Web-based oral health promotion program for older adults: Development and preliminary evaluation

ObjectiveThis study reports on the impact evaluation of a Web-based oral health promotion programme aimed at improving the oral health knowledge, attitudes, practices and self-efficacy of independent-living older adults from Melbourne, Australia.MethodsWith ethics approval from the University of Melbourne, a convenience sample of volunteers 55 years or older was invited to participate in a study to test a web-based oral health promotion program. Consenting volunteers were asked to undergo a structured interview as part of the pre-intervention data collection. The intervention was based on the ORHIS (Oral Health Information Seminars/Sheets) Model and involved computer interaction with six oral health presentations, with no direct oral health professional input. A one group pre-test–post-test quasi-experimental design was chosen to evaluate the intervention. A series of paired t-tests were used to compare pre-test with post-test results.ResultsForty-seven active, independent-living older adults participated in this evaluation. After the intervention participants responded with higher levels of achievement than before participating in this Web-based oral health program. Participants showed significant improvements in oral health attitudes (4.10 vs. 4.94; p < 0.01), knowledge (18.37 vs. 23.83; p < 0.0001), and self-efficacy (84.37 vs.89.23; p < 0.01), as well as, self-reported oral hygiene practices (i.e., frequency of use of dental floss) (p < 0.05).ConclusionThe e-ORHIS approach was successful in improving oral health knowledge, attitudes and self-efficacy. As such, it represents a helpful approach for the design of (oral) health interventions in older adults. Further evaluation with a larger sample is required to test the long-term impact including the economic evaluation of the e-ORHIS approach.     

Using path analysis to model the process of change in HbA1c among African Americans and Latinos in a community health worker diabetes intervention

ObjectiveTo examine which components of a culturally tailored community health worker (CHW) intervention improved glycemic control and intermediate outcomes among Latina/o and African American participants with diabetes.MethodsThe sample included 326 African American and Latina/o adults with type 2 diabetes in Detroit, MI. CHWs provided interactive group diabetes self-management classes and home visits, and accompanied clients to a clinic visit during the 6-month intervention period. We used path analysis to model the processes by which each intervention component affected change in diabetes self-efficacy, diabetes-related distress, knowledge of diabetes management, and HbA1c.ResultsThe group-based healthy lifestyle component was significantly associated with improved knowledge. The group-based self-management section was significantly associated with reduced diabetes-related distress. Intervention class attendance was positively associated with self-efficacy. Diabetes self-management mediated the reductions in HbA1c associated with reductions in diabetes distress.ConclusionsPath analysis allowed each potential pathway of change in the intervention to be simultaneously analyzed to identify which aspects of the CHW intervention contributed to changes in diabetes-related behaviors and outcomes among African Americans and Latinas/os.Practice Implications: Findings reinforce the importance of interactive group sessions in efforts to improve diabetes management and outcomes among Latina/o and African American adults with diabetes.     

What do community-dwelling older adults with chronic pain value in a program of combined pain neuroscience education plus exercise?

ObjectiveTo explore the experience of older adults after a pain neuroscience education (PNE) and exercise intervention.MethodsFocus group interviews were conducted with 14 older adults after receiving 8-weekly sessions of PNE and exercise and encompassed older adults’ perceptions of the intervention and its impact. Interviews were transcribed verbatim and analyzed by 3 researchers using thematic analysis in a five-step approach (compiling, disassembling, reassembling, interpreting, and concluding).ResultsThree themes emerged: pain reconceptualization, motivational factors, and perceived improvements. Pain reconceptualization was illustrated by participants’ ability to use language that related to PNE concepts (n = 12), increased self-efficacy (n = 5), and adjusted emotions (n = 2) and behaviors (n = 6). Motivational factors were the group-administered intervention (n = 6) and the physical therapists’ communication skills (n = 10). The intervention was perceived as having a positive impact on sleep (n = 3), well-being (n = 6), and activity/ability to perform activities (n = 8).ConclusionOlder adults understand PNE concepts and reconceptualize pain. PNE and exercise were perceived as having a positive impact on day-to-day life.Practice ImplicationsMode of administration, communication skills, and rapport are aspects of the intervention that are valued by older adults. Also, PNE might be used as a strategy to increase older adults’ adherence to physical activity.     

