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Rudin LR, Tetreault L, Xu R, Bauer KW, Pagoto SL, Duffy VB, Libby BA, Pham J, Waring ME. Sources and perceived credibility of child nutrition information in relation to maternal health literacy. Patient Educ Couns 2024; 123:108199. [PMID: 38359589 DOI: 10.1016/j.pec.2024.108199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To examine sources and perceived credibility of child nutrition information by maternal health literacy. METHODS US mothers of children (0-12 years) who used social media regularly (N = 340) completed an online survey. Health literacy was assessed using the Newest Vital Sign. Child nutrition information sources and perceived credibility of sources were compared by health literacy using logistic and quantile regression models. RESULTS Seventeen percent of mothers had limited health literacy. Compared to mothers with adequate health literacy, those with limited health literacy were more likely to get child nutrition information from siblings, extended family, dietitians, doctors, nurse practitioners, or physician assistants, and government agencies, and less likely to get information from Facebook. Mothers with limited health literacy rated information from parents, friends, Facebook, and Instagram as more credible than mothers with adequate health literacy. While perceived credibility of information from doctors, nurse practitioners, or physician assistants was high overall, mothers with limited health literacy perceived information from these health care providers as less credible. CONCLUSIONS Sources of child nutrition information and perceived credibility differ by maternal health literacy. PRACTICE IMPLICATIONS Pediatric providers are encouraged to refer parents to engaging resources that provide evidence-based child nutrition information.
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Affiliation(s)
- Lauren R Rudin
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Lauryn Tetreault
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Valerie B Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Brooke A Libby
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Julie Pham
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
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Schroeder MW, Waring ME, Fowler NR, Mace RA, Pagoto SL. Association Between Subjective Cognitive Decline and Twice-Weekly Muscle-Strengthening Activities in Middle-Aged and Older US Adults: An Analysis of the 2019 Behavioral Risk Factor Surveillance System. Am J Health Promot 2024; 38:615-624. [PMID: 38226478 DOI: 10.1177/08901171231224517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
PURPOSE Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD. DESIGN Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. SAMPLE 114 164 respondents, representing approximately 59 million US adults aged ≥45. MEASURES SCD was indicated if the respondent reported confusion or memory loss during the past 12 months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week). ANALYSIS Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C. RESULTS US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0). CONCLUSION Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.
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Affiliation(s)
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Nicole R Fowler
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN, USA
| | - Ryan A Mace
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Waring ME, Arigo D, Rudin LR, Pagoto SL, Moore Simas TA, Horkachuck AB. Interest in an Instagram-delivered gestational weight gain intervention among pregnant women with pre-pregnancy overweight or obesity. Mhealth 2024; 10:12. [PMID: 38689614 PMCID: PMC11058595 DOI: 10.21037/mhealth-23-43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/03/2023] [Indexed: 05/02/2024] Open
Abstract
Background Barriers to attending in-person lifestyle interventions are common during pregnancy. The majority of young adults use Instagram, and pregnancy-related content abounds on this social media platform. The aims of this study were to assess interest in an Instagram-delivered gestational weight gain (GWG) intervention, examine characteristics associated with program interest, describe interest in specific program components, and to explore perceived advantages of and concerns about the proposed intervention. Methods English-speaking pregnant women with pre-pregnancy overweight or obesity in the US who use Instagram completed a cross-sectional online survey (N=229). Participants reported interest in a proposed Instagram-delivered GWG intervention (very/quite a bit versus somewhat/a little bit/not at all interested), demographics, and Instagram use habits. Characteristics associated with program interest were examined using logistic regression models. Responses to open-ended questions about program likes and concerns were content-analyzed. Results Thirty-four percent were very or quite a bit interested in an Instagram-delivered GWG intervention, and women with children, those who were more extraverted, and those with greater engagement on Instagram were more likely to report interest. Among participants with high program interest, 63-95% were interested in specific intervention components and 52-82% were willing to engage in different aspects of the intervention. Participants liked the potential for information, peer support, convenience, and accountability, but reported concerns about privacy/confidentiality, social pressure, time required, and negative psychological consequences. Conclusions Fostering a positive, supportive group culture may be key to leveraging Instagram to deliver a GWG intervention.
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Affiliation(s)
- Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, USA
| | - Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ, USA
- Department of Family Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Lauren R. Rudin
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, USA
| | - Tiffany A. Moore Simas
- Departments of Obstetrics & Gynecology, Pediatrics, Psychiatry, and Population & Quantitative Health Sciences, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, USA
| | - Alexa B. Horkachuck
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Stapleton JL, Manne SL, Pagoto SL, Leip A, Greene K, Hillhouse JJ, Merritt AS, Shelton BJ. A Social Media-Delivered Melanoma Prevention Program for Young Women Engaged in Frequent UV Tanning: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e56562. [PMID: 38502173 PMCID: PMC10988380 DOI: 10.2196/56562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Rates of melanoma have increased dramatically in the United States over the past 25 years, and it has become among the most prevalent cancers for young adult women. Intentional skin tanning leads to a pattern of intense and intermittent UV radiation exposure that is associated with increased risk of melanoma. Frequent tanning is most common among young women and is linked to a variety of sociocultural pressures that negatively impact body image and drive appearance control behaviors. Unfortunately, there are no established interventions designed for frequent tanners. This intervention addresses this gap with unique content informed by body image and acceptance-based interventions. The intervention is delivered using Facebook secret groups, an approach designed to support behavior change and ensure scalability. OBJECTIVE This study aims to describe the rationale and methodology of a randomized controlled trial of a melanoma prevention program targeting young women engaged in frequent indoor or outdoor UV tanning. METHODS Participants are women aged 18-25 years who report high-risk tanning (ie, at least 10 indoor tanning sessions in the past 12 months or 10 outdoor sessions in the previous summer). After recruitment and screening, participants completed a baseline survey and were randomly assigned to receive the intervention or an attention-matched control condition. Both conditions were 8-week-long Facebook groups (approximately 25 members each) with daily posting of content. Follow-up surveys are administered at 3, 8, and 18 months after baseline. The primary trial outcome is the combined number of indoor and outdoor tanning sessions reported at the 8-month follow-up. Hypothesized intervention mediators are assessed at the 3-month follow-up. RESULTS This project was funded by a National Cancer Institute award (R01 CA218068), and the trial procedures were approved by the University of Kentucky Institutional Review Board in February 2020. Trial recruitment and enrollment occurred in 6 waves of data collection, which started in February 2022 and closed in May 2023. The study is closed to enrollment but remains open for follow-ups, and this protocol report was prepared before data analyses. As of February 2024, all participants have completed the 8-month follow-up assessment, and data collection is scheduled to close by the end of 2024 after the collection of the 18-month follow-up. CONCLUSIONS This trial will contribute unique knowledge to the field of skin cancer prevention, as no fully powered trials have examined the efficacy of an intervention designed for frequent indoor or outdoor tanning. The trial may also contribute evidence of the value in translating principles of body image and acceptance-based interventions into the field of skin cancer prevention and beyond. If successful, the use of the Facebook platform is intended to aid in dissemination as it provides a way to embed the intervention into individuals' everyday routines. TRIAL REGISTRATION ClinicalTrials.gov NCT03441321; https://clinicaltrials.gov/study/NCT03441321. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56562.
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Affiliation(s)
- Jerod L Stapleton
- Markey Cancer Center, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Sherry L Pagoto
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, United States
| | - Allison Leip
- Department of Family Sciences, University of Kentucky, Lexington, KY, United States
| | - Kathryn Greene
- Department of Communication, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Joel J Hillhouse
- Department of Community and Behavioral Health, East Tennessee State University, Johnson City, TN, United States
| | - Allison S Merritt
- Markey Cancer Center, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Brent J Shelton
- Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, United States
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Palmer LE, Pagoto SL, Workman D, Lewis KA, Rudin LR, De Luna N, Herrera V, Brown N, Bibeau J, Arcangel K, Waring ME. Health and education concerns about returning to campus and online learning during the COVID-19 pandemic among US undergraduate STEM majors. J Am Coll Health 2023; 71:2604-2611. [PMID: 34666630 PMCID: PMC9125396 DOI: 10.1080/07448481.2021.1979009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 08/13/2021] [Accepted: 09/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE We examined undergraduates' concerns about returning to campus and online learning from home. PARTICIPANTS Undergraduates majoring in STEM (Science, Technology, Engineering, and Mathematics) at US universities/colleges. METHODS Participants completed an online survey in July 2020. We content-analyzed responses to open-ended questions about concerns about fall 2020. RESULTS Students (N = 64) were 52% women, 47% low socioeconomic status (SES), and 27% non-Hispanic white. Concerns about returning to campus included student noncompliance with university COVID-19 prevention guidelines (28%), infection risk (28%), poor instructional quality (26%), inadequate university plans for preventing/handling outbreaks (25%), negative impacts on social interactions (11%), and transportation/commuting (11%). Concerns about learning from home included difficulty focusing on schoolwork (58%), lack of hands-on/experiential learning (24%), negative impacts on social interactions (19%), family/home environment (15%), concerns that online learning wastes time/money (10%), and inadequate technology/Internet access (5%). CONCLUSIONS Universities should address student concerns and provide resources to overcome barriers to effective learning.
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Affiliation(s)
- Lindsay E. Palmer
- Department of Mathematics, The Pennsylvania State University, University Park, PA
- Department of Psychology, The Pennsylvania State University, University Park, PA
- Department of Women’s, Gender, and Sexuality Studies, The Pennsylvania State University, University Park, PA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Deja Workman
- Department of Mathematics, The Pennsylvania State University, University Park, PA
| | - Kathrine A. Lewis
- Department of Mathematics, The Pennsylvania State University, University Park, PA
- Department of Psychology, The Pennsylvania State University, University Park, PA
- Department of Women’s, Gender, and Sexuality Studies, The Pennsylvania State University, University Park, PA
| | - Lauren R. Rudin
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Nina De Luna
- Department of Mathematics, The Pennsylvania State University, University Park, PA
| | - Valeria Herrera
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Nathanial Brown
- Department of Mathematics, The Pennsylvania State University, University Park, PA
| | - Jessica Bibeau
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Kaylei Arcangel
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
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Pagoto SL, Palmer L, Horwitz-Willis N. The Next Infodemic: Abortion Misinformation. J Med Internet Res 2023; 25:e42582. [PMID: 37140975 DOI: 10.2196/42582] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/16/2023] [Accepted: 03/08/2023] [Indexed: 05/05/2023] Open
Abstract
The World Health Organization (WHO) defines an infodemic as the proliferation of false or misleading information that leads to confusion, mistrust in health authorities, and the rejection of public health recommendations. The devastating impacts of an infodemic on public health were felt during the COVID-19 pandemic. We are now on the precipice of another infodemic, this one regarding abortion. On June 24, 2022, the Supreme Court of the United States (SCOTUS) decision in Dobbs v. Jackson Women's Health Organization resulted in the reversal of Roe v. Wade, which had protected a woman's right to have an abortion for nearly 50 years. The reversal of Roe v. Wade has given way to an abortion infodemic that is being exacerbated by a confusing and rapidly changing legislative landscape, the proliferation of abortion disinformants on the web, lax efforts by social media companies to abate abortion misinformation, and proposed legislation that threatens to prohibit the distribution of evidence-based abortion information. The abortion infodemic threatens to worsen the detrimental effects of the Roe v. Wade reversal on maternal morbidity and mortality. It also comes with unique barriers to traditional abatement efforts. In this piece, we lay out these challenges and urgently call for a public health research agenda on the abortion infodemic to stimulate the development of evidence-based public health efforts to mitigate the impact of misinformation on the increased maternal morbidity and mortality that is expected to result from abortion restrictions, particularly among marginalized populations.
