Engagement In Health Promotion Activities Research Articles

Food Insecurity Impacts Diet Quality, Health-Promoting Activities, and Perceived Stress

Food insecurity, defined as inadequate access to nutritious food, affects over two billion people globally. Poor nutrition and stress associated with food insecurity may negatively impact the performance of health-promoting activities. It may also increase stress levels through irregular eating patterns and concern over accessing suffcient food. However, the impact of food insecurity on engagement in health-promoting activities, stress, and dietary factors has yet to be studied extensively. This study aims to fill this gap by assessing the impact of food insecurity on health-promoting activities, perceived stress, and diet quality. It is hypothesized that food insecurity will negatively impact perceived stress levels and the frequency of engagement in health-promoting activities. It also hypothesized that those who engage in these activities more frequently will have better diet quality. An anonymous survey was administered to adults through various social media platforms. The survey contained demographic questions and seven validated scales: the Food Insecurity Experience Scale, Satisfaction, Alertness, Timing, Effciency, and Duration (SATED) Questionnaire, Health Promoting Activities Scale, Rosenberg Self Esteem Scale, Perceived Stress Scale, International Physical Activity Questionnaire, and the Food Mood Questionnaire. These scales measured food insecurity status, sleep quality, frequency of health-promoting activities and self-care, self-esteem, perceived stress levels, physical activity, and dietary habits, respectively. Data from 561 individuals were analyzed using Pearson’s Correlation Coeffcient in IBM SPSS Version 28.0. The results indicate that being unable to eat healthy and nutritious food was negatively associated with performing personal care tasks (r= -0.136, p< 0.01) and social activities (r= -0.146, p< 0.01). It was also found that having to skip a meal was positively associated with being upset when something happens unexpectedly (r= 0.218, p< 0.01) and feeling unable to control the important things in life (r= 0.242, p< 0.01). Further, performing personal care tasks was negatively associated with eating fast food (r= -0.120, p< 0.01) and positively associated with consuming dark green, leafy vegetables (r= 0.216, p< 0.01), whole grains (r= 0.195, p< 0.01), and fruit (r= 0.287, p< 0.01). Our results suggest that food insecurity can negatively impact mental well-being, diet quality, and health-promoting behaviors. Interventions aimed at improving food security, and therefore diet quality, may have benefits for improving overall health and well-being. No funding was provided to conduct this research study. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

How COVID-19 Ceases All Older Adult Services & the Way Out for Community-Dwelling Older Adults with Chronic Pain

The COVID-19 pandemic started at the beginning of 2020. It significantly impacted the older adults in Hong Kong, with most of the community centers and elderly centers being closed down under various restrictive measures. Thus, community-based health promotion activities were temporarily paused, which decreased older adults’ health-promoting behaviors and motivation to stay active. This research aimed to improve the quality of life and the health of older adults with chronic pain through the pain management program. This study was conducted face-to-face on the campus of Hong Kong Metropolitan University. This dyadic pain management program (DPM) was an 8-week group-based program. The DPM comprised 4 weeks of campus-based activities and 4 weeks of digital-based activities delivered via a WhatsApp group. An 80% participation rate in the campus-based activities was regarded as completing the DPM. The control group only received lesson leaflets. Pain intensity, pain self-efficacy, psychological health of pain victims, caregiver burden inventory, and a semi-structured interview were evaluated at week 1 (T0), week 8 (T1), and week 12 (T2) after randomization. The IBM-SPSS version 22 was used to perform statistical analyses. Using non-pharmacological methods and regular exercise for 12 weeks improved physical health in terms of pain intensity, pain self-efficacy, and psychological health in anxiety, depression, and stress. For caregivers, their burden decreased after the pain management program. These findings indicated that Pender’s Health Promotion Model is helpful to empower the participants and their caregivers with knowledge, skills, and power to manage their chronic pain situations. Utilizing this model as a framework, Researchers can design more effective non-pharmacological interventions for older adults to increase their engagement in health-promoting activities in the community.

