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Kim J, Nwaogu C, Mitchell RB, Johnson RF. Influence of Economic Connectedness on Pediatric Obstructive Sleep Apnea Severity and Adenotonsillectomy Outcomes. Otolaryngol Head Neck Surg 2024. [PMID: 38881394 DOI: 10.1002/ohn.860] [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: 10/28/2023] [Revised: 04/09/2024] [Accepted: 04/19/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To examine the influence of economic connectedness (EC), a measure of social capital, on obstructive sleep apnea (OSA) severity and adenotonsillectomy outcomes in children. STUDY DESIGN Retrospective study. SETTING Single tertiary medical center. METHODS The study population included 286 children who were referred for full-night polysomnography for OSA and underwent adenotonsillectomy. The primary outcome was the relationship between EC and the presence of severe OSA, and secondary outcomes included postoperative emergency room visits and residual OSA after adenotonsillectomy. Linear regression, Kruskal-Wallis test, Pearson's χ2 test, and multiple logistic regression were used for categorical and continuous data as appropriate. RESULTS In this population, the median age was 9.0 (interquartile range [IQR] = 6.9-11.7) and 144 (50.3%) were male. The majority were white (176, 62.0%), black (60, 21.1%), and/or of Hispanic ethnicity (173, 60.9%). The median EC of this population was 0.64 (IQR = 0.53-0.86). Higher EC was associated with decreased odds of having severe OSA (odds ratio: 0.17, 95% confidence interval = 0.05-0.61). However, EC was not associated with either postoperative emergency room visits or residual OSA. CONCLUSION EC was significantly associated with severe OSA (ie, apnea-hypopnea index ≥ 10) but not with postoperative emergency room visits or residual OSA after adenotonsillectomy. Further research is needed to understand the effects of various social capital measures on pediatric OSA and adenotonsillectomy outcomes.
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Affiliation(s)
- Jenny Kim
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Cullins Nwaogu
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ron B Mitchell
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, USA
| | - Romaine F Johnson
- Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, USA
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Prochnow T, Patterson MS, Amo C, Curran L, Francis AN, Green E. Cultivating an Active Living Plan Through a Social-Ecological Evaluation. FAMILY & COMMUNITY HEALTH 2023; 46:229-241. [PMID: 37703511 DOI: 10.1097/fch.0000000000000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Physical activity (PA) social-ecological model (SEM) posits the importance of several levels of influence critical for PA promotion within communities. The purpose of this study was to examine an SEM evaluation informing a county-wide active living plan in McLennan County, Texas in the United States. Mixed-methods evaluation occurred in 4 stages: (1) county policies (n = 15) were evaluated for PA promoting strategies; (2) PA resource assessments (PARAs) were conducted via Google Maps (n = 171); (3) surveys (n = 244) included the International Physical Activity Questionnaire and interpersonal and intrapersonal factors related to PA; and (4) focus groups (n = 5) were conducted with residents (n = 30), discussing barriers and facilitators to being active. Logistic regression determined significant associations between SEM factors and meeting PA recommendations. Policy scans and PARAs identified strengths and areas of improvement (eg, equitable project selection and disparities in resource quality). Residents reporting fewer barriers (OR = 0.89, P =.01), more perceived behavioral control (odds ratio [OR] = 1.38, P = .01), more social co-participation in PA (OR = 1.20, P = .03), and living in zip codes with higher mean PARA score (OR = 1.22, P = .04) were significantly more likely to meet PA recommendations (Nagelkerke R2 = 0.32). Focus groups also discussed safety and disparities in access and quality. This study suggests the utility of the SEM when evaluating and promoting community PA.
