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Hamzah KQA, Mohd Zulkefli NA, Ahmad N. Health-seeking behaviour during times of illness among urban poor women: a cross-sectional study. BMC Womens Health 2024; 24:334. [PMID: 38849787 PMCID: PMC11157716 DOI: 10.1186/s12905-024-03178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Urban poor women face dual challenges regarding gender inequalities and urban poverty, which make them more likely to have health problems and affect their health-seeking behaviour. This study aimed to determine the prevalence of health-seeking behaviour during times of illness and predictors of sought care among urban poor women in Kuala Lumpur, Malaysia. METHODS This cross-sectional study was performed among 340 randomly selected women residents from April to May 2023. Data was collected using a validated and reliable self-administered questionnaire and analysed using SPSS version 28.0 software. The dependent variable in this study was health-seeking behaviour during times of illness, while the independent variables were sociodemographic characteristics, socioeconomic characteristics, medical conditions, women's autonomy in decision-making, social support, perceived stigma, and attitude towards health. Multiple logistic regression was used to identify the predictors of sought care during times of illness. RESULTS Study response rate was 100%, where 72.4% sought care during times of illness. Being non-Malay (AOR = 4.33, 95% CI: 1.847, 10.161), having healthcare coverage (AOR = 2.60, 95% CI: 1.466, 4.612), rating their health as good (AOR = 1.87, 95% CI: 1.119, 3.118), and having pre-existing chronic diseases (AOR = 1.92, 95% CI: 1.130, 3.271) were identified as predictors of sought care during times of illness. CONCLUSION The present study showed that health-seeking behaviour during times of illness among the participants was appropriate. Health promotion and education, with a focus on educating and raising awareness about the importance of seeking timely healthcare, are crucial to improving health-seeking behaviour among urban poor women. Collaboration with relevant stakeholders is needed to develop comprehensive strategies to improve access to healthcare facilities for these women.
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Affiliation(s)
- Khadijahtul Qubra Amizah Hamzah
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia
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Millar SR, Harrington JM, Perry IJ, Phillips CM. Lifestyle factors and BMI attenuate relationships between biomarkers of inflammation and depressive symptoms and well-being: A cross-sectional study. Brain Behav Immun Health 2024; 37:100759. [PMID: 38560580 PMCID: PMC10979065 DOI: 10.1016/j.bbih.2024.100759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/14/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
Background Mental disorders are a growing public health concern and evidence has linked chronic low-grade inflammation with depression and well-being. Research also suggests that certain modifiable lifestyle factors such as smoking, alcohol use, physical activity, diet quality and BMI are related to psychological health. These may modulate the relationship between low-grade inflammation and mental health conditions. In this study we examined inflammatory biomarker associations with two psychological health scores and investigated whether relationships are influenced by lifestyle factors and BMI. Methods This was a cross-sectional study of 1824 middle-to older-aged men and women randomly selected from a large primary care centre. Depressive symptoms and well-being were assessed using the 20-item Centre for Epidemiologic Studies Depression (CES-D) Scale and the World Health Organization-Five (WHO-5) Well-Being Index. Linear regression analyses were performed to examine depression and well-being score relationships with six inflammatory biomarkers, and a composite inflammatory biomarker score, adjusting for demographic characteristics, health conditions, lifestyle factors and BMI. Results Depression and well-being score associations with complement component 3 (CES-D only) c-reactive protein, interleukin 6, leptin, white blood cell counts, neutrophils and the inflammatory biomarker score were observed. These relationships survived adjustment for demographic variables and health conditions but were attenuated in models which included lifestyle factors and BMI. In final models, only leptin (β = 0.566, p = 0.018) and inflammatory score (β = 0.137, p = 0.004) associations with the CES-D score remained. Conclusions These findings suggest that the relationship between systemic low-grade inflammation and depressive symptoms and well-being may be largely explained by lifestyle factors and adiposity, highlighting the potential importance of promoting a healthy lifestyle in the treatment of depressive disorders.
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Affiliation(s)
- Seán R. Millar
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Ivan J. Perry
- School of Public Health, University College Cork, Cork, Ireland
| | - Catherine M. Phillips
- School of Public Health, University College Cork, Cork, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
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Wong VWH, Yiu EKL, Ng CH, Sarris J, Ho FYY. Unraveling the associations between unhealthy lifestyle behaviors and mental health in the general adult Chinese population: A cross-sectional study. J Affect Disord 2024; 349:583-595. [PMID: 38176449 DOI: 10.1016/j.jad.2023.12.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/24/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND This study examined the cumulative risk of unhealthy lifestyle behaviors and the associations between overall lifestyle and common mental disorders (CMDs), insomnia, stress, health-related quality of life (HRQOL), and functional impairment. Additionally, the treatment preferences for managing CMDs and insomnia were examined. METHODS A survey was conducted on 1487 Chinese Hong Kong adults, assessing their lifestyle behaviors (i.e., diet and nutrition, substance use, physical activity, stress management, restorative sleep, social support, and environmental exposures), mental health-related outcomes, and treatment preferences via a vignette. RESULTS The findings revealed significant additive relationships between the number of 'worse' lifestyle domains and the risk of all outcomes. A healthier overall lifestyle was significantly associated with reduced risks of all outcomes (AORs = 0.88 to 0.93). Having healthier practices in diet and nutrition, substance use, stress management, restorative sleep, and social support domains were significantly associated with lower risks of all outcomes (AORs = 0.93 to 0.98), except that substance use was not significantly associated with stress. Physical activity was inversely associated with only depressive symptoms (AOR = 0.98), anxiety symptoms (AOR = 0.99), and stress (AOR = 0.99). Environmental exposures were not significantly associated with functional impairment but with all other outcomes (AORs = 0.98 to 0.99). Besides, lifestyle interventions (55 %) were significantly more preferred for managing CMDs and insomnia relative to psychotherapy (35.4 %) and pharmacotherapy (9.6 %). CONCLUSIONS Our findings underscore the importance of considering lifestyle factors when managing CMDs, insomnia, stress, HRQOL, and functional impairment, with a particular emphasis on adopting a multicomponent treatment approach.
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Affiliation(s)
| | - Eric Kwok-Lun Yiu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Jerome Sarris
- Western Sydney University, NICM Health Research Institute, Westmead, NSW, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
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Lonergan C, Millar SR, Kabir Z. Associations between adiposity measures and depression and well-being scores: A cross-sectional analysis of middle- to older-aged adults. PLoS One 2024; 19:e0299029. [PMID: 38446756 PMCID: PMC10917308 DOI: 10.1371/journal.pone.0299029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Obesity and mental health are significant global health concerns. Evidence has linked increased adiposity with depression and well-being; however, there is limited documented evidence in Ireland. Research also suggests lifestyle factors and disease conditions to be related to mental health. These may modulate relationships between adiposity and depression and well-being. METHODS This was a cross-sectional study of 1,821 men and women aged 46-73 years, randomly selected from a large primary care centre. Depression and well-being were assessed using the 20-item Centre for Epidemiologic Studies Depression Scale (CES-D) and the World Health Organization-Five (WHO-5) Well-Being Index. Linear regression analyses were performed to examine relationships between mental health scores (dependent variable) and adiposity (independent variable) defined using body mass index (BMI) and waist-height ratio while adjusting for demographic characteristics, lifestyle factors and disease conditions. RESULTS BMI and waist-height ratio had a significant positive association with depression scores and a significant inverse association with well-being scores in males and females. These associations were maintained following adjustment for demographic variables and lifestyle factors. In final models where disease conditions were adjusted for, BMI (β = 0.743, p < .001) and waist-height ratio (β = 0.719, p < .001) associations with the CES-D score remained significant. In stratified analyses, relationships between measures of adiposity and depression were found to be stronger in females (BMI: β = 0.806, p = .007; waist-height ratio: β = 0.768, p = .01) than males (BMI: β = 0.573, p = .049; waist-height ratio: β = 0.593, p = .044) but no effect modification was identified. CONCLUSIONS These findings suggest that increased adiposity is significantly associated with poorer mental health, independent of lifestyle factors and disease conditions. Targeted interventions for reducing depression should include better population-level weight management measures.
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Affiliation(s)
| | - Seán R. Millar
- School of Public Health, University College Cork, Cork, Ireland
| | - Zubair Kabir
- School of Public Health, University College Cork, Cork, Ireland
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Waaler PN, Bongo LA, Rolandsen C, Lorem GF. An individually adjusted approach for communicating epidemiological results on health and lifestyle to patients. Sci Rep 2024; 14:3199. [PMID: 38331938 PMCID: PMC10853548 DOI: 10.1038/s41598-024-53275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
If scientific research on modifiable risk factors was more accessible to the general population there is a potential to prevent disease and promote health. Mobile applications can automatically combine individual characteristics and statistical models of health to present scientific information as individually tailored visuals, and thus there is untapped potential in incorporating scientific research into apps aimed at promoting healthier lifestyles. As a proof-of-concept, we develop a statistical model of the relationship between Self-rated-health (SRH) and lifestyle-related factors, and a simple app for conveying its effects through a visualisation that sets the individual as the frame of reference. Using data from the 6th (n = 12 981, 53.4% women and 46.6% men) and 7th (n = 21 083, 52.5% women and 47.5% men) iteration of the Tromsø population survey, we fitted a mixed effects linear regression model that models mean SRH as a function of self-reported intensity and frequency of physical activity (PA), BMI, mental health symptoms (HSCL-10), smoking, support from friends, and HbA1c ≥ 6.5%. We adjusted for socioeconomic and demographic factors and comorbidity. We designed a simple proof-of-concept app to register relevant user information, and use the SRH-model to translate the present status of the user into suggestions for lifestyle changes along with predicted health effects. SRH was strongly related to modifiable health factors. The strongest modifiable predictors of SRH were mental health symptoms and PA. The mean adjusted difference in SRH between those with 10-HSCL index = 1.85 (threshold for mental distress) and HSCL-10 = 1 was 0.59 (CI 0.61-0.57). Vigorous physical activity (exercising to exhaustion ≥ 4 days/week relative to sedentary) was associated with an increase on the SRH scale of 0.64 (CI 0.56-0.73). Physical activity intensity and frequency interacted positively, with large PA-volume (frequency ⨯ intensity) being particularly predictive of high SRH. Incorporating statistical models of health into lifestyle apps have great potential for effectively communicating complex health research to a general audience. Such an approach could improve lifestyle apps by helping to make the recommendations more scientifically rigorous and personalised, and offer a more comprehensive overview of lifestyle factors and their importance.
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Affiliation(s)
- Per Niklas Waaler
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Ailo Bongo
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christina Rolandsen
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
- Deloitte AS, Oslo, Norway
| | - Geir F Lorem
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway.
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Zhang J, Zhang Y, Wu Z, Fu X. Enhancing understanding of healthy aging based on time-varying dependencies among multidimensional health, life satisfaction, and health behaviors of older adults aged 60 years and over. BMC Public Health 2024; 24:192. [PMID: 38229050 PMCID: PMC10790531 DOI: 10.1186/s12889-024-17752-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/11/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Healthy aging is a process of not only achieving good health but also increasing the life satisfaction of older adults aged 60 years and over, in which health behaviors play an important role. There is a lack of research on the time-varying dependencies between health, life satisfaction, and health behaviors, impeding a deeper understanding of healthy aging. PURPOSE To develop an integrated framework for modeling the interrelationships among the components of healthy aging between multiple time slices. METHODS Based on the Chinese Longitudinal Healthy Living Survey (CLHLS) data in the three waves of 2011/2012, 2014, and 2017/2018, Bayesian network and dynamic Bayesian network are jointly employed to study the relationships among the components of healthy aging within one time slice, as well as to explore the time-varying dependencies among the components between time slices. RESULTS The results of structure learning reveal the direction of effects between different dimensions of health, with mental health and social health affecting physical health and self-rated health affecting both physical and mental health. In addition, health behaviors are found to affect mental health and social health, while self-rated health can influence life satisfaction. The parameters learned from the data show the magnitude and direction of concurrent effects, one-period lagged effects and two-period lagged effects between the factors, which find that the time-varying dependencies vary but are generally positive, long-term, and accumulative over time. In addition, the results of autoregressive effects show the positive predictive effects of health and life satisfaction. CONCLUSIONS It confirms the influence pathway from health behaviors to multidimensional health to life satisfaction, and the time-varying dependencies among the components of healthy aging, which facilitates a deeper understanding of healthy aging. Combining the results of autoregressive effects and descriptive statistics, it further indicates that healthy aging is a comprehensive result arising from interactions of multiple factors. Policymakers should guide older adults aged 60 years and over to adopt healthier behaviors and ensure the long-term sustainability and continuity of policies.
