American Journal of Health Promotion

This study aimed to investigate the risks of esophageal cancer (EC), protective behaviors, and risk awareness among Turkish adults aged 50 years and older, as well as their relationships with sociodemographic characteristics.

Cross-sectional. Recruitment took place between February-April 2022, via online google forms and WhatsApp.

Participants completed the survey online throught WhatsApp.

Analyses included 214 participants (≥50 years from three provinces of Turkey); 73.8% female (n:158), 62.6% between 50-60 years (n:134 ), 55.6% had a university education (n:47).

Study-specific survey items included questions about demographics, risky conditions and diseases, preventive health behaviors and Esophageal Cancer Knowledge Test (ECRKT).

Frequency or Mean, Percentage, Independent Samples t-Test, one-way analysis of variance (ANOVA), post hoc analysis (Tukey, LSD), and Cohen’s effect size and linear regression analysis.

The participants had low ECRKT scores (x:13.50 ± 9.33, Min:0, Max:31) and reported the most consumed hot beverages (36.9%) among negative EC preventive behaviors. Male gender, not working, not having previously received training on EC, low education and income status cause low knowledge and awareness about EC (P < 0.05). Most of the participants had oral herpes (54.7%), vitamin deficiency (49.1%), and obesity (47.2%) in the past or now. Regarding the participants’ EC risk knowledge and, female gender, being between 50-60 years old, and being employed had a weak effect (η²<0.01), while having previous EC training had a moderate effect (η² = 0.006), and having university or higher education had a large positive effect (η² = 0.14) (P < 0.05). Participants’ level of education and previous educational experiences contribute significantly to esophageal cancer risk knowledge (P < 0.01).

These findings highlight adults aged ≥50 years are exposed to significant EC risks, and have poor knowledge of EC risks. These results highlight the urgent need for educational campaigns to improve EC awareness.

Pre-exposure prophylaxis (PrEP) is a critical tool for HIV-prevention, yet PrEP uptake among Black sexual minority men (BSMM) is relatively low, despite greater HIV vulnerability. Stigma in healthcare settings can be a substantial barrier to PrEP use among BSMM, with implications for the HIV epidemic. We used a sequential explanatory mixed-methods approach to assess quantitative relationships between anticipated healthcare stigma and reduced PrEP use among BSMM, and qualitatively explore stigmatizing experiences within healthcare settings among this population.

We utilized 2 data sources. First, cross-sectional data from a pilot sample of BSMM (n = 151) was collected in late 2020 in the United States. We tested for associations between healthcare stigma and PrEP use using modified Poisson regression. Subsequently, we selected participants (n = 23) from this sample in the D.C. metropolitan area for qualitative interviews starting in 2022; we used thematic analysis to investigate forms of experienced and anticipated healthcare stigma related to PrEP use.

We found 82% lower PrEP use associated with an interquartile range increase in anticipated healthcare stigma after adjustment (aPR = 0.18, 95% CI 0.06, 0.59). Subsequently, our qualitative investigation revealed that identity-specific stigma, negative socioeconomic assumptions, and assumptions of sexual risk were prevalent themes in the healthcare stigmatization experienced by BSMM. Identity-based and socioeconomic stigma were heavily interlinked due to longstanding structural racism and homophobia. Assumptions of sexual risk were particularly complex.

We discovered a significant negative relationship between anticipated healthcare stigma and PrEP use, further elucidated in our qualitative findings. This builds upon our previous work exploring intracommunity PrEP stigma among BSMM. Healthcare stigma serves as an additional obstacle to accessing PrEP for BSMM. This highlights its importance as a target for provider-level health equity policy and research interventions. Future research exploring this stigma in specific healthcare settings is recommended.

This study examines the mediating roles of social media use and trust in the relationship between experts’ health recommendations being conflicting and changing and their intention to receive cancer screening tests using the O₁-S-O₂-R model.

Cross-sectional.

Data were extracted from the Health Information National Trends Survey (HINTS) 6.

Of 6252 individuals, 5014 were used in the final analysis. The total weighted sample size is 255,489,241.

Conflicting & Changing Health Recommendations (O ₁ ): How often experts’ health recommendations seem to conflict and change. Social Media Use (S): The use of social media to seek and share health information. Trust in Cancer Information (O ₂ ): Trust in cancer information from doctors, government health agencies, and scientists. Interest in Cancer Screening in the next year (R).

Multiple and logistic regressions were performed with the weighted sample. A PROCESS mediation model with a 5000 bootstrapping sample was also performed.

The perception of health recommendations from experts conflicting was a positive, marginally significant predictor of social media use for seeking and sharing health information (P = .08), which generated higher trust in cancer information from government health agencies (P < .05) and higher intention to receive cancer screening tests within the next year (P < .01).

With strong digital health literacy and appropriate social media algorithms, social media could reinforce cancer screening behaviors.

The impact of gun violence on mental health is not limited to individuals who have experienced a shooting. This report enumerates, for the entire US population, the prevalence of anxiety and stress about gun violence. It also describes evidence-informed interventions that may improve these symptoms by reducing gun violence.

Surveys representing the US population.

