervention period (30.2 minutes [95% CI 6.9, 53.5], P = 0.01), compared to the control arm. There were no changes in sleep duration among participants who were more extroverted and motivated or participants who were less motivated and at-risk.Conclusions:Changes in sleep during a physical activity intervention varied by behavioral phenotype. Behavioral phenotypes may help to precisely identify who is likely to improve sleep duration during a physical activity intervention.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-17T09:12:04Z
      DOI: 10.1177/08901171211015089
       
  • Understanding the Effects of Individual and State-Level Factors on
           American Public Response to COVID-19

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      Authors: Feng Hao, Wanyun Shao
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine multilevel predictors on American public response to COVID-19.Design:Multilevel study.Setting:A national survey was conducted by Qualtrics from August 24 to September 11, 2020. The state-level variables were constructed on data from multiple sources.Subjects:2,440 respondents 18 years and older from all 50 states and D.C.Measures:The outcome variable is the public response to COVID-19 measured by threat perception, behavioral adjustment, and policy support. The predictors include individual-level sociodemographic factors and state-level indicators about public health conditions, political context, and economic recovery.Analysis:Multilevel structural equation modeling is used for statistical estimation.Results:People from states with more COVID-19 cases (β = 0.020, p < 0.1), mandatory face mask policies (β = 0.069, p < 0.05), and liberal governments (β = 0.002, p < 0.05) are more likely to respond while people from states whose economies have recovered closer to the pre-pandemic level are less likely to do so (β = −0.005, p < 0.05). Regarding individual-level predictors, older people (β = 0.005, p < 0.001) and people with better education (β = 0.029, p < 0.01), leaning toward the Democrat Party (β = 0.066, p < 0.001) and liberal political ideology (β = 0.094, p < 0.001), and have stronger generalized trust (β = 0.033, p < 0.001) are more likely to respond than their counterparts.Conclusion:Differences in the public response to the pandemic stem from variations in individual characteristics and contextual factors of states where people live. These findings contribute to the rapidly growing literature and have implications for public health policies.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-13T08:58:06Z
      DOI: 10.1177/08901171211017286
       
  • E-Cigarette Beliefs and Intentions Among U.S. Adults Before and After
           EVALI Outbreak

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      Authors: Julia M. Alber, Kimiya Ganjooi, Siena Gibbs, Rebeca Almeida, Lorraine D. Jackson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study examined attitudes, perceived control, perceived norms, intention, and policy support before and after the peak of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) cases among 2 independent samples of U.S. adults.Design:This study used a successive independent samples design.Setting:Data was collected through online surveys in July 2019 (n = 521) and October 2019 (n = 536).Subjects:Participants were recruited through the Qualtrics Survey Panel. Eligibility criteria included: 1) 18 years or older, and 2) currently living in the U.S.Measures:The 2 surveys were collected from 2 separate samples examined e-cigarette attitudes, perceived control, perceived norms, intention, and policy support.Analysis:Linear regressions were used to examine the association between time, attitudinal, and belief factors associated with intention and policy support.Results:Participants in the October sample (n = 521) were significantly more likely to have negative attitudes towards e-cigarettes when compared to the July sample (n = 536), F(8,1047) = 52.671, p < .01, R2 = 0.287. Lower perceived social acceptance towards e-cigarettes and negative attitudes were related to higher support for restricting where e-cigarettes could be used, F(11, 1042) = 63.218, p < .010, R2 = .401. Higher perceived control over accessing e-cigarettes, but lower social acceptance of e-cigarettes and negative beliefs were associated with higher support for limiting places where e-cigarettes could be purchased, F(11,1039) = 36.200, p < .01, R2 = .277.Conclusion:Results indicate that EVALI cases may have had an immediate negative effect on attitudes but did not appear to decrease intention to use e-cigarettes. Results could inform future public health campaigns' programming and research. More research is needed to understand the long-term impact of EVALI on e-cigarette use.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-12T10:04:27Z
      DOI: 10.1177/08901171211016327
       
  • A Systematic Review of Multi-Component Comprehensive School Physical
           Activity Program (CSPAP) Interventions

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      Authors: Ann Pulling Kuhn, Peter Stoepker, Brian Dauenhauer, Russell L. Carson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:To identify, review, and describe multicomponent physical activity (PA) interventions in terms of: (a) number and combination of Comprehensive School Physical Activity Program (CSPAP) components, (b) study characteristics, and (c) primary outcomes.Data Source:Five electronic databases (i.e., PubMed, PsychInfo, Physical Education Index, Sport Discus, and ERIC).Study Inclusion and Exclusion Criteria:Included articles were peer-reviewed, written in English language, published since 1987, and included multicomponent school-based interventions.Data Extraction:Data items extracted were: school level, setting, CSPAP component description, health outcomes, academic outcomes, main conclusion, and reference.Data Synthesis:Included articles were synthesized by: (1) CSPAP components utilized, and (2) research outcome measured (i.e., health or academic).Results:Across 32 studies, 11 included physical education plus 1 additional CSPAP component (PE + 1); 10 included PE + 2 additional CSPAP components; 8 included PE + 3 additional CSPAP components; and 1 included all 5 CSPAP components. Two other studies included 2 or 3 CSPAP components without PE. Most interventions targeted health outcomes (94%) rather than academic outcomes (6%).Conclusions:Multicomponent approaches aligned with CSPAPs are effective in promoting PA and other positive outcomes for youth in schools. Future research should seek to understand effects of CSPAP components on a variety of outcomes and settings.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-06T09:30:21Z
      DOI: 10.1177/08901171211013281
       
  • Theoretical Mediators of Diabetes Risk and Quality of Life Following a
           Diabetes Prevention Program for Latino Youth With Obesity

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      Authors: Erica G. Soltero, Stephanie L. Ayers, Marvyn A. Avalos, Armando Peña, Allison N. Williams, Micah L. Olson, Yolanda P. Konopken, Felipe G. Castro, Kimberly J. Arcoleo, Colleen S. Keller, Donald L. Patrick, Justin Jager, Gabriel Q. Shaibi
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study tested self-efficacy and social support for activity and dietary changes as mediators of changes in type 2 diabetes related outcomes following a lifestyle intervention among Latino youth.Setting and Intervention:Latino adolescents (14-16 years) with obesity (BMI% = 98.1 ± 1.4) were randomized to a 3-month intervention (n = 67) that fostered self-efficacy and social support through weekly, family-centered sessions or a comparison condition (n = 69).Measures:Primary outcomes included insulin sensitivity and weight specific quality of life. Mediators included self-efficacy, friend, and family social support for health behaviors. Data was collected at baseline, 3-months, 6-months, and 12-months.Analysis:Sequential path analysis was used to examine mediators as mechanisms by which the intervention influenced primary outcomes.Results:The intervention had a direct effect on family (β = 0.33, P < .01) and friend social support (β = 0.22, P < .001) immediately following the intervention (3-months). Increased family social support mediated the intervention’s effect on self-efficacy at 6-months (β = 0.09, P < .01). However, social support and self-efficacy did not mediate long-term changes in primary outcomes (P> .05) at 12-months.Conclusions:Family social support may improve self-efficacy for health behaviors in high-risk Latino youth, highlighting the important role of family diabetes prevention. Fostering family social support is a critical intervention target and more research is needed to understand family-level factors that have the potential to lead to long-term metabolic and psychosocial outcome in vulnerable youth.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-05T09:36:14Z
      DOI: 10.1177/08901171211012951
       
