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American Journal of Health Promotion
Number of Followers: 23

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0890-1171 - ISSN (Online) 2168-6602
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A Shot of Faith—Analyzing Vaccine Hesitancy in Certain Religious
Communities in the United States
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  Authors: Sarosh Nagar, Tomi Ashaye
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Vaccine hesitancy in the United States continues to hamper ongoing coronavirus vaccination efforts. One set of populations with higher-than-average initial rates of vaccine hesitancy are certain religious groups, such as white evangelicals, African-American Protestants, and Hispanic Catholics. This article discusses the reasons underlying vaccine hesitancy in these populations, focusing on new trends in religious, political, and ideological beliefs that may influence vaccine acceptance. By using recent data and empirical case studies, this article describes how these trends could hinder the effectiveness of certain vaccine promotion strategies while also improving the potential efficacy of other forms of vaccine promotion, such as faith-based outreach. (100)
  Citation: American Journal of Health Promotion
  PubDate: 2022-01-03T07:42:16Z
  DOI: 10.1177/08901171211069547
Are Gross Motor Skill Interventions an Equitable Replacement for Outdoor
Free Play Regarding Children’s Physical Activity'
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  Authors: Kara K. Palmer, Jacquelyn M. Farquhar, Katherine M. Chinn, Leah E. Robinson
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThe purpose of this study was to determine if children engaged in equal amounts of physical activity during an established gross motor skill intervention (the Children’s Health Activity Motor Program (CHAMP)) and outdoor free play.DesignCross-sectional study; sample: Ninety-nine children (Mage = 4.21, 51% boys) were randomly divided into two movement environments: CHAMP (n = 55) or control/outdoor free play (n = 44).MeasuresPhysical activity was assessed using GT3X+ Actigraph accelerometers worn on the waist across four mornings. Average physical activity across the four days during either CHAMP or outdoor free play was extracted and categorized as light, moderate, vigorous, or MVPA. Physical activity data were reduced in the Actilife software using the cutpoints from Evenson et al.AnalysisA 2 (treatment) x 2 (sex) mixed measures ANOVA was used to compare the amount of time children spent in light, moderate, vigorous, and MVPA.ResultsThere was a significant main effect for treatment for light PA (F(3,95) =13.60, P
  Citation: American Journal of Health Promotion
  PubDate: 2022-01-03T07:09:52Z
  DOI: 10.1177/08901171211063261
In Briefs
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  Pages: 5 - 12
  Abstract: American Journal of Health Promotion, Volume 36, Issue 1, Page 5-12, January 2022.
  
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-13T12:24:47Z
  DOI: 10.1177/08901171211068089
  Issue No: Vol. 36, No. 1 (2021)
Persistent Barriers to Colorectal Cancer Screening Completion Amid
Centralized Outreach: A Mixed Methods Study
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  Authors: Jocelyn V. Wainwright, Shivan J. Mehta, Alicia Clifton, Claire Bocage, Shannon N. Ogden, Sarah Cohen, Katharine A. Rendle
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo understand patient experiences and persistent barriers to colorectal cancer (CRC) screening amid centralized outreach at urban family medicine practices.ApproachFollowing a pragmatic trial assessing mailed fecal immunochemical test (FIT) outreach, we invited a subset of participants to complete a semi-structured qualitative interview and structured questionnaire.SettingSingle urban academic healthcare system.ParticipantsSixty patients who were eligible and overdue for CRC screening at the time of trial enrollment.MethodUsing Andersen’s Behavioral Model, we developed an interview guide to systematically assess factors shaping screening decisions and FIT uptake. Close-ended responses were analyzed using descriptive statistics. Qualitative data were analyzed using the constant comparative method.ResultsMost participants (82%) self-reported that they had ever completed any modality of CRC screening, and nearly half (43%) completed the mailed FIT during the trial. Most patients (60%) preferred FIT to colonoscopy due to its private, convenient, and non-invasive nature; however, persistent barriers related to screening beliefs including fear of test results and cancer treatment still prevented some patients from completing any form of CRC screening.ConclusionsMailed FIT can overcome many structural barriers to CRC screening, yet clear communication and follow-up amid centralized outreach are essential. For some patients, tailored outreach or navigation to address screening-related fears or other screening beliefs may be needed to ensure timely completion of CRC screening.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-31T11:25:49Z
  DOI: 10.1177/08901171211064492
Motivations and Experiences in a Physical Activity Program for Cancer
Survivors: Findings from Key Informant Interviews
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  Authors: Melissa Dunn, Lauren Milius, Amanda Ivarra, Maria Cooper, Nimisha Bhakta
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeLIVESTRONG at the YMCA is an evidence-based 12-week physical activity (PA) program for cancer survivors. The purpose of our study was to understand the factors that motivated cancer survivors to begin the program, how the program impacted their habits, and how their experience influenced their motivation to continue with the program.Approach or DesignKey informant interviewsSettingPhone interviews conducted between April 15 and June 1, 2020.Participants27 cancer survivors in Texas who previously participated in the LS program.MethodParticipants completed a 30- to 60-minute interview with one of four interviewers. All interviews were recorded, transcribed, and analyzed for themes.ResultsMost interviewees were motivated to begin the program because of a desire to feel better after treatment. The most cited motivator to continue in the program was the community of cancer survivors. During the program, interviewees enjoyed learning different exercises, the community of cancer survivors, and the supportive teachers. Nearly all interviewees adopted or changed a healthy habit as a result of the program.ConclusionThese results could be used by healthcare professionals to better understand what motivates cancer survivors to participate in a PA program. Results could also be used to plan or modify other PA programs for cancer survivors.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-31T07:18:29Z
  DOI: 10.1177/08901171211061939
Individual and Collective Positive Health Behaviors and Academic
Achievement Among U.S. High School Students, Youth Risk Behavior Survey
2017
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  Authors: Georgianne Tiu Hawkins, Seung Hee Lee, Shannon L. Michael, Caitlin L. Merlo, Sarah M. Lee, Brian A. King, Catherine N. Rasberry, J. M. Underwood
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeWe examined associations between academic grades and positive health behaviors, individually and collectively, among U.S. high school students.DesignCross-sectional study design.Setting:Data were from the 2017 national Youth Risk Behavior Survey. Response rates were 75% for schools, 81% for students, and 60% overall (n = 14,765 students).SubjectsYouth in grades 9th–12th.MeasuresWe focused on youth behaviors that can prevent or delay the onset of chronic health conditions. Seven dietary, 3 physical activity, 2 sedentary screen time, and 4 tobacco product use behaviors were assessed. Variables were dichotomized (0/1) to indicate that a score was given to the positive health behavior response (e.g.,, did not smoke cigarettes = 1). A composite score was created by summing each positive health behavior response among 16 total health behaviors.AnalysisMultivariable logistic regression analyses for each individual health behavior, and a multivariable negative binomial regression for the composite score, were conducted with self-reported academic grades, controlling for sex, grade in school, race/ethnicity, and body mass index (BMI) categories.ResultsControlling for covariates, students who reported mostly A’s had 2.0 (P < .001) more positive health behaviors; students who reported mostly B’s had 1.3 (P < .001) more positive health behaviors; and students who reported mostly C’s had .78 (P < .001) more positive health behaviors, compared to students who reported mostly D’s/F’s.ConclusionsHigher academic grades are associated with more positive individual and cumulative health behaviors among high school students. Understanding these relationships can help inform efforts to create a healthy and supportive school environment and strive for health equity.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-30T12:56:06Z
  DOI: 10.1177/08901171211064496
The “Best of 2021 List” of Health Promotion Researchers
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  Authors: Paul E. Terry
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Each year the editorial team of the American Journal of Health Promotion selects our “Best of the Year List” of health promotion studies from the prior year. This editorial features the Editor’s Picks Awards, the Editor in Chief Awards, the Michael P. O’Donnell Award and the Dorothy Nyswander Award for the research and writing published in 2021 in this journal. Our criteria for selection includes: whether the study addresses a topic of timely importance in health promotion, the research question is clearly stated and the methodologies used are well executed; whether the paper is often cited and downloaded; if the study findings offer a unique contribution to the literature; and if the paper is well-written and enjoyable to read. Awardees in 2021 offered new insights into addressing discrimination against race or sexual identity, preferred sources of information about COVID-19 and the impact of community and workplace interventions on healthy lifestyles. This year’s award winning research spans from character to culture relative to improving well-being.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-29T07:46:58Z
  DOI: 10.1177/08901171211073204
Volunteers: An Effective Medium for Delivering Therapeutic Lifestyle
Interventions
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  Authors: Lillian M. Kent, Paul M. Rankin, Darren P. Morton, Rebekah M. Rankin, Roger L. Greenlaw, Heine S. Englert
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeLifestyle modification programs have been shown to effectively treat chronic disease. The Coronary Health Improvement Program has been delivered by both paid professional and unpaid volunteer facilitators. This study compared participant outcomes of each mode in the United States.DesignPre-/post-analysis of CHIP interventions delivered between 1999 and 2012.SettingProfessional-delivered programs in Rockford Illinois 1999-2004 and volunteer-delivered programs across North America 2005-2012.SubjectsAdults ≥21 years (professional programs N = 3158 34.3% men, mean age = 54.0 ± 11.4 years; volunteer programs N = 7115 33.4% men, mean age = 57.4 ± 13.0 years).MeasuresBody mass index, blood pressure (systolic and diastolic), blood lipid profile (total cholesterol, high-density lipoprotein, triglycerides, low-density lipoprotein), and fasting plasma glucose.AnalysisAnalysis of Covariance, with adjustment for age, gender, BMI change and baseline biometric and effect sizes.ResultsThe professional-delivered programs achieved significantly greater reductions in BMI (.4%, P < .001) and HDL (1.9%, P < .001) and the volunteer-delivered programs achieved greater reductions in SBP (1.4%, P < .001), DBP (1.1%, P < .001), TC (1.4%, P = .004), LDL (2.3%, P < .001), TG (4.0%, P = .006), and FPG (2.7%, P < .001). However, the effect size differences between the groups were minimal (Cohen’s d .1-.2).ConclusionsLifestyle modification programs have been shown to effectively treat chronic disease. The Complete Health Improvement Program (CHIP) lifestyle intervention has been delivered by both paid professional and unpaid volunteer facilitators. This study compared selected chronic disease biometric outcomes of participants in each mode in the United States. It found volunteer-delivered programs do not appear to be any less effective than programs delivered by paid professionals, which is noteworthy as volunteers may provide important social capital in the combat of chronic disease.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-28T08:00:32Z
  DOI: 10.1177/08901171211062581
The COVID Pandemic as Mosaic
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  Authors: David L. Katz
  Abstract: American Journal of Health Promotion, Ahead of Print.
