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Background: The Mamanet Cachibol League (MCL), a community-based model developed in Israel, promotes physical activity and amateur team sports among women. Women in the Arab society have traditionally played few sports, especially team sports. Aims: The study aimed to assess the differences in health indicators and well-being, including psychosomatic symptoms, self-reported health, healthy eating habits, and social support, by comparing Arab women MCL participants and nonparticipants and examines benefits and motivations of community-based team sports for participants. Methods: An explanatory sequential mixed-methods approach included a cross-sectional study with intervention and control groups of Israeli Arab women aged 25–59 years. Two-way analyses of covariance and multiple regression models evaluated demographics, well-being, healthy eating, and social support. Quality in-depth interviews with 30 MCL participants further explained the quantitative findings. Results: MCL participants reported higher self-assessed health (P <.001) and decreased psychosomatic symptoms (P <.001) than nonparticipants. Healthier eating and well-being were also linked to MCL participation. The women sense of belonging improved social interactions, personal and professional happiness, and group dedication. MCL attendees felt empowered because the group advocated equality and valued women. Women said their involvement helped their families. Conclusions: Findings on the MCL community-based model suggest that team sports may serve as an effective tool for promoting health and well-being of Arab women and foster positive community relationships. The sense of belonging and personal empowerment derived from being part of a sports team may also contribute to positive mental health outcomes. [ABSTRACT FROM AUTHOR]

The onset of retirement and children leaving the family home may offer a "window of opportunity" for individuals to influence regular moderate- to vigorous-intensity physical activity; therefore, this study examines the feasibility of a moderate- to vigorous-intensity physical activity intervention among recently retired participants (RET) and parents (P) with children who recently left the family home. A total of 46 inactive RET and nine inactive P were randomized to a 10-week web intervention (n = RET = 25/P = 4) or waitlist control (n = RET = 21/P = 5). Intervention techniques followed the multiprocess action control framework. Enrollment (37.5% for P; 40% for RET), retention (89% for P; 83% for RET), and satisfaction were high. One hundred percent of intervention-sectioned participation increased moderate- to vigorous-intensity physical activity compared with 52% of controls; large effect size differences were observed for key multiprocess action control constructs. Participants were highly satisfied with the intervention; however, recruitment challenges of P support moving to a randomized controlled trial for only the RET group. [ABSTRACT FROM AUTHOR]

Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected. Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005–2011) and post-disaster (2013–2019) changes. There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes. Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases. Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues. • We evaluated Hurricane Sandy's impact on adolescent health using difference-in-difference logistic regression models. • No association found between Hurricane Sandy exposure and mental health outcomes (depression, suicidality). • Exposure was linked to changes in substance use, physical (in)activity, and risky sexual behaviors. • Mental health did not moderate the link between disaster exposure and adolescent health. • Youth in areas exposed to the hurricane demonstrated smaller decreases in smoking and larger increases in cannabis use. • Adolescents identifying as Hispanic and Other races were at the highest risk for adverse health outcomes. [ABSTRACT FROM AUTHOR]

This randomized controlled trial investigated the effectiveness of a Healthy Living Awareness Program for the Prevention of Osteoporosis based on the Information-Motivation-Behavioral Skills Model (HLAPPO-IMB) in university students [intervention group (n = 43), control group (n = 44)]. The intervention group completed the online training to prevent osteoporosis in the information stage of the IMB. In the motivation stage, the researchers texted (WhatsApp) the intervention group spot and reminder notifications concerning the prevention of osteoporosis. They also provided them with telephone counseling. In the final stage, the researchers evaluated whether the intervention group participants developed target behavioral skills. The intervention group had significantly higher mean posttest and follow-up Osteoporosis Knowledge Test scores than the control group (respectively, r = .519, r = .513, p < .001), indicating a large effect size in the posttest and follow-up test. There was no significant difference in pretest and follow-up Osteoporosis Health Belief Scale, Osteoporosis Self-Effective Scale, and International Physical Activity Questionnaire-Short Form scores between the groups (p > .05). The results showed that the HLAPPO-IMB helped the intervention group participants expand their knowledge of osteoporosis. However, it did not improve their self-efficacy in doing weight-bearing exercises, taking calcium, and engaging in physical activity. [ABSTRACT FROM AUTHOR]

Background Solitary drinking is a risky drinking pattern associated with increased substance use and psychosocial problems. However, very little is known regarding the associations between drinking alone and broader health status and behaviors. Purpose Accordingly, this study examined the relationship between health metrics and solitary drinking among individuals who currently drink (N = 99, 46.46% female, 88.89% White). Methods U.S. participants between 21 and 40 years old were recruited. Measures included self-reported diet, physical activity, sleep, cannabis use, general and solitary alcohol use, and objective anthropomorphic measures (e.g. body mass index [BMI]) using data from both a baseline appointment and 30 days of daily diary responses. Adjusting for general alcohol use, age, and gender, associations at baseline were assessed through regression analyses, while daily data were analyzed via mixed effects models. Results Several health measures were associated with solitary drinking. Specifically, solitary drinking was related to consuming fewer servings of fruits and vegetables and greater quantities of alcohol based on daily data. Baseline data showed an association between solitary drinking and higher BMIs, poorer sleep quality, greater sugar consumption, and hazardous drinking. Conclusions These findings suggest that beyond substance and psychosocial problems associated with solitary drinking, this drinking behavior may be a warning sign for health risks and, subsequently, broader health problems. [ABSTRACT FROM AUTHOR]

We aimed to generate a model of cancer-related fatigue (CRF) of clinical importance 2 years after diagnosis of breast cancer building on clinical and behavioral factors and integrating pre-treatment markers of systemic inflammation. Women with stage I-III hormone receptor-positive/human epidermal growth factor receptor 2-negative breast cancer were included from the multimodal, prospective CANTO cohort (NCT01993498). The primary outcome was global CRF of clinical importance [European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 ≥40/100] 2 years after diagnosis (year 2). Secondary outcomes included physical, emotional, and cognitive CRF (EORTC QLQ-FA12). All pre-treatment candidate variables were assessed at diagnosis, including inflammatory markers [interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, interferon γ, IL-1 receptor antagonist, tumor necrosis factor-α, and C-reactive protein], and were tested in multivariable logistic regression models implementing multiple imputation and validation by 100-fold bootstrap resampling. Among 1208 patients, 415 (34.4%) reported global CRF of clinical importance at year 2. High pre-treatment levels of IL-6 (quartile 4 versus 1) were associated with global CRF at year 2 [adjusted odds ratio (aOR): 2.06 (95% confidence interval [CI] 1.40-3.03); P = 0.0002; area under the receiver operating characteristic curve = 0.74]. Patients with high pre-treatment IL-6 had unhealthier behaviors, including being frequently either overweight or obese [62.4%; mean body mass index 28.0 (standard deviation 6.3 kg/m2)] and physically inactive (53.5% did not meet World Health Organization recommendations). Clinical and behavioral associations with CRF at year 2 included pre-treatment CRF [aOR versus no pre-treatment CRF: 3.99 (95% CI 2.81-5.66)], younger age [aOR per 1-year decrement: 1.02 (95% CI 1.01-1.03)], current tobacco smoking [aOR versus never: 1.81 (95% CI 1.26-2.58)], and worse insomnia or pain [aOR per 10-unit increment: 1.08 (95% CI 1.04-1.13), and 1.12 (95% CI 1.04-1.21), respectively]. Secondary analyses indicated additional associations of IL-2 [aOR per log-unit increment: 1.32 (95% CI 1.03-1.70)] and IL-10 [0.73 (95% CI 0.57-0.93)] with global CRF and of C-reactive protein [1.42 (95% CI 1.13-1.78)] with cognitive CRF at year 2. Emotional distress was consistently associated with physical, emotional, and cognitive CRF. This study proposes a bio-behavioral framework linking pre-treatment systemic inflammation with CRF of clinical importance 2 years later among a large prospective sample of survivors of breast cancer. • 34.4% of 1208 stage I-III breast cancer survivors had cancer-related fatigue of clinical importance 2 years after diagnosis. • High pre-treatment levels of the pro-inflammatory cytokine IL-6 were associated with global fatigue 2 years later. • Individuals with high levels of IL-6 had higher BMI and were less physically active than those with lower levels. • Higher pre-treatment IL-2 and IL-10 were also associated with higher and lower likelihood of global fatigue, respectively. • Higher C-reactive protein was associated with higher likelihood of cognitive fatigue. [ABSTRACT FROM AUTHOR]

