Assess Health Behaviors Research Articles

Value of Knowing following Amyloid PET Results Disclosure in Mild Cognitive Impairment

AbstractBackgroundPersonal utility is commonly cited as a rationale for Alzheimer’s disease (AD) biomarker testing. Yet, limited reports document how the value of knowing one’s AD biomarker status manifests in cognitively symptomatic patients. Emerging literature suggests two potential dimensions to the construct: a) inherent value, or “knowledge for the sake of knowledge,” and b) value of knowing as a basis for action. We describe actions taken by patients following amyloid PET results disclosure with the goal of elucidating the value of knowing AD biomarker status in cognitively symptomatic populations.MethodWe analyzed longitudinal health behavior assessments completed by patients with mild cognitive impairment who learned of being amyloid positive (n = 12), negative (n = 22), or assigned to a comparison group (n = 37). Patients were 92% non‐Hispanic white, 59% male, 73±8.61 years old with 16.25±2.49 years of education. Qualitative interviews supplemented scan group participants’ data. Both questionnaires and qualitative interviews focused on activities newly adopted to promote cognitive health or plan ahead.ResultOver 12 months of follow‐up, all participants reported at least one behavior change from baseline. Amyloid positive patients reported the most behavior changes (mean = 4.67/14±1.83) while amyloid negative patients reported the fewest (mean = 3.72±1.58). Across groups, no significant differences were observed in changes to: lifestyle, vitamin/supplement use, stress reduction activities, cognitive stimulation, and advance directive completion. Amyloid negative participants were significantly less likely than controls to consider long‐term care insurance (63.6% vs. 89.2%; P = .025), and to endorse changes classified as “other” (36.4% vs. 64.9%; P = 0.037). After adjusting for education level, gender, and MMSE, logistic regression showed that amyloid negative patients were 74% less likely than controls to report “other” changes (OR = 0.26, 95% CI [0.08, 0.85], P = 0.025), and 78% less likely to consider long‐term care insurance (OR = 0.22, 95% CI [0.06, 0.86], P = 0.03). Qualitative analysis yielded insight into “other” activities, including changes in employment, driving, and residential status, and engagement in other non‐medical activities (pursuing bucket list activities and mending strained relationships), particularly among amyloid positive patients.ConclusionValue of knowing one’s amyloid status may differ by scan result and encompass a wide range of actions to enhance not only cognition but quality of life.

Platform for the interdisciplinary study of cardiovascular, metabolic and neurovascular diseases (PICMAN) protocol

Through extensive multisystem phenotyping, the central aim of Project PICMAN is to correlate metabolic flexibility to measures of cardiometabolic health, including myocardial diastolic dysfunction, coronary and cerebral atherosclerosis, body fat distribution and severity of non-alcoholic fatty liver disease. This cohort will form the basis of larger interventional trials targeting metabolic inflexibility in the prevention of cardiovascular disease. Participants aged 21–72 years with no prior manifest atherosclerotic cardiovascular disease (ASCVD) are being recruited from a preventive cardiology clinic and an existing cohort of non-alcoholic fatty liver disease (NAFLD) in an academic medical centre. A total of 120 patients will be recruited in the pilot phase of this study and followed up for 5 years. Those with 10-year ASCVD risk ≥ 5% as per the QRISK3 calculator are eligible. Those with established diabetes mellitus are excluded. Participants recruited undergo a detailed assessment of health behaviours and physical measurements. Participants also undergo a series of multimodality clinical phenotyping comprising cardiac tests, vascular assessments, metabolic tests, liver and neurovascular testing. Blood samples are also being collected and banked for plasma biomarkers, ‘multi-omics analyses’ and for generation of induced pluripotent stem cells (iPSC). Extensive evidence points to metabolic dysregulation as an early precursor of cardiovascular disease, particularly in Asia. We hypothesise that quantifiable metabolic inflexibility may be representative of an individual in his/her silent, but high-risk progression towards insulin resistance, diabetes and cardiovascular disease. The platform for interdisciplinary cardiovascular-metabolic-neurovascular diseases (PICMAN) is a pilot, prospective, multi-ethnic cohort study.

