In Briefs

Abstract

Paul E. Terry	330	Editorial The “Best of 2020 List” of Health Promotion Researchers Each year, the editorial team of the American Journal of Health Promotion selects our “Best of the Year List” of health promotion studies from the prior year. This editorial features the Editor’s picks, the Editor in Chief’s favorites and other award categories for the research and writing published in 2020 in this journal. Our criteria for selection includes: whether the study addresses a topic of timely importance in health promotion, the research question is clearly stated and the methodologies used are well executed; whether the paper is often cited and downloaded; if the study findings offer a unique contribution to the literature; and if the paper is well-written and enjoyable to read. Awardees in 2020 offered new insights into confronting systemic racism, the impact of state health policies on eating behaviors, the role of leaders in influencing employee health practices and the role of physicians in influencing patient health practices. You will see how researchers are studying psychological and emotional resiliency in ever more specific populations.
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Omoye Imoisili Carrie Dooyema Lyudmyla Kompaniyets Elizabeth A. Lundeen Sohyun Park Alyson B. Goodman Heidi M. Blanck	334	Quantitative Research Prevalence of Overweight and Obesity Among Children Enrolled in Head Start, 2012–2018 Head Start enrollees are often children living in low-income households, who are at high risk for obesity and overweight. This article is the first to combine all available BMI data from the annual Head Start Program Information Report (PIR) from 2012, when body mass index measurements were added to the PIR, with data through 2018, and to examine trends in overweight and obesity among Head Start participants in all 50 states and the District of Columbia. Over time, the prevalence of obesity and overweight in Head Start children remained stable but continues to be high. Available state data may be used to develop plans for action to support efforts to improve health among young children; plan and highlight the need for healthy growth and obesity interventions for low-income families; and may be useful for state and national stakeholders to monitor obesity and overweight prevalence over time in this unique population.
Joey A. Lee Erin Heberlein Emily Pyle Thomas Caughlan Darvi Rahaman Margaret Sabin Jill L. Kaar	344	Quantitative Research Evaluation of a Resiliency Focused Health Coaching Intervention for Middle School Students: Building Resilience for Healthy Kids Youth mental health issues are a major public health concern in the U.S. with suicide as the second leading cause of death among 10–24-year-old. To combat this alarming statistic at a national level, schools offer a framework for efficient wide-spread dissemination of mental health programs utilizing their existing systems. The Building Resilience for Healthy Kids Program aimed to evaluate the feasibility and utility of implementing a school-based 1:1 resilience-focused health coaching intervention for 6th grade students (11-12 years old) over eight sessions during the school day. A health coach met with each child weekly in a private setting within the school and worked with the student in creating resilience-related goals focused on improving their coping skills and self-efficacy via motivational interviewing techniques. Students (n = 287) were found to have a significant increase in key mental health parameters, including resilience and self-efficacy, at the end of the intervention period. These findings demonstrate that 1:1 health coaching may be an effective strategy for building resilience in youth which may then lead to improved mental health outcomes in adolescence and beyond.
Martha J. Nepper Jennifer R. McAtee Weiwen Chai	352	Quantitative Research Effect of a Workplace Weight-Loss Program for Overweight and Obese Healthcare Workers Healthcare workers are an overlooked population with obesity and other health concerns. This study assessed the impact of the Better Living intervention, a 16-week workplace weight-loss program among overweight and obese healthcare employees using novel approaches such as combining group-based meetings/activities with individual appointments with nutrition/health experts. Our results show weight (5.6% weight loss), BMI, lifestyle behaviors (nutrition, physical activity), sleep quality and depression were improved after the Better Living intervention. Thus, our findings support the implementation of programs like Better Living as they may benefit employees working in healthcare settings and are critically needed for addressing obesity among healthcare workers. Further emphasis should be placed on long-term weight management to prevent weight regain after the initial weight loss.