Background: Studies have shown apolipoprotein E (APOE) genotype disclosure to be safe and well-tolerated in cognitively unimpaired (CU) older adults. This study aimed to examine the effect of the disclosure process on decisions about future directives and health behaviors in community-dwelling CU older adults from the Butler Alzheimer's Prevention Registry (BAPR). Methods: CU APOE E4 non-carriers (n = 106) and carriers (n = 80) aged 58-78 completed in-person psychological readiness screening to undergo APOE disclosure. Follow-up assessments were completed online 3 days, 6 weeks, and 6 months post-disclosure. The primary outcomes were future directives, dietary habits, and physical activity scores. Results: Disclosure was associated with decision making on future directives in E4 carriers (t = 3.59, P =.01) at 6 months compared to baseline, but not non-carriers. Family history of memory impairment, SCD endorsement, and education consistently predicted scores on future directives. A significant interaction between E4+ and SCD endorsement on future directive scores was noted (OR = 163.06, 9.5-2,799.8). E4 + carrier status was associated with physical activity (W = 60,148, P =.005) but not dietary habits scores. Conclusions: Our findings indicate that disclosure led to a change in future directives but not protective health behaviors, specifically in E4 carriers. Future work will explore whether pairing disclosure with education about the role of lifestyle factors in AD risk and providing guidelines on making risk-lowering lifestyle modifications as an intervention approach leads to positive change. [ABSTRACT FROM AUTHOR]

This paper describes the work-related information collected in several important U.S. national health and behavior surveys, to highlight data gaps that prevent identifying responses by vulnerable workers in the gig economy, with emphasis on the growing digital platform sector of the work force. The national information systems used to understand health status and health behaviors, including drug use, rely on outdated census categories for self-employed workers. This paper describes the importance of understanding the needs of this growing part of the labor sector and describes how some of the most well-known and utilized national surveys fail to meet this need. For the agencies conducting national health and behavior surveys, we propose revisions to the categories used to classify type of worker and recommend adoption of a new Worker-Employer Relationship Classification model. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethods and MeasuresResultsConclusionAlthough linked with subjective wellbeing, little research has examined relations of values with health behaviors and health. Because values are principles that guide behavior across situations, this exploratory retrospective study examined how individuals’ highest value relates to their health behaviors and health.Participants were 3865 (aged 18–89 years) adults who completed the Health Information National Trends Survey (HINTS), a nationally-representative survey administered by the US National Cancer Institute. HINTS 5 Cycle 4 data were collected early in 2020. Participants selected the value most important to them in their day-to-day life from a set of seven values. Five categories of health-related measures were assessed in relation to values: substance use, physical activity, cancer screening, general health, and coping.Top values were safety of family (29.9%), happiness (20.9%), and autonomy (14.1%). Findings indicated that some top values, such as health and religion, were associated favorably with some health behaviors, while other top values, such as happiness or autonomy, were in some instances associated with poorer health behaviors.These results, while exploratory, suggest that individuals’ highest value may be meaningfully related to their health behaviors and self-reported health status. Future research into values and health appears warranted. [ABSTRACT FROM AUTHOR]

Self-rated health is a common assessment used in epidemiological research and an independent predictor of morbidity and mortality. We investigate if a single measure of self-rated health in late adolescence predict mortality between 46 and 70 years of age. This study was based on 47 286 Swedish men that conscribed 1969–1970 at age 18–20 and that were still alive in 1997. Self-rated health and data on potential explanatory factors (psychological factors, health status markers and health behaviors) were collected at conscription. Adult socioeconomic position in 1990 was derived from registries. Death and cause of death (cancer, cardiovascular disease, violent and alcohol abuse related disorders) were derived from the Causes of Death Register between 1997 and 2019. Conscripts that rated their health as fair or poor/very poor had significantly higher hazard of all-cause mortality than conscript that rated their health as very good (HRfair = 1.27, 95%CI:1.18–1.37 and HRpoor = 1.25, 95%CI:1.11–1.41) and disease-specific mortality. Adjusting for all explanatory factors attenuated the risk estimates by 9–100%. In conclusion, poor self-rated health reported in late adolescence predicts all-cause and disease-specific mortality between the ages of 46 and 70 years. Psychological factors and health behaviors measured at conscription may serve as potential explanatory factors underlying the predictive ability of self-rated health in late adolescence. [ABSTRACT FROM AUTHOR]

Background: The literature shows that social support is an important factor influencing health behaviors. This study aimed to explore the relationships and intrinsic pathways of social support, loneliness, economic income, and health behaviors among older adults during the Corona Virus Disease 2019 (COVID-19) pandemic, and to provide a theoretical basis for the implementation of health behaviors interventions for older adults. Methods: A cluster-random-sampling survey was adopted within two towns in Dongguan, China. Demographic characteristics, social support, loneliness, economic income and health behaviors were measured. The Social Support Appraisals scale (SS-A), the ULS-8 Loneliness Scale, and the Self-rated abilities for health practice scale (SRAHPS) were used to measure social support, loneliness, and health behaviors in older adults, respectively. A moderated mediation model was built to examine the relationships among social support, loneliness, economic income, and health behaviors using the SPSS PROCESS 4.0 macro. We conducted bootstrapping of regression estimates with 5000 samples and a 95% confidence interval. Results: 621 older adults completed the questionnaire. Most of the participants were female, accounting for 75.0%, and the average age was 81.11 years (SD = 8.11). The median (interquartile range) of the participants' average monthly economic income was 800 (500–1000)RMB. The results of the mediation analysis showed that loneliness partly mediated the relationship between social support and health behaviors (B = 0.024, 95%CI: 0.007, 0.042), with the mediating effect accounting for 4.56% of the total effect. The moderation mediation analysis revealed a positive moderating role of economic income in the relationship between social support and loneliness (B = 0.114, 95%CI: 0.054, 0.174). Specifically, the relationship between social support and loneliness was found to be weaker for older adults with a high economic income compared to those with a lower economic income. Conclusion: The provision of enhanced social support and the alleviation of loneliness among older adults during an epidemic can facilitate the development of healthy behaviours, particularly among those who are economically disadvantaged. [ABSTRACT FROM AUTHOR]

Background: Colombia, which hosts over 3 million of the Venezuelan diaspora, is lauded for its progressive approach to social integration, including providing migrants access to its universal health coverage system. However, barriers to healthcare persist for both migrant and host populations, with poorly understood disparities in healthcare-seeking behaviors and associated costs. This is the first study to link healthcare-seeking behaviors with costs for Venezuelan migrants in Colombia, encompassing costs of missing work or usual activities due to healthcare events. Methods: We use self-reported survey data from Venezuelan migrants and Colombians living in Colombia (September-November 2020) to compare healthcare-seeking behaviors and cost variables by nationality using two-sampled t-tests or Chi-square tests (X2). The International Classification of Diseases was used to compare reported household illnesses for both populations. Average health service direct costs were estimated using the Colombian Government's Suficiencia database and self-reported out-of-pocket (OOP) payments for laboratory and pharmacy services. Indirect costs were calculated by multiplying self-reported days of missed work or usual activities with estimated income levels, derived by matching characteristics using the Gran Enquesta Integrada de Hogares database. We calculate economic burdens for both populations, combining self-reported healthcare-seeking behaviors and estimated healthcare service unit costs across six healthcare-seeking behavior categories. Results: Despite similar disease profiles, Venezuelan migrants are 21.3% more likely to forego formal care than Colombians, with 746.3% more Venezuelans reporting lack of health insurance as their primary reason. Venezuelan women and uninsured report the greatest difficulties in accessing health services, with accessing medications becoming more difficult for Venezuelan women during the COVID-19 pandemic. Colombians cost the health system more per treated illness event (US$40) than Venezuelans (US$26) in our sample, over a thirty-day period. Venezuelans incur higher costs for emergency department visits (123.5% more) and laboratory/ pharmacy OOP payments (24.7% more). Conclusions: While Colombians and Venezuelans share similar disease burdens, significant differences exist in access, cost, and health-seeking behaviors. Increasing Venezuelan health insurance enrollment and tackling accessibility barriers are crucial for ensuring healthcare equity and effectively integrating the migrant population. Findings suggest that improving migrant access to primary healthcare would produce savings in Colombian healthcare expenditures. [ABSTRACT FROM AUTHOR]

