Behavioral Health Risk Factors Research Articles

Epidemiology for public health practice: The application of spatial epidemiology.

Spatial epidemiology is the description and analysis of geographic patterns and variations in disease risk factors, morbidity and mortality with respect to their distributions associated with demographic, socioeconomic, environmental, health behavior, and genetic risk factors, and time-varying changes. In the Letter to Editor, we had a brief description of the practice for the mortality and the space-time patterns of John Snow's map of cholera epidemic in London, United Kingdom in 1854. This map is one of the earliest public heath practices of developing and applying spatial epidemiology. In the early history, spatial epidemiology was predominantly applied in infectious disease and risk factor studies. However, since the recent decades, noncommunicable diseases have become the leading cause of death in both developing and developed countries, spatial epidemiology has been used in the study of noncommunicable disease. In the Letter, we addressed two examples that applied spatial epidemiology to cluster and identify stroke belt and diabetes belt across the states and counties in the United States. Similar to any other epidemiological study design and analysis approaches, spatial epidemiology has its limitations. We should keep in mind when applying spatial epidemiology in research and in public health practice.

Effects of Subjective Health Perception on Health Behavior and Cardiovascular Disease Risk Factors in Patients with Prediabetes and Diabetes.

The purpose of this study is to confirm the health behavior performance rate and cardiovascular disease-related indicators according to the subjective health perception of prediabetic and diabetic patients using the 2016–2019 National Health and Nutrition Examination Survey (NHANES) data. This study classified hemoglobin A1c ≥ 6.5% as diabetes and 5.7–6.4% prediabetes among 2485 adults over 40 years of age among the data from the National Health and Nutrition Examination Survey. In addition, subjective health perception was divided into ‘good’ and ‘bad’ and then cross-classified into four groups (Good/PDM, Bad/PDM, Good/DM, and Bad/DM) to analyze the differences between the four groups. All statistical analyses were performed using SAS 9.4 (SAS Institute Inc., Cary, NC, USA), and complex sample analysis was performed using weights according to the KNHANES raw data usage guidelines from the Korea Centers for Disease Control and Prevention. The rate of subjective health awareness was higher in men than in women in both prediabetic- and diabetic-stage subjects and adults in the prediabetic stage were higher than in the elderly. The better the subjective health status, the higher the ratio of normal weight, proper sleep time, exercise, and eating out among health-related behaviors. As a result of analyzing blood pressure and blood indices related to the cardiovascular disease risk (Framingham Risk Score), in all indicators except blood pressure, the better the subjective health status and the lower the risk of cardiovascular disease. As a result, for disease prevention and continuous management through healthy behaviors in prediabetic and diabetic patients, it is necessary to improve the positive subjective perception of health.

Behavioral Health Risk Factors and Motivation to Change among Cardiovascular General Hospital Patients Aged 50 to 79 Years.

Little is known about the (co-)occurrence of smoking, alcohol at-risk drinking, physical inactivity and overweight, and the motivation to change these behavioral health risk factors (HRFs) in older general hospital patients with cardiovascular disease. Between October and December 2016, all consecutively admitted patients aged 50 to 79 years were proactively recruited on 3 cardiology wards and asked to participate in a survey on HRFs and behavior change motivation. Of the eligible patients, 80.4% participated in the survey (n = 328). The mean age was 66.5 years (standard deviation 9.0), and 65.5% were male. At least 1 HRF was present in 91.8% (n = 280), at least 2 HRFs in 54.4% (n = 166), and 3 or 4 HRFs in 12.1% (n = 37) of participants. The proportion of older adults who contemplated or were changing or planning to change their behavior to meet health behavior recommendations ranged between 66.0% (smoking) and 93.2% (alcohol consumption). The results indicate a notable co-occurrence of behavioral HRFs in older patients with cardiovascular disease. The majority of older adults were at least considering changing the respective behavior. To prevent and treat diseases efficiently, hospitalization may be a suitable moment for systematic multiple HRF screening and intervention.

