Commentary on Future of Health Behavior Research: Aging Perspectives

This Commentary provides personal reflections on the future of health behavior research and the role of AAHB in the preparation of the next generation of researchers and educators for high quality relevant research and practice. Comments center around the four questions presented to Research Laureates at the 2017 AAHB Annual Meeting. Themes include: 1) a life-course perspective as a priority game changer in furthering health behavior research; 2) multiple disciplines to advance health behavior research; 3) pathways to a successful doctoral program; and 4) forward thinking for identifying risk factors for public health problems and contextually-based health behavior solutions

Evidence-Based Programming for Older Adults

There is increased world-wide concern about the impact of multiple chronic conditions, especially among the rapidly aging population. Simultaneously, over the past decade there has been an emergence of state-wide and national initiatives to reduce the burden of chronic conditions that draw upon the translation of evidence-based programs (EPB) into community practice. Yet, little has been written about the national and international implementation, dissemination, and sustainability of such programs. This Research Topic features articles about EBPs for older adults, including a range of articles that focus on the infrastructure needed to widely disseminate EBP as well as individual participant impacts on physical, mental, and social aspects of health and well-being. Using a pragmatic research perspective, this Research Topic will advance knowledge that aims to enhance practice, inform policy and build systems of support and delivery in regard to the reach, effectiveness, adoption, implementation, and maintenance of evidence-based interventions for older adults. The focus is on knowledge transfer rather than knowledge generation but with a dual emphasis on the dissemination and sustainability of EBP that have been tested and shown effective as well as the adaptation of practice-based interventions into evidence-based programs. This Research Topic draws upon grand-scale efforts to deliver these programs, and include both U.S. as well as international examples. Commentaries discuss processes in the development and measurement of EBP and reflect perspectives from program developers and major national and regional funders of EBP as well as professionals and practitioners in the field. The full-length articles focus on four major programmatic areas: (1) chronic disease self-management programs; (2) fall prevention programs; (3) general wellness and physical activity programs; and (4) mental health programs. Additionally, articles are included to discuss cross-cutting issues related to building partnerships and the research infrastructure for the implementation, evaluation, and dissemination of evidence-based programming. The intent of this Research Topic is to enhance practice, inform policy, and build systems of support and delivery for EBP. It is written for a diverse audience and contains practical implications and recommendations for introducing, delivering, and sustaining EBP in a multitude of settings

Mexican Americans With Type 2 Diabetes: Perspectives on Definitions, Motivators, and Programs of Physical Activity

IntroductionResearch documents that Mexican Americans bear excess health risk because of physical inactivity and have higher morbidity and mortality rates from chronic diseases than do other ethnic groups. Factors influencing physical activity in this minority population, however, are not well understood. This study examines perceptions of physical activity in a population of Mexican Americans who have type 2 diabetes and live in the Texas-Mexico border region and identifies motivators and barriers to physical activity in this group.MethodsThis study used a qualitative research design and employed six focus groups comprising 39 Mexican Americans with type 2 diabetes who live in the Texas–Mexico border region. A team of bilingual Mexican American researchers systematically reviewed and analyzed focus group data by means of qualitative data analysis software. The study was conducted during 2005–2006.ResultsMost participants considered physical activity to be related not only to exercise but also to occupational and home activities. Walking was the preferred type of activity. Motivators to physical activity included family support and the sense of well-being derived from physical activity. Barriers to physical activity included individual and environmental factors, such as lack of time, physical pain, depression, being overweight, unsafe neighborhoods, and lack of facilities. Participants suggested that the ideal intervention would be low in cost, family-based, close to home, and led by bilingual instructors.ConclusionHealth promotion efforts to prevent or reduce the effects of chronic disease among Mexican Americans with type 2 diabetes in the Texas–Mexico border region should focus on implementing neighborhood-based, family-oriented walking interventions

Parental safety concerns and active school commute: correlates across multiple domains in the home-to-school journey