Sexual minoritized (SM) adults experience health disparities and report higher rates of trauma history compared to heterosexual adults. This scoping review synthesizes the extant literature that investigates associations between trauma and physical health among SM adults. It also describes research instruments utilized to assess trauma in relation to health outcomes among SM adults. We searched CINAHL, LGBT+ Life, PsycINFO, and PubMed to identify studies meeting inclusion criteria: peer-reviewed, English, assessed trauma as an independent variable, and assessed health behaviors or outcomes among SM adults. From 587 nonduplicate articles, 69 full texts were reviewed; 18 met criteria and were included in this review. To enhance rigor, we utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Scoping Reviews checklist. Most (n = 12) of the included studies were cross-sectional. Trauma was assessed 16 different ways, including 9 validated measures, in relation to 5 health behaviors and 17 health conditions. Trauma was operationalized by history of childhood sexual abuse, adverse childhood experiences, lifetime rape, current symptoms of post-traumatic stress disorder, and lifetime victimization among SM adults. All but one study found associations between trauma and one or more unfavorable health behaviors or outcomes. Studies used widely heterogeneous instruments to assess trauma, health, and SM identity. Greater specification and standardization of measurement is needed, along with contextualized assessments of trauma and its impact on health such as sexual minority stress-related victimization and resilience, and post-traumatic growth and recovery processes. [ABSTRACT FROM AUTHOR]

Anomalous aortic origin of a coronary artery (AAOCA) is associated with sudden death in the young. Risk stratification and management decision-making remain challenging. Data addressing post-diagnosis perceptions of exercise behavior and safety are lacking. We aimed to determine how AAOCA affects exercise behaviors, safety perceptions, and emotional well-being of patients/parents. Qualitative and quantitative analysis of AAOCA patient-/parent-specific survey was conducted to examine exercise frequency/restrictions, perceived safety of competitive/recreational exercise, and psychosocial well-being. Subgroups stratified by AAOCA subtype, surgical intervention, and physician-driven restrictions were compared using chi-squared and Fisher's exact tests. Cohen's kappa determined agreement in parent/child responses. AAOCA subtypes included 13 (24%) left AAOCA, 36 (67%) right AAOCA, and 5 (9%) other/unknown. Of 54 parents and 41 paired child responses, 22% of patients were physician-restricted from exercise. Parents imposed restrictions on competitive/recreational exercise 34%/26% of the time, respectively. Children without physician restrictions still self-restricted exercise 35% of the time. Parents reported feeling their child was unsafe exercising 61% competitively and 33% recreationally. Twenty-two percent of children reported feeling unsafe exercising, with good agreement to parental perceptions of competitive exercise safety (kappa = 0.779, p < 0.001). One-third of parents and children reported feeling sad, angry, or lonely, and about half reported feeling different. Importantly, 47% of children desired to exercise more. No difference was seen across restriction status, AAOCA subtype, or surgical management strategy. Conclusion: There are different perceptions of exercise behavior and safety following AAOCA evaluation, regardless of risk category or management strategy, impacting their well-being. These unmet needs should be at the forefront of care. What Is Known: • AAOCA is one of the leading causes of sudden cardiac death in the young. • Exercise restriction varies according to AAOCA subtype and its perceived risk of inducing myocardial ischemia. What Is New: • There are different perceptions of exercise behavior and safety in patients and parents following a diagnosis of AAOCA, impacting their well-being. • Risk category or management strategy has no effect in patients' and parents' perception of exercise safety. • These unmet needs in this population should be at the forefront of care. [ABSTRACT FROM AUTHOR]

Objective: Health literacy is important while attending a residential college where daily decisions can impact one's physical and mental health and knowing who or what to trust for information is of the utmost importance in claiming more decision-making autonomy. Participants: A total of 189 students at a University in the Northeastern United States participated in this study. Methods: A cross-sectional survey assessment of shared beliefs around health behaviors was conducted. Results: Areas of high consensus center around knowledge of positive health behaviors. Consensus lessens as participants are faced with statements that require more independent thinking, more information, and more subjectivity. Gender differences are also prevalent. Conclusions: Exercising agency is needed when making a commitment to one health choice vs. another. Agency in emerging adulthood has been found to be positively correlated with commitment and deliberate decision-making both of which are needed as college students face independent health choices. [ABSTRACT FROM AUTHOR]

How does financial education lead to improved financial behavior and higher financial well-being? An influential Consumer Financial Protection Bureau model introduced in 2015 proposes that the goal of financial education is to improve financial well-being and that financial education does so by increasing financial knowledge, which improves financial behavior, which improves financial well-being. In this study, the authors test links in the Consumer Financial Protection Bureau model, examining the differential roles of objective and subjective knowledge. They also test whether an analogous model might capture effects of physical health education on physical health knowledge, behavior, and well-being. They report a quasi-experiment comparing changes in financial and physical health knowledge, behavior, and well-being at two time points in a semester for students enrolled in a personal finance class, a personal health class, or neither. This study reports the first causal estimates of flow from financial education to financial knowledge to financial behaviors to a validated measure of subjective financial well-being. Financial education caused large changes in both objective and subjective knowledge. Yet only subjective knowledge mediated the large effects of financial education on changes in downstream behaviors. The authors find weaker but similar results for physical health. The findings suggest that financial education efforts should be refocused to foster subjective knowledge and improved behavior. [ABSTRACT FROM AUTHOR]

Older adults in assisted living facilities (ALF) are at risk for low physical activity (PA) and high sedentary behavior (SB), both of which place them at risk for negative health outcomes. The purpose of this scoping review was to synthesize evidence describing the volume of device-measured PA/SB, factors associated with PA/SB, and interventions designed to change PA/SB in older adults living in ALF. Twenty articles representing 15 unique studies were identified from eight electronic databases and grey literature. Residents in ALF spent 96–201 min/day in light PA (n = 2 studies), 1–9.74 min/day in moderate to vigorous PA (n = 2 studies), and 8.5–11.01 hr/day of SB during waking hours (n = 3 studies). Factors associated with PA included 16 personal factors (n = 6 articles), one social factor (n = 2 articles), and two environmental factors (n = 2 articles). Factors associated with SB included 14 personal factors (n = 4 articles) and one social factor (n = 1 article). No intervention successfully changed PA/SB. [ABSTRACT FROM AUTHOR]

This article reviews economic studies based on data from high income countries published from 2007 to early 2024 to address three questions: (1) How accurate are subjective beliefs, mainly measured by subjective probabilities, compared to their objective counterparts? Objective evidence comes from another source (e.g., life table, empirical study, expert opinion), or subsequent realizations of beliefs elicited at baseline. (2) How are subjective beliefs determined? (3) Do subjective beliefs affect health behaviors? Several domains are included: survival, and health behaviors—smoking, alcohol consumption and impaired driving, preventive care, diet, and COVID-19 precautions. Results on a single domain, (e.g., survival), do not generalize to, e.g., COVID-19 results. Subjective probabilities embody private information (e.g., self-assessed health, parent longevity). However, individuals seem insufficiently informed about population-level probabilities. There is no systematic overestimation or underestimation of objective probabilities. Several determinants of beliefs are identified (demographic characteristics, education, cognition, current self-assessed health, health histories), but evidence on underlying mechanisms is lacking, how determinants, (e.g., education), affect beliefs. Subjective beliefs, even with substantial noise, often affect health behaviors. Given prior evidence that beliefs are influenced by health shocks, this article reviews research on effects of health shocks on health behaviors. A major health shock to an individual—a new diagnosis (e.g., diabetes) or a serious adverse health event (e.g., heart attack), by changing subjective probabilities leads to some healthier behaviors, however, sometimes only temporarily. Behaviors may also be influenced by utility loss following a health shock, e.g., learning about pecuniary and non-pecuniary costs of hospitalization. [ABSTRACT FROM AUTHOR]

