Hybrid journal (It can contain Open Access articles) ISSN (Print) 0957-4824 - ISSN (Online) 1460-2245 Published by Oxford University Press[425 journals]
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First page: daad036 Abstract: SummaryTo inform public health policy implementation in Australia, our study investigated the level of public support for six policy initiatives addressing unhealthy diet. The policy initiatives included taxing soft drinks and energy drinks, taxing less healthy food and beverage purchases, zoning to restrict the supply of junk foods near schools, prohibiting advertising and promotion of less healthy food and beverages to children under the age of 16 and restricting sugar-sweetened beverages from vending machines in schools, and public places. Data from a cross-sectional population-based study for 4040 Australians aged 15+ years, were analysed. A high overall support across all policy initiatives was observed. Nearly three-quarter of public support was observed for policy initiatives targeting children (zoning to restrict the supply of junk food near schools, prohibiting advertising and promotion of less healthy food and beverages to children under the age of 16 and restricting sugars-sweetened beverages from vending machines in schools), and half of Australians supported policy initiatives of taxing soft drinks and energy drinks and taxing less healthy food and beverage purchases. Australian women and those with tertiary level of education were more likely to support public health initiatives targeting children and all policy initiatives respectively. Interestingly, young adults expressed low level of support for all policy initiatives. The study demonstrated considerable public support for policy initiatives focussed on protecting children from unhealthy diet in Australia. Framing, designing and implementing policies targeting children is potentially a good starting point for policymakers to create a health promoting food environment. PubDate: Mon, 22 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad036 Issue No:Vol. 38, No. 3 (2023)
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First page: daad047 Abstract: SummaryTobacco smoking uptake is still a major public health concern, especially among youngsters living in vulnerable situations. Finding optimal ways to engage youngsters in smoking prevention is important. Compared to traditional settings such as schools, social work settings providing sports-based and recreational activities (SR-settings) tend to reach and engage youngsters more. This study aimed to gain insight into the reasons for smoking uptake among youngsters living in vulnerable situations and the conditions through which SR-settings are potentially beneficial for smoking prevention initiatives. Data were collected in two SR-settings in Flanders, Belgium, by means of five focus group discussions and six individual interviews with youngsters (n = 38, mean age = 12.9 ± 2.61 years, 69.7% boys) and eight individual interviews with youth workers (n = 8, mean age = 27.5 ± 7.95 years, 87.5% men). A thematic analysis (TA) approach was applied to analyse the data. Besides individual factors, such as attitudes towards smoking, the desire to be part of a group and conformity to group norms seem to be important drivers of smoking uptake among youngsters in vulnerable situations. The presence of powerful role models in SR-settings with whom youngsters identify may counteract group norms by encouraging healthy behaviour. SR-settings seem suitable for questioning perceptions of vulnerable youngsters, unlike other settings where they may struggle to be heard. The conditional characteristics of SR-settings, such as authentic group processes, having meaningful roles, and being heard, make these contexts promising venues for smoking prevention efforts among vulnerable youngsters. Youth workers who have established trusting relationships with youngsters seem well-suited to communicate smoking prevention messages. A participatory approach, in which youngsters are involved in developing smoking prevention programs, is desirable. PubDate: Thu, 18 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad047 Issue No:Vol. 38, No. 3 (2023)
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First page: daad023 Abstract: African Americans living in low socioeconomic circumstances are at high risk of poor health outcomes; this is particularly true for those with hypertension. Many African Americans with chronic hypertension living in the rural impoverished Southeastern USA have low health literacy and are socially isolated. These factors are known to have a negative impact on health outcomes, but it is possible that social support may overcome some of the effect of low health literacy. Since little has been reported about this association, we examined the association between social functioning and health literacy in a rural African American population in the Southeast USA. We used baseline data from participants in the Southeastern Collaboration to Improve Blood Pressure Control, a pragmatic trial