Digital Commons Network^™

Examining The Relationship Between Health Literacy And Preventive Care Use, Xuewei Chen, Guofan Luo, Ming Li, Gary Kreps

Health Behavior Research

We examined the role of health literacy on preventive care among college students and assessed individual health literacy skills from a theory-based multidimensional perspective using both subjective and objective measures. Methods: Participants (n=561) completed our online survey with valid responses. Data collection was conducted from April to June 2020. We assessed participants’ health literacy using different measures, including Health Insurance Literacy Measure (HILM), eHealth Literacy Scale (eHEALS), All Aspect of Health Literacy Scale (AAHLS), and the Newest Vital Sign (NVS). The first three were subjective measures. The last one was an objective test. Preventive care included annual flu vaccinations, annual …

Associations Of Essential Worker Status, Sex, Lifestyle Behaviors, And Moods: Findings From A Sample Of Working Adults In The United States During The Early Stages Of The Covid-19 Pandemic, Ali Boolani, Joel Martin, Erica Jansen, Nelson Cortes, Shane Caswell, Jeremy Lackman, Staci Drewson, Matthew Lee Smith

Health Behavior Research

COVID-19 profoundly impacted the world by causing disruptions in the global job markets due to business closures to support physical distancing in the earliest stages of the pandemic. To maintain basic societal function in the early stages of the pandemic, workers were classified based on the nature of their employment responsibilities as essential (i.e., continued working outside the home) and non-essential (i.e., required to work from home). Using a cross-sectional design, this study identified the lifestyle behaviors (sleep, diet, physical activity) and mood among US workers. An internet-based survey was used to collect data from US adults from April 13 …

A Longitudinal Examination Of Multiple Forms Of Stigma On Minority Stress, Belongingness, And Problematic Alcohol Use, Akanksha Das, Rose Marie Ward, Lauren Haus, Jackson Heitt, Jeffrey Hunger

Health Behavior Research

College students who experience stigma report problematic alcohol use. However, the stigma-health link focuses on one form of stigma, thereby excluding the intersectional oppression of experiencing multiple forms of stigma. The present work has two primary aims: 1) evaluating whether additive intersectional minority stress confers greater problematic alcohol use among multiply-stigmatized college students one year later, and 2) whether that link can be explained by 1) lower belongingness and 2) greater drinking to cope motives. Students (N=427) ranging in stigmatized identities (14.3% zero; 46.4% one; 29.5% two; 9.8% three or more), participated in an annual health survey at two subsequent …

Class Standing Differences In Bystander Intervention Intentions To Prevent Sexual Assault: A Reasoned Action Approach, Sarah E. Rush Griffin, Christine Hackman, Paul Branscum, Neha Gautam

Health Behavior Research

The purpose of this study was to examine differences in determinants of bystander intervention (BI) participation based on undergraduate students' year in school using the Reasoned Action Approach (RAA). Students (n = 291) were recruited from general education courses at two universities in the United States and completed an online survey evaluating intentions, attitudes, perceived norms, and perceived behavioral control (PBC) associated with engaging in BI. Next, attitudes, perceived norms, and PBC were used to predict intentions using separate linear regression models – one model with upper-level students and another model with first-year students. Both models significantly predicted intentions, with …

Adverse Childhood Experiences And Current Cannabis Use Among U.S. Young Adults, Afolakemi C. Olaniyan, Keith A. King, Laura A. Nabors, Ashley L. Merianos

Health Behavior Research

Cannabis use is a significant public health issue among U.S. young adults. The objective of this study was to assess the associations between adverse childhood experiences (ACEs) and current cannabis use among U.S. young adults. We conducted a secondary analysis of the 2021 Behavioral Risk Factor Surveillance System (BRFSS) data, which involved 498 U.S. young adults 18-24 years old who had data available for analysis on ACEs and current cannabis use. Unadjusted and adjusted logistic regression models were fitted to examine the associations between ACEs and current cannabis use. Adjusted models included participants’ sex, race/ethnicity, education level, and household income …

Psychometric Properties Of The Adolescent And Young Adult Men – Health Indicators Scale (Ayam-His), Michael J. Rovito, Shari Dworkin, Keri Allen, Kathy E. Rovito, Sydney Martinez

Health Behavior Research

The goal of this current study was to evaluate the psychometric properties of the AYAM-HIS among a select sample of AYAMs, a priority population experiencing disparate health outcomes compared to women. These preliminary results indicate that AYAM-HIS yielded reliable and valid data, thus providing a means to measure indicators of health behaviors and possible outcomes within this population. The AYAM-HIS can provide the necessary information to assess current health behaviors so as to provide a foundation from which interventions can be designed. Future research into reducing survey fatigue related to AYAM-HIS and testing with diverse populations are warranted.