A Needs Assessment of Ohio Farmers’ Self-Reported Health Behaviors

ABSTRACT The study purpose was a needs assessment, to identify and quantify health behavior risk-factors of Ohio farmers in sleep, mental health, fruit/vegetable serving frequency, physical activity, tobacco, alcohol and illicit drug use, and weight status. Guided by the RE-AIM implementation framework, the research question was What behavioral choices pose health risk factors for Ohio farmers? This cross-sectional, quantitative, descriptive study used Qualtrics’ hyperlinks, QR codes, or paper-and-pencil surveys to collect data on seven focused health behaviors. The survey combined valid and reliable public domain questionnaires. The target audience included Ohio farmers representing various commodities. Extension educators at the county, regional, and state level provided access and data collection during their existing community-based programs and annual pesticide training sessions. The survey has been opened from January 20, 2020 to December 5, 2020 with modified recruitment during COVID. A convenience sample of 505 farmers participated. The majority self-identified as male, married, white, non-Latino, and worked full-time. The most frequent commodity was field crops. Most farmers reported 7-to-8 h of sleep, but the MOS SLP6 subscale indicated 89.5% of the farmers reported a score greater than 51. The two PHQ-2 questions showed 9.6% of the farmers scored >3, indicating a likely major depression disorder. Fruit and vegetable serving frequency appeared less than dietary recommendations. Time spent in physical activity did not meet guidelines. Almost 80% of the farmers said they did not use tobacco; the most common choice was chews and snuffs. Audit-C showed 31.4% of the men and 27.7% of the women can be categorized as hazardous drinkers. Illicit drug use was reported by 3.7%. Most farmers were obese or overweight. Male respondents were 83.5% overweight or obese; females 70.8% were overweight or obese. Males ages 55–64 years were mostly likely to be obese (58%) followed by males ages 35–44 years (46%). Results were compared to Ohio’s Behavioral Risk Factor Surveillance System. These data will assist county Extension educators in identifying health prevention programming important for farm populations, utilizing community resources and services. While the findings of Ohio farmers may not be generalizable to other state farming communities, this survey and lessons learned can serve as a model for other Extension assessments.

Enhancing the implementation of the Making Every Contact Count brief behavioural intervention programme in Ireland: protocol for the Making MECC Work research programme

Background: Brief behavioural interventions offered by healthcare professionals to target health behavioural risk factors (e.g. physical activity, diet, smoking and drug and alcohol use) can positively impact patient health outcomes. The Irish Health Service Executive (HSE) Making Every Contact Count (MECC) Programme supports healthcare professionals to offer patients brief opportunistic behavioural interventions during routine consultations. The potential for MECC to impact public health depends on its uptake and implementation. Aim: This protocol outlines the ‘Making MECC Work’ research programme, a HSE/Health Behaviour Change Research Group collaboration to develop an implementation strategy to optimise uptake of MECC in Ireland. The programme will answer three research questions: (1) What determines delivery of MECC brief interventions by healthcare professionals at individual and organisational levels? (2) What are patient attitudes towards, and experiences of, receiving MECC interventions from healthcare professionals? (3) What evidence-informed implementation strategy options can be consensually developed with key stakeholders to optimise MECC implementation? Methods: In Work Package 1, we will examine determinants of MECC delivery by healthcare professionals using a multi-methods approach, including: (WP1.1) a national survey of healthcare professionals who have participated in MECC eLearning training and (WP1.2) a qualitative interview study with relevant healthcare professionals and HSE staff. In Work Package 2, we will examine patient attitudes towards, and experiences of, MECC using qualitative interviews. Work Package 3 will combine findings from Work Packages 1 and 2 using the Behaviour Change Wheel to identify and develop testable implementation strategy options (WP 3.1). Strategies will be refined and prioritised using a key stakeholder consensus process to develop a collaborative implementation blueprint to optimise and scale-up MECC (WP3.2). Discussion: Research programme outputs are expected to positively support the integration of MECC brief behaviour change interventions into the Irish healthcare system and inform the scale-up of behaviour change interventions internationally.

Enhancing the implementation of the Making Every Contact Count brief behavioural intervention programme in Ireland: protocol for the Making MECC Work research programme.

