American Journal of Health Promotion

Health literacy strategies were using plain language, using visual aids, using the teach-back method, limiting the number of items provided, and providing culture-sensitive care. This study aimed to assess predictors of intention to use health literacy strategies in patient education among healthcare professionals.

An institutional-based cross-sectional study, theory of planned behavior.

Bahir Dar, Northwest Ethiopia, from March 10 to April 10, 2023.

422 healthcare professionals.

Six items with a response range from 1 = strongly disagree to 5 = strongly agree each item was summed on a five-point Likert scale and its score range (6-30).

Linear regression, SPSS version 25.

A total of 389 healthcare professionals participated with a response rate of 92.18%. The overall mean intention towards health literacy strategies score was 24.02 with (SD ± 3.84). Subjective norm [(β, .231; 95% CI: .129, .333)], attitude [β, .162; 95% CI: .072, .252], perceived behavioral control [(β, .121; 95% CI: .022, .221)], having got training [(β, .125; 95% CI: .348, .530)] and knowing health literacy [(β, .251; 95% CI: .131, .371)] were factors.

The mean score of intention to use health literacy strategies was very low. Attitude, subjective norm, perceived behavioral control, training, and knowledge of health literacy strategies were predictors. Therefore, different strategies should be applied to increase the utilization of health literacy strategies.

To investigate how physical function performance and arthritis-related pain relate to sensor assessed movement behaviors in a diverse sample of inactive adults with various forms of arthritis.

Cross-sectional study.

Columbia, SC.

Adults with arthritis (n = 267; 60.0% Black, 92.0% female, 64.1 ± 9.4 years) from a telephone-based walking intervention.

Movement behaviors (moderate to vigorous intensity physical activity, MVPA; sedentary time) were assessed with ActiGraph accelerometers at baseline. Physical function was assessed through the six-minute walk test (6MWT) and the 30-second chair stand test (30CST). Arthritis-related pain was measured through a visual analog scale.

Multiple linear regression was used to examine the extent to which physical function performance and pain predicted movement behaviors while adjusting for sociodemographic and health characteristics.

Better 6MWT performance was positively associated with more MVPA per week (P < 0.001). Worse performance in the 6MWT (P < 0.001) and less pain (P = 0.02) were associated with more daily time spent sedentary. Performance in the 30CST was not significantly associated with either movement behavior.

These findings emphasize the importance of functional endurance and pain management in promoting physical activity and sedentary behavior among inactive adults with arthritis. Future public health interventions should prioritize strategies to enhance these components to effectively promote physical activity and less sedentary time.

Risk perception for tuberculosis (TB) and previous receipt of a TB test and/or vaccine were assessed to inform TB prevention efforts.

Cross-sectional.

The 2020, 2021, and 2022 Estilos survey data.

2837 U.S. Hispanic adults (≥18 years).

Self-reported receipt of a TB test and/or vaccine, perceived risk for TB, and demographic characteristics.

Weighted proportions and 95% Confidence Intervals (CIs) were calculated. Associations between demographic characteristics and TB questions were assessed using chi-square tests. Multinomial logistic regression was used to examine perceived risk for TB among those who received a TB test and/or vaccine vs those who did not.

Overall, 7.2% (95%CI [4.8, 10.5]) of U.S. Hispanic adults reported receiving a TB test but not a vaccine, 15.3% (95%CI [12.5, 18.7]) reported receiving a vaccine but not a test, and 28.3% (95%CI [24.7, 32.2]) reported receiving both a TB test and TB vaccine. Respondents who reported previous receipt of a TB test, with or without previous receipt of a TB vaccine, had a significantly higher odds of feeling any risk for TB than those without previous receipt of a TB test or vaccine (aOR = 2.79, 95% CI = 1.19-6.52 for those tested but not vaccinated; aOR = 1.89, 95% CI = 1.11-3.20 for those both tested and vaccinated).

