Risk Behavior Interventions Research Articles

General hospital patients’ attitude towards systematic health risk behavior screening and intervention

BackgroundSystematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval.MethodsAll 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients’ approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0–20 (i.e., scores of 0–6, 7–13, 14–20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses.ResultsThe mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval.ConclusionHigh approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers.Trial registrationClinicalTrials.gov Identifier NCT05365269 on May 9, 2022.

Childhood Sexual Abuse Moderates the Long-Term Effect of an HIV Prevention Intervention Among Men Who Have Sex With Men With Crystal Methamphetamine Use Disorder

Men who have sex with men (MSM) with a history of childhood sexual abuse (CSA) are more likely to report crystal methamphetamine use and condomless anal intercourse (CAI) than MSM without CSA. MSM with CSA may benefit less in HIV prevention interventions due to long-term psychological effects. Data are from a pilot randomized, controlled trial testing an integrated HIV risk reduction and behavioral activation counseling intervention vs standard of care among MSM with methamphetamine use disorder, which showed effects at reducing CAI. We conducted a secondary analysis (N= 38) to preliminarily assess whether CSA moderated the intervention effects on the two primary outcomes: CAI acts with men whose HIV serostatus was either positive or unknown (1) overall (CAI overall) and (2) while under the influence of methamphetamine (CAI with methamphetamine). At the immediate postintervention assessment, the interaction term between CSA and intervention arm was not statistically significant for either outcome, indicating no moderation effect. However, at the 3-month postintervention assessment, the interaction term was significant for both outcomes. At this time point, for those without CSA, there was a significantly lower number of CAI acts in the intervention condition vs the comparison condition for both outcomes. For those with CSA, however, there was no significant difference between the intervention and comparison conditions for CAI overall, although for the outcome CAI with methamphetamine, the intervention condition had higher levels. Future HIV prevention interventions among MSM with methamphetamine use disorder should consider screening for CSA and addressing CSA-related psychological distress, which may potentially preserve intervention effects.

Identification of influence factors in overweight population through an interpretable risk model based on machine learning: a large retrospective cohort.

The identification of associated overweight risk factors is crucial to future health risk predictions and behavioral interventions. Several consensus problems remain in machine learning, such as cross-validation, and the resulting model may suffer from overfitting or poor interpretability. This study employed nine commonly used machine learning methods to construct overweight risk models. The general community are the target of this study, and a total of 10,905 Chinese subjects from Ningde City in Fujian province, southeast China, participated. The best model was selected through appropriate verification and validation and was suitably explained. The overweight risk models employing machine learning exhibited good performance. It was concluded that CatBoost, which is used in the construction of clinical risk models, may surpass previous machine learning methods. The visual display of the Shapley additive explanation value for the machine model variables accurately represented the influence of each variable in the model. The construction of an overweight risk model using machine learning may currently be the best approach. Moreover, CatBoost may be the best machine learning method. Furthermore, combining Shapley's additive explanation and machine learning methods can be effective in identifying disease risk factors for prevention and control.

HIV Focused Sexual Risk-Reduction Interventions Targeting Adolescent Boys and Young Men in Sub-Saharan Africa: A Scoping Review

Adolescent girls and young women’s exceptionalism with HIV interventions has left adolescent boys and young men (ABYM) trailing behind, thus becoming a marginalized and underserved population. The scoping review aimed to provide an overview of interventions that have targeted sexual risk behaviors in ABYM in Sub-Saharan Africa (SSA) over the previous 21 years with critical insights on ‘what works’ in preventing the sexual transmission of HIV. A scoping review guided by Arksey and O’Malley’s (in Int J Soc Res Methodol 8(1):19–32, 16) framework and the 2015 Johanna Briggs Institute’s guidelines was conducted. A search of literature published between 2000 and 2020 was reviewed and twenty nine interventions from nine Sub Saharan African countries that met the eligibility criteria were reviewed. The review provides evidence on the successes and the limitations of sexual risk behavior interventions for ABYM in SSA. There is clear and consistent evidence that interventions reduce sexual risk behaviors in adolescent boys and young men. Their efficiency seems to grow with the length and intensity of the intervention. Positive effects were generally observed in condom use and on measures of HIV knowledge, attitudes and sexual behaviors as well as uptake of HIV tests and voluntary male circumcision. This review shows that sexual-risk interventions engaging men and boys in SSA are promising and warrant further rigorous development in terms of conceptualization, design and evaluation.

