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Fan Y, Shen BJ, Ho MHR. Loneliness, perceived social support, and their changes predict medical adherence over 12 months among patients with coronary heart disease. Br J Health Psychol 2024; 29:814-832. [PMID: 38782875 DOI: 10.1111/bjhp.12732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 04/03/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES This study investigated whether changes in loneliness and perceived social support predicted medical adherence in patients with coronary heart disease (CHD) over 12 months. Moreover, short-term and long-term buffering effects of social support on the association between loneliness and medical adherence were systematically examined. DESIGN A three-wave longitudinal study. METHODS Participants were 255 CHD patients with a mean age of 63 years. Medical adherence, loneliness, and perceived social support were assessed at baseline, 3 months, and 12 months. Hierarchical regression analyses were conducted to examine the influences of loneliness and social support as well as their changes on medical adherence over 12 months. Moderation analyses were performed to test buffering effects of baseline social support and its changes against loneliness and its changes, respectively. RESULTS Changes in loneliness significantly predicted medical adherence at 12 months (β = -.23, p = .001) but not at 3 months (β = -.10, p = .142). Changes in social support predicted medical adherence at both 3 (β = .23, p = .002) and 12 months (β = .26, p = .001). Social support concurrently buffered the adverse impact of loneliness on medical adherence (B = .29, SE = .12, p = .020) at baseline but did not at 3 or 12 months (Bs = -.21 to .40, SEs = .12 to .30, ps = .177 to .847). CONCLUSIONS Findings highlight the importance of monitoring loneliness and perceived social support continuously over time for CHD patients to promote medical adherence.
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Affiliation(s)
- Yunge Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | | | - Moon-Ho Ringo Ho
- Psychology Program, Nanyang Technological University, Singapore City, Singapore
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2
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Kim Y, Rangel J, Colabianchi N. Food Environments and Cardiovascular Disease: Evidence From the Health and Retirement Study. Am J Prev Med 2024; 67:201-209. [PMID: 38484903 DOI: 10.1016/j.amepre.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Residential food environments are one of the important determinants of cardiovascular health. However, past literature has been limited by short-term follow-ups, time-invariant environmental measurements at baseline, and/or not investigating both healthy and unhealthy aspects of the food environment. This study examines the effects of time-varying healthy and unhealthy food environments on incident cardiovascular disease (CVD) over 10 years, extracting data from the Health and Retirement Study (2006-2016; N=10,413). METHODS Cox proportional hazards modeling was performed with inverse probability weighting to assess the association between time-varying food environmental measures (i.e., densities of grocery stores, supercenters/club stores, full-service restaurants, and fast-food restaurants) and incident CVD over 10 years. Education level and race/ethnicity were tested as potential moderators. Analyses were conducted in 2022-2023. RESULTS Race/ethnicity had a significant interaction effect with supercenters/club stores and indicated that a 1-standard-deviation increase in the density of supercenters/club stores was associated with a 6%-8% lower risk of incident CVD in non-Hispanic Black (HR=0.78, 95% CI=0.70-0.87) and Hispanic older adults (HR=0.69, 95% CI=0.50-0.96), but not non-Hispanic White older adults. Additionally, education had a significant interaction effect with full-service restaurants, indicating that a 1-standard-deviation increase in the density of full-service restaurants was associated with a 10% lower risk of incident CVD in individuals with 13+ years of schooling, but not those with 0-12 years of schooling. CONCLUSIONS Findings suggest that public policymakers should be aware of the benefits and nuances of varying food environment components as they can contribute to positive or negative cardiovascular health.
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Affiliation(s)
- Yeonwoo Kim
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas; School of Social Work, University of Texas at Arlington, Arlington, Texas.
| | - Joseph Rangel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
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Fan Y, Zhou L, Chen X, Su J, Zhong S. Determinants and outcomes of health-promoting lifestyle among people with schizophrenia. BMC Psychiatry 2024; 24:177. [PMID: 38439019 PMCID: PMC10913642 DOI: 10.1186/s12888-024-05625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Healthy lifestyle is an important protective factor of developing cardiovascular disease in people with schizophrenia. However, little is known about the determinants of lifestyle and its contribution to metabolic syndrome. This study aimed to explore the influencing factors of health-promoting lifestyle (HPL) and its association with metabolic syndrome among people with schizophrenia. METHODS A cross-sectional study was conducted in twenty-two primary health centers of Guangzhou, China between December 2022 and April 2023. A total of 538 patients with schizophrenia were recruited through convenience sampling. Self-administered scales, questionnaires, and clinical data were collected. Scales and questionnaires included social-demographic information, Health-Promoting Lifestyles Profile (HPLP-C), UCLA Loneliness Scale (ULS), and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Cluster analyses were used to divide participants into two groups based on the distribution characteristics of HPLP-C scores. Logistic regression models were used to identify factors associated with HPL and the association between HPL and metabolic syndrome. RESULTS There were 271 participants in the high HPL group and 267 participants in the low HPL group. Logistic regression analysis revealed that loneliness posed a risk factor for high HPL, while high education and moderate-vigorous physical activity served as protective factors for high HPL. Low HPL was a risk factor for the prevalence of metabolic syndrome. CONCLUSIONS Promotion of high education literacy and a physically active lifestyle should be priority targets in the health management of schizophrenia. Primary healthcare providers can play a pivotal role in assisting patients to mitigate metabolic syndrome by reinforcing healthy lifestyle strategies.
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Affiliation(s)
- Yu Fan
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Xiyuan Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Jinghua Su
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Shaoling Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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Eglin M, Schmid JP, Ronel J, Khatami R, Leiggener C, Koenig HG, Hefti R. Impact of social support and religiosity/spirituality on recovery from acute cardiac events and heart surgery in a Swiss study. Int J Psychiatry Med 2023:912174231225801. [PMID: 38156371 DOI: 10.1177/00912174231225801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of social support and religiosity/spirituality (R/S) on the recovery from an acute cardiac event or cardiac surgery during cardiac rehabilitation (CR). METHODS The study has a prospective design. A convenience sample of 159 patients participating in a CR program were enrolled. Religiosity/spirituality, social support, anxiety, depression, health related quality of life (QoL) and exercise capacity (6-min walk test, cycle ergometer test) were assessed. RESULTS Social support was significantly associated with less anxiety (P < .01), less depression (P < .01), and better QoL (P < .05) on admission. After adjustment for age, gender, education level, and morbidity, social support remained significantly associated with less depression (P < .001). Religiosity/spirituality was significantly associated with less depression (P < .05), better QoL (P < .05), and better exercise capacity (P < .05) at admission. After adjustment for covariates, however, significance was lost. There were no significant associations of social support or R/S with the course of CR measured by change in QoL or exercise capacity. CONCLUSION Social support may be a protective factor against depression in the recovery from cardiac events or surgery. Neither social support nor R/S had a significant impact on the course of the 3-week CR program.
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Affiliation(s)
- Micha Eglin
- University of Basel, Faculty of Medicine, Basel, Switzerland
| | | | - Joram Ronel
- Department of Psychosomatic Medicine and Psychotherapy, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Ramin Khatami
- Centre of Sleep Medicine and Sleep Research, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Christoph Leiggener
- University of Basel, Faculty of Medicine, Basel, Switzerland
- Department of Oral- and Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Harold G Koenig
- Departments of Medicine and Psychiatry, Duke University Health System, Durham, NC, USA
- Department of Medicine, Division of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - René Hefti
- University of Basel, Faculty of Medicine, Basel, Switzerland
- Research Institute for Spirituality and Health (RISH), Langenthal, Switzerland
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Nordin S, Norberg M, Braf I, Johansson H, Lindahl B, Lindvall K, Nordin M, Nyman E, Vallström C, Wennberg P, Liv P, Näslund U. Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age. Psychol Health 2023:1-15. [PMID: 37994844 DOI: 10.1080/08870446.2023.2286296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/31/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults. METHODS AND MEASURES Cross-sectional data were obtained from participants aged 40-60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations. RESULTS Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 - 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 - 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT. CONCLUSION The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.