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Affiliation(s)
- Sherry L Pagoto
- UConn Center for mHealth and Social Media, UConn Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Lindsay Palmer
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Nate Horwitz-Willis
- Planned Parenthood Advocacy Fund of Massachusetts, Boston, MA, United States
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Waring ME, Pagoto SL, Moore Simas TA, Blackman Carr LT, Eamiello ML, Libby BA, Rudin LR, Heersping GE. Delivering a Postpartum Weight Loss Intervention via Facebook or In-Person Groups: Results From a Randomized Pilot Feasibility Trial. JMIR Mhealth Uhealth 2023; 11:e41545. [PMID: 37103991 PMCID: PMC10176149 DOI: 10.2196/41545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/22/2022] [Accepted: 03/10/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Postpartum weight retention contributes to weight gain and obesity. Remotely delivered lifestyle interventions may be able to overcome barriers to attending in-person programs during this life phase. OBJECTIVE This study aimed to conduct a randomized feasibility pilot trial of a 6-month postpartum weight loss intervention delivered via Facebook or in-person groups. Feasibility outcomes were recruitment, sustained participation, contamination, retention, and feasibility of study procedures. Percent weight loss at 6 and 12 months were exploratory outcomes. METHODS Women with overweight or obesity who were 8 weeks to 12 months post partum were randomized to receive a 6-month behavioral weight loss intervention based on the Diabetes Prevention Program lifestyle intervention via Facebook or in-person groups. Participants completed assessments at baseline, 6 months, and 12 months. Sustained participation was defined by intervention meeting attendance or visible engagement in the Facebook group. We calculated percent weight change for participants who provided weight at each follow-up. RESULTS Among individuals not interested in the study, 68.6% (72/105) were not interested in or could not attend in-person meetings and 2.9% (3/105) were not interested in the Facebook condition. Among individuals excluded at screening, 18.5% (36/195) were ineligible owing to reasons related to the in-person condition, 12.3% (24/195) related to the Facebook condition, and 2.6% (5/195) were unwilling to be randomized. Randomized participants (n=62) were a median of 6.1 (IQR 3.1-8.3) months post partum, with a median BMI of 31.7 (IQR 28.2-37.4) kg/m2. Retention was 92% (57/62) at 6 months and 94% (58/62) at 12 months. The majority (21/30, 70%) of Facebook and 31% (10/32) of in-person participants participated in the last intervention module. Half (13/26, 50%) of Facebook and 58% (15/26) of in-person participants would be likely or very likely to participate again if they had another baby, and 54% (14/26) and 70% (19/27), respectively, would be likely or very likely to recommend the program to a friend. In total, 96% (25/26) of Facebook participants reported that it was convenient or very convenient to log into the Facebook group daily compared with 7% (2/27) of in-person participants who said it was convenient or very convenient to attend group meetings each week. Average weight loss was 3.0% (SD 7.2%) in the Facebook condition and 5.4% (SD 6.8%) in the in-person condition at 6 months, and 2.8% (SD 7.4%) in the Facebook condition and 4.8% (SD 7.6%) in the in-person condition at 12 months. CONCLUSIONS Barriers to attending in-person meetings hampered recruitment efforts and intervention participation. Although women found the Facebook group convenient and stayed engaged in the group, weight loss appeared lower. Research is needed to further develop care models for postpartum weight loss that balance accessibility with efficacy. TRIAL REGISTRATION ClinicalTrials.gov, NCT03700736; https://clinicaltrials.gov/ct2/show/NCT03700736.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Tiffany A Moore Simas
- Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School/UMass Memorial Health, Worcester, MA, United States
- Department of Pediatrics, University of Massachusetts Chan Medical School/UMass Memorial Health, Worcester, MA, United States
- Department of Psychiatry, University of Massachusetts Chan Medical School/UMass Memorial Health, Worcester, MA, United States
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School/UMass Memorial Health, Worcester, MA, United States
| | - Loneke T Blackman Carr
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, United States
| | - Madison L Eamiello
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Brooke A Libby
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Lauren R Rudin
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Grace E Heersping
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
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Waring ME, Pagoto SL, Rudin LR, Ho C, Horkachuck A, Kapoor IA, Foye Q. Factors associated with mothers' hesitancy to receive a COVID-19 vaccine. J Behav Med 2023; 46:179-184. [PMID: 34981306 PMCID: PMC8723796 DOI: 10.1007/s10865-021-00268-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/21/2021] [Indexed: 10/25/2022]
Abstract
Vaccine hesitancy can impact maternal and child vaccination rates. We examined factors associated with mothers' hesitancy to receive a COVID-19 vaccine using data from an online survey conducted from mid-February to mid-March 2021. Among unvaccinated participants (N = 203), 28% reported that they would probably not or definitely not get a COVID-19 vaccine. Mothers with high school/GED/trade/technical education (38% hesitant, aOR = 4.0, 95% CI: 1.2-13.2), Associate's degree (43%, aOR = 6.8, 95% CI: 2.4-19.5), and Bachelor's degree (30%, aOR = 3.1, 95% CI: 1.1-8.4) were more likely to report vaccine hesitancy compared to mothers with a graduate degree (19%). Non-Hispanic Black mothers (40% hesitant, aOR = 2.8, 95% CI: 1.0-7.6) were more likely to be vaccine hesitant compared to non-Hispanic white mothers (19%). Mothers with low pandemic-related anxiety were more likely to report vaccine hesitancy than mothers with high pandemic-related anxiety (56% vs 23% hesitant; aOR = 4.8, 95% CI: 1.7-14.1). Research is needed to understand informational, emotional, and attitudinal factors contributing to COVID-19 vaccine hesitancy among mothers to develop and test effective public health messaging to increase vaccination rates.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, 358 Mansfield Rd, Unit 1101, Storrs, CT, 06269, USA.
| | - Sherry L Pagoto
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, 358 Mansfield Rd, Unit 1101, Storrs, CT, 06269, USA
| | - Lauren R Rudin
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, 358 Mansfield Rd, Unit 1101, Storrs, CT, 06269, USA
| | - Chloe Ho
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, 358 Mansfield Rd, Unit 1101, Storrs, CT, 06269, USA
| | - Alexa Horkachuck
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, 358 Mansfield Rd, Unit 1101, Storrs, CT, 06269, USA
| | - Indra A Kapoor
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, 358 Mansfield Rd, Unit 1101, Storrs, CT, 06269, USA
| | - Quamyia Foye
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, 358 Mansfield Rd, Unit 1101, Storrs, CT, 06269, USA
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Jake-Schoffman DE, Waring ME, DiVito J, Goetz JM, Pan C, Pagoto SL. The Relationship Between How Participants Articulate Their Goals and Accomplishments and Weight Loss Outcomes: Secondary Analysis of a Pilot of a Web-Based Weight Loss Intervention. JMIR Mhealth Uhealth 2023; 11:e41275. [PMID: 36927569 PMCID: PMC10131988 DOI: 10.2196/41275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/15/2022] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In behavioral weight loss interventions, participants are asked to set weekly goals to support long-term habits that lead to weight loss. Although participants are asked to set and accomplish weekly goals, we do not know how often they do this and whether doing so is associated with weight loss. Web-based weight loss interventions allow for the analysis of participant engagement data, including how participants articulate their goals and accomplishments. OBJECTIVE Using engagement data from a web-based weight loss intervention, we examined whether participants articulating their goals and accomplishments in measurable and repeating terms were associated with greater weight loss. METHODS Adults with overweight or obesity received a 12-week Facebook-delivered weight loss intervention based on the Diabetes Prevention Program Lifestyle Intervention. Participants replied to conversation threads that queried about their goals and accomplishments. Two independent coders classified participants' posts that articulated goals or accomplishments as measurable or repeating. Crude and age-adjusted linear regression models were used to examine the relationship between the frequency of post type and percent weight loss. RESULTS Participants (N=53; n=48, 91% female; n=48, 91% non-Hispanic White) were on average 46.2 (SD 10.5) years old with a mean BMI of 32.4 (SD 4.8) kg/m2. Over 12 weeks, participants shared a median of 4 (IQR 1-8) posts that reported goals and 10 (IQR 4-24) posts that reported accomplishments. Most participants shared ≥1 post with a goal (n=43, 81%) and ≥1 post with an accomplishment (n=47, 89%). Each post reporting a goal was associated with 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing ≥1 post with a repeating goal was associated with an average of 2.2% greater weight loss (95% CI -3.9% to -0.4%). Each post with a repeating goal was associated with an average of 0.5% greater weight loss (95% CI -1.0% to 0.0%). Sharing ≥1 post with measurable and repeating goals was associated with an average of 1.9% greater weight loss (95% CI -3.7% to -0.2%). Sharing each post with an accomplishment was associated with an average of 0.1% greater weight loss (95% CI -0.1% to 0.0%). Every post with an accomplishment that was repeating was associated with an average of 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing other types of goals and accomplishments was not associated with weight loss. CONCLUSIONS In a web-based weight loss intervention, stating goals in repeating or both measurable and repeating terms was associated with greater weight loss, but simply stating them in measurable terms was not. For accomplishments, only those articulated in repeating terms were associated with greater weight loss. Posts about one-time goals and accomplishments represent an opportunity to encourage planning for future behaviors. Future research should examine if stating goals and accomplishments in repeating terms signals habit formation.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, United States
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Joseph DiVito
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Jared M Goetz
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Cindy Pan
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
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McVay MA, Lavoie HA, Rajoria M, Leong MC, Lou X, McMahon LN, Patnode CD, Pagoto SL, Jake-Schoffman DE. Pre-Enrollment Steps and Run-Ins in Weight Loss Trials: A Meta-Regression. Am J Prev Med 2023; 64:910-917. [PMID: 36822955 DOI: 10.1016/j.amepre.2023.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION The generalizability of study findings may be influenced by pre-enrollment trial procedures, including the use of behavioral run-in periods. The study goals were to determine whether behavioral run-in periods and other pre-enrollment processes affect outcomes in randomized trials of behavioral weight loss interventions that have contributed to clinical guidelines. METHODS The sample was behavioral weight loss intervention trials included in the 2018 U.S. Preventive Services Task Force systematic review. Information on pre-enrollment processes (total steps, in-person steps, behavioral run-in) was abstracted, and meta-regressions were conducted in 2022 to test whether pre-enrollment processes were associated with weight loss at 6 or 12 months and trial retention at 12 months. RESULTS Across 80 trials, the median number of total pre-enrollment steps was 2 (range=1-5), and that of in-person pre-enrollment steps was 1 (range=0-4). Almost one-third of the trials (k=24; 30%) used a behavioral run-in. The most common run-in tasks were self-monitoring physical activity (k=9) or both physical activity and diet (k=6). Greater weight loss was observed in trials with behavioral run-ins at 6 months (-2.33 kg; 95% CI= -3.72, -0.93) and, to an attenuated extent, at 12 months (-0.86 kg; 95% CI= -1.72, 0.01) compared to those without run-ins. The total number of pre-enrollment steps was also associated with greater 6-month weight loss (-0.85 kg; 95% CI= -1.59, -0.11). Higher retention was associated with total number of pre-enrollment steps and in-person steps and marginally with the presence of run-ins. DISCUSSION The use of more pre-enrollment processes is associated with greater weight loss in behavioral weight loss trials and may impact the generalizability of outcomes.
