bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a “Nondieting” Stress Reduction Program for Overweight Women: A Randomized Trial
Authors: Katzer Lisa , Bradshaw Alison J. , Horwath Caroline C. , Gray Andrew R. , O'Brien Sue , Joyce Janine 
Published: June 2010

Purpose. Determine if a “nondieting” intervention focused on intensive training in eliciting the relaxation response enhances health outcomes compared with nondieting interventions without such training. Design. Randomized trial with follow-up at 10 weeks, 4 months, and 12 months. Setting. General community. Subjects. Total of 225 overweight and obese women with at least one other cardiovascular risk factor. Interventions. Three 10-week nondieting interventions: a group program (P1) focused on intensive training in techniques for eliciting the relaxation response (n = 60), a group program (P2) focused on healthy eating and physical activity (n = 61), and a self-guided, mail-delivered version of P2 (P3; n = 101). Measures. The Revised Symptom Checklist measured psychological distress, the Medical Symptoms Checklist measured the experience of medical symptoms, and the Health-Promoting Lifestyle Profile measured a range of lifestyle behaviors. Self-efficacy for low-fat eating, intuitive eating, and body mass index were also assessed. Analysis. An intention-to-treat analysis was used. Results. At 12 months, P1 produced statistically greater improvements in stress management behaviors and medical symptom discomfort and was the only program to significantly improve self-efficacy for low-fat eating. In P1, the effect sizes for reductions in depression (0.75) and interpersonal sensitivity (0.85) were large. At 12 months, mean weight was unchanged. Conclusion. Inclusion of intensive relaxation response training in a nondieting program for overweight women enhanced stress management and medical symptoms outcomes but not weight outcomes.
Predictors of Stage Transitions in the Precaution Adoption Process Model
Authors: De Vet Emely , De Nooijer Jascha , Oenema Anke , De Vries Nanne K. , Brug Johannes 
Published: June 2010

Purpose. To explore psychosocial correlates and predictors of stage transitions in the precaution adoption process model (PAPM) for fruit intake. Design. A cohort completed three electronic questionnaires, at baseline (time 0), 35 days later (time 1), and another 32 days later (time 2). Setting. Secured Internet Web site. Subjects. A cohort of 735 adults was formed from a random sample of an existing Internet panel. The mean age was 37.5 years, 51% were women, and 90% were of Dutch origin. Most respondents (48%) had a medium level of education. Measures. Precaution adoption process model stage, risk perception, perception of own fruit intake level, attitude, pros, cons, subjective norms, social support, modeling, self-efficacy, and fruit intake (assessed using a food frequency questionnaire). Analysis. Cross-sectional differences in psychosocial variables and fruit intake across PAPM stages at baseline were analyzed using analysis of variance with Tukey multiple comparisons tests. Predictors of PAPM stage transitions between time 0 and time 1 and between time 1 and time 2 were analyzed using logistic regression analysis. Results. Factors related to attitude and social influences may be important if one is to decide to act, whereas strong self-efficacy may also be required for acting on the decision to act. Conclusion. Although the results should be replicated in a larger and more representative sample, the PAPM seems a good framework for studying fruit intake.
Faith-Health Collaboration in the United States: Results from a Nationally Representative Study
Authors: Steinman Kenneth Jacob , Bambakidis Athe 
Published: June 2010