  
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-27T01:34:45Z
  DOI: 10.1177/08901171211063998
Connecting Implementation Science, Community-Engaged Research, and Health
Promotion to Address Cancer Inequities in Massachusetts: The UMB/DF-HCC
U54 Outreach Core
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  Authors: Shoba Ramanadhan, S. Tiffany Donaldson, C. Eduardo Siqueira, Charlotte Rackard-James, Elecia Miller, Jamiah Tappin, Natalicia Tracy, Sara Minsky, Aileene A. Maldonado-Campos, Carmenza Bruff, Sitara Mahtani, Marina S. Teixeira, Vish Viswanath
  Abstract: American Journal of Health Promotion, Ahead of Print.
  The Outreach Core of the U54 Partnership between the Dana-Farber/Harvard Cancer Center and the University of Massachusetts Boston created a new model for addressing cancer inequities that integrates implementation science, community-engaged research, and health promotion. Key elements of the approach include engaging a Community Advisory Board, supporting students from underrepresented minority backgrounds to conduct health promotion and community-engaged research, increasing the delivery of evidence-based cancer prevention programs to underserved communities (directly and by training local organizations), supporting research-practice partnerships, and disseminating findings. Our model highlights the need for long-term investments to connect underserved communities with evidence-based cancer prevention.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-23T10:44:57Z
  DOI: 10.1177/08901171211062800
Low Amount and Intensity of Leisure-time Physical Activity in Asian Indian
Adults
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  Authors: Aayush Visaria, Bharath Nagaraj, Megh Shah, Nikhit Kethidi, Anurag Modak, Jai Shahani, Rachana Chilakapati, Maya Raghuwanshi
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeWe sought to describe leisure-time, aerobic, and muscle strengthening physical activity (PA) patterns in U.S. Asian Indians, in comparison to other races/ethnicities.Design, Setting, and SampleWe utilized the 2011–2018 National Health Interview Surveys, a set of cross-sectional, nationally representative surveys of the U.S. noninstitutionalized population. Our study population included 257 652 adults who answered PA questions.MeasuresPA was classified per 2008 U.S. guidelines and continuously per estimated metabolic equivalents (METs). Race was classified into White, Black, Asian Indian, Other Asian, and American Indian/Alaskan Native/Multiracial.AnalysisWe used survey design-adjusted, multivariable logistic regression to determine odds of sufficient and highly active physical activity levels, adjusting for predisposing, enabling, need, and health care service factors as guided by the Anderson Model. We also used linear regression to determine racial differences in average MET-minutes/week. Analysis was additionally stratified by comorbidity status.ResultsWhile Asian Indians (N = 3049) demonstrated similar odds of sufficient aerobic PA as Whites (aOR [95% CI]: .97 [.88,1.07]), Asian Indians had 22% lower odds of meeting highly active aerobic PA levels (.78 [.71,0.87]) and 18% lower odds of meeting sufficient muscle strengthening PA levels (.82 [.73,0.91]). This translated to an average 172 (95% CI: 45 300) fewer MET-minutes. Furthermore, this decrease in MET-minutes/week was especially apparent in those without hypertension (β[95% CI]: −164 [-314,-15]) without diabetes (−185 [-319,-52]), and low/normal BMI (−422 [-623,-222]).ConclusionAsian Indians, especially those without comorbidities, are less likely to engage in high-intensity physical activity than Whites.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-16T06:27:08Z
  DOI: 10.1177/08901171211059807
“Mother’s Health and Well-Being Matters: Is a Mediated Social Cohesion
Public Health Intervention Feasible'”
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  Authors: Cheryl Jones, Marley Gibbons, Kate Magsamen-Conrad, Kathleen T. Ulanday, Jessica Watterson, Ingrid Oakley-Girvan, Lauren C. Houghton, Kajal Gokal
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo test the feasibility of introducing ‘Free Time for Wellness’ (FT4W) an intervention to increase healthy behaviours and reduce the risk of cancer.DesignFeasibility study; Setting: Washington Heights, New York, USA is a low socioeconomic status area.SubjectsMothers aged 18 and above with children under 12 years of age and living in Washington Heights were recruited.InterventionFT4W, a community-based intervention delivered through a neighbourhood-based app, offering weekly dance and yoga classes, food pantry visits and group playdates. Childcare professionals cared for participants' children during wellness activities.MeasuresA bespoke before and after survey was designed and tested for its ability to collect relevant data to assess the impact of FT4W. Outcomes included recruitment rates, participation, attrition, acceptability, and success of the community champion.AnalysisComparisons of proportions and meansResultsTwenty-one mothers participated in the study of which 90% attended ≥ 1 FT4W activity; 65% ≥ 2; 52% ≥ 3. The survey was completed by a 100% of participants indicating it was easy to understand and not too burdensome. All measures detected change in constructs from baseline to follow-up. Availability of childcare was the most commonly (66%) reported reason participants were able to engage in the offered wellness activities.ConclusionConducting a larger-scale trial to assess the impact of FT4W is feasible considering 4 major lessons. (1) Recruitment, retention, and acceptability rates were high; however, moms need additional support to increase participation in wellness activities and improve tech literacy. (2) Research measures were sensitive enough to detect change, but the timing of assessments needs to be considered. (3) Participants greatly valued access to professional childcare. (4) The Community Champion is a necessary, but difficult role to fill that requires careful consideration by the Institutional Review Board (IRB).
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-15T12:28:43Z
  DOI: 10.1177/08901171211055317
Assessing Social Network Influences on Adult Physical Activity Using
Social Network Analysis: A Systematic Review
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  Authors: Tyler Prochnow, Megan S. Patterson
  Abstract: American Journal of Health Promotion, Ahead of Print.
  ObjectiveSocial network analysis (SNA) can measure social connectedness and assess impact of interpersonal connections on health behaviors, including physical activity (PA). This paper aims to systematically review adult PA studies using SNA to understand important social network concepts relative to PA.Data SourceA search was performed using PsycINFO, MEDLINE, PubMed, and Web of Science.Study Inclusion and Exclusion CriteriaTo be included in the search, articles needed to 1) include a measure of PA, 2) conduct an SNA in which specific relationships were measured, and 3) conduct an analysis between social network measures and PA.Data ExtractionKey study elements including network design and results were extracted.Data SynthesisData were synthesized to answer 2 questions: 1) how has adult PA been investigated using SNA approaches and 2) how is an adult’s social network associated with PA behaviors'ResultsA final sample of 28 articles remained from an initial 11 085 articles. Network size, homophily, network composition, and network exposure to PA were all associated with individual level PA across studies. Lastly, longitudinal and intervention studies showed a more complex picture of social influence and diffusion of PA behavior.ConclusionsAdults’ PA behaviors are influenced by their networks. Capitalizing on this influence, researchers should engage not just individual behavior change but also the social influences present within the person’s life.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-13T03:32:37Z
  DOI: 10.1177/08901171211060701
Promoting Healthy Food Access and Nutrition in Primary Care: A Systematic
Scoping Review of Food Prescription Programs
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  Authors: Matthew Little, Ebony Rosa, Cole Heasley, Aiza Asif, Warren Dodd, Abby Richter
  Abstract: American Journal of Health Promotion, Ahead of Print.
  ObjectiveTo conduct a scoping review to synthesize evidence on food prescription programs.Data SourceA systematic search of PubMed, CINAHL, Web of Science, Embase, and the Cochrane Library was conducted using key words related to setting, interventions, and outcomes.Study Inclusion and Exclusion CriteriaPublications were eligible if they reported food prescription administered by a health care practitioner (HCP) with the explicit aim of improving healthy food access and consumption, food security (FS), or health.Data ExtractionA data charting form was used to extract relevant details on intervention characteristics, study methodology, and key findings.Data SynthesisStudy and intervention characteristics were summarized. We undertook a thematic analysis to identify and report on themes. A critical appraisal of study quality was conducted using the Mixed Methods Appraisal Tool (MMAT).ResultsA total of 6145 abstracts were screened and 23 manuscripts were included in the review. Food prescriptions may improve fruit and vegetable consumption and reduce food insecurity (FI). Evidence for impacts on diet-related health outcomes is limited and mixed. The overall quality of included studies was weak. Addressing barriers such as stigma, transportation, and poor nutrition literacy may increase utilization of food prescriptions.ConclusionFood prescriptions are a promising health care intervention. There is a need for rigorous studies that incorporate larger sample sizes, control groups, and validated assessments of dietary intake, food security, and health.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-10T01:40:53Z
  DOI: 10.1177/08901171211056584
A Culturally Adapted Colorectal Cancer Education Video for the Somali
Community in Minnesota: A Pilot Investigation
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  Authors: Motohiro Nakajima, Abdifatah Haji, Sakhaudiin Mohamud, Osmon Ahmed, James S. Hodges, Rebekah Pratt
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study aims to develop and test feasibility of a colorectal cancer (CRC) education video appropriate for Somali immigrants.DesignOne-group pretest–posttest design.SettingMinneapolis, MN.SampleThirty-one Somali men (mean age = 60.6; SD = 13.0).InterventionA CRC education video was developed in the Somali language with Somali community partners. Participants were invited to a workshop and watched the video.MeasuresLevels of understanding about CRC and screening were assessed before vs after the video.AnalysisBinomial tests were conducted to examine changes in level of understanding.ResultsAnalysis on pre–post, within-person changes in understanding about cancer, and CRC screening showed that proportions with a positive change in understanding risks of cancer (80%) and benefits of CRC screening (90%) were significantly higher than expected if the video had no effect (50%; P = .012, P < .001, respectively). Ninety-three percent of participants agreed that the video contained useful information.ConclusionThese results provide evidence of usefulness of culturally tailored videos to facilitate CRC screening in the Somali community. Results of this study were limited by a small sample size and lack of a control group.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-10T01:00:53Z
  DOI: 10.1177/08901171211057690
Process Evaluation in Health Communication Media Campaigns: A Systematic
Review
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  Authors: Hannah Getachew-Smith, Andy J. King, Charlotte Marshall, Courtney L. Scherr
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Objective. The objective is to examine the scope of health communication media campaign process evaluation methods, findings, and dissemination practices. Data Source. A systematic review of peer-reviewed literature was conducted using database searches. Study Inclusion and Exclusion Criteria. Published studies on process and implementation evaluation of health campaigns with a media component were included. Exclusion criteria included not health, non-empirical, no media campaign, or a focus on other evaluation types. Data Extraction. Articles were assessed for general campaign information, theory use, and details about process evaluation plan and procedures. Data Synthesis. A coding scheme based on 9 process evaluation best practice elements (e.g., fidelity and context) was applied. Process evaluation methods, measures, and reporting themes were synthesized. Results. Among 691 unique records, 46 articles were included. Process evaluation was the main focus for 71.7% of articles, yet only 39.1% reported how process evaluation informed campaign implementation strategy. Articles reported 4.39 elements on average (SD = 1.99; range 1–9), with reach (87.0%) and recruitment (73.9%) described most frequently, yet reporting was inconsistent. Further, the level of detail in reporting methods, theory, and analysis varied. Conclusions. Process evaluation provides insight about mechanisms and intervening variables that could meaningfully impact interpretations of outcome evaluations; however, process evaluations are less often included in literature. Recommendations for evidence-based process evaluation components to guide evaluation are discussed.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-08T03:35:07Z
  DOI: 10.1177/08901171211052279
Informing the Physical Activity Evaluation Framework: A Scoping Review of
Reviews
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  Authors: Leanne Kosowan, Stephen Shannon, Janet Rothney, Gayle Halas, Jennifer Enns, Maxine Holmqvist, Pamela Wener, Leah Goertzen, Alan Katz
  Abstract: American Journal of Health Promotion, Ahead of Print.
