Opportunities For Health Promotion Research Articles

School-Based Cardiovascular Health Promotion in Adolescents

School-based interventions offer an opportunity for health promotion in adolescence. To assess the effect of 2 multicomponent educational health promotion strategies of differing duration and intensity on adolescents' cardiovascular health (CVH). The SI! Program for Secondary Schools is a 4-year cluster randomized clinical intervention trial conducted in 24 secondary schools from Barcelona and Madrid, Spain, from September 7, 2017, to July 31, 2021. Eligible participants were adolescents enrolled in the first grade of secondary school. Schools and their participants were randomized to receive a health promotion intervention (SI! Program) over 4 school years (long-term intervention [LTI], 8 schools, 412 adolescents) or 2 school years (short-term intervention [STI], 8 schools, 504 adolescents) or to receive the standard curriculum (control, 8 schools, 441 adolescents). The primary end point was the between-group difference at 2 and 4 years in the change from baseline of the overall CVH score, as defined by the American Heart Association (range, 0-14 points, with a higher score indicating a healthier CVH profile). Intervention effects were tested with multilevel mixed-effects models. A complete-case intention-to-treat analysis was performed as the primary analysis. Of the randomized students, the study enrolled 1326 adolescents (684 [51.6%] boys, mean [SD] age, 12.5 [0.4] years at recruitment) with a study completion rate of 86.0%. Baseline overall CVH scores were 10.3 points in the LTI group, 10.6 points in the STI group, and 10.5 points in the control group. After 2 years, at halfway through the LTI and at the end of the STI, the difference in the CVH score change was 0.44 points (95% CI, 0.01-0.87; P = .04) between the LTI group and the control group and 0.18 points (95% CI, -0.25 to 0.61; P = .39) between the STI group and the control group. At 4 years, differences for the LTI and STI groups vs control were 0.12 points (LTI: 95% CI, -0.19 to 0.43; P = .42) and 0.13 points (STI: 95% CI, -0.17 to 0.44; P = .38). No adverse events were reported. Overall, the tested school-based health promotion strategies in this randomized clinical trial had a neutral effect on the CVH of the adolescents. Although there was evidence of a marginal beneficial effect at a point halfway through implementation in the LTI group, such a benefit was not noted at 4 years. Further research is warranted into the efficacy of school-based health promotion programs. ClinicalTrials.gov Identifier: NCT03504059.

Is breakfast consumption detrimental, unnecessary, or an opportunity for health promotion? A review of cardiometabolic outcomes and functional food choices.

Breakfast consumption is generally considered a health-promoting habit for cardiometabolism, particularly with regard to chrononutrition. Glucose uptake is enhanced by proper insulin secretion triggered by the pancreatic clock, averting metabolic dysregulation related to insulin resistance. Breakfast skipping, in turn, is often considered a behaviour detrimental to health, in part due to putative inverse metabolic actions compared to breakfast consumption, such that breakfast skipping may promote circadian desynchrony. However, most ill health concerns about breakfast skipping are inferred from observational research, and recent well-controlled randomized clinical trials have shown benefits of breakfast skipping for cardiovascular risk factors. Accordingly, this review describes the effects of breakfast consumption versus breakfast skipping on cardiovascular risk factors (blood pressure and glycaemic and lipid indices). In addition, the view of breakfast consumption as an opportunity for functional food ingestion is considered to provide further insights into decision-making practice. Collectively, both breakfast consumption and breakfast skipping can be considered viable habits, but they depend on individual preferences, planning, and the specific foods being consumed or omitted. When consumed, breakfast should consist primarily of functional foods typical for this meal (e.g., eggs, dairy products, nuts, fruits, whole grains, coffee, tea, etc.). While breakfast consumption aligns with chrononutrition principles, breakfast skipping can contribute to a calorie deficit over time, which has the potential for widespread cardiometabolic benefits for patients with overweight/obesity. The concepts and practical considerations discussed in the present review may aid health care personnel in personalising breakfast consumption recommendations for diverse patient populations.

