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van den Bekerom L, van Gestel LC, Schoones JW, Bussemaker J, Adriaanse MA. Health behavior interventions among people with lower socio-economic position: a scoping review of behavior change techniques and effectiveness. Health Psychol Behav Med 2024; 12:2365931. [PMID: 38903803 PMCID: PMC11188964 DOI: 10.1080/21642850.2024.2365931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/04/2024] [Indexed: 06/22/2024] Open
Abstract
Background Behavior change interventions can unintendedly widen existing socio-economic health inequalities. Understanding why interventions are (in)effective among people with lower socio-economic position (SEP) is essential. Therefore, this scoping review aims to describe what is reported about the behavior change techniques (BCTs) applied within interventions and their effectiveness in encouraging physical activity and healthy eating, and reducing smoking and alcohol consumption according to SEP. Methods A systematic search was conducted in 12 electronic databases, and 151 studies meeting the eligibility criteria were included and coded for health behavioral outcomes, SEP-operationalization, BCTs (type and number) and effectiveness. Results Findings suggest that approaches for measuring, defining and substantiating lower SEP vary. Current studies of behavior change interventions for people of different SEP do not systematically identify BCTs, making systematic evaluation of BCT effectiveness impossible. The effectiveness of interventions is mainly evaluated by overall intervention outcomes and SEP-moderation effects are mostly not assessed. Conclusion Using different SEP-operationalizations and not specifying BCTs hampers systematic evidence accumulation regarding effective (combinations of) BCTs for the low SEP population. To learn which BCTs effectively improve health behaviors among people with lower SEP, future intervention developers should justify how SEP is operationalized and must systematically describe and examine BCTs.
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Affiliation(s)
- Loes van den Bekerom
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
| | - Laurens C. van Gestel
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | - Jan W. Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, the Netherlands
| | - Jet Bussemaker
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- The Institute of Public Administration, Leiden University, Leiden, the Netherlands
| | - Marieke A. Adriaanse
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
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Wieland ML, Molina L, Goodson M, Capetillo GP, Osman A, Ahmed Y, Elmi H, Nur O, Iteghete SO, Torres-Herbeck G, Dirie H, Clark MM, Lohr AM, Smith K, Zeratsky K, Rieck T, Herrin J, Valente TW, Sia IG. Healthy immigrant community study protocol: A randomized controlled trial of a social network intervention for cardiovascular risk reduction among Hispanic and Somali adults. Contemp Clin Trials 2024; 138:107465. [PMID: 38309526 PMCID: PMC10923143 DOI: 10.1016/j.cct.2024.107465] [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: 08/15/2023] [Revised: 12/18/2023] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Immigrants to the United States face structural barriers that contribute to rising cardiovascular risk factors and obesity after immigration. This manuscript describes the development of the Healthy Immigrant Community protocol and baseline measures for a stepped wedge cluster randomized trial to test the effectiveness of a social network intervention for cardiovascular risk reduction among two immigrant populations. METHODS We developed a social network-informed, community-based, participatory research-derived health promotion intervention with Hispanic and Somali immigrant communities in Minnesota consisting of mentoring, educational and motivational sessions, group activities, and a community toolkit for healthy weight loss delivered by culturally concordant health promoters (HPs) to their social networks. Using a stepped wedge cluster randomized design, social network-based groups were randomly assigned to receive the intervention either immediately or after a delay of one year. Outcomes, measured at baseline, 6 months, 12 months, and 24 months, were derived from the American Heart Association's "Life's Simple 7": BMI and waist circumference, blood pressure, fasting blood glucose, total cholesterol, physical activity level, and dietary quality. RESULTS A total of 51 HPs were enrolled and randomized (29 Hispanic; 22 Somali). There were 475 participants enrolled in the study, representing a mean social network group size of 8 (range, 5-12). The mean BMI of the sample (32.2) was in the "obese" range. CONCLUSION Processes and products from this Healthy Immigrant Community protocol are relevant to other communities seeking to reduce cardiovascular risk factors and negative health behaviors among immigrant populations by leveraging the influence of their social networks.
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Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership.
| | | | - Miriam Goodson
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership; Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Ahmed Osman
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Yahye Ahmed
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | - Hindi Elmi
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Omar Nur
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | | | - Gloria Torres-Herbeck
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | | | - Matthew M Clark
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership
| | | | - Katherine Zeratsky
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Thomas Rieck
- Rochester Healthy Community Partnership; Department of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, USA
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thomas W Valente
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Irene G Sia
- Rochester Healthy Community Partnership; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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Joseph CA, Seguin ML. "Something Fun to Look Forward to": Lessons From Implementing the Prescription for Health Farmers' Market Initiative in Rural Upper Michigan. Health Promot Pract 2023; 24:903-910. [PMID: 35713177 DOI: 10.1177/15248399221093966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fruit and vegetable (FV) prescription programs are an increasingly popular community-based approach to addressing food insecurity and improving nutrition by connecting local health care and food systems. The Prescription for Health farmers' market FV prescription program was piloted in a rural, low-access low-income Michigan community in 2017. The program enrolled 33 adult participants with chronic disease and provided weekly farmers' market FV vouchers, educational nutrition handouts, and seasonal healthy recipes over 10 weeks. Weight, blood pressure, and the following self-rated variables were assessed pre- and post program: dietary habits, food literacy, physical health, and mental health. While most metrics remained generally unchanged, one of the strongest findings from our data included significant improvement in quality of life. Increased social interaction as a result of the attending the farmers' market was a prominent theme from informal open-ended participant feedback. Given the ongoing public health crisis of loneliness and social isolation, this finding led us to consider the farmers' market as an avenue for creating opportunities for meaningful social connection among participants and farmers. To this end, we discuss health outcomes of the Prescription for Health pilot program, reflect on unique aspects of implementing this program in a rural area, and explore future opportunities for farmers' market prescription programs as an innovative form of nature-based social prescribing.
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Affiliation(s)
- Carly A Joseph
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
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Caetano LDC, Garcez A, Bairros FDS, Costa JSDD, Olinto MTA. Association between social capital and food patterns in women from Southern Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:1915-1926. [PMID: 37436306 DOI: 10.1590/1413-81232023287.10562022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/10/2022] [Indexed: 07/13/2023] Open
Abstract
The present study aimed to verify the association between psychosocial aspects (social capital) and food patterns in adult women. A cross-sectional, population-based study was conducted with a representative sample of 1,128 women, aged 20 to 69 years, living in the urban area of the municipality of São Leopoldo, Rio Grande do Sul, Brazil, in 2015. The food patterns were identified based on the frequency of food intake and classified as: healthy (fruits, vegetables, and whole foods), at-risk (ultraprocessed foods), and Brazilian (rice and beans), while social capital was evaluated using a collective efficacy scale. It was observed that 18.9% of the sample was classified with high collective efficacy. After adjusting for potential confounding factors, a 44% higher probability was observed for adherence to the healthy pattern (PR [prevalence ratio] = 1.44; 95%CI [95% confidence interval]: 1.01-2.03; p = 0.040) and 71% higher for the Brazilian pattern (PR = 1.71; 95%CI: 1.18-2.47; p= 0.004) among women with a higher level of collective efficacy, when compared to those with a low level of collective efficacy. Thus, this study verified a significant relationship between psychosocial aspects and food intake in women.
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Affiliation(s)
- Lisandréa da Conceição Caetano
- Programa de Pós-Graduação em Ciências da Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre RS Brasil
| | - Anderson Garcez
- Programa de Pós-Graduação em Ciências da Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre RS Brasil
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos. São Leopoldo RS Brasil
| | | | | | - Maria Teresa Anselmo Olinto
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2.400, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
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Ingham N, Labonté K, Dube L, Paquet C, Nielsen DE. A More Supportive Social Environment May Protect Against Nutritional Risk: A Cross-Sectional Analysis Using Data From the Canadian Longitudinal Study on Aging. J Nutr 2023; 153:1793-1802. [PMID: 37277163 DOI: 10.1016/j.tjnut.2023.01.020] [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: 08/30/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Nutritional risk has been linked to individual social factors, but the relationship with the overall social environment has not been assessed. OBJECTIVES To evaluate associations between different support profiles of the social environment and nutritional risk using cross-sectional data from the Canadian Longitudinal Study on Aging (n = 20,206). Subgroup analyses were performed among middle-aged (range, 45-64 y; n = 12,726) and older-aged (≥65 y, n = 7480) adults. Consumption of major food groups [whole grains, proteins, dairy products, and fruits and vegetables (FV)] by social environment profile was a secondary outcome. METHODS Latent structure analysis (LSA) classified participants into social environment profiles according to data on network size, social participation, social support, social cohesion, and social isolation. Nutritional risk and food group consumption were assessed with the SCREEN-II-AB and Short Dietary questionnaires, respectively. ANCOVA was conducted to compare SCREEN-II-AB mean scores by social environment profile, adjusted for sociodemographic and lifestyle factors. Models were repeated to compare mean food group consumption (times/day) by social environment profile. RESULTS LSA identified 3 social environment profiles classified as low, medium, and high support (17%, 40%, and 42% of the sample, respectively). Adjusted mean SCREEN-II-AB scores significantly increased with increasing social environment support, with the low support score indicating high nutritional risk status [low, medium, high support, respectively: 37.1 (99% CI: 36.9, 37.4), 39.3 (39.2, 39.5), 40.3 (40.2, 40.5), all comparisons P < 0.0001]. Results were consistent among age subgroups. The low support social environment profile had lower consumption of protein [low, medium, high support, respectively (mean ± SD): 2.17 ± 0.09, 2.21 ± 0.07, 2.23 ± 0.08, P = 0.004], dairy (2.32 ± 0.23, 2.40 ± 0.20, 2.38 ± 0.21, P = 0.009), and FV (3.65 ± 0.23, 3.94 ± 0.20, 4.08 ± 0.21, P < 0.0001), with some variation among age subgroups. CONCLUSIONS The low support social environment profile had the poorest nutritional outcomes. Therefore, a more supportive social environment may protect against nutritional risk among middle- and older-aged adults.
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Affiliation(s)
- Nicole Ingham
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, Canada
| | - Katherine Labonté
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, Canada
| | - Laurette Dube
- Desautels Faculty of Management, McGill University, Montréal, QC, Canada
| | - Catherine Paquet
- Centre Nutrition, santé et société (NUTRISS), INAF, Université Laval, Quebec City, QC, Canada; Centre de Recherche, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec City, QC, Canada
| | - Daiva E Nielsen
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, Canada.
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van der Put A, Ellwardt L. Employees' healthy eating and physical activity: the role of colleague encouragement and behaviour. BMC Public Health 2022; 22:2004. [PMID: 36319982 PMCID: PMC9628058 DOI: 10.1186/s12889-022-14394-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/04/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Exercising and eating healthy are not just an individual choice, but influenced by family members, friends, or neighbours. Little is known, however, about colleagues, who are another important interpersonal influence. Many people spend many hours at work, surrounded by mostly the same colleagues, who could therefore significantly shape employees’ (un)healthy choices. We studied to what extent colleagues may play a part in one another’s eating and exercise behaviours by focusing on two pathways: colleagues can encourage a healthy lifestyle or act as role models whose behaviours can be observed and copied. Methods: We used the European Sustainable Workforce Survey, with data on 4345 employees in 402 teams in 113 organisations. We used network autocorrelation models, which resemble regression models, to study to what extent employee encouragement is related to fruit and vegetable consumption, and physical activity. Specific to this type of model is the inclusion of a network correlation parameter which allows for the outcome of an employee to be directly associated with the outcomes of their colleagues. In this way we tested whether colleagues’ behaviours were related to one another. Results: We found that employees were more likely to eat fruit and vegetables as well as engage in physical activity when their colleagues encourage a healthy lifestyle. Employees’ healthy eating behaviours were positively related to their colleagues’ fruit and vegetable consumption, while we found a negative correlation concerning physical activity. Conclusion: Overall, colleagues’ encouragement and own healthy behaviours have the potential to contribute to creating a culture of health in the workplace and support all employees in making healthy choices.
