Examining The Effectiveness Of Interventions Designed To Increase Mammography Adherence Among African American Women

The objective of this paper was to assess and synthesize the key findings, conclusions, and recommendations of mammography interventions targeting African American women conducted between 1999 and 2010. Collection of materials for this study included searches of academic databases using the following inclusion criteria: 1) publication in the English language, 2) between 1999 and 2010, 3) conducted in the United States, 4) targeting African American women. Titles and abstracts of identified studies were evaluated independently by two researchers. A total of 24 studies met the inclusion criteria. Interventions were categorized as either practice-based or community-based. Classifications were then sub-categorized based on the employment of targeted or tailored strategies. Culturally-appropriate tailored and targeted messages are an effective approach to increase screening mammography adherence. Community-wide interventions that employ lay health advisors were found to assist in offsetting issues related to trust and access. Interventions delivered in faith-based settings were effective mediums for increasing adherence to screening guidelines. Stepped-care interventions were an efficient, cost-effective method for increasing adherence among non-compliant populations. The majority of the identified studies relied upon theoretical frameworks to guide the intervention. Community-based interventions should progress from atheoretical to theory-based intervention frameworks

Social Cognitive Models of Fruit and Vegetable Consumption, Moderate Physical Activity, and Sleep Behavior in Overweight and Obese Men

Background. Approximately 35% of men in the United States are obese, though little theoretical work examining predictors correlates of obesity exists for this population. The purpose of this study was to test the capacity of Bandura’s social cognitive model of health behavior to account for variance in fruit and vegetable consumption, moderate physical activity, and sleep behavior in overweight and obese men. Methods. Data were collected from overweight and obese men using previously validated questionnaires. Structural equation models were built to examine the direct and indirect effects the social cognitive theory constructs of self-efficacy, outcome expectation, socio-structural factors, and goals on the behaviors under investigation. Results. A total of 305 men participated in this study (Mage=44.52; SD=6.95). Overall fit for the social cognitive models of health behavior were adequate, accounting for 35.0%, 31.2%, and 21.1% of the variance in the fruit and vegetable consumption, moderate physical activity, and sleep behavior correlates, respectively. Self-efficacy had the greatest total effect on fruit and vegetable consumption (βtotal=.500) and sleep behavior (βtotal=.406), while goals has the greatest total effect on moderate physical activity (βtotal=.495). The indirect effects of self-efficacy on the three behaviors demonstrates the relative importance of self-efficacy as a mediator for health behavior change. Discussion. Men are underrepresented in behavioral obesity prevention and treatment research. This study provides support for the social cognitive model of health behavior as a theoretical framework for predicting behaviors hypothesized to protect against and treat obesity in men. Additionally, this study represents the first attempt to model correlates social cognitive constructs on sleep behavior

Modeling Risk Factors for Sleep- and Adiposity-Related Cardiometabolic Disease: Protocol for the Short Sleep Undermines Cardiometabolic Health (SLUMBRx) Observational Study

Background: Obesity and short sleep duration are significant public health issues. Current evidence suggests that these conditions are associated with cardiovascular disease, metabolic syndrome, inflammation, and premature mortality. Increased interest in the potential link between obesity and short sleep duration, and its health consequences, has been driven by the apparent parallel increase in the prevalence of both conditions in recent decades, their overlapping association with cardiometabolic outcomes, and the potential causal connection between the two health issues. The SLUMBRx (Short Sleep Undermines Cardiometabolic Health) study seeks to contribute to the development of a comprehensive adiposity-sleep model while laying the groundwork for a future research program that will be designed to prevent and treat adiposity- and sleep-related cardiometabolic disease risk factors. Objective: This SLUMBRx study aims to address 4 topics pertinent to the adiposity-sleep hypothesis: the relationship between adiposity and sleep duration; sex-based differences in the relationship between adiposity and sleep duration; the influence of adiposity indices and sleep duration on cardiometabolic outcomes; and the role of socioecological factors as effect modifiers in the relationship between adiposity indices, sleep, and cardiometabolic outcomes. Methods: SLUMBRx will employ a large-scale survey (n=1000), recruiting 159 participants (53 normal weight, 53 overweight, and 53 obese) to be assessed in 2 phases. Results: SLUMBRx was funded by the National Institutes of Health, Heart, Lung, and Blood Institute through a K01 grant award mechanism (1K01HL145128-01A1) on July 23, 2019. Institutional Review Board (IRB) approval for the research project was sought and obtained on July 10, 2019. Phase 1 of SLUMBRx, the laboratory-based component of the study, will gather objective adiposity indices (air displacement plethysmography and anthropometrics) and cardiometabolic data (blood pressure, pulse wave velocity and pulse wave analysis, and a blood-based biomarker). Phase 2 of SLUMBRx, a 1-week, home-based component of the study, will gather sleep-related data (home sleep testing or sleep apnea, actigraphy, and sleep diaries). During phase 2, detailed demographic and socioecological data will be collected to contextualize hypothesized adiposity and sleep-associated cardiometabolic disease risk factors. Collection and analyses of these data will yield information necessary to customize future observational and intervention research. Conclusions: Precise implementation of the SLUMBRx protocol promises to provide objective and empirical data on the interaction between body composition and sleep duration. The hypotheses that will be tested by SLUMBRx are important for understanding the pathogenesis of cardiometabolic disease and for developing future public health interventions to prevent its conception and treat its consequences

