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Objective: Schools are important settings for health promotion. In schools, children and adolescents can be reached regardless of their social background, which represents a unique opportunity for promoting health. Several studies have demonstrated the importance of school leadership in initiating and sustaining health promotion; however, efforts to systematically review the influence of school leadership on school health promotion are still lacking. Hence, this paper analyses empirical studies published in scientific journals on school leadership and health promotion in schools. Design: Systematic literature review. Method: Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a review was conducted using two main databases: Web of Science and Scopus, which retrieved 51 eligible articles. Results: The review of these articles resulted in the identification of seven main themes -- school leaders' health; attitudes, knowledge and behaviour; accountability; support from school leaders; shared leadership approaches; capacity building and parent engagement. Conclusion: This systematic literature review expands the literature by highlighting the school leadership factors that promote school health promotion in Oceania, Europe, North America, South America, Africa and Asia continents. Future systematic literature reviews could explore studies and different aspects of health promotion by teachers, especially in the Asian context.

In this paper we make a case for 'Little Data', which is real-time, self-collected, idiosyncratic datasets maintained by individuals about themselves on myriad topics. We develop and offer a methodology for combining these messy, highly personal insights, to make deductive observations about collective practices. In testing this approach, we use the case study of the 2020-21 stay-at-home orders imposed in the U.S.A., U.K., and Western Europe during the Coronavirus pandemic to operationalise and demonstrate the applicability of this method. Our main finding is to show that whilst stay-at-home orders did have a significant impact on habits during the COVID-19 pandemic, these changes were often counterintuitive, of an insightful nature on topics that would otherwise not be investigated, and always short-lived. Our main contribution is to present Little Data, despite and because of its fragmented and disparate nature, as a viable and useful tool to understand personal habits at finite junctures.

We study the relationship between macroeconomic conditions and health in the United States using data from the Behavioral Risk Factor Surveillance System between 2004 and 2017. Unlike many existing studies that use state or county as the level of aggregation, our analysis uses a sample of metropolitan and micropolitan statistical areas. Our results suggest strong associations between worsening macroeconomic conditions and reduced access to care and health insurance coverage. While we do not detect any robust relationships between business cycles and health outcomes in the general population, we do find consistent evidence of worse self-reported health during economic downturns among minorities and less-educated individuals. In addition, there is some suggestive evidence of countercyclicality of healthier lifestyle choices. However, the findings for health behavior outcomes are not robust to adjusting for multiple hypothesis testing., (© 2021 John Wiley & Sons Ltd.)

This paper takes on a different address to youth fitness testing from previous literature by applying a cross-cultural comparison of youth fitness testing in both the US and China. Utilizing a modified version of Bronfenbrenner's Ecological Model, the chronosystem (historical evolution over time), and macrosystem (social and cultural vantage point) factors, in particular, are explored within the realm of youth fitness testing. From the lens of this model changes and characteristics of youth fitness testing practice are identified. It is concluded that both fitness testing batteries were revised periodically as time passes, even though more revisions and debates occurred in the US. Although both countries made the shift from skill-related fitness to health-related fitness, social and cultural values in both countries dictated the implementation styles of youth fitness testing and the use of the current youth fitness testing results. Future theoretical research on youth fitness testing should investigate the other three factors of the model.

Comprehensive School Physical Activity Programs (CSPAP) coordinate physical activity opportunities for school-age children through physical education, programs offered before/after school and during the school day, and those facilitated through staff involvement and community engagement. An active school is considered to implement quality physical education and one additional CSPAP component. This paper aims to describe evidence-based school initiatives that have used a multicomponent approach to integrating CSPAP in schools. Common themes will be summarized to provide strategies and suggestions on creating, implementing, and sustaining a CSPAP in schools. The Let's Get Fit to Learn partnered with local underserved elementary schools to increase physical activity at school designed to improve or increase health and on-task behaviors. The Whole Communities-Whole Health is an equity-centered, community-engaged research project one outcome is to deeply integrate physical activity into the school curriculum. SWITCH (School Wellness Integration Targeting Child Health) is an evidence-based CSPAP designed to build capacity through a partnership with 4-H Youth Development. In Ireland, Active School Flag is a national initiative focused on self-reflection, action planning and collaboration at the school level and provides options for schools to achieve the "Flag." Multicomponent CSPAP purposefully links multiple points of intervention to maximize physical activity opportunities for children. Given the implementation of culturally relevant and contextually grounded learning opportunities in and around schools, the potential for impact and sustainability is high.

Medical folk wisdom (MFW) refers to widely held, but factually inaccurate, beliefs about disease, immunity, pregnancy, and other medically-relevant topics. Examples include the idea that fasting when feverish ("starving a fever") can increase the pace of recovery, or that showering after sex can prevent pregnancy. The pervasiveness of MFW, and whether or not it-like other forms of medically-relevant misinformation-shapes Americans' health behaviors and policy preferences is an important and under-studied question. We begin this research by proposing and validating a novel measure of MFW; including a short-form scale suitable for administration in public opinion surveys. We find that nearly all Americans-irrespective of socio-economic status, political orientation, and educational background-endorse at least some aspects of MFW. Concerningly, and consistent with the idea that folk wisdom challenges scientific expertise, we additionally find that those highest in MFW tend to place less value on medical expertise and the role experts play in shaping health policy. However, this skepticism does not appear to translate to peoples' health actions, as MFW appears to have an inconsistent effect on public participation in healthy behaviors.

