Encouraging Healthy Behaviors Research Articles

Adverse Effects of the COVID-19 Pandemic on Movement and Play Behaviours of Children and Youth Living with Disabilities: Findings from the National Physical Activity Measurement (NPAM) Study.

All children and youth require ample physical activity (PA), low levels of sedentary behaviour (SB), and adequate sleep to stay healthy. Children and youth living with disabilities (CYWD) tend to have fewer opportunities for participation in PA and outdoor play compared with their typically developing peers. In turn, CYWD are typically less active and more sedentary, on average, compared with their peers. The COVID-19 pandemic reduced opportunities for many children and youth to participate in PA and outdoor play. The purpose of this study was to assess parent-perceived changes in PA (including outdoor play), SB (including screen time), and sleep quality and quantity, due to COVID-19 and related restrictions, in a national cohort of Canadian CYWD. We recruited parents of school-aged CYWD (N = 151) in May 2020. In an online survey, parents reported their child’s previous 7-day PA, SB, and sleep, as well as perceived changes in their child’s movement and play behaviours due to COVID-19 and related restrictions. Parent-perceived parental support for their child’s movement and play behaviours during the pandemic was also assessed. We used descriptive statistics to describe the child’s movement behaviours and assessed the association between movement behaviours and parental factors using Pearson and point-biserial correlations. Few (5.3%) CYWD met PA recommendations and 13.2% met screen time recommendations during the acute period of the COVID-19 pandemic. More CYWD (66.2%) were meeting sleep recommendations. Overall, only 1.3% of CYWD were meeting the combined movement guidelines. Parent encouragement was positively associated with the child’s outdoor PA (0.23), wheeling, walking, and biking (0.19), indoor PA (0.16), and family-based PA (0.26). Parental co-play was similarly positively associated with the child’s outdoor PA (0.26), wheeling, walking, and biking (0.39), indoor PA (0.16), and family-based PA (0.26). Parents perceived their CYWD to be less active and more sedentary as a result of COVID-19 and the related restrictions. Parents of CYWD have an important role in encouraging healthy movement behaviours. Return to movement and play post-COVID guidelines should include tailored strategies for CYWD and their families to mitigate the negative impacts of the pandemic.

Perceived Diet Quality, Eating Behaviour, and Lifestyle Changes in a Mexican Population with Internet Access during Confinement for the COVID-19 Pandemic: ESCAN-COVID19Mx Survey.

Perceived changes in diet quality, emotional eating, physical activity, and lifestyle were evaluated in a group of Mexican adults before and during COVID-19 confinement. In this study, 8289 adults answered an online questionnaire between April and May 2020. Data about sociodemographic characteristics, self-reported weight and height, diet quality, emotional eating, physical activity, and lifestyle changes were collected. Before and after confinement, differences by sociodemographic characteristics were assessed with Wilcoxon, Anova, and linear regression analyses. Most participants were women (80%) between 18 and 38 years old (70%), with a low degree of marginalisation (82.8%) and a high educational level (84.2%); 53.1% had a normal weight and 31.4% were overweight. Half (46.8%) of the participants perceived a change in the quality of their diet. The Diet Quality Index (DQI) was higher during confinement (it improved by 3 points) in all groups, regardless of education level, marginalisation level, or place of residence (p < 0.001). Lifestyle changes were present among some of the participants, 6.1% stopped smoking, 12.1% stopped consuming alcohol, 53.3% sleep later, 9% became more sedentary, and increased their screen (43%) as well as sitting and lying down time (81.6%). Mexicans with Internet access staying at home during COVID-19 confinement perceived positive changes in the quality of their diet, smoking, and alcohol consumption, but negative changes in the level of physical activity and sleep quality. These results emphasise the relevance of encouraging healthy lifestyle behaviours during and after times of crisis to prevent the risk of complications due to infectious and chronic diseases.

Do Incentives Crowd Out Motivation? A Feasibility Study of a Community Vector-Control Campaign in Peru

Incentives are a useful tool in encouraging healthy behavior as part of public health initiatives. However, there remains concern about motivation crowd out—a decline in levels of motivation to undertake a behavior to below baseline levels after incentives have been removed—and few public health studies have assessed for motivation crowd out. Here, we assess the feasibility of identifying motivation crowd out following a lottery to promote participation in a Chagas disease vector control campaign. We look for evidence of crowd out in subsequent participation in the same behavior, a related behavior, and an unrelated behavior. We identified potential motivation crowd out for the same behavior, but not for related behavior or unrelated behaviors after lottery incentives are removed. Despite some limitations, we conclude that motivation crowd out is feasible to assess in large-scale trials of incentives.