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Affiliation(s)
- Jianghua Zhang
- School of Management, Shandong University, Jinan, 250100, China
| | - Yunbao Zhang
- School of Management, Shandong University, Jinan, 250100, China
| | - Zhiyi Wu
- School of Management, Shandong University, Jinan, 250100, China
| | - Xuemei Fu
- School of Management, Shandong University, Jinan, 250100, China.
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Navarra-Ventura G, Coronado-Simsic V, Riera-Serra P, Castro A, García-Toro M, Roca M, Gili M. Associations between unhealthy lifestyle and depression: Cross-sectional results from the Spanish National Health Survey. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00035-2. [PMID: 38591831 DOI: 10.1016/j.sjpmh.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/02/2023] [Accepted: 08/25/2023] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Depression usually worsens lifestyle habits, but previous evidence also suggests that an unhealthy lifestyle (UL) increases the risk of depression. Many studies have analyzed the association between lifestyle and depression in several nationally representative samples, but none have done so in the Spanish adult population. Our aim was to examine the associations between UL habits and depression in Spain. MATERIALS AND METHODS Analysis of cross-sectional data from the latest National Health Survey published in 2018 (N=23,089). Data on depression and 4 lifestyle factors (diet, physical exercise, smoking, and alcohol consumption) were used. These factors were combined into an UL index ranging from 0 (healthiest lifestyle) to 4 (unhealthiest lifestyle). The prevalence of depression at different levels of the UL index, and the association between depression and both the cumulative UL index and the 4 UL factors was analyzed using parametric and non-parametric tests. RESULTS Sedentarism was the most prevalent UL factor, followed by unhealthy diet, smoking and high-risk alcohol consumption. Having ≥1 UL factors was associated with a higher prevalence of depression compared to having 0 UL factors (2.5% vs. ≥5.2%), regardless of the cumulative number UL factors (1, 2, 3 or 4). Being physically inactive (OR=1.6) and a smoker (OR=1.3) increased the likelihood of depression. Being a high-risk wine drinker (OR=0.26) decreased the likelihood of depression. Dietary intake was not significant. CONCLUSIONS The prevalence of depression changes depending on several modifiable lifestyle factors. Policy makers should therefore spare no resources in promoting strategies to encourage healthy lifestyles and prevent the acquisition of UL habits.
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Affiliation(s)
- Guillem Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Victoria Coronado-Simsic
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain
| | - Pau Riera-Serra
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain.
| | - Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Mauro García-Toro
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Medicine, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain
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Roberts KE, Beckenkamp PR, Ferreira ML, Ho EK, Carvalho-E-Silva AP, Calais-Ferreira L, Ferreira PH. The impact of aggregate positive lifestyle behaviors on low back pain resilience and care seeking. Spine J 2023; 23:1405-1413. [PMID: 37393016 DOI: 10.1016/j.spinee.2023.06.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/02/2023] [Accepted: 06/17/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND CONTEXT Low back pain (LBP) is a global issue, and the high associated costs are mainly attributed to a small proportion of people with LBP who seek care. Importantly, the impact of aggregate positive lifestyle behaviors on LBP resilience and care seeking is not known. PURPOSE This study aimed to evaluate the relationship between positive lifestyle behaviors and LBP resilience. STUDY DESIGN This study was a prospective longitudinal cohort study. PATIENT SAMPLE Data was collected as part of the AUstralian Twin BACK Study (AUTBACK). Participants who reported a lifetime previous history of LBP at baseline were included in this analysis (n = 340). OUTCOME MEASURES The outcomes of interest were the number of weeks without activity limiting LBP and total number of days of healthcare usage, health practitioner care, self-management care, and medication intake. METHODS A lifestyle behavior score was built using variables of body mass index (BMI), physical activity, smoking status, and sleep quality. Negative binomial regression analyses were used to assess the relationship between the positive lifestyle behavior score and the count outcomes of number of weeks without activity limiting LBP and number of days participants used care. RESULTS After adjusting for covariates, no association was found between participants' positive lifestyle behavior score and their number of weeks without activity limiting LBP (IRR: 1.02, 95% CI 1.00-1.05). There was a statistically significant relationship between higher positive lifestyle behavior scores and fewer number of days of participants' total healthcare usage (IRR:0.69, 95% CI 0.56-0.84), healthcare practitioner visits (IRR:0.62, 95% CI 0.45-0.84), use of self-management strategies (IRR:0.74, 95% CI 0.60-0.91), and use of pain medication (IRR:0.55, 95% CI 0.44-0.68). CONCLUSION People who adopt optimal lifestyle behaviors, such as engaging in adequate physical activity, achieving optimal quality sleep, maintaining an ideal BMI, and not smoking, may not experience less time suffering from activity limiting LBP, but are less likely to use healthcare and pain medication for their LBP.
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Affiliation(s)
- Katharine E Roberts
- Faculty of Medicine and Health, The University of Sydney, Western Avenue Camperdown, Sydney, Australia.
| | - Paula R Beckenkamp
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Western Avenue Camperdown, Sydney, Australia
| | - Manuela L Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Western Avenue Camperdown, Sydney, Australia
| | - Emma K Ho
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Western Avenue Camperdown, Sydney, Australia
| | - Ana P Carvalho-E-Silva
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Western Avenue Camperdown, Sydney, Australia
| | - Lucas Calais-Ferreira
- Twins Research Australia, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Grattan Street Parkville, Melbourne, Australia
| | - Paulo H Ferreira
- Faculty of Medicine and Health, School of Health Sciences, Charles Perkins Centre, The University of Sydney, Western Avenue Camperdown, Sydney, Australia
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Feng Z, van den Broek T, Perra O, Cramm JM, Nieboer AP. Longitudinal health behaviour patterns among adults aged ≥50 years in China and their associations with trajectories of depressive symptoms. Aging Ment Health 2023; 27:1843-1852. [PMID: 36444931 DOI: 10.1080/13607863.2022.2149694] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Against the background of the growing recognition of the need for a holistic perspective on health behaviour, we aim to identify longitudinal patterns of multiple health behaviours, and to assess associations of such patterns with depressive symptoms among older people in China. METHODS Using three waves of China Health and Retirement Longitudinal Study data (n = 8439), we performed latent class growth analyses (LCGAs) to identify longitudinal patterns of multiple health behaviours. Random-effects models were estimated to assess associations between health behaviour patterns and depressive symptoms. RESULTS The best fitting LCGA model had seven classes: (1) connected active non-smokers (average posterior probability: 21.8%), (2) isolated active non-smokers (24.7%), (3) isolated inactive non-smokers (17.0%), (4) isolated active smokers (14.5%), (5) connected active smokers (12.2%), (6) increasingly connected and active non-smokers (5.4%), and (7) moderately connected inactive smokers (4.4%). Depressive symptoms were highest in the four classes with lower probabilities of social participation across waves. No evidence was found of change over time in depressive symptomatology gaps between people with different health behaviour trajectories. CONCLUSION Health behaviour patterns characterized by consistently low social participation were associated with raised depressive symptomatology, suggesting that focusing on social participation may benefit later-life mental health promotion strategies.
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Affiliation(s)
- Zeyun Feng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Thijs van den Broek
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Oliver Perra
- School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Alosaimi N, Sherar LB, Griffiths P, Pearson N. Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: a systematic review. BMC Public Health 2023; 23:1572. [PMID: 37596591 PMCID: PMC10436445 DOI: 10.1186/s12889-023-16372-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/24/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Physical activity (PA), sedentary behaviour (SB) and diet play an important role in the physical and mental health of young people. Understanding how these behaviours cluster, and the impact of clusters on health is important for the development of public health interventions. This review examines the prevalence of clusters of PA, sedentary time, and dietary behaviours, and how clusters relate to physical and mental health indicators among children, adolescents and young adults. METHODS Electronic (PubMed, Web of Science and Scopus) and manual searches were conducted for articles that were (i) observational studies including children, adolescents and/or young adults aged 5-24 years, (ii) examined the 'patterning', 'clustering', or 'co-existence' of each of PA, dietary behaviour and SB, and (iii) published in English up to and including July 2022. In addition to information on clustering, data on physical and mental health outcomes were extracted where reported. Included studies were assessed using the Cochrane risk of bias for observational studies. A narrative synthesis was conducted due to high heterogeneity. This review was registered with PROSPERO (CRD42021230976). RESULTS Forty-nine cross-sectional studies and four prospective cohort studies from eighteen countries reporting data from 778,415 individual participants were included. A broad range of clusters (n = 172) were found (healthy, unhealthy, and mixed). Mixed clusters were common (n = 98), and clusters of high diet quality, low PA and high SB were more prevalent in girls, while mixed clusters of high PA, high SB and low diet quality were more prevalent in boys. Unhealthy clusters comprising low moderate to vigorous PA, low consumption of fruits and vegetables, and high screen time were prevalent, particularly in those from lower socioeconomic status families. Compared to those with healthy behavioural clusters, those with unhealthy and mixed clusters had a higher adiposity, higher risk of cardiovascular disease, poorer mental health scores, and lower cardiorespiratory fitness. CONCLUSIONS PA, SB and diet cluster in healthy, unhealthy and mixed patterns in young people that differ across sociodemographic characteristics. Unhealthy clusters are associated with poorer health outcomes. Intervention strategies targeting un-clustering multiple unhealthy behaviours should be developed and evaluated for their impact on health outcomes.
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Affiliation(s)
- Noura Alosaimi
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK.
| | - Lauren B Sherar
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Paula Griffiths
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
| | - Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
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11
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Zhao H, Shi H, Ren Z, He M, Cui L, Wang S, Zhao J, Li W, Wei Y, Zhang W, Chen Z, Liu H, Zhang X. Longitudinal relationship between body mass index and depressive symptoms among Chinese adults: The moderating roles of lifestyle factors and age. J Psychosom Res 2023; 170:111380. [PMID: 37244071 DOI: 10.1016/j.jpsychores.2023.111380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This study aims to verify the moderating roles of lifestyle factors and age between body mass index (BMI), BMI trajectory and depressive symptoms of Chinese adults through a prospective design. METHODS The participants who are 18 years old and above from the China Family Panel Studies (CFPS) were included in the 2016 baseline and 2018 follow-up research. BMI was calculated according to self-report weight (kilogram) and height (centimeter). Depressive symptoms were evaluated via the Center for Epidemiologic Studies Depression (CESD-20) scale. Inverse probability-of-censoring weighted estimation (IPCW) was used to check whether selection bias existed. Modified Poisson regression was performed to calculate prevalence and risk ratios as well as 95% confidence intervals. RESULTS After adjustment, it was found that the positive associations of persistent underweight (RR = 1.154, P < 0.001) and normal weight → underweight (RR = 1.143, P < 0.001) with 2018 depressive symptoms were significant among middle-aged people, while the negative association of persistent overweight/obesity (RR = 0.972, P < 0.001) was significant in young adults. Notably, smoking moderated the relationship between baseline BMI and subsequent depressive symptoms (interaction P = 0.028). Also, exercise regularly and exercise duration weekly moderated the relationships of baseline BMI (interaction P = 0.004 and 0.015) and trajectories of BMI (interaction P = 0.008 and 0.011) with depressive symptoms among Chinese adults, respectively. CONCLUSION Weight management strategies for underweight and normal weight → underweight adults should pay attention to the role of exercise in maintaining normal weight and improving depressive symptoms.
