Preventive Health Behaviors Research Articles

Dyadic Associations Between Self-perceptions of Aging and Health Behaviors Among Middle-aged and Older Couples.

Research and theory suggest that older adults' self-perceptions of aging (SPA) are associated with their health behavior engagement. Likewise, romantic partners often play a key role in shaping each other's health behaviors. This study aims to explore the longitudinal dyadic associations between SPA and health behaviors among couples in midlife and older adulthood. Data were drawn from 3,330 couples ages 50-96 (Mmen = 67.22 [9.43]; Mwomen = 65.42 [8.96]) from the Health and Retirement Study, using pooled samples from 2010/2012 to 2012/2014. We estimated actor-partner interdependence models with moderation to assess whether and to what extent a partner's SPA moderated the links between positive and negative SPA and engagement in preventive and risky health behaviors two years later. Women's SPA moderated the association between men's SPA and men's risky health behaviors only when women reported extreme levels of negative or positive SPA. In contrast, men's SPA did not moderate the associations between women's SPA and women's health behaviors. This study's findings emphasize that links between SPA and health behaviors operate within the broader social environment and in the context of romantic relationships. The results highlight how couples' perceptions of aging relate to their own and their partners' health behaviors. This work contributes to the literature on the gendered and social nature of health behaviors and has implications for designing interventions targeting SPA.

Study protocol for a hybrid implementation-effectiveness trial of Game Changers for Cervical Cancer Prevention in Uganda.

Cervical cancer (CC) is the leading cause of cancer-related deaths among Uganda women, yet rates of CC screening are very low. Training women who have recently screened to engage in advocacy for screening among women in their social network is a network-based strategy for promoting information dissemination and CC screening uptake. Drawing on the Exploration, Preparation, Implementation and Sustainment (EPIS) framework for implementation science, this hybrid type 1 randomized controlled trial (RCT) of a peer-led, group advocacy training intervention, Game Changers for Cervical Cancer Prevention (GC-CCP), will examine efficacy for increasing CC screening uptake as well as how it can be implemented and sustained in diverse clinic settings. In the Preparation phase we will prepare the four study clinics for implementation of GC-CCP and the expected increase in demand for CC screening, by using qualitative methods (stakeholder interviews and client focus groups) to identify and address structural barriers to easy access to CC screening. In the Implementation phase, GC-CCP will be implemented over 36 months at each clinic, with screened women (index participants) enrolled as research participants receiving the intervention in the first 6 months as part of a parallel group RCT overseen by the research study team to evaluate efficacy for CC screening uptake among their enrolled social network members. All research participants will be assessed at baseline and months 6 and 12. Intervention implementation and supervision will then be transitioned to clinic staff and offered as part of usual care in the subsequent 30 months as part of the Sustainability phase. Using the RE-AIM framework, we will evaluate engagement in GC-CCP and CC advocacy (reach), alter CC screening (effectiveness), adoption into clinic operations, implementation outcomes (acceptability, feasibility, fidelity, cost-effectiveness) and maintenance. This is one of the first studies to use a network-driven approach and empowerment of CC screened peers as change agents to increase CC screening. If shown to be an effective and sustainable implementation strategy for promoting CC screening, this peer advocacy model could be applied to other preventative health behaviors and disease contexts. NIH Clinical Trial Registry NCT06010160 (clinicaltrials.gov; date: 8/17/2023).

COVID-19 vaccination attitudes and acceptance among people with serious mental illness.