Findings can help inform education and interventions to raise awareness and encourage TB testing for those at risk for TB.

To analyze temporal trends (2006-2023) and projections (2030) of the prevalence of Diabetes Mellitus (DM) and health risk and protective factors among adults with DM in Brazil.

Time-series study.

Data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey.

Population-based sample of 806 169 adults, including 74 381 adults with DM.

Prevalence of DM, health risk factors (eg, prolonged screen time on TV, sweetened beverage consumption, heavy episodic drinking, hypertension) and protective factors (eg, commuting physical activity, self-rated health).

Temporal trends (2006-2023) and projections (up to 2030) were analyzed using Prais-Winsten regression models. Results were expressed as average annual percentage point changes (pp/y).

The prevalence of DM increased from 5.5% to 10.2% between 2006 and 2023 (0.22 pp/y), with a higher increment in the recent period (2018-2023: 0.56 pp/y). By 2030, the prevalence is projected to reach 10.8%. Among adults with DM, recent trends revealed increases in prolonged screen time on TV (0.96 pp/y), sweetened beverage consumption (1.62 pp/y), and heavy episodic drinking (1.51 pp/y), alongside decreases in hypertension (−0.98 pp/y), poor self-rated health (−0.53 pp/y), and commuting physical activity (−0.97 pp/y).

The prevalence of DM has risen significantly in Brazil and is projected to continue growing. Simultaneously, worsening trends in health risk and protective factors among adults with DM highlight the urgent need for reformulated public health policies focused on DM prevention and management.

To assess the effectiveness of a school-based intervention to promote healthy behaviors and prevent weight gain in children.

Cluster randomized trial.

Seven elementary schools from Mexico.

475 children aged 8 to 12 years.

It was called “Family Particip-Action to prevent childhood obesity”, which was implemented under PRECEDE-PROCEDE model, and using two pedagogical strategies: socio-constructivist and social ecological model. Thirty theoretical-practical workshops on healthy diet were performed, and physical activity (PA) practice was encouraged by sportive tournaments.

Body mass index (BMI), waist circumference (WC), index of key healthy foods, PA and family function were assessed. The effect of the improvement of diet on the risk reduction of overweight, obesity, overweight/obesity, and abdominal obesity were estimated with generalized linear models with binomial log-linear regressions.

BMI and WC of children exposed to health promotion intervention were significantly lower after 24 months of intervention than control group: −1.2 kg/m² (P = 0.014) and −5.6 cm (P = 0.000), respectively. Children intervened and categorized into the healthiest diet reduced the risk of overweight by 31% (P = 0.032), obesity by 54% (P = 0.007), overweight/obesity by 35% (P = 0.001), and abdominal obesity by 41% (P = 0.002), comparing to control group.

The combined effect of encouraging healthy food consumption, sportive tournaments, healthful school environment, and family support, can reduce the risk of weight gain in children.

To examine associations between preschooler screen time trajectories and physical activity outcomes at age 5.5.

A longitudinal cohort study of Canadian parents with preschoolers.

Data were collected in Nova Scotia, Canada, during the COVID-19 pandemic in Spring/Summer 2020 and 2021, and Summer/Fall 2022.

A community-based convenience sample of 315 parents of preschool-aged children (54% boys) was followed longitudinally when children were 3.5 (2020), 4.5 (2021), and 5.5 years old (2022).

Parent-reported screen time at 3.5, 4.5, and 5.5 years was used to estimate preschooler screen time trajectories. Using growth mixture modeling (GMM), three groups were identified: low (mean = 0.89 h/day, 23%), average (mean = 2.96 h/day, 56%), and high (mean = 6.42 h/day, 21%) screen time trajectory groups. At age 5.5, physical activity was directly assessed using accelerometers to capture light, moderate, and vigorous-intensity physical activity. Parents also reported child sex, family configuration, and educational attainment.