Examining the relationship between poor sleep health and risky driving behaviors among college students

Objective: Risky driving behaviors, such as texting while driving, are common among young adults and increase risk of traffic accidents and injuries. We examine the relationship between poor sleep and risky driving behaviors among college students as potential targets for traffic injury prevention. Methods: Data for this study were obtained from a cross-sectional survey administered to a college student sample in the United States Midwest (n = 1,305). Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI). Risky driving behaviors were measured, including sending texts/emails; reading texts/emails while driving; talking on the phone while driving; falling asleep while driving; and driving under the influence. Risky driving behavior was defined as a response of "just once," "rarely," "sometimes," "fairly often" or "regularly" (reference = "never"). Logistic regression was used to examine the relationship between sleep and risky driving, after adjusting for confounders. Results: Among participants, 75% reported sending texts/emails while driving, 82% reported reading texts/emails while driving, and 84% reported phone talking while driving; 20% reported falling asleep while driving; 8% reported driving under the influence; and 62% reported 3 or more risky behaviors. Compared to those reporting no sleep disturbance, those with sleep disturbance "once or twice a week" were more likely to report sending a text/email while driving (aOR: 2.9, 95%CI:1.7-4.9), reading a text/email while driving (aOR:3.1,95%CI:1.5-5.5), talking on the phone while driving (aOR:1.9, 95%CI:1.0-3.4), and falling asleep while driving (aOR:3.4,95%CI:1.5-7.4). Compared to those reporting no daytime dysfunction, those reporting issues "once or twice a week" were more likely to report talking on the phone while driving (aOR:1.7, 95%CI:1.1-2.7) and falling asleep while driving (aOR:3.6,95%CI:2.3-5.6). Conclusions: Future research may consider designing behavioral interventions that aim to improve sleep, reduce drowsy driving among young adults

Associations between sleep disturbances, personality, and trait emotional intelligence

Insomnia is defined by difficulty falling asleep, staying asleep, or waking earlier than desired with inability to return to sleep. Complaints of nonrestorative sleep (NRS) are often associated with insomnia but can occur independently. Fragmented sleep and NRS have been shown to relate to one’s mood, one’s ability to process their own or others’ emotions, and can lead to changes in cognitions and behaviors. Personality traits related to increases in anxiousness may play a role in the development and maintenance of sleep disorders and associated daytime impairment of NRS. The relations between sleep disturbance, personality traits, and trait emotional intelligence are underrepresented in the current literature and findings have been mixed. This study addressed some inconsistencies by identifying associations between the Big Five personality traits, trait emotional intelligence (TEI), complaints of NRS, and disrupted sleep associated with insomnia. We predicted that neuroticism would relate to poorer sleep and that conscientiousness and TEI would be associated with better sleep. Openness to experience, extraversion, and agreeableness are not often discussed in the literature, but were expected to associate similarly as conscientiousness. Results provided support for the idea that trait characteristics are associated with insomnia severity and restorative sleep quality. These findings indicated that personality and TEI may play a role in development and maintenance of sleep disorders and daytime impairment of NRS; higher conscientiousness, lower neuroticism, and higher TEI possibly demonstrate a protective role to experiencing negative effects of poor sleep. (Published By University of Alabama Libraries

Predictors of depression diagnoses and symptoms in veterans: results from a national survey