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Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Margareta Norberg
- Section of Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Irma Braf
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Helene Johansson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Bernt Lindahl
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Kristina Lindvall
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Emma Nyman
- Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Patrik Wennberg
- Section of Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ulf Näslund
- Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Partridge JA, Anton PM, Wallace JP, Lake LL. Exercise social support, barriers, and instructions in venous thromboembolism survivors: a descriptive study. Res Pract Thromb Haemost 2023; 7:102147. [PMID: 37601020 PMCID: PMC10439440 DOI: 10.1016/j.rpth.2023.102147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Diagnosis of venous thromboembolism (VTE) can be a significant life event that leads to changes in physical activity and exercise. Currently, little is known about the psychosocial experiences of survivors including perceived sources of social support, exercise barriers, and instructions for exercise from medical providers. Objectives This study aimed to explore psychosocial characteristics associated with VTE survivors' postdiagnosis exercise. Specifically, 1) what are the main sources of social support utilized by VTE survivors for exercise, 2) what are the most significant exercise barriers (eg, physical, social, and psychological) faced by VTE survivors, and 3) what specific information relative to exercise is provided by medical professionals following diagnosis? Methods VTE survivors (n = 472) were recruited through social media groups to participate in open-ended questions about psychosocial characteristics pertaining to postdiagnosis exercise. Results VTE survivors reported multiple forms of exercise social support, although almost 1 in 4 participants reported having no support for exercise. Several postdiagnosis exercise barriers were noted, and the data indicated a wide variety of information from their medical providers regarding engaging in exercise following their diagnosis, suggesting that the unique benefits and drawbacks to these instructions should be examined in more detail. Conclusion Although VTE survivors identified numerous categories of social support, there also exist numerous barriers, including a lack of standardized instructions for exercise. Further exploration of these characteristics is needed to better serve this population to encourage postdiagnosis exercise.
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Affiliation(s)
| | - Philip M. Anton
- Southern Illinois University Carbondale, Carbondale, Illinois, USA
| | | | - Leslie L. Lake
- National Blood Clot Alliance, Philadelphia, Pennsylvania, USA
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Abstract
Background This study aims to examine the effect of time-variant perceived neighborhood social cohesion, perceived neighborhood physical disorder, and local crime on cardiovascular disease (CVD) incidence from 2006 through 2016. Methods and Results We obtained data from the Health & Retirement Study. Respondents aged ≥50 years and with no recorded history of CVD until 2006 (N=8826) were included and followed for 10 years. Cox proportional hazards models were estimated with CVD incidence as an outcome variable and time-variant social environment factors (perceived neighborhood social cohesion, perceived neighborhood physical disorder, and local crime) as exposures, after controlling for sociodemographic factors and CVD-related risk/protective factors. Our results showed that perceived neighborhood social cohesion was associated with CVD among Black respondents, but not Hispanic and White respondents. Perceived neighborhood physical disorder and local crime rates were not associated with CVD incidence across all racial and ethnic groups. Conclusions The results demonstrate that perceptions of favorable social environments need to be considered to reduce CVD risk among Black adults. Further research is needed to identify different pathways through which living in favorable social environments benefits cardiovascular health by racial and ethnic groups.
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Affiliation(s)
- Yeonwoo Kim
- Department of Kinesiology University of Texas at Arlington Arlington TX
| | - Ahyoung Lee
- Ewha Institute for Age Integration Research Ewha Womans University Seoul South Korea
| | - Catherine Cubbin
- Steve Hicks School of Social Work University of Texas at Austin Austin TX
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Bytyci Katanolli A, Probst-Hensch N, Ann Obas K, Gerold J, Zahorka M, Jerliu N, Ramadani Q, Fota N, Merten S. Perceived barriers to physical activity behaviour among patients with diabetes and hypertension in Kosovo: a qualitative study. BMC PRIMARY CARE 2022; 23:257. [PMID: 36180857 PMCID: PMC9523175 DOI: 10.1186/s12875-022-01866-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
In a cohort of primary health care users across Kosovo (KOSCO cohort), high rates and poor control of diabetes and hypertension were observed. These conditions can be prevented and better controlled by adapting to a healthy lifestyle. Physical activity is an important target, as inactivity and related obesity were very prevalent in the KOSCO cohort. This qualitative study aims to identify individual and structural barriers to physical activity perceived by patients with diabetes and/or hypertension so as to inform health care providers and policy-makers in Kosovo on strategies for promoting physical activity.
Methods
Interviews were conducted from July to October 2020 with 26 public primary health care users from five municipalities of Kosovo (Mitrovica, Vushtrri, Fushe Kosova, Gjakova, and Malisheva). The qualitative study was nested into the KOSCO cohort. KOSCO was implemented in 2019 and recruited consecutive patients visiting the public primary health care centres in these municipalities. Participants of this qualitative sub-study were selected if they had a doctor’s diagnosis of diabetes and/or hypertension. The interview guide consisted of questions related to physical activity barriers these patients are facing, despite having received motivational counselling sessions in primary healthcare centres. Data were analysed using a framework methodology.
Results
Three main themes moderating physical activity behaviour were identified: 1) neighbourhood built environment, 2) health-related problems, and 3) social support. The barriers to physical activity related to the first theme were structural features of the neighbourhoods such as: crowded sidewalks, lack of green spaces, lack of proper lighting in public spaces, as well as dense traffic. In regards to the second theme, the main health reasons for study participants to delay physical activity were related to: physical discomfort as well as stress, worry, and lack of energy. An additional barrier to exercise was lack of social support specifically from friends.
Conclusion
The study identifies structural and individual targets for integrated and inter-sectoral physical activity promotion efforts.
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Tian Y, Shi Z. The Relationship between Social Support and Exercise Adherence among Chinese College Students during the COVID-19 Pandemic: The Mediating Effects of Subjective Exercise Experience and Commitment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811827. [PMID: 36142099 PMCID: PMC9517627 DOI: 10.3390/ijerph191811827] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 05/07/2023]
Abstract
This study aimed to investigate the relationship between social support and exercise adherence among Chinese college students during the COVID-19 pandemic, as well as the mediating effects of subjective exercise experience and commitment in the relationship, in order to provide a reference for improving exercise adherence among Chinese college students during the COVID-19 pandemic. The Perceived Available Support in Sport Questionnaire, Subjective Exercise Experience Scale, Exercise Commitment Scale, and Exercise Adherence Scale were administered to 459 eligible college students in Jinan, Shandong Province, through convenience sampling. Results showed that social support positively predicted exercise adherence among college students. The separate and joint mediating effects of subjective exercise experience and commitment between social support and college students' exercise adherence were significant. This study demonstrated that social support can positively predict exercise adherence among college students. In addition, subjective exercise experience and commitment played mediation roles between social support and college students' exercise adherence, both separately and jointly. Therefore, enhancing social support and improving the level of subjective exercise experience and exercise commitment among college students may be an effective strategy for improving exercise adherence among Chinese college students during the COVID-19 pandemic.
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Montayre J, Ho MH, Chang HCR, Liu MF, Chang CC, Fernandez R. Predictors of health-related quality of life in older New Zealanders with cardiovascular health problems. Australas J Ageing 2021; 41:274-281. [PMID: 34873808 DOI: 10.1111/ajag.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/25/2021] [Accepted: 10/20/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE With longer life expectancies, cardiovascular diseases are increasingly common among older adults, which also leads to functional changes that severely impact their quality of life. This study aimed to identify the predictors of health-related quality of life (HRQOL) among older New Zealanders with cardiovascular health problems. METHODS A cross-sectional data analysis of the 2015/16 New Zealand Health Survey was performed. In total, 2203 older New Zealanders with cardiovascular health problems were identified and included in the final analyses. The association between demographics, physical activity, health measurements, and HRQOL was examined using a multiple linear regression model. RESULTS Significant differences in HRQOL were identified between the demographics and cardiovascular risk factors. Predictors of higher HRQOL among older New Zealanders with cardiovascular conditions were increased physical activity (β = 0.218), age (β = -0.067), employed (β = 0.137), lower waist circumference (β = -0.261), male (β = 0.127), and being without a history of diabetes (β = -0.071). CONCLUSION Physical activity is the strongest predictor of HRQOL in older adults with cardiovascular problems. Older female New Zealanders with cardiovascular health problems have lower perceptions of their health status. These predictors should be considered while designing and developing intervention and health education that aims to improve the HRQOL of older adults.