Associations Between Delta-8 Thc And Four Loko Retail Availability In Fort Worth, Texas, Cassidy R. Loparco, Sofia Olsson, Vishaldeep Sekhon, Kayla K. Tillett, Robert A. Yockey, Melvin D. Livingston, Pamela J. Trangenstein, Matthew E. Rossheim

Health Behavior Research

Alcohol and cannabis are two of the most widely used substances among young people, and availability and price are two of the most significant determinants of use. Four Loko products contain up to 5.5 standard alcoholic drinks in a single can, are one of the least expensive ready-to-drink alcohol products on the market and are commonly consumed by underage drinkers. Delta-8 THC is a psychoactive substance with no federal regulations regarding minimum purchase age, ingredients and synthesis, marketing, and testing for potency or contaminants. Delta-8 THC products can be inexpensively synthesized and are sold for low prices. Given that young …

Strategy For Expanding Nutrition Professionals’ Competency: A Pilot Case Study In Dissemination And Implementation Science Training, Ayron E. Walker, Elizabeth A. Claydon, Samantha E. Scarneo-Miller, Daniel Totzkay, Melissa D. Olfert

Health Behavior Research

Dissemination and Implementation (D&I) science trainings are essential to build knowledge among a variety of current and future health professionals.

The objective of this study was to pilot-test and assess implementation of a nutrition-specific D&I science training.

Participants (students enrolled in nutrition and public health programs) completed pre/post surveys and exit interviews. Descriptive statistics and a qualitative thematic analysis used deductive coding; in which coding and theme development are directed by existing concepts. Initial coding was completed by one researcher and validated by an additional researcher to describe and provide examples of the categories the Kirkpatrick Model and Implementation Outcomes …

Overcoming Hesitancy To Submit Manuscripts For Peer Review, Tyler Prochnow, Bobbie L. Johannes, Ashley L. Merianos, Juanita-Dawne R. Bacsu, Matthew L. Smith

Health Behavior Research

Publishing completed research is essential for knowledge dissemination and career advancement, yet many academics experience submission anxiety. Reasons include fear of rejection, imposter syndrome, and perfectionism. This commentary reviews drivers of submission hesitancy and outlines evidence-based strategies to empower manuscript submission. Consequences of delays are detrimental for individual productivity and scientific progress. Indicators of unhelpful rumination during endless revisions include excessive time re-reviewing background literature or endlessly analyzing data. Plagiarism angst can also stall submission. Strategies to promote manuscript submission include setting readiness checklists and timeline goals, seeking mentor perspectives on drafts, forming peer writing groups for accountability, understanding text …

Alcopops Disproportionately Consumed By Minors In Sexual Assault Cases, Matthew E. Rossheim, Kwynn M. Gonzalez-Pons, Kayla Tillett, Ryan D. Treffers, Pamela J. Trangenstein, Jennifer Lerch, Faye Taxman, Kaylin Greene, Cassidy Loparco, David H. Jernigan

Health Behavior Research

Alcohol is present in a large proportion of sexual assault cases. However, research largely overlooks the role that providing alcoholic beverages – particularly those with high-alcohol- content and/or whose flavors mask the taste of alcohol – may have in making young people more vulnerable to being assaulted. This research is especially important given the rise in the availability of sugar-sweetened alcopops and their high-alcohol-content counterparts “supersized alcopops,” which contain up to 5.5 standard alcoholic drinks. In the current study, we examined whether alcopops and supersized alcopops, relative to beer, were involved in disproportionately more sexual assault cases involving victims who …

Comparative Effects Of Weight Loss Associated With A Consistent Volume Of Exercise Within Education-Focused Vs. Self-Regulation-Focused Obesity Treatments In Women, James J. Annesi