This study examines attitudes towards COVID-19 vaccination among a diverse cohort of adults with serious mental illness (SMI), participant characteristics that are associated with vaccine acceptance, and barriers to COVID-19 vaccination among this population. A 28-item questionnaire was administered to 185 adults with SMI receiving care at a university-based outpatient psychiatric clinic. Variables included demographics, health behaviors, and vaccination status. Chi-square tests were used for categorical demographic comparisons on binary COVID-19 vaccine status. Female participants were more likely to have received COVID-19 vaccination (77.6%) than male (55.7%) participants. White (73.3%) and Hispanic/Latino (81.8%) participants were more likely to have received vaccination than Black/African American (54.9%) participants. Participants who reported having seen a primary care provider (PCP) within the past two years were more likely to be vaccinated (72.1%) than those who had not (41.7%). Participants who reported having received an influenza vaccine in the past two years were more likely to be vaccinated (80.2%) than those who had not (41.8%). Participants who had not been vaccinated were more likely to report greater concerns about all potential barriers to vaccination, including concerns about side effects, cost, health effects, and distrust of clinicians and governments. The overall vaccination rate of study participants with SMI was similar to that of the general population. Efforts to enhance engagement in primary care may help improve preventative health behaviors in people with SMI.

Small-area and socially differentiated analyses of the utilization of screening examinations in the city of Hamburg: a secondary data analysis

Social reporting in Hamburg identifies existing inequalities at the urban area level. These social-contextual variations may potentially influence preventive health behaviors. The aim of this article is to examine correlations between the degree of social regional disadvantage of Hamburg's population and the utilization of regular screening examinations for children, adolescents, and adults through small-area analysis. The analyses are based on claims data from 2017 of insured individuals living in Hamburg from three cooperating statutory health insurance funds. A socially contextual indicator (1 = "very low" to 7 = "high") was assigned to the data at urban area level. Based on this, binary correlations between the social indicator and calculated utilization rates (stratified by gender and age) of early detection examinations were examined using Kendall's tau correlation analysis. The study population included N = 433,053 individuals (53.7 % female) from the city of Hamburg. Strong positive associations were found between utilization rates and social contextual index classes for U7 to U9 examinations (r > 0.7; p-values < 0.05) as well as cervical cancer screening (r > 0.9; p-values = 0.002), indicating that utilization increases with the rising social status of the urban area level. Additionally, strong positive correlations can be observed in some subgroups for prostate cancer screening (> 59 years: r = 0.905, p-value = 0.004) and colorectal cancer screening (women aged 50-60 years: r = 0.905, p-value = 0.004). No significant correlations were found for other subgroups, as well as for skin cancer screening, breast cancer screening and the J1 examination (p-value > 0.05). Strong negative associations have only been detected for the general health check-up for individuals aged 35 to 59 (women: r = -0.810, p-value = 0.011; men: r = -0.714, p-value = 0.024). The results indicate inequalities in the use of early detection examinations provided by statutory health insurers for children and adults to the disadvantage of urban areas ranking lower in social status. This socially selective utilization may lead to an accumulation of health problems in urban areas that are already disadvantaged socially, which would result in an exacerbation of existing social and health inequalities. Small-scale and socially differentiated analyses of healthcare provision should be seen as a regular component of regional healthcare provision. They provide starting points for a more needs-oriented further development of the healthcare system and secondary prevention services.

How low education increases COVID-19 mortality: the mediating role of vaccination, distrust in science, and lack of preventative health behavior.

Previous research shows the significant correlation between low education and COVID-19 mortality in underprivileged communities, even when accounting for factors like poverty and race. The exact mechanisms by which low education gives rise to COVID-19 mortality, however, are less clear. We propose that low education predicts COVID-19 morality because low education gives rise to a less engaged, less agentic approach to one's own healthcare. We operationalize low engagement and low agentic behavior as four variables that mediate the effect of low education on COVID-19 mortality: (i) vaccination, (ii) distrust of science (Republican vote), (iii) poor health, and (iv) prevention. We model COVID-19 mortality in 3108 counties of the United States, using deaths across 60 fortnights. All four indicators of an agentic, engaged approach to health are statistically significant mediators of the relationship between low education and COVID-19 mortality: vaccination [IRR=1.02; (1.02, 1.03)]; Republican vote [IRR: 1.07; (1.06, 1.09)]; poor health [IRR: 1.01; (1.01, 1.02)]; and prevention [IRR: 1.00, (1.001, 1.003)]. These findings suggest that low level of formal education predicts mortality from COVID-19 because low levels of education gives rise to a less engaged and less agentic approach to one's own health.