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Affiliation(s)
- Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Li Cui
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shixun Wang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jieyu Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Yachen Wei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Wenjing Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Ziqiang Chen
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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Ahmad K, Keramat SA, Ormsby GM, Kabir E, Khanam R. Clustering of lifestyle and health behaviours in Australian adolescents and associations with obesity, self-rated health and quality of life. BMC Public Health 2023; 23:847. [PMID: 37165347 PMCID: PMC10170850 DOI: 10.1186/s12889-023-15724-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/21/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE The primary aim of this study was to identify clusters of lifestyle and health behaviours and explore their associations with health outcomes in a nationally representative sample of Australian adolescents. METHODS The study participants were 3127 adolescents aged 14-15 years who participated in the eighth wave of the birth cohort of the Longitudinal Study of Australian Children (LSAC). A latent class analysis (LCA) was performed to identify clusters based on the behaviours of physical activity, alcohol consumption, smoking, diet, eating disorders, sleep problems and weight consciousness. Multinomial logistic regression models were fitted to the following health outcome variables: obesity, self-rated general health and pediatric health-related quality of life, to investigate their associations with LCA clusters. RESULTS Based on the prevalence of health behaviour related characteristics, LCA identified gender based distinct clusters of adolescents with certain outward characteristics. There were five clusters for male and four clusters for female participants which are named as: healthy lifestyle, temperate, mixed lifestyle, multiple risk factors, and physically inactive (male only). Adolescents in the healthy lifestyle and temperate clusters reported low and moderately active health risk behaviours, for example, low physical activity, inadequate sleep and so on, while these behaviours were prevailing higher among adolescents of other clusters. Compared to adolescents of healthy lifestyle clusters, male members of physically inactive (OR = 3.87, 95% CI: 1.12 - 13.33) or mixed lifestyle (OR = 5.57, 95% CI: 3.15 - 9.84) clusters were over three to five times more likely to have obesity; while for female adolescents, members of only multiple risk factors clusters (OR = 3.61, 95% CI: 2.00 - 6.51) were over three time more likely to have obesity compared to their counterpart of healthy lifestyle clusters. Adolescents of physically inactive (b = -9.00 for male only), mixed lifestyle (b = -2.77 for male; b = -6.72 for female) or multiple risk factors clusters (b = -6.49 for male; b = -6.59 for female) had a stronger negative association with health-related quality of life scores compared to adolescents of healthy lifestyle clusters. CONCLUSION The study offers novel insights into latent class classification through the utilisation of different lifestyles and health-related behaviours of adolescents to identify characteristics of vulnerable groups concerning obesity, general health status and quality of life. This classification strategy may help health policy makers to target vulnerable groups and develop appropriate interventions.
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Affiliation(s)
- Kabir Ahmad
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia.
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
- Present Address: School of Business, Faculty of Business, Education, Law and Arts, and Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
| | - Syed Afroz Keramat
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Gail M Ormsby
- Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia
| | - Enamul Kabir
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
- School of Mathematics, Physics and Computing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Rasheda Khanam
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
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Di Gessa G, Zaninotto P. Health Behaviors and Mental Health during the COVID-19 Pandemic: Evidence from the English Longitudinal Study of Aging. J Appl Gerontol 2023:7334648231159373. [PMID: 36854708 PMCID: PMC9978235 DOI: 10.1177/07334648231159373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Stay-at-home and lockdown measures during the COVID-19 pandemic had an impact on health-related behaviors which in turn posed a risk to mental health, particularly among older people. In this study, we investigated how changes to health behaviors (physical activity, sleeping, eating, and drinking) impacted mental health (depression, quality of life, and life satisfaction) during and beyond the initial phase of the COVID-19 lockdown. Using data from Wave 9 (2018/19) and two COVID-19 sub-studies (June/July 2020; November/December 2020) of the English Longitudinal Study of Ageing (N = 4989), we found that health behaviors changes during lockdown were associated with poorer mental health in June/July 2020. However, in November/December 2020, higher depression, lower quality of life, and lower life satisfaction were more likely only among respondents who reported less physical activity, eating more, changes in sleep patterns, and drinking more alcohol. Public health programs should support healthy behaviors as we emerge from the pandemic.
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Affiliation(s)
- Giorgio Di Gessa
- Institute of Epidemiology and
Health Care, Department of Epidemiology and Public Health, University College
London, London, UK,Giorgio Di Gessa, Department of
Epidemiology and Public Health, University College London, 1-19 Torrington
Place, London WC1E 7HB, UK.
| | - Paola Zaninotto
- Institute of Epidemiology and
Health Care, Department of Epidemiology and Public Health, University College
London, London, UK
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Akhtar SN, Saikia N, Muhammad T. Self-rated health among older adults in India: Gender specific findings from National Sample Survey. PLoS One 2023; 18:e0284321. [PMID: 37068072 PMCID: PMC10109469 DOI: 10.1371/journal.pone.0284321] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/28/2023] [Indexed: 04/18/2023] Open
Abstract
INTRODUCTION The self-rated health (SRH) is a widely adopted indicator of overall health. The sponge hypothesis suggests that predictive power of SRH is stronger among women compared to men. To gain a better understanding of how gender influences SRH, this study examined whether and what determinants of gender disparity exist current self-rated health (SRHcurrent) and change in SRH (SRHchange) among older adults in Indian setting. MATERIALS AND METHODS We used cross-sectional data from the 75th National Sample Survey Organizations (NSSO), collected from July 2017 to June 2018. The analytical sample constitutes 42,759 older individuals aged 60 years or older with 21,902 older men and 20,857 older women (eliminating two non-binary individuals). Outcome measures include two variables of poor/worse SRH status (SRHcurrent and SRHchange). We have calculated absolute gaps in the prevalence of poor SRHcurrent and worse SRHchange by background characteristics. We carried out binary logistic regression models to examine the predictors of poor SRHcurrent and worse SRHchange among older adults. RESULTS The overall absolute gender gap in poor SRHcurrent was 3.27% and it was 0.58% in worse SRHchange. Older women had significantly higher odds of poor SRHcurrent [AOR = 1.09; CI = 0.99, 1.19] and worse SRHchange [AOR = 1.09; CI = 1.02, 1.16] compared to older men. Older adults belonging to middle-aged, oldest-old, economically dependent, not working, physically immobile, suffering from chronic diseases, belonging to Muslim religion, and Eastern region have found to have higher odds of poor SRHcurrent and worse SRHchange. Educational attainments showed lower odds of have poor SRHcurrent and worse SRHchange compared to those with no education. Respondents belonging to richest income quintile and those who were not covered by any health insurance, belonging to Schedule caste, OBC, Western and Southern regions are found to have lower odds of poor SRHcurrent and worse SRHchange. Compared to those in the urban residence, respondents from rural residence [AOR = 1.09; CI = 1.02, 1.16] had higher odds of worse SRHchange. CONCLUSIONS Supporting the sponge hypothesis, a clear gender gap was observed in poor current SRH and worse change in SRH among older adults in India with a female disadvantage. We further found lower socioeconomic and health conditions and lack of resources as determinants of poor current SRH and its worse change, which is crucial to address the challenge of the older people's health and their perception of well-being.
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Affiliation(s)
- Saddaf Naaz Akhtar
- Department of Social Work, Ben-Gurion University of the Negev, Beersheva, Israel
| | - Nandita Saikia
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
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15
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Roberts KE, Beckenkamp PR, Ferreira ML, Duncan GE, Calais-Ferreira L, Gatt JM, Ferreira P. Positive lifestyle behaviours and emotional health factors are associated with low back pain resilience. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:3616-3626. [PMID: 36208321 DOI: 10.1007/s00586-022-07404-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/18/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To evaluate the relationship between lifestyle behaviours, emotional health factors, and low back pain (LBP) resilience. METHODS This retrospective longitudinal study utilised 1,065 twins with a recent history of LBP from the Washington State Twin Registry. A lifestyle behaviour score was built using variables of body mass index, physical activity engagement, sleep quality, smoking status, and alcohol consumption. An emotional health score was built using variables of the absence of depressed mood, perceived stress, and active coping. The main outcome was LBP resilience, assessed as recovery ("bouncing back"), and sustainability (maintaining high levels of function despite LBP). RESULTS After adjusting for covariates, there was no relationship between the lifestyle behaviour score (OR 1.05, 95% CI 0.97-1.15, p = 0.218) and the emotional health score (OR 1.08, 95% CI 0.98-1.19, p = 0.142) with the likelihood of recovering from LBP. There was however, evidence of a positive association between the lifestyle behaviour score (β 0.20, 95% CI 0.04-0.36, p = 0.013), the emotional health score (β 0.22, 95% CI 0.00-0.43, p = 0.049), and greater levels of sustainability. These results were confirmed by a within-pair analysis (lifestyle behaviour score: β 1.79, 95% CI 0.05-3.53, p = 0.043) and (emotional health score: β 0.52, 95% CI 0.09-0.96, p = 0.021) adjusting for genetic and early shared environmental confounding. CONCLUSION Findings from this study suggest that people who adopt optimal lifestyle behaviours and positive emotional factors are more likely to be resilient and maintain high levels of function despite suffering from LBP.
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Affiliation(s)
- K E Roberts
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - P R Beckenkamp
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - M L Ferreira
- Sydney Musculoskeletal Health, Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - G E Duncan
- Washington State Twin Registry, Elson S Floyd College of Medicine, Washington State University Health Sciences Spokane, Spokane, USA
| | - L Calais-Ferreira
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - J M Gatt
- Neuroscience Research Australia and the School of Psychology, The University of New South Wales, Sydney, NSW, Australia
| | - P Ferreira
- School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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16
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Chen Y, Wang P, He Y, Jiang F, Liu H, Liu Y, Liu T, Tang YL, Zhu J. Gender differences in the association between lifestyle behaviors and mental health among psychiatrists in China. J Affect Disord 2022; 318:196-203. [PMID: 36041580 DOI: 10.1016/j.jad.2022.08.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Mental health symptoms are common among health professionals and the influence of lifestyle behaviors on psychiatrists' mental health is insufficiently understood. Based on a nationwide sample, we aimed to survey the lifestyle behaviors and mental health status among psychiatrists, and to identify the co-occurrence and gender differences in lifestyle behaviors. METHODS Data were collected through an anonymous questionnaire among psychiatrists in China. Depression, Anxiety and Stress Scale - 21 (DASS-21) was used to evaluate mental health symptoms. Latent class analysis (LCA) was used to explore the co-occurrence of lifestyle behaviors. The multivariate logistic regression model was used to examine the effects of demographic and lifestyle factors. RESULTS 4520 psychiatrists were included in the analysis with 11.5 % of them reporting smoking, 10 % reporting alcohol misuse, 35.2 % reporting physical inactivity, and 23.1 % reporting insomnia. The prevalence of depression, anxiety and stress symptoms were 29.2 %, 34.5 %, and 12.2 %, respectively. Significant gender differences were found in smoking (P < 0.001), alcohol misuse (P < 0.001), and physical inactivity (P < 0.001), but not in insomnia. Based on these four high-risk health behaviors above, three lifestyle behavior clusters with huge gender differences were identified through the LCA. Accordingly, the unhealthy lifestyle classes, though defined differently for males and females, were significantly associated with depression, anxiety, and stress. CONCLUSIONS The co-occurrence and significant gender differences in multiple lifestyle behaviors exist in this group, highlighting the need for gender-specific comprehensive interventions against mental health symptoms and the urgency of promoting their well-being.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, USA; Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioural Sciences, Emory University, Atlanta, USA.
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Sapranaviciute-Zabazlajeva L, Sileikiene L, Luksiene D, Tamosiunas A, Radisauskas R, Milvidaite I, Bobak M. Lifestyle factors and psychological well-being: 10-year follow-up study in Lithuanian urban population. BMC Public Health 2022; 22:1011. [PMID: 35590278 PMCID: PMC9118629 DOI: 10.1186/s12889-022-13413-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/06/2022] [Indexed: 11/14/2022] Open
Abstract
Background Several lifestyle behaviours, including physical activity, smoking, alcohol consumption, nutrition habits, and social activity have been associated with psychological well-being (PWB). However, their effect on PWB prospectively has been less studied. The aim of the present study was to evaluate the influence of lifestyle factors on higher future PWB during the 10-year follow-up of middle-aged and elderly urban population. Methods In the baseline survey (2006 to 2008), 7115 men and women 45–72 years of age were examined within the framework of the international study Health, Alcohol and Psychosocial Factors in the Eastern Europe (HAPIEE). In the follow-up survey (in 2016), which was performed among all 6210 participants who survived till that year, 4266 individuals participated responding to postal questionnaires. PWB was assessed by a CASP-12 questionnaire. The lifestyle behaviours, including smoking and nutrition habits, alcohol consumption, social and physical activity, were evaluated by the questionnaire. Multivariable logistic regression models were applied for statistical data analysis. Results After accounting for several potential confounders, healthy levels of lifestyle behaviours were associated with higher PWB after 10-year follow-up. Never-smokers in men and former smokers in women had higher PWB by 43 and 67% odds respectively in comparison with smokers. Physical activity in women and high social activity both in men in women was positively related to higher PWB. More frequent fresh vegetable and fruit consumption was associated with higher odds of higher PWB (odds ratio 1.57 in men and 1.36 in women, p < 0.05) compared to less frequent consumption of such food groups. Dose-response relationship between increasing number of healthy lifestyle factors and higher PWB was determined both in men and women. Conclusions Lifestyle factors such as never smoking and former smoking, high social activity, and more frequent fresh vegetable and fruit consumption increased the odds of higher PWB over 10 years of follow-up in men and women groups. The increase of the protective health behaviour score was directly associated with the odds of higher PWB.