  ObjectiveRobust program evaluations can identify effective promotion strategies. This scoping review aimed to analyze review articles (including systematic reviews, meta-analysis, meta-synthesis, scoping review, narrative review, rapid review, critical review, and integrative reviews) to systematically map and describe physical activity program evaluations published between January 2014 and July 2020 to summarize key characteristics of the published literature and suggest opportunities to strengthen current evaluations.Data SourceWe conducted a systematic search of the following databases: Medline, Scopus, Sportdiscus, Eric, PsycInfo, and CINAHL.Inclusion/Exclusion Criteria s were screened for inclusion based on the following criteria: review article, English language, human subjects, primary prevention focus, physical activity evaluation, and evaluations conducted in North America.ExtractionOur initial search yielded 3193 articles; 211 review articles met the inclusion criteria.SynthesisWe describe review characteristics, evaluation measures, and “good practice characteristics” to inform evaluation strategies.ResultsMany reviews (72%) did not assess or describe the use of an evaluation framework or theory in the primary articles that they reviewed. Among those that did, there was significant variability in terminology making comparisons difficult. Process indicators were more common than outcome indicators (63.5% vs 46.0%). There is a lack of attention to participant characteristics with 29.4% capturing participant characteristics such as race, income, and neighborhood. Negative consequences from program participation and program efficiency were infrequently considered (9.3% and 13.7%).ConclusionContextual factors, negative outcomes, the use of evaluation frameworks, and measures of program sustainability would strengthen evaluations and provide an evidence-base for physical activity programming, policy, and funding.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-07T06:29:49Z
  DOI: 10.1177/08901171211050059
Assessment of Exclusive, Dual, and Polytobacco E-Cigarette Use and
COVID-19 Outcomes Among College Students
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  Authors: Ashley L. Merianos, Alex M. Russell, E. Melinda Mahabee-Gittens, Adam E. Barry, Meng Yang, Hsien-Chang Lin
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study examined current (past 30-day) dual- and polytobacco use patterns and COVID-19 symptomatology, testing, and diagnosis status among college student electronic cigarette (e-cigarette) users.DesignCross-sectional online questionnaire administered during October–December 2020.SettingFour large, U.S. public universities in geographically diverse locations.SampleCollege students (N=756) ages 18–24 who reported current e-cigarette use.MeasuresCurrent use of e-cigarettes, combustible cigarettes, and cigars, and self-reported COVID-19 symptomatology, testing, and diagnosis status were measured.AnalysisMultivariable logistic regression models accounting for students’ demographics, university site, fraternity/sorority membership, and current residence.ResultsOver half (53.6%) of students were exclusive e-cigarette users, 20.4% were dual e-cigarette and combustible cigarette users, 4.6% were dual e-cigarette and cigar users, and 21.4% were poly users of e-cigarettes, combustible cigarettes, and cigars. Compared to exclusive e-cigarette users, dual users of e-cigarettes and combustible cigarettes (AOR=2.12, 95%CI=1.05–4.27) and poly users of e-cigarettes, combustible cigarettes, and cigars (AOR=3.70, 95%CI=1.78–7.70) had increased odds of COVID-19 symptomatology, even when accounting for covariates. While current tobacco use groups did not differ based on COVID-19 testing, polytobacco users had significantly increased odds (AOR=2.16, 95%CI=1.11–4.20) of having received a positive COVID-19 diagnosis.ConclusionGiven use of two or more tobacco products increased COVID-19-related risks, results underscore the need to prevent dual- and polytobacco use behaviors in college student e-cigarette users.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-06T09:19:32Z
  DOI: 10.1177/08901171211055904
Associations of At-Risk Drinking, Current Smoking, and Their Co-Occurrence
With Primary Care Service Utilization
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  Authors: John R. Moore, Yessenia Castro, Catherine Cubbin, Kirk von Sternberg
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeSmoking and at-risk drinking are each associated with lower primary care utilization, but the influence of their co-occurrence is not known. The current study compared associations of endorsement of one behavior vs endorsement of both with primary care utilization.DesignCross-sectional telephone survey.SettingAll United States and Territories.Subjects246 801 adults aged 18–64.MeasuresThe outcome was endorsement of attending a past-year primary care visit. Predictor variables included drinking and smoking status examined individually and combined.AnalysisMultivariable logistic regressions, adjusted for socio-demographics and number of chronic health conditions.ResultsThe odds of attending a past-year primary care visit were 24% lower for persons who drank at risk levels compared to the odds of persons who did not drink and 36% lower for persons who smoked vs those who did not smoke. Among persons who endorsed at least one risk behavior, the odds of attending a past-year primary care visit were 25–35% lower for those who engaged in multiple behaviors compared to the odds of persons who engaged in one behavior.ConclusionSubstance use screening and intervention services in primary care may not be reaching individuals with the greatest need for services. Proactive outreach and identification of primary care utilization barriers are needed, with special consideration of those with co-occurring substance use.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-05T08:10:36Z
  DOI: 10.1177/08901171211056130
Understanding the Development, Evaluation, and Sustainability of Community
Health Networks Using Social Network Analysis: A Scoping Review
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  Authors: Vicki Lynn Simpson, Zachary Joseph Hass, Jitesh Panchal, Bethany McGowan
  Abstract: American Journal of Health Promotion, Ahead of Print.
