Search

BackgroundBaby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. ObjectiveThe intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. MethodsA random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. ResultsAlmost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t217.60=−2.98, P=.003. Younger age (b=−0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R2 =.17, R2adj =.14, F9,229=5.277, P

BackgroundPatients with chronic obstructive pulmonary disease (COPD) often report inadequate access to comprehensive patient education resources. ObjectiveThe purpose of this study was to incorporate community-engagement principles within a mixed-method research design to evaluate the usability and acceptability of a self-tailored social media resource center for medically underserved patients with COPD. MethodsA multiphase sequential design (qual → QUANT → quant + QUAL) was incorporated into the current study, whereby a small-scale qualitative (qual) study informed the design of a social media website prototype that was tested with patients during a computer-based usability study (QUANT). To identify usability violations and determine whether or not patients found the website prototype acceptable for use, each patient was asked to complete an 18-item website usability and acceptability questionnaire, as well as a retrospective, in-depth, semistructured interview (quant + QUAL). ResultsThe majority of medically underserved patients with COPD (n=8, mean 56 years, SD 7) found the social media website prototype to be easy to navigate and relevant to their self-management information needs. Mean responses on the 18-item website usability and acceptability questionnaire were very high on a scale of 1 (strongly disagree) to 5 (strongly agree) (mean 4.72, SD 0.33). However, the majority of patients identified several usability violations related to the prototype’s information design, interactive capabilities, and navigational structure. Specifically, 6 out of 8 (75%) patients struggled to create a log-in account to access the prototype, and 7 out of 8 patients (88%) experienced difficulty posting and replying to comments on an interactive discussion forum. ConclusionsPatient perceptions of most social media website prototype features (eg, clickable picture-based screenshots of videos, comment tools) were largely positive. Mixed-method stakeholder feedback was used to make design recommendations, categorize usability violations, and prioritize potential solutions for improving the usability of a social media resource center for COPD patient education.

BackgroundParticipatory Web 2.0 interventions promote collaboration to support chronic disease self-management. Growth in Web 2.0 interventions has led to the emergence of e-patient communication tools that enable older adults to (1) locate and share disease management information and (2) receive interactive healthcare advice. The evolution of older e-patients contributing to Web 2.0 health and medical forums has led to greater opportunities for achieving better chronic disease outcomes. To date, there are no review articles investigating the planning, implementation, and evaluation of Web 2.0 chronic disease self-management interventions for older adults. ObjectiveTo review the planning, implementation, and overall effectiveness of Web 2.0 self-management interventions for older adults (mean age ≥ 50) with one or more chronic disease(s). MethodsA systematic literature search was conducted using six popular health science databases. The RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model was used to organize findings and compute a study quality score (SQS) for 15 reviewed articles. ResultsMost interventions were adopted for delivery by multidisciplinary healthcare teams and tested among small samples of white females with diabetes. Studies indicated that Web 2.0 participants felt greater self-efficacy for managing their disease(s) and benefitted from communicating with health care providers and/or website moderators to receive feedback and social support. Participants noted asynchronous communication tools (eg, email, discussion boards) and progress tracking features (eg, graphical displays of uploaded personal data) as being particularly useful for self-management support. Despite high attrition being noted as problematic, this review suggests that greater Web 2.0 engagement may be associated with improvements in health behaviors (eg, physical activity) and health status (eg, HRQoL). However, few studies indicated statistically significant improvements in medication adherence, biological outcomes, or health care utilization. Mean SQS scores were notably low (mean=63%, SD 18%). Studies were judged to be weakest on the Maintenance dimension of RE-AIM; 13 reviewed studies (87%) did not describe any measures taken to sustain Web 2.0 effects past designated study time periods. Detailed process and impact evaluation frameworks were also missing in almost half (n=7) of the reviewed interventions. ConclusionsThere is need for a greater understanding of the costs and benefits associated with using patient-centered Web 2.0 technologies for chronic disease self-management. More research is needed to determine whether the long-term effectiveness of these programs is sustainable among larger, more diverse samples of chronically ill patients. The effective translation of new knowledge, social technologies, and engagement techniques will likely result in novel approaches for empowering, engaging, and educating older adults with chronic disease.

Few studies explore the components of sexual satisfaction as specified by college students. This cross-sectional study examined sexual satisfaction at the event level for undergraduate students (n = 1,090), focusing on differences between males/females. Survey results revealed for both males and females, being comfortable with a partner, experiencing orgasm, and having a partner "with skills" predicted sexual satisfaction. Satisfied males reported feeling safe with their partners, spent time touching/kissing, and had "romantic" partners. Satisfied females had partners with previous sexual experience, whom they desired, and vice-versa. These findings can inform comprehensive sexuality education efforts to incorporate the teaching of satisfaction into sexual health.

