Engagement In Health-promoting Behaviors Research Articles

Barriers and enablers to promoting grandchildren’s physical activity and reducing screen time: a qualitative study with Australian grandparents

BackgroundWith an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children’s engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children’s physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children’s physical activity and reducing screen time. The present study sought to explore these perceptions.MethodsSemi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis.ResultsKey reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents’ age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children’s fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view).ConclusionsFindings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents’ age and health status, as well as any environmental barriers, are likely to be well-received.

The utility of coping through emotional approach: A meta-analysis.

A systematic review and meta-analysis was conducted to examine associations between attempts to cope with stressors through the two facets of emotional approach coping (EAC; i.e., processing and expressing stressor-related emotions) and indicators of physical and mental health. EBSCO databases including MEDLINE, PsycINFO, and Cochrane Collections were searched from inception to November 2022. In all, 86 studies were included in a meta-analytic evaluation using a random-effects model and meta-regression analysis. EAC was associated with better overall health (r = .05; p = .04; 95% confidence interval = [.003, .10]). Emotional expression (EE) and emotional processing (EP) also were positively associated with better overall health, although these relationships were not statistically significant. In meta-regressions examining specific health domains, EAC was linked to better health in biological/physiological, physical, and resilience-related psychological adjustment domains, as well as to worse outcomes in the risk-related psychological adjustment and mental/emotional distress domains. Results for EE and EP mirrored this pattern; however, only EP was associated with more engagement in health-promoting behaviors. Coping with stressors through emotional approach appears to be associated with better mental and physical health, with some observed differences for EE and EP. The literature on EAC and health is marked by heterogeneity across study methodologies and measures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Affecting Health-Promoting Behaviors in Patients Diagnosed with Myocardial Infarction

Background: Cardiovascular diseases, including myocardial infarction (MI), represent a significant global health burden, particularly in developing countries like Pakistan. Health-promoting behaviors (HBs) play a crucial role in the management and prevention of MI, potentially reducing morbidity and mortality rates among affected individuals. Objective: This study aimed to identify the factors influencing health-promoting behaviors among patients diagnosed with myocardial infarction and to evaluate the level of engagement in such behaviors. Methods: A cross-sectional descriptive study was conducted at a tertiary care hospital in Pakistan from September 2022 to June 2023. The study population consisted of 318 patients diagnosed with MI (ST and non-STEMI), selected through purposive sampling. Data were collected on demographic characteristics, health behavior data using the Song-and-Lee Health Behaviors Checklist, and analyzed using SPSS version 25 for descriptive and inferential statistics, including independent t-tests, ANOVA, and multiple linear regression. Results: The overall mean score of health-promoting behaviors among participants was 2.14 ± 0.21, indicating a moderate level of engagement. The highest mean score was observed in eating behaviors (2.26 ± 0.34), while the lowest was in health responsibility (2.00 ± 0.40). Gender and smoking status significantly influenced health-promoting behaviors, with females and non-smokers exhibiting better HB scores. Significant differences in HBs were noted across gender, co-morbidity, and history of hospitalization, but not within age, BMI, and smoking groups. Conclusion: The study concluded that myocardial infarction patients exhibit a moderate level of engagement in health-promoting behaviors, with significant variations influenced by gender and smoking status. There is a need for targeted nursing strategies to enhance health-promoting behaviors, particularly focusing on dietary habits, smoking cessation, and health responsibility among MI patients.

59 An Examination of the Moderating Effect of Self-Efficacy on the Association Between Health Literacy and Healthy Activity Engagement in Older Adults