Purpose. Estimate the prevalence of and identify characteristics associated with religious congregations' collaboration with health agencies. Design. Cross-sectional analyses of self-report data from the National Congregations Study, a random sample of religious congregations generated from the 1998 General Social Survey. Setting. United States. Subjects. Key informants from 1236 congregations. Each respondent described a single congregation. Measures. Respondents provided open-ended descriptions of congregational programs. Researchers coded program descriptions by content (e.g., domestic violence) and whether the program involved collaboration with a secular agency. Other congregational characteristics (e.g., denomination) were measured by validated measures and linked census tract data. Results. Overall, 11.1% of congregations participated in faith-health collaboration (FHC). Logistic regression analyses found that FHC was more common among congregations with more members, with a small proportion of congregants under 35 years, and with a senior pastor with a graduate degree. Other effects were conditional; for instance, denominational differences varied depending on urban/suburban/rural location and the proportion of low-income members. Conclusion. This study provides the first national estimates of the prevalence of FHC. Such collaborative efforts may require different approaches in different areas. These results can help practitioners identify congregations that may be more willing to collaborate.
The Association between Medical Costs and Participation in the Vitality Health Promotion Program among 948,974 Members of a South African Health Insurance Company
Authors: Patel Deepak N. , Lambert Estelle V. , da Silva Roseanne , Greyling Mike , Nossel Craig , Noach Adam , Derman Wayne , Gaziano Thomas 
Published: June 2010

Purpose. Examine the association between the levels of participation in an incentive-based health promotion program (Vitality) and inpatient medical claims among members of a major health insurer. Design. A 1-year, cross-sectional, correlational analyses of engagement with a health promotion program and hospital claims experience (admissions costs, days in hospital, and admission rate) of members of a national private health insurer. Setting. Adult members of South Africa's largest national private health insurer, Discovery Health. Insured members were also eligible for voluntary membership in an insurance-linked incentivized health promotion program, Vitality. Subjects. The study sample included 948,974 adult members of the Discovery Health plan for the year 2006. Of these, 591,134 (62.3%) were also members of the Vitality health promotion program. Measures. The study sample was grouped based on registration and the level of engagement with the Vitality health promotion program into the following: not registered (37.5%), registered but not engaged with any health promotion activity (21.9%), low engagement (30.9%), and high engagement (9.5%). High engagement was defined a priori by the accumulation of an arbitrary number of points on the Vitality program, allocated against specific activities (knowledge, fitness-related activities, assessment and screening, and healthy choices). Hospital admission costs, the number of days in hospital, and hospital admission rates were compared among highly engaged members and those members who were not enrolled in the program, nonengaged, and lowly engaged. Data were normalized for age, gender, plan type, and chronic disease status. Results. Highly engaged members had lower costs per patient, shorter stays in hospital, and fewer admissions compared with other groups (p < .001). Low or no engagement was not associated with lower hospital costs. Admission rates were also 7.4% lower for cardiovascular disease, 13.2% lower for cancers, and 20.7% lower for endocrine and metabolic diseases in the highly engaged group compared with any of the other groups (p < .01). Conclusions. Engagement in an incentive-based wellness program, offered by a health insurer, was associated with lower health care costs.
Behavioral, Demographic, Psychosocial, and Sociocultural Concomitants of Stage of Change for Physical Activity Behavior in a Mixed-Culture Sample
Authors: Cardinal Bradley J. , Lee Jong-Young , Kim Young-Ho , Lee Hyo , Li Kin-Kit , Si Qi 
Published: June 2010

Purpose. Examine behavioral, demographic, psychosocial, and sociocultural concomitants of the stages of change for physical activity behavior among college students in South Korea (n = 221) and the United States (n = 166). Methods. Measures obtained in this cross-sectional study included age; body mass index; nationality; gender; exercise behavior; processes of change; decisional balance; self-efficacy; stage of change; and predisposing, reinforcing and enabling factors. Results. The amount of variance explained for stage of change by the transtheoretical model constructs (i.e., decisional balance, processes of change, self-efficacy) ranged from 11% to 29% (all p < .001), whereas the predisposing (2%; p = .052), reinforcing (3%; p = .06), and enabling (5%; p < .001) factors were not as important. In multivariate ordinal logistic regression analysis, gender (odds ratio [OR] = 3.3; p < .001), gender by nationality interaction (OR = .27; p < .01), weekly exercise behavior (OR = 1.04; p < .001), and behavioral processes of change (OR = 1.12; p < .001) were each significant concomitants of the stages of change. Discussion. In terms of physical activity behavior, South Korean women were more likely than South Korean men to be in the early stages, whereas American men were slightly more likely to be in the early stages than American women when all the concomitants were accounted for. Among the psychosocial stage of change concomitants, only the behavioral processes of change were found to be important.
Television Viewing: Moderator or Mediator of an Adolescent Physical Activity Intervention?
Authors: Graham Dan J. , Schneider Margaret , Cooper Dan M. 
Published: June 2010

