Lifestyle Behaviors Research Articles

Physical Activity Behaviour and Motivation During and Following Pulmonary and Cardiac Rehabilitation: A Repeated Measures Study.

Exercise rehabilitation programmes are important for long-term health and wellbeing among people with cardiac and pulmonary diseases. Despite this, many people struggle to maintain their physical activity once rehabilitation ends. This repeated measures study tracked changes in physical activity behaviour and motivation during and after completing a community-based exercise rehabilitation programme. Cardiac and pulmonary exercise rehabilitation patients (N = 31) completed six once-monthly measures of physical activity (MET·min), self-determined motivation, intention, and habit strength for rehabilitation exercise (within rehabilitation sessions) and lifestyle physical activity (outside of rehabilitation sessions). Linear regression and random effects models with estimated marginal means were used to test for associations between physical activity motivation and behaviour and change during and post-rehabilitation. Overall physical activity decreased after rehabilitation (823 MET·min) despite patients becoming more self-determined for lifestyle physical activity during rehabilitation. More self-determined motivation, stronger intentions, and stronger habits were associated with more lifestyle physical activity behaviour. However, none of these motivation variables were significantly associated with rehabilitation exercise behaviour. Among community-based cardiac and pulmonary rehabilitation patients, physical activity levels decreased following exercise rehabilitation programmes. The findings revealed clear distinctions in the motivation of rehabilitation exercise compared to lifestyle physical activity. Exercise rehabilitation programmes might improve the longevity of outcomes by integrating approaches to enhance lifestyle physical activity beyond the clinic.

Dietary Health Communication and Conversation Analysis: A Scoping Review

ABSTRACT Globally, many people don’t eat a healthy diet despite policies and public health frameworks deployed to improve dietary status. Healthy diets can prevent, manage, and even reverse chronic disease, highlighting the importance of health professionals addressing healthy diets in clinical consultations. Conversation analysis (CA) is a method that can be used to understand dietary talk in these clinical consultations; however, it is unclear to what extent CA has been used for this purpose. Using PRISMA guidelines, a scoping review was conducted with the aim of identifying and summarizing research where CA was used to examine the dietary health conversations between health professionals and adults. A systematic search resulted in 4161 articles retrieved, with 13 studies meeting inclusion criteria. Included studies used CA to examine a variety of phases of dietary health encounters, including dietary assessment, advice-giving and resistance to this dietary advice, and dietary (lifestyle) behavior change negotiations, with n = 6 using audio or video recording, respectively. Studies were conducted in seven countries and across primary, secondary, and tertiary settings. We highlighted that dietary talk, irrespective of purpose (e.g., evaluation, assessment, or persuasion [e.g., behavior change]), is under-researched within the CA field. This is a need for further research using CA on dietary talk across a range of settings, conditions, populations, and talk purposes to understand how health professionals impact patient dietary behaviors. Such understanding has the potential to contribute to the improvement of dietary health communication approaches and patient outcomes.

An expert consensus on the most effective components of integrated motivational interviewing and cognitive behavioural therapy for lifestyle behaviour change: protocol for an online modified Delphi study

IntroductionBehaviour change interventions are advocated as a key approach to manage behavioural risk factors such as insufficient physical activity, poor diet and smoking. Integrated motivational interviewing and cognitive behavioural therapy...

Pay Attention to Hypertension (PAtH): Findings from a cardiovascular health promotion intervention for adults with intellectual disabilities participating in Special Olympics programming.

Cardiovascular disease (CVD) affects adults globally. People with intellectual disabilities (PWID) may be at higher risk of CVD and associated risk factors (e.g. obesity, hypertension, and diabetes). We developed Pay Attention to Hypertension (PAtH), a cardiovascular health promotion intervention, and tested its impact on changes in blood pressure (BP), lifestyle behaviours and health-related empowerment among PWID. PAtH was developed with a Special Olympics community organisation that supports PWID in developing self-confidence and social skills through participation in sports. The 6-month intervention consisted of 1-h individualised virtual sessions delivered monthly by nursing students/novice nurses. Sessions covered specific themes, including monitoring BP, adopting healthy lifestyles and managing stress, and were individually tailored to the capacities and needs of participants. A single group pre-post-intervention design was used to assess the intervention's effects among participants who completed the intervention and data collection. Data included baseline and follow-up BP measurements from 7-day logbooks and questionnaires assessing lifestyle behaviours [physical activity (PA), screen time and diet], and health-related empowerment. Seventy-four participants were included in the analyses. Between baseline and follow-up, there were no changes in systolic and diastolic BP, PA or leisure screen time. The proportion of participants who reported adding salt when cooking decreased from baseline to follow-up (19.7% vs. 12.7%, P=0.034), and we found improvements for several items measuring health-related empowerment (P≤0.003). Improvements in health-related empowerment were found following PAtH. More intensive interventions may be needed to result in changes in lifestyle behaviours and BP. The integration of adapted cardiovascular health promotion initiatives within well-established community organisations such as Special Olympics is a promising avenue to contribute to cardiovascular health promotion among PWID.