Honors colleges aim to provide unique first-year experiences that promote life skills and emphasize process over product in an interdisciplinary setting that builds community. A two-semester, five-semester-hour course sequence with colloquia tackles these challenges by introducing an entrepreneurial mindset that pushes students toward innovative understanding and building of community. The first iteration includes an introduction to design thinking; identification of wicked problems; collection of data using immersion experiences, interviews, and literature review; and experiments (n = 35) in project-based entrepreneurial methodologies using "Lean LaunchPad." The second iteration involves assessment, applied qualitative analysis, out-of-class learning, and peer mentoring. Results provide a framework for developing innovative thinking, an entrepreneurial mindset, and community engagement among first-year students--a design that, the authors conclude, has not only developed in students specific, non-academic skills (such as resiliency and creative self-confidence) but effectively doubled the size (as mandated by the university) of the first-year class. Implications for future iterations are considered, calling for strengthening administrative support, increasing academic/community partnership, and sustaining funding beyond the first year.

BackgroundeHealth literacy refers to the ability of individuals to seek, find, understand, and appraise health information from electronic resources and apply such knowledge to addressing or solving a health problem. While the current generation of college students has access to a multitude of health information on the Internet, access alone does not ensure that students are skilled at conducting Internet searches for health information. Ensuring that college students have the knowledge and skills necessary to conduct advanced eHealth searches is an important responsibility particularly for the medical education community. It is unclear if college students, especially those in the medical and health professions, need customized eHealth literacy training for finding, interpreting, and evaluating health- and medical-related information available on the Internet. ObjectiveThe objective of our review was to summarize and critically evaluate the evidence from existing research on eHealth literacy levels among college students between the ages of 17 and 26 years attending various 4-year colleges and universities located around the world. MethodsWe conducted a systematic literature review on numerous scholarly databases using various combinations of relevant search terms and Boolean operators. The records were screened and assessed for inclusion in the review based on preestablished criteria. Findings from each study that met inclusion criteria were synthesized and summarized into emergent themes. ResultsIn the final review we analyzed 6 peer-reviewed articles and 1 doctoral dissertation that satisfied the inclusion criteria. The number of participants in each reviewed study varied widely (from 34 to 5030). The representativeness of the results from smaller studies is questionable. All studies measured knowledge and/or behaviors related to college student ability to locate, use, and evaluate eHealth information. These studies indicated that many college students lack eHealth literacy skills, suggesting that there is significant room for improvement in college students’ ability to obtain and evaluate eHealth information. ConclusionAlthough college students are highly connected to, and feel comfortable with, using the Internet to find health information, their eHealth literacy skills are generally sub par. College students, especially in the health and medical professions, would be well served to receive more customized college-level instruction that improves general eHealth literacy.

Alcohol misuse among young adults remains a primary public health concern given the wide range of short- and long-term physical, social, and societal consequences of the behavior. On-premise drinking establishments, which allow alcohol consumption on site (i.e., bars), are frequent locations for young adult alcohol use. Risks for alcohol misuse within the bar setting are key factors to identify for prevention. Notably, alcohol price and promotions are associated with alcohol consumption among young adults. This study sought to develop and pilot test an observational protocol to assess the alcohol environment at on-premise drinking establishments. Following qualitative exploration of salient risk factors in these settings through focus groups with young adults, an observational tool was adapted and tested in a feasibility study. The refined tool was then pilot tested with two independent data collectors conducting natural observation at 13 establishments in the downtown nightlife district of a small, southeastern city. High interrater reliability was noted. Descriptive summary statistics of bar characteristics demonstrate low alcohol prices with variability across types of alcohol (e.g., beer, wine, and liquor), greater numbers of alcohol promotions inside rather than outside the building, and higher rates of manual versus electronic age verification procedures. Observational assessment of alcohol price and marketing at on-premise drinking establishments as described in this study is needed to inform prevention policy and programs to reduce harms associated with young adult alcohol misuse.

Background: Dental diseases are associated with chronic health conditions and decreased psychological and sociological wellbeing. Young adulthood presents a pivotal stage as dental hygiene behaviors developed and practiced during this time persist into later life. The Theory of Planned Behavior (TPB) is a commonly used theoretical framework to examine intention to engage in dental behaviors. Purpose: To systematically summarize research studies using TPB questionnaires to assess predictive factors of oral hygiene behaviors among young adult populations. Methods: A four-phase article identification process ensured articles met the inclusion criteria. Quality appraisal assessments were used to evaluate questionnaire construction methodology. Results: Twelve articles met the study's inclusion criteria. Each study incorporated supplemental predictive factors such as oral health knowledge and expected social outcomes in addition to the TPB constructs. Discussion: Evidence from this systematic review suggests that TPB is a useful theoretical framework for designing questionnaires that assess dental hygiene behaviors of young adults. Translation to Health Education Practice: Health education specialists should administer oral hygiene behavior surveys that utilize TPB and TPB-related constructs to better understand factors associated with improved intentions toward dental hygiene behaviors among young adults.

