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1.

Objective

To examine whether digital marketing strategies are more strongly associated with energy drink use than other marketing and whether Theory of Planned Behavior (TPB) constructs mediated the effects of digital marketing on energy drink use.

Design

A cross-sectional online survey using the TPB was administered in 2016.

Setting

Illawarra region of New South Wales, Australia.

Participants

A total of 359 young adults aged 18–24 years completed the survey. Participants were mainly students.

Main Outcome Measures

Relative impacts of digital and other marketing on energy drink use and the mediating effects of TPB constructs: attitudes, subjective norm, and perceived behavioral control.

Analysis

Stepwise regression analysis was employed to compare the effects on energy drink use from digital and other marketing. Mediation analysis was used to examine the mediating effects of the TPB constructs.

Results

Digital marketing was more strongly associated than other marketing with young adults’ energy drink use. Attitudes, subjective norms, and perceived behavioral control mediated the effects of digital marketing on energy drink use.

Conclusions and Implications

The marketing of unhealthy food and beverages such as energy drink products on the Internet requires greater scrutiny. Future interventions may focus on strategies to attenuate young adults’ attitudes toward energy drinks, denormalize energy drink use, and strengthening self-efficacy to reject energy drinks among this age group.  相似文献   

2.

Objectives

To gain insight into the current implementation of national guidelines on training, examination and registration of proficiencies for the safe use of medical devices and to explore the barriers and facilitators faced during the implementation of these national guidelines.

Methods

A questionnaire was sent to all Dutch hospitals and interviews were held with staff at six hospitals.

Results

There are differences between hospitals in the implementation stage, but also within hospitals. The questionnaire showed differences between training and examination for devices used by nurses and those used by medical specialists. The interviews showed that most barriers and facilitators for implementation of the national guidelines can be found in organizational factors.

Conclusions

According to the hospitals, implementation of national guidelines for the safe use of medical devices is a complex process that involves all departments. Furthermore, the staff do not always feel a sense of urgency to improve the safe use of medical devices. To facilitate implementation, more national guidance could be helpful.  相似文献   

3.

Objectives

After implementing a health system reform plan in Iran, Helicopter Emergency Medical Services (HEMS) have been developed to provide critical care for time-sensitive critical patients. The current study aimed to explore the challenges experienced in providing and developing helicopter emergency medical services in Iran.

Methods

A qualitative study was conducted by using a content analysis approach. Data were collected through interviews with 27 experienced persons.

Results

Four main challenges facing HEMS were explored including infrastructure deficiencies, safety concerns for staff, patients and public, insufficient resource management and the problems related to staff competencies.

Conclusions

Based on the results, the development program of Iranian helicopter emergency medical services should be revised. It seems that developing national standards and regulations is prerequisite to improving the quality of services. Considering the safety concerns and high cost of HEMS in Iran, it is suggested that more commitment is needed for triage criteria.  相似文献   

4.

Objective

Determination of feasibility of online nutrition education in the federal workplace.

Design

Pretest–posttest pilot study with data collection occurring from September to December, 2016.

Setting

Two US Department of Agriculture workplaces.

Participants

Convenience sample of 26 federal government employees. Posttest response rate was 85% (22 of 26 employees).

Intervention

A 12-week online nutrition education program designed and taught by registered dietitian nutritionists.

Variables Measured

Program component satisfaction, use, and understanding ratings and clinical measures including body composition, blood pressure, and skin carotenoid level (biomarker for fruit and vegetable intake).

Analysis

Paired t tests to determine whether significant changes occurred after the intervention.

Results

Mean number of class videos viewed and program components used were 7 and 5 (out of 12 for both). Mean program component ratings ranged from 4.0 to 4.7 (n?=?12, maximum score of 5) for the surveyitems motivated/helped me to eat healthier. Statistically significant decreases were observed in body mass index, percent body fat, and visceral fat level.

Conclusions and Implications

Online nutrition education in the federal workplace is feasible for some employees as evidenced by the program components’ high satisfaction and understanding ratings and high retention rate. Limited evidence was apparent for the intervention's positive impact on health outcomes.  相似文献   

5.
6.