Sleep is the best medicine: assessing sleep, disordered eating, and weight-related functioning

Sleep quality is linked to disordered eating, obesity, depression, and weight-related functioning. Most research, however, has focused on clinical populations. The current study investigated relationships between sleep quality, disordered eating, and patterns of functioning in a community sample to better understand relationships among modifiable health behaviors. Participants (N = 648) recruited from Amazon Mechanical Turk completed assessments of eating, depression, weight-related functioning, and sleep. Self-reported height and weight were used to calculate body mass index (M = 27.3, SD = 6.9). Participants were on average 37.6 years (SD = 12.3), primarily female (65.4%), and White, not Hispanic (72.7%). Over half of participants endorsed poor sleep quality, and average sleep scores were above the clinical cutoff for poor sleep quality. Sleep scores were significantly positively correlated with disordered eating, depression, and weight-related functioning, even after adjusting for age, body mass index, and sex. Multivariate regression models predicting weight-related functioning and depression showed that both sleep quality and disordered eating independently predicted depression. Sleep quality did not independently predict weight-related functioning; however, disordered eating did. To the best of our knowledge, this is the first study to assess sleep behaviors, disordered eating, and weight-related functioning in a community sample of weight diverse participants. Results indicate that most participants endorsed poor sleep quality, which was associated with disordered eating patterns, including binge eating and poorer weight-related functioning, even after controlling for body mass index, highlighting that this relationship exists across the weight spectrum. These results speak to the importance of health behavior assessment and intervention within nonclinical samples.Level of evidence Level III: evidence obtained from well-designed cohort or case–control analytic studies

Abstract 15452: Using a Commercial Virtual Health Platform to Effectively Treat Obesity and Improve Cardiometabolic Risk Factors at Scale

Introduction: Obesity is a critical risk factor for cardiometabolic disease, yet effective treatment has not been available at scale for the >200 million Americans who meet criteria for obesity treatment. To improve access to evidence-based treatment, we established a virtual metabolic health company to provide medically supervised obesity treatment at scale. Research Questions: This real-world evaluation examines the impact of a virtual health program on weight and related cardiometabolic markers as well as self-reported assessment of key health behaviors in food, exercise, sleep, and emotional health. Methods: Data were analyzed for individuals who completed at least 12 months in the core program. Obesity treatment involved GLP-1 receptor agonist medications combined with a proprietary intensive lifestyle intervention delivered with virtual coaching. Weights were submitted via cellular connected scale. Waist circumference, metabolic labs, and patient questionnaires were also analyzed at baseline and 12 months. Results: The cohort includes 2,643 patients who completed at least 12 months. Average weight loss at 12, 15, and 18 months was 15.58% (n=2,397), 15.97% (n=1,319), and 15.82% (n=569). Improvement was observed for all collected metabolic markers: waist circumference, AST/ALT, lipids, HbA1c, insulin, hs-CRP. Specifically for cardiovascular labs, 12 month endpoints showed improvement in HDL in 51% (n= 1180), in LDL for 61% (n=1174), in hs-CRP for 81% (n=956). Of n=303 with abnormal A1c at baseline, 72.9% achieve A1c <5.7%. Average reduction in waist circumference was 5.95 inches (n=1,507). Positive changes were also seen for patient-reported outcomes. Discussion: Given limited access to effective obesity treatment as a pathway to better cardiometabolic disease management, novel approaches must be developed. Results from 2,643 enrollees in a virtual metabolic health program demonstrate clinically significant and sustained weight loss through 18 months, with improvement in associated key cardiometabolic risk markers, health behaviors, and patient-reported outcomes. This commercial program demonstrates promising results in cardiometabolic risk improvement through medically managed weight loss delivered virtually.

Fifty years of evidence on perinatal experience among refugee and asylum-seeking women in Organization for Economic Co-operation and Development (OECD) countries: A scoping review.

