In Briefs

Abstract

		Editorial
Paul E. Terry	593	Well-Being and Evolving Work Autonomy: The Locus of Control Construct RevisitedWill the new ways we work have positive or negative effects on well-being? How will hybrid work arrangements, flexible schedules, and increased telework impact job satisfaction and life satisfaction? Many factors related to employee productivity, creativity, and collaboration are being assessed as organizations consider how less time spent at a workplace impacts work culture and organizational success. This editorial argues that the internal–external locus of control construct could offer useful insights into the differential affects that new work arrangements may have on worker satisfaction. For many, greater autonomy will be felt as consistent with their beliefs and preferences for greater control in how they perform their work. Others may feel more stressed by the loss of structure and direction provided in a traditional workplace setting. Principles of motivation are discussed alongside the potentialities and hazards attendant to changes in the longstanding social contract between employers and employees
THE SCIENCE OF INDIVIDUAL AND COLLECTIVE WELL-BEING
		Critical Issues and Trends
Shoba Ramanadhan S. Tiffany Donaldson C. Eduardo Siqueira Charlotte Rackard-James Elecia Miller Jamiah Tappin Natalicia Tracy Sara Minsky Aileene A. Maldonado-Campos Carmenza Bruff Sitara Mahtani Marina S. Teixeira Vish Viswanath	597	Connecting Implementation Science, Community-Engaged Research, and Health Promotion to Address Cancer Inequities in Massachusetts: The UMB/DF-HCC U54 Outreach CoreThe Outreach Core of the U54 Partnership between the Dana-Farber/Harvard Cancer Center and the University of Massachusetts Boston created a new model for addressing cancer inequities that integrates implementation science, community-engaged research, and health promotion. Key elements of our approach include engaging a Community Advisory Board, supporting students from under-represented minority backgrounds to conduct health promotion and community-engaged research, increasing the delivery of evidence-based cancer prevention programs to underserved communities (directly and by training local organizations), supporting research-practice partnerships, and disseminating findings. Our model highlights the need for long-term investments to connect underserved communities with evidence-based cancer prevention
		Quantitative Research
Aleksandra M. Golos Daniel J. Hopkins Syon P. Bhanot Alison M. Buttenheim	602	Partisanship, Messaging, and the COVID-19 Vaccine: Evidence From Survey ExperimentsRather than uniting under the shared threat of COVID-19, the United States has been fragmented by partisanship throughout the pandemic. Though partisanship is known to fuel the selective collection of information from trusted messengers, this is poorly understood in the context of COVID-19. In our study of 2037 (May 2020) and 1577 (October 2020) Pennsylvania adults, we found widespread and persistent partisanship in COVID-19 attitudes, including reduced trust in counter-partisan sources of information compared to non-partisan sources. We also conducted a randomized experiment to assess the impact of partisan or scientific messaging on vaccination intentions. Scientific endorsement of the vaccine increased overall odds of intending to vaccinate by 32% in May, and increased odds among Democrats by 142% in October. Moreover, it did not significantly affect independents or Republicans. While partisan endorsement only positively influences those with congruent beliefs, scientific messaging produces consistent effects across political affiliation
		Quantitative Research
Xue-Qing Peng Ni Yang Chi Zhang Anita Nyarkoa Walker Yi-Zhan Shen Hua Jiang Sen Li Hua You Hua Zhou Li Wang	612	Cognitive Factors of Weight Management During Pregnancy Among Chinese Women: A Study Applying Protective Motivation TheoryTo promote appropriate weight gain during pregnancy, this study explored the psychological cognitive factors of weight management during pregnancy based on protective motivation theory (PMT). We collected cross-sectional data among pregnant women (n = 533) in Changzhou, China in 2020. Structural equation modeling was used to examine the weight management’s cognitive factors, path relationships, and the influence of maternal characteristics. The results showed that self-efficacy cognition could promote gestational weight management behavior, but response cost cognition hindered gestational weight management. Parity moderated pregnant women’s self-efficacy cognition, where the self-efficacy of nullipara promoted weight management behaviors, but the self-efficacy of multipara had no significant effect. Also, the response cost factors stably existed in primipara and multipara groups, with multipara, being positively affected by response efficacy. In conclusion, psychological and cognitive intervention can promote gestational weight management. Noteworthily, such intervention design can be based on behavioral psychological factors and their action paths