  • The Impact of Theory in HPV Vaccination Promotion Research: A Systematic
           Review and Meta-Analysis

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      Authors: Xizhu Xiao, Danielle Ka Lai Lee, Rachel Min Wong, Porismita Borah
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:Numerous studies examined HPV vaccination promotional strategies. However, an overview of theory use, a synthesis of strategies’ effectiveness and an examination of the moderating influence of theory are absent.Data Source:We retrieved studies from Academic Search Complete, Business Source Complete, PubMed, PsycINFO, Web of Science, CMMC, CINAHL, and MEDLINE.Study Inclusion and Exclusion Criteria:1) peer-reviewed articles written in English, 2) experimental or quasi-experimental, 3) measure HPV vaccination-related outcomes, 4) had to contain a control condition and report statistics necessary for conversion (for meta-analysis only).Data Extraction:70 and 30 studies were included for the systematic review and meta-analysis respectively.Data Synthesis:Four major categories were coded: study information, theory use, type of theory, and outcomes. Two independent coders coded the sample (Cohen’s Kappa ranged from .8 to 1).Results:Most of the studies were based in the U.S. (77%, k = 54) with convenient samples (80%, k = 56), targeted toward females (46%, k = 32), and around a quarter did not employ any theories (47%, k = 33). Among theory-driven studies, the most commonly used were Framing (22%, k = 19), Health Belief Model (HBM; 13%, k = 12), and Narrative (7%, k = 6). Among controlled studies, promotional strategies were significantly more effective compared to the control (r+ = .25, p < .001). Strategies guided by the information, motivation, behavioral skills model (IMB) were more effective (r+ = .75, p < .001) than studies guided by framing theory (r+ = −.23, p < .001), HBM (r+ = .01, p < .001), and other theories (r+ = .11, p < .001).Conclusion:This review contributes to HPV vaccination promotion literature by offering a comprehensive overview of promotional strategies and practical suggestions for future research and practices.
      Citation: American Journal of Health Promotion
      PubDate: 2021-05-05T09:35:30Z
      DOI: 10.1177/08901171211012524
       
  • Neighborhood Environment and Child Health in Immigrant Families: Using
           Nationally Representative Individual, Family, and Community Datasets

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      Authors: Jeong-Kyun Choi, Megan Kelley, Dan Wang, Hannah Kerby
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study aimed to examine neighborhood effects on the physical and socioemotional health of children from immigrant families, after controlling for parents’ demographic characteristics, socioeconomic status, acculturation, and health care issues.Design:Pooled cross-sectional data were merged with community profiles.Setting:The United States in 2013, 2014, and 2015.Participants:10,399 children from immigrant families in the 2013-2015 National Health Interview Surveys and the U.S. Census Data.Measures:Both objective and subjective measures of neighborhood environments were assessed, including neighborhood physical disorder, socioeconomic status, demographic composition, community resources, and social trust.Analysis:Descriptive statistics, logistic regression models.Results:About half of the sampled children were male (51%); 68% were white; 56% were of Hispanic; and 34% were school-aged. Three neighborhood factors—neighborhood trust, area-level poverty rate, and the presence of primary care physician—were identified as significant predictors for child health outcomes. Foreign-born population, green space, and food desert were not significant. At the individual level, parents’ racial and ethnic minority status, non-marital status, and healthcare issues were found to be risk factors. Families’ financial resources and parental education were identified as protective factors of socioemotional health.Conclusion:Intervention approaches to build on neighborhood trust may have broad potential to improve child outcomes. Programs focusing on immigrant families with children in high poverty neighborhoods should be a high priority.
      Citation: American Journal of Health Promotion
      PubDate: 2021-04-28T07:38:44Z
      DOI: 10.1177/08901171211012522
       
  • Place, Power, and Premature Mortality: A Rapid Scoping Review on the
           Health of Women in Appalachia

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      Authors: Jessica R. Thompson, Lauren R. Risser, Madeline N. Dunfee, Nancy E. Schoenberg, Jessica G. Burke
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:Appalachian women continue to die younger than in other US regions. We performed a rapid scoping review to summarize women’s health research in Appalachia from 2000 to 2019, including health topics, study populations, theoretical frameworks, methods, and findings.Data Source:We searched bibliographic databases (eg, PubMed, PsycINFO, Google Scholar) for literature focusing on women’s health in Appalachia.Study Inclusion and Exclusion Criteria:Included articles were: (1) on women’s health in Appalachia; (2) published January 2000 to June 2019; (3) peer-reviewed; and (4) written in English. We excluded studies without reported data findings.Data Extraction:Two coders reviewed articles for descriptive information to create summary tables comparing variables of interest.Data Synthesis:Two coders co-reviewed a sub-sample to ensure consensus and refine data charting categories. We categorized major findings across the social-ecological framework.Results:A search of nearly 2 decades of literature revealed 81 articles, which primarily focused on cancer disparities (49.4%) and prenatal/pregnancy outcomes (23.5%). Many of these research studies took place in Central Appalachia (eg, 42.0% in Kentucky) with reproductive or middle-aged women (82.7%). Half of the studies employed quantitative methods, and half used qualitative methods, with few mixed method or community-engaged approaches (3.7%). Nearly half (40.7%) did not specify a theoretical framework. Findings included complex multi-level factors with few articles exploring the co-occurrence of factors across multiple levels.Conclusions:Future studies should: 1) systematically include Appalachian women at various life stages from under-represented sub-regions; 2) expand the use of rigorous methods and specified theoretical frameworks to account for complex interactions of social-ecological factors; and 3) build upon existing community assets to improve health in this vulnerable population.
      Citation: American Journal of Health Promotion
      PubDate: 2021-04-28T07:34:02Z
      DOI: 10.1177/08901171211011388
       
  • Virtual Group Visits: Hope for Improving Chronic Disease Management in
           Primary Care During and After the COVID-19 Pandemic