Background: While conspiracy theories cover many different themes, medical conspiracy theories (MCTs) have become particularly prevalent in modern societies. As beliefs in MCTs can become a source of "infodemics", influence individual health behaviors and cause distrust in medical institutions and personnel, healthcare workers must find ways to overturn patients' conspiracy thinking. However, as the medical world is not free of these beliefs, in this study, we investigated beliefs in MCTs among medical and health science students and their association with reported health behaviors. Methods: Our sample was derived from a self-administered, anonymized, computer-assisted web survey conducted among 1,175 medical and health science students enrolled at the Poznan University of Medical Sciences, Poland. Results: From a set of twenty different MCTs, one-third of students rejected all of them, 18% believed in one, 15% in two, 10% in three, and 24% supported four or more conspiracy theories. In addition, many students were hesitant or unsure about MCTs. We also found that nursing and midwifery students were the most likely to believe in MCTs, while medical and dental students were the least supportive. Support for MCTs was higher among students in the early years of their studies and who declared themselves religious and conservative. This study also highlights the association between students' support for MCTs and their reported health behaviors, including avoiding vaccinations, using alternative medicine, taking vitamin C, or using social media as an essential source of health information. Conclusions: As medical and health science students are prone to conspiratorial thinking, they should be trained to act as a trusted and reliable source of medical information, to mitigate conspiratorial beliefs, and to act as role models for their patients and society, effectively shaping health behaviors in the population. [ABSTRACT FROM AUTHOR]

Simple Summary: Patient activation is a very important psychological construct to examine in individuals who have chronic conditions, because it assesses the one's confidence in managing their own health and care. For childhood cancer survivors, continued follow-up is imperative to monitor late effects conditions; yet many do not adhere to surveillance guidelines. Therefore, investigating this construct could highlight risk factors in the population that contribute to low activation. Furthermore, examining the long-term impact of patient activation on psychological health as well as its contribution to health behavior could provide a reasonable target for interventions to enhance health outcomes in survivors. Background: Patient activation describes a willingness to take action to manage health and is associated with health outcomes. The purpose of this study was to characterize patient activation and its association with psychological outcomes and health behaviors in childhood cancer survivors. Methods: Participants were from the St. Jude Lifetime Cohort Study (SJLIFE). Activation levels (1–4, 4 = highest activation) were measured with the Patient Activation Measure (PAM). Psychological outcomes and health behaviors were obtained via self-report. Cognitive function was assessed by trained examiners. ANOVA or chi-squared tests were utilized to assess group-level differences in activation. Multivariable regression models were used to assess associations between PAM scores and outcomes of interest. Results: Among 2708 survivors and 303 controls, more survivors endorsed lower activation levels than the controls (11.3 vs. 4.7% in level 1) and fewer survivors endorsed the highest level of activation than the controls (45.3 vs. 61.5% in level 4). Not endorsing depression (OR: 2.37, 95% CI 1.87–2.99), anxiety (OR: 2.21, 95% CI 1.73–2.83), and somatization symptoms (OR: 1.99, 95% CI 1.59–2.50), general fear (OR: 1.45, 95% CI 1.23–1.71) and body-focused (OR: 2.21, 95% CI 1.83–2.66), cancer-related worry, and physical (OR: 2.57, 95% CI 2.06–3.20) and mental (OR: 2.08, 95% CI 1.72–2.52) HRQOL was associated with higher levels of activation. Lower activation was associated with not meeting physical activity guidelines (OR: 2.07, 95% CI 1.53–2.80). Conclusions: Survivors endorsed lower activation levels than peers. Interventions to improve physical and psychological health outcomes could leverage these results to identify survivors who benefit from support in patient activation. [ABSTRACT FROM AUTHOR]

Climate change presents a substantial global threat to human health and wellbeing. Planetary health, an emerging field, provides a comprehensive framework to comprehend the intricate interplay between ecological stability, human health, and ecosystems, particularly within the context of climate change. This study investigates the planetary health perspective on climate change by exploring global knowledge. The Scopus database is used as the source of data. The analysis encompassed a performance evaluation aimed at scrutinizing both quantitative and qualitative indicators. Visualization techniques utilizing VOSviewer software were deployed to analyze collaboration patterns, co-citation links among prominent knowledge-sharing platforms, and key topics derived from keyword co-occurrence matrices. Additionally, using SciMAT software, the study conducted thematic evolution and intellectual analyses to identify both driving and emerging themes, while also examining coherence among different themes across various periods. The study also explores policy implications, and the relevance of COVID-19 in the context of planetary health and climate change. Through this analysis, 261 relevant publications are identified, with the United States being the leading contributor (90 documents; 34.5% of publications). At the institutional level, the Australian National University secured the top position, representing 4.6% of the total with 12 documents. The Lancet Planetary Health journal was the most prolific source, contributing 15 documents (5.7%). In terms of impact, The Lancet journal held a central position as the most cited source. The primary funding organization was the Wellcome Trust, based in the United Kingdom. Motor themes shaping the future of this field include vector-borne diseases, human demographics, informal settlements, air pollution, carbon footprint of animal-based foods, and pro-environmental attitudes and behaviors. The study underscores the significance of leveraging the momentum surrounding infectious diseases like COVID-19 and the impacts of climate change to advance planetary health concepts. Integration of the social sciences and enhanced multidisciplinary cooperation are crucial for progress. Additionally, increased funding for developing countries, and legislative empowerment are essential to foster further research. Article Highlights: Planetary health and climate change global knowledge is analyzed using performance analysis and visualization mapping. Stimulating collaboration to advance the principles of planetary health is fundamental for effectively combating climate change. Managing the socioeconomic determinants of equity and health deserves to be the top priority of climate change initiatives. [ABSTRACT FROM AUTHOR]

AbstractThe objectives of this prospective study were to explore the health-related lifestyle of police cadets and assess changes in their health behaviors following entry into the police force. To do so, 190 police cadets completed an online questionnaire assessing their physical activity level, sedentary behaviors, diet quality, sleep hygiene, alcohol consumption, cigarette smoking, and stress level. One year following their graduation from the police training program, participants were invited to, once again, complete the questionnaire. Our results suggest that police cadets generally display healthy lifestyles, with very few cadets being physically inactive, smokers, reporting insufficient sleep duration, and displaying obesity. Nevertheless, paired-sample comparisons highlighted significant decreases in physical activity, fruit and vegetable intake, sleep duration, and sleep quality at the follow-up. Likewise, significant increases in fast-food consumption and BMI were observed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has contributed to the increase in mortality and morbidity rates globally, but it has also led to a generalized worsening of mental health and risk behaviors in different population groups regardless of the measures adopted by different governments. In this paper, using data from a Spanish survey of emotional well-being, we aim to explore through mixed graphical models the complex structure of relationships between the mental health of populations, their lifestyles, and forms of cultural and leisure consumption during the pandemic. The results bring to light some interesting findings, such as the association between teleworking and greater rest or greater stress with the use of social media, a variable that enables the connection with other mental health problems of greater severity. Increased physical activity and the consumption of streaming content at home, as well as increased care for family, friends, and neighbors, are some of the variables that show relevant associations. These findings highlight the usefulness and versatility of this network approach for the study of health behaviors and health outcomes, which offer the researcher a holistic and organic view of the relational structure of complex data characterized by high dimensionality and variables with different levels of measurement. [ABSTRACT FROM AUTHOR]

Nighttime blood pressure (BP) and BP dipping (daytime–nighttime BP) are prognostic for cardiovascular disease. When compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping. Neighborhood deprivation may contribute to disparities in cardiovascular health, but its effects on resting and ambulatory BP patterns in young adults are unclear. Therefore, we examined associations between neighborhood deprivation with resting and nighttime BP and BP dipping in young Black and White adults. We recruited 19 Black and 28 White participants (23 males/24 females, 21 ± 1 yr, body mass index: 26 ± 4 kg/m2) for 24-h ambulatory BP monitoring. We assessed resting BP, nighttime BP, and BP dipping (absolute dip and nighttime:daytime BP ratio). We used the area deprivation index (ADI) to assess average neighborhood deprivation during early and mid-childhood and adolescence. When compared with White participants, Black participants exhibited higher resting systolic and diastolic BP (Ps ≤ 0.029), nighttime systolic BP (114 ± 9 vs. 108 ± 9 mmHg, P = 0.049), diastolic BP (63 ± 8 vs. 57 ± 7 mmHg, P = 0.010), and attenuated absolute systolic BP dipping (12 ± 5 vs. 9 ± 7 mmHg, P = 0.050). Black participants experienced greater average ADI scores compared with White participants [110 (10) vs. 97 (22), P = 0.002], and select ADI scores correlated with resting BP and some ambulatory BP measures. Within each race, select ADI scores correlated with some BP measures for Black participants, but there were no ADI and BP correlations for White participants. In conclusion, our findings suggest that neighborhood deprivation may contribute to higher resting BP and impaired ambulatory BP patterns in young adults warranting further investigation in larger cohorts. NEW & NOTEWORTHY: We demonstrate that young Black adults exhibit higher resting blood pressure, nighttime blood pressure, and attenuated systolic blood pressure dipping compared with young White adults. Black adults were exposed to greater neighborhood deprivation, which demonstrated some associations with resting and ambulatory blood pressure. Our findings add to a growing body of literature indicating that neighborhood deprivation may contribute to increased blood pressure. [ABSTRACT FROM AUTHOR]