Background: Brief behavioural interventions offered by healthcare professionals to target health behavioural risk factors (e.g. physical activity, diet, smoking and drug and alcohol use) can positively impact patient health outcomes. The Irish Health Service Executive (HSE) Making Every Contact Count (MECC) Programme supports healthcare professionals to offer patients brief opportunistic behavioural interventions during routine consultations. The potential for MECC to impact public health depends on its uptake and implementation. Aim: This protocol outlines the 'Making MECC Work' research programme, a HSE/Health Behaviour Change Research Group collaboration to develop an implementation strategy to optimise uptake of MECC in Ireland. The programme will answer three research questions: (1) What determines delivery of MECC brief interventions by healthcare professionals at individual and organisational levels? (2) What are patient attitudes towards, and experiences of, receiving MECC interventions from healthcare professionals? (3) What evidence-informed implementation strategy options can be consensually developed with key stakeholders to optimise MECC implementation? Methods: In Work Package 1, we will examine determinants of MECC delivery by healthcare professionals using a multi-methods approach, including: (WP1.1) a national survey of healthcare professionals who have participated in MECC eLearning training and (WP1.2) a qualitative interview study with relevant healthcare professionals and HSE staff. In Work Package 2, we will examine patient attitudes towards, and experiences of, MECC using qualitative interviews. Work Package 3 will combine findings from Work Packages 1 and 2 using the Behaviour Change Wheel to identify and develop testable implementation strategy options (WP 3.1). Strategies will be refined and prioritised using a key stakeholder consensus process to develop a collaborative implementation blueprint to optimise and scale-up MECC (WP3.2). Discussion: Research programme outputs are expected to positively support the integration of MECC brief behaviour change interventions into the Irish healthcare system and inform the scale-up of behaviour change interventions internationally.

Knowledge and practice regarding the behavioural risks of cancer among college students in Ethiopia.

In recent years, morbidity and mortality due to cancer has been increasing in Ethiopia, putting it among the most important public health issues. Cancer and associated complications can be prevented provided that effective interventions are put in place to control risk factors. Therefore, this study aimed to assess the level of knowledge and practice of preventable behavioural risk factors of cancer. We conducted a cross-sectional study among 200 college students in Northeast Ethiopia utilising quantitative methods of data collection. Data on socioeconomic characteristics, health belief variables, knowledge and behavioural risk factors (alcohol consumption, tobacco smoking, physical activity and dietary practice) were collected. The level of knowledge and practice was summarised using descriptive statistics. To investigate the variation in knowledge and practice across sociodemographic characteristics, we performed Pearson Chi-square test or Fisher’s exact test. The majority (81.0%) of participants was male and 82.0% were in the age group of 18–24 years. More than half (61.0%) of them had poor knowledge about the behavioural risk factors of cancer. Nearly one-third (30.5%) consume alcohol, whereas 16.0%, 18.0% and 20.0%, respectively, smoke tobacco, consume street food and packed-fried snacks daily. Alcohol consumption (p = 0.02) and level of vigorous physical activity (p = 0.001) were significantly higher among males than females. Alcohol consumption, tobacco smoking and unhealthy dietary practice were remarkably high, whereas knowledge towards the behavioural risk factors was low. Therefore, health education and collaborative action between different sectors are needed to counter the emerging problem.The trial is registered in ClinicalTrials.gov (https://register.clinicaltrials.gov) NCT04269018.

Documentation of Behavioral Health Risk Factors in a Large Academic Primary Care Clinic.

Objective:To determine the prevalence of alcohol, smoking, and physical activity status documentation at a family health team in Toronto, Ontario, and to explore the patient characteristics that predict documentation of these lifestyle risk factor statuses.Design:Manual retrospective review of electronic medical records (EMRs).Setting:Large, urban, academic family health team in Toronto, Ontario.Participants:Patients over the age of 18 that had attended a routine clinical appointment in March, 2018.Main Outcome Measures:Prevalence and content of risk factor status in electronic medical records for alcohol, smoking, and physical activity.Results:The prevalence of alcohol, smoking, and physical activity documentation was 86.4%, 90.4%, and 66.1%, respectively. These lifestyle risk factor statuses were most often documented in the “risk factors” section of the EMR (83.7% for alcohol, 88.1% for smoking, and 47.9% for physical activity). Completion of a periodic health review within 1 year was most strongly associated with documentation (alcohol odds ratio [OR] 9.79, 95% Confidence Interval [CI] 2.12, 45.15; smoking OR 1.77 95% CI 0.51, 6.20; physical activity OR 3.52 95% CI 1.67, 7.40).Conclusion:Documentation of lifestyle risk factor statuses is strongly associated with having a recent periodic health review. If “annual physicals” continue to decline, primary care providers should final additional opportunities to address these key determinants of health.