		Quantitative Research
Dale S. Mantey Stephanie L. Clendennen Andrew E. Springer Melissa B. Harrell	623	Perceived Parental Knowledge Reduces Risk for Initiation of Nicotine and Cannabis Vaping: A Longitudinal Study of AdolescentsThe popularity of nicotine and cannabis vaping among youth remains a serious public health concern. Our study found that the risk for initiation of vaping nicotine and vaping cannabis was significantly lower among youth who reported higher rates of parental knowledge. Parental knowledge was a protective factor again initiation of nicotine and cannabis vaping over the course of 12 months
		Quantitative Research
Lillian M. Kent Paul M. Rankin Darren P. Morton Rebekah M. Rankin Roger L. Greenlaw Heine S. Englert	633	Volunteers: An Effective Medium for Delivering Therapeutic Lifestyle InterventionsLifestyle modification programs have been shown to effectively treat chronic disease. The Complete Health Improvement Program (CHIP) lifestyle intervention has been delivered by both paid professional and unpaid volunteer facilitators. This study compared selected chronic disease biometric outcomes of participants in each mode in the United States. It found volunteer-delivered programs do not appear to be any less effective than programs delivered by paid professionals, which is noteworthy as volunteers may provide important social capital in the combat of chronic disease
		Quantitative Research
Kara K. Palmer Jacquelyn M. Farquhar Katherine M. Chinn Leah E. Robinson	643	Are Gross Motor Skill Interventions an Equitable Replacement for Outdoor Free Play Regarding Children’s Physical Activity?There is a need for gross motor programming to teach fundamental motor skills to young children. When these programs are implemented, they often replace children’s outdoor free play. However, it is unclear if there are unintentional negative consequences to children’s physical activity when outdoor free play is replaced. The purpose of this study was to determine if children engaged in equal amounts of physical activity during an established gross motor skill intervention (the Children’s Health Activity Motor Program (CHAMP)) and outdoor free play. Children in CHAMP engaged in less light physical activity but equal amounts of all other physical activity behaviors compared with their peers in outdoor free play. These results support that gross motor interventions, especially the CHAMP program, provide equal opportunities for children to be active compared with outdoor free play while simultaneously providing children with developmentally appropriate gross motor instruction
		Quantitative Research
Georgianne Tiu Hawkins Seung Hee Lee Shannon L. Michael Caitlin L. Merlo Sarah M. Lee Brian A. King Catherine N. Rasberry J. M. Underwood	651	Individual and Collective Positive Health Behaviors and Academic Achievement Among U.S. High School Students, Youth Risk Behavior Survey 2017Previous studies have examined the relationship between health behaviors and academic achievement. However, no study has considered a combined measure of multiple positive health behaviors in relation to academic grades among a nationally representative sample. To address this gap in the scientific literature, associations between multiple health behaviors that can prevent or delay the onset of chronic health conditions were investigated. Specifically, 7 dietary, 3 physical activity, 2 sedentary screen time, and 4 tobacco product use behaviors and academic grades were examined among U.S. high school students in grades 9-12. The objectives of this study were to (1) provide updated estimates of associations between individual positive health behaviors and academic grades from the 2017 Youth Risk Behavior Survey and (2) assess how collective positive health behaviors are associated with academic grades.Health behavior variables were first dichotomized (0/1) to indicate that a score was given to the positive health behavior response. For example, did not smoke cigarettes = 1. A composite score (count variable) was created by summing each positive health behavior response among 16 total health behaviors. For each individual health behavior, multivariable logistic regression analyses were conducted. For the composite score, a multivariable negative binomial regression was conducted with self-reported academic