American Journal of Health Promotion最新文献

{"title":"Aligning Clinical Practice with Evidence: Primary Care Pediatricians' Perspectives on Standardizing Obesity Management.","authors":"Nia Imani Bodrick, Noah Kim, Erynn Richards, Kaleab Ribbiso, Rachel Nassau, Laura Fischer, Kofi Essel, Alicia Tucker","doi":"10.1177/08901171261417441","DOIUrl":"https://doi.org/10.1177/08901171261417441","url":null,"abstract":"<p><p>PurposeA Quality Improvement (QI) initiative was implemented to improve evidence-based pediatric obesity related clinical care. We evaluated changes in clinicians' knowledge and confidence and their perception of improvements and challenges in obesity-related clinical care post-QI implementation.ApproachThe study included pre and post-intervention self-report surveys, semi-structured qualitative interviews, and randomized chart reviews.SettingThe setting was two primary care centers in Washington, DC between March 2021-March 2022.ParticipantsOf the 42 clinicians offered multi-modal interventions, 33% completed both surveys. Of the 17 clinicians offered a qualitative interview, 15 were completed (88%).MethodQuantitative analysis was conducted using McNemar's exact test and qualitative data underwent thematic analysis.ResultsData analysis demonstrated an overall positive and significant change in clinician confidence in diagnosing and managing pediatric obesity (<b>Χ</b>² = 12.0, <i>P</i> = 0.0005). The post-intervention thematic analysis of semi-structured clinician interviews identified three major themes: (1) improvement in clinical obesity management, (2) barriers to effective clinical obesity management, and (3) deeper self-reflection of obesity stigma on clinical weight management.ConclusionsWhile barriers exist in managing obesity within medical homes, the implementation of a targeted QI initiative may improve pediatric clinicians' confidence in providing evidence based culturally competent care.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":"40 8","pages":"1008-1017"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Assessment of Provider Perceptions of Medicare Annual Wellness Visits (AWVs).","authors":"Ghenella Salanio, Brittney Fraumeni, Sunny A Linnebur, Sarah Billups, Danielle R Fixen","doi":"10.1177/08901171261421321","DOIUrl":"https://doi.org/10.1177/08901171261421321","url":null,"abstract":"<p><p>PurposeNationally, completion of Medicare Annual Wellness Visits (AWVs) is associated with better management of chronic diseases, lower hospitalization rates, and improvement of health outcomes, but utilization of AWV services has been relatively low locally at our institution. The purpose of this study was to evaluate provider perceptions surrounding barriers or challenges that affect AWV completion rates locally.DesignSemi-structured qualitative interviews.SettingProviders from one geriatric clinic and two internal medicine clinics were interviewed virtually or in-person.Participants19 providers (13 attending physicians, 1 nurse practitioner, and 5 resident physicians).MethodsInterviews were recorded, and AI-generated transcripts were created. Transcripts were analyzed, coded inductively, and categorized thematically.ResultsSix over-arching themes emerged which highlighted: perceived value and purpose of AWVs, barriers that affect implementation, interventions for effective facilitation, and thoughts surrounding pharmacist-led AWVs.ConclusionProviders believed that the process for completing AWVs was complex and time-consuming, and many thought they offered limited value for older patients with more acute healthcare needs. Opinions on pharmacist-led AWVs were divided in the provider groups interviewed: those with experience appreciated a team-based effort to reduce clinic burden while those without exposure were uncertain that some AWV components are within a pharmacist's scope of practice.