Members of the Organization for Economic Co-operation and Development (OECD) play a significant role in hosting and supporting refugees. Refugees and asylum seekers in OECD countries may face unique challenges in accessing perinatal healthcare. These challenges can impact their use of and experience with perinatal health services leading to poor maternal and infant outcomes. This scoping review describes the general trends in perinatal health research among refugees/asylum seekers in OECD countries over the past fifty years (1970 to 2021) as well as summarizes their perinatal experience. Databases including Embase and Medline were searched using relevant key words for "refugee/ asylum seeker", "perinatal ", and " OECD countries.". Articles were excluded if they only involved economic migrants or internally displaced persons, conducted in non-OECD countries, only assessed health behaviors and practices during pregnancy (e.g., smoking), or were published in a language other than English. The final list of articles included 82 unique studies. In the 40 years between 1970 and 2009, very few studies (n = 9) examined perinatal health among refugees/ asylum seekers in OECD countries. However, an increasing trend was observed over the past decade. Early studies (1980 to 2009) focused more on traditional perinatal outcomes; however, from 2010 onwards, studies related to perinatal experience were more likely to emerge in the global health literature. Access to timely prenatal care remains a challenge with failure to address the root causes of the problem in several OECD countries including those with a long history of hosting refugees. The limited availability of interpretation services and the lack of a patient-centered approach to care have also interfered with the perceived quality of care. In addition, perceived isolation and the limited social support experienced by this vulnerable population have negatively impacted their perinatal experiences in several OECD countries. Refugee/asylum seekers in OECD countries face a number of challenges during the perinatal period. Policy changes and further research are needed to address access barriers and identify specific interventions that can improve their well-being during this critical period.

Health behaviors and cancer screening in family caregivers vs. general population

Abstract Purpose This study aimed to compare health behaviors and healthcare utilization between family caregivers of advanced cancer patient and general population. Methods Data of 158 family caregivers were obtained from one oncologic clinic and from 3,775 Korean adults aged 40 years or older who participated in the Eighth Korea National Health and Nutrition Examination Survey. Propensity-score matching was employed to match family caregivers with general population (1:1). We assessed health behaviors and healthcare visit, cancer screening, and influenza vaccination among two groups. Further, we performed subgroup analysis to explore factors associated with health behaviors and healthcare utilization of family caregivers. Results After propensity-score matching, the proportion of individuals performing moderate to high-intensity physical activity (MVPA) of 500 METs or more was higher in the caregiver group (p = 0.004). Also, the proportion of cancer screenings over a two-year period was significantly lower in the family caregiver group compared to the non-caregiver group (62.1% versus 73.1%, p = 0.045). In subgroup analysis, family caregivers with higher HADS depression scores were less likely to engage in MVPA, while those with higher HADS anxiety scores showed a significant decrease in healthcare visits. Family caregivers who received social care/economic support had an increased aOR in healthcare visits for own health (aOR 0.18 95% CI 0.04-0.91). Moreover, caregivers who had high competency and rewards were more likely to engage in MVPA. Conclusions The caregiver's has vulnerable aspects of and healthcare utilization, affected by their depression or anxiety. Social care/economic support was associated with improved health behavior and utilization of caregivers. Further studies for multi-dimensional support for caregivers’ health is needed. Key messages • Family caregivers, especially those with higher levels of depression or anxiety, face challenges in terms of their health and healthcare utilization. • Social care/economic support is crucial in improving their health behaviors and healthcare access.

Compensatory health motivations and behaviors scale: Development, evaluation, psychometric properties and a preliminary validation

The “Compensatory Health Beliefs” scale assesses the degree to which one believes that unhealthy behaviours can be compensated through healthier ones. However, no validated scale to assess compensatory weight-related behaviors exists. The study's objective was to develop (Study 1) and validate (Study 2) a questionnaire measuring compensatory health motivations and behaviors (CHMB) and to assess their associations with body mass index (BMI) and psychological weight-related measures. An initial 34-item measure was constructed based on a target sample's (Study 1, n = 158) suggestions and refined based on expert feedback. The measure was then tested in a representative Canadian adult sample (N = 1400, 48.7% male). The sample was stratified by sex and age and then randomly split into two (N = 701 for exploratory factor analysis; N = 699 for confirmatory factor analysis (CFA) cross-validation). Fit indices, standardized Cronbach's alphas and the associations between the CHMB model with cognitive restraint, weight concerns, and BMI were assessed in multiple linear regression models controlling for age and sex. The final CHMB model (n = 17 items) consisted of four subscales: (1) motivation, (2) use on special occasions, (3) general use, (4) compensatory health beliefs. Fit indices (Goodness of Fit Index = 0.922) and Cronbach's alphas were good (α = 0.88). In multiple linear regression models, all CHMB subscales were associated with greater cognitive restraint in eating. Compensatory behavior use on special occasions was associated with greater weight concern (B = 0.12, p < .0001), while general compensatory behavior use was associated with lower weight concern (B = −0.07, p < .05). None of the subscales were associated with BMI. The validated CHMB scale allows for the assessment of compensatory health motivations and behaviors in a Canadian population. Research on whether this scale can predict weight changes and general health is needed.