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Affiliation(s)
| | - Lolita Sileikiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania.
| | - Dalia Luksiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania
| | - Abdonas Tamosiunas
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania
| | - Ricardas Radisauskas
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania
| | - Irena Milvidaite
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu av. 15, LT-50162, Kaunas, Lithuania
| | - Martin Bobak
- Institute of Epidemiology and Health care, University College London, London, UK
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Unhealthy Lifestyle Behaviours and Psychological Distress: A Longitudinal Study of Australian Adults Aged 45 Years and Older. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074399. [PMID: 35410079 PMCID: PMC8998634 DOI: 10.3390/ijerph19074399] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023]
Abstract
Individual associations between lifestyle behaviours and mental health have been established; however, evidence on the clustering of these behaviours and the subsequent impact on mental health is limited. The purpose of this study was to examine cross-sectional and longitudinal associations between combined unhealthy lifestyle behaviours (physical activity, sitting time, sleep duration, processed meat consumption, vegetable consumption, fruit consumption, smoking status, alcohol consumption) and the development of psychological distress (measured using the Kessler Psychological Distress Scale) in a large Australian sample. Participants were 163,707 Australian adults from the 45 and Up Study. Data from baseline (2006–2009) and follow-up wave 1 (2012) were analysed using binary logistic regression. The odds of reporting high or very high psychological distress at follow-up were significantly higher for those reporting five (AOR = 2.36; 95% CI 1.41–3.97, p = 0.001) or six or more (AOR = 3.04; 95% CI 1.62–5.69, p = 0.001) unhealthy lifestyle behaviours, in comparison to those reporting no unhealthy lifestyle behaviours at baseline. These findings suggest that a holistic, multi-faceted lifestyle approach addressing multiple behaviours may be required to support and promote positive mental health and to reduce the likelihood of psychological distress.
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Nari F, Jeong W, Jang BN, Lee HJ, Park EC. Association between healthy lifestyle score changes and quality of life and health-related quality of life: a longitudinal analysis of South Korean panel data. BMJ Open 2021; 11:e047933. [PMID: 34675011 PMCID: PMC8532554 DOI: 10.1136/bmjopen-2020-047933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES We aimed to determine the influence of changes in the aggregate score of healthy lifestyle factors on health-related quality of life (HRQOL) and overall quality of life (QOL) in the Korean older adult population. DESIGN This study used a longitudinal design. SETTING AND PARTICIPANTS Data on 9474 participants aged 45 years or older were extracted from the Korean Longitudinal Study on Aging for the period 2006-2016. A composite score of four lifestyle factors (smoking, drinking, physical activity and body mass index) was calculated, and biennial changes in aggregate score were computed. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes were HRQOL and QOL. RESULTS Generalised estimating equation analysis results showed that those with healthy lifestyle score changes from 'Low-High' (β =-0.987, p=0.002; β =-1.288, p<0.0001), 'High-Low' (β =-1.281, p<0.0001; β =-1.952, p<0.0001) and 'Low-Low' (β =-1.552, p<0.0001; β =-2.398, p<0.0001) groups were more likely to be have lower HRQOL and QOL estimates than those in 'High-High' group. Female gender, older age and depression had a more negative impact on HRQOL, while male gender and younger age had a more negative impact on QOL, especially in the Low-Low group. The relationship between changes in scores and HRQOL and QOL varied across different elements of healthy lifestyle scores. Changes in physical activity, drinking and smoking status were significantly associated with lower HRQOL and QOL. CONCLUSION The findings suggest an association between a low healthy lifestyle score and poor quality of life, in both general and health-related aspects. Strategies targeting the Korean ageing demographic to promote a healthier lifestyle should be encouraged.
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Affiliation(s)
- Fatima Nari
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Korea (the Republic of)
- Yonsei University Institute of Health Services Research, Seodaemun-gu, Korea (the Republic of)
| | - Wonjeong Jeong
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Korea (the Republic of)
- Yonsei University Institute of Health Services Research, Seodaemun-gu, Korea (the Republic of)
| | - Bich Na Jang
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Korea (the Republic of)
- Yonsei University Institute of Health Services Research, Seodaemun-gu, Korea (the Republic of)
| | - Hyeon Ji Lee
- Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Korea (the Republic of)
- Yonsei University Institute of Health Services Research, Seodaemun-gu, Korea (the Republic of)
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
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Wang X, Arafa A, Liu K, Eshak ES, Hu Y, Dong JY. Combined healthy lifestyle and depressive symptoms: a meta-analysis of observational studies. J Affect Disord 2021; 289:144-150. [PMID: 33979724 DOI: 10.1016/j.jad.2021.04.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND To systematically summarize the association between combined lifestyle (at least three factors, including but not limited to smoking, drinking, physical activity, body mass index, diet) and depressive symptoms by a meta-analysis in general populations. METHODS Multiple electronic databases were searched for observational studies investigating combined lifestyle factors and depressive symptoms published before September 2020. Pooled risk estimates were calculated using random-effects models. Publication bias was conducted using the Egger's and Begg's tests. RESULTS A total of 12 studies with 185,899 participants were included. The pooled OR of depressive symptoms in meta-analysis of 7 cross-sectional studies was 0.53 (0.39, 0.72), I2 = 83.6%, P for heterogeneity <0.001 and the pooled RR was 0.33 (0.12, 0.89), I2 = 95.3%, P for heterogeneity <0.001 in meta-analysis of 5 cohort studies for people with the highest versus lowest score of heathy lifestyles. In sensitivity analyses, the heterogeneity was significantly reduced in cross-sectional studies (pooled OR = 0.74 [0.65, 0.85], I2 = 21.7%, P for heterogeneity = 0.27) and cohort studies (pooled RR = 0.53 [0.38, 0.74], I2 = 15.2%, P for heterogeneity = 0.32). The publication bias corrected by "trim-and-fill" analysis yielded unchanged results. LIMITATIONS Limitations included residual confounding in original studies, heterogeneity between studies, and potential publication bias in the analysis of cross-sectional studies. CONCLUSION The healthy lifestyle was associated with a reduced risk of depressive symptoms. Adherence to overall healthy lifestyles is essential for the primary prevention of depression in general populations.
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Affiliation(s)
- Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Ahmed Arafa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Ehab S Eshak
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan; Department of Public Health, Faculty of Medicine, Minia University, El-Minya, Egypt
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Medical Informatics Center, Peking University Health Science Center, Beijing, China
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan.
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21
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Johnson E, Millar SR, Shiely F. The association between BMI self-selection, self-reported BMI and objectively measured BMI. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13252.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: It is challenging to measure BMI accurately in population studies because it is an expensive and time-consuming task. As a result, subjectively measured BMI, calculated from self-reported height and weight, which we know to be inaccurate, is often used. The purpose of this study is to determine whether using a different, subjective method of measuring BMI, BMI self-selection, would be more accurate. BMI self-selection is determined by asking participants to place themselves in one of the BMI categories, underweight, normal weight, overweight or obese. Methods: A quantitative survey conducted in the outpatient departments of two hospitals in the South West of Ireland. Participants >18 years were included. Pregnant women were excluded. The final sample included 70 participants. Survey completion, including self-reported height and weight and BMI self-selection, preceded the objectively measured weight and height. Demographic and lifestyle factors were also recorded. Results: 59% of the sample were overweight or obese –63% of females and 54% of males. The sensitivity for correct BMI self-selection for normal weight, overweight and obese categories was 90%, 36% and 33% respectively. The sensitivity for BMI categories calculated from self-reported height and weight was 83%, 57% and 59% respectively. In analysis, age, regular alcohol consumption, unhealthy diet and lower levels of physical activity were all associated with underestimation of BMI. Conclusion: BMI self-selection is an accurate tool when used with normal weight individuals but shows poorer ability to demonstrate accurate measurement in overweight and obese BMI categories. It is inferior to the traditional self-reported BMI method for measuring BMI levels in the general population. Presently, we recommend continuing with self-reported BMI for BMI measurement in large population studies. However, further testing of BMI classification in larger studies is suggested and investigation into alternative objective methods of measurement is warranted.
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22
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Xue Y, Lu J, Zheng X, Zhang J, Lin H, Qin Z, Zhang C. The relationship between socioeconomic status and depression among the older adults: The mediating role of health promoting lifestyle. J Affect Disord 2021; 285:22-28. [PMID: 33621711 DOI: 10.1016/j.jad.2021.01.085] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depression is the most frequent psychiatric disorder among the older adults, the purpose of this study is to explore the mediation effect of health promoting lifestyle on the relationship between Socioeconomic Status (SES) and depression, so as to provide practical reference for effectively preventing and alleviating depression of the older adults. METHODS A multi-stage random sampling method was conducted in Shanxi Province. A total 8526 older adults were included in the analysis. Regression analysis was used to explore the relationship between the socioeconomic status, health promoting lifestyle and depression, and the mediation effect test process was used to verify the mediating mechanism of health promoting lifestyle on this relationship. RESULTS 62.1% of the older adults had depression symptoms in this study, and there were significant differences in depression scores among the older adults with gender, age, residence, marital status, endowment pattern, self-care ability, exercise frequency, physical examination frequency, daily diet rules(P<0.05). The results of mediating effect analysis showed that health promoting lifestyle as mediation effect between social economic status and depression was established, and the mediating effect was accounted for (a*b/c) 63.1%. LIMITATIONS Given the cross-sectional study, it is not possible to make causal inferences. CONCLUSIONS There were different degrees of depression in the older adults. The lower the SES is, the higher the risk of depression is. This result once again confirms the social causation theory. Combined with the theory of health risk behavior, the study further confirmed the applicability of lifestyle mechanism in the intermediate mechanism of the relationship between SES and depression in the elderly. Thus, in addition to providing material support and financial assistance, helping the elderly develop a healthy lifestyle is also effective measure to improve their depression.
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Affiliation(s)
- Yaqing Xue
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiao Lu
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiao Zheng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- Department of prevention and health care, Shantou Central Hospital/Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, Guangdong, China
| | - Zuguo Qin
- Health Publicity and Education Center of Guangdong Province, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University Guangzhou, Guangdong, China.
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23
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Fukunaga A, Inoue Y, Yamamoto S, Miki T, Nanri A, Ishiwari H, Ishii M, Miyo K, Konishi M, Ohmagari N, Mizoue T. Association Between Adherence to Healthy Lifestyles and Depressive Symptoms Among Japanese Hospital Workers During the COVID-19 Pandemic. Asia Pac J Public Health 2021; 33:847-853. [PMID: 33829896 DOI: 10.1177/10105395211007604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The objective of this study was to investigate the association between adherence to healthy lifestyles (as measured by the healthy lifestyle index [HLI]) and depressive symptoms among staff members at a large national medical institution in Tokyo, Japan, during the coronavirus disease 2019 (COVID-19) pandemic. The study sample consisted of 1228 staff members aged between 21 and 73 years who participated in a cross-sectional survey conducted in July 2020. We constructed the HLI by assigning 1 point to each healthy lifestyle factor: normal body mass index, sufficient physical activity, non-smoking status, non-to-moderate alcohol consumption, and sufficient sleep duration. The multivariate adjusted odds ratios (95% confidence interval) for depressive symptoms were 1.00 (reference), 0.71 (0.46-1.11), 0.66 (0.43-1.01), and 0.56 (0.33-0.94) for participants with HLI scores of 0 to 2, 3, 4, and 5, respectively (P for trend = 0.032). The present study suggests the role of healthy lifestyles in mental health among hospital staff working during the pandemic.