Asthma,COPD, and home environments: Interventions with older adults

BackgroundWe describe a multifaceted home environmental intervention project involving low-income older adults with asthma who have a greater risk of asthma-related respiratory impacts because they spend up to 90% of their time in the home where many allergens and respiratory irritants are found. Although sufficient evidence suggests that home interventions are effective in improving health of children with asthma, the Task Force on Community Preventive Services has stated that evidence is insufficient for the effectiveness of home interventions on adults with asthma.ObjectiveTo evaluate the hypothesis that multifaceted home environmental interventions improve the respiratory health and reduce asthma triggers for older adults with asthma.MethodsWe conducted community health worker–led interventions in the homes of 86 low-income older adults (age 62 or older) diagnosed with asthma, residing in public and private subsidized housing in Lowell, Massachusetts, from 2014 to 2017. Health and environmental assessment at baseline and follow-up 1 year later included collecting data on respiratory health, quality of life, medication use, doctor/emergency room/hospital visits, using the St. George Respiratory Questionnaire and Asthma Control Test and evaluation of asthma trigger activities and exposures through questionnaires and home surveys. Interventions included education on asthma and environmental triggers and environmental remediation.ResultsStatistically significant reductions in self-reported environmental asthma triggers and health improvements were found in the following areas: doctor visits, use of antibiotics for chest problems, respiratory symptoms and quality of life indicators, and asthma control (ACT score).ConclusionOur results provide evidence that multifaceted home interventions are effective in improving the environmental quality and respiratory health of an older adult population with asthma.     

The effects of an integrated health education and exercise program in community-dwelling older adults with hypertension: A randomized controlled trial

Objective

The aim of this study was to examine the effectiveness of HAHA (Healthy Aging and Happy Aging) program, which is an integrated health education and exercise program for community-dwelling older adults with hypertension. Methods: Older adults with hypertension from one senior center were randomly allocated to experimental (n = 18) or control group (n = 22). Experimental group received health education, individual counseling and tailored exercise program for 12 weeks. Results: The mean ages were 71 years (experimental group) and 69 (control group). After the intervention, systolic blood pressure of experimental group was significantly decreased than that of control group. Scores of exercise self-efficacy, general health, vitality, social functioning, and mental health in SF-36 were statistically higher than those of control group. Conclusion: The HAHA program was effective in control of systolic blood pressure and improving self-efficacy for exercise and health-related quality of life.     

The effects of Lavender and Chamomile essential oil inhalation aromatherapy on depression,anxiety and stress in older community-dwelling people: A randomized controlled trial

BackgroundConsidering the prevalence of mental health problems in older adults, this study aims to investigate the effect of inhalation aromatherapy using lavender and chamomile essential oils on depression, anxiety, and stress of community-dwelling older people.MethodsA three-armed, parallel, randomized, and controlled trial design was used in this study. 183 participants were enrolled and randomly assigned to three groups (n = 61): the lavender, chamomile, and control groups. The participants in the experimental groups inhaled three drops of 1.5% lavender and chamomile essential oils for 30 nights. The participants in the control group inhaled only distilled water in a similar fashion. Data were collected using the Depression, Anxiety, and Stress-Scale (DASS) at baseline, immediately after the intervention, and one month after the intervention. Chi-square, Fisher's exact, one-way ANOVA, and repeated measures ANOVA were used for data analysis.ResultsStatistically significant improvement occurred in depression, anxiety, and stress levels immediately and one month after the intervention in lavender and chamomile groups compared to the control group (p < 0.01).ConclusionInhalation aromatherapy with both lavender and chamomile essential oils helped decrease depression, anxiety, and stress levels in community-dwelling older adults.     

Effectiveness and acceptability of a text message intervention (DTEXT) on HbA1c and self-management for people with type 2 diabetes. A randomized controlled trial

ObjectiveDetermine the effectiveness and acceptability of a text message intervention (DTEXT) on HbA1c and self-management behaviors for Australian adults with type 2 diabetes.MethodsUsing intention to treat analysis and generalized estimating equations, this randomized controlled trial of 395 adults determined change in HbA1c at 3 and 6 months between the intervention and control group. Secondary outcomes included change in nutrition, physical activity, blood lipid profile, body mass index, quality of life, self-efficacy, medication taking and program acceptability.ResultsNo significant difference was observed between the intervention or control group for HbA1c at 3 months (P = 0.23) or 6 months (P = 0.22). Significant improvements were seen in consumption of vegetables at 3 months (P < 0.001) and 6 months (P = 0.04); fruit at 3 months (P = 0.046) and discretionary sweet foods at 3 months (P = 0.02). No other significant effects seen. The intervention demonstrated high rates of acceptability (94.0%) and minimal withdrawal (1.5%).ConclusionsDTEXT was an acceptable text message intervention that improved some nutritional behaviors in people with type 2 diabetes, but did not significantly improve HbA1c or other outcomes. Further research is required to optimize DTEXT.Practice implicationsDTEXT provides an acceptable, feasible form of self-management support that may complement existing diabetes care.     

