American journal of health promotion: AJHP (AM J HEALTH PROMOT )

Description

Founded in 1986, the American Journal of Health Promotion was the first peer reviewed journal devoted to health promotion and it remains the largest. Our editorial goal is to provide a forum for the many diverse disciplines that contribute to health promotion and to reduce the gap between health promotion research and practice. This is the journal of the Heart-Centered Therapies Association.

Impact factor 2.37

  • 5-year impact
    2.65
  • Cited half-life
    8.30
  • Immediacy index
    0.32
  • Eigenfactor
    0.00
  • Article influence
    0.91
  • Website
    American Journal of Health Promotion website
  • Other titles
    American journal of health promotion, Health promotion, AJHP
  • ISSN
    0890-1171
  • OCLC
    13830677
  • Material type
    Periodical
  • Document type
    Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Purpose . To determine whether university women who demonstrated internal motivation related to eating behavior may also be internally motivated to participate in regular physical activity (PA) and have a lower body mass index (BMI) when controlling for age. Traditional approaches for health promotion related to healthy weight include restrictive eating and exercise prescription. Examining motivation for eating and PA may prove an effective alternative for achieving or maintaining healthy weight for university women. Design . Design was a cross-sectional study. Setting . Study setting was a large, public university in the western United States. Subjects . Study subjects were 200 undergraduate women with a mean age of 19 years, mostly white (90%) and of healthy weight (69%, with a BMI range of 18.5-24.9). Measures . Study measures were the Intuitive Eating Scale and the Behavioral Regulation in Exercise Questionnaire. Analysis . Correlations and regression models were used. Intuitive eating was examined in the sample as a whole and among subgroups of respondents grouped based on tertile rankings of intuitive eating scores. Results . There was evidence that women who demonstrated internal motivation related to eating were also internally motivated to participate in regular PA. Women who reported being internally motivated to eat were significantly more likely to engage in PA for pleasure and to view PA as part of their self-concept. Women who reported high levels of intuitive eating had significantly lower BMI scores than those reporting medium or low levels when controlling for age. Conclusion . For women to achieve or maintain a healthy weight, it may be best for health professionals to examine motivation for eating and PA rather than the encouragement of restrictive eating and exercise prescriptions.
    American journal of health promotion: AJHP 01/2015; 29(3):e91-e99.
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    ABSTRACT: Purpose . To investigate pathways in the association between fear of crime and obesity. Design . A cross-sectional survey was administered among residents aged 18 years and older across all Census tracts. Setting . Genesee County, Michigan. Subjects . A total of 3192 residents. Measures . Body mass index (BMI) was calculated by using the respondents' reported height and weight. Composite fear-of-crime and depressive symptoms scores were calculated by using several survey items. Analysis . Path analysis examined the effects of fear of crime on BMI. Results . Fear of crime was associated with higher BMI. Depressive symptoms mediated the relationship between fear of crime and BMI (p < .001). Moderate exercise mediated the association between depressive symptoms and BMI (p < .001). Conclusion . Fear of crime was associated with depressive symptoms, which in turn were associated with reduced exercise and subsequently higher BMI.
    American journal of health promotion: AJHP 01/2015;
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    ABSTRACT: Purpose . To evaluate the effectiveness of FUEL Your Life, a translation of the Diabetes Prevention Program for worksites. Design . A randomized control group design was conducted in five worksites of a large transportation company. Measures were collected pretest, posttest (6 months), and follow-up (12 months). Setting . Railroad maintenance facilities of Union Pacific Railroad. Subjects . Participants consisted of 362 workers (227 treatment, 135 control). Intervention . FUEL Your Life was translated from the Diabetes Prevention Program to better fit within the context of the worksite. The primary difference was the use of peer health coaches to provide social support and reinforcement and an occupational nurse to provide lesson content (six sessions of 10 minutes) to participants instead of the lifestyle coaches employed by the Diabetes Prevention Program, resulting in a less structured meeting schedule. Measures . The primary outcomes were weight and body mass index (BMI), with secondary outcomes including eating behaviors, physical activity, and social support. Analysis . Latent growth modeling was used to measure changes in the outcomes over time. Results . Participants in the intervention group maintained weight/BMI (-.1 pounds/-.1 BMI), whereas the control participants gained weight/BMI (+2.6 pounds/+.3 BMI), resulting in a statistically significant difference between groups. Fifty-five percent of intervention participants lost some weight, whereas only 35% of the control group lost weight. Conclusions . FUEL Your Life, a low intensity intervention, was not effective for promoting weight loss, but was effective for helping workers maintain weight over a 12-month period.