Background: Despite the expansion in human papillomavirus (HPV) vaccination recommendations, vaccine uptake and completion remain low among Black individuals. An 8‐week Facebook intervention (#HPVvaxtalks) was developed to increase knowledge and awareness of HPV risk factors, risk perceptions, and vaccination intention and uptake. This article details the formative phase of experts' feedback and participants' satisfaction on the components of the #HPVvaxtalks for content useability, acceptability, relevance, and visual appeal to inform further refinements. Method: A convenience sample of 5 experts and 13 young Black adults were invited to provide feedback on #HPVvaxtalks intervention content. The experts reviewed and provided feedback via a survey and open‐ended questions. After incorporating suggestions from experts' feedback, 13 participants viewed #HPVvaxtalks posts, took part in a virtual focus group, and completed a survey. Qualitative data were thematically analyzed and integrated with survey results. Results: Experts and participants mean age were 41.9 ± 2.3 and 21.2 ± 1.9 years, respectively. Experts and participants reported positive ratings for intervention posts, including useability, acceptability, relevance, and visual appeal. Data provided areas for improvements of #HPVvaxtalks. Conclusion: Experts indicated strong content validity and participants showed satisfaction with #HPVvaxtalks content. Ensuring acceptability, relevance, and appeal of the intervention for the target population is an integral part of intervention development. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression is among the most common complications associated with child‐bearing having a period prevalence rate of 17%. Despite the prevalence of postpartum depression, recognition and treatment remains low. Methods: This paper examines the predictors of help‐seeking behavior among a sample (N = 326) of postpartum women. A cross‐sectional survey was deployed, and participants were recruited via social media through snowball and convenient sampling techniques. Results: Binary logistic regression was used to analyze the data. Results indicate the severity of depression and favorable attitudes toward help‐seeking were predictors of help‐seeking behavior among postpartum women in this sample. Discussion/conclusion: This study has implications for healthcare workers, including the allied health professions. Access to treatment is, in part, influenced by a woman's ability to ask for help from health professionals. Social workers and nurses have an opportunity to educate and discuss postpartum mental health and improve treatment seeking. [ABSTRACT FROM AUTHOR]

Generativity is a main adulthood developmental task, centred on the concern to contribute for the wellbeing of younger generations, and has been associated with improved health and wellbeing. Generativity, nevertheless, has not been explored in persons with rare late-onset neurological diseases, such as transthyretin-related familial amyloid polyneuropathy (TTR-FAP). This study aims at examining generativity in older individuals with TTR-FAP and consider its association with satisfaction with life and self-rated health. The method is descriptive-comparative, using a sample of persons without family history of a hereditary disease. A total of 69 adults were recruited: 31 with TTR-FAP (through the national patient's association); 38 non-TTR-FAP (through researchers' social networks). Participants completed self-administered questionnaires, assessing quantitative measures of generativity (Loyola Generative Scale, LGS, Portuguese version), satisfaction with life (Satisfaction with Life Scale, SWLS, Portuguese version), self-rated health (single item of self-perceived health), and social and demographic data. Main findings indicated that (i) no significant differences were found on generativity, satisfaction with life and self-rated health between older persons with and without TTR-FAP; (ii) generativity was positively correlated with satisfaction with life and satisfaction with life was positively correlated with self-rated health in older TTR-FAP adults, but not in the non-TTR-FAP group; (iii) from linear regression models, satisfaction with life was predicted by "hereditary disease (TTR-PAF)", "formal education (University degree)", "professional Status (retired)", and "age"; self-rated health was only predicted by related to "professional Status (retired)". Results contribute to building a body of work on the development and aging psychosocial experiences in individuals from families with severe hereditary diseases. Also, they are relevant for the provision of care to people living with hereditary conditions and their families. Generative members will be better positioned and may be involved in promoting healthier behaviors in their family members. [ABSTRACT FROM AUTHOR]

This study examined the relationship between individual, household, and community-level factors with obesity-related health behaviors. Households (n = 6110) were enumerated, and participants (>18 years) reported their screen time and how many sugar-sweetened beverages they consumed per day. Individuals from food insecure and higher SES households were more likely to report higher sugar-sweetened beverage consumption. Screen time was negatively associated with age (p <.01), and being female was associated with 35 minutes more screen time per day (p <.01). Community and household factors were independent drivers of behavior that need to be incorporated into individual level interventions, or considered in analyses. [ABSTRACT FROM AUTHOR]

Objective Household chaos, defined as a lack of organization, structure, and predictability, has been linked to deleterious childhood health outcomes and may hinder attempts to initiate and maintain healthy lifestyle changes. This study examined the associations of household chaos and obesity-related health conditions in a sample of youth being treated for obesity. Methods Participants were 715 patients (61.8% girls; M age = 12.3 years; 68.7% non-Hispanic Black; M % of 95th BMI %-ile = 146.9%) enrolled in a pediatric weight management clinic. Caregiver report of household chaos was measured using the Confusion, Hubbub and Order Scale (CHAOS). Physiological obesity-related comorbidities (e.g. insulin resistance, hypertension, dyslipidemia) were assessed by a medical clinician and abstracted from electronic medical records; health conditions were dichotomized as present or not present. Psychological functioning was measured with the Pediatric Symptom Checklist, a caregiver-completed mental health screen that assesses internalizing, externalizing, and attention concerns. Results The Wilcoxon rank-sum test was used to test differences in household chaos scores for each obesity-related health condition. Caregivers of youth diagnosed with hypertension and obstructive sleep apnea reported significantly lower levels of household chaos, while caregivers who reported clinical levels of psychological dysfunction reported higher levels of chaos. Conclusions Traditional management of childhood obesity requires changes across multiple health domains (e.g. dietary, exercise, sleep), and such change may be facilitated by structure and consistency. Present findings suggest that psychological resources within pediatric weight management settings should address individual patient-level factors associated with physiological and mental health as well as household functioning. [ABSTRACT FROM AUTHOR]

Are teenage and adult smoking causally related? Recent anti‐tobacco policy is predicated on the assumption that preventing teenagers from smoking will ensure that fewer adults smoke, but direct evidence in support of this assumption is scant. Using data from three nationally representative sources and instrumenting for teenage smoking with cigarette taxes experienced at ages 14–17, we document a strong positive relationship between teenage and adult smoking: deterring 10 teenagers from smoking through raising cigarette taxes roughly translates into 5 fewer adult smokers. We conclude that efforts to reduce teenage smoking can have long‐lasting consequences on smoking participation and, presumably, health. [ABSTRACT FROM AUTHOR]

Abstract Introduction Childhood cancer survivors experience many health problems that they must protect themselves from their destructive physical and psychological effects. Understanding experiences of children about self-protective care will help health care providers manage long-term care plans. Therefore, this study was conducted with the aim of exploring self-protection care in childhood cancer survivors. Methods This is a phenomenological study that was conducted in the clinics and cancer care centers of Urmia and Khoy in Iran. 27 participants were selected by purposive sampling until data saturation. The data was collected using a semi-structured and in-depth face to face interview. Content analysis approach used for data analysis and MAXQUDA 10 software used for data management. Results Data analysis led to the emergence of “self-protection health care” as a main category, two categories “maintaining physical health” and “keeping a strong mindset” and 9 sub-categories including “abstain activities that may cause harm”, “refusing contact with others for possible infection”, “monitoring symptoms and side-effects of cancer coming back”, “avoiding unhealthy diet”, “knowing about cancer from similar others”, “keep away negative thoughts and emotions”, “drawing on spiritual resources”, “creating a bridge to life again” and “being healthy for the sake of one’s family”. Conclusion According to the results of this study, self-protection is one of the most important cares for childhood cancer survivors. Over time, the influence of the clinical team and parents on children’s health care diminishes. Therefore, they should promote their health and well-being behaviors and use a variety of protective approaches to self-care.