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Affiliation(s)
- Anne van der Put
- grid.5477.10000000120346234Department of Sociology, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands
| | - Lea Ellwardt
- grid.6190.e0000 0000 8580 3777Institute of Sociology and Social Psychology, University of Cologne, Albert Magnus Platz, 50923 Cologne, Germany
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Aniya F, Sakima A, Takakura M, Shirai K, Shimabukuro M, Todoriki H, Okumura K, Takemura K, Kinjyo N, Ohya Y. Effect of Nutrition Education on the Vegetable Intake of Residents in Okinawa. Circ Rep 2022; 4:131-144. [PMID: 35342842 PMCID: PMC8901247 DOI: 10.1253/circrep.cr-21-0152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background:
Increasing vegetable intake is recommended for promoting health in communities. This study investigated the effects of nutrition education on vegetable intake and the factors associated with changes in vegetable intake among residents of Okinawa. Methods and Results:
Subjects (n=1,345; mean [±SD] age 56.8±14.6 years; 40.5% male) were recruited from among local residents participating in the Yui Kenko Project. Subjects completed the brief-type self-administered diet history questionnaire (BDHQ) and questionnaires on socioeconomic demographics and social capital. Subjects were divided into 2 groups according to residential area, namely south Okinawa (n=679), where local health promotion activities have been undertaken since the early 2000s, and central Okinawa (n=666). Survey results were fed back to each subject, and health lectures were then conducted at local community centers. After 1 year, the BDHQ was repeated to investigate changes in vegetable and nutritional parameters. After the intervention, residents of south Okinawa increased their crude and energy-adjusted vegetable intake (P<0.05), whereas residents of central Okinawa showed decreased vegetable intake (P<0.05). Univariable and multivariable regression models indicated that, in south Okinawa, participation in local health promotion activities and agreement with general trust were positively correlated with changes in energy-adjusted vegetable intake, whereas in central Okinawa no correlations were observed. Conclusions:
The status of social capital should be taken into account when implementing initiatives to increase vegetable intake in communities.
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Affiliation(s)
- Fumika Aniya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus
| | | | - Minoru Takakura
- School of Health Sciences, Faculty of Medicine, University of the Ryukyus
| | - Kokoro Shirai
- Public Health Graduate School of Medicine, Osaka University
| | - Masumi Shimabukuro
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus
| | - Hidemi Todoriki
- School of Health Sciences, Faculty of Medicine, University of the Ryukyus
| | - Koichiro Okumura
- Medical Safety Management Unit, University of the Ryukyus Hospital
| | - Katsuya Takemura
- Division of Community Medicine and International Medicine, University of the Ryukyus Hospital
| | | | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus
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Apostolaki I, Pepa A, Vlassopoulos A, Kapsokefalou M. Social Capital and Self-Perceived Quality of Life-Interrelated Predictors of Mediterranean Diet Adherence in Older Adults. Nutrients 2021; 13:3100. [PMID: 34578978 PMCID: PMC8465589 DOI: 10.3390/nu13093100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
Living a healthy life in a supporting environment are key elements towards higher diet quality in older age. The Mediterranean Diet in Older Adults (MINOA) study collected cross-sectional data from adults ≥65 years old (n = 436) from April 2014 to November 2015 in rural Crete, aiming to understand the interrelations between Mediterranean Diet adherence, Social Capital and Health-Related Quality of Life (HRQL). Multivariate linear regression, carried out using SPSS 20.0, revealed that both Social Capital and HRQL has a positive impact on Mediterranean Diet adherence after adjustment for confounders and independently of each other. Total Social Capital as well as its Value of Life/Social Agency component (β = 0.04 and β = 0.1, p < 0.05, respectively) had a positive relationship with Mediterranean Diet adherence. As far as HRQL is concerned, only the Physical Health components were found to have a positive association with Mediterranean Diet adherence (β = 0.09, p < 0.001). At the same time Total Social Capital was also seen to have a positive relationship with perceived Physical and Mental Health (β = 0.21 and β = 0.28, p < 0.001, respectively). In a population of older adults Social Capital, HRQL and Mediterranean Diet adherence seem to share intricate interrelations that impact both diet quality and quality of life overall.
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Affiliation(s)
- Ioanna Apostolaki
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
- Department of Social Medicine, Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Aleks Pepa
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
| | - Antonis Vlassopoulos
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
| | - Maria Kapsokefalou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
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Donohue JA, Severson T, Martin LP. The food pharmacy: Theory, implementation, and opportunities. Am J Prev Cardiol 2021; 5:100145. [PMID: 34327488 PMCID: PMC8315372 DOI: 10.1016/j.ajpc.2020.100145] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/11/2020] [Accepted: 12/29/2020] [Indexed: 01/03/2023] Open
Abstract
The food pharmacy is an emerging program model designed to increase the access to and consumption of healthful foods, particularly fruits and vegetables. Existing research on the efficacy of the food pharmacy model shows that these programs have been effective in improving patient understanding of nutrition and removing barriers to healthy eating, and in turn may have a significant impact on diet-related health outcomes. However, efforts to date aiming to evaluate program effectiveness have been small and lack rigorous research methods. More research is needed to adequately assess the longitudinal effects of food pharmacy programs on healthful food intake and diet-related health outcomes. In this review, we outline the strengths and limitations of previous programs and explore possible options to improve the scalability and sustainability of food pharmacy programs.
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Affiliation(s)
| | - Tracy Severson
- Oregon Health & Science University, Portland, OR, United States
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van der Avoort CMT, Ten Haaf DSM, de Vries JHM, Verdijk LB, van Loon LJC, Eijsvogels TMH, Hopman MTE. Higher Levels of Physical Activity Are Associated with Greater Fruit and Vegetable intake in Older Adults. J Nutr Health Aging 2021; 25:230-241. [PMID: 33491039 DOI: 10.1007/s12603-020-1520-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE High levels of physical activity (PA) and optimal nutrition independently improve healthy aging, but few data are available about how PA may influence food preferences in older populations. Therefore, the aim of our study was to establish if there is an association between habitual PA and intake of nutrient-dense foods (i.e. fruits and vegetables). DESIGN A cross-sectional survey was conducted. SETTING The Netherlands. PARTICIPANTS 2466 older adults (56% male, age 62±9 yr). MEASUREMENTS PA was assessed using the short questionnaire to assess health (SQUASH) and participants were classified into quintiles of weekly PA (MET-h/wk). Total fruit and vegetable intake was assessed using a validated food frequency questionnaire (FFQ) and were corrected for energy intake (g/kcal/d) in the analyses. Multiple regression analyses were performed to determine the association between PA and fruit and vegetable intake, including covariates. RESULTS Being in the higher quintiles of PA (Q3, Q4 and Q5) was positively associated with more daily fruit and vegetable consumption, even after correction for total energy intake (Q3; β=0.089, P<0.001, Q4; β=0.047, P=0.024, Q5; β=0.098, P<0.001). CONCLUSIONS Older adults who are moderately to highly physically active tend to consume more fruit and vegetable compared to less active peers, when corrected for total energy intake. Female gender, under- and overreporting dietary intake (Goldberg score), non-smoking, high level of education, less alcohol consumption and a lower body mass index positivity affected this relationship. Our data will help health-care professionals to accelerate their efforts to treat and prevent chronic diseases.
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Affiliation(s)
- C M T van der Avoort
- Cindy M.T. van der Avoort, MSc., Institute of Sport and Exercise Studies, HAN University of Applied Sciences, Heyendaalseweg 141, 6525 AJ Nijmegen, The Netherlands, Tel: + 31-24-3530500, E-mail:
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Yoshida Y, Broyles S, Scribner R, Chen L, Phillippi S, Jackson-Thompson J, Simoes EJ, Tseng TS. Social support modifies the negative effects of acculturation on obesity and central obesity in Mexican men. ETHNICITY & HEALTH 2020; 25:1103-1114. [PMID: 29944431 PMCID: PMC9044708 DOI: 10.1080/13557858.2018.1492708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
Background: This study examined the moderating role of social support in the acculturation-obesity/central obesity relationship in Mexican American (MA) men and women. Methods: Data from NHANES 1999-2008 were used. Acculturation derived from language use, country of birth and length of residence in the U.S. Social support assessed emotional and financial support. BMI (≥30) and waist circumference (≥88 cm for women; ≥102 cm for men) measured obesity and central obesity, respectively. Weighted multivariate logistic regression models were used to describe associations. Results: Compared to less acculturation, more acculturation was associated with higher odds of obesity (ORs 2.48; 95% CI 1.06-5.83) and central obesity (2.90; 1.39-6.08) among MA men with low/no social support, but not among MA men reporting high social support. The modifying effects was not observed among women. Conclusion: Higher amounts of social support appeared to attenuate the risk of obesity/central obesity associated with acculturation. Interventions enhancing social support maybe effective among acculturated MAs, particularly among men.
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Affiliation(s)
- Yilin Yoshida
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
- Missouri Cancer Registry & Research Center, 401 Clark Hall, Columbia, Missouri 65211
| | - Stephanie Broyles
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Richard Scribner
- Epidemiology program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
| | - Liwei Chen
- Department of Public Health Sciences, Clemson University, 503 Edwards Hall, Clemson, SC 29634-0745
| | - Stephen Phillippi
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
| | - Jeanette Jackson-Thompson
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
- Missouri Cancer Registry & Research Center, 401 Clark Hall, Columbia, Missouri 65211
| | - Eduardo J. Simoes
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
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Kroenke CH, Le GM, Conroy SM, Canchola AJ, Shariff-Marco S, Gomez SL. Egocentric social networks, lifestyle behaviors, and body size in the Asian Community Health Initiative (CHI) cohort. PLoS One 2020; 15:e0232239. [PMID: 32374741 PMCID: PMC7202641 DOI: 10.1371/journal.pone.0232239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 04/10/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Social networks have been shown to influence lifestyle behaviors in non-Latinx white (NLW) populations. We examined their influence in Asian American, Native Hawaiian and Pacific Islander (AANHPI) women. METHODS We included 477 AANHPI women from the Asian Community Health Initiative Study who provided egocentric (degree, density, composition) and epidemiologic (size, types of ties) social network data and data on alcohol intake, physical activity, smoking, diet, and body size. We used logistic regression to evaluate associations of social network measures and dichotomous outcomes, and linear regression for continuous outcomes. RESULTS In multivariable-adjusted analyses, higher degree and/or proportion of friends were significantly related to higher Western diet, higher odds of any alcohol consumption, and lower odds of physical inactivity and body mass index (BMI)≥23 kg/m2. Additionally, a higher proportion of NLW in women's networks was related to lower Asian diet but also lower waist size. Community participation was related to higher Western diet and lower Asian diet. By contrast, degree and/or proportion of relatives were positively related to BMI, waist size and to a higher odds of BMI≥23 kg/m2 and of ever smoking 100 cigarettes. Being married was related to fewer alcoholic drinks per week and higher Asian diet. A higher density of relationships with frequent contact was also associated with higher Asian diet. CONCLUSIONS AANHPI women with larger proportions of friends and NLWs in their networks had more Western health behaviors and smaller body size. Norms for health behaviors and body size may be influenced by the size, composition, and structure of social networks, relevant to chronic disease prevention.