Intersections of Racial/Ethnic and Religious Identities on Bodily Well-Being for Black College-Attending Emerging Adults.

Black undergraduates face threats to healthy weight and body image (i.e., bodily well-being). Having a strong racial/ethnic identity can promote health during emerging adulthood. However, less is known about the intersections of racial/ethnic and religious identities on the bodily well-being of Black college-attending emerging adults, despite evidence to indicate that aspects of religiosity are also associated with health. We use quantitative data from 767 Black college-attending emerging adults in the Multi-University Study of Identity and Culture to examine the independent contributions of racial/ethnic and religious identity for bodily health, and test a potential interaction between racial/ethnic and religious identity on bodily health outcomes. Results from a multivariate linear regression model indicate that Black college-attending emerging adults with both high religious identity and high racial/ethnic identity exploration had higher body mass index and less positive body image. Findings suggest ways to strengthen the development of culturally appropriate public health prevention and intervention efforts that target body image and weight for Black college-attending emerging adults. IMPACT STATEMENT: Black college-attending emerging adults face challenges to their health, particularly threats to healthy weight and body image during this period of psychosocial transitions. The developmental process of navigating racial/ethnic and religious identities during this time raises challenges and opportunities for health promotion for this population. Yet, research that explores the role of these identities remains scarce. We found that Black college-attending emerging adults had higher body mass index and more negative body image when they reported more racial/ethnic identity exploration coupled with higher religious identities. Results shed light on the complex ways that navigating both racial/ethnic and religious identities may put some Black college-attending emerging adults at greater health risk. Health education and promotion practice focused on improving Black emerging adult health in college contexts should ensure that behavioral interventions are appropriately nuanced and situated in these populations' developmental and cultural considerations.

Environmental health perceptions of urban youth from low-income communities: A qualitative photovoice study and framework.

Children are amongst the most susceptible groups to environmental exposures, for both immediate and life-course health outcomes. Despite their increased susceptibility, children's knowledge, experiencesand voices are understudied. A deeper understanding of children's environmental health perceptions has the potential to better inform policy, develop targeted interventionsand improve public health outcomes. In this study, our community-academic partnership used the Photovoice research method to examine how urban children from low-income communities perceive environmental influences on their health. Twenty children, ages 10-12, took photographs and participated in focus group interviews regarding their perspectives on how the environment influences their health. Qualitative analyses revealed five major thematic categories: environmental exposures, environmental health sentiments, environmental health outcomes, interest in environmental healthand environmental health solutions. We used the findings to develop an environmental health perspective theoretical framework that can inform future work designed to promote the environmental health and well-being of children from low-income communities in urban communities. Photovoice enabledchildren from low-income communities to capture and communicate their environmental health perceptions. These findings have the potential to inform and identify potential targets and opportunities for environmental health interventions and promotion in their communities. Partnerships with community-based organizations were central to the present study. By design, these community-based partners were involved in the conduct and procedures of the study.

Assessment of health-related behaviors among medical students: A cross-sectional study.

Students sometimes participate in harmful activities that adversely influence their behaviors and well-being throughout college, which is one of the sensitive phases in an individual's life. Aim: To assess the health-related behaviors of university students. A cross-sectional study that includes systematic randomly selected 383 students from various colleges of Ras Al Khaimah Medical and Health Sciences University (RAKMHSU),Ras Al Khaimah Emirate, United Arab Emirates. A self-reported questionnaire included students' demographic traits and behaviors, including safety, medication intake, cigarette smoking, nutrition, physical activity, and health-related topics. Most participants were females (69.7%), 13.3% were obese while 28.2% were overweight. The data revealed a significant difference between male and female students regarding medication intake without prescription, nutrition, physical activity, and health-related topics. The data also revealed that the majority of the students were attempting to lose weight, and the former male smokers had fewer trials to quit the use of all tobacco products than females. More than a quarter of participants were overweight, and the majority of students did not adhere to the guidelines for safety and nutritious eating. This study recognized significant health promotion opportunities for university students that can be carried out to establish a healthier youth for society.