Objective:Engagement in activities that promote overall brain health and well-being is often a key step in reducing risks to cognitive health in older adults. Given that higher health literacy has been found to be associated with healthier lifestyles, it is unsurprising that it has been the focus of many studies and programs aimed at improving the health outcomes of older adults. An equally important factor to consider when it comes to such efforts is the role of moderating variables in the relationship between health literacy and engagement in healthy behaviors. The present study examined the moderating effect of self-efficacy, a variable that has been shown to be positively associated with both health literacy and health behaviors. We hypothesized that increased self-efficacy will strengthen the relationship between health literacy and healthy activity engagement in a sample of community-living older adults.Participants and Methods:Forty-nine older adults (age: M = 64.35, SD = 8.00; education: M = 16.39, SD = 2.37; 87.76% female) completed a health literacy measure (Newest Vital Sign; NVS), a self-efficacy questionnaire (General Self-Efficacy Scale; GSE), and a lifestyle behaviors questionnaire (Healthy Aging Activity Engagement Scale; HAAE). The NVS is a performance-based measure in which participants are asked to interpret the verbal and numerical information of a nutrition label to make health-related decisions. The GSE is a self-report measure that evaluates one’s belief in their ability to handle challenges, solve problems, and accomplish goals. The HAAE is a self-report measure that assesses one’s engagement in healthy activities across multiple health domains.Results:To examine whether self-efficacy moderates the relationship between health literacy and healthy activity engagement, a moderation analysis was conducted using Hayes’ PROCESS macro for SPSS with age and education included in the model as covariates. The results revealed no significant interaction between health literacy and self-efficacy, b = 0.23, p = .59, 95% CI [-0.60 to 1.05].Conclusions:Contrary to expectations, in the present sample, the degree of self-efficacy was not a condition under which level of health literacy exerted its influence on healthy activity engagement in older adults. Future studies with larger and more nationally representative samples are needed to explore self-efficacy and other potential moderating factors in order to identify individual characteristics that support older adults’ adoption and engagement in health-promoting behaviors.

Body (dis)satisfaction and health screening behaviors: A systematic review of observational studies.

Engagement in health-promoting behaviors has been argued to be dependent on psychological factors in addition to simply having knowledge or access to resources. We systematically reviewed the evidence for the association between body (dis)satisfaction and health screening behaviors using six electronic databases and supplementary manual searches in the current study. To be included in the review, studies had to be empirical, in any language, and examined the potential link between body (dis)satisfaction and health screening. Findings from the final 16 quantitative and 12 qualitative studies generally suggest that people who were more satisfied or less dissatisfied with their bodies were more likely to engage in health screening. This review also highlighted key gaps in the literature such as the limited studies that included men as participants and the lack of examination of the underlying mechanisms and contingencies of the relationship between body (dis)satisfaction and health screening behaviors.

Evaluating Health-promoting Lifestyle Profile among Menopausal Women: A Meta-analysis

Background: Menopause is one of the most drastic experiences in a woman's life because of a spectrum of vasomotor symptoms which affect the quality of life and lifestyle. Although many treatments for these symptoms are available, they can be used for only a short duration. The nonpharmacologic therapies associated with healthy lifestyle behaviors are increasing. Health-Promoting Lifestyle Profile- II (HPLP-II), a self-report questionnaire designed to assess an individual's engagement in health-promoting behaviors, has focused on six dimensions of behavioral health promotion. This study aimed to review the degree of lifestyle modification in menopausal women based on the questionnaire HPLP-II. Methods: A comprehensive search was conducted for articles using HPLP-II after literature as the identified instrument for menopausal women's lifestyle, followed by a meta-analysis. Results: Among 8525 unique titles, 13 studies with 2648 participants were included. Quality assessment was “good” for most of them. The summary effect of participant age was 55.78 years and 49.1 years for menopausal age. Analysis of the pooled studies yielded a mean HPLP total score of 127.69. There was no evidence of publication bias. Conclusion: Our meta-analysis showed a moderately rated health-promoting behavioral profile in menopausal women. The spiritual growth subscale received the highest score, whereas physical activity received the lowest score and was at the lower limit of the moderate range. Health policymakers, patients, and healthcare providers can use these results to improve the healthy lifestyles of menopausal women.

The interplay of ADHD symptoms and exercise in youth

The interplay of ADHD symptoms and exercise in youth

An Innovative Adaptation of an HIV Status-Neutral, Community-Informed, Socioemotional Asset-Building Intervention With the House Ball Community.