Barriers and enablers of older adults initiating a deprescribing conversation

ObjectiveTo examine older adults’ perceptions and identify barriers and enablers to initiating a conversation about stopping medication(s) with their healthcare provider.MethodsWe conducted one focus group (n = 3) and in-depth, face-to-face, individual interviews (n = 6) using an interview guide. Older adults aged ≥65 years in a retirement community who were taking ≥5 medications were recruited. Focus groups and interviews were audio-recorded and transcribed verbatim. Both a deductive analysis, informed by the Theoretical Domains Framework, and an inductive analysis were conducted.ResultsFive themes and fourteen sub-themes were identified. Theme 1, ‘older adult-related barriers’, discusses limited or varying self-efficacy, past unsuccessful deprescribing experiences and limited familiarity with medications/deprescribing. Theme 2, ‘provider-related barriers’, discusses trust, short office visits, lack of communication and multiple providers. Theme 3, ‘environmental/social-related barriers’, involves limited availability of resources and access to telehealth/internet. The remaining themes (Themes 4–5) identified enablers including strategies to promote older adults’ self-efficacy and improved healthcare communication.ConclusionConsumer-centric tools could improve older adults’ self-efficacy to initiate deprescribing conversations.Practice ImplicationsRemoving barriers and implementing enablers may empower older adults to initiate deprescribing conversations with providers to take fewer medications. Ultimately, this could be a catalyst for increased translation of deprescribing in practice.     

Associations between loneliness and physical frailty in community-dwelling older adults: A systematic review and meta-analysis

ObjectivesOlder adults may be at increased risk of loneliness. Frailty is also common in older adults, however, associations between loneliness and frailty have been understudied. This systematic review and meta-analysis aimed to explore evidence on how loneliness and frailty are correlated.MethodsA systematic search of the literature was conducted using 4 electronic databases in February 2022 for any studies published in 2000 or later that provided cross-sectional or longitudinal associations between loneliness and physical frailty in community-dwelling older adults. A meta-analysis was attempted to combine data when possible.ResultsFrom 1386 studies identified by the initial search, 16 studies were included for this review. Standardized mean difference (SMD) meta-analysis based on mean loneliness score across 3 frailty groups provided by 6 cross-sectional studies showed that worse frailty status was significantly associated with a higher degree of loneliness (SMD between frail and robust, frail and prefrail, and prefrail and robust were 0.77 (95% confidence interval (CI)= 0.57–0.96), 0.37 (95%CI=0.25–0.50), and 0.30 (95%CI=0.20–0.40), respectively.) Meta-analyses combining cross-sectional data from 6 studies revealed that frailty was significantly associated with a higher risk of loneliness compared with robustness (3 studies: pooled OR=3.51, 95%CI=2.70–4.56 for frailty, pooled OR=1.88, 95%CI=1.57–2.25 for prefrailty) and compared with non-frailty (4 studies: pooled OR=2.05, 95%CI=1.76–2.39). A meta-analysis involving two longitudinal studies showed that baseline loneliness was associated with a significantly higher risk of worsening frailty (2 studies: pooled OR=1.41, 95%CI=1.16–1.72).ConclusionsThis systematic review and meta-analysis was the first, to our knowledge, to quantitatively demonstrate significant cross-sectional and longitudinal associations between loneliness and frailty in community-dwelling older adults.     

