搜索结果：American journal of health promotion : AJHP

ObjectiveWe systematically reviewed evidence on the association between habitual walking (regular, non-prescribed walking as part of daily living quantified by duration, distance, step count, frequency and/or volume) and health outcomes among community-dwelling older adults.Data SourceMEDLINE, Embase, Global Health, and Psych Info databases; searched from inception to 5th September 2025.Study Inclusion and Exclusion CriteriaProspective cohort studies on habitual walking and health outcomes among older adults (65+ years) published in English were included.Data extraction and synthesisQuality of studies was assessed using the risk of bias in non-randomised studies of exposure (ROBINS-E) tool. A meta-analysis (random effects model) examined the association between daily step count and all-cause mortality.ResultsOf 25 175 records identified, 46 studies (367 843 older adults and 28 unique outcomes) were included. The pooled estimates of walking are based on 19 206 older adults. Older adults who performed an average of 5694 steps/day, had a 13% lower risk of all-cause mortality (HR: 0.87, 0.80-0.95) per additional 1000 steps/day. Benefits remained similar regardless of walking pace. Walking benefits were observed across mortality, disease onset, hospitalisation, cognitive, psychological and functional outcomes.ConclusionWalking is a simple, accessible method of physical activity with minimal risk of injury, associated with a lower risk of multiple health outcomes. Public health campaigns and policies should advocate walking to promote healthier ageing.

ObjectivesInvestigate the types of health professionals delivering physical activity (PA) interventions to persons with physical disabilities (PwPD), the settings, and the characteristics of these interventions.Data SourceFive major databases were used to extract peer-reviewed articles published from 2002-2025.Inclusion and Exclusion CriteriaStudies with a PA-based intervention for PwPD at least 18 years of age were included. Studies were excluded if published in non-English, if fewer than 51% of the study included PwPD, or if disability was only age-related.Data ExtractionArticles were reviewed and coded by two independent reviewers using a standard form. Extracted data included study design, sample size, population diagnosis, profession conducting the intervention, intervention setting and country, and characteristics of the PA intervention.Data SynthesisData were synthesized using descriptive and qualitative methods.ResultsNinety-eight articles were included. Various professionals provided PA interventions; physical therapy and research staff were the most common. PA interventions were delivered in a variety of settings with community-based centers being most prevalent. PA interventions varied in frequency, intensity, duration, and type.ConclusionPA interventions are conducted by a variety of health professions and settings. Less-involved professions could play a larger role in the provision of these interventions to promote health management for PwPD. PA intervention characteristics vary widely which may impact efficient development of evidence-based exercise programming for PwPD.

In the year of America's semi quincentennial, many are reflecting on our nation's proclaimed right to happiness. What would our Founding Fathers make of our acrimonious and divisive politics, of the role of social media in the diminished self-images of our youth, or of the steady rise in depression and suicidal ideation over the past decade? This editorial joins debates about what conditions are contributing to declines in happiness and challenges health promotion professionals to focus on the proven role that common health practices play in bolstering emotional well-being.

PurposeThe primary purpose of this study was to evaluate the effectiveness of the Health for Hearts United Longitudinal Trial in reducing blood pressure levels in mid-life and older Black Americans. The secondary purpose was to explore the role of religiosity.DesignCommunity-based quasi-experimental design with six churches (three treatment, three comparison).SettingTwo-county area of North Florida.SampleMid-life and older Black Americans (overall sample, n = 64, Mean age = 58.1, SD = ±9.1; 68.3% female), stratified by age and sex. Treatment group (n = 39, Mean age = 57.6, SD = ±9.2 years; 63.9% female). Comparison group (n = 25, Mean age = 59, ±9.0 years; 75% female).MeasuresQuestionnaire (three-item religiosity scale, age, sex, education level, marital status, blood pressure medication) and clinical measures (resting blood pressure, height, weight, C-reactive protein).AnalysisBivariate analysis, repeated measures analysis of variance (ANOVA).ResultsThe results of the repeated measures ANOVA demonstrated a significant decrease in systolic blood pressure between baseline and 18 months for both treatment and comparison groups. Between 18 and 24 months, both groups increased in systolic blood pressure, but the treatment group increased less than the comparison group. Diastolic blood pressure showed increases between baseline and 18 months for both groups, but a larger decrease between 18 and 24 months for the treatment group in contrast to the comparison group. Significant covariates in the study included age and marital status with religiosity not found to be significant.ConclusionThis study demonstrates that participation in a longitudinal church-based study for 18 months can reduce systolic blood pressure in mid-life and older Black Americans.

