فهرست مطالب

Health Promotion Perspectives - Volume:9 Issue: 1, Jan 2019

Health Promotion Perspectives
Volume:9 Issue: 1, Jan 2019

  • تاریخ انتشار: 1397/11/24
  • تعداد عناوین: 11
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  • Peter D. Hart*, Diona J. Buck Pages 1-12
    Background
    Resistance training (RT) is recommended as part of our national physical activity guidelines which includes working all major muscle groups on two or more days a week.Older adults can gain many health benefits from RT, such as increased muscle strength,increased muscle mass, and maintenance of bone density. Additionally, certain dimensions of health-related quality of life (HRQOL) have been shown to improve in older adults due to RT intervention. The purpose of this study was to use systematic review and meta-analytic techniques to examine the effect of RT on HRQOL in older adults.
    Methods
    A systematic review of current studies (2008 thru 2017) was conducted using PubMed. Studies were included if they used a randomized controlled design, had RT as an intervention, measured HRQOL using the SF-36/12 assessment, and included adults 50+ years of age. Eight dimension scores (physical functioning, bodily pain, physical role function, general health, mental health, emotional role function, social function, and vitality) and two summary scores (physical component and mental component) were extracted. Ten meta-analyses were performed using standardized mean effect sizes and random effects models. Study quality,moderator and sensitivity analyses were conducted.
    Results
    A total of 16 studies were included in the analyses with a mean Physiotherapy Evidence Database (PEDro) score of 4.9 (SD=1.0). Among the mental health measures, RT had the greatest effect on mental health (Effect size [ES]=0.64, 95% CI: 0.30-0.99, I2=79.7). Among the physical health measures, RT had the largest effect on body pain (ES=0.81, 95% CI: 0.26-1.35, I2=85.9).Initially, RT did not significantly affect measures of emotional role function, social function or physical role function. However, after removing a single study, RT significantly increased all HRQOL measures.
    Conclusion
    The meta-analytic evidence presented in this research clearly supports the promotion of RT in improving HRQOL in older adults.
    Keywords: Systematic review, Meta-analysis, Resistance training, SF-36, Health-related quality of life
  • Traci Hayes*, Manoj Sharma , Mohammad Shahbazi , Jung Hye Sung , Russell Bennett , Jacqueline Reese, Smith Pages 13-23
    Background
    The United States Department of Health and Human Services (USDHHS)recommends that adults achieve 150 minutes per week of moderate-intensity aerobic activity.Most African American women do not meet these guidelines. The purpose of this study was to determine the efficacy of an intervention based on the fourth generation, multi-theory model (MTM) of health behavior change for initiating and sustaining physical activity among African American women when compared to a first generation, knowledge-based intervention.
    Methods
    The randomized controlled trial (RCT) utilized a pre-test, post-test and 6-week followup evaluation with an experimental (n=25) group and a comparison group (n=23). Process evaluation for satisfaction and program fidelity was conducted along with impact evaluation for changes in MTM constructs, intent to initiate and sustain physical activity, minutes of physical activity, body mass index (BMI), waist circumference and blood pressure in hypertensives.
    Results
    The MTM-based intervention proved significantly efficacious in increasing the minutes of physical activity from pre-test mean of 37 minutes to 172 minutes at follow-up (mean difference135.08 minutes, 95% CI: 106.04 to 164.13, P<0.0001), reducing waist circumference from pretest mean of 39 inches to 38 inches at follow-up (mean difference -1.12 inches, 95% CI: -1.70 to-0.545, P<0.001) and modifying the MTM construct of changes in physical environment from a mean of 7 units at pre-test to 9 units at follow-up (mean difference 2.08 units, 95% CI: 0.73 to 3.43, P<0.004) when compared to the knowledge-based intervention over time.
    Conclusion
    There were directional improvements in the mean scores for most of the study variables over time for the MTM intervention group and statistically significant improvement in minutes of physical activity and waist circumference.
    Keywords: Physical activity, Exercise, Women, Methods, Prevention, control, Statistical, numerical data
  • Jessica L. Thomson*, Melissa H. Goodman , Alicia S. Landry Pages 24-30
    Background
    Physical activity levels were low for pregnant and postpartum participants in a diet and physical activity intervention. To explore micro level characteristics of participants’neighborhoods related to physical activity, an ancillary study was conducted.
    Methods
    This cross-sectional study encompassed the neighborhood street segments of women participating in a diet and physical activity intervention that was conducted in the Lower Mississippi Delta. A neighborhood was defined as all street segments within one-fourth walking mile of a participant’s home address. Street segments were measured using the Rural Active Living Assessment’s Street Segment Assessment tool. In the field and on foot, raters measured street segments using neighborhood maps with segments identified.