Abiodun O. Oluyomi, Eileen Nehme, and Deanna M. Hoelscher are with The Michael and Susan Dell Center for Healthy Living, UT School of Public Health, Austin Regional Campus, The University of Texas Health Science Center at Houston, Austin, TX USA -- Chanam Lee is with the Department of Landscape Architecture and Urban Planning, College of Architecture, Texas AM University, College Station, TX USA -- Diane Dowdy and Marci G. Ory are with the School of Rural Public Health, Texas AM HeaBackground: Empirical evidence of the relationship between safety concerns and walking to school (WTS) is growing. However, current research offers limited understanding of the multiple domains of parental safety concerns and the specific mechanisms through which parents articulate safety concerns about WTS. A more detailed understanding is needed to inform environmental and policy interventions. This study examined the relationships between both traffic safety and personal safety concerns and WTS in the U.S. Methods: This cross-sectional analysis examined data from the Texas Childhood Obesity Prevention Policy Evaluation (T-COPPE) project, an evaluation of state-wide obesity prevention policy interventions. All study data were from the survey (n = 830) of parents with 4th grade students attending 81 elementary schools across Texas, and living within two miles from their children's schools. Traffic safety and personal safety concerns were captured for the home neighborhood, en-route to school, and school environments. Binary logistic regression analysis was used to assess the odds of WTS controlling for significant covariates. Results: Overall, 18% of parents reported that their child walked to school on most days of the week. For traffic safety, students were more likely to walk to school if their parent reported favorable perceptions about the following items in the home neighborhood environment: higher sidewalk availability, well maintained sidewalks and safe road crossings. For the route to school, the odds of WTS were higher for those who reported "no problem" with each one of the following: traffic speed, amount of traffic, sidewalks/pathways, intersection/crossing safety, and crossing guards, when compared to those that reported "always a problem". For personal safety in the en-route to school environment, the odds of WTS were lower when parents reported concerns about: stray or dangerous animals and availability of others with whom to walk. Conclusions: Findings offered insights into the specific issues that drive safety concerns for elementary school children’s WTS behaviors. The observed associations between more favorable perceptions of safety and WTS provide further justification for practical intervention strategies to reduce WTS barriers that can potentially bring long-term physical activity and health benefits to school-aged children.Public [email protected]

Evidence-Based Program to Reduce Fall-Related Risk Among Older Adults: A Comparison of Program Efficacy by Ethnicity

Despite rapid growth among the Hispanic population in the United States, seniors within this ethnic group are typically underrepresented in evidence-based programs. The purpose of this study is to examine the relative efficacy of A Matter of Balance/Volunteer Lay Leader Model (AMOB/VLL), an eight session fall risk prevention program, for non-Hispanic White and English-speaking Hispanic participants on key study outcomes. Data were collected from 1,233 seniors enrolled in AMOB/VLL in Texas. Compared to non-Hispanic White participants, a significantly larger proportion of Hispanic participants were younger (?2=50.23, df=3, p<0.001), had less than a high school education (?2=200.31, df=2, p<0.001), and resided in less affluent areas. From baseline to post-intervention, significant improvements in falls efficacy (t=- 9.13, df=167, p<0.001), days limited from usual activity (t=1.99, df=164, p=0.049), and unhealthy mental days (t=2.51, p=0.013) were seen among Hispanic participants. Significant improvements among nonHispanic White participants were observed for falls efficacy (t=-15.90, df=868, p<0.001). Although significant improvements were found for each ethnic group, the magnitude of improvement among Hispanic participants exceeded that of non-Hispanic Whites in some aspects. Identifying participant characteristics and positive outcomes specific to Hispanics can inform strategies to maximize program reach and effectiveness among this vulnerable and underserved population

Otago Exercise Program in the United States: Comparison of 2 Implementation Models

Author(s): Shubert, TE; Smith, ML; Goto, L; Jiang, L; Ory, M

HPV-Related Cancer Prevention and Control Programs at Community-Based HIV/AIDS Service Organizations: Implications for Future Engagement

Background: People living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and, men who have sex with men (MSM) are disproportionately affected by genital warts and cancers caused by human papillomavirus (HPV). We assessed community-based HIV/AIDS service organizations' (ASOs) staff awareness, knowledge, attitudes, and beliefs about HPV and effective cancer prevention tools, namely HPV vaccination, Pap, and HPV tests. The potential engagement of ASO staff in future efforts to reduce the disproportionate burden of genital warts and HPV-related cancers among HIV-positive women and MSM was explored.Methods: In May-June 2016, staff were recruited from three ASOs located in the South United States Census region—a geographical area disproportionately affected by HIV/AIDS. Participants completed a 30-min self-administered, 118-item paper and pencil survey about HPV and cancer. Data analysis was conducted using Stata/SE 14.2.Results: ASO staff (n = 30) were 83% non-Hispanic Black, 40% lesbian/gay, and worked with people living with HIV for an average of 11.4 ± 7.7 years. All reported hearing of HPV and 77% had heard of the HPV vaccine (n = 23). While all knew HPV can cause cervical cancer, only 67% knew HPV can cause anal cancer. Most (61%) thought the HPV vaccine could prevent cervical cancer. Fewer (39–48%) thought the HPV vaccine could prevent anal, oral, penile, vaginal, and vulvar cancers. All were willing to encourage MSM and female clients to talk to a healthcare provider about HPV vaccination. Almost all were willing to promote HPV vaccination to clients (91–95%) and navigate clients to adult safety net HPV vaccine providers (86–95%). More than half (59–67%) thought they could positively influence their MSM and female clients' HPV vaccine decision-making.Conclusion: HPV vaccination and the Pap and HPV tests are effective cancer prevention tools that can reduce the disproportionate burden of genital warts and HPV-related cancers among HIV-positive women and MSM. Engaging ASO staff in cancer prevention efforts may increase HPV vaccination rates and early detection of HPV-related cancers among HIV-positive women and MSM. Exploring ASOs as community-based settings for promoting effective cancer prevention tools may foster opportunities to reduce the disproportionate burden of genital warts and HPV-related cancers among HIV-positive women and MSM