Determinants of health-promoting lifestyle behaviors in rural older women

Effects of middle-aged and elderly people's self-efficacy on health promotion behaviors: Mediating effects of sports participation

Objective

This study explores the relationship between self-efficacy, sports participation, and health promotion behavior for middle-aged and elderly people. Therefore, it provides a theoretical reference for improving the quality of life for middle-aged and elderly adults and promoting a healthy lifestyle for the elderly.

Methods

A total of 591 (men: 36.2%; women: 63.8%; age: above 50 years) middle-aged and elderly adults from five cities of Henan Province were selected as the research objects by convenient sampling. The self-efficacy, sports participation, and health promotion behavior scales were used for the questionnaire survey. Amos24.0 was used to test the structural equation model, intermediary function test, and bootstrap analysis. Results: The self-efficacy of middle-aged and elderly people positively impacted health promotion behavior. The path coefficient was 0.439. Sports participation played a partial intermediary role between self-efficacy and health promotion behavior (χ 2/df = 1.785, root mean square error of approximation = 0.036, root mean square residual = 0.021, goodness-of-fit index = 0.967, comparative fit index = 0.976, Tucker-Lewis Index = 0.971) The proportion of intermediary effect was 26.34% (0.100, 0.225).

Conclusion

(1) Self-efficacy can significantly and positively affect health promotion behavior for middle-aged and elderly people; (2) sports participation plays a partial intermediary role between self-efficacy and health promotion behavior. From this point of view, we can enhance the self-efficacy of middle-aged and elderly people and improve their healthy life behavior by advancing sports participation. Thus, it provides theoretical support and practical guidance for promoting national health.

A Comparison between Healthy Lifestyle Behaviors and Physical Activity Levels of Elderly İndividuals Residing in the City Center and Rural, and Analyzing Their Relationship with Depression

ABSTRACT Purpose: Our study aimed to determine the differences in the levels of physical activity and healthy lifestyle behaviours in elderly individuals living in urban and rural and to examine their relationship with depression. Methods: Individuals who are over 65 and residing in the city and rural were included in the study. The Healthy Lifestyle Behaviour’s Scale-II, the Physical Activity Scale for the Elderly, and the Geriatric Depression Scale-15 were used on the participants Results: Healthy Lifestyle Behaviour’s Scale-II scores was no significant difference between the two groups (p=0.430). Physical Activity Scale for the Elderly score in rural (p= 0.001); Geriatric Depression Scale-15 score was statistically higher in the city (p= 0.01). While the relationship between the Healthy Lifestyle Behaviour’s Scale-II and Geriatric Depression Scale-15 scores was significant in both groups (p= 0.001 and p= 0.03), the relationship between the Elderly Physical Activity Scale-II and Geriatric Depression Scale-15 scores was significant only in the rural (p= 0.001). Conclusion: The elderly individuals in rural are more physically active than in city, the elderly living in city have higher depression levels. The factors affecting depression in the elderly living in cities need to be examined in detail.

Effect of positive event recording based on positive psychology on healthy behaviors and readmission rate of patients after PCI: a study protocol for a prospective, randomized controlled trial

BACKGROUND

Unhealthy behaviors of coronary heart disease (CHD) patients are closely related to the occurrence of major heart events, which increases the readmission rate and brings a heavy economic burden to families and society. Therefore, it is necessary for health care workers to take active preventive and therapeutic measures to keep or establish healthy behaviors of patients. Positive psychological intervention has been proved to be effective, but it has not been reported in the field of CHD in China. The purpose of this study is to explore the effects of positive event recording based on positive psychology on the healthy behaviors, readmission rate, and anxiety of patients with CHD, in order to provide new ideas for the development of secondary prevention strategies for CHD.

METHODS

This is a prospective, single-center, randomized controlled trial (RCT). The subjects will be enrolled from the Department of Cardiology, the First Affiliated Hospital of Soochow University. There are 80 cases in total; according to the random number table, the subjects are randomly divided into the intervention group (n = 40) and the control group (n = 40). The patients in the intervention group will receive the intervention of recording positive events once a week for 3 months, while the patients in the control group receive conventional nursing. The primary outcomes will include healthy behaviors, readmission rate, and anxiety, and the secondary outcomes will include psychological capital, subjective well-being, and corresponding clinical laboratory indicators. The protocol was approved by the Medical Ethics Committee of Soochow University (approval no. SUDA20200604H01) and is performed in strict accordance with the Declaration of Helsinki formulated by the World Medical Association. All participants provide written informed consent.

DISCUSSION

This study will verify whether positive event recording based on positive psychology can make patients maintain healthy behaviors, reduce readmission rate, and improve anxiety after PCI. Then, this study will provide new ideas and references for the development of secondary prevention strategies for patients with CHD.

TRIAL REGISTRATION

Chinese Clinical Trials Registry 2000034538. Registered on 10 July 2020.

Lifestyle, Demographic and Socio-Economic Determinants of Mental Health Disorders of Employees in the European Countries

Ensuring the health and well-being of workers should be a top priority for employers and governments. The aim of the article is to evaluate and rank the importance of mental health determinants: lifestyle, demographic factors and socio-economic status. The research study is based on EHIS 2013-2015 data for a sample of N = 140,791 employees from 30 European countries. The results obtained using machine learning techniques such as gradient-boosted trees and SHAPley values show that the mental health of European employees is strongly determined by the BMI, age and social support from close people. The next vital features are alcohol consumption, an unmet need for health care and sports activity, followed by the affordability of medicine or treatment, income and occupation. The wide range of variables clearly indicates that there is an important role for governments to play in order to minimize the risk of mental disorders across various socio-economic groups. It is also a signal for businesses to help boost the mental health of their employees by creating holistic, mentally friendly working conditions, such as offering time-management training, implementing morning briefings, offering quiet areas, making employees feel valued, educating them about depression and burnout symptoms, and promoting a healthy lifestyle.

Lifestyle and Self-Perceived Quality of Life in Sports Students: A Case Study

Adolescence has been considered a crucial stage for the adoption of healthy habits such as physical activity. In addition, numerous research studies have shown that physical activity is a positive factor for health behaviors and quality of life. In this sense, the aim of this study was to examine the relationship between physical activity levels and perceived quality of life in a sample of students studying physical activity and sport. This is a descriptive observational study with a population of physical activity and sports students from the San Pablo High School in Seville, Spain. The participants (N = 86), with a mean age of 18.56 ± 1.88 years, were pursuing professional qualifications in Physical Activity and Sport. They were administered the short version of the International Physical Activity Questionnaire (IPAQ-SF) and the SF-36 questionnaire on perceived health status. For data analysis, a correlation analysis (Spearman’s rho) was performed. The results indicate that students attending sports-related vocational training programs engaged in more physical activity (96.9%) than the population average suggested by the World Health Organization (20%). In addition, a direct relationship was shown between participating in physical activity and perceived health. Depending on the intensity of the physical activity, students found less physical interference (IPAQ Vigorous—Physical Function (rho = 0.252; p = 0.019); IPAQ Sedentary—Bodily Pain (rho = 0. 223; p < 0.039); IPAQ Total—Physical Function (rho = 0.256; p = 0.018)) and emotional interference (IPAQ Moderate—Emotional Role (rho = 0.237; p = 0.028)) when performing exercise or activities of daily life; therefore, physical activity appears to be beneficial for self-perception of quality of life.