Associations Between Personality Traits and Energy Balance Behaviors in Emerging Adulthood: Cross-Sectional Study.

Internalizing and externalizing personality traits are robust risk factors for substance use and mental health, and personality-targeted interventions are effective in preventing substance use and mental health problems in youth. However, there is limited evidence for how personality relates to other lifestyle risk factors, such as energy balance-related behaviors, and how this might inform prevention efforts. This study aimed to examine concurrent cross-sectional associations between personality traits (ie, hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) and sleep, diet, physical activity (PA), and sedentary behaviors (SB), 4 of the leading risk factors for chronic disease, among emerging adults. Data were drawn from a cohort of young Australians who completed a web-based, self-report survey in 2019 during early adulthood. A series of Poisson and logistic regressions were conducted to examine the concurrent associations between the risk behaviors (sleep, diet, PA, and sitting and screen time) and personality traits (hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) among emerging adults in Australia. A total of 978 participants (mean age 20.4, SD 0.5 years) completed the web-based survey. The results indicated that higher scores on hopelessness were associated with a greater daily screen (risk ratio [RR] 1.12, 95% CI 1.10-1.15) and sitting time (RR 1.05, 95% CI 1.0-1.08). Similarly, higher scores on anxiety sensitivity were associated with a greater screen (RR 1.04, 95% CI 1.02-1.07) and sitting time (RR 1.04, 95% CI 1.02-1.07). Higher impulsivity was associated with greater PA (RR 1.14, 95% CI 1.08-1.21) and screen time (RR 1.06, 95% CI 1.03-1.08). Finally, higher scores on sensation seeking were associated with greater PA (RR 1.08, 95% CI 1.02-1.14) and lower screen time (RR 0.96, 95% CI 0.94-0.99). The results suggest that personality should be considered when designing preventive interventions for lifestyle risk behaviors, particularly in relation to SB, such as sitting and screen time. Australian New Zealand Clinical Trials Registry ACTRN12612000026820; https://tinyurl.com/ykwcxspr.

Caring Attributes in Interventions for Sexual Risk Behaviors Among Adolescents

This review used Simone Roach’s approach to identify caring science hidden in effective research interventions for adolescents’ sexual risk behaviors (ASRBs). Fifteen studies met the criteria for effective adolescent sexual risk interventions (EASRIs) during a systematic review. We analyzed the EASRIs, outcomes, and research process, and 16 EASRI components were assigned. Furthermore, based on Roach’s attributes as related to research, each intervention and research process was critiqued and analyzed. Critique resulted in the creation of domains for each caring attribute as related to the research process and EASRIs. Roach’s six Cs may help develop and enhance EASRI, thereby reducing SRB.

Correlates of the nicotine metabolite ratio in Alaska Native people who smoke cigarettes.

Research on nicotine metabolism has primarily focused on white adults. This study examined associations between nicotine metabolism, tobacco use, and demographic characteristics among Alaska Native adults who smoke cigarettes. Participants (N = 244) were Alaska Native adults who smoked and who provided a plasma sample at baseline (70.1%) or follow-up (29.9%) of a randomized controlled trial of a cardiovascular risk behavior intervention. At baseline, participants self-reported age, sex, Alaska Native heritage, cigarettes per day, time to first cigarette upon wakening, menthol use, perceived difficulty staying quit, tobacco withdrawal symptoms, and past-month tobacco product use, binge drinking, and cannabis use. At 3-, 6-, 12-, and 18-month follow-ups, participants self-reported 7-day point prevalence abstinence from smoking. Height and weight were measured to calculate body mass index (BMI). Participants' nicotine metabolite ratio (NMR), calculated as the ratio of plasma cotinine and trans-3' hydroxycotinine, was log-transformed. The sample (52.0% male, age M = 47.0 years [SD = 13.8], 60.3% of Inupiaq heritage) averaged 12.5 cigarettes per day (SD = 10.5); 64.0% smoked within 30 min of wakening. NMR was not significantly associated with age, sex, Alaska Native heritage, BMI, cigarettes per day, time to first cigarette upon wakening, menthol use, perceived difficulty staying quit, past-month dual tobacco product use, withdrawal symptoms, past-month binge drinking, past-month cannabis use, or abstinence from smoking (all p-values > .050). Characteristics that relate to NMR in Alaska Native adults may differ from those typically identified among white adults. Specifically, results may suggest that Alaska Native adults with slower nicotine metabolism do not titrate their nicotine intake when smoking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multiple versus single risk behaviour interventions for people with severe mental illness: a network meta-analysis and qualitative synthesis

