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Background: Patients with atrial fibrillation (AF) have significantly lower health-related quality of life (HRQoL) compared to the general population and patients with other heart diseases. The research emphasis on the influence of AF symptoms on HRQoL overshadows the role of individual characteristics. To address this gap, this study's purpose was to test an incremental predictive model for AF-related HRQoL following an adapted HRQoL conceptual model that incorporates both symptoms and individual characteristics. Methods: Patients attending an AF specialty clinic were invited to complete an online survey. Hierarchical regression analyses were conducted to examine whether individual characteristics (overall mental health, perceived stress, sex, age, AF knowledge, household and recreational physical activity) incremented prediction of HRQoL and AF treatment satisfaction beyond AF symptom recency and overall health. Results: Of 196 participants (mean age 65.3 years), 63% were male and 90% were Caucasian. Most reported 'excellent' or 'good' overall and mental health, had high overall AF knowledge scores, had low perceived stress scores, and had high household and recreation physical activity. The mean overall AF Effect On Quality-Of-Life Questionnaire (AFEQT) and AF treatment satisfaction scores were 70.62 and 73.84, respectively. Recency of AF symptoms and overall health accounted for 29.6% of the variance in overall HRQoL and 20.2% of the variance in AF treatment satisfaction. Individual characteristics explained an additional 13.6% of the variance in overall HRQoL and 7.6% of the variance in AF treatment satisfaction. Perceived stress and household physical activity were the largest contributors to overall HRQoL, whereas age and AF knowledge made significant contributions to AF treatment satisfaction. Conclusions: Along with AF symptoms and overall health, individual characteristics are important predictors of HRQoL and AF treatment satisfaction in AF patients. In particular, perceived stress and household physical activity could further be targeted as potential areas to improve HRQoL. [ABSTRACT FROM AUTHOR]

Background: Technology holds great potential for promoting health equity for rural populations, who have more chronic illnesses than their urban counterparts but less access to services. Yet, more participatory research approaches are needed to gather community‐driven health technology solutions. The purpose was to collaboratively identify and prioritize action strategies for using technology to promote rural health equity through community stakeholder engagement. Methods: Concept mapping, a quantitative statistical technique, embedded within a qualitative approach, was used to identify and integrate technological solutions towards rural health equity from community stakeholders in three steps: (1) idea generation; (2) sorting and rating feasibility/importance and (3) group interpretation. Purposeful recruitment strategies were used to recruit key stakeholders and organizational representatives from targeted rural communities. Results: Overall, 34 rural community stakeholders from western Canada (76% female, mean age = 55.4 years) participated in the concept mapping process. In Step 1, 84 ideas were generated that were reduced to a pool of 30. Multidimensional scaling and cluster analysis resulted in a six‐cluster map representing how technological solutions can contribute toward rural health equity. The clusters of ideas included technological solutions and applications, but also ideas to make health care more accessible regardless of location, training and support in the use of technology, ensuring digital tools are simplified for ease of use, technologies to support collaboration among healthcare professionals and ideas for overcoming challenges to data sharing across health systems/networks. Each cluster included ideas that were rated as equally important and feasible. Key themes included organizational and individual‐level solutions and connecting patients to newly developed technologies. Conclusions: Overall, the grouping of solutions revealed that technological applications require not only access but also support and collaboration. Concept mapping is a tool that can engage rural community stakeholders in the identification of technological solutions for promoting rural health equity. Patient or Public Contribution: Rural community stakeholders were involved in the generation and interpretation of technological solutions towards rural health equity in a three‐step process: (1) individual brainstorming of ideas, (2) sorting and rating all ideas generated and (3) collective interpretation and group consensus on final results. [ABSTRACT FROM AUTHOR]

