Browsing by Subject "Health behavior"
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Item Association Between Built Environment or Health Behavior and Good Health Status Using ACSM American Fitness Index® Data Between 2018 and 2022(2023-12) Seo, Bojung; Han, Jiali; Nan, Hongmei; Monahan, Patrick O.; Duszynski, Thomas J.The US cities still have room for improvement in residents’ health and there are significant differences in general health measures between the cities. High quality environment assets and personal healthier behaviors of residents were known as factors related to better health. Because both sufficient sleep and higher level of personal physical activity are well-known indicators to attain optimal health of individuals, city-level measures of resident health behaviors, such as sleep quantity, and environmental assets that support physical activity may jointly improve residents’ general health. Further, sufficient sleep may mediate the effect of activity-related environmental factors on general health. However, evidence regarding such associations at the city level is lacking. The American College of Sports Medicine (ACSM) American Fitness Index® (AFI) data currently provide both environment assets and health indicators for the 100 largest US cities. The aim of this research was to test the following three hypotheses using the 2018 to 2022 AFI data. First, the association between environment indicators of cities and good health status of residents was examined. Second, the association between personal health behaviors of residents and good health status was also examined. Lastly, the moderating or mediating effect of sleep on the association between significant environmental factors and good health status was examined. This study discovered that activity-related environment factors, such as availability of parks within a 10-minute walk, Walk Score®, Bike Score®, and adoption of Complete Streets policy, were significantly associated with the self-reported general health status of residents. This study also demonstrated all measured healthy behaviors including meeting physical activity guidelines, using active transport to work, sufficient intake of fruits and vegetables, sufficient sleep, and non-smoking were positively related to general health status of city residents. This study also identified the synergistic interaction between sufficient daily sleeping and environment factors related to the level of physical activity on residents’ good health status. Overall, these findings will provide evidence for better understanding the health-related unmet needs of residents in US cities, and also create valuable context and support for development and targeting of more efficacious public health interventions and messaging.Item Characteristics of Veterans with non-VA encounters enrolled in a trial of standards-based, interoperable event notification and care coordination(American Board of Family Medicine, 2021) Kartje, Rebecca; Dixon, Brian E.; Schwartzkopf, Ashley L.; Guerrero, Vivian; Judon, Kimberly M.; Yi, Joanne C.; Boockvar, Kenneth; Epidemiology, School of Public HealthIntroduction: Understanding how veterans use Veterans Affairs (VA) for primary care and non-VA for acute care can help policy makers predict future health care resource use. We aimed to describe characteristics of veterans enrolled in a multisite clinical trial of non-VA acute event notifications and care coordination and to identify patient factors associated with non-VA acute care. Methods: Characteristics of 565 veterans enrolled in a prospective cluster randomized trial at the Bronx and Indianapolis VA Medical Centers were obtained by interview and chart review. Results: Veterans' mean age was 75.8 years old, 98.3% were male, and 39.2% self-identified as a minority race; 81.2% reported receiving the majority of care at the VA. There were 197 (34.9%) veterans for whom a non-VA acute care alert was received. Patient characteristics significantly associated with greater odds of a non-VA alert included older age (OR = 1.05; 95% CI, 1.04-1.05); majority of care received is non-VA (OR = 1.83; 95% CI, 1.06-3.15); private insurance (OR = 1.39; 95% CI, 1.19-1.62); and higher income (OR = 4.01; 95% CI, 2.68-5.98). Conclusions: We identified several patient-level factors associated with non-VA acute care that can inform the design of VA services and policies for veterans with non-VA acute care encounters and reintegration back into the VA system.Item Community-Based Exercise Program Attendance and Exercise Self-Efficacy in African American Women(2014-01-29) Virgil, Kisha Marie; Mikesky, Alan E.; Keith, NiCole R.; De Groot, Mary K.; Hess, Lisa M.; Mushi-Brunt, Christina R.Rates of chronic disease and physical inactivity are disproportionately high among African American women. Despite the known benefits of physical activity and an increasing number of programs designed to increase activity, attendance rates to many exercise programs remain low. There is much to learn about program types, such as healthy lifestyle programs (HLP); individual factors, such as self-efficacy; and mediating variables that may influence exercise program attendance. An observational study design was used to compare exercise self-efficacy and attendance in a community-based exercise program in African American women who were enrolled in a HLP (N = 53) to women who were not (N = 27). Exercise program attendance was gathered across six months; demographics, self-efficacy and physical activity behaviors were assessed through surveys; and physiological variables (resting heart rate and blood pressure, height, and weight) and physical fitness (muscular strength and endurance and