United States.

Adults and adolescents.

Self-reported anxiety and stress.

Descriptive frequencies.

On 3 surveys of adults (N sizes 2015 to 3192), between 27% and 38% selected “extremely anxious”, 26% to 35% selected “somewhat anxious”, and 12% selected “not at all anxious” when asked about gun violence concerns. When asked, 37% of respondents stated that they had avoided going somewhere over the past 6 months due to fear or anxiety about gun violence. In a survey of teens (N = 743) and their parents (N = 1058), 25% of teens selected “very worried” and another 32% “somewhat worried” about the possibility of a shooting happening at their school. In response to the same question, 24% of parents selected “very worried” and another 39% “somewhat worried”.

Anxiety and stress about gun violence are pervasive in America. Secure gun storage, universal background checks and extreme risk protection orders are among the interventions that reduce gun violence and may thereby reduce the anxiety and stress it generates.

Self-care is recognized as an important element in the comprehensive management of patients with heart failure. The study aimed to explore the correlations of self-care behaviors in chronic heart failure patients in Kermanshah, West Iran.

Descriptive and analytical cross-sectional.

Hospital.

The research population included 597 (246 female and 351 male) patients with chronic heart failure visiting Imam Ali Cardiovascular Hospital in Kermanshah in 2022.

Demographic information, European Heart Failure Self-care Behavior Scale.

Independent-sample t test, ANOVA, and Kruskal-Wallis in SPSS-24. The significance level was set at 5%.

The participants’ age was 63.04 ± 14.1 years. The mean and standard deviation of the participants’ self-care behaviors was 2.91 ± 31.00, and only 20.60% of the patients reported engaging in satisfactory self-care behaviors. Self-care behaviors were significantly related to Income level, ethnicity, family history of background disease, history of co-morbidity, history of addiction, access to medical centers, and not with any other variables.

Based on the study’s results, most participants exhibited moderate self-care behaviors, suggesting that these patients may need preventive educational interventions to acquire the knowledge, skills, and attitudes necessary for effective self-care behaviors. Therefore, it is essential to design and implement a health promotion educational intervention aimed at convincing these patients to make lifestyle changes and adhere to their dietary and medication regimens to improve self-care behaviors.

To assess diet quality and nutrition self-efficacy in pregnant women, the relationship between diet quality and nutrition self-efficacy, and differences in diet quality and self-efficacy when information obtained from health and non-health professionals.

Observational cross-sectional study.

Online survey.

Australian pregnant women.

Australian Eating Survey measured diet quality, Ralf Schwarzer and Britta Renner nutrition self-efficacy scale measured nutrition self-efficacy.

Spearman’s correlation measured the association between diet quality and nutrition self-efficacy. Linear regression examined the influence of nutrition self-efficacy on diet quality. T-tests examined differences in diet quality and nutrition self-efficacy scores in groups who did/did not obtain nutrition information from health professionals.

Participants (n = 171) (mean (SD) age 32.5 (3.9) years, 81.9% born in Australia) reported a mean diet quality score of 33.9 (8.7) out of 73 and mean nutrition self-efficacy score of 14.7 (3.7) out of 20. A moderate positive linear relationship was observed between diet quality and nutrition self-efficacy (r _s = 0.27, P < .001). Nutrition information was obtained by 88%, most commonly via the internet. Diet quality scores were not significantly different when nutrition information was obtained from health professionals (t(24) = −0.823, P = .32), however, nutrition self-efficacy scores were significantly higher (U = 856, z = 2.18, P = .03).

Pregnant women report poor diet quality. Improving nutrition self-efficacy may be effective for improving diet quality. Evidence-based nutrition information should be accessible via the internet and promoted by health authorities.

To examine multimorbidity prevalence by race/ethnicity and unique health disparities for Native Hawaiian and Other Pacific Islanders (NHPI).

Cross-sectional study.

This study uses combined data from the 2014 National Health Interview Survey (NHIS) and the 2014 NHPI-NHIS.

38,965 adults, including a representative sample of 2,026 NHPIs.

Self-reported diagnoses of ten chronic conditions and race/ethnicity, including Non-Hispanic (NH) Whites, NH Blacks, NH Asians, NH NHPIs, Hispanics and NH Mixed Race. Covariates include age, sex, marital status, education, family income, and employment status.

We used multinomial logistic regression models to evaluate the adjusted association between race/ethnicity and number of chronic conditions: none, 1, and ≥ 2 (multimorbidity).

Compared to Whites, Asians and Hispanics (aRRR = 0.39, P < .001 and aRRR = 0.59, P < .001) had significantly lower odds of having multimorbidity relative to no chronic condition. In contrast, Black Americans and NHPIs (aRRR = 1.27, P < .001 and aRRR = 1.22, P < .05) had significantly higher odds of multimorbidity compared to Whites. Of note, NHPIs showed significantly higher odds of multimorbidity compared to Asians (aRRR = 3.07, P < .001).

Our findings highlight significantly higher risk of multimorbidity for NHPIs relative to Whites as well as Asians. This underscores the importance of disaggregating NHPI data from Asians as a whole. Future studies should incorporate additional social factors relevant to the NHPI community.

