Preventing Behavioral-Risks Incidence among School Children: The Role of School-Based Health Promotion Program

This article addresses the important role school health education program can play in reducing youth risky behaviors that lead to incarceration, diseases and fatalities or that impact their academic performance in school. Children growing up are at risks of exposure to different behaviors and common social influences which if unchecked result in unexpected health consequences common among youth in America today. According to US Centers for Disease Control & Prevention, the six leading behaviors that cause death, disability, and social problems among American children are: unintentional injuries and violence, alcohol and drug use, tobacco use, unhealthy diets, inadequate physical activities, and sexual behaviors and diseases. This article shows that school health program: 1) can provide the foundation for children to learn desired healthy behaviors in order to preserve life, 2) protects the future of children and that of the nation, 3) can teach students skills to recognize risky behaviors and resist them, 4) can boost community efforts to achieve desired health behaviors, 5) closes socio-economic gaps that interfere with basic nurturing of children, and 6) finally links local stakeholders as partners in promoting community safety. Through review of literature, the authors found that it costs ($588) daily or (214,620) annually to incarcerate a juvenile and only $75 daily for the cost of individualized community-based services. The cost to New York is over $900,000, yet does not address the causative issues. The authors recommend that schools teach comprehensive school health from kindergarten to grade 12 and employ health educators to support teachers teach health promotion and education.

Health behaviors of Korean adults with hepatitis B:Findings of the 2016 Korean National Health and Nutrition Examination Survey

AIM To assess the frequencies of five health-related behaviors(smoking, alcohol consumption, body weight, sleep dura-tion, and physical activity) in Korean adults with chronic hepatitis B.METHODS Data were obtained from the 2016 Korean National Health and Nutrition Examination Survey. In total, 5887 subjects(2568 males, 3319 females) over 19 years old were enrolled in this study. Interviews were performed to obtain information on demographic characteristics and medical conditions. A self-administered questionnaire and medical examination were used to assess the smoking history, alcohol use, physical activity, sleep duration, and body weight of the subjects. Chronic hepatitis B was diagnosed based on detection of hepatitis B surface antigen(HBs Ag). The subjects were categorized into HBs Ag positive and negative groups, and a complex sampling analysis was conducted to compare the health behaviors between these groups.RESULTS Among males, the current smoking rate in the HBs Ag positive group was higher than that in the negative group(45.5% vs 38.5%). In the positive group, the rates of monthly and high-risk alcohol use were 70.4% and 17.6% in males and 45.9% and 3.8% in females, respectively. The rate of alcohol use was similar between the two groups [P = 0.455(males) and P = 0.476(females)]. In the HBs Ag positive group, 32.3% and 49.9% of males and 26.5% and 49.6% of females were overweight and physically inactive, respectively. High-risk alcohol consumption and physical inactivity were significantly associated with self-perceived health status.CONCLUSION Our data demonstrate that a large proportion of Korean adults with chronic hepatitis B have poor health behaviors. Further studies are needed to confirm our results.

Clustering of Multiple Risk Behaviors among Ethnically Diverse Adolescents Living in Hawaii

The current study examined the prevalence and clustering of 5 health-risk behaviors among adolescents in Hawaii, including physical inactivity, low fruit and vegetable consumption, junk food consumption, excessive television time, and inadequate sleep. High school students were recruited from 5 classrooms in Oahu Hawaii. Data were collected in the spring semester of 2011. Proportions were used to describe the prevalence of single and multiple health risk behaviors. Significant health behavior clusters were revealed using an observed-to-expected (O/E) ratio method. Participating adolescents (n = 114) were 11th and 12th grade students with a mean age of 16.28 (SD = 0.62). Participants were predominantly female (75%) and Filipino-American (68%). Seventy-seven percent of adolescents were physically inactive, 90% watched excessive TV, 66% consumed inadequate fruits and vegetables, 94% reported inadequate levels of sleep, and 80% consumed excessive junk food. Overall, 94% reported at least 3 risk factors, 73% reported at least 4 risk factors, and 37% reported all 5 risk factors. No significant clusters were found. Conclusion: Health-risk behaviors cluster and occur more often than expected among adolescents living in Hawaii. Non-significant clustering may be due to insufficient variability within the sample data;future examinations of this highly understudied population are necessary.

