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Li Y, Rhubart D. Cannabis use, social support and social engagement among working-age adults in rural America. Prev Med Rep 2024; 43:102794. [PMID: 38975281 PMCID: PMC11225026 DOI: 10.1016/j.pmedr.2024.102794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 07/09/2024] Open
Abstract
Objective Cannabis use has been linked to physical, psychological, and behavioral changes. Although research indicates separately that informal social support and formal social engagement - which are correlated measures - serve as protective factors in cannabis use, much of this research focuses on youth and more urban samples, limiting our understanding of if these findings are true for rural populations where social support and social engagement are particularly important for health and health behaviors. To fill the research gap, this study examines the effects of informal social support (tangible support and emotional support) and formal social engagement on cannabis use among rural working-age adults. Methods This research analyzed 1,122 observations from a cross-sectional online survey conducted in 2022 of working-age adults (18-64) from rural America. Multilevel logistic regression models were used to predict cannabis use in the past 12 months using informal social support (tangible support and emotional support) and formal social engagement and other sociodemographic covariates and state legalization status. Results Multilevel logistic modeling indicates that low emotional support and low formal social engagement are associated with a higher odds of reporting cannabis use in the past 12 months among rural working-age adults, net of other sociodemographic variables and state legalization status. Conclusions The study suggests that emotional support and social engagement may contribute to cannabis use prevention among rural working-age adults. These findings should inform future research as well as the development of tailored health interventions targeting rural working-age adults.
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Affiliation(s)
- Yiping Li
- Department of Biobehavioral Health, The Pennsylvania State University, Biobehavioral Health Building, University Park, PA 16802, USA
| | - Danielle Rhubart
- Department of Biobehavioral Health, The Pennsylvania State University, Biobehavioral Health Building, University Park, PA 16802, USA
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Dyal BW, Yoon SL, Powell-Roach KL, Li D, Kittelson S, Weaver M, Krieger JL, Wilkie DJ. Perceptions of Palliative Care: Demographics and Health Status Among the General Population in Florida and the United States. Am J Hosp Palliat Care 2024; 41:363-372. [PMID: 37379569 PMCID: PMC10783876 DOI: 10.1177/10499091231186819] [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] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Palliative care (PC) helps maintain quality of life for seriously ill patients, yet, many Americans lack knowledge of PC. AIM To explore the relationships between knowledge of PC of individuals living in north-central Florida and throughout the United States. DESIGN This cross-sectional survey with three sampling approaches, one was a community-engaged sample and two were panel respondent samples. Respondents and setting: Respondents of the Florida sample (n1 = 329) and the community-engaged sample (n2 = 100), were representative of the 23 Florida county general population. Respondents of the national sample (n = 1800) were adult members of a panel owned by a cloud-based survey platform. RESULTS Young adults compared with adults (OR 1.62, 95% CI 1.14-2.28, P .007), middle-adults (OR 2.47, 95% CI 1.58-3.92, P < .001) and older-adults (OR 3.75, 95% CI 2.50-5.67, P < .001) were less likely to agree that the goal of PC is to help friends and family cope with a patient's illness, and that the goal of PC is to manage pain and other physical symptoms compared with adults (OR 1.67, 95% CI 1.20-2.30, P .002) middle-adults (OR 2.58, 95% CI 1.71-3.95, P < .001) and older-adults (OR 7.19, 95% CI 4.68-11.2, P < .001). Participants with greater rural identity (OR 1.39, 95% CI 1.31-1.48, P < .001) were more likely to agree that accepting PC means giving up. CONCLUSIONS Increased knowledge of PC might be influenced through targeting educational interventions and educating the general population through social media use.
