American Journal of Health Promotion

Examine changes in sleep duration by 3 behavioral phenotypes during a workplace wellness program with overweight and obese adults.

Secondary analysis of a randomized clinical trial

Remotely monitored intervention conducted across the United States

553 participants with a body mass index ≥25

Participants were randomized to 1 of 4 study arms: control, gamification with support, gamification with collaboration, and gamification with competition to increase their physical activity. All participants were issued a wrist-worn wearable device to record their daily physical activity and sleep duration.

The primary outcome was change in daily sleep duration from baseline during the 24 week intervention and follow-up period by study arm within behavioral phenotype class.

Linear mixed effects regression.

Participants who had a phenotype of less physically active and less social at baseline, in the gamification with collaboration arm, significantly increased their sleep duration during the intervention period (30.2 minutes [95% CI 6.9, 53.5], P = 0.01), compared to the control arm. There were no changes in sleep duration among participants who were more extroverted and motivated or participants who were less motivated and at-risk.

Changes in sleep during a physical activity intervention varied by behavioral phenotype. Behavioral phenotypes may help to precisely identify who is likely to improve sleep duration during a physical activity intervention.

This study examined attitudes, perceived control, perceived norms, intention, and policy support before and after the peak of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) cases among 2 independent samples of U.S. adults.

This study used a successive independent samples design.

Data was collected through online surveys in July 2019 (n = 521) and October 2019 (n = 536).

Participants were recruited through the Qualtrics Survey Panel. Eligibility criteria included: 1) 18 years or older, and 2) currently living in the U.S.

The 2 surveys were collected from 2 separate samples examined e-cigarette attitudes, perceived control, perceived norms, intention, and policy support.

Linear regressions were used to examine the association between time, attitudinal, and belief factors associated with intention and policy support.

Participants in the October sample (n = 521) were significantly more likely to have negative attitudes towards e-cigarettes when compared to the July sample (n = 536), F(8,1047) = 52.671, p < .01, R² = 0.287. Lower perceived social acceptance towards e-cigarettes and negative attitudes were related to higher support for restricting where e-cigarettes could be used, F(11, 1042) = 63.218, p < .010, R² = .401. Higher perceived control over accessing e-cigarettes, but lower social acceptance of e-cigarettes and negative beliefs were associated with higher support for limiting places where e-cigarettes could be purchased, F(11,1039) = 36.200, p < .01, R² = .277.

Results indicate that EVALI cases may have had an immediate negative effect on attitudes but did not appear to decrease intention to use e-cigarettes. Results could inform future public health campaigns' programming and research. More research is needed to understand the long-term impact of EVALI on e-cigarette use.

To examine multilevel predictors on American public response to COVID-19.

Multilevel study.

A national survey was conducted by Qualtrics from August 24 to September 11, 2020. The state-level variables were constructed on data from multiple sources.

2,440 respondents 18 years and older from all 50 states and D.C.

The outcome variable is the public response to COVID-19 measured by threat perception, behavioral adjustment, and policy support. The predictors include individual-level sociodemographic factors and state-level indicators about public health conditions, political context, and economic recovery.

Multilevel structural equation modeling is used for statistical estimation.

People from states with more COVID-19 cases (β = 0.020, p < 0.1), mandatory face mask policies (β = 0.069, p < 0.05), and liberal governments (β = 0.002, p < 0.05) are more likely to respond while people from states whose economies have recovered closer to the pre-pandemic level are less likely to do so (β = −0.005, p < 0.05). Regarding individual-level predictors, older people (β = 0.005, p < 0.001) and people with better education (β = 0.029, p < 0.01), leaning toward the Democrat Party (β = 0.066, p < 0.001) and liberal political ideology (β = 0.094, p < 0.001), and have stronger generalized trust (β = 0.033, p < 0.001) are more likely to respond than their counterparts.

Differences in the public response to the pandemic stem from variations in individual characteristics and contextual factors of states where people live. These findings contribute to the rapidly growing literature and have implications for public health policies.

Assessed socioeconomic factors in health information seeking behavior and trust of information sources from 2007 to 2017.

Pooled cross-sectional survey data.

Health Information National Trends Survey.

Data included 6 iterations of U.S. adults (Pooled: N = 19,496; 2007: N = 3,593; 2011: N = 3,959; 2013: N = 3,185; FDA 2015: N = 3,738; 2017: N = 3,285; and FDA 2017: N = 1,736).

Outcome variables were health information seeking, high confidence, and high trust of health information from several sources. Independent variables were education and income group, controlling for other sociodemographic variables.

Weighted descriptive and multivariate logistic regression for the pooled sample assessed associations by education and income. Fully interacted models with education/income-survey year interactions compared differences in outcomes between years.