Black men who have sex with men (MSM) have the highest incidence of new HIV diagnoses compared to other populations and face multiple stigmas. Some have found refuge in the House Ball Community (HBC)-a national network of Black lesbian, gay, bisexual, and transgender (LGBT) kinship commitments (families) that affirm gender expression(s) and sexualities and provide skills-building for its members. Internal and external socioemotional assets influence the health of young Black sexual and gender minorities; building these assets in the HBC is critical to facilitating engagement in health-promoting behaviors. To address this critical gap in HIV prevention, we describe an adaptation of 3MV, a best-evidence, group-level retreat-based risk reduction intervention developed for HIV-negative Black MSM. Clinicians, researchers, HBC members/leaders, and community experts collaborated to adapt 3MV for the HBC. Our Family, Our Voices (OFOV) is an HIV status-neutral, risk-reduction intervention that focuses on asset-building for young, gender-diverse Black HBC members, with the HBC family unit as the focus of the intervention. We describe the collaborative adaptation process and the development of HBC-relevant intervention topics. This novel adaptation and collaborative community model provides a framework for researchers and clinicians to follow when adapting evidence-based interventions for priority populations.

Health promoting behaviors and associated factors among older adults: a narrative review

PurposeThis study aims to examine the recent literature on health-promoting behavior, health needs and associated factors among older adults.Design/methodology/approachAn massive search of five databases involving documents in the past decade was commenced.FindingsThis review showed a significant relationship between older adults’ demographic characteristics (marital status, income, chronic disease, education level and smoking status) and health-promoting behaviors. This review showed that older adults with a high level of education, high income, chronic diseases and smoker and married older adults are associated with better health-promoting behaviors.Originality/valueThe result of the current review supports the Pender Health Promotion Model that individual personal characteristics can affect the level of engagement in health-promoting behaviors. Assessing the health-promoting behaviors of older adults can help in identifying their health needs.

Health-promoting behaviors among hypertensive adult patients with and without comorbidities in Indonesia: a cross-sectional study†

Abstract Objective The aim of this study was to evaluate health-promoting behaviors among hypertensive patients with and without comorbidities. Methods A cross-sectional study using multistage cluster sampling in Indonesia was applied. The health-promoting behaviors were assessed using Health-Promoting Lifestyle Profile 2 and analyzed using independent t-test, point-biserial correlation, and logistic regression. Results A total of 116 participants joined this study. The score of health-promoting behaviors in adults with and without hypertension was 2.90 and 2.79, respectively. Hypertensive patients with comorbidities had significantly higher results than those without comorbidities, with the following results for the considered subscales: total score (t = −2.00, P = 0.047); health responsibility (t = −3.46, P = 0.001); and nutrition (t = −2.82, P = 0.006). Positive correlations were found between health responsibility (r pb = 0.260, P < 0.01), nutrition (r pb = 0.255, P < 0.01), and health-promoting behaviors (r pb = 0.185, P < 0.05) and the existing comorbidity. Only gender indicated a significant outcome for the existing comorbidity in hypertensive patients (odds ratio = 4.314, P = 0.027, 95% confidence interval = 1.185–15.706). Conclusions Hypertensive patients with comorbidities showed higher engagement in health-promoting behaviors and the male gender was a significant predictor for existing comorbidity among patients with hypertension.

What drives the use of wearable healthcare devices? A cross-country comparison between the US and Korea.

ObjectiveGiven the rapid growth of the wearable healthcare device market, we examined the associations among health-related and technology-related characteristics of using wearable healthcare devices and demonstrated how the associations differ between the US and Korean users.MethodsOnline self-administered surveys were conducted with 4098 participants (3035 in the US and 1063 in Korea) who were recruited through two online survey service providers based on quota sampling. The primary outcome was the use of wearable healthcare devices. Seven health-related, two technology-related, and five socio-demographic factors were included as explanatory variables. Binary logistic regression analyses and a Chow test were conducted.ResultsThe health-related characteristics that were significantly associated with using wearable healthcare devices included disease-related worries (β = 0.11**), health information seeking (β = 0.26***), physical activity (β = 0.62***), and health-related expenditures ($50–$199, β = 0.38***; $200 or more, β = 0.56***). Hedonic (β = 0.33***), social (β = 0.31***), and cognitive innovativeness (β = 0.14*) also exhibited positive relationships. Younger, higher earner, and individuals with a child were more likely to use wearable healthcare devices. However, for Korean users, several associations disappeared including health information seeking, hedonic and social innovativeness, age, and household income.ConclusionsKey drivers of using wearable healthcare devices include greater concern about a specific illness, active engagement in health-promoting behaviors, and hedonic and social motivation to adopt new technologies. However, more country-specific considerations are needed in future studies to identify the main benefits for target markets.