Determinants of Preventive Health Behavior for Hepatitis B in Pregnant Women: A Cross-Sectional Study.

Vertical transmission from mother to child during the perinatal period is a key route of hepatitis B infection. The infection rate among children of mothers who are hepatitis B carriers is high. This study was designed to investigate the hepatitis-B-related preventive health behavior of pregnant women and related factors. A cross-sectional study design was used, and 184 pregnant women aged 20 years or above were recruited at obstetrics clinics as participants. The Demographic Characteristics Questionnaire, Hepatitis B Knowledge Questionnaire, Hepatitis B Health Beliefs Questionnaire, and Preventive Health Behavior Questionnaire were used to collect study data between October 2017 and March 2018. Most of the participants had received a hepatitis B test because of either a pregnancy checkup (38.0%) or a health examination (32.1%), and most (77.7%) were not hepatitis B carriers. Using multiple linear regression, four significant determinants of hepatitis B preventive health behavior were identified, including marital status (β = 2.45, p = .008, 95% CI [0.66, 4.25]), test for hepatitis B infection status (β = -2.83, p = .013, 95% CI [-5.06, -0.60]), hepatitis B knowledge (β = 0.21, p = .001, 95% CI [0.09, 0.33]), and hepatitis B health beliefs (β = 0.11, p < .001, 95% CI [0.05, 0.16]). The participants who were not married or had never received a hepatitis B test exhibited better hepatitis-B-related preventive health behavior. Moreover, both hepatitis B knowledge and hepatitis B health belief scores were found to relate positively to preventive health behavior. Healthcare providers should strengthen health education in outpatient clinics and provide post-hepatitis B health-related materials in the community. In particular, internet resources such as hepatitis-B-related health education apps and other channels should be used to increase hepatitis B knowledge in perinatal women and eliminate hepatitis B.

Exploring Role of Physical Activity and Emotional Exhaustion to improve Preventive Health Behavior among Students of Chinese Colleges

Objective: College’s students often face health issues while studying, therefore, they must look for factors to develop preventive health behavior. This study attempts to examine effect of physical activity, emotional exhaustion, student self-efficacy and resilience on preventive health behavior. Methodology: A cross-sectional research design was adopted to analyse data collected from the Chinese college’s students through a 7-Point Likert scale questionnaire. Simple random sampling technique was adopted to identify the respondents. The response rate of research was 73.22%. Smart PLS was employed to analyse the collected data. Results: The results of study reveal that physical activity, emotional exhaustion, student self-efficacy have significant effect on resilience. Resilience also has significant impact on preventive health behavior. Results of study also statistically confirmed the mediating effect of resilience. Conclusion: The importance of resilience to develop preventive health behavior was proved in this study. This research also emphasized on the vitality of physical activity, emotional exhaustion, and student self-efficacy in the context of Chinese college’s students.

