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.

基于福格行为模型的社区主要不良心脏事件高危者的健康干预

目的探讨基于福格行为模型的健康干预对社区主要不良心脏事件高危者生活方式、用药依从性及院前延迟行为意向的影响。方法将不良心脏事件高危者按照社区分为对照组和干预组各66人。对照组采用常规健康管理,干预组在对照组的基础上依据福格行为模型从动机、能力和提示3个关键要素进行健康干预6个月并随访3个月。在干预前、干预后和随访后对两组健康促进生活方式、院前延迟行为意向、用药依从性进行评价。结果对照组60人、干预组57人完成干预及随访。干预及随访后,干预组健康促进生活方式、用药依从性评分显著高于对照组,院前延迟行为意向评分显著低于对照组(均P<0.05)。结论基于福格行为模型的健康干预有利于提高社区不良心脏事件高危者的健康促进生活方式和用药依从性,降低院前延迟行为意向。

新冠疫情下的儿童青少年健康危险行为:基于家庭风险的视角

新冠疫情期间儿童青少年健康危险行为激增,但随着生活逐渐恢复,其影响仍在持续。新冠疫情期间儿童青少年健康危险行为的变化主要体现在屏幕使用时间过长、身体活动骤减、久坐时间增加、饮食单一、饮食不规律、晚睡更晚起等方面,本文构建疫情背景下儿童青少年健康危险行为的家庭风险框架以解释健康危险行为变化的内在机制,这一框架结合生命史理论可为儿童青少年后疫情时代健康危险行为的持续提供解释。未来研究需长期追踪儿童青少年健康危险行为的发展轨迹,并加强家庭风险、生命史理论与儿童青少年健康风险行为关系的实证研究,为类似重大突发性事件、自然灾害等提供处理儿童青少年健康问题的普遍解决思路。

巯基砷在土水环境-植物体系中迁移转化与健康风险的研究进展

巯基砷是砷物质结构中双键氧(=)、羟基(—OH)或甲基(—CH_(3))被双键硫(=)或巯基(—SH)取代的新型砷化合物,普遍存在于淹水的含硫土壤中,威胁着土壤健康和食品安全。伴随分析方法的进步,对巯基砷在土水环境-植物体系中分布规律和环境行为的研究不断取得新进展。本文对巯基砷的化学形态和分析方法、巯基砷在土水环境中的生物地球化学行为、巯基砷在土水环境-植物体系中的迁移转化与赋存规律、巯基砷在稻米中的赋存和健康风险等4个方面进行了阐述,重点梳理了巯基砷在环境行为中所发生的形态和含量变化情况,并对巯基砷研究的发展趋势进行了展望。

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。

缺血性脑卒中患者复发风险感知与健康行为的相关性研究

目的了解缺血性脑卒中患者复发风险感知、健康行为现状并分析两者之间关系。方法采用一般资料调查表、缺血性脑卒中复发风险感知量表及脑卒中患者健康行为量表对乌鲁木齐市某三甲医院的214名缺血性脑卒中患者进行调查。结果缺血性脑卒中患者复发风险感知总分(86.67±9.27)分,健康行为总分(68.78±6.53)分,两者呈正相关(r=0.389,P<0.05);控制一般资料后,复发风险感知可独立解释缺血性脑卒中患者健康行为14.5%的变异(P<0.05)。结论缺血性脑卒中患者复发风险感知及健康行为水平均处于中等水平,复发风险感知正向预测健康行为。临床医护人员可以从风险感知角度对缺血性脑卒中患者进行健康教育,促进患者健康行为,减少卒中复发。

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。

健康生活方式指导员健康科普分享意愿影响因素研究

目的 探索健康生活方式指导员通过在线平台分享健康科普意愿的影响因素,为更好地发挥指导员的健康传播与促进作用提供依据。方法 基于计划行为理论(Theory of Planned Behavior,TPB)和益处与风险评价理论(Theory of Benefit and Risk Assessment,BRA),2022年9月在南京市健康生活方式指导员中进行实证研究,分析感知风险、感知益处、分享态度、主观规范和感知行为控制对分享意愿的影响及机制。结果 参与调查的指导员1665名,模型解释了分享意愿87%的变化(R^(2)=0.87)和分享行为;32%的变化(R^(2)=0.32)。分享态度(β=0.388)、主观规范(β=0.596)、感知行为控制(β=0.105)和感知益处(β=0.081)正向影响指导员分享健康科普意愿(P<0.05)。分享态度在感知益处和分享意愿间起部分中介作用,中介效应为0.205 (95%CI:0.180~0.235);分享态度在感知风险和分享意愿间起完全中介作用,中介效应为0.076 (95%CI:0.064~0.091)。结论 基于TPB和BRA的整合模型可以较好地解释南京市指导员通过在线平台分享健康科普意愿的影响因素,为开展指导员培训和实施干预措施提供依据。

