Comparison of lifestyles among obese and nonobese African American and European American women in the community

Comparison of health-promoting behaviours, eating behaviour patterns and perceived social support in normal-weight and overweight pregnant women: An unmatched case-control study

Aim

The interventions based on adopting a healthy lifestyle during pregnancy have conflicting results. This study aimed to compare health-promoting, dietary patterns and social support in normal and overweight pregnant women.

Design

An unmatched case-control design was used.

Methods

A total of 360 pregnant women were selected using multistage cluster sampling and divided into two groups of normal and overweight cases. Data were collected using demographic and obstetrics characteristics, health-promoting lifestyle, perceived social support and eating behaviour questionnaires.

Results

The evaluation of the health-promoting behaviours and dietary patterns demonstrated a significant difference between the mean of total scores and their subdomains including self-actualization, nutrition, consumption of healthy and low-fat foods, fast food and sweets, as well as emotional eating and accidental planning. There was no significant difference between the two groups about social support.

Does body mass index moderate the association between posttraumatic stress disorder symptoms and suicidal ideation in Iraq/Afghanistan veterans?

Suicide, PTSD, and obesity co-occur at high rates among returning veterans, yet limited research exists regarding the relationship among these variables. Self-report and diagnostic interview data from a longitudinal study of Iraq and Afghanistan veterans (N=130) enrolled in VA healthcare examined these inter-relations. As hypothesized, body mass index (BMI) significantly moderated the association between PTSD and suicidal ideation such that the association between PTSD and suicidal ideation was strongest among individuals with a high BMI. Programs that focus on health promotion, trauma treatment, and weight management should continue to monitor suicide risk.

Obesity in urban women: associations with sleep and sleepiness, fatigue and activity

BACKGROUND

African-American women (AAW) have the highest prevalence of obesity and therefore are at greater risk for obesity-related symptoms and diseases. Obese individuals frequently report poorer sleep quality, more daytime sleepiness, more severe fatigue, and higher physical inactivity than normal weight individuals. The relationships among these variables have not been well-characterized in obese, urban-dwelling, AAW.

METHODS

This descriptive, correlational study examined the relationships among sleep quality, daytime sleepiness, fatigue, level of physical activity, and body mass index (BMI) in AAW living in an urban setting. A convenience sample of 69 young adult women with a BMI of greater than 30 kg/m(2) completed measures of sleep quality, sleepiness, fatigue severity, sense of community, and physical activity. Further analysis was done to determine if any of the study variables predicted level of physical activity.

FINDINGS

There was a strong and significant correlation between BMI and overall fatigue severity and a significant, negative correlation between BMI and physical activity performance. BMI was significantly correlated with sleep latency but not global sleep quality. There were significant relationships between fatigue severity and poorer global sleep quality and daytime sleepiness. Multiple regression analysis showed BMI and age accounted for a significant amount of the variance in physical activity.

CONCLUSIONS

Higher BMI was associated with significant fatigue. Fatigue severity was associated with poorer global sleep quality, daytime sleepiness, and a sense of community. Higher BMI may be a barrier to having an active lifestyle.

Predictors of initial weight loss among women with abdominal obesity: a path model using self-efficacy and health-promoting behaviour

AIM

To identify predictors of initial weight loss among women with abdominal obesity by using a path model.

BACKGROUND

Successful weight loss in the initial stages of long-term weight management may promote weight loss maintenance.

DESIGN

A longitudinal study design.

METHODS

Study participants were 75 women with abdominal obesity, who were enrolled in a 12-month Community-based Heart and Weight Management Trial and followed until a 6-month assessment. The Weight Efficacy Lifestyle, Exercise Self-Efficacy and Health Promoting Lifestyle Profile-II measured diet self-efficacy, exercise self-efficacy and health-promoting behaviour respectively. All endogenous and exogenous variables used in our path model were change variables from baseline to 6 months. Data were collected between May 2011-May 2012.

FINDINGS

Based on the path model, increases in both diet and exercise self-efficacy had significant effects on increases in health-promoting behaviour. Increases in diet self-efficacy had a significant indirect effect on initial weight loss via increases in health-promoting behaviour. Increases in health-promoting behaviour had a significant effect on initial weight loss.

CONCLUSION

Among women with abdominal obesity, increased diet self-efficacy and health-promoting behaviour were predictors of initial weight loss. A mechanism by which increased diet self-efficacy predicts initial weight loss may be partially attributable to health-promoting behavioural change. However, more work is still needed to verify causality. Based on the current findings, intensive nursing strategies for increasing self-efficacy for weight control and health-promoting behaviour may be essential components for better weight loss in the initial stage of a weight management intervention.

Health promotion and prevention strategies

Opiate dependency is a medical disorder that requires treatment intervention. Primary health care not only entails treatment of illness but also involves disease prevention and health promotion. Based on Pender's revised Health Promotion Model, a descriptive study comparing the health promoting behaviors/practices in abusing and recovering opiate-dependent drug users is analyzed. Using the Health Promoting Lifestyle Profile II, a comparative descriptive, exploratory, nonexperimental design study was conducted to identify key health-promoting behaviors in recovering opiate-dependent drug users. Prevention strategy recommendations are discussed, along with future research recommendations.