Background and Objectives Telehealth holds potential for inclusive and cost-saving health care; however, a better understanding of the use and acceptance of telehealth for health promotion among rural older adults is needed. This systematic review aimed to synthesize evidence for telehealth use among rural-living older adults and to explore cost-effectiveness for health systems and patients. Research Design and Methods This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study designs reporting health promotion telehealth interventions with rural-living adults aged 55 and older were eligible for review. Following screening and inclusion, articles were quality-rated and ranked by level of evidence. Data extraction was guided by the Technology Acceptance Model and organized into outcomes related to ease of use, usefulness, intention to use, and usage behavior along with cost-effectiveness. Results Of 2,247 articles screened, 42 were included. Positive findings for the usefulness of telehealth for promoting rural older adults' health were reported in 37 studies. Evidence for ease of use and usage behavior was mixed. Five studies examined intention to continue to use telehealth and in 4 of these, patients preferred telehealth. Telehealth was cost-effective for health care delivery (as a process) compared to face to face. However, findings were mixed for cost-effectiveness with both reports of savings (e.g. reduced travel) and increased costs (e.g. insurance). Discussion and Implications Telehealth was useful for promoting health among rural-living older adults. Technological supports are needed to improve telehealth ease of use and adherence. Cost-effectiveness of telehealth needs more study, particularly targeting older adults. [ABSTRACT FROM AUTHOR]

Background: To reduce person-to-person contact, the COVID-19 pandemic has driven a massive shift to virtual care. Defined as the use of technology (synchronous or asynchronous) to support communication between health care providers and patients, rural-urban differences in virtual care are relatively unexplored. Objective: The 2-fold purpose of this study was to examine rural and urban virtual care access, use, and satisfaction during the pandemic and to identify any unmet needs. Methods: This study was a cross-sectional online survey exploring virtual care among rural and urban adults in summer 2021 using a combination of fixed and open-ended response options. Quantitative data were analyzed using both descriptive and inferential statistics, and qualitative data were analyzed using inductive thematic content analysis. Results: Overall, 501 (373, 74.4% female; age range 19-86 years; 237, 47.3% rural-living) Western Canadians completed the survey. Virtual care use was high among both rural (171/237, 72.2%) and urban (188/264, 71.2%) participants, with over one-half (279/501, 55.7%) reporting having only started to use virtual care since the pandemic. The self-reported need for mental health programs and services increased during the pandemic, compared with prior for both rural and urban participants. Among virtual care users, interest in its continuation was high. Our analysis also shows that internet quality (all P<.05) and eHealth literacy (all P<.001) were positively associated with participants' perceptions of virtual care usefulness, ease of use, and satisfaction, with no rural-urban differences. Rural participants were less likely to have used video in communicating with doctors or health care providers, compared with urban participants (P<.001). When describing unmet needs, participants described a (1) lack of access to care, (2) limited health promotion and prevention options, and (3) lack of mental health service options. Conclusions: The increased demand for and use of virtual care may reflect increased availability and a lack of alternatives due to limited in-person services during the COVID-19 pandemic, so a balance between virtual care and in-person care is important to consider postpandemic. Further, ensuring availability of high-speed internet and education to support patients will be important for providing accessible and effective virtual care, especially for rural residents. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative study was to explore working men's perspectives about sleep health and the intersecting influences of gender and work, describing participant's views on current and potential programming and organizational support to promote sleep health. Twenty men employed in male-dominated industries in the north-central region of Alberta, Canada, participated in 4 consultation group discussions addressing motivators, facilitators and barriers to sleep health. Participants reported sleeping an average of 6.36 (SD ±1.1) hours per night, and the majority worked more than 40 hours per week. Data were analyzed using an inductive approach. The findings provided important insights. In normalizing sleep deprivation and prioritizing the need to "just keep going" on six or less hours of sleep, the men subscribed to masculine ideals related to workplace perseverance, stamina and resilience. Workplace cultures and practices were implicated including normative dimensions of overtime and high productivity and output, amid masculine cultures constraining emotions and conversations about sleep, the sum of which muted avenues for discussing, let alone promoting sleep. Challenges to good sleep were primarily constructed around time constraints, and worry about meeting work and home responsibilities. Men's preferences for workplace support included providing and incentivizing the use of sleep health resources, designing work for sleep health (e.g., shift schedules, overtime policies) and getting advice from experienced coworkers and experts external to the workplace organization. These findings hold potential for informing future gender-sensitive programming and organizational practices to support sleep health among working men. [ABSTRACT FROM AUTHOR]