Nurse-led health coaching programme to improve hospital-to-home transitional care for stroke survivors: A randomised controlled trial

ObjectiveTo evaluate the effects of a nurse-led health coaching programme for stroke survivors and family caregivers in hospital-to-home transition care.MethodsA total of 140 dyads of stroke survivors and their family caregivers were recruited and randomly assigned to either the intervention group (received a 12-week nurse-led health coaching programme) or the usual care group. The primary outcome was self-efficacy, and secondary outcomes were quality of life (QoL), stroke-related knowledge, and caregiver-related burden. The outcomes were measured at baseline, 12 and 24 weeks.ResultsStroke survivors in the intervention group demonstrated a significant improvement in self-efficacy at 12 weeks (x?: 24.9, 95%CI: 20.2–29.6, p < 0.001) and at 24 weeks (x?: 23.9, 95%CI: 19.2–28.6, p < 0.001) compared to the usual care group. Findings also demonstrated significant increases in stroke survivors’ QoL, stroke-related knowledge, and reduction in unplanned hospital readmissions and caregiver-related burden. There were no statistically significant changes in other outcomes between the two groups.ConclusionThe nurse-led health coaching programme improved health outcomes for both stroke survivors and their caregivers.Practice ImpactionFindings from the study suggest that nurse-led health coaching should be incorporated into routine practice in hospital-to-home transitional care for stroke survivors and their caregivers.     

Correlates of functional fitness in older adults

Background: Self-efficacy has been shown to be both an antecedent and determinant of behaviors such as physical activity and may explain variance in the performance of functional tasks among older adults.Purpose: The objectives of the current study were: first, to identify potential latent factors of functional fitness (i.e., the ability to perform activities of daily living) among older adults; and second, to determine the extent to which self-efficacy contributed to the variance in functional fitness over and above other known correlates.Methods: Older adults (n = 190, M age = 69.4 years) completed a functional fitness test battery, maximal graded exercise test, and demographics and self-efficacy questionnaires.Results: Structural equation modeling supported two latent factors of functional fitness representing “Flexibility” and “Physical Power.” Further analyses indicated sex as the sole significant correlate of Flexibility. Greater Physical Power was associated with being male, younger, and having higher self-efficacy.Conclusions: These results support the role of self-efficacy as a correlate of performance on functional tasks. Targeting flexibility and physical power to improve functional fitness among older men and women, respectively, warrants examination. This study was funded by grants from the National Institute on Aging (#AG-12113, #AG-18008) and the Institute for the Study of Aging (#2000035).     

More than just tracking time: Complex measures of user engagement with an internet-based health promotion intervention

BackgroundThere has been a rise in internet-based health interventions without a concomitant focus on new methods to measure user engagement and its effect on outcomes. We describe current user tracking methods for internet-based health interventions and offer suggestions for improvement based on the design and pilot testing of healthMpowerment.org (HMP).MethodsHMP is a multi-component online intervention for young Black men and transgender women who have sex with men (YBMSM/TW) to reduce risky sexual behaviors, promote healthy living and build social support. The intervention is non-directive, incorporates interactive features, and utilizes a point-based reward system. Fifteen YBMSM/TW (age 20–30) participated in a one-month pilot study to test the usability and efficacy of HMP. Engagement with the intervention was tracked using a customized data capture system and validated with Google Analytics. Usage was measured in time spent (total and across sections) and points earned.ResultsAverage total time spent on HMP was five hours per person (range 0–13). Total time spent was correlated with total points earned and overall site satisfaction.ConclusionMeasuring engagement in internet-based interventions is crucial to determining efficacy. Multiple methods of tracking helped derive more comprehensive user profiles. Results highlighted the limitations of measures to capture user activity and the elusiveness of the concept of engagement.     

Psychological effects and mediators of a group multi-component program for breast cancer survivors

This study evaluated the short-term impact of YWCA Encore, a mixed-modality group exercise and information support program for breast cancer patients situated in the community setting. Australian post-surgical breast cancer patients (N = 162) were assigned to either the 8-week Encore intervention or a Waitlist control. Intervention impact was assessed in terms of quality of life, cancer-specific distress, and social support. Changes in familiarity with exercise, self-efficacy and social support were tested as mediators of the intervention impact on quality of life. Overall adherence and satisfaction with the program were high. Significant enhancements at follow-up for quality of life and social support were evident for intervention compared with control participants. Familiarity with exercise and self-efficacy satisfied the requirements for mediation of quality of life. These findings provide evidence for psychosocial benefits of YWCA Encore multi-component program and support the use of such community-based programs for breast cancer survivors. The role of exercise familiarity and self-efficacy as probable mediators of the multi-component intervention is a critical finding and highlights the need for future investigations into the underlying mediating processes of similar interventions for cancer patients.     