To identify potential predictors and correlates of compliance and to examine differences between patient and provider perspectives on compliance. One hundred eighty-four patients (84 men and 96 women) were recruited from a chronic pain treatment program for this telephone follow-up study. Health care providers (HCPs) reported making more recommendations than patients reported hearing. Patients rated themselves as more compliant than did HCPs. Overall compliance rates at a >6-month follow-up were 89% from the patients’ perspective and 70% from the HCPs’ perspective. HCPs rated compliance specific to psychological care as more related to positive outcomes than did patients. Participants’ pain and anxiety ratings at a >6-month follow-up and satisfaction with treatment were significantly associated with patients’ compliance ratings. For HCP-rated compliance, only HCPs’ perceived benefit and interference from compliance were associated. Results suggest important disparities between HCPs and patients on remembered recommendations, levels of compliance, and health-related importance of complying with recommendations. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about health-related advertising on university environments. Given the power of advertising and its potential effect on health behaviors, the purpose of this paper is to assess the health-related advertisement environment and policies on university campuses. Design/methodology/approach: In total, ten geographically and ethnically diverse US university campuses that were trained in using the health-related advertisement survey tool participated in the study. Inter-rater reliability with data collectors at each university was established before data commencement began in Spring 2011. The survey tool assessed the types, locations, and prevalence of health-related advertisements and messages (e.g. nutrition, alcohol, tobacco) on campus, and included both advertisements and messages related to any aspect of health by any sponsor. Current campus health-related policies from each institution were collected as well. Findings: The largest proportion of advertisements on all campuses were for diet/nutrition, exercise/fitness, and alcohol. The majority of advertisements promoted positive health behaviors recommended by health professionals. Unbranded advertisements were more likely to promote positive health behaviors than branded advertisements. Diet/nutrition, tobacco, and drug advertisements were more likely to be positive, whereas alcohol-related advertisements tended to be negative. Originality/value: The paper's findings indicate significant gaps in campus health-related policies with regard to healthy eating and physical activity and lack of policies covering health-related advertisement content. Benchmark data like those reported here can help campus stakeholders set priorities and work with campus decision makers to advocate for the development and implementation of healthy campus policies that support healthy environments. (Contains 4 tables.)

In the last 30 years, the application of the Delphi technique has been increasing. With the recent availability and established popularity of Internet-based research tools, the Internet has been identified as a means for mitigating Delphi limitations, maximizing its advantages, and expanding the breadth of its application. The discourse on the application of "e-Delphi" has been speculative in nature, however, with pragmatic analysis of Internet-based Delphi administration being limited in scope. Concomitantly, methodological guidance for conducting the e-Delphi in health education is limited, with best-practice implementation strategies yet to emerge. This paper advances the understanding of the e-Delphi technique, contributes to the evolution of this Internet-based research methodology, and provides guidance for the e-Delphi researcher in health education. Further, it offers a contribution to the discourse about Internet-based inquiry generally, and on using the e-Delphi technique in health education specifically. The authors illustrate that e-Delphi has a range of benefits that are effective and efficient in assuaging traditional Delphi limitations; nevertheless, a set of methodological issues remain unaddressed and make apparent the need for future research investments to better understand and alleviate challenges presented for e-Delphi research in health education. (Contains 1 figure and 2 tables.)

Legalized gambling is growing substantially and provides both a dilemma and an opportunity for those in the health promoting professions. Gambling represents a form of economic development and, for certain segments of society, improved health and quality of life. On the other hand, gambling is a known addiction, with a host of sociological problems associated with its practice. Consequently, a number of opportunities and responsibilities emerge for health educators. This paper provides both background information and suggestions for professional development, and begins a dialogue in the health education literature on this largely neglected and misunderstood topic.

Aim: To conduct a discursive review on continuous glucose monitoring use among Black older adults and to address the issue of racial disparities in diabetes management and outcomes. Type 2 diabetes mellitus is a global health concern with significant complications and mortality rates. Black older adults are disproportionately affected. Initially designed for type 1 diabetes, continuous glucose monitoring has emerged as an innovative tool for type 2 diabetes mellitus management. Despite its potential, there are challenges related to adherence and digital literacy among Black older adults for managing Diabetes. Design: A discursive review. Methods: Searching literature in PubMed, Scopus, and Google Scholar for papers published from 2017 to 2023, we explored the use of continuous glucose monitoring in Black older adults with type 2 diabetes mellitus, examining barriers, facilitators and challenges. Discussion: We highlight recommendations from the literature which included barriers, facilitators, and cultural factors associated with continuous glucose monitoring use. Findings underscore the importance of addressing these challenges to reduce racial–ethnic disparities in type 2 diabetes mellitus management among Black older adults. Nurses and advanced practice registered nurses are at the forefront and can play a pivotal role in exploring and implementing interventions to promote access and proper use of continuous glucose monitoring among Black older adult patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

A cross-sectional study was conducted to determine preventive-health-activity engagement in community-dwelling older adults participating in student-led health screenings in east Alabama. From 2017-2019, health professions students conducted health screenings at 23 community and independent living sites to assess medical and social needs of adults. Clients' responses to questions regarding vaccinations (flu/pneumonia/shingles), cancer screenings (colon/sex-specific), and other (dental/vision) screenings were aggregated to create a preventive health behavior (prevmed) score. Chi-square, t-tests, and regression analyses were conducted. Data from 464 adults ages 50-99 (72.9±10.1) years old were analyzed. The sample was 71.3% female, 63.1% Black/African American (BA), and 33.4% rural. Linear regression indicated BA race (p=0.001), currently unmarried (p=0.030), no primary care provider (p<0.001) or insurance (p=0.010), age <65 years (p=0.042) and assessment at a residential site (p=0.037) predicted lower prevmed scores. Social factors predict preventive health activity engagement in community-dwelling adults in east Alabama, indicating several opportunities to improve health outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index subdatabases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, cokeywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatricsrelated journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies. [ABSTRACT FROM AUTHOR]

