bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Behaviors of Employed and Insured Adults in the United States, 2004-2005
Authors: Hughes M. Courtney , Hannon Peggy A. , Harris Jeffrey R. , Patrick Donald L. 
Published: June 2010

Purpose. To examine the prevalence of health behaviors, including clinical preventive services and lifestyle risk behaviors, among insured workers and to determine whether disparities in health behaviors based on demographic factors exist among this group. Design. Cross-sectional analysis of 2004–2005 Behavioral Risk Factor Surveillance System data. Setting. United States. Subjects. A representative sample of noninstitutionalized employed and insured adults aged 18 to 64 years (139,738 in 2004 and 159,755 in 2005). Measures. Self-reported clinical preventive services utilization and lifestyle-related behaviors, as well as multiple logistic regression analyses assessing the independent effects of demographic and access variables on health behaviors. Results. Among insured workers, rates of not using recommended clinical preventive services ranged from 8.5% (cervical cancer screening) to 73.9% (influenza vaccination). Rates for engaging in lifestyle-related risks ranged from 5.5% (heavy drinking) to 77.1% (inadequate fruit-vegetable consumption). In multivariate analyses, lower income, lower education, cost as a barrier to health care, and no health care provider were associated with significantly decreased clinical preventive services utilization (p < .01). Lower education and no health care provider were associated with lifestyle-related risks (p < .01). Conclusions. Working insured adults are not meeting recommendations for health behaviors. Significant disparities in health behaviors related to socioeconomic status exist among this group. Employers and insurers should consider these poor health behaviors and disparities when designing insurance benefits addressing clinical preventive services utilization and workplace health promotion programs addressing lifestyle-related behaviors.
Looking at Research Consent Forms through a Participant-Centered Lens: The PRISM Readability Toolkit
Authors: Ridpath Jessica R. , Wiese Cheryl J. , Greene Sarah M. 
Published: June 2010

Synopsis Communicating in lay language is an underdeveloped skill among many researchers—a limitation that contributes to low readability among research consent forms and may hinder participant understanding of study procedures and risks. We present the Project to Review and Improve Study Materials (PRISM) and its centerpiece, the PRISM Readability Toolkit. The toolkit provides strategies for creating study materials that are readable and participant centered, focusing on consent forms but also addressing other participant materials. Based on plain language principles, this free resource includes a flexible menu of tools, such as an editing checklist, before and after examples, easy-to-read template language, and a list of alternative words. Among PRISM's ongoing goals is to test the toolkit with populations groups.
Health Care Behaviors and Decision-Making Processes among Enrollees in a State High-Risk Insurance Pool: Focus Group Findings
Authors: Hall Jean P. , Carroll Shawna L. , Moore Janice M. 
Published: June 2010

Purpose. To better understand the relationship between health insurance coverage and health care behaviors of persons with potentially disabling conditions enrolled in a state high-risk insurance pool. Design. Six focus groups with risk pool enrollees at two sites. Setting. Suburban areas in the state of Kansas. Participants. Forty-two individuals 29 to 62 years, all with potentially disabling physical or mental health conditions. Method. Qualitative analysis of focus group transcripts using pile sorting and theme identification. Results. High premiums and deductibles limit participants' ability to afford basic health services and access to prescription medications despite their middle-class socioeconomic status. Participants report delaying or forgoing needed medical care because of lack of coverage and/or out-of-pocket costs. They employ numerous and potentially dangerous strategies to minimize costs, especially for prescription medications. Some report “saving up” needed procedures until their total costs will exceed that year's deductible. Conclusion. Individuals in the risk pool were making medical decisions on the basis of cost rather than need. Many shared stories of medical complications as a result of delayed care, and most expressed stress related to the difficulty of making decisions about their care and use of prescribed medications. The individual, nongroup insurance market, with its higher out-of-pocket costs, may not meet the needs of people with chronic health conditions.
Satisfaction with a Weight Loss Program: What Matters?
Authors: VanWormer Jeffrey J. , Martinez Anna M. , Cosentino Dan , Pronk Nicolaas P. 
Published: June 2010