Effects of a parenting sexual education program for immigrant parents: A cluster randomized trial

ObjectivesThe aim was to assess the effects of a parental sex education program on knowledge, attitudes, self-efficacy, and practices among immigrant parents.MethodsA cluster randomized trial was conducted at immigrant activity centers in northern Taiwan. Recruited participants were randomly assigned to an experimental (four centers, n = 86) or control (four centers, n = 67) group. A practical booklet and a booster session were delivered. In total, 132 participants’ knowledge, attitudes, self-efficacy, and practice of parenting sexual education were examined at the baseline and 6 weeks after the intervention.ResultsAfter controlling for possible confounders, the posttest scores of self-efficacy of the experimental group were higher than those of the control group. The Johnson-Neyman procedure indicated that the intervention was effective for participants who had pretest knowledge, attitude, and practice scores of <14.62, <110.27, and <41.5, respectively.ConclusionsAn intervention with both practical booklet and booster session can improve knowledge, attitudes, self-efficacy and practices of parental sex education among immigrant parents.Practice implicationsIn addition to practical booklets, health care professionals should provide booster sessions that meet the needs of immigrant parents to prevent sexual problems among children and adolescents at an early age.     

Effects of a HAPA-based multicomponent intervention to improve self-management precursors of older adults with tuberculosis: A community-based randomised controlled trial

ObjectiveTo evaluate the effectiveness of a multicomponent intervention based on the Health Action Process Approach (HAPA) model to improve the self-management precursors of older adults with tuberculosis (TB).MethodsA cluster-randomised controlled trial was conducted. Older adults with TB in the intervention communities received HAPA-based multicomponent interventions at the beginning of treatment and in the first and sixth months after treatment initiation, and those in the control communities received health education alone. Self-management precursors were measured at baseline and 1 week after each intervention.ResultsAmong 262 randomized patients, 244 (93%) completed the trial. Compared with the control group, self-management precursor scores for the intervention group increased significantly over time (β_group*time = 2.92, p < 0.001) in the following 3 precursors: behaviour belief (β_group*time = 0.35, p < 0.001), behaviour plan (β_group*time = 0.72, p < 0.001), and self-efficacy (β_group*time = 1.85, p < 0.001). Education was significantly associated with behaviour belief (β = 0.18, p < 0.05). Chronic comorbidity was significantly associated with behaviour plan (β=−0.26, p < 0.05).ConclusionCompared with single health education, the HAPA-based multicomponent interventions significantly improved the self-management precursor of older adults with TB.Practice implicationsThis HAPA-based multicomponent intervention strategy may be a promising self-management mode for the routine health care of TB patients.     

The use of medical care and the prevalence of serious illness in an adult Prader–Willi syndrome cohort

IntroductionAdults with Prader–Willi syndrome (PWS) have an increased occurrence of several medical conditions. We report on the consequences of high morbidity rates such as prevalence rate of hospital admissions, medication use and surgery in a Dutch cohort of adults with PWS. Special attention is paid to causes and symptoms of serious illness.MethodParticipants were contacted via the Dutch Prader–Willi Parent Association and through physicians specializing in persons with ID. The persons with PWS and their main caregivers were visited at home. Information was collected through semi-structured interviews on 102 adults with PWS.ResultsThe need for medical care in the neonatal period is associated with hypotonia and feeding problems. Hospital admissions for respiratory tract infections are frequent. During childhood most hospital admissions were due to PWS syndrome specific surgery. During adolescence hospital admissions occurred for scoliosis surgery and endocrine evaluations. At adult age, hospitalization was associated with inguinal hernia surgery, diabetes mellitus, psychosis, erysipelas, water and drug intoxications. In the older group, respiratory infections were again the main reason for hospital admissions. Frequently used medications at adult age included psychotropics, laxatives, anti-diabetics and dermatologic preparations. Abnormal drinking patterns, problems with anesthesia, decreased ability to vomit, abnormal pain awareness and unpredictable fever responses were frequent and often lead to delayed diagnoses of serious conditions.DiscussionPeople with PWS are frequent users of medical-care. Reasons for hospitalization and medication use are age specific. Knowledge on the different presentation of symptoms in people with PWS is needed. In case of unexplained illness, disturbances of consciousness and behavioral changes in people with PWS, an infection should be ruled out in the first place. Information from this study may help in preventing conditions and recognizing conditions in an early stage. Adequate preventive management and treatment of PWS related morbidity, could reduce medical care use in the long term and could improve quality adjusted life years.     