Associations Between Daily Activities, Stress, and Sleep Among Adults During the COVID-19 Pandemic.

The COVID-19 pandemic introduced lifestyle changes that appeared to impact adults' engagement in health-promoting activities. Researchers observed increased stress, sleep problems, and sedentary activity, and decreased physical activity during the pandemic. This secondary analysis examined the frequency that adults engaged in different daily activities and links between activity types, stress, and sleep during the pandemic. Fifty-three adults completed a single online survey in January 2021 where they reported demographics, COVID-19 pandemic experiences, daily activities, stress, and sleep. Sum scores were calculated to indicate total frequency of different activity types. Regressions were used to examine whether the frequency of different activity types predicted sleep duration and stress. There was a trend-level relationship between the frequency of activities done outdoors and stress scores, such that doing outdoor activities more often was linked with less stress (P = .098). Higher income also tended to be linked with more stress (P = .053), as did younger age (P = .028). When restricting the outdoor activity variable to physical outdoor activities only, the relationship with stress became significant (P = .013). These results suggest that engaging in physical activity outdoors may reduce stress during the COVID-19 pandemic.

Migrant women's engagement in health-promotive activities through a women's health collaboration.

Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach. The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities. This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis. Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes. The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.

Mind Over Body Connection: Aging expectations and subjective health and well-being among older adults

Background: There is credible evidence that a person's beliefs about the aging process are linked to and influence a variety of health outcomes. Purpose: This study determined whether aging expectations predict health-related quality of life. Furthermore, the study determined whether engagement in healthy lifestyles mediates the relationship between these variables. Methods: A descriptive-correlational study. This study enlisted a total of 95 respondents aged 60 to 85 years old in a large metropolitan area. Data were analyzed using linear regression and mediation analysis. Results: Aging expectations and engagement in healthy lifestyles are a significant predictor of health-related quality of life (p< 0.05). Moreover, engagement in healthy lifestyles is found to be a significant mediator between the variables. Conclusion: Older adults who have positive aging expectations and engage in health promotion activities are more likely to report better health. Therefore, programs that promote a positive aging expectation and engagement in health-promoting activities should be implemented.

The clustering of physical activity and screen time behaviours in early childhood and impact on future health-related behaviours: a longitudinal analysis of children aged 3 to 8 years

Background Meeting physical activity and screen time guidelines has been associated with improved health in children. Research has shown that lifestyle behaviours happen in combination and can be tracked into later life. Thus, a complex approach is needed to identify the effects of physical activity and screen time altogether. This study aims to identify clusters of both behaviours in a cohort of Irish 3-year-old children (n = 8833) and determine the association with sociodemographic characteristics and behaviours at age 5 and 7-8.MethodsData from the “Growing Up in Ireland” study collected between 2010 and 2016 was used in this study. Two-step cluster analysis was used to understand how physical activity and recreational screen time behaviours group together among 3-year-old children. Binary logistic regressions were conducted to examine if cluster placement at age 3 determined physical activity and recreational screen time behaviours at age 5 and 7-8 years, while controlling for gender of child, gender, age and employment status of the primary caregiver.ResultsSix clusters were identified in 9771 (49.3% female) 3-year-old children with the majority falling into a “High Active & Mixed Screen Time” (23.2%). Those in the “High Active & Mixed Screen Time” cluster at age 3 were more likely to engage in all physical activities reported at age 5 (p < 0.01) and age 7-8 (p < 0.01) when compared to a “Low Active & Screen Time Exceed” cluster. Children categorised in a “Moderate Active & Screen Time Below” and “Moderate Active & Screen Time Exceed” were more likely to engage in the same physical activities at age 5 and 7-8 (p < 0.05 - p < 0.01). However, children in the latter cluster were also more likely (p < 0.05) to play on a computer or tablet device.ConclusionsThis paper highlights the importance of establishing positive health-related behaviours during early childhood, as this predicts future engagement in health-promoting activities. Regardless of screen time level, being part of a cluster with moderate or high levels of physical activity positively influences a child’s future physical activity at age 5 and again at age 7 -8 years. The multiple layers of influence on a child’s development should be leveraged to support the adoption of health-enhancing behaviours.