A comparative study on the physical fitness of college students from different grades and majors in Jiangxi province.

Research to date has not provided a clear understanding of how different grades and majors affect the physical fitness of college students. It is postulated that there are significant disparities in physical health among college students of different grades and majors. The purpose of this study was to evidence these health disparities and to engage in an extensive analysis and discussion thereof. A sample of 8,772 (2,404 boys and 6,368 girls) Chinese college students from freshman to junior years, aged 17-22, including 12 different majors in four colleges, were recruited in Jiangxi Province. All seven physical fitness indicators (body mass index (BMI), forced vital capacity, 50-m dash, standing long jump, sit and reach, upper body muscle strength, and endurance runs) were conducted for all participants. One-way ANOVA and LSD tests were conducted to compare the physical fitness scores of different grades in the same major. Independent sample t-tests were utilized to compare the differences in every physical fitness indicator for different majors. Pearson's correlations among 12 majors for every grade were conducted to study the significant corrections between the two physical fitness indicators. The body mass index (BMI) and physical fitness indicator (PFI) for college students of different grade were investigated using a nonlinear regression model. The current state of physical fitness among college students is concerning, as the majority of students were barely passing (with a passing rate of 75.3%). Specifically, junior students exhibited lower scores than freshman and sophomore students across all 12 majors. From freshman to junior year, majors of music (78.01±4.58), English (79.29±5.03), and education (76.26±4.81) had the highest scores, respectively, but major art consistently scored the lowest, which were 73.85±6.02, 74.97±5.53, and 72.59±4.84, respectively. Pairwise comparisons revealed more significant differences in individual physical fitness indicators among the three grades in humanities than in sciences. Pearson's correlations showed significant correlations among seven physical fitness indicators in all three grades. PFI had a parabolic trend with BMI both for boy and girl college students in Jiangxi province. The physical fitness indicators of college students in Jiangxi province significantly differed in grades and majors, showing undesirable phenomena. The physical fitness of senior and humanities major college students was much weaker and needs sufficient attention. The relationship between BMI and PFI presented an inverted "U"-shaped change characteristic. Continued nationwide interventions are needed to promote physical activity and other healthy lifestyle behaviors in China.

Nurse-Led Physical Screening of Patients With Substance Use Disorders: A Cross-Sectional Study.

Somatic comorbidity is the main cause of reduced life expectancy in patients with substance use disorders (SUDs). This study aims to investigate somatic health challenges in patients with SUDs using the USS. Patient self-management of somatic health and quality of life were also assessed. In our study, a stratified random sample of 136 clients who received treatment at a specialist addiction facility was drawn to investigate their physical health and lifestyle behaviours using the Utrecht Somatic Screening 2.0 (USS 2.0). The sample included three subgroups, that is, patients receiving outpatient treatment through Flexible Assertive Community Treatment (FACT), Heroin-Assisted Treatment (HAT) and Opioid Replacement Therapy (ORT). Pain, self-management and quality of life were also measured. Descriptive statistics were used to analyse the data. The findings indicate that many patients experience a large number of somatic health problems, including pain and exhaustion. The most prevalent conditions in this study are cardiovascular disease (25%) and COPD (20%), underweight and poor oral health. Tobacco smoking is prevalent among 88% of patients. Fifty percent of the patients expressed a need for support in managing their physical health. Somatic health care and lifestyle promotion should be tailored to the specific characteristics of patients. Patients with SUDs suffer from poor physical health and show unhealthy lifestyle behaviours, which demand the promotion of tailored somatic health.