PurposeWorksite health promotion programs (WHPPs) can promote a healthier lifestyle for blue-collar workers, yet their participation is generally low. From a social ecological perspective, this study aims to identify determinants associated with blue-collar workers' initial WHPP participation.DesignObservational study.SettingA freight transport sector-initiated WHPP in the Netherlands.ParticipantsThe study sample included 3916 blue-collar workers. Data from 976 white-collar workers were used for comparisons.MeasuresData were obtained from an online health survey as part of the WHPP. Participation in a follow-up intervention was measured by attendance registration of the first consultation.AnalysisAssociations between determinants and participation were tested, using logistic regression. Interactions of determinants with job group were studied to explore differences in associations with participation between blue- and white-collar workers.ResultsThe final multivariable logistic model identified contract security (OR = 2.06), a neutral work-life balance (OR = 1.24), more chronic conditions (OR = 1.67), poorer self-rated health (OR = 2.17), and insufficient sleep (OR = 1.24) as being associated with WHPP participation. The determinants were largely consistent across blue- and white-collar workers. The model showed good fit, but provided little explanatory power (Nagelkerke R2 = .058).ConclusionWhile a sector-initiated WHPP may be able to reach workers not typically reached by employer-based programs, barriers still seem to exist for workers with less secure contracts, poor work-life balance, and fewer health complaints.

PurposeTo evaluate the reach and short-term effectiveness of the Turn To social marketing campaign, which encourages healthy coping strategies for mental health challenges and promotes mental health communication in Texas.DesignA cross-sectional survey was conducted in March 2023, 3&#xa0;months after the campaign launch.SettingData were collected online.SampleA sample of adult Texans (N = 1979).MeasuresMental health-related norms, efficacy, behaviors, and campaign awareness.AnalysisMultivariable linear regressions and multivariable logistic regressions were performed to assess the relationship between campaign awareness and potential campaign outcomes.ResultsExposure to the campaign was positively associated with higher levels of self-efficacy (B = .009, P < .001) and response efficacy (B = .042, P = .045) in stress management, stronger perceived norms of seeking (B = .088, P < .001) and providing (B = .088, P < .001) mental health support, and a greater likelihood of engaging in recommended behaviors-such as asking for help from one's social network (OR = 2.126, P < .001).ConclusionsOur findings suggest that the campaign has achieved several indicators of early success. Social marketing campaigns may offer a feasible and promising approach to encouraging healthy coping strategies for mental health issues and fostering social connection through more open conversations about mental health challenges.

PurposeDetermine feasibility of estimating economic externalities associated with influences that products of individual corporations have on their customers' health behaviors.DesignOur methodology included four steps: (1) model influence of company product(s) on user behavior at the population level; (2) calculate relative risks of developing selected diseases/conditions associated with product use; (3) estimate the number of cases of selected disease/conditions that could be attributed to the company's influence; and (4) summarize annual cost of attributable cases.SettingUnited States.SampleThree companies: Burger King, Netflix and Niantic Labs.MeasuresAnnual US healthcare costs associated with the use of commercial products and services by adults.AnalysisWe estimated costs and benefits (costs avoided) by linking product use and population exposure with relative risks of major chronic conditions, as established in dose-response meta-analysis studies, to calculate population attributable fractions and then linking potentially attributable cases to annual healthcare costs.ResultsAnnual cost potentially attributable to Burger King was $4.9 billion and Netflix $32.4 billion; annual benefit attributable to Niantic Labs was $322 million.ConclusionWe demonstrated a methodology for estimating economic externalities that could be associated with the use of different commercial products/services.