Background People with severe mental illness die 15–20 years earlier than the general population. Reasons why include that people with severe mental illness are more likely to smoke and be physically inactive as a result of social inequalities. Objectives (1) Evaluate the clinical effectiveness of multiple risk behaviour interventions on behaviour change (e.g. smoking abstinence), and outcomes affected by behaviours (e.g. weight loss). (2) Compare the clinical effectiveness of interventions targeting multiple and single risk behaviours. (3) Examine the factors affecting outcomes (e.g. intervention content). (4) Assess the factors affecting experiences of interventions (e.g. barriers and facilitators). Data sources The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE™ (Elsevier, Amsterdam, the Netherlands), MEDLINE, PsycInfo® (American Psychological Association, Washington, DC, USA) and Science Citation Index (Clarivate Analytics, Philadelphia, PA, USA) were searched from inception to October 2018, and an updated search was conducted in March 2020. An Applied Social Sciences Index and Abstracts (ASSIA) search and an updated Cochrane Central Register of Controlled Trials search were undertaken in September 2020. Study selection Randomised controlled trials targeting single or multiple health risk behaviours among people with severe mental illness were included. Qualitative evidence on factors affecting the effectiveness of risk behaviour interventions was included. Study appraisal Network meta-analyses were conducted to compare the effectiveness of multiple and single risk behaviour interventions. The mean differences were estimated for continuous outcomes; if this was not possible, standardised mean differences were calculated. Thematic syntheses of qualitative studies were conducted. Results A total of 101 studies (67 randomised controlled trials and 34 qualitative studies) were included. Most outcomes were smoking abstinence, weight and body mass index. Just over half of studies were rated as having a high overall risk of bias. Trials focusing on smoking alone led to greater abstinence than targeting smoking and other behaviours. However, heterogeneity means that other explanations cannot be ruled out. For weight loss and body mass index, single risk behaviour (e.g. physical activity alone) and multiple risk behaviour (e.g. diet and physical activity) interventions had positive but modest benefits. For example, any risk behaviour intervention led to a 2 kg greater weight loss (–2.10 kg, 95% credible interval –3.14 to –1.06 kg) and approximately half a point (i.e. 0.5 kg/m2) greater body mass index reduction (–0.49 kg/m2, 95% credible interval –0.97 to –0.01 kg/m2) than treatment as usual. There were potential synergies for targeting multiple health behaviours for reduction in systolic and diastolic blood pressure. No evidence was found of a deterioration in mental health for people with severe mental illness engaging in interventions to reduce health risk behaviours. Qualitative studies found that people with severe mental illness favoured interventions promoting physical and mental health together, and that took their condition into account. However, trials focused mainly on promoting physical health. Limitations Most quantitative studies focused on weight and body mass index; few assessed behavioural outcomes. Qualitative studies often addressed different aims. Conclusions Multiple and single risk behaviour interventions were associated with positive but modest benefits on most outcomes. Interventions seeking to promote physical health were not associated with deterioration in mental health. There was a lack of overlap between quantitative and qualitative studies. Future work Further research is needed to investigate whether or not health behaviour changes are maintained long term; tailoring weight-loss interventions for people with severe mental illness; and in terms of methods, co-production and mixed-methods approaches in future trials. Study registration This study is registered as PROSPERO CRD42018104724. Funding This project was funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 6. See the NIHR Journals Library website for further project information.