Onsite screening and enhanced EAP counseling improves overall health, depression, and work outcomes: Four-wave longitudinal pilot study at a community health center in Vermont

Over a 2-year period, patients at a rural community health center in Vermont were screened on-site for multiple behavioral health risk factors and, if found at risk, were offered no-cost counseling on-site at the health center. The treatment was delivered by two licensed employee assistance program (EAP) counselors highly proficient in an evidence-based motivational interviewing approach. Longitudinal data at four time points were examined: baseline; end of treatment (3 months); and 3 and 6 months post-treatment. Tests of paired data of baseline versus each later time point found significant improvement for global health (Patient-Reported Outcomes Measurement Information System [PROMIS]-10) in the total sample (N = 120); depression symptoms (Patient Health Questionnaire 9-item scale [PHQ-9]) among a subsample with depression as a clinical issue (n = 68); and work presenteeism and estimated hours of lost work time among the employed subsample (n = 46). Improvement in global health was significantly associated with improvement (reductions) in hours of lost work productivity at all later times (r = .33, .35, .50). Improvement in global health was moderated by level of household income (more improvement among patients with lower income levels), but not by clinical or demographic factors. Practical implications for behavioral health screening and intervention (BSI) in medical settings and onsite EAP counseling programs are discussed.

Behavioral Health Risk Factors for Nonmedical Prescription Opioid Use in Adolescence.

Adolescent nonmedical prescription opioid use is associated with overdose and other adverse outcomes, but its risk factors are poorly understood. Data were drawn from a prospective cohort study of Los Angeles, California, high school students. At baseline (mean age = 14.6 years), students completed self-report screening measures of problem alcohol, cannabis, and drug use and 6 mental health problems (major depression, generalized anxiety, panic disorder, social phobia, obsessive-compulsive disorder, and hypomania or mania). Past 6-month nonmedical prescription opioid use (yes or no) was assessed across 7 semiannual follow-ups. Among baseline never users of nonmedical prescription opioids (N = 3204), average past 6-month prevalence of new nonmedical prescription opioid use across the 42-month follow-up was 4.4% (range 3.5%-6.1%). In a multivariable model co-adjusting for 9 baseline behavioral problems and other factors, major depression, hypomania or mania, cannabis, alcohol, and other drug use problems were associated with increased odds of nonmedical prescription opioid use over follow-ups. Cumulative indices of behavioral health comorbidity showed successively greater odds of subsequent nonmedical prescription opioid use for students with 1 (odds ratio [OR]: 3.74; 95% confidence interval [CI]: 2.79-5.01), 2 (OR: 8.79; 95% CI: 5.95-12.99), or 3 (OR: 9.69; 95% CI: 5.63-16.68) vs 0 baseline substance use problems, and similar increases were associated with increasing number of mental health problems (1 [OR: 1.60; 95% CI: 1.03-2.88] to all 6 [OR: 3.98; 95% CI: 1.09-14.82] vs 0). Behavioral health problems may be associated with increased risk of subsequent nonmedical prescription opioid use during mid to late adolescence, with successively greater risk for those with greater behavioral health comorbidity. In pediatric clinical practice or school-based prevention, behavioral health screeners may be useful for identifying youth at high risk for nonmedical prescription opioid use.

Telehealth Adoption by Mental Health and Substance Use Disorder Treatment Facilities in the COVID-19 Pandemic.