Perception and prevalence of behavioral risk factors: the lifestyle risk scale (LRS)

Objective: To develop a lifestyle risk scale (LRS) of health-related behaviors based on risk assessments of study participants. Method: By means of pairwise comparisons of assessed risks associated with tobacco, alcohol, obesity, fast-food, physical inactivity, and lack of sleep, each at four levels, 24 behaviors were ranked on a unidimensional risk scale. Results: Overall, use of tobacco was assigned the highest risk score (3.7), consumption of fast-food and lack of sleep the lowest (1.7, 1.6). Minor risk factors (lack of sleep and fast-food) were, at their highest levels, assigned similar risk values as major risk factors (tobacco, alcohol, obesity) at their lowest levels. Lifestyles of female participants were less hazardous than those of male participants, as measured with the LRS. In contrast, perception of behavioral health risks was more precise in men. Conclusions: The LRS provides a practical quantification to identify and compare groups with different risk behavior patterns as well as clusters of risky health behaviors in and across populations. It can also support the communication of behavioral health risks.

Promoting Health Behavior Change in Canada: A Quality Improvement Project Integrating Prevention and Wellness in Frontline Care

Background: The critical need for Health Behaviour Change (HBC) for preventative care has been highlighted by the COVID-19 pandemic. This quality improvement project assessed the effectiveness and acceptability of Fountain of Health HBC tools as a minimal intervention for primary and secondary prevention among Canadian clinicians and their patients. Methods: Clinicians received HBC education and tools (paper tools and app-based) to assist their patients in setting a S.M.A.R.T (Specific, Measurable, Action-oriented, Realistic, Time-limited) goal at baseline and assessed four weeks later. Primary outcome measures were: 1) patient self-report of success at goal attainment;2) patient self-reported evaluation of change in well-being and health attitudes;and 3) clinician experience and engagement. Results: A total of 2184 clinicians received HBC education. Of these, 759 clinicians registered to participate in the project. 961 patients set S.M.A.R.T. HBC goals using either the paper tools (PT) or the app format. Patient data revealed nearly all patients (89% of PT users and 90% of app users) at least partially succeeded in attaining their goal at a four-week follow-up. Most patients (85% of PT and 80% of app users) also reported improvement in their well-being. A significant difference in health beliefs and attitudes was found in both PT (p < 0.001) and app users (p = 0.003). Conclusions: HBC is challenging. Educating and providing clinicians with HBC tools as a minimal intervention was found to be a successful health prevention strategy to improve patient well-being and health attitudes, and achieve S.M.A.R.T. goals. Results show HBC tools, education, and support for clinicians are both acceptable and effective for HBC in frontline care. These findings are relevant and timely given greater reliance on virtual care in the wake of the COVID-19 pandemic. Further research with rigorous methodology is needed to implement programs to achieve sustainable HBC to promote health on a large scale.

复发风险感知对首发缺血性脑卒中患者健康行为的影响

目的 探讨首发缺血性脑卒中患者复发风险感知对其健康行为的影响,为促进脑卒中患者健康管理提供依据。方法 于2022-03—2023-05采用一般资料调查表、缺血性脑卒中患者复发风险感知量表、脑卒中患者健康行为量表对238例首发缺血性脑卒中患者进行问卷调查。结果 238例首发缺血性脑卒中患者复发风险感知量表得分(91.58±15.23)分,健康行为量表得分(68.27±14.05)分。分层回归分析显示,复发风险感知是首发缺血性脑卒中患者健康行为的重要预测因子,可独立解释健康行为16.5%的变异。结论 复发风险感知是首发缺血性脑卒中患者健康行为的重要影响因素,提高脑卒中患者复发风险感知水平有助于促进患者健康行为。

Health behavior after intrahepatic cholestasis of pregnancy

Background: Pregnancy is an opportunity to adopt favorable health behaviors. We studied whether intrahepatic cholestasis of pregnancy (ICP) promotes favorable health behavior in later life. Design: A prospective controlled cohort study. The method was a questionnaire survey in 2010 among 575 women with ICP and 1374 controls, all having delivered between the years 1969 and 1988 in Tampere University Hospital in Finland. Questionnaires were sent to 544 ICP patients and 1235 controls. Responses were received from 1178 (response rate 66.2%). The main outcome measures concerning recent or current health behavior were smoking, alcohol consumption, physical activity, body mass index (BMI) and special diet. Results: Current smoking was less common in the ICP group than among controls (10.5% vs 15.7%, p = 0.017). Assessed by smoking pack years there was a similar difference: in the ICP group 11.7% of women had at least 10 smoking pack years compared to 18.0% of the controls (p = 0.006). Recent alcohol consumption did not separate the two groups. The groups did not differ as to reported physical activity assessed in MET units. Fewer ICP women had had BMIs of 30 or more during pregnancy compared with controls (18.8% vs 25.1%, p = 0.023). In other points of life the BMI differences were not statistically significant. Weight-loss diet and gallbladder diet were more common in the ICP group (6.3% vs 3.6%, p = 0.044, and 3.0% vs 1.3%, p = 0.038). Conclusions: Having developed ICP two to four decades earlier seemed to constitute an effective intervention for smoking habits but not for other aspects of health behavior.