Developing Resources for Staff and Adapting Programing During COVID-19 at Fred Victor

Fred Victor is an organization that supports those experiencing poverty and homelessness in Toronto. As a practicum student in the Health Promotions department at Fred Victor, I gained experience working on health promotion projects and was able to work directly with the community. Throughout the practicum, I worked on several projects to adapt Fred Victor’s services during COVID-19. First, I worked to develop a resilience toolkit for Fred Victor staff. COVID-19 has led to higher levels of stress. This prompted Fred Victor to develop tools to support their staff. I designed a toolkit that instructs managers on how to promote resilience in their supervision sessions and team meetings. This toolkit provided information on what resilience is, as well as practical actions that managers can take to promote resilience in staff. This project involved knowledge translation to convey the research on resilience to Fred Victor staff in an accessible way. Additionally, I worked to support the development of online peer support groups. Typically, Fred Victor runs weekly in-person peer support groups for community members. However, due to COVID-19, these groups had to move to an online format. I helped facilitate this transition by developing a guide for facilitating online group programming. This guide included information on the best platforms to run online programming, how to create a safety agreement, and best practices for facilitating the group. I then conducted outreach to community members to ask for their input on the format and content of the groups. These projects are important to public health as they work to meet the public health goal to improve quality of life by promoting and encouraging healthy behaviours. These projects played an important role in promoting the health of Fred Victor staff and clients during COVID-19 by providing them with support and tools to manage their mental health.

Educational level, ethnicity and mortality rates in Israel: national data linkage study

BackgroundMany studies have shown significant gaps in mortality, and cause specific mortality by educational status. This study investigated these measures in Israel by educational and ethnic status in recent decades.MethodA mortality follow-up till 2017 was done of a cohort of Israeli residents aged 25–64 in 2000 who remained in Israel and had available educational data, grouped into under 8, 9–11, 12, 13–15 and 16 and above years of education. Indirect age adjustment was used to calculate Standard Mortality Ratios (SMRs) by sex and educational group, and a Cox regression model to assess relative risk of total and cause specific mortality controlling for age and ethnic group (Jews and Others and Arabs).The analysis was repeated for each ethnic group separately.Results2,776,422 persons were included of whom 174,792 (6.3%) died till 2017. SMR’s for total mortality of males and females with less than 8 years of education compared to 16 and over were 2.2 and 1.8, respectively. Corresponding HR were 2.13 (95% CI 2.08–2.18) and 1.77 (95% CI 1.72–1.82), respectively.The highest cause specific hazard ratios in males were for homicide, 4.40 (95% CI 3.19–6.07), respiratory diseases, 4.01 (95% CI 3.61–4.44), infectious diseases, 3.55 (95% CI 3.15–3.19) and diabetes 3.41 (95% CI 3.06–3.79) and in females for diabetes, 4.41 (95% CI 3.76–5.16), infectious diseases, 4.16 (95% CI 3.52–4.91), respiratory diseases, 4.13 (95% CI 3.55–4.81), and heart disease, 2.96 (95% CI 2.66–3.29).Education-adjusted risk of all-cause mortality for Arab males was 1.07 (1.05–1.09) times that of Jews and Others and non-significant in females. High mortality risk was found for Arab males and females compared to Jews and Others for homicide, diabetes, heart and cerebrovascular disease and for respiratory disease in males. Lower risk was found for suicide and infectious diseases in both sexes andcancer in females.ConclusionWe found significant effect of educational level on all-cause and cause specific mortality, particularly respiratory diseases, infectious diseases, diabetes and homicide. Our results highlight the importance of increasing the educational level of all groups in the population and of encouraging healthy behavior in the lower educated.