Health Promoting Behaviors and Risk of Cardiovascular Events among Patients with Cardiovascular Diseases

BACKGROUND: Engagement in health-promoting behaviors (HPB) among patients with cardiovascular diseases (CVD) is important, particularly for the high-and-very-high-risk group. However, information concerning HPB and risk of cardiovascular events among patients with CVD is limited. AIM: This study aimed to explore HPB and risk of cardiovascular events among patients with CVD. METHODS: A cross-sectional quantitative study was conducted among adults with confirmed CVD (n = 167) using multistage cluster sampling. Health-Promoting Lifestyle Profile 2 and World Health Organization/International Society of Hypertension Risk Prediction Chart were used for measuring HPB and cardiovascular risk levels. Data were analyzed using Pearson correlation, one-way ANOVA and multiple linear regression tests. RESULTS: Women, marriage, low income, and hypertension dominated with 60 years as mean age. Among the subscales of HPB, interpersonal relationship had the highest score while physical activity in the poorest score and almost half of the respondents had a low-risk of cardiovascular events. There was a significant correlation between the nutrition subscale and cardiovascular risk levels and it showed significant difference between low-and high/ very- high-risk groups of cardiovascular events. Although the risk of cardiovascular events did not demonstrate prediction of HPB, age (β _= 0.250; CI = 0.001–0.013), educational level (β _= 0.200; CI = 0.005–0.107), presence of diabetes (β _= 0.183; CI = 0.013–0.286), and smoking (β _= –0.195; CI = –0.372–[–0.005]) explained 20.7% of the HPB variance. CONCLUSION: Therefore, the authorities of stakeholders need to consider that a tailor-made health-promoting program should be proposed particularly to increase physical activity and promotes healthy nutrition among patients with CVD. Furthermore, considering special needs among patients with CVD are crucial to support them within their cultural perspective.

Use of the Health Belief Model for Weight Control Promotion Using Vegetarian Meal Plans

A health belief model is used to evaluate people's beliefs about health problems and predict engagement in health-promoting behaviors. Overweight and obesity are health problems that could be corrected by healthier diet. Eighty-seven employees of the Taipei Tzu Chi Hospital participated in a month-long program that offered 500-calorie vegetarian meals. The health belief model questionnaire was designed and administered. Body composition (weight, body mass index, body fat, body water, and muscle mass) was measured weekly. Additionally, the number of meals taken and visits to nutrition consultants were analyzed. Overall, a higher perceived susceptibility was related to a decrease in weight, body fat, and muscle. Higher perceived benefits or higher perceived barriers were both related to a decrease in weight and body fat, but to an increase in body water and muscle. In the overweight or obese group, a significant correlation was found between perceived barriers and weight. No significant relationship was found between the health belief model and the total number of meals or number of visits to nutrition consultants. Perceived benefits and barriers were significantly related to changes in weight, body fat, body water, and muscle. With vegetarian meal plans as the cue for action, the health belief model can be utilized to predict changes in body composition.

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.

Integrating Health at Every Size principles into adolescent care.

Weight trends continue to increase in adolescents, but current weight-focused interventions have not demonstrated any lasting impact on overall health. Among adolescents, experiencing weight bias increases risks of harmful weight-related behaviors and decreases engagement in health-promoting behaviors, thus leading to worsened health outcomes. The Health at Every Size (HAES) approach may be an avenue to promote health holistically among adolescents without eliciting harmful weight-related behavior and improving provider-patient rapport. The purpose of this review is to summarize the literature on integrating HAES principles into healthcare and to generate recommendations for healthcare providers. Research among adults shows that HAES-informed care can improve some physical health measures and generates improvements in behavioral and psychological outcomes, as well as promotion of social justice and equity. HAES-informed recommendations for adolescent care de-emphasize weight loss and focus on removing barriers to engaging in health-promoting behaviors at the point of assessment, in the diagnosis and management of medical complications, and in treatment. HAES principles can be an invaluable tool for providers who aim to improve overall health whilst avoiding a focus on weight among their clients.

