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


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.

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    American Journal of Health Promotion website
  • Other titles
    American journal of health promotion, Health promotion, AJHP
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    Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    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 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 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 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 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 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;
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    ABSTRACT: Abstract Purpose . Health promotion in youth is likely to benefit from enhancing academic achievement and physical activity. The present study examines how kindergarten childhood self-regulation skills and behaviors predict involvement in both structured and unstructured physical and nonphysical extracurricular activities in the fourth grade. As a second objective this study also investigated how kindergarten childhood participation in extracurricular activities predicts classroom engagement, reflective of self-regulation, by the fourth grade. Design . Secondary analyses were conducted using prospective-longitudinal data. Setting . The Quebec Longitudinal Study of Child Development, Quebec, Canada. Subjects . Participants were randomly selected at birth from a stratified sample of 2694 born in Québec, Canada, between 1997 and 1998. Participants were included if they had complete data on teacher ratings of child self-regulation as measured by classroom engagement and parent ratings of sports participation (n = 935). Measures . Teachers reported self-regulation skills in children through a measure of classroom engagement. Parents provided reports of child participation extracurricular activities. Analysis . Ordinary least-squares regressions were conducted. Results . A higher-frequency kindergarten involvement with structured physical activities was associated with fourth-grade classroom engagement (β = .061, 95% confidence interval [CI]: .017, .104). Better kindergarten classroom engagement predicted more frequent participation in fourth-grade structured physical activities (β = .799, 95% CI: .405, 1.192) and team sports (β = .408, 95% CI: .207, .608). Conclusion . Results suggest mutual relations between physical activity and self-regulation from kindergarten to grade four. This suggests strong learning skills indicative of self-regulation and opportunities to participate in supervised physical activities or sports teams may help children develop healthy dispositions and behaviors in emerging adolescence.
    American journal of health promotion: AJHP 11/2014;
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    ABSTRACT: Abstract Purpose . Examine whether concurrently consuming a healthy diet and regularly being physically active among U.S. youth is more favorably associated with cardiovascular disease (CVD) biomarkers than other physical activity and dietary patterns. Design . Cross-sectional. Setting . United States (National Health and Nutrition Examination Survey) 2003-2006. Subjects . Two thousand six hundred twenty-nine youth (6-17 years). Measures . Healthy Eating Index (HEI), accelerometer-determined physical activity, biomarkers, and anthropometry. Four categories were created: consuming a healthy diet (top 40% of HEI) and active (sufficient to meet guidelines); unhealthy diet and active; healthy diet and inactive; and unhealthy diet and inactive. Analysis . Multivariable regression. Results . Children consuming a healthy diet and who were active had significantly lower waist circumference (β = -5.5, p < .006), C-reactive protein (CRP) (β = -.2, p < .006), and triglycerides (β = -27.9, p < .006) than children consuming an unhealthy diet and who were inactive. Children engaging in both healthy behaviors had significantly lower CRP (β = -.11, p < .001) and total cholesterol levels (β = -7.8, p = .004) than those only engaging in sufficient activity; there were no significant differences in biomarker levels among children engaging in both healthy behaviors and those only consuming a healthy diet. No associations were significant for adolescents. Conclusion . Concurrent healthy eating and regular physical activity among children is favorably associated with CVD biomarkers when compared with unhealthy diet and inactivity.
    American journal of health promotion: AJHP 11/2014;
  • American journal of health promotion: AJHP 11/2014; 29(2):TAHP9-10.
  • American journal of health promotion: AJHP 11/2014; 29(2):TAHP11-2.
  • American journal of health promotion: AJHP 11/2014; 29(2):TAHP5-8.
  • American journal of health promotion: AJHP 11/2014; 29(2):TAHP2-4.
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    ABSTRACT: Abstract Objective . This systematic review synthesizes the evidence on the cost-effectiveness of population-level interventions to promote physical activity. Data Source . A systematic literature search was conducted between May and August 2013 in four databases: PubMed, Scopus, Web of Science, and SPORTDiscus. Study Inclusion and Exclusion Criteria . Only primary and preventive interventions aimed at promoting and maintaining physical activity in wide population groups were included. An economic evaluation of both effectiveness and cost was required. Secondary interventions and interventions targeting selected population groups or focusing on single individuals were excluded. Data Extraction . Interventions were searched for in six different categories: (1) environment, (2) built environment, (3) sports clubs and enhanced access, (4) schools, (5) mass media and community-based, and (6) workplace. Data Synthesis . The systematic search yielded 2058 articles, of which 10 articles met the selection criteria. The costs of interventions were converted to costs per person per day in 2012 U.S. dollars. The physical activity results were calculated as metabolic equivalent of task hours (MET-hours, or MET-h) gained per person per day. Cost-effectiveness ratios were presented as dollars per MET-hours gained. The intervention scale and the budget impact of interventions were taken into account. Results . The most efficient interventions to increase physical activity were community rail-trails ($.006/MET-h), pedometers ($.014/MET-h), and school health education programs ($.056/MET-h). Conclusion . Improving opportunities for walking and biking seems to increase physical activity cost-effectively. However, it is necessary to be careful in generalizing the results because of the small number of studies. This review provides important information for decision makers.
    American journal of health promotion: AJHP 11/2014; 29(2):71-80.
  • American journal of health promotion: AJHP 11/2014; 29(2):v-viii.
  • American journal of health promotion: AJHP 09/2014; 29(1):TAHP10-TAHP12.
  • American journal of health promotion: AJHP 09/2014; 29(1):TAHP2- TAHP7.
  • American journal of health promotion: AJHP 09/2014; 29(1):v-vi.