Association of modifiable risk factors and infectious diseases among individuals with hypertension: a prospective cohort study

BackgroundA comprehensive assessment of combined modifiable risk factors in relation to infectious diseases among individuals with hypertension is lacking, and the potential mechanisms of these associations remain unclear. To investigate the prospective associations of a combination of lifestyle behaviors and cardiometabolic factors with the risk of infectious diseases among individuals with hypertension and to estimate whether and to what extent blood biomarkers mediate these associations.MethodsThis cohort study included 147,188 participants with hypertension and complete data on modifiable risk factors from the UK Biobank. Health score was constructed from eight modifiable risk factors, including four lifestyle behaviors (diet, physical activity, smoking, and sleep duration) and four cardiometabolic factors (body mass index, blood lipids, blood glucose, and blood pressure). Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the health score and infectious diseases. The mediation analysis was performed to assess the potential intermediation effects of blood biomarkers.ResultsOver a median follow-up of 12.5 years, 27,398 participants with infectious diseases were documented, with 960 respiratory infectious diseases and 7940 digestive infectious diseases. After adjusting for potential confounders, the HR (95% CI) for the highest versus the lowest quartile of health score was 0.64 (0.62, 0.66) for infectious diseases, 0.72 (0.60, 0.86) for respiratory infectious diseases, and 0.66 (0.62, 0.71) for digestive infectious diseases. Stratified factors including duration of hypertension did not modify the associations between the health score and infectious diseases. In addition, biomarkers including inflammation and renal function collectively explained 46.60% of the associations between the combined lifestyle factors and infectious disease risk among individuals with hypertension.Conclusions and relevanceIdeal management of combined modifiable risk factors was associated with lower risks of infectious diseases and might produce profound changes in blood biomarkers among individuals with hypertension. Additionally, specific biomarkers appeared to serve as an intermediate between combined lifestyle factors and infectious diseases. These insights highlighted the important role of a combination of healthy lifestyle and favorable cardiometabolic status in reducing disease burden and facilitated the understanding of biological mechanisms underlying modifiable risk factors with infectious diseases.

Burden landscape of hepatobiliary and pancreatic cancers in Chinese young adults: 30 years' overview and forecasted trends.

Hepatobiliary and pancreatic (HBP) cancers impose a considerable burden on young populations (aged 15 to 49 years), resulting in a substantial number of new cases and fatalities each year. In young populations, the HBP cancers shows extensive variance worldwide and the updated data in China is lacking. To investigate the current status, trends, projections, and underlying risk factors of HBP cancers among young populations in China. The Global Burden of Disease Study 2019 provided data on the annual incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) of HBP cancers in young Chinese adults between 1990 and 2019. Temporal trends were assessed using estimated annual percentage change and hierarchical clustering. Sex-specific mortality and DALYs caused by various risks were analyzed across China and other regions, with future trends until 2035 projected using the Bayesian age-period-cohort model. From 1990 to 2019, incident cases, deaths, DALYs, ASIR, ASMR, and ASDR for liver cancer (LC) in young Chinese individuals decreased, classified into 'significant decrease' group. Conversely, cases of gallbladder and biliary tract cancer and pancreatic cancer rose, categorized as either 'significant increase' or 'minor increase' groups. The contribution of risk factors to mortality and DALYs for HBP tumors increased to varying degrees. Healthy lifestyle behaviors, such as tobacco control, weight management, alcohol moderation, and drug avoidance, could lower HBP cancers incidence. Moreover, except for LC in females, which is likely to initially decline slightly and then rise, the forecasting model predicted that the ASIR and ASMR for all HPB cancers subtypes by gender will increase among young adults. HBP cancers burden among young adults in China is expected to increase until 2035, necessitating lifestyle interventions and targeted treatment strategies to mitigate the public health impact of these cancers.

A 5-Year Mortality Prediction Model for Prostate Cancer Patients Based on the Korean Nationwide Health Insurance Claims Database.