Inadequate sleep is an on-going risk to the health and mission readiness of U.S. Armed Forces, with estimates of sleep problems high above U.S. civilian populations. Intervening early in the career of active duty Air Force personnel (or "Airmen") with education and the establishment of healthy behaviors may prevent short and long term-detriments of sleep problems. This paper describes the results of a qualitative study seeking to understand the facilitators and barriers to achieving good sleep in a technical training school during the first year of entry into the United States Air Force. Using the social ecological framework and content analysis, three focus groups with Airmen were conducted to explore themes at the individual, social, environmental, and organizational/policy level. Overall, results indicated a cohort motivated to achieve good sleep, and also struggling with a number of barriers across each level. This paper highlights opportunities for population health interventions during technical training aimed at supporting Airmen in developing healthy sleep behaviors early in the course of their career. [ABSTRACT FROM AUTHOR]

The authors reflect on the need to modify the behavior of the U.S. food industry to control the obesity epidemic. They explore the trend of vertical integration in the market which enable firms to reduce cost and increase product value. They argue that producers gain their profits via larger market shares and excessive food trade resulting to obesity. They add that campaigns intended to avoid obesogenic foods are futile unless the industry's assumed anti-social behavior is changed.

To the extent that social science scholarship engages real-world developments it remains grounded and better able to resist elite agendas. With this in mind this article argues for the critical encounter with what I argue is the most significant struggle around food and agriculture today--the amorphous and broad-based movement that strives to resist the further degradation of food environments and ensure healthy eating in society. This struggle is inevitably engaged with contemporary neoliberal agendas that have transformed and degraded food environments as they have privileged profit making over healthy diets. The article considers different sites where the struggle over healthy eating is taking place, both at the level of the state and more extensively in civil society. It considers the debate over bovine growth hormone in Canada and the wider efforts to turn around school food environments as examples of state-centered and civil-society struggles, respectively, that illustrate different dimensions of the healthy-eating movement today. In each case the agendas of transnational food corporations are seen to be directly contradicting efforts to ensure healthy diets. The article considers some notable successes among advocates of healthy eating, in the United States and Canada and most notably in Britain, and examines some of the factors that may account for this success. Overall, I argue that this struggle has the potential to challenge the hegemony of neoliberal discourse in fundamental ways. The article concludes with a call for academics, and rural sociologists in particular, to give a much greater priority to healthy-eating struggles, and considers a number of areas where academic practitioners can aid activists' efforts to resist the further degradation of diets and establish healthier food environments.

Skin cancer is an increasing problem in Europe, America and Australasia, although largely preventable by avoiding excessive ultraviolet (UV) exposure. This paper presents the findings of a systematic review of qualitative research about the prevention of skin cancer attributable to UV exposure. The aim is to understand elements that may contribute to the successful or unsuccessful conveyance of skin cancer prevention messages and their uptake by the public. A systematic review was undertaken using evidence identified through searching electronic bibliographic databases and Web sites and reference list checks. Predefined inclusion and exclusion criteria were used. Sixteen study reports (relating to 15 separate studies) were included from the United Kingdom, United States, Australia, Canada and New Zealand. Each included study was quality appraised, and the findings were extracted into an evidence table. A coding scheme, framed by the Health Belief Model, was developed by the reviewers and informed analysis and synthesis. This showed that most people perceived their susceptibility to skin cancer, and its severity, as low. While benefits of adopting changed behaviour were acknowledged, there were substantial barriers to this, including positive perceptions of a tan as healthy and attractive and the hassle of covering up or using sunscreen. Peers, parents and media may offer "cues to action" that encourage adoption of preventative behaviour and finally self-efficacy or the perceived ability to make such changes. Effective health education messages will need to address the barriers to adopting protective behaviours identified through this review.

Abstract: An exhaustive bibliography which assesses the methodological rigor of the patient compliance literature, and citation data from the Science Citation Index (SCI) are combined to determine if methodologically rigorous papers are used with greater frequency than substandard articles by compliance investigators. There are low, but statistically significant, correlations between methodological rigor and citation indicators for 138 patient compliance papers published in SCI source journals during 1975 and 1976. The correlation is not strong enough to warrant use of citation measures as indicators of rigor on a paper-by-paper basis. The data do suggest that citation measures might be developed as crude indicators of methodological rigor. There is no evidence that randomized trials are cited more frequently than studies that employ other experimental designs. [ABSTRACT FROM AUTHOR]

The current state of physical fitness in American youth is unknown. While evidence exists that obesity levels are increasing in children and youth, data on declines in physical fitness measures (i.e., cardiorespiratory and musculoskeletal fitness) are lacking. Tracking of physical fitness components has been poorly done. Surveillance of behaviors known to relate to health-related fitness (e.g., physical activity, sedentariness) and actual health-related fitness outcomes (e.g., cardiorespiratory fitness, body composition, musculoskeletal health, and, perhaps, blood lipids, cholesterol, etc.) are important to measure. Both behaviors and outcomes are important to measure--if they are not measured, people perceive them as "not" important. In this paper, the author asserts that it is time that well defined, valid measures of health-related fitness components are identified and procedures are developed that permit surveillance and tracking of physical fitness components in children and youth. Development of surveillance systems should include many interested parties, the medical profession, professional organizations (e.g., AAHPERD and ACSM), governmental agencies (e.g., PCPFS, CDC, and HHS), teachers, epidemiologists, research scientists, measurement experts, and parents. It will be difficult to arrive at the appropriate process and measures to obtain. Nonetheless, it is an important task. It is time to initiate surveillance that results in meaningful data with which to make evidenced-based decisions about fitness levels that impact curricular and health decisions. (Contains 4 tables and 4 figures.)