Instrumented measures of sedentary behaviour and physical activity are associated with mortality in community-dwelling older adults: A systematic review,meta-analysis and meta-regression analysis

BackgroundSedentary behaviour (SB) and physical activity (PA) can be objectively assessed with inertial sensors to describe bodily movement. Higher SB and lower PA is associated with higher chronological age and negative health outcomes. This study aimed to quantify the association between instrumented measures of SB (i-SB) and PA (i-PA) and mortality in community-dwelling older adults, to subsequently compare the quantitative effect sizes and to determine the dose-response relationships.MethodsAn electronic search in six databases from inception to 27th of June 2019 was conducted. All articles reporting on i-SB or i-PA and mortality in community-dwelling older adults aged 60 years or older were considered eligible. A meta-analysis was conducted for the association between i-SB and i-PA and mortality expressed in Hazard Ratios (HR) and 95% Confidence Intervals (95% CI). A meta-regression analysis was performed to determine the dose-response relationship between i-SB and steps per day and mortality.ResultsTwelve prospective articles representing eleven cohorts, reporting data of 38,141 participants were included. In total 2502 (6.4%) participants died during follow-up (2.0 to 9.8 years). Comparing the most sedentary with the least sedentary groups of participants resulted in a pooled HR of 2.44 (95% CI 1.82–3.25). Comparing the least active with the most active groups of participants resulted in a pooled HR of 1.93 (95% CI 1.39-2.69); 2.66 (95% CI 2.11–3.35); 3.43 (95% CI 2.61–4.52), and 3.09 (95% CI 2.33–4.11) for light, moderate-to-vigorous-, total PA and steps per day, respectively. Meta-regression analyses showed clear dose-response relationships between i-SB and steps per day and mortality risk.ConclusionBoth i-SB and i-PA are significantly associated with mortality in community-dwelling older adults, showing the largest effect size for total physical activity. Dose-response relationships could be observed for i-SB and steps per day.     

Making the Most of Your Healthcare intervention for older adults with multiple chronic illnesses

Objective

This study tested the efficacy of a patient engagement intervention for older adults with multiple chronic illnesses.

Methods

Seventy-nine participants were randomly assigned to receive the intervention (Intervention Group), contacts on a different topic (Safety Group), or Usual Care. The Intervention and Safety Groups attended a 2-h workshop and participated in phone calls; one before and one after a naturally-occurring medical encounter. The Intervention Group discussed patient engagement concepts from publicly distributed content. The Safety Group discussed general safety (e.g., fire safety, identity theft). Self-report measures were gathered by telephone interview at Baseline and 6-months following Baseline.

Results

We did not find expected improvements in patient activation and health-related quality of life. However, the Intervention Group was the only group to show a statistically significant improvement in self-efficacy for self-management.

Conclusion

The intervention shows promise for improving quality of life and/or health, but requires refinement to reach persons not already engaged in their healthcare and to strengthen its effects.

Practice implications

Patient-directed skills training interventions may be a successful way to support clinicians’ and others’ efforts to encourage older patients to be actively involved in their care.     

Sun protective behaviors among adolescents and young adults in the United States

PurposeWe described sun protective behaviors in adolescents and young adults (AYA) compared to older adults.MethodsWe used data from the 2013–2018 National Health and Nutrition Examination Survey, a nationally representative samples of the civilian, noninstitutionalized US population (10,710 respondents aged between 20 and 59 and without a history of skin cancer diagnoses). The primary exposure for the study was age group: aged 20–39 defined as AYA and aged 40–59 as adults. The outcome variable was sun protective behaviors: stay in the shade, wear a long-sleeved shirt, use sunscreen, at least one of the three; and all three measures. Multivariable logistic regression models were used to assess association between age group and sun protective behaviors adjusting for sociodemographic factors.ResultsOverall, 51.3% of respondents were AYA, 76.1% reported staying in the shade, 50.9% using sunscreen, 33.3% wearing long-sleeved clothes, 88.1% engaging in one of the three behaviors, and 17.1% engaging in all three behaviors. In the adjusted models, the odds of engaging in all three behaviors among AYAs was 28% (aOR: 0.72, 95% CI: 0.62–0.83) lower than adult respondents. Compared to adults, AYAs were 22% less likely to wear long sleeved clothes (aOR: 0.78, 95% CI: 0.70–0.87). There were no significant differences in the odds of engaging in at least one sun protective behavior, using sunscreen, and staying in the shade between AYAs and adults.ConclusionsMore targeted interventions need to be implemented to decrease the risk of skin cancer in the AYA population.