Background: Alcohol-use frequency likely has a causal impact on chronic conditions. Many university/college athletic departments have implemented policies that allow alcohol sales at sporting events. Few studies have assessed the social context and impact of sales at college football games on fan behavior. One method for retrospectively assessing such behavior is to analyze event-specific social media posts to capture behavior displayed as photographs and text captions on event days. Purpose: This study analyzed online data, specific to a Southeast university, posted on Instagram, after implementation of a policy to allow alcohol sales. Methods: The posts were coded by alcohol presentation, alcohol/account type, account owner's gender, caption, context, likes, and comments present. Results: Key findings included--(i) an increase in alcohol images after policy implementation, although not statistically significant, (ii) alcohol posts portrayed alcohol in an overwhelmingly positive context, and (iii) alcohol content was posted more frequently by women and non-alcohol related businesses, and the primary alcohol present was beer in these posts. Discussion: The use of Instagram for assessing the social context of alcohol use among Instagram users did allow for a better understanding of social characteristics in the context of a specific social activity (i.e., sporting event). Translation to Health Education Practice: This research provides viable data collection methods for examining the social context of event-specific drinking (Area 1.2) and promotes discussions regarding how social media posts impact drinking behaviors among those who view the posts.

The "American Journal of Health Education" (AJHE) has been published for over 50 years. Over time, the mission and goal of AJHE have evolved from a publication focused primarily on school health issues in the United States to an international journal focused on chronic disease, and related lifestyle factors, for health education and health promotion researchers and practitioners, Certified Health Education Specialists (CHES®) and Master Certified Health Education Specialist (MCHES®). The purpose of this feature article is to discuss how the Responsibilities and Competencies for Health Education Specialists articulate with the mission of the "American Journal of Health Education."

COVID-19 is highly contagious respiratory illness that has spread globally to over 200 countries and territories. Like never before, the world has become reliant on effective health education to facilitate behavioral responses that will slow the spread of COVID-19 pandemic. The prevention, risk mitigation, and containment of COVID-19 is an extremely high public health priority, especially for adults with Chronic Obstructive Pulmonary Disease (COPD) who have compromised respiratory systems. However, despite being uniquely trained in the health education process, health education specialists have limited guidance for systematically communicating scientific information and personal health recommendations to the public during viral outbreaks. In this commentary, we propose three guidelines, linked to the Areas of Responsibility, Competencies, and Sub-competencies for Health Education Specialists, which we believe will attenuate morbidity and mortality risks associated with COVID-19 among those with underlying pulmonary conditions: 1) conduct novel health education needs assessments that systematically monitor respiratory symptoms and hygienic/sanitary behaviors; 2) build capacity to adapt, implement, and evaluate evidence-based health education strategies that optimize adoption of behaviors that protect lung health; and 3) develop communication plans for effectively and efficiently disseminating lung health education materials that address viral pandemic risk reduction, mitigation, and containment.

Background: Type 1 Diabetes (T1D) requires consistent disease management for blood sugar regulation. A theoretical framework can assist with interpreting behavioral processes needed for disease management. However, limited qualitative studies have explored disease management practices among college students with T1D using a theoretical framework. Purpose: To theoretically explore college students' engagement in T1D self-care behaviors to further understand disease management experiences. Methods: One-on-one interviews with 31 full-time college students attending universities in the Southeastern United States. A thematic analysis was conducted to generate subthemes. Results: Subthemes explained self-care maintenance behaviors performed daily (i.e. carry supplies, administer insulin), self-care monitoring behaviors (e.g. analyzing blood sugar trends), and how self-care behaviors were adjusted when previous behaviors were no longer effective for blood sugar regulation. Discussion: Although participants routinely performed T1D self-care behaviors, additional information is needed on how technology is used for self-care monitoring. Future studies should explore college students' T1D self-care management behaviors to determine strategies that are used to improve their blood sugar. Translation to Health Education Practice: Findings from this study can assist health education specialists and healthcare professionals with creating interventions to support disease management among college students living with T1D. [ABSTRACT FROM AUTHOR]

Health Professionals are needed to address and improve health status. This paper presents a teaching technique that will help students acquire and develop applied health education and promotion skills. This paper introduces a 7C Framework to encourage teachers to use Challenge, Courage, Commitment, Competence, Connection, Contribution, and Consequences. The results of three innovative student initiated health promotion projects, provoked by these methods, are provided as evidence of its effectiveness. The innovative 7C framework provides a preparatory framework educators can use to help future health professionals not just meet, but exceed expectations.