The Impacts of Pilates and Yoga on Health-Promoting Behaviors and Subjective Health Status.

This study investigates whether Pilates and yoga lead people to adopt generally health-promoting lifestyle elements and feel better about their physical and mental fitness. To this end, we designed an 8 week exercise program of Pilates and yoga reviewed by veteran practitioners and conducted an experimental study through which we collected the data from 90 volunteered adult subjects between ages 30 and 49 (mean age = 35.47), equally represented by women and men without previous experience with Pilates or yoga. In the 8 week long experiment, we assigned the subjects to three groups, where subjects in the two exercise groups regularly took part in either Pilates or yoga classes, and the control group participated in neither exercise classes. All participants completed two surveys, the Health-Promoting Lifestyle Profile (HPLP II) and the Health Self-Rating Scale (HSRS), before and after their assigned program. In our analysis of pre- and post-treatment differences across the three groups, we ran ANOVA, ANCOVA, and Sheffé test, implemented using SPSS PASW Statistics 18.00. Our results indicate that Pilates and yoga groups exhibited a higher engagement in health-promoting behaviors than the control group after the program. Subjective health status, measured with HSRS, also improved significantly among Pilates and yoga participants compared to those in the control group after the program. The supplementary analysis finds no significant gender-based difference in these impacts. Overall, our results confirm that Pilates and yoga help recruit health-promoting behaviors in participants and engender positive beliefs about their subjective health status, thereby setting a positive reinforcement cycle in motion. By providing clear evidence that the promotion of Pilates or yoga can serve as an effective intervention strategy that helps individuals change behaviors adverse to their health, this study offers practical implications for healthcare professionals and public health officials alike.

The Relationship Between the Implementation of Statutory Preventative Measures, Perceived Susceptibility of COVID-19, and Personality Traits in the Initial Stage of Corona-Related Lockdown: A German and Austrian Population Online Survey.

Background: Particularly during the early and middle stages of the COVID-19 pandemic, a population's compliance with precautionary measures (e.g., hygiene rules, smart working, travel restrictions, and quarantine) is paramount in preventing the virus from spreading.Objective: The investigation and documentation of different socio-demographic and personality-specific factors in regards to preventative measures and consequent specific health behaviors during the COVID-19 pandemic, based on the Health Belief Model.Method: An online survey was conducted on N = 3,006 individuals living in Germany and Austria during the early stages of lockdown. The questionnaire consisted of a self-administered section, exploring the dimensions posited in the Health Belief Model: perceived severity, perceived susceptibility, perceived barriers, perceived benefits of health-promoting measures, and engagement in health-promoting behaviors. Additionally, the following standardized scales were used to record personality determinants: the Stress Coping Style Questionnaire SVF 78 to evaluate coping and processing strategies in stressful circumstances, the Positive and Negative Affect Schedule (PANAS) to assess the emotional state induced by the coronavirus crisis, the UI-18 scale to diagnose the intolerance of uncertainty, and the State-Trait Anxiety Inventory (STAI) to assess anxiety.Results: In line with the Health Belief model, four groups were created based on perceived susceptibility and engagement in health-promoting behaviors, and consequently studied in relation to personality determinants. Those four groups differed significantly in regards to almost all personality dimensions (p ≤ 0.005). Group 1 (n = 450) shows a reduced engagement with protective measures and displays underestimation of the COVID-19-pandemic. Group 2 (n = 984) displays many positive personality variables and high compliance with protective measures. Group 3 (n = 468) perceives the subjective risk of disease as high, but high emotional discomfort and stress caused by the protective measures leads to the activation of a complex fear defense. Group 4 (n = 1,004) is highly anxious and therefore compliant.Conclusion: This typification has implications for establishing the appropriate support systems. This is particularly important to encourage compliance with preventive regulations within the groups, which showed poor abidance for several reasons. For Group 1, further education on the realistic threat and efficient protective measures is as central as the fostering of empathy for others; with its resource-conscious exemplary behavior Group 2 could be used as a positive social role model. Group 3 would benefit from promoting self-care, while Group 4 requires information on psychosocial assistance availability in order to mitigate the high stress to which the group members are subjected.