Children in the high screen time trajectory group engaged in significantly less light-intensity physical activity (b = −29.98, P < .05) compared to children in the average screen time trajectory. No significant differences were observed between the low and average screen time trajectory groups for light-intensity physical activity. Additionally, no significant differences in moderate or vigorous-intensity physical activity were observed between the screen time trajectory groups.

Higher screen time in preschoolers is associated with reduced engagement in light-intensity physical activity. These findings highlight the importance of monitoring screen time to ensure that children have opportunities to engage in light-intensity physical activities such as active and outdoor play. Limiting early childhood screen time may support healthier physical activity patterns and promote early childhood development.

To understand general COVID-19 pandemic-related stressors among caregivers of children ages 3-15, and describe institutional, interpersonal, and personal protective factors used to cope with pandemic-related stress.

Semi-structured, in-depth interviews.

Maryland.

Caregivers of children enrolled in the COVID-19 Family Study; 38 caregivers during 2020 (T1) and 22 caregivers during repeat interviews in 2021 (T2).

The research team developed interview guides informed by the Family Stress Model (FSM) for T1 and T2 interviews. Interviews were analyzed using content coding to later construct themes related to how stressors and protective factors changed over time.

The thematic analysis is described across four concepts: caregiver stressors, institutional protective factors, interpersonal protective factors, and personal factors. In T1 interviews, stressors included viral exposure, remote work and school, and social distancing. During T2 interviews, caregivers described re-opening of work, school, and businesses and shifting back into pre-pandemic routines as continuing stressors. In both rounds of interviews, caregivers described a variety of institutional, interpersonal, and personal protective factors to cope with stress. Commonly mentioned protective factors included government aid (i.e., stimulus checks, free school lunches), family time, and hobbies.

Findings highlight the necessity of multi-tiered (institutional, interpersonal, personal) approaches to support caregivers navigating stressful experiences during times of extraordinary duress, especially emphasizing interventions that incorporate various levels of the socioecological model.

Develop a parsimonious model of individuals at heightened-risk for 3-year cardiometabolic multimorbidity (CM) onset.

An observational, secondary analysis of Canadian Longitudinal Study on Aging (CLSA) data.

CLSA is a national cohort study in Canada. Baseline data were collected between 2010-2015, and follow-up data were collected between 2015-2018.

CLSA included community-dwelling adults aged 45-85 at recruitment from across Canada.

Health conditions: stroke, heart disease or heart attack and diabetes. Personal factors: age, sex, marital status, household income, education, and ethnicity. Environmental factors: social support, personal assistance, and location of residence. CM cases: at least two of stroke, heart disease and diabetes at follow-up assessment.

Hierarchical logistic regression analyses with backwards elimination procedures were used to develop a parsimonious prediction model.

The sample consisted of 41 841 individuals, representing a weighted population of 13 741 119. The population had a mean age of 62.3 years (SD = 10.1), was 53% female, predominantly married or in common-law relationships (77%), post-secondary graduates (61%), white (95%), and lived in an urban area (81%). Males (OR:1.93, 95%CI:1.65-2.25, P < 0.001), ≥65 years (OR:1.51, 95%CI:1.29-1.76), P < 0.001), who had stroke (OR:20.09, 95%CI:12.88-30.35, P < 0.001), heart disease (OR:15.55, 95%CI:12.60-19.26, P < 0.001), or diabetes (OR:12.57, 95%CI:10.37-15.31, P < 0.001), not completed post-secondary (OR:1.30, 95%CI:1.04-1.61, P = 0.017), income of <50k (OR:1.29, 95%CI:1.10-1.52, P = 0.002), and received home care (OR:1.56, 95%CI:1.17-2.04, P = 0.002) were at heightened risk of CM.

Developing a profile of high-risk individuals may enhance the efficiency of CM prevention and reduce disease onset. Critical limitations include the CLSA exclusion criteria, and the small proportion of minoritized individuals that restrict generalizability in these populations.