The study examined temporal and geographic trends in telehealth availability at U.S. behavioral health treatment facilities and risk factors for not offering telehealth. Longitudinal data on 15,691 outpatient behavioral health treatment facilities were extracted daily from the Substance Abuse and Mental Health Services Administration's Behavioral Health Treatment Services Locator between January 20, 2020, and January 20, 2021. Facilities operated by the Department of Veterans Affairs were excluded. Bivariate analyses were used to assess trends in telehealth availability in 2020 and 2021. Multivariable regression analysis was used to examine facility- and county-level characteristics associated with telehealth availability in 2021. Telehealth availability increased by 77% from 2020 to 2021 for mental health treatment facilities and by 143% for substance use disorder treatment facilities. By January 2021, 68% of outpatient mental health facilities and 57% of substance use disorder treatment facilities in the sample were offering telehealth. Mental health and substance use disorder treatment facilities that did not accept Medicaid as a form of payment were less likely to offer telehealth in 2021, compared with facilities that accepted Medicaid. Mental health and substance use disorder treatment facilities that accepted private insurance were more likely to offer telehealth in 2021, compared with facilities that did not accept private insurance. Although 2020 saw a dramatic increase in telehealth availability at behavioral health treatment facilities, 32% of mental health treatment facilities and 43% of substance use disorder treatment facilities did not offer telehealth in January 2021, nearly 1 year into the pandemic.

Associations between insufficient sleep and prescription opioid misuse among high school students in the United States

The aim of this study was to estimate the association between insufficient sleep and prescription opioid misuse among US high school students. Participants were 6,884 high school students who self-reported on sleep duration and prescription opioid misuse in the 2019 Youth Risk Behavior Survey. Sleep duration was categorized by the Youth Risk Behavior Survey according to the American Academy of Sleep Medicine guidelines as follows: recommended sleep duration (8-9 hours) vs insufficient sleep (< 8 hours). Participants also reported whether they had any prescription opioid misuse during their lifetime and whether they had prescription opioid misuse within the past 30 days. Most (79.4%) participants reported sleeping less than 8 hours per night. Among all youth, 12.9% reported lifetime prescription opioid misuse and 6.2% reported current prescription opioid misuse. Prevalence of both lifetime and current opioid medication misuse was higher among those also reporting insufficient sleep compared to those reporting recommended sleep duration (14.3% vs 7.7%, P < .0001 for lifetime misuse and 6.6% vs 4.3%, P = .0091 for current misuse). In multivariate models, insufficient sleep was associated with an increased odds of lifetime prescription opioid misuse (adjusted odds ratios = 1.4; 95% confidence interval, 1.1-1.2; P = .006); however, we did not find an association between sleep duration and current prescription opioid misuse in multivariate analysis. Sleep duration is associated with lifetime opioid misuse among US youth. Longitudinal studies are needed to test whether causal relationships exist, and to understand biobehavioral mechanisms that underlie associations between sleep deficiency and opioid misuse in adolescents. Groenewald CB, Rabbitts JA, Tham SW, Law EF, Palermo TM. Associations between insufficient sleep and prescription opioid misuse among high school students in the United States. J Clin Sleep Med. 2021;17(11):2205-2214.

Exploring the Impact of COVID-19 Response on Population Health in Saudi Arabia: Results from the "Sharik" Health Indicators Surveillance System during 2020.

Background: Although some studies have explored the effects of responses to COVID-19 on mortality, there are limited data on their effects on more immediate health risk factors and the trends of chronic diseases. Objective: To explore the prevalence of some behavioral health risk factors, intermediate risk factors, and chronic diseases at different timepoints during 2020 using the data available from a currently used surveillance system in Saudi Arabia. Methods: This study undertook a secondary analysis of data from the Sharik Health Indicators Surveillance System (SHISS). The SHISS employs short cross-sectional phone interviews, conducted in all 13 administrative regions of Saudi Arabia on a quarterly basis. Each interview lasts approximately 4 min and is conducted by a trained data collector. The SHISS collects demographic data, as well as data on the major behavioral and intermediate chronic disease risk factors and the major chronic diseases, including diabetes, heart disease, stroke, cancer, and chronic respiratory diseases. Results: Of the 44,782 potential participants contacted in 2020, 30,134 completed the interview, with a response rate of 67.29%. Out of the total participants, 51.2% were female. The mean age was 36.5. The behavioral risk factors in this period exhibited significant changes compared to those in the first quarter (Q1) of 2020, when there were no significant restrictions on daily activities. These significant changes are related to reductions in fruit and vegetable intake (adjusted odds ratio (AOR), 0.23) and physical activity (AOR, 0.483), and a significant increase in e-cigarette use (AOR 1.531). In terms of the intermediate risk factors observed in the SHISS, significant increases in hypercholesterolemia (AOR, 1.225) and hypertension (AOR, 1.190) were observed. Finally, heart disease (AOR, 1.279) and diabetes (AOR, 1.138) displayed significant increases compared to Q1. Conclusions: This study shows some evidence of the impact of responses to COVID-19 on the health of the population in Saudi Arabia. Significant reductions in fruit and vegetable intake and physical activity, and significant increases in e-cigarette use, hypertension, and hypercholesterolemia may increase the burden of chronic diseases in Saudi Arabia in the near future. Thus, continuous monitoring of the health risk factors within the population, and early interventions, are recommended to prevent future increases in chronic diseases.