Protective Health Behaviors among Critical Care Nurses Concerning Pressure Ulcer Prevention for Hospitalized Patients at Baghdad Teaching Hospitals

Background: Pressure ulcers remain a serious complication for immobile patients and a burden for healthcare professionals. Objectives: To assess health behavior prevention among critical care nurses regarding pressure ulcer prevention for hospitalized patients and to find out the relationship between critical care nurses health behavior prevention and sociodemographic variables. Methods: A cross-sectional design study was carried out in critical care units at three teaching hospitals. The study period extended from November 1, 2022, to January 28, 2023. Non-probability purposive sampling, whose target population was 100 nurses who work in critical care units in Baghdad, Iraq. The data were collected using a self-administered questionnaire. The data was collected from November 10th through December 23rd, 2022. Study instruments consist of two parts. First, the demographic sheet included sociodemographic information about the participants. The second part includes nurses’ attitudes toward the pressure ulcer prevention instrument (APuP). The collected data was analyzed using SPSS version 26. Results: Findings of the current study showed nearly three-quarters (74%) of critical care nurses had positive health behaviors regarding pressure ulcer prevention based on a total mean score of 2.26. Conclusion: This study concluded that the critical care units’ nurses surveyed in this study demonstrate an acceptable level of knowledge regarding pressure ulcer prevention and treatment. Continuing education or in-service training should be provided to enhance critical care units’ nurses’ practices and positive health behaviors about pressure ulcer prevention.

Health behaviours of patients with affective disorders: a cross-sectional study

BackgroundSevere mental disorders, including affective disorders (AD), are associated with high rates of physical illnesses that lead to premature patient death. Excess somatic comorbidity may be partially explained by lifestyle factors. This study aimed to investigate the health behaviours (HBs) of patients with AD in comparison to the HBs of patients with type 2 diabetes (T2D) and healthy controls (HCs) and to examine associations among HBs and sociodemographic and clinical factors, subjective quality of life and health status, and health locus of control.MethodsThe sample consisted of 108 patients with AD, including 60 with bipolar disorder (BP) and 48 with unipolar disorder (UAD). Analyses included comparisons with a subgroup of AD individuals, patients with T2D and HCs matched in age and sex. The Health Behaviour Inventory was used to evaluate the overall levels of HBs and 4 HB categories. To identify independent determinants of health behaviours, a multivariate linear regression analysis was performed with factors identified as significant in bivariate analyses.ResultsMost AD patients had a low level of HBs (40%), followed by moderate (35%) and high levels (25%), and there were no significant differences in HBs between the BP and UAD groups. Compared with the T2D and HC groups, the AD group had a significantly lower level of overall HBs and lower levels of HBs in one of the categories. Independent predictors of overall HBs were quality of life (β = 0.28, p < 0.001), age (β = 0.27, p = 0.002), and depressive symptoms (β = 0.23, p = 0.008). A total of 30% of the variance in HBs was explained.ConclusionsThese findings emphasise the need for a systematic assessment of single and multiple health behaviours to provide better care for patients with AD and reduce the potential adverse effects of an unhealthy lifestyle.

Comparative Assessment of Oral Health Attitudes and Behaviors of First-Time and Previous Dental Patients UndergoingExodontia Treatment During the COVID-19 Pandemic in Private Dental Clinics in Riyadh City, Saudi Arabia.