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Affiliation(s)
- Tyler Prochnow
- Department of Health Behavior, Texas A&M University School of Public Health, College Station (Drs Prochnow and Patterson, and Mss Amo, Curran, and Francis); and Waco-McLennan County Public Health District, Waco, Texas (Ms Green)
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Prochnow T, Curran LS, Amo C, Patterson MS. Bridging the Built and Social Environments: A Systematic Review of Studies Investigating Influences on Physical Activity. J Phys Act Health 2023; 20:438-459. [PMID: 36997160 DOI: 10.1123/jpah.2022-0403] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND The purpose of this review was to examine articles assessing aspects of the built and social environment simultaneously, and how these environments influence physical activity (PA). A thorough review of studies is needed to identify patterns across studies and gaps for future research and practice. METHODS To be included, articles needed to contain: (1) self-report or objective measure of PA; (2) a measure of the built environment; (3) a measure of the social environment; and (4) an analysis between built environment, social environment, and PA. A systematic literature search of 4358 articles resulted in 87 articles. RESULTS Several populations were present within the sample including various age groups and different countries. As previously established, the built environment and social environment were consistently associated with PA; however, mediating factors between these 2 layers were less clear. Further, there was a lack of longitudinal and experimental study designs. CONCLUSIONS Results suggest a need for longitudinal and experimental designs with validated and granular measures. As communities recover from the COVID-19 pandemic, a thorough understanding of how built environment factors enhance or detract from social connectedness and how this reciprocal relationship impacts PA behavior is needed for future policy, environment, and systematic change.
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Affiliation(s)
- Tyler Prochnow
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX,USA
| | - Laurel S Curran
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX,USA
| | - Christina Amo
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX,USA
| | - Meg S Patterson
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX,USA
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Appelqvist-Schmidlechner K, Heikkinen R, Vasankari T, Virtanen T, Pihlainen K, Honkanen T, Kyröläinen H, Vaara JP. Relationships between psychosocial well-being and leisure time physical activity among 160.000 young Finnish men: a cross-sectional study during 2015-2021. Arch Public Health 2023; 81:26. [PMID: 36797747 PMCID: PMC9936718 DOI: 10.1186/s13690-023-01040-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023] Open
Abstract
Evidence on the relationship between psychosocial well-being and physical activity (PA) is insufficient, especially in young adults between 18 and 29 years. Identifying protective factors for psychosocial well-being as well as factors that may promote PA behaviour in this specific age group is crucial.The aim of the present study was to explore the association between self-reported leisure time physical activity (LTPA) and a number of measures of psychosocial well-being in a large sample of Finnish young men. The sample used for this study is based on registers of the Finnish Defence Forces and consist of questionnaire-based data collected from 159,776 young healthy men (18-29 years, mean age 19 years) who started their military service during the period from 2015 to 2021. Sum scores were calculated for self-esteem and prosocial behaviour. Physical activity, number of friends and the relationship with the parents were each measured with a single question. Unadjusted and adjusted (education, financial situation of the family, family structure) logistic regression models were calculated.A multinominal logistic regression analysis showed that a higher level of LTPA was associated with a higher level of both prosocial behaviour (OR 6.12, 95% CI 5.88-6.36) and self-esteem (OR 4.41 95% CI 4.28-4.54). Further, LTPA had a positive relationship with good social relations, both with peers and parents. The odds ratio for participation in any LTPA weekly was higher (OR 2.74; CI 2.27-3.20) among those who had a close and trustworthy relationship with their parents compared to those men with more challenging relationships with their parents (OR 1.77; CI 1.46-2.14). An inactive lifestyle (PA less than once a week) seemed to be most common among men with no friends. About one third (31%) of men with no friends reported to engage in LTPA less than once a week, while only 10% of men with very many good friends reported to engage in similarly inactive LTPA behaviour.LTPA seems to be positively associated with self-esteem, prosocial behaviour and good social relations among young adult men. Actions aimed at promoting LTPA may have a positive impact on psychosocial well-being among young men, or vice versa. The relationship between PA and psychosocial well-being is complex and interrelated.
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Affiliation(s)
- Kaija Appelqvist-Schmidlechner
- Finnish Institute for Health and Welfare, Equality Unit, Helsinki, Finland. .,Centre for Military Medicine, Helsinki, Finland.