cardiovascular endurance) were measured at baseline. Descriptive statistics were used to describe participants and groups were compared using T-tests, chi-square and non-parametric statistics. Finally, mediation analyses were conducted using multiple regression models to assess self-efficacy as a potential mediator to exercise program attendance. Women who enrolled in this study were of low income (61% having an annual income less than $20,000), obese with a mean (standard deviation) body mass index (BMI) of 37.7 (7.6), pre-hypertensive with a mean (standard deviation) systolic blood pressure of 125.9 (14.4), and scored poorly and marginally on two fitness tests. On average, women reported being Moderately Confident in their ability to exercise regularly, yet had low attendance in the exercise program with a median number .5 days over six months and there were no significant differences in exercise self-efficacy (p = .23) or attendance in the exercise program between groups (p = .79). Additionally, exercise self-efficacy was not a mediating variable to program attendance. Women in this study had little discretionary income and several chronic disease risk factors, yet exercise program attendance was low even in those enrolled in a HLP. Identifying factors that increase exercise self-efficacy and factors that influence attendance beyond self-efficacy may help future program design and attendance.Item Diet and exercise intervention adherence and health-related outcomes among older long-term breast, prostate, and colorectal cancer survivors(2013) Winger, Joseph G.; Mosher, Catherine E.; Rand, Kevin L.; Stewart, Jesse C.; Grahame, Nicholas J.Given the numerous benefits of a healthy diet and exercise for cancer survivors, there has been an increase in the number of lifestyle intervention trials for this population in recent years. However, the extent to which adherence to a diet and exercise intervention predicts health-related outcomes among cancer survivors is currently unknown. To address this question, data from the Reach out to ENhancE Wellness in Older Cancer Survivors (RENEW) diet and exercise intervention trial were analyzed. RENEW was a yearlong telephone and mailed print intervention for 641 older (>65 years of age), overweight (body mass index: 25.0-39.9), long-term (>5 years post-diagnosis) survivors of colorectal, breast, and prostate cancer. Participants were randomized to the diet and exercise intervention or a delayed-intervention control condition. The RENEW telephone counseling sessions were based on determinants of behavior derived from Social Cognitive Theory (SCT) (e.g., building social support, enhancing self-efficacy). These factors have been hypothesized to improve health behaviors, which in turn should improve health outcomes. Thus, drawing on SCT and prior diet and exercise research with cancer survivors, I hypothesized that telephone counseling session attendance would be indirectly related to health-related outcomes (i.e., physical function, basic and advanced lower extremity function, mental health, and body mass index) through intervention-period strength and endurance exercise and dietary behavior (i.e., fruit and vegetable intake, saturated fat intake). The proposed model showed good fit to the data; however, not all of the hypothesized relationships were supported. Specifically, increased telephone counseling session attendance was related to engagement in all of the health behaviors over the intervention period. In turn, (a) increased endurance exercise was related to improvement in all of the health-related outcomes with the exception of mental health; (b) increased strength exercise was solely related to improved mental health; (c) increased fruit and vegetable intake was only related to improved basic lower extremity function; and (d) saturated fat intake was not related to any of the health-related outcomes. Taken together, these findings suggest that SCT determinants of behavior and the importance of session attendance should continue to be emphasized in diet and exercise interventions. Continued exploration of the relationship between adherence to a diet and exercise intervention and health-related outcomes will inform the development of more cost-effective and efficacious interventions for cancer and other medical populations.Item The health-related uses and gratifications of YouTube: Motive, cognitive involvement, online activity, and sense of empowerment(2015-07) Park, Daniel Youngjoon; Goering, Elizabeth M.; White-Mills, Kim D.; Brann, MariaThe purpose of this study was to examine the relationships among motives for health-related YouTube use, cognitive involvement with health information on YouTube, post-exposure online activity, and sense of empowerment regarding health and health care. As a result of the analysis of data from 263 participants, social utility, convenient information-seeking, habit-passing time, and exciting entertainment motives were identified as four motives for health-related YouTube use. Social utility and convenient information-seeking motives were positively related to cognitive involvement and cognitive involvement was positively related to perceived control. Social utility motive was negatively related to perceived competence, whereas convenient information-seeking motive was positively related to perceived competence. Habit-passing time motive was negatively related to goal internalization, whereas convenient information-seeking and exciting entertainment motives were positively related to goal internalization. The findings from this study imply that YouTube could be a useful health communication media for health professionals and organizations to use for empowering