The COVID-19 lockdown affected oral health behaviors. This study aims to assess and compare the oral health attitudes and behaviors of first-time and previous patients undergoing dental extractions during the COVID-19 pandemic at private dental clinics in Riyadh City, Saudi Arabia. This cross-sectional study was conducted among patients aged 18-65 years undergoing dental extractions at private dental clinics in Riyadh City, Saudi Arabia. Four hundred and eighty patients were selected using a convenient sampling methodology. A structured, close-ended questionnaire investigated demographic information, tooth extraction attendance, and oral health attitudes and behaviors using 20 items Hiroshima University Dental Behavioral Inventory (HUDBI). A total of 480 exodontia patients [282 (58.8%) males and 198 (41.2%) females] participated in this study. All patients used a stiff-bristled toothbrush and wereconcerned about their teeth' color and bad breath. Similarly, all the participants did not feel brushed unless they used strong strokes, and the dentist told them to brush very well. An overall mean HUDBI score of 6.34±1.12 was observed. Patients with a primary education (5.61±0.79), income ≤5000 SAR (6.00±0.92), residing in rural areas (5.84±0.93), and government employees (5.62±0.96) exhibited lower HU-DBI scores compared to their counterparts. The study revealed a significant variation in HUDBI scores across different demographic factors, including education, income, residence, occupation, and reason for extraction (p<0.001). The HUDBI score of first-time attendees to dental extraction (5.88±1.03) was found to be significantly poorer than to those of previous attendees (6.63±1.09), (p<0.001). Patients who underwent dental extractions at private dental clinics in Riyadh City, Saudi Arabia, during the post-lockdown COVID-19 pandemic exhibited average oral health attitudes and behaviors. Oral health attitudes and behaviorsdiffered by socioeconomic status. Patients undergoing dental extractions for reasons other than dental caries and periodontal diseases and first-time attendees demonstrated poor oral health attitudes and behaviors.

Discrimination and intimate partner violence among a sample of bisexual and gay men in the United States: a cross-sectional study.

Intimate partner violence (IPV) is becoming more recognized as a public health concern among sexual minority men, including bisexual and gay men. Guided by the Minority Stress Model, we assessed the relationship between perceived discrimination and three forms of IPV among a sample of bisexual and gay men living in the United States. We analyzed data as part of the Men's Body Project, a cross-sectional study launched in 2020 to assess health behaviors of bisexual and gay men. A total of 549 individuals participated in the survey, of which 52% were gay and 48% were bisexual men. Perceived discrimination was significantly associated with elevated odds ratios ranging from 1.15 to 1.18 across three forms of IPV, with Physical IPV odds ratio being highest. Given the significant association between perceived discrimination and IPV, interventions aimed at addressing IPV experiences among sexual minority men must consider the role of minority stress.

Assessment of Health Behaviors of Patients After SARS-CoV-2 Infection

Objective: Past infection with COVID-19 increases the risk of occurrence of thromboembolic events in veins and arteries, respiratory failure, and damage to the heart muscle, liver, and nervous system. Pro-health behaviors of patients who had been infected with SARS-CoV-2 are the determinant of maintaining and strengthening the state of health. We assessed health behaviors of convalescent patients after SARS-CoV-2 infection and determined the relationships between these behaviors and the selected social and demographic characteristics.Methods: The study included 125 patients who had been infected with SARS-CoV-2; we used the Health Behavior Inventory (HBI), and an author-constructed questionnaire.Results: Overall, 60.8% of respondents presented a mediocre level of health behaviors (5-6 stens), 24.8% low (1-4 stens), and 14.4% high (7-10 stens). We found the highest mean value in the case of one HBI category: positive psychological attitude (3.51±0.67), followed by prophylactic behaviors (3.42±0.73), and correct eating habits (3.36±0.84). The lowest value (demonstrating the least pro-health behavior of respondents) concerned health practices (3.23±0.78).Conclusions: COVID-19 convalescent patients presented a mediocre set of health behaviors. We found statistically significant relationships between health behaviors by education and age. Persons who have had SARS-CoV-2 should receive health education in all areas of health behavior.

Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health.