To assess the association between secure firearm storage and economic instability.

Cross-sectional survey.

California, Minnesota, Nevada, and New Mexico.

Respondents to the 2022 and 2023 Behavioral Risk Factor Surveillance System who reported presence of a firearm in or around the home.

Economic instability was defined by receipt of food stamps, experiencing threats to shut off utilities, inability to pay bills, employment instability, unreliable transportation, and food insecurity. Firearm storage was dichotomized to “loaded and unlocked” or “all other storage”.

Logistic regression with complex survey weights.

Among survey respondents who reported a firearm in or around the home (n = 29,977), 25.8% (95% CI: 24.7-26.8%) reported at least one indicator of economic instability, and 17.4% (95% CI: 16.5-18.3%) stored at least one firearm loaded and unlocked. After controlling for age, sex, and the presence of a child in the home, the odds of storing a firearm loaded and unlocked were 1.26 (95% CI 1.07-1.48) times higher for those experiencing economic instability compared to those who were not.

These results provide evidence for the association between economic instability and firearm storage behaviors. In promoting secure firearm storage, economic instability may need to be considered as a correlate of that behavior.

This study aims to evaluate causal relationships among eating rate, caloric intake, and weight gain using longitudinal data and to clarify how caloric intake mediates the effect of eating rate on weight gain.

A longitudinal cohort study with a 4-year follow-up.

Data were collected from Daihatsu Co, Ltd employees, a major Japanese automobile manufacturer with 4 plants in Japan.

Of the 12,816 working-age Japanese individuals who underwent health checkups in 2020, 7,784 without excess weight or non-communicable diseases were included.

The eating rate was self-reported, and caloric intake was calculated based on cafeteria meal choices.

Annual change in body mass index (BMI), calculated as the difference in BMI between consecutive years.

Mediation analyses using a mixed-effects model were conducted to assess whether caloric intake mediates the effect of eating rate on BMI.

Caloric intake in the fast-eating and ordinal-eating groups exceeded that of the slow-eating group by 19.21 kcal [9.28, 29.13] and 10.01 kcal [1.20, 18.81], respectively. Higher caloric intake was associated with a more significant BMI increase, rising by .09 [.06, .13] per interquartile range increase. The proportion of mediated impact among the impact of eating rate is .19% [.09, .32].

Faster eating independently contributes to BMI increases, with minimal mediation by caloric intake. Interventions targeting eating pace may prevent obesity, though the study population may limit generalizability.

This systematic review summarizes the effectiveness and the dose of walking interventions on specific cognition domains in older adults, including executive function, memory, attention, processing speed, and global cognition.

Published randomized controlled trials in PubMed, Embase, and Web of Science until 10 May 2023.

Studies include older adults without Alzheimer’s or related dementias, involving a walking intervention and performance-based neuropsychological assessments for executive function, memory, processing speed, attention, or global cognition.

Two independent research assistants reviewed 8424 studies and included 17 studies.

Participant demographics, intervention features (type, intensity, time, frequency, duration, format, and context), cognitive assessment tools, and main findings.

Nine studies found a favorable effect of walking interventions on at least one cognitive domain. Walking interventions improved executive function (n = 6) and memory (n = 3). These studies delivered the intervention individually (n = 3) for at least 40 minutes (n = 6) each time, three times per week (n = 8), between 6 to 26 weeks (n = 8), and walking at a moderate to vigorous intensity (n = 7).

Walking interventions may improve specific domains of cognitive function in older adults, particularly executive function and memory. More standardized reporting of intervention design and participant compliance based on published guidelines is needed to determine the dose-response association and the long-term effect of walking interventions on cognition.

Co-creation is crucial for fostering active patient engagement in health management. However, the efficacy of co-creation in chronic disease management varies, and there is a lack of detailed description regarding co-creation practice. This study aimed to explore the effectiveness of co-creation on health outcomes and cost-effectiveness, detailing its implementation.

PubMed, Embase, Scopus, Cochrane Library and Web of Science.

We included peer-reviewed randomized controlled trials, published in English, that analyzed the effects of co-creation on physical health, participation outcomes, psychological health, self-efficacy and cost-effectiveness.

Two researchers independently screened the articles and assessed the quality of the 16 included studies using a pre-prepared checklist.

Meta-analyses were conducted to summarize the characteristics, outcomes, and risk of bias of the included studies.

The results showed that co-creation significantly enhanced patients’ physical health (P = 0.006) and participation outcomes (P = 0.009). Subgroup analysis revealed that co-creation combined with theory was better than co-creation without theory in improving physical health (P = 0.007). However, no significant difference was observed between the two groups regarding psychological health, self-efficacy and cost-effectiveness (P = 0.29) (P = 0.11) (P = 0.50).

Co-creation effectively improved patients’ physical health and participation outcomes, without affecting psychological health, self-efficacy, and cost-effectiveness. Social determinants were found to play a more crucial role in influencing physical health of patients. Additionally, age disparities might impact the cost-effectiveness of co-creation. Future research should explore the influence of intergenerational co-creation on health promotion.