Associations of positive and negative affect on health risk behaviors among Latinos.

Negative affect is widely emphasized in behavior modification interventions. However, positive affect is associated with smoking cessation, physical activity, and healthy dietary habits and may be an important treatment target. Few studies have examined the relationship between positive affect and health behaviors among Latinos, who disproportionately experience modifiable health risk behaviors. This study examined the independent associations of positive affect and negative affect on modifiable health risk behaviors among Latino adults. Data came from 432 persons who participated in one of two studies examining determinants of modifiable health risk behaviors among Latino adults. Primary outcomes were current smoking, at-risk drinking, insufficient physical activity, and insufficient fruit and vegetable consumption. Predictors were positive and negative affect as measured by the Positive and Negative Affect Schedule. Associations between positive and negative affect and health risk behaviors were examined using multiple logistic regression. Positive affect was associated with lower odds of insufficient physical activity and insufficient fruit and vegetable consumption and lower odds of engaging in multiple health risk behaviors. Negative affect was associated with higher odds of at-risk drinking and current smoking. Emphasis on increasing positive affect may be warranted for multiple health risk behavior interventions targeting Latinos. Intervention development efforts may also consider prioritizing positive affect for physical activity and dietary interventions, and negative affect for at-drinking and smoking cessation interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Community mobilisation approaches to preventing and reducing adolescent multiple risk behaviour: a realist review protocol

BackgroundAdolescent multiple risk behaviour (MRB) continues to be a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, rather than targeting the wider environmental or structural context. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. Despite this, there are gaps in the current literature, theory and implementation that would benefit from a realist approach due to the suitability of this methodology to analysing complex interventions. The objective of this study is to understand ‘how, why, for whom and in what circumstances and time periods’ do community mobilisation interventions work to prevent and/or reduce adolescent multiple risk behaviour.MethodsThis is a protocol for a realist review. The review will use a six-stage iterative process, guided by the RAMESES framework. We will systematically search PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological s, from their inception to 2021. Studies will be screened for relevance to the programme theory and included based on a priori eligibility criteria including (1) reporting a community mobilisation intervention (2) targeting two health risk behaviors (3) for adolescent populations. Two independent reviewers will select, screen and extract data related to the program theory from all relevant sources. A realist logic of analysis will be used to identify all context-mechanism-outcome configurations that contribute to our programme theory. The findings will be synthesised to produce a refined programme theory model.DiscussionThe goal of this realist review is to identify and refine a programme theory for community mobilisation approaches to the prevention and/or reduction of adolescent multiple risk behaviour. Our aim is that the findings surrounding the programme theory refinement can be used to develop and implement adolescent multiple risk behaviour interventions and maintain collaboration between local policy makers, researchers and community members.Systematic review registrationThis realist review is registered on the PROSPERO database (registration number: CRD42020205342).

Adolescent Risk Behavior Screening and Interventions in Hospital Settings: A Scoping Review

Risky behaviors are the main threats to adolescents' health; consequently, evidence-based guidelines recommend annual comprehensive risk behavior screening. To review studies of adolescent risk behavior screening and interventions in urgent care, emergency department (ED), and hospital settings. Our data sources included PubMed (1965-2019) and Embase (1947-2019). Studies were included on the basis of population (adolescents aged 10-25 years), topic (risk behavior screening or intervention), and setting (urgent care, ED, or hospital). Studies were excluded if they involved younger children or adults or only included previously identified high-risk adolescents. Data extracted were risk behavior screening rates, screening and intervention tools, and attitudes toward screening and intervention. Forty-six studies were included; most (38 of 46) took place in the ED, and a single risk behavior domain was examined (sexual health [19 of 46], mood and suicidal ideation [12 of 46], substance use [7 of 46], and violence [2 of 46]). In 6 studies, authors examined comprehensive risk behavior screening, demonstrating low rates at baseline (∼10%) but significant increases with clinician reminder implementation. Adolescents and clinicians were highly accepting of risk behavior screening in all settings and preferred electronic screening over a face-to-face interview. Reported barriers were time constraints and limited resources. Only 1 included study was a randomized controlled trial, and there was large heterogeneity of included studies, potentially limiting generalizability. Rates of adolescent risk behavior screening are low in urgent care, ED, and hospital settings. Our findings outline promising tools for improving screening and intervention, highlighting the critical need for continued development and testing of interventions in these settings to improve adolescent care.