Racial and Ethnic Disparities in Health Status, Chronic Conditions, and Behavioral Risk Factors Among Prostate Cancer Survivors, United States, 2015.

IntroductionLittle is known about perceived health status and behavioral risk factors among prostate cancer survivors. The objective of this study was to describe racial and ethnic differences in self-reported health status, chronic conditions, and selected behavioral risk factors among prostate cancer survivors in the US.MethodsWe used data from the 2015 National Health Interview Survey to calculate the prevalence of various levels of health status, chronic conditions, behavioral risk factors, and sociodemographic characteristics among prostate cancer survivors aged 50 years or older. We stratified results by race and ethnicity.ResultsOf the 317 prostate cancer survivors in our sample, 33.1% reported no physical activity, 64.2% reported being current drinkers, 26.1% characterized their drinking as moderate/heavy, 42.3% reported being former smokers, and 8.7% were current smokers. Nearly one-third (29.1%) of survivors were obese (body mass index ≥30), and 15.1% had 3 to 6 chronic conditions. A greater percentage of White (29.7%) than Black (14.2%) or Hispanic (16.3%) survivors were moderate/heavy drinkers. A greater percentage of Black (16.2%) than White (7.5%) or Hispanic (7.3%) survivors were current smokers. A greater percentage of Black (25.1%) or Hispanic (27.7%) than White (11.4%) survivors had 3 to 6 chronic conditions.ConclusionAs the population of older men increases, prostate cancer diagnoses and those surviving the disease will also increase. Significant racial and ethnic group differences in behavioral risk factors and chronic conditions exist among prostate cancer survivors. Public health could prioritize efforts to improve health behaviors among prostate cancer survivors and use targeted interventions to address disparities.

Prevalence and characteristics of campus-based employee wellness programs among United States accredited colleges and universities.

Employee wellness programs (EWPs) aim to support positive changes in employees' modifiable behavioral health risk factors for disease prevention and management. This study described the prevalence and characteristics of EWPs in US accredited college and university campuses. Identification of the prevalence of EWPs and programming activities offered in 3039 accredited higher education institutions/campuses, and characteristics of these institutions/campuses were conducted, mainly through searching the institution's web page. Overall, 36%of the institutions/campuses offered EWPs, with a significantly larger percentage of 4-year public colleges/universities providing EWPs and wellness programming activities than the 4-year private colleges/universities and community colleges. When limiting the institutions/campuses to 4-year colleges and universities with at least 500 employees, the percentage of these institutions/campuses offering EWPs increased to 57.7%, which was comparable to the findings in the literature. The percentage of the institutions/campuses offering wellness programming activities ranged from 18.1%for injury prevention and ergonomics to 30.2%for stress management. The percentage of institutions/campuses offering injury prevention and ergonomics was significantly lower than the percentage of institutions/campuses offering other typical wellness activities. The prevalence of EWPs offered in accredited college and university campuses do not meet the national goal of 75%, which was set by Healthy People 2010.