Although health literacy (HL) skills may change over time, most research treats HL as a constant, using baseline HL to predict other health-related constructs. Few studies have explored change in HL over time. We examined person-level differences in HL trajectories. We identified subgroups (latent classes) based on longitudinal assessments of HL and examined the association of class membership with demographic and oral health variables. We used four measurement waves of parental HL data, reflecting the risk of limited HL, collected as part of an intervention to reduce dental decay in American Indian children (N = 579 parent-child dyads at baseline). Repeated measures latent class analysis (RMLCA) models were estimated to identify subgroups of HL trajectories over time. We examined class membership in association with baseline demographics and with 36-month assessments of parental oral health knowledge, beliefs, and behaviors as well as pediatric oral health. A four-class model best fit the data. The largest class (high HL; 49.7% of the sample) was characterized by high levels of HL at all waves. A second class (improving HL; 17.7%) improved over all waves. The remaining two classes were characterized as moderate HL (20%) and low HL (12.6%) and maintained relatively stable HL levels over time. Higher educational attainment was associated with membership in the high HL and improving HL classes. Older age among this young-adult sample and higher income also were associated with high HL class membership. Parents in the high HL and improving HL classes exhibited more favorable performance on measures of oral health knowledge, beliefs, and behavioral adherence than did those in the other classes. Class membership was not associated with pediatric oral health. RMLCA demonstrated person-level variability in HL trajectories. Longitudinal patterns were associated with baseline demographics and prospectively with parental oral health knowledge, beliefs, and behaviors, but not with pediatric oral health. [HLRP: Health Literacy Research and Practice. 2023;7(2):e89-e98.].

Health behavior profiles in young survivors of childhood cancer: Findings from the St. Jude Lifetime Cohort Study.

There is limited understanding of associations between a combination of health behaviors (physical activity, sedentary/screen-time, diet) and cardiometabolic health risk factors, physical performance, and emotional health among young (<18) childhood cancer survivors (CCS). The aims of this research were to address this gap by 1) deriving health behavior adherence profiles among CCS, and 2) examining associations among demographic, diagnosis and/or treatment exposures, cardiometabolic, physical performance, and emotional functioning with health behavior profile membership. Participants included 397 CCS (≥5years post-diagnosis; 10-17 years old) enrolled in the St. Jude Lifetime Cohort Study who completed physical health evaluations and questionnaires assessing health behaviors and psychological functioning. Latent profile analysis was used to derive profiles of health behavior adherence. Logistic regression and t-tests were used to examine mean-level differences and associations between profile membership with demographic, diagnosis, treatment exposures, cardiometabolic health, psychological functioning, and physical performance. Two profiles emerged: inactive-unhealthy-diet ("IU") and active-sedentary-unhealthy-diet ("ASU") to guidelines. More participants in IU demonstrated higher resting heart rate (mean [M], 76.54; SD = 12.00) and lower motor proficiency scores (M=34.73; SD=29.15) compared to ASU (resting heart rate, M=71.95, SD=10.74; motor proficiency, M=50.40, SD=31.02). CCS exhibited low adherence to multiple health behavior guidelines, with adherence patterns differentially associated with cardiometabolic health (i.e., resting heart rate) and physical performance. However, robust protection against all health variables was not observed. Findings suggest interventions designed to improve health outcomes should target multiple health behaviors simultaneously. Pediatric cancer survivors are at-risk for detrimental health outcomes associated with cancer and treatment. Engagement in healthy lifestyle behaviors serves to reduce health vulnerabilities among adult survivors but less is known about associations with lifestyle behaviors on young survivors. This study documents patterns of lifestyle behaviors among survivors of pediatric cancer, factors that increase susceptibility to nonadherence, and associations among lifestyle behaviors and health indicators.

Hyperbolic modeling and assessment of hypothetical health behaviors during a viral outbreak using crowdsourced samples.