This paper investigates the relationship between school-based sex education policies and sexual health-related statistics of young people in four developed countries: the Netherlands, France, Australia, and the United States of America. Drawing upon literature searches in relevant CD-ROM databases, Internet websites, government reports and libraries, school-based sex education policies and a range of sexual health indicators for young people are described for each country. While the average age of first intercourse is approximately the same for each country, the analysis indicates that those countries with pragmatic and sex positive government policies (France, Australia and especially the Netherlands) have better sexual health-related statistics than the one country with a primarily sexual abstinence-based policy (the United States). The findings suggest that abstinence-based policies do not necessarily result in improved sexual health outcomes for young people. Furthermore, liberal policies do not necessarily "promote" sexual activity and may serve to better equip young people with skills that enable sexual health sustaining behaviours. Although a causal relationship between school-based sex education policies and sexual health outcomes cannot be proved, the analysis does suggest that young people's reproductive and sexual health is best served when sex between young people is acknowledged, accepted and regulated rather than proscribed in all contexts outside marriage. (Contains 3 tables and 2 notes.)

This paper explores racial differences in maternal risk factors associated with adverse pregnancy outcomes across urban and rural geographies using 2019 data from the Behavioral Risk Factor Surveillance System. Bivariate chi-square tests and logistic regression were performed which showed statistically significant geographical differences among Non-Hispanic (NH) Black pregnant women across income levels (p =.016) and perceived health status (p =.003). Regression analyses indicated an increased racial gap between NH White pregnant women and other racial/ethnic groups. The findings support that there are statistically significant racial differences in maternal risk factors across urban and rural geographies for NH Black and Hispanic pregnant women. [ABSTRACT FROM AUTHOR]

Health care providers have highlighted the need for tools and resources that support promotion of exercise behavior within comprehensive multiple sclerosis (MS) care. This study involved a final quality improvement evaluation of exercise promotion models and materials for inclusion within this setting. Our research team distributed a paper-based survey containing Likert scales, open answer questions, and copies of the models for editing. We distributed this survey among health care providers across the United States. We conducted a novel mixed-methods analysis evaluating quantitative, qualitative, and creative data. We received completed surveys from 13 health care providers who strongly rated the clarity and applicability of the models and materials, and reported that no major improvements were necessary. The minor improvements were specific per comprehensive MS care center. The feedback indicated that the "Exercise in Medicine" models and materials are guides such that the processes should be integrated into real world practice by amending roles and responsibilities with the team members and structure per comprehensive MS care center. This paper presents finalized models and materials for exercise promotion within comprehensive MS care that are ready to be tested for feasibility and efficacy in a clinical trial. Health care providers require support to promote exercise within the context of comprehensive MS care. The practice models in this article provide guides regarding how to promote exercise in this context. Implementing these exercise promotion guides can reduce the burden of neurologists, and ensure patients receive exercise support from appropriate providers. These guides should be implemented within the context of each individual care center, and not as an explicit step by step guide as each care center is unique. [ABSTRACT FROM AUTHOR]

Purpose: A broader challenge of co-creating digital solutions with patients addresses the question how to apply an open-access digital platform with trusted digital health information as a measure to transform the way patients access and understand health information. It further addresses use this for adherence to treatment, risk minimization and quality of life throughout the integrated patient journey. The aim of this paper is to demonstrate the early steps in towards progress to co-creating the digital solution. Design/methodology/approach: To coordinate the co-creation process, the authors established a multiphased plan to deep-dive into user needs and behaviors across patient journeys, to identify nuances and highlight important patterns in stakeholder and end-user segment at various stages in the patient's journey. Findings: A set of tools was designed to serve as a human-centered compass throughout the lifecycle of the project. Those tools include shared objects; personas, user journeys, a set of performance indicators with related requirements – all those tools being consistently refined in ongoing co-creation workshops with members of the cross-functional stakeholder groups. Originality/value: In this study, a multidisciplinary, public-private partnership looked at integrated digital tool to improve access, understanding and adherence to treatment for diverse groups of patients across all stages of their health journeys in a number of countries including European Union (EU) and United States of America (USA). As a result of this work, the authors attempt to increase the possibility that the improved availability and understanding of health information from trusted sources translates to higher levels of adherence to treatment, safer use of medication (pharmacovigilance), better health outcomes and quality of life integrated in the patient's journey. [ABSTRACT FROM AUTHOR]