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Affiliation(s)
- Brenda W. Dyal
- Family, Community and Health System Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Saunjoo L. Yoon
- Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Keesha L. Powell-Roach
- Department of Community and Population Health, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Derek Li
- University of Florida Health Science Center, University of Florida, Gainesville, FL, USA
| | - Sheri Kittelson
- Division of Palliative Care, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Weaver
- Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
| | - Janice L. Krieger
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Diana J. Wilkie
- Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, FL, USA
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Luetke Lanfer H, Rossmann C, Kargbo SI. Exploring the Contextual Factors of Religious Leader Participation in Health Communication: Evidence from a Qualitative Study in Sierra Leone. JOURNAL OF RELIGION AND HEALTH 2023; 62:1695-1715. [PMID: 35987844 PMCID: PMC9392582 DOI: 10.1007/s10943-022-01632-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
As there are many and sometimes ambivalent intersections of health and religion, strategic collaborations with religious opinion leaders in health campaigns have been increasingly explored. Despite the known influence of distinct contextual factors within emergency and non-emergency settings, existing research seldom distinguishes between those different factors and their impact on the inclusion of religious leaders as health messengers. To compare the contextual factors of religious leaders as health messengers during emergency and non-emergency situations in a setting with high religious affiliations, this study used a qualitative approach and triangulated the perspectives of three different samples, including (religious) opinion leaders, members of religious communities, and developers of health communication strategies in Sierra Leone. The results provide multifaceted insights into contextual factors applicable to emergency and non-emergency settings as well as the risks and opportunities. Recommendations for the incorporation of religious leaders in health promotion activities in consideration of different contextual factors are provided.
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Affiliation(s)
- Hanna Luetke Lanfer
- School of Public Health, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Constanze Rossmann
- Division of Communication and Media Research, LMU Munich, Oettingenstr. 67, 80538 Munich, Germany
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Smalls BL, Adegboyega A, Combs E, Rutledge M, Westgate PM, Azam MT, De La Barra F, Williams LB, Schoenberg NE. The mediating/moderating role of cultural context factors on self-care practices among those living with diabetes in rural Appalachia. BMC Public Health 2021; 21:1784. [PMID: 34600524 PMCID: PMC8487504 DOI: 10.1186/s12889-021-11777-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/13/2021] [Indexed: 11/27/2022] Open
Abstract
Background The aim of this study was to examine whether cultural factors, such as religiosity and social support, mediate/moderate the relationship between personal/psychosocial factors and T2DM self-care in a rural Appalachian community. Methods Regression models were utilized to assess for mediation and moderation. Multilevel linear mixed effects models and GEE-type logistic regression models were fit for continuous (social support, self-care) and binary (religiosity) outcomes, respectively. Results The results indicated that cultural context factors (religiosity and social support) can mediate/moderate the relationship between psychosocial factors and T2DM self-care. Specifically, after adjusting for demographic variables, the findings suggested that social support may moderate the effect of depressive symptoms and stress on self-care. Religiosity may moderate the effect of distress on self-care, and empowerment was a predictor of self-care but was not mediated/moderated by the assessed cultural context factors. When considering health status, religiosity was a moderately significant predictor of self-care and may mediate the relationship between perceived health status and T2DM self-care. Conclusions This study represents the first known research to examine cultural assets and diabetes self-care practices among a community-based sample of Appalachian adults. We echo calls to increase the evidence on social support and religiosity and other contextual factors among this highly affected population. Trial registration US National Library of Science identifier NCT03474731. Registered March 23, 2018, www.clinicaltrials.gov.
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Affiliation(s)
- Brittany L Smalls
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, 2195 Harrodsburg Road, Suite 125, Lexington, KY, 40504, USA. .,Center for Health Equity Transformation, College of Medicine, University of Kentucky, 372 Healthy Kentucky Building, Lexington, KY, 40536, USA.
