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Background: Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures, and examined cross-sectional and prospective associations between health literacy and adolescent health behaviors and outcomes. Methods: We conducted a short-term prospective study of 250 adolescents (mean age = 14 years; 57% female; 48% African American) who were entering or in the ninth grade in an urban school district. Health literacy was assessed by individual interviews at baseline, and health-related behaviors and outcomes were assessed by a paper-and-pencil survey at baseline and at a 6-month follow-up. Results: Nearly half of the sample was reading at least 2 grades below expected levels. Lower baseline health literacy was associated with a lower self-rating of general health, unhealthier diet, heavier weight, and greater engagement in problem behaviors and sexual behaviors at baseline. Lower baseline health literacy also was associated with a greater increase in substance use over time. Conclusions: Results point to the pressing need to improve health literacy in urban high school students.

BackgroundTobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation across diverse populations. ObjectiveThe purpose of this meta-analysis is to (1) evaluate the efficacy of text messaging interventions on smoking outcomes, (2) determine the robustness of the evidence, and (3) identify moderators of intervention efficacy. MethodsElectronic bibliographic databases were searched for records with relevant key terms. Studies were included if they used a randomized controlled trial (RCT) to examine a text messaging intervention focusing on smoking cessation. Raters coded sample and design characteristics, and intervention content. Summary effect sizes, using random-effects models, were calculated and potential moderators were examined. ResultsThe meta-analysis included 20 manuscripts with 22 interventions (N=15,593; 8128 (54%) women; mean age=29) from 10 countries. Smokers who received a text messaging intervention were more likely to abstain from smoking relative to controls across a number of measures of smoking abstinence including 7-day point prevalence (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.22, 1.55, k=16) and continuous abstinence (OR=1.63, 95% CI=1.19, 2.24, k=7). Text messaging interventions were also more successful in reducing cigarette consumption relative to controls (d+=0.14, 95% CI=0.05, 0.23, k=9). The effect size estimates were biased when participants who were lost to follow-up were excluded from the analyses. Cumulative meta-analysis using the 18 studies (k=19) measuring abstinence revealed that the benefits of using text message interventions were established only after only five RCTs (k=5) involving 8383 smokers (OR=1.39, 95% CI=1.15, 1.67, P

Stress management interventions (SMIs) can alleviate the psychosocial stress often experienced by women with heart failure. The purpose of this meta-analysis was to summarize women's participation rates, and predictors of participation, in SMIs for the management of psychosocial distress in women with chronic HF. Studies were retrieved from bibliographic databases, reference sections of relevant papers, and research registries. Included studies (a) evaluated a SMI approach for the management of chronic HF, (b) sampled chronic HF patients, and (c) used a randomized controlled trial (RCT) design. Independent coders extracted the relevant data. Thirty-five RCTs met inclusion criteria (N = 3,649; mean age = 63.5 ± 7.0 years). All studies sampled both men and women; the mean proportion of women who participated in the trials was 38.8% (95% confidence interval [CI] = 34.5–43.4; I2 = 82.4, 95% CI = 81.0–83.6). Women's participation rates were higher in studies sampling more HF patients with hypertension (B = 1.01, SE = 0.45, P =.046) but fewer HF patients prescribed beta blockers (B = −1.10, SE = 0.33, P =.006), F (2,12) = 6.27, P = 0.014, adjusted R2 = 61%. SMIs may offer women a complementary or integrative approach to standard treatment to help manage the psychological distress associated with HF. Future research should explore the potential benefits of offering stress management approaches to women as part of comprehensive HF care. [ABSTRACT FROM AUTHOR]

Menthol cigarette use among women who smoke cigarettes during pregnancy is high, but little is known about the factors that contribute to preference for menthol cigarette use during pregnancy. This study investigated preferences, perceptions, and intentions to use menthol vs. non-menthol cigarettes in a sample of pregnant women. Pregnant women (N = 124, Mage = 26.2 years, 50% minorities) completed a study investigating the impact of maternal smoking on biobehavioral markers of fetal risk. During the third trimester, participants self-reported preferences (liking, attractiveness, smoothness, interest), perceptions of harm (general, pregnancy-specific), and intentions to use menthol and non-menthol cigarettes. We examined differences in responses based on whether participants endorsed (1) cigarette use during pregnancy (yes/no) and (2) lifetime cigarette use (yes/no). Sixty-two participants endorsed cigarette smoking during pregnancy (85.5% smoked menthol cigarettes), and 94 participants reported lifetime use. Overall, menthol cigarettes were perceived as more likeable and smoother vs. non-menthol (ps <.001) – even among participants who never smoked cigarettes (ps <.05). All participants rated both menthol and non-menthol cigarette use as harmful. Compared to participants who did not smoke during pregnancy, participants who smoked during pregnancy rated menthol cigarettes as less harmful for pregnant women (p =.001), while there were no differences between groups in harm perceptions toward non-menthol cigarettes. Menthol may increase cigarettes appeal for pregnant women. Implications for regulation of menthol cigarettes are discussed. Future studies may investigate the role of sensory perception, marketing, and health education in influencing these factors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Home-based cardiac rehabilitation (CR) heavily relies on patients' personal motivation to engage in behavior change. Patients' core values (e.g., health, family) may serve as motivational factors to strengthen program engagement. This study sought to identify personal values of veterans participating in home-based CR. METHOD: Veterans enrolled in a home-based CR program at the Providence VA Medical Center completed a self-report questionnaire assessing core values at intake and completion. Descriptive statistics and non-parametric tests (e.g., Friedman, Wilcoxon sign rank comparisons) were used to assess differences in core value ratings between intake and completion. RESULTS: Sixty-six patients (72±7 years, 86% white, 97% male) completed the questionnaire. Patients most often rated independence (86%), family (70%), and health (67%) as important values. Value ratings did not change from intake to discharge (ps >.20). CONCLUSIONS: Future research should evaluate whether incorporating values-based activities in home-based CR can improve patient adherence to treatment and outcomes. [ABSTRACT FROM AUTHOR]