Abstract Background Hypertension is a common condition during adolescence with increasing prevalence globally, alongside the epidemic of unhealthy lifestyles and obesity. Health behaviors have been shown to be associated with hypertension risk in adults. Life’s essential 8 (LE8), as a comprehensive indicator to evaluate cardiovascular health (CVH), includes 4 health factors and 4 health behaviors. This study aims to evaluate the association between health behaviors defined in LE8 and hypertension among adolescents. Methods Data of this study were extracted from the National Health and Nutrition Examination Surveys (NHANES) 2007–2018. Health behaviors of LE8 including diet, physical activity and tobacco smoke exposure. The outcome was the odd of hypertension in adolescents. The weighted univariate and multivariate logistic regression was unitized to explore the relationship between CVH score and hypertension in adolescents. Subgroup analysis and sensitivity analysis were further conducted to explore the association across different populations. Results Totally 3,941 adolescents aged 12–17 years were included, with the mean aged of 14.48 ± 0.04 years. Of whom, 203 (5.15%) had hypertension. After adjusted all covariates, high CVH score was associated with the lower odds of hypertension (OR = 0.32, 95%CI: 0.17–0.61), especially in boys (OR = 0.23, 95%CI: 0.11–0.51) and adolescents with overweight/obesity (OR = 0.24, 95%CI: 0.10–0.56). Sensitivity analysis reported that the association between CVH score and the odds of hypertension was also robust after excluding self-reported hypertension and medication taking (OR = 0.37, 95%CI: 0.18–0.74). Conclusion A high CVH score, indicating a greater adherence of health behaviors, was associated with a reduced odds of hypertension, especially among boys and overweight/obesity adolescents. Large-scale prospective cohort studies are needed to further explore the association between health behaviors defined in LE8 and hypertension among adolescents.

Abstract Self-rated health is a common assessment used in epidemiological research and an independent predictor of morbidity and mortality. We investigate if a single measure of self-rated health in late adolescence predict mortality between 46 and 70 years of age. This study was based on 47 286 Swedish men that conscribed 1969–1970 at age 18–20 and that were still alive in 1997. Self-rated health and data on potential explanatory factors (psychological factors, health status markers and health behaviors) were collected at conscription. Adult socioeconomic position in 1990 was derived from registries. Death and cause of death (cancer, cardiovascular disease, violent and alcohol abuse related disorders) were derived from the Causes of Death Register between 1997 and 2019. Conscripts that rated their health as fair or poor/very poor had significantly higher hazard of all-cause mortality than conscript that rated their health as very good (HRfair = 1.27, 95%CI:1.18–1.37 and HRpoor = 1.25, 95%CI:1.11–1.41) and disease-specific mortality. Adjusting for all explanatory factors attenuated the risk estimates by 9–100%. In conclusion, poor self-rated health reported in late adolescence predicts all-cause and disease-specific mortality between the ages of 46 and 70 years. Psychological factors and health behaviors measured at conscription may serve as potential explanatory factors underlying the predictive ability of self-rated health in late adolescence.

Abstract Background Colombia, which hosts over 3 million of the Venezuelan diaspora, is lauded for its progressive approach to social integration, including providing migrants access to its universal health coverage system. However, barriers to healthcare persist for both migrant and host populations, with poorly understood disparities in healthcare-seeking behaviors and associated costs. This is the first study to link healthcare-seeking behaviors with costs for Venezuelan migrants in Colombia, encompassing costs of missing work or usual activities due to healthcare events. Methods We use self-reported survey data from Venezuelan migrants and Colombians living in Colombia (September-November 2020) to compare healthcare-seeking behaviors and cost variables by nationality using two-sampled t-tests or Chi-square tests (X 2 ). The International Classification of Diseases was used to compare reported household illnesses for both populations. Average health service direct costs were estimated using the Colombian Government’s Suficiencia database and self-reported out-of-pocket (OOP) payments for laboratory and pharmacy services. Indirect costs were calculated by multiplying self-reported days of missed work or usual activities with estimated income levels, derived by matching characteristics using the Gran Enquesta Integrada de Hogares database. We calculate economic burdens for both populations, combining self-reported healthcare-seeking behaviors and estimated healthcare service unit costs across six healthcare-seeking behavior categories. Results Despite similar disease profiles, Venezuelan migrants are 21.3% more likely to forego formal care than Colombians, with 746.3% more Venezuelans reporting lack of health insurance as their primary reason. Venezuelan women and uninsured report the greatest difficulties in accessing health services, with accessing medications becoming more difficult for Venezuelan women during the COVID-19 pandemic. Colombians cost the health system more per treated illness event (US$40) than Venezuelans (US$26) in our sample, over a thirty-day period. Venezuelans incur higher costs for emergency department visits (123.5% more) and laboratory/ pharmacy OOP payments (24.7% more). Conclusions While Colombians and Venezuelans share similar disease burdens, significant differences exist in access, cost, and health-seeking behaviors. Increasing Venezuelan health insurance enrollment and tackling accessibility barriers are crucial for ensuring healthcare equity and effectively integrating the migrant population. Findings suggest that improving migrant access to primary healthcare would produce savings in Colombian healthcare expenditures.

Abstract Childhood disadvantage is associated with increased adult psychological distress, but the role of behavioral risk factors in the pathway remains unclear. We examined whether behavioral risk factors mediate the effects of childhood disadvantage on adult psychological distress. We used the Helsinki Health Study data of employees of the City of Helsinki, Finland, aged 19–39 (mean age 32.0) years at baseline (2017). We included women (n = 2397) and men (n = 586) who responded to both baseline and follow-up (2022) surveys. At baseline, eight types of childhood disadvantage were asked retrospectively, and six adult behavioral risk factors were included. Psychological distress was measured by the DASS-21 at follow-up. We conducted mediation analyses using generalized structural equation modeling. Among women, we found indirect path effects of childhood disadvantage on adult psychological distress through behavioral risk factors (symptoms of depression: β = 0.68, 95% CI 0.20–1.17; anxiety: β = 0.54, 95% CI 0.13–0.95; and stress: β = 0.69, 95% CI 0.20–1.09). Among men, childhood disadvantage contributed only directly to adult depressive (β = 0.71, 95% CI 0.16–1.26) and stress (β = 0.61, 95% CI 0.10–1.13) symptoms. Our findings suggest that behavioral risk factors can mediate some of the adverse effects of childhood disadvantage on adult psychological distress among women.

Abstract Background The literature shows that social support is an important factor influencing health behaviors. This study aimed to explore the relationships and intrinsic pathways of social support, loneliness, economic income, and health behaviors among older adults during the Corona Virus Disease 2019 (COVID-19) pandemic, and to provide a theoretical basis for the implementation of health behaviors interventions for older adults. Methods A cluster-random-sampling survey was adopted within two towns in Dongguan, China. Demographic characteristics, social support, loneliness, economic income and health behaviors were measured. The Social Support Appraisals scale (SS-A), the ULS-8 Loneliness Scale, and the Self-rated abilities for health practice scale (SRAHPS) were used to measure social support, loneliness, and health behaviors in older adults, respectively. A moderated mediation model was built to examine the relationships among social support, loneliness, economic income, and health behaviors using the SPSS PROCESS 4.0 macro. We conducted bootstrapping of regression estimates with 5000 samples and a 95% confidence interval. Results 621 older adults completed the questionnaire. Most of the participants were female, accounting for 75.0%, and the average age was 81.11 years (SD = 8.11). The median (interquartile range) of the participants’ average monthly economic income was 800 (500–1000)RMB. The results of the mediation analysis showed that loneliness partly mediated the relationship between social support and health behaviors (B = 0.024, 95%CI: 0.007, 0.042), with the mediating effect accounting for 4.56% of the total effect. The moderation mediation analysis revealed a positive moderating role of economic income in the relationship between social support and loneliness (B = 0.114, 95%CI: 0.054, 0.174). Specifically, the relationship between social support and loneliness was found to be weaker for older adults with a high economic income compared to those with a lower economic income. Conclusion The provision of enhanced social support and the alleviation of loneliness among older adults during an epidemic can facilitate the development of healthy behaviours, particularly among those who are economically disadvantaged.