The workplace provides an important delivery point for health promotion, yet many programs fail to engage men. A gender-sensitive 8-week team challenge-based intervention targeting increased physical activity was delivered at a petrochemical worksite. The purpose of this study was to examine men's pre–post physical activity and sleep following the intervention, as well as to explore program acceptability and gather men's recommendations for health promotion. Pre–post surveys assessed physical activity, sleep, program exposure, acceptability, and suggestions for continued support. Overall, 328 men completed baseline surveys and 186 (57%) completed follow-up surveys. Walking increased by 156.5 min/week, 95% confidence interval (61.2, 251.8), p =.001. Men with higher program exposure increased moderate and vigorous activity 49.4 min more than those with low exposure (p =.026). Sleep duration and quality were higher postintervention, though changes were modest. Program acceptability was high as was intention to maintain physical activity. Men's suggestions to enable physical activity involved workplace practices/resources, reducing workload, and leadership support. These findings suggest that a gender-sensitive physical activity workplace intervention showed promise for improving physical activity and sleep among men. The men's suggestions reflected workplace health promotion strategies, reinforcing the need for employers to support ongoing health promotion efforts. [ABSTRACT FROM AUTHOR]

Background: Predictors of men's health behaviors and interest in workplace health promotion are not well known. The aim of this study was to describe men's interest in workplace health promotion and associated health behaviors. Method : Male employees (N = 781) at six workplaces in British Columbia, Canada, were invited to complete a survey of their health behaviors, demographics, and interest in health promotion prior to implementation of a workplace health program. Findings : A total of 227 male employees (M age = 43.6 years; SD = 12.1) completed the survey (response rate = 29%). Regarding health behaviors, 62.1% reported 150 weekly minutes of moderate-to-vigorous physical activity (MVPA), 29.3% consumed 5+ servings of fruit/vegetables per day, 56.8% reported 7+ hours sleep/night, 14.4% smoked, and 81.3% consumed alcohol. Men spent 50% of their workday sitting, and higher body mass index (BMI), higher income, and greater hours worked were related to greater hours sitting. Age was inversely related to MVPA. Alcohol consumption was lower among men who were older, had higher income, and worked fewer hours. Most men were interested in being physically active (85%), managing stress (85%), eating healthy (89%), and cancer screening (91%). Higher stage of change for physical activity (β =.20, p =.003) and fruit/vegetable consumption (β =.18, p =.027) were related to interest in these activities. Conclusions/Application to Practice : Occupational health providers should consider worker demographics and could support interventions that target individuals with varying levels of health behaviors given the importance of meeting the needs of often sedentary workers. [ABSTRACT FROM AUTHOR]

The workplace provides an important setting to promote men's mental health, yet few studies have explored the gendered views of men and workplace representatives in male-dominated industries about workplace mental health promotion. Consultations with working men (N = 23) and interviews with seven representatives from male-dominated industries in northern British Columbia, Canada were conducted. Findings highlight the impact of masculine workplace cultures on men's mental health and practices that limit men's disclosures about vulnerabilities, as well as discussions about promoting mental health. Within such milieus a healthy mind was viewed as vital for workplace safety. Participant recommendations focused on reducing stigma, promoting enjoyable activities, and creating sustainable efforts toward building social cohesion. Overall, efforts to promote mental health in male-dominated industries should be tailored for the unique needs of men and should include paid time to engage in wellness activities and positive strategies that facilitate group comradery. Given male-dominated workplaces in particular constitute unique contexts where adherence to masculine ideals is normed, the findings hold potential for advancing mental health promotion programs designed to reach men. [ABSTRACT FROM AUTHOR]