  ObjectiveIdentify the scope of the literature which reports use of social network analysis to inform, support, or evaluate health promotion–focused community network/partnership development.Data SourceA comprehensive search (not date-limited) of PubMed, CINAHL, Web of Science Core Collection, PsycInfo, and the Cochrane Library Database for Systematic Reviews.Inclusion and Exclusion CriteriaCriteria for inclusion included published in the English language and used social network analysis to inform, support, or evaluate development of community networks/partnerships aiding health promotion efforts. Studies were excluded if they did not use social network analysis or were not focused upon health promotion.Data ExtractionThree of the four authors extracted data using a summary chart to document information regarding study aims, target issue/population, methods, and key outcomes of the social network analysis.Data SynthesisThe extracted data were qualitatively analyzed by 3 authors to categorize key social network analysis outcomes into categories.ResultsNinety-seven studies representing 9 geographical regions were included, with the majority (69) published after 2010. Key outcomes included the effectiveness of social network analysis to identify network characteristics, track network change over time, compare similar networks across locations, and correlate network attributes with outcomes.ConclusionFindings support the utility of social network analysis to inform, support, and evaluate development of sustainable health promotion–focused networks/partnerships.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-04T01:08:42Z
  DOI: 10.1177/08901171211045984
Approaches for Implementing Healthy Food Interventions in Settings With
Limited Resources: A Case Study of Sodium Reduction Interventions in
Emergency Food Programs Addressing Food Insecurity
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  Authors: Karen Strazza, Julia Jordan, Kate Ferriola-Bruckenstein, Heather Kane, John Whitehill, Emily Teachout, Ben Yarnoff
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study describes how recipients of the Centers for Disease Control and Prevention funded Sodium Reduction in Communities Program (SRCP) worked with emergency food programs to improve access to healthy food to address chronic conditions.DesignSRCP recipients partnered with emergency food programs to implement sodium reduction strategies including nutrition standards, procurement practices, environmental strategies, and behavioral economics approaches.SettingSRCP recipients and emergency food programs in Washington County and Benton County, Arkansas and King County, Washington.SubjectsSRCP recipient staff, emergency food program staff, and key stakeholders.MeasuresWe conducted semi-structured interviews with key stakeholders and systematic review of program documents.AnalysisData were analyzed using effects matrices for each recipient. Matrices were organized using select implementation science constructs and compared in a cross-case analysis.ResultsDespite limited resources, emergency food programs can implement sodium reduction interventions which may provide greater access to healthy foods and lead to reductions in health disparities. Emergency food programs successfully implemented sodium reduction interventions by building on the external and internal settings; selecting strategies that align with existing processes; implementing change incrementally and engaging staff, volunteers, and clients; and sustaining changes.ConclusionFindings contribute to understanding the ways in which emergency food programs and other organizations with limited resources have implemented public health nutrition interventions addressing food insecurity and improving access to healthy foods. These strategies may be transferable to other settings with limited resources.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-03T06:35:28Z
  DOI: 10.1177/08901171211056121
The Association Between Veteran Status and Obesity Differs Across
Race/Ethnicity
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  Authors: Adolfo G. Cuevas, Leslie E. Cofie, Sarah Nolte
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study aims to evaluate the interaction between veteran status and race/ethnicity on obesity status.DesignCross-sectional surveySettingThe 2013–2017 National Health Interview SurveySampleA total of 151,765 adults (8.62% veterans and 91.38 nonveterans) with 69.30% identifying as White, 13.05% identifying as Hispanic, 12.57% identifying as Black, and 5.08% identifying as AsianMeasuresObesity status (measured using self-reported body mass index), race/ethnicity, survey year, age, marital status, educational attainment, federal poverty level, health insurance, type of insurance, self-reported health status, and whether participant had a usual care source.AnalysisWeighted logistic regression analysisResultsIn a fully adjusted model, there was no evidence that veterans overall had higher odds of obesity compared to nonveterans (adjusted odd ratio (aOR): 1.05, 95% CI: .99, 1.11). White veterans had lower odds of obesity compared to White nonveterans (OR: .93, 95% CI: .87, .98). Hispanic veterans had higher odds of obesity compared to Hispanic nonveterans (aOR: 1.53, 95% CI: 1.23, 1.90). There was no evidence of an association between veteran status and obesity status for Black and Asian adults.ConclusionsEffectual prevention strategies are needed to decrease obesity risks among active and retired Hispanic veterans.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-03T05:39:52Z
  DOI: 10.1177/08901171211052994
Perceived Stress as a Pathway for the Relationship Between Neighborhood
Factors and Glycemic Control in Adults With Diabetes
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  Authors: Joshua K. Egede, Jennifer A. Campbell, Rebekah J. Walker, Leonard E. Egede
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeNeighborhood factors such as crime, discrimination, and violence are increasingly recognized as correlates of poor glycemic control. However, pathways for these relationships are unclear. This study examined stress and self-efficacy as potential pathways for the relationship between neighborhood factors and glycemic control in adults with type 2 diabetes.DesignCross-sectional study.SettingTwo primary care clinics in southeastern US.Participants615 adults aged 18 years and older.MeasuresValidated measures were used to capture neighborhood factors, stress, and self-efficacy, while hemoglobin A1c (HbA1c) was abstracted from the electronic health record.AnalysisPath analysis was used to investigate direct and indirect relationships between neighborhood factors, stress, self-efficacy, and glycemic control.ResultsIn the final model, violence (r = .17, P = .024), discrimination (r = .46, P < .001), and crime (r = .36, P = .046) were directly associated with higher perceived stress. Stress (r = −.5, P < .001) was directly associated with lower self-efficacy. Self-efficacy was directly associated with better general diet (r = .12, P < .001), better specific diet (r = .04, P < .001), more exercise (r = .08, P < .001), and lower HbA1c (r = −.11, P < .001). Stress (r = .05, P < .001), crime (r = .20, P < .001), and discrimination (r = .08, P < .001) were indirectly associated with higher HbA1c.ConclusionStress and self-efficacy are potential pathways for the relationship between neighborhood factors like violence, discrimination, and crime and glycemic control. Interventions aimed at mitigating stress and improving self-efficacy may improve self-care behaviors and glycemic control.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-03T05:31:52Z
  DOI: 10.1177/08901171211050369
Active Women over 50. Promoting Physical Activity in Women Over 50: A
Randomized Trial
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  Authors: Geraldine Wallbank, Catherine Sherrington, Leanne Hassett, Colleen G. Canning, Roberta Shepherd, Bethan Richards, Catherine Mackay, Anne Tiedemann
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study aims to test the effect of an information and support intervention on physical activity (PA) in women aged 50+ years.DesignRandomized wait-list controlled trial.SettingSydney, Australia.Sample126 female university and health service employees, aged 50+.InterventionInformation session, activity tracker, regular motivational emails.MeasuresProportion achieving ≥ 10,000 steps/day (primary outcome), daily step count, proportion meeting 150 mins/week of moderate to vigorous PA (MVPA), self-reported PA.AnalysisOdds-ratios and general linear regression models.ResultsAt 3 months, the intervention group reported significantly more vigorous PA (1.04 hours, 95% CI 0.24 to 1.85, P = .01, measured by IPAQ), were more likely to achieve 300 mins/week of MVPA (OR = 1.98, 95% CI 0.89 to 4.36, P = .09, measured by Actigraph) than the control wait-list group, and reported adopting PA promotion strategies (technology = 31/58% or goal-setting = 39/74%). No significant between-group differences in the primary outcome were detected (1.39, 95% CI 0.61 to 3.18, P = .44).ConclusionsThis low-dose intervention significantly increased self-reported vigorous PA time and non-significantly increased the proportion of people achieving 300 mins/week of MVPA but did not significantly increase the proportion of participants achieving 10,000 steps/day. Relatively small effects may be important at a population level given the minimal resources needed to deliver this intervention.
  Citation: American Journal of Health Promotion
  PubDate: 2021-12-02T04:28:47Z
  DOI: 10.1177/08901171211045678
Health Care Providers’ Knowledge, Attitudes, and Practices and the
Association With Referrals to the National Diabetes Prevention Program
Lifestyle Change Program
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  Authors: LaShonda R. Hulbert, Xuanping Zhang, Boon Peng Ng, Kunthea Nhim, Tamkeen Khan, Michael J. Cannon
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo examine how health care providers’ knowledge, attitudes, and practices affect their referrals to the National Diabetes Prevention Program.DesignCross-sectional, self-report data from DocStyles—a web-based surveySettingUSASamplePracticing family practitioners, nurse practitioners, pharmacists, and internists, n = 1,503.MeasuresQuestions regarding health care providers’ knowledge, attitudes, and practices and their referrals to the National Diabetes Prevention Program.AnalysisBivariate and multivariate analyses were used to calculate predictive margins and the average marginal effect.ResultsOverall, 15.2% of health care providers (n = 1,503) reported making a referral to the National Diabetes Prevention Program. Health care providers were more likely to make referrals if they were familiar with the program (average marginal effect = 36.0%, 95% CI: 29.1%, 42.8%), reported knowledge of its availability (average marginal effect=49.1%, 95% CI: 40.2%, 57.9%), believed it was important to make referrals to the program (average marginal effect = 20.7%, 95% CI: 14.4%, 27.0%), and used electronic health records to manage patients with prediabetes (average marginal effect = 9.1%, 95% CI: 5.4%, 12.7%). Health care providers’ demographic characteristics had little to no association with making referrals.ConclusionMaking referrals to the National Diabetes Prevention Program was associated with health care providers’ knowledge of the program and its reported availability, their attitudes, and their use of the electronic health record system to manage patients with prediabetes.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-30T04:26:29Z
  DOI: 10.1177/08901171211044937
Mammography Screening Disparities in Asian American Women: Findings From
the California Health Interview Survey 2015–2016
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  Authors: Hui Xie, Yannan Li, Nickolas Theodoropoulos, Qian Wang
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo identify mammography screening prevalence and predictors in Asian American women, focusing on the potential disparities in race and its influence on screening behaviors.DesignA secondary analysis utilized the California Health Interview Survey (CHIS) 2015–2016. SettingCalifornia, U.S.SampleCisgender women who were non-Hispanic (NH) White, Chinese, Filipino, Vietnamese, Japanese, Korean, or “other Asian”, aged 40 or above (unweighted N=13 451).MeasuresSocioeconomics, chronic health conditions, and preventive care utilization were mesuared as potential risk factors, where up-to-date mammography screening as the outcome variable.AnalysisMultivariable adjusted logistic regressions were generalized to identify the up-to-date mammography screening behaviors in relation to potential factors, stratified by race and ethnicity.ResultsThe prevalence for up-to-date mammography screening in NH-White and Asian American women were 68.06% and 65.97%, respectively. In NH-White women, receiving an up-to-date mammogram was associated with age, birthplace, smoking status, diabetes, hypertension, health insurance coverage, and a preventive care visit in the past 12 months, whereas only age and a preventive care visit were significant predictors in Asian women.ConclusionsThe findings indicate that utilization disparities exist in mammogram in relation to socioeconomics, chronic health conditions, preventive care utilization, when comparing between race and ethnicity. Asian American women with borderline hypertension and no preventive care visits may require more public health outreach and cancer education.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-24T07:25:01Z
  DOI: 10.1177/08901171211048136
Hepatitis a Vaccine Promotion Using Facebook Ads to Reach At-Risk Groups
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  Authors: Pamela Schwartz, Jennifer L. Sedillo, Jessica L.C. Sapp
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo evaluate using Facebook ads to promote hepatitis A vaccination to at-risk groups.DesignThis descriptive research study used Facebook ads and posts to deliver a social media health campaign.SettingThe social networking site Facebook was used to target audiences in the United States.SubjectsAdults in the United States with Facebook accounts were the general audience with at-risk audiences having interests or profile attributes in either LGBTQ or food service groups.MeasuresFacebook Ads Manager was used to determine impressions, engagement rates, link clicks, and cost per result of the ads. These metrics were measured to examine the use of Facebook ads and targeting audiences.AnalysisQuantitative data were analyzed using descriptive statistics, and the Pearson correlation coefficient analysis was used to determine if the amount spent on each ad had any correlation with reach, results, cost per result, or impressions.ResultsThe campaign resulted in a reach of 53 422 users, 70 542 impressions, 457 unique link clicks (483 link clicks), an average cost per results of $0.92 USD, and the total amount spent of $445.68 USD. The amount spent was positively correlated with reach (r = .969), results (r = .994), cost per result (r = .841), and impressions (r =.957).ConclusionThe social media health campaign was effective in reaching an audience about hepatitis A vaccination. Using interest groups was not more cost-effective than a using a general audience for link clicks.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-24T07:14:39Z
  DOI: 10.1177/08901171211044594
The Effects of Exclusive Walking on Lipids and Lipoproteins in Women with
Overweight and Obesity: A Systematic Review and Meta-Analysis
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  Authors: Anjulyn M. Ballard, Ashlee Davis, Brett Wong, Rodney Lyn, Walter R. Thompson
  Abstract: American Journal of Health Promotion, Ahead of Print.