Hybrid courses are becoming increasingly common at the university level. With this type of course comes questions about the effectiveness of each method of instruction (face-to-face and online) when used concurrently. The available literature supports a hybrid format for many university subjects; however, research in this area with a personal health course is lacking. The purpose of this study was to determine if there was a significant difference in knowledge gained through each method of instruction experienced by students in a foundations curriculum personal health course. The hybrid design of the course in this study allowed for analysis between face-to-face and online instruction within the same group of students. Results from a two-way ANOVA show no statistically significant difference between knowledge gained through each method of instruction. The findings support the use of a hybrid format in personal health courses and future studies to determine what makes these hybrid health courses most effective.

The National Commission of Health Education Credentialing, Inc. (NCHEC) created the Category 1 COVID-19 Claim Form Opportunity to document how Certified Health Education Specialists (CHES®) and Master Certified Health Education Specialists (MCHES®) assisted communities during the COVID-19 pandemic. Using data submitted by CHES®/MCHES® (n = 3,098 claim forms), the purpose of this study was to (a) describe the settings where CHES® and MCHES® completed their pandemic work and (b) assess differences in the type of pandemic work completed by CHES® compared with MCHES® based on specific Areas of Responsibility (AOR) for Health Education Specialists. Findings showed that CHES® and MCHES® engaged in seven AOR during the pandemic, with the largest proportion of CHES® (n = 859; 33%) and MCHES® (n = 105; 21.9%, documenting COVID-19-related activities in health departments. CHES® reported higher engagement than MCHES® in activities such as COVID-19 reporting/tracking, χ2 (1, N = 3,098) = 27.3, p <.001; outbreak response, χ2 (1, N = 3,098) = 4.3, p =.039; and vaccination, χ2 (1, N = 3,098) = 5.2, p =.023. Conversely, MCHES® reported higher participation than CHES® in screening/testing, χ2 (1, N = 3,098) = 174.2, p <.001; administration of budgets/operations, χ2 (1, N = 3,098) = 30.1, p <.001; and adapting educational activities at college/universities, χ2 (1, N = 3,098) = 46.1, p <.001. CHES® were more likely than MCHES® to indicate working in all AOR except for Area 2—Plan Health Education/Promotion. Results support that employer-verified health education skills in all AOR were transferable during COVID-19, especially for CHES® employed within state/county health departments. [ABSTRACT FROM AUTHOR]

Purpose: The researchers evaluated the efficacy of an advocacy lesson to assess change in intentions to advocate for school health education. This study also measured changes in participants' understanding the importance of school health education and perceived effectiveness in applying advocacy skills. Methods: A convenience sample of college students participated in an advocacy lesson. Pre and posttests to assess changes in intentions to advocate for school health education and student perceptions of effectiveness of the lesson were completed by 161 students. Summed factor mean scores were compared using paired samples t-tests. Multiple linear regression analysis was used to determine the extent to which changes in participants' attitudes, subjective norms, and perceived behavioral control predicted their intentions to advocate for school health education. Results: Changes in attitude and subjective norms served as significant predictors of intention to advocate for school health education. Participants perceived the lesson to be effective in building advocacy skills, creating awareness of the impact of school health education, and understanding of quality school health education. Discussion: Study implications suggest this advocacy lesson can help students understand the importance of quality health education, increase perceived abilities to effectively advocate, and increase intentions to advocate for school health education. (Contains 5 tables.)

Background: An overlooked group for school health education advocacy training is college students enrolled in personal health courses. They will be investors and stakeholders in the quality of public education, and the health and academic success of students. Purpose: In this article we present the process used to develop a theory-based instrument that can help to assess changes in intentions to advocate for school health education after exposure to an advocacy training intervention conducted with college students enrolled in personal health courses. The instrument constructs were developed based on Theory of Planned Behavior (TPB). Methods: Researchers used a comprehensive instrument design framework, involving the Standards for Educational and Psychological Testing and four stages of pretesting to develop and test the instrument items. A confirmatory factor analysis (CFA) was used to test the relationship among ordinal items in the Likert-type instrument and the constructs in TPB, which the items were developed to measure. Results: Fit indices for the structural model indicated that the proposed model provided a satisfactory fit for the data. Therefore, the final instrument consists of 53 items, measuring intentions of students to engage in school health education advocacy, as a result of implementing an advocacy-training lesson. Discussion: This study resulted in an instrument to measure the effectiveness of an advocacy-training lesson for college students that produces valid and reliable scores. Translation to Health Education Practice: The instrument development processes can be replicated by practitioners when creating surveys to administer in their respective populations. (Contains 1 table and 2 figures.)