CARDIOVASCULAR RISK FACTORS AND MENTAL HEALTH OUTCOMES AMONG LGB+ OLDER ADULTS

Abstract Emerging evidence highlights that sexual and gender minority (SGM) adults exhibit a higher prevalence of cardiovascular disease (CVD) and its risk factors compared with their non-SGM peers. This increased susceptibility underscores a critical intersection with cognitive health given the link between CVD and cognitive decline and early-onset dementia. Additionally, mental health challenges such as depression and anxiety not only heighten CVD risk but also predict severe cardiovascular complications. Utilizing cross-sectional data from the National Health Interview Survey (NHIS), this study examined these interconnected health issues among older adult LGB+ populations to inform comprehensive interventions aimed at addressing both cardiovascular and cognitive health. This cross-sectional study analyzed data from the 2022 NHIS data to describe cardiovascular and cognitive health characteristics among LGB+ and non-LGB+ older adults using chi-squared tests. The sample was limited to adults who self-reported being age 50 years or older. A CVD risk variable was created based on Framingham criteria. Data from 13,426 participants, including 341 LGB+ individuals, revealed significant differences in demographic characteristics, health, and lifestyle. LGB+ older adults were younger and more frequently formally educated. They exhibited lower rates of CVD risk factors and increased physical activity and preventative health behaviors, yet higher incidence of depression and anxiety and higher rates of smoking and alcohol use. These preliminary findings highlight the unique characteristics of LGB+ older adults in terms of cardiovascular health, offering potential targets for culturally tailored interventions.

Health action process approach and spinal cord injury: a scoping review.

Spinal cord injury may result in chronic pain, difficulty walking and breathing, and/or paralysis. People with spinal cord injury (PwSCI) experience increased risk for chronic diseases and psychosocial distress (e.g. type 2 diabetes, substance use disorders) and premature mortality. The Health Action Process Approach (HAPA) is a social cognitive health behavior framework validated to explain modifiable preventative health behaviors (e.g. physical exercise, healthy eating, substance misuse) among people with chronic conditions. The present scoping review investigates what, how, and how much peer-reviewed research literature applies HAPA to preventative health behaviors among PwSCI. A search was conducted in seven community health databases including PubMed, CINAHL, PsycINFO, SocIndex, Scopus, Web of Science, Sociological Abstracts, and Library and Information Science Source. Seven peer-reviewed articles were identified. Conventional content analysis was used in the full-text review to identify themes and calculate theme frequency. All studies were quantitative and applied HAPA to physical exercise. HAPA explained differences in sports participation, leisure time physical activity, and strength training. A strong predictor of physical exercise was belief in the capability to overcome psychosocial barriers. More attention is needed on HAPA-identified barriers, and customized HAPA-based interventions to promote physical exercise among PwSCI.

Socioeconomic determinants of cancer screening adherence among cancer survivors: analysis from the 2020 Behavioral Risk Factor Surveillance System.

Factors associated with cancer survivors' preventive health behaviors are understudied. We hypothesized that socioeconomic and health-care access factors may be associated with adherence to recommended cancer screenings. We conducted a cross-sectional analysis using the 2020 Behavioral Risk Factor Surveillance System. Cancer survivors eligible for United States Preventive Services Task Force-recommended breast, cervical, prostate, and colorectal screenings were included. Multivariable logistic regression models were used to identify socioeconomic factors significantly associated with screening adherence. Overall, 64 958 (weighted national estimate = 29 066 143) cancer survivors were included. Adherence rates varied across cancer types: 80.9% for breast, 88.9% for cervical, 54.1% for prostate, and 84.7% for colorectal cancer. Key predictors of low adherence included lower income (breast: adjusted odds ratio [aOR] = 0.56, 95% confidence interval [CI] = 0.43 to 0.74; cervical: aOR = 0.38, 95% CI = 0.24 to 0.59; prostate: aOR = 0.36, 95% CI = 0.24 to 0.52; colorectal: aOR = 0.74, 95% CI = 0.57 to 0.96), lack of health-care coverage for colorectal cancer (aOR = 0.51, 95% CI = 0.36 to 0.73), time since last checkup between 1 and 2 years prior for breast (aOR = 0.58, 95% CI = 0.45 to 0.75), prostate (aOR = 0.66, 95% CI = 0.47 to 0.91), and colorectal (aOR = 0.69, 95% CI = 0.56 to 0.86) cancer, and no health-care provider for breast (aOR = 0.68, 95% CI = 0.47 to 0.98), prostate (aOR = 0.45, 95% CI = 0.31 to 0.65), and colorectal (aOR = 0.51, 95% CI = 0.40 to 0.66) cancer. Cancer survivors' adherence to screening is associated with factors including lack of health-care coverage, lower income, time since the last exam, and having a personal provider. Targeted interventions accounting for such factors may help mitigate these disparities.