Men are a hard-to-reach group in the promotion of modifiable behaviors such as physical activity. Examining the individual differences among men that might predict positive behavior changes could support customization of health promotion programs. This study examined the role of emotional outlook, positive emotion, and ego-resilience in determining men’s physical activity and health-related quality of life following implementation of a gender-sensitive workplace health intervention. Using a pre–post within-subjects design, computer-assisted telephone interviewing (CATI) was used to collect measures of emotion and ego-resilience along with physical activity and health-related quality of life (using the 12-item short form [SF-12]) at baseline (n = 139) and after 6 months (n = 80) from adult men (Mage = 43.7, SD = 12.5). Baseline emotional outlook and ego-resilience were both positively related to increased physical activity at follow-up among men. Emotional outlook and positive emotion were positively related to ego-resilience, and ego-resilience mediated the relationship between these and the physical component of health-related quality of life. Workplace health interventions that incorporate the promotion of personal resources hold potential for greater impacts. [ABSTRACT FROM AUTHOR]

Objective: To explore published empirical literature in order to identify factors that facilitate or inhibit collaborative approaches for health promotion using a scoping review methodology.Data Source: A comprehensive search of MEDLINE, CINAHL, ScienceDirect, PsycINFO, and Academic Search Complete for articles published between January 2001 and October 2015 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Study Inclusion and Exclusion Criteria: To be included studies had to: be an original research article, published in English, involve at least 2 organizations in a health promotion partnership, and identify factors contributing to or constraining the success of an established (or prior) partnership. Studies were excluded if they focused on primary care collaboration or organizations jointly lobbying for a cause.Data Extraction: Data extraction was completed by 2 members of the author team using a summary chart to extract information relevant to the factors that facilitated or constrained collaboration success.Data Synthesis: NVivo 10 was used to code article content into the thematic categories identified in the data extraction.Results: Twenty-five studies across 8 countries were identified. Several key factors contributed to collaborative effectiveness, including a shared vision, leadership, member characteristics, organizational commitment, available resources, clear roles/responsibilities, trust/clear communication, and engagement of the target population.Conclusion: In general, the findings were consistent with previous reviews; however, additional novel themes did emerge. [ABSTRACT FROM AUTHOR]

The workplace health promotion program, POWERPLAY, was developed, implemented, and comprehensively evaluated among men working in four male-dominated worksites in northern British Columbia, Canada. The purpose of this study was to explore the POWERPLAY program’s acceptability and gather recommendations for program refinement. The mixed-method study included end-of-program survey data collected from 103 male POWERPLAY program participants, interviews with workplace leads, and field notes recorded during program implementation. Data analyses involved descriptive statistics for quantitative data and inductive analysis of open-ended questions and qualitative data. Among participants, 70 (69%) reported being satisfied with the program, 51 (51%) perceived the program to be tailored for northern men, 56 (62%) believed the handouts provided useful information, and 75 (74%) would recommend this program to other men. The findings also highlight program implementation experiences with respect to employee engagement, feedback, and recommendations for future delivery. The POWERPLAY program provides an acceptable approach for health promotion that can serve as a model for advancing men’s health in other contexts. [ABSTRACT FROM AUTHOR]

There is an increasing need for mental health promotion strategies that effectively engage men. Although researchers have examined the effectiveness of diverse mental wellness interventions in male-dominated industries, and reviewed suicide prevention, early intervention, and health promotion interventions for boys and men, few have focused on sex-specific program effects. The purpose of this review was to (a) extend the previous reviews to examine the effectiveness of mental health promotion programs in males, and (b) evaluate the integration of gender-specific influences in the content and delivery of men’s mental health promotion programs. A search of MEDLINE, CINAHL, PsycINFO, and EMBASE databases for articles published between January 2006 and December 2016 was conducted. Findings from the 25 included studies indicated that a variety of strategies offered within (9 studies) and outside (16 studies) the workplace show promise for promoting men’s mental health. Although stress was a common area of focus (14 studies), the majority of studies targeted multiple outcomes, including some indicators of positive well-being such as self-efficacy, resilience, self-esteem, work performance, and happiness/quality of life. The majority of programs were offered to both men and women, and six studies explicitly integrated gender-related influences in male-specific programs in ways that recognized men’s interests and preferences. [ABSTRACT FROM AUTHOR]