PurposeThis study explored the types of health-related goals, the strategies employed, and challenges experienced by Latina caregivers of children with intellectual and developmental disabilities (IDD).DesignThis study focuses on exploratory data on goal setting obtained through qualitative observations and documentation of the intervention arm from a two-site RCT.Setting & SampleTwenty-six Latina caregivers were recruited and assigned to receive the intervention across 2 sites-Texas and Illinois.InterventionA 10-session culturally tailored health promotion intervention was delivered to participants by promotoras addressing caregivers' wellness, physical activity, healthy eating, and navigating the environment and decision-making. Goal setting was incorporated throughout the intervention. Promotoras worked closely with participants to develop action plans and provided support as needed.MeasureTo analyze qualitative data, we used a deductive analytical approach based on transcript discussions and early data extraction. Qualitative data were categorized into types of goals, strategies used, subcategories, and barriers encountered.ResultsTwenty caregivers identified a total of 68 goals; 61.7% were achieved or in progress. Health promotion strategies included engaging in physical activity, changing nutrition/eating habits, participating in wellness activities, and using reminders. Caregivers experienced stress, feeling overwhelmed, and a lack of support.ConclusionThis study has some limitations, which are fully discussed. Despite the challenges they experienced, caregivers achieved or reported progress towards most of their goals.

The advent of an operational definition of "ultraprocessed foods" (UPFs) intrinsic to the Nova classification has meaningfully advanced research on the topic. A large volume of studies, including metabolic ward trials, have begun to enumerate the many potential harms of UPFs. This inventory of harms is in turn conducive to public policy responses. The connection between the two is on clear display in the 2025 Dietary Guidelines for Americans, which inveigh directly against consumption of "hyperprocessed food," generally interpreted to mean UPFs. The harms of UPFs, however, are no less subject to the "instead of what?" consideration than any other component of diet. Whereas most UPFs displace more wholesome, more nutrient dense, more satiating alternatives from the diet; and whereas most foods in this category may be expressly engineered to minimize satiety and maximize consumption in the service of profit - there are notable exceptions with regard to intention, substitution, and effects. Salient among these is the category of plant-based meats, expressly designed to substitute for meat, and beef most particularly. The case is made that application of "instead of what?" as a use-case filter helps to differentiate between the majority of UPFs apt to confer net harm, and the rarer but potentially important exceptions to that rule. Another key consideration is variation by population and culture; the net effects of a subset of UPFs on overall diet quality could conceivably be favorable in one population, detrimental in another. These distinctions suggest the importance of nuance in the development of public policies responsive to the harms of UPFs, allowing for use cases with the potential to confer net benefit. Optimal policy responses to the burgeoning study of UPFs will accommodate the limited, but important, heterogeneity of that food class.

PurposeCOVID-19 devastated communities globally, with the United States leading in fatalities despite extensive control efforts. In 2021, COVID-19 vaccines emerged as the most promising solution, with an efficacy rate exceeding 95% after full vaccination. However, herd immunity remains an elusive target with only 70% of the U.S. population fully vaccinated. This study investigates whether prior vaccination and medical history significantly predict COVID-19 vaccine acceptance and uptake.DesignUsing data collected from the 66th largest U.S. city after the widespread deployment of COVID-19 vaccines and boosters, we employed logistic regression to test whether an individual's history of vaccination and prior medical engagement positively influence COVID-19 vaccine-related decisions.SettingCross-sectional U.S. survey from July-October 2022 (N = 397) and November 2023-February 2024 (N = 429).SubjectsAdult Residents of the City of Newark, New Jersey (Aged 18+).MeasuresNewark Community Health Survey (2022, 2023).ResultsIndividuals with a history of preventive care, such as attending at least one non-emergency medical visit in the past year, receiving either the pneumococcal or influenza vaccine within the past year, strongly predicted COVID-19 vaccine acceptance. These predictors also demonstrated a strong positive association with the completion of the primary vaccine series and a higher overall total vaccine uptake.ConclusionFuture vaccine campaigns should prioritize "low engagement" populations who lack both recent routine medical visits and a history of previous vaccinations.