Symptoms of depression, anxiety, and post-traumatic stress disorder and their relationship to health-related behaviors in over 12,000 US military personnel: Bi-directional associations

Background Military personnel are at greater risk of psychological disorders and related symptoms than civilians. Limited participation in health-promoting behaviors may increase presence of these disorders. Alternatively, these symptoms may limit engagement in health-promoting behaviors.Methods Self-reported data from the 2015 Department of Defense Health Related Behaviors Survey were used to assess bi-directional relationships between health-related behaviors (obesity, physical activity [PA], alcohol, smoking, sleep) and self-reported psychological disorders (generalized anxiety disorder [GAD], depression, post-traumatic disorder [PTSD]) in U.S. military personnel.Outcomes Among 12 708 respondents (14.7% female; 28.2% 17−24 y; 13.7% obese), self-reported depression was reported by 9.2%, GAD by 13.9%, and PTSD by 8.2%. Obesity and short sleep were associated with self-reported depression, GAD, and PTSD; current smoking was associated with higher odds of GAD; higher levels of vigorous PA were associated with lower odds of GAD; higher levels of moderate PA associated with lower odds of PTSD; and higher alcohol intake associated with higher odds of depression and PTSD. Self-reported depression, GAD, and PTSD were associated with higher odds of short sleep, obesity, and low levels of PA.Interpretation Obesity, short sleep, and limited engagement in health-promoting behaviors are associated with higher likelihood of self-reported psychological disorders, and vice-versa. Encouraging and improving health-promoting behaviors may contribute to positive mental health in military personnel.

“That is when I changed and my whole life changed”: Turning points in health perceptions among LGBTQ adults of color

ABSTRACT This study explored turning points in health perceptions among lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults of color living in a major US city. Turning points in health perceptions were elicited from 38 participants through in-depth interviews and were examined using interpretive phenomenological analysis. Findings revealed three key themes: (a) diagnosis and disease; (b) death or illness of family and friends; and (c) changes in environmental context and body. The positive impacts of turning points are discussed, including the development of active coping skills, engagement in health-promoting behaviors, and increased community connectedness. Implications for future research are also suggested.

Perceived Facilitators and Barriers to Nigerian Nurses' Engagement in Health Promoting Behaviors: A Socio-Ecological Model Approach.

Nurses make up the single largest healthcare professional group in the Nigerian healthcare system. As frontline healthcare providers, they promote healthy lifestyles to patients and families. However, the determinants of Nigerian nurses’ personal health promoting behaviors (HPBs) remain unknown. Utilizing the socio-ecological model (SEM) approach, this study aimed to explore the perceived facilitators and barriers to Nigerian nurses’ engagement in HPBs. HPBs were operationalized to comprise of healthy dietary behaviors, engagement in physical activity, low-risk alcohol consumption, and non-smoking behaviors. Our study was carried out in a large sub-urban tertiary health facility in Nigeria. Data collection was via face-to-face semi-structured interviews and participants were registered nurses (n = 18). Interview data were transcribed verbatim and analyzed thematically to produce nine themes that were mapped onto corresponding levels of influence on the SEM. Findings show that in Nigeria, nurses perceive there to be a lack of organizational and policy level initiatives and interventions to facilitate their engagement in HPBs. The determinants of Nigerian nurses’ HPBs span across all five levels of the SEM. Nurses perceived more barriers to healthy lifestyle behaviors than facilitators. Engagement in healthy behaviors was heavily influenced by: societal and organizational infrastructure and perceived value for public health; job-related factors such as occupational stress, high workload, lack of protected breaks, and shift-work; cultural and religious beliefs; financial issues; and health-related knowledge. Organizations should provide facilities and services to support healthy lifestyle choices in Nigeria nurses. Government policies should prioritize the promotion of health through the workplace setting, by advocating the development, implementation, regulation, and monitoring of healthy lifestyle policies.