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":"40 8","pages":"1018-1024"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Multidimensional Activity Participation and Sleep Health in the Context of Active Aging: A Cohort Study Based on the CLHLS From 2005 to 2018.","authors":"Chi Zhang, Xiao Wan, Yan Ding, Suwen Hu, Xi Li, Jintao Luo, Ye Zheng, Feng Gong, Juan Yang, Yinan Zhao, Qin Zhou, Hui Feng","doi":"10.1177/08901171261417503","DOIUrl":"10.1177/08901171261417503","url":null,"abstract":"<p><p>PurposeThis study aimed to explore the association of total multidimensional activity participation and different types of activity on sleep health.DesignCohort study.SettingThe study used Chinese Longitudinal Healthy Longevity Survey (CLHLS) sleep data collected from 2005 onward (2005-2018).SampleA total of 1038 older adults aged 60 and older.MeasuresMultidimensional activity participation was assessed across ten items. Sleep quality and sleep duration were assessed using a single item each. Sociodemographic variables were included as covariates.AnalysisWe used a generalized linear mixed effects model to analyze the relationship between total multidimensional activity participation, activity types, and sleep health.ResultsPhysical activities were positively correlated with sleep quality (β = .010, <i>P</i> < .01). Moreover, cognitive activities were negatively correlated with short sleep duration (OR = .973, <i>P</i> < .05). In sleep quality, males (β = .224, <i>P</i> < .001), urban/town areas (β = .126, <i>P</i> < .01), high quality of life (β = .081, <i>P</i> < .01), health (β = .100, <i>P</i> < .001), and mental health (β = .014, <i>P</i> < .01) protected factors, while having heart disease (β = -.248, <i>P</i> < .001) was a risk factor. Regarding short sleep duration, urban/town areas (OR = .761, <i>P</i> < .01) and high health (OR = .808, <i>P</i> < .001) were negatively correlated with it. Heart disease (OR = 1.589, <i>P</i> < .01) was positively correlated with short sleep duration.ConclusionIt is necessary to consider the role of multidimensional characteristics in promoting sleep health and active aging.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"922-932"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between A Body Shape Index and Depression: Evidence From NHANES 2005-2018 With Mediation Analysis of the Triglyceride-Glucose Index.","authors":"Fengjiao Liang, Banghua Yang","doi":"10.1177/08901171261417501","DOIUrl":"10.1177/08901171261417501","url":null,"abstract":"<p><p>PurposeGrowing evidence suggests a bidirectional relationship between depression and obesity. This study examined the association between A Body Shape Index (ABSI) and depressive symptoms among U.S. adults and explored the mediating role of the triglyceride-glucose (TyG) index.DesignCross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES, 2005-2018).SettingUnited States, utilizing NHANES data collected between 2005 and 2018.Participants15200 non-institutionalized U.S. adults aged >=20 years with complete data on ABSI, depression (assessed by PHQ-9), and TyG index.MethodsMultivariate logistic regression, smooth curve fitting, subgroup/interaction analysis, and sensitivity analyses assessed the ABSI-depression link. Mediation analysis quantified the TyG index's role.ResultsAfter adjusting for potential confounders, a significant positive association was observed between ABSI and depressive symptoms. Participants in the highest ABSI quartile (Q4) had higher odds of depression compared to those in the lowest quartile (Q1). Subgroup and sensitivity analyses confirmed the robustness and independence of this association. Mediation analysis revealed that the TyG index partially mediated the relationship between ABSI and depression, with a mediation effect accounting for 5.31% of the total association.ConclusionThis large cross-sectional study highlights a significant association between higher ABSI and depressive symptoms among U.S. adults. These findings highlight the need for further research to explore underlying mechanisms and potential clinical implications.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"976-986"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Weight Status Moderates the Impact of Exercise Referral Schemes on Improving Patients' Body Mass Index.","authors":"Carson Halliwell, Renaud Tremblay, Jonathon R Fowles, Ryan E R Reid, Rebecca Moyer, Taniya S Nagpal, Myles W O'Brien","doi":"10.1177/08901171261419478","DOIUrl":"10.1177/08901171261419478","url":null,"abstract":"<p><p>PurposeTo determine whether baseline body mass index (BMI) moderates BMI changes following completion of an exercise referral scheme (ERS).DesignRetrospective analysis.SettingData from the National ReferAll Database.Sample634 adults out of 39,283 (64% female; mean age 54 ± 15 years).InterventionParticipants completed a community-based ERS involving physical activity counseling and supervised exercise.MeasuresBMI was calculated as weight (kg) divided by height (m²) and