Jaehyun Kim Junhyoung Kim Ronald D. Williams Jr Areum Han	362	Quantitative Research The Association of Social Support and Leisure Time Physical Activity With Mental Health Among Individuals With Cancer The purpose of this study was to examine the relationship among three types of social support, leisure time physical activity (LTPA), and mental health among people with cancer. The results of path analysis indicated that individuals with cancer who perceived emotional support tended to engage in LTPA and thus reported better mental health. Therefore, we suggest that promoting LTPA through encouraging positive emotions can be an effective strategy by which to improve mental health among people with cancer. Specifically, community-based programs and events can provide rich opportunities for people with cancer to establish social support networks and form a sense of friendship in their community, which will, in turn, result in LTPA participation and better mental health. The findings from this study will help inform policymakers and health professionals about how to develop more effective interventions to promote health behaviors and improve mental health among individuals with cancer.
Jonathan L. Blitstein Danielle Lazar Kathleen Gregory Colleen McLoughlin Linda Rosul Caroline Rains Talya Hellman Chelsey Leruth Jairo Meija	369	Quantitative Research Foods for Health: An Integrated Social Medical Approach to Food Insecurity Among Patients With Diabetes This study examines the effects of implementing a social-medical standard-of-care practice to patients as part of an integrated model of care designed to promote a culture of health. The model requires providers to acknowledge that food insecure patients frequently face tough choices between affording food, medications, and household bills that negatively affect health. Results showed a decrease in mean HbA1c (Δ = −0.22, P = .01) over the study period. The model examining change over time, glycemic control, and food security status (F1, 352 = 5.80, P = .02) indicated that among participants with poor glycemic control (33.12%), food secure participants exhibited significantly greater levels of improvement than food insecure participants (Δ = −0.55, P = .04). Among participants with good glycemic control, changes in HbA1c were not significantly different between food secure and food insecure participants (Δ = 0.23, P = 0.21). This study shows that food security screening coupled with nutrition education and access to community food resources can be implemented as an integrated standard-of-care practice in a health care setting and can contribute to improved glycemic control. However, it may be difficult for patients who are food insecure to benefit from supportive, social medicine interventions. Health care providers may need to consider additional means to help address the challenges these patients face.
Jana L. Hirschtick Delvon T. Mattingly Beomyoung Cho Luis Zavala Arciniega David T. Levy Luz Maria Sanchez-Romero Jihyoun Jeon Stephanie R Land Ritesh Mistry Rafael Meza Nancy L. Fleischer	377	Quantitative Research Exclusive, Dual, and Polytobacco Use Among US Adults by Sociodemographic Factors: Results From 3 Nationally Representative Surveys Multiple tobacco product use may influence cessation behaviors and exacerbate health disparities. Using three national surveys (2014-16), we estimated the adult prevalence of exclusive and multiple product use by sex, race/ethnicity, education, income, and age, using four product groupings: cigarettes, ENDS, other combustibles, and smokeless. Exclusive cigarette use was the most prevalent pattern (10.9-12.8% of US population). Multiple product use was less prevalent (2.9-6.5%) but represented 16.7-25.5% of use among tobacco users. Cigarette plus ENDS use was similar by sex, but men were more likely to use cigarettes plus either other combustibles or smokeless. Among race/ethnic subgroups, non-Hispanic (NH) Whites were most likely to use cigarettes plus ENDS use, while NH Blacks were most likely to use cigarettes plus other combustibles. Multiple product use was less common among adults with higher education, income, and age. Sociodemographic differences in multiple product use likely have important implications for resulting health disparities.