| | - Adebola Adegboyega
- Department of Statistics, College of Arts and Science, University of Kentucky, 725 Rose Street, Multidisciplinary Science Building 0082, Room 303, Lexington, KY, 40536, USA
| | - Ellen Combs
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, 2195 Harrodsburg Road, Suite 125, Lexington, KY, 40504, USA
| | - Matthew Rutledge
- Center for Health Equity Transformation, College of Medicine, University of Kentucky, 372 Healthy Kentucky Building, Lexington, KY, 40536, USA.,Department of Statistics, College of Arts and Science, University of Kentucky, 725 Rose Street, Multidisciplinary Science Building 0082, Room 303, Lexington, KY, 40536, USA
| | - Philip M Westgate
- Department of Biostatistics, College of Public Health, University of Kentucky, 725 Rose Street, MDS 205, Lexington, KY, 40536, USA
| | - Md Tofial Azam
- Department of Biostatistics, College of Public Health, University of Kentucky, 725 Rose Street, MDS 205, Lexington, KY, 40536, USA
| | - Felipe De La Barra
- University of Kentucky College of Medicine, William R. Willard Education Building, MN 150, Lexington, KY, 40536, USA
| | - Lovoria B Williams
- Center for Health Equity Transformation, College of Medicine, University of Kentucky, 372 Healthy Kentucky Building, Lexington, KY, 40536, USA.,College of Nursing, University of Kentucky, 751 Rose Street, 539 CON, Lexington, KY, 40536, USA
| | - Nancy E Schoenberg
- Center for Health Equity Transformation, College of Medicine, University of Kentucky, 372 Healthy Kentucky Building, Lexington, KY, 40536, USA.,Department of Behavioral Science, College of Medicine, University of Kentucky, Medical Center, MN 150, Lexington, KY, 40536, USA
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Misra R, Shawley-Brzoska S, Khan R, Kirk BO, Wen S, Sambamoorthi U. Addressing Diabetes Distress in Self-Management Programs: Results of a Randomized Feasibility Study. JOURNAL OF APPALACHIAN HEALTH 2021; 3:68-85. [PMID: 35770030 PMCID: PMC9192112 DOI: 10.13023/jah.0303.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management. METHODS This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN (n=10 per group) completed baseline and 12-week assessments. Diabetes distress was measured by using a validated Diabetes Distress Survey (17-item Likert scale; four sub-scales of emotional burden, physician related burden, regimen related burden, and interpersonal distress). Baseline and post-intervention changes in diabetes distress were compared for both groups; reduction in distress in the intervention groups are depicted using waterfall plots. The mean age, HbA1c and BMI were 55 ± 9.6 years, 7.8 ± 2.24 and 36.4 ± 8.8, respectively. Diabetes distress (total; mean) was 1.84±0.71. RESULTS Participants reported higher diabetes distress related to emotional burden (2.1±0.94) and regimen-related distress (2.0 ± 0.74); physician-related distress was the lowest (1.18±0.64). In general, diabetes distress reduced among intervention participants and was especially significant among those with HbA1c ≤ 8% (r=0.28, p=0.4), and systolic/diastolic BP ≤140/80 mm Hg (r=0.045, P=0.18). IMPLICATIONS Findings suggest that lifestyle self-management programs have the potential to reduce diabetes distress.
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Affiliation(s)
| | | | - Raihan Khan
- College of Health and Behavioral Studies, James Madison University
| | | | - Sijin Wen
- School of Public Health, West Virginia University
| | - Usha Sambamoorthi
- Texas Center for Health Disparities, University of North Texas Health Sciences Center
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Harrington RA, Califf RM, Balamurugan A, Brown N, Benjamin RM, Braund WE, Hipp J, Konig M, Sanchez E, Joynt Maddox KE. Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association. Circulation 2020; 141:e615-e644. [PMID: 32078375 DOI: 10.1161/cir.0000000000000753] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Understanding and addressing the unique health needs of people residing in rural America is critical to the American Heart Association's pursuit of a world with longer, healthier lives. Improving the health of rural populations is consistent with the American Heart Association's commitment to health equity and its focus on social determinants of health to reduce and ideally to eliminate health disparities. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders to make rural populations a priority in programming, research, and policy. This advisory first summarizes existing data on rural populations, communities, and health outcomes; explores 3 major groups of factors underlying urban-rural disparities in health outcomes, including individual factors, social determinants of health, and health delivery system factors; and then proposes a set of solutions spanning health system innovation, policy, and research aimed at improving rural health.
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Hoogland AI, Hoogland CE, Bardach SH, Tarasenko YN, Schoenberg NE. Health Behaviors in Rural Appalachia. South Med J 2019; 112:444-449. [PMID: 31375842 DOI: 10.14423/smj.0000000000001008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To better understand the disproportionate burdens from cancer, cardiovascular disease, diabetes mellitus, stroke, and other chronic conditions related to energy balance, we studied diet and physical activity patterns in younger and older adults in rural Appalachia by using a nonclinical, cross-sectional, community-based sampling approach. METHODS A total of 651 younger (ages 18-59) and 254 older (ages ≥60) Appalachians were recruited from 43 churches or community organizations. Participants answered questions about fruit and vegetable intake and physical activity. Analyses were adjusted for clustering within churches. RESULTS Compared with older Appalachians, younger Appalachians consumed significantly fewer fruits and vegetables (P = 0.01) and reported significantly more moderate-to-vigorous physical activity (P = 0.01). Regardless of age, engagement in healthy behaviors was suboptimal and well below national averages. CONCLUSIONS This community-based sample demonstrated elevated behavioral risk factors that likely contribute to some of the nation's highest rates of premature mortality. Despite suboptimal dietary intake and physical activity, results indicate some potential leverage points between the generations that may be used to improve health. For example, the older generation could benefit from engaging with their younger relatives in physical activities while advocating for a better-rounded diet. Given traditions of intergenerational connectedness, mutual aid, and self-reliance, transmission of healthier behaviors across the generations may be beneficial in the rural Appalachian context.