African Immigrant Health: The Health Promotion Beliefs of Zimbabwean Immigrants in the United States.

To examine the health beliefs that can influence engagement in cardiovascular disease (CVD) risk reduction health promotion activities among Zimbabwe-born immigrants in the US. Focus group interviews with 37 New England-based Zimbabwean immigrants in the US conducted between January and April 2019. Focus groups were led by study investigators who were members of the Zimbabwean community. Interviews were audio-recorded and transcribed. Data were analyzed using framework analysis. Five themes emerged: (1) negative attitudes toward ill health, (2) mistrust toward western medicine, (3) stigma and taboo toward ill health, (4) a negative change in eating habits and (5) negative attitudes toward physical exercise. The participants' attitudes and beliefs may interfere with their engagement in health promotion activities aimed at reducing the burden of CVD risk in this population. Understanding these beliefs paves the way for development of culturally congruent health promotion interventions in Zimbabwean and other African immigrant populations.

Health and Well-Being of Hispanic/Latino Meatpacking Workers in Nebraska: An Application of the Health Belief Model.

Meatpacking is dirty, dangerous, and demanding work. In the United States, the industry predominately employs people from racial/ethnic minority backgrounds and immigrants, with 45% of the workforce identifying as Hispanic/Latino. Little is known about how the work environment affects worker engagement in health-promoting activities; however, occupational health professionals are uniquely positioned to advance worker health, safety, and general well-being. Hispanic/Latino meatpacking workers with work-related musculoskeletal pain and active health concerns were recruited to participate in a study to explore health, health behaviors, and the work environment. Five focus groups (N = 28) were conducted in Nebraska between March 2019 and February 2020. Thematic analysis using the Health Belief Model constructs was used to explain workers' health behaviors including utilization of occupational health services at their workplace. Workers believed that there was little they could do to prevent and treat health problems. They understood the perceived threat of health problems and the benefits of self-care, but the perceived barriers often outweighed the benefits. The workplace had few prompts to motivate or incentivize self-care both in and outside of work. In addition, workers did not trust the occupational health office and saw few benefits to accessing services. Together, these conditions resulted in low self-efficacy and limited engagement in health-promoting behaviors. Occupational health professionals should promote Total Worker Health and foster trust by providing culturally, linguistically, and literacy appropriate services and by identifying opportunities and reducing barriers for workers to engage in activities to promote their health, safety, and well-being.

ESPO/ Behavioral and Social Sciences Section Symposium: Promoting Behaviors That Support Healthy Aging

Maintaining healthy behaviors has been linked to positive emotional and physical health outcomes. Older adults are at a greater risk for functional decline and can benefit from the protective effects of health behaviors. The purpose of this symposium is to present and highlight: (1) innovative research linking health behaviors and health outcomes among older adults, and (2) work of emerging scholars in the Behavioral and Social Sciences (BSS) section. The papers highlight findings from descriptive studies and randomized trials testing behavioral health interventions. O’Brien and Hess describe patterns of engagement in health-promoting activities and highlight mediating and moderator factors. Fausto and colleagues report on physical activity and cognitive health benefits of a multi-level intervention focused on heart and brain health for older African American residents of public and subsidized housing. Still and colleagues assess the efficacy of a multi-component technology-based intervention on hypertension self-management in African American older adults. Nehrkorn-Bailey and colleagues report on the pilot testing of AgingPLUS, an intervention targeting attitudinal and motivational barriers to physical activity and highlight improvements in grip strength and blood pressure. Lastly, Wierenga and colleagues test an emotion regulation intervention following a cardiac event and highlight the intervention’s potential efficacy in improving mental health and physical activity. These papers underscore the importance of promoting healthy behaviors in older adults and the need for large-scale interventions that support healthy aging. As discussant, Atienza will assess the strengths and limitations of these papers, and consider how emerging scholars can contribute to the field.