    Results
    Mean street segment length was 0.22 miles (SD = 0.14). All segments had flat terrain with residential (98%), open spaces (74%), and public/civic (34%) as the most prevalent land uses. Almost three-fourths of segments did not have any sidewalks (69%), sidewalk buffers or defined shoulders (73%), crosswalks or pedestrian signage (69%), or posted speed limits (74%).However, 88% had stop signs and almost all (96%) had street lighting and were paved multi lane roads (95%) with low traffic volume (90%). Most residential structures present were single family detached homes (95%) and the most common public/civic and commercial structures were churches (24%) and convenience stores (9%), respectively. Almost all of the street segments were rated as walk able (99%) and aesthetically pleasing (94%).
    Conclusion
    Neighborhood street segments surrounding Delta Healthy Sprouts participants’homes were walk able and aesthetically pleasing. However, safety features such as sidewalks,pedestrian signage, and posted speed limit signs were lacking. To address these inadequate pedestrian safety features, infrastructure changes are needed for small rural towns.
    Keywords: Neighborhood, Built environment, Physical activity, Safety
  • Mohsen Saffari , Chung, Ying Lin , Harold G. Koenig , Keisha, Gaye N. O’Garo , Anders Brostrm , Amir H. Pakpour* Pages 31-39
    Background
    Dementia is prevalent among older adults and frequently causes dependence on family caregivers. Caregivers may experience a form of stigmatization called affiliate stigma that negatively affects their mental health. The current study sought to establish the psychometric properties of a tool to measure affiliate stigma among Iranian caregivers.
    Methods
    Overall, 541 caregivers of older people with dementia were included in this cross sectional study. Several measures were used to assess the psychometric properties of the Affiliate Stigma Scale (ASS) including the Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS), Short Form 12 (SF-12), Rosenberg Self-Esteem Scale (RSES), and Multidimensional Scale of Perceived Social Support (MSPSS). Convergent and discriminate validity were examined.Exploratory and confirmatory factor analyses were utilized to assess the factor structure of the Ass and a Rasch model was used to evaluate the measurement functioning of the scale.
    Results
    Factor loadings ranged from 0.69 to 0.83 and test-retest reliability from 0.72 to 0.89.Item difficulty ranged widely from -0.66 to 0.89. No considerable differential item functioning (DIF) was found across gender. Confirmatory factor analysis confirmed the three cognitive,effective, and behavioral dimensions of the scale (comparative fit index [CFI]=0.931 to 0.995,root mean square error of approximation [RMSEA]=0.046 to 0.068). Internal consistency was acceptable (Cronbach’s α: 0.88 to 0.94). Significant and positive relationships were found between affiliate stigma and depression, anxiety, and care giving burden (β =0.35 to 0.46).
    Conclusion
    The ASS is a psychometrically valid measure for assessing affiliate stigma in Iranian caregivers of people with dementia. Application of this tool among other caregivers, language sand cultures deserves further study.
    Keywords: Stigma, Family caregivers, Dementia, Psychometrics
  • Uma Vadassery Sankar*, V Raman kutty , TN Anand Pages 40-49
    Background
    There is no single best indicator to assess the childhood socioeconomic position (CSEP) in public health research. The aim of the study is to develop and validate a new questionnaire, with adequate psychometric properties, to measure the childhood SEP of the young adults.
    Methods
    The first phase consisted of a qualitative phase to identify the variables to measure childhood SEP through the in-depth interviews among 15 young adults (18-45 years) of rural Kerala. The second phase was a quantitative phase to validate the questionnaire through a cross sectional survey among 200 young adults of Kerala. We did content validity, reliability tests and construct validity by using exploratory factor analysis of the questionnaire to demonstrate its psychometric properties.
    Results
    The qualitative analysis reported 26 variables spread across 5 domains to measure the CSEP. Finally, the questionnaire has 11 questions with 3 domains named as value added through paternity, maternal occupation-related factors and parental education. The questionnaire has good reliability (Cronbach's α=0.88) also.
    Conclusion
    We have developed a reliable and valid questionnaire to measure the childhood SEP of younger adults and can be used in various public health research.
    Keywords: Childhood socioeconomic position, Questionnaire, Psychometric properties, Validation, Measurement, Development
  • Priscila Costa*, Talita Ermini , Cecilia Helena de Siqueira Sigaud Pages 50-54
    Background
    To determine the effects of an educational playful intervention on nasal hygiene behaviors among preschool (3-4 years old) children.