Patient satisfaction is a key principle of high-quality care, important to all health systems. While evidenced-based guidelines recommend tobacco use counseling to all hospitalized patients who use tobacco, scant knowledge exists about patient satisfaction with these services. The Satisfaction with Inpatient Tobacco Treatment Study (1) proposes a novel survey tool to measure patient satisfaction with inpatient tobacco treatment and (2) provides survey results from our hospital’s Tobacco Treatment Program.

Creation and administration of an 8-item Likert scale survey to assess inpatient tobacco use counseling.

A random sample of inpatients who received remote inpatient tobacco use treatment at UNC Health’s Tobacco Treatment Program were selected for participation. The survey was administered by telephone and email.

Survey items assessed constructs of patient satisfaction, resource availability pre- and post-discharge, the perceived benefits of inpatient tobacco treatment counseling, and patient-reported smoking cessation.

Survey responses were analyzed using descriptive statistics and Fisher’s Exact Tests.

The majority of respondents reported satisfaction with tobacco use counseling. 92% strongly agreed or agreed that the consultations improved their overall hospital experience and 90% said they quit or cut down on their tobacco use after discharge. Results did not vary significantly by race, insurance status, or gender.

Patient satisfaction with inpatient tobacco cessation treatment was high across multiple domains, as was patient-reported smoking cessation. The survey instrument can be further validated and adapted for program assessment and quality improvement in other tobacco treatment programs.

To characterize individual- and structural-level stigma associated with government (ie, SNAP, WIC) and emergency food program (ie, food banks, pantries, cupboards, soup kitchens) utilization in the US.

5 databases (PubMed, PsychINFO, Web of Science, CINAHL, Sociological Abstracts) were searched in June 2024.

Included peer-reviewed articles (January 2004 - June 2024), in the US, in English, original research or systematic reviews, and report on data closely related to general food insecurity, government and emergency food program participation, and stigma manifestations among adults.

Data on study characteristics and stigma were extracted using a structured template.

Descriptive statistics and thematic analysis were used.

Our search yielded 99 articles. A majority studied individual-level stigma (57.4%) and used qualitative designs (62.6%). Among the 9 identified populations, food insecure adults were the most frequently studied (25.2%). Anticipated stigma (29.8%) was the most commonly reported stigma manifestation, deterring program participation.

This review underscores the significance of addressing food insecurity-related stigma to enhance the effectiveness of food assistance programs. Given the extensive evidence of the impact of stigma on program participation, policymakers and program administrators should design, implement and test strategies to address stigma. Future research should explore intersectional stigma, develop a food insecurity-related stigma measure, and evaluate stigma-reduction interventions longitudinally and across program settings.

This scoping review aimed to synthesise research on the relationships between health literacy and adherence to physical activity guidelines in adults.

A search of MEDLINE, ProQuest, Scopus, CINAHL, Web of Science (Core Collection), PubMed, and PsycINFO was conducted using keywords. Observational and intervention studies written in English were reviewed.

Eligible research studies used a validated, objective measure of health literacy. Physical activity needed to be reported as either a primary or secondary outcome, and groups needed to be dichotomised as physically active, inactive, or similar.

Out of 2098 articles identified, 19 met the inclusion criteria.

A numerical analysis of the studies was performed. A narrative summary supplemented the analysis to synthesise the main themes and patterns.

Fifteen studies examined the association between total health literacy scores and achieving >150 minutes of moderate-to-vigorous physical activity weekly. Nine studies reported a positive association, while others found no significant association. In particular, studies using self-reported physical activity more frequently found an association, whereas no association was found when using objective physical activity measures.

The findings of this review were inconclusive. The lack of a standardised health literacy instrument presents a barrier to progress in the field of physical activity and health literacy research. Moreover, longitudinal relationships between health literacy, mediators and physical activity must be investigated.