Qualitative systematic review of general practitioners’ (GPs’) views and experiences of providing postnatal care

ObjectivesDevelop an understanding of the views and experiences of general practitioners (GPs) about their role in postnatal care, including barriers and facilitators to good care, and timing and content of...

5612969 INSIGHTS FROM AN ENGAGEMENT EVENT TO SUPPORT COLLABORATION BETWEEN CHILDREN WITH SICKLE CELL DISORDER, THEIR FAMILIES AND HEALTH SERVICES

Introduction: The APPG inquiry into sickle cell disorder (SCD) services found “serious care failings,” detailing SCD patients avoiding hospitals due to fear and lack of trust.1 It is often said that patients and families ‘do not engage’ or are ‘hard to reach,’ reflecting that services are not always accessible. Aims: In response, we organised a collaborative event reaching out to children and young people (CYP) with SCD and their families in a fun, accessible way. This aimed to test the theory that in an alternative and informal environment, there would be significant uptake of health promotion opportunities. Methods: The organising committee invited patient and parent representation, working closely with targeted charities. Three NHS trust charities contributed to funding and Tottenham Hotspur provided the venue. The event was widely advertised through health services via mailing lists, flyers and social media. Health promotion activities included Expert Panel Question and Answer session, myth busting and research stalls, transition workshops and complementary therapies. Performances from the B positive choir, celebrity DJing, arts and crafts, outdoor games and dance ensured the event was entertaining. Additionally, there was a session on career advice, as suggested by one of the patient representatives. Volunteers collected written feedback with open questions aiming to identify what attendees enjoyed, learnt, and improvement suggestions. Results: The event proved popular with 212 people cared for by 24 trusts (across London, Bedfordshire, Bristol, Cambridgeshire, Essex, Hertfordshire and Kent) registered in addition to their friends and family members. Despite train strikes on the day, 123 adults and 153 CYP across a range of ages (15% 1-4 y/o, 29% 5-10, 39% 11-15, 20% 16-18) attended. 64 submitted event feedback. We asked carers and CYP what was most valued about the event. Responses demonstrated: 61% said education about SCD, particularly learning about general management and emerging treatments such as gene therapy. 44% stated Fun and Enjoyment encouraged positive engagement for children and families rather than solely focused on health education. 16% valued the Sense of Community through connecting with other families as well as professionals in an informal setting. Conclusion: This demonstrates the feasibility of large-scale public health events through collaboration with stakeholders. There is demand for accessible, inclusive, and fun educational events in non-clinical settings. The high proportion of attendees learning more about SCD shows this does not detract from educational gain, but can strengthen care in an empowering way. It is important that the event feedback shapes further work. Attendees including families with newly diagnosed children were invited to peer support groups and people signed up to be informed of future events. Future plans include: Hosting similar events with interested networks. Event development to include more interactive workshops, events for young adults and opportunities for CYP and families to connect and form supportive communities. Deep Dive Event into the Experience of Care to investigate and guide what improvements can be made to SCD services. Reference 1. All Party Parlimentary Group (APPG) and the Sickle Cell Society, No One’s Listening: An Inquiry into the Avoidable Deaths and Failures of Care for Sickle Cell Patients in Secondary Care 2021 https://www.sicklecellsociety.org/wp-content/uploads/2021/11/No-Ones-Listening-PDF-Final.pdf

Life in lockdown: a qualitative study exploring the experience of living through the initial COVID-19 lockdown in the UK and its impact on diet, physical activity and mental health