Perceptions of COVID-19 and HIV Risk and Related Preventive Health Behaviors in Rural Zambia.

Risk perception, its relationship to preventive health behaviors and other factors (e.g., direct experience of a disease) are important for determining effective targets for disease prevention. Whether these relationships are the same for various diseases has not been well-researched. Drawing on a holistic model of risk perception, this study compares levels of perceived risk for COVID-19 and HIV in a rural Zambian community, examines hypothesized correlates of perceived risk, and evaluates whether higher perceived risk and/or its correlates are associated with practicing preventive behaviors for each disease. The sample included 118 adults participating in a larger study of families affected by HIV. Via surveys, information about risk perception, preventive behaviors, knowledge about, trust in information sources, direct experience and hearing about each disease, and prosociality, were collected. For each disease, perceived risk was not related to its preventive behaviors. Levels of perceived risk for COVID-19 and HIV differed significantly, as did their correlates. Having trusted sources of information about HIV was related to higher perceived risk of HIV. Direct experience of COVID-19 was related to higher perceived risk of COVID-19, but only at a level of interest. Although practicing preventive behaviors for each condition was related to higher levels of knowledge about each disease at a level of interest, willingness to engage in behavior beneficial to others (prosociality) was significantly related only to COVID-19 preventive behaviors. Different diseases provoke different levels of perceived risk and engagement with preventive behaviors and may be correlated with distinct factors. These differences may be due to history of experience with a disease, as well as cultural factors.

Educational Interventions to Improve Knowledge and Attitudes Toward Human Papillomavirus (HPV) Vaccination and Cervical Cancer Screening Among Japanese University Students.

Aim This study evaluates university students' knowledge and attitudes toward Human Papillomavirus (HPV) vaccination and cervical cancer screening and assesses the impact of educational interventions. Methods Participants from Osaka Metropolitan University, Osaka City University, and Osaka Prefecture University completed questionnaires before and after receiving educational materials, including cartoons and a video featuring medical professionals. We compared the correct answer rates for knowledge-related questions and evaluated changes in behavioral characteristics and attitudes toward HPV vaccination and cervical cancer screening before and after distributing the educational materials. The Health Belief Model (HBM) was used to measure changes in perceived susceptibility, severity, benefits, and barriers. Results A total of 15,061 students were invited to participate, with 234 completing the study. Significant improvements in knowledge related to HPV, cervical cancer, and associated preventative measures were observed post-intervention. The percentage of correct answers to knowledge-based questions increased across all items (P<0.01). Furthermore, positive attitudes toward HPV vaccination significantly rose, with male participants demonstrating the most substantial change (P<0.01). In terms of the HBM, perceived susceptibility and perceived benefits increased significantly among male participants (P=0.0055 and P<0.001, respectively), while perceived barriers were reduced (P<0.001). Among female participants, only the perceived benefit increased significantly (P<0.001). Most participants rated the educational materials as clear and easy to understand, reinforcing the utility of engaging and accessible content in promoting health awareness. Conclusion Educational interventions can effectively improve knowledge and attitudes toward HPV vaccination, potentially increasing preventative health behaviors and reducing the incidence of cervical cancer.