grades. Models controlled for sex, grade in school, race/ethnicity, and body mass index (BMI) categories. After adjusting for covariates, students who reported mostly A’s had 2.0 (P < .001) more positive health behaviors; students who reported mostly B’s had 1.3 (P < .001) more positive health behaviors; and students who reported mostly C’s had .78 (P < .001) more positive health behaviors, compared to students who reported mostly D’s/F’s. Results illustrate that higher academic grades are associated with more positive individual and cumulative health behaviors among high school students.Uncovering new evidence on the relationship between health behaviors and academic grades is important and timely, as recently, the National Academies of Sciences, Engineering, and Medicine published a consensus study report titled, Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century, underscoring the importance of the promotion of youth and adolescent health behaviors through health programs and on the development of healthy behaviors early on in life. Understanding these relationships can help inform efforts to create a healthy and supportive school environment and strive for health equity. In addition, public health and health care professionals in the community can promote health and wellness activities among school-aged youth and reach those who may have lower academic achievement – those who may have the greatest healthcare needs, but the most to gain from any academic benefit linked to positive health behaviors
		Quantitative Research
Jeffrey R. Harris Christine M. Kava Kwun C. Gary Chan Marlana J. Kohn Kristen Hammerback Amanda T. Parrish Christian D. Helfrich Peggy A. Hannon	662	Pathways to Employee Outcomes in a Workplace Health Promotion ProgramWhile the literature on workplace health promotion programs is large and generally positive, recent studies have raised concerns about program effectiveness. Using data from a randomized controlled trial, we identified significant bivariate correlations among employers’ implementation of evidence-based interventions (EBIs) to promote chronic-disease prevention, employees’ perceived implementation and perceived employer support, and five employee health and productivity outcomes: healthy eating, physical activity, perceived stress, depression risk, and health-related presenteeism. Our findings suggest a potential pathway for an effect of EBI implementation on employee health behaviors and productivity outcomes that are important to employers. Our findings support broader dissemination of EBIs for physical activity and healthy eating, as well as more focus on improving employer support for employee health. They also suggest we need better interventions for cancer screening and tobacco cessation
		Quantitative Research
Mary Kay Rayens Teresa McGeeney Amanda T. Wiggins Amanda Bucher Melinda Ickes Luz Huntington-Moskos Patti Clark Ellen J. Hahn	673	Smoke-free Ordinances and Youth Tobacco Use in KentuckyComprehensive smoke-free laws restricting workplace smoking are linked to reduced smoking prevalence in adults, but less is known about the association between these laws and youth use. Our purpose was to determine the associations of strength of local smoke-free laws and urban/rural location with cigarette and smokeless tobacco use among Kentucky adolescents; data were from the 2004-18 biennial Kentucky Incentives for Prevention survey (N = 353 502). Students in counties with a comprehensive smoke-free law were 23% less likely to smoke cigarettes and 16% less likely to use smokeless, compared to those in counties without a law. Students in counties with moderate/weak laws did not differ in likelihood of use for either product, compared to those in counties without a law. Students in urban counties were 14% less likely to smoke, but there was no difference in likelihood of smokeless use by urban/rural location
		Quantitative Research
Patricia M. Herman Julie Bucho-Gonzalez Usha Menon Laura A. Szalacha Linda Larkey	678	Cost-Effectiveness of Community-to-Clinic Tailored Navigation for Colorectal Cancer Screening in an Underserved Population: Economic Evaluation Alongside a Group-Randomized TrialColorectal cancer (CRC) screening is generally agreed to be cost-effective. However, the cost-effectiveness of screening promotion, especially community-based promotion, is still to be determined. This study provides evidence of the cost-effectiveness of a program using community-based group education (GE) and an intervention group who also received community-to-clinic navigation (GE+TN) to increase CRC screening in an underserved population Screening rates (26.5% GE+TN; 10.4% GE; 16.1% increase 95% CI: 7%, 23%) and costs per participant ($271 GE+TN; $167 GE . a net cost increase of $104 95% CI: $1, $189) were significantly higher in the intervention group. Incremental cost-effectiveness was $646 (95% CI: -$68, $953) per additional person screened. Depending on the value placed on an additional person screened, adding community-to-clinic navigation for CRC screening promotion may be highly cost-effective
