Suboptimal Health Behaviors Research Articles

What Women with HIV Know about Heart Health and Cardiovascular Risk and Intervention Preferences.

Cardiovascular disease (CVD) is a significant health concern influenced by various determinants. Stigma and resilience have emerged as factors in CVD development and management. Women with HIV (WWH) have higher CVD rates than women without HIV. To improve cardiovascular health for WWH, a comprehensive understanding of how these factors interact, the understanding about individual awareness and willingness to engage in risk-reduction interventions are needed. Methods: As part of a study examining CVD risk among WWH aged >35 years old, 90-min focus groups were conducted (May 2022) in the English language. Focus groups aimed to elicit participants' CVD risk knowledge and potential prevention strategies. Transcripts underwent a qualitative analysis. Results: Nineteen WWH participated in three focus groups. Participants experienced the following: (a) enacted stigma related to their HIV diagnosis (e.g., family, church member, healthcare staff); (b) a recent event (e.g., hospitalization of self/family, death in family, chest pain) triggered both heart health-promoting lifestyle changes and suboptimal health behaviors (e.g., COVID-19 pandemic: unhealthy snacking). Participants wanted to obtain more knowledge ("on a mission") about CVD risk. In total, 100% expressed willingness to take medication or embark on other lifestyle changes to prevent future CVD events. Although participants identified preventative heart health behaviors (e.g., eating healthy foods; exercising; limiting stress, substances, and smoking), misconceptions were also identified (e.g., "catching" heart disease). Conclusions: Understanding the interplay of the different factors related to heart health is needed both at the provider and the patient level to inform interventions that reduce CVD risk amongst racial/ethnic minoritized women with HIV, living in the Southern region of the US.

Empowering Pregnant Women: A Community-Based Health Education Intervention to Promote Healthy Behaviors

Pregnant women in rural areas like Lubuk Alung often face barriers to accessing quality health information and care, leading to suboptimal health behaviors during pregnancy. This study aimed to evaluate the impact of a community-based health education intervention on pregnant women's knowledge, attitudes, and practices regarding healthy behaviors in Lubuk Alung. A quasi-experimental study was conducted with 150 pregnant women (75 intervention, 75 control) in Lubuk Alung. The intervention group received a 12-week program of structured health education sessions delivered by trained community health workers. Sessions covered topics such as nutrition, exercise, antenatal care, childbirth preparation, and breastfeeding. The control group received standard antenatal care. Pre- and post-intervention surveys assessed knowledge, attitudes, and self-reported practices related to healthy behaviors. The intervention group demonstrated significant improvements in knowledge about healthy behaviors (p<0.001), more positive attitudes towards these behaviors (p<0.01), and increased adoption of practices like consuming a balanced diet, engaging in regular physical activity, attending antenatal care visits, and exclusive breastfeeding (p<0.05). The control group showed minimal changes. In conclusion, community-based health education interventions are effective in empowering pregnant women in rural settings. They increase knowledge, shift attitudes, and promote the adoption of healthy behaviors during pregnancy. Such programs should be integrated into routine antenatal care services in areas like Lubuk Alung.

Comparison of Health Behaviors of Healthcare Workers and the General Public in Israel: A Cross-Sectional Survey.

Healthcare workers (HCWs) are role models and advisors for promoting health behaviors among their patients. We conducted a cross-sectional survey to identify and compare the health behaviors of 105 HCWs and 82 members of the Israeli public. Of 13 health behaviors examined, undergoing screening tests, getting influenza vaccines and smoking were significantly different between the HCWs and the public. Further comparison between physicians and other HCWs (e.g., nurses, physiotherapists, dieticians) showed that the physicians reported the least favorable health behaviors: having less than 7 h of sleep, being less likely to eat breakfast, having greater alcohol consumption and being least likely to undergo regular screening tests. Analysis of a composite healthy lifestyle score (which included 11 health behaviors) showed statistically significant differences among the three groups (p = 0.034): only 10.6% of the physicians had a high healthy lifestyle score compared to the other HCWs (34.5%). In conclusion, the HCWs and the public report suboptimal health behaviors. Beyond the concern for HCWs' personal health, their health behaviors have implications for the health of patients and the general public, as they play an important role in health promotion and counseling. HCWs' suboptimal "health profile" mandates implementing policies to improve their knowledge of recommended health behaviors, primarily targeting physicians, even at an early phase of their professional journey.