BackgroundIn response to the COVID-19 pandemic, the UK imposed a national lockdown prompting change to daily routines. Among behaviours impacted by the lockdown, diet and physical activity may be particularly important due to their association with mental health and physical health. The aim of this study was to explore people’s experiences of how lockdown impacted their physical activity, dietary behaviours and mental health, with a view to informing public health promotion.MethodsThis phenomenological qualitative study used semi-structured telephone interviews. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted, guided by the Framework Approach.ResultsForty participants (28 female) completed an interview (mean duration: 36 min) between May and July 2020. The overarching themes identified were (i) Disruption (loss of routines, social interaction and cues to physical activity) and (ii) Adaptation (structuring the day, accessing the outdoor environment, finding new ways for social support). The disruption to daily routines altered people’s cues for physical activity and eating; some participants spoke of comfort eating and increased alcohol intake in the early days of lockdown, and how they consciously tried to change these when restrictions lasted longer than first anticipated. Others spoke of adapting to the restrictions using food preparation and meals to provide both routine and social time for families. Disruptions from the closure of workplaces resulted in flexible working times for some, allowing for physical activity to be built into the day. In later stages of restrictions, physical activity became an opportunity for social interaction and several participants reported intending to continue to replace sedentary means of socialising (e.g., meeting in cafes) with more active, outdoor activities (e.g., walking) once restrictions were lifted. Staying active and building activity into the day was seen as important to support physical and mental health during the challenging times of the pandemic.ConclusionsWhilst many participants found the UK lockdown challenging, adaptations to cope with the restrictions presented some positive changes related to physical activity and diet behaviours. Helping people sustain their new healthier activities since restrictions have lifted is a challenge but presents an opportunity for public health promotion.

Determinants of early initiation of first antenatal care visit in Ethiopia based on the 2019 Ethiopia mini-demographic and health survey: A multilevel analysis.

Early initiation of the first antenatal care visit provides a critical opportunity for health promotion, disease prevention, and curative care for women and their unborn fetuses. However, in developing countries, including Ethiopia, it is underutilized and most of the pregnant women didn't attend antenatal care visits during the first trimester (early). Therefore, the objective of this study was to estimate the prevalence of early initiation of antenatal care visits and its determinants among reproductive-age women in Ethiopia. A secondary data analysis was done based on the 2019 intermediate Ethiopian demographic health survey. The data were weighted by sampling weight for probability sampling and non-response to restore the representativeness of the data and have valid statistical estimates. Then, a total weighted sample of 2,935 women aged 15-49 years who gave birth in the five years preceding the survey and who had antenatal care visits for their last child was included. A multilevel mixed-effects logistic regression model was fitted to examine the determinants of early initiation of first antenatal care visits. Finally, statistical significance was declared at a p-value < 0.05. In this study, the overall magnitude of early initiation of the first antenatal care visit was 37.4% (95%CI: 34.6-40.2%). Women who attend higher education (AOR = 2.26: 95%CI; 1.36-3.77), medium wealth status (AOR = 1.80: 95%CI; 1.17-2.76), richer wealth status (AOR = 1.86: 95%CI; 1.21, 2.85), richest wealth status (AOR = 2.34: 95%CI; 1.43-3.83), living in Harari region (AOR = 2.24: 95%CI; 1.16-4.30), and living at Dire-Dawa city (AOR = 2.24: 95%CI; 1.16-4.30) were higher odds of early initiation of first ANC visits. However, women who were rural resident (AOR = 0.70: 95%CI; 0.59-0.93), household headed by male (AOR = 0.87: 95%CI; 0.72, 0.97), having ≥ 5 family size (AOR = 0.71: 95%CI; 0.55-0.93), and living in SNNPRs (AOR = 0.44: 95%CI; 0.23-0.84) were lower odds of early initiation of first ANC visits. The prevalence of early initiation of first antenatal care remains low in Ethiopia. Women's education, residence, wealth status, household head, having ≥ 5 family sizes, and region were determinants of early initiation of first antenatal care visits. Improving female education and women's empowerment through economic transitions with special attention given to rural and SNNPR regional state residents could maximize the early initiation of first antenatal care visits. Furthermore, to increase early antenatal care uptake, these determinants should be considered when designing new policies or updating policies and strategies on antenatal care uptake to help increase early attendance, which can help in the reduction of maternal and neonatal mortality and to achieve sustainable development goals 3 by 2030.