  ObjectiveTo evaluate the effects of walking, independent of diet and weight-loss, on lipids and lipoproteins in women with overweight and obesity.Data SourceAcademic Search Complete, Alternative Health Watch, Global Health, Health Source, CINAHL, MEDLINE, EMBASE, SportDiscus, and ProQuest.Study Inclusion and Exclusion Criteria(1) experiment-control design; (2) women with overweight or obesity; (3) walking as the experiment’s independent variable; (4) four or more weeks; and (5) pre- to post-assessment of lipids and/or lipoproteins. Excluded studies reported use of lipid-lowering medication, diet or other modes of physical activity, and alternative interventions as the control.Data ExtractionData extraction and study quality were completed by the first 2 authors using the Cochrane review protocol and risk of bias assessment.Data SynthesisRaw mean difference between the experiment and control groups using a random effects model.ResultsMeta-analyses of 21 interventions (N = 1129) demonstrated exclusive walking improves total cholesterol (raw mean difference = 6.67 mg/dL, P = .04) and low-density lipoproteins (raw mean difference = 7.38 mg/dL, P = .04). Greater improvement in total cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins existed in women with obesity.ConclusionsExclusive walking aids in normalizing total cholesterol and LDLs in women with overweight and obesity. Exclusive walking can be used as a non-pharmacologic therapy, which may have positive clinical outcomes for individuals who especially struggle with diet and weight-reduction.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-23T07:43:35Z
  DOI: 10.1177/08901171211048135
Using a Social Determinants of Health Summary Measure to Predict General
Health Status in the BRFSS
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  Authors: Candace C. Nelson
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study aims to assess the relationship between social determinants of health (SDoH) burden and overall health.DesignThree years of Behavioral Risk Factor Surveillance System (BRFSS) data (2017–2019) were combined for this cross-sectional study.SettingMassachusetts.SubjectsOut of a possible 21,312 respondents, 16,929 (79%) were eligible for inclusion.MeasuresTo create the SDoH summary measure, items assessing social risk experiences including financial instability (1 item), housing instability (2 items), perceptions of neighborhood crime (1 item), and food insecurity (2 items) were summed to create a count of risk experiences. Outcome measures included self-rated general health, days of poor physical health, and days of poor mental health.AnalysisMultivariable logistic regression was used to evaluate the association between each outcome and the SDoH summary measure, adjusting for demographic confounders.ResultsIn adjusted analyses, respondents who reported experiencing 1, 2, 3, or 4+ SDoH had a 1.6 (95% CI: 1.3–2.0), 2.9 (95% CI: 2.3–3.7), 3.2 (95% CI: 2.4–4.3), or 5.3 (95% CI: 4.0–7.0) increased odds (respectively) of self-rated fair/poor health, compared to those who reported zero SDoH. The adjusted relationship between the SDoH summary measure and physical health and mental health was similar in magnitude and statistically significant.ConclusionsThese results demonstrate that the overall burden of risk due to SDoH is an important predictor of health.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-23T07:37:42Z
  DOI: 10.1177/08901171211044994
Lessons Learned During Large-Scale Implementation Project Focused on
Workplace Lactation Practices and Policies
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  Authors: Amanda Hickey, Margaret Henning, Lissa Sirois
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis practice-based research funded by the Centers for Disease Control and Prevention (CDC) focuses on the translation of evidence-based practices and policies into real-world applications. To the best of our knowledge, this is the largest study to research the implementation process for lactation accommodations and policies for work sites.Design or ApproachPre-/post-test evaluation of work-site lactation accommodations, and 6-month follow-up with business that worked on the project.Setting/Participants34 businesses across New Hampshire.MethodThe team developed work-site selection criteria to award mini-grants; developed trainings and a toolkit; and worked with 34 businesses over a 3-year period. Pre-/post-implementation data were collected using the CDC work-site scorecard. A 6-month follow-up phone interview was conducted with each site.ResultsWe assessed the CDC scorecard and evaluated the challenges of implementing lactation spaces by industry. In our 6-month follow-up, we found that spaces were still being utilized and we identified specific research to inform practical evidence-based applications and lessons learned when implementing a work-site lactation space.ConclusionWe successfully provided financial/technical support to develop or improve 45 lactation spaces, with policies and practices to support mothers and families for 34 businesses. We identified key takeaway lessons that can be used to guide the development of lactation spaces and policies in work sites. Sites self-report that these work-site changes were sustainable at 6-month follow-up.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-20T02:40:41Z
  DOI: 10.1177/08901171211055692
Addressing Hispanic Obesity Disparities Using a Community Health Worker
Model Grounded in Motivational Interviewing
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  Authors: Louis D. Brown, Denise Vasquez, Diane I. Lopez, Erin M. Portillo
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo determine whether Hispanic residents receiving the Healthy Fit intervention enhanced with Motivational Interviewing (MI) experienced greater improvements in body composition, relative to participants receiving the initial intervention.DesignQuasi-experimental evaluation.SettingEl Paso, Texas.SampleAmong 656 baseline participants, 374 (54%) completed the 12-month assessment.InterventionIn Healthy Fit, community health workers (CHWs) promote nutrition and exercise. To strengthen intrinsic motivation and help participants overcome barriers to change, we incorporated a 30-minute motivational interview into the baseline assessment. Follow-up phone calls at 1, 3, and 6 months were identical across conditions.MeasuresCHWs assessed body mass index (BMI) and body fat percentage (BFP) using a bioelectrical impedance scale.AnalysisRegression models estimated differences between intervention conditions on change in BMI and BFP from baseline to the 12-month assessment.ResultsParticipants receiving MI had 2.13 times higher odds of losing weight (OR = 2.14, 95% CI [1.30, 3.53], P = .003) and 2.59 times higher odds of reduced BFP (OR = 2.59, 95% CI [1.51, 4.41], P < .001), relative to initial intervention participants. MI participants lost an average of 1.23 kg (2.71 lbs.) and their BFP declined 2% over 12 months.ConclusionFindings suggest CHW use of MI is a promising approach for promoting incremental changes in diet and exercise, which Healthy Fit integrates into a low-cost intervention.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-18T10:57:41Z
  DOI: 10.1177/08901171211049679
Women, Infants, and Children Cash Value Benefit Redemption Choices in the
Electronic Benefit Transfer Era
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  Authors: Qi Zhang, Junzhou Zhang, Kayoung Park, Chuanyi Tang, Patrick W. McLaughlin, Brian Stacy
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study aims to examine the relationship between cash value benefit (CVB) redemption outcomes in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) across food processing types and socio-demographics.DesignCross-sectional and panel analyses.SettingVirginia.Subjects98,067 Virginia WIC households.MeasuresCVB redemption rate.ResultsThe predominant share of CVB redemption was for fresh produce (77.3%). Non-Hispanic whites and blacks redeemed a smaller share of fresh produce than Hispanic participants (P < .001). Non-Hispanic black WIC households have a significantly lower CVB redemption rate than non-Hispanic white WIC households (β = −.008, P < .001). Households with a child participant tend to have a higher redemption rate (β = .01, P < .001). The redemption rates of fruits and of vegetables were positively correlated with household size.ConclusionsMinority status and household size were significantly related to CVB redemptions among Virginia WIC participants.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-18T09:55:21Z
  DOI: 10.1177/08901171211045804
A Qualitative Examination of COVID-19’s Impacts on Physical Activity and
Perceptions of Remote Delivery Interventions
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  Authors: Grace Ellen Brannon, Sophia Mitchell, Madison A. Ray, Salman Bhai, Muhammad Shaalan Beg, Karen M. Basen-Engquist, Yue Liao
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThe COVID-19 pandemic is correlated with decreased physical activity (PA). Transitioning to remote work may impact people’s acceptability and preferences for remotely delivered behavioral interventions, including PA. The objective was to examine perceptions of COVID-19 impacts on PA engagement and motivation, and perspectives related to remotely delivered PA interventions.DesignCross-sectional small-group interview.SettingHarris County, Texas. Participants: Insufficiently active, overweight/obese adults (16 healthy adults [aged 25–52 years], and 7 cancer survivors [aged 50–74 years]).MethodGroup discussion was guided by semi-structured questions. Audio-transcribed data (278 pages) was analyzed using Braun and Clarke’s process centering identification, analysis, organization, description, and reports.ResultsOverall, participants expressed a decreased level of PA due to the pandemic. Difficulties (e.g., care-taking activities, working from home, and safety concerns) negatively affected motivation. Participants indicated high acceptability of remotely delivered PA interventions, with advantages of virtual technology features (e.g., did not have to maintain a gym membership) and even accountability in maintaining a PA routine (e.g., using virtual groups to engage in community support).ConclusionParticipants described COVID-19 negatively affects access to PA opportunities yet also expressed willingness to engage in remotely delivered PA interventions instead of in-person programs because of their COVID-19 experiences. Remote interventions can greatly increase accessibility and offer opportunities to provide personalized motivation and accountability that people need to be more physically active.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-17T11:47:38Z
  DOI: 10.1177/08901171211053845
Mediation of the Relationship of Acculturation With Glycemic Control in
Asian Americans With Diabetes
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  Authors: Namrata Sanjeevi
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo assess the role of physical activity and healthcare access in mediating the association of acculturation with cardiometabolic health in Asian American adults with diabetes.DesignCross-sectional study.SettingNational Health and Nutrition Examination Survey (NHANES) 2011–2018.SubjectsNon-pregnant Asian American adults with doctor diagnosed diabetes.MeasuresParticipants were classified into low, moderate, and high acculturation status. Self-reported leisure-time, work, and transportation-based physical activity were summed for overall physical activity. Health insurance, frequency of healthcare receipt, and glycohemoglobin (HbA1c) check in the past year indicated healthcare access. Cardiometabolic health indicators included HbA1c, total and high density lipoprotein-cholesterol, and systolic and diastolic blood pressure.AnalysisLinear and logistic regression estimates, standardized using y-standardization, and assessed mediation of acculturation with cardiometabolic health.ResultsLow acculturation was significantly related to greater leisure-time inactivity odds [OR (95% CI) = 2.25 (1.05, 4.82)], overall insufficient activity [OR (95% CI) = 2.30 (1.12, 4.74)], and uninsured status [OR (95% CI) = 5.62 (1.55, 20.41)]. Asian Americans with low acculturation had significantly higher log HbA1c than those with high acculturation (β ± SE = .078 ± .038); however, this association was not significant after adjusting for leisure-time activity. Leisure-time activity mediated 48.9% of acculturation and HbA1c association, and the indirect effect was statistically significant [estimate (95% CI) = .021 (.002, 0.047)].ConclusionsResults suggest that promoting sufficient leisure-time activity could improve glycemic control in least acculturated Asian Americans with diabetes.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-17T03:53:21Z