Dorota Weziak-Bialowolska Piotr Bialowolski Tyler J. VanderWeele Eileen McNeely	388	Quantitative Research Character Strengths Involving an Orientation to Promote Good Can Help Your Health and Well-Being. Evidence From two Longitudinal Studies We examined the impact of an orientation to promote good – one aspect of strength of character, understood in this study as having consistent thoughts and taking actions that contribute to the good of oneself and others – on a wide set of subsequent flourishing outcomes that include physical and mental health, as well as, happiness and life satisfaction, meaning and purpose, and close social relationships. We used data from two longitudinal studies comprising data from 1,209 employees of a U.S. organization and 495 Mexican apparel workers from the supply chain of a major global brand. We found that an orientation to promote good was positively associated with subsequently higher levels of life satisfaction and happiness, self-assessed mental health and physical health, social connectedness, and purpose in life, as well as with a lower risk of anxiety and loneliness. Possible effects on positive affect (feeling happy) and negative affect (feeling sad, stressed, and lonely) while-at-work were also identified. This study strengthens the evidence that an orientation to promote good may play a positive role in improving functioning across numerous areas of well-being.
Brook E. Harmon Shaila M. Strayhorn Nathan T. West Michael Schmidt Benjamin L. Webb Lindsey Grant select Stacy Smith	399	Qualitative Research Strategies for Designing Clergy and Spouse Obesity-Related Programs Clergy have influence on the health of congregations and communities yet struggle with health behaviors. Interventions tailored to their occupation-specific demands and unique needs may provide a solution. Based on insights from eighteen clergy and fourteen spouses, clergy-focused interventions should target both clergy and spouses while accounting for the influence of congregations. Strategies should help clergy and spouses overcome barriers related to making time, establishing boundaries, managing unhealthy church traditions, and balancing family needs while trying to improve health. Participants’ past experiences informed the strategies they suggested for the content (e.g., menu planning, competition) and format (i.e., combining technology with face-to-face) of future programs. The relationship between clergy, spouse, and congregation was identified as an important factor for obesity-related programs to consider. Strategies, whether face-to-face or eHealth, must meet the unique needs of clergy and their spouses while helping them develop healthy eating skills and build camaraderie among participants.
Karin Bammann Carina Recke Birte Marie Albrecht Imke Stalling Friederike Doerwald	409	Qualitative Research Promoting Physical Activity Among Older Adults Using Community-Based Participatory Research With an Adapted PRECEDE-PROCEED Model Approach: The AEQUIPA / OUTDOOR ACTIVE Project Developing successful physical activity (PA) promotion remains challenging; however, interventions using community-based participatory research (CBPR) frameworks have revealed encouraging results. One popular CBPR framework for health promotion is the PRECEDE-PROCEED model (PPM), but its translation into practice is not clear. This paper presents an adapted PPM that incorporates a socio-ecological model (SEM) and has an extended list of program components, which was used to develop a PA promotion program. Participants were aged 65-75 years from a district in Bremen, Germany. Barriers and drivers of PA were assessed using a mixed methods design including a population-based survey, semi-structured focus groups and narrative participatory walking interviews. Interventions were developed utilizing various participatory methods. The adapted PPM might be a good starting point for multi-level interventions, however inclusion of all social groups and targeting all levels of the SEM may be challenging, and therefore requires special consideration and sustained attention in future research.