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Affiliation(s)
- Megan A McVay
- Department of Health Education & Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida.
| | - Hannah A Lavoie
- Department of Health Education & Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida
| | - Melinda Rajoria
- Department of Neuroendovascular Surgery, Baptist Research Institute, Jacksonville, Florida
| | - Man Chong Leong
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, Florida
| | - XiangYang Lou
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, Florida
| | - Leah N McMahon
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | | | - Sherry L Pagoto
- Department of Allied Health Science, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Danielle E Jake-Schoffman
- Department of Health Education & Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida
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Waring ME, Moore Simas TA, Heersping GE, Rudin LR, Balakrishnan K, Burdick AR, Pagoto SL. Development and feasibility of a web-based gestational weight gain intervention for women with pre-pregnancy overweight or obesity. Mhealth 2023; 9:13. [PMID: 37089268 PMCID: PMC10119439 DOI: 10.21037/mhealth-22-49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/06/2023] [Indexed: 02/25/2023] Open
Abstract
Background Excessive gestational weight gain is associated with negative maternal and infant health outcomes. Digital health approaches may help overcome barriers to participating in lifestyle interventions requiring in-person visits. The purpose of this study was to develop and examine the feasibility of a web-based gestational weight gain intervention. Methods Intervention development included feedback and input from pregnant women. We conducted a 12-week one-arm pilot study during which participants engaged in an online discussion board with coaches and other pregnant women, tracked their weight gain with an interactive graph, and accessed a list of online resources for pregnancy health. Feasibility outcomes were recruitment, retention, engagement and sustained participation, intervention acceptability, and website usability. Gestational weight gain was an exploratory outcome. Results Participants (n=12) were on average 16.8 [standard deviation (SD): 2.0] weeks gestation with average pre-pregnancy body mass index of 30.5 (SD: 4.8) kg/m2. Participant retention was 92% (n=11). Participants logged into the website a median of 21 times [interquartile range (IQR), 8-37; range, 2-98] over 12 weeks, and 58% (n=7) logged into the website during the last week of the intervention. All participants said they would be very likely or likely to participate again, and 100% said they would be very likely or likely to recommend the intervention to a pregnant friend. In post-intervention interviews, 64% (n=7) explicitly said that the website was easy to use, but 100% (n=11) mentioned usability issues. When asked their preferred intervention platform, 18% (n=2) somewhat or strongly preferred a private website, 18% (n=2) had no preference, and 64% (n=7) somewhat or strongly preferred Facebook. Seventy percent (n=7) had excessive gestational weight gain, 10% (n=1) inadequate gestational weight gain, and 20% (n=2) gained within recommended ranges. Conclusions Additional development work is needed before moving to efficacy testing. Most notably, usability issues with the investigator-developed website and participant preference suggest a switch to a commercial social media platform.
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Affiliation(s)
- Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, USA
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
| | - Tiffany A. Moore Simas
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
| | - Grace E. Heersping
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Lauren R. Rudin
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Kavitha Balakrishnan
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Abigail R. Burdick
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, USA
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Waring ME, Pagoto SL, Moore Simas TA, Heersping G, Rudin LR, Arcangel K. Feedback on Instagram posts for a gestational weight gain intervention. Transl Behav Med 2022; 12:568-575. [PMID: 35191497 PMCID: PMC9150071 DOI: 10.1093/tbm/ibac001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Lifestyle interventions can facilitate healthy gestational weight gain but attending in-person meetings can be challenging. High rates of use and the popularity of pregnancy content suggests Instagram as a possible platform for delivering gestational weight gain interventions. We assessed the logistics and acceptability of creating a private Instagram group and to obtain feedback on intervention posts. We conducted a 2-week study with pregnant women with pre-pregnancy overweight or obesity who use Instagram daily. Participants created a private Instagram account and followed other participants and a moderator who shared twice-daily posts about physical activity and healthy eating during pregnancy. Participants provided feedback through a follow-up survey and focus group/interviews. Engagement data was abstracted from Instagram. Participants (N = 11) were on average 26.3 (SD: 7.4) weeks gestation and 54% had obesity pre-pregnancy. All participants followed the moderator's account, 73% followed all other participants, participants engaged with 100% of study posts, 82% felt comfortable sharing in the group, and 73% would participate in a similar group if pregnant in the future. While participants felt the posts were visually attractive and included helpful information, they wanted more personalized content and felt reluctant to post photos they felt were not "Instagram worthy." Moderators should foster an environment in which participants feel comfortable posting unedited, authentic photos of their lives, perhaps by sharing personal photos that are relatable and represent their own imperfect lives. Results will inform further development and testing of an Instagram-delivered gestational weight gain intervention.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Tiffany A Moore Simas
- Departments of Obstetrics and Gynecology, Pediatrics, Psychiatry, and Population and Quantitative Health Sciences, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, USA
| | - Grace Heersping
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Lauren R Rudin
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Kaylei Arcangel
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
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13
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Pagoto SL, Schroeder MW, Xu R, Waring ME, Groshon L, Goetz JM, Idiong C, Troy H, DiVito J, Bannor R. A Facebook-Delivered Weight Loss Intervention Using Open Enrollment: Randomized Pilot Feasibility Trial. JMIR Form Res 2022; 6:e33663. [PMID: 35522466 PMCID: PMC9123537 DOI: 10.2196/33663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/05/2022] [Accepted: 03/07/2022] [Indexed: 12/27/2022] Open
Abstract
Background Behavioral weight loss programs typically enroll 12-40 people into groups that then suffer from declining engagement over time. Web-based patient communities, on the other hand, typically offer no limits on capacity and membership is fluid. This model may be useful for boosting engagement in behavioral weight loss interventions, which could lead to better outcomes. Objective In this study, we aimed to examine the feasibility and acceptability of continuously enrolling participants into a Facebook-delivered weight loss intervention for the first 8 of 16 weeks relative to the same intervention where no new participants were enrolled after randomization. Methods We conducted a randomized pilot trial to compare a Facebook weight loss group that used open enrollment with a group that used closed enrollment on feasibility and acceptability in adults with BMI 27-45 kg/m2. The feasibility outcomes included retention, engagement, and diet tracking adherence. We described the percentage loss of ≥5% weight in both groups as an exploratory outcome. We also explored the relationship between total volume of activity in the group and weight loss. The participants provided feedback via web-based surveys and focus groups. Results Randomized participants (68/80, 85% women) were on average, aged 40.2 (SD 11.2) years with a mean BMI of 34.4 (SD 4.98) kg/m2. We enrolled an additional 54 participants (50/54, 93% female) in the open enrollment condition between weeks 1 and 8, resulting in a total group size of 94. Retention was 88% and 98% under the open and closed conditions, respectively. Randomized participants across conditions did not differ in engagement (P=.72), or diet tracking adherence (P=.42). Participant feedback in both conditions revealed that sense of community was what they liked most about the program and not enough individualized feedback was what they liked the least. Weight loss of ≥5% was achieved by 30% (12/40) of the participants randomized to the open enrollment condition and 18% (7/40) of the participants in the closed enrollment condition. Exploratory analyses revealed that the open condition (median 385, IQR 228-536.5) had a greater volume of engagement than the closed condition (median 215, IQR 145.5-292; P=.007). Furthermore, an increase of 100 in the total volume of engagement in the Facebook group each week was associated with an additional 0.1% weekly weight loss among the randomized participants (P=.02), which was independent of time, individual participant engagement, and sociodemographic characteristics. Conclusions Open enrollment was as feasible and acceptable as closed enrollment. A greater volume of engagement in the Facebook group was associated with weight loss, suggesting that larger groups that produce more engagement overall may be beneficial. Future research should examine the efficacy of the open enrollment approach for weight loss in a fully powered randomized trial. Trial Registration ClinicalTrials.gov NCT02656680; https://clinicaltrials.gov/ct2/show/NCT02656680
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Affiliation(s)
- Sherry L Pagoto
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Matthew W Schroeder
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Ran Xu
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Molly E Waring
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Laurie Groshon
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Jared M Goetz
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Christie Idiong
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Haley Troy
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Joseph DiVito
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Richard Bannor
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
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Waring ME, Pagoto SL, Moore Simas TA, Heersping G, Rudin LR, Arcangel K. Correction to: Feedback on Instagram posts for a gestational weight gain intervention. Transl Behav Med 2022; 12:713. [PMID: 35451021 DOI: 10.1093/tbm/ibac035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Tiffany A Moore Simas
- Departments of Obstetrics and Gynecology, Pediatrics, Psychiatry, and Population and Quantitative Health Sciences, University of Massachusetts Medical School/ UMass Memorial Health Care, Worcester, MA, USA
| | - Grace Heersping
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Lauren R Rudin
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Kaylei Arcangel
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
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Pagoto SL, Waring ME, Groshon LC, Rosen AO, Schroeder MW, Goetz JM. Proof-of-Concept Feasibility Trial of a Dissonance-Based Sun Safety Intervention for Young Adult Tanners. Ann Behav Med 2022; 56:830-841. [PMID: 35179176 PMCID: PMC9345184 DOI: 10.1093/abm/kaab116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Melanoma is the second most common cancer in young adults. Social media may be a means to conduct interventions to increase sun safety in young adults. PURPOSE We conducted a randomized proof-of-concept pilot trial to evaluate the feasibility and acceptability of a dissonance-based social media intervention designed to promote sun safety in young adult tanners. METHODS Young adult tanners (N = 66) were randomized into two 4-week interventions in which participants were incentivized to create content for a social media campaign on healthy skin or healthy lifestyle. Feasibility outcomes included retention, participation, acceptability, and contamination. We also examined the impact of participation on motivation to engage in the target health behaviors and outdoor tanning intentions. RESULTS Retention was 100%. Most Healthy Skin (88%) and Healthy Lifestyle participants (91%) created ≥1 post. Acceptability was high with 94% and 97% of participants in Healthy Skin and Healthy Lifestyle conditions, respectively, agreeing they would recommend the campaign to a friend. At 4 weeks, Healthy Skin participants reported greater declines in motivation to tan indoors (p = .0017) and outdoors (p = .0003), and greater increases in motivation to wear sunscreen (p = .0009) and protective clothing (p = .0342). Healthy Skin participants reported greater declines in intentions to tan outdoors in the next year (p = .0286). CONCLUSIONS A dissonance-based, social media sun safety intervention was feasible and acceptable. Future research should examine the efficacy and longer-term effects of this intervention in young adults at elevated risk for skin cancer. TRIAL REGISTRATION Clinicaltrials.gov NCT03834974 https://clinicaltrials.gov/ct2/show/NCT03834974.