Parental Support Is Associated With Healthy Movement Behaviours In Children With Disabilities During Covid-19

Parental support of healthy movement behaviours (i.e., daily physical activity, PA; reduced sedentary behaviours, SB; and adequate sleep) is important, particularly in children and youth with disabilities (CYWD), who are often less active and more sedentary, on average, compared with typically developing children. The COVID-19 pandemic and related public health restrictions have limited children’s PA and increased SBs and placed significant stress on families of CYWD. Parental support of healthy movement behaviours may be critical in mitigating the negative effects of the COVID-19 pandemic for CYWD. PURPOSE: To assess the association between parental support and healthy movement behaviours in CYWD during the initial phase of the COVID-19 pandemic. METHODS: We recruited parents of school-aged CYWD (n = 151) in April/May 2020. Parents assessed their child’s previous 7-day PA, SB, and sleep, perceived changes in their child’s movement behaviours due to the COVID-19 restrictions, and perceived parental support of their child’s movement behaviours during COVID-19. We assessed the association between movement behaviours and parental factors using Pearson and point-biserial correlations, where * = p < .05 and ** = p < .01. RESULTS: Few CYWD were meeting the combined healthy movement behaviour guidelines (1.3%) during the initial phase (April/May 2020) of the COVID-19 pandemic. Parent encouragement was positively associated with increased child’s outdoor PA (.23**), wheeling, walking, and biking (.19**), indoor PA (.16**), chores (.19*), and family-based PA (.26**). Parental co-play was similarly positively associated with the child’s increased outdoor PA (.26**), wheeling, walking, and biking (.39**), and family-based PA (.26**). Overall parent capability and opportunity to support movement behaviours was positively associated with the child’s increased child’s outdoor PA (.38**), wheeling, walking, and biking (.26**), chores (.16*), and family-based PA (.37**), as well as increased sleep quality (0.31**) and decreased screen time (-.22**). CONCLUSIONS: Parents of CYWD have an important role in encouraging healthy movement behaviours. As we recover from the COVID-19 pandemic, return to play recommendations should consider the role of the family in supporting healthy movement behaviours in CYWD.

Strategies used by providers to support individuals with spinal cord injury in weight management: a qualitative study of provider perspectives

This is a descriptive qualitative study. To explore recommended strategies employed by healthcare providers to support individuals with SCI in weight management. Fourteen veteran administration hospitals in the United States and the Shirley Ryan AbilityLab (SRALab) SCI Model Systems in Illinois. Semi-structured interviews were conducted with interprofessional SCI providers involved in weight management with individuals living with SCI. Thematic analysis methods were used. A total of 25 interprofessional providers were interviewed. Providing clinical expertise to assist in weight management included (1) checking progress or status of weight over time, (2) monitoring and tracking other health-related indicators, (3) stressing weight-related health risks, (4) providing education, (5) encouraging healthy behaviors, and (6) identifying and accessing resources. Fostering provider-patient relationships included (1) establishing and maintaining rapport and (2) tailoring/individualizing weight management treatment. Coordinating a team approach included (1) involving a dietitian or nutritionist, (2) communicating the same message, and (3) involving the informal caregiver/family. Weight management strategies should incorporate patient preferences and goals, informed through provider expert and personalized clinical advice, and supported within the context of interprofessional team collaboration that includes caregivers and family.

Long-term weight loss success and the health behaviours of adults in the USA: findings from a nationally representative cross-sectional study

ObjectiveTo describe the relationship between long-term weight loss (LTWL) success and lifestyle behaviours among US adults.DesignSerial cross-sectional data from National Health and Nutrition Examination Survey cycles 2007–2014.Setting and participantsPopulation-based nationally...

Social media use impacts body image and eating behavior in pregnant women

Social media (SM) use may have detrimental effects on the physical and mental wellbeing of young adults, including body image dissatisfaction (BID) and changes in dietary behavior. This issue may be of particular concern in pregnant women since adequate dietary behavior is essential during pregnancy for the health of the mother and fetus. The present study aimed to investigate how SM use and posting as well as dependence on technological devices relate to body image and dietary behavior in pregnant women. A descriptive, cross-sectional design was used. A sample of 192 Lebanese pregnant women (29.6 ± 6.2 years old) completed a self-report questionnaire assessing the aforementioned variables. SM usage and posting were both associated with healthy eating behaviors (p = 0.049 and p = 0.03 respectively). On the other hand, SM posting was associated with higher negative body image scores (p = 0.04), postnatal image concerns (p = 0.02), as well as competitiveness with regard to the pregnant body (p = 0.02). Also, dependence on technological devices and internet was associated with higher negative body image scores (p < 0.001), postnatal image concerns (p < 0.001) and increased anxiousness towards the pregnant body (p = 0.02). While SM use and posting are associated with healthy eating behaviors, SM posting and dependence on technological devices are also associated with increased appearance comparison and BID in pregnant women. The present study adds to the growing evidence supporting a significant impact of SM use on physical and mental wellbeing, emphasizing potential deleterious effects during pregnancy. Practical implications are discussed in terms of media literacy interventions and recommendations for healthcare team members to improve maternal counselling and support by encouraging healthy body image, diet and lifestyle behaviors during pregnancy.