基于结构方程模型的原发性骨质疏松症高危女性健康促进行为的影响因素分析

目的基于结构方程模型探讨原发性骨质疏松症高危女性健康促进行为的影响因素,为制订有效干预方案提供理论参考。方法2023年2-5月,采用便利抽样法选取衡阳市4所社区卫生服务中心的400名原发性骨质疏松症高危女性为研究对象,采用一般资料调查表、电子健康素养量表、领悟社会支持量表、骨质疏松症自我效能量表和健康促进生活方式量表Ⅱ对其进行调查,采用结构方程模型进行影响因素分析。结果工作状态、文化程度、疾病认知程度、领悟社会支持、自我效能直接影响健康促进行为(效应值分别为0.199、0.109、0.155、0.263、0.207);电子健康素养不仅直接影响,还可通过领悟社会支持和自我效能的部分中介作用影响健康促进行为(直接效应值为0.515,总中介效应值为0.231)。结论原发性骨质疏松症高危女性的健康促进行为受多种因素协同影响。社区医务人员应重点关注在职、文化程度与疾病认知程度较低者,可通过开展电子健康干预、调动社会支持系统、增强自我效能,以提升其健康促进行为水平。

天津市中小学生日常用眼行为调查及近视相关影响因素研究

目的探究天津市中小学生用眼行为情况与近视相关风险因素,以期针对性做好眼健康科普宣传与用眼教育指导工作。方法横断面调查研究。于2021年12月面向天津全市中小学生下发眼健康调研问卷,调查学生用眼习惯;并结合2021年下半年校园视力筛查数据构建多因素Logistic回归模型,探究近视相关风险因素。结果共计回收问卷821459份,其中有效问卷701104份。小学生学习性电子产品使用时间与娱乐性电子产品使用时间大部分低于1 h(占比分别为57.74%与40.98%)。初中生学习性电子产品使用时间与娱乐性电子产品使用时间>2 h的人群(占比分别为26.61%与35.05%)较小学生(占比分别为11.21%与20.93%)均明显增多。大部分高中生每日学习性及娱乐性电子产品使用时间与纸质材料阅读时间均>2 h。51.59%的小学生睡眠时长不达标,初中生与高中生睡眠时长达标率分别为60.09%与64.99%。大部分(55.74%)中小学生日均户外活动时间为1~2 h。多元回归分析结果显示,小学生近视发生风险与电子产品使用时间(包括学习型与娱乐性)、近距离纸质材料阅读时间、户外活动时间、入睡时间及睡眠时长均相关(均为P<0.05);初中生近视发生风险则与娱乐性电子产品使用时间、近距离纸质材料阅读时间、户外活动时间及睡眠时长均相关(均为P<0.05);高中生近视发生风险仅与近距离纸质材料阅读时间及户外活动时长相关(均为P<0.05)。结论天津市小学生、初中生及高中生电子产品使用时间>2 h的人群比例逐渐升高,睡眠时长达标率逐步增加,其近视发生风险均与近距离纸质材料阅读时间及户外活动时长相关。整个社会应广泛开展科普宣传、加强用眼行为管理,实现我国儿童青少年近视率降低的目标。

福建省中学生健康危险行为现状及影响因素研究

目的 分析福建省中学生健康危险行为的状况及影响因素,为改善中学生健康生活方式提供科学依据。方法 于2023年1—2月对419名福建省中学生进行网络问卷调查。结果 根据健康危险行为潜在类别结果,将中学生分为低风险组(77.3%)、中风险组(12.2%)和高风险组(10.5%)。男性、居住在农村、BMI超重、留守、就读于八年级与九年级、住校和成绩差的中学生健康危险行为数量多的可能性更大。以低风险组为参照,留守与就读于八年级的中学生为中风险组的可能性更大,就读于八年级和九年级的中学生为高风险组的可能性更大。结论 福建省中学生总体健康危险行为状况较好,聚集程度较轻,但网络成瘾与缺乏锻炼问题突出,建议有针对性地对中学生进行健康教育。