The Effectiveness of Multiple Risk Behaviour Interventions for People with Severe Mental Illness (HEALTH Study): Systematic Review and Component Network Meta-Analysis

Background: People with severe mental illness die 15-20 years earlier than the general population. This excess mortality is explained largely by preventable physical health conditions. Evaluating the effectiveness of interventions that target risk behaviours in people with SMI is a global health priority. Interventions focussing on single behaviours may be ineffective in changing health outcomes. No systematic review has compared the effectiveness of targeting multiple or single risk behaviours in this population. Methods: We searched Cochrane Central Register of Controlled Trials (CENTRAL), Embase, MEDLINE, PsycINFO and Science Citation Index in March 2020 and Applied Social Science Index and Abstracts (ASSIA) in September 2020. We included randomised controlled trials of single or multiple health risk behaviour interventions in people with SMI. The study is registered on PROSPERO (CRD42018104724). We conducted network meta-analyses to compare effectiveness of interventions targeting multiple and single risk behaviours. Findings: We included 67 RCTs. Just over half of studies had high overall risk of bias. Trials focusing on smoking alone led to greater smoking abstinence than targeting smoking and other behaviours. However, heterogeneity means we cannot rule out other interpretations explanations. For weight loss (e.g. any risk behaviour intervention: -2.10 kg, 95% CrI -3.14, -1.06) and BMI (e.g. any risk behaviour intervention: -0.49, 95% CrI -0.97, -0.01) all risk behaviour interventions had positive but modest benefits compared with treatment as usual. There were potential synergies for targeting multiple health behaviours for reduction in systolic blood pressure. We found no evidence of a deterioration in mental health for people with SMI engaging in these interventions. Interpretation: Multiple and single risk behaviour interventions were associated with positive but modest benefits. Targeting smoking alone appeared to be more effective, but few studies assessed behavioural outcomes. Interventions were not associated with deterioration in mental health. Funding: National Institute for Health Research Declaration of Interest: We declare no competing interests.

Lower-Risk Cannabis Use Guidelines: Adherence in Canada and the U.S.

This study examines the prevalence of risky cannabis use based on adherence to the Lower-Risk Cannabis Use Guidelines. Respondents aged 16-65 years in Canada and the U.S. (N=27,024) completed the online 2018 International Cannabis Policy Study. Participants completed measures corresponding to the Lower-Risk Cannabis Use Guidelines and Alcohol, Smoking and Substance Involvement Screening Test. Analyses were conducted in 2019. More than half of the respondents (57.3%, n=15,489) had ever used cannabis, and 28.1% (n=7,584) had used it in the past 12 months (current use). The majority of current consumers (88.8%) reported nonadherence to ≥1 guideline other than ever use. These behaviors included smoking ≥50% of all cannabis consumed (69.8%), using high-tetrahydrocannabinol products (44.9%), initiating cannabis use before age 16 years (35.9%), daily/near-daily use (32.2%), driving after cannabis use (26.1%), cannabis use during pregnancy or with a history of psychosis or substance abuse (17.3%), and synthetic cannabis use (5.9%). More respondents in U.S. legal recreational cannabis states reported nonadherence than those in jurisdictions where recreational cannabis remained illegal. Specifically, consumers in U.S. legal states were significantly more likely to use high-tetrahydrocannabinol products than consumers in U.S. illegal states or Canada and more likely to drive after cannabis use than consumers in Canada (p<0.001 for all). Adherence to Lower-Risk Cannabis Use Guidelines was strongly associated with Alcohol, Smoking and Substance Involvement Screening Test scores. Lower-Risk Cannabis Use Guideline adherence differed by jurisdiction and sociodemographic profile. As more jurisdictions legalize nonmedical cannabis, targeted interventions for key risk behaviors (e.g., using high-potency cannabis, early initiation age, driving after cannabis use) are warranted.

