International Journal of Environmental Research and Public Health

2018

Jump to: 2017

10 pages, 326 KiB

Open AccessArticle

Eating Healthy, Growing Healthy: Impact of a Multi-Strategy Nutrition Education on the Assortments of Beverages Served in Preschools, Poland

by Joanna Myszkowska-Ryciak and Anna Harton

Int. J. Environ. Res. Public Health 2018, 15(7), 1355; https://doi.org/10.3390/ijerph15071355 - 28 Jun 2018

Cited by 11 | Viewed by 4263

Abstract

Day-care centers are the ideal place for conducting nutrition intervention to improve children’s nutrition. The aim of this study is to evaluate the effectiveness of a multi-strategy childcare-base intervention in improving compliance with nutrition guidelines regarding beverages supply in preschools. The intervention included [...] Read more.

Day-care centers are the ideal place for conducting nutrition intervention to improve children’s nutrition. The aim of this study is to evaluate the effectiveness of a multi-strategy childcare-base intervention in improving compliance with nutrition guidelines regarding beverages supply in preschools. The intervention included the staff training, audit, feedback, and ongoing support provided by trained educators. The emphasis was put on adequate nutrition, including recommended beverages, reducing sugar-sweetened beverages and increasing water availability. Enrolled were 478 full-board preschools from Poland (4.2% of all preschools in the country). The assortment of beverages served to children within ten consecutive days was assessed based on menus and inventory reports at the baseline, and three months after the intervention. Education increased significantly the percentage of preschools serving water to meals and between meals (67% vs. 83% and 93% vs. 99%, respectively), fruit/herbal tea (75% vs. 81%), and natural fruit juices (46% vs. 56%). The percentage of preschools offering fruit/soft drinks decreased from 23% to 15%. This study shows that education has a great potential in improving the assortment of beverages served in preschools. Future research is needed to determine barriers in better optimizing the assortment of beverages in preschool settings. Full article

9 pages, 303 KiB

Open AccessArticle

Gender and Sexual Orientation Differences in Human Papillomavirus (HPV) Vaccine Uptake among Chinese Young Adults

by Edmond Pui Hang Choi, Janet Yuen Ha Wong, Angel Yin Yim Lau and Daniel Yee Tak Fong

Int. J. Environ. Res. Public Health 2018, 15(6), 1099; https://doi.org/10.3390/ijerph15061099 - 28 May 2018

Cited by 18 | Viewed by 5948

Abstract

To date, empirical studies on HPV vaccine uptake are still limited in Chinese populations and mainly conducted in female cohorts. In order to inform health services planning and health promotion programmes for HPV vaccination, this cross-sectional study aimed to report the prevalence of [...] Read more.

To date, empirical studies on HPV vaccine uptake are still limited in Chinese populations and mainly conducted in female cohorts. In order to inform health services planning and health promotion programmes for HPV vaccination, this cross-sectional study aimed to report the prevalence of self-reported HPV vaccination status and to examine gender and sexual orientation differences in the uptake of HPV vaccine in Chinese college students. The overall prevalence of HPV vaccine uptake was 27.6% (n = 242), with a significantly higher prevalence in females (39.7%) than in males (4.7%). 91.4% of subjects heard about HPV vaccination, with a significantly higher prevalence in females (93.8%) than in males (86.8%). The prevalence of HPV vaccine uptake was only 2.6% for bisexual/ homosexual males and 5.0% for heterosexual males. Only 45.8% of the overall subjects knew HPV vaccination is not for females only, with a significantly higher prevalence in females (49.7%) than in males (38.6%). The low prevalence of male HPV vaccine uptake and awareness called for the need to have more male-specific HPV campaigns to promote HPV vaccination awareness and uptake in males to reduce the overall prevalence of HPV infection. Full article

9 pages, 861 KiB

Open AccessArticle

Risk Perceptions of Cellphone Use While Driving: Results from a Delphi Survey

by Motao Zhu, Toni M. Rudisill, Kimberly J. Rauscher, Danielle M. Davidov and Jing Feng

Int. J. Environ. Res. Public Health 2018, 15(6), 1074; https://doi.org/10.3390/ijerph15061074 - 25 May 2018

Cited by 17 | Viewed by 6357

Abstract

Cellphone use while driving has been recognized as a growing and important public health issue by the World Health Organization and U.S. Center for Disease Control and Prevention. Surveys typically collect data on overall texting while driving, but do not differentiate between various [...] Read more.

Cellphone use while driving has been recognized as a growing and important public health issue by the World Health Organization and U.S. Center for Disease Control and Prevention. Surveys typically collect data on overall texting while driving, but do not differentiate between various forms of cellphone use. This study sought to improve the survey indicators when monitoring cellphone use among young drivers. Experts and young drivers were recruited to propose behavioral indicators (cellphone use while driving behaviors) and consequential indicators (safety consequences of cellphone use while driving) in 2016. Subsequently, experts and young drivers selected the top indicators using the Delphi survey method. We enrolled 22 experts with published articles on cellphone use while driving nationally, and seven young drivers who were freshmen at a state university. Sending a text or e-mail on a handheld phone was picked as the top behavioral indicator by both groups. However, young drivers chose playing music on a handheld phone as the second most important behavioral indicator, which was overlooked by experts. Injury/death and collision were the top two consequential indicators. Experts and young drivers identified the important survey indicators to monitor cellphone use while driving. Full article

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11 pages, 318 KiB

Open AccessArticle

Body Weight Misperception and Its Association with Unhealthy Eating Behaviors among Adolescents in China

by Hanyi Yan, Yingru Wu, Theresa Oniffrey, Jason Brinkley, Rui Zhang, Xinge Zhang, Yueqiao Wang, Guoxun Chen, Rui Li and Justin B. Moore

Int. J. Environ. Res. Public Health 2018, 15(5), 936; https://doi.org/10.3390/ijerph15050936 - 8 May 2018

Cited by 29 | Viewed by 6357

Abstract

This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students (N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based [...] Read more.