Factors Affecting Health-Promoting Lifestyle Among Older Women With Chronic Disease

The current cross-sectional descriptive study applies the Health Promotion Model to explore associations among sociodemographics, psychological factors (self-esteem), self-efficacy, perceptions of current health, and social support affecting older women with at least one chronic disease in South Korea. Convenience sampling of 232 older women aged ≥65 from a welfare center in South Korea showed that a health-promoting lifestyle is significantly and positively correlated with self-esteem, self-efficacy, perception of current health, and social support. Multiple regression analysis revealed that social support had the greatest effect on health-promoting lifestyle, explaining 49% of the dependent variable variance. Nurses serve a crucial role in providing care for older women by helping them within community settings to find resources for senior fitness, encouraging them to pursue health-related habits, and strengthening support systems by encouraging participation in social activities and maintaining strong relationships and interactions with family and friends. [Journal of Gerontological Nursing, 45(10), 29-38.].

Health-related quality of life and associated factors in patients with myocardial infarction after returning to work: a cross-sectional study

BACKGROUND

Return to work following myocardial infarction (MI) represents an important indicator of recovery. However, MI can cause patients to feel pressure, loneliness and inferiority during work and even detachment from employment after returning to work, which may affect their quality of life. The aims of this study were to identify the influencing factors of Health-related quality of life (HRQoL) in patients with MI after returning to work and explore the correlations between these factors and HRQoL.

METHOD

This was a cross-sectional study. All participants were recruited from tertiary hospitals in China from October 2017 to March 2018. The general data questionnaire, Short-Form Health Survey-8 (SF-8), Health Promoting Lifestyle ProfileII (HPLPII), Medical Coping Modes Questionnaire (MCMQ) and Social Supporting Rating Scale (SSRS) were used to assess 326 patients with myocardial infarction returned to work after discharge. Multiple linear regression analysis was performed to explore factors related to HRQoL in patients with MI after returning to work.

RESULTS

The sample consisted of 326 patients. The mean total score of quality of life was 28.03 ± 2.554. According to the multiple linear regression analysis, next factors were associated with better HRQoL: younger age (B = - 0.354, P = 0.039), higher income (B = 0.513, P = 0.000), less co-morbidity (B = - 0.440, P = 0.000), the longer time taken to return to work (B = 0.235, P = 0.003), fewer stents installed (B = - 0.359, P = 0.003), participation in cardiac rehabilitation (CR) (B = - 1.777, P = 0.000), complete CR (B = - 1.409, P = 0.000), better health behaviors such as more health responsibility (B = 0.172, P = 0.000) and exercise (B = 0.165, P = 0.000), better nutrition (B = 0.178, P = 0.000) and self-realization (B = 0.165, P = 0.000), stress response (B = 0.172, P = 0.000), more social support such as more objective support (B = 0.175, P = 0.000), subjective support (B = 0.167, P = 0.000) and better utilization of social support (B = 0.189, P = 0.028), positive copping strategies such as more coping (B = 0.133, P = 0.000) and less yield (B = - 0.165, P = 0.000).

CONCLUSIONS

HRQoL of MI patients after returning to work is not satisfactory. Health behavior, coping strategies, social support are factors which can affect HRQoL. A comprehensive and targeted guide may be a way to improve HRQoL and to assist patients' successful return to society.

Determining Middle-Aged and Older Adults' Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction

BACKGROUND

Global population is getting older and the prevalence of dementia continuously increases. Understanding the related health beliefs is bound to enable lifestyle-based interventions that maximize public engagement in dementia risk reduction behaviors. The aim of this study was to determine health beliefs on dementia prevention behaviors and lifestyle changes and to determine the factors influencing these beliefs among middle-aged and older people in Turkey.

MATERIALS AND METHODS

This descriptive and cross-sectional study was conducted with 284 individuals aged 40 years and older, using nonprobability convenience sampling. Data were collected using a demographic characteristic form and the Turkish version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia scale. The study utilized the value, mean, percentage frequency distribution, correlation, independent t test, and the one-way analysis of variance test.

RESULTS

The mean age of the participants included in the study was 56.99 ± 12.05, 68.7% of individuals were males. The mean education years of the participants were 11.22 ± 4.55. The majority (72.2%) of participants expressed subjective memory complaints. Presence of family history of dementia was 28.2%. Age, gender, education years, subjective memory complaints, presence family history of dementia, prior experience as a caregiver of dementia, and willingness to know their own risk were determined as essential factors that influence several health belief factors related to dementia risk reduction.

CONCLUSION

Our findings indicate that males, older adults, and lower-educated and income are priority groups that should be guided for lifestyle and behavioral changes regarding dementia risk reduction.

Health Behavior Change and Complementary Medicine Use: National Health Interview Survey 2012

Background and objectives: Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients' health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods: This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results: Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more regularly (34.9%), eating healthier (31.4%), eating more organic foods (17.2%), reducing/stopping smoking (16.6% of smokers), or reducing/stopping drinking alcohol (8.7% of drinkers). Individual CAM therapies motivated positive health behavior changes in 22% (massage) to 81% (special diets) of users. People were more likely to report being motivated to change health behaviors if they were: aged 18-64 compared to those aged over 65 years; of female gender; not in a relationship; of Hispanic or Black ethnicity, compared to White; reporting at least college education, compared to people with less than high school education; without health insurance. Conclusions: A sizeable proportion of respondents were motivated by their CAM use to undertake health behavior changes. CAM practices and practitioners could help improve patients' health behavior and have potentially significant implications for public health and preventive medicine initiatives; this warrants further research attention.

Determining health-promoting behavior in smokers preparing to quit: a holistic and personalized approach

Background

Smoking cessation practices enable health professionals to identify lifestyle of their patients as an initial step to achieve predictive, preventive, and personalized medicine (PPPM). In this study, we aimed to investigate the relationship between the smoking habit and health-promoting behavior of patients who planned to quit smoking.

Methods

In this descriptive study, Health-Promoting Lifestyle Profile II (HPLP-II) was implemented to current smokers admitted to smoking cessation outpatient clinics of two tertiary hospitals. Patients without any comorbidities were included. Sociodemographic variables, Fagerström dependency test, and smoking habit were recorded. Descriptive and analytical statistical evaluations were performed.