Objective

This investigation sought to identify the physical activity (PA) terms and concepts that are best understood by low-income adults.

Design

This was a cross-sectional study using semistructured cognitive interviews that employed retrospective verbal probing techniques.

Setting

Interviews were conducted in Expanded Food and Nutrition Education Program (EFNEP) sites in New Jersey, Tennessee, and Washington.

Participants

A convenience sample of 57 adults participating in or eligible for participation in EFNEP.

Phenomenon of Interest

Participants’ interpretations and conceptualizations of PA concepts and terms.

Analysis

Template and constant comparative analysis.

Results

Participants interpreted many PA terms and concepts in unintended ways. Exercise was the term that came closest to conveying moderate to vigorous PA. Terms used to describe muscle-strengthening activities were mostly understood. Intentional engagement in extra activities was difficult for participants to conceptualize despite multiple tested wordings; making small changes to be active came closest to conveying this concept. Participants’ comprehension of the PA terms differed by their PA and literacy levels.

Conclusions and Implications

Nutrition educators should be mindful of the terminologies they used in communicating messages and assessing PA behaviors to EFNEP participants or similar populations.  相似文献   

7.

Objective

To develop and pilot-test Wellness Champions for Change (WCC) to enhance local wellness policy (LWP) implementation by forming wellness teams.

Design

Randomized, controlled school-level pilot study.

Setting

Five Maryland school districts.

Participants

A total of 63 elementary, middle, or high schools.

Intervention(s)

Developed from stakeholder interviews, focus groups, and existing programs. Schools were randomized within district to (1) WCC training (6-hour, single-day teacher training), (2) WCC training plus technical assistance (TA), or (3) delayed training (control).

Main Outcome Measure(s)

Online teacher/administrator survey pre-post (spring, 1 year apart) that examined the direct effect of the intervention on active wellness team formation (postintervention, 8-item sum score) and LWP implementation (29 items, not implemented to fully implemented)/indirect effect of intervention on LWP implementation via active wellness team formation.

Analysis

Adjusted linear or logistic regression and mediation modeling.

Results

Postintervention, WCC plus TA and WCC had more active wellness teams (vs control, β?=?1.49, P?=?.02 and β?=?1.42, P?=?.03, respectively). No direct effect of intervention on LWP implementation was found. Formation of active wellness teams mediated the association between both WCC plus TA and WCC and LWP implementation (WCC plus TA confidence interval [CI], 1.22–16.25; WCC CI, 10.98–15.61 [CI was significant without 0]).

Conclusions and Implications

The WCC intervention approaches indirectly affected LWP implementation through the formation of active wellness teams. These results support building and school-level wellness teams.  相似文献   

8.
9.
10.

Objective

To examine the role of parent concern in explaining nonresponsive feeding practices in response to child fussy eating in socioeconomically disadvantaged families.

Design

Mediation analysis of cross-sectional survey data.

Setting

Socioeconomically disadvantaged urban community in Queensland, Australia.

Participants

Cohabiting mother–father pairs (n?=?208) with children aged 2–5 years.

Main Outcome Measure(s)

Two validated measures of nonresponsive feeding: persuasive feeding and reward for eating.

Analysis

Mediation analysis tested concern as a mediator of the relationship between child food fussiness (independent variable) and parent nonresponsive feeding practices (dependent variables), adjusted for significant covariates and modeled separately for mothers and fathers.

Results

Maternal concern fully mediated the relationship between child food fussiness and persuasive feeding (indirect effect: B [SE]?=?0.10 [0.05]; 95% confidence interval [CI], 0.01–0.20). Concern also fully mediated the relationship between child food fussiness and reward for eating for mothers (indirect effect: B [SE]?=?0.17 [0.07]; CI, 0.04–0.31) and fathers (indirect effect: B [SE]?=?0.14 [0.05]; CI, 0.04–0.24)

Conclusions and Implications

Concern for fussy eating behaviors may explain mothers’ and fathers’ nonresponsive feeding practices. In addition to providing education and behavioral support, health professionals working with socioeconomically disadvantaged families can incorporate strategies that aim to alleviate parents’ concerns about fussy eating.  相似文献   

11.