Opportunities for improved cardiovascular disease prevention in oncology patients.

Cancer patients often have cardiovascular risk factors at the time of cancer diagnosis, which are known to increase the risk of cardiotoxicity. Cancer survivors have significantly higher cardiovascular risk. Current cardiovascular disease prevention guidelines are based on studies that largely excluded these patients. We reviewed recent data regarding cardiovascular disease prevention in this population. Nonpharmacologic therapies aiming to reduce 'lifestyle toxicity' produced by cancer treatments have demonstrated potential to decrease the incidence of adverse outcomes. Exercise before, during and after cancer treatment not only promotes higher quality of life and cardiorespiratory fitness but also reduces adverse cardiovascular outcomes. Lipid and cardiometabolic disease management is paramount but predominantly based on data that excludes these populations of cancer patients and survivors. A comprehensive approach including medical evaluation, prescriptive exercise, cardiac risk factor modification, education, counseling, pharmacologic and behavioral interventions are needed in cancer patients. These interventions constitute the core of cardio-oncology rehabilitation programs, which if implemented appropriately may help reduce cardiovascular events in this population. Knowledge gaps in these areas are starting to be addressed by ongoing clinical trials.

Multiple risk behaviour intervention to prevent depression in primary care.

Primary care is the ideal setting for promotion and prevention intervention. Multiple risk behaviour interventions present several advantages over single-risk lifestyle interventions. Multiple risk behaviour interventions could be easily implemented in primary care to prevent non-communicable disease and depression. To test the effectiveness of a multiple risk behaviour intervention to promote Mediterranean diet, physical activity, and/or smoking cessation in people attending Spanish primary health care with incidence of depression and symptoms of depression. This was a secondary analysis of the EIRA study that aims to test the effectiveness of a multiple risk behaviour intervention to promote healthy lifestyles. Twenty-six primary care centres were randomised to receive multiple risk behaviour intervention or usual care. The multiple risk behaviour intervention included individual sessions, group sessions, communitarian activities, and SMS reception. Participants were followed for 10-14 months. The primary outcomes of this study were incidence of depression and reductions of depressive symptoms. Three thousand and sixty-seven participants were included. Females accounted for 45.13% and 93.88% were Spanish. Age varied between 45 and 75 years old. The effectiveness of the intervention will be calculated using the Patient Health Questionnaire (PHQ-9) and the Composite International Diagnostic Interview (‎CIDI)‎ depression section. Linear and logistic regression will be used to create predictive models. Primary care is the most accessible service in the health system for patients. Hence primary care is the ideal setting for health education, promotion, and prevention interventions. This study will provide high-quality evidence about the effectiveness of multiple risk behaviour interventions over depression prevention.

Identification of Risk Factors Associated with Obesity and Overweight-A Machine Learning Overview.

Social determining factors such as the adverse influence of globalization, supermarket growth, fast unplanned urbanization, sedentary lifestyle, economy, and social position slowly develop behavioral risk factors in humans. Behavioral risk factors such as unhealthy habits, improper diet, and physical inactivity lead to physiological risks, and “obesity/overweight” is one of the consequences. “Obesity and overweight” are one of the major lifestyle diseases that leads to other health conditions, such as cardiovascular diseases (CVDs), chronic obstructive pulmonary disease (COPD), cancer, diabetes type II, hypertension, and depression. It is not restricted within the age and socio-economic background of human beings. The “World Health Organization” (WHO) has anticipated that 30% of global death will be caused by lifestyle diseases by 2030 and it can be prevented with the appropriate identification of associated risk factors and behavioral intervention plans. Health behavior change should be given priority to avoid life-threatening damages. The primary purpose of this study is not to present a risk prediction model but to provide a review of various machine learning (ML) methods and their execution using available sample health data in a public repository related to lifestyle diseases, such as obesity, CVDs, and diabetes type II. In this study, we targeted people, both male and female, in the age group of >20 and <60, excluding pregnancy and genetic factors. This paper qualifies as a tutorial article on how to use different ML methods to identify potential risk factors of obesity/overweight. Although institutions such as “Center for Disease Control and Prevention (CDC)” and “National Institute for Clinical Excellence (NICE)” guidelines work to understand the cause and consequences of overweight/obesity, we aimed to utilize the potential of data science to assess the correlated risk factors of obesity/overweight after analyzing the existing datasets available in “Kaggle” and “University of California, Irvine (UCI) database”, and to check how the potential risk factors are changing with the change in body-energy imbalance with data-visualization techniques and regression analysis. Analyzing existing obesity/overweight related data using machine learning algorithms did not produce any brand-new risk factors, but it helped us to understand: (a) how are identified risk factors related to weight change and how do we visualize it? (b) what will be the nature of the data (potential monitorable risk factors) to be collected over time to develop our intended eCoach system for the promotion of a healthy lifestyle targeting “obesity and overweight” as a study case in the future? (c) why have we used the existing “Kaggle” and “UCI” datasets for our preliminary study? (d) which classification and regression models are performing better with a corresponding limited volume of the dataset following performance metrics?