Results

A total of 200 patients, 134 men (67%) and 66 women (33%) with a mean age of 34.49 ± 8.82, were included to the study. Among them, 90 (45%) were white collar, and 110 (55%) were blue-collar workers. Patients with BMI ≥ 25 were 126 (63%); Fagerström test score median was 7. Packages per year, dependency scores, the age the patients started smoking, and cigarettes smoked per day inversely correlated with health-promoting behavior. Our patients had high scores in spiritual growth and interpersonal relationships and had low scores in physical activity and stress management. Health-promoting behavior, health responsibility, self-actualization, and interpersonal relationships were less favorable in blue-collar workers than white-collar workers.

Conclusions

Smoking behavior affects especially physical activity and stress management in the study population preparing for smoking cessation. Health-promoting activities in smokers are influenced by occupation as well as dependency levels and smoking habits. Differences exist among white and blue-collar workers in health-promoting behavior. Defining and screening multiple health risk behavior in smokers empower predictive measures and targeted preventive medicine, such as maintaining healthy nutrition and leaving sedentary lifestyle along with efforts to quit smoking. Awareness about health-promoting behavior and thus identifying smokers who need lifestyle interventions can provide and attenuate a holistic and personalized approach in preventive medicine.

Assessment of health-promoting lifestyle behaviors of adults living in the semi-rural area

OBJECTIVE

The aim of the present study was to determine the level of healthy lifestyle behaviors and related factors in the individuals who applied to the primary health-care center.

METHODS

The study is a cross-sectional study of adults aged 18 years and over who applied to the primary health-care center. The sample size of the study was calculated as 992 people and 995 participants were accessible. The health-promoting behaviors of the individuals were assessed by the Health-Promoting Lifestyle Profile II (HPLP-II). In the analysis of the data, Mann-Whitney U-test, Kruskal-Wallis tests, and multiple linear regression analysis were used to determine effective variables on scale score.

RESULTS

The mean age of the participants was 43.8±17.1. Of the total participants, 45.7% (n=455) of them were female. The median score obtained from the HPLP-II was 132. Health responsibility, nutrition, and interpersonal relations subscale scores of male were lower than female patients, while physical activity subscale scores were higher in male patients. In participants under the age of 48 years in the study, health responsibility, nutrition, interpersonal relations, and stress management subscale scores were higher. The scores of the married participants were higher than the areas out of the stress management subdimension. Stress management subscale scores were higher in individuals with primary and lower education levels in terms of health care, nutrition, and interpersonal relations. Those who had good family income status and health perception scores also received higher scores in terms of all subscale scores.

CONCLUSION

Gender, age group, marital status, education level, income level, physician-diagnosed chronic disease history, and perceived health status were found to be related to health-promoting behaviors. Educational programs should be prepared in these issues by determining the issues that individuals are lacking in protecting and developing their health and social needs should be taken into consideration when these programs are being prepared.

Associations of Health Self-efficacy With Engagement in Health-Promoting Behaviors and Treatment Adherence in Rural Patients

Rural residents have lower levels of engagement in health-promoting behaviors and treatment adherence than their urban counterparts. This cross-sectional study sought to understand the role of health self-efficacy as a precursor to engagement in health-promoting behaviors and treatment adherence in 273 rural patients. Structural equation model was used to examine whether health self-efficacy predicted engagement in health-promoting behaviors and treatment adherence. Results show that health self-efficacy predicts engagement in health-promoting behaviors and treatment adherence. Boosting patients' health self-efficacy could be a way of increasing their engagement in health-promoting behaviors and treatment adherence and thus of improving their health outcomes.

Healthy Weight in Lesbian and Bisexual Women Aged 40 and Older: An Effective Intervention in 10 Cities Using Tailored Approaches

BACKGROUND

Lesbian and bisexual women are more likely to be overweight or obese than heterosexual women, leading to increased weight-related health risks.

METHODS

Overweight women aged 40 or older who self-identified as lesbian, bisexual, or "something else" participated in five pilot interventions of 12 or 16 weeks' duration. These tailored interventions took place at lesbian and bisexual community partner locations and incorporated weekly group meetings, nutrition education, and physical activity. Three sites had non-intervention comparison groups. Standardized questionnaires assessed consumption of fruits and vegetables, sugar-sweetened beverages, alcohol, physical activity, and quality of life. Weight and waist-to-height ratio were obtained through direct measurement or self-report.

ANALYTICAL PLAN

Within-person changes from pre-intervention to post-intervention were measured using paired comparisons. Participant characteristics that influenced the achievement of nine health objectives were analyzed. Achievement of health objectives across three program components (mindfulness approach, gym membership, and pedometer use) was compared with the comparison group using generalized linear models.

RESULTS

Of the 266 intervention participants, 95% achieved at least one of the health objectives, with 58% achieving three or more. Participants in the pedometer (n = 43) and mindfulness (n = 160) programs were more likely to increase total physical activity minutes (relative risk [RR], 1.67; 95% confidence interval [CI], 1.18-2.36; p = .004; RR, 1.38; 95% CI, 1.01-1.89; p = .042, respectively) and those in the gym program (n = 63) were more likely to decrease their waist-to-height ratio (RR, 1.89; 95% CI, 0.97-3.68, p = .06) compared with the comparison group (n = 67).

CONCLUSION

This effective multisite intervention improved several healthy behaviors in lesbian and bisexual women and showed that tailored approaches can work for this population.

The Associations Among Individual Factors, eHealth Literacy, and Health-Promoting Lifestyles Among College Students

Background

eHealth literacy is gaining importance for maintaining and promoting health. Studies have found that individuals with high eHealth literacy are more likely to adopt healthy eating, exercise, and sleep behaviors. In addition, previous studies have shown that various individual factors (eg, frequency of seeking information on health issues, degree of health concern, frequency of eating organic food, and students’ college major) are associated with eHealth literacy and health-promoting lifestyles. Nevertheless, few studies have explored the associations among individual factors, eHealth literacy, and health-promoting lifestyles among college students. Moreover, there is a lack of studies that focus on eHealth literacy as a predictor of psychological health behaviors.

Objective

To examine the associations among various individual factors, eHealth literacy, and health-promoting lifestyles.

Methods

The eHealth Literacy Scale is a 12-item instrument designed to measure college students’ functional, interactive, and critical eHealth literacy. The Health-promoting Lifestyle Scale is a 23-item instrument developed to measure college students’ self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management. A nationally representative sample of 556 valid college students in Taiwan was surveyed. A questionnaire was administered to gather the respondents’ background information, including the frequency of seeking information on health issues, the frequency of eating organic food, the degree of health concern, and the students’ major. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health-promoting lifestyles.