Healthcare Practitioner’s Views on the Teddy Bear Hospital (TBH) by IMACATS in Malaysia

Introduction: This is a part of a bigger study entitled “Exploring the Views of Healthcare Practitioners on the Teddy Bear Hospital (TBH) as a Personal Safety Module Towards Prevention of Child Sexual Abuse (CSA): A Qualitative Study”. TBH is a make-believe-play hospital utilising soft toys to demonstrate a pretend clinical setting with the aim to educate children on health issues. Studies has shown its effectiveness and reducing anxiety towards the hospital setting and increasing health-related knowledge. IMAM Children’s and Teen Super teen (IMACATS) is one of the non-governmental organisations (NGO) which has adopted this concept to tailor to the local community. The volunteers are healthcare practitioners who are engaged with children in their practice.Objective: To explore the views of healthcare professional towards TBH by IMACATS in Malaysia.Methods: In-depth qualitative audio recorded interviews were conducted with a purposive sample of 18 healthcare professionals. The data obtained were transcribed and analysed thematically.Results: Three themes were derived from the interviews: i) Awareness of the TBH concept. Seven participants have volunteered in TBH previously. However, there was a speculation that many doctors are still unknowing of this concept. ii) Benefits of TBH. This includes reducing children’s anxiety, changing children’s presumption on healthcare, increasing children’s health knowledge and encouraging healthy behaviour and bridging the gap between the public and healthcare. iii) Suggestion of Module for future TBH: (a) More school-based programmes should be organised in addition to hospital and community based; (b) Ministry of Health (MOH) should encourage children health screening using this concept; (c) A module for hospitalised children should be conducted.Conclusion: Participants interviewed suggested for TBH to be organised in a wider scale as it is an approachable concept for educating children. There are many ways in which it can benefit this community.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S18

Description of an integrated e-health monitoring system in a Portuguese higher education institution: the e.cuidHaMUstm program.

The World Health Organization and the International Labour Organization recognize that workplace health is not only affected by occupational hazards, but is mainly affected by social determinants and individual factors. An accelerated rise in noncommunicable diseases has fostered the importance of creating supportive environments and encouraging healthy behaviours. Therefore, an operational approach to making workplaces healthy and sustainable is needed. This paper describes the development of an e-Health monitoring program entitled 'Integrated eHealth Monitoring System for Health Management in Universities' (e.cuidHaMUsTM) as a possible solution to that operational approach. We developed the program e.cuidHaMUsTM that proposes to detect risk behaviours related to noncommunicable diseases and to implement problem-solving measures by establishing a health-promoting workspace in a Portuguese higher education institution. Based on the 'I-Change' conceptual model, our program provides personalized feedback; improves health-related knowledge, attitude and good practices; and encourages actions to promote healthy lifestyles through individual health capacitation. Focusing on evaluation as an activity that generates knowledge, the e.cuidHaMUsTM program aggregates all the relevant health information, shares the results with decision-makers and evaluates health-related policy changes in the workplace. This paper presents the design of the e.cuidHaMUsTM program, the development of an eHealth web platform to share information between the different stakeholders, and a questionnaire to evaluate the health status of higher education institution workers (e.cuidHaMUs.QueST®). Also, the procedures for data collection and analysis are outlined. The e.cuidHaMUsTM program can enhance health surveillance through cross-sectional and longitudinal studies and provide scientific evidence to support the envisioned interventions and promotions of healthy lifestyles. This program is an effort to incorporate a holistic culture of health-promoting workspace in higher education institution policies.