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Affiliation(s)
- Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Mu-Hsing Ho
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Megan F Liu
- School of Gerontology Health Management, Taipei Medical University, Taipei, Taiwan
| | - Chia-Chi Chang
- School of Gerontology Health Management, Taipei Medical University, Taipei, Taiwan.,College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Centre for Research in Nursing and Health, St George Hospital, Sydney, New South Wales, Australia
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Hu J, Fitzgerald SM, Owen AJ, Ryan J, Joyce J, Chowdhury E, Reid CM, Britt C, Woods RL, McNeil JJ, Freak-Poli R. Social isolation, social support, loneliness and cardiovascular disease risk factors: A cross-sectional study among older adults. Int J Geriatr Psychiatry 2021; 36:1795-1809. [PMID: 34231940 DOI: 10.1002/gps.5601] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/20/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Social health reflects one's ability to form interpersonal relationships. Poor social health is a risk factor for cardiovascular disease (CVD), however an in-depth exploration of the link through CVD risk factors is lacking. AIM To examine the relationship between social health (social isolation, social support, loneliness) and CVD risk factors among healthy older women and men. METHODS Data were from 11,498 healthy community-dwelling Australians aged ≥70 years from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and the ASPREE Longitudinal Study of Older Persons sub-study. Ten-year CVD risk was estimated using the Atherosclerotic CVD Risk Scale (ASCVDRS) and the Framingham Risk Score (FRS). RESULTS Physical inactivity and experiencing depressive symptoms were the only CVD risk factors that consistently differed by all three social health constructs. Loneliness was associated with greater ASCVDRS (women: β = 0.01, p < 0.05; men: β = 0.03, p < 0.001), social isolation with greater FRS (women: β = 0.02, p < 0.01; men: β = 0.03, p < 0.01) and the social health composite of being lonely (regardless of social isolation and/or social support status) with greater ASCVDRS (women: β = 0.01, p = 0.02; men: β = 0.03, p < 0.001). Among men, loneliness was also associated with greater FRS (β = 0.03, p < 0.001) and social support with greater ASCVDRS (β = 0.02, p = 0.01). Men were more socially isolated, less socially supported and less lonely than women. CONCLUSION Social isolation, social support and loneliness displayed diverse relationships with CVD risk factors and risk scores, emphasising the importance of distinguishing between these constructs. These findings inform on potential avenues to manage poor social health and CVD risk among older adults.
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Affiliation(s)
- Jessie Hu
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Sharyn M Fitzgerald
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice J Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Johanna Joyce
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Enayet Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,School of Public Health, Curtin University, Perth, Australia
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,School of Public Health, Curtin University, Perth, Australia
| | - Carlene Britt
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
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Huang J, Li Y, Brellenthin AG, Lee DC, Sui X, Blair SN. Causal mediation analysis between resistance exercise and reduced risk of cardiovascular disease based on the Aerobics Center Longitudinal Study. J Appl Stat 2021; 49:3750-3767. [DOI: 10.1080/02664763.2021.1962260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jiasheng Huang
- School of Mathematical Sciences, Peking University, Beijing, People's Republic of China
| | - Yehua Li
- Department of Statistics, University of California at Riverside, Riverside, CA, USA
| | | | - Duck-chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, USA
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Steven N. Blair
- Department of Exercise Science and Epidemiology/Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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13
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Görgülü E, Bieber M, Engeroff T, Zabel K, Etyemez S, Prvulovic D, Reif A, Oertel V. Physical activity, physical self-perception and depression symptoms in patients with major depressive disorder: a mediation analysis. Eur Arch Psychiatry Clin Neurosci 2021; 271:1205-1215. [PMID: 34282468 PMCID: PMC8429392 DOI: 10.1007/s00406-021-01299-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/04/2021] [Indexed: 11/21/2022]
Abstract
Physical inactivity is discussed as one of the most detrimental influences for lifestyle-related medical complications such as obesity, heart disease, hypertension, diabetes and premature mortality in in- and outpatients with major depressive disorder (MDD). In contrast, intervention studies indicate that moderate-to-vigorous-intensity physical activity (MVPA) might reduce complications and depression symptoms itself. Self-reported data on depression [Beck-Depression-Inventory-II (BDI-II)], general habitual well-being (FAHW), self-esteem and physical self-perception (FAHW, MSWS) were administrated in a cross-sectional study with 76 in- and outpatients with MDD. MVPA was documented using ActiGraph wGT3X + ® accelerometers and fitness was measured using cardiopulmonary exercise testing (CPET). Subgroups were built according to activity level (low PA defined as MVPA < 30 min/day, moderate PA defined as MVPA 30-45 min/day, high PA defined as MVPA > 45 min/day). Statistical analysis was performed using a Mann-Whitney U and Kruskal-Wallis test, Spearman correlation and mediation analysis. BDI-II scores and MVPA values of in- and outpatients were comparable, but fitness differed between the two groups. Analysis of the outpatient group showed a negative correlation between BDI-II and MVPA. No association of inpatient MVPA and psychopathology was found. General habitual well-being and self-esteem mediated the relationship between outpatient MVPA and BDI-II. The level of depression determined by the BDI-II score was significantly higher in the outpatient low- and moderate PA subgroups compared to outpatients with high PA. Fitness showed no association to depression symptoms or well-being. To ameliorate depressive symptoms of MDD outpatients, intervention strategies should promote habitual MVPA and exercise exceeding the duration recommended for general health (≥ 30 min/day). Further studies need to investigate sufficient MVPA strategies to impact MDD symptoms in inpatient settings. Exercise effects seem to be driven by changes of well-being rather than increased physical fitness.
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Affiliation(s)
- Esra Görgülü
- Institute of Occupational, Social and Environmental Medicine, University Hospital of Frankfurt, Frankfurt am Main, Germany.
| | - Miriam Bieber
- grid.411088.40000 0004 0578 8220Institute of Occupational, Social and Environmental Medicine, University Hospital of Frankfurt, Frankfurt am Main, Germany
| | - Tobias Engeroff
- grid.7839.50000 0004 1936 9721Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Kirsten Zabel
- grid.411088.40000 0004 0578 8220Institute of Occupational, Social and Environmental Medicine, University Hospital of Frankfurt, Frankfurt am Main, Germany
| | - Semra Etyemez
- grid.21107.350000 0001 2171 9311Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - David Prvulovic
- grid.411088.40000 0004 0578 8220Institute of Occupational, Social and Environmental Medicine, University Hospital of Frankfurt, Frankfurt am Main, Germany
| | - Andreas Reif
- grid.411088.40000 0004 0578 8220Institute of Occupational, Social and Environmental Medicine, University Hospital of Frankfurt, Frankfurt am Main, Germany
| | - Viola Oertel
- grid.411088.40000 0004 0578 8220Institute of Occupational, Social and Environmental Medicine, University Hospital of Frankfurt, Frankfurt am Main, Germany
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Boyle HK, Dunsiger SI, Bohlen LC, Emerson JA, Lee HH, Stevens CJ, Williams DM. Affective response as a mediator of the association between the physical and social environment and physical activity behavior. J Behav Med 2020; 43:773-782. [PMID: 31734890 PMCID: PMC7228837 DOI: 10.1007/s10865-019-00118-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 11/09/2019] [Indexed: 10/25/2022]
Abstract
Perceptions of the physical and social environment have been shown to be predictive of physical activity (PA) behavior. However, the mechanisms of this association have not been examined. Affective response to PA was examined as a putative mediator of the association between perceptions of the PA environment and subsequent PA behavior. As part of a PA promotion study, 59 low-active overweight or obese but otherwise healthy adults completed real-time assessments of the perceived physical and social PA environment, affective response to PA, and PA behavior over a 6-month period. As hypothesized, decreased latency to and greater duration of subsequent PA was predicted by engaging in PA with a partner (b = 17.24, SE = .45, p < .01), engaging in PA outdoors versus indoors (b = 3.70, SE = 0.67, p < .01), and perceived pleasantness of the physical (b = 0.59, SE = .17, p < .01) and social settings (b = 0.68, SE = .16, p < .01). Affective response to PA (a shift toward feeling good versus bad during PA) mediated the association between engaging in PA with a partner (a path: 0.53(.11), p < .01, b path: 0.42(.12), p < .01, ab path: 0.22(.08), 95% CI .09-.41) and perceived pleasantness of the physical (a path: .38(.02), p < .01; b path: .65(.23), p = .01; ab path: .25(.09), 95% CI .08-.43) and social setting (a path: .35(.02), p < .01; b path: .57(.23), p = .01; ab path: .20(.08), 95% CI .03-.37) and PA behavior, but not the association between engaging in PA outdoors versus indoors and PA behavior. These findings suggest that perceived environmental variables may have their effects on PA through the process of psychological hedonism.