Prostate cancer is the fourth most common cancer and eighth leading cause of cancer-related mortality worldwide. Its incidence is increasing in South Korea. This study aimed to investigate a predictive model for the 5-year survival probability of prostate cancer patients in a Korean primary care setting. This retrospective study used data from the nationwide insurance claims database. The main outcome was survival probability 5 years after the initial diagnosis of prostate cancer. Potential confounding factors such as age, body mass index (BMI), blood pressure, laboratory results, lifestyle behaviors, household income, and comorbidity index were considered. These variables were available in the national health check-up information. A Cox proportional hazards regression model was used to develop the predictive model. The predictive performance was calculated based on the mean area under the receiver operating characteristic curve (AUC) after 10-fold cross-validation. The mean 5-year survival probability was 82.0%. Age, fasting glucose and gamma-glutamyl transferase levels, current smoking, and multiple comorbidities were positively associated with mortality, whereas BMI, alkaline phosphatase levels, total cholesterol levels, alcohol intake, physical activity, and household income were inversely associated with mortality. The mean AUC after 10-fold cross-validation was 0.71. The 5-year survival probability model showed a moderately good predictive performance. This may be useful in predicting the survival probability of prostate cancer patients in primary care settings. When interpreting these results, potential limitations, such as selection or healthy user biases, should be considered.

Effect of stressors during COVID-19 lockdown on malnutrition and health-risk behaviors among Jordanian college students: A cross-sectional study.

A stressful condition such as the emergence of the coronavirus and its related lockdown measures might trigger alterations in college students' behaviors. This cross-sectional study aimed to identify the changes in college students' dietary and lifestyle behaviors during the lockdown and the effect of lockdown-related stressors on health-risk behaviors. A web-based survey was conducted among undergraduate college students in Jordan. Weight and height were reported by the students. The students' dietary and lifestyle behaviors and their changes during 1 month of the countrywide lockdown were assessed. The Perceived Stress Scale-4 was utilized to assess stress levels. Results indicated that 77.2% of the students reported weight changes. Notably, 45.9% increased their intake of unhealthy food, while and 38% opted for healthier food choices. Most students experienced alterations in physical activity (80.0%), screen time (86.2%), smoking, and sleep patterns (85.4%), with a higher tendency toward adopting health-risk behaviors. Perceptions of curfew-related stress were associated with distance learning-related stress (OR = 2.73, CI: 1.08-6.90, P = .034), and a greater change in physical activity (OR = 3.59, CI: 1.36-9.48, P = .010). Additionally, weight changes were associated with perception of other types of stressors (OR = 3.39, CI: 1.39-8.28, P = .007). Overall, there was a considerable increase in malnutrition and health-risk behaviors among students during the lockdown. Understanding students' responses to these stressful conditions and the role of stress in driving behavioral changes are crucial for developing interventions that enhance college students' adaptation to such changes and maintaining healthy dietary and lifestyle behaviors in the future.

Regular physical activity improves physical function and health-related quality of life among middle-aged and older women who suffered a fragility fracture-a population-based cohort.

To evaluate the long-term impact of physical activity on physical function and health-related quality of life (HRQoL) in women ≥ 50 years old who suffered a fragility fracture. We evaluated the association of physical activity with physical function and HRQoL in women ≥ 50 years old who self-reported at least one low-impact fracture ≥ 40 years old from the EpiDoC cohort, a population-based cohort. Self-reported data regarding sociodemographics, clinical, and lifestyle behaviors were collected through a semi-structured questionnaire at baseline during a face-to-face clinical interview. During a long-term follow-up, a phone interview was conducted to evaluate physical activity (using a non-validated scale developed for the EpiDoC study), physical function (Health Assessment Questionnaire), and HRQoL (European Quality of Life - 5 Dimension). Women were divided into three groups according to the frequency of physical activity (non-frequent = 0 times/week, frequent = 1-2 times/week, or very frequent = ≥ 3 times/week). The association of physical activity frequency (non-frequent, frequent, and very frequent) with physical function and HRQoL over time was assessed through linear mixed models considering varying intercepts for each woman. This study followed 323 post-fracture women, during a mean follow-up of 3.9 ± 3.5 years. Frequent (β = - 0.1419 [- 0.2783, - 0.0064]) and very frequent (β = - 0.1908 [- 0.2944, - 0.0881]) physical exercise were associated with improvements in physical function relative to non-frequent physical exercise adjusted for BMI, multimorbidity, hospitalizations, alcohol and smoking habits, and the number of fragility fractures at baseline. As for HRQoL, a positive association was found for exercise frequency, specifically frequent (β = 0.1305 [0.0646, 0.1958]) and very frequent (β = 0.1354 [0.0856, 0.1859]) suggesting improvements for HRQoL, in this follow-up period. These findings based on longitudinal data with long-term follow-up suggest that regular physical activity is associated with better function and HRQol among middle-aged and older post-fracture osteoporotic Portuguese women.