  DOI: 10.1177/08901171211052562
The Potential Win-win Strategy for Healthy Aging and Environmental
Protection: Environmental Volunteering
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  Authors: Chung-Shan Hung, Ching-Hui Loh, Jyh-Gang Hsieh, Jia-Ching Chen, Yan-Wei Lin, Chia-Feng Yen
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeTo explore the physical activity level of community environmental volunteering (CEV) participants and the differences in physical functions and daily activity patterns between the older adults who engaged in intensive CEV (≥15 hours/week) and non-intensive CEV (
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-06T08:59:15Z
  DOI: 10.1177/08901171211055599
Shared Determinants for Human Papillomavirus and COVID-19 Vaccination
Intention: An Opportunity for Resource Consolidation
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  Authors: Ayokunle A. Olagoke, Leslie R. Carnahan, Olakanmi Olagoke, Yamilé Molina
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThis study aimed at targeting shared factors that influence the prevention of multiple diseases, which can help address various health problems simultaneously. We identified correlates of human papillomavirus (HPV) vaccination that overlap with COVID-19 vaccination.DesignCross-sectional survey data.SettingOnline Qualtrics recruitment panel.SubjectReligious parents of 342 adolescents who were unvaccinated for HPV (response rate was 68.1%).MeasuresOutcome variables were COVID-19 vaccination intention for (1) self, (2) child, and (3) HPV vaccination intention for child. Independent variables were psychological factors. Covariates were sociodemographic and socioeconomic factors.AnalysisWe conducted multivariate linear regressions on each outcome variable after controlling for covariates.ResultSome psychological correlates of HPV overlapped as protective factors for all three outcomes. Higher perceived vulnerability of child to HPV was associated with higher vaccination intention against COVID-19 for self (β = .37, 95% confidence interval [CI] = .25–.48), child (β = .32, .21–.44), and HPV for child (β = .38, .27–.49). Higher perceived response efficacy of HPV vaccine was associated with greater vaccination intention against COVID-19 for self (β = .46, .33–.59), child (β = .41, .28–.53), and HPV for child (β = .75, .64–.85).ConclusionGiven the overlap in HPV and COVID-19 vaccination correlates, interventions should target shared factors that address both diseases to maximize public health efforts. A major limitation of this study is the inability to measure the actual vaccination behavior.
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-05T10:20:36Z
  DOI: 10.1177/08901171211053933
Exploring COVID-19 Vaccine Hesitancy Among Stakeholders in African
American and Latinx Communities in the Deep South Through the Lens of the
Health Belief Model
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  Authors: Lori B. Bateman, Allyson G. Hall, William A. Anderson, Andrea L. Cherrington, Anna Helova, Suzanne Judd, Robert Kimberly, Gabriela R. Oates, Tiffany Osborne, Corilyn Ott, Melissa Ryan, Christian Strong, Mona N. Fouad
  Abstract: American Journal of Health Promotion, Ahead of Print.
  PurposeThe purpose of this study was to qualitatively explore perceptions related to COVID-19 vaccination intention among African American and Latinx participants and suggest intervention strategies.ApproachNinety minute virtual focus groups (N = 8), segmented by county, race and ethnicity were conducted with stakeholders from 3 vulnerable Alabama counties.ParticipantsParticipants (N = 67) were primarily African American and Latinx, at least 19 years, and residents or stakeholders in Jefferson, Mobile, and Dallas counties.SettingFocus groups took place virtually over Zoom.MethodsThe semi-structured guide explored perceptions of COVID-19, with an emphasis on barriers and facilitators to vaccine uptake. Focus groups lasted approximately 90 minutes and were audio recorded, transcribed, and analyzed by a team of 3 investigators, according to the guidelines of Thematic Analysis using NVivo 12. To provide guidance in the development of interventions to decrease vaccine hesitancy, we examined how themes fit with the constructs of the Health Belief Model.ResultsWe found that primary themes driving COVID-19 vaccine hesitancy, ordered from most to least discussed, are mistrust, fear, and lack of information. Additionally, interventions to decrease vaccine hesitancy should be multi-modal, community engaged, and provide consistent, comprehensive messages delivered by trusted sources.
  Citation: American Journal of Health Promotion
  PubDate: 2021-10-31T05:29:56Z
  DOI: 10.1177/08901171211045038
Knowledge and Beliefs Regarding Harm From Specific Tobacco Products:
Findings From the H.I.N.T. Survey
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  Authors: Wenxue Lin, Joshua E. Muscat
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:Determine whether dual tobacco users have different levels of knowledge about nicotine addiction, perceived harm beliefs of low nicotine cigarettes (LNCs) and beliefs about electronic cigarettes (e-cigarettes)Design:Quantitative, Cross-sectionalSetting:Health Information National Trends Survey 5 (Cycle 3, 2019)Participants:Nationally representative adult non-smokers (n=3113), exclusive cigarette smokers (n=302), and dual (cigarette and e-cigarette) users (n=77).Measures:The survey included single item measures on whether nicotine causes addiction and whether nicotine causes cancer. A five-point Likert scale assessed comparative harm of e-cigarettes and LNCs relative to conventional combustible cigarettes (1=much more harmful, 3=equally harmful…5 = much less harmful, or don’t know).Analysis:We used weighted multiple linear regression model to estimate means and 95% confidence intervals (CI) of e-cigarettes and LNCs beliefs by current tobacco user status.Results:Over 97% of dual users, 83% of non-smokers and 86% of exclusive cigarette smokers correctly identified that nicotine is addictive. The majority of subjects incorrectly identified nicotine as a cause of cancer, with dual users having the lowest proportion of incorrect responses (60%). Dual users rated e-cigarette harmfulness as less harmful than combustibles (mean=2.20; 95% CI=1.73, 2.66) while exclusive cigarette smokers and non-smokers rated them as similarly harmful. LNCs were considered equally harmful and addictive as conventional cigarettes.Conclusion:Dual users had a higher knowledge base of tobacco-related health effects. The effectiveness of policies or medical recommendations to encourage smokers to switch from cigarettes to LNCs or e-cigarettes will need to consider accurate and inaccurate misperceptions about the harm and addictiveness of nicotine. Improved public health messages about different tobacco products are needed.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-02T09:05:29Z
  DOI: 10.1177/08901171211026116
On the Need for an Association for Vaccinated Person’s Rights
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  Authors: Paul E. Terry
  First page: 13
  Abstract: American Journal of Health Promotion, Ahead of Print.
  COVID-19 has been more difficult to contain in the United States than in other countries due, in part, to our nation’s rootedness in preserving individual freedoms, sometimes in defiance of the need for social accountability for health. With growing evidence that anti-vaccination proponents are increasingly organized, funded, and influential, this editorial argues that the right to health should transcend individual freedoms that have a likely probability of spreading harm to others. An association for vaccinated person’s rights, much like ANSR, an association for non-smokers rights, may be needed to counter anti-vaccination rights organizers. Advancing a goal of mostly “vaccinated and fully immunized populations’ would make members of such a group ‘VIP-ers.’”
  Citation: American Journal of Health Promotion
  PubDate: 2021-11-26T03:24:02Z
  DOI: 10.1177/08901171211059620
Survey Fraud and the Integrity of Web-Based Survey Research
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  Authors: Ronli Levi, Ronit Ridberg, Melissa Akers, Hilary Seligman
  First page: 18
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Compared to traditional paper surveys, online surveys offer a convenient, efficient, and socially distant way to conduct human subjects research. The popularity of online research has grown in recent decades. However, without proper precautions, false respondents pose a serious risk to data integrity. In this paper, we describe our research team’s own encounter with survey fraud, steps taken to preserve the integrity of our study, and implications for future public health research.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-10T08:51:27Z
  DOI: 10.1177/08901171211037531
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
  First page: 21
  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
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
  First page: 29
  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
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
  First page: 38
  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
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
  First page: 46
  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
Weight, Weight Perceptions, and Health and Well-Being Among Canadian
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  Authors: Lei Chai, Jia Xue
  First page: 55
  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
How Ready Are Young Adults to Participate in Community Service' An
Application of the Transtheoretical Model of Behavior Change
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  Authors: Natalie Fenn, Cheyenne Reyes, Kathleen Monahan, Mark L. Robbins
  First page: 64
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:Engaging in community service, or unpaid work intended to help people in a community, is generally associated with greater overall well-being. However, the process of beginning and maintaining community service engagement has been sparsely examined. The current study applied the Transtheoretical Model (TTM) of behavior change to understanding community service readiness among young adults.Design:Cross-sectional design using an online survey.Setting:Participants were undergraduate students recruited at a mid-sized Northeastern US university in Spring 2018.Sample:Participants (N = 314) had a mean age of 20.36 years (SD = 3.69), were primarily White (78%), female (72%), and from moderately high socioeconomic backgrounds (as measured by parental level of education).Measures:Socio-demographics including age, gender, race-ethnicity, and parental level of education; readiness, pros, cons, and self-efficacy for community service; civic engagement behavior; well-being.Analysis:Participants were classified into very low (n = 62), low (n = 59), moderate (n = 92), high (n = 46), and very high (n = 55) readiness for community service groupings. A MANOVA was conducted to assess relationships between groupings and community service TTM constructs, civic engagement, and well-being.Results:There were significant differences between readiness groupings on all main outcome variables, F(20, 1012) = 10.34, p < .001; Wilks’ Λ = 0.54, η2 = .14. Post-hoc Games-Howell tests showed that those exhibiting higher levels of readiness reported fewer cons, greater pros, higher self-efficacy, more overall civic engagement, and greater well-being compared to lower readiness individuals.Conclusion:Consistent with previous TTM applications, self-efficacy and the importance of pros increased across readiness groupings while the importance of cons decreased. Study findings may be used to inform readiness-tailored interventional work for increasing community service. This area of study would benefit from longitudinal research examining community service readiness beyond the college environment.