| | - Risto Heikkinen
- Statistical Analysis Services, Analyysitoimisto Statisti Oy, Jyväskylä, Finland
| | - Tommi Vasankari
- grid.415179.f0000 0001 0868 5401UKK Institute for Health Promotion Research, Tampere, Finland ,grid.502801.e0000 0001 2314 6254Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Toni Virtanen
- Finnish Defence Research Agency, Human Performance Division, Tuusula, Finland
| | - Kai Pihlainen
- Defence Command, Training Division, Helsinki, Finland
| | - Tuomas Honkanen
- grid.418253.90000 0001 0340 0796Centre for Military Medicine, Helsinki, Finland
| | - Heikki Kyröläinen
- grid.449286.50000 0004 0647 6253Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland ,grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jani P. Vaara
- grid.449286.50000 0004 0647 6253Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
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Cao Q(K, Dabelko-Schoeny H, Warren K, Lee MY. The Loneliness of Low-Income Older Adults in a Federal Volunteering Program: A Network Perspective. Gerontol Geriatr Med 2023; 9:23337214231219097. [PMID: 38143874 PMCID: PMC10748629 DOI: 10.1177/23337214231219097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
Volunteering has been associated with increased social interactions and reduced feelings of loneliness among older adults. However, a growing number of social network analyses (SNA) conducted in the general population outside of volunteering contexts suggest that lonely individuals tended to interact with other lonely individuals in the network, reinforcing loneliness through peer associations. To better understand the psychosocial impact of peer interactions among older adults within volunteer programs, this study examines how older adults' loneliness is correlated with their peers' loneliness within the Senior Companions Program (SCP). This study collected information on the social networks within an SCP in a Midwest Metropolitan and feelings of loneliness among low-income Russian, Khmer, Somali, Nepali, and English-speaking older volunteers (N = 41). A linear network autocorrelation model (LNAM) was constructed to quantify how volunteers' loneliness is correlated with their peers' loneliness within SCP. The LNAM results indicated that less lonely volunteers tended to make friends with lonelier volunteers (ρ = -.06, p < .05) in SCP even when accounting for statistical controls. The finding that more and less lonely individuals connect indicates an altruistic tendency for less lonely individuals to interact with those who are lonelier. This may be an important pathway by which volunteering addresses loneliness.
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Affiliation(s)
| | | | - Keith Warren
- The Ohio State University College of Social Work, Columbus, OH, USA
| | - Mo Yee Lee
- The Ohio State University College of Social Work, Columbus, OH, USA
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Zhou P, Zhao Y, Xiao S, Zhao K. The impact of online health community engagement on lifestyle changes: A serially mediated model. Front Public Health 2022; 10:987331. [PMID: 36262240 PMCID: PMC9574256 DOI: 10.3389/fpubh.2022.987331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/24/2022] [Indexed: 01/26/2023] Open
Abstract
Background Due to reduced physical labor and increased food availability, making healthy lifestyle changes is becoming increasingly challenging. Prior studies have suggested that strong ties (such as friends or family members) help promote positive lifestyle behavior changes while weak ties like online friends hardly make a difference in activating healthy lifestyle changes. More recent studies have found evidence of positive lifestyle changes brought about by health APPs. Yet, the process through which online health community (OHC) engagement is related to healthy lifestyle changes has not been fully explored. Methods Drawing on social network theory and the self-efficacy literature, we argued that the information and emotional support which users obtained from OHCs is positively associated with health self-efficacy, which in turn is positively associated with lifestyle changes. Then we constructed a serially mediated model between OHC engagement and healthy lifestyle changes and collected 320 valid questionnaires through an online survey. We tested the model by applying structural equation modeling via Mplus 8.3, which uses bootstrapping (5,000 samples) to test the significance of the mediated paths. Results This study demonstrated that the informational and emotional support that users receive from OHC engagement positively affects healthy lifestyle changes via the mediating role of health self-efficacy. We also found that healthy lifestyle changes are an outcome of enhanced health self-efficacy through the effect of informational and emotional support from OHC engagement. Conclusions Our findings help explain how OHC users make healthy lifestyle changes by utilizing the informational and emotional support to develop health self-efficacy. The results also highlight the value of informational and emotional support as important resources which users acquire from OHC engagement. Thus, we suggest that OHC users utilize the informational and emotional support to enhance health self-efficacy and facilitate healthy lifestyle changes. Future research could explore the dynamic process through which OHC engagement influences lifestyle changes by designing longitudinal research and addressing the limitations of the present study.
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Affiliation(s)
- Ping Zhou
- Innovation and Entrepreneurship Education Research Center, Guangdong University of Foreign Studies, Guangzhou, China
| | - Yujie Zhao
- School of Management, Shanghai University, Shanghai, China,*Correspondence: Yujie Zhao
| | - Suping Xiao
- School of Management, Sun Yat-sen University, Guangzhou, China
| | - Kangsheng Zhao
- Department of Economic Management, Guangdong Construction Polytechnic College, Guangzhou, China
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