that recruited rural African Americans with persistently uncontrolled hypertension and collected survey data. Overall, 33.5% of the 1221 person sample reported social isolation, 26.0% reported low instrumental support, 36.0% reported low emotional support, and 63.4% had inadequate health literacy. All three domains of low social functioning were significantly associated with low health literacy, and this effect was robust to multivariable adjustment for sociodemographics and cognitive functioning for social isolation (adjusted odds ratio 1.62, 95% confidence intervals 1.20–2.20). In conclusion, the majority of this sample living in the NC and AL Black Belt had high social functioning but inadequate health literacy. Tests of interventions to improve social support, especially social isolation, may be warranted to overcome low health literacy in this high-risk rural population. PubDate: Mon, 15 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad023 Issue No:Vol. 38, No. 3 (2023)
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First page: daad039 Abstract: SummaryPhysical activity programs run by local government, public health and not-for-profit sectors are a key public health strategy for improving rates of physical activity within local communities. However, these programs are underutilized. This is especially the case among members of refugee-background communities whose participation could have far-ranging and multilevel benefits. To explore how greater engagement among refugee-background communities with these programs could be fostered in Brisbane, Queensland, Australia, a qualitative study was undertaken from the perspectives of both community-based physical activity program providers and agencies involved in delivering services to refugee-background communities. This study involved a series of semi-structured interviews with a purposive sample of personnel from agencies that work with individuals and families from refugee-background communities and organizations that provide low-cost or no-cost physical activity programs and initiatives. Reflexive thematic analysis was used to interpret meaning from these data. Three themes relating to how participation in community-based physical activity programs could be improved among refugee-background communities were identified: improving cultural safety through intersectoral collaboration; confronting constraints imposed by the broader public health policy environment; and building capacity and empowering the community to diversify the sector. The findings highlight the importance of localized, deep-level intersectoral collaborations in bridging the gap between the health and social care needs of refugee-background communities and existing physical activity programs. However, a range of systems-produced barriers to the creation of such collaborations must be addressed to enable local actors to help mitigate and address the systemic exclusion of marginalized populations from participation in broader society. PubDate: Mon, 15 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad039 Issue No:Vol. 38, No. 3 (2023)
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First page: daad028 Abstract: This study aimed to exhaustively explore the characteristics of food advertising on TV in Guatemala and Costa Rica. The International Network for Food and Obesity Non-Communicable Diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) methodology was applied. In 2016, we recorded 1440 h of video among 10 TV channels. We used the Pan American Health Organization (PAHO) Nutrient Profile (NP) Model to identify ‘critical nutrients’, whose excessive consumption is associated with NCDs. We created a nutritional quality score (0 if the product did not exceed any critical nutrient, 1 if the product exceeded one and 2 if it exceeded ≥2). We classified food ads as permitted (score = 0) and not-permitted (score 1 or 2) for marketing. Persuasive marketing techniques were classified as promotional characters (e.g. Batman), premium offers (e.g. toys), brand benefit claims (e.g. tasty) and health-related claims (e.g. nutritious). In Guatemala, foods that exceeded one critical nutrient were more likely to use persuasive marketing techniques, and in Costa Rica were those with an excess of ≥2 critical nutrients, compared with foods without any excess in critical nutrients [Guatemala: promotional characters (odds ratio, OR = 16.6, 95% confidence interval, CI: 5.8, 47.3), premium offers (OR = 3.4, 95% CI: 1.4, 8.2) and health-related claims (OR = 3.5, 95% CI: 2.2, 5.7); Costa Rica: health-related claims (OR = 4.2, 95% CI: 2.0, 8.5)]. In conclusion, Guatemalan and Costa Rican children are exposed to an overabundance of not-permitted food ads on TV. This justifies implementing national policies to reduce exposure to not-permitted food for marketing, including on TV and other media. PubDate: Mon, 15 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad028 Issue No:Vol. 38, No. 3 (2023)