Purpose. To determine whether the amount of television (TV) watched by participants enrolled in a physical activity intervention mediates or moderates program effectiveness. Design. Nine-month, controlled, school-based physical activity intervention. Setting. Public high school. Participants. One hundred twenty-two sedentary adolescent females (mean + standard deviation age = 15.04 + 0.79 years). Intervention. Supervised in-class exercise, health education, and internet-based self-monitoring. Measures. Physical activity by 3-day physical activity recall; TV viewing by self-reports; cardiovascular fitness by cycle ergometer. Analysis. T-tests were conducted to examine between-group differences. Linear regression equations tested the mediating or moderating role of TV watching relative to the intervention. Results. TV viewing moderated the intervention's effect on vigorous activity; the intervention significantly predicted change in physical activity among high (β = −.45; p < .001), but not among low (p > .05), TV watchers. TV viewing did not mediate the intervention effect. Conclusions. Consistent with displacement theory, adolescents who watched more TV prior to the intervention showed postintervention increases in vigorous physical activity and concomitant decreases in TV viewing, whereas those who watched less TV showed no change in physical activity or TV viewing.
Factors Which Influence Tobacco Use among Junior Enlisted Personnel in the United States Army and Air Force: A Formative Research Study
Authors: Haddock C. Keith , Taylor Jennifer E. , Hoffman Kevin M. , Poston Walker S. C. , Peterson Alan , Lando Harry A. , Shelton Suzanne 
Published: June 2010

Background. Despite the implementation of a host of tobacco control initiatives, tobacco use among active duty members of the U.S. Military remains high. It has been suggested that a positive culture of tobacco, which drives consumption, exists in the military. However, little is know about factors that impact tobacco use among military personnel. Objective. This study provides the first formative data on the culture of tobacco in the U.S. Military. Methods. A total of 15 focus groups on six military installations were conducted (n = 189). These military installations were located throughout the continental United States and were of average size for each service. Results. Participants suggested that the primary method the military uses to discourage use is tobacco bans. Unfortunately, they also believed that the military accommodates tobacco use so that smoking remains convenient despite the bans on tobacco use. Smoking was believed to be encouraged through liberal smoking breaks, social interaction within designated smoking areas, and cheap and convenient tobacco products sold on military installations. Additionally, smoking was seen as an effective method to combat the stress and boredom of military life and to avoid weight gain. Conclusions. Suggestions for addressing the culture of tobacco are suggested.
Associations of Cycling with Urban Sprawl and the Gasoline Price
Authors: Rashad Inas 
Published: June 2010

Purpose. Determine the relationships between cycling and urban sprawl and between cycling and the gasoline price. Analysis. Cross-sectional multivariate regression analyses using pooled data from two individual-level national surveys to analyze the effects of variations in levels of urban sprawl and the gasoline price on cycling as a form of physical activity. Setting. Metropolitan areas representative of the U.S. population, 1990 to 2001. Subjects. Behavioral Risk Factor Surveillance System: 146,730 individuals at least 18 years old in the United States; Nationwide Personal Transportation Survey: 73,903 individuals at least 18 years old in the United States. Measures. Self-reported information on bicycling served as the dependent variable. Urban sprawl and the gasoline price served as key independent variables. Results. Living in a metropolitan area with a lower degree of urban sprawl increased the probability of cycling in the past month by 3.4 to 4.4 percentage points and 1.6 to 2.1 percentage points from the means for men and women, respectively. Increasing the gasoline price by one dollar increased the probability of cycling by 4.3 to 4.7 percentage points and 2.9 to 3.5 percentage points for men and women, respectively. Conclusion. Results indicate that the prevalence of cycling is higher in less sprawling areas and areas with higher gasoline prices. More research is needed to refine results on how individuals respond to incentives and the roles that monetary and time costs play in improving public health.
Comparing Individualized Rehabilitation to a Group Wellness Intervention for Persons with Multiple Sclerosis
Authors: Plow Matthew A. , Mathiowetz Virgil , Lowe Dawn A. 
Published: June 2010