The role of motivation and self-efficacy on the practice of health promotion behaviours in the overweight and obese middle-aged American women

The study investigated the relationship between motivation, self-efficacy and demographic variables, and determined if they affect the performance of health promotion behaviours in overweight or obese middle-aged American women. The sample consisted of middle-aged American women from a small town in Michigan. Two groups of women aged 30-65, one with a body mass index (BMI) range of 25-29, and the second with a BMI of ≥ 30, completed the Health Self-Determinism Index, the General Self-Efficacy Scale and the Health Promoting Lifestyle Profile-II. Self-efficacy was found to be a significant predictor in the performance of health-promoting behaviours in both the overweight and obese participants in this study. Motivation was not found to be a significant predictor of performance of health promotion behaviours in either participant group. Education was found to be a significant predictor of performance of health promotion behaviours in the obese participants only. Nurses need to develop effective methods of supporting self-efficacy in both the overweight and obese middle-aged American women. Nursing-based research focusing on interventions to improve self-efficacy, as well as studies identifying effective educational techniques to improve the practice of health promotion behaviours in this population is necessary. Further investigation into the effect of motivation and demographics on the performance of health promotion behaviours is also needed.

Motivators and barriers to participating in health promotion behaviors in Black men

There is limited research examining the health promotion behaviors (HPBs) of low-income Black men. This study examined the relationship between HPBs, and motivators and barriers to participating in these behaviors in Black men (N = 107), aged 21 to 56. Using descriptive statistics, more than 96% of the participants reported they were motivated because of the desire to be healthy. Canonical correlation analysis and conditional random forest were used to determine the importance of individual motivators and barriers. Canonical correlation analysis yielded one interpretable canonical variate that explained 39.5% of the variance in sets of motivators and barriers, and health promotion lifestyle variables. Men with fewer motivators and more barriers took less responsibility for their health, participated in less physical activity, and reported less spiritual growth. Having too many things to do and not knowing what to do best predicted participation in HPBs.

Health-related quality of life and health-promoting behaviors in black men

This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (> or =14) mentally unhealthy days. There were strong correlations between mentally unhealthy days and various health-promoting behaviors. The contrast between participants' overall health and mental health is disconcerting. Implications for social work practice with low-income black men to improve health promotion are discussed.

Comparison of health-promoting behavior between Taiwanese and American adolescents: a cross-sectional questionnaire survey

OBJECTIVES

The main aim of this study was to compare the health promotion practices of Taiwanese (n=265) and American (n=285) adolescents, using the revised Adolescent Health Promoting scale.

METHODS

A comparative and descriptive design was used. Categorical data analysis was applied to explore the association of culture differences and adolescent health-promoting behaviors.

RESULTS

Findings indicated significant differences between Taiwanese and American adolescents in some demographic characteristics: American participants had higher self-perceived health status (p<0.001), parental educational level (p<0.001), overweight percentage (p<0.001), and rate of living only with the mother (p<0.001) than the Taiwanese participants. Taiwanese adolescents had a higher frequency of health-promoting behavior than Americans in terms of healthy diet behavior, stress management, health responsibility, and social support (p<0.01), but less frequently engaged in exercise and life appreciation (p<0.001). Because many of the demographic characteristics between the two countries, such as the parent's educational level, differ significantly, a comparison can be difficult. However, healthy behavior is an important measure of demand for preventive health services.

CONCLUSIONS

The findings should sound an alarm for all public health professionals to take heed of what is happening to our youth based on culture differences. School and family health promotion counseling should be encouraged for adolescents to improve their lifestyle habits. Based on the findings, school health promotion programs should focus on factors for which there may be significant local ethnic differences. For the locales in this study, Taiwanese adolescents need encouragement to improve their exercise and life appreciation behaviors. For American adolescents, healthy diet, stress management, health responsibility, and social support should be emphasized.

Gender differences in health-promoting lifestyles of African Americans

Despite progress in meeting Healthy People 2010 goals, African American (AA) men and women have higher mortality and morbidity rates as compared with Caucasian Americans. These may be attributed to lifestyle behaviors; however, this is a complex, multifactorial problem. The purpose of this study was to examine gender differences among AA lifestyle behaviors. A descriptive comparative design was used. The sample consisted of 223 AAs residing in southeastern United States. The health-promoting lifestyle profile (HPLP) was used to measure health-promoting behaviors. Independent t-test analysis revealed no statistically significant gender differences for total HPLP scores, t(220) = -1.49, p = 0.14. When controlling for income, education, and marital status, no significant interactions were seen with gender on HPLP. Independent t-test analyses revealed statistically significant differences for interpersonal relationship support, t(221) = -1.97, p = 0.05, health responsibility, t(214) = -2.46, p = 0.02, and nutrition t(219) = -3.27, p < 0.01, with women scoring higher than men. Although gender differences in AAs are evident for specific health-promoting lifestyle behaviors, these differences become less dominant when education and marital status were used as covariates.