Purpose. Satisfaction is understudied in weight loss programs. The purpose of this study was to examine the association between participant/program experiences and satisfaction with a weight loss intervention. Design. A prospective cohort design was utilized. Setting. The study was conducted in the Minneapolis metro area. Sample. Participants were obese employees of a managed care organization. One hundred were enrolled, and 78 had complete data available. Intervention. Treatment included telephone counseling along with a home telemonitoring scale and instructions to self-weigh daily. Measures. Outcomes included overall program satisfaction and willingness to refer the program to others. Predictors included demographics, treatment group, participation in other programs, expected weight, general health, body mass index, diet quality, physical activity, body image, mental health, counseling, and self-weighing. Analysis. Quantitative predictor-outcome associations were examined using multiple logistic regressions. Qualitative satisfaction responses were analyzed using a general inductive approach. Results. Weight loss (odds ratio [OR] = 1.83, p = .008), improved diet (OR = 1.27, p = .092), increased physical activity (OR = 1.05, p = .034), and improved body image (OR = 1.38, p = .051) were independent predictors of overall satisfaction. Treatment group (OR = 14.83, p = .015) and number of counseling calls (OR = 1.49, p = .009) were predictors of willingness to refer the program. Qualitative themes indicated desire to integrate counseling on emotional issues. Conclusion. Health progress explained overall satisfaction, whereas treatment characteristics explained willingness to endorse the intervention. Concentrating on these factors may improve retention. Limitations included self-reported measures.
Engaging Community Businesses in Human Immunodeficiency Virus Prevention: A Feasibility Study
Authors: Rovniak Liza S. , Hovell Melbourne F. , Hofstetter C. Richard , Blumberg Elaine J. , Sipan Carol L. , Batista Marcia F. , Martinez-Donate Ana P. , Mulvihill Mary M. , Ayala Guadalupe X. 
Published: June 2010

Purpose. To explore the feasibility of engaging community businesses in human immunodeficiency virus (HIV) prevention. Design. Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures, both of which were provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-program, and post-program. Customer feedback was obtained through an online survey. Setting. Participants were selected from a San Diego, California neighborhood with a high rate of acquired immune deficiency syndrome. Participants. Fifty-one business owners/managers who represented 10 retail categories, and 52 customers. Measures. Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction, and business owners'/managers' willingness to provide future support for HIV prevention were measured. Analysis. Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data. Results. The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or who refused to participate (41%; p < .05). Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures (p < .05). More than 90% of customers supported distributing condoms and brochures in businesses, and 96% of business owners/managers described their program experience as positive. Conclusion. Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested.
Potential Societal Savings from Reduced Sodium Consumption in the U.S. Adult Population
Authors: Polar Kartika , Sturm Roland 
Published: June 2010

Purpose. Policies that address the food environment at the population level may help prevent chronic disease, but their value to society is still uncertain. Dietary sodium is linked to increased prevalence of hypertension, a primary risk factor for cardiovascular and renal diseases. This study calculates the potential societal savings of reducing hypertension and related cardiovascular disease via a reduction in population-level sodium intake. On average, U. S. adults consume almost twice the recommended maximum of dietary sodium, most of it from processed foods. Design. This study modeled sodium-reduction scenarios by using a cross-sectional simulation approach. The model used population-level data on blood pressure, antihypertensive medication use, and sodium intake from the National Health and Nutrition Examination Survey (1999–2004). This data was then combined with parameters from the literature on sodium effects, disease outcomes, costs, and quality of life to yield model outcomes. Measures. This study calculated the following outcome measures: hypertension prevalence, direct health care costs, and quality-adjusted life years for noninstitutionalized U.S. adults. Analysis. The simulation was conducted with STATA 9.2 and Microsoft Excel. Survey weights were used to calculate population averages. Results. Reducing average population sodium intake to 2300 mg per day, the recommended maximum for adults, may reduce cases of hypertension by 11 million, save $18 billion health care dollars, and gain 312,000 QALYs that are worth $32 billion annually. Greater reductions in population sodium consumption bring even greater savings to society. Conclusions. Large benefits to society may result from efforts to lower sodium consumption on a population level by modest amounts over time. Although savings in direct health care costs are likely to be quite high, they could easily be matched or exceeded by the value of quality-of-life improvements.
Reported Barriers to Cancer Screening: Montana Behavioral Risk Factor Surveillance System 2007
Authors: Ballew Carol , Cummings Susan J. , Oreskovich Joanne 
Published: June 2010