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Affiliation(s)
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
| | - Laurie C Groshon
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
| | - Aviana O Rosen
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
| | - Matthew W Schroeder
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
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Jake-Schoffman DE, Brown SD, Baiocchi M, Bibeau JL, Daubenmier J, Ferrara A, Galarce MN, Hartogensis W, Hecht FM, Hedderson MM, Moran PJ, Pagoto SL, Tsai AL, Waring ME, Kiernan M. Methods-Motivational Interviewing Approach for Enhanced Retention and Attendance. Am J Prev Med 2021; 61:606-617. [PMID: 34544560 PMCID: PMC9302384 DOI: 10.1016/j.amepre.2021.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/15/2021] [Accepted: 04/02/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Suboptimal and differential participant engagement in randomized trials-including retention at primary outcome assessments and attendance at intervention sessions-undermines rigor, internal validity, and trial conclusions. METHODS First, this study describes Methods-Motivational Interviewing approach and strategies for implementation. This approach engages potential participants before randomization through interactive, prerequisite orientation sessions that illustrate the scientific rationale behind trial methods in accessible language and use motivational interviewing to diffuse ambivalence about participation. Then, this study examines the potential improvements in retention (proportion of participants assessed at follow-up visits) and attendance (e.g., mean percentage of intervention sessions attended, percentage of participants who attended 0 sessions) in 3 randomized weight-management trials that quickly added prerequisite orientations to their protocols following early signs of suboptimal or differential participant engagement (Supporting Health by Integrating Nutrition and Exercise [2009-2013, n=194]; Get Social [2016-2020, n=217]; GestationaL Weight Gain and Optimal Wellness [2014-2018, n=389]). Using a pre-post analytical design, adjusted estimates from regression models controlling for condition and assessment timepoint (analyses from 2020) are reported. RESULTS After adding prerequisite orientations, all 3 trials attained higher participant engagement. Retention at assessments was 11.4% and 17.3% higher (Get Social and Supporting Health by Integrating Nutrition and Exercise, respectively). Mean percentage of attendance at intervention sessions was 8.8% higher (GestationaL Weight Gain and Optimal Wellness), and 10.1% fewer participants attended 0 intervention sessions (Get Social). Descriptively, all the remaining retention and attendance outcomes were consistently higher but were nonsignificant. Across the trials, adding prerequisite orientations did not impact the proportion of eligible participants enrolled or the baseline demographics. CONCLUSIONS The Methods-Motivational Interviewing approach shows promise for increasing the rigor of randomized trials and is readily adaptable to in-person, webinar, and conference call formats. TRIAL REGISTRATION All 3 trials are registered at www.clinicaltrials.gov (Supporting Health by Integrating Nutrition and Exercise: NCT00960414; Get Social: NCT02646618; and GestationaL Weight Gain and Optimal Wellness: NCT02130232).
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education & Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida.
| | - Susan D Brown
- Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Internal Medicine, University of California, Davis, Sacramento, California
| | - Michael Baiocchi
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, California
| | - Jessica L Bibeau
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Jennifer Daubenmier
- The Institute for Holistic Health Studies, San Francisco State University, San Francisco, California
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Maren N Galarce
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Wendy Hartogensis
- UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Frederick M Hecht
- UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Patricia J Moran
- UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Sherry L Pagoto
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Ai-Lin Tsai
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Molly E Waring
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Michaela Kiernan
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
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Busch AM, Conroy D, Pagoto SL. Reaching Intermittent Tobacco Users With Technology: New Evidence. Am J Public Health 2021; 111:1567-1569. [PMID: 34436926 PMCID: PMC8589054 DOI: 10.2105/ajph.2021.306449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Andrew M Busch
- Andrew M. Busch is with the Department of Medicine, Hennepin Healthcare, University of Minnesota Medical School, Minneapolis. David E. Conroy is with the Department of Kinesiology, Pennsylvania State University, University Park. Sherry L. Pagoto is with the Institute for Collaboration on Health, Intervention, and Policy, and the Department of Allied Health Sciences, University of Connecticut, Storrs
| | - David Conroy
- Andrew M. Busch is with the Department of Medicine, Hennepin Healthcare, University of Minnesota Medical School, Minneapolis. David E. Conroy is with the Department of Kinesiology, Pennsylvania State University, University Park. Sherry L. Pagoto is with the Institute for Collaboration on Health, Intervention, and Policy, and the Department of Allied Health Sciences, University of Connecticut, Storrs
| | - Sherry L Pagoto
- Andrew M. Busch is with the Department of Medicine, Hennepin Healthcare, University of Minnesota Medical School, Minneapolis. David E. Conroy is with the Department of Kinesiology, Pennsylvania State University, University Park. Sherry L. Pagoto is with the Institute for Collaboration on Health, Intervention, and Policy, and the Department of Allied Health Sciences, University of Connecticut, Storrs
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Weikert AE, Pagoto SL, Handley E, Courtney JB, Brunke-Reese D, Conroy DE. Golfers' Interest in Multilevel Sun-Protection Strategies. Int J Environ Res Public Health 2021; 18:ijerph18147253. [PMID: 34299704 PMCID: PMC8305060 DOI: 10.3390/ijerph18147253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 01/03/2023]
Abstract
Active adults accumulate more ultraviolet (UV) radiation exposure and are at greater risk of skin cancer than inactive adults. Golf is a popular sport that increases UV exposure because it is played outdoors in daylight. This study evaluated adult golfers’ interest in multilevel sun-protection strategies and characterized differences in interest as a function of golfer characteristics. Adult golfers (N = 347) completed a web survey to rate their interest in 20 sun-protection strategies. We estimated descriptive statistics and evaluated differences in interest as a function of demographics, perceived risk, sun-protective behavior, and golf exposure. Golfers reported the greatest interest in environmental supports for sun protection, but these ratings were driven by golfers who already perceived golf as a risk behavior and used sunscreen diligently. Vulnerable golfers—those with a golf-related sunburn in the past year or who spend more time golfing—expressed interest in a broader range of intervention components, including education, family support, and text messages. Multilevel skin cancer prevention interventions are needed for golfers. Intervention components of interest involved support and reminders, which suggests they are open to sun-safety behaviors but need help executing them.
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Affiliation(s)
- Amanda E. Weikert
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Eric Handley
- Golf Teaching and Research Center, The Pennsylvania State University, University Park, PA 16082, USA;
| | - Jimikaye B. Courtney
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
| | - Deborah Brunke-Reese
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
| | - David E. Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA
- Correspondence: ; Tel.: +1-814-863-3451
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19
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Affiliation(s)
- Sherry L Pagoto
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs.,Department of Allied Health Sciences, University of Connecticut, Storrs
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park
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20
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Amante DJ, Harlan DM, Lemon SC, McManus DD, Olaitan OO, Pagoto SL, Gerber BS, Thompson MJ. Evaluation of a Diabetes Remote Monitoring Program Facilitated by Connected Glucose Meters for Patients With Poorly Controlled Type 2 Diabetes: Randomized Crossover Trial. JMIR Diabetes 2021; 6:e25574. [PMID: 33704077 PMCID: PMC7995078 DOI: 10.2196/25574] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/23/2020] [Accepted: 01/09/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Patients with poorly controlled type 2 diabetes (T2D) experience increased morbidity, increased mortality, and higher cost of care. Self-monitoring of blood glucose (SMBG) is a critical component of diabetes self-management with established diabetes outcome benefits. Technological advancements in blood glucose meters, including cellular-connected devices that automatically upload SMBG data to secure cloud-based databases, allow for improved sharing and monitoring of SMBG data. Real-time monitoring of SMBG data presents opportunities to provide timely support to patients that is responsive to abnormal SMBG recordings. Such diabetes remote monitoring programs can provide patients with poorly controlled T2D additional support needed to improve critical outcomes. OBJECTIVE To evaluate 6 months of a diabetes remote monitoring program facilitated by cellular-connected glucose meter, access to a diabetes coach, and support responsive to abnormal blood glucose recordings greater than 400 mg/dL or below 50 mg/dL in adults with poorly controlled T2D. METHODS Patients (N=119) receiving care at a diabetes center of excellence participated in a two-arm, 12-month randomized crossover study. The intervention included a cellular-connected glucose meter and phone-based diabetes coaching provided by Livongo Health. The coach answered questions, assisted in goal setting, and provided support in response to abnormal glucose levels. One group received the intervention for 6 months before returning to usual care (IV/UC). The other group received usual care before enrolling in the intervention (UC/IV) for 6 months. Change in hemoglobin A1c (HbA1c) was the primary outcome, and change in treatment satisfaction was the secondary outcome. RESULTS Improvements in mean HbA1c were seen in both groups during the first 6 months (IV/UC -1.1%, SD 1.5 vs UC/IV -0.8%, SD 1.5; P<.001). After crossover, there was no significant change in HbA1c in IV/UC (mean HbA1c change +0.2, SD 1.7, P=.41); however, those in UC/IV showed further improvement (mean HbA1c change -0.4%, SD 1.0, P=.008). A mixed-effects model showed no significant treatment effect (IV vs UC) over 12 months (P=.06). However, participants with higher baseline HbA1c and those in the first time period experienced greater improvements in HbA1c. Both groups reported similar improvements in treatment satisfaction throughout the study. CONCLUSIONS Patients enrolled in the diabetes remote monitoring program intervention experienced improvements in HbA1c and treatment satisfaction similar to usual care at a specialty diabetes center. Future studies on diabetes remote monitoring programs should incorporate scheduled coaching components and involve family members and caregivers. TRIAL REGISTRATION ClinicalTrials.gov NCT03124043; https://clinicaltrials.gov/ct2/show/NCT03124043.
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Affiliation(s)
- Daniel J Amante
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - David M Harlan
- Division of Diabetes, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Stephenie C Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - David D McManus
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Oladapo O Olaitan
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, Institute for Collaborations on Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Ben S Gerber
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Michael J Thompson
- Division of Diabetes, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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Kwasnicka D, Luszczynska A, Hagger MS, Quested E, Pagoto SL, Verboon P, Robinson S, Januszewicz A, Idziak P, Palacz I, Naughton F. Theory-based digital intervention to promote weight loss and weight loss maintenance (Choosing Health): protocol for a randomised controlled trial. BMJ Open 2020; 10:e040183. [PMID: 33234638 PMCID: PMC7684829 DOI: 10.1136/bmjopen-2020-040183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Digital behavioural weight loss interventions have the potential to improve public health; however, these interventions are often not adequately tailored to the needs of the participants. This is the protocol for a trial that aims to determine the effectiveness and cost-effectiveness of the Choosing Health programme as a means to promote weight loss and weight loss maintenance among overweight/obese adults. METHODS AND ANALYSIS The proposed study is a two-group randomised controlled trial with a nested interrupted time series (ITS) within-person design. Participants (n=285) will be randomly assigned to either the Choosing Health digital intervention or a control group. For intervention participants, ecological momentary assessment will be used to identify behavioural determinants for each individual in order to tailor evidence-based behaviour change techniques and intervention content.Control group participants will receive non-tailored weight loss advice via e-book and generic emails. The primary outcome is the mean difference in weight loss between groups at 6 months controlled for baseline. Secondary outcomes include blood pressure and percentage of body fat; self-reported measures of physical activity, sitting time, quality of life, cost and theory-derived correlates of weight loss. Secondary outcomes will be measured at baseline, 3, 6 and 12 months. The primary outcome for ITS will be daily weight loss plan adherence. Data will be analysed using regression and time series analyses. ETHICS AND DISSEMINATION Ethics approval was granted by Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland, approval number 03/P/12/2019. The project results will be disseminated through structured strategy implemented in collaboration with the Ministry of Health. TRIAL REGISTRATION DETAILS This trial was registered with www.clinicaltrials.gov; registration number NCT04291482.
