Abstract
Paul E. Terry |
646 |
Tribalism in America and our polarized body politic has, sadly, become part of our daily digest. Is it possible that place-based discrimination will be shown to be an even more powerful impediment to our collective well-being than other formidable health influencers like race or income? If so, how would such a social diagnosis inform strategic planning in health promotion? Waddell and Reed wrote about “possible causal pathways” that show the interaction effects, both positive and negative, between work, health and well-being. That businesses have focused on individual choices, rather than social influences, isn’t merely a philosophical leaning of the private sector. Individualism has dominated collectivism in the healthcare, health research and health promotion sectors as well. Of the $36 billion approved this year to fund the National Institutes of Health, most will go to biomedical research and a paltry $11 million will be allocated to worksite health promotion. Similarly, in spite of the training of public health professionals about the primacy of social determinants as a predictor of well-being, health education and behavior research over the past two decades has overwhelmingly focused on individual interventions and interpersonal characteristics. A new federal survey of worksite health promotion in America shows modest growth in the past decade in the number of companies sponsoring comprehensive approaches to worksite health promotion. However, of the five elements constituting a comprehensive approach, the greatest gain in the past two decades has been the increase in companies offering a supportive social and physical environment. This editorial argues that we must think more deliberately about the causal chain that links neighborly social support and collective well-being if we are ever to solve for related issues like obesity, mental illness and addiction. |
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Laura A. Linnan Laurie Cliff Jason E. Lang Michael Penne Maija S. Leff |
652 |
The Workplace Health in America (WHA) survey provides a nationally-representative snapshot of workplace health promotion and protection practices among United States (US) worksites, benchmarks integration of OSH and health promotion efforts in US worksites, and updates trends from previous surveys. The survey is a random sample of US worksites with ≥10 employees, stratified by region, size and sector that assesses workplace health promotion programs, program administration, evidence-based strategies, health screenings, disease management, incentives, worklife policies, implementation barriers, and occupational safety and health (OSH). Results indicate that among eligible worksites, 46.1% offered some type of health promotion program. The proportion of comparable worksites with comprehensive programs rose from 6.9% in 2004 to 17.1% in 2017 (p<.0001). OSH programs were more prevalent than health promotion programs, and 83.5% of all worksites had an individual responsible for employee safety, while only 72.2% of those with a health promotion program had an individual responsible for it. Smaller worksites were less likely than larger to offer most programs. We conclude that the prevalence of health promotion programs has increased, but only 11.8% have comprehensive programs. Persistent deficits in smaller worksites require targeted approaches; integrating OSH and health promotion efforts may help. |
Stephen J. Onufrak Hatidza Zaganjor Latetia V. Moore Heather C. Hamner Joel E. Kimmons Leah M. Maynard Diane Harris |
666 |
Although evidence suggests that efforts to improve the healthfulness of foods eaten or purchased from cafeterias and vending machines can be successful, little is known about the foods consumed from these venues and the people who consume them. Using 24-hour dietary recall data from NHANES 2005-2014 (N = 25 549 adults), we estimated the prevalence of consuming foods, assessed the most commonly consumed foods, and calculated dietary quality of foods. On a given day, 3.1% of adults consumed foods from cafeterias and 3.9% from vending machines. Common cafeteria foods included vegetables and fruits, but cafeteria foods were generally high in sodium and low in whole grains. Sugar-sweetened beverages and candies accounted for approximately half of all vending calories. Foods chosen from cafeterias and vending machines do not align well with the Dietary Guidelines for Americans. Improving the dietary quality of foods consumed from these venues could impact millions of adults. |
Traci R. Snedden John Scerpella Stephanie A. Kliethermes Rocío S. Norman Liga Blyholder Jen Sanfilippo Timothy A. McGuine Bryan Heiderscheit |
675 |