Abstract P641: Gaming the Way to Cardiovascular Health in Nepal: A Digital Approach in Adolescents

High prevalence of behavioral risk factors for cardiovascular disease (CVD) warrants a life course approach for efficient prevention. Our previous HARDIC trial in semi-urban Nepal shows conventional CVD educational interventions for mothers improved knowledge, attitude, and practice (KAP). Digital cardiovascular health promotion provides opportunities to efficiently reach adolescents. Our aim was therefore to develop such digital health promotion through a serious game that is educational and entertaining, as an innovative way to reach adolescents. We conducted a mixed-method study to assess adolescents’ KAP and perception regarding CVD, explored opportunities for digital cardiovascular health promotion, and developed a concept for a serious game prototype. In total, 649 adolescents grades 8-10 in two government and seven private schools in a semi-urban community of Nepal were surveyed cross-sectionally following parental consent. A self-administered questionnaire assessed KAP of CVD, mobile phone use, internet availability at home and gaming behaviors. For deeper understanding of adolescents’ perception on CVD, we conducted eight focus group discussions (FGDs) separately among boys and girls (n=76). The health belief model and the technology acceptance model guided FGD development and analysis. Eighty percent of adolescents were aged 13-15 years, 49% were girls and 40.4% studied in government schools. The median (IQR) percent scores for KAP were 70.6 (10.59), 78.5 (8.46) and 69.5 (11.59), respectively. Good KAP (median percent scores &gt;75%) was found in 27.7%, 69% and 27.8% adolescents, respectively. Knowledge ( p &lt;0.001), attitude ( p =0.025) and practice ( p &lt;0.001) was higher among adolescents in private than government schools. Girls had better attitude than boys (&lt;0.001). Furthermore, 98% adolescents had smartphone access and 91.6% had internet access.Preliminary FGD analyses show that adolescents mentioned physical, nutritional, mental, environmental, and hereditary causes for CVD. Financial and work-related burdens, as well as psychological, mental and family-related issues were perceived to influence CVD severity. Temptations for junk food and physical inactivity were barriers to follow heart-healthy behavior. Adolescents perceived serious games as beneficial and easy to use for creating CVD awareness. The game should offer challenge and exhibit increased levels of difficulty to remain stimulating throughout its intended use.We conclude that the existing gaps in knowledge and practice, with good attitude and excellent mobile and internet prerequisites, provide great opportunity for serious games in Nepal. The prototype of “Happy Heart” is being pilot-tested among adolescents, suggesting a promising way forward for digital cardiovascular health promotion.

Reasons mothers of young children delayed or skipped preventive health care during the first year of the COVID-19 pandemic.

Preventive health care provides opportunity for preventive screenings and health promotion. Mothers of young children may disproportionately experience barriers to preventive care during the COVID-19 pandemic. We examined delaying and skipping preventive health care during the first year of the COVID-19 pandemic among mothers and described reasons for delaying or skipping care. Mothers of children aged 0-12 years from the United States completed an online survey in February/March 2021 and reported receipt of preventive care during the COVID-19 pandemic, reasons for delaying or skipping care, demographics, and experiences with COVID-19. Participants (N = 306) were on average 35.9 (SD: 6.2) years old, racially/ethnically diverse, and 74.8% had at least a Bachelor's degree. From March 2020 to March 2021, 16.0% delayed and 20.6% skipped their physical examination, and 20.9% had not planned on receiving a physical examination. The most common reasons for delaying and skipping care were COVID-19 infection concerns, perception that delaying care would not negatively impact health, provider rescheduling, time, and childcare. Primary care teams may need to re-engage mothers who skipped preventive care during the pandemic, including addressing concerns about COVID-19 infection.

Mothers' perceptions of their children's weight: opportunity for health promotion in Kuwait.