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Affiliation(s)
- Holly K Boyle
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Shira I Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | | | - Jessica A Emerson
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Harold H Lee
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Courtney J Stevens
- Dartmouth Centers for Health and Aging, Geisel School of Medicine, Lebanon, NH, USA
| | - David M Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
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Healthy Lifestyle and Incidence of Metabolic Syndrome in the SUN Cohort. Nutrients 2018; 11:nu11010065. [PMID: 30598006 PMCID: PMC6357191 DOI: 10.3390/nu11010065] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 01/22/2023] Open
Abstract
We assessed the relationship between a healthy lifestyle and the subsequent risk of developing metabolic syndrome. The “Seguimiento Universidad de Navarra” (SUN) Project is a prospective cohort study, focused on nutrition, lifestyle, and chronic diseases. Participants (n = 10,807, mean age 37 years, 67% women) initially free of metabolic syndrome were followed prospectively for a minimum of 6 years. To evaluate healthy lifestyle, nine habits were used to derive a Healthy Lifestyle Score (HLS): Never smoking, moderate to high physical activity (>20 MET-h/week), Mediterranean diet (≥4/8 adherence points), moderate alcohol consumption (women, 0.1–5.0 g/day; men, 0.1–10.0 g/day), low television exposure (<2 h/day), no binge drinking (≤5 alcoholic drinks at any time), taking a short afternoon nap (<30 min/day), meeting up with friends >1 h/day, and working at least 40 h/week. Metabolic syndrome was defined according to the harmonizing definition. The association between the baseline HLS and metabolic syndrome at follow-up was assessed with multivariable-adjusted logistic regressions. During follow-up, we observed 458 (4.24%) new cases of metabolic syndrome. Participants in the highest category of HLS adherence (7–9 points) enjoyed a significantly reduced risk of developing metabolic syndrome compared to those in the lowest category (0–3 points) (adjusted odds ratio (OR) = 0.66, 95% confidence interval (CI) = 0.47–0.93). Higher adherence to the Healthy Lifestyle Score was associated with a lower risk of developing metabolic syndrome. The HLS may be a simple metabolic health promotion tool.
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Díaz-Gutiérrez J, Ruiz-Canela M, Gea A, Fernández-Montero A, Martínez-González MÁ. Relación entre un índice de estilo de vida saludable y el riesgo de enfermedad cardiovascular en la cohorte SUN. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.09.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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17
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Lee CG, Park S, Yoo S. The longitudinal effect of parental support during adolescence on the trajectory of sport participation from adolescence through young adulthood. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:70-76. [PMID: 30356459 PMCID: PMC6180530 DOI: 10.1016/j.jshs.2016.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 11/15/2016] [Accepted: 11/25/2016] [Indexed: 06/08/2023]
Abstract
BACKGROUND One efficient way to increase physical activity is through sport participation because participation in sport activities inherently includes many enjoyable aspects, such as social interaction, competition, personal challenge, and goal achievement. The main purpose of this study was to investigate the longitudinal effect of parental support during adolescence on the trajectory of sport participation from adolescence through young adulthood. METHODS The data used in this study came from the National Longitudinal Study of Adolescent to Adult Health (Add Health). It is a 4-wave longitudinal study that followed up a nationally representative sample of middle and high school students in the US. A series of multilevel logistic regression models were used to examine the effect of parental support at Wave 1 on the trajectory of sport participation from Wave 1 to Wave 4. RESULTS The effect of parental support during adolescence on participants' sport participation lasted until they become young adults (Wave 3) (p < 0.001). Among the male participants, parental support at Wave 1 was a significant predictor for sport participation at Waves 1, 2, and 3 (p < 0.001). However, a significant effect of parental support at Wave 1 on sport participation in early young adulthood (Wave 3) becomes insignificant when adjusting for self-esteem and depression. Among the female participants, parental support at Wave 1 was a significant predictor for sport participation at Waves 1, 2, and 3 (p < 0.01) even after depression and self-esteem were introduced into the model. That is to say, unlike male participants, parental support during adolescence has an independent effect on sport participation from adolescence (Wave 1) through early young adulthood (Wave 3) over and above the effects of depression and self-esteem in female participants. CONCLUSION The results of this study contributed to the literature by providing important information on the longitudinal effect of parental support during adolescence on the trajectory of sport participation from adolescence through young adulthood using a nationally representative sample of participants transitioning from adolescence to young adulthood.
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Affiliation(s)
- Chung Gun Lee
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea
| | - Seiyeong Park
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea
| | - Seunghyun Yoo
- Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
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Díaz-Gutiérrez J, Ruiz-Canela M, Gea A, Fernández-Montero A, Martínez-González MÁ. Association Between a Healthy Lifestyle Score and the Risk of Cardiovascular Disease in the SUN Cohort. ACTA ACUST UNITED AC 2017; 71:1001-1009. [PMID: 29287797 DOI: 10.1016/j.rec.2017.10.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/04/2017] [Indexed: 01/21/2023]
Abstract
INTRODUCTION AND OBJECTIVES A healthy lifestyle (HLS) is essential to attaining optimal cardiovascular health. Our objective was to assess the association between a HLS score and the incidence of hard cardiovascular disease (CVD) events. METHODS The SUN project is a dynamic, prospective, multipurpose cohort of Spanish university graduates with a retention proportion of 92%. In 19 336 participants, we calculated a HLS score ranging from 0 to 10 points: never smoking, physical activity (> 20 METs-h/wk), Mediterranean diet adherence (≥ 4/8 points), low body mass index (≤ 22), moderate alcohol intake (women, 0.1-5g/d; men, 0.1-10g/d), low television exposure (≤ 2h/d), no binge drinking (≤ 5 alcoholic drinks anytime), taking a short afternoon nap (< 30min/d), meeting up with friends> 1h/d and working> 40h/wk. RESULTS After a median follow-up of 10.4 years, we identified 140 incident cases of CVD. After adjustment for potential confounders, the highest category of HLS score adherence (7-10 points) showed a significant 78% relative reduction in the risk of primary CVD compared with the lowest category (0-3 points) (adjusted HR, 0.22; 95%CI, 0.11-0.46). Each healthy habit was individually associated with a lower risk of CVD. CONCLUSIONS A HLS score including several simple healthy habits was associated with a lower risk of developing primary CVD. This index may be useful to reinforce CVD prevention without the need to include traditional risk factors.