Abstract Climate change presents a substantial global threat to human health and wellbeing. Planetary health, an emerging field, provides a comprehensive framework to comprehend the intricate interplay between ecological stability, human health, and ecosystems, particularly within the context of climate change. This study investigates the planetary health perspective on climate change by exploring global knowledge. The Scopus database is used as the source of data. The analysis encompassed a performance evaluation aimed at scrutinizing both quantitative and qualitative indicators. Visualization techniques utilizing VOSviewer software were deployed to analyze collaboration patterns, co-citation links among prominent knowledge-sharing platforms, and key topics derived from keyword co-occurrence matrices. Additionally, using SciMAT software, the study conducted thematic evolution and intellectual analyses to identify both driving and emerging themes, while also examining coherence among different themes across various periods. The study also explores policy implications, and the relevance of COVID-19 in the context of planetary health and climate change. Through this analysis, 261 relevant publications are identified, with the United States being the leading contributor (90 documents; 34.5% of publications). At the institutional level, the Australian National University secured the top position, representing 4.6% of the total with 12 documents. The Lancet Planetary Health journal was the most prolific source, contributing 15 documents (5.7%). In terms of impact, The Lancet journal held a central position as the most cited source. The primary funding organization was the Wellcome Trust, based in the United Kingdom. Motor themes shaping the future of this field include vector-borne diseases, human demographics, informal settlements, air pollution, carbon footprint of animal-based foods, and pro-environmental attitudes and behaviors. The study underscores the significance of leveraging the momentum surrounding infectious diseases like COVID-19 and the impacts of climate change to advance planetary health concepts. Integration of the social sciences and enhanced multidisciplinary cooperation are crucial for progress. Additionally, increased funding for developing countries, and legislative empowerment are essential to foster further research.

Abstract Background While conspiracy theories cover many different themes, medical conspiracy theories (MCTs) have become particularly prevalent in modern societies. As beliefs in MCTs can become a source of “infodemics”, influence individual health behaviors and cause distrust in medical institutions and personnel, healthcare workers must find ways to overturn patients’ conspiracy thinking. However, as the medical world is not free of these beliefs, in this study, we investigated beliefs in MCTs among medical and health science students and their association with reported health behaviors. Methods Our sample was derived from a self-administered, anonymized, computer-assisted web survey conducted among 1,175 medical and health science students enrolled at the Poznan University of Medical Sciences, Poland. Results From a set of twenty different MCTs, one-third of students rejected all of them, 18% believed in one, 15% in two, 10% in three, and 24% supported four or more conspiracy theories. In addition, many students were hesitant or unsure about MCTs. We also found that nursing and midwifery students were the most likely to believe in MCTs, while medical and dental students were the least supportive. Support for MCTs was higher among students in the early years of their studies and who declared themselves religious and conservative. This study also highlights the association between students’ support for MCTs and their reported health behaviors, including avoiding vaccinations, using alternative medicine, taking vitamin C, or using social media as an essential source of health information. Conclusions As medical and health science students are prone to conspiratorial thinking, they should be trained to act as a trusted and reliable source of medical information, to mitigate conspiratorial beliefs, and to act as role models for their patients and society, effectively shaping health behaviors in the population.

School racial segregation is increasingly recognized as a threat to US public health: rising segregation in recent decades has been linked to a range of poor health outcomes for Black Americans. Key theorized mediators of these harms remain underexamined, including experiences of interpersonal and institutional racism driving increased stress, and peers health behaviors influencing students own. Using cross-sectional survey data on a national sample of adolescents, we investigated associations between school segregation and these two potential mediating pathways, operationalized as adolescents perceptions of prejudice from fellow students and the health behaviors of their peers (drinking and smoking). We further investigated whether associations were modified by individual race/ethnicity and school racial composition. Pooling across all schools and students, higher levels of school segregation were associated with decreased perceptions of peer prejudice (OR 0.54, 95% CI = 0.34-0.86), but not with peers health behaviors. However, this masked important differences by respondents race/ethnicity and school racial/ethnic composition. In predominantly White schools, school segregation was not associated with Black students perceptions of peers prejudice, but higher levels of segregation were associated with increased rates of peers drinking and smoking. In predominantly non-White schools, in contrast-where most Black students are educated-higher levels of school segregation were not associated with perceived peer prejudice nor unhealthier peer behaviors for Black students (in fact, peers health behaviors improved). And across both school types, higher levels of district segregation were associated with lower odds of reporting peer prejudice among non-Black students of color. Our findings suggest that the paths between school segregation and poor health depend on the type of school children attend in segregated districts. In schools predominantly serving students of color, structural factors upheld by school segregation-i.e., material, educational, disciplinary, or economic disadvantage-likely dominate over peer behaviors as the primary drivers of segregations health harms.

Objectives: Using "digital inequality" as a conceptual framework, this study evaluates the feasibility and usability of a technology-delivered intervention (an "app") for Alzheimer's and related dementia family caregivers. Time for Living and Caring (TLC) is an on-line intervention that provides virtual coaching and self-administered education and resources. Methods: A sample of family caregivers (n = 163) used the tool for 16 weeks, which included completing the Computer Proficiency Questionnaire (CPQ-12) at baseline. Analyses investigate the relationship between age, CPQ scores, intervention use, appraisal, and caregiver outcomes. Results: Age was inversely associated with CPQ; however, CPQ scores did not have a significant relationship with participant's self-perceived benefits or intervention appraisal. Computer Proficiency Questionnaire scores provided insight regarding research feasibility, with lower scores associated with greater odds of discontinuing engagement. Discussion: CPQ-12 scores can be used as a screening tool to identify those who may need additional support to engage with and benefit from technology-delivered interventions. [ABSTRACT FROM AUTHOR]

Objectives: To describe the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence‐based lifestyle intervention known as the Diabetes Prevention Program (DPP). Data Sources and Study Setting: 2012–2024 VA administrative and survey data. Study Design: This is a summary of findings and impacts from four effectiveness‐implementation projects focused on in‐person and/or online DPP across VA sites. Data Collection/Extraction Methods: Patient demographics, participation data, and key findings and impacts were summarized across reports from the VA Diabetes‐Mellitus Quality Enhancement Research Initiative (QUERI‐DM) Diabetes Prevention Program (VA DPP) Trial, QUERI‐DM Online DPP Trial, the Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI DPP Project, and EMPOWER 2.0 QUERI Program. Principal Findings: Between 2012 and 2024, four VA QUERI studies enrolled 963 Veterans in DPP across 16 VA sites. All participants had overweight/obesity with one additional risk factor for type 2 diabetes (i.e., prediabetes, elevated risk score, or history of gestational diabetes) and 56% (N = 536) were women. In addition to enhancing the reach of and engagement in diabetes prevention services among Veterans, these projects resulted in three key impacts as follows: (1) informing the national redesign of VA MOVE! including recommendations to increase the number of MOVE! sessions and revise guidelines across 150+ VA sites, (2) enhancing the national evidence base to support online DPP delivery options with citations in national care guidelines outside VA, and (3) demonstrating the importance of gender‐tailoring of preventive care services by and for women Veterans to enhance engagement in preventive services. Conclusions: Over the past decade, the evolution of VA QUERI DPP projects increased the reach of and engagement in diabetes prevention services among Veterans, including women Veterans who have been harder to engage in lifestyle change programs in VA, and resulted in three key impacts informing type 2 diabetes and obesity prevention efforts within and outside of VA. [ABSTRACT FROM AUTHOR]

Objective (s): In a situation where the vaccine was not completely accurate and up-to-date against different strains of the virus in all people of the world, compliance with health guidelines was the main key to prevent transmission. But what is clear is that compliance with health protocols is not the same among all communities and depends on factors. This article examines the effects and attitudes of health protocols. Methods: This research was a descriptive-quantitative cross-sectional study, which was conducted among 385 students of Shahid Beheshti University of Medical Sciences, Iran in the last week of May 2022. Factors affecting the adherence to water hygiene behaviors due to covid-19 were investigated using a questionnaire and the results were analyzed and reported in ordinal regression with SPSS 25 software. Results: The ratio of the average score of compliance (19.08) from the total of eight health behaviors to the maximum score (25) was reported as 76%. It was reported that the score of awareness was very high, 94%, and the average score of attitude was about 75%. In the ordinal regression, it was found that having knowledge was not effective in following all health protocols and only two behaviors of avoiding attending gatherings and avoiding losing when meeting acquaintances showed a statistically significant relationship. In other words, with the increase of each score of awareness, the chance of having higher compliance scores in these two behaviors increased by about 1.5 times. On the other hand, the attitude score had a statistically significant relationship with most of the behaviors, except the compliance of coughing and sneezing into a handkerchief or the corner of the arm, and it had a positive simultaneous effect on the compliance of the behaviors. Conclusion: The high level of awareness among the studied community can partially indicate the effectiveness of interventions in increasing awareness, but the gap between awareness, attitude and behavior indicates the need to pay attention to other factors affecting attitude and behavior.