Health Behavior Research

Although exercise is generally included in behavioral weight-management treatments, its association with weight loss cannot be reconciled by its corresponding energy expenditures in formerly low-active adults with obesity. It has been suggested that the self-regulation needed to maintain exercise carries over to more controlled eating (i.e., coaction) and weight loss, with exercise-associated mood improvements also having positive impacts on eating behaviors and weight. To clarify these findings to improve behavioral interventions, women randomly assigned to community-based obesity treatments with either a self-regulation focus (n = 40) or educational focus (n = 25) were included in the present reanalysis …

“We Have To Improve Our Culture About This”: Family Planning Decision-Making Among Women And Men Living In Florence, Italy, Alyssa Amidei, Taylor Raff, Andrea L. Demaria

Health Behavior Research

The male condom is the most widely used family planning method in Italy and Southern Europe. Most family planning research is focused on women and, therefore, could be missing significant gender differences in behavior, as male partners play a critical role in decision-making and pregnancy prevention. This study aimed to explore attitudes toward contraceptive methods, including decision-making and desired improvements related to family planning in Italy. Semi- structured interviews with 42 men and women aged 18–50 years (29.1±7.9) living in or near Florence, Italy, were conducted between May and June 2019. Techniques from thematic analysis allowed for a constant comparative …

The Cigarillo Purchase Task: A Qualitative Analysis, Amanda J. Quisenberry, Sarah J. Koopman Gonzalez, Elizabeth Klein, Erika Trapl

Health Behavior Research

The cigarillo purchase task is a novel procedure modeled after the cigarette purchase task. This procedure can be used to assess the reinforcing value, or the positive behavioral response, to cigarillo products. Little research has used the cigarillo purchase task and the aim of the current study was to evaluate user’s understanding of and thoughts about a cigarillo purchase task. A convenience sample of young adults ages 21-28 were recruited online to participate in semi-structured interviews about cigarillo and e-cigarette use. The analysis included responses from participants who were current users of cigarillos (n=7) or cigarillos and e-cigarettes (n=8). Audio-recorded …

Positive College Experiences Moderate The Association Between Resilience And Anxiety Symptoms Among Underrepresented College Students, Jihun Woo, Erum Z. Whyne, Jaylen I. Wright, H. Matthew Lehrer, Mary A. Steinhardt

Health Behavior Research

Generalized anxiety disorders are among the most prevalent mental health concerns for college students. Resilience, one’s ability to recover from adversity, is a critical component in reducing anxiety. The association between resilience and anxiety may be strengthened by positive college experiences of institutional support and experiential learning, particularly among underrepresented students. This study explored whether positive college experiences (Gallup “Big Six”) moderated the association between resilience (Brief Resilience Scale) and anxiety symptoms (Generalized Anxiety Disorder-7) among underrepresented college students (N = 430; 73.5% first year; 38.1% first generation) at a large public institution. Controlling for demographic variables, greater resilience …

Embracing Diversity And Adapting To The Shifting Landscape Of Health Behavior Research: American Academy Of Health Behavior Presidential Note, Hsien-Chang Lin

Health Behavior Research

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Intersectionality, Measurement, Methods, And Translation: Reflections On The 2023 Aahb Conference, David Seal, Annie Nguyen, Lisa Benz Scott, Scott Rhodes

Health Behavior Research

Intersectionality is a critical yet understudied and often misused concept in health behavior research. To address this, the American Academy of Health Behavior organized its 2023 annual scientific conference held on March 12-15^th, 2023 around issues of intersectionality conceptualization, measurement, and methods (San Francisco, California). The conference, titled “The science of identities: Measurement & methods for translational health behavior research,” brought together a diverse group of nearly 170 health behavior researchers from across the United States to highlight current research and challenges facing intersectionality. The conference included two invited keynotes and eight symposium presentations. Here, we …

An Exploratory Model Of Shared Decision-Making In Women's Reproductive Health In Indiana: A Cross-Sectional Study, Stephanie Meier, Alfu Laily, Laura Schwab Reese, Monica Kasting, Andrea L. Demaria

Health Behavior Research

Ecological approaches to shared decision-making (SDM) are underexplored in women’s reproductive health. The purpose was to identify ecological factors important to women in contraceptive and prenatal care SDM. In this cross-sectional study, women (18-45 years) living in Indiana who had sought reproductive healthcare completed an online survey (N=432). Multiple linear regression was utilized to identify predictors of SDM. Furthermore, exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were conducted to explore ecological factors associated with SDM in contraception and prenatal care. Healthcare professional type was associated with decreased contraceptive SDM scores, but not prenatal care SDM scores. Access, …