Citizens’ engagement in health risk communication and preventive behaviors: the mediating role of perceived shared responsibility in the COVID-19 pandemic

ABSTRACT Background In times of a public health emergency such as COVID-19, a government-centric approach may not be sufficient to contain the epidemic and ensure citizens’ compliance. This study proposes a theoretical model that integrates individual-oriented, social-oriented, and community-oriented factors to predict individuals’ engagement in preventive behaviors and citizen health emergency communication (CHEC). Perceived shared responsibility, which results from the communal nature of the pandemic, is tested as a mediator in the relationships between different motivations and behaviors in the context of COVID-19. Method To test the model, an online survey with a quota sample of 1,301 adults reflecting the composition of the U.S. population was conducted via Qualtrics. Results Results show that perceived severity, self-efficacy, worry, and social support significantly increase the perception of shared responsibility, subsequently increasing individuals’ adherence to preventive behaviors and their engagement in CHEC. In this process, shared responsibility serves as a mediator between some tested relationships between motivators and two types of behaviors (i.e. communication and prevention). Conclusions During a public health emergency, individuals’ preventive behaviors and communication behaviors are determined by the individual-oriented (e.g. perceived severity), social-oriented (e.g. social support), and community-oriented (e.g. perception of shared responsibility) factors. In this mechanism, the perception of shared responsibility explains how some motivators influence individuals’ communication and prevention behaviors.

Relationship Between Perceived COVID-19 Risk and Change in Perceived Breast Cancer Risk: Prospective Observational Study.

Whether COVID-19 is associated with a change in risk perception about other health conditions is unknown. Because COVID-19 occurred during a breast cancer study, we evaluated the effect of COVID-19 risk perception on women's breast cancer risk perception. This study aims to evaluate the relationship between perceived risk of COVID-19 and change in perceived breast cancer risk. We hypothesized that women who perceived greater COVID-19 risk would evidence increased perceived breast cancer risk and this risk would relate to increased anxiety and missed cancer screening. Women aged 40-74 years with no breast cancer history were enrolled in a US breast cancer prevention trial in outpatient settings. They had provided breast cancer risk perception and general anxiety before COVID-19. We performed a prospective observational study of the relationship between the perceived risk of COVID-19 and the change in perceived breast cancer risk compared to before the pandemic. Each woman was surveyed up to 4 times about COVID-19 and breast cancer risk perception, general anxiety, and missed medical care early in COVID-19 (May to December 2020). Among 13,002 women who completed a survey, compared to before COVID-19, anxiety was higher during COVID-19 (mean T score 53.5 vs 49.7 before COVID-19; difference 3.8, 95% CI 3.6-4.0; P<.001) and directly related to perceived COVID-19 risk. In survey wave 1, anxiety increased by 2.3 T score points for women with very low perceived COVID-19 risk and 5.2 points for those with moderately or very high perceived COVID-19 risk. Despite no overall difference in breast cancer risk perception (mean 32.5% vs 32.5% before COVID-19; difference 0.24, 95% CI -0.47 to 0.52; P=.93), there was a direct relationship between change in perceived breast cancer risk with COVID-19 risk perception, ranging in survey wave 4 from a 2.4% decrease in breast cancer risk perception for those with very low COVID-19 risk perception to a 3.4% increase for women with moderately to very high COVID-19 risk perception. This was not explained by the change in anxiety or missed cancer screening. After adjustment for age, race, education, and survey wave, compared to women with very low perceived COVID-19 risk, perceived breast cancer risk increased by 1.54% (95% CI 0.75%-2.33%; P<.001), 4.28% (95% CI 3.30%-5.25%; P<.001), and 3.67% (95% CI 1.94%-5.40%; P<.001) for women with moderately low, neither high nor low, and moderately or very high perceived COVID-19 risk, respectively. Low perceived COVID-19 risk was associated with reduced perceived breast cancer risk, and higher levels of perceived COVID-19 risk were associated with increased perceived breast cancer risk. This natural experiment suggests that a threat such as COVID-19 may have implications beyond the pandemic. Preventive health behaviors related to perceived risk may need attention as COVID-19 becomes endemic.