Respiratory and Allergic Effects in Children Exposed to Pesticides-A Systematic Review.

Pesticide exposure may affect children’s respiratory and allergic health, although results from epidemiological studies have not reached consensus. This review aims to analyze the scientific evidence on respiratory and allergic effects of exposure to agricultural pesticides in children aged up to 12 years old. The databases PubMed, Web of Science, Scielo, and Lilacs were screened to select articles published in English, Spanish, or Portuguese, and 21 articles were included in this review. Most investigations were conducted in North America (mostly in the United States), while no studies conducted in Latin America or Africa were found, despite their intensive use of pesticides. Children are exposed to pesticides through multiple pathways from the prenatal period throughout later developmental stages and may experience several respiratory effects. Most studies (79%) found positive associations with pesticide exposure and children’s respiratory and allergic effects such as asthma, wheezing, coughs, acute respiratory infections, hay fever, rhinitis, eczema, chronic phlegm, and lung function impairments. Contrastingly, 21% of the studies found no associations between pesticide exposure and children’s respiratory health. The vast differences among the characteristics of the studies hamper any comparison of the results. Exposure to pesticides may have several impacts on childhood respiratory health. More studies must be conducted, especially in low- and middle-income countries, preferably with comparable research protocols adapted to local realities. Efforts should be made to develop comprehensive risk mitigation strategies and behavioral interventions to reduce children’s exposure to pesticides used in agriculture and respiratory health effects, and to ensure healthy childhood growth.

Epidemic characteristics of hepatitis C in Shenzhen, 2008-2017

Objective To explore the epidemic characteristics and trend of hepatitis C in Shenzhen, and to provide a theoretical basis for effective strategy for general prevention and control of hepatitis C. Methods The incidence data of hepatitis C in Shenzhen during 2008-2017 were collected from national diseases reporting information system from Chinese Information System for Diseases Control and Prevention to conduct descriptive epidemiological analysis. Results A total of 18 671 cases of hepatitis C reported in Shenzhen from 2008 to 2017, and the incidence ranged from 14.16/100 000 to 22.31/ 100 000, the average incidence rate was 18.54/100 000. It showed low morbidity, no death, no agglomeration, no obvious seasonal high incidence, but the overall incidence showed a slow upward trend. All ages had morbidity, and the cases were mainly concentrated in the 20-50 age group. The annual incidence of the 0-year-old group in Shenzhen was maintained at around 15 cases, and the incidence of the under 10 years old group accounted for 1.2% of all cases. The population of hepatitis C in Shenzhen were mainly due to household chores and workers. Conclusion The incidence of hepatitis C in Shenzhen is mainly dominated by young, middle- aged and household chores, workers people. At the same time, mother- to- child transmission is also one of the important ways for hepatitis C transmission in Shenzhen. Therefore, we will continue to carry out health education and risk behavior interventions for the prevention and treatment of hepatitis C infection in migrating populations, enhance their awareness of prevention, reduce behavioral risks and conduct prenatal examinations. The implementation of hepatitis C maternal and child blockade is the most effective way to prevent and control hepatitis C in Shenzhen. 摘要： 目的 分析深圳市丙肝发生、流行特征及变化趋势, 为制定有针对性的丙肝防控措施提供理论依据。 方法 对中国疾病预防控制信息系统“传染病报告信息管理系统” 2008—2017 年报告的深圳市丙肝病例信息进行描述 性分析。 结果 深圳市 2008—2017 年累计报告丙肝病例数18 671例, 发病率在14.16/10万~22.31/10万之间, 年均发病 率18.54/10万, 呈现出无死亡、无聚集性疫情、无明显季节性高发的散发特征, 但总体发病呈缓慢上升趋势。各年龄组 均有发病, 病例主要集中在20~50岁年龄组。深圳市0岁组年发病数维持在15例左右, 10岁组以下的发病占到全部病 例数的1.2%。深圳市丙肝发病人群主要以家务待业及工人为主。 结论 深圳市丙肝的发病主要以青壮年劳务工和家 务待业人群为主; 同时, 母婴传播也是深圳市丙肝传播的主要途径之一。因此, 持续开展针对流动人群丙肝感染防治 知识的健康教育和危险行为的干预, 增强其防范意识, 降低行为风险以及开展母婴阻断是深圳市预防和控制丙肝的最 有效的手段。