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Affiliation(s)
- Candyce H. Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Gem M. Le
- Division of General Internal Medicine, Department of Medicine, UCSF Center for Vulnerable Populations, UCSF, San Francisco, CA, United States of America
| | - Shannon M. Conroy
- Division of General Internal Medicine, Department of Medicine, UCSF Center for Vulnerable Populations, UCSF, San Francisco, CA, United States of America
| | - Alison J. Canchola
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
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Schlosser AV, Joshi K, Smith S, Thornton A, Bolen SD, Trapl ES. "The coupons and stuff just made it possible": economic constraints and patient experiences of a produce prescription program. Transl Behav Med 2020; 9:875-883. [PMID: 31570919 DOI: 10.1093/tbm/ibz086] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although produce prescription (PRx) programs have been shown to improve fruit and vegetable (FV) consumption, few studies have examined how economic constraints influence participant experience. We conducted a qualitative study of patient experience of a 3-month PRx program for hypertension (PRxHTN) including 3 safety-net clinics and 20 farmers' markets (FMs). We interviewed 23 PRxHTN participants using semistructured guides to understand their program experiences. Interviews were audio-taped, transcribed, and analyzed to identify a priori and emergent themes. PRxHTN participants completing qualitative interviews were mostly middle-aged (mean: 62 years) African American (100%) women (78%). Economic hardship as a barrier to maximum program participation and sustainability was a main theme identified, with three subthemes: (i) transportation issues shaped shopping and eating patterns and limited participant ability to access FMs to utilize PRxHTN vouchers; (ii) limited and unstable income shaped participant shopping and eating behavior before, during, and after PRxHTN; and (iii) participants emphasized individual-level influences like personal or perceived motivations for program participation, despite significant structural constraints, such as economic hardship, shaping their program engagement. Future PRx programs should bolster economic and institutional supports beyond FM vouchers such as transportation assistance, partnering with local food banks and expansion to local grocery stores offering year-round FV access to support sustained behavior change. Additionally, structural competency tools for providers may be warranted to reorient focus on structural influences on program engagement and away from potentially stigmatizing individual-level explanations for program success. These efforts have potential to enhance the translation of PRx programs to the needs of economically vulnerable patients who struggle to manage chronic illness and access basic nutrition.
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Affiliation(s)
- Allison V Schlosser
- Department of Anthropology, Case Western Reserve University, Cleveland, OH, USA
| | - Kakul Joshi
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | | - Anna Thornton
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Shari D Bolen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.,Better Health Partnership, Cleveland, OH, USA.,Department of Medicine, MetroHealth Medical Center, Cleveland, OH, USA.,Center for Health Care Research and Policy, Case Western Reserve University at the MetroHealth System, Cleveland, OH, USA
| | - Erika S Trapl
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
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Spadola CE, Rottapel RE, Zhou ES, Chen JT, Guo N, Khalsa SBS, Redline S, Bertisch SM. A sleep hygiene and yoga intervention conducted in affordable housing communities: Pilot study results and lessons for a future trial. Complement Ther Clin Pract 2020; 39:101121. [PMID: 32379660 DOI: 10.1016/j.ctcp.2020.101121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND and purpose: Inadequate sleep is highly prevalent among socioeconomically disadvantaged and racial/ethnic minority communities and is often related to maladaptive sleep behaviors and stress. There is scant research investigating the delivery of these interventions in underserved communities. The purpose of this study was to develop and test the feasibility and acceptability of a sleep education and yoga intervention for socioeconomically disadvantaged and racial/ethnic diverse adults. MATERIALS AND METHODS We present quantitative and qualitative data from a single-arm sleep education and yoga pilot study (n = 17) conducted in two affordable housing communities, and the multi-modal process we employed to refine the intervention for a future trial. RESULTS Participants were age 43.6 years on average (±19.3 years) and 88.2% were female. Nearly 56% identified as non-Hispanic Black and 19% as Hispanic/Latino. Results showed significant pre/post-intervention improvements in sleep duration (5.4 ± 1.2 h/night vs 6.9 ± 1.7 h/night; p < 0.01), sleep-related impairment (-8.15; p < 0.01), sleep disturbance (-5.95; p < 0.01), and sleep hygiene behaviors (-5.50; p < 0.01). CONCLUSION This study indicates intervention acceptability and improvements in sleep and sleep hygiene. Future randomized controlled trials are needed to assess efficacy.
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Affiliation(s)
- Christine E Spadola
- Sandler School of Social Work, Florida Atlantic University, Boca Raton, FL, USA.
| | - Rebecca E Rottapel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Eric S Zhou
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Sleep Medicine Harvard Medical School, Boston, MA, USA
| | - Jarvis T Chen
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
| | - Na Guo
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Sat Bir S Khalsa
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine Harvard Medical School, Boston, MA, USA
| | - Suzanne M Bertisch
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine Harvard Medical School, Boston, MA, USA
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15
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Sapra KJ, Yang W, Walczak NB, Cha SS. Identifying High-Cost Medicare Beneficiaries: Impact of Neighborhood Socioeconomic Disadvantage. Popul Health Manag 2020; 23:12-19. [DOI: 10.1089/pop.2019.0016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Katherine J. Sapra
- Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Baltimore, Maryland
| | | | | | - Stephen S. Cha
- UnitedHealthCare Community and State, Minnetonka, Minnesota
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Schlosser AV, Smith S, Joshi K, Thornton A, Trapl ES, Bolen S. "You Guys Really Care About Me…": a Qualitative Exploration of a Produce Prescription Program in Safety Net Clinics. J Gen Intern Med 2019; 34:2567-2574. [PMID: 31512182 PMCID: PMC6848686 DOI: 10.1007/s11606-019-05326-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/27/2019] [Accepted: 08/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although research shows produce prescription (PRx) programs increase fruit and vegetable (FV) consumption, little is known about how participants experience them. OBJECTIVE To better understand how participants experience a PRx program for hypertensive adults at 3 safety net clinics partnered with 20 farmers' markets (FMs) in Cleveland, OH. DESIGN We conducted semi-structured interviews with 5 program providers, 23 patient participants, and 2 FM managers. PARTICIPANTS Patients interviewed were mainly middle-aged (mean age 62 years), African American (100%), and women (78%). Providers were mainly middle-aged men and women of diverse races/ethnicities. INTERVENTION Healthcare providers enrolled adult patients who were food insecure and diagnosed with hypertension. Participating patients attended monthly clinic visits for 3 months. Each visit included a blood pressure (BP) check, dietary counseling for BP control, a produce prescription, and produce vouchers redeemable at local FMs. APPROACH Patient interviews focused on (1) beliefs about food, healthy eating, and FMs; (2) clinic-based program experiences; and (3) FM experiences. Provider and market manager interviews focused on program provision. All interviews were audio-taped, transcribed, and analyzed thematically. KEY RESULTS We identified four central themes. First, providers and patients reported positive interactions during program activities, but providers struggled to integrate the program into their workflow. Second, patients reported greater FV intake and FM shopping during the program. Third, social interactions enhanced program experience. Fourth, economic hardships influenced patient shopping and eating patterns, yet these hardships were minimized in some participants' views of patient deservingness for program inclusion. CONCLUSIONS Our findings highlight promises and challenges of PRx programs for economically disadvantaged patients with a chronic condition. Patient participants reported improved interactions with providers, increased FV consumption, and incorporation of healthy eating into their social networks due to the program. Future efforts should focus on efficiently integrating PRx into clinic workflows, leveraging patient social networks, and including economic supports for maintenance of behavior change.
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Affiliation(s)
- Allison V Schlosser
- Department of Bioethics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Samantha Smith
- Epidemiology, Surveillance, & Informatics, Cuyahoga County Board of Health, Parma, OH, USA
| | - Kakul Joshi
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Anna Thornton
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Erika S Trapl
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Shari Bolen
- Better Health Partnership, Cleveland, OH, USA
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
- Center for Health Care Research and Policy, Case Western Reserve University at the MetroHealth System, Cleveland, OH, USA
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Quante M, Khandpur N, Kontos EZ, Bakker JP, Owens JA, Redline S. A Qualitative Assessment of the Acceptability of Smartphone Applications for Improving Sleep Behaviors in Low-Income and Minority Adolescents. Behav Sleep Med 2019; 17:573-585. [PMID: 29400557 PMCID: PMC6294701 DOI: 10.1080/15402002.2018.1432483] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Daily behaviors such as sleep can be targeted by smartphone app-based interventions, with potential utility among young people of minority ethnic backgrounds who commonly access smartphone devices and are short sleepers. There is a need to understand the acceptability and youth's readiness to use apps to improve sleep, and to identify desired app components that would motivate engagement. Participants and Methods: We conducted three focus group discussions (N = 27 total, age 14-18 years) within low- and middle-income ethnically diverse Boston neighborhoods. We also interviewed 10 participants who provided specific feedback on two commercially available sleep-promoting apps, one of which they had used on their smartphone preceding the interviews. All focus group discussions and interviews were audio-recorded, transcribed, and thematically analyzed. Results: We identified several barriers to adoption of sleep hygiene interventions, namely reluctance to follow scheduled sleep routines on weekends and concern about "parting" with electronics at bedtime. Participants were intrigued by the idea of adopting an app-based sleep intervention, but were skeptical that they could successfully adopt sleep hygiene practices, and were more interested in making changes on school days than on weekends. Nonetheless, the overall feedback on two commercial sleep apps, neither targeted at youth, was positive, with a good adherence and engagement rate, and perceived health benefits. Conclusions: Our findings highlight the need to adapt sleep hygiene recommendations to targeted populations, considering preferences and social and cultural contextual factors. Our research also underscores the importance of the platform, setting, and messenger when delivering health information to adolescents.