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。

结直肠癌高危人群参与结肠镜筛查的现状及影响因素分析

目的探讨结直肠癌高危人群结肠镜筛查的参与现状及其影响因素,为促进直肠癌高危人群的主动健康管理行为提供思路。方法选取杭州市临平区50~70岁结直肠癌高危人群624例作为研究对象,调查高危人群的一般资料、结肠镜筛查参与情况,采用二元Logistic回归分析结直肠癌高危人群参与结肠镜筛查的影响因素。结果624例结直肠癌高危人群,148例参与结肠镜检查,结肠镜检查参与率为23.72%;多因素分析结果显示,年龄、吸烟、喝酒、家庭月收入、息肉个人史、结肠癌家族史、大便习惯或性状改变、医疗保险、知晓结直肠癌相关症状、健康教育形式均为结直肠癌高危人群参与结肠镜筛查的独立影响因素(均P<0.05)。构建结直肠癌高危人群参与结肠镜筛查的风险预测模型,模型拟合度检验结果显示,χ^(2)=4.095,P=0.848;预测模型的AUC为0.892(P<0.05)。结论临床可基于年龄、吸烟、喝酒、息肉个人史、结肠癌家族史、大便习惯或性状改变等因素,干预结直肠癌高危人群参与结肠镜筛查的健康行为。

强化健康宣教护理在高危压疮患者中的应用效果

目的:观察强化健康宣教护理在高危压疮患者中的应用效果。方法:回顾性分析2019年2月至2022年12月该院收治的206例高危压疮患者的临床资料,按照护理方案不同将其分为研究组与对照组各103例。对照组给予常规健康宣教护理,研究组给予强化健康宣教护理,比较两组护理前后疾病认知评分、健康行为[健康促进生活方式量表Ⅱ(HPLPⅡ)]评分,以及压疮发生率和护理满意度。结果:护理后,两组疾病知识、自我护理、用药知识、预防保健等疾病认知评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05);护理后,两组HPLPⅡ评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05);研究组压疮发生率低于对照组,差异有统计学意义(P<0.05);研究组护理满意率为91.26%(94/103),高于对照组的79.61%(82/103),差异有统计学意义(P<0.05)。结论:强化健康宣教护理应用于高危压疮患者可提高疾病认知评分、健康行为评分和护理满意度,降低压疮发生率,其效果优于常规健康宣教护理。

基于身体素质、健康行为养成探究儿童反复肺炎支原体感染的风险因素及应对策略

目的基于身体素质、健康行为养成探究儿童反复肺炎支原体(MP)感染的风险因素及应对策略。方法将2022年1月至2023年10月于河南省直第三人民医院就诊的208例反复MP感染儿童纳入反复感染组,按1∶2比例选择同期门诊体检的416例健康儿童纳入健康组,调查两组一般资料、身体素质、健康行为、是否缺乏微量元素、25-羟基维生素D[25(OH)D]水平,采用单因素、Lasso回归、logistic回归方程分析儿童反复MP感染影响因素。结果年龄≤6岁、身体素质不及格、每日视屏时间≤63.84 min、未每日开窗通风、手卫生不规范、每周运动时间≤2.6 h、出门未戴口罩、偏食/挑食、爱吃油炸/快餐类食品、缺乏微量元素、25(OH)D水平≤32.30μg·L^(-1)是儿童发生反复MP感染的影响因素(P<0.05)。结论年龄较小、身体素质差、每日视屏时间长、不经常开窗通风、手卫生不规范、每周运动时间短、出门不戴口罩、偏食/挑食、爱吃油炸/快餐类食品、缺乏微量元素及维生素D是儿童发生反复MP感染的危险因素,临床可据此制定针对性防治措施,预防反复MP感染。

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.