Purpose. Compare the efficacy of two interventions designed to promote health and physical activity (PA). Design. This study was a randomized clinical trial using a time series design. Subjects were randomized into individualized physical rehabilitation (IPR) and group wellness intervention (GWI). Primary questionnaires were administered twice preintervention and twice postintervention. Physical fitness and PA frequency were assessed preintervention and postintervention. Setting. Clinic based in a metropolitan area. Subjects. Fifty volunteers with multiple sclerosis. Interventions. IPR consisted of four physical therapy sessions plus three telephone calls. GWI consisted of seven educational sessions. Measures. Primary: SF-36 Health Survey, Modified Fatigue Impact Scale, Mental Health Inventory. Secondary: physical assessment, PA frequency. Analysis. Stability of primary questionnaires between the two pretests was examined. Efficacy of interventions was evaluated by multivariate analysis of variance (MANOVA) and effect sizes. Results. Primary measures were stable between pretests. MANOVA showed nonsignificant differences between interventions. Eight weeks postintervention, both groups had improved PA, fatigue, resting heart rate, and strength. Effect sizes suggested that IPR had a greater effect on preventing decline of physical health, whereas GWI had a greater effect on improving mental health. Conclusion. Preliminary evidence indicated that health and PA improved in both groups. Effect sizes suggested that participants benefited more physically from IPR and more mentally from GWI. Future research should determine whether combining therapeutic exercise with group education improves both mental and physical health.
The Use of Exploratory Factor Analysis in Public Health: A Note on Parallel Analysis as a Factor Retention Criterion
Authors: Patil Vivek H. , McPherson Matthew Q. , Friesner Daniel 
Published: June 2010

Purpose. Exploratory factor analysis is used to identify latent factors for public health interventions. The most popular factor retention criterion, the eigenvalue greater than one (EVG1) rule, leads to the retention of more factors than warranted. The use of parallel analysis (PA) as a factor retention criterion is recommended. Design. Environmental factors that are likely to affect the propensity of individuals to walk are identified. Results from PA are compared with those obtained by using the EVG1 rule. Setting. Telephone survey data were collected from three communities (spanning 12 counties) in the Appalachian region. Participants. The sample was composed of adults between the ages of 40 and 65 years. There were 1019 completed surveys. Measures. The data on 14 variables, including measures of neighborhood safety, beauty, and access to walking facilities were collected. Analysis. A principal components analysis was performed. The factors retained after using the EVG1 rule were compared with the factors retained after using PA. Varimax rotation was used to aid factor interpretation. Results. The EVG1 rule led to the retention of nearly twice the number of latent factors as did the PA criterion. Conclusion. The use of the EVG1 rule in research may mislead policy makers to focus on trivial interventions. They are urged to use PA to obtain more parsimonious and externally valid interventions.
Sources of Human Immunodeficiency Virus and Sexually Transmitted Disease Information and Responses to Prevention Messages among Massachusetts Men Who Have Sex with Men
Authors: Mimiaga Matthew J. , Reisner Sari L. , Goldhammer Hilary , Tetu Ashley M. , Belanoff Candice , Mayer Kenneth H. 
Published: June 2010