Association between allostatic load and accelerated white matter brain aging: findings from the UK biobank.

White matter (WM) brain age, a neuroimaging-derived biomarker indicating WM microstructural changes, helps predict dementia and neurodegenerative disorder risks. The cumulative effect of chronic stress on WM brain aging remains unknown. In this study, we assessed cumulative stress using a multi-system composite allostatic load (AL) index based on inflammatory, anthropometric, respiratory, lipidemia, and glucose metabolism measures, and investigated its association with WM brain age gap (BAG), computed from diffusion tensor imaging data using a machine learning model, among 22 951 European ancestries aged 40 to 69 (51.40% women) from UK Biobank. Linear regression, Mendelian randomization, along with inverse probability weighting and doubly robust methods, were used to evaluate the impact of AL on WM BAG adjusting for age, sex, socioeconomic, and lifestyle behaviors. We found increasing one AL score unit significantly increased WM BAG by 0.29years in association analysis and by 0.33years in Mendelian analysis. The age- and sex-stratified analysis showed consistent results among participants 45-54 and 55-64years old, with no significant sex difference. This study demonstrated that higher chronic stress was significantly associated with accelerated brain aging, highlighting the importance of stress management in reducing dementia and neurodegenerative disease risks.

Associations of Regular Internet Usage with All-Cause and Cause-Specific Mortality: A Prospective Cohort Study

ObjectivesThe impact of internet usage on mortality is not widely known. This study intended to investigate the associations between regular internet usage and the risks of all-cause and cause-specific mortality, while also ascertaining potential factors that may modify these correlations. DesignA community-based prospective cohort study. Setting and ParticipantsThe study included 21,481 individuals [mean (SD) age, 64.1 (11.0) years] from the Health and Retirement Study, with data collected between 2006 and 2020. MethodsThe Cox proportional hazards regression model was used to evaluate the associations between regular internet usage and the risks of all-cause and cause-specific mortality, adjusting for demographic factors, lifestyle behaviors, and other potential confounding factors. Moreover, we explored the association between daily hours of internet usage and the risk of outcomes. ResultsRegular internet usage was significantly associated with a lower risk of all-cause mortality (hazard ratio, 0.78; 95% CI, 0.74-0.83) and cardiovascular mortality (hazard ratio, 0.72; 95% CI, 0.64-0.82). No significant interaction effects were observed for age, sex, regular exercise, or current alcohol consumption (all P interactions > .05). Additionally, estimations for daily hours of usage indicated a U-shaped relationship with all-cause mortality. Adults who used 2.1 to 4 hours per day had the lowest risk; however, not all estimations showed their significance on account of the limited sample size. Conclusions and ImplicationsRegular internet usage was associated with a lower risk of all-cause and cardiovascular mortality, which may prompt consideration of the beneficial impact of internet usage on lifespan.

Traditional and non-traditional cardiovascular risk factor profiles in young patients with coronary artery disease

Study objectiveThere is an increasing trend in myocardial infarction (MI) hospitalizations in young individuals. The prevalence of modifiable cardiovascular risk factors is high in this population. This study aims to assess the prevalence of traditional and non-traditional cardiovascular risk factors among young patients with coronary artery disease (CAD) including novel lipid and dietary biomarkers with a focus on potential gender differences. DesignThe Young Heart study is a prospective, single-center pilot cohort study. Baseline data included medical history, medications, and lifestyle factors. We also collected blood samples for lipid profile, lipoprotein (a), high-sensitivity C-reactive protein (hsCRP), and trimethylamine N-oxide (TMAO). ParticipantsA total of 60 patients aged <60 years with CAD (on coronary CT or invasive angiogram) were included in the study. ResultsThe median age was 51 years and predominantly male (70 %). Baseline assessment revealed a high prevalence of hypertension (76.7 %), hyperlipidemia (91.7 %), and obstructive CAD (88.3 %). 36.7 % had diabetes, 28.3 % had prediabetes, and 38.3 % had prior MI. Uncontrolled risk factors were prevalent, including increased waist circumference (54.6 %), metabolic syndrome (60.0 %), and LDL ≥70 mg/dL (47.5 %), Lp(a) ≥75 nmol/L (47.5 %). Furthermore, 41.7 % had hsCRP ≥2 mg/L, and 28.3 % had suboptimal TMAO levels. 70.0 % of patients were on guideline-directed doses of statins. ConclusionYoung patients with CAD demonstrated a substantial burden of traditional and non-traditional cardiovascular risk factors. The study findings highlight the need for targeted interventions to improve risk factor control and optimize lifestyle behaviors. Further investigation is warranted to assess the impact of these interventions on cardiovascular outcomes.