We found information seeking, confidence, and trust were associated with income and education, which supported previously reported findings. Additionally, our findings indicated low-and medium-income groups had significantly lower odds of seeking health information compared to those in a high-income group. Regarding trust of information, a high school education was associated with higher odds of trust in family and friends. We also found that, over time, information seeking, confidence, and trust behavior differed by income and education, with some differences persisting.

Disparities by income and education in trust of information sources remained across time. Understanding optimal information sources, their reach, and their credibility among groups could enable more targeted interventions and health messaging. We also describe the implications for our findings in the context of COVID-19.

The objective of this study is to identify the relationship between COVID-19 experiences, perceived COVID-19 behavioral control, social norms and attitudes, and future intention to follow social distancing guidelines.

This is a cross-sectional study.

Participants responded to an on-line survey in June 2020.

The study included 3,183 residents within Quebec, Canada aged 18 and over.

Measures include perceived COVID-19 related discrimination, fear of COVID-19 infection, prior exposure to COVID-19, and prior social distancing behavior. Participants self-reported attitudes, perceived behavioral control, and perceived norms related to social distancing. Finally, we measured social distancing behavioral intention.

We evaluated a theory of planned behavior (TPB) measurement model of social distancing using confirmatory factor analysis (CFA). The association between COVID-19 perceived discrimination, fear of infection, previous social distancing behavior, exposure to COVID-19, TPB constructs and behavioral intentions to social distance were estimated using SEM path analysis.

TPB constructs were positively associated with intention to follow social distancing guidelines. Fear of COVID-19 infection and prior social distancing behavior were positively associated with behavioral intentions. In contrast, perceived discrimination was negatively associated with the outcome. Associations between fear of COVID-19, perceived COVID-19 discrimination and behavioral intentions were partially mediated by constructs of TPB.

COVID-19 prevention efforts designed to emphasize positive attitudes, perceived control, and social norms around social distancing should carefully balance campaigns that heighten fear of infection along with anti- discrimination messaging.

To examine whether social network characteristics of US-and foreign-born individuals are related to hypertension, diabetes and obesity prevalence.

Cross-sectional.

Six San Francisco Bay Area counties.

N = 1153 cohorts of young and older adults (21-30 and 50-70 years).

Network structure and support measures were calculated using name elicitation and interpreter questions common in egocentric surveys. Hypertension and diabetes were self-reported, and overweight/obesity was determined using body mass index calculations. Foreign-birth status was based on country of birth.

Adjusted and unadjusted logistic regression models were used to examine associations between network characteristics and hypertension, diabetes and overweight/obesity. These relationships were tested for moderation by foreign-birth status, age and gender.

Higher percentages of family members (AOR = 4.16, CI: 1.61-10.76) and same-sex individuals (AOR = 3.41, CI: 1.25-9.35) in the composition of respondents’ networks were associated with overweight/obesity. Higher composition of family members (AOR = 3.54, CI: 1.09-11.48) was associated with hypertension. Respondents whose networks composed of higher numbers of advice individuals (AOR = 0.88, CI: 0.77-0.99), female respondents (AOR = 0.52, CI: 0.35-0.77) and foreign-born respondents (AOR = 0.54, CI: 0.32-0.92) were less likely to report overweight/obesity. Diabetes was associated with higher composition of individuals living within 5-minutes to respondents (AOR = 5.13, CI: 1.04-25.21).

Family and network support members such as advice individuals could be potential targets for chronic disease prevention, particularly among older adults and immigrants.

Public health campaigns are still relatively rare in mental health. This paper aims to find consensus on the preventive self-management actions (i.e. “healthy behaviors”) for common mental health problems (e.g. depression and anxiety) that should be recommended in mental health campaigns directed at the general public.

A 3-round Delphi study

23 international experts in mental health and 1447 members of the public, most of whom had lived experience of mental health problems.

The modified Delphi study combined quantitative and qualitative data collection: 1) online qualitative survey data collection thematically analyzed, 2) recommendations rated for consensus, 3) consensus items rated by public panel on a Likert scale.

Expert consensus was reached on 15 behaviors that individuals can engage in to sustain mental health. Eight were rated as appropriate by more than half (50%) of the public panel, including: avoiding illicit drugs (80%, n = 1154), reducing debt (72%, n = 1043), improving sleep (69%, n = 1000), regulating mood (65%, n = 941), having things to look forward to (60%, n = 869).

A series of healthy behaviors for the promotion and protection of mental health received expert and public consensus. To our knowledge, this is the first study to offer a set of actions for public health messaging for the prevention of poor mental health. Future research should focus on evaluating effectiveness of these actions in a universal primary prevention context.

To examine disparities in psychological health-related quality of life (HRQoL) among sexual minority women within racial/ethnic subgroups.

A secondary analysis of the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS).

United States.

Noninstitutionalized, cisgender, adult women in the U.S (unweighted n = 81,947).

Socioeconomics, health behaviors, and healthcare access as risk factors, whereas 1 item measures psychological HRQoL as an outcome.