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      Authors: Jacob B. Mirsky, Anne N. Thorndike
      Abstract: American Journal of Health Promotion, Ahead of Print.
      As health care systems respond to the COVID-19 pandemic, new virtual care approaches are emerging for health promotion and chronic disease management. Virtual group visits (VGVs) supporting a healthy lifestyle, adapted from the well-established shared medical appointment (SMA) model, hold promise as a primary care delivery tool for preventing and managing chronic disease. In order to establish VGVs as standard of care, evidence for clinical effectiveness, financial sustainability, and access for vulnerable populations is needed. In the future, VGVs could improve the quality and reach of chronic disease prevention and management strategies.
      Citation: American Journal of Health Promotion
      PubDate: 2021-04-28T07:14:03Z
      DOI: 10.1177/08901171211012543
       
  • Face Mask Use During the COVID-19 Outbreak: How Did Educated Brazilians
           Behave'

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      Authors: Danilo Euclides Fernandes, Michelle T. P. Riguetti, Gianna Mastroianni Kirsztajn
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To describe Brazilians’ behavior regarding face mask use and health literacy during the COVID-19 pandemic before and after the Ministry of Health of Brazil formal recommendation.Design:Cross-sectional surveys using a web-based questionnaire. Participants were recruited via snowball techniques.Setting:São Paulo state, the urban epicenter of the COVID-19 pandemic in Brazil at the time of the study.Participants:2.203 clicks to the survey link and 1.223 surveys completed (55.5% response rate). However, only 1118 surveys were considered after the exclusion criteria (>18 years-old and consent).Measures:Demographics, educational status, COVID-19-related symptoms (headache, cough, sore throat, rhinorrhea, fever, asthenia, diarrhea, dyspnea, nausea, vomiting, vertigo, anosmia, and ageusia), and face mask use.Analysis:Self-reports of COVID-19 symptoms were categorized as dichotomous variables (Cohen’s h = 0.94). Pearson Chi-square test evaluated differences between T1 and T2 and logistic multiple regression analyzed odds-ratio for the presence of symptoms and independent variables.Results:Face mask use increased from 43.60% in T1 to 90.52% in T2 (P < .0001) as the pandemic went on. Health literacy also changed within 2 weeks and people started to assume everybody should use face masks (62.93% in T1 vs 94.12% in T2; P < .0001; ES = 0.29) during outside activities (43.60% in T1 vs 90.52% in T2; P < .0001; ES = 0.39). Self-reports of face mask use were associated with fewer self-reports of COVID-19 symptoms (OR = 0.65, P = .01, 95% CI 0.48; 0.88).Conclusion:Face mask use was already high among educated Brazilians before the formal recommendation by the authorities. This may have contributed to fewer self-reports of COVID-19-related symptoms.
      Citation: American Journal of Health Promotion
      PubDate: 2021-04-27T07:45:31Z
      DOI: 10.1177/08901171211011352
       
  • Why Should Businesses Support Public Health'

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      Authors: Inge Myburgh, Ron Z. Goetzel, Enid Chung Roemer, Karen B. Kent
      Abstract: American Journal of Health Promotion, Ahead of Print.
      The COVID-19 pandemic presents a unique opportunity to gain support from the business community for rebuilding a more effective and resilient public health infrastructure in the U.S. This commentary provides the rationale for more engaged business involvement in efforts to promote public health during the time of COVID-19. Drawing on the current pandemic, the commentary highlights the implications of a fragmented public health system for businesses and the nation at large, the shortcomings of which are apparent as never before.
      Citation: American Journal of Health Promotion
      PubDate: 2021-04-16T07:29:25Z
      DOI: 10.1177/08901171211009050
       
  • Improving Evidence-Based Program Repositories: Introducing the
           Evidence-Based Cancer Control Programs (EBCCP) Web Repository

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      Authors: Antoinette Percy-Laurry, Prajakta Adsul, Annabelle Uy, Cynthia Vinson
      Abstract: American Journal of Health Promotion, Ahead of Print.
      To reduce the research to practice gap, promoting the utility of evidence-based repositories is essential among both practitioners and researchers. Organizing these repositories to address the needs of these audiences requires a user-centered design approach as proposed recently in an article by Harden et al, 2020. This commentary builds on the proposed solutions to introduce a recently redesigned Evidence-Based Cancer Control Programs (EBCCP) web repository (formerly Research-Tested Intervention Programs (RTIPs)) from the National Cancer Institute. Specifically, we describe the user-centered redesign process, strategies for broader dissemination of the repository using digital tools and provide future directions for the evidence-based program repository.
      Citation: American Journal of Health Promotion
      PubDate: 2021-04-08T08:02:11Z
      DOI: 10.1177/08901171211006589
       
  • A Comparison of Two Diabetes Self-Management Education Programs for the
           Reduction of Participant A1c Levels

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      Authors: Edward Sharpless, Nancy Borkowski, Stephen J. O’Connor, Larry Hearld, Jeffery Szychowski
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Compare the effectiveness of two educational teaching methods for diabetic patients.Design:Quasi-experimental study comparing two interventions using a pretest/post-test design.Setting:Three clinics within a western U.S. regional health system.Subjects:818 adult diabetic participants (60.5 mean age, 52% female) attended one to four sessions between 2013-2017, and had A1c tests within 180 days of first attended session and 30 to 365 days after last attended session.Intervention:A group-based, highly interactive learning experience (n = 561) and a traditional, lecture-style class (n = 257).Measures:Pre and post measures of A1c.Analysis:Paired t-tests measured change within each group pre-post intervention. Two-sample t-tests measured mean change pre-post intervention between the two groups. Multivariable linear regression measured mean change in A1c between groups, adjusted for pre-test scores and controlling for demographic variables.Results:Both interactive and traditional teaching interventions were effective at significantly reducing patient A1c levels by 1.3 (p < 0.001) and 1.0 (p < 0.001) points respectively. The between groups difference in A1c was not significant, t(512) = 1.66, p = 0.0985, but when controlling for age, pre-A1c and days post-A1c, the interactive intervention was significantly (p < 0.05) more effective reducing patient A1c levels by 0.19 points than the traditional intervention.Conclusion:Group-based, interactive diabetes self-management education programs may be an effective model for reducing patient A1c levels.
      Citation: American Journal of Health Promotion
      PubDate: 2021-04-01T09:05:28Z
      DOI: 10.1177/08901171211003829
       
  • Perceived Beliefs, Uncertainty, and Behavioral Responses During the
           COVID-19 Outbreak in China: Findings From a Convenience Sample