Results

The study found that factors such as medical majors (t₅₅₀=2.47-7.55, P<.05) and greater concern with health (t₅₅₀=2.15-9.01, P<.05) predicted college students’ 4-6 health-promoting lifestyle dimensions and the 3 dimensions of eHealth literacy. Moreover, critical eHealth literacy positively predicted all 6 health-promoting lifestyle dimensions (t₅₄₇=2.66-7.28, P<.01), functional literacy positively predicted 2 dimensions (t₅₄₇=2.32-2.98, P<.05), and interactive literacy predicted only the self-actualization dimension (t₅₄₇=2.81, P<.01).

Conclusions

This study found that participants who majored in medical fields had greater concern with their health and frequently sought health information, exhibited better eHealth literacy, and had a positive health-promoting lifestyle. Moreover, this study showed that college students with a higher critical eHealth literacy engaged better in health-promoting activities than those with functional and interactive literacy.

Physical inactivity in relation to self-rated eyesight: cross-sectional analysis from the English Longitudinal Study of Ageing

Background

To assess the cross-sectional association between self-rated eyesight and physical activity behaviour in a large general population sample of older English adults.

Methods

Analyses of data from the English Longitudinal Study of Ageing. Participants provided information on self-rated eyesight (categorised as: excellent/very good/good/fair-poor) and their own physical activity levels (categorised as: inactive/moderate only at least 1/week, vigorous at least 1/week). Associations between self-rated eyesight and physical activity levels were examined using logistic regression.

Results

A total of 6634 participants (mean age 65.0±9.2 years) were included in the analyses. In adjusted logistic regression models, those with fair-poor and good eyesight were significantly more likely to be inactive than those who reported excellent eyesight (OR 2.07, 95% CI 1.58 to 2.72; OR 1.59, 1.27 to 1.99, respectively).

Conclusion

In this sample of older English adults, those with self-rated fair-poor vision were over twice as likely to be physically inactive than those who reported having excellent vision. When consistent data have emerged, interventions to increase physical activity in those who have poor eyesight are needed.

Health Promoting Lifestyle Behaviors in Menopausal Women: A Cross-Sectional Study

BACKGROUND

Determining health promoting lifestyle behaviors of age-specific groups of women provides valuable information for designing health promotion intervention programs. Hence the present study was conducted to assess health promoting lifestyle behaviors in menopausal women.

METHODS

The present descriptive cross-sectional study examined health promoting lifestyle behaviors in 400 menopausal women admitted to health care centers in Neka city-north of Iran-from March 2015 to July 2015. Health promoting lifestyle behaviors were evaluated using a demographic characteristics form and the Health Promoting Lifestyle Profile II (HPLP II) through simple convenience sampling. Data were analyzed in SPSS version 18 using descriptive and inferential statistics at the significance level of P<0.05.

RESULTS

The mean score of participants' health promoting lifestyle behaviors was 136.43±19.61, ranging from 88 to 194. The logistic regression test revealed women's health promoting lifestyle behaviors to be significantly related to their place of residence (P=0.009, odds ratio=1.73) and their spouse's level of education (P=0.027, odds ratio=0.58). The Pearson correlation test showed significant relationships between mean score of the six sub-scale of health promoting lifestyle behaviors with each other (P<0.001).

CONCLUSION

These findings have implications for addressing the role of men to promote health promoting lifestyle behaviors among rural menopausal women.

Practice of Health-Promoting Behaviors by Nursing Home Residents

The decade of the '90s witnessed the emergence of health promotion as a national priority for all age groups. Despite the fact that Healthy People 2010 identified objectives for the nursing home population, little is known about factors that promote the practice of health-promoting behaviors by nursing home residents. This study examined the separate and combined contributions of personal and contextual influences on the practice of health-promoting behaviors by nursing home residents. One hundred eighty-four residents and 90 staff members from six nursing homes participated in this study. Using a modified version of contextual regression analysis, 57.8% of the variance in health-promoting lifestyle (HPL) behaviors was explained when all variables were entered into the equation. Personal influences explained a significant amount of variation (53.5%) in current HPL behaviors. These findings underscore the importance of looking at ways to support the efforts of nursing home residents to engage in the practice of health-promoting behaviors.

Patterns and correlates of physical activity behaviour over 10 years in older adults: prospective analyses from the English Longitudinal Study of Ageing

OBJECTIVE

Few studies have examined how levels of activity intensity fluctuate throughout later life in older adults and no study has identified correlates of sustained activity levels in this age group. The aim of the present analysis was to investigate stability of activity over a 10-year period and identify potential correlates of sustained activity levels in older adults.

DESIGN

Analyses of data from the English Longitudinal Study of Ageing. Participant-reported physical activity data were collected in 2002 (baseline), 2004, 2006, 2008, 2010 and 2012. Participant age, sex, smoking, depressive symptoms, work status, wealth, and long-standing illness were recorded at baseline. Multiple logistic regression was used to examine associations between baseline exposure variables and persistent physical activity (reporting moderate and/or vigorous physical activity at least once a week at all 6 assessments over the 10-year time period).

RESULTS

A total of 5022 participants (mean age 61 years; 2114 male) were included in the analyses. There was reasonable stability in the physical activity measure over the 6 time points (Cronbach's α 0.85). There was an overall trend for increasing levels of inactivity and a reduction in vigorous activity. Age, female sex, having ever smoked, long-standing illness, arthritis, obesity, and depressive symptoms were associated with a lower likelihood of being persistently active (defined as reporting moderate and/or vigorous physical activity at least once a week over all 6 assessment points). Those with greater wealth were 4 times more likely to be persistently active.

CONCLUSIONS

In the present analyses time spent in vigorous-intensity activity declined in later life. A range of sociodemographic and biomedical factors were associated with being persistently active in older adults.

Health-promoting lifestyle and its predictors among Iranian adolescent girls, 2013

INTRODUCTION

Health-promoting behaviors have considerable effects on improving life quality and decreasing healthcare expenses. This study aimed to determine the status of health-promoting behaviors and its subscales, as well as its relationship with self-efficacy and some socio-demographic characteristics in adolescent Iranian girls.

MATERIALS AND METHODS

The participants in this study were 750 adolescent girls aged 14-18 years, living in the city of Sanandaj, Iran in 2013. Samples were selected randomly. Questionnaires used in the study were the "Adolescent Healthy Lifestyle" and "Sherer General Self-efficacy" questionnaires. Multivariate linear regresion analysis was used to determine predictors of health-promoting lifestyle.