    Methods
    A quasi-experimental before-after study was conducted with 39 children attending public daycare center in Sao Paulo, Brazil. A group-based intervention consisted of two educational sessions to promote healthy behaviors for nasal hygiene. It was adopted playful strategies such as a story told by puppets, card games and simulation of nasal hygiene in front of the mirror. The outcome was evaluated by observing six healthy behaviors for nasal hygiene one week before and after the intervention. Differences in the outcome before and after the intervention were tested using Wilcoxon signed rank test and McNemar’s test.
    Results
    The median of healthy nasal hygiene behaviors went from 3.0 to 4.0 after the intervention, with a significant statistical difference (P=0.0004) and a difference of behaviors. After the intervention, forcing the air out of one opened nostril increased from 5.1%to 30.8% (P=0.001, CI 95%: 0-0.440), forcing the air out of the other nostril increased from 5.1% to 28.2% (P=0.003/CI 95%: 0-0.50), throwing the piece of toilet paper in the garbage increased from 53.8% to 87.21% (P=0.04, CI 95%: 0.035-0.65), and sanitizing the hands with soap and water increased from 15.4% to 43.6% (P=0.039-0.76).
    Conclusion
    the educational playful intervention improved the autonomy of preschoolers to adopt healthy nasal hygiene behaviors.
    Keywords: Child Day Care centers, Child health, Health education, Pediatric nursing
  • Ali Mohammad Abbasi , Majid Motamedzadeh*, Mohsen Aliabadi , Rostam Golmohammadi , Leili Tapak Pages 55-64
    Background
    This study aimed to investigate the effect size (ES) of air temperature on the executive functions of human brain and body physiological responses.
    Methods
    In this empirical study, the participants included 35 male students who were exposed to 4 air temperature conditions of 18°C, 22°C, 26°C and 30°C in 4 separate sessions in an air conditioning chamber. The participants were simultaneously asked to take part in the N-backtest. The accuracy, electrocardiogram (ECG) signals and the respiration rate were recorded to determine the effect of air temperature.
    Results
    Compared to moderate air temperatures (22°C), high (30°C) and low (18°C) air temperatures had a much more profound effect on changes in heart beat rate, the accuracy of brain executive functions and the response time to stimuli. There were statistically significant differences in the accuracy by different workload levels and various air temperature conditions(P<0.05). Although the heart beat rate index, the ratio between low frequency and high frequency (LF/HF), and the respiratory rate were more profoundly affected by the higher and lower air temperatures than moderate air temperatures (P<0.05), this effect was not statistically significant, which may be due to significant reduction in the standard deviation of normal-to normal intervals (SNND) and the root of mean squared difference between adjacent normal heart beat (N-N) intervals (RMSSD) (P>0.05).
    Conclusion
    The results confirmed that the unfavorable air temperatures may considerably affect the physiological responses and the cognitive functions among indoor employees.Therefore, providing them with thermal comfort may improve their performance within indoor environments.
    Keywords: Air temperature, Executive functions of brain, Electrocardiogram, Respiratory rate, N-back test
  • Paul D. Loprinzi * Pages 65-70
    Background
    The primary objective of this study was to evaluate the association between habitual physical activity engagement and perceived controllability of memory function. Secondary objectives included the evaluation of physical activity on memory strategy use, and whether the latter mediates the relationship between physical activity on memory controllability.
    Methods
    Two-hundred and nine young adults (Mage=25 y) completed a brief survey evaluating physical activity (Physical Activity Vital Signs Questionnaire), memory strategy use (Memory Functioning Questionnaire), and memory controllability (Memory Controllability Inventory).
    Results
    Physical activity was not associated with memory strategy use (β=0.68; 95% CI: -1.25,2.62; P=0.48), nor was memory strategy use associated with memory controllability. Physical activity was consistently associated with various attributes of memory controllability, including Present Ability (β=1.10; 95% CI: 0.07, 2.12; P=0.03), Potential Improvement (β=0.84; 95% CI:0.05, 1.63; P=0.03), Effort Utility (β=0.87; 95% CI: 0.11, 1.61; P=0.02), Inevitable Decrement (β=-1.19; 95% CI: -2.19, -0.19; P=0.02) and Alzheimer’s likelihood (β=-1.21; 95% CI: -2.29,-0.12; P=0.02).
    Conclusion
    Physical activity is consistently associated with greater perceptions of memory controllability. Future longitudinal and experimental work on this topic is warranted to evaluate if physical activity can foster an individual’s ability to modify their behavior and cognitions to enhance and preserve memory function.
    Keywords: Episodic memory, Exercise, Movement, Perceptions, Self-efficacy
  • Kelli F. Koltyn*, Kevin M. Crombie , Angelique G. Brellenthin , Brianna Leitzelar , Laura D. Ellingson , Jill Renken , Jane E. Mahoney Pages 71-76
    Background
    Older adults spend most of their day in sedentary behavior (SB) (i.e., prolonged sitting), increasing risk for negative health outcomes, functional loss, and diminished ability for activities of daily living. The purpose of this study was to develop and pilot test an intervention designed to reduce SB in older adults that could be translated to communities.