Purpose. Sexually transmitted disease (STD) rates have continued to increase among men who have sex with men (MSM). The present study used qualitative methods to assess sources of human immunodeficiency virus (HIV)/STD information and responses to HIV/STD prevention messages among MSM. This was done to understand how to design more effective media campaigns on HIV/STD prevention and testing for this population. Design. One-on-one semistructured, qualitative interviews and a brief demographic written survey were conducted. Setting. A Massachusetts community-based organization specializing in HIV/AIDS healthcare. Participants. A novel, modified, respondent-driven sampling method was used to recruit a diverse sample of 50 Massachusetts MSM between January and April 2005; qualitative interviews were conducted until redundancy in responses was achieved. Method. Qualitative data were analyzed using content analysis. NVIVO software was used to organize transcripts, identify themes, and report frequency of responses. Results. Respondents reported having derived information on sexual health from multiple media sources. Direct outreach, gay- and HIV-centered organizations, print and broadcast media, public transportation ads, and the Internet held the greatest potential for dissemination. Primary care providers were also frequently seen as trusted sources of HIV/STD prevention information. Ideas for content often included having “people just like you” in ads. Conclusion. Health messages that focus on getting tested for HIV and STDs, practicing safe sex, and incorporating straightforward and accurate information on prevention may be the most acceptable to MSM. Providers should be proactive in disseminating information about HIV/STD prevention.
Socioeconomic Status and Tobacco Expenditures among Moroccans: Results of the “Maroc Tabagisme” Survey
Authors: Tachfouti Nabil , Berraho Mohammed , Elfakir Samira , Serhier Zineb , Elrhazi Karima , Slama Karen , Najjari Chakib 
Published: June 2010

Purpose. To investigate the relationship of sociodemographic and economic characteristics to tobacco expenses among Moroccan daily smokers. Design. Cross-sectional (“Maroc Tabagisme” Survey) study. Setting. Random sample of 9195 subjects representative of the Moroccan population. Subjects. Household subjects 15 years and older. Measures. Data were collected from selected households using a questionnaire about smoking, educational level, occupation, and household monthly income. Analysis. Associations between sociodemographic and economic characteristics, smoking status, and tobacco expenses were assessed by multivariate analysis in a sample of 5959 respondents who provided details about their family income. Results. Of 5959 participants, 28.5% of men and 2.8% of women were daily smokers. Compared with students, the odds of daily smoking were higher among blue-collar workers (odds ratio, 2.66). Tobacco expenses increased with higher family monthly income (p < .001). Moreover, smokers whose family monthly income was less than 1000 Moroccan dirham (MAD) spent 50.9% on tobacco, while those with family monthly income of 6000 MAD or higher spent 13.0% on tobacco. Conclusions. There was a strong association between tobacco expenses and sociodemographic and economic characteristics. Among households with low monthly income, up to half of the monthly income is spent on tobacco.
Health Insurers Promoting Employee Wellness: Strategies, Program Components and Results
Authors: Murphy Brigid M. , Schoenman Julie A. , Pirani Hafiza 
Published: June 2010

Purpose. To examine health insurance companies' role in employee wellness. Approach. Case studies of eight insurers. Setting. Wellness activities in work, clinical, online, and telephonic settings. Participants. Senior executives and wellness program leaders from Blue Cross Blue Shield health insurers and from one wellness organization. Methods. Telephone interviews with 20 informants. Results. Health insurers were engaged in wellness as part of their mission to promote health and reduce health care costs. Program components included the following: education, health risk assessments, incentives, coaching, environmental consultation, targeted programming, onsite biometric screening, professional support, and full-time wellness staff. Programs relied almost exclusively on positive incentives to encourage participation. Results included participation rates as high as 90%, return on investment ranging from $1.09 to $1.65, and improved health outcomes. Conclusion. Health insurers have expertise in developing, implementing, and marketing health programs and have wide access to employers and their employees' health data. These capabilities make health insurers particularly well equipped to expand the reach of wellness programming to improve the health of many Americans. By coupling members' medical data with wellness-program data, health insurers can better understand an individual's health status to develop and deliver targeted interventions. Through program evaluation, health insurers can also contribute to the limited but growing evidence base on employee wellness programs.