Aims

This study analyzes public preferences for the adoption of personal genomic testing (PGT) to determine the important attributes for PGT adoption and to qualitatively compare their relative importance.

Methods

The best–worst scaling method is used for the analysis by using 13 attributes related to adoption of PGT. A web-based survey was conducted to collect data from 604 respondents in South Korea in November 2017.

Results

The results show that accuracy of test is the most important attribute with the following order of importance: accuracy of test > risk of disease > aim of test, insurance reimbursement/coverage, price, burden of disease, testable items > privacy protection > method of collecting sample, person explaining the results, medical intervention availability, test accessibility > time required for completing test.

Conclusions

From a consumer perspective, the findings suggest that it is important how PGT can accurately provide information on various high-risk, high-burden diseases, even though there are no known preventive or treatment measures. Further, the price of PGT is burdensome, and therefore, insurance coverage is important. If accurate and reliable information is provided, how to request PGT and who explains the result are not important.  相似文献   

12.

Background

Today, there is a clear understanding of what Brexit means in legal terms and how it involves the health-related issues but, there is no clear view as to how these issues can vary for different Brexit scenarios or how Brexit negotiations impact the citizens healthcare concerns.

Objective

In this study, we investigate the facts and issues surrounding Brexit options and their possible influences on healthcare issues from the public perspectives.

Methods

We designed two scenarios for controlled online experiments. We used Analysis of Variance to compare participants’ perceptions about the two Brexit scenarios (hard and soft). Data were collected from four countries (England, Scotland, Wales and Northern Ireland). Totally, 459 respondents participated in the two experiments.

Results

The findings show that there are significance differences in respondents’ perceptions of medical products and technologies, information management, service delivery, and healthcare leadership between two Brexit scenarios. Our results show that perception of health risks is significantly lower for soft Brexit scenario comparing to the hard Brexit. Soft Brexit perceived to be significantly more effective in improving medical technology accessibility, information management, service delivery, and healthcare leadership.

Conclusions

This work is among the first attempts to describe the way the British public feel about the possible Brexit options’ implications for healthcare. The significant difference between Brexit scenarios on medical products, information management, service delivery, and healthcare leadership indicates that the future EU–UK relations depend on how effectively the entire health community and policy systems in the UK address these challenges. The results of this study recommend guidelines for reshaping existing agreements or reaching new arrangements in the Brexit negotiations.  相似文献   

13.

Objective

To examine dietary intake differences resulting from a sugar-sweetened beverage reduction intervention by 3 Supplemental Nutrition Assistance Program (SNAP) participation groups: SNAP participants (n?=?56), income-eligible nonparticipants (n?=?30), and income-ineligible nonparticipants (n?=?60).

Methods

Adults in southwest Virginia were enrolled in a 6-month behavioral trial. The researchers collected SNAP enrollment status and 3 24-hour dietary recalls at baseline and 6 months. Repeated-measures ANOVAs were used to assess differences in dietary intake among SNAP participation groups.

Results

No significant group?×?time differences were found for energy density, Healthy Eating Index scores, Healthy Beverage Index scores, or intake of total calories, added sugars, and sugar-sweetened beverages. However, several within-group improvements were noted: income-ineligible nonparticipants and SNAP participants improved in more areas compared with income-eligible nonparticipants, including intake of total calories, added sugars, and sugar-sweetened beverages.

Conclusions and Implications

This exploratory analysis suggests that the overall effectiveness of a sugar-sweetened beverage intake reduction intervention was not influenced by SNAP eligibility and participation status, because there were no significant group by time differences over the intervention. It is important to recognize for future programs that different approaches to improving dietary intake may be needed to match the characteristics of this audience better. This may be accomplished by attempting to decrease the disparity gap between income-eligible nonparticipants and those receiving SNAP or who are income ineligible through the use of programs such as SIPsmartER.  相似文献   

14.

Objectives

The Canadian healthcare system is caught in a perpetual cycle of pilot projects which precludes the spread of innovative projects. Social franchising is a governance and operating model used to support the scaling of certain types of social initiatives. This paper presents an overview of social franchising, discusses its applicability to HIT innovations, and proposes a framework based on this model for the Champlain BASE? eConsultation program.