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      Authors: Dan Wu, Ian R. H. Rockett, Tingzhong Yang, Xiaozhao Yousef Yang, Mengmeng Wang, Can Jiao
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To investigate perceived beliefs, uncertainty, and behavioral responses among Chinese residents toward the COVID-19 outbreak, and explore their relationships amid an incipient pandemic.Design:A cross-sectional correlational survey with a combination of a convenience and snowball sampling design.Setting:This study was conducted online from February 7 to 14, 2020, the third week after the lockdown of Wuhan city on January 23.Participants:A total of 2,654 residents was contacted, 2,534 agreed to participate, and 2,215 completed valid questionnaires. The sample covered 30 provinces, municipalities, autonomous regions of China, and a broader region.Measures:The Uncertainty About COVID-19 Scale was applied to assess perceived public uncertainty. Five dimensions of health beliefs about COVID-19 and 12 health-related response behaviors were measured.Analysis:Univariate analysis and multiple linear regression models were used to identify associations. Mediation was assessed by a bootstrapping technique.Results:Five constructs of health beliefs were found to be significant predictors of multiple response behaviors. Uncertainty about COVID-19 has a direct relationship with general response behaviors (β=-0.119**) and sanitization practices (β=-0.068**). Emergency coping behaviors aside, uncertainty also partially mediated associations between perceived susceptibility, perceived effectiveness, and perceived barriers influencing general response behaviors and sanitization practices, respectively.Conclusion:Findings provide evidence-based information to government and policymakers for designing effective health communication messages and intervention strategies by targeting the key constructs of the health belief model and reducing perceived uncertainty about COVID-19. They support public health-related response behaviors to prevent COVID-19 spread among the population.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-31T09:03:09Z
      DOI: 10.1177/08901171211004249
       
  • Association of the Quality Rating and Improvement System, Texas Rising
           Star, on Physical Activity and Screen Time Policies and Practices in Texas
           Child Care Centers

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      Authors: Erin E. Dooley, Cari Browning, Christina A. Thi, Deanna M. Hoelscher, Courtney E. Byrd-Williams
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Quality rating and improvement systems (QRIS) are systems approaches to assist states in providing high quality early childhood education. Texas Rising Star (TRS), a voluntary QRIS, exceeds state licensing standards and meets some obesity prevention guidelines. This study examines differences in physical activity, screen time, and outdoor policies and practices by QRIS certification.Design:Cross-sectional.Setting:Online.Sample:After exclusion criteria, respondents were 431 Texas childcare centers.Measures:2016 survey of policies and Go NAPSACC best practices.Analysis:Chi-square and t-tests indicated differences in 1) practices and 2) policies by QRIS status.Results:TRS-certified centers reported more policies for physical activity (M = 4.57 ± 3.07 vs. 3.61 ± 2.95, p = 0.009) and screen time (M = 1.91 ± 1.84 vs. 1.28 ± 1.56, p < 0.001) than non-certified centers. TRS-certified centers reported significantly higher frequencies for 7 of 14 physical activity practices, however no significant differences for screen time practices were found. Additionally, TRS-certified centers reported more outdoor practices, including more classrooms/storage (p < 0.001) and vegetable gardens (p = 0.025).Conclusion:TRS-certified centers reported more physical activity policies and practices, more screen time policies, and more outdoor practices. TRS certification was not associated with screen time practices. QRIS can be a practical way to insert obesity prevention in early care and education. Using items from a widely used survey enables comparisons, however future research is needed in larger-scale studies. Some COVID-19 implications are discussed.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-31T09:02:00Z
      DOI: 10.1177/08901171211003826
       
  • Association Between Self-Reported Sedentary Behavior and Health-Related
           Quality of Life Among Multimorbidity Patients in Singapore

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      Authors: Jue Hua Lau, Eng Sing Lee, Yunjue Zhang, Janhavi Ajit Vaingankar, Edimansyah Abdin, Siow Ann Chong, Mythily Subramaniam
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Background:The study examined the association between sedentary behavior and self-rated health-related quality of life (HRQoL) in a sample of patients with multimorbidity in Singapore recruited from a primary care clinic.Methods:Sedentary behavior and physical activity were assessed with the International Physical Activity Questionnaire short form (IPAQ-SF). HRQoL was assessed with EuroQol-5 Dimension (EQ-5D) utility index, visual analogue scale (EQ-VAS) and its 5 subscales (Mobility, Self-care, Usual Activities, Pain/Discomfort, and Anxiety/Depression). Depression was assessed via Patient Health Questionnaire (PHQ-9). Logistic and linear regression analyses adjusting for the effect of physical activity, depression, and sociodemographic variables (i.e., age, gender, ethnicity, education) were conducted.Results:932 patients participated in the study (mean age:64.5±8.5 years, range: 35-80) and 55% were men. Results indicated that women were less likely to have sedentary behavior (≥7 hrs/day) than men. Results indicated sedentary behavior was associated with lower EQ-5D index scores, but not EQ-VAS scores. Participants who were sedentary for ≥7 hrs/day were more likely to endorse having problems with mobility, self-care, and usual activities, but not with pain/discomfort, nor anxiety/depression.Conclusion:Sedentary behavior was associated with poorer HRQoL. There is a need for interventions and health promotions to reduce sedentary behavior in patients with multimorbidity.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-19T09:05:58Z
      DOI: 10.1177/08901171211001274
       
  • Civic Engagement and Well-Being: Examining a Mediational Model Across
           Gender

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      Authors: Natalie Fenn, Mark L. Robbins, Lisa Harlow, Shanna Pearson-Merkowitz
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The relationship between civic engagement and mental health is generally positive, yet particularly complex among those from low socioeconomic backgrounds and women. The current study examined pathways between civic engagement and well-being to clarify its merit as a health promotional tool for young adults.Design:Cross-sectional design using an online questionnaire.Setting:Participants were recruited at a mid-sized Northeastern US university.Sample:Participants (N = 438) were primarily White (78%) and female (72%).Measures:Demographics, socioeconomic status, civic engagement behavior, well-being, meaning in life, self-efficacy toward service, and social support.Analysis:Structural equation modeling to test an a priori model of civic engagement behavior and well-being in young adults. Models were conducted across men and women, covarying for social support.Results:The full effects model fit well, demonstrating positive relationships between civic engagement and well-being for both men and women with mediation by service self-efficacy and meaning in life (χ2(2) = 1.05, p = .59; CFI = 1.0; RMSEA = .00, 90%CI [.00, .07]; R 2 = .46). Type of engagement (civic, electoral, sociopolitical) showed mixed results in relation to well-being.Conclusion:Civic activity was associated with well-being when mediated by service self-efficacy while sociopolitical voice correlated to stronger well-being when mediated by meaning in life. Future longitudinal studies should be conducted among more socioeconomically diverse populations to verify the role of civic engagement in health promotion.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-19T09:04:39Z
      DOI: 10.1177/08901171211001242
       
  • Extent of and Reasons for Vaccine Hesitancy in Adults at High-Risk for
           Pneumococcal Disease