Background: Video-linking with other countries provides a low-cost vehicle for students to learn more about health issues of other cultures and reflectively discuss the public health promotion and education activities of those countries in real time. Purpose: This article presents a case study of international videoconferencing in the higher education setting. Methods: Undergraduate students enrolled in three different public health courses at East Carolina University (ECU) in Greenville, North Carolina, USA were linked with graduate students enrolled in the public health master's degree program at the Freie Universitat (FU) in Berlin, Germany for two videoconference sessions during the fall semester of 2008. A pre-post knowledge scale was administered to assess the impact of the learning modality with the student participants. Results: Utilizing this technology for fostering intercultural communication proved to be an effective method of instruction for student participants. Discussion: Intercultural communication has become a marketable skill for future public health professionals, and incorporating these communications skills into professional preparation programs provides unique learning experiences for students. Translation to Health Education Practice: Videoconferencing technology provides learners with synchronous experience for interacting with other cultures furthers understanding about global perspectives. Today, globalization introduces challenges and opportunities for health educators. Moreover, increasing communication and fostering dialogue between the future public health leaders improves knowledge levels and ideas for resource utilization. (Contains 2 tables.)

Background: Powdered alcohol, a new form of crystalline alcohol sold under the brand name Palcohol, has yet to be widely distributed in the United States due to political and public concerns surrounding potential for misuse. Purpose: Given the limited research on powdered alcohol, researchers examined YouTube videos on this controversial substance to gain insights into its use. Methods: Researchers thematically evaluated YouTube videos describing knowledge of powdered alcohol use, its effects, as well as the cultural context surrounding its use. Results: Of the videos that met study inclusion criteria (n = 210), 38% were coded as "news report," 20% "opinion," 19% "policy," 11% "user-generated information," 7% "education," 3% "misuse," 2% "development," and 1% "use." One in three videos about powdered alcohol included negative viewpoints about the product (n = 71, 34%). Discussion: The majority of reviewed YouTube videos described negative implications of consuming powdered alcohol (eg, high potential for unintentional over consumption). Translation to Health Education Practice: Findings suggest ways in which health researchers can use popular social media websites, such as YouTube, to address divides between sensationalized public perceptions of chronic health risks and evidence-based research of new alcoholic products.

It is a health education truism that instructional material will be more effective when audience characteristics are taken into account at the outset of program development. One strategy for disseminating relevant health information to individuals is known as "tailored messaging," which accounts for intra-individual information processing needs. This customized approach to health communication is proposed to catch individuals' attention and have a positive effect on cognitive-behavioral responses to health information. Because of the increased attention this communication strategy has received within the recent health education literature, this paper (1) revisits the origins of tailored communication, (2) contrasts tailored versus targeted communication, (3) outlines potential problems and weaknesses of tailoring, (4) discusses challenges associated with implementing and evaluating tailored health interventions, and (5) proposes a path and recommendations for the future of tailored messaging in health education. Future research should consider developing empirical models of tailoring to help clarify pathways for successful application. In addition, health education researchers should come to a consensus regarding whether tailoring represents a cost- effective, feasible alternative to targeted messaging. (Contains 4 tables.)

Although e-health interventions provide new opportunities for health education, there has been cause for concern regarding the purported information technology gap between those who have access to digital applications and those who do not--termed the "digital divide." The literature suggests, however, that this divide may now be illusory, driven primarily by a myriad of societal divides such as income, education, and literacy inequities. Such disparities may be the true propagators of what is now becoming a mythical digital divide. The purpose of this article is to identify the evolutionary nature of the digital divide and speculate as to how and why it has become a mirage in today's increasingly technological world. Based on this discussion, suggestions are made regarding how health educators can enable the use of technology to better health through the study of consumer health informatics and e-health behavioral support. (Contains 2 figures.)

Health education researchers have called for research articles in health education to adhere to the recommendations of American Psychological Association and the American Medical Association regarding the reporting and use of effect sizes and confidence intervals (CIs). This article expands on the recommendations by (a) providing an overview of CIs, (b) evaluating the use and interpretation of CIs in selected journals in health education, (c) presenting how to calculate CIs using statistical software, and (d) suggesting how to interpret and use CIs. Thirty-three articles in the "American Journal of Health Behavior" and "Health Education & Behavior" were evaluated. The evaluation showed that although CIs were reported in approximately half of the evaluated quantitative studies, they were not interpreted in any of the studies. The lack of interpretation of CIs indicates that health educators might not fully understand the meaning of CIs and consequently could not make use of CIs except for presenting the numbers. This article intends to increase health researchers' understanding of CIs, encourage the practice of thinking meta-analytically, and facilitate the use of CIs in the future. (Contains 1 figure and 1 table.)

Regression analyses are frequently employed by health educators who conduct empirical research examining a variety of health behaviors. Within regression, there are a variety of coefficients produced, which are not always easily understood and/or articulated by health education researchers. It is important to not only understand what these coefficients are, but also understand what each represents and how each is interpreted. By correctly interpreting regression coefficients (Pearson r, Pearson r[superscript 2], Multiple R[superscript 2], a, b, [beta], r[subscript s], r[superscript 2][subscript s], partial correlation and semi-partial correlation), the informed health behavior researcher can better understand the dynamics of his/her data. The purpose of this manuscript is to describe and explain some of the coefficients produced in regression analysis. Specifically, the manuscript will describe (a) why and when each regression coefficient is important, (b) how each coefficient can be calculated and explained, and (c) the uniqueness between and among specific coefficients. A data set originally used by Holzinger and Swineford (1939) will be referenced throughout the manuscript to tangibly illustrate how coefficients should be calculated and interpreted in both simple and multiple regression analyses. (Contains 5 figures.)