风险感知与信息支持:媒介接触对老年人健康行为意愿的影响研究

老年人是疾病防控的重点人群,制定有效的针对老年群体的健康传播策略,提升其防控意识,促使其采纳积极的防控行为至关重要。本文通过问卷调查研究老年人在不同媒介渠道的健康信息接触对其疾病防控行为意愿的影响及效果差异。结果显示:通过传统媒体接触健康信息对老年人疾病防控行为意愿的影响效果要高于网络媒体;老年人通过两类媒体接触健康信息均可以通过影响其恐惧、感知严重性和行为态度进而影响其疾病防控行为意愿。因此,要根据不同媒介的特点发挥其在健康传播中的作用,传统媒体要在坚守权威性和公信力的同时提升易读性和趣味性,网络媒体要杜绝涉疫谣言,为老年人提供更准确、便捷的健康信息。健康传播要唤起老年群体对疾病的风险意识,提高他们对疾病的风险感知。同时,健康传播要从老年人的视角出发,多措并举提升他们的防控行为态度。

Incorporating HPS Model into Lebanese Public Schools: Comparison of Adolescents’ Smoking, Alcohol and Drug Use Behavior in HPS versus Other Public and Private Schools in Lebanon

In 2010, the World Health Organization supported the Lebanese Ministry of Education and Higher Education to establish a network of 10 Health Promoting Schools (HPS). This study was undertaken to address the extent to which the HPS model was able to produce changes in the risk behaviors of adolescents (Smoking, Drinking, and Drug Use) and prepare them to respond to evolving health challenges. A cross-sectional survey was carried out during 2011-2012 and compared Grade 6 - 9 students in HPS, and 10 other public and private schools. The Youth Risk Behavior Survey [1], and Carbon Monoxide measurements in adolescent breaths were used for data collection. Findings revealed that the current School Health Program failed to address issues of concern to adolescents with no significant differences in risk behaviors: smoking, alcohol and drug use. The HPS network needs reassessment to upgrade the outcomes of health education curricula. Expected learning outcomes and healthy practices must be designed to match students’ age, grade level, and developmental milestones.

Association between Cardiovascular Disease Risk Factor Knowledge and Lifestyle

Objective: To relate cardiovascular risk factor knowledge to lifestyle. Methods: In this cross-sectional study, food consumption and lifestyle characteristics were recorded using mailed questionnaires. The dietary pattern was described using the Mediterranean Diet Score (MDS). An open ended questionnaire without predefined choices or answers was used to capture cardiovascular knowledge. Results: Lack of physical activity, smoking and eating too much fat were the 3 most cited potential cardiovascular risk factors, while being overweight, eating too much salt and a low consumption of fruits and vegetables were the least cited risk factors. Age, Body Mass Index, physical activity, smoking, income and dietary habits were not consistently associated with knowledge of risk factors. A low socioeconomic position as measured by the indicator education was associated with a lower knowledge of established and modifiable cardiovascular risk factors. Conclusions: Risk factor knowledge, an essential step in prevention of CVD, is not systematically associated with a healthier lifestyle. The findings of this study confirm that there is a gap between risk factor knowledge and lifestyle.

基于云平台的护理干预对冠心病高危人群疾病知识及健康管理行为的影响

目的:探讨基于云平台的护理干预对冠心病高危人群疾病知识及健康管理行为的影响。方法:2021年10月—2022年10月选取本院体检中心筛查出的冠心病高危人群160例为研究对象,采用随机双盲试验将病人分为观察组及对照组,各80例,对照组行常规健康宣教并定期体检,观察组基于云平台对病人实施护理干预。干预后比较两组疾病知识知晓率、体验依从性健康管理行为水平及冠心病发病率。结果:干预后观察组疾病知识知晓率(包括合理饮食、运动锻炼、危险因素控制、冠心病早期表现及症状、躯体症状监测、情绪管理)及体检依从率高于对照组,冠心病发生率低于对照组,健康行为量表(HPLP)总分及各维度评分高于对照组,差异均有统计学意义(P<0.05)。结论:基于云平台的护理干预能有效提高冠心病高危人群疾病知识及健康管理行为,从而有效预防冠心病的发生。

体育运动对宁夏南部地区青少年健康危险行为的影响

青少年是一个国家的未来。随着当前社会全方位的高速发展,青少年的生活环境以及所受到的教育模式也在不断变化。青少年在成长以及接受教育的过程中,除学习是需要关注的一个方面外,健康发展这方面的问题也需要更多的关注和重视。现代社会的高速发展给青少年带来了许多好与坏的影响,特别是心智还没有完全发育成熟的青少年极易受到影响,再加上青春期,青少年心理上也会产生一定的变化,容易引起一些心理和行为上的问题,如吸烟、饮酒、故意伤害、自残等。这些行为不仅危害了青少年自身的身心健康,也相应地影响到家庭的安宁以及学校、社会的和谐。青少年阶段是一个人发育和成长的重要阶段,但是一些不良的、危害健康的行为,会对青少年的身心健康造成非常大的伤害。体育运动对青少年的影响较大,引导青少年学生在体育运动中寻找自我价值,是改变青少年学生心态的一种有效方式。自我价值和心态是改变青少年危险行为的关键。当前,关于西部贫困地区体育运动对青少年学生的健康危险行为及其对策研究的文章相对较少,而宁夏南部地区是一个发展相对落后的地区,更值得研究和探讨。