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      Authors: Justin Gatwood, Madison McKnight, Kelsey Frederick, Kenneth Hohmeier, Shiyar Kapan, Chi-Yang Chiu, Chelsea Renfro, Tracy Hagemann
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To determine the extent of and reasons for hesitancy toward vaccination among adults at high-risk for pneumococcal disease.Design:Cross-sectional.Setting:Online survey in March-April 2019 via QuestionPro.Subjects:Tennessee adults (18-64 years) at high-risk of pneumococcal disease (n = 1,002).Measures:Modified version of the validated Vaccine Hesitancy Scale assessed vaccine-related beliefs, reasons for hesitancy, external influences on vaccination, and prior vaccinationAnalysis:Descriptive and inferential statistics provided an overview of the responses and comparisons among subgroups. Logistic regression determined the odds of being hesitant using the listed beliefs and influencers as predictors. Thematic analysis was performed on the qualitative data gathered from free response questions throughout the survey.Results:Analysis included 1,002 complete responses (12% response rate [total viewed = 8,331]) with 34.3% indicating hesitancy toward one or more recommended vaccinations, with 53% of which indicating hesitancy to the pneumococcal vaccine despite it being recommended by the Advisory Committee on Immunization Practices (ACIP) for all respondents. The odds of vaccine hesitancy or resistance were higher in minorities (OR: 1.6; 95% CI: 1.19-2.11), those not believing others like them get vaccinated (OR: 1.82; 95% CI: 1.262-2.613), and respondents recalling negative media about vaccines (OR: 2.56; 95% CI: 1.797-3.643).Conclusions:Patients at high-risk of pneumococcal disease lack awareness of the need for the recommended vaccine, and provider education may need improving to increase vaccination in this population.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-04T09:39:42Z
      DOI: 10.1177/0890117121998141
       
  • Examination of the ‘5-2-1-0’ Recommendations in Racially Diverse Young
           Children Exposed to Tobacco Smoke

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      Authors: E. Melinda Mahabee-Gittens, Lili Ding, Ashley L. Merianos, Jane C. Khoury, Judith S. Gordon
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The ‘5-2-1-0’ guidelines recommend that children: eat ≥5 servings of fruits/vegetables (‘5’), have ≤2 hours of screen-time (‘2’), have ≥1 hour of activity (‘1’), and drink 0 sugar-sweetened beverages (‘0’) daily. The pediatric emergency department (PED) treats children at risk for obesity and tobacco smoke exposure (TSE). We examined body mass index (BMI), overweight, obesity, TSE, and ‘5-2-1-0’ rates in children with TSE in the PED.Design:Cross-sectional study of PED children.Setting:The PED of a children’s hospital.Sample:Children with TSE>6 months-5 years old (N = 401).Measures:Sociodemographics, ‘5-2-1-0’ behaviors, BMI, and cotinine-confirmed TSE.Analysis:Associations between ‘5-2-1-0’ and sociodemographics were examined with logistic regression.Results:Mean (SD) age = 2.4 (1.6) years; 53.1% were Black; 65.8% had low-income; and 93.4% had TSE. Of 2-5-year-olds, mean (SD) BMI percentile was 66.2 (30.1), 16.1% were overweight and 20.6% were obese. In total, 10.5% attained ‘5’, 72.6% attained ‘2’, 57.8% of 2-5-year-olds attained ‘1’, and 9.8% attained ‘0’. Compared to White children, “other” race children were more likely to meet ‘5’ (aOR(95% CI):4.67(1.41, 5.45)); 2-5-years-olds (aOR(95%CI):0.60(0.38, 0.95)) and Black children (aOR(95%CI):0.36(0.21, 0.60)) were at decreased odds to meet ‘2’ compared to younger or White children, respectively. Compared to younger children, 2-5-year-olds were at decreased odds to meet ‘0’ (aOR(95%CI):0.08(0.02, 0.26)).Conclusion:Racially diverse, low-income children with TSE had low ‘5-2-1-0’ attainment. Interventions are needed to improve lifestyle habits in this population.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-01T09:12:30Z
      DOI: 10.1177/0890117121995772
       
  • Leisure-Time Physical Activity Reduces the Risk of Long-Term Sickness
           Absence Among Older Healthy Female Eldercare Workers

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      Authors: Rubén López-Bueno, Thomas Clausen, Joaquín Calatayud, José A. Casajús, Lars L. Andersen
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:This study aimed to examine the association between leisure-time physical activity (PA) and risk of long-term sickness absence (LTSA).Design:Data on LTSA (≥3 consecutive weeks during a 1-year follow-up) were acquired from the Danish Register for Evaluation of Marginalization and linked to a questionnaire via personal identification number.Setting:Eldercare workers from 36 Danish municipalities.Subjects:Data were retrieved from 4605 healthy Danish female eldercare (i.e., workers assisting senior citizens with daily activities and health) aged 19 to 69 years, who answered a questionnaire on health, and work environment in 2005.Measures:Calculated risk of LTSA and its association with self-reported leisure-time PA.Analysis:A Cox proportional hazards model was used to calculate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI).Results:Eldercare workers showed significantly reduced risk of LTSA when performing moderate (HR = 0.67, 95%CI 0.47-0.96), and vigorous leisure-time PA (HR = 0.45, 95%CI 0.25-0.81) (reference group: sedentary). In subgroup analyses, females over 45 years showed a risk reduction of LTSA for moderate (HR = 0.54, 95%CI 0.32-0.90), and vigorous leisure-time PA (HR = 0.43, 95%CI 0.18-0.99), whereas younger eldercare workers did not show significant risk reductions for either moderate (HR = 0.86, 95%CI 0.51-1.43) or vigorous leisure-time PA (HR = 0.50, 95%CI 0.21-1.16) in the fully adjusted model.Conclusions:The results indicate that moderate and, particularly, vigorous leisure-time PA reduced risk of LTSA in eldercare workers aged over 45 years.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-22T09:42:21Z
      DOI: 10.1177/0890117121995789
       
  • Psychological Stress and Lowered Physical Activity Enjoyment in
           Adolescents With Overweight/Obesity