participants were categorized by BMI: normal weight (<25.0 kg/m²), overweight (25.0-29.9 kg/m²), and obesity classes I (30.0-34.9 kg/m²), II (35.0-39.9 kg/m²), and III (≥40.0 kg/m²).AnalysisA 5 × 2 mixed methods analysis of covariance, adjusted for age, sex, ERS type, and follow-up duration examined BMI changes over time by group. Linear regression assessed the relation between baseline BMI and BMI change.ResultsBaseline BMI predicted BMI reduction (β = -0.07 ± 0.01, 95% CI: -0.09 to -0.04, <i>P</i> < .001). Compared to the normal weight group, individuals with obesity classes I-III had significantly greater reductions in BMI (mean difference range: 0.83-1.01 kg/m², all <i>P</i> < .001). No significant difference was observed between normal weight and overweight participants (<i>P</i> = .207).ConclusionThis study provides evidence that ERS can be effective in improving BMI outcomes among individuals who have an elevated initial BMI. These findings support the continued development and refinement of ERS as a scalable public health strategy to promote weight-related improvements.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"941-946"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"America's Pursuit of Happiness: What Role for the Health Promotion Profession?","authors":"Paul E Terry","doi":"10.1177/08901171261471657","DOIUrl":"10.1177/08901171261471657","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"915-917"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity in Rural-Dwelling Older Adults: A Scoping Review of Epidemiological Findings and Intervention Approaches.","authors":"Maki Karakida, Jaqueline Contrera Avila","doi":"10.1177/08901171251415460","DOIUrl":"10.1177/08901171251415460","url":null,"abstract":"<p><p>ObjectiveReview studies targeting obesity/overweight among older rural adults to: (1) summarize obesity prevalence and identify high-risk groups in epidemiological studies, and (2) describe the types of obesity interventions and outcomes examined in this population.Data SourceCINAHL Ultimate, PubMed, Google Scholar, MEDLINE.Study Inclusion/Exclusion CriteriaInclusion criteria: peer-reviewed intervention/epidemiological studies in English, adults aged 50+ with overweight/obesity who were rural dwellers. Exclusion criteria: review/meta-analysis articles, child/adolescent obesity, youth or adults aged <50, examining obesity with other chronic conditions, published before the year 2000.Data ExtractionStudy population/design/methodology/results, publication year (2000-2024), type of intervention, methodology of epidemiological studies.Data SynthesisStudy characteristics and outcomes were summarized in the assessment/intervention matrix tables.ResultsSeventeen articles met the inclusion criteria: 6 epidemiological studies (US = 3, overseas = 3), 7 community-based interventions, 3 remote interventions, and 1 hybrid intervention. Epidemiological studies showed that the obesity/overweight prevalence ranged from 11.2%-64.6%. Women were consistently more likely to be obese/overweight than men. While one US study found significant associations between lower educational attainment and higher obesity rates, one non-US study reported no association between educational attainment and obesity. Community-based interventions with nutrition/exercise sessions and remote/hybrid interventions were reported to support weight and/or insulin resistance management.ConclusionFuture interventions should prioritize high-risk subgroups, such as American Indians/Alaska Natives, older women, and individuals with lower educational attainment.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"1025-1035"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reach and Effectiveness of the South Carolina <i>No Drama</i> Contraceptive Media Campaign: A Mixed-Methods Approach.","authors":"Melissa L White, Michael G Smith, Liane M Ventura, Liwen Zeng, Kate E Beatty, Deborah L Quesenberry, Amal J Khoury","doi":"10.1177/08901171251390676","DOIUrl":"10.1177/08901171251390676","url":null,"abstract":"<p><p>PurposeThe South Carolina Choose Well contraceptive access initiative launched a statewide media campaign, <i>No Drama</i>, in 2018. We evaluated the reach and effectiveness of <i>No Drama</i> and provided recommendations for future campaigns.DesignA convergent mixed methods design triangulated data collected between 2018 and 2021 from (1) surveys of women of reproductive age seeking care at Choose Well-participating