PurposeThis study examined whether the frequency and duration of participation in community cafes-nonprofit, pay-what-you-can restaurants-are associated with food security, dietary improvement, and psychosocial well-being among adult patrons.DesignCross-sectional, multi-site observational study using an instrumental-variables regression framework to reduce selection bias.SettingEleven community cafes operating under the pay-what-you-can model across the U.S.SampleThe analytic sample included 137 adult patrons who had eaten at a cafe within the past month (65% female, 65.7% White).MeasuresPrimary exposures were the frequency of cafe meals and the duration since first visit. Outcomes included food security (USDA six-item module), self-reported dietary improvement, social connectedness, and loneliness. Covariates included gender, race, and cafe site fixed effects.AnalysisTwo-stage instrumental-variable regression models used geographic distance as an instrument for cafe participation. Logistic regression estimated odds of food security, and linear models examined continuous outcomes (P < 0.05). Estimates are interpreted as local effects for patrons whose participation is influenced by access.ResultsLonger duration since first cafe visit was associated with higher odds of being food secure (OR = 2.93, 95% CI = 1.21-7.09). No significant associations were observed for dietary or psychosocial outcomes.ConclusionSustained engagement in cafes is associated with a greater likelihood of being food secure, indicating the importance of long-term participation in dignity-based health promotion strategies.

PurposeRecruitment and retention challenges hinder development of interventions to reduce income-related inequities in childhood obesity and dental caries. We examined whether participation in a digital nutrition and oral health intervention differed by participant and community characteristics.DesignLongitudinal analysis of an ongoing randomized clinical trial (RCT).SettingLow-income communities.Subjects216 caregivers of 2-6-year-old children completed a recruiting program; 154 consented and 79 completed the first component of the RCT.InterventionWe used a digital tailored message program to recruit participants into a RCT, where a virtual, dietitian-facilitated motivational interviewing (MI) session was the first required component for continued participation in the intervention.MeasuresWe assessed demographics and ZIP-code level community characteristics.AnalysisWe used logistic regression models to examine consent for and completion of MI sessions by participant and community characteristics.ResultsCaregivers reporting healthier child diets were more likely to consent to (OR = 1.3, 95% CI = 1.1-1.5 per 20-point on liking-based measure) and complete the MI session (OR = 1.2, 95% CI = 1.0-1.3 per 1-point on frequency-based measure). Those participating in food assistance or educational programs for low-income children (OR = 0.5; 95% CI = 0.2-0.9), and from communities with greater social vulnerability related to housing/transportation (OR = 0.7, 95% CI = 0.5-1.0) were less likely to complete the MI session.ConclusionsApproaches are needed that engage vulnerable families in nutrition and oral health interventions, thereby enhancing efforts to promote health equity.

PurposeTo examine the association between knowledge of smoking-related diseases, exposure to anti-smoking advertising, sociodemographic factors with smoking cessation intention among current smokers.DesignA quantitative cross-sectional design using secondary data from the 2021 Global Adult Tobacco Survey (GATS) Indonesia.SettingA nationally representative dataset covering Indonesian adults.SampleA total of 2874 adult current smokers aged 15&#xa0;years and above.MeasuresKey variables included respondents' knowledge of smoking-related diseases (lung cancer, heart attack, and stroke) and exposure to anti-smoking messages through five media channels: television, radio, newspapers, billboards, and the internet.AnalysisComplex sample logistic regression to identify predictors of cessation intention while adjusting for sociodemographic factors.Results42.7% of smokers expressed an intention to quit. Knowledge of smoking-related diseases-particularly lung cancer-and exposure to anti-smoking messages via the internet were significant predictors of quit intention. Traditional media exposure and general health knowledge showed comparatively weaker associations.ConclusionThese findings suggest that targeted tobacco control interventions should strengthen disease-specific health education and prioritize digital media strategies to enhance smoking cessation intention across diverse population groups.