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Affiliation(s)
- Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Aleksandra Luszczynska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Martin S Hagger
- Psychological Sciences, University of California, Merced, Merced, California, United States
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eleanor Quested
- Physical Activity and Well-being Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Sherry L Pagoto
- Department of Allied Health Sciences, The UConn Center for mHealth and Social Media, University of Connecticut, Connecticut, New England, United States
| | - Peter Verboon
- Department of Psychology and Educational Sciences, Open Universiteit Nederland Faculteit Managementwetenschappen, Heerlen, Limburg, The Netherlands
| | - Suzanne Robinson
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Anna Januszewicz
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Paulina Idziak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Iga Palacz
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Felix Naughton
- School of Health Sciences, University of East Anglia Faculty of Medicine and Health Sciences, Norwich, Norfolk, UK
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Affiliation(s)
- Sherry L. Pagoto
- Department of Allied Health Sciences, Institute for Collaborations on Health, Interventions, and Policy, University of Connecticut, Storrs
| | - Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
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Abstract
This cross-sectional study examines the proportion of gyms from 3 large national chains in the United States that offer tanning services, the number of tanning beds offered by these gyms, and regional differences in the number of gyms that provide tanning services.
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Affiliation(s)
| | - David E. Conroy
- Department of Kinesiology, Pennsylvania State University, University Park
| | - Kelsey Arroyo
- Department of Allied Health, University of Connecticut, Storrs
| | - Jared Goetz
- Department of Allied Health, University of Connecticut, Storrs
| | - Ashley B. West
- Department of Kinesiology, Pennsylvania State University, University Park
| | - Samantha Mulcahy
- School of Health Sciences, Oakland University, Rochester, Michigan
| | - Molly E. Waring
- Department of Allied Health, University of Connecticut, Storrs
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Waring ME, Libby BA, Moore Simas TA, Bracken ML, Bibeau JL, Herrera V, Wang J, Pagoto SL. Delivering a Post-Partum Weight Loss Intervention via Facebook or In-Person Groups: Protocol for a Randomized Feasibility Pilot Trial. JMIR Res Protoc 2019; 8:e15530. [PMID: 31778116 PMCID: PMC6908979 DOI: 10.2196/15530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Postpartum weight retention contributes to long-term weight gain and obesity for many women. Lifestyle interventions with numerous visits are logistically challenging for many postpartum women. Delivering a lifestyle intervention via social media may overcome logistic challenges to participation in in-person weight loss programs. OBJECTIVE The objective of this study is to conduct a randomized feasibility pilot trial of a 6-month postpartum weight loss intervention delivered via Facebook or in-person groups with 72 postpartum women with overweight or obesity. METHODS Women with overweight or obesity who are 8 weeks to 12 months postpartum (N=72) will be recruited from the Hartford, Connecticut community. Eligible participants must also own an iPhone or Android smartphone and be an active Facebook user. Participants will receive a 6-month postpartum weight loss intervention based on the Diabetes Prevention Program lifestyle intervention and adapted for postpartum women. Participants will be randomized to receive the intervention via a private Facebook group or in-person group meetings. Assessments will occur at baseline, weekly during the intervention, at 6 months (at the end of the intervention), and at 12 months. Primary feasibility outcomes are recruitment, sustained participation, contamination, retention, and feasibility of assessment procedures including measurement of costs to deliver and receive the intervention. We will describe 6- and 12-month weight loss as an exploratory outcome. RESULTS Recruitment began in September 2018. The first wave of the intervention began in February 2019, and the second wave of the intervention is expected to begin in fall 2019. We anticipate completing follow-up assessments in fall 2020, and results will be analyzed at that time. CONCLUSIONS Results will inform the design of a large randomized controlled trial to assess whether delivering a postpartum weight loss intervention via Facebook is noninferior for weight loss and more cost-effective than delivering the intervention via traditional in-person groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15530.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Brooke A Libby
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, United States
- Department of Pediatrics, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, United States
- Department of Psychiatry, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Madison L Bracken
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, United States
| | - Jessica L Bibeau
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Valeria Herrera
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Justin Wang
- Social Sciences Department, Community College of Rhode Island, Warwick, RI, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
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25
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Pagoto SL, Nahar VK, Frisard C, Conroy DE, Lemon SC, Oleski J, Hillhouse J. A Comparison of Tanning Habits Among Gym Tanners and Other Tanners. JAMA Dermatol 2019; 154:1090-1091. [PMID: 30027270 DOI: 10.1001/jamadermatol.2018.1779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Sherry L Pagoto
- UConn Center for Health and Social Media, UConn Institute for Collaboration on Health, Interventions, and Policy, Department of Allied Health Sciences, University of Connecticut, Storrs
| | - Vinayak K Nahar
- Department of Dermatology, University of Mississippi Medical Center, Jackson.,Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, School of Mathematics and Sciences, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, Tennessee
| | - Christine Frisard
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - David E Conroy
- Department of Kinesiology, Pennsylvania State University, University Park
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Jessica Oleski
- UConn Center for Health and Social Media, UConn Institute for Collaboration on Health, Interventions, and Policy, Department of Allied Health Sciences, University of Connecticut, Storrs
| | - Joel Hillhouse
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City
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26
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Buller DB, Walkosz BJ, Berteletti J, Pagoto SL, Bibeau J, Baker K, Hillhouse J, Henry KL. Insights on HPV vaccination in the United States from mothers' comments on Facebook posts in a randomized trial. Hum Vaccin Immunother 2019; 15:1479-1487. [PMID: 30785361 DOI: 10.1080/21645515.2019.1581555] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
In the United States, parents' health beliefs affect HPV vaccination decisions for children. Our team acquired insights into mothers' health beliefs from their reactions and comments to posts on HPV vaccination in a social media adolescent health campaign in a randomized trial (n = 881 mothers; 63.1% reported daughters had 1+ doses of the HPV vaccine) evaluating communication intended to reduce daughters' indoor tanning. A total of 10 HPV vaccination messages in didactic (n = 7) and narrative (n = 3) formats were posted on vaccination need, uptake, and effectiveness and stories of young women who died from cervical cancer and a mother's decision to vaccinate her daughters. These posts received 28 reactions (like, love, and sad buttons; mean = 2.8 per post) and 80 comments (mean = 8.0 per post). More comments were favorable (n = 43) than unfavorable (n = 34). Data was not collected on views for posts. The most common favorable comment reported that daughters were vaccinated (n = 31). Unfavorable comments cited safety concerns, lack of physician support, distrust of pro-vaccine sources, and increased sexual activity of daughters. Mothers posting unfavorable (18.2%) as opposed to favorable (78.6%) comments or not commenting (64.0%) were less likely to have had their daughters vaccinated (chi-square = 22.27, p < 0.001). Favorable comments often did not state reasons for vaccinating. Concerns about lack of vaccine safety remain a barrier. Mothers may express distrust in pro-vaccine sources to reduce discomfort with not vaccinating daughters to reduce their risk for HPV infection. Many mothers who remained silent had vaccinated daughters, which suggests they did not resisit HPV vaccination.
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Affiliation(s)
| | | | | | - Sherry L Pagoto
- b Department of Allied Health Sciences, University of Connecticut , Storrs , CT , USA
| | - Jessica Bibeau
- b Department of Allied Health Sciences, University of Connecticut , Storrs , CT , USA
| | - Katie Baker
- c Community and Behavioral Health, East Tennessee State University , Johnson City , TN , USA
| | - Joel Hillhouse
- c Community and Behavioral Health, East Tennessee State University , Johnson City , TN , USA
| | - Kimberly L Henry
- d Applied Social and Health Psychology, Colorado State University , Storrs , CT , USA
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Abstract
Twitter may be useful for learning about indoor tanning behavior and attitudes. The objective of this study was to analyze the content of tweets about indoor tanning to determine the extent to which tweets are posted by people who tan, and to characterize the topics of tweets. We extracted 4,691 unique tweets from Twitter using the terms "tanning bed" or "tanning salon" over 7 days in March 2016. We content analyzed a random selection of 1,000 tweets, double-coding 20% of tweets (κ = 0.74, 81% agreement). Most tweets (71%) were by tanners (n = 699 individuals) and included tweets expressing positive sentiment about tanning (57%), and reports of a negative tanning experience (17%), burning (15%), or sleeping in a tanning bed (9%). Four percent of tweets were by tanning salon employees. Tweets posted by people unlikely to be tanners (15%) included tweets mocking tanners (71%) and health warnings (29%). The term "tanning bed" had higher precision for identifying individuals who engage in indoor tanning than "tanning salon"; 77% versus 45% of tweets captured by these search terms were by individuals who engaged in indoor tanning, respectively. Extrapolating to the full data set of 4,691 tweets, findings suggest that an average of 468 individuals who engage in indoor tanning can be identified by their tweets per day. The majority of tweets were from tanners and included reports of especially risky habits (e.g., burning, falling asleep). Twitter provides opportunity to identify indoor tanners and examine conversations about indoor tanning.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Katie Baker
- Department of Community and Behavioral Health, East Tennessee State University College of Public Health, Johnson City, TN
| | - Anthony Peluso
- Department of Community and Behavioral Health, East Tennessee State University College of Public Health, Johnson City, TN
| | - Christine N May
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT.,Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
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28
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Arigo D, Jake-Schoffman DE, Wolin K, Beckjord E, Hekler EB, Pagoto SL. The history and future of digital health in the field of behavioral medicine. J Behav Med 2019; 42:67-83. [PMID: 30825090 PMCID: PMC6644720 DOI: 10.1007/s10865-018-9966-z] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/23/2018] [Indexed: 01/03/2023]
Abstract
Since its earliest days, the field of behavioral medicine has leveraged technology to increase the reach and effectiveness of its interventions. Here, we highlight key areas of opportunity and recommend next steps to further advance intervention development, evaluation, and commercialization with a focus on three technologies: mobile applications (apps), social media, and wearable devices. Ultimately, we argue that future of digital health behavioral science research lies in finding ways to advance more robust academic-industry partnerships. These include academics consciously working towards preparing and training the work force of the twenty first century for digital health, actively working towards advancing methods that can balance the needs for efficiency in industry with the desire for rigor and reproducibility in academia, and the need to advance common practices and procedures that support more ethical practices for promoting healthy behavior.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, USA.