O076 Changes in Sleep and Perceived Health risk in early Career Paramedics

Abstract Shift work is associated with increased chronic disease risk and suboptimal health behaviours. However, our understanding of the impact of shift work on health behaviours is impacted by a lack of longitudinal studies that examine health behaviours in shift workers relative to behaviours prior to shift work commencement. To address this limitation, we examined sleep changes and perceived health risk (i.e., individual’s perception of risk to their health) in intern paramedics during the first 12 months of shift work. The current study examined self-report sleep quality and duration in 21 interns (15 Female, 6 Male, aged 23.0 [20.0, 36.0]) from one Australian Ambulance service. Data were collected quarterly for a year (pre-shift work, and then 3, 6, 9 and 12 months post recruitment training). Linear mixed models, controlling for chronotype and baseline perceived health risk, showed that the first 12 months of shift work were associated with a significant decline in sleep quality (p=0.021) but no change in sleep duration (p=0.76). Linear mixed models also showed that perceived health risk significantly increased (p=0.036). Substantial between-subjects differences were observed, highlighting individual differences in response to shift work onset on sleep and perceived health risk. This study demonstrates that commencement of shift work is associated with a decline in sleep quality and increase in perceived health risk in early career paramedics. The considerable individual differences observed in this study highlight a need for larger studies with more participants, and a focus on personalised strategies for workers commencing shift work.

The Development and Validation of the Health Belief Model for Shift Workers (HBM-SW) Scale

ABSTRACT Objective Shift work is associated with circadian misalignment, sleep loss, and suboptimal health behaviors, which may contribute to longer term negative health outcomes. To inform future interventions for shift workers, the present study aimed to develop and evaluate the Health Belief Model for Shift Workers (HBM-SW) scale. Methods The HBM-SW development involved a seven-step process, including a literature review, expert panel analysis, cognitive interviews with shift workers, and a trial with a pilot sample of shift workers (n = 153). Utilizing exploratory factor analysis for factor identification and item reduction, the developed scale loaded on seven factors in line with the theoretical framework of the Health Belief Model: Perceived Threat, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, Self-efficacy, and Health Motivation. Validation of the scale was conducted utilizing Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire, and Food Frequency Questionnaire. Results The pilot sample had an average age of 34.0 (18.0) years, was majority female (54.2%), with an average of 8.0 (11.0) years shift work experience. The HBM-SW showed good – excellent (α = 0.74–0.93) internal consistency and moderate – good (ICC = 0.64–0.89) test re-test reliability. Using health behavior outcome measures, the HBM-SW scale showed meaningful correlations with sleep quality, sleep duration, diet quality and leisure time physical activity, and acceptable validity and reliability. Further testing should be conducted in a larger sample to facilitate confirmatory factor analysis. Conclusions The developed Health Belief Model for Shift Workers scale is likely beneficial for use in future studies of interventions for shift workers.

Parent Behavior Management Training for Child ADHD Enhanced to Address Health Behaviors: Comparison of Telemedicine “Telegroup” Versus In-Person Delivery

Objective: ADHD is associated with suboptimal health behaviors including physical activity (PA). LEAP is a parent BMT group program enhanced to focus on health behaviors, integrated with mHealth technology. Little is known about implementing BMT via telemedicine “telegroups.” Methods: Children ages 5 to 10 with ADHD and their caregiver wore activity trackers and participated in an 8 to 9 week parent BMT and social media group emphasizing PA, sleep, and screen use. A 7-day child accelerometer-wear and parent and teacher measures were completed pre- and post-group. Groups were in-person prior to the COVID-19 pandemic and in telegroup format during the pandemic. Results: Thirty-three families participated in person and 23 participated via virtual telegroup. Group attendance was superior for telegroup with equivalent satisfaction and skill use. Changes in health behavior and clinical outcomes were equivalent. Conclusions: LEAP is a feasible and novel BMT intervention that can be delivered in an accessible telegroup format with high participation and acceptability.