PurposeThe aim of this study was to optimize essential components for Food is Medicine (FIM) interventions by selecting the modes with the least participant burden and lowest cost-to-burden ratio delivery in community-based outpatient settings.DesignRandomized crossover (Phase 1) and parallel (Phase 2) design pilot trials.SettingCommunity-based outpatient healthcare clinic in Jackson, Mississippi.ParticipantsForty-eight participants were randomized and 32 completed the program.InterventionThe 12-week, phase 2 trial included an integrated and a traditional delivery of two psychosocial-structural combinations of study arms.MeasuresThe primary outcomes were participant burden and cost-to-burden ratio.AnalysisRepeated measures ANOVA were used to analyze differences across time, in intervention arms, and within groups ANOVA to analyze for modality combination differences.ResultsParticipants were mostly women, had a mean age of 40, all identified as Black or African American, and about one-third had not attained a 4-year degree or higher. The study found that face-to-face delivery had the lowest cost-to-burden ratio and achieved higher attendance and satisfaction compared to virtual modalities, though both formats showed high use of meals/vouchers and reduced added sugar intake over time (F(3) = 5.62, P = .001). Attrition was more common among younger (P < .01), less-educated (P = .02), and lower-income participants (P < .01), with recruitment largely driven by social networks.ConclusionThe face-to-face modality was found to be a better approach than the virtual modality, with limited impact of an integrated delivery in this population.

PurposeThis study explores how internet use can undermine patient engagement through information overload and health anxiety, and how patient-centered communication (PCC) may buffer or reshape these effects.DesignA cross-sectional survey design was used.SettingThe study conducted online survey through Qualtrics.SampleA random sample of U.S. adults aged 18 or older completed online survey for $2.30 compensation. After excluding ineligible responses, the final sample was included for the analysis (N = 356).MeasuresKey variables included internet use, information overload, health anxiety, patient engagement, and PCC, demonstrating high reliability.AnalysisSimple mediation analysis and moderated mediation analysis were conducted.ResultsSimple mediation analysis showed that internet use was positively associated with information overload which increased health anxiety (indirect effect = 0.013, 95% CI [0.002, 0.027]). The indirect effect of internet use on engagement was significant at low (-1 SD; PCC = 2.798; b = -0.005, 95% CI [-0.011, -0.002]), and medium levels of PCC (mean; PCC = 3.731; b = -0.003, 95% CI [-0.007, -0.001]), but not at high levels.ConclusionThis study suggests that healthcare providers should take continuing PCC education to overcome generic barriers that patients encounter both online and in clinical settings, thereby improving health outcomes.

PurposeTo evaluate the pathways through which preconception health knowledge relates to preconception health behaviors via behavioral skills among Chinese reproductive-aged individuals and couples using the Information-Motivation-Behavioral Skills model, and to assess dyadic partner effects.DesignCross-sectional study with individual-level mediation and dyadic path models.SettingPopulation-based survey in Zhejiang Province, China (July-September 2023).Sample1991 individuals (1086 women; 905 men), including 458 heterosexual couples.MeasuresPreconception health behavior score (0-100) summing >20 guideline-recommended behaviors; preconception health knowledge; behavioral skills; sociodemographics.AnalysisIndividual-level mediation estimated with Sobel-Goodman tests; dyadic effects estimated using Actor-Partner Interdependence Model extended to Mediation (APIMeM) via path analysis; two-sided tests with P < 0.05.ResultsMean behavior scores: women 71.27 &#xb1; 9.03; men 71.12 &#xb1; 9.96. Women: total effect of knowledge on behaviors 0.896 (P = 0.001); direct 0.785 (P = 0.003); indirect via skills 0.111 (P = 0.033). Men: total 1.731 (P < 0.001); direct 1.313 (P < 0.001); indirect 0.418 (P < 0.001). Dyadic analyses showed partner skill-to-behavior effects: women's skills &#x2192; men's behaviors &#x3b2; = 0.127 (P = 0.003); men's skills &#x2192; women's behaviors &#x3b2; = 0.153 (P = 0.001).ConclusionPreconception knowledge and behavioral skills are linked to healthier preconception behaviors, with meaningful partner interdependence. Couple-centered, skill-building interventions may improve preconception health and pregnancy outcomes. Cross-sectional design limits causal inference; self-reported behaviors may introduce bias; findings from one province may limit generalizability.