This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students (N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based on the World Health Organization’s Global School-Based Student Health Survey was employed to assess responses. Self-reported data, including weight, height, body weight perception, and eating habits, were collected. Body Mass Index (BMI) for age z-score was calculated from self-reported height and weight using WHO AnthroPlus. We used descriptive, logistic regression analysis and a Kappa test to analyze the data using SPSS. Overall, 56.6% of participants did not correctly categorize their weight status; these were much more likely to be girls. Compared with the correctly-perceived group, those who underestimated their weight tended to report eating late at night, having dinners with family, and checking nutrition labels. In contrast, weight overestimating students were less likely to report eating late at night, having breakfasts with family, having dinners with family, and discussing nutrition topics over meals. Body weight misperception was associated with unhealthy eating behaviors among Chinese adolescents. Full article

12 pages, 507 KiB

Open AccessArticle

Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life

by Sarah Appleton, Tiffany Gill, Anne Taylor, Douglas McEvoy, Zumin Shi, Catherine Hill, Amy Reynolds and Robert Adams

Int. J. Environ. Res. Public Health 2018, 15(5), 930; https://doi.org/10.3390/ijerph15050930 - 7 May 2018

Cited by 37 | Viewed by 6044

Abstract

Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA). We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of [...] Read more.

Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA). We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of 2889 active participants of The North West Adelaide Health Study (response rate = 54%, male n = 704; female n = 856; age 30–100 years) assessed previously diagnosed OSA, OSA symptoms, insomnia, doctor-diagnosed medical conditions, and the SF-36. In weighted analyses, self-reported diagnosed OSA (men: 12.6%, n = 95; women: 3.3%, n = 27) and OSA symptoms (men: 17.1%; women: 9.7%) were more common in men. Diagnosed OSA showed stronger adjusted associations with typical OSA features in women, including obesity (women-odds ratio (OR), 95% CI: 5.7, 1.9–17.1, men: 2.2, 1.2–4.0), daytime sleepiness (women: 6.4, 2.7–15.6, men: 3.3, 2.1–5.4), and loud snoring (women: 25.4, 9.4–69.1, men: 8.7, 5.2–14.4). Diagnosed OSA was independently associated with cardiovascular disease (CVD) in men, and in women with high cholesterol, respiratory disease, insomnia, and reduced SF-36 Physical Component Summary score. In both sexes, OSA symptoms were significantly associated with depression, insomnia, and moderate to severe impairments in SF-36 physical and mental component summary scores. Diagnosed women showed clinical characteristics overtly related to OSA. A higher index of clinical suspicion of OSA may be required in women for a condition regarded as male-predominant to increase equity in health outcomes. Full article

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12 pages, 303 KiB

Open AccessArticle

Health Risk Behavior Patterns in a National Adult Population Survey

by Ulrich John, Monika Hanke and Jennis Freyer-Adam

Int. J. Environ. Res. Public Health 2018, 15(5), 873; https://doi.org/10.3390/ijerph15050873 - 27 Apr 2018

Cited by 29 | Viewed by 4516

Abstract

Background: The aim of this paper is to analyze the co-occurrence of health risk behaviors (HRBs), namely, tobacco smoking, alcohol risk drinking, overeating, and physical inactivity, as well as their 16 combinations (patterns), which are stratified by age and gender. Methods: [...] Read more.

Background: The aim of this paper is to analyze the co-occurrence of health risk behaviors (HRBs), namely, tobacco smoking, alcohol risk drinking, overeating, and physical inactivity, as well as their 16 combinations (patterns), which are stratified by age and gender. Methods: The data of 19,294 study participants, from a telephone survey among the adult general population of Germany that was conducted in 2012, were analyzed. Results: In adults, two or more of the four HBRs were found among 51.5% of females and 61.9% of males. The single most prevalent HRB pattern among all of the female (20.7, 19.6–21.8%) and male participants (18.2, 17.1–19.3%) was being overweight combined with a lack of physical activity, and its prevalence increased by 4% with each year of life. A multinomial regression analysis revealed that education was inversely associated with 11 of the 15 HRB patterns. The risk of having four, compared to zero, HRBs was 3.3 (2.5–4.4) for males relative to females. Conclusion: Similar to the findings from other western countries, the majority of the participants in this adult national sample from Germany had two or more HRBs. The most common of all possible HRB patterns was overweight and inactivity. The data confirm inverse relations between education and most HRB patterns. Full article

4 pages, 250 KiB

Open AccessCorrection

Correction: Lee, Y.-H., et al. Beverage Intake, Smoking Behavior, and Alcohol Consumption in Contemporary China—A Cross-Sectional Analysis from the 2011 China Health and Nutrition Survey. Int. J. Environ. Res. Public Health 2017, 14, 493

by Yen-Han Lee, Zhi Wang, Timothy C. Chiang and Ching-Ti Liu

Int. J. Environ. Res. Public Health 2018, 15(5), 846; https://doi.org/10.3390/ijerph15050846 - 25 Apr 2018

Cited by 5 | Viewed by 3317

Abstract

The authors wish to add the following amendments and corrections to their paper published in IJERPH [1]. [...] Full article

13 pages, 826 KiB

Open AccessArticle

Patterns of Physical Activity and the Risk of Coronary Heart Disease: A Pilot Study

by Mustafa Al-Zoughool, Haila Al-Ahmari and Altaf Khan

Int. J. Environ. Res. Public Health 2018, 15(4), 778; https://doi.org/10.3390/ijerph15040778 - 17 Apr 2018

Cited by 6 | Viewed by 4444

Abstract

Background: In the current study, we investigated the effect of physical activity (PA) on the risk of coronary heart disease (CHD). Methods: In total, 146 cases of CHD and 157 matched controls were included in the study. Data on sociodemographics, lifestyle, [...] Read more.