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Affiliation(s)
- Mirja Quante
- Department of Neonatology, University of Tuebingen, Germany
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Neha Khandpur
- Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
- Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA
| | - Emily Z. Kontos
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA
| | - Jessie P. Bakker
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Judith A. Owens
- Harvard Medical School, Boston, MA
- Boston Children’s Hospital, Boston, MA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
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18
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Dinis MAP, Sousa HFP, Moura AD, Viterbo LMF, Pinto RJ. Health Behaviors as a Mediator of the Association Between Interpersonal Relationships and Physical Health in a Workplace Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132392. [PMID: 31284473 PMCID: PMC6651570 DOI: 10.3390/ijerph16132392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 11/16/2022]
Abstract
The etiology of diseases is multifactorial, involving genetic, environmental, and lifestyle-related behaviors. Considering the pathway that involves behavioral processes, a huge body of empirical evidence has shown that some healthy behaviors such as non-smoking, any or moderate alcohol consumption, a healthy diet, (e.g., fruit and vegetable intake), and physical activity, decrease the risk of disease and mortality. This study aimed to explore the potential mediating effect of combined health behaviors on the association between interpersonal relationships and physical health in a Brazilian adult worker population from the Occupational Health Service within the oil industry in Bahia, Brazil. The sample included 611 workers, of which 567 (92.8%) were males and 44 (7.2%) females, age ranging from 18 to 73 years (M = 41.95; SD = 8.88). The significant predictors of physical health were interpersonal relationships and health behaviors. Health behaviors contributed significantly to a reduction in the effect of interpersonal relationships on physical health outcomes. As far as it is known, there has been no prior work in Brazil that simultaneously examined the best predictors of physical health in oil workers using this conceptual model. Interventions in the workplace environment need to consider health behavior as a mediator between interpersonal relationships and physical health, aligned in a global psychosocial approach to health at work.
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Affiliation(s)
- Maria Alzira Pimenta Dinis
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal.
| | - Helder Fernando Pedrosa Sousa
- Department of Mathematics (DM. UTAD), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Andreia de Moura
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University of Porto (ULP), Rua Augusto Rosa 24, 4000-098 Porto, Portugal
| | - Lilian M F Viterbo
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal
| | - Ricardo J Pinto
- Digital Human-Environment Interaction Lab (HEI-Lab), Lusófona University of Porto (ULP), Rua Augusto Rosa 24, 4000-098 Porto, Portugal
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19
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Emmons KM, Gandelman E. Translating behavioral medicine evidence to public policy. J Behav Med 2019; 42:84-94. [PMID: 30825091 DOI: 10.1007/s10865-018-9979-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 10/05/2018] [Indexed: 12/12/2022]
Abstract
Behavioral medicine has made significant contributions to our understanding of how to prevent disease and improve health. However, social and environmental factors continue to have a major influence on health in ways that will be difficult to combat on a population level without concerted efforts to scale interventions and translate the evidence into public health policies. Now is also the right time to increase our efforts to produce policy relevant research and partnerships that will maximize the chances that our evidence is taken to scale in ways that can influence population health broadly, and perhaps contribute to the reduction of the recalcitrant health disparities that plague virtually every area of behavioral medicine focus. As a field we must take an active role in policy translation, learning from the public policy and political science disciplines, and our own pioneers in policy translation. This article discusses importance of accelerating evidence translation to policy, and suggests several factors that could enhance our translation efforts, including embracing policy translation as a key goal in behavioral medicine, increasing our understanding in variability of evidence-based policy adoption across and within states, improving our understanding of how to most effectively communicate our findings to policy makers, conducting research that is responsive to policy makers' needs, and considering the important role of local policy partnerships.
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Affiliation(s)
- Karen M Emmons
- Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Room 601, 677 Huntington Ave, Boston, MA, 02115, USA.
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20
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Quante M, Khandpur N, Kontos EZ, Bakker JP, Owens JA, Redline S. "Let's talk about sleep": a qualitative examination of levers for promoting healthy sleep among sleep-deprived vulnerable adolescents. Sleep Med 2018; 60:81-88. [PMID: 30606643 DOI: 10.1016/j.sleep.2018.10.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/13/2018] [Accepted: 10/19/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Deficient sleep is highly prevalent in disadvantaged adolescents and contributes to a range of adverse health and behavioral outcomes. We examined mediating mechanisms and strategies that adolescents adopt to improve sleep, and possible levers for promoting sleep in this population. METHODS We conducted three focus groups (N = 27 total, age 14-18 years) in adolescents living in low- and middle-income racially/ethnically diverse neighborhoods of Boston, Massachusetts. Participants completed a survey on their sleep and health habits prior to the moderator-led discussions. Discussions were audio-recorded, transcribed, and thematically analyzed. RESULTS The study population did not meet the minimum sleep recommendations, and we found a high prevalence of "social jet-lag." We also identified a disconnect between the acknowledgment of the importance of sleep and actual behavior, especially for electronic use. Phone use and screen time were the most commonly cited barriers to a good night's sleep, along with caffeine consumption, which was also high in this sample. There was also a general lack of awareness of sleep hygiene practices and recommendations. Participants reported regulating food intake and physical activity, using allopathic sleep aids, creating a comfortable sleeping environment, and a routine as some strategies to improve sleep. CONCLUSION Results from this study suggest facilitating the linkage between participant-generated mediating factors and strategies for better-designed interventions. These include making the negative impact of sleep on health more explicit, improving youth awareness about sleep hygiene, targeting caffeine consumption and electronic use, and introducing sleep recommendations through appropriate and effective channels.
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Affiliation(s)
- Mirja Quante
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Neonatology, University of Tuebingen, Tuebingen, Germany.
| | - Neha Khandpur
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brazil; Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA, USA
| | - Emily Z Kontos
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA
| | - Jessie P Bakker
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Judith A Owens
- Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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21
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Safe sex norm questionnaire for female sex workers: development and validation study in Iran. Public Health 2018; 164:82-90. [PMID: 30218915 DOI: 10.1016/j.puhe.2018.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/22/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of the present study was to develop and validate a safe sex norm questionnaire as an appropriate instrument which would be adaptable to the female sex worker (FSW) population. STUDY DESIGN A mixed method study. METHODS Appropriate content was prepared through a literature review. Content validation indices were assessed using interviews with content experts and lay experts. A conservative approach was used to assess the inter-rater agreement among the participants about the instrument relevance and clarity. The scale content validity index was computed using the average method. Non-parametric Mokken scale analysis was used for assessing scalability and unidimensionality of the questionnaire in a sample of 170 FSWs in Tehran. To evaluate the reliability and internal consistency of the questionnaire intra-class correlation and Cronbach's alpha were employed. RESULTS A list of 34 items was finalized, with subscales for actual behavioral norms and for perceived norms. The relevance of the actual and perceived norms subscales in the final questionnaire was higher than 96%; clarity of the subtests was 99% and higher. The comprehensiveness of the actual and perceived norms subscales was 85% for both. Mokken scale analysis showed that the two subscales were distinct constructs, and all items are good indicators for the constructs. CONCLUSION Our findings support that the safe sex norm questionnaire is a valid and reliable measure that would be useful to harm reduction programs and help effective HIV prevention among female sex workers.
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22
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Dulin A, Risica PM, Mello J, Ahmed R, Carey KB, Cardel M, Howe CJ, Nadimpalli S, Gans KM. Examining neighborhood and interpersonal norms and social support on fruit and vegetable intake in low-income communities. BMC Public Health 2018; 18:455. [PMID: 29621989 PMCID: PMC5887203 DOI: 10.1186/s12889-018-5356-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 03/22/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We examined whether neighborhood-, friend-, and family- norms and social support for consumption and purchase of fruits and vegetables (F&V) were associated with F&V intake among low-income residents in subsidized housing communities. We examined baseline data from a study ancillary to the Live Well/Viva Bien intervention. Participants included 290 residents in four low-income subsidized housing sites who were ≥ 18 years of age, English and/or Spanish speaking, and without medical conditions that prevented consumption of F&V. METHODS Linear regression models examined associations of norms and social support with F&V intake after adjustments for sociodemographic characteristics. RESULTS In the analysis, neighborhood social support for F&V was associated with a 0.31 cup increase in F&V intake (95% CI = 0.05, 0.57). The family norm for eating F&V and family social support for eating F&V were associated with a 0.32 cup (95% CI = 0.13, 0.52) and 0.42 cup (95% CI = 0.19, 0.64) increase in F&V intake, respectively. CONCLUSIONS To our knowledge, no other studies have examined neighborhood, family, and peer norms and social support simultaneously and in relation to F&V intake. These findings may inform neighborhood interventions and community-level policies to reduce neighborhood disparities in F&V consumption.
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Affiliation(s)
- Akilah Dulin
- Behavioral and Social Sciences, Center for Health Equity Research, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA.
| | - Patricia M Risica
- Behavioral and Social Sciences, Center for Health Equity Research, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA
| | - Jennifer Mello
- Center for Health Equity Research, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA
| | - Rashid Ahmed
- Center for Health Equity Research, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA
| | - Kate B Carey
- Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI, 02912, USA
| | - Michelle Cardel
- Health Outcomes and Policy, Institute for Child Health Policy, University of Florida, 2197 Mowry Road, 132, PO Box 100177, Gainsville, FL, 32610, USA
| | - Chanelle J Howe
- Epidemiology, Brown University School of Public Health, Box G-S121-2, Providence, RI, 02912, USA
| | - Sarah Nadimpalli
- Center for Health Equity Research, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA
| | - Kim M Gans
- Human Development and Family Studies, University of Connecticut, 348 Mansfield Road, Unit 1058, Room 320, Storrs, CT, 06269, USA
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Risica PM, Gorham G, Dionne L, Nardi W, Ng D, Middler R, Mello J, Akpolat R, Gettens K, Gans KM. A multi-level intervention in worksites to increase fruit and vegetable access and intake: Rationale, design and methods of the 'Good to Go' cluster randomized trial. Contemp Clin Trials 2018; 65:87-98. [PMID: 29242108 PMCID: PMC5912165 DOI: 10.1016/j.cct.2017.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Fruit and vegetable (F&V) consumption is an important contributor to chronic disease prevention. However, most Americans do not eat adequate amounts. The worksite is an advantageous setting to reach large, diverse segments of the population with interventions to increase F&V intake, but research gaps exist. No studies have evaluated the implementation of mobile F&V markets at worksites nor compared the effectiveness of such markets with or without nutrition education. METHODS This paper describes the protocol for Good to Go (GTG), a cluster randomized trial to evaluate F&V intake change in employees from worksites randomized into three experimental arms: discount, fresh F&V markets (Access Only arm); markets plus educational components including campaigns, cooking demonstrations, videos, newsletters, and a web site (Access Plus arm); and an attention placebo comparison intervention on physical activity and stress reduction (Comparison). Secondary aims include: 1) Process evaluation to determine costs, reach, fidelity, and dose as well as the relationship of these variables with changes in F&V intake; 2) Applying a mediating variable framework to examine relationships of psychosocial factors/determinants with changes in F&V consumption; and 3) Cost effectiveness analysis of the different intervention arms. DISCUSSION The GTG study will fill important research gaps in the field by implementing a rigorous cluster randomized trial to evaluate the efficacy of an innovative environmental intervention providing access and availability to F&V at the worksite and whether this access intervention is further enhanced by accompanying educational interventions. GTG will provide an important contribution to public health research and practice. Trial registration number NCT02729675, ClinicalTrials.gov.