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Affiliation(s)
- Jesús Díaz-Gutiérrez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain
| | - Miguel Ruiz-Canela
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Alfredo Gea
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Alejandro Fernández-Montero
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Departamento de Medicina del Trabajo, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Miguel Ángel Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Departamento de Nutrición, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States.
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Kim S, Thomas PA. Direct and Indirect Pathways From Social Support to Health? J Gerontol B Psychol Sci Soc Sci 2017; 74:1072-1080. [DOI: 10.1093/geronb/gbx084] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 06/15/2017] [Indexed: 12/14/2022] Open
Abstract
Abstract
Objectives
We aimed to investigate potential direct and indirect pathways linking social support and health, while considering mental health and chronic inflammation as inter-related outcomes. The study also contributes to the literature through testing potential bidirectional relationships between social support, mental health, and chronic inflammation.
Methods
This study uses Structural Equation Modeling and two waves of the National Social Life, Health, and Aging Project (NSHAP), including 1,124 community-living older adults aged 57–85 years at Wave 1 (2005).
Results
Analyses show that social support influenced mental health indirectly through better self-esteem. Moreover, social support was associated with lower levels of chronic inflammation but chronic inflammation did not influence social support.
Discussion
The growing number of older adults with an aging population urgently calls for a greater understanding of factors influencing their physical and mental health. The results of this study demonstrate the importance of social support in older adults’ health, while specifically focusing on understudied indirect pathways from social support to health.
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Affiliation(s)
- Seoyoun Kim
- Department of Sociology, Texas State University, San Marcos
| | - Patricia A Thomas
- Department of Sociology
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana
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20
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Hajduk AM, Hyde JE, Waring ME, Lessard DM, McManus DD, Fauth EB, Lemon SC, Saczynski JS. Practical Care Support During the Early Recovery Period After Acute Coronary Syndrome. J Appl Gerontol 2017; 37:881-903. [PMID: 28380706 DOI: 10.1177/0733464816684621] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the prevalence and predictors of receipt of practical support among acute coronary syndrome (ACS) survivors during the early post-discharge period. METHOD 406 ACS patients were interviewed about receipt of practical (instrumental and informational) support during the week after discharge. Demographic, clinical, functional, and psychosocial predictors of instrumental and informational practical support were examined. RESULTS 81% of participants reported receiving practical support during the early post-discharge period: 75% reported receipt of instrumental support and 51% reported receipt of informational support. Men were less likely to report receiving certain types of practical support, whereas married participants and those with higher education, impaired health literacy, impaired activities of daily living, and in-hospital complications were more likely to report receiving certain types of practical support. CONCLUSION Receipt of practical support is very common among ACS survivors during the early post-discharge period, and type of support received differs according to patient characteristics.
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Petrova D, Garcia-Retamero R, Catena A. Lonely hearts don't get checked: On the role of social support in screening for cardiovascular risk. Prev Med 2015; 81:202-8. [PMID: 26361754 DOI: 10.1016/j.ypmed.2015.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Regular cardiovascular risk screening can prevent cardiovascular disease through timely implementation of lifestyle changes or medication. However, few studies have investigated what factors promote regular screening for risk factors like hypertension and high blood cholesterol. The aim of this study was to investigate the relationship between social support and adherence to cardiovascular risk screening. METHODS We analyzed data from the Spanish National Health Survey-a cross-sectional representative survey conducted by the Spanish Ministry of Health in 2012 (N=21,007). Participants reported whether they had their blood pressure and cholesterol levels measured by a health professional in the previous 12 months. Social support (i.e., the perception that emotional and practical support was available when needed) was measured with a validated scale. Multiple logistic regressions were conducted adjusted for demographic and health-related factors. RESULTS Compared to individuals who reported a lack of social support, individuals who perceived sufficient social support were on average twice more likely to report participation in blood pressure screening, OR=2.06, 95% CI [1.60, 2.66] and cholesterol screening, OR=2.85, 95% CI [1.99, 4.09]. These effects were uniform across different demographics and were replicated in a previous wave of the survey. Factors associated with worse screening adherence were low social class, being single or widowed, smoking, alcohol consumption, and no history of cardiovascular risk. DISCUSSION Perceptions of social support are positively related to cardiovascular risk screening adherence. Future research should investigate what type of social support most effectively increases screening participation among high risk populations.
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Affiliation(s)
- Dafina Petrova
- Mind, Brain, and Behavior Research Center, University of Granada, Spain.
| | - Rocio Garcia-Retamero
- Mind, Brain, and Behavior Research Center, University of Granada, Spain; Max Planck Institute for Human Development, Germany
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center, University of Granada, Spain
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Determinants of Physical Activity Guideline Attainment in Australian Cardiac Patients: A 12-Month Study. J Cardiopulm Rehabil Prev 2015; 35:399-408. [PMID: 26378492 DOI: 10.1097/hcr.0000000000000137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Little is known about the type and intensity of physical activity (PA) reported by cardiac patients during the first year after hospitalization and whether patients are meeting recommended PA guidelines. In addition, the achievement of PA guideline over the course of recovery is largely unknown. METHODS A total of 136 patients consecutively admitted to 2 Australian hospitals after acute myocardial infarction (31%), or to undergo bypass surgery (29%) or percutaneous coronary intervention (40%), were interviewed at 6 weeks and at 4 and 12 months after admission. Physical activity at each time point was assessed by the Active Australia PA Survey. Medical and sociodemographic data, self-reported anxiety and depression, and cardiac rehabilitation attendance status were also recorded. Logistic regression was used to identify predictors of PA guideline attainment at each of the 3 time points. RESULTS At all 3 time points, walking was regularly performed by more than 95% of patients, while moderate- and vigorous-intensity PA reached only 40% and 59% participation by 12 months, respectively. Significant predictors of PA guideline attainment at 6 weeks posthospitalization were physical functioning, depression, and mode of PA. As hypothesized, different predictors were found at 4 months (living arrangements, PA mode, and attainment of 6-week PA guidelines) and 12 months (living arrangements, socioeconomic resources, PA mode, and attainment of 6-week PA guidelines). CONCLUSIONS The study highlighted the potential importance of modifying walking behavior in cardiac patients to achieve PA guidelines and the dynamic nature of variables influencing PA at various stages of recovery.
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Pedišić Ž, Greblo Z, Phongsavan P, Milton K, Bauman AE. Are total, intensity- and domain-specific physical activity levels associated with life satisfaction among university students? PLoS One 2015; 10:e0118137. [PMID: 25695492 PMCID: PMC4335071 DOI: 10.1371/journal.pone.0118137] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 01/07/2015] [Indexed: 11/20/2022] Open
Abstract
Background Thorough information about the relationship between physical activity (PA) and life satisfaction is still lacking. Therefore, this study examined the cross-sectional relationships between life satisfaction and meeting the World Health Organization (WHO) moderate to vigorous-intensity PA recommendations, total volume and duration of PA, intensity-specific PA (walking, moderate- and vigorous-intensity), domain-specific PA (work, transport-related, domestic, and leisure-time), and 11 domain and intensity-specific PA types among university students. Additionally, we examined the associations between life satisfaction and gender, age, disposable income, community size, smoking, alcohol intake, body mass index (BMI), and self-rated health. Methods The study included a random sample of 1750 university students in Zagreb, Croatia (response rate = 71.7%; 62.4% females; mean age 21.5 ± 1.8 years), using the International Physical Activity Questionnaire — long form and the Satisfaction with Life Scale. Results Higher life satisfaction was associated with female gender (β = 0.13; p = <0.001), younger age (β = -0.07; p = 0.024), higher disposable income (β = 0.10; p = 0.001), and better self-rated health (β = 0.30; p = <0.001). No significant association was found between life satisfaction and size of community (p = 0.567), smoking status (p = 0.056), alcohol consumption (p = 0.058), or BMI (p = 0.508). Among all PA variables, only leisure-time vigorous-intensity PA was significantly associated with life satisfaction after adjustments for socio-demographic characteristics, lifestyle and self-rated general health (β = 0.06; p = 0.045). Conclusions This study indicated a weak positive relationship between leisure-time vigorous-intensity PA and life satisfaction, whilst no such association was found for other PA variables. These findings underscore the importance of analyzing domain and intensity-specific PA levels in future studies among university students, as drawing conclusions about the relationship between PA and life satisfaction based on total PA levels only may be misleading.