    Methods
    Two pilot studies implementing a 4-week SB intervention were conducted. SB,physical function, and health-related quality of life were measured via self-report and objective measures. Participants (N=21) completed assessments pre- and post-intervention (studies 1 and 2) and at follow-up (4-weeks post-intervention; study 2). Due to the pilot nature of this research, data were analyzed with Cohen’s d effect sizes to examine the magnitude of change in outcomes following the intervention.
    Results
    Results for study 1 indicated moderate (d=0.53) decreases in accelerometry-obtained total SB and increases (d=0.52) in light intensity physical activity post-intervention. In study 2,there was a moderate decrease (d=0.57) in SB evident at follow-up. On average SB decreased by approximately 60 min/d in both studies. Also, there were moderate-to-large improvements in vitality (d=0.74; study 1) and gait speed (d=1.15; study 2) following the intervention. Further,the intervention was found to be feasible for staff to implement in the community.
    Conclusion
    These pilot results informed the design of an ongoing federally funded randomized controlled trial with a larger sample of older adults from underserved communities. Effective,feasible, and readily-accessible interventions have potential to improve the health and function of older adults.
    Keywords: Sitting, Older adults, Sedentary intervention, Behavior change, Self-regulation, Physical function
  • Seyed Rafie Arefhosseini , Mehdi Hedayati , Elnaz Vaghef, Mehrabany , Mehrangiz Ebrahimi, Mameghani *, Zahra Heidari Pages 77-84
    Background
    Adequate iodine intake by women in child-bearing age affects fetus neurodevelopment during pregnancy. A majority of previous studies has investigated iodine status among children, and there is limited data on female adolescents who are more exposed to consequences of iodine deficiency (ID) in their near-future pregnancies; thus, we aimed to assess iodine status, and knowledge on iodine deficiency disorders (IDDs) among adolescent school girls (14-19 years old) in Shahriar, Iran.
    Methods
    This cross-sectional study was conducted among 223 female students selected through multi-stage cluster sampling from 12 schools. Iodine and creatinine concentrations were measured in casual urine samples. Iodine content of household salts was also assessed.Data on intake of salt and iodine-rich food sources were collected applying a food frequency questionnaire (FFQ), and knowledge about iodine and IDDs were assessed by a questionnaire.
    Results
    Median and Mean (95% CI) concentrations of urinary iodine and creatinine were 129 µg/L, 137.62 µg/L (95% CI: 126.28, 148.95) and 1.72 g/L, 1.86 g/L (95% CI: 0.55-3.17),respectively. The frequency of mild, moderate and severe ID were 22.4%, 14.3% and 0%,respectively; 43.5% had adequate, and 3.1% had excessive urinary iodine levels. Mean saltiodine concentration was 21.69 (SD=10.56) ppm. Mean knowledge score was 12.7 (SD=3.44).About half of the students had a poor (25.1%) or fair (24.2%) knowledge about iodine deficiency.Adjusting for the confounders, no significant positive association was found between knowledge about iodine-rich food sources and goitrogens with urinary iodine excretion.
    Conclusion
    Adolescent girls in Shahriar had relatively poor knowledge of iodine, and about one third of them suffered from ID.
    Keywords: Iodine deficiency, Iodized salt, Knowledge, Adolescents
  • Corey H. Basch*, Nicole Milano , Grace C. Hillyer Pages 85-88
    Background
    Social media is a driving force in the sharing of information. The purpose of this study is to describe fluoride related content on Instagram, a popular social media platform.
    Methods
    Content categories were created and coded to better describe the nature of the posts.Data collection occurred in three sessions, two months apart. Only relevant posts that included images and had text written in the English language were included.
    Results
    The most common topics were conspiracy theory, contained in 37.3% of posts, followed by dangers of fluoride to health (30.3%) and benefits of fluoride to teeth (28.7%). Of the posts reviewed, 96/300 (32.0%) contained pro-fluoride content while 139/300 (63.0%) posts featured anti-fluoride content. Content varied significantly between pro- and anti-fluoride posts.
    Conclusion
    Our review of Instagram posts revealed that there were approximately 300 posts focused on fluoride related content. Of these posts, there was a higher number of anti-fluoride related content compared to pro-fluoride related content. With accessibility comes the potential for misinformation. Future efforts from medical providers need to focus on educating consumers about reliable sources for health information on the internet.
    Keywords: Fluoride, Social Media, Internet