Background: In the current study, we investigated the effect of physical activity (PA) on the risk of coronary heart disease (CHD). Methods: In total, 146 cases of CHD and 157 matched controls were included in the study. Data on sociodemographics, lifestyle, and medical history factors were collected using an interviewer-administered questionnaire. A standard World Health Organization (WHO)-based lifestyle questionnaire was used to assess PA. The risk of CHD was analyzed in relation to PA patterns using logistic regression. Results: Vigorous-intensity leisure PA was not associated with a lower risk of CHD. Subjects in the highest tertile of moderate occupational PA had a significantly lower risk of CHD compared to the lowest tertile (adjusted odds ratio (OR) 0.31, 95% confidence intervals (CI) 0.17–0.56). Subjects in the highest tertile of walking hasd an adjusted OR of 0.37 (95% CI 0.20–0.70). Subjects in the medium and highest tertiles of sedentary behavior had adjusted ORs of 2.01 (95% CI 1.06–3.79) and 3.88 (95% CI 2.14–7.02), respectively (p-value for trend < 0.001). Conclusion: The current results showed that both moderate occupational PA and walking protected against CHD. Sedentary behavior increased the risk of CHD. Full article

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11 pages, 339 KiB

Open AccessArticle

Relationship between the Manner of Mobile Phone Use and Depression, Anxiety, and Stress in University Students

by Aleksandar Višnjić, Vladica Veličković, Dušan Sokolović, Miodrag Stanković, Kristijan Mijatović, Miodrag Stojanović, Zoran Milošević and Olivera Radulović

Int. J. Environ. Res. Public Health 2018, 15(4), 697; https://doi.org/10.3390/ijerph15040697 - 8 Apr 2018

Cited by 49 | Viewed by 14225

Abstract

Objectives: There is insufficient evidence regarding the potential risk of mobile phone use on mental health. Therefore, the aim of this research was to examine the relationship between mobile phone use and mental health by measuring the levels of depression, anxiety, and [...] Read more.

Objectives: There is insufficient evidence regarding the potential risk of mobile phone use on mental health. Therefore, the aim of this research was to examine the relationship between mobile phone use and mental health by measuring the levels of depression, anxiety, and stress among university students in Serbia and Italy. Methods: This cross-sectional study was carried out at two distinguished universities in Serbia and Italy from March to May of the 2015/2016 academic year and included 785 students of both genders. The questionnaire was compiled and developed from different published sources regarding the manner and intensity of mobile phone use, along with the Depression Anxiety Stress Scale (DASS 42) for measuring psychological health. The statistical analysis of the data included the application of binary logistic regression and correlation tests. Results: Statistical analysis indicates that anxiety symptoms are somewhat more present in younger students (odds ratio (OR) = 0.86, 95% confidence interval (CI): 0.76–0.96), in those who send more text messages SMSs (OR = 1.15, 95% CI: 1.11–1.31), and in those who browse the internet less frequently (OR = 0.84, 95% CI: 0.73–0.95). Stress is more common in students who make fewer calls a day (OR = 0.79, 95% CI: 0.64–0.97), as well in those who spend more time talking on the mobile phone per day (OR = 1.28, 95% CI: 1.12–1.56). The strongest predictor of high stress levels was keeping the mobile phone less than 1 m away during sleeping (OR = 1.48, 95% CI: 1.12–2.08). Conclusions: The results indicated that the intensity and modality of mobile phone use could be a factor that can influence causal pathways leading to mental health problems in the university student population. Full article

15 pages, 1035 KiB

Open AccessArticle

German Public Support for Tobacco Control Policy Measures: Results from the German Study on Tobacco Use (DEBRA), a Representative National Survey

by Melanie Boeckmann, Daniel Kotz, Lion Shahab, Jamie Brown and Sabrina Kastaun

Int. J. Environ. Res. Public Health 2018, 15(4), 696; https://doi.org/10.3390/ijerph15040696 - 7 Apr 2018

Cited by 15 | Viewed by 9352

Abstract

Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”): [...] Read more.

Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”): a nationally representative, face-to-face household survey. Public support was measured on total ban of sale, raising the minimum age for sales, taxation of tobacco industry sales, research into e-cigarettes, and ban of smoking in cars when children are present. Associations were assessed with multivariate logistic regression. Over 50% of the German population support taxing industry profits (57.3%) and assessing e-cigarettes as an aid to quit smoking (55.5%). Over 40% support raising the legal age of sale (43.1%), and 22.9% support a total ban on tobacco sales. A smoking ban in cars when children are present was most popular (71.5%), even among current smokers (67.0%). There is public support for stricter tobacco control measures in Germany. A smoking ban in cars when children are present could be a feasible policy to implement. Full article

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15 pages, 309 KiB

Open AccessArticle

A Comparative Study of Behavior Problems among Left-Behind Children, Migrant Children and Local Children

by Hongwei Hu, Jiamin Gao, Haochen Jiang, Haixia Jiang, Shaoyun Guo, Kun Chen, Kaili Jin and Yingying Qi

Int. J. Environ. Res. Public Health 2018, 15(4), 655; https://doi.org/10.3390/ijerph15040655 - 1 Apr 2018

Cited by 50 | Viewed by 7465

Abstract

This study aims to estimate the prevalence of behavioral problems among left-behind children, migrant children and local children in China, and to compare the risks of behavioral problems among the three types of children. Data on 4479 children aged 6–16 used in this [...] Read more.

This study aims to estimate the prevalence of behavioral problems among left-behind children, migrant children and local children in China, and to compare the risks of behavioral problems among the three types of children. Data on 4479 children aged 6–16 used in this study were from a survey conducted in China in 2017. The school-age version of the Children Behavior Checklist was used to measure children’s behavioral problems. Descriptive analysis, correlation analysis, and logistic regressions were conducted. The prevalence of behavioral problems was 18.80% and 13.59% for left-behind children and migrant children, respectively, both of which were higher than that of local children. Logistic regression analysis showed that after adjustments for individual and environmental variables, the likelihood of total, internalizing and externalizing behavior problems for left-behind children and migrant children were higher than those for local children; left-behind children had a higher likelihood of internalizing problems than externalizing problems, while migrant children had a higher prevalence of externalizing problems. Left-behind children had a higher prevalence of each specific syndrome than migrant and local children. Both individual and environmental factors were associated with child behavioral problems, and family migration may contribute to the increased risks. Left-behind and migrant children were more vulnerable than local children to behavioral problems. Full article

17 pages, 548 KiB

Open AccessArticle

Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered

by Grzegorz Józef Nowicki, Patrycja Misztal-Okońska, Barbara Ślusarska, Ewa Rudnicka-Drożak, Magdalena Młynarska and Artur Czekierdowski

Int. J. Environ. Res. Public Health 2018, 15(3), 411; https://doi.org/10.3390/ijerph15030411 - 27 Feb 2018

Cited by 6 | Viewed by 4999

Abstract

Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women [...] Read more.

Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered (n = 235), pregnant women (n = 121) and childless women (n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values “positive mental attitude” and “health practices”, in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was “a successful family life”, while the most appreciated symbol of happiness was “love and friendship”. Our results suggest that the system of values and the perception of happiness symbols may influence women’s health behaviors. Positioning “health” in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed. Full article

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23 pages, 1809 KiB

Open AccessArticle

The Roles of Three Types of Knowledge and Perceived Uncertainty in Explaining Risk Perception, Acceptability, and Self-Protective Response—A Case Study on Endocrine Disrupting Surfactants

by Hien Ho and Tsunemi Watanabe

Int. J. Environ. Res. Public Health 2018, 15(2), 296; https://doi.org/10.3390/ijerph15020296 - 8 Feb 2018

Cited by 14 | Viewed by 6506

Abstract

The ubiquitous surfactants nonylphenol (NP) and its ethoxylates (NPEOs), which are known as endocrine disrupters, have appeared in the lists of restricted chemical substances, monitoring programs, and environmental quality standards of many countries due to their adverse effects. Recent studies have reported alarming [...] Read more.

The ubiquitous surfactants nonylphenol (NP) and its ethoxylates (NPEOs), which are known as endocrine disrupters, have appeared in the lists of restricted chemical substances, monitoring programs, and environmental quality standards of many countries due to their adverse effects. Recent studies have reported alarming levels of NP, as the final metabolite of NPEOs, in Vietnamese urban waters, whilst response to this issue is negligible. With the aim of addressing how the public perceives and expects to avoid the risk of endocrine disrupting surfactants (EDSs), the study tested the hypothesized roles of specific knowledge, general knowledge, and perceived uncertainty using structural equation modelling. The findings revealed that different types of knowledge played certain roles in explaining risk perception, risk acceptability, and self-protective response, which are distinguished by experience amongst the public. Evidence of the mediating role that perceived uncertainty may play in the decrease of risk perception and the increase of risk unacceptance has been provided. The insights gained from the study may help answer why the public are in favor of taking non-diet-related self-protective measures rather than changing their dietary habits, which illustrates a comparison with the basis of health belief model. The needs for building cognitive capacity amongst the public, particularly pregnant women and young mothers, and risk communication concerning endocrine disrupting contamination linked to reproductive health are highlighted. Full article

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16 pages, 1080 KiB

Open AccessArticle

CRP Genotypes Predict Increased Risk to Co-Present with Low Vitamin D and Elevated CRP in a Group of Healthy Black South African Women

by Pieter H. Myburgh, G. Wayne Towers, Iolanthé M. Kruger and Cornelie Nienaber-Rousseau

Int. J. Environ. Res. Public Health 2018, 15(1), 111; https://doi.org/10.3390/ijerph15010111 - 10 Jan 2018

Cited by 4 | Viewed by 4733

Abstract

Low 25-hydroxyvitamin D (25(OH)D) and elevated C-reactive protein (CRP) concentrations are independently associated with adverse health outcomes, including cardiovascular disease (CVD). Although an inverse association between these factors has been described, the underlying mechanisms remain unknown. We postulate that environment–gene interactions, through which [...] Read more.

Low 25-hydroxyvitamin D (25(OH)D) and elevated C-reactive protein (CRP) concentrations are independently associated with adverse health outcomes, including cardiovascular disease (CVD). Although an inverse association between these factors has been described, the underlying mechanisms remain unknown. We postulate that environment–gene interactions, through which 25(OH)D interacts with single nucleotide polymorphisms (SNPs) within the CRP gene, modulate CRP; that certain CRP genotypes predispose individuals to a co-phenotype of low 25(OH)D and elevated CRP concentrations; and that this co-phenotype is associated with higher CVD risk. Twelve CRP SNPs were genotyped, and both 25(OH)D and CRP were quantified, in 505 black South African women. Alarmingly, 66% and 60% of the women presented with deficient/insufficient 25(OH)D and elevated CRP concentrations, respectively. CRP concentrations were higher in individuals with lower 25(OH)D concentrations. However, no 25(OH)D–CRP genotype interactions were evident. Several genotypes were associated with an altered risk of presenting with the co-phenotype, indicating a genetic predisposition. Women presenting with this co-phenotype had higher blood pressure and increased anthropometric measures, which may predispose them to develop CVD. We recommend increasing vitamin D fortification and supplementation efforts to reduce inflammation among black women with vitamin D deficiency, thereby possibly curbing diseases contingent on the co-phenotype described here. Full article

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10 pages, 817 KiB

Open AccessArticle

Self-Medication Practice and Associated Factors among Residents in Wuhan, China

by Xiaosheng Lei, Heng Jiang, Chaojie Liu, Adamm Ferrier and Janette Mugavin

Int. J. Environ. Res. Public Health 2018, 15(1), 68; https://doi.org/10.3390/ijerph15010068 - 4 Jan 2018

Cited by 72 | Viewed by 11836

Abstract

Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in [...] Read more.

Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in the survey to collect information of self-medication behavior. Multivariable logistic regression analyses were used to measure correlates of the prevalence of self-medication. Results: Nearly half of the respondents would select self-medication, and 39.1% would see a doctor if they felt sick. The most common self-medicated illnesses were cold and cough, cardiovascular disease and gastrointestinal disease. The main reasons for self-medication were that the illness was not severe (enough) to see the doctor (45%); the patient did not think that the trouble of seeing a doctor was worth the effort (23%); the patient had no time to see the doctor (12%), and the patient did not want to pay high medical costs (15%). Logistic regression results suggested that respondents tended to select self-medication if the illness was minor or short-term (less than seven days). Conclusions: Our findings suggest that more strict regulation on over-the-counter medicines may be required to reduce health risks related to self-medication. Targeted health education on the risks of self-medication should be considered. Full article

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2017

Jump to: 2018

836 KiB

Open AccessArticle

The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research

by Joniqua Ceasar, Marlene H. Peters-Lawrence, Valerie Mitchell and Tiffany M. Powell-Wiley

Int. J. Environ. Res. Public Health 2017, 14(11), 1422; https://doi.org/10.3390/ijerph14111422 - 21 Nov 2017

Cited by 34 | Viewed by 8380

Abstract

Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment [...] Read more.

Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB), which influenced the study’s design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities. Full article

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Open AccessArticle

Prenatal Exposure to Environmental Tobacco Smoke and Hyperactivity Behavior in Chinese Young Children

by Qingmei Lin, Xiang-Yu Hou, Xiao-Na Yin, Guo-Min Wen, Dengli Sun, Dan-Xia Xian, Lijun Fan, Hui Jiang, Jin Jing, Yu Jin, Chuan-An Wu and Wei-Qing Chen

Int. J. Environ. Res. Public Health 2017, 14(10), 1132; https://doi.org/10.3390/ijerph14101132 - 27 Sep 2017

Cited by 27 | Viewed by 5388

Abstract

This study aimed to examine the association between prenatal environmental tobacco smoke (ETS) exposure and hyperactivity behaviors in young children. A cross-sectional study was undertaken among 21,243 participants from all of the kindergartens in Longhua District of Shenzhen, China. Multivariate logistic regression models [...] Read more.

This study aimed to examine the association between prenatal environmental tobacco smoke (ETS) exposure and hyperactivity behaviors in young children. A cross-sectional study was undertaken among 21,243 participants from all of the kindergartens in Longhua District of Shenzhen, China. Multivariate logistic regression models and hierarchical linear models were employed to assess the associations. After adjusting for potential confounders of gender, preterm birth, birth asphyxiation, etc., prenatal ETS exposure was significantly associated with an increased risk of hyperactivity behaviors in young children (OR (95% CI) = 1.51 (1.28–1.77); β (95% CI) = 0.017 (0.013–0.020)). Along with increases in children’s prenatal ETS exposure dose (measured by daily ETS exposure duration, daily cigarette consumption by household members, and overall score of prenatal ETS exposure), the children were also increasingly more likely to exhibit hyperactivity behaviors. Furthermore, children whose mothers had prenatal ETS exposure in any one or more of the pregnancy trimesters were more likely to exhibit hyperactivity behaviors as compared with those born to non-exposure mothers (all p < 0.05). Overall, prenatal ETS exposure could be associated with a detrimental impact on offspring’s hyperactivity behaviors, and public health efforts are needed to reduce prenatal ETS exposure. Full article

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Open AccessArticle

Providing a Clean Environment for Adolescents: Evaluation of the Tobacco Hazards Prevention Act in Taiwan

by Min-Li Chen, Li-Na Chou and Ya-Cheng Zheng

Int. J. Environ. Res. Public Health 2017, 14(6), 634; https://doi.org/10.3390/ijerph14060634 - 13 Jun 2017

Cited by 6 | Viewed by 5072

Abstract

Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise [...] Read more.

Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1) to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2) to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70), grocery stores (n = 83), and betel nut stalls (n = 81). The results indicated that among the 234 retailers, 171 (73.1%) of them routinely failed to confirm the buyers’ ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1%) to 59 (25.2%) and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9%) to 175 (74.8%) after counseling strategies had been provided, thereby revealing statistical significance (χ² = 11.26, p < 0.001). Study II: A total of 476 (89.1%) participants had received tobacco hazards prevention education and 58 (10.9%) had not. Among the various residential areas, the highest percentage of participants that did not received tobacco hazards prevention education located in the plane regions (8.4%). The government organizations should continue to adopt counseling strategies to reduce the rate of disobedience of the Tobacco Hazards Prevention Act by selling tobacco products to minors. Schools should pay close attention to tobacco hazard prevention education for junior high school students to ensure that such students are adequately educated about tobacco hazard prevention. Full article

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Open AccessArticle

Changes in Smoking Behavior over Family Transitions: Evidence for Anticipation and Adaptation Effects

by Damien Bricard, Stéphane Legleye and Myriam Khlat

Int. J. Environ. Res. Public Health 2017, 14(6), 610; https://doi.org/10.3390/ijerph14060610 - 7 Jun 2017

Cited by 13 | Viewed by 5258

Abstract

The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a [...] Read more.

The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a discrete-time logistic model to explore the timing of changes in terms of leads and lags effects up to three years around the event in order to measure both anticipation and adaptation mechanisms. Retrospective biographical data from the Santé et Itinéraires Professionnels (SIP) survey conducted in France in 2006 are used. Partnership formation was followed for both genders by a fall in smoking initiation and an immediate rise in smoking cessation. Childbirth was associated with increased smoking cessation immediately around childbirth, and additionally, females showed an anticipatory increase in smoking cessation up to two years before childbirth. Couple separation was accompanied by an anticipatory increase in smoking initiation for females up to two years prior to the separation, but this effect only occurred in males during separation. Our findings highlight opportunities for more targeted interventions over the life course to reduce smoking, and therefore have relevance for general practitioners and public policy elaboration. Full article

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Open AccessArticle

Water Consumption in European Children: Associations with Intake of Fruit Juices, Soft Drinks and Related Parenting Practices

by Krystallia Mantziki, Carry M. Renders and Jaap C. Seidell

Int. J. Environ. Res. Public Health 2017, 14(6), 583; https://doi.org/10.3390/ijerph14060583 - 31 May 2017

Cited by 17 | Viewed by 5369

Abstract

Background: High intake of fruit juices and soft drinks contributes to excessive weight gain and obesity in children. Furthermore, parenting practices play an important role in the development of children’s dietary habits. The way parents play this role in the development of [...] Read more.

Background: High intake of fruit juices and soft drinks contributes to excessive weight gain and obesity in children. Furthermore, parenting practices play an important role in the development of children’s dietary habits. The way parents play this role in the development of their children’s choices of beverages is still unclear. Objectives: To study the associations: (1) of both fruit juices and soft drinks consumption with water consumption of children and (2) The associations between parenting practices towards fruit juices and soft drinks and water consumption of children. Design: Cross-sectional data from 6 to 8 year old children from seven European communities (n = 1187) were collected. Associations among fruit juices, soft drinks, the respective parenting practices and the child’s water consumption were assessed by parental questionnaires. Results: The consumption of water was inversely associated with that of soft drinks but not with the consumption of fruit juices. The child’s water intake was favorably influenced when stricter parenting practices towards soft drinks were adopted (e.g., less parental allowance, low home availability and high parental self-efficacy in managing intake). There was less influence observed of parenting practices towards fruit juices. Fruit juices were consumed more often than soft drinks. Conclusions: Low consumption of soft drinks—and not of fruit juices—was associated with high water consumption in children in the current study. Moreover, parenting practices towards both fruit juices and soft drinks were associated with the water intake of the children, irrespective of their socio-economic status. Full article

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Open AccessArticle

Sleep Duration, Sleep Quality, Body Mass Index, and Waist Circumference among Young Adults from 24 Low- and Middle-Income and Two High-Income Countries

by Karl Peltzer and Supa Pengpid

Int. J. Environ. Res. Public Health 2017, 14(6), 566; https://doi.org/10.3390/ijerph14060566 - 26 May 2017

Cited by 33 | Viewed by 6623

Abstract

Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI), waist circumference (WC) and sleep patterns, including duration and disturbances. A cross-sectional questionnaire survey and anthropometric [...] Read more.

Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI), waist circumference (WC) and sleep patterns, including duration and disturbances. A cross-sectional questionnaire survey and anthropometric measurements were conducted with undergraduate university students that were randomly recruited in 26 universities in 24 low- and middle-income and two high-income countries. The sample included 18,211 (42.1% male and 57.9% female, mean age 21.0 in male and 20.7 years in female students) undergraduate university students. The overall BMI was a mean of 22.5 kg/m² for men and 22.0 kg/m² for women, and the mean WC was 78.4 cm for men and 73.8 cm for women. More than 39% of the students reported short sleep duration (≤6 h/day) and over 30% reported moderate to extreme sleep problems. In a linear multivariable regression, adjusted for sociodemographic and lifestyle factors, short sleep duration was positively associated with BMI in both men and women, and was positively associated with WC among women but not among men. Sleep quality or problems among men were not associated with BMI, while among women mild sleep problems were inversely associated with BMI, and poor sleep quality or problems were positively associated with WC both among men and women. The study confirmed an association between short sleep duration and increased BMI and, among women, increased WC, and an association between poor sleep quality and increased WC but not BMI. Further, differences in the association between sleep characteristics and BMI and WC were found by region and country income. Full article

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Open AccessArticle

Beverage Intake, Smoking Behavior, and Alcohol Consumption in Contemporary China—A Cross-Sectional Analysis from the 2011 China Health and Nutrition Survey

by Yen-Han Lee, Zhi Wang, Timothy C. Chiang and Ching-Ti Liu

Int. J. Environ. Res. Public Health 2017, 14(5), 493; https://doi.org/10.3390/ijerph14050493 - 7 May 2017

Cited by 36 | Viewed by 5819 | Correction

Abstract

Chinese residents enjoy various types of beverages in their daily life. With the rapid Westernization of contemporary China, several adverse health concerns—such as diabetes linked to sweetened beverages—have emerged. Until now, no research that examines associations between beverage consumption and smoking/drinking behaviors has [...] Read more.

Chinese residents enjoy various types of beverages in their daily life. With the rapid Westernization of contemporary China, several adverse health concerns—such as diabetes linked to sweetened beverages—have emerged. Until now, no research that examines associations between beverage consumption and smoking/drinking behaviors has been made available, despite the large Chinese populations partaking in such activities. We conducted a cross-sectional study to explore the association between beverage intake frequencies and smoking/drinking behaviors in 12,658 adult respondents who participated in the latest wave (2011) of the China Health and Nutrition Survey (CHNS). Further, we applied Tukey’s Honest Significance test for pairwise comparisons. We defined the consumption categories as daily (at least one serving per day), weekly (less than one serving per day, at least one serving per week), monthly (less than one serving per week, at least one serving per month), and less than monthly or none—for sweetened beverage, water, tea, and coffee consumptions. The data showed that both tea and sweetened beverages are associated with smoking/drinking behaviors. Compared to respondents who consume tea and sweetened beverages daily, the odds of smoking behaviors are lower for those who consume such beverages less frequently. Further policy implications are discussed, including higher taxes on sweetened beverages and lessons from other countries. Full article

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Open AccessArticle

Association between Sleep and Body Weight: A Panel Data Model Based on a Retrospective Longitudinal Cohort of Chinese Infants

by Tingting Sha, Yan Yan, Xiao Gao, Shiting Xiang, Guangyu Zeng, Shiping Liu and Qiong He

Int. J. Environ. Res. Public Health 2017, 14(5), 458; https://doi.org/10.3390/ijerph14050458 - 25 Apr 2017

Cited by 14 | Viewed by 5644

Abstract

The focus of this article is on sleep duration and sleep problems in infants and their association with body weight. A retrospective birth cohort of 519 infants was enrolled in a community-based study conducted in Changsha, China. Infant weight and other health-related information [...] Read more.

The focus of this article is on sleep duration and sleep problems in infants and their association with body weight. A retrospective birth cohort of 519 infants was enrolled in a community-based study conducted in Changsha, China. Infant weight and other health-related information were collected during regular standard checkups at the Community Health Service Centers when infants were 1, 3, 6, 8, and 12 months old. The sleep duration and sleep problems of infants were assessed by maternal self-reports. Panel data model was used to evaluate the association of sleep duration and sleep problems with infant body weight. Significant relevance between self-reported sleep duration and weight of infants has been reported in the literature tested by the fixed effects model (p < 0.01). However, this study indicated that sleep problems of infants had no effect on their weight (p = 0.151), after adjusting feeding patterns and socioeconomic factors of their families. This paper argues that, as a potentially modifiable risk factor, infant sleep duration deserves more attention from their parents and families in order to prevent and control overweight or obesity in infants as well as reducing the incidence of obesity in adults. Full article

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Open AccessArticle

A National Study of Social Media, Television, Radio, and Internet Usage of Adults by Sexual Orientation and Smoking Status: Implications for Campaign Design

by Andrew B. Seidenberg, Catherine L. Jo, Kurt M. Ribisl, Joseph G. L. Lee, Francisco O. Buchting, Yoonsang Kim and Sherry L. Emery

Int. J. Environ. Res. Public Health 2017, 14(4), 450; https://doi.org/10.3390/ijerph14040450 - 21 Apr 2017

Cited by 46 | Viewed by 8700

Abstract

Background: Smoking rates among lesbian, gay, and bisexual (LGB) people significantly exceed that of heterosexuals. Media interventions are an important part of tobacco control efforts, but limited information is available on LGB people’s media use. Methods: A nationally representative sample of [...] Read more.