Examining the Impact of Aging-Related Mindsets and Motivation on Activity Engagement in Older Adults

This study examined short- and long-term patterns of engagement in health-promoting activities due to implicit beliefs about cognitive aging (mindsets) and Need for Cognition (NFC; motivation) in older adults. Prior research suggests higher NFC and growth-oriented mindsets bolster participation by enhancing perceived benefits and minimizing perceived costs of engagement. Survey responses across three bursts of an ongoing longitudinal study (N=678-725 observations) were collected from 148 people aged between 64 and 81 and subjected to three-level multi-level analyses. Results show naturally-occurring, weekly variations in NFC and mindsets that also contribute to short-term variation in activity frequency, diversity, and selectivity. Additionally, NFC and age significantly mediated and moderated the effect of mindsets on some outcomes, respectively. Initial findings highlight the value of taking a dynamic approach and using Selective Engagement Theory to understand activity maintenance. They may also inform efforts to develop interventions that promote healthful behaviors in later life.

Patterns of older Australians’ engagement in health-promoting activities: a latent profile analysis

AbstractBeing active in later life is key to remaining physically and mentally healthy, and health in turn influences individuals’ ability to remain active. Activity prevalence figures can disguise the existence of clusters of older people who are very active due to regular participation in multiple categories of activity versus those who are sedentary. The aim of this study was to conduct segmentation analyses based on retired seniors’ engagement in various activities (walking, active sport/exercise, gardening and volunteering) to identify groups characterised by varying patterns of participation. The sample comprised 746 Western Australians aged 60+ years (range 60–95 years, average age 71.66 years, standard deviation = 6.57), 61 per cent of whom were female. Using latent profile analysis, four distinct segments emerged. Those respondents classified as belonging to the most active group exhibited moderate to high levels of participation across all four forms of activity, and tended to be older and more educated than other respondents. Those allocated to the least active group had very low levels of participation across most of the assessed activities and the least favourable physical and mental health scores. Overall, the results indicate the existence of highly divergent segments within the older population in terms of participation across various combinations of health-promoting activities. Segment membership appears to be more closely associated with physical and psychological factors than socio-demographic characteristics.

Strategies/factors facilitating community engagement in health promotion activities: Findings from the Jackson Heart Study Community Outreach Center

Background: Community engagement is a critical component of health promotion programs that are aimed to close gaps in health disparities. There is a need for community collaborators to develop services to improve the quality of life for at-risk populations emphasizing a reduction of risk factors and premature morbidity and mortality. Aim: This study aims to assess strategies implemented by Jackson Heart Study Community Outreach Center (JHS CORC) to influence or motivate community engagement in health promotion activities which focused on reduction of health disparities and improvement of the health status of the communities in three counties. Methods: This was a quantitative, correlation study of the perceptions of JHS participants and other stakeholders who were purposively selected. A self-administered questionnaire was utilized that elicited comments and perceptions from 128 participants regarding five subject areas measuring community engagement: (1) Ways to increase participation in the community outreach activities; (2) Reasons the respondents decided to participate in community outreach activities; (3) Interest in participating in a community research study similar to the JHS; (4) The best way to communicate about community outreach activities; (5) Diseases that affect the communities the most. The investigation explored the participants’ views of the five main subject areas as well as additional related supplemental questions accompanying each main category to gain an understanding of their perceptions based on demographic characteristics. Conclusion: It is important to encourage effective and sustainable community engagement in health promotion programs which focused on closing gaps in health disparities and improving the health status of the communities. This research builds on the existing literature on productive academia-community partnership as it presents effective strategies that have been developed by the JHS CORC at Jackson State University. The framework of JSU CORC’s strategies can be employed universally to promote health equity through prevention, education, training, and research, though elements may require tailoring for a given community.