Nutritional Status among Filipino Elderly: Prevalence and Correlates

Objective: The dual burden of undernutrition and overnutrition has received attention around the world, especially in the Philippines, where malnutrition is an issue that the country is continuously facing. Malnutrition have been prevalent and alarming concerns among the Filipino elderly through the years. Several studies support the claim that the prevalence of malnutrition is associated with factors, such as socioeconomic status, biochemical, clinical, dietary intake, and food security. This study aimed to determine the factors associated with the nutritional status of the Filipino elderly.&#x0D; Materials and Methods: The study utilized the 2013 National Nutrition Survey. Data of the 1,807 sampled Filipino elderly who had no physical defects were considered. The Rao-Scott test and a multiple correspondence analysis were conducted to assess the association of the nutritional status of the Filipino elderly with the socio-demographics, health/clinical conditions, and nutrient intake factors.&#x0D; Results: Majority (54.97%) of the Filipino elderly had a normal nutritional status. However, both the prevalence of underweight and overweight are still alarming with a 20.19% and 24.83% rate, respectively. The socio-demographic characteristics found that are associated with the nutritional status of the Filipino elderly include age, sex, occupation, and education. Health conditions and behavioral risk factors such as smoking and drinking alcohol beverages were also found to have significant association with the elderly’s nutritional status. Lastly, a significant association between the nutritional status and the intake of nutrients such as iron, Vitamin A, niacin, and thiamine was observed.&#x0D; Conclusion: With both underweight and overweight/obesity still rampant among the Filipino elderly, their lifestyle and food intake should be given much attention. Further studies about the nutritional status of the Filipino elderly should be conducted to have a sufficient basis on how society can help the elderly maintain and improve their nutritional conditions.

Hygienic characteristics of the cosmetologists' lifestyle

Modern trends in the deterioration of health and the growth of non-communicable diseases among the adult working-age population, including medical workers, actualize the importance of a healthy lifestyle for maintaining health and professional longevity. There were almost no studies related to cosmetologists' experienced group as representatives of aesthetic medicine. There is no scientific evidence on behavioral risks of this group. It justifies the relevance of this study. The study aims to analyze the essential components of the cosmetologists' lifestyle depending on age and the argumentation of priority behavioral health risk factors for preventive and recreational work justification. Sixty women (practicing cosmetologists in Volgograd at the age of 28-39 years (group A) and 40-53 (group B)) took part in the study. Lifestyle assessment included a modified questionnaire. The questionnaire consists of 5 blocks (block 1 - nutrition; 2 - physical activity, including hardening and active rest; 3 - daily regimen; 4 - personal hygiene; 5 - bad habits). It allows the analysis of the adherence to a healthy lifestyle based on the provision of quantitative data. Statistical data processing was carried out using the Excel package. The authors identified the essential and statistically significant differences in the cosmetologists' lifestyle depending on age. The respondents of group B demonstrated hygienically rational indicators in all blocks of the lifestyle more often. They had a more formed adherence to a healthy lifestyle: 504 answers in the category "insignificant risk" of respondents in group B versus 354 in group A. Distribution of answers in the "high risk" category: 119 responses in group B and 185 in group A. The lifestyle of 46.7% of the respondents in group B refers to a healthy lifestyle. 3.3% of the group B respondents have an anxious lifestyle, 50% have health risks. 10% of Group A respondents' lifestyle refers to a healthy lifestyle. 13.3% of Group A respondents' lifestyle refers to an anxious lifestyle; 76.7% of this group have health risks. There was almost no complex hygienic research profession of medical cosmetologists. Cosmetologists of the older age group (40-53 years old) are more conscious of maintaining a hygienically rational lifestyle. The most significant defects among cosmetologists aged 28-39 years are low physical activity, nutritional defects, insufficient duration of night rest, and excessive use of information and communication technologies for rest, accompanied by manifestations of neurotization and signs of pronounced fatigue. The obtained results argue the need to develop and implement informational and educational measures to prevent risk behavior patterns, taking into account the age of cosmetologists and the priority of the identified behavioral risk factors.