    American journal of health promotion: AJHP 01/2015;
  • Linda K Larkey, Darya McClain, Denise J Roe, Richard D Hector, Ana Maria Lopez, Brian Sillanpaa, Julie Gonzalez
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    ABSTRACT: Purpose . Screening rates for colorectal cancer (CRC) lag for low-income, minority populations, contributing to poorer survival rates. A model of storytelling as culture-centric health promotion was tested for promoting CRC screening. Design . A two-group parallel randomized controlled trial. Setting . Primary care, safety-net clinics. Subjects . Low-income patients due for CRC screening, ages 50 to 75 years, speaking English or Spanish. Intervention . Patients were exposed to either a video created from personal stories composited into a drama about "Papa" receiving CRC screening, or an instrument estimating level of personal cancer risk. Patients received a health care provider referral for CRC screening and were followed up for 3 months to document adherence. Measures . Behavioral factors related to the narrative model (identification and engagement) and theory of planned behavior. Analysis . Main effects of the interventions on screening were tested, controlling for attrition factors, and demographic factor associations were assessed. Path analysis with model variables was used to test the direct effects and multiple mediator models. Results . Main effects on CRC screening (roughly half stool-based tests, half colonoscopy) did not indicate significant differences (37% and 42% screened for storytelling and risk-based messages, respectively; n = 539; 33.6% male; 62% Hispanic). Factors positively associated with CRC screening included being female, Hispanic, married or living with a partner, speaking Spanish, having a primary care provider, lower income, and no health insurance. Engagement, working through positive attitudes toward the behavior, predicted CRC screening. Conclusion . A storytelling and a personalized risk-tool intervention achieved similar levels of screening among unscreened/underscreened, low-income patients. Factors usually associated with lower rates of screening (e.g., no insurance, being Hispanic) were related to more adherence. Both interventions' engagement factor facilitated positive attitudes about CRC screening associated with behavior change.
    American journal of health promotion: AJHP 01/2015;
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    ABSTRACT: Purpose . To assess environmental correlates of neighborhood recreational walking. Design . The study used a cross-sectional survey. Setting . The study was conducted in the local community. Subjects . Participants were adults who recently relocated and walk for recreation in their current neighborhood. Measures . The outcome measure was participant-reported neighborhood recreational walking in participants' prior neighborhood. Exposure measures were (1) participant-reported social and environmental characteristics of the prior neighborhood and (2) geographic information system-derived environmental characteristics assessed within a buffer around participant's prior address. Analysis . Participants reporting current neighborhood recreational walking (n = 231) were characterized by whether they walked for recreation in their prior neighborhood. Associations between neighborhood characteristics and neighborhood recreational walking were assessed using logistic regression. Results . Neighborhood recreational walking was associated with perceptions of the presence of recreational facilities (odds ratio [OR] = 2.49, 95% confidence interval [CI] = 1.29-4.84), interesting things to see (OR = 2.82, 95% CI = 1.46-5.45), and others being active (OR = 3.56, 95% CI = 1.80-7.05), and was inversely associated with concerns about crime (OR = .40, 95% CI = .20-.77) and traffic (OR = .43, 95% CI = .22-.87). This behavior was associated with objectively measured presence of walking trails (OR = 3.58, 95% CI = 1.07-4.46), percentage of street length with speed limits ≤25 mph (OR = 1.31 for 10% increase, 95% CI = 1.08-1.61), and percentage of tree canopy coverage (OR = 1.55 for 10% increase, 95% CI = 1.12-2.14). Conclusion . Recreational walking may be influenced by environmental factors that support a safe, enjoyable, and social experience, attributes that are not necessarily prioritized in transportation walking. Outcome and exposure specificity are important when studying recreational walking.