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Affiliation(s)
- Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takako Miki
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Hironori Ishiwari
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masamichi Ishii
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kengo Miyo
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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24
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Coiro MJ, Asraf K, Tzischinsky O, Hadar-Shoval D, Tannous-Haddad L, Wolfson AR. Sleep quality and COVID-19-related stress in relation to mental health symptoms among Israeli and U.S. adults. Sleep Health 2021; 7:127-133. [PMID: 33691986 DOI: 10.1016/j.sleh.2021.02.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVES The COVID-19 virus has resulted not only in high rates of morbidity and mortality across the globe, but in widespread mental health problems and sleep disruption, likely as a result of pandemic-related stressors. The current study examines associations among COVID-related stress, sleep quality, and mental health. DESIGN Cross-sectional data were collected via online surveys in May 2020. PARTICIPANTS were 2541 community adults ages 18-70 from Israel (N = 1969) and the U.S. (N = 572). MEASUREMENT Participants completed measures of COVID-related stress, sleep quality, and symptoms of anxiety, depression and adjustment disorder. RESULTS Participants reported high rates of depression and anxiety symptoms, adjustment difficulties, and poor sleep quality. In both countries, COVID-related stressors were associated with both anxiety and depression, and these associations were mediated by sleep disturbances. CONCLUSIONS These results support the role of sleep in mental health difficulties. Widespread, accessible, evidence-based interventions are urgently needed to improve health and mental health and to promote resilience in preparation for future global crises.
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Affiliation(s)
- Mary Jo Coiro
- Department of Psychology, Loyola University Maryland, Baltimore, Maryland.
| | - Kfir Asraf
- Department of Psychology, Max Stern Academic College of Emek Yezreel, Israel
| | - Orna Tzischinsky
- Department of Behavioral Science, Max Stern Academic College of Emek Yezreel, Israel
| | - Dorit Hadar-Shoval
- Department of Psychology, Max Stern Academic College of Emek Yezreel, Israel
| | - Lubna Tannous-Haddad
- Department of Behavioral Science, Max Stern Academic College of Emek Yezreel, Israel
| | - Amy R Wolfson
- Department of Psychology, Loyola University Maryland, Baltimore, Maryland
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25
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Nudelman G, Peleg S, Shiloh S. The Association Between Healthy Lifestyle Behaviours and Coronavirus Protective Behaviours. Int J Behav Med 2021; 28:779-787. [PMID: 33569759 PMCID: PMC7875448 DOI: 10.1007/s12529-021-09960-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND Based on models of cross-behavioural associations and the role of past behaviour in predicting behaviour, an association was hypothesized between healthy lifestyle behaviours prior to the COVID-19 pandemic and adherence to coronavirus protective behaviours. Self-assessed health was also examined as a potential moderator. METHODS A cross-sectional sample (N = 463) completed online questionnaires during a COVID-19-related lockdown that measured engagement in healthy lifestyle behaviours (e.g., exercising and eating fruits and vegetables), adherence to coronavirus protective behaviours (e.g., wearing a face mask and practicing social distancing), and self-assessed health (subjective evaluation of overall health). RESULTS As predicted, higher engagement in healthy lifestyle behaviours prior to the pandemic was significantly correlated with higher adherence to coronavirus protective behaviours (Pearson r(459) = .308, p < .001). Adherence levels were higher than engagement in healthy lifestyle behaviours, and self-assessed health was related to the latter but not to the former. Moderation was examined using model 1 in PROCESS for SPSS; as expected, the association was stronger among individuals with higher levels of self-assessed health (coefficient 95% CI [.04, .20]). CONCLUSIONS The findings highlight cross-behavioural facilitating processes, specifically between lifestyle behaviours and adherence to recommended protective behaviours during the pandemic. They also draw attention to the need to address individuals whose poorer evaluations of their general health might prevent them from implementing their behavioural intentions.
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Affiliation(s)
- Gabriel Nudelman
- The Academic College of Tel Aviv-Yaffo, Rabenu Yeruham St 2, Tel Aviv-Yafo, Israel.
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26
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The effectiveness of workplace health promotion programs on self-perceived health of employees with a low socioeconomic position: An individual participant data meta-analysis. SSM Popul Health 2021; 13:100743. [PMID: 33604445 PMCID: PMC7873680 DOI: 10.1016/j.ssmph.2021.100743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of the current study was to evaluate whether workplace health promotion programs improve self-perceived health of employees with a low socioeconomic position (SEP), and whether differential effects exist between individuals with a low SEP for gender, marital status or age. Individual participant data from six Dutch intervention studies aiming at promoting healthy behavior and preventing obesity in the work setting, with a total of 1906 participants, were used. The overall intervention effect and interaction effects for gender, marital status and age were evaluated using two-stage meta-analyses with linear mixed regression models. In the first stage effect sizes of each study were estimated, which were pooled in the second stage. Compared to control conditions, workplace health promotion programs did not show an overall improvement in self-perceived health of employees with a low SEP (β0.03 (95%CI: −0.03 to 0.09)). Effects did not differ across gender, marital status and age. Future research could be focused on the determinants of self-perceived health next to health behavior to improve the health of employees with a low SEP.
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27
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Food for thought: the importance of nutritional well-being during COVID-19. Ir J Psychol Med 2021:1-6. [PMID: 33455607 PMCID: PMC7900659 DOI: 10.1017/ipm.2021.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Individuals with mental illness have poorer physical health, nutritional status, and lowered life expectancy. Optimising their physical and nutritional status has become an increasingly important therapeutic goal. Current experience with COVID-19 has further emphasised the susceptibility to physical illness and poorer outcomes amongst individuals with mental illness and those who are nutritionally compromised. Although life as we knew it has been suspended until the widespread roll-out of a vaccine, individuals can take immediate action to improve physical and mental health by attending to and optimising their nutritional well-being. Clinicians within mental health services have a crucial role to play in assisting such change, and reminding their patients of the importance of pursuing a healthy and balanced diet.
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28
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Zhou W, Chen D, Hong Z, Fan H, Liu S, Zhang L. The relationship between health-promoting lifestyles and depression in the elderly: roles of aging perceptions and social support. Qual Life Res 2020; 30:721-728. [PMID: 33068235 DOI: 10.1007/s11136-020-02674-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE At present, it is not clear about the influence of health-promoting lifestyle, aging perceptions, social support, and other psychosocial factors on elderly depression. This study aims to explore the mediating role of aging perceptions between health-promoting lifestyle and elderly depression, and the moderating role of social support in the mediating process. METHODS A cross-sectional survey was conducted among 359 elderly people in six districts of a city. The Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-IIR), the Brief Aging Perceptions Questionnaire (B-PQ), the Center for Epidemiological Studies Depression Scale (CES-DR), and the Social Support Rate Scale (SSRS) were conducted and recollected on the spot. Stepwise analysis was used to test the mediating effect and moderating effect, and age and gender variables were controlled. RESULTS The results showed the following: (1) health-promoting lifestyle is an important influencing factor of elderly depression; (2) aging perceptions plays a mediating role in the relationship between health-promoting lifestyle and elderly depression, accounting for 31.8% of the total utility; and (3) social support plays a moderating role between aging perceptions and elderly depression, with a high level of social support. The effect of aging perceptions on depression is less than that of the elderly with low social support level. CONCLUSION Health-promoting lifestyle influence the depression of elderly people through aging perceptions and social support moderates the influence of aging perceptions on the elderly depression.
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Affiliation(s)
- Wei Zhou
- Department and Institute of Psychology, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, China.,School of Management, Jinan University, Jinan, 510632, China
| | - Defeng Chen
- Department and Institute of Psychology, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, China
| | - Zijing Hong
- Department and Institute of Psychology, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, China.,School of Management, Jinan University, Jinan, 510632, China
| | - Hang Fan
- Department and Institute of Psychology, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, China
| | - Shen Liu
- School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, 230022, China.
| | - Lin Zhang
- Department and Institute of Psychology, Ningbo University, No. 818 Fenghua Road, Jiangbei District, Ningbo, 315211, China.
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29
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Qi S, Qin Z, Wang N, Tse LA, Qiao H, Xu F. Association of academic performance, general health with health-related quality of life in primary and high school students in China. Health Qual Life Outcomes 2020; 18:339. [PMID: 33046101 PMCID: PMC7552487 DOI: 10.1186/s12955-020-01590-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To explore the association of academic performance and general health status with health-related quality of life (HRQoL) in school-aged children and adolescents in China. Methods In this cross-sectional study conducted in 2018, students (grade 4–12) were randomly chosen from primary and high schools in Nanjing, China. HRQoL, the outcome measure, was recorded using the Child Health Utility 9D, while self-rated academic performance and general health were the independent variables. Mixed-effects regression models were applied to compute mean difference (MD) and 95% confidence interval (CI) of HRQoL utility score between students with different levels of academic performance and general health. Results Totally, 4388 participants completed the study, with a response rate of 97.6%. The mean HRQoL utility score was 0.78 (SD: 0.17). After adjustment for socio-demographic attributes, physical activity, sedentary behavior, dietary patterns, body weight status and class-level clustering effects, students with fair (MD = 0.048, 95% CI 0.019, 0.078) and good (MD = 0.082, 95% CI 0.053, 0.112) self-rated academic performance reported higher HRQoL utility scores than those with poor academic performance, respectively. Meanwhile, students with fair (MD = 0.119, 95% CI 0.083, 0.154) and good (MD = 0.183, 95% CI 0.148, 0.218) self-assessed general health also recorded higher HRQoL utility scores than those with poor health, separately. Consistent findings were observed for participants by gender, school type and residential location. Conclusions Both self-rated academic performance and general health status were positively associated with HRQoL among Chinese students, and such relationships were independent of lifestyle-related behaviors and body weight status.
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Affiliation(s)
- Shengxiang Qi
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Zhenzhen Qin
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Na Wang
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Lap Ah Tse
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Huifen Qiao
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, Nanjing, 210029, China.
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China. .,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
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30
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Arora T, Grey I. Health behaviour changes during COVID-19 and the potential consequences: A mini-review. J Health Psychol 2020; 25:1155-1163. [PMID: 32551944 DOI: 10.1177/1359105320937053] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The COVID-19 pandemic has brought about profound changes to social behaviour. While calls to identify mental health effects that may stem from these changes should be heeded, there is also a need to examine potential changes with respect to health behaviours. Media reports have signalled dramatic shifts in sleep, substance use, physical activity and diet, which may have subsequent downstream mental health consequences. We briefly discuss the interplay between health behaviours and mental health, and the possible changes in these areas resulting from anti-pandemic measures. We also highlight a call for greater research efforts to address the short and long-term consequences of changes to health behaviours.
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Affiliation(s)
- Teresa Arora
- College of Natural & Health Sciences, Zayed University, United Arab Emirates
| | - Ian Grey
- Lebanese American University, Lebanon
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31
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Curran E, Rosato M, Ferry F, Leavey G. Prevalence and factors associated with anxiety and depression in older adults: Gender differences in psychosocial indicators. J Affect Disord 2020; 267:114-122. [PMID: 32063562 DOI: 10.1016/j.jad.2020.02.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND With increasing numbers of people living into old age, health functioning and good quality of life are central to public health policy in aging. However, quality of life for many elders is undermined by anxiety and depression. Understanding gender differences in the determinants of anxiety and depression symptoms is crucial to policy and practice. OBJECTIVE To examine gender-specific symptom subtypes of later-life anxiety and depression, in relation to their socio-demographic, social and health context. METHOD Cross-sectional study using data from The Irish Longitudinal Study on Ageing (TILDA, 2009-2011). Latent class analysis defined gender-specific symptom profiles for anxiety and depression. Correlates of latent classes were analysed using logistic regression, assessing associations between socio-demographic factors; social indicators and health indicators. RESULTS Four classes of self-reported anxiety and depression were derived: 'low', 'comorbidity', 'anxiety and subthreshold depression' and 'anxiety' only. With males 8% were comorbid, 26% subthreshold and 26% with anxiety only. With female 12% were comorbid, 27% subthreshold and 29% with anxiety only. While symptom expression may relate to stress from common ageing, our findings show clear gradations of symptoms associated with a range of social and health indicators. CONCLUSION Our findings support the actuality of comorbid depression and anxiety with further evidence for anxiety and subthreshold depression. A sizeable subgroup confirms that many older people experience anxiety only. Our study indicates the need for a more sensitive recognition of needs and a more nuanced policy agenda for older people towards improving the quality of their social life.