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First page: daad045 Abstract: Community-based health promotion has the potential to address existing health inequities, although such approaches are scarcely scaled up. For a successful scale up, various stakeholders at different levels and sectors need to be involved. The article’s aims are to assess what kind of external support communities need for implementation and to identify facilitators and barriers for scaling up community-based health promotion. Two national digital workshops were conducted in Germany with stakeholders at the community level (n = 161) and with stakeholders at the federal and state levels (n = 84). Protocols were compiled and coded using qualitative content analysis. During the first workshop, we revealed 11 themes for external support needs (‘Strategic approach’, ‘Define & compare indicators’, ‘International human resource’, ‘Tools & Aids’, ‘External conduction of the assessment’, ‘Involvement of people in difficult life situations’, ‘Overview of actors’, ‘Moderation’, ‘Obtain funding’, ‘Quality assurance/evaluation’ and ‘External support’). Eleven facilitators and barriers were identified for scaling up (‘Assessment and evaluation’, ‘Intersectoral collaboration and partnerships’, ‘Communication’, ‘Characteristics of the program’, ‘Political and legal conditions’, ‘Political support’, ‘Local coordinator’, ‘Resources’, ‘Participation’, ‘Strategic planning/methods’ and ‘Intermediary organization’). The identified results provide practice-based evidence on support needed for scaling up, facilitators that promote scaling up and barriers that might hinder scaling up community-based health promotion in Germany. In a next step, this practice-based evidence needs to be systematically integrated with scientific-based evidence on key components for scaling up such approaches for the development of an effective scaling-up concept. PubDate: Thu, 04 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad045 Issue No:Vol. 38, No. 3 (2023)
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First page: daad041 Abstract: Little is known about the role of WhatsApp in spreading misinformation during the start of the COVID-19 pandemic in Mexico. The aim of this study is to analyze the message content, format, authorship, time trends and social media distribution channels of misinformation in WhatsApp messages in Mexico. From March 18 to June 30, 2020 the authors collected all WhatsApp messages received via their personal contacts and their social networks that contained information about COVID-19. Descriptive and inferential statistics were used to analyze the scientifically inaccurate messages and the relationship between variables, respectively. Google image and video searches were carried out to identify sharing on other social media. Out of a total of 106 messages, the most frequently mentioned COVID-19 related message topics were prevention (20.0%), conspiracy (18.5%), therapy (15.4%) and origin of the virus (10.3%), changing throughout the pandemic according to users’ concerns. Half of all WhatsApp messages were either images or videos. WhatsApp images were also shared on Facebook (80%) and YouTube (~50%). Our findings indicate that the design of information and health promotion campaigns requires to be proactive in adapting to the changes in message content and format of misinformation shared through encrypted social media. PubDate: Thu, 04 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad041 Issue No:Vol. 38, No. 3 (2023)
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First page: daad044 Abstract: Limited research has examined the components of retirement planning and the effects on retirees’ health behaviors. This study aims to explore whether retirement planning is associated with different types of healthy lifestyles after retirement. We conducted a nationwide Health and Retirement Survey in Taiwan and analyzed the data from 2015 to 2016. A total of 3128 retirees aged 50–74 years were included in the analysis. Twenty items on retirement planning from five categories were administered, and 20 health-related behaviors were used for measuring healthy lifestyles. Results showed that five types of healthy lifestyles were found from the 20 health behaviors by factor analysis. After controlling for all covariates, various components of retirement planning were associated with different types of lifestyles. Retirees having any item of retirement planning would significantly increase the score of ‘healthy living’. Those with 1–2 items were also associated with the total score and the type of ‘no unhealthy food’. However, those with ≥ 6 items were the only group positively related to the type of ‘regular health checkups’ but negatively to the type of ‘good medication’. In conclusion, retirement planning offers a ‘window of opportunity’ for promoting healthy lifestyles after retirement. Pre-retirement planning should be advocated in the workplace to improve health-related behaviors, especially for those upcoming retired workers. In addition, a friendly environment and continuous programs should also be incorporated for better retirement life. PubDate: Thu, 04 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad044 Issue No:Vol. 38, No. 3 (2023)