clinics in South Carolina (n = 908); (2) interviews with clinic staff (n = 100); and (3) metrics about statewide utilization of the campaign.SettingCommunity - <i>No Drama</i> was implemented in communities across South Carolina. Clinical - Research data were collected at family planning (health department and federally qualified health center) clinics.MeasuresExposure to and reported effectiveness of the campaign in encouraging contraceptive appointments and contraceptive use were examined. Clinic staff perceptions of campaign strengths and areas for improvement were also explored.AnalysisModified Poisson regression models with Generalized Estimating Equations, and inductive coding with content analysis, were used to analyze survey and interview data, respectively. Contraceptive appointments requested through <i>No Drama</i> were examined.Results<i>No Drama</i> produced nearly 22 000 contraceptive appointment requests between 2018 and 2021. One-third of reproductive-age patients at Choose Well-participating clinics reported exposure to the campaign. Exposure differed by race/ethnicity and educational attainment of patients. Nearly half (46%) of exposed patients found the campaign very effective at encouraging contraceptive appointments. Perceiving the campaign as very effective in encouraging contraceptive counseling appointments and encouraging contraceptive use was associated with the frequency of exposure. Clinic staff reported that the campaign had widespread visibility and connected patients to clinics.Conclusion<i>No Drama</i> reached a portion of its intended audience and facilitated access to contraceptive care among exposed people. Future campaigns may consider increasing the rate of advertisements, ensuring clear messaging, involving community partners in campaign design, and diversifying campaign materials and locations.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"997-1007"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145436806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to Address Belonging.","authors":"Lisa Burt, Janis Davis-Street, Sarah Green","doi":"10.1177/08901171261477849","DOIUrl":"10.1177/08901171261477849","url":null,"abstract":"","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"1042-1044"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Relationship Between Food, Housing, and Transportation Insecurity and Chronic Disease Among US Women Using Nationally Representative Data.","authors":"Kobi V Ajayi, Samia Tasnim, Ping Ma, Robin Page","doi":"10.1177/08901171261421639","DOIUrl":"10.1177/08901171261421639","url":null,"abstract":"<p><p>PurposeTo examine the association between the social determinants of health (SDOH) and hypertension, diabetes, heart disease, and anxiety and/or depression among adult US women.DesignCross-sectional survey.Setting2022 Health Information National Trends Survey (HINTS).SampleWomen aged ≥18 years (N = 3535) participated from the U.S.MeasureOutcome variable was diagnosis of diabetes, hypertension, heart disease, and mental illnesses. Covariates included sociodemographic characteristics along with food, housing, and transportation insecurity.AnalysisSeparate weighted bivariate and multivariate logistic regression models were used to examine the unadjusted and adjusted odds ratios (AORs) associations between insecurities and chronic conditions, controlling for sociodemographic characteristics.ResultsHypertension (35.4%) and anxiety/depression (33.4%) were the most reported chronic conditions. Approximately 27% of the sample experienced all three forms of insecurity concurrently. Women with anxiety or depression had elevated levels of food, housing, and transportation insecurity (11.3%, 7.4%, 7.5%) than those with other chronic conditions. Adjusted models indicated that all three types of insecurity were significantly associated with chronic conditions. Food, housing, transportation, and any insecurity nearly doubled the odds of reporting any chronic condition (AOR = 2.15, 2.44, 1.70, and 2.20, respectively).ConclusionFindings highlight a strong association between SDOH and chronic conditions among women, necessitating the implementation of targeted policies and interventions to address sex-related health inequities to improve women's health.</p>","PeriodicalId":7481,"journal":{"name":"American Journal of Health Promotion","volume":" ","pages":"987-996"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}