Tobacco use is the leading cause of death in the United States and youth prevention is key to reducing tobacco use. American Indian/Alaska Native (AI/AN) individuals have a higher prevalence of tobacco use compared to other populations. This paper aims to evaluate the prevalence of tobacco products among youth within the Cherokee Nation reservation. Data from the 2019 Cherokee Nation Youth Risk Behavior Survey (YRBS) was used to analyze the prevalence of tobacco use (cigarettes, smokeless tobacco, electronic cigarettes, cigars, and ≥ 2 products) among students within Cherokee Nation. Weighted frequency and percentages were obtained for variables and 95% confidence intervals were computed using Taylor linearization variance estimators. Binary associations between variables were examined using the Rao-Scott Chi-square test. There were 1475 high students who participated in the 2019 Cherokee Nation YRBS. Males were more likely to report the use of smokeless tobacco and ≥ 2 products than females. Twelfth graders had a higher prevalence of reported e-cigarette use compared to lower grades. AI/AN students had a higher prevalence of current use of cigarettes and ≥ 2 products compared to other groups. The use of marijuana and alcohol was positively associated with the use of all tobacco products. Depression was also positively associated with the use of all products excluding smokeless tobacco. Grade, age, depression, and current use of other tobacco products, marijuana, and alcohol were associated with greater electronic cigarette intensity levels. Using the results, tribal and local organizations can promote evidence-based interventions that focus on reducing tobacco use among youth. [ABSTRACT FROM AUTHOR]

Purpose: In the USA, integrated care remains largely aspirational; a majority of Americans receive mental health care entirely within the primary medical care outpatient setting. A new instrument, the Multidimensional Behavioral Health Screen (MBHS) (McCord, 2020) was developed specifically to address this gap by systematically screening for a broad array of mental health issues in every patient, every visit. The goal of this current feasibility study was to evaluate the perceptions of the primary medical care providers regarding the usefulness and practicality of the MBHS, a necessary step toward broad-based implementation. Design/methodology/approach: The MBHS was given to 101 consenting patients in a primary medical outpatient setting, each of whom was then seen by one of six participating primary care providers (PCPs). Providers completed a brief survey rating the ease of use, understandability, helpfulness and perceived accuracy of the MBHS after each patient visit and a final summary survey at the conclusion of the study. Findings: Ratings were very positive overall, and the MBHS was clearly preferred to the traditional screening measures (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]). Providers offered suggestions for improvement and particularly for implementation. Research limitations/implications: The small sample size (101 patients and 6 PCPs) and limited geographical reach may limit generalizability. Surveying providers using similar methodology should be done with larger numbers of providers and more diverse primary medical care settings. Practical implications: This study provides evidence that the MBHS may be significantly effective in operationalizing the integrated care model in United States (US) healthcare systems. Social implications: The MBHS, a new behavioral health screening tool, was perceived by providers as useful in identifying mental health issues and guiding treatment decisions in the primary care setting. Originality/value: This paper identifies a novel screening instrument that implements new and emerging models of psychological dysfunction in a practical way in primary medical care, making integrated care a reality rather than an aspiration. [ABSTRACT FROM AUTHOR]

This paper reports secondary data analysis of associations between psychological distress and health behaviours among Cambodian Americans. Data are from baseline assessments from a diabetes prevention trial. All participants met stucriteria for depression and were free of diabetes. Participants (n = 191) completed surveys, a food frequency assessment, and wore sleep and physical activity actigraphy devices for 7 days. A factor analysis of symptoms of post-traumatic stress, baksbat (a Cambodian culture-bound syndrome), depression, and anxiety yielded a single factor named 'psychological distress'. Multivariate models controlling for psychotropic medications were run for the following outcomes: sleep actigraphy, self-reported sleep, physical activity actigraphy, self-reported physical activity, nutrition, and substance use. For actigraphy, higher distress was associated with lower moderate/vigorous physical activity and higher mean variability of 24 h total sleep time. Higher distress was also associated with worse self-reported sleep quality as indicated by standard, and culturally-specific, sleep indicators. Higher distress was also associated with lower use of food labels, lower carbohydrate consumption, and higher alcohol consumption as a coping mechanism. Interventions to mitigate diabetes risk in high-distress populations may benefit from strategies to decrease psychological distress. The sequelae of complex trauma may transcend discrete psychiatric diagnoses., (© 2022 John Wiley & Sons Ltd.)

Inconsistent engagement in pelvic floor muscle exercise (PFME) among patients with prostate cancer (PC) following radical prostatectomy may have contributed to varying effectiveness in improving urinary incontinence across studies. Identifying factors influencing engagement can help develop effective interventions to maximize participation, enhance urinary function and improve quality of life (QoL). This scoping review aims to systematically search for factors influencing PFME engagement among post radical prostatectomy patients managing urinary incontinence. Eligible publications in English were identified from various databases, including PubMed, CINAHL, ProQuest, PsycINFO and Scopus. A health science librarian was consulted to assist in formulating search terms, encompassing PC, PFME terms and influencing factors terms. We employed Colandrapp™ for data extraction, focusing on key themes such as study characteristics, PFME education and training, recommended sessions, engagement rates and factors influencing PFME engagement following radical prostatectomy. Results were presented in tables and supplemented by a narrative discussion addressing gaps in research knowledge. The synthesis drew from a diverse body of literature, blending quantitative and qualitative approaches, to contribute to a comprehensive understanding of PFME engagement factors. Twelve papers, based on 10 studies published between 2011 and 2018, met our inclusion criteria. The reviewed studies primarily employed longitudinal quantitative designs, except for one study that utilized a mixed‐method design. Only three studies incorporated theories to guide the selection of potential factors influencing PFME engagement. The factors examined across the reviewed studies encompassed aspects related to the patient–partner relationship, patient's action control, planning (dyadic or individual), self‐efficacy, perceived urinary incontinence and the patient–provider relationship. We observed conflicting findings regarding the factors influencing PFME engagement across studies. Our review underscores the importance of theory‐informed studies using rigorous methodology and precise theoretical and operational definitions of potential factors. Such studies can help pinpoint the most influential factors to enhance PFME engagement and, ultimately, improve symptoms and QoL for PC patients. The scoping review also showed critical implications for nursing practice. Nurses should develop individualized and culturally sensitive interventions, integrate health behaviour change theories, assess patient–partner relationships and action control and consider intention's mediating role in the enhancement of PFME engagement following radical prostatectomy. [ABSTRACT FROM AUTHOR]