  Citation: American Journal of Health Promotion
  PubDate: 2021-07-23T09:03:42Z
  DOI: 10.1177/08901171211034742
Evaluating Risk and Protective Factors for Suicidality and Self-Harm in
Australian Adolescents With Traditional Bullying and Cyberbullying
Victimizations
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  Authors: Md Irteja Islam, Fakir Md Yunus, Enamul Kabir, Rasheda Khanam
  First page: 73
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:To identify and compare important risk and protective factors associated with suicidality and self-harm among traditional bullying and cyberbullying victims aged 14-17-years in Australia.Design:Cross-sectional population-based study.Setting:Young Minds Matter, a nationwide survey in Australia.Subjects:Adolescents aged 14-17-years (n = 2125).Measures:Suicidality and self-harm were outcome variables, and explanatory variables included sociodemographic factors (age, gender, country of birth, household income, location, family type), risk factors (parental distress, family functioning, family history of substance use, child substance use, mental disorder, psychosis, eating disorders, sexual activity) and protective factors (high self-esteem, positive mental health or resilience, school connectedness, sleep) among 2 types of bullying victims—traditional and cyber. Traditional bullying includes physical (hit, kick, push) or verbal (tease, rumors, threat, ignorance), and cyberbullying includes teasing messages/pictures via email, social medial using the internet and/or mobile phones.Analysis:Bivariate analysis and binary logistic regression models. Statistical metrics include Hosmer-Lemeshow Goodness-of-Fit-test, VIF test, Linktest and ROC curve for model performance and fitness.Results:Overall, 25.6% of adolescents were traditional bullying victims and 12% were cyberbullying victims. The percentages of suicidality (34.4% vs 21.6%) and self-harm (32.8% vs 22.3%) were higher in cyberbullying victims than in traditional bullying victims. Girls were more often bullied and likely to experience suicidal and self-harming behavior than boys. Parental distress, mental disorder and psychosis were found to be significantly associated with the increase risk for self-harm and suicidality among both bullying victims (p < 0.05). While, eating disorder and sexual activity increased the risk of suicidality in traditional bullying victims and self-harm in cyberbullying victims, respectively. Positive mental health/resilience and adequate sleep were found be significantly associated with decreased suicidality and self-harm in both bullying victims.Conclusion:Suicidality and self-harm were common in bullying victims. The findings highlight that the risk and protective factors associated with suicidality and self-harm among adolescent who experienced traditional and cyberbullying victimization should be considered for the promotion of effective self-harm and suicide prevention and intervention programs.
  Citation: American Journal of Health Promotion
  PubDate: 2021-07-26T09:34:01Z
  DOI: 10.1177/08901171211034105
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
  First page: 84
  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
Patterns of Fitbit Use and Activity Levels Among African American Breast
Cancer Survivors During an eHealth Weight Loss Randomized Controlled Trial
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  Authors: Jeanne M. Ferrante, Aaron Lulla, Julie D. Williamson, Katie A. Devine, Pamela Ohman-Strickland, Elisa V. Bandera
  First page: 94
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:This study examined adherence with a physical activity tracker and patterns of activity among different subgroups of African American/Black breast cancer survivors (AABCS).Design:Secondary analysis of weight loss trial that used an activity tracker (FitBit) with or without a commercial eHealth program (SparkPeople) over 12 months.Setting and Subjects:AABCS (N = 44) in New Jersey.Measures and Analysis:Adherence with tracker use, steps per day, and active minutes per week were compared by demographic and clinical characteristics using nonparametric statistics.Results:Median adherence was over 6 days per week throughout the 12-months. Adherence was significantly correlated with steps and active minutes (p < 0.015). Groups with lower adherence included: those with 5 or more conditions (p = 0.039), had higher number of household members (p = 0.008), and younger than 60 years (p = 0.044). Median number of steps per day remained consistently around 7000 throughout 12 months. Factors associated with lower activity included: age> 60; retirement; higher number of household members, comorbidity, or baseline BMI; and those in the SparkPeople + Fitbit group. Self-monitoring, goal setting, and self-efficacy were significantly correlated with activity levels (p < 0.05).Conclusion:Use of a physical activity tracker may help increase activity levels in AABCS. Certain subgroups, e.g. those older than age 60 years, retired, with BMI over 40, higher number of comorbidities or more household members, may require additional interventions.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-04T09:00:14Z
  DOI: 10.1177/08901171211036700
Policy Support for Smoke-Free and E-Cigarette Free Multiunit Housing
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  Authors: Minal Patel, Emily M. Donovan, Michael Liu, Morgan Solomon-Maynard, Barbara S. Schillo
  First page: 106
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:Estimate public support for prohibiting multiunit housing (MUH) e-cigarette and cigarette use.Design:Cross-sectional study.Setting:Data from an online panel survey.Sample:A Fall 2018 nationally representative sample of 3,415 (99.3% response rate) United States (US) adults 18-64 years old.Measures:Policy support for prohibiting MUH smoking and e-cigarette use, sociodemographics, and tobacco perceptions and behaviors.Analysis:Weighted multivariate logistic regression examined predictors of support for prohibiting 1) cigarette use and 2) e-cigarette use in MUH.Results:Most respondents expressed support for prohibiting smoking (76.9%) and e-cigarette use (74.0%) in MUH. About 17% (n = 588) of the sample lived in MUH, and living in MUH was not predictive of support for either policy. For both cigarette and e-cigarette policies, current smokers (n = 630; OR = 0.44, p < 0.001; OR = 0.59, p < 0.01) and current e-cigarette users (n = 305; OR = 0.42, p < 0.001; OR = 0.22, p < 0.001) had lower odds of support. Notably, while most smokers supported prohibiting cigarette (51.4%) and e-cigarette use in MUH (51.1%), there was less support among current e-cigarette users for prohibiting cigarette (48.1%) and e-cigarette use in MUH (34.5%).Conclusion:Majority support for prohibiting smoking and e-cigarette use in MUH is promising for policy adoption; however, lower support of both policies among e-cigarette users needs to be examined, as increasing use of e-cigarettes may be shifting social norms away from support for smoke free housing policies.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-04T09:00:59Z
  DOI: 10.1177/08901171211035210
Examining Race and Gender Differences in Associations Among Body
Appreciation, Eudaimonic Psychological Well-Being, and Intuitive Eating
and Exercising
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  Authors: Kelly A. Romano, Kristin E. Heron
  First page: 117
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:The present study examined race and gender differences among positive psychological constructs, and adaptive eating and exercise behaviors.Design:Cross-sectional.Setting:Online.Sample:College students (N = 1,228; Mage = 22.27, SD = 5.83).Measures:Participants completed measures assessing positive body image, eudaimonic psychological well-being, and health behaviors.Analyses:Multi-group structural equation modeling was used to examine whether White versus Black race and, separately, woman versus man gender identity moderated associations among body appreciation, eudaimonic psychological well-being, and intuitive eating and intuitive exercising.Results:Results generally indicated that greater body appreciation was associated with greater eudaimonic psychological well-being (βs = 0.48, 0.56) and, in turn, intuitive eating (βs = −0.20, 0.25) and intuitive exercising (βs = −0.06, 0.23). However, notable variations in this pattern of results were identified based on the facet of intuitive eating and exercising under investigation, and participants’ racial identities. For example, greater eudaimonic psychological well-being strictly mediated a positive association between body appreciation and reliance on hunger and satiety cues intuitive eating behaviors among participants who identified as Black (95%CI: 0.01, 0.12), but not White (95%CI: −0.08, 0.04).Conclusions:Although the present findings warrant replication using longitudinal designs due to the cross-sectional nature of the present study, these findings suggest that increasing adults’ eudaimonic psychological well-being may help improve health-promoting eating and exercise behaviors, and should be assessed as a mechanism of change in future clinical research.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-05T09:18:09Z
  DOI: 10.1177/08901171211036910
The Effects of Exposure to Domestic Violence on Sleep Among Urban Adults
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  Authors: Daniel J. Schober, Susana Shrestha, Jessica C. Bishop-Royse
  First page: 129
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:Domestic violence contributes to poor health including sleep disruptions, which has been associated with risk for chronic conditions and ultimately, premature mortality. The present study examined the effects of ever witnessing domestic violence on sleep among urban neighborhoods of color.Design:Cross-sectional.Setting:Ten of Chicago’s 77 community areas.Participants:Adults, aged 18 years and older (N = 1,543, Response Rate = 28.4%). Over 49% of participants reported a Hispanic ethnicity, 34.8 percent reported being non-Hispanic Black and 14.2 percent reported being White.Measures:We used the Sinai Community Health Survey, 2.0, to examine: average hours of sleep in a 24-hour period, ever witnessing domestic violence, ever being emotionally or physically abused, frequent stress in the past 12 months, and other key covariates (race and ethnicity, annual household income, sex, and health status).Analysis:Multivariate logistic regression.Results:In the full model, participants who reported witnessing domestic violence were significantly less likely to report meeting sleep recommendations even after controlling for ever being emotionally or physically abused, frequently feeling stress, demographic factors, and health status. Non-Hispanic Blacks were most likely to report not meeting sleep recommendations (OR = .54, 95% CI = .30-.96, P = .036).Conclusion:Witnessing domestic violence contributes to not meeting sleep recommendations and this appears to be most salient for Non-Hispanic Blacks. These point-in-time findings document an important potential contributor to racial health disparities.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-10T08:52:29Z
  DOI: 10.1177/08901171211038474
Sense of Purpose in Life and Subsequent Physical, Behavioral, and
Psychosocial Health: An Outcome-Wide Approach
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  Authors: Eric S. Kim, Ying Chen, Julia S. Nakamura, Carol D. Ryff, Tyler J. VanderWeele
  First page: 137