This study examined the role of sport and physical activity involvement on the health-related quality of life among undergraduate student-athletes and general undergraduate college students (n = 1322). Using a cross-sectional survey design, VR-12 responses were assessed for differences in physical and mental health for self-reported sport and physical activity level. Significant differences in the mental component scores (MCS) were noted between levels of sport and physical activity; however, such differences were not detected in physical component score. After controlling for sex, a positive relationship between increased sport and physical activity level and greater MCS was found. Amid concerns regarding the mental health of young adults, findings of this study emphasize the importance of physical activity and represent the first prospective assessment of health-related quality of life among undergraduate athletes and general college students. Higher levels of sport and physical activity were associated with more positive mental health in these populations. |
David B. Buller Barbara J. Walkosz Mary Klein Buller Allan Wallis Peter A. Andersen Michael D. Scott Richard T. Meenan Gary R. Cutter |
683 |
This study conducted a two-year follow-up on a randomized controlled trial evaluating an occupational sun protection policy intervention with local government organizations. A total of 63 of the original 98 local government organizations participated in the follow-up assessment in which project staff observed sun safety communication and items in the workplace and surveys were conducted with frontline supervisors (n=330) and employees (n=1454). The results indicated that intervention organizations as opposed to controls had more sun safety messages from the intervention (p<0.001) and provided more sun safety items to support employees’ sun protection (p=0.025). Also, more frontline supervisors reported intervention organizations provided free/reduced priced sunscreen (p=0.005), communicated about sun safety (p<0.001) and more workers recalled receiving sun safety messages (p<0.001) and sun safety training (p<0.001) compared to control organizations. Implementation was greater at larger than smaller intervention organizations for wide-brimmed hats (p=0.009), long work pants (p=0.017), and shade structures (p=0.036). Based on these results, the sun safety policy intervention seemed to to produce actions by local government organizations to support employee sun safety, especially large organizations that may have processes, communication channels, and slack resources to achieve more implementation. |
Jin E. Kim-Mozeleski Hilary K. Seligman Irene H. Yen Susan J. Shaw David R. Buchanan Janice Y. Tsoh |
698 |
This study examined how changes in food insecurity longitudinally affect smoking status among smokers and non-smokers. The sample consisted of 4563 adult head-of-household respondents who participated in the 2003 (study baseline) and 2015 (study follow-up) waves of the Panel Study of Income Dynamics. The study aims were to examine (1) whether smokers’ likelihood of stopping smoking between baseline and follow-up was influenced by their food insecurity status, and (2) whether non-smokers’ likelihood of starting smoking between baseline and follow-up depended on their food insecurity status. Results from logistic regression analyses showed that among smokers at baseline, becoming food insecure (vs staying food secure) independently predicted lower likelihood of stopping smoking by follow-up (odds ratio [OR] = 0.66). Among non-smokers at baseline, becoming food insecure (vs staying food secure) independently predicted starting smoking by follow-up (OR = 3.77). Food insecurity has important consequences for health disparities, including those that may be related to tobacco use. |
Katrina R. Ellis Tiffany L. Young Dana Carthron Marcia Simms Shirley McFarlin Kia L. Davis Guarav Dave Giselle Corbie-Smith Crystal Cené |
708 |
Cardiovascular disease (CVD) is a leading cause of death among rural African Americans (AAs). The purpose of this study was to understand family influences on CVD-related knowledge and behaviors among rural AA adults. Using community-based participatory research methods, we interviewed AA adults from rural counties who reported one or more CVD risk factors (type 2 diabetes, hypertension, obesity, and personal or family history of CVD) or were the family members of such a person. Family health history and familial norms and preferences influenced participants’ CVD-related knowledge, beliefs, and behaviors. Families were helpful for increasing motivation for and overcoming barriers to healthy behaviors, such as hard-to-access community resources and physical health challenges. To a lesser extent, family members hindered or had little influence on behavior engagement. Understanding the role of families in responding to rural contextual factors that help or hinder healthy behaviors will be useful for family-engaged promotion, practice, and research. |
Janet A. Deatrick Heather Klusaritz Rahshida Atkins Ansley Bolick Cory Bowman Juan Lado Krista Schroeder Terri H. Lipman |
718 |