Mothers' perceptions of their children's weight remain mostly unknown in oil-rich countries of the Middle East. To compare maternal perceptions of their children's weight with actual body weight. We used the Kuwait nutritional surveillance data for 5 consecutive years (2015-2019) (N = 5119), which were collected through face-to-face interviews with mothers of children aged 2-5 years attending vaccination centres. Of the 5119 mothers in the study, 163 (3.18%) and 332 (6.48%) had obese or overweight children, respectively. Among 4624 mothers who had normal weight children, 1350 (29.20%) perceived their children's weight as below normal. Seventy-nine (48.47%) and 16 (9.82%) mothers of children with obesity thought their children had normal weight or were underweight, respectively. Mothers in Kuwait often underestimate the weight of their children, including those children who have normal weight. This highlights the importance of addressing maternal misperceptions during visits to the primary healthcare centre.

Older Adults' Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis.

Immersive virtual reality (IVR) can be defined as a fully computer-generated environment shown on a head-mounted display. Existing research suggests that key features of IVR can assist older adults in their everyday lives, providing opportunities for health promotion and tackling social isolation and loneliness. There has been a surge in qualitative studies exploring older adults' experiences and perceptions of IVR. However, there has been no systematic synthesis of these studies to inform the design of new, more accessible IVR technologies. This study aimed to systematically review and synthesize qualitative studies exploring older adults' experiences and perceptions of IVR. A systematic review and thematic synthesis were conducted following the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. In total, 2 reviewers completed title and abstract screening, full-text screening, data extraction, and quality appraisal. Thematic synthesis is derived from the qualitative method, thematic analysis. It involves 3 key steps: initial coding and grouping of these codes, the formation of descriptive themes from these codes, and going beyond these data to form analytical themes. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach. Overall, 13 studies were included in the final synthesis, including 224 participants across 9 countries and 5 continents. Confidence in the evidence ranged from high to moderate. Three descriptive themes were generated: practical aspects of IVR use, experiencing unique features of IVR, and perceptions of IVR. The findings from the descriptive themes suggested that there are several improvements that need to be made to existing IVR devices to facilitate older adults' use of this technology. However, older adults' responses to IVR were generally positive. Three analytical themes were generated: tolerating the bad to experience the good, buying in to IVR (don't judge a book by its cover), and "it proves to me I can do it." The analytical themes illustrated that older adults were willing to tolerate discomforts that accompany existing IVR technologies to experience features such as immersive social networking. There was a discrepancy between older adults' perceptions of IVR before use-which were generally negative-and after use-which were generally positive-and IVR provided a platform for older adults to access certain activities and environments more easily than in the real world because of limitations caused by aging. This review offers insights into older adults' experiences and perceptions of IVR and suggests how a few improvements to its existing hardware and software as well as how it is first presented could offer new opportunities for older adults to take part in meaningful activities tailored to their needs and preferences. PROSPERO CRD42020200774; https://tinyurl.com/8f48w2vt. RR2-10.1177/16094069211009682.

Free public transport and older people: An ethnographic study of an Australian bus service.

This study explores older people's use of a free bus service in Wollongong, Australia. The research focus was on understanding the experiences of people over the age of 60 who use the service and the extent to which it contributes to their physical, mental and social well-being. The ethnographic research utilised fieldwork and interviews for data collection. Participant observations took place on the bus, and interviews were undertaken at bus stops. Data were analysed using an inductive thematic approach. The research highlighted how bus services can be caring places for older people and a bus journey could be characterised as a therapeutic milieu. Travelling on the bus provided opportunities for health promotion due to active transport. Subsidised access to public transport supported people to maintain social connections throughout the city. Bus travel has contributed positively to the physical, mental and social well-being of people over the age of 60 in Wollongong.

Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands

BackgroundOral health promotion interventions have had limited success in reaching families in disadvantaged neighbourhoods resulting in persistent oral health inequality. This qualitative study provides insight into professionals’ perspectives on children’s poor oral health (≤ 4 years), their perceptions of the roles and responsibilities, and opportunities for child oral health promotion strategies.MethodsThirty-Eight professionals from different domains (community, social welfare, general health, dental care, public health, private sector) working in a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated through 24 semi-structured (group) interviews. Transcripts and notes were analysed through thematic analysis.ResultsProfessionals indicate that unhealthy diet, children’s non-compliance, poor parental coping, parental low oral health literacy, parent’s negative attitude, family’s daily struggles, and insufficient emphasis on childhood caries prevention in dental practices, general healthcare and social welfare organisations, underlie poor oral health. They hold parents most responsible for improving young children’s oral health, but recognise that families’ vulnerable living circumstances and lack of social support are important barriers. Interestingly, non-dental professionals acknowledge their beneficial role in child oral health promotion, and dental professionals stress the need for more collaboration.ConclusionA broad child-, parental-, and societal-centred educational communication strategy is perceived as promising. Professionals working within and outside the dental sector acknowledge that local and collective action is needed. This involves a better understanding of family’s complex daily reality. Furthermore, intensifying child oral health knowledge in dental practices is essential in collaboration with families, general health and social welfare organisations.

Optimizing Internet Use during Adolescence: eHealth Solutions

Internet offers an immense opportunity as a resource for education, training, and health promotion. This narrative review summarizes the opportunities for health promotion among adolescents through use of the Internet and technology (defined as eHealth). The details of technology and use of Internet for adolescent-health related topics such as nutrition, fitness, sexual health, adventure, and violence were searched through PubMed. The review reports few digital solutions to address key challenges during adolescence like promotion of nutrition and sexual reproductive health, prevention of noncommunicable diseases, substance abuse, and mental health issues. eHealth was concluded as a potential solution for preventive and promotional health practices during adolescence. However, concerns of Internet addiction, safety, privacy, mental health disorders, and misinformation need to be addressed and monitored during adolescence.

Overview.

South Africa (SA) faces multiple health challenges. Quantifying the contribution of modifiable risk factors can be used to identify and prioritise areas of concern for population health and opportunities for health promotion and disease prevention interventions. To estimate the attributable burden of 18 modifiable risk factors for 2000, 2006 and 2012. Comparative risk assessment (CRA), a standardised and systematic approach, was used to estimate the attributable burden of 18 risk factors. Risk exposure estimates were sourced from local data, and meta-regressions were used to model the parameters, depending on the availability of data. Risk-outcome pairs meeting the criteria for convincing or probable evidence were assessed using relative risks against a theoretical minimum risk exposure level to calculate either a potential impact fraction or population attributable fraction (PAF). Relative risks were sourced from the Global Burden of Disease, Injuries, and Risk Factors (GBD) study as well as published cohort and intervention studies. Attributable burden was calculated for each risk factor for 2000, 2006 and 2012 by applying the PAF to estimates of deaths and years of life lost from the Second South African National Burden of Disease Study (SANBD2). Uncertainty analyses were performed using Monte Carlo simulation, and age-standardised rates were calculated using the World Health Organization standard population. Unsafe sex was the leading risk factor across all years, accounting for one in four DALYs (26.6%) of the estimated 20.6 million DALYs in 2012. The top five leading risk factors for males and females remained the same between 2000 and 2012. For males, the leading risks were (in order of descending rank): unsafe sex; alcohol consumption; interpersonal violence; tobacco smoking; and high systolic blood pressure; while for females the leading risks were unsafe sex; interpersonal violence; high systolic blood pressure; high body mass index; and high fasting plasma glucose. Since 2000, the attributable age-standardised death rates decreased for most risk factors. The largest decrease was for household air pollution (-41.8%). However, there was a notable increase in the age-standardised death rate for high fasting plasma glucose (44.1%), followed by ambient air pollution (7%). This study reflects the continued dominance of unsafe sex and interpersonal violence during the study period, as well as the combined effects of poverty and underdevelopment with the emergence of cardiometabolic-related risk factors and ambient air pollution as key modifiable risk factors in SA. Despite reductions in the attributable burden of many risk factors, the study reveals significant scope for health promotion and disease prevention initiatives and provides an important tool for policy makers to influence policy and programme interventions in the country.

Lifestyle habits in Saudi adolescents with diagnosed diabetes: An opportunity for health promotion.