Methodology

A literature review on social franchising was performed to evaluate this model in non-healthcare and healthcare realms. A search was performed in electronic databases to identify peer-reviewed articles. Grey literature was also used to inform this review.

Results

Social franchising has been embraced internationally in healthcare and non-healthcare environments. Peer-reviewed articles related to social franchising and healthcare focused on patient outcomes in family planning and reproductive programs in low- and middle-income countries. Evidence related to developed and high-income countries was scarce, which may be attributed to the newness of this model. Evidence shows the model's ability to rapidly spread programs without sacrificing quality. A National BASETM model using social franchising is proposed for the Champlain BASE? program, which represents a recently developed eConsultation project with potential to address the challenges related to access to specialists.

Conclusion

Social franchising is the fastest growing healthcare approach in low- and middle-income countries. High-income countries (e.g. UK, Germany) are beginning to experiment with the model. The Canadian healthcare system should consider the model as a viable framework to scale and spread innovative HIT programs.  相似文献   

15.

Objective

To investigate (1) how perceived parental control, perceived parental modeling, and parent–teen co–decision making are associated with teenagers’ consumption of fruits and vegetables as well as sugary drinks and less healthful food; and (2) whether self-efficacy mediates this relationship.

Design

Cross-sectional survey.

Participants

A total of 1,657 adolescents aged 12–17years.

Main Outcome Measure(s)

Perceived parental control, perceived parental modeling, parent–teen co–decision making, self-efficacy, and consumption of fruits and vegetables as well as sugary drinks and less healthful food.

Analysis

Ordinary least-squares regressions and mediation analyses.

Results

After controlling for teenagers’ self-efficacy, perceived parental control was not significantly associated with teenagers’ fruit and vegetable consumption but it was negatively related to teenagers’ consumption of sugary drinks and less nutrient-dense food. Perceived parental modeling had a positive correlation to teenagers’ fruit and vegetable consumption and a negative relationship to their consumption of sugary drinks and less healthful food. Parent–teen co–decision making regarding teenagers’ food consumption emerged as a positive predictor for teenagers’ fruit and vegetable consumption but not for that of sugary drinks and foods with little nutritional value after controlling for self-efficacy.

Conclusions and Implications

Findings from this study demonstrated that perceived parental behaviors were related to teenagers’ nutrition intakes. Not exerting too much control and having teenagers participate in the decision-making process could help teenagers eat more healthily. Furthermore, providing a positive role model for teenagers can be an effective strategy to encourage teenagers to eat better.  相似文献   

16.

Objective

To determine the interrater reliability of the Preschool Movement Assessment (PMA), a unique field-based assessment tool for use by early childhood professionals in preschool settings.

Methods

A total of 123 preschool children, aged 3–5years, were assessed by 6 trained raters using the PMA tool in an intervention. Interrater agreement on individual items of the PMA was determined using the kappa (κ) and intraclass correlation coefficient statistics.

Results

Weighted κ values were 0.82–0.96, indicating excellent agreement for all constructs of the PMA. The 95% confidence intervals indicated that all weighted κ’s were statistically significant. The intraclass correlation coefficient for the PMA total score was 0.97.

Conclusions and Implications

After additional developmental research, the tool might serve to establish and support a minimum level of functional movements that should be attained before a child enters grade school.  相似文献   

17.

Objective

To examine the associations among acculturation, food environment, and food insecurity among Puerto Ricans in Boston.

Methods

The researchers used data from the second wave of the Boston Puerto Rican Health Study. The sample included 719 Puerto Rican adults in Boston. The researchers used logistic regression to examine the associations between psychological and language acculturation and food insecurity.

Results

Individuals with medium psychological acculturation were more likely to be food insecure than were those with low or high psychological acculturation (P = .01). The association between language acculturation and food insecurity differed by distance of residence from primary shopping location (P = .02).

Conclusions and Implications

This study extends the understanding of acculturation and food insecurity by investigating the impact of psychological and language acculturation. The findings highlight biculturalism, indicated by medium psychological acculturation, as a risk factor for food insecurity. People with low language acculturation who live far from food shopping locations had the highest prevalence of food insecurity.  相似文献   

18.