Purpose. To determine self-identified barriers to cancer screening participation in Montana among respondents to the Behavioral Risk Factor Surveillance System (BRFSS). Design. The 2007 BRFSS survey. Setting. State of Montana. Subjects. A total of 3433 respondents (2029 women) 50 years and older. Measures. Respondents who had never had an endoscopy and women who had not had a recent mammogram were asked why they had not been screened. Analysis. Associations between health care access variables and screening participation were assessed using X2 tests. Joint effects of multiple independent predictors of screening participation were assessed using odds ratios (ORs) and 95% confidence intervals (CIs) from multiple logistic regression analysis. Results. The strongest predictor of having an endoscopy (OR, 23.62; 95% CI, 18.42-30.28) or recent mammogram (OR, 10.87; 95%, CI, 6.42-18.40) was provider recommendation. The most common reasons for not being screened were respondent's belief that it was not necessary (44% for endoscopy and 39% for mammography), no provider recommendation (22% for endoscopy), and cost (12% for endoscopy and 19% for mammography). Among unscreened respondents whose providers recommended endoscopy and mammography, 30% and 36%, respectively, believed that it was not necessary. Conclusions. Many Montanans remain unaware of the importance of cancer screening. Health care providers and public health officials must increase patient education, and providers must continue to refer patients for screening.
Factors Associated with Incidental Sickness Absence among Employees in One Health Care System
Authors: Pai Chih-Wen , Mullin John , Payne Gina M. , Love Jeaneeta , O'Connell Gayle , Edington Dee W. 
Published: June 2010

Purpose. Assess the association of taking incidental sickness absence with health risks and health status. Design. Observational. Setting. One Midwest health care system. Subjects. Individuals who were employed for 2 years (2006–2007) and had completed at least one health risk appraisal (HRA) in 2007 (N = 3790). Measures. Outcomes were any incidental sickness absence and absence duration in 2007 measured by an absence tracking system. Health risks and health status were estimated by HRAs. Program participation was captured using 7-year HRA data and 5-year wellness data. Analysis. Multivariate, binary logistic regression for the probability of taking any absence day among the overall population as well as four demographic subgroups; proportional odds model for the probability of taking more absence days. Results. Different patterns were observed in association with taking incidental sickness absence among age and gender subgroups. Among the overall population, three health risks (smoking overweight, and use of medication for relaxation) were positively associated with taking absence (at least p <. 05 for all three health risks). Participation in a wellness program for more years was also associated with a less likelihood of taking absence (odds ratio, .72; p = .002). Results from the proportional odds model were consistent with results from the binary logistic regression. Conclusion. Sickness absence is an important productivity concern of employers. Employers may implement early interventions to focus on preventable causes. Special interventions may target absence-causing risks such as smoking behavior and excess body weight. Study limitation includes a lack of measures for psychosocial work environment.
Impact of Body Mass Index on the Effectiveness of a Disease Management—Health Promotion Intervention on Disability Status
Authors: Meng gdao , Wamsley Brenda R. , Friedman Bruce , Liebel Dianne , Dixon Denise A. , Gao Song , Oakes David , Eggert Gerald M. 
Published: June 2010

Purpose. To examine the impact of body mass index (BMI) on the effectiveness of a disease management—health promotion intervention among community-dwelling Medicare beneficiaries with disabilities. Design. Secondary data analyses of a randomized controlled trial. Settings. Nineteen counties in upstate New York and on the West Virginia—Ohio border. Subjects. Four hundred fifty-two Medicare beneficiaries who participated in the Medicare Primary and Consumer-Directed Care Demonstration between August 1998 and June 2002 and completed the 22-month follow-up. Intervention. Multicomponent disease management—health promotion intervention involving patient education, individualized health promotion coaching, medication management, and physician care management. Measures. Body mass index and dependence in Activies of Daily Living (ADLs). Analysis. Multivariate linear regression. Results. The intervention resulted in significantly less worsening in ADLs dependence among normal-weight participants (coefficient, − .42; p = .04). However, the intervention did not have a significant effect for underweight participants (F test p = .33 vs. underweight participants in the control group) or overweight or obese participants (F test p = .78 vs. overweight or obese participants in the control group). Conclusions. A positive effect of the intervention on disability was found among normal-weight participants but not among underweight or overweight or obese participants. Future health promotion interventions should take into consideration the influence of BMI categories on treatment effects.
Work Performance of Employees with Depression: The Impact of Work Stressors
Authors: Lerner Debra , Adler David A. , Rogers William H. , Chang g , Lapitsky Leueen , McLaughlin Thomas , Reed John 
Published: June 2010