P032 The Health Belief Model for Shift Workers Scale: The development and validation of a novel metric for use in shift working populations

Abstract Introduction Shift work is associated with circadian misalignment, sleep loss and suboptimal health behaviours, which may contribute to longer term negative health outcomes. interventions based on behavioural models may improve health behaviours in shift workers. To implement and evaluate these interventions, a validated metric based on behavioural theory specifically for use with shift workers would be beneficial. The present study aimed to develop and evaluate the Health Belief Model for Shift Workers (HBM-SW) scale. Methods The HBM-SW development involved a seven-step process, including a literature review, expert panel analysis, cognitive interviews with shift workers, and administration to pilot sample of shift workers (n=153). Validation of the HBM-SW was compared to Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire and Food Frequency Questionnaire. Results Utilising exploratory factor analysis for factor identification and item reduction, the developed scale loaded on seven factors in line with the theoretical framework of the Health Belief Model Perceived Threat, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, Self-Efficacy and Health Motivation. The HBM-SW showed good – excellent (α =0.74-0.93) internal consistency and moderate – good (ICC =0.64-0.89) test re-test reliability. Using health behaviour outcome measures, the HBM-SW scale showed meaningful correlations with sleep quality, sleep duration, diet quality and leisure time physical activity, and acceptable validity and reliability. Conclusion Further testing should be conducted in a larger sample to facilitate confirmatory factor analysis. The Health Belief Model for Shift Workers scale is likely to be beneficial for in future studies of interventions for shift workers.

Sleep disturbances among women in a Subarctic region: a nationwide study.

Study ObjectivesTo date, few studies have assessed sleep problems among women residing in Subarctic regions. Therefore, the aim of this large-scale population-based study was to assess the prevalence of severe sleep problems and associated factors among Icelandic women, living at 63–66°N.MethodsParticipants were 29 681 women (18–69 years old) who took part in the Icelandic Stress-And-Gene-Analysis study in 2018–2019. Background information, health-related behavior, and mental health symptoms were assessed with an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was used to assess severe sleep problems during the past month. Adjusting for age, marital status, number of children, education, personal income, work schedule, region, and response period, we used modified Poisson log-linear models to obtain prevalence ratios (PRs) with 95% confidence intervals (CIs).ResultsOverall, 24.2% of women reported severe sleep problems (PSQI >10). Women responding in the winter presented with an overall higher prevalence of severe sleep problems, compared to those responding in the summer (PR 1.21; 95% CI, 1.15 to 1.28). Severe sleep problems were more prevalent among young and late-midlife women, those who were single, had children, socio-economic challenges, worked shifts, and flexible hours. Furthermore, obesity, suboptimal health behaviors, excessive screen time, and mental health problems were associated with severe sleep problems.ConclusionSevere sleep problems are more common among women in Subarctic regions than elsewhere, particularly during winter. These findings motivate the development of preventive strategies and interventions for women in the Subarctic who suffer from sleep problems.

Co-Designing the Health4Me Text Message Intervention to Support and Improve Adolescent’s Physical and Mental Health Outcomes: An Active Research Partnership With Adolescents

Despite suboptimal lifestyle health behaviours, current approaches to adolescent cardiovascular disease (CVD) prevention are proving ineffective. Researchers have the responsibility to engage with adolescents as research partners. The aim is to co-design the Health4Me text message nutrition and physical activity support program with an adolescent advisory panel.

Individual, Interpersonal, and Home Environmental Factors Influencing Health Behaviors Among Chinese Childhood Cancer Survivors: A Structural Equation Analysis.