AimsThis study assessed lifestyle and health behavior habits among a representative sample of Saudi adolescents with self-reported diabetes and compared them to non-diabetic peers.MethodsThis was a nested case-control study, from the Jeeluna cohort, a nationwide, cross-sectional study of 12,575 Saudi boys and girls aged 10–19 years. Non-diabetic adolescents were matched to those with diabetes on a ratio of 4:1 based on age, gender and region. Retained information from the original study included: socio-demographics, lifestyle behaviors, tobacco/substance use, screen use, anthropometric measurements, and laboratory results.ResultsThe prevalence of diabetes was 0.7% (n = 87). Overall, 65% of diabetic participants were males, and 22.4% aged ≤14 years. Overall, both groups had low rates of healthful habits in their diet and physical activity. Both groups had similar rates of tobacco use, and high digital screen time. Adolescents with diabetes had more consistent sleeping pattern, were more likely to be on a diet, thought they spent enough time with their physician and obtained medical information more often from their health clinic. They were also more likely to feel down and to chat more often.ConclusionAdolescents with diabetes remain far from guideline targets but seem predisposed to better lifestyle and have more access to health as compared to their non-diabetic peers.

Swedish managers’ experience of yearly staff development dialogues, aiming for employee development, performance, and well-being

BackgroundSocietal development and a competitive corporate climate have resulted in increased emphasis on performance management (PM) but also sustainability and health challenges in working life. Opportunities for employee well-being, development and performance are thus highly relevant for organisations and society. PM includes a manager-employee dialogue process and is identified as a complex challenge when combined with employee development and well-being. Managers have a key role in PM, and research in collaboration with practitioners in specific contexts is needed. An exploratory study, focusing on managers’ experience of dialogues between managers and employees in practice, was therefore conducted in collaboration with an inter-municipal corporation company in southern Sweden.MethodsA qualitative study with an inductive design, supported by semi-structured focus group interviews, was chosen based on the exploratory character of the study. Thirty-five managers were approached in the company and 15, of varying age and managerial experience, agreed to participate. Staff Development Dialogues (SDD) were used in the company PM model to facilitate employee development, performance, and well-being. Data was analysed using conventional qualitative content analysis to obtain new insights without using pre-set classifications.ResultsThe analysis resulted in three categories of SDD experiences: SDD in a business context; Managers in relation to SDD; and Employees in relation to SDD. The findings revealed varying SDD experiences as well as approaches, and analytical themes were considered in relation to the organisational context and the specific SDD content and process. The study showed the importance of SDD adaptation and a well-being perspective in the dialogues was related to relational aspects and the manager-employee approach to SDDs.DiscussionThe findings confirm the complexity and challenges of PM including development and well-being. Adaptation to specific departments as well as employees is important, and using the same PM strategy throughout an organisation can be questioned. The identified link between a relational approach and a well-being perspective indicates a missed opportunity for systematic workplace health promotion. Strengthening the well-being perspective can, thus, improve the quality of an SDD model, which in turn can facilitate the creation of sustainable workplaces and better fulfilment of employers’ health-related obligations for systematic work environment management.

Spotlight on the Challenges of Depression following Retirement and Opportunities for Interventions.

As a major life transition characterized by changes in social, behavioral, and psychological domains, retirement is associated with numerous risk factors that can contribute to the development of depression in later life. Understanding how these risk factors intersect with overall health and functioning can inform opportunities for mental health promotion during this transition. The objective of this review is to summarize the literature on risk and protective factors for depression during retirement transitions, discuss challenges related to appropriate management of depression in later life, and describe opportunities for prevention and intervention for depression relating to retirement transitions, both within and beyond the health care system. Key implications from this review are that 1) the relationship between depression and retirement is multifaceted; 2) while depression is a common health condition among older adults, this syndrome should not be considered a normative part of aging or of retirement specifically; 3) the existing mental health specialty workforce is insufficient to meet the depression management needs of the aging population, and 4) therefore, there is a need for interprofessional and multidisciplinary intervention efforts for preventing and managing depression among older adults. In sum, both healthcare providers, public health practitioners, and community organizations have meaningful opportunities for promoting the mental health of older adults during such major life transitions.