RESULTS

Mean total score of health-promoting lifestyles in adolescent girls was 3.51 (SD 0.55) and its observed scores ranged from 1 to 5. The highest and lowest mean scores were obtained for life appreciation and physical activity subscales, respectively. Self-efficacy had significant positive correlation with the total health-promoting lifestyle scores and all its subscales. The variables of self-efficacy, current disease, mother's education, mother's occupation, and sufficiency of income for expenses remained in the multivariate linear regresion model and were able to explain 21% of the observed variance of the total score for health-promoting lifestyle.

CONCLUSION

The findings show that adolescents "sometimes" or "often" show health-promoting behaviors. In addition to self-efficacy as the main predictor, some of the socio-demographic characteristics are also among the predictors of health behaviors. With consideration of adolescence years as a foundation for one's future life, it is necessary to provide strategies to encourage a health-promoting lifestyle in adolescents.

Measuring health-promoting behaviors: cross-cultural validation of the Health-Promoting Lifestyle Profile-II

PURPOSE

Individual lifestyles have emerged as valuable health constructs. This study aims to psychometrically test the Portuguese (European) version of the Health-Promoting Lifestyle Profile-II.

METHODS

After an adequate linguistic and cultural adaptation of the Health-Promoting Lifestyle Profile-II scale, their psychometric properties were assessed (N = 889) by Cronbach's alpha and confirmatory factor analysis.

FINDINGS

Results showed an adequate fit to a 52-item, six-factor structure. A global alpha of .925 was obtained.

CONCLUSIONS

The Portuguese version demonstrated good validity and reliability in a wide adult sample, and can thus be applied to the Portuguese population.

IMPLICATIONS FOR NURSING PRACTICE

This instrument is useful as an evaluation tool for health-promoting lifestyles and as an instrument for testing the effectiveness of health-promoting programs.

The association of health-promoting lifestyle with quality of life among the Iranian elderly

BACKGROUND

As individuals live a longer life, health-promoting lifestyle (HPL) becomes even more essential, particularly with regard to maintaining functional independence and improving quality of life (QoL).

OBJECTIVES

This study aimed to determine the association between QoL and HPL in the Iranian elderly living in Shiraz.

MATERIALS AND METHODS

This analytical cross-sectional study was conducted in 2013 at retirement centers of Shiraz City, Iran. The sample included 500 elderly who aged > 60 years. Proportional stratified random sampling was used to select the elderly from retirement centers. QoL was assessed by the Farsi version of Short Form Health Survey questionnaire (SF-36) and HPL was measured by health-promoting lifestyle profile (HPLP II). Data were analyzed using independent-samples t test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression using SPSS 21.

RESULTS

There were significant differences in QoL in terms of sex, age, education, and marital status. There were significant differences in HPL in terms of gender, age and education (P < 0.05) There was a statistically significant association between QoL and HPL in the elderly (r = 0.42, P < 0.05). Based on HPLP II constructs, the significant predicting factors of QoL in the elderly consisted of spiritual growth, stress management, and physical activity (P < 0.05).

CONCLUSIONS

Health providers should improve the QoL in the elderly by facilitating HPL through health-promoting interventions, which will maintain and increase physical activity, stress management, and spiritual growth.

Decline in functional capacity is unaffected by diet quality alone or in combination with physical activity among generally healthy older adults with T2D from the NuAge cohort

BACKGROUND

Both diet quality (DQ) and physical activity (PA) have been shown to play a role in the prevention of functional capacity (FC) decline. Because older adults (OA) with T2D are at a higher risk of FC decline compared to their non-diabetic counterparts, our aim was to determine if DQ alone, or combined with PA is associated with FC decline in OA with T2D over a 3-year follow-up in a secondary analysis of the NuAge cohort.

METHODS

In 159 OA with T2D (mean age=75 years), FC change was calculated as the difference in FC scores at T1 and T4 measured by the SMAF (Système de Mesure de l'Autonomie Fonctionnelle). Baseline DQ was calculated from three non-consecutive 24-h dietary recalls collected at T1 using the validated Canadian Healthy Eating Index (C-HEI). PA change was calculated from Physical Activity Scale for the Elderly (PASE) as T4-T1. Associations were evaluated between FC decline and four combinations of variables: C-HEI score < or ≥70 with PASE change < or > median and analyzed by GLM while controlling for covariates.

RESULTS

Neither DQ alone nor DQ combined with PA change were associated with FC decline over follow-up.

CONCLUSIONS

The absence of effect may be explained by characteristics of this healthy sample of OA with T2D who showed relatively good adherence to dietary recommendations (mean C-HEI=70) and were highly functional shown by minimal, clinically non-significant FC decline over 3 years. More research is needed to confirm the role of DQ in preventing FC decline in a larger diabetic sample showing clinically significant FC decline.

Self-compassionate reactions to health threats

Four studies investigated the relationship between self-compassion, health behaviors, and reactions to illness. Participants completed measures of self-compassion, health-related thoughts and feelings, reactions to actual and hypothetical illnesses, and self-regulation. Study 1 revealed that self-compassion was related to health-related cognitions and affect for healthy and unhealthy participants. In Study 2, self-compassion predicted participants' reactions to actual illnesses beyond the influence of illness severity and other predictors of health behaviors. Self-compassionate people also indicated they would seek medical attention sooner when experiencing symptoms than people lower in self-compassion. Study 3 demonstrated that self-compassion is related to health-promoting behaviors even after accounting for self-regulatory capabilities and illness cognitions. Study 4 revealed that the relationship between self-compassion and health reactions is partially explained by a proactive approach to health, benevolent self-talk, and a motivation toward self-kindness. Overall, these studies demonstrate that self-compassion has important implications for health-promoting behaviors and reactions to illness.

[Lifestyles related with cardiovascular risk in university students]

OBJECTIVE

To analyze the lifestyles associated with cardiovascular risk in a university population in university admission.

MATERIAL AND METHODS

A descriptive, observational, cross-sectional students of the Catholic University San Antonio of Murcia. Select a sample of 672 college students enrolled in the first year of the race. The instrument used to collect the data, is a self-completed questionnaire anonymous, with a total of 59 questions.

RESULTS

With respect to smoking 242 are smokers (36%), 117 former smokers (17.4%), and 313 non-smokers (46.6%). When compared snuff consumption by sex, no differences are detected. By running the largest group of non-smokers often seen in students of physical sciences (59.1%) compared to the careers humanities (40.9%). 87.4% (587) of students surveyed report using alcohol, compared to 12.6% (85) no. According to the race group not detected association between race group and the fact consume alcohol or not. The 65.6% of students surveyed physical exercise commonly referred, being higher the frequency of exercise in men than in women (81.7% versus 49.4%) (P<.001). 54.3% of surveyed students follow a dietary pattern typical of the Mediterranean diet.

CONCLUSIONS

The University does not exercise the role that could mean in terms of enhancing healthy lifestyles and abandonment of harmful health styles.