Evaluation of a Behavioral Self-Care Intervention for Public Health Students

ABSTRACTBackground: Postgraduate education is recognized as a time of intense stress. Rates of anxiety and depression are elevated among graduate students, and longitudinal studies have documented increases in clinical symptoms over the course of training. Purpose: The current study was to evaluate whether an academically sponsored self-care intervention would increase engagement in health promotion activities. The primary goal was to determine whether self-care behaviors completed in the midst of a challenging academic program would prevent the worsening of student mental health. Methods: The self-care intervention included behavior change projects designed to increase health-promoting behaviors within 4 domains (nutrition, physical activity, mental health, social support). Students received incentives in the way of bonus points for maintaining health behaviors for the duration of the 12-week semester. Results: Results revealed significant increases in health-promoting behaviors. Importantly, mental health symptoms did not worsen over the course of the semester. Discussion: The study provides preliminary support for the utility of a brief self-care intervention for students in the health sciences. Translation to Health Education Practice: Future studies should examine the applicability of this intervention to students in other fields of study and through online education formats.

Engagement in health and wellness: An online incentive-based program.

Increasingly, corporate health promotion programs are implementing wellness programs integrating principles of behavioral economics. Employees of a large firm were provided a customized online incentive program to design their own commitments to meet health goals. This study examines patterns of program participation and engagement in health promotion activities. Subjects were US-based employees of a large, nondurable goods manufacturing firm who were enrolled in corporate health benefits in 2010 and 2011. We assessed measures of engagement with the workplace health promotion program (e.g., incentive points earned, weight loss). To further examine behaviors indicating engagement in health promotion activities, we constructed an aggregate, employee-level engagement index. Regression models were employed to assess the association between employee characteristics and the engagement index, and the engagement index and spending. 4220 employees utilized the online program and made 25,716 commitments. Male employees age 18–34 had the highest level of engagement, and male employees age 55–64 had the lowest level of engagement overall. Prior year health status and prior year spending did not show a significant association with the level of engagement with the program (p > 0.05). Flexible, incentive-based behavioral health and lifestyle programs may reach the broader workforce including those with chronic conditions and higher levels of health spending.

Association between Municipal Health Promotion Volunteers' Health Literacy and Their Level of Outreach Activities in Japan.

ObjectivesTo explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members).Study DesignA cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers.MethodsThe survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities (“healthy lifestyle,” “outreach to family,” “outreach to community”) and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers’ outreach activities.ResultsFour hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core health promotion activities. In bivariate analyses, active participation in the core activities was more prevalent among older volunteers (p<0.001 for all three activities). Self-rated health condition was associated with both outreach to family (p = 0.018) and community (p = 0.046). Years of experience as volunteer and perception of being recognized in the community also had statistically significant association with outreach to the community (p<0.001). In multiple logistic regression, those with higher level of health literacy were more likely than others to actively engage in outreach to family (OR = 1.70, 95% CI 1.03 to 2.80; OR = 1.76, 95%CI 1.04 to 3.00 for medium and high, respectively) and outreach to community (OR = 2.26, 95%CI 1.34 to 3.83; OR = 2.61 95%CI 1.49 to 4.58 for medium and high, respectively). Perception of being recognized in the community also had a statistically significant and positive impact on outreach to the community (OR = 1.52, 95%CI 1.17 to 1.99).ConclusionsVolunteers with higher health literacy were more likely to actively engage in outreach to family and outreach to community. Providing educational programs to improve volunteers’ health literacy may facilitate their work.