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Affiliation(s)
- Patricia M Risica
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA; Department of Epidemiology, Brown School of Public Health, Providence, RI 02912, USA.
| | - Gemma Gorham
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Laura Dionne
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - William Nardi
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Doug Ng
- Currently with Department of Surgery, Columbia University Medical Center, NY, New York 10032, USA
| | - Reese Middler
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Jennifer Mello
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Rahmet Akpolat
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA
| | - Katelyn Gettens
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
| | - Kim M Gans
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA; Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
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Shelton RC, Hatzenbuehler ML, Bayer R, Metsch LR. Future Perfect? The Future of the Social Sciences in Public Health. Front Public Health 2018; 5:357. [PMID: 29376047 PMCID: PMC5767592 DOI: 10.3389/fpubh.2017.00357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/15/2017] [Indexed: 11/13/2022] Open
Abstract
This is a critical and perhaps unprecedented time for the social sciences in public health. While there are many opportunities for the social sciences to continue making transformative contributions to improve population health, there are significant challenges in doing so, particularly in a rapidly changing political landscape. Such challenges are both external (e.g., congressional calls for reducing social science funding) and internal (e.g., scholars criticizing the social sciences for being stagnant and siloed). This paper highlights four key tensions that the field is grappling with and that have direct implications for how to train the next generation of social scientists in public health. We also discuss how departmental and institutional decisions made in response to these tensions will determine how the social sciences in public health are ultimately recognized, sustained, and advanced.
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Affiliation(s)
- Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, NY, United States
| | - Mark L Hatzenbuehler
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, NY, United States
| | - Ronald Bayer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, NY, United States
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, NY, United States
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Socio-economic factors associated with an increase in fruit and vegetable consumption: a 12-year study in women from the E3N-EPIC study. Public Health Nutr 2017; 21:740-755. [PMID: 29183405 DOI: 10.1017/s1368980017003196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To identify individual and contextual socio-economic factors associated with an increase in fruit and vegetable (F&V) consumption over a 12-year period and evaluate if some socio-economic factors were differentially associated with the change in consumption of some types of F&V. DESIGN Associations between increased F&V consumption and socio-economic factors were studied with multivariate logistic regression. SETTING E3N, a French prospective cohort study of 98 995 women. SUBJECTS E3N participants (n 58 193) with information on diet in 1993 and 2005, and numerous individual and contextual socio-economic factors available. RESULTS Associations between some individual socio-economic factors and changes in F&V consumption were observed. For instance, women who lived in a large household (>3 children v. no child) had higher probability of increasing their vegetable consumption (OR=1·33; 95 % CI 1·24, 1·42). This association was driven by higher consumption of courgette and raw cucumber. Living with a partner was associated with higher odds of increasing consumption of fruits (OR=1·07; 95 % CI 1·02, 1·13) such as pear, peach and grape. CONCLUSIONS Certain individual socio-economic factors, but none of the contextual socio-economic factors examined, were associated with an increase in F&V consumption. Factors associated with an increase in total F&V consumption were not necessarily associated with an increase in fruit or vegetable consumption separately, or with an increase in each subtype of fruit or vegetable. Magnitudes of the different associations observed also differed when F&V were considered together, separately or by subtype. Increases in F&V consumption were mostly observed in women with high socio-economic position. To develop effective nutritional interventions and policies that take the socio-economic environment of individuals into account, we recommend future research to further focus on (i) pathways through which population characteristics might influence changes in F&V consumption and (ii) existing interactions between individual and contextual socio-economic factors.
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Smith SG, Jackson SE, Kobayashi LC, Steptoe A. Social isolation, health literacy, and mortality risk: Findings from the English Longitudinal Study of Ageing. Health Psychol 2017; 37:160-169. [PMID: 29172607 DOI: 10.1037/hea0000541] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate the relationships between social isolation, health literacy, and all-cause mortality, and the modifying effect of social isolation on the latter relationship. METHODS Data were from 7731 adults aged ≥50 years participating in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing. Social isolation was defined according to marital/cohabiting status and contact with children, relatives, and friends, and participation in social organizations. Scores were split at the median to indicate social isolation (yes vs. no). Health literacy was assessed as comprehension of a medicine label and classified as "high" (≥75% correct) or "low" (<75% correct). The outcome was all-cause mortality up to February 2013. Cox proportional hazards models were adjusted for sociodemographic factors, health status, health behaviors, and cognitive function. RESULTS Mortality rates were 30.3% versus 14.3% in the low versus high health literacy groups, and 23.5% versus 13.7% in the socially isolated versus nonisolated groups. Low health literacy (adj. HR = 1.22, 95% CI 1.02-1.45 vs. high) and social isolation (adj. HR = 1.28, 95% CI 1.10-1.50) were independently associated with increased mortality risk. The multiplicative interaction term for health literacy and social isolation was not statistically significant (p = .81). CONCLUSIONS Low health literacy and high social isolation are risk factors for mortality. Social isolation does not modify the relationship between health literacy and mortality. Clinicians should be aware of the health risks faced by socially isolated adults and those with low health literacy. (PsycINFO Database Record
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Affiliation(s)
| | - Sarah E Jackson
- Institute of Epidemiology and Health Care, University College London
| | | | - Andrew Steptoe
- Institute of Epidemiology and Health Care, University College London
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Spadola CE, Rottapel R, Khandpur N, Kontos E, Bertisch SM, Johnson DA, Quante M, Khalsa SBS, Saper RB, Redline S. Enhancing yoga participation: A qualitative investigation of barriers and facilitators to yoga among predominantly racial/ethnic minority, low-income adults. Complement Ther Clin Pract 2017; 29:97-104. [PMID: 29122272 DOI: 10.1016/j.ctcp.2017.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/01/2017] [Accepted: 09/02/2017] [Indexed: 11/26/2022]
Abstract
Yoga is underutilized among racial/ethnic minorities and low-income populations. To enhance participation among these demographic groups and to inform a future clinical trial, we conducted a qualitative formative investigation, informed by the Social Contextual Model of health behavior change, to identify barriers and facilitators to yoga that could impact study participation. We recruited twenty-four racially/ethnically diverse adults, with and without prior yoga experience, from a low-income, urban housing community to participate in either an individual interview or focus group. A thematic data analysis approach was employed. Barriers to yoga engagement included the perception that yoga lacks physicality and weight loss benefits, fear of injury, lack of ability/self-efficacy to perform the practices, preference for other physical activities, and scheduling difficulties. Facilitators of yoga engagement included a quality yoga instructor who provides individualized instruction, beginner level classes, and promotional messaging that highlights the potential benefits of yoga, such as stress reduction.
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Affiliation(s)
- Christine E Spadola
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States.
| | - Rebecca Rottapel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States
| | - Neha Khandpur
- Department of Nutrition, Faculty of Public Health, University of Sao Paulo, Brazil
| | - Emily Kontos
- DynaMed, EBSCO Health, Ipswich, MA, United States
| | - Suzanne M Bertisch
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, United States
| | - Dayna A Johnson
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Mirja Quante
- Department of Neonatology, University of Tuebingen, Germany
| | - Sat Bir S Khalsa
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Robert B Saper
- Department of Family Medicine, Boston Medical Center, Boston, MA, United States
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
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Buden JC, Dugan AG, Faghri PD, Huedo-Medina TB, Namazi S, Cherniack MG. Associations Among Work and Family Health Climate, Health Behaviors, Work Schedule, and Body Weight. J Occup Environ Med 2017; 59:588-599. [PMID: 28471768 PMCID: PMC5477673 DOI: 10.1097/jom.0000000000001049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Correctional employees exhibit elevated obesity rates. This study examines interrelations among health behaviors, health climate, body mass index (BMI), and work schedule. METHODS Using survey results from correctional supervisors (n = 157), mediation and moderated-mediation analyses were performed to examine how health behaviors explain relationships between obesity, work health climate (WHC) and family health climate (FHC), and work schedule. RESULTS Over 85% of the sample was overweight/obese (mean BMI = 30.20). Higher WHC and FHC were associated with lower BMI, mediated by nutrition, and physical activity. The interaction effect between health behavior and work schedule revealed a protective effect on BMI. Overtime shift work may share a relationship with BMI. CONCLUSIONS Findings may have implications for reexamining organizational policies on maximum weekly overtime in corrections. They provide direction for targeted obesity interventions that encourage a supportive FHC and promote healthy behaviors among supervisors working overtime.
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Affiliation(s)
- Jennifer C. Buden
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Alicia G. Dugan
- Division of Occupational and Environmental Medicine, UConn Health Center, Farmington, CT
| | - Pouran D. Faghri
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | | | - Sara Namazi
- Division of Occupational and Environmental Medicine, UConn Health Center, Farmington, CT
| | - Martin G. Cherniack
- Division of Occupational and Environmental Medicine, UConn Health Center, Farmington, CT
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Blomster JI, Zoungas S, Woodward M, Neal B, Harrap S, Poulter N, Marre M, Williams B, Chalmers J, Hillis GS. The impact of level of education on vascular events and mortality in patients with type 2 diabetes mellitus: Results from the ADVANCE study. Diabetes Res Clin Pract 2017; 127:212-217. [PMID: 28395214 DOI: 10.1016/j.diabres.2017.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
Abstract
AIMS The relationship between educational level and the risk of all-cause mortality is well established, whereas the association with vascular events in individuals with type 2 diabetes is not well described. Any association may reflect a link with common cardiovascular or lifestyle-based risk factors. METHODS The relationships between the highest level of educational attainment and major cardiovascular events, microvascular complications and all-cause mortality were explored in a cohort of 11,140 individuals with type 2 diabetes. Completion of formal education before the age of 16 was categorized as a low level of education. Regional differences between Asia, East Europe and Established Market Economies were also assessed. RESULTS During a median of 5years of follow up, 1031 (9%) patients died, 1147 (10%) experienced a major cardiovascular event and 1136 (10%) a microvascular event. After adjustment for baseline characteristics and risk factors, individuals with lower education had an increased risk of cardiovascular events (hazard ratio (HR) 1.31, 95% CI 1.16-1.48, p<0.0001), microvascular events (HR 1.23, 95% CI 1.08-1.39, p=0.0013) and all-cause mortality (HR 1.34, 95% CI 1.18-1.52, p<0.0001). In regional analyses the increased risk of studied outcomes associated with lower education was weakest in Established Market Economies and strongest in East Europe. CONCLUSIONS A low level of education is associated with an increased risk of vascular events and death in patients with type 2 diabetes, independently of common lifestyle associated cardiovascular risk factors. The effect size varies between geographical regions.
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Affiliation(s)
- J I Blomster
- The George Institute for Global Health, University of Sydney, Sydney, Australia; University of Turku, Turku, Finland.
| | - S Zoungas
- The George Institute for Global Health, University of Sydney, Sydney, Australia; School of Public Health, Monash University, Melbourne, Australia
| | - M Woodward
- The George Institute for Global Health, University of Sydney, Sydney, Australia; Department of Epidemiology, Johns Hopkins University, Baltimore, USA; The George Institute for Global Health, University of Oxford, UK
| | - B Neal
- The George Institute for Global Health, University of Sydney, Sydney, Australia
| | - S Harrap
- Department of Physiology, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - N Poulter
- Imperial College London and Hammersmith Hospital, London, UK
| | - M Marre
- Service d'Endocrinologie Diabétologie Nutrition, Groupe Hospitalier Bichat-Claude Bernard, Paris, France
| | - B Williams
- University College London and the National Institute for Health Research UCL Hospitals Biomedical Research Centre, London, UK
| | - J Chalmers
- The George Institute for Global Health, University of Sydney, Sydney, Australia
| | - G S Hillis
- The George Institute for Global Health, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Perth Hospital, Perth, Australia
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Marino M, Buxton OM, Li Y. Covariate Selection for Multilevel Models with Missing Data. Stat (Int Stat Inst) 2017; 6:31-46. [PMID: 28239457 DOI: 10.1002/sta4.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Missing covariate data hampers variable selection in multilevel regression settings. Current variable selection techniques for multiply-imputed data commonly address missingness in the predictors through list-wise deletion and stepwise-selection methods which are problematic. Moreover, most variable selection methods are developed for independent linear regression models and do not accommodate multilevel mixed effects regression models with incomplete covariate data. We develop a novel methodology that is able to perform covariate selection across multiply-imputed data for multilevel random effects models when missing data is present. Specifically, we propose to stack the multiply-imputed data sets from a multiple imputation procedure and to apply a group variable selection procedure through group lasso regularization to assess the overall impact of each predictor on the outcome across the imputed data sets. Simulations confirm the advantageous performance of the proposed method compared with the competing methods. We applied the method to reanalyze the Healthy Directions-Small Business cancer prevention study, which evaluated a behavioral intervention program targeting multiple risk-related behaviors in a working-class, multi-ethnic population.