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Affiliation(s)
- Željko Pedišić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- * E-mail:
| | - Zrinka Greblo
- Department of Psychology, Centre for Croatian Studies, University of Zagreb, Zagreb, Croatia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Karen Milton
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Adrian E. Bauman
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
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Maier KJ, James AE. Hostility and social support explain physical activity beyond negative affect among young men, but not women, in college. Behav Med 2014; 40:34-41. [PMID: 24512364 DOI: 10.1080/08964289.2013.826170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We examined social support as a moderator of cynical hostility in relation to physical activity and body mass index among college students (n = 859; M = 18.71 years (SD = 1.22); 60% women, 84% White). After controlling for negative affect in hierarchical linear regression models, greater hostility was associated with lesser physical activity among those with low social support, as expected. Greater hostility was also associated with greater physical activity among those high in social support, ps < .05. Effects were observed for men only. Hostility and social support were unrelated to body mass index, ps > .05. Young men with a hostile disposition and low social support may be at risk for a sedentary lifestyle for reasons other than negative affect.
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Yates BC, Rowland S, Mancuso K, Kupzyk KA, Norman JF, Shurmur S, Tesina K. Reducing Cardiovascular Risk in Spouses of Cardiac Patients. West J Nurs Res 2014; 37:85-102. [DOI: 10.1177/0193945914551390] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few studies have examined risk-reducing interventions in spouses of coronary artery bypass patients. This study examined the effects of the Partners Together in Health (PaTH) intervention versus usual care on cardiovascular risk factors. Spouses in the experimental group ( n = 17/group) attended cardiac rehabilitation with patients and made the same physical activity and healthy eating changes as patients. Spouses in the usual care group attended educational classes with patients. Spouses’ 30-year cardiovascular risk was calculated using the Lifetime Risk Scale before and after cardiac rehabilitation (3 months), and at 6 months. Spouses in both groups significantly reduced 30-year risk scores at 3 and 6 months. Exercise was the key ingredient in lowering risk. There was a trend toward reduction in systolic blood pressure and an increase in high-density lipoprotein cholesterol in both groups. Although there were no group differences, having spouses participate in cardiac rehabilitation with the patient was effective for reducing spouses’ cardiovascular risk.
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Curchack-Lichtin JT, Chacko A, Halperin JM. Changes in ADHD symptom endorsement: preschool to school age. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 42:993-1004. [PMID: 24343794 PMCID: PMC4062613 DOI: 10.1007/s10802-013-9834-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
To investigate endorsement patterns among the 18 DSM-IV symptoms of ADHD in a longitudinal sample of children with and without ADHD (n = 144), as assessed at ages 4-5, 5-6, and 6-7 years. Symptom endorsements and diagnoses were determined at all time-points via K-SADS-PL interview administered to parents and supplemented by teacher questionnaires and clinician observations. Changes in endorsement patterns over time for each of the 18 DSM-IV symptoms were ascertained. Several symptoms, particularly those of inattention, were infrequently endorsed and of apparently limited diagnostic utility at ages 4-5; hyperactive/impulsive symptoms were more frequently endorsed among young children with ADHD than were inattentive symptoms. However, by ages 6-7, inattention items were somewhat superior at discriminating ADHD from Non-ADHD children. Several DSM-IV and now DSM-V symptoms provide limited diagnostic differentiation prior to school-age, particularly those most commonly observed in the context of formal schooling. Consideration should be made in future iterations of the DSM that account for such developmental and contextual differences.
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Rackow P, Scholz U, Hornung R. Effects of a new sports companion on received social support and physical exercise: an intervention study. Appl Psychol Health Well Being 2014; 6:300-17. [PMID: 24989147 DOI: 10.1111/aphw.12029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The role of social support in physical exercise is well documented. However, the majority of studies that investigate the associations between social support and physical exercise target perceived instead of received social support. Moreover, most studies investigate the effects of received social support using a descriptive correlational design. Thus, our study aimed at investigating the effects of received social support by conducting an intervention study. METHODS Participants were randomly assigned to an intervention (n = 118) or control group (n = 102). The intervention comprised regularly exercising with a new sports companion for eight weeks. To investigate the time course of physical exercise and received social support, growth curve modelling was employed. RESULTS Generally, both groups were able to improve their physical exercise. However, the control group tended to decrease again during the final point of measurement. Received social support, however, decreased slightly in the control group, but remained stable in the intervention group. CONCLUSIONS The intervention was suitable to sustain received social support for physical exercise across a two-month interval. Overall, these findings highlight the importance of further investigating social support for physical exercise applying an experimental approach.
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Relationship between objectively measured walkability and exercise walking among adults with diabetes. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2014; 2014:542123. [PMID: 24790613 PMCID: PMC3984782 DOI: 10.1155/2014/542123] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 03/03/2014] [Indexed: 01/21/2023]
Abstract
Little is known about the relationship between objectively measured walkability and walking for exercise among adults with diabetes. Information regarding walking behavior of adults with diabetes residing in 3 Upstate New York counties was collected through an interview survey. Walkability measures were collected through an environmental audit of a sample of street segments. Overall walkability and 4 subgroup measures of walkability were aggregated at the ZIP level. Multivariate logistic regression was used for analysis. Study participants (n = 208) were 61.0% female, 56.7% non-Hispanic White, and 35.1% African-American, with a mean age of 62.0 years. 108 participants (51.9%) walked for exercise on community streets, and 62 (29.8%) met the expert-recommended level of walking for ≥150 minutes/week. After adjustment for age, gender, race/ethnicity, education, BMI, physical impairment, and social support for exercise, walking any minutes/week was associated with traffic safety (OR 1.34, 95% CI 1.15–1.65). Walking ≥150 minutes/week was associated with overall walkability of the community (2.65, 1.22, and 5.74), as well as sidewalks (1.73, 1.12–2.67), street amenity (2.04, 1.12–3.71), and traffic safety (1.92, 1.02–3.72). This study suggests that walkability of the community should be an integral part of the socioecologic approach to increase physical activity among adults with diabetes.
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Ylimäki EL, Kanste O, Heikkinen H, Bloigu R, Kyngäs H. The effects of a counselling intervention on lifestyle change in people at risk of cardiovascular disease. Eur J Cardiovasc Nurs 2014; 14:153-61. [DOI: 10.1177/1474515114521725] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Outi Kanste
- National Institute for Health and Welfare, Oulu, Finland
| | | | | | - Helvi Kyngäs
- University of Oulu, Finland
- Northern Ostrobothnia Hospital District, Finland
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Kim S, Mazza J. Reliability, Validity, and Item Response of MOS Social Support Score among Incarcerated Women. WOMEN & CRIMINAL JUSTICE 2014; 24:1-21. [PMID: 24910502 PMCID: PMC4043332 DOI: 10.1080/08974454.2012.733327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Seijeoung Kim
- University of Illinois at Chicago, School of Public Health, Division of Health Policy and Administration
| | - Jessica Mazza
- University of Illinois at Chicago, School of Public Health, Division of Health Policy and Administration
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Coulon SM, Wilson DK, Egan BM. Associations among environmental supports, physical activity, and blood pressure in African-American adults in the PATH trial. Soc Sci Med 2013; 87:108-15. [PMID: 23631785 DOI: 10.1016/j.socscimed.2013.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 02/20/2013] [Accepted: 03/14/2013] [Indexed: 01/22/2023]
Abstract
High blood pressure disproportionately affects African-American adults and is a leading cause of stroke and heart attack. Engaging in recommended levels of physical activity reduces blood pressure, and social and physical environmental supports for physical activity may increase engagement in physical activity. Based on social cognitive theory within a bioecological framework, the present study tested hypotheses that perceived peer social support for physical activity and neighborhood walkability would be positively associated with physical activity, and that physical activity would mediate their relation with blood pressure. Baseline data were collected with 434 African-American adults in underserved communities (low income, high crime) participating in the Positive Action for Today's Health (PATH) trial. Perceived peer social support for physical activity and neighborhood walkability were measured with validated surveys. Physical activity was assessed with 7-day accelerometry (moderate-to-vigorous physical activity, min/day) and with a 4-week recall of walking. Three blood pressure assessments were taken by trained staff using standard protocols, with values from the second and third assessments averaged. The sample was predominantly female (63%), overweight (mean body mass index = 30.9, SD = 8.4), and had slightly elevated blood pressures with a mean systolic blood pressure of 132.4 (SD = 17.9) and a mean diastolic blood pressure of 81.4 (SD = 11.0). Results demonstrated that peer social support for physical activity (B = 2.43, p = .02) and neighborhood walkability (B = 2.40, p = .046) were significantly related to average daily moderate-to-vigorous physical activity. Neighborhood walkability was also significantly associated with self-reported average daily walking (B = 8.86, p = .02). Physical activity did not mediate their relation with blood pressure and no significant direct effects of these variables on blood pressure were found. The positive influence of social and physical environmental supports on physical activity in underserved African-American communities may guide intervention efforts and contribute to our understanding of physical activity and related health outcomes.
