Abstract
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 Awards, the Editor in Chief Awards, the Michael P. O’Donnell Award and the Dorothy Nyswander Award for the research and writing published in 2021 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 2021 offered new insights into addressing discrimination against race or sexual identity, preferred sources of information about COVID-19 and the impact of community and workplace interventions on healthy lifestyles. This year’s award winning research spans from character to culture relative to improving well-being.
To honor some of the best scientists in the health promotion discipline and, in particular, to recognize those who bring outstanding humanity to their field of inquiry and bigheartedness to their writing, I am pleased to announce the American Journal of Health Promotion (AJHP) Papers of the Year from 2021. Only two in ten papers submitted to this journal makes it to press so this is our chance to feature the best of the best. Reviewing the best studies reported on these pages gives us an opportunity to revisit unique research questions leading scholars in our field are pursuing and to consider how the results of their research can inform progress in our field. Selecting the best studies and papers from the past year from AJHP is inspiring as well as humbling. Inspiring because the quality of our submissions seems to get better every year. We are also humbled by the fact that we have undoubtedly neglected to feature a paper from 2021 that may prove to be among our most influential in years to come. This concern is corroborated by our journal’s rising ‘impact factor’, an indicator of how often our authors are cited by other researchers, making AJHP one of the most influential journals in our field.
Whether and how we are making progress in increasing parity in health promotion continued to be put to the test in 2021. One of the largest special issues we published in this journal was our “Parity in Health Promotion” issue in 2018. This year’s award winning scholars continued to offer our profession strategies for addressing systemic racism as they researched the impact of policies and interventions on ever more specific sub groups. Studying the effectiveness of a variety of behavior change initiatives has been a mainstay of this journal and the reach of interventions and factors that could improve reach continues to drive hypothesis testing. You will also see that this year’s featured papers range from studying the role of character to the role of culture in health promotion, a testament to the complexity and dynamism of the science informing our discipline.
We invite you to re-read the papers featured below because they impressed our editors as studies that are advancing our field via inspiring research questions and exemplary research methods. We also found these papers had vibrant discussion sections that had us considering best practices alongside potential next practices. Albert Einstein said: “To raise new questions, new possibilities, to regard old problems from a new angle, requires creative imagination and marks real advance in science.” 1
Our wholehearted gratitude goes out to these authors for bringing this journal bold ideas and taking risks by testing unique and provocative research questions.
Papers of the Year Award Criteria
The award criteria our journal editors considered were applied to both the study and the paper such that the: 1. Study addresses a topic of timely importance in health promotion. 2. Research question is clearly stated and the methodologies used are well executed. 3. Paper is often cited and/or downloaded. 4. Study findings offer a unique contribution to the literature. 5. Paper is well-written and enjoyable to read.
Editor in Chief Papers of the Year for 2021
Character Strengths Involving an Orientation to Promote Good Can Help Your Health and Well-Being. Evidence From two Longitudinal Studies.
Dorota Weziak-Bialowolska, PhD, Piotr Bialowolski, PhD, Tyler J. VanderWeele, PhD, Eileen McNeely, PhD.
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Effect of a workplace-based multicomponent intervention on hypertension control.
Wang, Z, Wang, X, Shen, Y, Suning, L., Chen, Z., Zheng, C., Kang,Y., Jiang, L., Hao.G., Chang, C., Gao, R.
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Michael P. O’Donnell Paper of the Year for 2021
Translating CDSMP to the Workplace: Results of the Live Healthy Work Healthy Program
Mark G. Wilson, HSD, David M. DeJoy, PhD, Robert J. Vandenberg, PhD, , Heather M. Padilla, PhD, Nicholas J. Haynes, MS, Heather Zuercher, MPH, Phaedra Corso, PhD, Kate Lorig, DrPH, Matthew L. Smith, PhD.
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Dorothy Nyswander Paper of the Year for 2021
Better Me within Randomized Trial: Faith-Based Diabetes Prevention Program for Weight Loss in African American Women
Heather Kitzman, PhD, Abdullah Mamun, PhD, Leilani Dodgen, MPH, Donna Slater, George King, MDiv, Alene King, BA, J. Lee Slater, BS, Mark DeHaven, PhD.
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Editors’ Picks Papers of the Year for 2021 (Volume 35)
Sexual Identity and Racial/Ethnic Differences in Awareness of Heart Attack and Stroke Symptoms: Findings From the National Health Interview Survey.