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First page: daad038 Abstract: Physical activity (PA) is recognized as essential for positive physical and mental well-being in young people. However, participation in PA is known to decline as adolescents emerge into adulthood under the influence of complex social and structural factors. Globally, COVID-19 restrictions resulted in changes to PA and PA participation levels in youth populations, providing a unique opportunity for gaining insight into PA barriers and enablers in circumstances of challenge, limitation and change. This article details young people’s self-reported PA behaviours during the 4-week 2020 COVID-19 lockdown in New Zealand. Taking a strengths-based view and drawing on the COM-B (capabilities, opportunity and motivation behaviour) model for behaviour change, the study explores factors enabling young people to sustain or increase PA during lockdown. Findings are drawn from qualitative-dominant mixed-methods analyses of responses to an online questionnaire: New Zealand Youth Voices Matter (16–24 years; N = 2014). Key insights included the importance of habit and routine, time and flexibility, social connections, incidental exercise and awareness of links between PA and well-being. Of note were the positive attitudes, creativity and resiliency demonstrated as young people substituted or invented alternatives to their usual PA. PA needs to change to adapt to new circumstances over the life course, and youth understanding and knowledge of modifiable factors may provide support for this. Thus these findings have implications for sustaining PA during late adolescence and emerging adulthood, a life phase that can be associated with significant challenge and change. PubDate: Thu, 04 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad038 Issue No:Vol. 38, No. 3 (2023)
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First page: daad037 Abstract: SummaryHealth literacy (HL) is an essential component of public health. Few tools are used to measure HL in Arabic-speaking countries, essentially the Short Test of Functional Health Literacy in Adults and the Single Item Literacy Screener. The new 12-item version of the European Health Literacy Survey Questionnaire (HLS-Q12), has not been validated in the Arabic language. This study aimed to translate the English version of HLS-Q12 into Arabic, test its structure and explain any variance in HLS-Q12 scores, allowing its use in Arabic-speaking healthcare contexts. A forward–backward translation was adopted. Reliability was assessed using Cronbach’s α. Confirmatory factor analysis (CFA) and Rasch Model evaluated the model fit of the Arabic version of HLS-12. The effects of different patient-related variables on HLS-Q12 scores were tested using linear regression. A total of 389 patients visiting the site hospital outpatient clinics participated in the study. HLS-Q12 mean ± SD score was 35.8 ± 5.0, 50.9% of the participants showed an intermediate HL score. Good reliability (α = 0.832) was observed. CFA confirmed the scale unidimensionality. Rasch analysis indicated HLS-Q12 items to be within the fit acceptable thresholds except for Item 12. The only item that displayed unordered response categories was Item 4. Most of the items were considered relatively easy by respondents. Linear regression revealed age, education, healthcare-related education and income to have effects significantly different from zero on HLS-Q12 score. Interventions targeting the most health-disparate groups of individuals with characteristics contributing to lower HL, are needed. PubDate: Wed, 03 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad037 Issue No:Vol. 38, No. 3 (2023)
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First page: daad024 Abstract: SummaryTechnology-based platforms are widely used to deliver mental health support. The aim of this study was to explore factors associated with the use of technology-based mental health platforms by students who may be vulnerable to develop a mental health condition in an Australian psychology student sample. Participants were 1146 students (18–30 years) at an Australian university who completed a survey regarding their current mental health symptoms and lifetime use of technology-based platforms. The student’s country of birth, having a previous mental health diagnosis, having a family member with a mental illness and greater stress scores predicted any type of online/technology-use. Greater symptoms correlated with lower helpfulness of online mental health programs and websites. Apps were perceived as more helpful by those with a mental illness history and associated with higher stress scores. The use of any type of technology-based platform was high in the sample overall. Further research may clarify why mental health programs are less popular, and how these platforms may be utilised to support mental health outcomes. PubDate: Wed, 03 May 2023 00:00:00 GMT DOI: 10.1093/heapro/daad024 Issue No:Vol. 38, No. 3 (2023)