This project described perceptions of physical activity, opinions on intergenerational approaches to physical activity, and a vision for increasing physical activity in an under resourced urban community. Systematic triangulation of youth, parent, and coach perspectives were gathered in 6 focus groups (2 youth, 2 parent, 2 coach) and analyzed through the lens of the Socio-Ecological Model and Community-Based Participatory Research methods. Factors on all levels of the Social-Ecological Model influence the perception of and engagement in physical activity for youth and their families. When physical activity is reframed as a broad goal that is normative and gender-neutral, a potential exists to engage youth and their families over their lifetimes. With attention to cross-sector collaboration and resource sharing, engaging and sustainable intergenerational physical activity interventions can be developed to promote health in under resourced urban communities. |
Deepa Srivastava Julia Torquati Maria Rosario T. de Guzman Dipti A. Dev |
727 |
Utilizing hermeneutic phenomenology design and developmental niche theoretical framework, the findings of this qualitative study contribute to a better understanding of how parental ethnotheories (ie, beliefs, motivations, attitude, values) serve as guides to parental feeding practices that promote preschoolers healthy eating in daily routines. Health promotion practitioners should consider parental ethnotheories that facilitate children’s mealtime routines, food socialization, parent–child engagement in food-related activities using effective communication, encouragement, and role modeling strategies to improve children’s healthy eating behaviors. |
Lindsey Haynes-Maslow Isabel Osborne Stephanie Jilcott Pitts |
736 |
Rural communities face barriers to accessing direct-education nutrition programs in the U.S. To better understand the barriers to implementing SNAP-Ed direct education programming in rural communities, as well as strategies to overcome these barriers, we interviewed 27 SNAP-Ed staff across 15 states nationwide and examined the barriers and facilitators to implementing direct-education in rural communities. SNAP-Ed staff cited common barriers to implementing direct-education lack of healthy food and physical activity infrastructure to reinforce messages taught in class, funding restrictions, transportation for participants, and SNAP-Ed staff being seen as ‘outsiders’ (not from the community). Facilitators included buy-in from local leaders, SNAP-Ed staff being from the community, and partnering with other organizations to increase recruitment and retention of SNAP-Ed participants. SNAP-Ed programs should explore innovative delivery modalities including online and text-messaging delivery due to transportation issues in widespread rural geographies, as well as implementing policy, systems, and environmental change initiatives. |
Sankalp Das Maribeth Rouseff Henry E. Guzman Chukwuemeka U. Osondu Doris Brown Brian Betancourt Teresa Ochoa Joseph Mora Virginia Lehn Shoshana B. Sherriff Muni B. Rubens Anshul Saxena Khurram Nasir Emir Veledar |
745 |
Baptist Health South Florida, a large health care organization, in Miami, Florida, has an ongoing multidimensional worksite health promotion intervention targeted at improving cardiometabolic health of high risk employees. The intervention was an intense lifestyle modification program that was targeted to the individual needs of the participants. In this study paired two-sample t tests for means were used to compare baseline and 3, 6, and 12 month measurements of 97 employees diagnosed with type 2 diabetes mellitus. Results showed improvement in Hemoglobin A1c levels and other cardiometabolic risk factors. |
Gregory Stewart Collin A. Webster Ali Brian David Stodden Cate A. Egan R. Glenn Weaver |
749 |
This research describes the use of movement integration strategies to get children active during general education classroom time in a low-income school district. This manuscript presents observational findings from the first study to objectively measure teachers use of movement integration strategies in a large sample of teachers (N = 48) across 8 elementary schools. Findings suggest that, contrary to current perceptions, children are moving in classrooms frequently. However, this is due to classroom routines and structure rather than teachers actively directing students to be active. Findings can be used to develop targeted interventions to reduce sedentary time and to get children more active during classroom time. |
Gergana Damianova Kodjebacheva Lisa M. Lapeyrouse Jamie Rahrig Loretta Walker Kanday Campbell |
756 |
Consumption of lead-contaminated water is associated with adverse pregnancy outcomes. This study elicited recommendations on interventions at multiple levels (i.e. women, partners, families, and communities) to promote safe water drinking behaviors among women of reproductive age. Qualitative data were collected via an online survey consisting of open-ended questions among 63 women and three focus groups among 27 women. Participants recommended professional materials regarding lead be placed in public places. Women highlighted the need for family-based interventions where women, partners, and relatives test water in homes, install water filters, cook lead-mitigating meals, and receive education on the risks of lead. Future investigations may examine the influence of such strategies on knowledge and behaviors that promote safe water drinking. |