Purpose. Depressed employees are vulnerable to adverse work outcomes. We hypothesized that work performance is impaired by depression and is worsened by exposure to psychosocial work stressors. Design. Longitudinal cohort study with surveys administered at baseline, 6, 12, and 18 months. Setting. Recruitment in primary care offices. Subjects. A total of 14,268 were screened; 286 depressed, employed adults (18–62 years) and 193 controls were enrolled. Measures. At-work limitations (presenteeism) and absenteeism were measured with the Work Limitations Questionnaire (WLQ) and WLQ Work Absence Module, respectively. Work stressors were assessed using a modified version of the Job Content Questionnaire. Analysis. Univariate and multivariate tests assessed the degree to which at-work limitations were related to depression and/or stressful work. Results. Presenteeism and absenteeism were significantly worse for the depression group at each time point (p ≤ .001). In cross-sectional models, presenteeism was associated with more severe depression symptoms, poorer general physical health, psychologically demanding work, the interaction of psychologically demanding work with depression, and less job control (r2 range = .33–.54). Absences were explained by depression symptom severity and poorer general physical health but not work stressors (r2 = .19). Because of minimal change in the work stressors, their longitudinal effects on outcomes were mostly nonsignificant. Conclusion. This study found that depression symptoms are related to work absences and impaired work performance, and results partly confirmed that work stressors add to this impact. Results suggest that workers with depression may benefit from care involving medical and vocational interventions.
How Does the Built Environment Relate to Body Mass Index and Obesity Prevalence among Public Housing Residents?
Authors: Heinrich Katie M. , Lee Rebecca E. , Regan Gail R. , Reese-Smith Jacqueline Y. , Howard Hugh H. , Haddock C Keith , Poston Walker S. Carlos , Ahluwalia Jasjit S. 
Published: June 2010

Purpose. This study examined associations of environmental variables with obesity prevalence and individual body mass index (BMI) among impoverished residents of public housing developments. Design. Cross-sectional data were drawn from two studies in the same Midwestern metropolitan area of participants within neighborhoods. Setting. Pathways to Health interviewed housing development residents and Understanding Neighborhood Determinants of Obesity assessed built environment factors in the surrounding neighborhoods (i.e., 800–m radius from center of housing development). Subjects. Four hundred twenty-one residents participated (mean age = 43.8 years; 72.0% women, 59.6% high school degree, 79.6% African-American). Fifty-five physical activity resources were identified and assessed. Measures. Demographics and measured weights and heights were obtained for participants. The Physical Activity Resource Assessment measured the type, accessibility, features, amenities, qualities, and incivilities of neighborhood physical activity resources. Neighborhood street connectivity was also measured. Results. Average age-adjusted BMI was 31.4 (SD = 1.3), with 45% of residents obese. High negative correlations were found between BMI and street connectivity (p = .05) and between obesity prevalence and resource accessibility (p = .09), number of amenities (p = .04), and amenity quality (p = .04). Higher resource accessibility, feature quality, number of amenities, and fewer incivilities per resource accounted for 71% of obesity variance (p < .05). Male gender and higher feature quality, F(11, 407)37.19 and 12.66, p < .001, predicted lower BMI among residents. Conclusion. Supportive neighborhood environments were related to lower obesity prevalence and lower BMI among residents.
Changing the Hearts and Minds of Policy Makers: An Exploratory Study Associated with the West Virginia Walks Campaign
Authors: Leyden Kevin M. , Reger-Nash Bill , Bauman Adrian , Bias Tom 
Published: June 2010

Purpose. To pilot test whether West Virginia Walks changed local policy makers' awareness of walking-related issues. Design. A quasi-experimental design with preintervention and postintervention mail surveys. Setting. Morgantown, WV (intervention community), and Huntington, WV (comparison community). Subjects. One hundred thirty-three and 134 public officials in Morgantown and 120 and 116 public officials in Huntington at baseline and at follow-up, respectively. Intervention. An 8–week mass media social ecological campaign designed to encourage moderate-intensity walking among insufficiently active persons aged 40 to 65 years. Measures. Policy makers listed three problems they believed needed to be addressed in their community. They then rated the severity of several problems that many communities face using a Likert scale, with 1 representing “not a problem” and 5 representing “an extremely important problem.” Analysis. Independent sample t-tests were used to examine differences in mean responses at baseline and at follow-up. Results. Statistically significant increases in the perceived importance of walking-related issues were observed among policy makers in Morgantown but not in the comparison community. Conclusions. Integrated communitywide health promotion campaigns designed to influence the public can also affect the perceptions of policy makers. Future research should examine this linkage and determine whether resource allocation and policy changes follow such interventions.