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      Authors: Tiwaloluwa A. Ajibewa, Lexie R. Beemer, Kendrin R. Sonneville, Alison L. Miller, Claudia Toledo-Corral, Leah E. Robinson, Rebecca E. Hasson
      First page: 766
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:The purpose of this study was 2-fold: 1) to determine the cross-sectional associations between psychological stress, physical activity enjoyment, and physical activity participation [moderate-to-vigorous physical activity (MVPA), total physical activity (TPA)]; and 2) to determine the moderating effect of physical activity enjoyment on the associations between stress, MVPA, and TPA in adolescents with overweight/obesity.Design:Cross-sectional, secondary data analysis of the Health and Culture Project and the Stress, Obesity, and Diabetes in Adolescents study.Sample:One hundred and ten adolescents (73% female; 65.4% non-white; age 15.8 ± 1.9 years) with overweight/obesity (BMI percentile ≥ 85th percentile) were included in this analysis.Measures:Psychological stress was assessed using the Perceived Stress Scale (PSS-14); enjoyment was measured via the Physical Activity Enjoyment Scale; and MVPA and TPA were objectively measured using accelerometry over a minimum of 4 days.Results:Higher perceived stress was associated with lower physical activity enjoyment (β = −0.41 ± 0.15; p = 0.008). Stress was not associated with MVPA or TPA (ps> 0.05), nor was enjoyment a significant moderator in the associations between stress and MVPA or stress and TPA (pinteraction> 0.05).Conclusions:These findings suggest that psychological stress is associated with lower physical activity enjoyment among adolescents with overweight/obesity. Longitudinal studies are needed to understand the long-term effects of stress on psychological factors that may serve as antecedents to physical activity participation among adolescents with overweight/obesity.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-25T09:28:15Z
      DOI: 10.1177/0890117121997042
       
  • The Magnitude and Determinants of Partial Redemptions of Food Benefits in
           the Special Supplemental Nutrition Program for Women, Infants and Children
           (WIC)

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      Authors: Xuemei Li, Patrick W. McLaughlin, Tina L. Saitone, Richard J. Sexton
      First page: 775
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:WIC provides food assistance to low-income pregnant and postpartum women, infants, and children ages 1- 4. A partial redemption (PR) occurs when a participant redeems only a portion of the prescribed benefit, thereby not obtaining the full nutritional benefit. We study the magnitude and determinants of PRs using electronic benefit transfer data.Design/Setting:Statistical analysis of all WIC transactions from Feb 2016 to Nov 2018.Subjects:Oklahoma WIC participants.Measures:The probability of a WIC household fully redeeming a food category. A random effects probit model is used to study determinants of PRs.Analysis:Estimate the marginal effects of key variables on households’ likelihood of full redemption: location—urban/rural, number of members in WIC, duration in the program, number of shopping trips, shopping venue, and prescribed foods.Results:Overall 18.5% of $ value of benefits are unredeemed, 29.3% excluding formula. Some foods have PRs> 40%. Only 17.3% of households fully redeem benefits in a given month. PRs increase with number of household members in WIC and duration of participation. PRs are lower for participants in rural locations, who shop more frequently, and who shop at WIC-specialized stores.Conclusions:Food packages with high PRs fail to impart prescribed benefits. Results pinpoint products and household characteristics associated with PRs, enabling targeted nutritional counseling and suggest food package choices need to be made with participant acceptance in mind.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-22T09:38:18Z
      DOI: 10.1177/0890117121992307
       
  • Effectiveness of Lifestyle Interventions in an Active Duty Air Force
           Population

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      Authors: Nicole H. Armitage, M. Kaye Kramer, Mary S. Nelson, DawnKimberly Hopkins, Ruby Langeslay, Jennifer A. Thornton
      First page: 784
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To examine the effectiveness of 3 lifestyle intervention programs in an active duty military population.Design:Experimental design with stratified random assignment to 1 of 3 intervention groups. Measures were taken at baseline, 3 months and 6 months.Setting:A Military Treatment Facility in the western U.S.Subjects/Intervention:122 active duty service members were enrolled and randomly assigned to 1 of 3 lifestyle intervention programs: the Diabetes Prevention Program-Group Lifestyle Balance (DPP-GLB), the Better Body Better Life (BBBL) program or the Fitness Improvement Program (FIP).Measures:weight, abdominal circumference, lipid and HbA1c levels, physical activity, and well-being as measured by the RAND SF-36 questionnaire.Analysis:Statistical analyses were performed to assess changes over time.Results:83 participants completed the study (BBBL N = 23, FIP N = 30, DPP-GLB N = 30). The DPP-GLB participants had statistically significant decreases in weight (-3.1 pounds, p = .01) and abdominal circumference (-0.9 inches; p = .01) over time. HbA1c was also significantly lower in this group at 6 months compared to baseline (p = .036). There were no statistically significant changes in weight, abdominal circumference, or HbA1c in the FIP or BBBL groups. No significant changes were observed in lipids in any of the groups.Conclusion:Results from this study indicate that the DPP-GLB program may be effective in reducing weight, abdominal circumference, and HbA1c in an active duty U.S. military population.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-04T09:37:01Z
      DOI: 10.1177/0890117121997308
       
  • The Longitudinal Association Between Exposure to Violence and Patterns of
           Health Risk Behaviors Among African American Youth

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      Authors: Hsing-Fang Hsieh, Ritesh Mistry, Daniel B. Lee, Briana A. Scott, Andria B. Eisman, Justin E. Heinze, Marc A. Zimmerman
      First page: 794
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:We investigate whether exposure to violence (ETV) during adolescence and emerging adulthood predicts engagement in chronic disease-related health risk behaviors years later among African Americans.Design:A longitudinal study following youth from mid-adolescence (mean age = 14.8 years) to young adulthood (mean age = 32.0 years).Setting:Flint, Michigan.Sample:Four hundred forty-two African American (96.2%) and mixed African American and White (3.8%) participants.Measures:Outcomes were diet, smoking, drinking, and physical inactivity. Covariates were ETV, sex, mother’s educational attainment, and substance use by siblings, peers, and parents.Analysis:Latent profile analysis was conducted to identify distinct patterns of adult health risk behaviors and assess the association of youth ETV and identified patterns.Results:Four latent profiles were identified: high substance use (n = 46; 10.41%), high overall risk (n = 71; 16.06%), low overall risk (n = 140; 31.67%) and inactive (n = 185, 41.86%). Relative to the low overall risk profile, ETV was associated with being in the high overall risk profile (b = 0.37, p = 0.04), but not other profiles. Female gender and higher maternal education were associated with being in the inactive profile compared to the low overall risk profile. Peer alcohol and tobacco use were associated with being in the high substance use profile.Conclusion:ETV during adolescence and emerging adulthood increased the risk of engagement in multiple health risk behaviors later in life.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-04T09:32:01Z
      DOI: 10.1177/0890117121995776
       
  • Seasonal Differences in the Cost and Engagement of Facebook Advertisements
           for a Physical Activity Smartphone App