The COVID-19 pandemic provided an opportunity to investigate factors related to public response to public health measures, which could help better prepare implementation of similar measures for inevitable future pandemics. To understand individual and environmental factors that influence likelihood in engaging in personal and public health measures, three crowdsourced convenience samples from Amazon Mechanical Turk (MTurk) completed likelihood-discounting tasks of engaging in health behaviors given a variety of hypothetical viral outbreak scenarios. Experiment 1 assessed likelihood of mask wearing for a novel virus. Experiment 2 assessed vaccination likelihood based on efficacy and cost. Experiment 3 assessed likelihood of seeking health care based on number of symptoms and cost of treatment. Volume-based measures and three-dimensional modeling were used to analyze hypothetical decision making. Hypothetical public and personal health participation increased as viral fatality increased and generally followed a hyperbolic function. Public health participation was moderated by political orientation and trust in science, whereas treatment-seeking was only moderated by income. Analytic methods used in this cross-sectional study predicted population-level outcomes that occurred later in the pandemic and can be extended to various health behaviors.

Health Behavior and Recreational Activity of Elderly People in Elderly Schools of Thailand

This research aimed to examine the health behaviors and recreational activities of the elderly and investigate the relationships between the physical, mental, emotional/intellectual, and the social aspects of the elderly in the elderly schools. The samples were 400 elderly people, who had been recruited via the Multi-Stage Random Sampling method. The data collection was completed by using a questionnaire developed by the researcher. It consisted of 3 parts: Firstly was The respondents' General Information, Secondly was The respondents' Recreational Activity Needs, and lastly was The Elderly Health Behavior Assessment, which had a 5-level rating scale. The questionnaire was rated with reliability of 0.924. The statistics used for data interpretation included means, percentages, standard deviations (S.D.), and Pearson's Product Moment Correlation Coefficient. The results presented that there were more females than males, with the average age range of 60-69 years. The elderly's needs for physical recreation activities with the three highest average scores were Stick exercises, and Yoga. Regarding the mental activities, the two highest average scores were Tree planting, and Gardening. The needs for emotional/intellectual health were Basketry, and Weaving. The highest average scores for the needs of the elderly on the social aspect were Rhythmic activities, and Singing. The overall physical health of the elderly was rated at a low level, while the overall scores for the mental, emotional/intellectual, and social health aspects were at moderate levels. The relationship between health promotion activities and the health quality of the elderly in the elderly schools was statistically significant at a level of 0.01.

Improving cardiovascular health behaviors through a comprehensive lifestyle intervention program during the pandemic in India

Abstract Funding Acknowledgements Type of funding sources: None. Background We have witnessed a dramatic dip in adherence to cardiovascular health behaviors during the COVID-19 pandemic. Data from across the globe has shown that risk factors for cardiovascular disease (CVD) such as decreased physical activity, poor diet, and increased depression, loneliness, and stress have peaked during the pandemic. Having been badly affected by the pandemic and having had prolonged periods of countrywide lockdown, the at-risk and established CVD population has faced a major challenge in adhering to a healthy lifestyle in India. Purpose This study aimed to analyze the change in cardiovascular health behaviors brought about by a comprehensive lifestyle intervention program (CLIP) during the pandemic in India. Methods All at-risk and CVD patients who had participated in the CLIP from mid 2020 to mid 2022 and had completed the internally validated health behavior assessment questionnaire, pre and post-program, were included in this retrospective study. A multidisciplinary team consisting of Physician, Physiotherapist, Dietician, and Counseling Psychologist provided the sessions online and/or in-person for the home-based and hybrid programs respectively. When a combination of online and in-person sessions were provided for a subject, it was called a hybrid program. The core components of the CLIP were exercise training, education on relevant health topics, nutritional guidance and psychosocial counseling. Results Age of the subjects (n=50) at enrolment was 54±13 years and 40 (80%) were male. The time between pre-program and post-program assessments was 110 (IQR 47) days. Number of at-risk and CVD patients attending home-based and hybrid programs are shown in the Figure. There were 4 couples in the study cohort; 21 (50%) of the remaining 42 subjects had at least 1 other family member attend the majority of sessions. There was a significant improvement in all the cardiovascular health behaviors, namely adequate daily intake of fruits, vegetables and whole grains, choice of heart-healthy foods between meals, sufficient weekly exercise and a reduction in self-reported chronic stress, upon completion of the CLIP (Table). Conclusions A comprehensive lifestyle intervention program that incorporates a multipronged approach to behavior modification is effective in improving cardiovascular health behaviors in individuals at-risk as well as with established cardiovascular disease in India. The ripple effect of behavior modification in the accompanying family members needs to be studied systematically.