Effectiveness of structured teaching versus child-to-child teaching program on knowledge regarding worm infestation to middle school children in Puducherry

Background: Worm infestations are one of the most widely prevalent neglected tropical diseases (NTDs) which are inextricably linked to poor sanitation and hygiene. Aims: This study aims to assess the effectiveness of structured teaching plan and child-to-child teaching in raising awareness about helminthiasis. Methods: Thirty-seven standard children each from two government secondary schools in Puducherry were selected by simple random sampling. Data on knowledge regarding worm infestation and selected demographic variables were collected using a structured questionnaire. Two groups with 30 subjects each were created, where Group 1 was taught according to a structured teaching plan, and a child-to-child teaching approach was adopted for Group 2. The effectiveness of interventions was adjudged using a paired t-test. The association between the level of knowledge and select demographic variables was examined using a Chi-square test. Results: A vast majority of subjects in Group 1 and Group 2 had inadequate and moderately adequate knowledge of helminthiasis, respectively, prior to intervention. However, the mean test scores of Group 1 increased by 20.6 following intervention with a structured teaching plan. An incremental mean difference of 19.16 was witnessed in Group 2. The child-to-child teaching program was found to be equally effective as a structured teaching plan. A statistically significant association was found between the level of knowledge and demographic variables such as age and place of defecation (P < 0.05). Conclusion: Peer learning was found to be a novel and reliable method of expanding the knowledge of middle school children on prevention of hookworm infestation, thereby encouraging healthy behaviors.

Association of pharmacotherapy with clinicians' nutritional counseling practices to diabetic and hypertensive patients

Background: Nutrition counseling is an important tool for encouraging healthy nutrition behaviors among individuals. The nutritional imbalance is rising worldwide, leading to the emergence of various diseases. Physicians have an important role in impeding healthy nutrition in patients. Aims and Objectives: The role of patients prone to pharmacotherapy on nutritional counseling and management (NCM) practices of clinicians to patients with diabetes or hypertension in the routine clinical practice was explored in this study. Materials and Methods: In this cross-sectional study, a total of 267 clinicians, including family doctors, general practitioners, and internists were purposively included. The attitudes toward NCM and their practices in routine clinical working were examined through the self-reported technique. Results: The mean age of the physicians was 34.18 and had experience for 5 years. A small percentage of them have completed the nutrition training course (26.59%). The study showed that different kinds of NCM, including nutritional assessment, therapy, and education, were presented to diabetic and hypertensive patients. The majority of the physicians emphasized their role (88.1%) in promoting nutritional therapy. Besides, most of them (88.0%) mentioned that a high priority must be given to NCM in routine clinical practice. The prone of patients to pharmacotherapy rather than diet therapy was determined to be a barrier to the NCM to diabetic and hypertensive patients. Conclusions: This study showed that physicians had good attitudes toward NCM; however, the prone of the diabetic and hypertensive patients to pharmacotherapy rather than diet therapy impedes the NCM by clinicians.

A qualitative study of the role of Samoan Church ministers in health literacy messages and health promotion in Auckland, New Zealand

ObjectiveHealth promotion and health literacy activities within church congregations are not a new concept; however, this has not yet been widely researched in New Zealand. This paper explores the views of Samoan Methodist Church ministers about health‐related issues and their role in health promotion and health literacy in their churches. MethodsThis was a qualitative research study with Samoan Methodist Church ministers from Auckland, New Zealand. Ten participants were interviewed face‐to‐face using a semi‐structured approach. A general inductive approach for analysis of qualitative data was utilised. Ethics approval was granted by the University of Auckland Human Participants Ethics Committee. ResultsAll of the church ministers described a holistic view of health and had a sense of responsibility for the holistic wellbeing of their members. Culture was seen as the main barrier to good health. Most of the ministers identified their role in health promotion as being associated with an external health provider. ConclusionChurch ministers are well‐respected leaders in the Samoan Church, which helps them play an important role in communicating health‐promoting messages and encouraging healthy behaviours. The elders and chiefs are recognised as the cultural leaders in the church; without their support, the cultural barriers to health will be difficult to overcome. Implications for public healthChurch ministers are important in health literacy messages and health promotion.

A Review of Physical Human Activity Recognition Chain Using Sensors

In the era of Internet of Medical Things (IoMT), healthcare monitoring has gained a vital role nowadays. Moreover, improving lifestyle, encouraging healthy behaviours, and decreasing the chronic diseases are urgently required. However, tracking and monitoring critical cases/conditions of elderly and patients is a great challenge. Healthcare services for those people are crucial in order to achieve high safety consideration. Physical human activity recognition using wearable devices is used to monitor and recognize human activities for elderly and patient. The main aim of this review study is to highlight the human activity recognition chain, which includes, sensing technologies, preprocessing and segmentation, feature extractions methods, and classification techniques. Challenges and future trends are also highlighted.