users in coping with health-related concerns.Item Mask-Wearing Behavior at the 2021 NCAA Men’s Basketball Tournament(American Medical Association, 2021) Vest, Joshua R.; Blackburn, Justin; Cash-Goldwasser, Shama; Peters Bergquist, Eleanor; Embi, Peter J.; Health Policy and Management, School of Public HealthThis cross-sectional study examines the mask-wearing behavior of attendees at the 2021 NCAA men’s basketball tournament in an attempt to help other venues prepare for future events during the pandemic.Item Optimism and cardiovascular health: Longitudinal findings from the CARDIA Study(Wolters Kluwer, 2020) Boehm, Julia K.; Qureshi, Farah; Chen, Ying; Soo, Jackie; Umukoro, Peter; Hernandez, Rosalba; Lloyd-Jones, Donald; Kubzansky, Laura D.; Medicine, School of MedicineObjective: Favorable cardiovascular health is associated with greater longevity free of cardiovascular disease. Although the prevalence of cardiovascular health decreases with age, less is known about protective factors that promote and preserve it over time. We investigated whether optimism was associated with better cardiovascular health over a 10-year period. Methods: Participants included 3188 Black and White men and women from the Coronary Artery Risk Development in Young Adults study. Self-reported optimism was assessed in 2000 (this study's baseline) with the revised Life Orientation Test. Favorable cardiovascular health was defined by healthy status on five components of cardiovascular functioning that were repeatedly assessed through 2010 either clinically or via self-report (blood pressure, lipids, body mass index, diabetes, and smoking status). Linear mixed-effects models examined whether optimism predicted cardiovascular health over time, adjusting for covariates such as sociodemographic characteristics, health behaviors, health status, and depression diagnosis. Results: In models adjusting for sociodemographic characteristics, optimism was associated with better cardiovascular health across all time points (β = 0.08, 95% confidence interval = 0.04-0.11, p ≤ .001) but not with rate of change in cardiovascular health. Findings were similar when adjusting for additional covariates. Optimism did not interact significantly with race (p = .85) but did with sex, such that associations seemed stronger for women than for men (p = .03). Conclusions: Optimism may contribute to establishing future patterns of cardiovascular health in adulthood, but other factors may be more strongly related to how slowly or quickly cardiovascular health deteriorates over time.Item The role of anticipated regret and health beliefs in HPV vaccination intentions among young adults(Springer, 2016-06) Christy, Shannon M.; Winger, Joseph G.; Raffanello, Elizabeth W.; Halpern, Leslie F.; Danoff-Burg, Sharon; Mosher, Catherine E.; Department of Psychology, School of ScienceAlthough cognitions have predicted young adults' human papillomavirus (HPV) vaccine decision-making, emotion-based theories of healthcare decision-making suggest that anticipatory emotions may be more predictive. This study examined whether anticipated regret was associated with young adults' intentions to receive the HPV vaccine above and beyond the effects of commonly studied cognitions. Unvaccinated undergraduates (N = 233) completed a survey assessing Health Belief Model (HBM) variables (i.e., perceived severity of HPV-related diseases, perceived risk of developing these diseases, and perceived benefits of HPV vaccination), anticipatory emotions (i.e., anticipated regret if one were unvaccinated and later developed genital warts or HPV-related cancer), and HPV vaccine intentions. Anticipated regret was associated with HPV vaccine intentions above and beyond the effects of HBM variables among men. Among women, neither anticipated regret nor HBM variables showed consistent associations with HPV vaccine intentions. Findings suggest that anticipatory emotions should be considered when designing interventions to increase HPV vaccination among college men.Item Tailored information increases patient/physician discussion of colon cancer risk and testing: The Cancer Risk Intake System trial(Elsevier, 2016-12) Skinner, Celette Sugg; Gupta, Samir; Bishop, Wendy Pechero; Ahn, Chul; Tiro, Jasmin A.; Halm, Ethan A.; Farrell, David; Marks, Emily; Morrow, Jay; Julka, Manjula; McCallister, Katharine; Sanders, Joanne M.; Rawl, Susan M.; IU School of NursingAssess whether receipt of tailored printouts generated by the Cancer Risk Intake System (CRIS) - a touch-screen computer program that collects data from patients and generates printouts for patients and physicians - results in more reported patient-provider discussions about colorectal cancer (CRC) risk and screening than receipt of non-tailored information. Cluster-randomized trial, randomized by physician, with data collected via CRIS prior to visit and 2-week follow-up telephone survey among 623 patients. Patients aged 25-75 with upcoming primary-care visits and eligible for, but currently non-adherent to CRC screening guidelines. Patient-reported discussions with providers about CRC risk and testing. Tailored recipients were more likely to report patient-physician discussions about personal and familial risk, stool testing, and colonoscopy (all p < 0.05). Tailored recipients were more likely to report discussions of: chances of getting cancer (+ 10%); family history (+ 15%); stool testing (+ 9%); and colonoscopy (+ 8%) (all p < 0.05). CRIS is a promising strategy for facilitating discussions about testing in primary-care settings.Item Talking to Patients About Cancer Screening Cessation(American Medical Association, 2017-08-01) Torke, Alexia M.; Medicine, School of Medicine