Childhood cancer survivors (CCSs) are at increased risk of chronic health conditions, which could be controlled with health behaviors. However, the health behaviors and related factors of Chinese CCSs remain unclear. The aims of this study were to examine multiple health behaviors among Chinese CCSs and explore the individual, interpersonal, and home environmental factors affecting health behaviors. This cross-sectional study recruited 204 participants from 3 grade-A tertiary hospitals in Guangzhou, China. Participants provided data on health behaviors (smoking, drinking, drug use, screen time, internet addiction, dietary behaviors, physical activity, and sleep behaviors) and their determining factors. Structural equation modeling was used to analyze the data. Chinese CCSs reported low rates of smoking, drinking, and drug use (0%-6.4%), but only 51% of survivors met screen time recommendations, and 24.5% of them had Internet addiction. Few survivors reported frequent soft-drink, sugar, and fast-food intake (2.0 to 7.4%), but many were finicky eaters (55.4%) or seldom drank milk (41.7%). In addition, 67.6% and 47.5% of survivors did not meet physical activity and sleep time recommendations. Childhood cancer survivors' health behaviors were influenced by the individual (age, education level, and time since diagnosis), interpersonal (peer and family support), and home environmental (residential location, parents' educations level, and household income) factors. There were suboptimal health behaviors among Chinese CCSs. Targeted interventions should consider their individual, interpersonal, and home environmental factors. Knowledge of health behaviors and related factors of Chinese CCSs would help healthcare professionals develop further interventions to improve their care of this population.

“The Awesomeness and the Vastness of Who You Really Are:” A Culturally Distinct Framework for Understanding the Link Between Spirituality and Health for Black Sexual Minority Men

Despite health inequities, many Black sexual minority men are resilient and often utilize spirituality as a culturally distinct self-protective and self-enhancing resource to maintain their health. However, little is known about how spirituality impacts health within a cultural framework that is specific to Black sexual minority men. We conducted 10 individual in-depth interviews, reaching code saturation, with Black sexual minority men across the USA. Our study was guided by grounded theory and a Black psychology theoretical framework. Seven themes were discovered and revealed that participants’ level of spiritual consciousness influenced their engagement in psychological and behavioral processes that were related to mental and physical health. These themes were: (a) suboptimal worldview, (b) emotional revelation, (c) emotional emancipation, (d) emotional regulation, (e) health motivations, (f) health behaviors, and (g) links between spiritual consciousness, mental health, and physical health. Implications of these findings for clinicians and researchers are discussed.

Feasibility and preliminary efficacy of a positive psychology-based intervention to promote health behaviors in heart failure: The REACH for Health study

ObjectiveMost patients with heart failure (HF) struggle to adhere to health behaviors, and existing health behavior interventions have significant limitations. We developed a 12-week, phone-delivered, combined positive psychology (PP) and motivational interviewing (MI) intervention to promote well-being and adherence to physical activity, diet, and medications. In this three-arm, randomized trial, we assessed the feasibility, acceptability, and preliminary efficacy of the intervention compared to treatment as usual and MI-alone conditions in 45 patients with HF and suboptimal health behavior adherence. MethodsParticipants in the PP-MI or MI-alone conditions completed weekly phone sessions for 12 weeks. Those in PP-MI completed weekly PP exercises and set health behavior goals, while those in the MI-alone condition learned about HF-specific health behaviors and identified potential behavior changes. Primary study outcomes were feasibility (sessions completed) and acceptability (0–10 ratings of PP exercise ease and utility). The intervention's impact on psychological and behavioral outcomes was assessed using mixed effects regression analyses. ResultsParticipants in the PP-MI condition completed 73% of sessions and rated PP exercises as easy to complete (mean = 7.5 [SD 1.7] out of 10) and subjectively useful (mean = 7.5 [SD 1.6] out of 10). Compared to the control conditions, PP-MI led to medium effect-size improvements in positive affect (Cohen's d = 0.32–0.77), moderate to vigorous physical activity (d = 0.41–0.74), and medication adherence (d = 0.48–0.78). ConclusionThis PP-MI intervention was feasible, well-accepted, and associated with promising improvements in well-being and health behavior outcomes. Larger trials are needed to examine this intervention's impact on health behavior adherence and other important outcomes (NCT03220204).