Billy A. Caceres, PhD, RN, AGPCNP-BC, Meghan Reading Turchioe, PhD, MPH, RN, Anthony Pho, MSN, MPH, RN, ANP-C, Theresa A. Koleck, PhD, RN, Ruth Masterson Creber, PhD, MPH, RN, FAHA, Suzanne B. Bakken, PhD, RN, FAAN, FACMI.
6
Evaluation of a Community-Based Cardiovascular Prevention Program in Patients With Type 2 Diabetes
Yvonne Finn, MD, Miroslawa Gorecka, MB, Gerard Flaherty, MD, Fidelma Dunne, PhD, Timothy O’Brien, PhD, James Crowley, MD, David Wood, MD, Susan Connolly, PhD, Jennifer Jones, PhD, Irene Gibson, MA.
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Debunking the High Cost of Healthy Diets: Consumer Behavior Predicts Dietary Energy Density in a Nationally Representative Sample of US Adults
Jacqueline A. Vernarelli, PhD, Rebecca DiSarro, MPH.
8
Knowledge, Perceptions, and Preferred Information Sources Related to COVID-19 among Healthcare Workers: Results of a Cross Sectional Survey
Shyama Sathianathan, BS, Lauren Jodi Van Scoy, MD, Surav Man Sakya, BS, Erin Miller, BS, Bethany Snyder, MPH, Emily Wasserman, MAS, Vernon M. Chinchilli, PhD, John Garman, BS, Robert P. Lennon, MD, JD.
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Theoretical Mediators of Diabetes Risk and Quality of Life Following a Diabetes Prevention Program for Latino Youth with Obesity
Erica G. Soltero, PhD, Stephanie L. Ayers, PhD, Marvyn A. Avalos, MS, Armando Peña, MS, Allison N. Williams, MSW, Micah L. Olson, MD, Yolanda P. Konopken, BS, Felipe G. Castro, PhD, MSW, Kimberly J. Arcoleo, PhD, Colleen S. Keller, PhD, Donald L. Patrick, PhD, MSPH, Justin Jager, PhD, Gabriel Q. Shaibi, PhD.
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From Character to Culture as Contributors to Well-Being
Multi-dimensional problems call for multi-faceted solutions so it comes as no surprise that this year’s award winning studies tested an eclectic mix of health promotion hypotheses. Several of these featured studies focused on individual level interventions and associations such as the status of consumer beliefs about the costs of healthy food, the role of sexual identity in heart disease risk awareness or preferred sources of COVID-19 information among health professionals. Other of our award winning researchers focused on social forces that foster well-being such as the impact of community based or workplace based interventions on population level health improvement. But, whether at the individual or collective well-being level, our field continues to study multiple determinants of health and how to factor the most powerful predictors of well-being into solving for health disparities.
As much as the field of health promotion has had a long standing focus on supporting improvements in health habits, it remains that most professionals formally trained in this discipline were ensconced early on in the socio-ecological framework and the attendant interplay between social forces and individual choices. One of my Editor in Chief Award winning papers this year offers a brilliant review of how the continuum between personal flourishing and collective well-being should not only be considered seamless, but mutually reinforcing. Dorota Weziak-Bialowolska and colleagues wondered whether people taking actions that contribute to the good of others would have mental health and other well-being benefits. They found that this character orientation not only fostered happiness and life satisfaction, promoting good was also associated with less stress and loneliness at work and in the community. Weziak-Bialowolska’s findings were all the more interesting given she and colleagues examined this do-gooder tendency in two culturally different populations and found that the benefits of social connectedness are not confounded by culture. 11
While the benefits of some character traits seem inured to culture, the variation between countries relative to containing COVID-19 casts a light on how powerful other culturally influenced traits can be in mitigating choices and jeopardizing or protecting health. That China’s communal culture has certain distinct public health advantages over America’s independent streak is apparent when comparing adherence to masking and quarantine guidance or mandates.
Studies that demonstrate the vital role of culture in population health improvement, and that use multi-component interventions with large samples over long time periods, continue to be a rarity in our field. That is why, for the first time, I have conferred an Editor In Chief Award this year for a study that was not published in this journal. Wang and colleagues conducted a cluster randomized trial that compared 40 workplaces that were subject to a hypertension management intervention to 20 workplaces in a control group. This two year program that combined education and clinical visits with environmental supports produced extraordinary results with an “absolute reduction in blood pressure equivalent to a more than 20% decrease in stroke and a more than 10% decrease in coronary heart disease.” I included the Wang study as an award winner in this journal, in part, because the full manuscript of the study is open access, that is, available at no charge, on the JAMA Network web site. 12 You will see that even though the studied focused on blood pressure, other variables such as stress and drinking significantly improved.