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Affiliation(s)
- Miguel Marino
- Department of Family Medicine, Department of Public Health, Division of Biostatistics, Oregon Health and Science University, Portland, OR 97239 USA
| | - Orfeu M Buxton
- Associate Professor, Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802. Lecturer on Medicine, Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115. Associate Neuroscientist, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115. Adjunct Associate Professor, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115
| | - Yi Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109 USA
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Nicholls R, Perry L, Duffield C, Gallagher R, Pierce H. Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review. J Adv Nurs 2016; 73:1051-1065. [PMID: 27732741 DOI: 10.1111/jan.13185] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/28/2022]
Abstract
AIM The aim was to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses. BACKGROUND There is growing recognition of the influence of the workplace environment on the eating habits of the workforce, which in turn may contribute to increased overweight and obesity. Overweight and obesity exact enormous costs in terms of reduced well-being, worker productivity and increased risk of non-communicable diseases. The workplace is an ideal place to intervene and support healthy behaviours. This review aimed to identify barriers and facilitators to nurses' healthy eating in the workplace. DESIGN Integrative mixed method review. DATA SOURCES Five electronic databases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO. Reference lists were searched. Included papers were published in English between 2000-2016. Of 26 included papers, 21 were qualitative and five quantitative. REVIEW METHODS An integrative literature review was undertaken. Quality appraisal of included studies used standardized checklists. A social-ecological framework was used to examine workplace facilitators and constraints to healthy eating, derived from the literature. Emergent themes were identified by thematic analysis. RESULTS Review participants were Registered, Enrolled and/or Nurse Assistants primarily working in hospitals in middle or high income countries. The majority of studies reported barriers to healthy eating related to adverse work schedules, individual barriers, aspects of the physical workplace environment and social eating practices at work. Few facilitators were reported. Overall, studies found the workplace exerts a considerable negative influence on nurses' dietary intake. CONCLUSION Reorientation of the workplace to promote healthy eating among nurses is required.
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Affiliation(s)
- Rachel Nicholls
- Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Christine Duffield
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, New South Wales, Australia.,Edith Cowan University, Perth, Western Australia
| | - Robyn Gallagher
- Charles Perkins Centre, Sydney Nursing School, University of Sydney, New South Wales, Australia
| | - Heather Pierce
- Faculty of Health, University of Technology Sydney, New South Wales, Australia
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Bot SD, Mackenbach JD, Nijpels G, Lakerveld J. Association between Social Network Characteristics and Lifestyle Behaviours in Adults at Risk of Diabetes and Cardiovascular Disease. PLoS One 2016; 11:e0165041. [PMID: 27798709 PMCID: PMC5087858 DOI: 10.1371/journal.pone.0165041] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 10/05/2016] [Indexed: 11/29/2022] Open
Abstract
Objectives In this exploratory study we examined the associations between several social network characteristics and lifestyle behaviours in adults at increased risk of diabetes and cardiovascular diseases. In addition, we explored whether similarities in lifestyle between individuals and their network members, or the level of social support perceived by these individuals, could explain these associations. Methods From the control group of the Hoorn Prevention Study, participants with high and low educational attainment were approached for a structured interview between April and August 2010. Inclusion was stopped when fifty adults agreed to participate. Participants and a selection of their network members (e.g. spouses, best friends, neighbours, colleagues) completed a questionnaire on healthy lifestyle that included questions on fruit and vegetable intake, daily physical activity and leisure-time sedentary behaviour. We first examined associations between network characteristics and lifestyle using regression analyses. Second, we assessed associations between network characteristics and social support, social support and lifestyle, and compared the participants’ lifestyles to those of their network members using concordance correlation coefficients. Results Fifty adults (50/83 x 100 = 62% response) and 170 of their network members (170/192 x 100 = 89% response) participated in the study. Individuals with more close-knit relationships, more friends who live nearby, and a larger and denser network showed higher levels of vegetable consumption and physical activity, and lower levels of sedentary behaviour. Perceived social norms or perceived support for behavioural change were not related to healthy lifestyle. Except for spousal concordance for vegetable intake, the lifestyle of individuals and their network members were not alike. Conclusions Study results suggest that adults with a larger and denser social network have a healthier lifestyle. Underlying mechanisms for these associations should be further explored, as the current results suggest a minimal role for social support and modelling by network members.
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Affiliation(s)
- Sandra D. Bot
- Department of General Practice and Elderly Care, EMGO Institute for Health and Care Research, VU Medical Centre Amsterdam, Amsterdam, the Netherlands
- * E-mail:
| | - Joreintje D. Mackenbach
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU Medical Centre Amsterdam, Amsterdam, the Netherlands
| | - Giel Nijpels
- Department of General Practice and Elderly Care, EMGO Institute for Health and Care Research, VU Medical Centre Amsterdam, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU Medical Centre Amsterdam, Amsterdam, the Netherlands
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Quintiliani LM, Whiteley JA. Results of a Nutrition and Physical Activity Peer Counseling Intervention among Nontraditional College Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:366-374. [PMID: 25994357 PMCID: PMC4655196 DOI: 10.1007/s13187-015-0858-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED Health promotion efforts targeting nontraditional college students (older, part-time enrollment, and working) may be an optimal way to reach large populations that potentially face health disparities. A randomized trial was undertaken to examine the feasibility of a nutrition and physical activity behavioral intervention among nontraditional undergraduate college students at a large urban public university. Over 8 weeks, participants received either (1) a brief tailored feedback report plus three motivational interviewing-based calls from trained peer counselors (intervention; n = 40) or (2) the report only (control; n = 20). Participants mean age was 32 years (SD = 10), 58 % were female, 47 % were racial/ethnic minorities, and 25 % reported receiving public health insurance. Most (78 %) intervention group participants completed at least two of three peer counseling calls. At follow-up, those in the intervention vs. control group self-reported beneficial, but non-statistically significant changes in fruits and vegetables (+0.7 servings/day), sugary drinks (-6.2 oz/day), and fast food visits (-0.2 visits/week). For physical activity, there was a non-statistically significant decrease in moderate-vigorous physical activity (107.2 min/week) in the intervention vs. CONTROL GROUP Overall satisfaction with the program was high, although there were recommendations made for improving the structure and number of calls. Findings indicate that the intervention was feasible with promising effects on nutrition behaviors and the need to better target physical activity behaviors. Future work entails implementation in a larger sample with objectively measured behaviors.
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Affiliation(s)
- Lisa M Quintiliani
- Department of Medicine, Section of General Internal Medicine, Boston University, 801 Massachusetts Ave., Crosstown Center, 2nd Floor, Boston, MA, 02118, USA.
| | - Jessica A Whiteley
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Blvd., Science Center, 3rd floor, Boston, MA, 02125, USA
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Ward SA, Bélanger MF, Donovan D, Carrier N. Relationship between eating behaviors and physical activity of preschoolers and their peers: a systematic review. Int J Behav Nutr Phys Act 2016; 13:50. [PMID: 27075482 PMCID: PMC4831107 DOI: 10.1186/s12966-016-0374-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 04/08/2016] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Children learn by observing and imitating others, meaning that their eating behaviors and physical activity may be influenced by their peers. This paper systematically reviews how preschoolers' eating behaviors and physical activity relate to their peers' behaviors, and discusses avenues for future research. METHODS Six databases were searched for quantitative, peer-reviewed studies published up to July 2015 reporting on the correlates, predictors or effectiveness of peers on eating behaviors and physical activity in preschoolers. Risk of bias was independently assessed by two evaluators using the Quality Assessment Tool for Quantitative Studies. RESULTS Thirteen articles were included: six measured physical activity, and seven assessed eating behaviors. Four of the six physical activity studies reported that children were more active when peers were present, while large peer group size was negatively associated with physical activity in two cross-sectional studies. All nutrition interventions reported that children's eating behaviors may be influenced by their peers. CONCLUSIONS Although supported by weak evidence, peers appear to influence children's eating behaviors and physical activity. However, this influence may be moderated by the number of peers, gender, age and the perceived status of the role models. Future obesity prevention interventions should consider involving peers as agents for positive eating behaviors and physical activity in preschoolers.
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Affiliation(s)
- Stéphanie A. Ward
- />Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de formation médicale du Nouveau-Brunswick, 100, rue des Aboiteaux, Moncton, NB E1A 3E9 Canada
| | - Mathieu F. Bélanger
- />Department of Family Medicine, Université de Sherbrooke, Centre de formation médicale du Nouveau-Brunswick, Vitalité Health Network, Moncton, NB E1A 3E9 Canada
| | - Denise Donovan
- />Department of Community Health Sciences, Université de Sherbrooke, Centre de formation médicale du Nouveau-Brunswick, Moncton, NB E1A 3E9 Canada
| | - Natalie Carrier
- />École des sciences des aliments, de nutrition et d’études familiales, Université de Moncton, Moncton, NB E1A 3E9 Canada
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Rueff A, Logomarsino J. Increasing fruit and vegetable intake among manufacturing workers. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2016. [DOI: 10.1108/ijwhm-12-2014-0056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– Blue-collar manufacturing workers are more likely to have lifestyle risk factors, including a lower intake of fruit and vegetables, for the development of chronic diseases. The purpose of this paper is to assess the effects of worksite health-promotion interventions on fruit and vegetable intake among manufacturing workers.
Design/methodology/approach
– This paper reviews the evidence for the effectiveness of interventions and makes recommendations on best practices. Types of interventions and theoretical frameworks used in the workplace are reviewed, and findings are presented through research examples. Research for this paper was conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO.
Findings
– Positive results were found for the effectiveness of interventions to increase fruit and vegetable consumption. Multiple levels of intervention, an emphasis on employee participation in planning, higher self-efficacy, and social support were found to be effective.
Research limitations/implications
– Limitations of this review included self-reported data on fruit and vegetable intake. Also, determining if one intervention was more efficacious than another was difficult when multiple interventions were used within a study. Questions have been raised regarding the long-term impact of increased fruit and vegetable intake among employees.
Practical implications
– When planning programs, multiple levels of intervention will be needed to increase fruit and vegetable intake among workers. Also, employee participation should be emphasized when planning and implementing programs.
Originality/value
– The use of manufacturing companies should be considered as a platform for health-promotion programs. Increasing fruit and vegetable intake has the potential to impact numerous blue-collar workers to help reduce the risk of chronic disease.