Abstract Since 2016, China has progressively relaxed family planning policies to stimulate birth rates. This paper examines the behavioral health repercussions of China’s 2016 universal two-child policy (UTCP) by analyzing sleep pattern data from China Family Panel Studies. Napping is a composite indicator that denotes health outcomes, job quality, and personal well-being. It reveals work conditions and environments to some extent. UTCP may lead to heightened social expectations regarding pregnancy likelihood, and changes in social expectations within the workplace may make work environments less equitable and more stressful for females. Leveraging a difference-in-difference model, this paper explores how napping behaviors among the working-age cohort have responded to the policy shifts. Our analysis reveals a gender discrepancy in response to the policy, specifically, females exhibit a discernible reduction in the likelihood of napping, as well as in the duration of both daytime naps and daily sleep. Conversely, such effects are not significant among males. These results suggest policy consequences extend beyond individuals directly impacted by childbirth or contemplating parenthood. Hence, while promoting fertility is still the government’s goal, policymakers are encouraged to consider the broader challenges the female population faces from social and workplace environment factors.

Abstract Well-being is a continuous process requiring decisions and actions to maintain or build health. This study examines the indirect effect of health locus of control on life satisfaction via healthy behaviors based on living systems theory. Participants were 730 students of various majors related to medicine and health, aged between 19 and 30 (M = 22.29, SD = 1.64), including 79.04% women. Self-report measures were used to assess life satisfaction, multidimensional health locus of control, and health behavior. Women scored higher than men on the total health behavior scale, especially in a healthy diet and preventive behavior. Men scored higher than women on internal health locus of control (HLC), while women scored higher than men on the powerful others HLC in making decisions about their health. The study confirmed the mediating effect of healthy behavior on the relationship between the internal HLC and life satisfaction. The present mechanism highlights the crucial role of internal motivation in increasing subjective well-being by maintaining health behaviors among young adults. The role of intervention programs focused on improving internal HLC and health behaviors is discussed.

Objective To examine cardiovascular risk factors in 40-year-old participants in the health screening program targeted health dialogues (THDs).Design Cross-sectional study.Setting 99 Swedish healthcare centers.Intervention Metabolic risk factors and health behaviors were assessed. THDs were provided.Subjects 1831 (62.3%) THD participants that consented to take part in the research project.Main outcome measures (1) Prevalence of metabolic risk factors (blood pressure, LDL cholesterol, fasting plasma glucose, BMI, waist-hip ratio) and unhealthy behaviors (tobacco, alcohol, diet, physical activity) by sex, education, and place of birth. (2) Associations between different health behaviors and between the number of unhealthy behaviors and prevalence of metabolic risk factors. (3) THD participation by sociodemographics compared to age-matched controls.Results Men had a higher prevalence of all metabolic risk factors, excessive alcohol use and tobacco use than women. Lower educated individuals had a higher prevalence of metabolic risk factors (except for LDL cholesterol) and tobacco use than highly educated. Participants born outside Sweden had a higher prevalence of obesity, high waist-hip ratio, and tobacco use. Participants with 3–4 unhealthy behaviors had significantly higher prevalence of each of the metabolic risk factors except BMI. Women, highly educated and Swedish-born participants were slightly over-represented in the THDs.Conclusion Considering the associations between unhealthy behaviors and metabolic risk factors, the THD method, covering lifestyle as well as objective health measures, may be an appropriate method for early identification of individuals at risk for future non-communicable diseases in the whole population with a specific focus on certain groups.ClinicalTrials.gov NCT04912739

Abstract Purpose This study aims to comprehensively examine the determinants of depression among urban older adults in Seoul, utilizing the social-ecological model to address multifaceted influences. Methods A comprehensive analysis was conducted using data from the 2022 Seoul Aging Survey, which surveyed 2,914 individuals aged 65 and above. A multiple logistic regression analysis was performed to identify factors contributing to depressive symptoms, including socio-demographic characteristics, health behaviors and status, research accessibility, social support, and environmental influences. Results This study revealed that poor subjective health (OR = 1.47) and the presence of multiple chronic diseases (OR = 1.59) significantly increased the risk of depressive symptoms among urban older adults. From a social support standpoint, living alone was associated with a higher risk of depression (OR = 1.66), low food security (OR = 2.56), and low digital competency (OR = 2.70) were all significant predictors of depressive symptoms. Additionally, a lack of engagement with cultural facilities (OR = 2.15) was identified as a critical environmental factor contributing to depression. Conclusions The findings underscore the need for comprehensive policy and practical interventions aimed at preventing chronic disease, enhancing social support networks, improving digital literacy, ensuring food security, and expanding access to healthcare and cultural facilities. Such measures are crucial in mitigating depression among urban older adults, thereby enhancing their overall well-being and quality of life.

Abstract Background The United States (U.S.) has a growing population of Brazilian immigrant women. However, limited research has explored Pap tests and human papillomavirus (HPV) vaccination among this population. Methods Participants completed an online survey between July—August 2020. Bivariate analyses examined associations between healthcare-related variables (e.g., insurance, having a primary care provider) and demographics (e.g., age, education, income, marital status, years living in the U.S., primary language spoken at home) with 1) Pap test recency (within the past 3 years) and 2) HPV vaccination (0 doses vs. 1 + doses). Variables significant at p

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM.

Abstract Background After settling in the United States (US), immigrants often accumulate obesity and cardiovascular risk factors. As mood is often associated with health behaviors in the US population, mood may be an important mediating factor in immigrant populations. Methods The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention designed to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered “negative”, while ratings of good, very good, or excellent were considered “positive”. Results Hispanic/Latino (n = 268) and Somali (n = 181) adults enrolled in HIC completed baseline measures and were included in this analysis. Participants endorsing negative mood compared to positive mood had lower healthy eating scores (p = 0.02), lower physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood reported receiving less social support to eat healthy (p =

Abstract Background The shift work schedule is a common work arrangement that can disrupt typical sleep-wake rhythms and lead to negative health consequences. The present study aims to examine the effect of shift work on health-related quality of life (QoL) and explore potential behaviorial mediators (i.e., sleep, eating, exercise, smoking, drinking). Methods A cross-sectional survey was conducted among 4,449 petroleum workers in southwest China. Data on shift work status, health behaviors, and physical and mental health QoL were collected. We tested our model using path analysis and the Monte Carlo approach among 2,129 included participants. Results After adjusting for covariates, shift work did not exhibit a significant direct association with QoL. However, shift work indirectly related to poorer physical health quality of life via less frequent healthy food consumption; shift work also indirectly related to poorer mental health QoL via both less frequent healthy food consumption and physical exercise. No significant indirect effects were found via sleeping, smoking, or drinking. Conclusions Results suggest that shift work presents a challenge for QoL among Chinese petroleum workers due to their lesser engagement in two specific health behaviors: healthy eating and physical exercise. Healthy eating and exercise may present an even more prominent threat to shift workers’ QoL than sleep and substance use. Strategies targeting shift work schedule as well as eating and exercise behaviors may help protect against poor QoL and adverse physical and mental health outcomes in this vulnerable group.