L. Aubree Shay Kilian J. Kimbel Caitlin N. Dorsey Leslie C. Jauregui Sally W. Vernon Jeffrey T. Kullgren Beverly B. Green	421	Qualitative Research Patients' Reactions to Being Offered Financial Incentives to Increase Colorectal Screening: A Qualitative Analysis Our study sought to explore financial incentives as an intervention to improve colorectal cancer screening (CRCS) adherence among traditionally disadvantaged patients who have never been screened or are overdue for screening. We used qualitative methods to describe patients’ attitudes towards the offer of incentives. Patients generally had positive attitudes towards both types of incentives, however, half did not recall the incentive offer at the time of the interview. Among those who recalled the offer, almost all were screened compared to a minority among those who did not remember the offer. Most screeners stated that staying healthy was their primary motivator for screening, but many suggested that the incentive helped them prioritize and complete screening. Incentives to complete CRCS may help motivate patients who would like to screen but have previously procrastinated. Future studies should ensure that the incentive offer is noticeable and shorten the deadline for completion of FIT screening
Tyler Prochnow Megan S. Patterson Christina N. Bridges Hamilton Haley Delgado Samantha Craig M. Renee Umstattd Meyer	430	Applied Research Brief Network Autocorrelation of Perceived Physical Activity Skill Competence Among Adolescents at a Summer Care Program: A Pilot Study Adolescent physical activity (PA) is considered vital for healthy psychological, social, and physical development. Adolescents who report feeling they are more competent in PA are more likely to achieve recommended amounts of PA. This study aims to investigate adolescents’ perceived PA skill competence at a summer care program and the possible role that friendship networks have in an adolescent’s competence levels. Adolescents at a summer care program reported perceived skill competency and up to five peers whom they hung around with most at the program at the start and end of summer. Linear network autocorrelation models determined a significant network effect for scores at time 1 and time 2, indicating adolescent perceived skill competence scores were associated with those of their friends. Practitioners may wish to encourage group or collaborative skill competency improvement activities as well as pairing adolescents with differing skill competencies to foster improvement and possible competency diffusion.
Fred Molitor select Celeste Doerr	434	Applied Research Brief Dietary Behaviors and Obesity of Children from Low-Income Households by Gender of Caregiver and Child One-fourth of children from low-income households across California are obese. Nutrition education and obesity prevention programs, such as the United States Supplemental Nutrition Assistance Program-Education (SNAP-Ed), focus on mothers for programs and interventions designed to reduce the risk of childhood obesity. This approach overlooks families with male caregivers of children, including those with single fathers. The purpose of our study was to investigate obesity rates and related behaviors by gender of child and caregiver. Caregivers and children from over 2,000 SNAP-Ed eligible households across California were recruited for a telephone survey. An extensive interview was conducted to document all foods and beverages that children consumed during the previous day. Children’s diets and obesity rates were similar for female versus male caregivers. However, female caregivers’ sons, compared with daughters, ate more sugar, had more unhealthful diets overall, and were more likely to be obese. We conclude that SNAP-Ed’s focus on mothers rather than fathers is just, but more effective childhood nutrition education and obesity prevention efforts should specifically target families with female caregivers of male children.
Katherine M. Johnson Alyssa M. Lederer Jessica L. Liddell Sydney Sheffield Alicia McCraw	438	Applied Research Brief Teaching to Impact Sexual Violence? The Evaluation of a Curricular Intervention for First-Year College Students Campus sexual violence is a major public health problem. Prior research calls for longer, more intensive programming to increase intervention effectiveness. In this study, we evaluated a 3-credit, semester-long curricular intervention, developed after our university climate survey found higher than average rates of sexual violence. Using a quasi-experimental survey design (beginning v. end of semester, intervention (n = 49) v. comparison (n = 60) course), we found promising results that a curricular intervention has potential to influence students’ knowledge, attitudes, and behavioral intentions regarding gender, sexuality, and sexual violence. Notably, students in the intervention course showed significantly greater rates of change in reducing heteronormative views, decreasing sexual misconduct apathy, and increasing awareness of campus resources. If resources are put into curricular interventions, effects may diffuse more widely to create a safer, healthier campus climate.