The Relationship Antecedents Of Smoking (Ras) Scale: A New Scale To Assess Couple-Focused Triggers To Smoke., Erin M. Tooley, Joseph L. Fava, Belinda Borrelli

Health Behavior Research

The purpose of this pilot study is to assess the reliability and construct validity of a measure of relationship-focused antecedents for smoking (RAS). The scale includes both positively-valenced items (e.g.. “I feel like smoking when I am relaxing with my partner”) and negatively-valenced items (e.g., “I feel like smoking when my partner criticizes me”). Participants included 123 individuals who smoke cigarettes with co-habitating smoking (n=63) or non-smoking (n=60) romantic partners. Participants completed the RAS and a series of measures associated with smoking outcomes. Principal component analysis with varimax rotation resulted in a 2-component solution. The RAS showed excellent internal consistency …

Investigating Moderation In The Prospective Relationship Of Marijuana Use To Subsequent Illicit Substance Use: Evidence From Add Health, Radhika Prasad, Ming Wen, Zobayer Ahmmad, Daniel Adkins

Health Behavior Research

Whereas socially normalized substances (e.g., marijuana) may increase the probability of subsequent progression to more harmful illicit substances, previous empirical research on the topic has yielded inconsistent results. Few studies have prospectively examined whether age of first documented current marijuana use is related to later harmful illicit substance use over multiple life course stages, or considered potential moderation of the process by age of first documented current marijuana use, gender, or race/ethnicity. To investigate this topic, data from five waves of the National Longitudinal Study of Adolescent to Adult (N=20,774), spanning ages 12-42, were used to analyze the prospective association …

The American Academy Of Health Behavior 2023 Annual Scientific Meeting: "The Science Of Identities: Measurement & Methods For Translational Health Behavior Research"

Health Behavior Research

The American Academy of Health Behavior (AAHB) hosted its 23rd Annual Scientific Meeting at the Grand Hyatt in San Francisco, California on March 12-15, 2023. The meeting's theme was "The Science of Identities: Measurement & Methods for Translational Health Behavior Research". This publication describes the meeting theme and includes the refereed abstracts presented at the 2023 Annual Scientific Meeting.

Potentially Misleading Weight Loss Advertisements Targeting Men: Examining Influence Of Celebrity Athlete Endorsement On Ad Believability And Purchase Intentions, Andrew C. Pickett, Katie M. Brown, Zack J. Damon, Natasha T. Brison

Health Behavior Research

Given the prevalence of false or exaggerated claims in advertisements for weight loss products, as well as risks associated with use of unproven dietary supplements and exercise plans, they are subject to heightened scrutiny from regulators. However, celebrity athlete endorsers are increasingly featured in advertisements promoting weight loss products targeting men. This study employed a 2x2 (athlete endorser vs. non-celebrity; plausible vs. unrealistic advertising claim) experimental design, whereby participants (n= 292) were exposed to one of four ad conditions. Results suggest the athlete endorser was perceived as more credible than a non-celebrity, being rated as more expert. Significant …

Effects Of Body Satisfaction And Emotional Eating On Obesity Treatment-Related Changes In Weight And Waist Circumference Over 2 Years: A Serial Multiple Mediation Analysis, James J. Annesi, Francine A. Stewart

Health Behavior Research

Maintenance of lost weight beyond 6 months in adults with obesity remains problematic. To reliably impact obesity over the long term, an improved understanding of treatment-associated changes in psychosocial factors is required. Women are especially susceptible to body image concerns and emotional eating; however, associations among those variables within weight-management processes have been limited to either cross-sectional or short-term analyses. Women with obesity (M_age = 47.4 years, SD = 8.6) who participated in either a year-long YMCA-based cognitive-behavioral treatment emphasizing self-regulation of exercise and eating (n = 54), or a similar treatment that also included brief phone …

The Indirect Effect Of Smoking Level In The Association Between Urban Stress And Readiness To Quit Smoking Among Adults Experiencing Homelessness, Carol Wang, Tzu-An Chen, Maggie Britton, Michael S. Businelle Phd, Darla E. Kendzor Phd, Lorna Mcneill, Lorraine R. Reitzel