The purpose of this research was to assess the frequency of nutrition label use among college students and its relationship to nutrition and label knowledge, attitudes, and beliefs regarding diet-disease relationships, and to determine factors predictive of frequent or infrequent label use. This study utilized a cross-sectional design. Volunteer participants included a convenience sample of 1,294 students from a large university in Texas. A 57-item survey instrument was used to assess nutrition label knowledge, attitudes, behaviors, and beliefs about diet-disease relationships. Open-ended items were included to capture reasons for frequent/infrequent label use. Statistical analyses included frequency distributions, Pearson's correlations, independent sample t-tests, and binary logistic regression. Label users had greater knowledge, more favorable attitudes, and more accurate perceptions of diet-disease relationships than nonusers. Females exhibited greater knowledge, more favorable attitudes, and more frequent label use than males. Health reasons, looking for specific information, weight control, and knowledge predicted frequent label use. Desire for certain foods, time constraints, and "don't care" attitudes predicted infrequent use. These predictors of frequent/infrequent use suggest important points of intervention for increasing label use among selected groups of college students. (Contains 5 tables.)

Background: College students actively seek online health information and use Instagram, an image- and video-based social networking website, to build social networks grounded in trust and behavioral norms (social capital), which have the potential to prevent chronic disease. Purpose: This study aimed to (1) examine how intensity of Instagram use moderates the relationship between eHealth Literacy and online social capital in college students and (2) discuss how Instagram can be used as a social awareness platform for chronic disease prevention among college students. Methods: Hierarchical regression analyses were conducted to analyze web-based survey data from a random sample of college students (N = 327). Results: Online bridging social capital was associated with greater ehealth literacy (P < 0.05) and intensity of Instagram use (P < 0.001), when controlling for sociodemographic variables. The relationship between ehealth literacy and online bridging social capital was strongest among respondents with average-intensity (P < 0.01) and high-intensity (P < 0.01) Instagram use compared to low Instagram intensity. Discussion: High intensity of Instagram use may strengthen college students' low ehealth literacy, especially when interacting with heterogeneous connections with weaker ties. Translation to Health Education Practice: Health Education Specialists should continue to explore how college students' intensity of Instagram use can be strengthened to build bridging online social capital and ultimately prevent chronic disease.

With more than 12 million students enrolled in over 1,150 two-year institutions, enrollment at these institutions constitutes approximately 44% of all undergraduates in the United States. Despite this, research and prevention efforts related to drinking behaviors among college students attending two-year institutions are limited, with similar information regarding students at traditional four-year institutions readily available. This study sought to examine alcohol use patterns among students at a two-year college compared to a four-year institution. It was conducted at a large (20,000+ students), public, four-year institution and a medium (8,000+), public, two-year institution located in the same community. The Core Alcohol and Drug Survey, a 39-item instrument used by colleges and universities for assessing the nature, scope, and consequences of high risk drinking behaviors in college students, was administered to students at both a two-year (n = 581) and a four-year institution (n = 928) (Cremeens & Chaney, 2012). The prevalence estimates of current alcohol use among students at the two-year institution in this study are comparable to national estimates for students attending four-year institutions (67.5% and 69.0%, respectively). Estimates of high-risk alcohol use at the four-year institution in this study were higher than national prevalence estimates for similar colleges. Current drinkers and binge drinkers at both institutions experienced the same negative consequences. While the study results provide insight into the need for alcohol prevention efforts at community colleges, there are important factors and practical considerations related to these efforts presented here for community colleges and administrators to contemplate.

Background: Prevention has been identified as a primary strategy for reducing health care costs, with potential Medicare savings up to $142.8 billion annually. Falls alone resulted in $28.2 billion in direct care costs. A growing body of research documents significant benefits of tai chi (TC) for balance and prevention and management of chronic diseases in older adults. Purpose: To identify facilitators and barriers to TC from a theory-driven approach, using the Health Belief Model (HBM) coupled with a fishbone diagram. Methods: Focus groups consisted of active users of a fitness facility at an active living community. Group 1 had never considered adoption of TC (n = 10). The second group were members of the community TC classes (n = 11). The HBM was used to categorize responses. A 10-point scale permitted comparison of group means and standard deviation. Results: Primary barriers included lack of awareness of benefits, need for evidence-based benefits, and limitations related to teaching style. The largest opportunity for promotion of TC related to perceived threats from falls and benefits for balance. Translation to Health Practice: Findings can be used by health educators to develop and test effective cues to action to promote adoption of TC.