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Affiliation(s)
- Aasha I Hoogland
- From the Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, the Department of Psychology, University of South Florida, Tampa, the Sanders Brown Center on Aging, Graduate Center for Gerontology, University of Kentucky, Lexington, the Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, and the Department of Behavioral Science, University of Kentucky, Lexington
| | - Charles E Hoogland
- From the Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, the Department of Psychology, University of South Florida, Tampa, the Sanders Brown Center on Aging, Graduate Center for Gerontology, University of Kentucky, Lexington, the Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, and the Department of Behavioral Science, University of Kentucky, Lexington
| | - Shoshana H Bardach
- From the Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, the Department of Psychology, University of South Florida, Tampa, the Sanders Brown Center on Aging, Graduate Center for Gerontology, University of Kentucky, Lexington, the Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, and the Department of Behavioral Science, University of Kentucky, Lexington
| | - Yelena N Tarasenko
- From the Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, the Department of Psychology, University of South Florida, Tampa, the Sanders Brown Center on Aging, Graduate Center for Gerontology, University of Kentucky, Lexington, the Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, and the Department of Behavioral Science, University of Kentucky, Lexington
| | - Nancy E Schoenberg
- From the Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, the Department of Psychology, University of South Florida, Tampa, the Sanders Brown Center on Aging, Graduate Center for Gerontology, University of Kentucky, Lexington, the Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, and the Department of Behavioral Science, University of Kentucky, Lexington
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Sombans S, Lohana P. Finding a Better Solution for Asthma Control in Children. Cureus 2018; 10:e3344. [PMID: 30473977 PMCID: PMC6248683 DOI: 10.7759/cureus.3344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Asthma is a chronic respiratory condition that is very common among children. With proper management and follow-ups, this condition can be easily controlled in a child. However, there are several factors that are negatively influencing a proper care of asthmatic children throughout the world. In this mini-review, the roles of the parents, the schools and the child himself were analyzed and several possible solutions to improve those hurdles were discussed.
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Affiliation(s)
- Shaheen Sombans
- Internal Medicine, Bharati Vidyapeeth University Medical College and Hospital, Pune, IND
| | - Petras Lohana
- Internal Medicine, Liaquat University of Medical and Health Sciences Hospital, Karachi, PAK
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Zimmermann K, Carnahan LR, Khare MM, Chakraborty A, Risser H, Molina Y, Geller SE. Effectiveness of a Faith-placed Cardiovascular Health Promotion Intervention for Rural Adults. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2018; 12:8. [PMID: 34422456 PMCID: PMC8375394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Cardiovascular disease (CVD) is the leading cause of mortality in the US. Further, rural US adults experience disproportionately high CVD prevalence and mortality compared to non-rural. Cardiovascular risk-reduction interventions for rural adults have shown short-term effectiveness, but long-term maintenance of outcomes remains a challenge. Faith organizations offer promise as collaborative partners for translating evidence-based interventions to reduce CVD. METHODS We adapted and implemented a collaborative, faith-placed, CVD risk-reduction intervention in rural Illinois. We used a quasi-experimental, pre-post design to compare changes in dietary and physical activity among participants. Intervention components included Heart Smart for Women (HSFW), an evidence-based program implemented weekly for 12 weeks followed by Heart Smart Maintenance (HSM), implemented monthly for two years. Participants engaged in HSFW only, HSM only, or both. We used regression and generalized estimating equations models to examine changes in outcomes after one year. RESULTS Among participants who completed both baseline and one-year surveys (n = 131), HSFW+HSM participants had significantly higher vegetable consumption (p = .007) and combined fruit/vegetable consumption (p = .01) compared to the HSM-only group at one year. We found no differences in physical activity. CONCLUSION Improving and maintaining CVD-risk behaviors is a persistent challenge in rural populations. Advancing research to improve our understanding of effective translation of CVD risk-reduction interventions in rural populations is critical.
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