    American journal of health promotion: AJHP 01/2015;
  • Maria Perales, Irene Calabria, Carmina Lopez, Evelia Franco, Javier Coteron, Ruben Barakat
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    ABSTRACT: Purpose . The aim of the present study was to examine the influence of moderate physical exercise throughout pregnancy on the duration of labor stages. Design . Study was a randomized controlled trial. Setting . The study took place at Hospital Puerta de Hierro and Hospital Severo Ochoa in Madrid, Spain. Subjects . We examined 166 pregnant women (31.6 ± 3.8 years), and all had uncomplicated and singleton gestation. Of these 83 were allocated to the exercise group (EG) and 83 to the control group (CG). Intervention . Women from the EG participated in a physical conditioning program throughout pregnancy, which included 55- to 60-minute sessions, 3 days per week. Measures . Pregnancy outcomes were measured: duration of labor stages, gestational age, weight gain, type of delivery, birth weight, birth size, head circumference, Apgar score, pH of umbilical cord. Analysis . Student's unpaired t-tests and χ(2) tests were used; p values of < .05 indicated statistical significance. Cohen's d was used to determine the effect size. Results . Significant differences were found in the duration of the first stage of labor (EG = 389.6 ± 347.64 minutes vs. CG = 515.72 ± 353.36 minutes; p = .02, effect size Cohen's d = .36). The second and third stages did not differ between the study groups. Conclusion . A physical exercise program during pregnancy is associated with a shorter first stage of labor. These results may have important relevance to public health.
    American journal of health promotion: AJHP 01/2015;
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    ABSTRACT: Purpose . To examine why high-risk individuals targeted for a telephone care management program participated at low rates. Design . Study design consisted of qualitative, semistructured interviews. Setting . The setting was a large national insurer's telephone-based care management program. The program employed registered nurses to provide individually tailored education and counseling about health and health care. Subjects . Study subjects comprised members of a national insurer who were recruited to participate in a care management program but had either dropped out of the program after a short period of initial engagement or had never participated despite recruitment efforts. Measures . Interview content was divided into four categories: knowledge of the case management program, barriers to program participation, perceptions of benefits of the program, and suggestions for program improvement. Analysis . Investigators conducted a directed content analysis. Results . The most commonly cited barriers to participation were a lack of perceived need and a sense of distrust toward the program and its staff. The most commonly cited benefits were psychosocial support and goal setting. Conclusion . Care management programs may benefit from changes to how insurance plan members are selected for the program and from adjusting program content to address perceived needs among members.
    American journal of health promotion: AJHP 01/2015;
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    ABSTRACT: Abstract Purpose . To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). Design . A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Setting . Ongoing worksite health management program implemented across multiple U.S. locations. Subjects . Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Intervention . Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Measures . Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis . Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. Results . The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. Conclusion . An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.
    American journal of health promotion: AJHP 01/2015; 29(3):147-57.
  • American journal of health promotion: AJHP 01/2015; 29(3):v-viii.