Background: Smoking rates among lesbian, gay, and bisexual (LGB) people significantly exceed that of heterosexuals. Media interventions are an important part of tobacco control efforts, but limited information is available on LGB people’s media use. Methods: A nationally representative sample of 12,900 U.S. adults completed an online questionnaire assessing media use, smoking status, and demographic information. Multivariable logistic regression was used to assess relationships between media use with sexual orientation and smoking status. Results: A total of 590 (4.6%) respondents identified as LGB, of which 29% were smokers. Regardless of sexual orientation and smoking status, the Internet was the most popular media channel used, followed by television and radio. LGB respondents had significantly greater odds of having accounts on social media websites, accessing Facebook daily, and being a frequent Internet user, compared to heterosexual respondents. Similar media use was found between smokers and non-smokers, but smokers had greater odds of being frequent television viewers and frequent Internet users, compared to non-smokers. Conclusions: Compared to heterosexuals, LGB respondents reported greater use of the Internet, especially social media. Media campaigns targeting LGB populations can maximize reach by utilizing social media alongside traditional media channels. Full article

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Open AccessArticle

Who Is Using Outdoor Fitness Equipment and How? The Case of Xihu Park

by Hsueh-wen Chow, Andrew J. Mowen and Guan-lin Wu

Int. J. Environ. Res. Public Health 2017, 14(4), 448; https://doi.org/10.3390/ijerph14040448 - 21 Apr 2017

Cited by 45 | Viewed by 8169

Abstract

Outdoor fitness equipment (OFE) placed in public parks has the potential to encourage physical activity. However, little is known about OFE users and use patterns. This study employed onsite and video observations of OFE usage to describe user characteristics and patterns in Xihu [...] Read more.

Outdoor fitness equipment (OFE) placed in public parks has the potential to encourage physical activity. However, little is known about OFE users and use patterns. This study employed onsite and video observations of OFE usage to describe user characteristics and patterns in Xihu Park. Results indicate that OFE in this park attracted considerable use, particularly in the early morning and late afternoon. During these peak-hour observations, approximately 12 users per hour used the OFE, with the majority being females and seniors. The triple arm stretch and air walker were the most popular stations. However, most OFE users interacted with less than three of the available six OFE stations. Furthermore, users spent an average of less than nine minutes on all OFE stations combined. While OFE equipment was well-used in this urban park, it appears users did not interact with OFE at rates to produce a sufficient bout or level of physical activity during their park visit. Further investigations of OFE are encouraged to determine their health impact. Full article

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Open AccessArticle

Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland

by Katarzyna Milcarz, Leokadia Bak-Romaniszyn and Dorota Kaleta

Int. J. Environ. Res. Public Health 2017, 14(4), 447; https://doi.org/10.3390/ijerph14040447 - 21 Apr 2017

Cited by 9 | Viewed by 4374

Abstract

This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed [...] Read more.

This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the “Reducing Social Inequalities in Health” program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes—a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS. Full article

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Open AccessArticle

Smoke-Free Laws and Hazardous Drinking: A Cross-Sectional Study among U.S. Adults

by Nan Jiang, Mariaelena Gonzalez, Pamela M. Ling, Kelly C. Young-Wolff and Stanton A. Glantz

Int. J. Environ. Res. Public Health 2017, 14(4), 412; https://doi.org/10.3390/ijerph14040412 - 13 Apr 2017

Cited by 1 | Viewed by 4399

Abstract

Tobacco and alcohol use are strongly associated. This cross-sectional study examined the relationship of smoke-free law coverage and smoke-free bar law coverage with hazardous drinking behaviors among a representative sample of U.S. adult drinkers (n = 17,057). We merged 2009 National Health [...] Read more.

Tobacco and alcohol use are strongly associated. This cross-sectional study examined the relationship of smoke-free law coverage and smoke-free bar law coverage with hazardous drinking behaviors among a representative sample of U.S. adult drinkers (n = 17,057). We merged 2009 National Health Interview Survey data, American Nonsmokers’ Rights Foundation U.S. Tobacco Control Laws Database, and Census Population Estimates. Hazardous drinking outcomes included heavy drinking (>14 drinks/week for men; >7 drinks/week for women) and binge drinking (≥5 drinks on one or more days during past year). Chi-square tests compared hazardous drinking by sociodemographic factors. Multivariable logistic regression models were used to examine if smoke-free law and bar law coverages were associated with hazardous drinking, controlling for sociodemographics and smoking status. Subset analyses were conducted among drinkers who also smoked (n = 4074) to assess the association between law coverages and hazardous drinking. Among all drinkers, smoke-free law coverage was not associated with heavy drinking (adjusted odds ratio (AOR) = 1.22, 95% confidence interval (CI) = 0.99–1.50) or binge drinking (AOR = 1.09, 95% CI = 0.93–1.26). Smoke-free bar law coverage was also found to be unrelated to hazardous drinking. Similar results were found among those drinkers who smoked. Findings suggest that smoke-free laws and bar laws are not associated with elevated risk for alcohol-related health issues. Full article

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Open AccessArticle

Television Viewing and Its Association with Sedentary Behaviors, Self-Rated Health and Academic Performance among Secondary School Students in Peru

by Bimala Sharma, Rosemary Cosme Chavez, Ae Suk Jeong and Eun Woo Nam

Int. J. Environ. Res. Public Health 2017, 14(4), 383; https://doi.org/10.3390/ijerph14040383 - 5 Apr 2017

Cited by 14 | Viewed by 5638

Abstract

The study assessed television viewing >2 h a day and its association with sedentary behaviors, self-rated health, and academic performance among secondary school adolescents. A cross-sectional survey was conducted among randomly selected students in Lima in 2015. We measured self-reported responses of students [...] Read more.

