Chronic disease risk typologies among young adults in community college

Objectives: To address chronic disease risk holistically from a behavioral perspective, insights are needed to refine understanding of the covariance of key health behaviors. This study aims to identify distinct typologies of young adults based on 4 modifiable risk factors of chronic disease using a latent class analysis approach, and to describe patterns of class membership based on demographic characteristics, living arrangements, and weight. Methods: Overall, 441 young adults aged 18-35 attending community colleges in the Minnesota Twin Cities area completed a baseline questionnaire for the Choosing Healthy Options in College Environments and Settings study, a RCT. Behavioral items were used to create indicators for latent classes, and individuals were classified using maximum-probability assignment. Results: Three latent classes were identified: ‘active, binge-drinkers with a healthy dietary intake’ (13.1%); ‘non-active, moderate-smokers and non-drinkers with poor dietary intake’ (38.2%); ‘moderately active, non-smokers and non-drinkers with moderately healthy dietary intake’ (48.7%). Classes exhibited unique demographic and weight-related profiles. Conclusions: This study may contribute to the literature on health behaviors among young adults and provides evidence that there are weight and age differences among subgroups. Understanding how behaviors cluster is important for identifying groups for targeted interventions in community colleges

Identifying and describing segments of office workers by activity patterns: Associations with demographic characteristics and objectively measured physical activity

Purpose - The purpose of this paper is to identify and characterize patterns of physical activity among office workers employed in largely sedentary occupations at a major health insurer located in the Southeastern USA. Design/methodology/approach - The authors used latent class analysis to identify segments of office workers (n=239) based on their self-reported activities of daily living and exercise behaviors. The authors examined the association of demographic characteristics with segment membership, and differences in accelerometer-measured weekly minutes of light and moderate-vigorous physical activity across segments. Findings - The authors identified two segments and labeled them "exerciser" and "non-exerciser." Being female was associated with lower odds of membership in the "exerciser" segment (OR=0.18; 95% CI=0.06, 0.52), while those with at least a bachelor's degree were more likely to be in the "exerciser" segment (OR=2.12; 95% CI=1.02, 4.40). Mean minutes of moderate-vigorous physical activity per week were greater for the "exerciser" segment than the "non-exerciser" segment. Practical implications - Based on this sample, the authors found that office workers in sedentary occupations were roughly equally divided and distinguished by their engagement in exercise-type behaviors. The findings underscore the need for innovative workplace programming that enhances activity opportunities particularly for those that are not likely to exercise. Originality/value - A scarcity of research on activity patterns among office workers inhibits development of targeted worksite activity programming. The present research reveals two segments of workers with regard to their activity patterns and suggests ways for worksites to meet their unique needs

Relationship between concussion history and concussion knowledge, attitudes, and disclosure behavior in high school athletes

Objective: Examine the association between self-reported concussion history and measures of concussion knowledge, attitude, and disclosure behavior. Design: Cross-sectional survey. Setting: Classroom. Participants: A convenience sample of high school athletes (n = 167; mean age = 15.7 years) from multiple sports completed a validated survey. Independent Variables: Concussion history (main predictor) was defined as the number of self-recalled concussions during participants' high school career. Main Outcome Measures: The outcomes were recalled concussion disclosure behavior (3 measures) and scales assessing both concussion knowledge and concussion attitude. Results: A greater number of previous concussions was associated with worse attitude to concussion and negative concussion disclosure behavior. For every 3 additional self-recalled concussions, there was a mean decrease of 7.2 points (range of possible scores = 14-98) in concussion attitude score (P = 0.002), a 48% decrease in the self-reported proportion of concussion events disclosed (P = 0.013), and an increased prevalence of self-reported participation in games (67%) and practices (125%) while experiencing signs and symptoms of concussion (P < 0.001). Increased concussion history did not affect concussion knowledge score (P = 0.333). Conclusions: Negative trends in concussion disclosure behavior were identified in youth athletes with a positive history of concussion. Improving disclosure in this subgroup will require targeted efforts addressing negative attitude to concussion

Demographic, parental, and personal factors and youth athletes' concussion-related knowledge and beliefs

Context: Currently, significant attention is focused on improving care for patients with concussions through legislative mandates that include educational interventions. Few researchers have examined young athletes' concussion knowledge and the factors that may influence their knowledge. Objective: To use the socioecological model to examine demographic, parental, and personal factors associated with youth athletes' knowledge of concussion. Our ultimate goal is to inform the planning and implementation of youth sport concussion-related interventions. Design: Cross-sectional survey. Setting: Gymnasium and classroom. Patients or Other Participants: North Carolina and Arizona youth athletes (n ¼ 225; age ¼ 8 to 15 years) active in football, boys' or girls' soccer, boys' or girls' ice hockey, or boys' or girls' lacrosse in 2012-2013. Main Outcome Measure(s): Participants completed a validated, self-administered survey. The intention and belief measures were guided by the theory of planned behavior. Perceptions of concussion and intention to seek care were examined using descriptive statistics. Athletes' concussion knowledge was modeled using linear regressions and generalized estimating equations, with child demographic and personal factors and parental knowledge and attitudes about concussion as predictors. Results: Geography, sport, parental attitudes toward concussion, and athlete age were associated with athlete knowledge in the univariable analyses (P, .10). In the multivariable model, geographic location (North Carolina versus Arizona, mean difference [MD] ¼ 2.2, 95% confidence interval [CI] ¼ 1.1, 3.2), sport (girls' soccer versus girls' lacrosse, MD ¼ 2.2, 95% CI ¼ 0.7, 3.6), more favorable parental attitudes toward concussion (MD ¼ 1.2 for a 2-standard deviation shift; 95% CI ¼ 0.3, 2.1), and older age (.12 years, MD ¼ 1.6; 95% CI ¼ 0.5, 2.6) were associated with better knowledge about concussion. Conclusions: Geographic location, sport, parental attitudes about concussion, and athlete's age influenced athletes' concussion-related perceptions, indicating the need to address multiple levels of the socioecological model when targeting youth sport interventions. Parental interventions that translate to an improved culture of youth sport by improving youth athletes' perceptions and experiences are key areas for future work