Assessment of Health Behaviours and Satisfaction with Life among Catholic Priests in Poland

The aim of the study was to assess the relationship between the health behaviours of diocesan priests in Poland and their level of life satisfaction. The specific goal was to determine the factors that most affect their quality of health (internal health control, the influence of others or coincidence) and life satisfaction (positive mental attitude, preventive behaviour, eating habits, health practices). The study involved 250 diocesan priests from the Podkarpackie region who took part in the research by completing an anonymous questionnaire. The questions were mainly based on tools for assessing health behaviours, namely the HBI—health behaviour inventory, MHLC—multidimensional scale of health locus of control and the SWLS—satisfaction with life scale. The general index of health behaviour of clergymen on the HBI scale was 77.12 ± 16.20 (Me = 78), showing a moderate level on the sten scale. On the MHLC health locus of control scale, the respondents believed that their health depended most on internal control: 25.27 ± 5.10 and the influence of others: 23.13 ± 5.57, are of utmost importance for their health. To a lesser extent they believed that health was dependent on chance: 17.60 ± 5.95. The SWLS satisfaction with life index was 22.51 ± 5.43 (Me = 23), also within the moderate range of the sten scale. The factors most closely related to the assessment of life satisfaction were positive mental attitudes and the overall HBI index. The health behaviours of priests measured by the HBI scale and the level of satisfaction with the life of SWLS clergymen are within a moderate range. On the MHLC scale, priests likewise believe that their health depends on themselves and then on others. They are clearly less likely to indicate accidental causes.

Assessment of Health Behaviors of Patients with Hepatitis C.

In Poland, 1.9% of the population is infected with the hepatitis C virus (HCV). About 70%- 80% of the infected patients develop chronic hepatitis. The higher the level of health-promoting behaviors a person infected with HCV has, the higher their quality of life. The aim of this study was to assess health behaviors of patients with hepatitis C and determine the relationship with selected social and demographic characteristics. This survey study included 220 patients infected with HCV and used the Health Behavior Inventory (HBI), and an author-constructed questionnaire. Overall, 40.5% of respondents reported average health behaviors (5-6 stens), with 30.9% low (1-4 stens), and 28.6% high (7-10 stens). The highest mean value was observed for 3 HBI categories: prophylactic behaviors (3.4±0.7), positive psychological attitude (3.4±0.6), and health practices (3.4±0.7). The lowest value related to few health-promoting behaviors concerned positive eating habits (3.3±0.7). Patients diagnosed with chronic hepatitis C presented an average level of health behavior. Significant differences in health behavior were noted by sex, age, marital status, and employment status. These patients should be provided with health education, especially regarding high-level nutrition.

An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.

This study tested the preliminary effectiveness of an electronic health record (EHR)-automated population health management (PHM) intervention for smoking cessation among adult patients of a federally qualified health center in Chicago. Participants (N = 190; 64.7% women, 82.1% African American/Black, 8.4% Hispanic/Latino) were self-identified as smokers, as documented in the EHR, who completed the baseline survey of a longitudinal "needs assessment of health behaviors to strengthen health programs and services." Four weeks later, participants were randomly assigned to the PHM intervention (N = 97) or enhanced usual care (EUC; N = 93). PHM participants were mailed a single-page self-determination theory (SDT)-informed letter that encouraged smoking cessation or reduction as an initial step. The letter also addressed low health literacy and low income. PHM participants also received automated text messages on days 1, 5, 8, 11, and 20 after the mailed letter. Two weeks after mailing, participants were called by the Illinois Tobacco Quitline. EUC participants were e-referred following a usual practice. Participants reached by the quitline were offered behavioral counseling and nicotine replacement therapy. Outcome assessments were conducted at weeks 6, 14, and 28 after the mailed letter. Primary outcomes were treatment engagement, utilization, and self-reported smoking cessation. In the PHM arm, 25.8% of participants engaged in treatment, 21.6% used treatment, and 16.3% were abstinent at 28 weeks. This contrasts with no quitline engagement among EUC participants, and a 6.4% abstinence rate. A PHM approach that can reach all patients who smoke and address unique barriers for low-income individuals may be a critical supplement to clinic-based care.