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      Authors: Celine Northcott, Rachel Curtis, Svetlana Bogomolova, Timothy Olds, Corneel Vandelanotte, Ronald Plotnikoff, Carol Maher
      First page: 803
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To evaluate the performance of Facebook advertisements for a physical activity smartphone app at different times of the year.Design:A repeated cross-sectional study examined the cost and engagement levels of advertisements during 3 time points: Post-Easter April-May 2019, Pre-Summer October 2019, and New Year January 2020 . Setting:Advertisements were delivered on Facebook.Subjects:The target population was Australian females aged 25-60 years.Measures:Cost was evaluated in terms of reach per dollar. Engagement was evaluated in terms of click-through and app downloads per reach.Analysis:ANOVA and Chi-square were used to assess differences in reach per dollar, click-through, and app downloads per reach between time points.Results:Reach per dollar was highest in Post-Easter, but declined in Pre-Summer and New Year (reach/$ 34.8 vs 31.5 vs 27.5; p = .004). Click-through was highest in New Year followed by Post-Easter, then Pre-Summer (click-through 3.2% vs 1.9% vs 1.2%; p < .001). New Year and Post-Easter advertisements achieved higher app downloads per reach than Pre-Summer (downloads 0.9% vs 0.7% vs 0.3%; p < .001).Conclusion:Facebook advertisements were cheaper in the first time-point, and appear to be getting more expensive (i.e. declining reach/$). Advertisements in the New Year achieved the highest click-through and app downloads per reach, suggesting a useful time of year to promote physical activity products.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-01T09:18:57Z
      DOI: 10.1177/0890117121997304
       
  • A Qualitative Investigation of Facilitators to Black and Latino Adolescent
           and Young Adults’ Participation in a Couple-Based HIV Prevention Study

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      Authors: Yzette Lanier, Alena Goldstein, Claudine Lavarin, Elizabeth Choi, Keosha Bond, Katerin Riascos
      First page: 809
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Recruitment and retention of adolescents and young adults (AYAs) in couple-based HIV prevention research can be difficult. This study’s primary objective is to identify factors that influenced Black and Latino AYAs to participate in couple-based HIV/STI prevention research.Design:In-depth, semi-structured qualitative interviews.Setting:Face-to-face interviews with couples recruited from the South Bronx, New York.Participants:Twenty-three heterosexual couples (46 individuals) aged 16-28 (M = 20.1, SD = 3.01).Methods:Participants completed 60 to 90-minute individual and dyadic interviews. All interviews were audio-recorded and transcribed. Thematic analysis was conducted to identify key themes. Results:Two levels of influence emerged from participants’ interviews regarding their reasons for study participation: 1) individual factors (interest in the study topic, study incentives, opportunity to help their community, and opportunity to learn something new), 2) interpersonal factors (positive interactions with the research team, partner’s desire to participate and relationship strengthening). There were key differences by gender and recruitment order.Conclusion:Black and Latino AYAs report multiple reasons for participating in couple-based research. Highlighting the benefits of study participation to themselves, their relationships, and their communities may be an important strategy for engaging AYAs in couple-based research.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-01T09:17:54Z
      DOI: 10.1177/0890117121997040
       
  • Redefining Basic Needs for Higher Education: It’s More Than Minimal Food
           and Housing According to California University Students

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      Authors: Suzanna M. Martinez, Erin E. Esaryk, Laurel Moffat, Lorrene Ritchie
      First page: 818
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:A student-specific definition of basic needs for higher education is warranted to inform programs and policies for underserved students. The purpose of this study was to: 1) explore how students define basic needs, 2) understand experiences of housing insecurity, and 3) understand experiences of food insecurity within the context of housing insecurity.Design:Qualitative research elicited student perceptions of basic needs and experiences of housing and food insecurity.Setting:Focus group discussions were conducted at 5 University of California campuses between February and March 2019.Participants:Undergraduate (n = 37) and graduate (n = 21) students were recruited from campus basic needs centers.Methods:Each student completed a brief survey. Researchers conducted 11 focus groups using a semi-structured interview guide. Transcripts were coded to identify themes.Results:Students were female (76%), age 23.6 (SD = 5.8) years; 46% were Pell grant recipients; and 52% were first-generation college students. Most had experienced food insecurity (98%) and 26% had experienced homelessness. Eight themes were identified: 1) students define basic needs as more than minimal food and shelter and as the responsibility of students and the university, 2) students encounter multifaceted housing insecurity issues, 3) affording rent is a priority that most often leads to experiencing food insecurity, 4) transportation barriers interfere with meeting students’ basic needs to succeed as students, 5) students with nontraditional characteristics, graduate students, and out-of-state students face unique challenges in meeting basic needs, 6) limited financial aid and lack of financial aid guidance are barriers to meeting basic needs, 7) fees contribute additional challenges to students meeting basic needs, and 8) additional university basic needs services are essential.Conclusion:A student-informed definition of basic needs included food, housing, mental health, sleep, hygiene, and transportation. This understanding of basic needs can inform future research, programs, and policy to address housing insecurity in higher education.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-22T09:37:39Z
      DOI: 10.1177/0890117121992295
       
  • College Students’ Reasons for Using JUULs

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      Authors: Kyra V. Newcombe, Page D. Dobbs, Julia S. Oehlers, Chris M. Dunlap, Marshall K. Cheney
      First page: 835
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:To identify reasons that college students use JUUL and explore associations between reasons for using JUUL and social and behavioral (tobacco use) factors.Design:On-line, cross-sectional survey.Setting:Large southwestern university in the US.Subjects:Undergraduate students (n = 605) who owned JUUL and used it weekly.Measures:The study measured age of JUUL initiation, JUUL dependence, and use of other e-cigarettes and other tobacco products. Participants described reasons for JUUL use as brief open-ended responses.Analysis:Responses were categorized by 2 researchers using an inductive procedure. Logistic regressions examined associations between demographics and use frequency and categorized reasons for using JUUL.Results:Four reasons for using JUUL emerged: self-help (48.4%), social (30.4%), experience (42.8%), and substance use/addiction (42.3%). Daily JUUL users were 1.66 (95% CI: 1.05-2.63) times as likely to use JUUL for self-help than those who used JUUL 1-3 days/week. Those who had never tried a cigarette were twice (OR = 2.08; 95% CI: 1.22-3.54) as likely as cigarette-first users to use JUUL for social reasons. Males (OR = 1.87; 95% CI: 1.32-2.65) had higher odds of using JUUL for the experience than females, and JUUL and other e-cigarettes users were 4.37 (95% CI: 1.83-10.45) times as likely as JUUL-only users to use JUUL due to substance use/addiction.Conclusion:JUUL users report unique reasons for use (e.g., addiction) not previously reported for older models of e-cigarette devices.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-04T09:39:53Z
      DOI: 10.1177/0890117121992292
       
  • Eat Well El Paso!: Lessons Learned From a Community-Level Restaurant
           Initiative to Increase Availability of Healthy Options While Celebrating
           Local Cuisine