Investigating the Impact of Health-Protective Behaviors on Morbidity and non-Morbidity COVID-19 among Workers in Oil Refining Industry Using Machine Learning algorithms

Introduction: The prevalence of COVID-19 has significantly impacted work environments and the workforce. Therefore, identifying the most important preventive and control strategies, as well as assessing their effectiveness, is of paramount importance. Various studies have shown that machine learning algorithms can be used to predict complex and nonlinear issues, including predicting the behavior of various diseases such as COVID-19 and the parameters affecting it, and can be beneficial. The purpose of this study has been to examine the importance of preventive measures and hygiene behaviors in preventing COVID-19 in the oil refining industry using various machine learning models. Material and Methods: For this purpose, demographic information and health behaviors of individuals were collected. Subsequently, a multi-layer perceptron (MLP), radial basis function (RBF), and support vector machine (SVM) models were compared to enhance the analysis of the effects of preventive measures on COVID-19 infection. Finally, the most influential factors affecting the likelihood of COVID-19 infection were determined using sensitivity analysis. Results: The results showed that the accuracies achieved in predicting the impact of preventive measures and health behaviors on COVID-19 in occupational settings were 78.1%, 81.2%, and 78.1% by MLP, RBF, and SVM respectively. The RBF model was identified as the most accurate model for predicting the impact of health behaviors on COVID-19 disease Additionally, the level of social distancing with customers, handwashing frequency and disinfection, the availability of cleansing and disinfecting agents for hands and surfaces in the workplace, and gatherings for eating meals and snacks were identified as the most significant health behaviors influencing the prevalence of COVID-19 in the workplace. Conclusion: Studies of this nature can underscore the importance of attention to preventive measures and health behaviors in unprecedented circumstances. Furthermore, the utilization of artificial intelligence models and tools such as DSS (Decision Support Systems) can serve as powerful tools for optimizing control measures in work environments.

Exploring the Mediating Roles of Trust in Health Authorities, Self-Efficacy, and Health Information Acceptance in the Relationship between Political Orientation and Health Preventive Behaviors

Exploring the Mediating Roles of Trust in Health Authorities, Self-Efficacy, and Health Information Acceptance in the Relationship between Political Orientation and Health Preventive Behaviors

The mediating role of health literacy for COVID-19 between preventive behaviors and quality of life

The coronavirus disease 2019 (COVID-19) pandemic rapidly developed around the world. Plenty of health information about the virus was available from multiple media platforms, but such information was not always accurate. Identifying misinformation depends on an individual's health literacy. The purposes of this study were to explore sociodemographic factors affecting health literacy in terms of COVID-19 and preventive behaviors, and relationships among health literacy, preventive behaviors, and quality of life by path modeling. A cross-sectional study design was conducted in July to November 2020. Participants were healthy adults aged over 20years in the United States. Data collection used self-developed questionnaires designed by our research team and the World Health Organization-Quality of Life Scale. Descriptive analyses, independent t-tests, a one-way analysis of variance, and a partial least squares path model were performed for the statistical analyses. In total, 467 people responded. Results showed significant differences in health literacy and preventive behavior scores in terms of age, gender, alcohol consumption, smoking status, being a health professional, and having been tested for COVID-19. A significant path model was developed with satisfactory to good composite reliability, good convergent validity and discriminant validity, and an acceptable model fit. Health literacy was a significant mediator between preventive behaviors and quality of life in the path model. Individuals can improve their health literacy to reinforce engaging in preventive behaviors and promoting quality of life during the pandemic.

Procrastination and preventive health-care in the older U.S. population

Maintaining health preventive behaviours in later life reduces the risk of non-communicable diseases. However, these behaviours often require effort and discipline to adopt and may be prone to procrastination. This study examined whether procrastination affected engagement in health preventive behaviours among older adults. We applied generalised additive models to data from the 2020 wave of the United States Health and Retirement Study. Our analytic sample consisted of adults aged 50+ (n=1338; mean=68.24; range=50-95). Our analysis focused on six health preventive behaviours: prostate exams, mammograms, cholesterol screenings, pap smears, flu shots, and dental visits. Procrastination was associated with less frequent engagement in mammograms and cholesterol screenings among women, though it had no significant association with pap smears or flu shots. Additionally, procrastination interacted with depression reducing the likelihood of prostate exams in men and dental visits in both men and women, such that individuals with high procrastination and low depression were associated with less frequent engagement in both preventive health behaviours. Procrastination may be a behavioral risk factor for maintaining optimal health in older adults. Given that procrastination is a potentially modifiable behaviour, interventions aimed at reducing procrastination, such as simplifying tasks or providing default appointment, could improve engagement in critical health preventive behaviours.