		Quantitative Research
Ralph Amuanyu Welwean Elizabeth Andersen-Rodgers Adebayo Akintunde Xueying Zhang	687	Evaluating the Impact of Strong and Weak California Flavored Tobacco Sales Restriction Policies on the Tobacco Retail EnvironmentThe tobacco industry heavily marketed flavored tobacco products in the retail environment to entice youth and young adults to smoke. In response, many local jurisdictions in California have implemented tobacco control policies such as those that restrict the sale of flavored tobacco products. Very little is known about the effects these policies had on the availability of flavored tobacco products in the retail environment. This study evaluated the success of local flavored tobacco policies in reducing the availability of menthol cigarettes and other flavored non-cigarette tobacco products in communities across California. It showed the importance of strong local flavored tobacco policies in reducing the sale of such products at licensed tobacco retail stores. As more jurisdictions in California adopt policies aimed at reducing the availability of these products, understanding their impacts could promote adoption and create a safer retail environment for all people
		Qualitative Research
Jocelyn V. Wainwright Shivan J. Mehta Alicia Clifton Claire Bocage Shannon N. Ogden Sarah Cohen Katharine A. Rendle	697	Persistent Barriers to Colorectal Cancer Screening Completion Amid Centralized Outreach: A Mixed Methods StudyScreening for colorectal cancer (CRC) can detect cancer at more treatable stages and reduce CRC deaths, but screening rates remain suboptimal. Effective strategies are needed to improve screening rates, particularly among those at greatest risk of CRC mortality including underserved populations. This article examines patient perspectives on persistent barriers to CRC screening among a predominantly Black cohort of urban family medicine patients. Participants (n = 60) completed a semi-structured qualitative interview and structured questionnaire. Most patients (60%) preferred a stool-based test to colonoscopy due to its private, convenient, and non-invasive nature; however, persistent screening beliefs including fear of test results and cancer treatment still prevented some patients from completing any form of CRC screening. Our findings offer contextual insight into the specific factors that make at-home testing a favorable option for many patients. Additionally, our data support the importance of using direct outreach to address negative screening beliefs and increase CRC screening rates
		Applied Research Brief
Samantha Garrels Elizabeth Macias Eric Bender Joel Spoonheim Thomas E. Kottke	706	An Email Coaching Option Increases Participant Program Utilization and Coach ProductivityIn general, increasing the number of ways in which a behavior change program is offered increases the likelihood of success. The evidence that, in particular, using email to coach improves program efficiency is less robust. When we added an email option to phone coaching, our coaches were able to support more participants, participants who used the option were more likely to complete the benchmark of 3 sessions, and the overall percentage of participants who completed 3 sessions increased. Our experience suggests that all stakeholders benefit when an email coaching option is added to a phone-based program
		Applied Research Brief
Yusuke Hayashi Paul Romanowich Donald A. Hantula	710	Predicting Intention to Take a COVID-19 Vaccine in the United States: Application and Extension of Theory of Planned BehaviorThe present study evaluated the Theory of Planned Behavior (TPB) as an explanation for intention to take a COVID-19 vaccine. One hundred seventy-two USA residents recruited during March and April 2021 completed an online survey in which their intention, perceived behavioral control, attitude, and subjective norm toward taking a COVID-19 vaccine were assessed. In addition to these traditional TPB variables, anticipated regret from not taking a COVID-19 vaccine, health locus of control with COVID-19, and perceived community benefit from COVID-19 vaccination were included in the model. The extended TPB model accounted for 72.5% of the variance in intention to take a COVID-19 vaccine, with perceived behavioral control, attitude, and perceived community benefits being significant unique predictors for intention. These findings suggest that TPB is a useful theoretical framework for understanding intention to take a COVID-19 vaccine, which has important implications for developing effective strategies promoting vaccine acceptance