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Affiliation(s)
- Emma Curran
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK.
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
| | - Finola Ferry
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Northern Ireland, UK
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32
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Plys E, Desrichard O. Associations Between Positive and Negative Affect and the Way People Perceive Their Health Goals. Front Psychol 2020; 11:334. [PMID: 32194483 PMCID: PMC7063053 DOI: 10.3389/fpsyg.2020.00334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 02/12/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Why are people who suffer from depressive symptoms or chronic negative mood less likely to adopt a healthy lifestyle? We postulated that adoption of health goals (HGs) and health behaviors is impeded by negative affect (NA) and facilitated by positive affect (PA). Our aim was to assess the associations between NA and PA, measured as a state and as a trait, and perceptions of HGs and related means. In our studies we tested the relationship between perceptions of HGs and affect measured as a state and as a trait. Methods Participants in three online studies were asked to choose and evaluate a health goal (Studies 1–3) or a health goal and related means (Study 3). In Study 1 we used the personal project analysis to assess 10 dimensions of HGs, inter-goal interference, and inter-goal facilitation; in Studies 2 and 3 we used a specially designed questionnaire to assess the difficulty, attainability, controllability, and congruency with self-identity of HGs and related means. We used the Positive and Negative Affect Schedule to measure trait and state affect and the NEO PI-R to measure neuroticism and extraversion. Results Participants perceived their HGs and related means in mood-congruent ways. High NA participants perceived their HGs to be less controllable, less attainable, more difficult, and less congruent with their self-identity. They also perceived their related means to be more difficult and less congruent with their self-identity. In contrast, high PA participants perceived their HGs and related means to be more attainable and more congruent with their self-identity, and they evaluated their related means as less difficult. In addition, our results suggest that state affect is better associated with perceptions of HGs than trait affect. Conclusion The adoption and attainment of HGs is likely to be facilitated by PA but impeded by NA. PA and NA may also impact the adoption and maintenance of healthy lifestyles. These results help provide a better understanding of the reasons why people with depression or negative mood adhere to behaviors that compromise their health.
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Affiliation(s)
- Ekaterina Plys
- Health Psychology Research Group, Faculty of Psychology and Education Sciences, University of Geneva, Geneva, Switzerland
| | - Olivier Desrichard
- Health Psychology Research Group, Faculty of Psychology and Education Sciences, University of Geneva, Geneva, Switzerland
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Liu Y, Mitsuhashi T, Yamakawa M, Sasai M, Tsuda T, Doi H, Hamada J. Combined effects of body mass index and unhealthy behaviors on disability in older Japanese adults: the Okayama study. PeerJ 2019; 7:e8146. [PMID: 31803538 PMCID: PMC6886483 DOI: 10.7717/peerj.8146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/03/2019] [Indexed: 11/22/2022] Open
Abstract
Background Body mass index (BMI) is a significant predictor of functional disability in older adults. However, when evaluated, the association between BMI and incident functional disability, considering behaviors only as covariates or not, may not be appropriate. The primary purpose of the study was to investigate the combined effects of BMI and unhealthy behaviors on the risk of incident functional disability. Methods This was a retrospective cohort study that took place in Okayama City, Japan. Data on BMI and unhealthy behaviors were obtained using the health check-up questionnaire. The certification of Long-Term Care Insurance was used to measure functional disability. Cox proportional hazard models were used; adjusted hazard ratios (HRs) with 95% confidence interval (CI) were calculated for incidence of functional disability across categories of BMI and number of unhealthy behaviors. Results The relationship between BMI and incident functional disability was U-shaped (HR = 1.18, 95% CI [1.11–1.25], among the underweight range; and 1.26 [1.19–1.34] among the obesity range), and its risk was significantly higher within the normal-to-overweight range of BMI values with co-occurring unhealthy behaviors (with normal weight range and one, 1.17 [1.01–1.21]; two, 1.29 [1.18–1.41]; and three or four unhealthy behaviors 1.38 [1.24–1.54]; as well as among overweight range and one, 1.16 [1.05–1.27]; two, 1.26 [1.15–1.38]; and three or four unhealthy behaviors, 1.47 [1.31–1.64]). In each BMI category, the risk of incident functional disability increased with increasing number of unhealthy behaviors (p < 0.05 for linear tread), with the highest risk (1.87 [1.58–2.20]) occurring in combination with at least three unhealthy behaviors with BMI ≥ 27.5, for both sexes (2.20 [1.64–2.92] in men and 1.66 [1.35–2.04] in women). Conclusion It is necessary to consider the combined effects of BMI and behaviors on incident functional disability. Furthermore, interventions targeting multiple behaviors should be considered as such interventions may offer greater benefits than simple interventions.
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Affiliation(s)
- Yangyang Liu
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama University, Okayama, Japan
| | - Michiyo Yamakawa
- Department of Epidemiology and Preventive Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Megumi Sasai
- Sri Lanka Office, Japan International Cooperation Agency, Colombo, Sri Lanka
| | - Toshihide Tsuda
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan
| | - Hiroyuki Doi
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Jun Hamada
- Department of Health Economics and Policy, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Feng Z, Cramm JM, Nieboer AP. A healthy diet and physical activity are important to promote healthy ageing among older Chinese people. J Int Med Res 2019; 47:6061-6081. [PMID: 31709866 PMCID: PMC7045665 DOI: 10.1177/0300060519882590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/24/2019] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the associations between multiple health behaviours and health outcomes among older Chinese adults. Methods Data from the World Health Organization’s Study on global AGEing and adult health Wave 1 (2007–2010), collected among the older Chinese population, were included in this study. Smoking, diet, and physical activity were analysed by linear regression for any associations with depressive symptoms, quality of life (QoL), cognitive function, and physical function. Results A total of 13 367 participants aged >49 years were included in the analyses. After controlling for key socioeconomic factors, healthy diet was significantly associated with higher QoL (β = 0.099) and better cognitive function (β = 0.023). Physical activity was significantly associated with fewer depressive symptoms (β = –0.020), higher QoL (β = 0.086), better cognitive function (β = 0.072), and better physical function (β = –0.155 [higher scores = poorer physical function]). No relationship was found between smoking and any health-related outcome included in this study. Conclusion This study demonstrates the importance of healthy diet and physical activity for health outcomes in the older Chinese population.
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Affiliation(s)
- Zeyun Feng
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
- Department of Health Technology Assessment, Shanghai Health
Development Research Centre (Shanghai Medical Information Centre), Shanghai,
China
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
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Lifestyles and the risk of depression in the “Seguimiento Universidad de Navarra” cohort. Eur Psychiatry 2019; 61:33-40. [DOI: 10.1016/j.eurpsy.2019.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/05/2019] [Accepted: 06/11/2019] [Indexed: 12/18/2022] Open
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Hunter RF, Gough A, Murray JM, Tang J, Brennan SF, Chrzanowski-Smith OJ, Carlin A, Patterson C, Longo A, Hutchinson G, Prior L, Tully MA, French DP, Adams J, McIntosh E, Xin Y, Kee F. A loyalty scheme to encourage physical activity in office workers: a cluster RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background
Increasing physical activity in the workplace can provide physical and mental health benefits for employees and economic benefits for the employer through reduced absenteeism and increased productivity. However, there is limited evidence on effective behaviour change interventions in workplace settings that led to maintained physical activity. This study aimed to address this gap and contribute to the evidence base for effective and cost-effective workplace interventions.
Objectives
To determine the effectiveness and cost-effectiveness of the Physical Activity Loyalty scheme, a multicomponent intervention based on concepts similar to those that underpin a high-street loyalty card, which was aimed at encouraging habitual physical activity behaviour and maintaining increases in mean number of steps per day.
Design
A cluster randomised controlled trial with an embedded economic evaluation, behavioural economic experiments, mediation analyses and process evaluation.
Setting
Office-based employees from public sector organisations in Belfast and Lisburn city centres in Northern Ireland.
Participants
A total of 853 participants [mean age 43.6 years (standard deviation 9.6 years); 71% of participants were female] were randomly allocated by cluster to either the intervention group or the (waiting list) control group.
Intervention
The 6-month intervention consisted of financial incentives (retail vouchers), feedback and other evidence-based behaviour change techniques. Sensors situated in the vicinity of the workplaces allowed participants to monitor their accumulated minutes of physical activity.
Main outcome measures
The primary outcome was mean number of steps per day recorded using a sealed pedometer (Yamax Digiwalker CW-701; Yamax, Tasley, UK) worn on the waist for 7 consecutive days and at 6 and 12 months post intervention. Secondary outcomes included health, mental well-being, quality of life, work absenteeism and presenteeism, and the use of health-care resources.
Results
The mean number of steps per day were significantly lower for the intervention group than the control group [6990 mean number of steps per day (standard deviation 3078) vs. 7576 mean number of steps per day (standard deviation 3345), respectively], with an adjusted mean difference of –336 steps (95% confidence interval –612 to –60 steps; p = 0.02) at 6 months post baseline, but not significantly lower at 12 months post baseline. There was a small but significant enhancement of mental well-being in the intervention group (difference between groups for the Warwick–Edinburgh Mental Wellbeing Scale of 1.34 points, 95% confidence interval 0.48 to 2.20 points), but not for the other secondary outcomes. An economic evaluation suggested that, overall, the scheme was not cost-effective compared with no intervention. The intervention was £25.85 (95% confidence interval –£29.89 to £81.60) more costly per participant than no intervention and had no effect on quality-adjusted life-years (incremental quality-adjusted life-years –0.0000891, 95% confidence interval –0.008 to 0.008).
Limitations
Significant restructuring of participating organisations during the study resulted in lower than anticipated recruitment and retention rates. Technical issues affected intervention fidelity.
Conclusions
Overall, assignment to the intervention group resulted in a small but significant decline in the mean pedometer-measured steps per day at 6 months relative to baseline, compared with the waiting list control group. The Physical Activity Loyalty scheme was deemed not to be cost-effective compared with no intervention, primarily because no additional quality-adjusted life-years were gained through the intervention. Research to better understand the mechanisms of physical activity behaviour change maintenance will help the design of future interventions.
Trial registration
Current Controlled Trials ISRCTN17975376.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ruth F Hunter
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Aisling Gough
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jennifer M Murray
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jianjun Tang
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Sarah F Brennan
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | | | | | - Chris Patterson
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Alberto Longo
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - George Hutchinson
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - Lindsay Prior
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - David P French
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Yiqiao Xin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frank Kee
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
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Song X, Wu J, Yu C, Dong W, Lv J, Guo Y, Bian Z, Yang L, Chen Y, Chen Z, Pan A, Li L. The distribution and correlates of self-rated health in elderly Chinese: the China Kadoorie Biobank study. BMC Geriatr 2019; 19:168. [PMID: 31200646 PMCID: PMC6570897 DOI: 10.1186/s12877-019-1183-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 06/05/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Self-rated health (SRH) have been widely used as a valid indicator of health status at the population and individual level. We aimed to investigate the distribution and correlates of global SRH and age-comparative SRH in elderly Chinese. METHODS Survey of 57,693 men and 67,089 women aged 60 years and above was conducted in five rural (Gansu, Sichuan, Hunan, Henan, Zhejiang) and five urban areas (Heilongjiang, Shandong, Jiangsu, Guangxi, Hainan) in China between 2004 and 2008. Logistic regression models were used to calculate the relations of different factors with global SRH and age-comparative SRH. RESULTS Among the participants, 38.33% reported their global SRH as good or excellent while 61.67% as fair or poor, and 17.70% reported better age-comparative SRH while 17.99% as worse. In the multivariate model, compared to women, men tended to report a good global SRH and better age-comparative SRH, urban residents tend to report good global SRH and better age-comparative SRH. The socioeconomic and health behavior factors that were associated with good global SRH and better age-comparative SRH (with varying strengths of association) included: high educational level, high household income, house ownership, quitting smoking by own choices, occasional and current alcohol drinking, overweight, and high physical activity level. The factors that were associated with poor global SRH and worse age-comparative SRH included: quitting smoking by illness, former drinking, underweight, and weight lost ≥2.5 kg in the previous year. CONCLUSIONS We found a moderate level of good global SRH and a low level of better age-comparative SRH among elderly Chinese. We identified a number of demographic, socioeconomic and health behavior factors that were related to SRH measures. Our study emphasizes the importance of incorporating both global and age-comparative SRH measures in future studies, and considering gender inequalities and urban/rural disparity, as well as socioeconomic status and health behaviors as important modifiers of health.