South African adult caregivers as "protective shields": Serving as a buffer between stressful neighborhood conditions and youth risk behaviors.

Low-income youths in KwaZulu-Natal, South Africa, face elevated risks to their well-being from exposure to neighborhood conditions correlated with engaging in risky behaviors. These risks can be mitigated through adult caregivers who serve as protective shields, buffering adverse conditions. However, this protective role is dependent on the caregivers' mental health and well-being. This secondary analysis uses baseline data from 475 child-caregiver dyads in an HIV-prevention program to examine the mediating effects of caregiver mental health on the relationship between neighborhood conditions and child risk-behaviors. Multivariate analyses identify the direct and indirect effects of neighborhood stressors and caregiver mental health on child risk-behavior. Findings suggest that caregivers mitigate the impact of neighborhood conditions on their children, but caregivers' mental health is directly affected by neighborhood conditions. Therefore, caregivers' mental health and well-being must be considered key elements in developing youth risk-behavior interventions.

Brief Motivational Interviewing Delivered by Clinician or Computer to Reduce Sexual Risk Behaviors in Adolescents: Acceptability Study.

BackgroundClinicians are expected to screen their adolescent patients for an increasing number of health behaviors and intervene when they uncover risky behaviors, yet, the clinic time allotted to screen, intervene, and provide resources is insufficient. Brief motivational interviewing (MI) offers succinct behavior change counseling; however, for implementation, clinicians need training, skill, and time. Computerized screening and counseling adjuvants may help clinicians increase their scope of behavioral screening, especially with sensitive topics such as sexual health, and provide risk-reduction interventions without consuming provider time during visits.ObjectiveThe objectives of this study were to (1) understand the extent to which health care providers use brief MI for sexual health discussions with adolescent patients and (2) assess the acceptability of incorporating a brief MI-based intervention to reduce sexual risk behaviors into their clinical practice delivered by either themselves or a computer.MethodsAt a national medical conference, surveys were administered to clinicians who provide sexual health care to adolescents. They were asked about their current use of MI for sexual risk behavior discussions and their willingness to implement computerized sexual health screening and computerized sexual risk behavior interventions into their clinical practice.ResultsThe large majority (87.6%, 170/194) of clinicians already used MI with their patients with less than half (72/148, 48.6%) reporting they had been formally trained in MI. Despite all (195/195, 100.0%) clinicians feeling very or completely comfortable discussing sexual risk behaviors with their patients, the large majority (160/195, 82.1%) reported it would be useful, very useful, or extremely useful for a computerized program to do it all: screen their patients, generate risk profiles, and provide the risk-reduction counseling rather than doing it themselves.ConclusionsIn this study, most clinicians used some form of brief MI or client-centered counseling when discussing sexual risk behaviors with adolescents and are very comfortable doing so. However, the large majority would prefer to implement computerized sexual health screening, risk assessment, and sexual risk behavior interventions into their clinical care of adolescents.