Determinants of health-promoting lifestyle behaviors among Arab immigrants from the region of the Levant

Arab immigrants in the United States are at risk for heart disease, stroke, and diabetes. We explored health-promoting lifestyle behaviors among Arab immigrants to the United States from the Middle Eastern region of the Levant. In 218 male and female Arab adults surveyed with the revised Health-Promoting Lifestyle Profile (HPLP-II), the mean for the HPLP-II was 2.73 (range 1-4), with spiritual growth and interpersonal relations the most frequently reported practices and physical activity the least frequently practiced dimension of health-promoting behaviors. Multiple linear regression analysis highlighted four determinants of health-promoting lifestyle behaviors: health insurance, acculturation, self-efficacy, and social support. Health promotion programs serving Arab immigrants should take these determinants into consideration.

Physical activity and transitioning to retirement: a systematic review

CONTEXT

The transition to retirement has been recognized as a turning point in determining physical activity and may present a critical "window" for promoting physical activity. This systematic review examined changes in physical activity across the retirement transition, whether these changes vary by SES, and what is known about predictors of these changes.

EVIDENCE ACQUISITION

Peer-reviewed articles and gray research literature, published between January 1980 and July 2010 in any country or language, were identified. Longitudinal and cross-sectional observational studies were included. Study selection, quality assessment, data extraction, and synthesis were performed between July 2010 and March 2011. A harvest plot approach to visualizing the findings was combined with a narrative synthesis.

EVIDENCE SYNTHESIS

Of the 19 included studies, 11 examined changes in exercise, or leisure-time physical activity, or both; seven, changes in total physical activity; and one study, both. Most studies used single-item measures of physical activity (n=9) or custom questionnaires (n=6). Results suggested that exercise and leisure-time physical activity increased after the retirement transition, whereas findings regarding total physical activity were inconsistent. SES moderated the association, with low SES being associated with a decrease and high SES with an increase in physical activity. Evidence on predictors of change was scarce and methodologically weak.

CONCLUSIONS

Evidence suggests that exercise and leisure-time physical activity increases after the retirement transition, but whether and how total physical activity changes is unclear. Imprecise physical activity measures used in primary studies limit conclusions, and this highlights the need for further research.

Psychometric properties of the Spanish version of the Health-Promoting Lifestyle Profile II

The Health-Promoting Lifestyle Profile II (HPLPII) has been psychometrically validated across several linguistic and cultural groups; however the Spanish version has not been psychometrically tested for the Spanish population. The purpose of this research was to evaluate the reliability and factor structure of the Spanish version of the HPLPII for Spanish people. Principal component analysis (PCA) revealed that a six-component model for 44 items accounted for 40% of the variance, and the scale had an internal consistency of .87. Confirmatory factor analysis demonstrated that a better fit of the six-component structure emerged from the PCA than from the model proposed in the original version of the HPLPII, suggesting that the health-promoting lifestyle might be sensitive to context and culture.

Do empowerment strategies facilitate knowledge and behavioral change? The impact of family health advocacy on health outcomes

This study evaluates the impact of a Family Health Advocacy (FHA) intervention on 46 African American women ages 13 to 35 living in a rural southern community. FHA utilizes empowerment strategies to provide education and social support to reduce risk factors for poor pregnancy outcomes. Use of a paired t test demonstrated a statistically significant difference between pretest and posttest scores in the acquisition of knowledge of safer sex practices, alcohol consumption, early prenatal care, maternal infection, and nutrition. Behavioral change was not realized in the areas of nutrition or behaviors that cause risk of maternal infection. Social workers can influence behavioral change for at-risk populations by addressing microlevel barriers such as education and resources and macrolevel barriers such as advocacy for expanded health and social services.

The role of social support in multiple morbidity: self-management among rural residents

Social support generally is considered a valuable asset that may compensate for health service deficiencies among rural populations. Employing a mixed methods approach, we explored how vulnerable rural residents described social support in the context of self-management for multiple chronic conditions. Participants generally felt support was available, though emotional/informational support was perceived as less available than other types of support. Participants did not rely heavily on informal support to help them manage their multiple morbidities, preferring to call on their doctor and their own resources. We discuss implications of these findings for meeting this vulnerable population's self-management needs.

Determinants of self-rated health in old age: a population-based, cross-sectional study using the International Classification of Functioning

BACKGROUND

Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas.

METHODS

The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF.

RESULTS

Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, p < 0.001), upper extremity capacity (adjOR = 1.13, p = 0.040), household physical activity (adjOR = 1.01, p = 0.016), and older age (adjOR = 1.09, p = 0.006); but decreased with more depressive symptoms (adjOR = 0.79, p < 0.001).

CONCLUSIONS

The results highlight a collection of ICF body functions, activities and personal factors associated with higher SRH among community-dwelling older people. Some of these, such as physical capacity, depressive symptoms, and habitual physical activity are of particular interest due to their potential for change through public health interventions. The use of ICF conceptual framework and widely accepted standardized assessments should make these results comparable and relevant in an international context.

Nutritional issues of Korean Americans

This cross-sectional, descriptive study examined factors influencing healthy eating of Korean Americans in a convenience sample of 517 Korean adults in a Midwestern city. Participants completed a self-administered survey written in either English or Korean as their preferences, which measured health, acculturation, healthy eating benefits, barriers, and self-efficacy as well as healthy eating practice. Descriptive statistics, cluster analysis, and structural equation modeling were used for analysis. Participants reported retaining elements of the traditional Korean diet regardless of acculturation. The worst eating habits were seen in participants who were younger (t = 4.57), currently not married (t = 3.10), less educated (F = 5.03), and acculturated to American society (F = 5.93) at the p < .05. Clinicians should provide culturally sensitive interventions targeting Korean Americans with poor dietary habits by providing population-specific, tailored interventions about the benefits of healthy eating and modeling healthier recipes for traditional Korean dishes.

Determinants of health-promoting lifestyle behaviour in the rural areas of Hungary

Today chronic non-communicable diseases are the major cause of death and disability worldwide. Chronic diseases are determined by common risk factors (e.g. smoking). The purpose of this study was to develop a health-promoting behaviour index, and to evaluate the impact of the social and the demographic characteristics of the individuals, self-rated health and certain features of settlements on the score of this index. A population-based, cross-sectional health survey was conducted. Altogether 91 settlements with various sizes of population, and at various stages of social, economic and infrastructural development took part in the survey. The survey was based on interviewer-administered questionnaires, 3380 subjects filled in the questionnaires correctly, and the response rate was 82.4%. Questions on lifestyle factors referred to smoking, nutritional habits and physical activity. Low level (5.5%) of people have achieved the 'complete' health-promoting behaviour, including non-smoking, healthy nutrition and physical activity. There were significant associations between health-promoting behaviour and demographic, social and economic characteristics of the individuals and their dwelling place. The lower prevalence of healthy lifestyle activities among lower educated, lower income and aged people living in small settlements call the attention to the higher risk of these people. On planning interventions, special attention should be paid to the geographically, infrastructurally, socially and demographically disadvantaged population groups to provide equal opportunities for them, to live a healthy way of life. The application of the health-promoting index might be used to monitor the effects of interventions to alter lifestyle at community level.