		Literature Review
Kristin A. Grogg Peter R. Giacobbi Emma K. Blair Treah S. Haggerty Christa L. Lilly Carena S. Winters George A. Kelley	714	Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping ReviewThe purpose of this scoping review was to examine interventions that focused on physical activity assessment and promotion in clinical settings in the United States. A literature search was performed in six major databases for interventions with practicing health professionals who performed physical activity assessment and promotion in adults from 2008 to 2019. Studies were excluded if they were published in non-English, observational or case study designs, or gray literature. Studies were screened and coded using the (PRISMA-ScR) framework. Of 654 identified studies, 78 met eligibility criteria and were independently coded. Forty-three of the studies were randomized trials with most delivered by physicians and nurses in primary care. Fifty-six studies reported statistically significant findings in outcome measures such as anthropometrics and chronic disease risk factors, with 17 demonstrating improvements in physical activity. The assessment and promotion of physical activity in clinical settings appears to be effective but warrants continued research
Knowing Well, Being Well
Rachel Mosher Henke	738	Out of Pocket Costs and Health Care UtilizationIndividuals use health care differently when they have a higher versus lower out of pocket costs. It is important to understand the implications of financial requirements on health behaviors given the current prevalence of high deductible benefit designs, and how any barriers to access can be addressed. Contributors to this month’s Knowing Well Being Well explore the effectiveness as value-based insurance designs at aligning patient incentives with use of value based care, motivate the importance of equitable health benefits, and provide a physician’s perspective on patient financial requirements
Christine Eibner Christine Buttorff Matthew Cefalu Dmitry Khodyakov Erin A. Taylor	KWBW740	The Effect of the Medicare Advantage Value-Based Insurance Design Model Test on Utilization in 2017In 2015, the Centers for Medicare & Medicaid Services (CMS) announced the Medicare Advantage (MA) Value-Based Insurance Design (VBID) model test, which allows MA insurers to use flexible benefit design strategies, such as reduced cost-sharing, to encourage beneficiaries with chronic disease to use high-value care. This article describes the results of analysis using MA encounter data to estimate the impact of VBID on health services utilization in 2017 using a differences-in-difference research design. Findings suggest that VBID successfully increased the use of high-value services among eligible MA beneficiaries, an important first step along the pathway to better chronic disease management, lower spending, and improved beneficiary health
Bruce W. Sherman Irene Dankwa-Mullan	KWBW 745	For the Commercially Insured, Equitable Health Benefits Begin With Equitable Health Insurance DesignEquitable health benefit design is central to addressing the health inequities of individuals with commercial health insurance in the United States. To do so, employers and other plan sponsors must take action to identify and address unmet health and well-being priorities among racialized groups and low-income workers. These historically underrepresented subpopulations will also benefit from more equitable approaches to healthcare benefits design that recognize and meaningfully address access and affordability concerns. Targeted appropriately, these actions have the potential to foster greater employee engagement and productivity, leading to enhanced business performance
Michael R. Udwin	KWBW 751	Patient Financial Requirements From a Physician’s Perspective: An Interview With Michael UdwinRachel Henke interviews Dr Michael Udwin, a board-certified obstetrician gynecologist who spent many years in clinical practice and is now a Medical Director at CareFirst BlueCross BlueShield based in Baltimore, Maryland to obtain a physician’s perspective on patient financial requirements. Dr Udwin provides insight on the importance of price transparency at the point of care. Lack of information about the relative costs of different treatments during patient-provider discussions about treatment options can result in nonadherence and subsequent undesirable health outcomes