| | | | | | - Ellen Beckjord
- Population Health and Clinical Affairs, University of Pittsburgh Medical Center Health Plan, Pittsburgh, USA
| | - Eric B Hekler
- Department of Family Medicine Public Health, Center for Wireless and Population Health Systems, University of California, San Diego, San Diego, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, Center for mHealth and Social Media, University of Connecticut, Storrs, USA
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Affiliation(s)
- V K Nahar
- Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, U.S.A.,Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN, U.S.A
| | - J L Oleski
- UConn Center for Health and Social Media, UConn Institute for Collaboration on Health, Interventions, and Policy, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, U.S.A
| | - A R Choquette
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, U.S.A
| | - J J Hillhouse
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, U.S.A
| | - S L Pagoto
- UConn Center for Health and Social Media, UConn Institute for Collaboration on Health, Interventions, and Policy, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, U.S.A
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30
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Coups EJ, Manne SL, Pagoto SL, Criswell KR, Goydos JS. Facebook Intervention for Young-Onset Melanoma Patients and Their Family Members: Pilot and Feasibility Study. JMIR Dermatol 2018. [DOI: 10.2196/derma.9734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Jeter JM, Bowles TL, Curiel-Lewandrowski C, Swetter SM, Filipp FV, Abdel-Malek ZA, Geskin LJ, Brewer JD, Arbiser JL, Gershenwald JE, Chu EY, Kirkwood JM, Box NF, Funchain P, Fisher DE, Kendra KL, Marghoob AA, Chen SC, Ming ME, Albertini MR, Vetto JT, Margolin KA, Pagoto SL, Hay JL, Grossman D, Ellis DL, Kashani-Sabet M, Mangold AR, Markovic SN, Meyskens FL, Nelson KC, Powers JG, Robinson JK, Sahni D, Sekulic A, Sondak VK, Wei ML, Zager JS, Dellavalle RP, Thompson JA, Weinstock MA, Leachman SA, Cassidy PB. Chemoprevention agents for melanoma: A path forward into phase 3 clinical trials. Cancer 2018; 125:18-44. [PMID: 30281145 DOI: 10.1002/cncr.31719] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/10/2018] [Accepted: 07/12/2018] [Indexed: 12/12/2022]
Abstract
Recent progress in the treatment of advanced melanoma has led to unprecedented improvements in overall survival and, as these new melanoma treatments have been developed and deployed in the clinic, much has been learned about the natural history of the disease. Now is the time to apply that knowledge toward the design and clinical evaluation of new chemoprevention agents. Melanoma chemoprevention has the potential to reduce dramatically both the morbidity and the high costs associated with treating patients who have metastatic disease. In this work, scientific and clinical melanoma experts from the national Melanoma Prevention Working Group, composed of National Cancer Trials Network investigators, discuss research aimed at discovering and developing (or repurposing) drugs and natural products for the prevention of melanoma and propose an updated pipeline for translating the most promising agents into the clinic. The mechanism of action, preclinical data, epidemiological evidence, and results from available clinical trials are discussed for each class of compounds. Selected keratinocyte carcinoma chemoprevention studies also are considered, and a rationale for their inclusion is presented. These data are summarized in a table that lists the type and level of evidence available for each class of agents. Also included in the discussion is an assessment of additional research necessary and the likelihood that a given compound may be a suitable candidate for a phase 3 clinical trial within the next 5 years.
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Affiliation(s)
- Joanne M Jeter
- Department of Medicine, Divisions of Genetics and Oncology, The Ohio State University, Columbus, Ohio
| | - Tawnya L Bowles
- Department of Surgery, Intermountain Health Care, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah
| | | | - Susan M Swetter
- Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center Cancer Institute, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Fabian V Filipp
- Systems Biology and Cancer Metabolism, Program for Quantitative Systems Biology, University of California Merced, Merced, California
| | | | - Larisa J Geskin
- Department of Dermatology, Cutaneous Oncology Center, Columbia University Medical Center, New York, New York
| | - Jerry D Brewer
- Department of Dermatologic Surgery, Mayo Clinic Minnesota, Rochester, Minnesota
| | - Jack L Arbiser
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.,Division of Dermatology, Veterans Affairs Medical Center, Atlanta, Georgia
| | - Jeffrey E Gershenwald
- Departments of Surgical Oncology and Cancer Biology, Melanoma and Skin Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Emily Y Chu
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - John M Kirkwood
- Melanoma and Skin Cancer Program, Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Neil F Box
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - David E Fisher
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Kari L Kendra
- Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, Ohio
| | - Ashfaq A Marghoob
- Memorial Sloan Kettering Skin Cancer Center and Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Suephy C Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.,Division of Dermatology, Veterans Affairs Medical Center, Atlanta, Georgia
| | - Michael E Ming
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mark R Albertini
- Department of Medicine, University of Wisconsin, School of Medicine and Public Health, University of Wisconsin Carbone Cancer Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - John T Vetto
- Division of Surgical Oncology, Oregon Health & Science University, Portland, Oregon
| | - Kim A Margolin
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, California
| | - Sherry L Pagoto
- Department of Allied Health Sciences, UConn Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, Connecticut
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Douglas Grossman
- Departments of Dermatology and Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Darrel L Ellis
- Department of Dermatology, Vanderbilt University Medical Center and Division of Dermatology, Vanderbilt Ingram Cancer Center, Nashville, Tennessee.,Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Affairs Medical Center, Nashville, Tennessee
| | - Mohammed Kashani-Sabet
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California
| | | | | | | | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - June K Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Debjani Sahni
- Department of Dermatology, Boston Medical Center, Boston, Massachusetts
| | | | - Vernon K Sondak
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida.,Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Maria L Wei
- Department of Dermatology, University of California, San Francisco, San Francisco, California.,Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Jonathan S Zager
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Sarcoma, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - John A Thompson
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Martin A Weinstock
- Center for Dermatoepidemiology, Veterans Affairs Medical Center, Providence, Rhode Island.,Department of Dermatology, Brown University, Providence, Rhode Island.,Department of Epidemiology, Brown University, Providence, Rhode Island.,Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island
| | - Sancy A Leachman
- Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Pamela B Cassidy
- Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
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Abstract
PURPOSE OF REVIEW Social media is widely used and has potential to connect adults with obesity with information and social support for weight loss and to deliver lifestyle interventions. The purpose of this review is to summarize recent observational and intervention research on social media and obesity. RECENT FINDINGS Online patient communities for weight loss abound but may include misinformation. Systematic reviews and meta-analyses suggest that social media-delivered lifestyle interventions modestly impact weight, yet how social media was used and participant engagement varies widely. The rapidly changing social media landscape poses challenges for patients, clinicians, and researchers. Research is needed on how patients can establish supportive communities for weight loss and the role of clinicians in these communities. Emerging research on meaningful engagement in, and the efficacy and cost-effectiveness of, social media-delivered lifestyle interventions should provide insights into how to leverage social media to address the obesity epidemic.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA.
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Marta M Holovatska
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
| | - Claudia Mejia
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
| | - Jamasia C Williams
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
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Affiliation(s)
- Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
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Buscemi J, Bennett GG, Gorin SS, Pagoto SL, Sallis JF, Wilson DK, Fitzgibbon ML. A 6-year update of the health policy and advocacy priorities of the Society of Behavioral Medicine. Transl Behav Med 2018; 7:903-911. [PMID: 28573355 DOI: 10.1007/s13142-017-0507-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Government policy affects virtually every topic of interest to health behavior researchers, from research funding to reimbursement for clinical services to application of evidence to impact health outcomes. This paper provides a 6-year update on the expansion of Society of Behavioral Medicine's (SBM) public policy and advocacy agenda and proposed future directions. SBM's Health Policy Council is responsible for ensuring coordination of the policy-related activities of the Health Policy Committee (HPC), the Civic and Public Engagement Committee (CPEC), and the Scientific and Professional Liaison Council (SPLC). These committees and councils have written letters to Congress, signed onto advocacy letters with hundreds of organizations, and developed and disseminated 15 health policy briefs, the majority of which have been presented to legislative staffers on Capitol Hill. With the assistance of the SPLC, SBM has collaborated on policy efforts with like-minded organizations to increase the impact of the Society's policy work. Moving forward, SBM plans to continue to increase efforts to disseminate policy work more broadly and develop long-term relationships with Congressional staffers. SBM leadership realizes that to remain relevant, demonstrate impact, and advance the role of behavioral medicine, we must advance a policy agenda that reflects our mission of better health through behavior change.
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Stapleton JL, Manne SL, Day AK, Levonyan-Radloff K, Pagoto SL. Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability. JMIR Res Protoc 2018; 7:e54. [PMID: 29463495 PMCID: PMC5840477 DOI: 10.2196/resprot.9429] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/06/2018] [Accepted: 01/06/2018] [Indexed: 12/29/2022] Open
Abstract
Background There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. Objective To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Methods Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. Results The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). Conclusions This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within an interactive social media format. The findings suggest that Facebook metrics of intervention post engagement (ie, likes and comments) may vary based on post types and that designing specifically labeled discussion posts may be helpful for soliciting engagement as well as challenging beliefs.
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Affiliation(s)
- Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers University, New Brunswick, NJ, United States
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers University, New Brunswick, NJ, United States
| | - Ashley K Day
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | | | - Sherry L Pagoto
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, United States
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Haughton CF, Silfee VJ, Wang ML, Lopez-Cepero AC, Estabrook DP, Frisard C, Rosal MC, Pagoto SL, Lemon SC. Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review. Prev Med Rep 2018; 9:131-137. [PMID: 29616185 PMCID: PMC5880332 DOI: 10.1016/j.pmedr.2018.01.012] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 12/21/2022] Open
Abstract
Obesity remains a persistent public health and health disparity concern in the United States. Eliminating health disparities, particularly among racial/ethnic minority groups, is a major health priority in the US. The primary aim of this review was to evaluate representation of racial/ethnic sub-group members in behavioral weight loss interventions conducted among adults in the United States. The secondary aims were to assess recruitment and study design approaches to include racial/ethnic groups and the extent of racial/ethnic sub-group analyses conducted in these studies. PubMed, PsycInfo, Medline, and CINAHL were searched for behavioral weight loss intervention trials conducted in 2009–2015 using keywords: weight, loss, overweight, obese, intervention and trial. Most of the 94 studies included a majority of White participants compared to any other racial/ethnic group. Across the included studies, 58.9% of participants were White, 18.2% were African American, 8.7% were Hispanic/Latino, 5.0% were Asian and 1.0% were Native Americans. An additional 8.2% were categorized as “Other”. Nine of the 94 studies exclusively included minority samples. Lack of adequate representation of racial and ethnic minority populations in behavioral trials limits the generalizability and potential public health impact of these interventions to groups that might most benefit from weight loss. Given racial/ethnic disparities in obesity rates and the burden of obesity and obesity-related diseases among minority groups in the United States, greater inclusion in weight loss intervention studies is warranted. Describes racial/ethnic minority inclusion in behavioral weight loss studies Majority of studies continue to include a majority white sample. Modest increases in the representation of some racial/ethnic minority groups. Lack of adequate representation of minority groups limits generalizability. Greater racial/ethnic inclusion in weight loss intervention studies is warranted.