Sleep Quality Is Associated With Nighttime Heart Rate Variability In Young Adults

Heart rate variability (HRV) reflects autonomic nervous system function, and low nighttime HRV is linked to reduced parasympathetic control. Optimal parasympathetic function is important for the induction and maintenance of sleep, overall wellbeing, and is inversely associated with chronic disease. In young adults, 60% of whom report poor sleep quality, disrupted parasympathetic function may reflect suboptimal health and lifestyle behaviors. While there is an established relationship between physical activity (PA), stress, and nighttime HRV, the associations between HRV and other lifestyle-related factors such as sleep quality and social jet lag (SJL) in young adult populations are yet to be determined. PURPOSE: The purpose of this study was to determine the relationship between nighttime HRV and sleep characteristics in young adults. METHODS: Healthy young adults (n=33, 18.6 ± 0.7 years, 69.6% female) wore a chest-strap heart rate monitor for 24 hours and a triaxial accelerometer on the non-dominant wrist for 7 days during free-living PA and sleep. Average sleep duration and SJL were determined from objective sleep data, with SJL calculated as the difference in hours between the midpoint of sleep on weeknights (school) and weekend (free) nights. The Pittsburgh Sleep Quality Index (PSQI) and Perceived Stress Scale were used as subjective measures of sleep quality and stress. Nighttime HRV outcomes were calculated using R-R intervals between the hours of 1:00 AM - 5:00 AM. Linear regression assessed multivariate relationships among sleep duration, quality, SJL, and HRV while controlling for moderate-to-vigorous PA and perceived stress. RESULTS: Independent of average sleep duration and SJL, perceived sleep quality was associated with the HRV outcomes low frequency (LF; B= -10.62 ± 4.85, 95% CI: -20.56, -.67) and high frequency power (HF; B= 10.55 ± 4.84, 95% CI: .61, 20.49). Following control for PA and stress, these relationships remained significant and the association between SJL and LF/HF ratio approached significance (B= -.33 ± .18, 95% CI: -.69, .04). CONCLUSIONS: Our findings suggest that both LF and HF HRV components are related to sleep quality in young adults, highlighting a potential relationship between sleep quality and nighttime autonomic nervous system function.

An Exploration of Health Behaviors in a Mind-Body Resilience Intervention for Parents of Children with Developmental Disabilities

Parents of children with special needs such as learning and attentional disabilities (LADs) and autism spectrum disorder (ASD) are at high risk for stress-related disorders. The demands of parenting may compete with time for self-care behaviors such as physical activity, healthy eating, and adequate sleep. The objective was to describe health behaviors among this understudied population and assess the changes after a resilience intervention. This was a secondary data analysis of a randomized controlled pilot virtual mind-body resilience intervention (Stress Management and Resiliency Training: A Relaxation Response Resiliency Program) trial for parents of children with LADs (n = 52) and ASD (n = 47). Parents completed self-report questionnaires about their weekly physical activity, eating behaviors, sleep duration, and fatigue before and after the 8-week intervention. Descriptive statistics and pre-post intervention effect sizes (Cohen's d) were calculated. Both parent groups reported suboptimal levels of health behaviors at baseline, but ASD parents reported lower health behaviors than LAD parents. LAD parents improved more on physical activity, with a higher percentage meeting recommendations at postintervention follow-up (d = 0.71) than ASD parents (d = 0.01). Eating behaviors showed small effect size improvements for both groups. Although sleep duration improved only with small or medium effect sizes for both groups, ASD parents rated their fatigue lower after the intervention (d = 0.81). Parents of children with special needs who participated in a virtual resilience intervention demonstrated suboptimal health behaviors. There is a need for targeted interventions for health behaviors that can promote resilience in these high-stress populations.

Social Relations, Community Engagement and Potentials: A Qualitative Study Exploring Resident Engagement in a Community-Based Health Promotion Intervention in a Deprived Social Housing Area.