PurposeTo examine the relationship between fall-related mortality, disability-adjusted life years (DALY), healthcare expenditures, and research funding and determine whether fall prevention funding is proportional to fall-related public health impact.DesignCross-sectional.SettingUnited States.SampleNot applicable.MeasuresMortality rates (2018-2022) for leading causes of death were obtained from CDC WONDER. Disability-adjusted life-year (DALY) rates (2021) were obtained from the World Health Organization. Healthcare expenditures (2016) were obtained from the Institute for Health Metrics and Evaluation. Research funding data (2018-2022) were obtained from NIH ExPORTER and linked to causes of death using MeSH term searches.AnalysisLinear regression models were used with log-transformed research funding as the dependent variable and log-transformed mortality rates, DALY rates, and healthcare expenditures as predictors.ResultsFall mortality rate was 13.1 deaths per 100&#xa0;000 individuals, fall-related DALY rate was 713.2 per 100&#xa0;000, and fall-related healthcare expenditures were $106.6 billion. Falls ranked 12th in mortality, 8th in DALY, and 5th in healthcare costs but 20th in research funding, receiving $489 million over 5 years. Falls received significantly less funding than expected based on mortality rates (predicted $1.95 billion), DALY rates (predicted $3.27 billion) and healthcare expenditures (predicted $5.63 billion).ConclusionAlthough falls have a significant impact on older adults' health and mortality, fall research funding is disproportionately low. To reduce mortality and mitigate rising healthcare costs associated with falls, federal investment in fall prevention research should be a higher priority.

PurposeTrust is a critical part of patient-provider relationships and has been shown to improve patient outcomes, including increased utilization of preventative services and greater adherence to medications. However, few studies have examined health care provider trust (HCPT) among older sexual minority men (SMM) and its association with healthcare avoidance.DesignCross-sectional secondary data analysis.Setting/Sample: Baseline data from the MACS/WIHS Combined Cohort Study's Stigma and Non-Communicable Disease Syndemic Sub-Study (N = 997).MethodsMultiple linear and multivariable logistic regression models were conducted to estimate associations between HCPT and past-year healthcare avoidance.ResultsParticipants had a mean age of 59&#xa0;years (SD = 13.3); 64% were White, 30% Black, and 5% identified as other races. Fifty-six percent were living with HIV. HCPT was lower among Black SMM (b = -2.23; 95% CI = -4.46, 0.00) and was positively associated with multiple income groups and having 1 (b = 3.80; 95% CI = 1.49, 6.11), 2 (b = 2.96; 95% CI = 0.67, 5.25), and 3 (b = 3.03; 95% CI = 0.53, 5.53) chronic health conditions. Past-year healthcare avoidance was inversely associated with HCPT (aOR = 0.95; 95% CI = 0.94, 0.97) and age (age 26-45 years vs 65-75 years, aOR = 0.26; 95% CI = 0.11, 0.58).ConclusionThis work demonstrates various associations between healthcare provider trust and sociodemographic and health factors. Furthermore, lower HCPT was associated with a higher likelihood of avoiding medical care, indicating the importance of provider trust for accessing health services.

UPMC Prescription for Wellness (PFW) is a platform that&#xa0;enables&#xa0;provider-payer care coordination for health care consumers who need enhanced support. UPMC healthcare&#xa0;and network&#xa0;providers&#xa0;use PFW to refer their patients who are UPMC Health Plan&#xa0;members&#xa0;to&#xa0;payer-sponsored&#xa0;clinical and wellness services.&#xa0;PFW is integrated&#xa0;into EMRs,&#xa0;offers&#xa0;multi-channel outreach,&#xa0;and enables UPMC's provider and payer organizations to efficiently collaborate on supporting the health of the&#xa0;patient-member&#xa0;population&#xa0;they&#xa0;both serve.&#xa0;Because the payer-sponsored clinical services are "prescribed" by trusted healthcare providers, PFW&#xa0;dramatically improves patient-member&#xa0;engagement. In this Critical Issues and Trends article, we detail specifics of PFW implementation as well as lessons learned over the past decade to enable readers to replicate this program that&#xa0;demonstrates how&#xa0;payer-sponsored clinical and wellness services can offer&#xa0;a viable&#xa0;set of options to improve health when prescribed by a healthcare provider.