Characterizing Patients with Uncontrolled Blood Pressure at an Urban Hospital in Hanoi, Vietnam.

Great efforts to advance the diagnosis and treatment of hypertension for controlling hypertension have been made; however, the rates of uncontrolled blood pressure are still high. This study explored the rate of uncontrolled hypertension in patients with hypertension managed in an urban hospital of Vietnam and identified associated factors. A cross-sectional survey was performed from August to October 2019 among hypertensive patients at an urban hospital in Hanoi, Vietnam. Blood pressure was evaluated at the time of medical examination. Demographic, clinical, and behavioral characteristics were also collected. Multivariate logistic regression was used to identify the factors related to uncontrolled hypertension. Among 220 patients, the rate of uncontrolled hypertension was 40.5%. Females had a lower likelihood of having uncontrolled hypertension compared to males (adjusted OR = 0.33; 95% CI = 0.11–0.98). Higher duration of diseases (adjusted OR = 1.07; 95% CI = 1.01–1.14) and higher body mass index (adjusted OR = 1.23; 95% CI = 1.05–1.45) were positively associated with uncontrolled hypertension. Patients who carried supplies needed for self-care, cut down on stress, exercised regularly, and stopped/cut down on smoking were also less likely to develop uncontrolled hypertension. This study reveals that uncontrolled hypertension was common among hypertensive patients in Vietnam. Improving self-care capacity and encouraging healthy behaviors are critically important to control blood pressure, particularly among patients who were males and had high disease duration and body mass index.

Examining Responsiveness to an Incentive-Based Mobile Health App: Longitudinal Observational Study.

BackgroundThe Carrot Rewards app was developed as part of a public-private partnership to reward Canadians with loyalty points for downloading the app, referring friends, completing educational health quizzes, and health-related behaviors with long-term objectives of increasing health knowledge and encouraging healthy behaviors. During the first 3 months after program rollout in British Columbia, a number of program design elements were adjusted, creating observed differences between groups of users with respect to the potential impact of program features on user engagement levels.ObjectiveThis study examines the impact of reducing reward size over time and explored the influence of other program features such as quiz timing, health intervention content, and type of reward program on user engagement with a mobile health (mHealth) app.MethodsParticipants in this longitudinal, nonexperimental observational study included British Columbia citizens who downloaded the app between March and July 2016. A regression methodology was used to examine the impact of changes to several program design features on quiz offer acceptance and engagement with this mHealth app.ResultsOur results, based on the longitudinal app use of 54,917 users (mean age 35, SD 13.2 years; 65.03% [35,647/54,917] female), indicated that the key drivers of the likelihood of continued user engagement, in order of greatest to least impact, were (1) type of rewards earned by users (eg, movies [+355%; P<.001], air travel [+210%; P<.001], and grocery [+140%; P<.001] relative to gas), (2) time delay between early offers (−64%; P<.001), (3) the content of the health intervention (eg, healthy eating [−10%; P<.001] vs exercise [+20%, P<.001] relative to health risk assessments), and (4) changes in the number of points offered. Our results demonstrate that reducing the number of points associated with a particular quiz by 10% only led to a 1% decrease in the likelihood of offer response (P<.001) and that each of the other design features had larger impacts on participant retention than did changes in the number of points.ConclusionsThe results of this study demonstrate that this program, built around the principles of behavioral economics in the form of the ongoing awarding of a small number of reward points instantly following the completion of health interventions, was able to drive significantly higher engagement levels than those demonstrated in previous literature exploring the intersection of mHealth apps and financial incentives. Previous studies have demonstrated the presence of incentive matters to user engagement; however, our results indicate that the number of points offered for these reward point–based health interventions is less important than other program design features such as the type of reward points being offered, the timing of intervention and reward offers, and the content of the health interventions in driving continued engagement by users.

MHealth Apps as Effective Persuasive Health Technology: Contextualizing the "Necessary" Functionalities.