Timothy A. Brusseau Ryan D. Burns James C. Hannon |
760 |
Adolescents within the Juvenile Justice System tend to display poor health behaviors, including low levels of physical activity. The purpose of this study was to examine the trends in total and segmented sedentary and physical activity behaviors during a Sports, Play, and Recreation for Kids (SPARK) program in incarcerated adolescent boys. The sample was 86 adolescent boys incarcerated within two Juvenile Justice facilities in the US. The SPARK program was implemented over 36 weeks. Sedentary behaviors decreased and physical activity behaviors increased at 24-weeks after program implementation. This study highlights the potential of SPARK to affect sedentary and physical activity behaviors in this population. |
Mohammad Javad Koohsari Andrew T. Kaczynski Tomoki Nakaya Ai Shibata Kaori Ishii Akitomo Yasunaga Ellen W. Stowe Tomoya Hanibuchi Koichiro Oka |
764 |
Cross-sectional data from older adults (aged 65-84 years) living in Japan were used to examine associations between objectively assessed walkable urban design attributes with body mass index (BMI) and to test whether objectively assessed physical activity and sedentary behavior mediated such associations. Walkable urban design attributes, including population density, availability of physical activity facilities, intersection density, and access to public transportation stations, were objectively calculated using geographic information systems. Physical activity, sedentary behavior, and BMI were objectively measured. Higher population density and Walk Score—a free composite measure of walkability—were associated with lower BMI. Light and moderate-to-vigorous physical activities were partially mediated the relationships between these walkable environmental attributes and BMI. Developing active-friendly environmental policies to (re)design neighborhoods may not only promote active travel behaviors but also help in improving residents’ health status in non-Western contexts. |
Roy F. Oman Taylor Lensch Nada Amroussia Kristen Clements-Nolle Minggen Lu Yueran Yang |
768 |
Research has shown that youth assets protect youth from many risk behaviors. However, measurement of youth assets in the field is not standardized and the psychometric properties of the asset instrument could be improved. Researchers as well as practitioners now have the Youth Asset Survey revised (YAS-R), which measures 17 youth assets with demonstrated reliability, functionality, and validity, freely available for their use. The availability of the YAS-R will improve measurement of youth assets and may encourage the standardization of asset measurement which will increase the utility of comparisons across studies and practice. |
Sam Cole Susan M. Zbikowski Andrew Renda Anne Wallace Jessica M. Dobbins Matt Bogard |
774 |
This observational study used Healthy Days, a reliable, validated assessment tool, developed by the Centers for Disease Control and Prevention, designed to measure perceived health-related quality of life (HRQOL), to describe changes in HRQOL among health coaching program participants. Our findings indicate significant reductions in HRQOL, following 6 months of health coaching, and support the use of HRQOL measures like Healthy Days, which are known to be highly correlated with traditional measures of health, to evaluate health coaching programs. |
Megan A. Kirk Mohammad Amiri Meysam Pirbaglou Paul Ritvo |
778 |
The purpose of this systematic review and meta-analysis was to examine the effectiveness of wearable device interventions (eg, FitBit) to promote physical activity behavior change among populations diagnosed with cardiometabolic chronic disease. Studies that were randomized controlled trials (RCTs) published between January 2000 and May 2018 that used a wearable device for the full intervention in adults (18+) diagnosed with a cardiometabolic chronic disease were included. Excluded trials included studies that used devices at pre–post only, devices that administered medication, and interventions with no prospective control group comparison. Overall, a total of 35 studies examining 4528 participants met the inclusion criteria. Study quality and RCT risk of bias were assessed using the Cochrane Collaboration Tool. There was heterogeneity among targeted conditions, methodology, and intervention effects. Statistically significant increases in PA steps/day (mean difference [MD] = 2592 steps/day; 95% confidence interval, CI: 1689-3496) and moderate to vigorous physical activity min/wk (MD = 41.94 min/week; 95% CI: 22.94-60.94) were found for the intervention condition. The conclusion of the research was that wearable devices positively impact physical health in clinical populations with cardiometabolic diseases. Future research using the most current technologies (eg, FitBit, Garmin) will serve to amplify these findings. |