The suicide numbers among active duty military personnel eclipsed the number of combat deaths in 2011. Before the wars in Iraq and Afghanistan, the incidence of suicide in active duty US service members was consistently 25% lower than in the civilian population. Currently military and veteran suicide rates exceed those found in the general population, with 22 per day being the most conservative estimates by the Veteran's Administration. The reasons for this are multi-faceted, with the question looming as to whether repeated ground combat tours have a deleterious effect on resilience and overall mental health. Operational tempo in the last ten years has exceeded all previous expectations and metrics; frequent trips to Iraq and Afghanistan are commonplace for this community. The purpose of this study was to examine the relationship between ten key variables and rates of diagnosed depression and symptoms of undiagnosed depression in a national sample of veterans to generate predictive models for the condition in military veterans. This study utilized secondary data analysis of veteran respondents using the 2012 Behavioral Risk Factors Surveillance Survey conducted by the Centers for Disease Control and Prevention. Logistic regression analysis explored associations between diagnosed and undiagnosed depression in veteran respondents and independent variables including: veteran era, sex, ethnicity, race, relationship status, physical activity, binge drinking, smoking, physical disability and pain, and beliefs about mental health care's usefulness. This timely and culturally-relevant line of inquiry offers insight that may guide targeted resilience programming for the veteran community. (Published By University of Alabama Libraries

Development and validation of a theory of planned behavior-based instrument to predict human papillomavirus vaccination intentions of college males at a southeastern university

Background. Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States. College-age males influence acquisition and transmission of HPV due to engagement in high-risk sexual behaviors. HPV vaccination is an efficacious strategy for reducing the burden of HPV-associated morbidity; yet rates of HPV vaccination remain low among college males. The purpose of this study was to operationalize the direct constructs of the theory of planned behavior (TPB) to predict the HPV vaccination behavioral intentions of male undergraduate college students attending a large public southeastern university. Methods. A non-experimental, cross-sectional study design was employed with 256 vaccine-eligible college males. Instrumentation comprised a qualitative elicitation study, face and content validity by a panel of seven experts, readability and comprehensibility by pilot test, stability reliability by test-retest, internal consistency applying Cronbach’s alpha, construct validity applying confirmatory factor analysis, and predictive validity applying structural equation modeling. Results. Approximately one third (31.3%) of the sample was unaware of HPV and nearly half (45.3%) of the sample was unaware of the HPV vaccine. The final structural model exhibited acceptable fit of the data (Chi-square test = 129.78; degrees of freedom, df = 70, p = .000; Kline’s alternative, KA = 1.854; Goodness-of-fit index, GFI = 0.932; Normed fit index, NFI = .948; Root mean square error of approximation, RMSEA = 0.054). Attitude toward the behavior and subjective norm were significant predictors of behavioral intention, accounting for 58% of the variance in behavioral intention. Perceived behavioral control was found to be a non-significant predictor of behavioral intention. Overall, college males reported low behavioral intentions to get the vaccine (M = 8.52; SD = 5.30). Discussion. A valid and reliable instrument designed to measure constructs from the TPB was developed to predict HPV vaccination intentions of college males. Findings from this study provided an instrument that may be applied in the design and evaluation of TPB-based interventions to promote HPV vaccination among undergraduate college males. Future research may examine possible mediators and moderators of TPB constructs to fully operationalize the theoretical framework. (Published By University of Alabama Libraries

Relationships between high school students' health behaviors and perceptions of their 9th grade health education experience

In the majority of U.S. schools, health education has been delivered in a fragmented and disorganized way resulting in poor quality. While studies have assessed the perceptions of health education from lead health education teachers and school administrators, a review of the literature revealed no studies of high school students' perceptions of school health education. The perceived experiences and perceptions of school health education among high school students have not been fully explored. The purpose of this study was to a) assess the perceptions of a 9th grade health education course from 10th and 11th graders attending a rural high school in West Central Alabama, b) identify students' self-reported current health behaviors and c) explore the relationship between the perceptions of their 9th grade health education course and reported health behaviors. Results showed that for each of the National Health Education Standards at least 60% of the students indicated that the course helped them to perform the standard. Results also showed that for each of the six CDC risk behaviors at least 50% of students indicated that the course helped them to make decisions about the risk behaviors. Additionally, at least 55% of high school students in grades 10-11 perceived their 9th grade health education course to be effective in helping them to make decisions about their general health and decisions related to the six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, a) behaviors that contribute to unintentional injuries and violence, b) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection, c) alcohol and other drug use, d) tobacco use, e) unhealthy dietary behaviors, and f) inadequate physical activity. Over 60% of 10th grade students and 55.4% of 11th grade students perceived their 9th grade health education course to be effective in preparing them to use decision-making skills to enhance health. Similarly, 10th grade students (70.8%) and 11th grade students (59.5%) perceived their 9th grade health education course to be effective in preparing them to comprehend concepts related to health promotion and disease prevention. (Published By University of Alabama Libraries