Purpose: The purpose of this study was to explore how Pinterest group pinboards are used to communicate health information on chronic obstructive pulmonary disease (COPD). Method A nonprobability census sampling method retrieved 399 pins from the 10 most followed COPD group pinboards. Pins were coded according to COPD information categories, visual communication tools, and sources of self-efficacy. Chi-square analyses explored whether COPD information categories varied by visual communication tools and sources of self-efficacy. Mann-Whitney Wilcoxon tests determined whether or not differences existed in the number of repins/likes of visual communication tools by COPD information categories. Results: Half of the pins included COPD self-management information (n = 214; 45.92%). Photographs of real people included more women than men (P = 0.032), more patients than providers (P = 0.001), and more self-management information than general COPD information (P = 0.021). Infographics were repinned (Mdn = 107.8; P = 0.03) and photographs of real people were liked (Mdn = 76.54; P = 0.04) more than other visual communication tools. Self-management pins incorporated verbal persuasion (P = 0.001) and social modeling (P = 0.001). Discussion: Pinterest may be a useful social networking website to disseminate COPD patient education targeted at women living with or at high risk for COPD. Translation to Health Education Practice: Health educators can refer female users of social media to Pinterest for literacy-sensitive information on COPD.

Background: From 1990 to 2050, the population aged 60 years and older will rise from 9% to 21%. Healthy aging initiatives are vital to promote individual, community, and global well-being during this transformation. Accurate health measurement tools are needed to successfully guide strategies and plot progress. The validated multi-dimensional Salutogenic Wellness Promotion Scale (SWPS) measures health and has demonstrated that increased engagement in measured health-promoting behaviors relates to improved health, higher life satisfaction, and fewer problems. Methods: To extend existing work to the growing older adult population, an older adult version of the SWPS(-OA), a perceived health assessment, satisfaction with life survey (SWLS), and a depression scale (Center for Epidemiological Studies--Depression, CES-D) were pilot tested with 6 groups (N = 218) of older adults. Results: Data produced a Cronbach's alpha of 0.933, significant positive correlations between the SWPS-OA and health (r = 0.955, n = 218, P < 000) and with life satisfaction (r = 0.715, n = 218, P < 000) and a significant negative correlation between SWPS-OA and depression (r = - 0.867, n = 218, P < 000). Discussion: This pilot test suggests that the SWPS-OA holds promise as a psychometrically sound tool to assess, evaluate, and promote older adults' health. Translation to Health Education Practice: Using the SWPS-OA to assess and evaluate lifestyles of older adults can help health professionals develop a plan to improve health and quality of life of older adults which research has shown also helps prevent and avoid problems such as chronic diseases.

Health education and behavior researchers and practitioners often develop, adapt, or adopt surveys/scales to quantify and measure cognitive, behavioral, emotional, and psychosocial characteristics. To ensure the integrity of data collected from these scales, it is vital that psychometric properties (i.e., validity and reliability) be assessed. The purpose of this investigation was to (a) determine the frequency with which published articles appearing in health education and behavior journals report the psychometric properties of the scales/subscales employed and (b) outline the methods used to determine the reliability and validity of the scores produced. The results reported herein are based on a final sample of 967 published articles, spanning seven prominent health education and behavior journals between 2007 and 2010. Of the 967 articles examined, an exceedingly high percentage failed to report any validity (ranging from 40% to 93%) or reliability (ranging from 35% to 80%) statistics in their articles. For health education/behavior practitioners and researchers to maximize the utility and applicability of their findings, they must evaluate the psychometric properties of the instrument employed, a practice that is currently underrepresented in the literature. By not ensuring the instruments employed in a given study were able to produce accurate and consistent scores, researchers cannot be certain they actually measured the behaviors and/or constructs reported.

Health education researchers have continued to explore creative new ways to leverage the Internet and diverse new media applications to increase the efficacy of their interventions. The number of new media and health education studies continues to grow, as does the number of manuscripts related to new media that are submitted to "Health Education & Behavior." In this issue, five articles were selected to be published together as a "theme section" on the topic of New Media for Health Education. These articles explore many of the most popular new media channels available for health education research and practice today, including smartphone apps, mobile-based text messages, web-based tailored messages, and video games. Together, these articles provide a state-of-the-art snapshot of health education and new media in 2013. These articles are: (1) "Apps of Steel: Are Exercise Apps Providing Consumers with Realistic Expectations? A Content Analysis of Exercise Apps for Presence of Behavior Change Theory," Cowan et al. (2013)); (2) "Design, Development, and Formative Evaluation of a Smartphone Application for Recording and Monitoring Physical Activity Levels: The 10,000 Steps 'iStepLog'," Kirwan, Duncan, Vandelanotte, and Mummery (2013); (3) "User Preferences for a Text Message-Based Smoking Cessation Intervention," Bock, Heron, Jennings, Magee, and Morrow (2013); (4) "Can a Website-Delivered Computer-Tailored Physical Activity Intervention be Acceptable, Usable, and Effective for Older People?" Ammann, Vandelanotte, de Vries, and Mummery (2013); and (5) "Using Active Video Games for Physical Activity Promotion: A Systematic Review of the Current State of Research," Peng, Crouse, and Lin (2013). In sum, the first three articles demonstrate the growing emphasis on mobile phone--based health interventions (also known as mHealth) through the use of apps and SMS, whereas the last two articles focus on the significant,but not yet realized promise, of web-based tailored interventions and video games for health promotion. (Contains 1 figure.)