Shorouk Ibrahim Mohamed Habiballah Iman El Sayed	442	Literature Review Efficacy of Electronic Cigarettes for Smoking Cessation: A systematic Review and Meta-Analysis Background: Smoking is a major public health problem and widely recognized as one cause of premature morbidity and mortality. No updated evidence to conclude about the certainty of evidence for adopting E-Cigarettes as smoking cessation intervention despite enough debate. We aim to synthesize available evidence to assess the efficacy as well as safety of E-Cigarettes versus different forms of NRT and placebo to quit smoking. Methods: We comprehensively searched of clinical trials in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), PsycINFO, Science Direct, Center for reviews and dissemination and HTA database and Trip database. We also searched clinicalTrial.gov and WHO International Clinical Trials Registry Platform (ICTRP) portal. We searched grey literature including Dissertations (ProQuest Dissertations and Theses), Web of Science Thomson Reuters: Conference Proceedings Citation Index, and unpublished manuscripts, examined the references of relevant articles, hand searched topic-specific journals and contacted authors for incomplete data. After data extraction, we assessed the risk of bias using the Cochrane RoB 2 tool. We synthesized data by random-effects model through the Mantel-Haenszel method and R software. We conducted subgroup analysis by length of follow-up and sensitivity analysis by restricting to only studies with low risk of bias. We created a summary of findings table based on GRADE approach. Results: We retrieved 12 clinical trials involving 9863 participants. Four studies were judged as low risk of bias across five domains of RoB 2 tool and the rest were judged as unclear risk of bias. CO- validated one-month continuous abstinence rate was significantly higher in E-cigarettes group than control (5 studies, 32.6 vs 23.1%, N = 1970, RR 1.335, 95 % CI 1.068; 1.667, moderate evidence). However, Three-month and six- month abstinence rate didn’t differ significantly between E-cigarettes and control groups (3 Studies, 12.1 vs 12.8%, N = 1099, RR 1.52, 95% CI 0.348; 6.701) and (7studies, N = 5435,10.2 vs 6.6%, RR 1.347, 95%CI 0.953; 1.903, very low evidence) respectively. There is very low certainty evidence of effect of E-cigarettes compared to control whether NRT or placebo on sustained reduction of 50% or greater in baseline cigarette consumption at different follow-up periods (1 month, 3 studies, 50.9 vs 33.2%, N = 955, RR 1.29, 95 % CI 0.59; 2.82), (3 Month , 3 studies, 43.2 vs 25.3%, N = 1067, RR 1.36, 95 % CI 0.66; 2.79), (6 month , 5 studies, 27.1 vs 13.4%, N = 1981, RR 1.38, 95 % CI 0.90; 2.11) and at 12 month (1 study, 14.5 vs 12%, N = 300, RR 1.21, 95 % CI 0.64; 2.27). Only one study of 884 participants displayed improved point abstinence by 46% (improvement range 17-82%) in E-cigarettes group relative to control at 12 months (1study, 32.7 vs 22.3%, N = 884, RR 1.46, 95 % CI 1.17; 1.82, moderate evidence). E-cigarettes may increase the proportion of serious adverse effect at 6 month-follow up (1 study, 9.3 vs 5.1%, N = 657, RR 1.81, 95 % CI 1.03; 3.19, low evidence) Conclusion: We are uncertain if E-cigarettes improve continuous abstinence rate at short term (1 month). There is very low certainty evidence of the effect of E-cigarettes compared to control whether NRT or placebo on the sustained reduction of 50% or greater in baseline cigarette consumption as well as 7-day point prevalence abstinence rate at 1-,3-, and 6-month follow-up periods. Long term efficacy of E-cigarettes is unknown, and E-cigarettes may increase or have no effects on the proportion of serious adverse effect at 6 months follow up. The information presented are indeed useful for policy makers, public health practitioners, and to encourage further research. Further clinical trials are needed to assess the long-term efficacy and safety of E-cigarettes and ongoing trials are urgently needed to help concluding about the efficacy of E-cigarettes for smoking cessation.
John A. Batsis Meredith N. Roderka Vanessa K. Rauch Lillian M. Seo Xingyi Li Peter R. DiMilia Tyler L. Gooding Diane Gilbert-Diamond Auden C. McClure Robert M. Roth	456	Literature Review Impact of Diet and Exercise on Weight and Cognition in Older Adults: A Rapid Review To the best of our knowledge this paper highlights a crucial gap in the literature regarding a lack of randomized control trials looking at this specific population. Obesity is a global public health crisis. The combination of an aging population and a projected 82 million older adults who will have dementia in 2030 according to WHO is why it is critical that future studies look at both diet and exercise interventions to assess their impact on both obesity and cognition.