Experiences of a Digital Behavior Change Intervention to Prevent Weight Gain and Promote Risk-Reducing Health Behaviors for Women Aged 18 to 35 Years at Increased Risk of Breast Cancer: Qualitative Interview Study.

Breast cancer is the most common form of cancer in women. Adult weight gain and modifiable health behaviors, including smoking, alcohol intake, and lack of physical activity, are well-known risk factors. Most weight gain in women occurs between the ages of 18 and 35 years. Digital interventions have the potential to address logistical challenges that arise in reaching women in this age range. We designed a digital intervention targeting weight gain prevention and other modifiable health behaviors for young women at increased risk of breast cancer. Women aged 18 to 35 years were recruited to this single-arm intervention study over 2 months to test the acceptability and usability of the intervention, which comprised a group welcome event held via videoconferencing, app, and private Facebook group. This nested qualitative substudy explored women's views and experiences of being part of the digital health intervention to inform future intervention development for a feasibility study. A total of 20 women aged 23 to 35 years who were at increased risk of breast cancer were interviewed via telephone within 1 month after completing the intervention, between February 2023 and March 2023. The women were asked about their experiences of the digital intervention and the extent to which it may have influenced their health behaviors. Data were analyzed thematically and organized using the framework approach. The interviews lasted for a median of 37 (IQR 30-46) minutes. Overall, the women perceived the digital health intervention comprising education, tracking, and support to be acceptable for weight gain prevention. In total, 4 themes were generated. A "missed opportunity" in breast cancer prevention services encompasses the lack of services that currently exist for young women at increased risk of breast cancer. The pros and cons of being part of a community encompasses the divergent views that the women had regarding engaging with other women at increased risk. The importance of an interactive app focuses on features that the women would want from the app to promote engagement with the intervention. The different wants and needs of different age groups highlights that an intervention such as this one would need to be customizable to suit the needs of women at different life stages. There is an unmet need in prevention services for young women aged 18 to 35 years at increased risk of breast cancer. The women perceived the app to be an acceptable intervention for weight gain prevention but emphasized that the intervention would need to be customizable to meet the needs of different age groups within the group of women aged 18 to 35 years. The digital intervention could be a scalable behavior change strategy for UK family history clinics.

Learning First Aid Knowledge Not Only for the Self But Also for Others: Toward a Collective Protection Motivation Theory

ABSTRACT The practice of learning first aid knowledge on social media has gained considerable attention as a strategy for improving public health. Yet despite this recognition, the practice has not drawn commensurate academic attention. Different from individual health protection behavior, first aid knowledge learning is a collective preventive health behavior due to its collective attributes of protecting the health of others. To address the behavior, we extend the protection motivation theory (PMT) with a mixed-methods approach. Specifically, our qualitative study allows us to clarify the motivations for the behavior, confirm the applicability of PMT in this new context, and identify self- and collective cognition as well as other contextualized factors. The subsequent quantitative study validates the effect of these motivations, with the results indicating that collective cognition shows stronger effects than self-cognition in such a collective behavior context, and emotions (i.e. anticipated regret) play a significant mediating role between cognitive appraisals and protective behaviors. This study extends the health behavior literature and expands PMT by validating self- and collective dimensions. It also offers practical guidelines to practitioners on how to motivate individuals to learn first aid knowledge on social media.