Background: Past research suggests that parent-child communication can serve as protective factors to reduce alcohol misuse among college-aged children. Purpose: This article presents the methodology used and preliminary findings for developing and validating an instrument to assess parent-college student communication regarding alcohol use. During November 2011, a convenience sample of 208 parents of students attending a large, southeastern university was recruited to participate. Methods: A rigorous process of test development was used to develop and test a 47-item instrument. Exploratory factor analysis (EFA) was used to investigate desired variable measurement of the underlying constructs for selected items. Results: EFA findings revealed that items measured 3 factors, including constructs from social cognitive theory, self-efficacy of parents to communicate with child, and outcome expectations. Moreover, the results support reliability of these items to measure self-efficacy and outcome expectations of parents. Discussion: Preliminary results suggest that the survey has evidence for producing valid and reliable scores. Translation to Practice: Further testing and validating this instrument will provide a mechanism for assessing parent--college child communication as a protective factor for high-risk drinking behaviors among college students.

Background: Truancy and alcohol use are quality indicators of academic achievement and success. However, there remains a paucity of substantive research articulating the impact these deviant behaviors have on an adolescent's educational aspirations. The purpose of this study is to assess whether recent alcohol use and truancy impact students' educational aspirations among a nationally representative sample of US high school seniors. Methods: This study conducted a secondary data analysis of the Monitoring the Future project data, 2006. Logistic regression was conducted to assess how alcohol use and truancy affected educational aspirations. Subsequent interaction effects were assessed in the final multivariable model. Demographic variables such as age, sex, race, and father and mother's educational level were included as covariates in the regression model. Results: Results indicate that as students engage in increased alcohol use and/or truancy, educational aspirations decrease. Thus, students who indicated a desire to attend a 4-year college/university were less likely to engage in high-risk drinking behavior and/or truancy. Moreover, in testing the interaction between truancy and alcohol use, as it relates to educational aspirations, the logistic regression model found both of these independent variables to be statistically significant predictors of the likelihood students would attend a 4-year college/university. Conclusions: To ensure that adolescents further their education and maximize their potential life opportunities, school and public health officials should initiate efforts to reduce alcohol consumption and truancy among students. Furthermore, future research should examine the risk and protective factors that may influence one's educational aspirations. (Contains 3 tables.)

The purpose of this study was to develop a culturally sensitive instrument to assess the quality of distance education courses offered at a university in the southern United States through evaluation of student attitudes, opinions, and perceptions of distance education. Quality indicators, identified in a systematic literature review, coupled with an ecological framework served as the theoretical foundation for the instrument development process. The process of test development, outlined in the "Standards for Educational and Psychological Testing" (1999), was used and combined with Dillman's (2000) four stages of pretesting to construct the instrument. Results indicated that the model constructed from the quality indicators and ecological framework provided valid and reliable measures of student attitudes, opinions, and perceptions of quality of the distance education courses. (Contains 6 tables and 3 figures.)

Survey research is important for understanding health and improving practice among health professions. However, survey research can have drawbacks, such as overuse and excessively lengthy questionnaires that burden respondents. These issues lead to poor response rates and incomplete questionnaires. Low and incomplete response rates result in missing data and reduced sample size, damaging the value, usability and generalizability of the information collected. To address issues related to response rates and improve health research, shorter surveys are recommended because they impose less of a burden on respondents and are useful with larger populations. Health-related surveys also often focus on the factors leading to ill health without dedicating equal attention to factors supporting positive health. This study developed and tested a short form (SF) of the validated Salutogenic Wellness Promotion Scale (SWPS), which measures causes of health (rather than causes of disease), using responses from 2052 college students. The participants answered questions about their demographics and completed the SWPS and a perceived health assessment. Statistical tests demonstrated the SWPS-SF had significant relationships with the full SWPS, health status, and Grade Point Average (GPA). Statistical tests were also used to establish cutoff scores that had a high true positive and low false negative rate. These cutoff scores demonstrated a relationship of higher performance and better health. These promising results suggest this short test can provide valid information without burdening the respondents. Authors recommend additional tests be completed to validate the SWPS-SF. [ABSTRACT FROM AUTHOR]