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    ABSTRACT: Abstract Purpose . A criticism of incentives for health behaviors is that incentives undermine intrinsic motivation. The objective of this study was to determine the impact of monetary incentive provision on participation motives for exercise in first-year college students at a northeastern public university. Design . Randomized-controlled trial. Setting . Public university in the Northeastern United States. Subjects . One hundred seventeen first-year college students. Intervention . Participants were randomized to one of three conditions: a control condition receiving no incentives for meeting fitness-center attendance goals; a discontinued-incentive condition receiving weekly incentives during fall semester 2011, and no incentives during spring semester 2012; or a continued-incentive condition receiving weekly incentives during fall semester, and incentives on a variable-interval schedule during spring semester. Measures . The Exercise Motivation Inventory 2 measured exercise participation motives at baseline, end of fall semester, and end of spring semester. Fitness-center attendance was monitored by using ID-card check-in/check-out records. Analysis . Repeated-measures analyses using linear mixed models with first-order autoregressive covariance structures were run to compare motive changes in the three conditions. Results . Participation motives of Enjoyment and Revitalization associated with intrinsic motivation did not decrease significantly over time in any of the conditions, F(4, 218) = 2.25, p = .065 and F(4, 220) = 1.67, p = .16, respectively. Conclusion . Intrinsically associated participation motives for exercise did not decrease with incentive provision. Therefore, incentives may encourage fitness-center attendance without negatively impacting participation motives for exercise.
    American journal of health promotion: AJHP 01/2015; 29(3):192-9.
  • American journal of health promotion: AJHP 01/2015;
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    ABSTRACT: Purpose. To examine the relationship between perceived workplace health support and employee productivity. Design. A quantitative cross-sectional study. Setting. Washington State agencies. Subjects. A total of 3528 employees from six state agencies were included in this analysis. Measures. Perceived workplace health support was assessed by two questions that queried respondents on how often they felt supported by the workplace for healthy living and physical activity. The Work Productivity and Activity Impairment Questionnaire was used to measure health-related absenteeism and presenteeism in the past 7 days. Analysis. Multivariate linear regression was used to estimate the mean differences in productivity by levels of perceived health support. Results. Most participants were between 45 and 64 years of age and were predominantly non-Hispanic white. Presenteeism varied significantly by the level of perceived workplace health support, with those who felt least supported having higher presenteeism than those who felt most supported. The difference in presenteeism by perceived workplace support remained significant in models adjusting for sociodemographic and health characteristics (mean difference: 7.1% for support for healthy living, 95% confidence interval: 3.7%, 10.4%; 4.3% for support for physical activity, 95% confidence interval: 1.7%, 6.8%). Absenteeism was not associated with perceived workplace health support. Conclusion. Higher perceived workplace health support is independently associated with higher work productivity. Employers may see productivity benefit from wellness programs through improved perceptions of workplace health support.
    American journal of health promotion: AJHP 01/2015; 29(3):139-146.
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    ABSTRACT: Abstract Purpose . To examine associations of intervention dose with weight, physical activity, glycemic control, and diet outcomes in a randomized trial of a telephone counseling intervention. Design . Study design was a secondary analysis of intervention group. Setting . Study setting was primary care practices in a disadvantaged community in Australia. Subjects . Participants were adult patients with type 2 diabetes (n = 151). Intervention . Up to 27 telephone counseling calls were made during 18 months. Measures . Intervention dose was assessed as the number of calls completed (in tertile categories). Primary outcomes were weight and HbA1c, and moderate to vigorous intensity physical activity via accelerometer. Secondary outcomes were dietary energy intake and diet quality via a validated questionnaire. Analysis . Analyses employed were bivariate associations of call completion with sociodemographics, and confounder-adjusted linear mixed models for associations of call completion with outcomes (multiple imputation of missing data). Results . Only previous diagnosis of depression/anxiety had a statistically significant (p = .008) association with call completion. Call completion was significantly associated with weight loss (p < .001) but not the other outcomes (p > .05). Relative to low call completion, mean weight loss (as a percentage of baseline weight) was greater in the high-call completion group by -3.3% (95% confidence interval, -5.0% to -1.5%). Conclusion . Increased dose of intervention was associated with greater weight loss. More needs to be done to retain patients for the duration of weight loss and behavior change interventions, particularly those with diabetes and comorbid depression, who were the most difficult to engage.