The authors examined the relationships among identity, emotional intelligence, and intimacy. Participants were 325 emerging adults (69% women) who completed measures of identity processing styles (informational, normative, and diffuse-avoidant), identity commitment, and intimacy. A subsample (n = 174) completed the Mayer-Salovey-Caruso Emotional Intelligence Test. The informational and normative identity styles were positively related to intimacy, whereas the diffuse-avoidant identity style was inversely related to intimacy. The informational style was positively related to emotional intelligence, and the diffuse-avoidant style was inversely related to emotional intelligence. Emotional intelligence was also positively related to intimacy. Mediation analyses revealed that emotional intelligence mediates the relationships between identity processing and intimacy for the informational (partial mediation) and diffuse-avoidant (full mediation) styles. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine patterns of relationships between identity processing styles and a range of beneficial and problematic coping strategies. Participants completed self-report measures of identity styles (informational, normative, and diffuse-avoidant), identity commitment, and 15 different coping strategies. The diffuse-avoidant style was positively associated with denial, disengagement, and substance use, and it was also positively related to humor. The normative and informational styles were positively correlated with active coping, planning, restraint, seeking social support, and turning to religion; however, the informational style was more highly correlated with all of these coping strategies except turning to religion. The informational style was the only identity style that was positively related to acceptance and positive reinterpretation and growth. [ABSTRACT FROM AUTHOR]

Relationships among identity processing styles, defense styles, and life distress were examined in a sample of 276 emerging adults (M = 19.71 years). Respondents completed the Identity Style Inventory, Revised; the Defense Style Questionnaire; and the Life Distress Inventory. Correlations and structural equation analyses revealed that the informational identity style was positively related to the mature defense style, all three identity styles were positively related to the neurotic defense style, and the diffuse-avoidant identity style was positively related to the immature defense style. Mediation analyses revealed that the positive relationship between the diffuse-avoidant style and life distress was mediated by the immature defense style. The results suggest potential implications of the diffuse-avoidant style for maladjustment through the use of immature defenses. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine patterns of differences in proactive, adaptive forms of positive adjustment as a function of identity processing style. Three hundred undergraduate students (98 men, 202 women) completed self-report measures of identity styles (informational, normative, diffuse-avoidant), identity commitment, curiosity/exploration, proactive coping, and emotional intelligence. All three identity styles and identity commitment were found to be related to curiosity/exploration, proactive coping, and emotional intelligence. These relationships were positive with identity commitment and the informational and normative styles. When the overlapping variance accounted for by identity commitment was controlled via hierarchical regression, all three identity styles significantly predicted emotional intelligence, with positive predictions from the normative and informational styles. However, only the informational identity style made a unique positive contribution to curiosity/exploration and to proactive coping. These results are discussed in terms of the role of identity processing style in positive adjustment. [ABSTRACT FROM AUTHOR]

Background: A number of real-world digital literacy training programs exist to support engagement with mobile devices, but these have been understudied., Objective: The purpose of this study was to examine the effectiveness and program acceptability of a digital skills training program among middle-aged and older adults (aged ≥50 years) and to gather participants' recommendations for lifelong digital skills promotion., Methods: The Gluu Essentials digital skills training program includes learning resources to support tablet use. Through pre-post surveys, this study assessed mobile device proficiency, confidence in going online and in avoiding frauds and scams, the frequency of engaging in online activities, program engagement, acceptability, and suggestions for continued support., Results: A total of 270 middle-aged and older adults completed baseline surveys. Of these 270 participants, 145 (53.7%) completed follow-up surveys. Our findings indicate that mobile device proficiency increased (P<.001), whereas confidence was unchanged. Participants also reported going online more frequently to shop (P=.01) and access government services (P=.02) at follow-up. Program engagement varied considerably, but program acceptability was high. Participants' recommendations included the need for providing ongoing programs for support and training because technology constantly changes, reducing costs for technology and internet access, and keeping learning resources simple and easy to access., Conclusions: The Gluu Essentials digital skills training program increased mobile device proficiency and frequency of web-based activities (shopping and accessing government services) among middle-aged and older adults., (©Cherisse L Seaton, Kathy L Rush, Eric Ping Hung Li, Mohammad Khalad Hasan, Linda Fawcus. Originally published in JMIR Aging (https://aging.jmir.org), 10.11.2023.)