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Affiliation(s)
- Sandra M Coulon
- Department of Psychology, University of South Carolina, Barnwell College, Columbia, SC 29208, USA.
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Worrall-Carter L, Ski C, Scruth E, Campbell M, Page K. Systematic review of cardiovascular disease in women: assessing the risk. Nurs Health Sci 2011; 13:529-35. [PMID: 22070582 DOI: 10.1111/j.1442-2018.2011.00645.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cardiovascular disease is the number one cause of death for women. In an effort to reduce cardiovascular burden for women, identifying risk factors and increasing awareness of sex differences are fundamental. This systematic review examines cardiovascular disease risk for women. A search of the literature was undertaken using key health databases. Search terms used were cardiovascular disease AND women OR gender. Additional references were manually identified from this literature; 58 articles were reviewed in total. On average, cardiovascular disease presents 10 years later in women compared to men. By this time, they are more likely to suffer from more comorbidities, placing them at higher risk. The complexity of cardiovascular disease identification in women is accentuated through atypical symptoms, and has the potential to lead to delayed and/or misdiagnosis. It is clear through identifying sex differentiation in cardiovascular risk factors that there has been an increased awareness of symptom presentation for women. In light of the sex differences in risk factors, sex-specific aspects should be more intensively considered in research/practice to improve clinical outcomes for female cardiovascular disease patients.
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Affiliation(s)
- Linda Worrall-Carter
- St Vincent's/ACU Centre for Nursing Research, Australian Catholic University, 486 Albert Street, Melbourne, Australia.
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Kouvonen A, De Vogli R, Stafford M, Shipley MJ, Marmot MG, Cox T, Vahtera J, Väänänen A, Heponiemi T, Singh-Manoux A, Kivimäki M. Social support and the likelihood of maintaining and improving levels of physical activity: the Whitehall II Study. Eur J Public Health 2011; 22:514-8. [PMID: 21750013 PMCID: PMC3402714 DOI: 10.1093/eurpub/ckr091] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Evidence on the association between social support and leisure time physical activity (LTPA) is scarce and mostly based on cross-sectional data with different types of social support collapsed into a single index. The aim of this study was to investigate whether social support from the closest person was associated with LTPA. Methods: Prospective cohort study of 5395 adults (mean age 55.7 years, 3864 men) participating in the British Whitehall II study. Confiding/emotional support and practical support were assessed at baseline in 1997–99 using the Close Persons Questionnaire. LTPA was assessed at baseline and follow-up in (2002–04). Baseline covariates included socio-demographics, self-rated health, long-standing illnesses, physical functioning and common mental disorders. Results: Among participants who reported recommended levels of LTPA at baseline, those who experienced high confiding/emotional support were more likely to report recommended levels of LTPA at follow-up [odds ratio (OR): 1.39, 95% confidence interval (CI): 1.12–1.70 in a model adjusted for baseline covariates]. Among those participants who did not meet the recommended target of LTPA at baseline, high confiding/emotional support was not associated with improvement in activity levels. High practical support was associated with both maintaining (OR: 1.34, 95% CI: 1.10–1.63) and improving (OR: 1.25, 95% CI: 1.02–1.53) LTPA levels. Conclusion: These findings suggest that emotional and practical support from the closest person may help the individual to maintain the recommended level of LTPA. Practical support also predicted a change towards a more active lifestyle.
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Affiliation(s)
- Anne Kouvonen
- Warsaw School of Social Sciences and Humanities, Wroclaw Faculty, Wroclaw, Poland.
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Abstract
This section, multilevel policies, reviews the impact that has been and can be made by health policy changes at multiple levels, strategies and resources for increasing adherence to population prevention recommendations, and how changes at the microlevel and macrolevel of the environment can provide opportunities and rewards for healthy behaviors and disincentives for unhealthy behaviors. Policies that support primary prevention of cardiovascular disease require the participation of numerous stakeholders at multiple levels, such as governmental and regulatory agencies. Such policy changes support a healthy lifestyle, as in designated smoke-free areas; laws that mandate that food purveyors reduce sodium and fat content or, eliminate trans-fats; and availability of safe parks and bike and walking trails; and also provide a supportive environment that in turn reinforces adherence to primary prevention. Health-related policies have a major impact at the societal level in both developed and developing countries; thus, it is important to understand the role that policy plays in promoting a healthier lifestyle and the prevention of cardiovascular disease. This section discusses how health policies can impact primary prevention and adherence to healthful recommendations, with examples focused on physical activity and diet.
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Perrino T, Brown SC, Huang S, Brown CH, Gómez GP, Pantin H, Szapocznik J. Depressive symptoms, social support, and walking among Hispanic older adults. J Aging Health 2011; 23:974-93. [PMID: 21508305 DOI: 10.1177/0898264311404235] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Depressive symptoms and physical inactivity are health risks among minority older adults. This study examined whether social support moderated the relationship of depressive symptoms to walking behavior among 217 community-dwelling, Hispanic older adults. METHOD Cross-sectional analyses were used to test whether different forms of social support interacted with depressive symptoms to affect both likelihood and amount of walking. RESULTS Analyses showed a significant interaction between depressive symptoms and instrumental support related to the likelihood of walking and a marginally significant interaction between depressive symptoms and instrumental social support related to the amount of walking. Depressive symptoms were associated with a lower likelihood and lower amount of walking among participants receiving high levels of instrumental social support (e.g., help with chores) but not low instrumental support. Emotional and informational support did not moderate the depression to walking relationship. CONCLUSION Receiving too much instrumental support was related to sedentary behavior among depressed older adults.
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Guimarães EDC, Melo ECP. Características do apoio social associados à prematuridade em uma população de puérperas de baixa renda. ESCOLA ANNA NERY 2011. [DOI: 10.1590/s1414-81452011000100008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Trata-se de um estudo caso-controle que teve como objetivo investigar a associação entre prematuridade e o nível de apoio social, segundo variáveis socioeconômicas, demográficas e relacionadas à saúde e à assistência, em uma população de puérperas de baixa renda atendidas em um hospital público do município do Rio de Janeiro. Foram entrevistados 108 casos e 228 controles, em um total 336 mulheres. A idade das mulheres variou entre 14 e 45 anos. A média da idade foi de 25,8 anos (desvio-padrão: 6,9) para os casos e de 24,9 (desvio-padrão 6,5) para os controles. Quanto à raça/etnia autorreferida, 77,1% denominaram-se não brancas. Da amostra, 68,8% iniciaram o pré-natal antes do terceiro trimestre gestacional. O número de consultas durante o pré-natal, ocorrência de ameaça de parto prematuro e história de prematuridade anterior mostraram-se associados ao nível de apoio, calculado a partir do escore total das dimensões do apoio social.