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Vainio A, Niva M, Jallinoja P, Latvala T. From beef to beans: Eating motives and the replacement of animal proteins with plant proteins among Finnish consumers. Appetite 2016; 106:92-100. [PMID: 26952560 DOI: 10.1016/j.appet.2016.03.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 11/18/2022]
Abstract
A better understanding of the motives underlying the adoption of sustainable and healthy diets is needed for designing more effective policies. The aim of the study was to examine how eating motives were associated with self-reported changes in the consumption of beef, beans, and soy products, i.e., changes related to reducing animal and increasing plant proteins. The study analysed a survey of an adult population living in Finland (N = 1048). The eating motives were measured with the Eating Motivation Survey (TEMS), which distinguishes between 15 eating motives. Six clusters of consumers based on self-reported changes in food choices were identified with latent class analysis (LCA). Four clusters had established food consumption patterns ("Beef only", "Beef and beans", "Beef, beans, and soy products", and "No beef"), one was undergoing a change, and one had attempted a change earlier. ANOVA with planned contrasts revealed that the motives relating to natural concerns, health, and weight control were higher, and convenience and price lower, among those who had an established diet including beans and soy products, as compared to those who consumed only beef. Those undergoing a dietary change expressed a higher endorsement of natural concerns as well as health, sociability, social image, and price motives than those with an established diet including beans and soy products. The results suggest that eating motives play an important role in changing towards more sustainable food consumption patterns in which meat/beef is replaced with plant proteins.
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Affiliation(s)
- Annukka Vainio
- Natural Resources Institute Finland (Luke), Helsinki, Finland.
| | - Mari Niva
- Consumer Society Research Centre, University of Helsinki, Helsinki, Finland.
| | - Piia Jallinoja
- Consumer Society Research Centre, University of Helsinki, Helsinki, Finland.
| | - Terhi Latvala
- Natural Resources Institute Finland (Luke), Helsinki, Finland.
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Mackenbach JD, Lakerveld J, van Lenthe FJ, Kawachi I, McKee M, Rutter H, Glonti K, Compernolle S, De Bourdeaudhuij I, Feuillet T, Oppert JM, Nijpels G, Brug J. Neighbourhood social capital: measurement issues and associations with health outcomes. Obes Rev 2016; 17 Suppl 1:96-107. [PMID: 26879117 DOI: 10.1111/obr.12373] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 12/15/2015] [Indexed: 01/01/2023]
Abstract
We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes.
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Affiliation(s)
- J D Mackenbach
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - J Lakerveld
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - F J van Lenthe
- Department of Public Health, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - I Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, USA
| | - M McKee
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - H Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - K Glonti
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - S Compernolle
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - T Feuillet
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
| | - J-M Oppert
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Sorbonne Universités, Université Pierre et Marie Curie, Université Paris 06; Institute of Cardiometabolism and Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - G Nijpels
- Department of General Practice and Elderly Care, EMGO Institute for Health and Care Research, VU Medical Center Amsterdam, The Netherlands
| | - J Brug
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
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Leske S, Strodl E, Harper C, Clemens S, Hou XY. Psychological distress may affect nutrition indicators in Australian adults. Appetite 2015; 90:144-53. [DOI: 10.1016/j.appet.2015.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 01/22/2015] [Accepted: 02/02/2015] [Indexed: 10/23/2022]
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Tamers SL, Thompson B, Cheadle AD, Zheng Y, Bishop SK, Beresford SAA. Promoting Changes in Obesogenic Behaviors: Does Coworker Social Support Play a Role? Am J Health Promot 2015; 29:311-3. [DOI: 10.4278/ajhp.130709-arb-352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To examine the association between worksite social support and changes in diet, physical activity, and body mass index (BMI). Design. Cohort analysis of an underlying randomized, controlled weight gain prevention worksite trial: Promoting Activity and Changes in Eating. Setting. The trial occurred in the greater Seattle area. Subjects. Baseline and follow-up data were obtained on a nested cohort of employees (n = 958–1078) from 33 small- to medium-sized worksites. Measures. Worksite social support, diet, physical activity, and BMI measures were assessed using a self-reported questionnaire. Analysis. To adjust for multilevel data and multiple time points, we used generalized estimating equations and logistic mixed models. Results. Higher baseline worksite social support was associated with greater changes in fruit and vegetable intake (p= .001; summary food-frequency questions). Conclusion. This study does not support a conclusive relationship between worksite social support and health behavior change.
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Kempe A, O’Leary ST, Kennedy A, Crane LA, Allison MA, Beaty BL, Hurley LP, Brtnikova M, Jimenez-Zambrano A, Stokley S. Physician response to parental requests to spread out the recommended vaccine schedule. Pediatrics 2015; 135:666-77. [PMID: 25733753 PMCID: PMC6046639 DOI: 10.1542/peds.2014-3474] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To assess among US physicians (1) frequency of requests to spread out recommended vaccination schedule for children <2 years, (2) attitudes regarding such requests, and (3) strategies used and perceived effectiveness in response to such requests. METHODS An e-mail and mail survey of a nationally representative sample of pediatricians and family physicians from June 2012 through October 2012. RESULTS The response rate was 66% (534 of 815). In a typical month, 93% reported some parents of children <2 years requested to spread out vaccines; 21% reported ≥ 10% of parents made this request. Most respondents thought these parents were putting their children at risk for disease (87%) and that it was more painful for children (84%), but if they agreed to requests, it would build trust with families (82%); further, they believed that if they did not agree, families might leave their practice (80%). Forty percent reported this issue had decreased their job satisfaction. Most agreed to spread out vaccines when requested, either often/always (37%) or sometimes (37%); 2% would often/always, 4% would sometimes, and 12% would rarely dismiss families from their practice if they wanted to spread out the primary series. Physicians reported using a variety of strategies in response to requests but did not think they were effective. CONCLUSIONS Virtually all providers encounter requests to spread out vaccines in a typical month and, despite concerns, most are agreeing to do so. Providers are using many strategies in response but think few are effective. Evidence-based interventions to increase timely immunization are needed to guide primary care and public health practice.
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Affiliation(s)
- Allison Kempe
- Children's Outcomes Research, Children's Hospital Colorado, Aurora, Colorado; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado;
| | - Sean T. O’Leary
- Children’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado,Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Allison Kennedy
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lori A. Crane
- Children’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado,Department of Community and Behavioral Health, Colorado School of Public Health, Denver, Colorado
| | - Mandy A. Allison
- Children’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado,Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Brenda L. Beaty
- Children’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado
| | - Laura P. Hurley
- Children’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado,Division of General Internal Medicine, Denver Health, Denver, Colorado
| | - Michaela Brtnikova
- Children’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado
| | | | - Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Springvloet L, Lechner L, Oenema A. Can individual cognitions, self-regulation and environmental variables explain educational differences in vegetable consumption?: a cross-sectional study among Dutch adults. Int J Behav Nutr Phys Act 2014; 11:149. [PMID: 25480542 PMCID: PMC4275939 DOI: 10.1186/s12966-014-0149-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 11/24/2014] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Educational differences in health-related behaviors, where low- and moderate-educated individuals have poorer outcomes than high-educated individuals, are persistent. The reasons for these differences remain poorly understood. This study explored whether individual cognitions, self-regulation and environmental-level factors may explain educational differences in vegetable consumption. METHODS A cross-sectional study was conducted among 1,342 Dutch adults, of whom 54.5% were low/moderate-educated. Individuals completed an online questionnaire, assessing education, vegetable consumption, demographics, individual cognitions (attitude towards consuming 200 grams of vegetables a day, self-efficacy, subjective norm, intention, perception of vegetables as being expensive), self-regulation (general self-regulation, vegetable-specific action- and coping planning) and environmental-level factors (perception of availability of vegetables in the supermarket and availability of vegetables at home). The joint-significance test was used to determine significant mediation effects. RESULTS Low/moderate-educated individuals consumed less vegetables (M = 151.2) than high-educated individuals (M = 168.1, β = -0.15, P < .001). Attitude and availability of vegetables at home were found to partially mediate the association between education and vegetable consumption (percentage mediated effect: 24.46%). DISCUSSION Since attitude and availability of vegetables at home partially explain the difference in vegetable consumption between low/moderate- and high-educated individuals, these variables may be good target points for interventions to promote vegetable consumption among low/moderate-educated individuals.
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Affiliation(s)
- Linda Springvloet
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Anke Oenema
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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Griep RH, Santos SM, Cardoso LDO, Fonseca MDJMD, Alves MGDM, Souto EP, Chor D. [Social capital in ELSA-Brasil: test-retest reliability of the Resource Generator scale]. Rev Saude Publica 2014; 47 Suppl 2:131-9. [PMID: 24346730 DOI: 10.1590/s0034-8910.2013047003805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 06/05/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the test-retest reliability of items of the Resource Generator scale for assessing social capital in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). METHODS The social capital was applied in a subsample of 281 participants from six ELSA investigation centers, on two occasions with an interval of seven to 14 days. The instrument consists of 31 items that represent concrete situations to evaluate the access to different types of resources. In addition, it evaluates the strength of ties (family, friends or acquaintances) for the available resources. Statistical analyses were performed through use of the kappa statistic (k) and prevalence-adjusted kappa (ka). RESULTS A high frequency was found for social resources (above 50%). Regarding the presence or absence of resources, prevalence-adjusted reliability (ka) varied from 0.54 to 0.97. With regard to the source for the resource, the reliability estimates ranged from ka = 0.45 ("someone who has good contacts with the media") to ka = 0.86 ("someone who completed secondary education"). CONCLUSIONS The scale presented adequate levels of reliability, which varied according to the type of resource.
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Understanding the sources of normative influence on behavior: the example of tobacco. Soc Sci Med 2014; 115:139-43. [PMID: 24910005 DOI: 10.1016/j.socscimed.2014.05.030] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 03/04/2014] [Accepted: 05/19/2014] [Indexed: 11/19/2022]
Abstract
Despite extensive research on social norms, the sources of norm formation are not well understood. Social exposure to a behavior (defined as the composite of ways through which people see that behavior in their social, physical, and symbolic environments) can serve as a source of normative influence. Using tobacco as a case study, we propose that research should move beyond categories of individuals as sources of norms and focus on a broader range of sources of normative influences. An understanding of social exposure as a source for norms may be important to better understand and intervene in environments to promote public health. We make policy recommendations arising from the explication of social exposure and propose directions for future research.
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Nelson CC, Wagner GR, Caban-Martinez AJ, Buxton OM, Kenwood CT, Sabbath EL, Hashimoto DM, Hopcia K, Allen J, Sorensen G. Physical activity and body mass index: the contribution of age and workplace characteristics. Am J Prev Med 2014; 46:S42-51. [PMID: 24512930 PMCID: PMC4007484 DOI: 10.1016/j.amepre.2013.10.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 10/29/2013] [Accepted: 10/29/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND The workplace is an important domain for adults, and many effective interventions targeting physical activity and weight reduction have been implemented in the workplace. However, the U.S. workforce is aging, and few studies have examined the relationship of BMI, physical activity, and age as they relate to workplace characteristics. PURPOSE This paper reports on the distribution of physical activity and BMI by age in a population of hospital-based healthcare workers and investigates the relationships among workplace characteristics, physical activity, and BMI. METHODS Data from a survey of patient care workers in two large academic hospitals in the Boston area were collected in late 2009 and analyzed in early 2013. RESULTS In multivariate models, workers reporting greater decision latitude (OR=1.02, 95% CI=1.01, 1.03) and job flexibility (OR=1.05, 95% CI=1.01, 1.10) reported greater physical activity. Overweight and obesity increased with age (p<0.01), even after adjusting for workplace characteristics. Sleep deficiency (OR=1.56, 95% CI=1.15, 2.12) and workplace harassment (OR=1.62, 95% CI=1.20, 2.18) were also associated with obesity. CONCLUSIONS These findings underscore the persistent impact of the work environment for workers of all ages. Based on these results, programs or policies aimed at improving the work environment, especially decision latitude, job flexibility, and workplace harassment should be included in the design of worksite-based health promotion interventions targeting physical activity or obesity.