Background: Telehealth can optimize access to specialty care for patients with atrial fibrillation (AF). Virtual AF care, however, may not fit with the complex needs of patients with AF., Objective: This study aims to explore the correlation among attitudes toward health care technologies, self-efficacy, and telehealth satisfaction as part of the future planning of virtual AF clinic care., Methods: Patients with AF older than 18 years from an urban-based, highly specialized AF clinic who had an upcoming telehealth visit were invited to participate in a web-based survey. The survey asked about demographic characteristics; use of technology; general, computer, and health care technology self-efficacy (HTSE) and health care technology attitudes, using a validated 30-item tool; and telehealth satisfaction questionnaire using a validated 14-item questionnaire. Data were analyzed with descriptive statistics, correlational analyses, and linear regression modeling., Results: Participants (n=195 of 579 invited, for a 34% response rate) were primarily older, male, and White, had postsecondary schooling or more, and had high self-reported overall and mental health ratings. A variety of technologies were used in their daily lives and for health care, with the majority of technologies comprising desktop and laptop computers, smartphones, and tablets. Self-efficacy and telehealth satisfaction questionnaire scores were high overall, with male participants having higher general self-efficacy, computer self-efficacy, HTSE, and technology attitude scores. After controlling for age and sex, only HTSE was significantly related to individuals' attitudes toward health care technology. Both general self-efficacy and attitude toward health care technology were positively related to telehealth satisfaction., Conclusions: Consistent with a previous study, only HTSE significantly influenced attitudes toward health care technology. This finding confirms that, in this regard, self-efficacy is not a general perception but is domain specific. Considering participants' predominant use of the telephone for virtual care, it follows that general self-efficacy and attitude toward health care technology were significant contributors to telehealth satisfaction. Given our patients' frequent use of technology and high computer self-efficacy and HTSE scores, the use of video for telehealth appointments could be supported., (©Kathy L Rush, Lindsay Burton, Cherisse L Seaton, Peter Loewen, Brian P O'Connor, Lana Moroz, Kendra Corman, Mindy A Smith, Jason G Andrade. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 14.09.2023.)

Objective: To describe the smoking patterns of patients receiving elective surgery and their knowledge about the benefits of smoking cessation to inform and strengthen support for patients to quit smoking in order to optimize surgical outcomes., Design: Patients who had elective surgery were screened for smoking status, and eligible patients completed a telephone survey., Setting: Two regional hospitals in northern British Columbia., Participants: Of 1722 patients screened, 373 reported smoking before surgery. Of these, 161 (59.0% women) completed a telephone survey., Main Outcome Measures: Patient smoking cessation, knowledge of the perioperative risks of smoking, use of resources, and health care provider advice and assistance., Results: Participants included 66 men and 95 women (mean [SD] age of 51.9 [14.0] years). In total, 7.5% of these patients quit smoking in the 8 weeks before their surgeries, although an additional 38.8% reduced their smoking. Only about half of the patients surveyed were aware that continuing to smoke increased their surgical risks. Further, only half of the patients surveyed reported being advised to quit before their surgeries by a health care professional. Few were using the provincial resources available to support smoking cessation (eg, QuitNow), and 39.6% were unaware of the provincial program to cover the cost of smoking cessation aids (eg, nicotine gum or patches), yet 62.7% of respondents were thinking about quitting smoking., Conclusion: Many surgical patients in northern British Columbia who smoked were unaware of the perioperative risks of smoking and the cessation support available to them. An opportunity exists for all health care professionals to encourage more patients to quit in order to optimize their surgical outcomes.