Weighted multivariable logistic regressions to estimate the odds of having adversely psychological HRQoL in relation to sexual orientation and other correlates within a racial/ethnic subgroup independently.

The prevalence of adverse psychological HRQoL was greater in bisexual and “other” sexual orientation women. Both bisexual (adjusted odds ratio [aOR] = 1.58; 95% confidence interval [CI] = 1.26-2.00) and “other” sexual orientation (Aor = 1.93; 95%CI = 1.26-2.96) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in non-Hispanic White women. Bisexual women (aOR = 3.42; 95%CI = 1.98-5.88) had greater adjusted odds of adversely psychological HRQoLcompared to their heterosexual peers in Latinas. No similar pattern was observed in non-Hispanic Black women.

Disparities in psychological HRQoL varied by sexual orientation identities within different racial/ethnic subgroups. The magnitude of the association for Latina bisexual women was strong. Implications for bisexual health among people with intersecting identities are discussed.

This study examined parents’ perceived importance of, and engagement in, school-based physical activity (PA) promotion.

A cross-sectional, quantitative survey design was employed.

The survey was conducted in the United States.

Using a probability-based panel (AmeriSpeak®), a national sample of 3599 parents was randomly recruited to participate in the survey and 1015 participants (28.2%) completed it. Parents or legal guardians of children enrolled in K-12 during the 2017-2018 school year were eligible to participate.

The survey was developed and distributed by a national collaborative for active schools with the support of a national research center.

Data were analyzed using structural equation modeling and path analysis.

The data supported a 6-factor solution encompassing perceived importance of PA before, during, and after school, communication with administrators, and volunteering and participating in school-based PA (CFI = .974, RMSEA = .034, SRMR = .056). Path coefficients from perceived importance of PA before/after school to current (β = .43; 95%CI[.25, .61]) and future communication with administrators (β = .40; 95%CI[.23, .55]) were statistically significant, as were coefficients from perceived importance of PA before/after school to past (β = .60; 95%CI[.35, .83]) and current volunteering/participating in school-based PA (β = .63; 95%CI[.42, .85]).

Parents’ perceived importance of school-based PA opportunities before and after school warrants emphasis in future research and advocacy.

To identify, review, and describe multicomponent physical activity (PA) interventions in terms of: (a) number and combination of Comprehensive School Physical Activity Program (CSPAP) components, (b) study characteristics, and (c) primary outcomes.

Five electronic databases (i.e., PubMed, PsychInfo, Physical Education Index, Sport Discus, and ERIC).

Included articles were peer-reviewed, written in English language, published since 1987, and included multicomponent school-based interventions.

Data items extracted were: school level, setting, CSPAP component description, health outcomes, academic outcomes, main conclusion, and reference.

Included articles were synthesized by: (1) CSPAP components utilized, and (2) research outcome measured (i.e., health or academic).

Across 32 studies, 11 included physical education plus 1 additional CSPAP component (PE + 1); 10 included PE + 2 additional CSPAP components; 8 included PE + 3 additional CSPAP components; and 1 included all 5 CSPAP components. Two other studies included 2 or 3 CSPAP components without PE. Most interventions targeted health outcomes (94%) rather than academic outcomes (6%).

Multicomponent approaches aligned with CSPAPs are effective in promoting PA and other positive outcomes for youth in schools. Future research should seek to understand effects of CSPAP components on a variety of outcomes and settings.

The aim of this review was to analyze the effectiveness of workplace exercise interventions on body composition (BC).

Studies published in PubMed, Scopus, SPORTDiscus, Web of Science, CINAHL and PsycINFO, from the earliest time point until 8 July 2020.

Inclusion criteria were worksite interventions, in adults, Randomized Controlled Trials (RCTs), real exercise practice, and measuring BC outcomes. Exclusion criteria were full-text non-available, abstract not in English, and exercise protocol missing.

157 studies were retrieved and assessed for inclusion by 2 independent reviewers, who also used the Cochrane’s Collaboration Tool to assess study quality and risk of bias.

We performed a meta-analysis to determine the effect size of the interventions on BC outcomes reported in at least 5 studies.

Twelve RCTs were included (n = 1270, 66% women), quality of studies being low to high (25% moderate, 67% high). Interventions achieved a statistically significant decrease in waist circumference (SMD = 0.24; 95% confidence interval (CI): 0.06 to 0.41; p = 0.008), total mass fat (SMD = 0.21; 95%CI: 0.00 to 0.41; p = 0.047), and body adiposity index (SMD = 0.20; 95%CI: 0.00 to 0.41; p = 0.049). No changes were observed in body weight (SMD = 0.08 95%CI: −0.02 to 0.18; p = 0.128). Additionally, muscle mass increased in interventions that included strength training. There were no adverse events reported.

The most effective workplace exercise interventions to improve BC combined supervised, moderate-intensity aerobic and strength training, for at least 4 months.