Why carve up your continuous data?

Continuous data are commonplace in social, biophysical, and health research. For various reasons, researchers often carve up data into ordered chunks. Such data carving results in less information being carried by the data, a reduction or spurious increase in statistical power, and resultant Type I or Type II errors. We give examples of data carving in selected nursing literature, and illustrate how unnecessary categorization can produce erroneous statistical results. Finally, we propose credible alternatives to data carving.

Evaluating a community-based exercise program for women cancer survivors

Approximately 8.9 million cancer survivors live in communities across the United States. As advances in cancer therapy continue to improve survival rates, this number will increase. Nurses in community, ambulatory, and rehabilitative settings are challenged to meet the rehabilitative needs of this population. Research indicates that exercise interventions can improve survivors' quality of life (QOL). This pilot study examined a community-based exercise program and its impact on women cancer survivors' QOL. By using a pretest, posttest one-group design, data were collected from two groups on demographics, psychosocial adjustment to illness, mood states, fatigue, symptom distress, and overall QOL. Findings suggested that for some women exercise improved psychological and social well-being. Future research and community-based nursing practice were addressed.

Circulating leptin: a marker of health in female students

We studied the relationship between serum leptin concentration and lifestyle factors in female nursing students. Serum leptin was estimated by radioimmunoassay and the correlation between these concentrations with serum lipids, physical fitness and Health-promoting Lifestyle Profile score was investigated. A total of 247 students took part in the study: mean age, 19.0 +/- 2.0 years; mean body mass index (BMI), 21.7 +/- 2.9 kg/m2; and mean serum leptin concentration, 10.8 +/- 11.5 ng/ml. Serum leptin was positively correlated with BMI, systolic and diastolic blood pressure, total cholesterol and serum triglyceride. Serum leptin level concentration inversely correlated with physical fitness score and lifestyle score. When the subjects were grouped according to BMI, the high-BMI group (BMI: > or = 24 kg/m2; n = 40) showed significantly lower fitness and lifestyle scores than the low-BMI group (BMI < or = 20 kg/m2; n = 70). Higher leptin, blood pressure, total cholesterol and triglyceride were seen in high-BMI compared with low-BMI subjects. We suggest that leptin is a useful marker for monitoring good health and may be useful as a motivational aid towards achieving and maintaining a healthy lifestyle.

Health disparities among vulnerable populations: evolution of knowledge over five decades in Nursing Research publications

BACKGROUND

Considerable attention has been focused recently on conducting research on the health disparities experienced by some Americans as the result of poverty, ethnicity, and/or marginalized social status. Nursing research has a major role to play in developing this body of knowledge.

PURPOSE

The purpose of this paper is to review the contributions that Nursing Research made through its publications over the last five decades in developing the body of tested knowledge about health disparities in vulnerable groups and to analyze the progress made.

METHODS

Criteria for reviewing the literature were established. All Nursing Research publications between 1952 and 2000 were searched manually, indexes of each year's bound volumes were reviewed, and computer searches were conducted. Included in the review were research reports, research briefs, and methodology articles.

RESULTS

Seventy-nine papers were found that met basic criteria for inclusion. The number of relevant publications increased each decade, with a sizable increase in numbers since 1990, and may be related to the social, political, and economic climate of each decade. The research questions asked and the methods used became more complex over time.

CONCLUSIONS

Nursing Research has made a significant contribution in disseminating the body of tested knowledge related to the health disparities experienced by vulnerable populations and the methodologies associated with vulnerable populations research. Areas for future research are community-based studies, intervention studies that provide tangible resources, and methodologic approaches that involve participants in the research process.

Diet and breast cancer surveillance behaviors among Harlem women

The consumption of green, yellow, and other vegetables, fruits and fruit juices may be protective against breast cancer, and, alongside regular breast cancer screening, may contribute to ethnic and racial differences in breast cancer rates. The purpose of this study is to assess the dietary and sociodemographic predictors of surveillance among Harlem women, using a population-based household survey. One half of the Harlem women in this sample consumed no or one fruit or vegetable per day. Logistic regression analyses revealed that women who consumed more fruits and vegetables had received more recent mammography, and that women who were unemployed were less likely to receive recent breast cancer screening than were those who worked full- or part-time. The high response rate and the representativeness of the sample are study strengths. Owing to the small sample size for women between 40-65, the ages for which screening mammography and clinical breast exam are recommended, subgroup analyses were limited. Therefore, additional study of age-adjusted dietary patterns and screening among African American women is suggested.

Health-promoting lifestyles and exercise: a comparison of older African American women above and below poverty level

The purpose of this study was to compare the health-promoting behaviors and exercise behaviors of older African American women above and below poverty level. Fifty-eight African American women completed a demographic form and the Health Promoting Lifestyle Profile (HPLP). Results indicated that African American women living above the poverty level had higher overall scores on the total HPLP and higher scores on the exercise subscale of the HPLP than women living below poverty level. Implications include teaching culturally specific, practical, and inexpensive exercise activities in primary care and community settings.