Health Behavior Research

Over 70% of adults experiencing homelessness are cigarette smokers, a fivefold greater rate than in the general U.S. population. Consequently, tobacco-related conditions are the leading causes of disease and death for this group. Adults experiencing homelessness tend to seek shelter in urban areas. Thus, they not only experience the daily stressors of being homeless, but they may additionally experience unique or additive urban stressors (e.g., stress related to using public services, crime and violence, and/or cultural conflicts with others). For some smokers, stress is known to increase smoking rates and decrease readiness to quit smoking. Likewise, increased smoking rates alone …

Indirect Effect Of Self-Regulated Exercise On Mood Through Self-Efficacy Changes, James J. Annesi

Health Behavior Research

To improve deficient long-term effects, an improved understanding of psychosocial factors occurring within behavioral obesity treatments is required. The aim of this study was to suggest paths from changes in self-regulation toward reduced negative mood to inform the direction of more comprehensive investigations and treatment foci. Initially low active women (N = 87) participated in a theory-driven community-based behavioral obesity program emphasizing self-regulation and exercise. There were significant (ps < .001) improvements in exercise amounts, exercise-related self-regulation and self-efficacy, negative mood, and emotional eating during the weight loss phase of baseline–Month 6, and significant (ps < .01) deteriorations during the weight-loss maintenance phase of Month 6–Month 24. During both phases, significant paths (95% CIs [-0.31, -0.01], [-0.14, -0.01], and [-0.50, -0.01]) from changes in self-regulation toward reduced negative mood were through self-efficacy, but not exercise change itself. The mood change-emotional eating change relationships were significant (95% CIs [0.16, 0.39] and [0.19, 0.48]). Although extensions of this research are required to better understand long-term obesity intervention processes, the present findings suggest importance of treatment foci on identified psychological mechanisms of exercise treatment-mood change relationships.

A Field Test Of Popular Chatbots’ Responses To Questions Concerning Negative Body Image, Ruopeng An, Christopher W. Byron Jr., Chen Chen, Xiaoling Xiang

Health Behavior Research

Background: Chatbots are computer programs, often built upon large artificial intelligence models, that employ dialogue systems to enable online, natural language conversations with users via text, speech, or both. Body image, broadly defined as a combination of thoughts and feelings about one’s physical appearance, has been implicated in many risk behaviors and health problems, especially among adolescents and young adults. Little is known about how chatbots respond to questions about body image.

Methods: This study assessed the responses of 14 widely-used chatbots (eight companion and six therapeutic chatbots) to ten body image-related questions developed upon validated instruments. Chatbots’ responses were …

Emotional Eating And Diet-Related Self-Efficacy, Motivation, And Norms In Adolescents, Tyler Mason, Rachel Dayag, Anna Dolgon-Krutolow, Kathy Lam, Diana Zhang, Vivienne Hazzard, Kathryn Smith

Health Behavior Research

The objective of the current study was to examine the association between emotional eating and self-efficacy, motivation, and social norms for consumption of fruits and vegetables (F/V) and energy-dense, nutrient-poor (EDNP) foods and beverages, as well as interactions with body mass index-z score (BMI-z). Adolescents completed self-report measures of demographics, emotional eating, and dietary health behavior theory constructs. Emotional eating was associated with lower self-efficacy for consumption of F/V and for limiting EDNP foods/beverages; greater motivation for limiting of EDNP foods/beverages; lower social norms for consumption of F/V; and greater social norms for consumption of EDNP foods/beverages. There were no …

A Descriptive Study Of Health Literacy And Social Determinants Of Health As Curricula Topics In Medical School Education, Nicholas J. Felter, Valerie A. Ubbes

Health Behavior Research

The purpose of this investigation was to assess the extent to which health literacy and social determinants of health exist together in medical school curricula, and the attitudes and beliefs of medical school educators toward the relevance of these topics taught in the curriculum. The research used a descriptive cross-sectional survey design of institutions that comprised the Accelerating Change in Medical Education (ACE) Consortium of the American Medical Association. The study population was 36 ACE institutions, but only 11 ACE institutions made up the study sample. Results also showed that five health literacy items were taught as curricula topics in …