Persuasive health technology (PHT) is any technology purposely designed to influence, reinforce, change, or shape health-related attitudes or behaviors. Behavioral interventions can be developed for the purpose of maintaining or improving a person’s health status. Delivering behavioral interventions via PHTs is a promising approach for encouraging healthy behaviors among individuals and populations. Important attributes of all PHTs include their functionalities. A functionality refers to any useful features, functions, capabilities, or technologies associated with computer hardware or software. Creating effective PHTs requires a deliberate selection of appropriate functionalities for supporting specific behavioral interventions. The number and types of functionalities necessary to create an effective PHT will be specific to the context of each project, influenced by project objectives, stakeholder goals, behavioral interventions, and a variety of real-world constraints. Selecting appropriate functionalities can be challenging. Fortunately, there are frameworks and models developed specifically for guiding the design of PHTs. The Persuasive Systems Design model describes 4 categories, and 28 design principles for creating effective persuasive interventions. These same design principles could also be useful for guiding the selection of appropriate functionalities.

O7 Fresh Fruit and Vegetable Availability and Cost in SNAP-participating Retail Stores in Mississippi: Differences by Rurality

Background Access to healthy, affordable food is an environmental factor that can influence food security. Research suggests healthy food availability varies by store type, rurality/urbanicity, Supplemental Nutrition Assistance Program (SNAP) participation, and sociodemographic characteristics. Objective The purpose of this study was to investigate differences in variety and cost of fresh fruits and vegetables in convenience stores, grocery stores, and supermarkets in Mississippi across Rural Urban Continuum Codes (RUCCs). Study Design, Setting, Participants A survey design was used to collect data in 461 convenience stores, grocery stores, and supermarkets. Trained surveyors (Extension county agents, Extension nutrition educators, and research team members) selected an assigned number of SNAP-participating stores by county to represent food availability across Mississippi. Measurable Outcome/Analysis Availability and cost data were collected using an adapted version of the Nutrition Environment Measures Survey-Corner Store (NEMS-CS). Metro areas were defined as those with RUCCs of 1 to 3, while non-metro areas were defined as those with RUCCs of 4 to 9. Independent samples t-tests and Mann-Whitney U tests were used to compare means in metro vs non-metro areas within store types. Results Variety of fresh fruits and fresh vegetables was greater in non-metro vs metro areas in convenience and grocery stores but not supermarkets. Cost of 6 most commonly available fruits and vegetables was similar within store types when comparing metro vs non-metro areas. Conclusion Elucidation of food availability patterns in retailers serving SNAP clients is important for planning outreach efforts. Smaller retailers may be important partners and could be a setting for SNAP-Education social marketing messages encouraging healthy food selection behaviors. Involving agents and educators in data collection and in building shared goals with local food retailers may be a promising strategy for improving purchase and consumption of healthy foods in Mississippi. Funding Mississippi State University Extension.

Nutrition Care Through the Healthcare Journey

The Sinai Health System comprises of two hospitals including Bridgepoint Active Healthcare, a rehabilitation and complex care hospital. Here, I worked as a dietetic student in inpatient medical rehab, transitional care, renal (kidney) and palliative care units for 8-weeks. In addition, I was placed at Bridgepoint Family Health Team (FHT) for 4-weeks, where I worked with the Diabetes Education Program (DEP) team, which consisted of a registered dietitian and advanced practice nurse. At the hospital, we supported patients to adequately meet their nutrition needs throughout rehabilitation and improve their overall nutritional status for a smooth transition back into community after discharge. By providing nutritional support and nutrition education, patients may be better equipped to take care of their health leading to better possible health outcomes, a reduced number of future hospital visits and therefore a reduced burden on the healthcare system. Additionally, we helped complex care patients to maintain their nutritional status during their long-term stays. Of particular mention are patients in the renal unit living with diabetes as it connected to my FHT rotation. At the FHT, the DEPT team saw adults at risk, recently diagnosed or living with diabetes to help prevent or manage their condition through diet counselling, education and encouraging healthy behaviours. The goal was to help prevent further complications associated with poorly managed diabetes, such as renal disease. This, represents the point of intersection of clinical practice and public health, where the bridge between preventative and curative healthcare can be observed. Ultimately, nutrition care throughout the various stages of the healthcare journey is important to public health and its mission - to decrease the prevalence of chronic disease, such as diabetes, and maintain and promote healthier communities through effective healthcare.