    American journal of health promotion: AJHP 11/2014;
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    ABSTRACT: Abstract Purpose . To assess tobacco screening and counseling in student health clinics, including facilitators, barriers, and associations with campus- and state-level variables. Design . We conducted a mixed-methods study with an online survey and qualitative interviews. Setting . Study setting was student health clinics on college campuses. Subjects . Subjects included 71 clinic directors or designees from 10 Southeastern states (quantitative survey) and 8 directors or designees from 4 Southeastern states (qualitative interviews). Measures . Quantitative measures included demographics, screening and counseling practices, clinic-level supports for such practices, perceptions of tobacco on campus, institution size, public/private status, state tobacco farming revenue, and state tobacco control funding. Qualitative measures included barriers and facilitators of tobacco screening and counseling practices. Analysis . Logistic and linear regression models assessed correlates of screening and counseling. Qualitative data were analyzed using multistage interpretive thematic analysis. Results . A total of 55% of online survey respondents reported that their clinics screen for tobacco at every visit, whereas 80% reported their clinics offer counseling and pharmacotherapy. Barriers included lack of the following: time with patients, relevance to chief complaint, student self-identification as a tobacco user, access to pharmacotherapy, and interest in quitting among smokers. In multivariable models, more efforts to reduce tobacco use, student enrollment, and state-level cash receipts for tobacco were positively associated with clinic-level supports. Conclusion . This study highlights missed opportunities for screening. Although reports of counseling were higher, providers identified many barriers.
    American journal of health promotion: AJHP 11/2014;
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    ABSTRACT: Abstract Objective . This review synthesizes the published literature on using mass media campaigns to reduce youth tobacco use, with particular focus on effects within population subgroups and the relative effectiveness of campaign characteristics. Data Source . A search of PubMed and PsycINFO conducted in March of 2014 yielded 397 studies with 34 suitable for inclusion. Study Inclusion and Exclusion Criteria . Included were quantitative studies that evaluate an antitobacco media campaign intended to influence youth cognitions or behavior or explore the relative effectiveness of campaign characteristics among youth. Data Extraction . An automated search and assessment of suitability for inclusion was done. Data Synthesis . Study outcomes were compared and synthesized. Results . Antitobacco media campaigns can be effective across racial/ethnic populations, although the size of the campaign effect may differ by race/ethnicity. Evidence is insufficient to determine whether campaign outcomes differ by socioeconomic status and population density. Youth are more likely to recall and think about advertising that includes personal testimonials; a surprising narrative; and intense images, sound, and editing. Evidence in support of using a health consequences message theme is mixed; an industry manipulation theme may be effective in combination with a health consequences message. Research is insufficient to determine whether advertising with a secondhand smoke or social norms theme influences youth tobacco use. Conclusion . Our recommendation is to develop antitobacco campaigns designed to reach all at-risk youth, which can be effective across racial/ethnic populations. Research priorities include assessing campaign influence among lower socioeconomic status (SES) and rural youth, disentangling the effects of message characteristics, and assessing the degree to which this body of evidence may have changed as a result of changes in youth culture and communication technology.
    American journal of health promotion: AJHP 11/2014;
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    ABSTRACT: Abstract Purpose . To examine behavioral and environmental factors that may be related to dietary behaviors among U.S. high school students. Design . Data were obtained from the 2010 National Youth Physical Activity and Nutrition Study, a cross-sectional study. Setting . The study was school-based. Subjects . Study subjects were a nationally representative sample of students in grades 9 to 12 (n = 11,458). Measures . Variables of interest included meal practices, in-home snack availability, and intakes of healthful foods/beverages (fruits, vegetables, water, and milk) and less healthful foods/beverages (fried potatoes, pizza, and sugar-sweetened beverages). Analysis . Sex-stratified logistic regression models were used to examine associations of meal practices and snack availability with dietary intake. Odds ratios (ORs) were adjusted for race/ethnicity and grade. Results . Eating breakfast daily, frequent family dinners, and bringing lunch from home were associated with higher odds of consuming at least three healthful foods or beverages. High fast-food intake was associated with lower odds of healthful dietary intake and higher odds of sugar-sweetened beverage intake (female OR = 3.73, male OR = 4.60). Students who mostly/always had fruits and vegetables available at home had increased odds of fruits (female OR = 3.04, male OR = 2.24), vegetables (female OR = 2.12, male OR = 1.65), water (female OR = 1.82, male OR = 1.85), and milk intake (female OR = 1.45, male OR = 1.64). Conclusion . Encouraging daily breakfast consumption, frequent family dinners, and fruit and vegetable availability at home may lead to higher intakes of healthful foods among high school students.