Emerging evidence points towards a lower quality of life, fragile social relations and suboptimal health behavior and status of residents living in social housing areas characterized by ethnic diversity and socioeconomic deprivation. Community-based health promotion interventions developed in collaboration with the target group and adjusted to the local context can affect the acceptance of and engagement in such interventions. However, few studies have investigated the potential of community-based interventions in deprived social housing areas. This study explores residents’ perspectives on engagement in a community-based health promotion intervention focusing on enhancing social relations. The study builds on qualitative methods including participant observations combined with pre- and post-intervention interviews with a selected group of residents (n = 9). Data were thematically analyzed with focuses on participation in an everyday life context, concepts of othering, and territorial stigmatization. Engagement in the intervention was motivated by the need to establish and enhance social relations, and to explore the world outside the housing area. However, barriers including cultural and language differences among residents, and competing contextual factors, challenged engagement. We conclude that participatory community-based interventions have a potential to enhance social relations in deprived social housing areas. However, adequate support and efforts to overcome the identified barriers are needed.

Time preferences, diabetes self-management behaviours and outcomes: a systematic review.

Time preferences, i.e. individuals' degree of patience/impatience in intertemporal choice, have been found to be associated with suboptimal health behaviours and health outcomes such as smoking, physical inactivity, unhealthy food intake and obesity. In this systematic review, we aimed to synthesise reported associations between time preferences, diabetes self-management behaviours, including use of diabetes technology, and outcomes. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, EconLit and all databases in the Web of Science Core Collection. Peer-reviewed studies of people with diabetes that included at least one diabetes-related behaviour or outcome and a measure of time preferences were included. Non-English language studies were excluded. A total of 961 records were identified, of which 12 articles were included. Three studies analysed both time-consistent and time-inconsistent preferences, three studies solely analysed time-inconsistent preferences and six studies did not explicitly define a time preference model. Measured outcomes across studies included self-care activities, such as medication-taking, exercising and eating a healthy diet, and biomedical outcomes, such as HbA1c and diabetes-related complications. There were 10 cross-sectional studies and two panel-data studies. No studies explicitly analysed the relationship between time preferences and diabetes technology use. Associations between measures of time preferences, diabetes self-management behaviours and clinical outcomes exist. Higher discount rates determined by both time-consistent and time-inconsistent models predict less diabetes-related self-care and worse outcomes. These findings may add to explanations of the observed variation in diabetes-related health and provide new insights for tailoring interventions and policies aimed at improving diabetes self-management.

Gestational diabetes exposure and adiposity outcomes in childhood and adolescence: An analysis of effect modification by breastfeeding, diet quality, and physical activity in the EPOCH study.

Intrauterine exposure to gestational diabetes (GDM) is associated with increased adiposity; however, not all offspring exposed to GDM exhibit excess adiposity. Examine whether optimal diet and activity behaviours in infancy, childhood, and adolescence modify the association between GDM exposure and adiposity. In 564 offspring (84 exposed to GDM), we assessed breastfeeding (maternal recall), dietary intake (food frequency questionnaire), physical activity (3-day recall), and adiposity (BMI, waist-to-height ratio, visceral and subcutaneous adipose tissue, and subscapular-to-triceps skinfold ratio) at 10.4 (SD, 1.5) and 16.7 (SD, 1.2)years. Optimal behaviours were defined as >6 breastmilk months, Healthy Eating Index score >60, and daily vigorous activity >1hour. Linear mixed models assessed the association between GDM exposure and adiposity among those with optimal versus suboptimal health behaviours, adjusting for sex, race/ethnicity, age, and pubertal status. GDM exposure was associated with increased skinfold ratio, visceral and subcutaneous adipose tissue among those with <6 breastmilk months (all Ps<.05), but only associated with increased skinfold ratio among those with >6 breastmilk months (P=.01). GDM exposure was associated with increases in all adiposity measures among those with Healthy Eating Index scores <60 (P<.01), but not those with scores >60 (P>.10). GDM exposure was associated with increased BMI and subcutaneous adipose tissue among those with >1hour of vigorous activity (P<.05) but not among those with <1hour of vigorous activity (P>.30). The association of GDM exposure with excess adiposity is attenuated in offspring with more optimal diet and activity behaviours in infancy, childhood, and adolescence.

Preconception Lifestyle and Weight-Related Behaviors by Maternal Body Mass Index: A Cross-Sectional Study of Pregnant Women.