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      Authors: Alisha H. Redelfs, Joy D. Leos, Holly Mata, Sarah L. Ruiz, Leah D. Whigham
      First page: 841
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Purpose:Restaurants have the potential to improve nutrition and positively shape social norms. We describe lessons learned and recommended strategies from Eat Well El Paso! (EWEP), a local restaurant initiative.Design:Descriptive case study.Setting:EWEP partnered with local restaurants from 2012-2017 in El Paso, Texas, along the US/Mexico border.Sample:Our sampling frame included EWEP staff and managers/owners at participating restaurants, of which the majority participated (80% and 85%, respectively).Intervention:EWEP was a local restaurant initiative led by the city public health department. EWEP contracted registered dietitians to assist locally-owned restaurants to increase availability of healthy menu options.Measures:Observation, key informant interviews, and document review assessed participation, barriers, and facilitators to restaurant participation and program sustainability.Analysis:Thematic and descriptive analyses.Results:57% of restaurants completed the full on-boarding process, but long-term retention was low (24% of completers). Restaurant managers/owners perceived value in marketing, nutritional analysis, and menu design. Barriers included scheduling, complexity of restaurant culture, fear of food inspections, restaurant turnover, competing responsibilities, and lack of dedicated funding.Conclusion:Although local context and sample size may limit generalizability, lessons learned and recommended strategies are relevant and informative for communities working to increase restaurants’ healthy menu options.
      Citation: American Journal of Health Promotion
      PubDate: 2021-03-10T09:23:27Z
      DOI: 10.1177/0890117121999184
       
  • Health Promotion Practices and Michel Foucault: A Scoping Review

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      Authors: Fernanda Carlise Mattioni, Priscila Tadei Nakata, Liciane Costa Dresh, Rosane Rollo, Liliane Spencer Bittencourt Brochier, Cristianne Famer Rocha
      First page: 845
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:To analyze Health Promotion (HP) practices in different settings worldwide, presented in studies that employed the Foucauldian framework.Data Source:Scoping review performed on LILACS, MEDLINE, IBECS, BDENF, SciELO, CINAHL, Embase, Web of Science, and Scopus databases.Study Inclusion and Exclusion Criteria:We included original articles, review articles, reflection articles, and case studies published in English, Portuguese, and Spanish, which addressed HP practices, analyzed using the Foucauldian framework.Data Synthesis:In the numerical synthesis, the characteristics of the included studies were described: number of studies, types of method, year of publication, characteristics of the study population, origin countries, and the HP practices addressed in the articles. The thematic synthesis was organized according to the nature of the HP practices presented and the Foucauldian analysis matrix used.Results:The review covered 34 studies, published between 2006 and 2019, whose analysis resulted in 2 thematic synthesis: 1) HP as a biopolitical strategy in the neoliberal context; 2) HP as an expression of resistance and counter-conduct, presenting tensions, struggles, and power games.Conclusion:The field of HP mostly consists of governmentality practices that reinforce the neoliberal health perspective. Some practices show resistance and counter-conduct in the face of governmentality practices, which explains the power relationships in the field of HP.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-01T09:51:46Z
      DOI: 10.1177/0890117121989222
       
  • Associations Between Self-Reported Sleep Duration and Mortality in
           Employed Individuals: Systematic Review and Meta-Analysis

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      Authors: Paula R. Pienaar, Tracy L. Kolbe-Alexander, Willem van Mechelen, Cécile R. L. Boot, Laura C. Roden, Estelle V. Lambert, Dale E. Rae
      First page: 853
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:Sleeping less or more than the 7-8 h has been associated with mortality in the general population, which encompasses diversity in employment status, age and community settings. Since sleep patterns of employed individuals may differ to those of their unemployed counterparts, the nature of their sleep-mortality relationship may vary. We therefore investigated the association between self-reported sleep duration and all-cause mortality (ACM) or cardiovascular disease mortality (CVDM) in employed individuals.Data sources:Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, searches between January 1990 and May 2020 were conducted in PubMed, Web of Science and Scopus. Inclusion/exclusion criteria: Included were prospective cohort studies of 18–64-year-old disease-free employed persons with sleep duration measured at baseline, and cause of death recorded prospectively as the outcome. Gray literature, case-control or intervention design studies were excluded.Data Extraction:Characteristics of the studies, participants, and study outcomes were extracted. The quality and risk of bias were assessed using the Newcastle-Ottawa Scale.Data synthesis:The pooled relative risks (RR) with 95% confidence intervals (CI) were obtained with a random-effects model and results presented as forest plots. Heterogeneity and sensitivity analysis were assessed.Results:Shorter sleep duration (≤6 h) was associated with a higher risk for (ACM) (RR: 1.16, 95% CI: 1.11 -1.22) and CVDM (RR: 1.26, 95% CI: 1.12 -1.41) compared to 7-8 h of sleep, with no significant heterogeneity. The association between longer sleep (≥8 h) and ACM (RR: 1.18, 95% CI:1.12 -1.23, P < 0.001) needs to be interpreted cautiously owing to high heterogeneity (I2 = 86.0%, P < 0.001).Conclusion:Interventions and education programs targeting sleep health in the workplace may be warranted, based on our findings that employed individuals who report shorter sleep appear to have a higher risk for ACM and CVDM.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-11T09:26:41Z
      DOI: 10.1177/0890117121992288
       
  • A Meta-Analytic Review of Interventions That Promote Meaning in Life

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      Authors: Nicholas Manco, Sherry Hamby
      First page: 866
      Abstract: American Journal of Health Promotion, Ahead of Print.
      Objective:Increasing meaning in life (MiL) among people experiencing disease or adversity may improve coping and resilience. The purpose of this review is to characterize the effects of MiL interventions.Data Source:A systematic search of PubMed, PsycInfo, and Google Scholar was conducted encompassing the following parameters: meaning in life, purpose in life, or sense of purpose with randomized controlled trials.Study Inclusion & Exclusion Criteria:Randomized controlled trials (RCTs) of interventions with at least one outcome that measured improvement in MiL and were published in English between January 2000 and January 2020.Data Extraction & Synthesis:33 randomized controlled trials (k = 35) were identified. Data were coded by authors and a research assistant for intervention type, control group type, and risk of bias. The random effects model of Review Manager 5.3 was used to produce SMD and evaluate heterogeneity.Results:The effect size for studies with a passive control group was SMD = 0.85 (95% CI 0.54 to 1.17) and for studies with an active control group was SMD = .032 (95% CI 0.09 to 0.55). Mindfulness programs produced the largest effect size (1.57) compared to passive controls, while narrative programs produced the largest effect relative to active controls (0.61). There was considerable heterogeneity in most estimates.Conclusion:Several interventions increase MiL, including some that are relatively brief and do not require licensed professionals.
      Citation: American Journal of Health Promotion
      PubDate: 2021-02-25T09:20:05Z
      DOI: 10.1177/0890117121995736
       
 
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