应用健康信念模式对大学生性传播疾病风险行为及其影响因素的研究

目的 了解大学生性传播疾病风险行为情况,并以健康信念模式为框架分析其影响因素,为大学生性健康教育提供参考。方法 采用自行设计的大学生性传播疾病认知及风险行为调查问卷对388名大学生进行调查,并用χ^(2)检验、秩相关分析和多元有序Logistic回归分析进行统计学处理。结果 大学生性传播疾病中、高风险行为分别有136人(35.05%)和26人(6.70%)。男生、来自城市和山区、父母文化程度高的学生风险行为等级更高(P<0.05);越反对一夜情及婚前性行为、感知严重性和自我效能得分越高,学生风险行为等级越低(P<0.05)。结论 大学生发生性传播疾病中、高风险行为的现象较普遍,可应用健康信念模式加强大学生性健康教育。

孕中晚期抑郁状况及其相关因素分析

目的 了解孕妇孕中晚期抑郁状况及其相关因素。方法 选择北京、山东、湖南为调查现场,依托当地妇幼保健机构,采用方便抽样,遵循自愿原则,采用2020年10月—2022年7月488例孕妇作为研究对象,孕妇年龄范围为19~45岁,孕周24~30周。应用爱丁堡抑郁量表(EPDS)筛查评估孕妇抑郁状况,自拟问卷线上调查孕妇社会人口学信息、妊娠状况、膳食摄入、健康危险行为和社会家庭支持等相关因素。结果 孕妇孕中晚期抑郁发生率为21.7%,年龄>29岁、家庭人均月收入>3 000元、教育水平较低(高中)、意外妊娠、孕前饮酒是孕妇抑郁发生的影响因素。结论 意外妊娠以及孕前饮酒等行为因素与孕期抑郁发生风险有关。

基于TPB扩展模型的后疫情时代康养旅游行为意向影响机制研究

新冠肺炎疫情加重了大众的身心压力,但也唤醒了人们的生命健康意识,康养旅游因其有效促进身心健康恢复的功能,逐渐被大众所关注。以计划行为理论为基础,加入疫情风险感知新变量,构建扩展的TPB(计划行为理论)模型,研究后疫情时代康养旅游行为意向的影响机制有助于促进康养旅游发展,从而缓解疫情给大众带来的负面情绪。结果表明:康养旅游者的主观规范对行为态度和行为意向有显著正向影响;康养旅游者的感知行为控制对行为态度和行为意向有显著正向影响;疫情风险感知对康养旅游者的行为态度的影响不显著,疫情风险感知对康养旅游者的行为意向有显著正向影响;康养旅游者的行为态度对行为意向有显著正向影响;康养旅游者的行为态度在主观规范、感知行为控制、疫情风险感知与行为意向之间均存在部分中介效应。

上海北外滩社区骨质疏松患者和高危人群的疾病认知及健康行为调查

目的 :调查社区骨质疏松(osteoporosis,OP)患者和高危人群对OP知识的认知度及健康行为。方法 :以2021年10-12月上海北外滩社区180名OP患者和高危人群作为研究对象,其中高危人群146例,患者34例;男性34例,女性146例;年龄52~90岁。采用自行设计的问卷(满分28分)进行OP知识及健康行为调查。结果 :OP知识问卷总分中位数为19.0分。OP患者和正常体质量指数者的得分较高(P <0.05)。OP患者在规律服用钙片和奶制品比例高于高危人群(73.53%和82.35%比20.55%和62.33%,χ^(2)=36.48,χ^(2)=4.94,均P <0.05)。24%的OP高危人群曾接受双能X线骨密度检测。电视、报纸、微信等媒体是OP知识的主要来源。结论 :上海北外滩社区OP患者及高危人群对骨质疏松知识了解处于中等水平,在某些方面仍存在认知缺陷,摄钙及自主行骨密度检测行为存在不足。医务人员应针对不同人群特点及知识掌握情况开展不同层次的健康指导,提高其自我保健意识。