Determinants of intention to disclose concussion symptoms in a population of U.S. military cadets

Objectives: Non-disclosure of concussion complicates concussion management, but almost nothing is known about non-disclosure in military settings. This study describes concussion disclosure-related knowledge, attitudes, perceived social norms, perceived control, and intention. Additionally, the study identifies determinants of high intention to disclose concussion symptoms. Design: Cross sectional survey. Methods: First-year service academy cadets completed a cross-sectional survey to assess perceptions of concussion disclosure. Independent variables included: gender, race, ethnicity, high school athlete status, NCAA athlete status, previous concussion history, previous concussion education, socioeconomic proxy, concussion-related knowledge, attitudes about concussion, perceived social norms (perceived peer/organizational support and actions), and perceived control over disclosure. Log-binomial regression was used to identify determinants of high intention to disclose concussion symptoms. Results: A total of 972 first-year military service academy cadets completed the survey [85% response; age = 18.4 ± 0.9 y]. In the simple models, previous concussion history was associated with lower intention to disclose concussion symptoms. High perceived control over disclosure, higher concussion knowledge, more favorable attitudes and social norms about concussion were associated with high intention to disclose. In the multivariable model, a 10% shift towards more favorable perceived social norms (PR = 1.28; p < 0.001) and attitudes (PR = 1.07; p = 0.05) about concussion were associated with high intention to disclose concussion symptoms. High perceived control over disclosure was associated with high intention to disclose concussion symptoms (PR = 1.39; p = 0.08). Conclusions: Concussion-related perceived social norms, attitudes, and perceived control are associated with intention to disclose. Organizationally appropriate intervention strategies can be developed from these data

Factors and expectations influencing concussion disclosure within NCAA Division I athletes: A mixed methodological approach

Background: Participation in sports is associated with many benefits to all aspects of health; however, it also comes with the risk of injury, particularly concussions. Self-disclosure and care seeking following a concussion are especially important because of the lack of outwardly visible signs and/or symptoms. Although recent research has explored factors affecting concussion disclosure, use of isolated methodologies limits the ability to contextualize how disclosure or nondisclosure occurs. Therefore, the purpose of this study was to describe the factors and expectations of National Collegiate Athletic Association (NCAA) athletes that may influence concussion disclosure. Methods: This mixed-methods convergent parallel research study included 25 NCAA Division I athletes representing 13 sports, all of whom completed a concussion-education session with pre-/post-test surveys and a semistructured interview. Eligible athletes were at least 18 years old and on an NCAA roster. The surveys focused on previous concussion-related disclosure behaviors, knowledge, attitudes, beliefs, norms, and intentions about disclosing concussion. Interviews focused on the athletes’ experiences related to concussion disclosure. Survey data were analyzed using descriptive statistics and Mann-Whitney U tests. Interviews were analyzed using a Consensual Qualitative Research tradition. Results: Participants had good concussion knowledge (median = 46.0), positive attitudes (median = 38.0), strong beliefs (median = 13.0), and strong intentions to disclose concussion symptoms (median = 7.0). None of the constructs differed by participants’ gender. Although quantitative findings were mostly positive, interview data highlighted factors that may explain why some participants are successful in disclosing concussions and why others may find disclosure difficult. Educational efforts, sport culture, and medical professional presence were the primary facilitators discussed by participants. Stigma, pressure, and a lack of team support were perceived as disclosure barriers. Conclusion: The context in which concussion disclosure occurs or does not occur is vital to the success of educational interventions. Interventions must prioritize stakeholder- and team-based perspectives on concussion to establish a network supportive to disclosure

Perceived social norms and concussion-disclosure behaviours among first-year NCAA student-athletes: implications for concussion prevention and education

Timely disclosure and identification of concussion symptoms are essential to proper care. Perceived social norms are a potential driving factor in many health-related decisions. The study purpose was to describe concussion disclosure behaviours and identify the association between perceived social norms and these disclosure behaviours. First-year student-athletes (n = 391) at two NCAA institutions completed a cross-sectional survey about concussion disclosure and disclosure determinants. Log-binomial regression models identified factors associated with concussion disclosure behaviour prevalence for: higher intention to disclose symptoms, disclosed all at time of injury, eventually disclosed all, and never participated with concussion symptoms. More favourable perceived social norms were associated with higher prevalence of intention to disclose (PR = 1.34; 95%CI: 1.18, 1.53) and higher prevalence of never participating in sports with concussion symptoms (PR = 1.50; 95%CI: 1.07, 2.10). Clinicians, coaches, sports administrators, and healthcare practitioners should be mindful of the need to create supportive social environments to improve concussion symptom disclosure

The effect of weight loss on health, productivity, and medical expenditures among overweight employees

10.1097/MLR.0b013e318286e437Medical Care516471-477MDLC