Objective

The purpose of this study was to identify which consumer characteristics influence their intention to use direct-to-consumer genetic testing (DTC-GT).

Methods

This study conducted a survey to obtain data pertaining to consumer characteristics and their intention to use DTC-GT and then analyzed the survey results econometrically. The consumer survey was conducted in August 2016 and included 2400 respondents residing in Korea, aged 20 to 59. This study used a binary probit model to investigate how consumer characteristics affect the intention to use DTC-GT.

Results

Respondents with knowledge of DTC-GT, a higher level of education, greater interest in healthcare management, greater familiarity with new technology, a higher income level, and a younger age exhibited greater intention to use DTC-GT. Marital status and gender were not determinants of intention to use DTC-GT.

Conclusions

Consumer characteristics are important factors affecting DTC-GT adoption; however, the effects differ depending on the characteristics.  相似文献   

19.

Objectives

This research focuses on assessing the potential technology adoption of medical devices particular to tracking the mobility of neurosurgery and orthopedics patients. Wearable medical devices that track the mobility of patients after spinal procedures could help surgeons to provide post-operative care, analysis of treatment outcomes, and patient mobility.

Methods

The assessment of medical devices by physicians is a complex process associated with various criteria and sub criteria. The hierarchical decision model (HDM) is used to break down the problem into hierarchical levels, and alternatives are calculated by using pairwise comparison scales and the judgment quantification technique. Inconsistencies, disagreement, sensitivity, and scenario analysis are performed as well. HDM research software is created by Ruby and R Studio.

Results

Patient perspective dominates in the main criteria for technology adoption potential of wearable devices for pervasive care in neurosurgery and orthopedics, followed by technical and financial criteria. The Valedo – wearable device, which aims to relieve back pain through exercises, motivation, and mobility tracking, received the highest ranking for adoption potential, while other devices also received high relative scores.

Conclusions

The framework could serve as a supplementary technology assessment tool, and could be tested in other settings: private clinics, small clinics etc. by taking into account the experts and special needs of the physicians in particular healthcare departments.  相似文献   

20.

Objective

To investigate how acculturation and poverty are independently and jointly associated with the use of the Nutrition Facts panel (nutrition label) and to examine the extent to which nutrition label use moderates the association of poverty and acculturation on dietary quality among Latinos.

Design

Cross-sectional analysis of the 2007/2008 and 2009/2010 waves of the National Health and Nutrition Examination Survey.

Participants

A total of 3,696 adults (aged >19 years) self-identified as Latino/Hispanic with food label use data from the most recent Consumer Behavior Phone Follow-Up Modules.

Main Outcome Measure(s)

Nutrition label use and dietary quality.

Analysis

Logistic regression.

Results

Acculturation moderated the association of income on the likelihood of using nutrition labels, such that lower-income English-speaking Latinos were half as likely as higher-income English-speakers to use nutrition labels (P?=?.01, odds ratio [OR]?=?0.44, 95% confidence interval [CI], 0.24–0.81); however, Spanish speakers were equally likely to use nutrition labels across income levels (P?=?.99; OR?=?1.00; 95% CI, 0.77–1.31). Nutrition label use moderated the association of acculturation on diet. Among English-speaking Latinos, those who read nutrition labels had less than half the risk for poor diet (P =.001; OR?=?0.43; 95% CI, 0.26–0.69); however, label use was not significantly associated with the diet quality of Spanish speakers (P?=?.07; OR?=?0.82; 95% CI, 0.67–1.02). Nutrition label use decreased the risk for poor dietary quality regardless of poverty status.

Conclusions and Implications

Overall, results demonstrated a positive association between the use of the Nutrition Facts panel for Latinos and dietary quality. An important nutrition education strategy among bicultural Latinos at risk for a poor diet as a result of acculturation may include label reading comprehension. This approach may also address the low rates of label use. The study provides evidence of segmented assimilation in which low-income, bicultural Latinos follow an underclass pattern of acculturation demonstrated by a lower likelihood of reading nutrition labels and higher-income, bicultural Latinos follow the more successful selective pattern.  相似文献   

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