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Affiliation(s)
- Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
| | - Wenhong Dong
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - on behalf of the China Kadoorie Biobank Collaborative Group
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191 China
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Fukunaga A, Inoue Y, Kochi T, Hu H, Eguchi M, Kuwahara K, Miki T, Kurotani K, Nanri A, Kabe I, Mizoue T. Prospective Study on the Association Between Adherence to Healthy Lifestyles and Depressive Symptoms Among Japanese Employees: The Furukawa Nutrition and Health Study. J Epidemiol 2019; 30:288-294. [PMID: 31155542 PMCID: PMC7280053 DOI: 10.2188/jea.je20190018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background While a growing body of research suggests a protective role of healthy lifestyle against depression, evidence from prospective studies is scarce. We constructed a healthy lifestyle index (HLI) and examined its prospective association with depressive symptoms in a Japanese working population. Methods Participants were 917 employees (19–68 years old) who were free from depressive symptoms at baseline in 2012–2013 and attended the 3-year follow-up survey. The HLI (range: 0–7 points) was constructed by assigning 1 point to each healthy lifestyle factor, namely, (1) normal body mass index (18.5–24.9 kg/m2), (2) non-smoking, (3) no or moderate alcohol intake (≤23 g ethanol/day), (4) adequate physical activity (≥7.5 metabolic equivalent-hours/week), (5) high vegetable intake (≥350 g/day), (6) high fruit intake (≥200 g/day), and (7) adequate sleep duration (6–8.9 hours/day), which was categorized into three groups (low: 0–2 points; middle: 3–4 points; and high: 5–7 points). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results A total of 155 incident cases (17.0%) of depressive symptoms were identified at the follow-up survey. Compared with the low HLI group, multivariable-adjusted odds ratios of depressive symptoms were 0.74 (95% confidence interval, 0.48–1.15) and 0.55 (95% confidence interval, 0.31–0.99) for the middle and high HLI groups, respectively (P-trend = 0.041). Conclusion The present study suggests the importance of adherence to multiple healthy lifestyle factors in prevention of depressive symptoms.
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Affiliation(s)
- Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation
| | - Huanhuan Hu
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Teikyo University Graduate School of Public Health
| | - Takako Miki
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Department of Mental Health, Graduate School of Medicine, The University of Tokyo.,Research Fellow of Japan Society for the Promotion of Science
| | - Kayo Kurotani
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University
| | - Isamu Kabe
- Department of Health Administration, Furukawa Electric Corporation
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
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Logsdon S, Branstetter ML, Main E. Perceived Health Status in Rural Manufacturing Workers. Workplace Health Saf 2019; 67:78-86. [DOI: 10.1177/2165079918794206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Manufacturing workers comprise 8.8% of the total U.S. workforce representing a sizable population for disease prevention and health promotion by occupational health nurses within worksite wellness programs. The purpose of this study was to examine the relationship between perceived health status and objective health status including existing chronic disease among rural manufacturing workers. Rural manufacturing workers ( n = 114) completed a general health survey and consented to a retrospective chart review. All were participants in a direct incentive wellness program with biometric data available. The majority of participants were males between the ages of 46 and 60 years, and nearly half of the sample had a college degree. A statistically significant difference was observed between number of chronic diseases and lower perceived health status. These findings have implications for occupational health nurses and other health care providers to identify workers at risk for chronic illness through self-perceived health status assessment.
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Adjibade M, Lemogne C, Julia C, Hercberg S, Galan P, Assmann KE, Kesse-Guyot E. Prospective association between combined healthy lifestyles and risk of depressive symptoms in the French NutriNet-Santé cohort. J Affect Disord 2018; 238:554-562. [PMID: 29940519 DOI: 10.1016/j.jad.2018.05.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/18/2018] [Accepted: 05/27/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several modifiable lifestyle indicators, including diet, smoking, alcohol consumption, weight and physical activity have been associated with depression; however, their combined effect has been less studied. The aim of this study was to calculate a Healthy Lifestyle Index (HLI) composed of the 5 above-mentioned indicators and investigate its association with incident depressive symptoms. METHODS The study sample consisted of 25,837 participants from the NutriNet-Santé study, initially free of depressive symptoms. The HLI was computed by assigning 1 point to each lifestyle indicator namely healthy diet, healthy weight, moderate or high physical activity, never smoking and low alcohol consumption. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Hazard Ratios were estimated using Cox proportional hazards models and population attributable risks (PAR) were calculated. RESULTS A total of 2112 incident cases of depressive symptoms were identified over a mean follow-up of 5 years. After accounting for a wide range of potential confounders, a 1-point increase in the HLI was associated with a 10% (95% CI 6%; 13%) reduction in the risk of depressive symptoms. The estimated PAR representing the proportion of cases that are attributable to non-adherence to specific healthy lifestyle indicators were 8% for healthy diet, 5% for healthy weight, 5% for non-smoking and 14% for the non-adherence to a combination of healthy diet, healthy weight and non-smoking. LIMITATIONS Some unmeasured factors related to both depression and lifestyle indicators, such as family history of depressive disorder, stressful life events, and sleep disorders might have led to potential residual confounding. CONCLUSIONS Modifying unhealthy lifestyles, especially diet, weight and smoking, is a potential target of major interest in the prevention of depressive symptoms in adults.
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Affiliation(s)
- Moufidath Adjibade
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, F-93017 Bobigny, France.
| | - Cédric Lemogne
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie de l'Adulte et du Sujet Agé, Paris, France; Inserm, U894, Centre de Psychiatrie et Neurosciences, Paris, France
| | - Chantal Julia
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, F-93017 Bobigny, France; Département de Santé Publique, Hôpital Avicenne, F-93017 Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, F-93017 Bobigny, France; Département de Santé Publique, Hôpital Avicenne, F-93017 Bobigny, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, F-93017 Bobigny, France
| | - Karen E Assmann
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, F-93017 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, F-93017 Bobigny, France
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Monzani D, D'Addario M, Fattirolli F, Giannattasio C, Greco A, Quarenghi F, Steca P. Clustering of Lifestyle Risk Factors in Acute Coronary Syndrome: Prevalence and Change after the First Event. Appl Psychol Health Well Being 2018; 10:434-456. [PMID: 30230683 DOI: 10.1111/aphw.12141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Healthy lifestyles are modifiable risk factors for acute coronary syndrome (ACS) onset and recurrence. While unhealthy lifestyles tend to cluster together within the general healthy population, little is known about the prevalence and clustering of these behaviours in people with ACS before and after the first acute event. The aim of this study was to identify lifestyle profiles of patients with ACS and to explore their change after their first coronary event. METHODS Three hundred and fifty-six patients completed self-report measures of healthy habits at the beginning of cardiac rehabilitation and 6 months later. By adopting a person-oriented approach, we analysed lifestyle clustering and its change over time. Differences in depression, anxiety, and negative illness perception among lifestyle profiles were assessed. RESULTS We identified seven profiles, ranging from more maladaptive to healthier clusters. Findings showed a strong interrelation among unhealthy habits in patients. We highlighted a moderate individual and group stability of cluster membership over time. Moreover, unhealthier lifestyle profiles were associated with higher levels of depression, anxiety, and negative illness perception. CONCLUSION These results may have implications for the development and implementation of multimodal interventions addressing wider-ranging improvement in lifestyles by targeting multiple unhealthy behaviours in patients with ACS.
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Song X, Wu J, Yu C, Dong W, Lv J, Guo Y, Bian Z, Yang L, Chen Y, Chen Z, Pan A, Li L. Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: the China Kadoorie Biobank study. BMC Public Health 2018; 18:744. [PMID: 29907132 PMCID: PMC6003165 DOI: 10.1186/s12889-018-5632-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/29/2018] [Indexed: 11/25/2022] Open
Abstract
Background Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH. Methods A total of 512,891 participants aged 30–79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Multivariate logistic regression models were used to estimate the odds ratios (ORs) for the associations between comorbidities (including diabetes, hypertension, coronary heart disease, rheumatic heart disease, stroke, tuberculosis, emphysema/bronchitis, asthma, cirrhosis/chronic hepatitis, peptic ulcer, gallbladder disease, kidney disease, fracture, rheumatic arthritis, psychiatric disorders, depressive symptoms, neurasthenia, head injury and cancer) and SRH. Population attributable risks (PARs) were used to estimate the contribution of multiple comorbidities to poor global SRH and worse age-comparative SRH. Results After adjusting for covariates, suffering from various diseases increased the chance of reporting a poor global SRH [OR (95% CI) ranged from 1.10 (1.07, 1.13) for fracture to 3.21 (2.68, 3.83) for rheumatic heart disease] and a worse age-comparative SRH [OR (95% CI) ranged from 1.18 (1.13, 1.23) for fracture to 7.56 (6.93, 8.25) for stroke]. From the population perspective, 20.23% of poor global SRH and 45.12% of worse age-comparative SRH could attributed to the cardiometabolic diseases, with hypertension (7.84% for poor global SRH and 13.79% for worse age-comparative SRH), diabetes (4.35% for poor global SRH and 10.71% for worse age-comparative SRH), coronary heart disease (4.44% for poor global SRH and 9.51% for worse age-comparative SRH) and stroke (3.20% for poor global SRH and 10.19% for worse age-comparative SRH) making the largest contribution. Conclusions Various diseases were major determinants of global and age-comparative SRH, and cardiometabolic diseases had the strongest impact on both global SRH and age-comparative SRH at the population level. Prevention measures concentrated on these conditions would greatly reduce the total burden of poor SRH and its consequences such as poor quality of life and use of health care services.
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Affiliation(s)
- Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China
| | - Wenhong Dong
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China.
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China. .,Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China.
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Mavaddat N, Sadler E, Lim L, Williams K, Warburton E, Kinmonth AL, Mant J, Burt J, McKevitt C. Perceptions of self-rated health among stroke survivors: a qualitative study in the United Kingdom. BMC Geriatr 2018; 18:81. [PMID: 29609550 PMCID: PMC5879795 DOI: 10.1186/s12877-018-0765-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/12/2018] [Indexed: 11/15/2022] Open
Abstract
Background Self-rated health predicts health outcomes independently of levels of disability or mood. Little is known about what influences the subjective health experience of stroke survivors. Our aim was to investigate stroke survivors’ perceptions of self-rated health, with the intention of informing the design of interventions that may improve their subjective health experience. Methods We conducted semi-structured interviews with a purposive sample of 28 stroke survivors recruited from a stroke unit and follow-up outpatient clinic, 4–6 months after stroke, to explore what factors are perceived to be part of self-rated health in the early stages of recovery. Qualitative data were analysed using a thematic analysis approach to identify underlying themes. Results Participants’ accounts show that stroke survivors’ perceptions of self-rated health are multifactorial, comprising physical, psychological and social components. Views on future recovery after stroke play a role in present health experience and are shaped by psychosocial resources that are influenced by past experiences of ill-health, dispositional outlook such as degree of optimism, a sense of control and views on ageing. Conclusions Severity of physical limitations alone does not influence perceptions of self-rated health among stroke survivors. Self-rated health in stroke survivors is a multidimensional construct shaped by changes in health status occurring after the stroke, individual characteristics and social context. Understanding the factors stroke survivors themselves associate with better health will inform the development of effective approaches to improve rehabilitation and recovery after stroke.