Adaptations to achieve physical activity in rural communities

This multiple, descriptive, explanatory case study design described and explained the perceptions of rural women regarding rural built environments conducive to physical activity. Sources of data included women's focus groups, city council focus groups, city administrator and clerk interviews, women's verification individual interviews, individuals referred to the researcher as individuals with perceived power, and analysis of documents. The study involved two rural communities with populations of 1,000 or less, and data were collected between March 2006 and April 2007. Content analysis of each data source and a combined data source analysis for each community was completed using NVivo7. Rural women adapted to conditions of built environments, seasonal concerns, wild animals, traffic control issues, other people, and personal needs. Adaptation emerged as a central theme in the women's focus groups as a way rural women engaged in physical activity.

Understanding behaviour to inform water supply management in developed nations--a review of literature, conceptual model and research agenda

Water is a scarce resource in many parts of the developed world. Two solutions are possible to address water scarcity: conservation of existing resources, or the further production of water from new sources e.g. through recycling of wastewater or desalination of seawater. However, the main hurdle to implementation of many of these solutions is often viewed as a lack of public willingness to adopt these alternative water behaviours. Research in this area is therefore crucial. Yet, and possibly due to the interdisciplinary nature of such research, there is currently no comprehensive overview of what has been done before. This study fills this gap by (1) choosing a general consumer behaviour perspective as a starting point, (2) developing a conceptual model of research required in the area of water-related public acceptance studies, (3) identifying eight key water-related behaviours which require future research attention, and (4) reviewing which areas of the conceptual model have been investigated in the past by conducting an extensive literature review of water-related social science research. The review established that the majority of work which has been conducted is located at the cross-roads of personal characteristics and behavioural intentions. Significant gaps exist in relation to researching the adoption of a wide range of demand-side water behaviours. This indicates a dominance of supply-side solutions in social-research exploration. The review identifies a number of research needs including: the exploration of actual adoption of water-related behaviours (rather than behavioural intentions); and to widen the scope of water behaviour enquiry to include more demand-side solutions. Given the increasing scarcity of water in many areas of the world, addressing these identified gaps will be of significant importance. Thus our model informs the social-research agenda for water policy.

Neighborhood safety, socioeconomic status, and physical activity in older adults

BACKGROUND

Neighborhood environment can have a substantial influence on the level of physical activity among older adults. Yet, the moderating influence of various measures of SES on the association between perceived neighborhood safety and leisure-time physical activity (LTPA) among older adults remains unknown.

PURPOSE

The study was designed to investigate the association between perceived neighborhood safety and LTPA in a nationally representative sample of older adults, and to evaluate SES characteristics as potential effect modifiers in the association between perceived neighborhood safety and LTPA.

METHODS

Cross-sectional data from the 2004 Health and Retirement Study of older adults aged >or=50 years were used to examine the association between perceived neighborhood safety and LTPA. Differences in LTPA were evaluated across three measures of SES: education, household income, and household wealth. SES was also evaluated as a potential effect modifier in the association between perceived neighborhood safety and LTPA. The analysis was conducted in 2008.

RESULTS

An SES gradient in LTPA was noted across measures of SES used in this study. After controlling for SES and demographic characteristics and functional limitations, older adults who perceived their neighborhood as safe had an 8% higher mean rate of LTPA compared to older adults who perceived their neighborhood as unsafe. The association was no longer significant when self-rated health was added. Additionally, SES was not a significant effect modifier in the association between perceived neighborhood safety and LTPA.

CONCLUSIONS

SES, demographic characteristics, and functional limitations substantially attenuated the positive association between perceived neighborhood safety and LTPA; however, with the inclusion of self-rated health, the association was no longer present. This finding suggests that self-rated health may mediate this association. The lack of significance in the interaction between perceived neighborhood safety and SES suggests that prevention efforts to increase physical activity among older adults should consider perceptions of neighborhood safety as a potential barrier regardless of SES.

The menopausal transition: does it induce women's worries about aging?

OBJECTIVE

This study examines whether patterns of worries about aging change in women during the menopausal transition.

DESIGN

A population-based sample of 261 Australian-born women aged 45-55 years at baseline participated in a longitudinal study. Data were collected at baseline and in the 5th year of annual follow-up interviews. Measures included the Attitudes to Aging Scale which is based on a scale developed by Kaufert and Syrotuik and contained the six-item version which examines worries about specific losses. Menopausal status was determined by menstrual status as follows: late reproductive, early menopausal transition, late menopausal transition, and postmenopause.

RESULTS

Data analysis carried out by cross-tabulation found that 36% of participants did not change their attitudes over the 5-year follow-up period, 30% became more worried and 33% became less worried and there was no significant difference between those who had or had not experienced the menopausal transition. There was no significant association between the scores on the Attitudes to Aging Scale and changes in the self-rated health, work status and marital status.

CONCLUSION

The menopausal transition does not induce an overall increase in worries about aging.

[Association between the consumption of tobacco and alcohol and physical exercise while at university]

OBJECTIVE

To find out the influence that going to University has on changing smoking and alcohol habits, and on physical exercise in students in the EU.

DESIGN

Cross-sectional descriptive study.

SETTING

University of Murcia.

PARTICIPANTS

A sample of 1179 students was selected.

INTERVENTIONS

A self-filled and anonymous questionnaire was used. It consisted of 36 questions using 4 measurement scales: level of health information on cardiovascular risks (CVR), smoking, alcohol consumption and doing physical exercise.

RESULTS

A total of 39.2% of university students in their last academic year said they were smokers, compared to 36.4% in the first year (NS). A total of 81.6% of first year students had consumed alcohol at weekends, compared to 81.1% of those in their last year (NS). In the overall assessment of alcohol consumption, 13% "stopped drinking or drank less: and 10% "drank more", although the majority (55%), did not change their drinking habits. As regards physical exercise, the number of students who did more physical exercise was 21.2% in the first academic year, compared to 20% of students in their last year (NS).

CONCLUSIONS

Going to University does not seem to exercise a positive influence on the habits and lifestyles of young people. Measures should be taken to encourage healthy lifestyles in Universities.

Are rural older Icelanders less physically active than those living in urban areas? A population-based study

BACKGROUND

Older people in rural areas have been labelled as physically inactive on the basis of leisure-time physical activity research. However, more research is needed to understand the total physical activity pattern in older adults, considering all domains of physical activity, including leisure, work, and domestic life.