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Affiliation(s)
| | | | - Monica L. Wang
- Boston University School of Public Health, Boston, MA, USA
| | | | | | | | | | - Sherry L. Pagoto
- University of Massachusetts Medical School, Worcester, MA, USA
- University of Connecticut, Storrs, CT, USA
| | - Stephenie C. Lemon
- University of Massachusetts Medical School, Worcester, MA, USA
- Corresponding author at: UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.UMass Worcester Prevention Research CenterDivision of Preventive and Behavioral MedicineUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcesterMA01655USA
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Pagoto SL, Bennett GG. Healthy Lifestyle for All Through Patient Care and Policy. JAMA Intern Med 2018; 178:152-153. [PMID: 29297014 DOI: 10.1001/jamainternmed.2017.6797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Waring ME, Moore Simas TA, Oleski J, Xiao RS, Mulcahy JA, May CN, Pagoto SL. Feasibility and Acceptability of Delivering a Postpartum Weight Loss Intervention via Facebook: A Pilot Study. J Nutr Educ Behav 2018; 50:70-74.e1. [PMID: 29325665 PMCID: PMC5769696 DOI: 10.1016/j.jneb.2017.09.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the feasibility and acceptability of a Facebook-delivered postpartum weight loss intervention. METHODS Overweight and obese postpartum women received a 12-week weight loss intervention via Facebook. Feasibility outcomes were recruitment, retention, engagement, and acceptability. Weight loss was an exploratory outcome. RESULTS Participants (n = 19) were 3.5 (SD 2.2) months postpartum with a baseline body mass index of 30.1 (SD 4.2) kg/m2. Retention was 95%. Forty-two percent of participants visibly engaged on the last day of the intervention, and 100% in the last 4 weeks; 88% were likely or very likely to participate again and 82% were likely or very likely to recommend the program to a postpartum friend. Average 12-week weight loss was 4.8% (SD 4.2%); 58% lost ≥5%. CONCLUSIONS AND IMPLICATIONS Findings suggested that this Facebook-delivered intervention is feasible and acceptable and supports research to test efficacy for weight loss. Research is needed to determine how best to engage participants in social network-delivered weight loss interventions.
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Affiliation(s)
- Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
- Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA
| | - Tiffany A. Moore Simas
- Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA
- Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | - Jessica Oleski
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Rui S. Xiao
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | | | - Christine N. May
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
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Geller AC, Jablonski NG, Pagoto SL, Hay JL, Hillhouse J, Buller DB, Kenney WL, Robinson JK, Weller RB, Moreno MA, Gilchrest BA, Sinclair C, Arndt J, Taber JM, Morris KL, Dwyer LA, Perna FM, Klein WMP, Suls J. Interdisciplinary Perspectives on Sun Safety. JAMA Dermatol 2018; 154:88-92. [PMID: 29117315 PMCID: PMC5839662 DOI: 10.1001/jamadermatol.2017.4201] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Overexposure to the sun is associated with an increased risk of melanoma and nonmelanoma skin cancer, but indications of improvements in sun protection behavior are poor. Attempts to identify emerging themes in skin cancer control have largely been driven by groups of experts from a single field. In December 2016, 19 experts from various disciplines convened for Interdisciplinary Perspectives on Skin Cancer, a 2-day meeting hosted by the National Academy of Sciences. The group discussed knowledge gaps, perspectives on sun exposure, implications for skin cancer risk and other health outcomes, and new directions. Five themes emerged from the discussion: (1) The definition of risk must be expanded, and categories for skin physiology must be refined to incorporate population diversities. (2) Risky sun exposure often co-occurs with other health-related behaviors. (3) Messages must be nuanced to target at-risk populations. (4) Persons at risk for tanning disorder must be recognized and treated. (5) Sun safety interventions must be scalable. Efficient use of technologies will be required to sharpen messages to specific populations and to integrate them within multilevel interventions. Further interdisciplinary research should address these emerging themes to build effective and sustainable approaches to large-scale behavior change.
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Affiliation(s)
- Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Nina G. Jablonski
- Department of Anthropology, The Pennsylvania State University, University Park
| | - Sherry L. Pagoto
- Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joel Hillhouse
- Community and Behavioral Health, East Tennessee State University, Johnson City
| | | | - W. Larry Kenney
- Department of Kinesiology, The Pennsylvania State University
| | - June K. Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Chief Editor, JAMA Dermatology
| | - Richard B. Weller
- MRC Centre for Inflammation Research, Queens Medical Research Institute, University of Edinburgh, Edinburgh, Scotland
| | - Megan A. Moreno
- Division of General Pediatrics, University of Washington, Seattle
| | - Barbara A. Gilchrest
- Department of Dermatology, Harvard Medical School and Massachusetts General Hospital, Boston
| | | | - Jamie Arndt
- Department of Psychological Sciences, University of Missouri, Columbia
| | - Jennifer M. Taber
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | | | | | | | | | - Jerry Suls
- National Cancer Institute, Rockville, Maryland
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40
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Jake-Schoffman DE, Silfee VJ, Waring ME, Boudreaux ED, Sadasivam RS, Mullen SP, Carey JL, Hayes RB, Ding EY, Bennett GG, Pagoto SL. Methods for Evaluating the Content, Usability, and Efficacy of Commercial Mobile Health Apps. JMIR Mhealth Uhealth 2017; 5:e190. [PMID: 29254914 PMCID: PMC5748471 DOI: 10.2196/mhealth.8758] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/11/2017] [Accepted: 10/29/2017] [Indexed: 02/06/2023] Open
Abstract
Commercial mobile apps for health behavior change are flourishing in the marketplace, but little evidence exists to support their use. This paper summarizes methods for evaluating the content, usability, and efficacy of commercially available health apps. Content analyses can be used to compare app features with clinical guidelines, evidence-based protocols, and behavior change techniques. Usability testing can establish how well an app functions and serves its intended purpose for a target population. Observational studies can explore the association between use and clinical and behavioral outcomes. Finally, efficacy testing can establish whether a commercial app impacts an outcome of interest via a variety of study designs, including randomized trials, multiphase optimization studies, and N-of-1 studies. Evidence in all these forms would increase adoption of commercial apps in clinical practice, inform the development of the next generation of apps, and ultimately increase the impact of commercial apps.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Valerie J Silfee
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.,Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, United States
| | - Edwin D Boudreaux
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.,Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Rajani S Sadasivam
- Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sean P Mullen
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jennifer L Carey
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Rashelle B Hayes
- Division of Consultation/Liaison Psychiatry and Psychology, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
| | - Eric Y Ding
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Gary G Bennett
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States.,Duke Digital Health Science Center, Duke University, Durham, NC, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
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41
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Wang ML, Waring ME, Jake-Schoffman DE, Oleski JL, Michaels Z, Goetz JM, Lemon SC, Ma Y, Pagoto SL. Clinic Versus Online Social Network-Delivered Lifestyle Interventions: Protocol for the Get Social Noninferiority Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e243. [PMID: 29229591 PMCID: PMC5742659 DOI: 10.2196/resprot.8068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/22/2017] [Accepted: 09/23/2017] [Indexed: 11/25/2022] Open
Abstract
Background Online social networks may be a promising modality to deliver lifestyle interventions by reducing cost and burden. Although online social networks have been integrated as one component of multimodality lifestyle interventions, no randomized trials to date have compared a lifestyle intervention delivered entirely via online social network with a traditional clinic-delivered intervention. Objective This paper describes the design and methods of a noninferiority randomized controlled trial, testing (1) whether a lifestyle intervention delivered entirely through an online social network would produce weight loss that would not be appreciably worse than that induced by a traditional clinic-based lifestyle intervention among overweight and obese adults and (2) whether the former would do so at a lower cost. Methods Adults with body mass index (BMI) between 27 and 45 kg/m2 (N=328) will be recruited from the communities in central Massachusetts. These overweight or obese adults will be randomized to two conditions: a lifestyle intervention delivered entirely via the online social network Twitter (Get Social condition) and an in-person group-based lifestyle intervention (Traditional condition) among overweight and obese adults. Measures will be obtained at baseline, 6 months, and 12 months after randomization. The primary noninferiority outcome is percentage weight loss at 12 months. Secondary noninferiority outcomes include dietary intake and moderate intensity physical activity at 12 months. Our secondary aim is to compare the conditions on cost. Exploratory outcomes include treatment retention, acceptability, and burden. Finally, we will explore predictors of weight loss in the online social network condition. Results The final wave of data collection is expected to conclude in June 2019. Data analysis will take place in the months following and is expected to be complete in September 2019. Conclusions Findings will extend the literature by revealing whether delivering a lifestyle intervention via an online social network is an effective alternative to the traditional modality of clinic visits, given the former might be more scalable and feasible to implement in settings that cannot support clinic-based models. Trial Registration ClinicalTrials.gov NCT02646618; https://clinicaltrials.gov/ct2/show/NCT02646618 (Archived by WebCite at http://www.webcitation.org/6v20waTFW)
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Affiliation(s)
- Monica L Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Molly E Waring
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jessica L Oleski
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - Zachary Michaels
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jared M Goetz
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
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Nahar VK, Olendzki E, Hillhouse JJ, Pagoto SL. Tanners' awareness and perceptions of legislation for tanning bed use. Photodermatol Photoimmunol Photomed 2017; 33:338-340. [PMID: 28703505 PMCID: PMC5701835 DOI: 10.1111/phpp.12333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Vinayak K. Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson
| | - Effie Olendzki
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Joel J. Hillhouse
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City
| | - Sherry L. Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
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Nahar VK, Rosenthal M, Lemon SC, Kane K, Cheng J, Oleski JL, Li W, Hillhouse JJ, Pagoto SL. Youth access to indoor tanning salons in urban versus rural/suburban communities. Photodermatol Photoimmunol Photomed 2017; 34:112-116. [PMID: 29080373 DOI: 10.1111/phpp.12364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND/PURPOSE Research suggests that youth proximity to tanning salons may promote use; however, little is known about tanning salon proximity to schools. We assessed the proximity of tanning salons to schools in urban versus rural/suburban communities across Worcester County, Massachusetts (population > 800K). To put findings in context, we compared school proximity to tanning salons to school proximity to McDonald's restaurants, a large franchise that also caters to young people. MATERIALS & METHODS Accessibility was measured by ArcGIS 10.2 Network Analyzer (ESRI, Redlands, CA, USA) and the most current road network data layer from Massachusetts Department of Transportation (MassDOT). RESULTS A total of 145 schools were observed in the study area, of which about 39% of schools were within 1 mile from a tanning salon. Urban schools (53.41%) had a higher proportion within 1 mile of a tanning salon than rural/suburban schools (17.54%; P < .001). More schools (39.31%) were within 1 mile of a tanning salon than schools within 1 mile of a McDonald's (22.70%; P < .001). CONCLUSIONS Schools may be particularly impactful for implementing skin cancer prevention programing.
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Affiliation(s)
- Vinayak K Nahar
- Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN, USA.,Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Meagen Rosenthal
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, USA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kevin Kane
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jie Cheng
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jessica L Oleski
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Wenjun Li
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Joel J Hillhouse
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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Xiao RS, Moore Simas TA, Pagoto SL, Person SD, Rosal MC, Waring ME. Sleep Duration and Diet Quality Among Women Within 5 Years of Childbirth in the United States: A Cross-Sectional Study. Matern Child Health J 2017; 20:1869-77. [PMID: 27090412 DOI: 10.1007/s10995-016-1991-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective Only 9 % of women with young children consume a high quality diet. The association between sleep duration and health may be U-shaped. We examined diet quality in relation to sleep duration among US women within 5 years of childbirth. Methods Data were from non-pregnant women aged 20-44 years within 5 years of childbirth who completed two 24-h dietary recalls (N = 896) in the National Health and Nutrition Examination Survey 2005-2012. Self-reported weekday/workday sleep duration was categorized as short (≤6 h), adequate (7-8 h), or long (≥9 h). The Healthy Eating Index (HEI-2010, range 0-100) estimated overall and components of diet quality. Multivariable-adjusted linear regression models estimated the association between sleep duration and diet quality, adjusting for age, race/ethnicity, and education. Results Thirty-four percent of women reported short, 57.1 % adequate, and 8.6 % long sleep duration. The average diet quality total score was 47.4 out of 100. Short sleep duration was not associated with diet quality. Long sleep duration was associated with lower quality diet (β = -4.3; 95 % CI -8.1 to -0.4), lower consumption of total fruit (β = -0.7; 95 % CI -1.3 to -0.1), whole fruit (β = -0.9; 95 % CI -1.6 to -0.2), and total protein (β = -0.7; 95 % CI -1.3 to -0.03), and higher consumption of empty calories (β = 2.2; 95 % CI -4.3 to -0.1). Conclusions for practice Future studies should examine the longitudinal association between sleep duration and diet quality among women following childbirth and whether interventions to improve sleep can enhance diet quality.