This paper examines the contributions of laboratory-based alcohol challenge research (ACR) to the development of HIV prevention interventions. Following a brief overview of HIV prevention interventions and related health behavior change models, we discuss how alcohol may influence mechanisms of behavior change. The paper highlights the value of ACR for: (1) elucidating mechanisms of action through which alcohol affects sexual risk behavior, (2) testing how alcohol may influence mechanisms thought to underlie HIV prevention interventions, (3) clarifying moderators of the causal influences of alcohol, (4) identifying novel intervention targets, and (5) developing strategies to reduce sexual risk among those who consume alcohol. We conclude with a discussion of the importance of using experimental research to identify mechanisms of behavior change that are specific to populations at high risk for HIV and outline some key implications for developing HIV prevention interventions that integrate the role of alcohol. [ABSTRACT FROM AUTHOR]

The paper introduces three empirical studies which relate the religious beliefs and practices or rural older adults from different ethnic groups to their health behaviors. It briefly describes the rationale for the studies and their main components, including their aims, study sites, study populations, methods used, and their principal findings. Then it discusses two primary themes which run through all the papers, namely rurality and cross-cultural comparisons. Finally, several secondary themes are discussed, including the importance of place, types of analysis, variable definition, causal relationships among variables, types of healing, locus of control, discourses about religion and health, and the religion and health connection. [ABSTRACT FROM AUTHOR]

There is much evidence showing that physical activity is related to optimal health, including physical and mental function, and quality of life. Additionally, data are accumulating with regard to the detrimental health impacts of sedentary behavior. Much of the evidence related to long-term health outcomes, such as cardiovascular disease and cancer—the two leading causes of death in the United States and worldwide—comes from observational epidemiologic studies and, in particular, prospective cohort studies. Few data on these outcomes are derived from randomized controlled trials, conventionally regarded as the "gold standard" of research designs. Why is there a paucity of data from randomized trials on physical activity or sedentary behavior and long-term health outcomes? A further issue to consider is that prospective cohort studies investigating these outcomes can take a long time to accrue sufficient numbers of endpoints for robust and meaningful findings. This contrasts with the rapid pace at which technology advances. Thus, while the use of devices for measuring physical behaviors has been an important development in large-scale epidemiologic studies over the past decade, cohorts that are now publishing results on health outcomes related to accelerometer-assessed physical activity and sedentary behavior may have been initiated years ago, using "dated" technology. This paper, based on a keynote presentation at 8th International Conference on Ambulatory Monitoring of Physical Activity and Movement 2022, discusses the issues of study design and slow pace of discovery in prospective cohort studies and suggests some possible ways to maximize the utility and comparability of "dated" device data from prospective cohort studies for research investigations using the Women's Health Study as an example. [ABSTRACT FROM AUTHOR]

The current issue is a call to action on the mental health crisis America is experiencing. Prevention and intervention programs are needed to address the gap in services. This current issue gathers the voices and perspectives from various populations' lived experiences with the intent to develop recommendations and solutions. [ABSTRACT FROM AUTHOR]

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations. [ABSTRACT FROM AUTHOR]

A recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM) highlights rising rates of working-age mortality in the United States, portending troubling population health trends for this group as they age. The Health and Retirement Study (HRS) is an invaluable resource for researchers studying health and aging dynamics among Americans ages 50 and above and has strong potential to be used by researchers to provide insights about the drivers of rising U.S. mortality rates. This paper assesses the strengths and limitations of HRS data for identifying drivers of rising mortality rates in the U.S. and provides recommendations to enhance the utility of the HRS in this regard. Among our many recommendations, we encourage the HRS to prioritize the following: link cause of death information to respondents; reduce the age of eligibility for inclusion in the sample; increase the rural sample size; enhance the existing HRS Contextual Data Resource by incorporating longitudinal measures of structural determinants of health; develop additional data linkages to capture residential settings and characteristics across the life course; and add measures that capture drug use, gun ownership, and social media use. [ABSTRACT FROM AUTHOR]

Many general population surveys have been conducted relating to the coronavirus/COVID-19. Some have reported on small samples of Jewish respondents, but issues specific to Judaism have not been well explored. This paper provides findings from the first broad coronavirus-related survey of the U.S. Orthodox Jewish community, conducted in May 2020 among 502 Jewish respondents who resided in the United States, self-identified as Orthodox Jews, and indicated whether they were Modern Orthodox or Haredi ("Ultra-Orthodox"). The survey broadly probed the impact of the pandemic through the lens of Jewish individual and communal attitudes, behaviors and practices, exploring such issues as people's health, finances, Jewish prayer and religious study, synagogues and their programs, what services their communities and its Jewish organizations are offering, the extent to which they avail themselves of these services and how they are perceived, changes in the perceived value of Jewish communal connection, and many other aspects, including how people assess the pandemic's impact on their overall "feelings of Jewishness." While many communal changes arising from the pandemic will prove to be transitory, others may become more permanent or, at the very least, create introspection with respect to normative religious observance. This paper references findings relating to the former, while focusing on the latter. Thus, we focus on and report survey findings relating to how the Orthodox community has melded its adherence to Halacha (Jewish law) and tradition with the need for change and flexibility required to deal safely with the pandemic. We will also share some of the communal views that have arisen on how such changes might play out in the years ahead. [ABSTRACT FROM AUTHOR]