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:Growing evidence indicates that a higher sense of purpose in life (purpose) is associated with reduced risk of chronic diseases and mortality. However, epidemiological studies have not evaluated if change in purpose is associated with subsequent health and well-being outcomes.Design:We evaluated if positive change in purpose (between t0; 2006/2008 and t1;2010/2012) was associated with better outcomes on 35 indicators of physical health, health behaviors, and psychosocial well-being (at t2;2014/2016).Sample:We used data from 12,998 participants in the Health and Retirement study—a prospective and nationally representative cohort of U.S. adults aged>50.Analysis:We conducted multiple linear-, logistic-, and generalized linear regressions.Results:Over the 4-year follow-up period, people with the highest (versus lowest) purpose had better subsequent physical health outcomes (e.g., 46% reduced risk of mortality (95% CI [0.44, 0.66])), health behaviors (e.g., 13% reduced risk of sleep problems (95% CI [0.77, 0.99])), and psychosocial outcomes (e.g., higher optimism (β = 0.41, 95% CI [0.35, 0.47]), 43% reduced risk of depression (95% CI [0.46, 0.69]), lower loneliness (β = −0.35, 95% CI [−0.41, −0.29])). Importantly, however, purpose was not associated with other physical health outcomes, health behaviors, and social factors.Conclusion:With further research, these results suggest that sense of purpose might be a valuable target for innovative policy and intervention work aimed at improving health and well-being.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-18T09:03:33Z
  DOI: 10.1177/08901171211038545
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
  First page: 148
  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
Revitalizing HIV Prevention Programs: Recommendations From Those Most
Impacted by the HIV in the Deep South
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  Authors: Michelle S. Williams, Tonia Poteat, Melverta Bender, Precious Ugwu, Paul A. Burns
  First page: 155
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:The incidence of new HIV infections is disproportionately high among Black men who have sex with men (BMSM) in Mississippi. Community-based organizations received funding through the ACCELERATE! initiative to implement interventions aimed at increasing BMSM’s access to HIV prevention, treatment and care interventions.Approach:We conducted a mixed methods evaluation of the ACCELERATE! initiative to assess its impact. We also explored factors that act as barriers to and facilitators of BMSM’s engagement in HIV prevention interventions.Setting:Interviews were conducted between July 2018 and February 2020.Participants:Thirty-six BMSM and 13 non-grantee key informants who worked in the field of HIV in Mississippi participated.Method:The qualitative data from the interview transcripts was analyzed using an iterative, inductive coding process.Results:We identified 10 key recommendations that were most common across all participants and that were aligned with UNAIDS Global AIDS Strategy strategic priorities. Several recommendations address the reduction of HIV- and LGBT-stigma. Two of the most common recommendations were to increase representation of the target population in health promotion program leadership and to include HIV with other Black health issues in community-based health education programs rather than singling it out. Another recommendation called for programs aimed at addressing underlying factors associated with HIV-risk behaviors, such as mental illness.Conclusion:Our results indicate that HIV education interventions in the Deep South need to be revitalized to enhance their reach and effectiveness.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-19T09:32:39Z
  DOI: 10.1177/08901171211041097
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
  First page: 165
  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
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
  First page: 169
  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
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
  First page: 175
  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
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
  First page: 180
  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
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
  First page: 185
  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
Stressful Life Events and Obesity in the United States: The Role of
Nativity and Length of Residence
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  Authors: Adolfo G. Cuevas, Michael V. Stanton, Keri Carvalho, Natalie Eckert, Kasim Ortiz, Shervin Assari, Yusuf Ransome
  First page: 190
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:Obesity is a public health issue in the United States (US), that disproportionately affects marginalized group members. Stressful life events (SLE) have been implicated as an obesogenic risk factor. However, there is scant research examining of the role of nativity status and length of residence in the relationship between SLE and obesity.Design:Cross-sectional survey.Setting:Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.Sample:A total of 34,653 participants were included in these analyses, of whom 10,169 (29.39%) had obesity.Measures:Obesity (measured using body mass index), stressful life events, race/ethnicity, gender, educational attainment, family income, marital status, current smoking status, and alcohol abuse.Analysis:Weighted logistic regression analysis.Results:A total of 10,169 (29.39%) had obesity. There was a significant interaction between SLE and nativity status/length of residence [F (3, 34,642) = 60.50, p < 0.01]. Based on stratified analyses, SLE were associated with greater odds of obesity for US-born individuals (OR = 1.07; 95% CI [1.05, 1.08]) and foreign-born individuals living in the US for ≥ 20 years (OR = 1.17; 95% CI [1.10, 1.25]). There was no evidence that SLE were associated with greater odds of obesity for foreign-born individuals living in the US 20 years. Further research is needed to understand the pathways that may link SLE to obesity among these groups.
  Citation: American Journal of Health Promotion
  PubDate: 2021-07-26T09:25:40Z
  DOI: 10.1177/08901171211034410
Characteristics Associated With Self-Reported Worry Among Adults About
Food Availability and Food Safety During the COVID-19 Pandemic—United
States, June 2020 Survey Data
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  Authors: Brianna L. Dumas, Seung Hee Lee, Diane M. Harris, Amy L. Yaroch, Mary A. Pomeroy, Heidi M. Blanck
  First page: 194
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:During a pandemic, persons might experience worry because of threats (real or perceived), or as part of stress-related reactions. We aimed to provide insight into Americans’ worry about food during COVID-19. Design, Subjects, Measures: Online survey data from June 2020 (n = 4,053 U.S. adults; 62.7% response rate) was used to assess 2 outcomes: worry about food availability (FA); food safety (FS). Adults with missing information about FA and FS were excluded from analysis (final n = 3,652).Analysis:We used descriptive statistics and multivariable logistic regression to examine characteristics associated with the outcomes and estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) for associations between sociodemographic variables and outcomes.Results:58.3% of respondents reported worry about FA; 57.5% about FS, with higher odds of worry for FA and FS (versus referents) in lower income households (FA: aOR = 1.76 95%CI [1.30, 2.39]; FS: 1.84[1.35, 2.51]); unemployed (1.54[1.05, 2.28]; 1.90[1.26,2.81]); non-Hispanic Black (1.55[1.14,2.12]); 2.25[1.65,3.07]); Hispanic (1.39[1.06,1.82]; 1.94[1.46,2.56]).Conclusion:Findings highlight the importance of strategies to reduce consumer worry about FA and FS and negative food behaviors, and the need for continued access to hunger safety net programs, which could have positive effects on nutrition security.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-10T08:37:27Z
  DOI: 10.1177/08901171211039499
Understanding Physical Activity Patterns Across the School Day in Urban
Pre-Kindergarten and Elementary Schoolchildren
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  Authors: Jennifer M. Sacheck, Emily F. Blake, Hannah Press, Qiushi Huang, Catherine M. Wright, Karina R. Lora, Allison C. Sylvetsky, Amanda J. Visek, Loretta DiPietro
  First page: 197
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Purpose:Despite recommendations that children accrue ≥60 min/day of moderate-to-vigorous physical activity (MVPA), numerous barriers may exist. We examined school-day MVPA patterns in lower-income children (pre-K to 5th grade) to determine whether they were meeting the minimum school-day guidelines of at least 30-min/day of MVPA and to identify opportunities for intervention.Methods:Students (N = 629, pre-K-5th grade) from 4 urban schools wore Actigraph GT3X+ accelerometers over 2 school days. Mixed effects models evaluated sex- and grade-specific differences in MVPA and sedentary time.Results:Only 34.6% of elementary and 25.3% of pre-K students met the school-time MVPA recommendation. Among elementary-aged children, boys accrued more MVPA than girls (30.8 ± 13.3 vs. 23.5 ± 10.7 min/day; p < 0.0001) with similar sex differences observed among pre-K children (51.3 ± 17.1 vs 41.9 ± 17.5 min/day; p < 0.001). Sedentary time also increased significantly with grade among elementary-aged children (207.9 ± 34.7 vs. 252.0 ± 36.1 min/day for those in 1st and 5th grade, respectively; p < 0.001), with girls accruing more sedentary time than boys (242.5 ± 48.2 vs. 233.8 ± 46.8 min/day; p < 0.0001).Conclusion:MVPA declines across elementary school years, with sex disparities observed as early as pre-K. Extended sedentary bouts and clustering of activity highlight opportunities for more movement throughout the school day.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-13T09:02:37Z
  DOI: 10.1177/08901171211039503
Assessing the Impact of Online Health Education Interventions From
2010-2020: A Systematic Review of the Evidence
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  Authors: Suzi B. Claflin, Shannon Klekociuk, Hannah Fair, Emmanuelle Bostock, Maree Farrow, Kathleen Doherty, Bruce V. Taylor
  First page: 201
  Abstract: American Journal of Health Promotion, Ahead of Print.
  Objective:Systematically review the evaluation and impact of online health education interventions: assess approaches used, summarize main findings, and identify knowledge gaps.Data Source:We searched the following databases: EMBASE, ERIC, MEDLINE, and Web of Science.Study Inclusion and Exclusion Criteria:Studies were included if (a) published in English between 2010-2020 in a peer-reviewed journal (b) reported an online health education intervention aimed at consumers, caregivers, and the public (c) evaluated implementation OR participant outcomes (d) included ≥ 100 participants per study arm.Data Extraction:Two authors extracted data using a standardized form.Data Synthesis:Data synthesis was structured around the primary outcomes of the included studies.Results:26 studies met the inclusion criteria. We found substantial heterogeneity in study population, design, intervention, and primary outcomes, and significant methodological issues that resulted in moderate to high risk of bias. Overall, interventions that were available to all (e.g., on YouTube) consistently attained a large global reach, and knowledge was consistently improved. However, the impact on other outcomes of interest (e.g., health literacy, health behaviors) remains unclear.Conclusion:Evidence around the impacts of the type of online health education interventions assessed in this review is sparse. A greater understanding of who online interventions work for and what outcomes can be achieved is crucial to determine, and potentially expand, their place in health education.
  Citation: American Journal of Health Promotion
  PubDate: 2021-08-12T09:44:37Z
  DOI: 10.1177/08901171211039308