Malaysians' mental health and lifestyle behavior during the COVID-19 pandemic: a qualitative approach

Malaysians' mental health and lifestyle behavior during the COVID-19 pandemic: a qualitative approach

The impact of a positive discipline group intervention on parenting self-efficacy among mothers of young children.

Instilling healthy behaviors in early childhood is crucial as they can have lifelong impacts. However, many Chinese mothers lack effective parenting strategies, resulting in low self-efficacy. Positive Discipline, a non-punitive and non-indulgent approach, can help enhance maternal parenting self-efficacy and promote healthy lifestyle behaviors in children. This study explores the impact of a Positive Discipline group intervention on the parenting self-efficacy of Chinese mothers and how it can contribute to promoting diet and healthy lifestyle behaviors in early childhood. We randomly selected 70 mothers with low parenting self-efficacy from a kindergarten in China, dividing them into an intervention group (35 participants) and a control group (35 participants). The intervention group received a 6-week Positive Discipline intervention, while the control group received no intervention. The intervention aimed at helping mothers nurture their children in a kind and firm manner. We used paired samples t-tests and independent samples t-tests to compare changes in parenting self-efficacy scores before and after the intervention. Results showed that the intervention group's parenting self-efficacy scores significantly improved after the intervention, from an average score of 25.00 ± 4.08 to 36.29 ± 2.99 (p < 0.05, Cohen's d = 3.156). Significant improvements were observed in areas like "believing their parenting style benefits their child's growth" and "knowing how to effectively parent their children." The control group's average scores showed no significant changes between pre- and post-intervention (pre: 25.07 ± 5.33; post: 24.86 ± 5.75, p > 0.05, Cohen's d = 0.076). Furthermore, 3 months post-intervention, the intervention group's scores remained significantly higher than pre-intervention (p < 0.05), demonstrating the intervention's lasting effect. This study demonstrates that the Positive Discipline group intervention significantly enhances parenting self-efficacy in Chinese mothers, promoting healthy lifestyle behaviors in early childhood. Providing continuous support and guidance to mothers can help solidify their parenting confidence, ensuring long-term intervention success. Future research should explore how group interventions can effectively integrate healthy behaviors into early childhood routines and impact children's diet and lifestyle behaviors.

Risk Factors Associated With Exaggerated Blood Pressure Response At The Time Of Exercise Treadmill Stress Test.

Exaggerated blood pressure response (EBPR) to exercise stress testing (EST) may be a marker of future hypertension and carry valuable information for the prediction of cardiovascular events. We sought to evaluate the clinical and resting EST parameters associated with increased likelihood to EBPR. The records of 14073 patients (mean age: 55±11 years) without known cardiovascular disease who underwent a treadmill EST were analysed. The overall prevalence of arterial hypertension was 44%. A considerable proportion (24%) of patients exhibited EBPR. Multivariate analysis of the entire study population showed that middle-aged individuals (40-60 years old), resting systolic BP>130mmHg and/or diastolic BP>80 mmHg, known arterial hypertension, current cigarette smoking and family history of premature coronary artery disease are all independent risk factors for EBPR (all P<0.001). Although the presence of arterial hypertension increased the likelihood of EBPR in the analysis of the entire population, the relevant association in subjects above 60 years old is statistically non-significant (P=0.120). Notably, the pre-test systolic BP>130mmHg and/or diastolic BP>80 mmHg level increased significantly the likelihood to manifest EBPR in all age categories (<40, 40-60 and >60 years old) independent of hypertension presence and in all hypertensive patients independently of antihypertension treatment intake (all P<0.001). Considering the diagnostic and prognostic utility of EBPR during treadmill EST the clinical and resting haemodynamic parameters that increase the likelihood to EBPR are targets for interventions and preventive measures to modify lifestyle risk behaviours and reduce hypertension and cardiovascular risk factors in the early stages.