The study assessed television viewing >2 h a day and its association with sedentary behaviors, self-rated health, and academic performance among secondary school adolescents. A cross-sectional survey was conducted among randomly selected students in Lima in 2015. We measured self-reported responses of students using a standard questionnaire, and conducted in-depth interviews with 10 parents and 10 teachers. Chi-square test, correlation and multivariate logistic regression analysis were performed among 1234 students, and thematic analysis technique was used for qualitative information. A total of 23.1% adolescents reported watching television >2 h a day. Qualitative findings also show that adolescents spend most of their leisure time watching television, playing video games or using the Internet. Television viewing had a significant positive correlation with video game use in males and older adolescents, with Internet use in both sexes, and a negative correlation with self-rated health and academic performance in females. Multivariate logistic regression analysis shows that television viewing >2 h a day, independent of physical activity was associated with video games use >2 h a day, Internet use >2 h a day, poor/fair self-rated health and poor self-reported academic performance. Television viewing time and sex had a significant interaction effect on both video game use >2 h a day and Internet use >2 h a day. Reducing television viewing time may be an effective strategy for improving health and academic performance in adolescents. Full article

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Open AccessArticle

Evaluation of the “Eat Better Feel Better” Cooking Programme to Tackle Barriers to Healthy Eating

by Ada L. Garcia, Rebecca Reardon, Elizabeth Hammond, Alison Parrett and Anne Gebbie-Diben

Int. J. Environ. Res. Public Health 2017, 14(4), 380; https://doi.org/10.3390/ijerph14040380 - 4 Apr 2017

Cited by 21 | Viewed by 8702

Abstract

We evaluated a 6-week community-based cooking programme, “Eat Better Feel Better”, aimed at tackling barriers to cooking and healthy eating using a single-group repeated measures design. 117 participants enrolled, 62 completed baseline and post-intervention questionnaires, and 17 completed these and a 3–4 months [...] Read more.

We evaluated a 6-week community-based cooking programme, “Eat Better Feel Better”, aimed at tackling barriers to cooking and healthy eating using a single-group repeated measures design. 117 participants enrolled, 62 completed baseline and post-intervention questionnaires, and 17 completed these and a 3–4 months follow-up questionnaire. Most participants were female, >45 years, and socioeconomically deprived. Confidence constructs changed positively from baseline to post-intervention (medians, scale 1 “not confident” to 7 “very confident”): “cooking using raw ingredients” (4, 6 p < 0.003), “following simple recipe” (5, 6 p = 0.003), “planning meals before shopping” (4, 5 p = <0.001), “shopping on a budget (4, 5 p = 0.044), “shopping healthier food” (4, 5 p = 0.007), “cooking new foods” (3, 5 p < 0.001), “cooking healthier foods” (4, 5 p = 0.001), “storing foods safely” (5, 6 p = 0.002); “using leftovers” (4, 5 p = 0.002), “cooking raw chicken” (5, 6 p = 0.021), and “reading food labels” (4, 5 p < 0.001). “Microwaving ready-meals” decreased 46% to 39% (p = 0.132). “Preparing meals from scratch” increased 48% to 59% (p = 0.071). Knowledge about correct portion sizes increased 47% to 74% (p = 0.002). Spending on ready-meals/week decreased. Follow-up telephone interviewees (n = 42) reported developing healthier eating patterns, spending less money/wasting less food, and preparing more meals/snacks from raw ingredients. The programme had positive effects on participants’ cooking skills confidence, helped manage time, and reduced barriers of cost, waste, and knowledge.) Full article

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Open AccessArticle

Why Do People Exercise in Natural Environments? Norwegian Adults’ Motives for Nature-, Gym-, and Sports-Based Exercise

by Giovanna Calogiuri and Lewis R. Elliott

Int. J. Environ. Res. Public Health 2017, 14(4), 377; https://doi.org/10.3390/ijerph14040377 - 4 Apr 2017

Cited by 66 | Viewed by 11855

Abstract

Exercise in natural environments (“green exercise”) confers numerous health benefits, but little is known about why people engage in green exercise. This study examined the importance of nature experiences as a motive for physical activity and the motivational profile of people who engage [...] Read more.

Exercise in natural environments (“green exercise”) confers numerous health benefits, but little is known about why people engage in green exercise. This study examined the importance of nature experiences as a motive for physical activity and the motivational profile of people who engage in green exercise compared to gym- and sports-based exercise. Physical activity motives and typical times spent in different domains of physical activity were reported by 2168 Norwegian adults in a survey. Experiencing nature was generally rated as the second-most important physical activity motive, exceeded only by convenience motives, and it was especially important for older adults and those who engage in greater amounts of instrumental physical activity. Green exercisers reported stronger motives concerning convenience and experiencing nature, whereas gym- or sports-based exercisers reported stronger motives for physical health and sociability. The motives associated with different leisure-time exercise domains may assist in understanding optimal promotion of green exercise. Full article

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Open AccessArticle

Influencing Factors of the Body Mass Index of Elementary Students in Southern Taiwan

by Li-Na Chou and Min-Li Chen

Int. J. Environ. Res. Public Health 2017, 14(3), 220; https://doi.org/10.3390/ijerph14030220 - 23 Feb 2017

Cited by 6 | Viewed by 12054

Abstract

The body mass index (BMI) of school children in Taiwan is markedly increasing. According to statistical data from the Taiwan Ministry of Education, the prevalence of obesity in school children from the southern part of the country is the highest in Taiwan. Thus, [...] Read more.

The body mass index (BMI) of school children in Taiwan is markedly increasing. According to statistical data from the Taiwan Ministry of Education, the prevalence of obesity in school children from the southern part of the country is the highest in Taiwan. Thus, exploring the factors influencing BMI in elementary school children from southern Taiwan is crucial. This study investigated the influencing factors including physical activity levels, sedentary behaviors, dietary habits, and perceived body shape on the BMIs of elementary school children from southern Taiwan. A cross-sectional design was used, and the participants consisted of 3251 fifth-grade students (1628 boys, 50.1%; 1623 girls, 49.9%). The average BMI values for boys and girls were 19.69 and 18.70 (kg/cm) respectively. Statistically significant associations were observed between BMI and sex, 31–60 min of daily vigorous or moderate physical activities levels, length of time spent watching television, time spent on video games or the computer, and intake of vegetable or meat gravy with rice (p < 0.001). Perceived body shape also affected the BMI of school children. The results of this study enable educational institutions in Taiwan to understand the factors affecting the BMI of school children and use this information as the basis for future healthy body weight policies. Full article

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