Simple Summary: HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) is unique amongst oropharyngeal cancers in its high responsiveness to treatment and its lower mortality rate. As a result, numerous clinical trials have been conducted to identify treatment modalities and protocols. In order for these trials to have meaningful impact on HPV-associated OPSCC patients, proper demographic representation by trial participants is essential. The aim of our systematic review and meta-analysis was to assess the demographics of trial participants for HPV-associated OPSCC clinical trials and compare them with those reported by national databases. We determined that clinical-trial participants were predominately non-smoking white men, with tonsils as the primary tumor site. These findings reflect the demographics reported by the National Cancer Database. Our results imply that HPV-associated OPSCC clinical trials appropriately represent the target population and offer immense benefit. The objective of our paper was to answer the following question: how do patients with HPV-related oropharyngeal squamous cell carcinoma OPSCC (Population) enrolled in clinical trials (Intervention), compared with national database reports of HPV-associated OPSCC patients (Comparison), present demographically (Outcome)? We conducted a systematic review and meta-analysis of studies pertaining to clinical trials of HPV-associated OPSCC and participant demographics in the United States. PubMed, Scopus, CINAHL, and the Cochrane Library were searched from inception to 2 February 2022. Studies of overlapping participant cohorts and/or studies conducted outside of the United States were excluded. Primary outcomes were patient age, sex, and race. Secondary outcomes were smoking history, alcohol history, history of prior cancer, and tumor origin site. Meta-analysis of single means (mean, N for each study, and standard deviation) for age, pack years, and smoking years was performed. Pooled prevalence rates of gender, race, alcohol history, tobacco history, and tumor origin site were expressed as a percentage, with 95% confidence intervals. Meta-analysis found patients to be predominately non-smoking white males, with tumors originating from the tonsil. Our findings reflected the demographics reported by the National Cancer Database (NCDB) for HPV-associated OPSCC. This indicates that HPV-associated OPSCC patients are appropriately represented in clinical trial demographics. [ABSTRACT FROM AUTHOR]

Objective: In this paper, we urge health behavior and policy experts to engage in rigorous science and evaluation of the evolving natural experiment to stop or adapt to the pandemic of COVID-19. Methods: We conducted scientific literature, media library, and governmental website searches with key words COVID-19, policy, health behavior, and pandemic as a rapid review. Results: As of March 26, 2020, approximately one-third of the world's population was under some COVID-related movement restriction. Moreover, 21 states in the United States initiated policies to stay-in-place, close businesses and schools, or create mechanisms for social distancing, with more states likely to take up these actions. Conclusions: As individuals and whole communities ascend Maslow's Hierarchy of Needs Scale, it is important to structure health behavior and policy evaluation and research to capture the lessons learned from this worldwide natural experiment of differing choices of support and restriction of individuals, groups, occupations, and whole countries. Whereas this may be the first pandemic of this magnitude and speed in the modern world, it likely will not be the last, making it imperative that we learn from and teach as many of these lessons as possible. [ABSTRACT FROM AUTHOR]

Research in indigenous communities is at the forefront of innovation currently influencing several new perspectives in engaged intervention science. This is innovation born of necessity, involving efforts to create health equity complicated by a history of distrust of research. Immense diversity across indigenous cultures, accompanied by variation in associated explanatory models, health beliefs, and health behaviors, along with divergent structural inequities add further complexity to this challenge. The aim of this Supplemental Issue on Promoting Health Equity through Rigorous, Culturally Informed Intervention Science: Innovations with Indigenous Populations in the United States is to highlight the promising new approaches and perspectives implemented by a group of engaged researchers and their community partners, as they seek to move intervention research forward within indigenous communities. Case studies presented are from projects led by members of the National Institutes of Health Intervention Research to Improve Native American Health (IRINAH) consortioum, investigators who conduct health promotion and disease prevention research among American Indians, Alaska Natives, and Native Hawaiians. The promising practices profiled include new strategies in (a) community partnerships, engagement, and capacity building; (b) integration of indigenous and academic perspectives; (c) alignment of interventions with indigenous cultural values and practices; and (d) implementation and evaluation of multilevel interventions responsive to complex cultural contexts. The IRINAH projects illustrate the evolution of an intervention science responsive to the needs, realities, and promise of indigenous communities, with application to health research among other culturally distinct health inequity groups. [ABSTRACT FROM AUTHOR]

Novel, public behaviors, such as masking, should be susceptible to normative influence. This paper advances the theory of normative social behavior by considering a new set of moderators of normative influence — superdiffuser traits — and by clarifying the antecedents and consequences of exposure to collective norms. We use data from a two-wave survey of a cohort living in one U.S. county during the pandemic (N = 913) to assess normative effects on masking. We also used a bipartite network (based on people shopping for food in the same stores) to examine exposure to collective norms. The results show different superdiffuser traits have distinct effects on the relationship between perceived injunctive norms and masking intentions. Exposure to collective norms influences masking, but this influence depends on how people interact with their social environments. Network analysis shows that behavioral homophily is a significant predictor of selective exposure to collective norms earlier (but not later) in the pandemic. Implications for understanding normative influence in a context where opinion leadership matters are discussed. [ABSTRACT FROM AUTHOR]