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Affiliation(s)
- N Mavaddat
- Division of General Practice, School of Medicine, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia. .,Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
| | - E Sadler
- Health Service & Population Research Department, King's Improvement Science and Centre for Implementation Science, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - L Lim
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - K Williams
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - E Warburton
- Department of Clinical Neurosciences, University of Cambridge, Neurology Unit, R3, Box 83, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - A L Kinmonth
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - J Mant
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - J Burt
- Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, UK
| | - C McKevitt
- School of Population Health Sciences, King's College London, Addison House, London, SE1 1UL, UK
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Podstawski R, Wesołowska E, Choszcz D, Markowski P, Klimczak J. Drinking behaviours and alcohol preferences of female and male students at a Polish university in 2000–2016. DRUGS: EDUCATION, PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1411887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Robert Podstawski
- Department of Physical Education and Sport, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Elżbieta Wesołowska
- Department of Social Science, University of Security in Poznań, Poznań, Poland
| | - Dariusz Choszcz
- Department of Heavy Duty Machines and Research Methodology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Piotr Markowski
- Department of Heavy Duty Machines and Research Methodology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Jarosław Klimczak
- Department of Tourism, Faculty of Environmental Sciences, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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Veromaa V, Kautiainen H, Juonala M, Rantanen A, Korhonen PE. Self-rated health as an indicator of ideal cardiovascular health among working-aged women. Scand J Prim Health Care 2017; 35:322-328. [PMID: 29096579 PMCID: PMC5730029 DOI: 10.1080/02813432.2017.1397299] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the relationship between self-rated health (SRH) and the American Heart Association's (AHA) concept of ideal cardiovascular health (CVH) among female municipal employees. Studies about the association are scarce, even though AHA recommends to use SRH status surveys in clinical practice and research settings of CVH. DESIGN Cross-sectional study conducted in 2014. SETTING SRH was assessed with a one-item question and the data of seven ideal CVH measurements (nonsmoking, body mass index <25.0 kg/m2, healthy diet, physical activity at goal, blood pressure <120/80 mmHg, cholesterol <5.18 mmol/l and glucose (HbA1c < 6.0%)) was gathered with a physical examination, laboratory tests, medical history and self-administrated questionnaires. SUBJECTS A total of 725 female subjects from 10 work units of the city of Pori, Finland. MAIN OUTCOME MEASURES SRH and ideal CVH. RESULTS Of the study subjects, 28.8% reported ill-health (poor/fair SRH). The sum of ideal CVH metrics was positively associated with good SRH driven by favorable health behaviors (nonsmoking, normal body mass index, healthy diet and physical activity). A linear decrease in the prevalence of 0-2 ideal CVH metrics, and a linear increase in 5-7 metrics was associated with better SRH. Nonsmoking and normal weight were the most potent indicators of good SRH in multivariate analysis. CONCLUSIONS Most of the subjects with 0-3 of the seven CVH metrics at ideal level were dissatisfied with their health. Since unhealthy lifestyle factors accumulate mainly to people feeling ill-health, the value of SRH is worth recognizing especially in primary health care.
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Affiliation(s)
- Veera Veromaa
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital, Turku, Finland
- Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
- CONTACT Veera Veromaa ICT-City, General Practice, Joukahaisenkatu 3-5, 20520 Turku, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Markus Juonala
- Department of Internal Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Ansa Rantanen
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital, Turku, Finland
- Health Centre of Salo, Salo, Finland
| | - Päivi E. Korhonen
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital, Turku, Finland
- Central Satakunta Health Federation of Municipalities, Harjavalta, Finland
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Ruiz-Castell M, Kandala NB, Perquin M, Bocquet V, Kuemmerle A, Vögele C, Stranges S. Depression burden in luxembourg: Individual risk factors, geographic variations and the role of migration, 2013-2015 European Health Examination Survey. J Affect Disord 2017; 222:41-48. [PMID: 28668715 DOI: 10.1016/j.jad.2017.06.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/22/2017] [Accepted: 06/26/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Depression is a complex mental disorder that affects an increasing proportion of the worldwide population. This study aims to estimate the prevalence of depressive symptoms in Luxembourg, associated risk factors and geographic variations. Additionally, it aims to assess whether first and second generation immigrants are at higher risk for depressive symptoms compared to non-immigrants. METHODS Representative cross-sectional data from 1499 residents of Luxembourg, aged 25-64 years, were collected from the Luxembourg European Health Survey (EHES-LUX). Depressive symptoms were defined as a score of ≥5 on the Patient Health Questionnaire for depression (PHQ-9) (i.e. mild, moderate or severe). Standard and Bayesian regression models were used to examine associations between depressive symptoms, immigration status and geographic distribution across Luxembourg. RESULTS The prevalence of depressive symptoms was 21.55% (15.54% mild, 3.54% moderate, and 2.49% moderately severe to severe). The odds of having depressive symptoms was higher among second generation immigrants compared to non-immigrants (OR: 1.58, 95% CI: 1.04, 2.41), independent of socioeconomic and behavioral characteristics. Healthier diet, higher social support and good health perception were protective towards experiencing depressive symptoms. One of the highest likelihoods of reporting depressive symptoms was observed in the South-West of the country with a positive effect at 80% credible region [CR] (1.42 [0.92, 2.73]). LIMITATIONS The participation rate was low (26.7%). The cross-sectional nature of the study does not allow us to establish causality. CONCLUSIONS Depression constitutes an important public health challenge in Luxembourg due to the impact on the overall health of the population. Social programs of health promotion should be developed to improve mental wellbeing in immigrants, especially those of second generation.
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Affiliation(s)
- Maria Ruiz-Castell
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg.
| | - Ngianga-Bakwin Kandala
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg; Department of Mathematics, Physics and Electrical Engineering, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK
| | - Magali Perquin
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Valéry Bocquet
- Competence Center in Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Andrea Kuemmerle
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Claus Vögele
- Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Saverio Stranges
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg; Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Amato K, Park E, Nigg CR. Prioritizing multiple health behavior change research topics: expert opinions in behavior change science. Transl Behav Med 2017; 6:220-7. [PMID: 27356992 DOI: 10.1007/s13142-015-0381-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Multiple health behavior change (MHBC) approaches are understudied. The purpose of this study is to provide strategic MHBC research direction. This cross-sectional study contacted participants through the Society of Behavioral Medicine email listservs and rated the importance of 24 MHBC research topics (1 = not at all important, 5 = extremely important) separately for general and underserved populations. Participants (n = 76) were 79 % female; 76 % White, 10 % Asian, 8 % African American, 5 % Hispanic, and 1 % Native Hawaiian/Pacific Islander. Top MHBC research priorities were predictors of behavior change and the sustainability, long-term effects, and dissemination/translation of interventions for both populations. Recruitment and retention of participants (t(68) = 2.17, p = 0.000), multi-behavioral indices (t(68) = 3.54, p = 0.001), and measurement burden (t(67) = 5.04, p = 0.001) were important for the underserved. Results identified the same top research priorities across populations. For the underserved, research should emphasize recruitment, retention, and measurement burden.
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Affiliation(s)
- Katie Amato
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, 96822, USA
| | - Eunhee Park
- College of Medicine, Seoul National University, Seoul, South Korea
| | - Claudio R Nigg
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, 96822, USA.
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Kelly JR, Allen AP, Temko A, Hutch W, Kennedy PJ, Farid N, Murphy E, Boylan G, Bienenstock J, Cryan JF, Clarke G, Dinan TG. Lost in translation? The potential psychobiotic Lactobacillus rhamnosus (JB-1) fails to modulate stress or cognitive performance in healthy male subjects. Brain Behav Immun 2017; 61:50-59. [PMID: 27865949 DOI: 10.1016/j.bbi.2016.11.018] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/28/2016] [Accepted: 11/16/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Preclinical studies have identified certain probiotics as psychobiotics - live microorganisms with a potential mental health benefit. Lactobacillus rhamnosus (JB-1) has been shown to reduce stress-related behaviour, corticosterone release and alter central expression of GABA receptors in an anxious mouse strain. However, it is unclear if this single putative psychobiotic strain has psychotropic activity in humans. Consequently, we aimed to examine if these promising preclinical findings could be translated to healthy human volunteers. OBJECTIVES To determine the impact of L. rhamnosus on stress-related behaviours, physiology, inflammatory response, cognitive performance and brain activity patterns in healthy male participants. METHODS An 8week, randomized, placebo-controlled, cross-over design was employed. Twenty-nine healthy male volunteers participated. Participants completed self-report stress measures, cognitive assessments and resting electroencephalography (EEG). Plasma IL10, IL1β, IL6, IL8 and TNFα levels and whole blood Toll-like 4 (TLR-4) agonist-induced cytokine release were determined by multiplex ELISA. Salivary cortisol was determined by ELISA and subjective stress measures were assessed before, during and after a socially evaluated cold pressor test (SECPT). RESULTS There was no overall effect of probiotic treatment on measures of mood, anxiety, stress or sleep quality and no significant effect of probiotic over placebo on subjective stress measures, or the HPA response to the SECPT. Visuospatial memory performance, attention switching, rapid visual information processing, emotion recognition and associated EEG measures did not show improvement over placebo. No significant anti-inflammatory effects were seen as assessed by basal and stimulated cytokine levels. CONCLUSIONS L. rhamnosus was not superior to placebo in modifying stress-related measures, HPA response, inflammation or cognitive performance in healthy male participants. These findings highlight the challenges associated with moving promising preclinical studies, conducted in an anxious mouse strain, to healthy human participants. Future interventional studies investigating the effect of this psychobiotic in populations with stress-related disorders are required.
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Affiliation(s)
- John R Kelly
- APC Microbiome Institute, University College Cork, Ireland; Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland
| | - Andrew P Allen
- APC Microbiome Institute, University College Cork, Ireland; Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland
| | - Andriy Temko
- Department of Electrical and Electronic Engineering, University College Cork, Ireland
| | - William Hutch
- INFANT Research Centre and Department of Pediatrics & Child Health, University College Cork, Ireland
| | - Paul J Kennedy
- APC Microbiome Institute, University College Cork, Ireland
| | - Niloufar Farid
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland
| | - Eileen Murphy
- Alimentary Health Ltd., Cork Airport Business Park, Cork, Ireland
| | - Geraldine Boylan
- INFANT Research Centre and Department of Pediatrics & Child Health, University College Cork, Ireland
| | - John Bienenstock
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
| | - John F Cryan
- APC Microbiome Institute, University College Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Ireland
| | - Gerard Clarke
- APC Microbiome Institute, University College Cork, Ireland; Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland
| | - Timothy G Dinan
- APC Microbiome Institute, University College Cork, Ireland; Department of Psychiatry and Neurobehavioral Science, University College Cork, Ireland.
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Linke SE, Strong DR, Myers MG, Edland SD, Hofstetter CR, Al-Delaimy WK. The relationships among physical activity, sedentary behaviour, obesity and quitting behaviours within a cohort of smokers in California. Public Health 2016; 141:232-240. [PMID: 27932008 DOI: 10.1016/j.puhe.2016.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 05/31/2016] [Accepted: 09/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Smoking, insufficient physical activity (PA), sedentary behaviour (SB) and obesity are leading risk factors for morbidity and premature mortality. Few studies examining the relationship between these behavioural risk factors and quitting behaviours among cohorts of smokers have been published. PURPOSE The goals of this study are to examine the cross-sectional relationships among behavioural health risk factors (insufficient PA, SB and obesity) and past year quitting behaviours within a sample of smokers. METHODS The California Smokers Cohort, conducted from 2011 through 2013, is a population-based survey of adult smokers in California. Using follow-up data (n = 1050), participants' self-reported health behaviours and past year quitting behaviours were examined in univariate analyses and multivariate logistic regression analyses controlling for demographic covariates. RESULTS In univariate analyses examining health behaviours among smokers, all three health behaviours examined (PA, SB and obesity) were related, and significantly more obese smokers with high PA and low SB reported a ≥20% smoking rate reduction than smokers with other combinations of health behaviours (48.8%, Chi-squared = 4.765, P = 0.045). In multivariate models adjusted for sociodemographic characteristics, obese smokers (odds ratio [OR] = 1.450, 95% confidence interval [CI]: 1.088-1.932, P = 0.011) and smokers with higher levels of PA (OR = 1.448, 95% CI: 1.111-1.887, P = 0.006) were more likely to report a past year ≥24-hour quit attempt regardless of SB, and obese smokers (OR = 1.760, 95% CI: 1.095-2.828, P = 0.019) were more likely to report being quit for ≥30 days regardless of PA and SB. CONCLUSIONS Overall, the results demonstrated that more physically active and obese smokers were more likely to report positive strides towards quitting. These findings support the potential positive effect of addressing multiple health behaviours along with smoking.
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Affiliation(s)
- S E Linke
- Department of Family Medicine & Public Health, University of California, San Diego, USA.
| | - D R Strong
- Department of Family Medicine & Public Health, University of California, San Diego, USA
| | - M G Myers
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, USA
| | - S D Edland
- Department of Family Medicine & Public Health, University of California, San Diego, USA
| | - C R Hofstetter
- Graduate School of Public Health, San Diego State University, USA
| | - W K Al-Delaimy
- Department of Family Medicine & Public Health, University of California, San Diego, USA
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