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Affiliation(s)
- Rui S Xiao
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, ASC7-1063, Worcester, MA, 01605, USA.
| | - Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA.,Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sherry L Pagoto
- Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sharina D Person
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, ASC7-1063, Worcester, MA, 01605, USA
| | - Milagros C Rosal
- Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Molly E Waring
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, ASC7-1063, Worcester, MA, 01605, USA.,Department of Obstetrics and Gynecology, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA
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45
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Waring ME, Schneider KL, Appelhans BM, Simas TAM, Xiao RS, Whited MC, Busch AM, Evans MM, Pagoto SL. Interest in a Twitter-delivered weight loss program among women of childbearing age. Transl Behav Med 2017; 6:277-84. [PMID: 27356998 DOI: 10.1007/s13142-015-0382-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Weight management through the childbearing years is important, yet few women have access to efficacious weight loss programs. Online social network-delivered programs may increase reach and thus impact. The aim of this study was to gauge interest in a Twitter-based weight loss intervention among women of childbearing age and the feasibility of recruitment via Twitter. We recruited English-speaking women aged 18-45 years (N = 63) from Twitter to complete an anonymous online survey including open-ended questions about program advantages and concerns. Forty percent of participants were obese and 83 % were trying to lose weight. Eighty-one percent were interested in a Twitter-delivered weight loss program. Interest was high in all subgroups (62-100 %). Participants (59 %) cited program advantages, including convenience, support/accountability, and privacy. Concerns (59 %) included questions about privacy, support/accountability, engagement, efficacy, and technology barriers. Research is needed to develop and evaluate social media-delivered interventions, and to develop methods for recruiting participants directly from Twitter.
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Affiliation(s)
- Molly E Waring
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, AS8-1077, Worcester, MA, 01605, USA. .,Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Kristin L Schneider
- Department of Psychology, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA
| | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Tiffany A Moore Simas
- Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.,Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | - Rui S Xiao
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, AS8-1077, Worcester, MA, 01605, USA
| | - Matthew C Whited
- Department of Psychology, East Carolina University, Greenville, NC, USA
| | - Andrew M Busch
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Martinus M Evans
- Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sherry L Pagoto
- Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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Abstract
Few surveillance tools exist for monitoring tanning bed injuries. Twitter data were examined to identify and describe reports of tanning bed-caused burns. Tweets sent in 2013 containing keywords for tanning bed use and burning were content analyzed to determine whether a burn caused by a tanning bed was described, and additional data on tanning behavior and burn characteristics were extracted. After content assessment, 15,178 (64 %) tweets were found to describe a tanning bed-caused burn. Sites most reportedly burnt were buttocks (n = 3117), face/head (n = 1020), and chest/breast (n = 546). Alarmingly, 200 burns to the eyes/eyelids were mentioned. A total of 456 tweets described burning >1 time from a tanning bed. A total of 211 tweets mentioned falling asleep inside the tanning bed. In 2013, over 15,000 tweets reported tanning bed-caused burns. Twitter data provides unique insight into tanning behaviors and injuries not captured through traditional public health surveillance.
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Affiliation(s)
- Andrew B Seidenberg
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, CB 7440, USA.
| | - Sherry L Pagoto
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Eleni Linos
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Mackenzie R Wehner
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Renata Dalla Costa
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
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Mounessa JS, Pagoto SL, Baker K, Antonishak J, Dellavalle RP. Creating the first indoor tan-free skin smart college campus. Prev Med Rep 2017; 6:44-46. [PMID: 28271019 PMCID: PMC5328714 DOI: 10.1016/j.pmedr.2017.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/14/2017] [Accepted: 02/18/2017] [Indexed: 11/11/2022] Open
Abstract
Given the prevalence and risk associated with indoor tanning among college students, university campuses constitute a prime target for skin cancer prevention. This report identifies the successes and challenges faced in promoting a campus-wide tan-free policy through the National Council on Skin Cancer Prevention (NCSCP) Indoor Tan-Free Skin Smart Campus Initiative. Beginning in February 2016, we communicated with university faculty or staff members who have participated in skin cancer prevention via education, clinical care, or research at 20 universities regarding the steps to adopt the tan-free policy. One campus, East Tennessee State University (ETSU), successfully fulfilled all criteria and implemented the policy change to become the first US Indoor Tan-Free Skin Smart Campus. The greatest challenge faced in recruiting campuses was gaining administrative support. Reported reasons for not adopting the policy change included wanting to wait for other schools to join first and not seeing it as a top priority. Despite the importance of improving skin cancer awareness and decreasing tanning among university students, we faced several challenges in promoting campus-wide policy change. We identify a need for research on effective ways to disseminate university health policies and increased involvement of healthcare providers in policy-related work.
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Affiliation(s)
- Jessica S. Mounessa
- University of Colorado School of Medicine, Department of Dermatology, Aurora, CO 80045, USA
- Denver Veterans Affairs Medical Center (VAMC), Department of Dermatology, Denver, CO 80220, USA
| | - Sherry L. Pagoto
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Katie Baker
- East Tennessee State University, College of Public Health, Johnson City, TN 37614, USA
| | - John Antonishak
- National Council on Skin Cancer Prevention, Washington, D.C. 21771, USA
| | - Robert P. Dellavalle
- University of Colorado School of Medicine, Department of Dermatology, Aurora, CO 80045, USA
- Denver Veterans Affairs Medical Center (VAMC), Department of Dermatology, Denver, CO 80220, USA
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48
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Busch AM, Tooley EM, Dunsiger S, Chattillion EA, Srour JF, Pagoto SL, Kahler CW, Borrelli B. Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial. BMC Public Health 2017; 17:323. [PMID: 28415979 PMCID: PMC5392972 DOI: 10.1186/s12889-017-4250-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 04/08/2017] [Indexed: 11/16/2022] Open
Abstract
Background Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC). Methods Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or SC. The nicotine patch was offered in both conditions. Smoking, mood, and stress outcomes were collected at end-of-treatment and 24-week follow-up. Results Fifty-nine participants (28 BAT-CS, 31 SC) were recruited over 42 weeks, and assessment completion was above 80% in both conditions. Treatment acceptability and fidelity were high. At 24 week follow-up adjusted odds ratios favoring BAT-CS were 1.27 (95% CI: 0.41–3.93) for 7-day point prevalence abstinence and 1.27 (95% CI: 0.42–3.82) for continuous abstinence. Time to first smoking lapse was significantly longer in BAT-CS (62.4 vs. 31.8 days, p = 0.03). At 24-weeks, effect sizes for mood and stress outcomes ranged from η2partial of.07–.11, with significant between treatment effects for positive affect, negative affect, and stress. Conclusions The design of this study proved feasible and acceptable. Results provide preliminary evidence that combining behavioral activation with standard smoking cessation counseling could be efficacious for this high risk population. A larger trial with longer follow-up is warranted. Trial registration NCT01964898. First received by clinicaltrials.gov October 15, 2013. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4250-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrew M Busch
- The Miriam Hospital, Providence, RI, USA. .,Warren Alpert Medical School of Brown University, Providence, RI, USA. .,Current correspondence address, Minneapolis Medical Research Foundation, 701 Park Avenue, S9-309, Minneapolis, MN, 55415-1623, USA.
| | | | - Shira Dunsiger
- The Miriam Hospital, Providence, RI, USA.,Brown University School of Public Health, Providence, RI, USA
| | - Elizabeth A Chattillion
- Warren Alpert Medical School of Brown University, Providence, RI, USA.,Providence VA Medical Center, Providence, RI, USA
| | - John Fani Srour
- Warren Alpert Medical School of Brown University, Providence, RI, USA.,Rhode Island Hospital, Providence, RI, USA
| | - Sherry L Pagoto
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Belinda Borrelli
- Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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49
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Fitzpatrick SL, Wilson DK, Pagoto SL. Society for Health Psychology (APA Division 38) and Society of Behavioral Medicine joint position statement on the Medicare Diabetes Prevention Program. Transl Behav Med 2017; 7:385-387. [PMID: 28144834 DOI: 10.1007/s13142-017-0468-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
Beginning in January 2018, the Centers for Medicare and Medicaid Services (CMS) plans to cover the Diabetes Prevention Program (DPP), also referred to as Medicare DPP. The American Psychological Association Society for Health Psychology (SfHP) and the Society for Behavioral Medicine (SBM) reviewed the proposed plan. SfHP and SBM are in support of the CMS decision to cover DPP for Medicare beneficiaries but have a significant concern that aspects of the proposal will limit the public health impact. Concerns include the emphasis on weight outcomes to determine continued coverage and the lack of details regarding requirements for coaches. SfHP and SBM are in strong support of modifications to the proposal that would remove the minimum weight loss stipulation to determine coverage and to specify type and qualifications of "coaches."
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Affiliation(s)
- Stephanie L Fitzpatrick
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
| | | | - Sherry L Pagoto
- University of Massachusetts Medical School, Worcester, MA, USA
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Morgan PJ, Young MD, Lloyd AB, Wang ML, Eather N, Miller A, Murtagh EM, Barnes AT, Pagoto SL. Involvement of Fathers in Pediatric Obesity Treatment and Prevention Trials: A Systematic Review. Pediatrics 2017; 139:peds.2016-2635. [PMID: 28130430 PMCID: PMC6200318 DOI: 10.1542/peds.2016-2635] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 12/26/2022] Open
Abstract
CONTEXT Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research. OBJECTIVE This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents (0-18 years). DATA SOURCES A systematic review of English, peer-reviewed articles across 7 databases. Retrieved records included at least 1 search term from 2 groups: "participants" (eg, child*, parent*) and "outcomes": (eg, obes*, diet*). STUDY SELECTION Randomized controlled trials (RCTs) assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have "actively participated" in the study. DATA EXTRACTION Two authors independently extracted data using a predefined template. RESULTS The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement. No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement. LIMITATIONS The review was limited to RCTs published in English peer-reviewed journals over a 10-year period. CONCLUSIONS Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers.
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Affiliation(s)
- Philip J. Morgan
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia;,Address correspondence to Philip J. Morgan, PhD, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Dr, Callaghan NSW, 2308, Australia. E-mail:
| | - Myles D. Young
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Adam B. Lloyd
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Monica L. Wang
- Department of Community Health Sciences, Boston University, Boston, Massachusetts;,Department of Social and Behavioral Sciences, Harvard University, Boston, Massachusetts
| | - Narelle Eather
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Andrew Miller
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Elaine M. Murtagh
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick, Limerick, Ireland; and
| | - Alyce T. Barnes
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Sherry L. Pagoto
- Department of Medicine, University of Massachusetts, Worcester, Massachusetts
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