Objective: For the past 2 decades, smoking from a hookah or waterpipe has been an evolving negative health behavior in the United States among college students, in part, because students have misconceptions about the potential risks involved with this practice. Methods: For this study, we used formative research to inform a college campus-based social marketing campaign to deter hookah smoking. This paper reports on the development and implementation of the social marketing campaign, with a key focus on the evaluation of behavior change using stages of change. Results: Overall, 828 of 1500 randomly selected students who were contacted responded to a survey following implementation of the campaign. The primary hookah message was recalled by 75% of students and key words describing it were ones included in message intent. The campaign also elicited students to change their social behaviors so as not to include hookah smoking or peers who smoked a hookah. Conclusions: Social marketing showed promise in getting some college students to reduce their exposure to hookah smoking. Messages became more relatable to the target audience through pretesting and formative research. Social marketing campaigns can influence college students to reduce personal use and deter exposure to hookah smoking. [ABSTRACT FROM AUTHOR]

A plethora of research has been conducted on physical activity (PA) during the school day as part of a CSPAP. Classroom activity, recess, and other school day opportunities such as active transitions, school-wide movement breaks, and drop-ins provide valuable opportunities for students to reach recommended levels of PA. In addition to the health benefits from engaging in PA during this time and decreasing bouts of sedentary behavior, positive outcomes have been demonstrated in terms of students' academic performance and social/emotional health. The purpose of this paper is to provide an overview of research conducted on PA during the school day over the past decade and offer suggestions to practitioners on efficient and effective ways to incorporate PA during school. Based on the collective efforts of researchers, we summarize the outcomes and provide the biggest "return on investment" for physical educators, classroom teachers, and PA professionals who are most likely to implement PA during the school day as part of a CSPAP. [ABSTRACT FROM AUTHOR]

Objectives: Given the increasing national-level efforts to reduce disparities in obesogenic behaviors in youth, in this paper, we assessed the change in disparities in meeting guidelines for fruits and vegetables intake (FV), physical activity (PA), and sedentary behavior (SB) among adolescents in the United States in the last 13 years. Methods: Using the Youth Risk Behavior Surveillance System (2005-2017), overall and characteristic-specific (sex, age, race/ethnicity) disparities ratios for meeting FV, PA, and SB guidelines were calculated using the Extended Gastwirth Index Method. Linear regressions, one-way analysis of variance, and posthoc tests assessed change in characteristic-specific disparities over the years. Linear and quadratic trends assessed change in characteristic-specific contributions to overall disparities. Results: Sex-specific and age-specific disparities increased for meeting FV and PA and decreased for meeting SB guidelines. Race/ethnicity-specific disparities decreased for meeting FV and SB guidelines. Characteristics-specific contributions to overall disparities for each behavior changed over the years. Conclusions: Disparities in obesogenic behaviors are still an ongoing concern despite national-level efforts to improve adolescents' behaviors. The methodology allowed for meaningful disparities ratios that facilitated comparison of categorical demographic characteristics across the years and identifying targetable intervention groups to reduce disparities.

Diet and nutrition are critical components of health, recovery from disease and illness, performance, and normal growth across the lifespan. Thus, it is important for physical therapists to be knowledgeable about nutrition and to have competency in providing information and guidance to patients/clients. Yet, there is an overwhelming amount of diet and nutrition information available from numerous sources, which makes it difficult to reach conclusions and determine the importance and relevance to patient care. The purpose of this perspective paper is to increase the knowledge and skills of physical therapists by providing guidelines for healthy eating and outlining diet and nutrition information most relevant for physical therapist practice and to clarify professional scope of practice related to diet and nutrition, including boundaries created by law, and the connection between healthy eating and health outcomes, muscle strength, bone health, and wound healing., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Aim: Prostate cancer (PCa) globally impacts men of African descent disproportionately more than any other ethnicity. Studies focusing on PCa among the U.S.-based Nigerian immigrant men (NIM) are limited. The purpose of this study was to investigate the predictive effects of health beliefs on NIM's prostate cancer screening intention using select constructs of two health behavior models. Subjects and methods: This study consisted of (N = 130) U.S. NIM, aged 40 years and older, who were recruited from local nonprofit associations in New Jersey. Pen-and-paper questionnaire data were gathered using the Behavioral Intention Scale and the modified version of the Champion's Health Belief Model Scale for Prostate Cancer, along with demographic questions. Data were analyzed in SPSS 25.0. Multiple regression analysis was conducted to evaluate how well perceived susceptibility, benefits, and barriers predicted the intention to undergo screening for prostate cancer. Results: The model was significantly related to intention (R2 = 0.22, F (4,125) = 9.02, p < 0.001). Beta weights indicated that only perceived susceptibility and perceived benefit shared in the 22% of intention variability. Perceived susceptibility (β = 0.61, p < 0.001) and perceived benefits (β = 0.41, p < 0.001) were thus the variables that significantly contributed to the model. Conclusion: Continuous education and awareness of prostate cancer and the importance of screening, as well as a better understanding of health belief perceptions, remain strategies healthcare providers can utilize to reach at-risk minority populations. [ABSTRACT FROM AUTHOR]