Improving Treatment Adherence in Schizophrenia

Poor treatment adherence among people with schizophrenia is associated with several negative outcomes, including increased risk of symptom relapse, persistent psychotic symptoms, frequent hospitalizations, increased emergency room use, and suicide attempts. In addition, the benefits of treatment adherence in this population include improved quality of life and reduced treatment costs. Clearly, feasible and effective strategies to maximize treatment adherence are essential. Interventions to promote adherence to medications include environmental cues and supports, technology-based interventions, medication management coordinators, adherence therapy, and the use of long-acting injectable medications. Interventions to promote continuity of care between inpatient and outpatient treatment include Assertive Community Treatment, transitional care models, and the use of peer support personnel as care navigators. Transitional care models have also demonstrated effectiveness in promoting adherence to primary care follow-up among people with schizophrenia and comorbid medical illnesses. In the context of complex treatment regimens for psychiatric and medical illnesses, thorough education and skill development on illness management and health promotion, tailored to the unique learning needs of PWS, are essential. In addition, more research is needed to address understanding of medical illnesses, the accuracy in which people with schizophrenia implement activities for medical illness self-management, and development of strategies to promote engagement in health promotion activities among people with schizophrenia.

Daily Life Experiences of Patients With a High-Grade Glioma and Their Caregivers: A Longitudinal Exploration of Rehabilitation and Supportive Care Needs.

There is a lack of knowledge regarding the breadth of needs for rehabilitation and supportive care across the disease and treatment trajectory for patients with a high-grade glioma (HGG) and their caregivers. The aim of this study was to elucidate the experiences and needs for rehabilitation and supportive care in patients with HGG and their caregivers. Patients with malignant glioma (N = 30) and their caregivers (N = 33) were interviewed five times during the first year of the HGG trajectory. A thematic analysis of interviews at five time points revealed five main themes describing the experiences related to the illness trajectory and needs for rehabilitation and supportive care. The five main themes identified were (a) individual strategy for acquiring prognostic information, (b) shared hope, (c) engagement in health promotion activities, (d) adjustment to symptom limitations, and (e) role transition from family member to caregiver. The individual and sometimes opposing preferences among patients and their caregivers for prognostic information is a chosen strategy that supports individual needs in managing the HGG trajectory. Patients and caregivers experience a feeling of solidarity, from which shared hope arises; however, this hope needs to be supported by healthcare professionals. Driven by hope, they seek to optimize the therapeutic effect of the oncological treatments by being engaged together in health promoting activities. As symptoms progressed, the need for information and guidance regarding symptoms and supportive care interventions became evident. Caregivers play a significant supporting role for the patients and need special support themselves and practical assistance especially when symptoms progress. Finally, there is a need for rehabilitation programs that target the cognitive ability of the patients to participate actively.

Perceptions of caregiver distress, health behaviors, and provider health-promoting communication and their relationship to stress management in MS caregivers

This study applied the Stress/Health Model to examine a novel approach for promoting stress management among 67 caregivers of persons with multiple sclerosis, who often face unique caregiving challenges. Hierarchical regressions indicated that caregiver distress (i.e., emotional burden) and engagement in other health-promoting activities (i.e., controlling alcohol use) were the best predictors of caregiver stress management. Communication with the MS care recipient’s health provider about caregiver engagement in health-promoting activities was associated with caregiver stress management, but not significantly more so than explained by the other factors (i.e., caregiver distress and engagement in health-promoting behaviors). A more controlled study would be indicated to further explain how to encourage, within the medical setting, caregiver engagement in self-care activities.

Health Innovation Project: A Concept Paper on a Virtual Health Promotion Program for Men

Abstract Many causes of mortality and morbidities in men are preventable. Men's poor engagement in health-promoting activities has been attributed to the socially constructed male gender identity. Hence, health innovations to promote men's health have to take into the account their social identity and health-seeking behavior. The innovation should be flexible, interactive, discreet, informative, and user-friendly. It should also facilitate self-care. Innovations that deploy information and computer technology (ICT) are promising. MyMan, a future web and mobile application that incorporates self-assessment, individual risk calculation, projection of future health status, and tailored advice, is in the process of prototype development for testing in the community. The main concern about this application is that it may have limited usefulness to an ICT-naive population. However, this may be overcome by having a similar application in health clinics where assistance in using the technology can be provided. A ...

Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis

In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population.