I had the pleasure of co-hosting a webinar with the co-authors of the China study and was glad for the opportunity to ask about external validity issues and whether their impressive results could be replicated in American companies. A study co-author, Zugui Zhang, who has worked in large organizations in both the USA and China, acknowledged that China’s “culture of collectivism” may make this study difficult to generalize in some organizations. The webinar, which also featured co-authors Zengwu Wang and Chun Chang and co-host Ron Goetzel, is available at no charge on the website of the Health Enhancement Research Organization. 13 I have contrasted this China based worksite health promotion success story with a less effective intervention conducted at the University of Illinois in a previous editorial. 14 In sum, too often researchers over-measure and under-intervene and sustainable behavior change relies on intentional organizational change. The impressive cardiovascular health gains demonstrated in Chinese companies considered alongside the historic level of preventable lives lost to COVID-19 in America begs this question for organizational and community leaders: might a tad more policy courage and unpopular (within a minority) regulation be worth the lives saved?
To be sure, American company leaders have shown they are quite capable of organizing on behalf of employee health. For example, whether a self-help disease management program could be “adapted to fit the unique characteristics of work organizations” was tested by Mark Wilson and colleagues in 14 worksites in a rural community. Their superbly executed research earned them this year’s “Michael P. O’Donnell Paper of the Year.” O’Donnell is this journal’s founder and Editor in Chief Emeritus and author of the “AMSO Framework.” AMSO is an acronym that features the role of awareness, motivation, skills and opportunity in behavior change. AMSO also serves as the organizing frame for O’Donnell’s book: “Health Promotion in the Workplace”, which is now available for free as a PDF. 15
I am certain O’Donnell resonated with Wilson and his teams’ approach to comparing the differences between usual approaches to disease self-management and an approach that tailored programs according to organizational factors. That is, an intervention to advance both skills and opportunity. The researchers found that the “work healthy” arm participants not only produced improvements on nearly all health outcomes measured, participants in the environmentally abetted arm of the study also showed significantly better chronic disease self-efficacy. 16 It seems this contemporary research affirms the ancient proverb that when we give a person a fish they eat for a day, but, well, Wilson and his colleagues’ paper explains the rest.
Dr. Heather Kitzman and colleagues won our “Dorothy Nyswander Paper of the Year Award” for their study of a faith based diabetes prevention program in support of weight loss in African American women. Nyswander is considered the pioneer of the field of health education and she called for an “open society” which was a society “where diversity is respected; where pressure groups cannot stifle and control the will of the majority or castigate the individual; where education brings upward mobility to all; where the best of health care is available to all; where poverty is a community disgrace not an individual’s weakness.” 17 Consistent with Nyswander’s grounding in respect for communities and local leaders, Kitzman’s intervention was conducted in churches and coordinated through pastors. A standard diabetes prevention approach was compared to an approach that featured lay health leaders. Five faith based components were also added to the standard curriculum. Both groups benefited from significant weight loss, that is, −2.6% at 10 months, and those in the faith based cohort who attended at least 15 sessions did even better with a 5.8% reduction in weight at 10 months. 18 Nyswander would be as impressed with the community organizing and participatory approach to this research as she would be with the health improvements.
Greater Reach and Equity in Health Promotion
When I have co-authored original research papers, I regularly take the lead on drafting the discussion section. Trying to put your study’s findings in the context of knowledge that preceded your hypothesis has always impressed me as the hardest, but also the most enjoyable part of research. When you read our 2021 award-winning author’s discussion sections you will see how they applied what they learned to continuous improvement for our discipline, to enlarging our field’s reach and, ultimately, to producing a more equitable world. Stephen Hawking said that “science is not only a disciple of reason but, also, one of romance and passion.” 19 These leaders show us how fastidious study methods and accessible scientific writing can be intentionally aligned with compassionate advocacy for health and well-being for all. Congratulations to these first authors and co-authors. We dedicate our selection and publishing of these “best papers” to all health promotion scientists who are confronting health disparities and working to achieve equity in workplaces, families and communities.