AIMS

We hypothesised that: (a) total physical activity would be the same for older people in urban and rural areas; and (b) urban and rural residency, along with gender and age, would be associated with differences in domain-specific physical activities.

METHODS

Cross-sectional data were collected in Icelandic rural and urban communities from June through to September 2004. Participants were randomly selected, community-dwelling, 65-88 years old, and comprised 68 rural (40% females) and 118 urban (53% females) adults. The Physical Activity Scale for the Elderly (PASE) was used to obtain a total physical activity score and subscores in leisure, during domestic life, and at work.

RESULTS

The total PASE score was not associated with rural vs. urban residency, but males were, in total, more physically active than females, and the 65-74-year-olds were more active than the 75-88-year-olds. In the leisure domain, rural people had lower physical activity scores than urban people. Rural males were, however, most likely of all to be physically active in the work domain. In both urban and rural areas, the majority of the physical activity behaviour occurred in relation to housework, with the rural females receiving the highest scores.

CONCLUSIONS

Older Icelanders in rural areas should not be labelled as less physically active than those who live in urban areas. Urban vs. rural living may, however, influence the physical activity patterns among older people, even within a fairly socioeconomically and culturally homogeneous country such as Iceland. This reinforces the need to pay closer attention to the living environment when studying and developing strategies to promote physical activity.

Effects of Baduanjin exercise on oxidative stress and antioxidant status and improving quality of life among middle-aged women

The purpose of this study was to evaluate the effects of Baduanjin exercise on oxidative stress, antioxidant status and quality of life in middle-aged women. A quasi-experimental design was adopted. Subjects were 31 middle-aged women. Subjects completed a supervised and standardized Baduanjin exercise program 3 times a week for 12 weeks. Malondialdehyde (MDA) level was measured and determined by using a spectrophotometer for oxidative stress. The superoxide dismutase (SOD) was measured for the antioxidant status. A 36-item Short Form Health Survey (SF-36) was used to evaluate changes in quality of life. All outcome measures were collected before intervention and at the end of a 12-week intervention. The results suggest that there are significant differences in serum SOD level with Baduanjin exercise. SOD level was significantly increased after exercise (p < 0.05). Baduanjin exercise contributed significantly to antioxidant status on these samples. However, a reduction in MDA level was observed. The t-test value was 2.03 with a p-value of 0.052. The changes may be meaningful at a 5% level. There are significant improvements in quality of life after the exercise program. Subjects had greater improvements in 4 dimensions of SF-36, namely physical function, body pain, social function and general mental health (p < 0.05). In conclusion, Baduanjin exercise has beneficial effects on improving quality of life, increasing antioxidant enzymes and reducing oxidative stress in middle-aged women. Reduction of MDA level may be more attributable to the increase in the antioxidant enzyme SOD.

Nutritional risk among Oklahoma congregate meal participants

OBJECTIVE

To determine if there were differences by demographic variables in response rates to Nutrition Screening Initiative (NSI) Checklist statements reported by over 50% of Oklahoma Older Americans Act Nutrition Program (OAANP) congregate meal participants categorized at high nutritional risk based on cumulative NSI Checklist scores.

DESIGN

This study evaluated Oklahoma State Unit on Aging statewide archival demographic and NSI Checklist data from 8892 OAANP congregate participants.

ANALYSIS

Data were analyzed using chi-square analyses.

RESULTS

Eighteen percent of congregate participants were categorized at high nutritional risk. Over 50% of participants categorized at high nutritional risk reported "yes" to having an illness or condition that affected food eaten; eating alone; taking 3 or more medications; and inability to shop, cook, and feed themselves. Significant differences were observed in participant "yes" response rates to these NSI Checklist statements by demographic variables. Participants responded "yes" more to these statements if they were female, of advanced age, and living alone or in rural areas.

CONCLUSIONS AND IMPLICATIONS

The results of this study indicate problem areas and population groups for targeting nutrition education programs and services among Oklahoma OAANP congregate meal participants.

Participation in health-promoting behaviour: influences on community-dwelling older Chinese people

AIM

This paper reports a study to determine the factors affecting community-dwelling older Chinese people's health-promoting behaviour in the domains of physical activity, healthy dietary practices and stress management, and to identify any barriers to these behaviours.

BACKGROUND

Previous studies have identified factors affecting different types of health-promoting behaviours, including perceived self-efficacy, perceived benefits and five individual characteristics (age, sex, marital status, education and perceived health) of older non-Chinese people. However, few studies have simultaneously taken these factors into account in examining community-dwelling Chinese older people's health-promoting behaviour.

METHOD

Individual face-to-face interviews were completed in 2002-2003 with a convenience sample of 896 community-dwelling older Chinese people in Hong Kong aged between the ages of 60 and 98 (years mean 76). Participants had no apparent communication and cognition impairments. A structured interview schedule was used to collect the data.

RESULTS

Multiple regression analysis showed that perceived self-efficacy, perceived benefits and sex together explained 38.4% of health-promoting behaviour among community-dwelling older Chinese people in Hong Kong. Fatigue during and after physical activity, enjoyment of unhealthy foods and inadequate family and peer support were the most frequently reported barriers to health-promoting behaviour.

CONCLUSION

When developing health promotion programmes to motivate community-dwelling older Chinese clients to participate in health-promoting behaviour and to minimize barriers, community nurses should include some activities to increase both the perceived self-efficacy and perceived benefits of health-promoting behaviour. Future studies should include more critical factors based on theories, empirical evidence and knowledge of culture with samples that are random and from more diverse community settings.

Using Participatory Action Research to Provide Health Promotion for Disadvantaged Elders in Shaanxi Province, China

OBJECTIVES

The objectives of the study were to (a) determine health promotion issues concerning disadvantaged elders, (b) identify social, economic, environmental, and personal factors that adversely influence disadvantaged elders' health, and (c) enable various stakeholders working within a coordinated framework to promote health among elders.

DESIGN

A participatory action research (PAR) model was used over a 2-year period in a remote disadvantaged rural village in Shaanxi province, China.

SAMPLE

Participants were 20 elders and 5 local administrators including government officers and village leaders.

RESULTS

Three themes were identified, including (a) health is the absence of illness and the ability to sustain self-sufficiency; (b) diseases are inevitable among elders; and (c) cost is the key barrier to accessing health services. Action plans were developed and plans were implemented by the participants and project team.

CONCLUSIONS

The project demonstrated that PAR is an optimum research method, which allows researchers to facilitate collaboration with all participants through research and supports democratic dialogue and deliberation through the participation process. Interpersonal relationship skills of researchers are crucially important in building cooperation among all stakeholders. Local government mobilization is essential for successful implementation and sustainability of the project.