Obesity is a rising global health challenge, particularly for reproductive-aged women. Our cross-sectional study of pregnant women (n = 223) examined associations between preconception body mass index (BMI) and socio-demographics, weight perceptions and lifestyle behaviors. Over half of women were overweight (33.2%) or obese (22.0%), 49.6% of which perceived their weight as normal. High proportions of women reported planning their pregnancies (70.0%) and were actively trying to lose or maintain their weight preconception (72.7%). Weight management approaches varied from reducing discretionary foods (63.7%) to professional support (8.1%). Obese women had significantly greater odds of reducing discretionary foods (odds ratio (OR) = 6.69 95% confidence interval (CI) 2.13–21.00, p = 0.001) and using structured diets (adjusted odds ratio (AOR) = 9.13 95% CI 2.90–28.81, p < 0.001) compared to normal-weight women. After adjusting for socio-demographics, compared to normal-weight women, overweight (AOR = 5.24 95% CI 2.19–12.56, p < 0.001) and obese (AOR = 2.85 95% CI 1.06–7.67, p = 0.04) women had significantly increased odds of exercising for weight management and significantly lower odds of taking folic-acid preconception (overweight: AOR = 0.40 95% CI 0.18–0.90, p = 0.01, obese: AOR = 0.38 95% CI 0.16–0.91, p = 0.03). Large proportions of women planning a pregnancy have an overweight/obese BMI, with associated suboptimal health behaviors and reduced health professional engagement preconception. Further research exploring women’s perspectives regarding preconception lifestyles is needed to inform effective preconception health promotion strategies.

A Positive Psychology Intervention to Promote Health Behaviors in Heart Failure: A Proof-of-Concept Trial.

ClinicalTrials.gov identifier: NCT02938052.

Islamophobia, Health, and Public Health: A Systematic Literature Review.

In 2017, a "Muslim ban" on immigrants to the United States was coupled with a continued rise in Islamophobia and hate crimes toward Muslims. Islamophobia undermines health equity, yet delineating the effects of Islamophobia globally is challenging as it affects a myriad of groups (geographically, racially, and socially). Additionally, stereotypes equate all Muslims with populations from the Middle East and South Asia. To date, health research pays insufficient attention to Islamophobia, Muslims, and those racialized to be Muslim. This literature review advances our understanding of racism and health by examining the racialization of religion, by specifically examining Islamophobia as a form of discrimination. Per PRISMA guidelines, we conducted a search in October 2017 using PubMed-MEDLINE and a combination of terms. We identified additional articles using other search engines. For inclusion, articles needed to include a descriptor of discrimination, contain an identifier of Muslim or Muslim-like identity (i.e., groups commonly perceived as Muslim, including Arabs, Middle Easterners, North Africans, and South Asians), include a health outcome, be in English, and be published between 1990 and 2017. We identified 111 unique peer-reviewed articles. We excluded articles that did not meet the following criteria: (1) examined Islamophobia, discrimination, or racism among a Muslim or Muslim-like population; (2) included a health outcome or discussion of health disparities; and (3) was conducted in North America, Europe, Australia, or New Zealand. This yielded 53 articles. The majority of studies (n = 34; 64%) were quantitative. The remaining studies were qualitative (n = 7; 13%), mixed methods (n = 2; 4%), or reviews (n = 10; 19%). Most studies were based in the United States (n = 31; 58%). Nearly half of the reviewed studies examined mental health (n = 24; 45%), and one fourth examined physical health or health behaviors (n = 13; 25%). Others focused on both physical and mental health (n = 10; 19%) or health care seeking (n = 7; 13%). Studies showed associations between Islamophobia and poor mental health, suboptimal health behaviors, and unfavorable health care-seeking behaviors. This study elucidates the associations between Islamophobia, health, and socioecological determinants of health. Future studies should examine the intersectional nature of Islamophobia and include validated measures, representative samples, subgroup analyses, and comparison groups. More methodologically rigorous studies of Islamophobia and health are needed. Public Health Implications. Addressing the discrimination-related poor health that Muslims and racialized Muslim-like subgroups experience is central to the goals of health equity and assurance of the fundamental right to health.