Hao Zhang Li Yin |
792 |
This study aims to identify groups of the social and built environment factors associated with obesity that have been studied substantially along with factors that need further attention, to guide the research, designing, and planning of the social and built environment for mitigating obesity prevalence. A systematic search of literature was undertaken from PubMed, Google Scholar, and Web of Knowledge. A meta-analysis of 153 empirical studies, selected from 2005 to 2015 based on a series of criteria, was conducted using factor analysis. The exploratory factor analysis was undertaken to group the prevalence and use of the social and built environment factors associated with obesity. The findings suggested that the research community has gained a substantial understanding of the D variables of the built environment, including density, diversity, design, distance to transit, and destination access. Factors concerning different age groups, minority populations, groups with low socio-economic status, food environment, and street-level urban design features have been less examined. The findings are important to guide future research directions, giving more attention to the factors in need of more in-depth research. Further attention is needed to study the susceptible populations while collaborating with community members, clinicians, and practitioners, to modify the built environment toward body mass index-healthy conditions. |
Méabh Corr Jennifer McSharry Elaine M. Murtagh |
806 |
Numerous benefits are associated with participation in physical activity (PA), however, globally most adolescent girls are considered insufficiently active. Interventions to date aiming to increase their activity levels have demonstrated modest effects and gaining an understanding of adolescent’s perceptions of PA is integral to improving PA levels. This present review synthesised qualitative research examining adolescent girls’ perceptions of PA. This review highlights possible future directions for researchers and those working with girls in schools and communities. The role of perceived motor competence and how this impacts girl’s participation levels must be considered in future, as lack of perceived competence impacts their participation. The important role of peers must also be considered for this cohort as they can impact their participation. Finally, it is important to provide opportunities for girls to engage in life-long PA by introducing them to other forms of PA that do not revolve around competitive team-based sports. |
| Sara S. Johnson |
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The gut microbiome is deservedly receiving a lot of attention. This issue provides an overview of its importance to multiple domains of mental and physical health and well-being and illustrates several food as medicine initiatives to inspire health promotion practitioners working in a variety of settings. |
| Dexter Shurney Kaitlyn Pauly |
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Dr. Dexter Shurney and Kaitlyn Pauley draw upon their expertise to set the stage for this issue by providing a comprehensive overview of the gut microbiome and underscoring that the prescription for improving the health of it is Lifestyle Medicine. In other words, as they so aptly stated, “Healthy Microbiomes = Healthy Humans”. |
| Leanne Mauriello Kristi Artz |
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Drs. Leanne Mauriello and Kristi Artz provide a step-by-step guide to creating, scaling, and sustaining an innovative Culinary Medicine Program that pairs the art of cooking with the science of medicine. Their article echoes the sentiment that leveraging culinary medicine to improve dietary patterns is a powerful first step to embracing lifestyle as medicine—a first step that has the potential to successfully bend the burgeoning healthcare cost curve. |
| Allison Hess Michelle Passaretti Stacy Coolbaugh |
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The authors share the inspiring story of creating a Fresh Food Farmacy, where culinary medicine for Type 2 Diabetes was implemented in conjunction with innovative strategies and partnerships for addressing social determinants of health to reduce barriers or food insecurity. Their case study is a creative example of placing the patient at the center of a multi-disciplinary care team. |
| Paula Martin Kara Classens James Fox Alyson Kass |
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These authors share their experience and lessons learned from developing a Culinary Medicine Conference to help transform a community. Their efforts built bridges and created collaborations between a diverse array of community stakeholders and medical professionals through interactive and immersive continuing professional development activities. |