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Affiliation(s)
- Candace C Nelson
- Department of Environmental Health, Harvard School of Public Health, Harvard University, Cambridge.
| | - Gregory R Wagner
- Department of Environmental Health, Harvard School of Public Health, Harvard University, Cambridge; National Institute for Occupational Safety and Health, Washington DC
| | - Alberto J Caban-Martinez
- Department of Environmental Health, Harvard School of Public Health, Harvard University, Cambridge
| | - Orfeu M Buxton
- Division of Sleep Medicine, Harvard Medical School, Harvard University, Cambridge; Department of Medicine, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston
| | | | - Erika L Sabbath
- Center for Population and Development Studies, Harvard University, Cambridge
| | - Dean M Hashimoto
- Partners Healthcare System, Dana Farber Cancer Institute, Boston
| | - Karen Hopcia
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Jennifer Allen
- Center for Community Based Research, Dana Farber Cancer Institute, Boston
| | - Glorian Sorensen
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Wang M, Druker S, Gapinski MA, Gellar L, Schneider K, Osganian S, Olendzki B, Pbert L. The Role of Social Support vs. Modeling on Adolescents' Diet and Physical Activity: Findings from a School-based Weight Management Trial. JOURNAL OF CHILD AND ADOLESCENT BEHAVIOR 2014; 2. [PMID: 30465024 PMCID: PMC6242294 DOI: 10.4172/2375-4494.1000132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective: Social influences play an important role in shaping adolescents’ dietary and physical activity behaviors. We examined the role of perceived modeling and perceived social support from family and friends on diet and physical activity behaviors among overweight and obese adolescents participating in a weight management trial. Methods: Six high schools were randomized to a school-nurse delivered behavioral weight management intervention or an information attention-control. Data on perceived support and modeling of healthy eating and physical activity from family and friends and dietary and physical activity behaviors were obtained from participants (N=82) at baseline and 2- and 6-months follow-up. Results: Linear mixed models were used to examine associations between social factors at baseline and diet and physical behaviors at 6 months. Friend support was correlated with increased fruit and vegetable consumption (0.4 servings/day) and decreased added sugar intake (−14.2 grams/day) (p’s<0.05). Family support for physical activity, friend support for physical activity, and family modeling of physical activity were associated with increased number of days/week active for ≥ 60 minutes/day (0.7 days/week; 0.6 days/week; and 0.4 days/week, respectively, p’s<0.05). Conclusions: Among overweight and obese high school adolescents, support from family and friends was associated with a greater number of improvements in diet and physical activity at follow-up than modeling. Strategies to solicit support may maximize efficacy of adolescent obesity intervention efforts.
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Affiliation(s)
- Monica Wang
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA.,Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115, USA
| | - Susan Druker
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
| | - Mary Ann Gapinski
- Massachusetts Department of Public Health, 250 Washington St., Boston, MA 02108, USA
| | - Lauren Gellar
- Nutrition Department, University of Tennessee, 1215 W. Cumberland Ave., Knoxville TN 37996, USA
| | - Kristin Schneider
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., North Chicago, IL 60064, USA
| | - Stavroula Osganian
- Department of Medicine, Children's Hospital Boston, 333 Longwood Ave., Boston, MA 02115, USA
| | - Barbara Olendzki
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
| | - Lori Pbert
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
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Morello MI, Madanat H, Crespo NC, Lemus H, Elder J. Associations among parent acculturation, child BMI, and child fruit and vegetable consumption in a Hispanic sample. J Immigr Minor Health 2013; 14:1023-9. [PMID: 22392140 DOI: 10.1007/s10903-012-9592-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The objective of this study was to investigate the association of parent acculturation with child fruit and vegetable consumption and obesity, as measured by body mass index (BMI). Participants included 250 Mexican-American and other Hispanic families living within San Diego County. Height and weight measurements were collected to calculate the age- and sex-specific BMI for each child and parent, and parents completed self-administered surveys. Child BMI z-score was significantly related to parent BMI after controlling for parent acculturation and parent birth place (β = 0.05, p < 0.01). Child fruit consumption was significantly associated with parent acculturation (β = -0.02, p = 0.01) and parent BMI (β = 0.02, p = 0.04) after adjusting for the other variables in the model. Child vegetable consumption was not significantly related to parent acculturation. Findings suggest that parental weight status may be more predictive of child obesity than acculturation, and highlight the need to examine culturally relevant behavioral and psychosocial factors related to childhood obesity and dietary behaviors.
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Affiliation(s)
- Monica I Morello
- Graduate School of Public Health, San Diego State University, San Diego, CA 92182, USA.
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47
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Simpson VL, Hyner GC, Anderson JG. Lifestyle Behavior Change and Repeat Health Risk Appraisal Participation: A Structural Equation Modeling Approach. Am J Health Promot 2013; 28:128-35. [DOI: 10.4278/ajhp.120306-quan-128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. Health risk appraisals (HRAs) have been used to address multiple health concerns and lifestyle behaviors. We explore the longitudinal relationship between emotional health, stage of change for five lifestyle behaviors, and lifestyle risks using HRA-generated data. Design. Secondary analysis of 3 years of HRA data. Setting. A large health care management services provider. Subjects. A total of 7535 adults employed across three companies who completed consecutive HRAs over a 3-year period. Measures. Self-report items concerning participant health, lifestyle behaviors, disease risk factors, job/life satisfaction, safety, and biometrics. Analysis. Structural equation modeling tested a hypothesized longitudinal, fully cross-lagged panel design. Results. Results indicated that greater numbers of physical and behavioral risks classified as high risk were associated with greater intention to change or an actual change in lifestyle behavior in the following year. In addition, poorer emotional health was associated with a higher number of risks. Conclusion. Data from repeat participation in HRAs can be useful in studying multiple risk behaviors and related health measures, supporting the design and evaluation of effective, individualized, and responsive health promotion activities for working adults.
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Harley AE, Sapp AL, Li Y, Marino M, Quintiliani LM, Sorensen G. Sociodemographic and social contextual predictors of multiple health behavior change: data from the Healthy Directions-Small Business study. Transl Behav Med 2013; 3:131-9. [PMID: 24073163 DOI: 10.1007/s13142-013-0196-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Multiple modifiable health behaviors contribute to the chronic diseases that are the leading causes of death in the USA. Disparities for meeting recommended health behavior guidelines exist across occupational classes and socioeconomic levels. The purpose of this paper was to investigate sociodemographic and social contextual predictors of multiple health behavior change in a worksite intervention. We analyzed data on four diet and exercise variables from an intervention trial with worksite-level randomization. Eight hundred forty-one employees had complete data from baseline (response rate = 84 %) and follow-up surveys (response rate = 77 %). Multilevel logistic regression estimated associations between least absolute shrinkage and selection operator-selected sociodemographic and social contextual predictor variables and the multiple health behavior change outcome (changing 2+ versus 0 behaviors). Gender, being married/partnered, and perceived discrimination were significantly associated with multiple health behavior change. Sociodemographic and social contextual factors predict multiple health behavior change and could inform the design and delivery of worksite interventions targeting multiple health behaviors.
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Affiliation(s)
- Amy E Harley
- Joseph J. Zilber School of Public Health, Center for Urban Population Health, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201 USA
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Nagler EM, Viswanath K, Ebbeling CB, Stoddard AM, Sorensen G. Correlates of fruit and vegetable consumption among construction laborers and motor freight workers. Cancer Causes Control 2013; 24:637-47. [PMID: 22729935 PMCID: PMC3784996 DOI: 10.1007/s10552-012-9998-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 05/16/2012] [Indexed: 02/05/2023]
Abstract
PURPOSE The aim of this study was to compare and contrast correlates of fruit and vegetable consumption in two blue-collar populations: construction laborers and motor freight workers. METHODS Cross-sectional data were collected from two groups of male workers: (1) construction laborers (n = 1,013; response rate = 44 %) randomly selected from a national sample, as part of a diet and smoking cessation study; and (2) motor freight workers (n = 542; response rate = 78 %) employed in eight trucking terminals, as part of a tobacco cessation and weight management study. Data were analyzed using linear regression modeling methods. RESULTS For both groups, higher income and believing it was important to eat right because of work were positively associated with fruit and vegetable consumption; conversely, being white was associated with lower intake. Construction laborers who reported eating junk food due to workplace stress and fatigue had lower fruit and vegetable intake. For motor freight workers, perceiving fast food to be the only choice at work and lack of time to eat right were associated with lower consumption. CONCLUSION Comparing occupational groups illustrates how work experiences may be related to fruit and vegetable consumption in different ways as well as facilitates the development of interventions that can be used across groups.
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Affiliation(s)
- Eve M Nagler
- Dana-Farber Cancer Institute, Center for Community-Based Research, Boston, MA 02115-5450, USA.
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Kalin SR, Fung TT. Comparison of child obesity prevention and control content in mainstream and Spanish-language US parenting magazines. J Acad Nutr Diet 2013; 113:133-40. [PMID: 23260730 DOI: 10.1016/j.jand.2012.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 09/21/2012] [Indexed: 11/18/2022]
Abstract
Mass media coverage of child obesity is rising, paralleling the child obesity epidemic's growth, and there is evidence that parents seek parenting advice from media sources. Yet little to no research has examined the coverage of child obesity in parenting magazines or Spanish-language media. The purpose of this study was to use qualitative and quantitative content analysis methods to identify, quantify, and compare strategies for child obesity prevention and control presented in mainstream and Spanish-language US parenting magazines. Child obesity-related editorial content in 68 mainstream and 20 Spanish-language magazine issues published over 32 months was gathered. Magazine content was coded with a manual developed by refining themes from the sample and from an evidence-based child obesity prevention action plan. Seventy-three articles related to child obesity prevention and control were identified. Most focused on parental behavior change rather than environmental change, and only 3 in 10 articles referred to the social context in which parental behavior change takes place. Child obesity-focused articles were not given high prominence; only one in four articles in the entire sample referred to child obesity as a growing problem or epidemic. Key differences between genres reflect culturally important Latino themes, including family focus and changing health beliefs around child weight status. Given mass media's potential influence on parenting practices and public perceptions, nutrition communication professionals and registered dietitians need to work to reframe media coverage of childhood obesity as an environmental problem that requires broad-based policy solutions. Spanish-speaking media can be an ally in helping Latina women change cultural health beliefs around child weight status.
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Affiliation(s)
- Sari R Kalin
- Nutrition and Health Promotion, Department of Nutrition, Simmons College, Boston, MA, USA.
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