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Shelton RC, McNeill LH, Puleo E, Wolin KY, Emmons KM, Bennett GG. The association between social factors and physical activity among low-income adults living in public housing. Am J Public Health 2011; 101:2102-10. [PMID: 21330588 DOI: 10.2105/ajph.2010.196030] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to examine the association between structural, functional, and normative social factors and physical activity among urban, low-income, racially/ethnically diverse adults. METHODS We conducted a baseline cross-sectional survey among residents of 12 low-income housing communities in metropolitan Boston, Massachusetts. Participants were also asked to wear a pedometer for 5 days. We analyzed complete data from 1112 residents (weighted n = 1635). RESULTS Residents with smaller social networks were significantly less physically active than were residents with larger social networks (b = -1503.7; P = .01) and residents with conflicting demands were more active than were residents with none (b = 601.6; P = .01), when we controlled for employment status, gender, poverty level, current health status, age, and perceived safety. Social networks were most strongly associated with physical activity among Hispanics and younger residents (aged 18-35 years). CONCLUSIONS These findings indicate that social factors, including social networks and role-related conflicting demands, may be important drivers of physical activity among low-income populations. Researchers and practitioners should consider social factors in developing multilevel physical activity interventions for this population.
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Affiliation(s)
- Rachel C Shelton
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY 10032, USA.
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Aggarwal B, Liao M, Allegrante JP, Mosca L. Low social support level is associated with non-adherence to diet at 1 year in the Family Intervention Trial for Heart Health (FIT Heart). JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2010; 42:380-8. [PMID: 20696617 PMCID: PMC2978807 DOI: 10.1016/j.jneb.2009.08.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 08/11/2009] [Accepted: 08/18/2009] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Evaluate the relationship between low social support (SS) and adherence to diet in a cardiovascular disease (CVD) lifestyle intervention trial. DESIGN Prospective substudy. SETTING AND PARTICIPANTS Blood relatives/cohabitants of hospitalized cardiac patients in a randomized controlled trial (n=458; 66% female, 35% nonwhite, mean age 50 years). MAIN OUTCOME MEASURES Non-adherence to diet using MEDFICTS (Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table, and Snacks) tool; SS using the Enhancing Recovery in Coronary Heart Disease Patients Social Support Instrument. ANALYSIS Logistic regression models adjusted for confounders. RESULTS Significant predictors (P<.05) of non-adherence to diet recommendations at 1 year included low SS, increased body mass index and waist size, lower physical activity, depression, pre-action stages of change, control group assignment, and being male. Those with low SS at baseline 2.7 greater odds of being non-adherent to diet at 1 year vs those with higher SS (95% confidence interval=1.1-6.4); there was no interaction by group assignment. CONCLUSION AND IMPLICATIONS Low SS at baseline was independently associated with non-adherence to diet at 1 year, suggesting that family members with low SS may be at heightened CVD risk as a result of poor dietary adherence.
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Affiliation(s)
| | - Ming Liao
- Columbia University Medical Center, New York, NY
| | | | - Lori Mosca
- Columbia University Medical Center, New York, NY
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Aggarwal B, Liao M, Mosca L. Predictors of physical activity at 1 year in a randomized controlled trial of family members of patients with cardiovascular disease. J Cardiovasc Nurs 2010; 25:444-9. [PMID: 20856131 PMCID: PMC2953569 DOI: 10.1097/jcn.0b013e3181defd3e] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Recommendations for physical activity to lower risk of cardiovascular disease (CVD) are widely known but not often followed. The purpose of this study was to determine the demographic, lifestyle, and psychosocial variables that predict improved physical activity among participants in a CVD prevention lifestyle intervention trial. SUBJECTS AND METHODS Adult family members (N = 501; 66% female; 36% nonwhite; mean age, 48 years) of cardiac patients were randomized to a 1-year special intervention that received education on physical activity or to a control intervention. Demographics, physical activity, stage of change, and CVD risk factors were measured systematically at baseline and 1 year (94% follow-up). Lipids were analyzed in a core laboratory. Linear regression models were adjusted for confounders. RESULTS At baseline, 21% of participants reported exercising more than 3 d/wk, which did not differ by group assignment. The special intervention and control intervention experienced significant increases in physical activity at 1 year with mean physical activity days per week in the special intervention significantly greater than the control intervention (2.5 vs 2.0 d/wk, P = .03). Significant predictors of increased physical activity at 1 year were group assignment (P = .03), female sex (P = .04), nonminority status (P <.01), greater readiness to change (P <.01), and baseline measurements of lower body mass index (P <.01) and waist size (P <.01), greater diet adherence (P <.01), higher high-density lipoprotein cholesterol (P <.01), lower high-sensitivity C-reactive protein (P = .02), less depression (P <.01), and higher social support (P = .03). In multiple regression models, group assignment, female, and nonminority status remained independent predictors of higher physical activity levels at 1 year. CONCLUSION Several predictors of improved physical activity levels at 1 year were documented among clinical trial participants. Racial/ethnic minorities and men were significantly less likely to make positive changes and may need more targeted efforts to improve physical activity levels.
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Affiliation(s)
- Brooke Aggarwal
- Preventive Cardiology, Columbia University Medical Center/New York-Presbyterian Hospital, New York, NY 10032, USA
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Affiliation(s)
- Gerard E. Mullin
- Johns Hopkins University Schools of Medicine, Baltimore, Maryland
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Dahmann N, Wolch J, Joassart-Marcelli P, Reynolds K, Jerrett M. The active city? Disparities in provision of urban public recreation resources. Health Place 2009; 16:431-45. [PMID: 20056472 DOI: 10.1016/j.healthplace.2009.11.005] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 10/25/2009] [Accepted: 11/07/2009] [Indexed: 11/25/2022]
Abstract
Recreation is critical to active living yet few studies have focused on disparities in the provision of recreational programs. We investigate the spatial distribution of public recreational programs in southern California. Findings indicate that more than half of all recreation programs take place away from a formal park site. Multivariate modeling results suggest that cities characterized by low household incomes, low fiscal capacity, minority populations, and multi-family housing are disadvantaged with respect to recreation provisions. Such disparities may increase health risks among populations in such communities. Urban planners and public health advocates should enhance recreation programs in lower-income non-white communities.
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Affiliation(s)
- Nicholas Dahmann
- University of Southern California, Department of Geography, 3620 South Vermont Avenue, Kaprielian Hall, Room 464, Los Angeles, CA 90089, USA
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White AM, Philogene GS, Fine L, Sinha S. Social support and self-reported health status of older adults in the United States. Am J Public Health 2009; 99:1872-8. [PMID: 19696390 DOI: 10.2105/ajph.2008.146894] [Citation(s) in RCA: 126] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We determined whether a representative national probability sample of US community-dwelling older adults who reported less social support also reported poorer general health status, which is a robust predictor of prospective mortality among elders. METHODS We analyzed 2 subsamples generated via random sampling with replacement from the full analytic sample of adults aged 60 years and older in the 1999-2002 National Health and Nutrition Examination Survey (n = 3476). We built multinomial logit models with the first analytic subsample (n = 1732). Then we tested the final models on the second subsample (n = 1744) to assess the differences in odds of reporting poor, fair, or good versus very good or excellent health. We fit the cross-validated final models to the full analytic sample. RESULTS After we controlled for age, race, gender, and educational attainment, older persons across all analytic samples who reported that they needed more support also reported having poorer health compared with better health 2 times more often than did older persons who were satisfied with the support available to them (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.7, 3.4; P < .001). CONCLUSIONS In the United States, older persons' satisfaction with the emotional support available to them is associated with better self-reported health status.
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Affiliation(s)
- Ann Marie White
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642, USA.
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