    American journal of health promotion: AJHP 11/2014;
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    ABSTRACT: Abstract Purpose . To elucidate factors that impact intention (INT) to be active as well as actual physical activity (PA) behavior in colorectal cancer survivors (CRC-S) using the theory of planned behavior (TpB). Planning for PA was explored as a mediator of the INT-behavior relationship. Chemotherapy-induced neuropathy and fatigue were also explored. Design . A cross-sectional quantitative mailed survey was used. Setting . The study was conducted among community-dwelling adults living in Pennsylvania when diagnosed with colorectal cancer (CRC). Subjects . Subjects comprised 843 CRC-S diagnosed with CRC in Pennsylvania in 2009. Measures . The survey included questions about planning for PA, TpB constructs, medical and social variables, and PA as measured by a modified Godin Leisure Time Questionnaire. Analysis . Descriptive statistics were used to characterize the sample. A mediation analysis was used to determine if planning mediated the relationship between INT and actual PA behavior. A stepwise regression was used to determine predictors of INT and PA. Results . Ninety-six CRC-S responded, with 25% meeting PA recommendations for health promotion, suggesting that CRC-S are insufficiently active. Perceived behavioral control (PBC) and social norm (SN) accounted for 43% of the variance in INT, whereas 30% of the variance in PA was explained by PBC and age. Neuropathy negatively impacted PA behavior (p = .008). Both action and coping planning partially mediated the INT-behavior relationship (β = 20.08, p = .007; β = 22.85, p = .001, respectively). Conclusion . Survivors at risk for inactivity are those with low PBC, low SN, and neuropathy, and those who are older.
    American journal of health promotion: AJHP 11/2014;
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    ABSTRACT: Abstract Purpose . To examine U.S. adult knowledge of the sugar content of sports drinks and whether this knowledge and other characteristics are associated with their sports drink consumption. Design . Nonexperimental. Setting . Nationally representative 2011 Summer ConsumerStyles survey data. Subjects . 3929 U.S. adults. Measures . The outcome variable was sports drink consumption in the past 7 days. The main exposure variable was knowledge about sports drinks containing sugar. The covariates were sociodemographic characteristics, physical activity, and weight status. Analysis . Multivariable logistic regression analysis was used to estimate adjusted odds ratios (ORs) for adults consuming sports drinks ≥1 times/wk after controlling for other characteristics. Results . Approximately 22% of adults reported consuming sports drinks ≥1 times/wk. Most adults (71%) agreed that sports drinks contain sugar; however, this agreement was not significantly associated with adults' sports drink consumption. The odds of drinking sports drinks ≥1 times/wk were significantly higher among younger adults aged 18 to 64 years (OR range: 5.46-2.71), males (OR = 2.09), high-school graduates (OR = 1.52), and highly active adults (OR = 2.09). Conclusion . There were disparities in sports drink consumption by sociodemographic characteristics and physical activity level; however, knowledge of sports drinks' sugar content was not associated with consumption. Understanding why some population groups are higher consumers may assist in the development of education, providing those groups with a better understanding of sports drinks' nutritional value and health consequences of excessive sugar consumption in any form.
    American journal of health promotion: AJHP 11/2014;