Health literacy and behavioral health factors in adults

ObjectivesThis study was to examine the relationship between health literacy (HL) and health behaviors in the South Bohemia Region in the Czech Republic (CR) and compare them to HL and health behaviors in the Visegrád group countries (Czech Republic, Hungary, Poland, and Slovakia). The paper reports the results from the research in the CR. Study designA quantitative descriptive study. MethodsThe sample was stratified by sex and age and included a representative sample of 303 adults. The data were collected using the combination of a country-specific questionnaire with the HLS-EU-16 standardized questionnaire. ResultsExercise was significantly associated with perceived health and HL; those with a lower level of HL did not exercise during the previous month. Based only on full answers (N = 251), inadequate HL was identified in 17.5% of the respondents (44), marginal HL in 31.5% (77), and adequate HL in 51% (128) of the respondents. Nearly 49% of the participants evaluated their health as ‘good’, 25.7% rated their health as ‘very good’ and ‘satisfactory’ by 25.7%. But 41.6% experienced one or more chronic diseases, 37.6% had some limitations to their health, and 20.5% smoked. For alcohol consumption, 26% drank weekly and 23% drank two to three times a month. Exercise varied from never (29.7%) to daily (7.9%). ConclusionBased on our results, we conclude that health behavior risk factors are still present in the South Bohemia region of the CR regardless of levels of HL reported on the HLS-EU-16.

External Validation of a Population-Based Prediction Model for High Healthcare Resource Use in Adults.

Predicting high healthcare resource users is important for informing prevention strategies and healthcare decision-making. We aimed to cross-provincially validate the High Resource User Population Risk Tool (HRUPoRT), a predictive model that uses population survey data to estimate 5 year risk of becoming a high healthcare resource user. The model, originally derived and validated in Ontario, Canada, was applied to an external validation cohort. HRUPoRT model predictors included chronic conditions, socio-demographics, and health behavioural risk factors. The cohort consisted of 10,504 adults (≥18 years old) from the Canadian Community Health Survey in Manitoba, Canada (cycles 2007/08 and 2009/10). A person-centred costing algorithm was applied to linked health administrative databases to determine respondents’ healthcare utilization over 5 years. Model fit was assessed using the c-statistic for discrimination and calibration plots. In the external validation cohort, HRUPoRT demonstrated strong discrimination (c statistic = 0.83) and was well calibrated across the range of risk. HRUPoRT performed well in an external validation cohort, demonstrating transportability of the model in other jurisdictions. HRUPoRT’s use of population survey data enables a health equity focus to assist with decision-making on prevention of high healthcare resource use.

Estimating the potential reduction in future sickness absence from optimizing group-level psychosocial work characteristics: a prospective, multicenter cohort study in German industrial settings

BackgroundAbsence from work due to sickness impairs organizational productivity and performance. Even in organizations with perfect work conditions, some inevitable baseline sickness absence exists amongst working populations. The excess sickness absence observed above this baseline rate has become the focus of traditional health promotion efforts, addressing preventable physical illness, health behavior and mental health at the personal level. However, a health and safety approach following the TOP-rule would consider work-group psychosocial work characteristics as a potential risk factor amenable to organizational measures. To date, there is a scarcity of studies relating psychosocial work characteristics to possible reduction of excess sickness-absence rates.MethodsWe aimed to estimate the potentially avoidable excess fraction of absence attributable to work-group psychosocial characteristics. We considered work-group averaged perception of psychosocial work characteristics as a proxy to the methodologically elusive objective assessment of organizational characteristics. Participants were recruited from multiple sites of a German automotive manufacturer with individuals nested within work groups. We predicted 12-month follow-up work-group sickness absence rates using data from a baseline comprehensive health examination assessing work characteristics, health behavior, and biomedical risk factors. We considered the quartile of work-groups yielding favorable psychosocial work characteristics as a realistic existing benchmark. Using the population attributable fraction method we estimated the potentially amenable sickness absence from improving work-group psychosocial characteristics.ResultsData from 3992 eligible participants from 29 work groups were analyzed (39% participation rate, average age 41.4 years (SD = 10.3 years), 89.9% males and 49% manual workers.). Work-group absence rates at follow up varied from 2.1 to 8.9% (mean 5.1%, 11.7 missed days). A prediction model of seven psychosocial work characteristics at the work group level explained 70% of the variance of future absence rates. The estimated reduction from improving psychosocial work characteristics to the benchmark level amounted to 32% of all sickness absence, compared to a 31% reduction from eliminating health behavioral and medical risk factors to the benchmark target.ConclusionsPsychosocial characteristics at the work-group level account for a relevant proportion of all sickness absence. Health promotion interventions should therefore address psychosocial characteristics at the work group level.