Baseline Health of University Workers Pre-Intervention in Lifestyle: HaSEN

Objective: The aim of the present study was to analyse and compare the initial health situation before starting the lifestyle programme in 4 editions of the programme. Theoretical framework: HaSEN is an annual intervention programme for the generation of healthy habits on eating behaviour (psychonutrition) and active lifestyle (physical exercise) in university workers in the contemplative phase of motivation to change. Methods: A total of 74 workers participated between the 2019, 2020, 2021 and 2022 editions from a Spanish university (24-59 years; M = 42.3; SD = 8.5) 19 men (26%) and 55 women (74%). Anthropometric, biological, lifestyle and psychological variables were analysed. Results and Discussion: Anthropometric, biological, lifestyle and psychological variables were analysed. Adherence to the Mediterranean diet in the 2021 edition workers at the start of the intervention was found to be higher than in 2019 and achievement motivation higher than in 2020, results that could be related to the special situation derived from the Covid-19 pandemic. Implications of the research: This shows the importance of knowing the baseline health status of workers in behaviours such as those observed in the last edition (2022) in terms of worsening adherence to the Mediterranean diet. This aspect highlights the need to apply interventions such as the HaSEN programme for the maintenance of a healthy lifestyle in terms of nutrition and physical exercise behaviour in the population under study. Originality/value: This study contributes to the scientific literature on public health in the population of university workers. It provides retrospective and prospective information on baseline health status and motivation to change habits to maintain a lifestyle in a working population subjected to high levels of work demands and the implications that this may have on the overall health status of this population.

Comparative Outcomes of a Cognitive-Behavioral Skills Building Program on the Mental Health and Healthy Behaviors of Prenursing Students

Background: Nursing students experience significantly more stress related diseases when compared to non-nursing students, and the state of their mental health can result in short-term increased attrition rates and increased nursing shortages. Purpose: A preexperimental pre-post study design was used to examine mental health and healthy behaviors among prenursing students. Methods: Cohorts received the MINDSTRONG© program either in-person or virtually. Data analysis included Personal Wellness Assessments completed at both pre- and poststudy for all participants (n = 110). Results: Both groups postintervention had statistically significant decreases in anxiety, depression, and stress and statistically significant increases in healthy lifestyle behaviors and beliefs. Students with elevated depression and anxiety scores at baseline had greater decreases postintervention than the overall groups. Conclusion: The outcomes for both cohorts were positive and effective in reducing stress, anxiety, and depressive symptoms. Healthy behaviors were improved and align with findings with an in-person format. Findings from this study support implementation of MINDSTRONG in synchronous sessions, either in-person or virtual.

Effects of school closure on lifestyle behaviours and health outcomes in children during the COVID-19 pandemic in Chile: A time-matched analysis.

The COVID-19 pandemic led to school closures, potentially impairing children's behaviours and health. We aimed to explore the effects of school closure on lifestyle behaviours (dietary habits, physical activity) and health outcomes (adiposity, fitness, self-esteem, self-concept) in children. We measured 247 children before school closure (October-November 2019) and after school reopening (October-November 2021) (COVID-19 group). To distinguish the changes due to school closure from changes due to growth, we included 655 age-matched children with cross-sectional measurements in October-November 2019 (control group). The response of this group (i.e., differences between children with 2 years of difference) was considered the expected response to growth. Two-way ANOVA was used to test age-by-group interactions, indicating an effect of school closure. In 7-to-9-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.4 points), resulting in higher physical inactivity prevalence (by 19 percent points) at 9 years. This was accompanied by larger-than-expected increases in fat percentage (by 6.1 percent point). In 8-to-10-year-old children, the COVID-19 group had higher physical inactivity prevalence at 10 years (by 20 percent points). This was accompanied by larger-than-expected increases in fat percentage (by 8.3 percent points), z-score BMI (by 0.90 units), and waist circumference (by 6.1 cm). In 9-to-11-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.3 points) and increases in self-concept (by 0.2 points). The response in dietary habits, fitness, or self-esteem was not different between groups. Overall, school closure negatively impacted physical activity and adiposity, particularly in the youngest children.