Making Mobile Health Information Advice Persuasive

As M-Health apps become more popular, users can access more mobile health information (MHI) through these platforms. Yet one preeminent question among both researchers and practitioners is how to bridge the gap between simply providing MHI and persuading users to buy into the MHI for health self-management. To solve this challenge, this study extends the Elaboration Likelihood Model to explore how to make MHI advice persuasive by identifying the important central and peripheral cues of MHI under individual difference. The proposed research model was validated through a survey. The results confirm that (1) both information matching and platform credibility, as central and peripheral cues, respectively, have significant positive effects on attitudes toward MHI, but only information matching could directly affect health behavior changes; (2) health concern significantly moderates the link between information matching and cognitive attitude and only marginally moderates the link between platform credibility and attitudes. Theoretical and practical implications are also discussed.

Mental health comorbidity and youth onset type 2 diabetes: A systematic review of the literature

Background Type 2 diabetes (T2D) is a burgeoning epidemic in children and adolescents. Adult T2D doubles the risk of depression and mental health comorbidity makes it more difficult to make the lifestyle, medication adherence and health behavior changes needed to optimize outcomes. There is limited research on the impact of depression and depressive symptoms on youth T2D. Methods A search of the literature in the last 10 years regarding youth with depression and T2D was conducted. Abstracts were screened by 2 randomly assigned authors for inclusion, and disagreement was resolved by a third author. Selected full-text articles were divided among all authors for review. Results 13 publications from 8 studies (N=2244, age 6–17) were included. 6 of 13 publications utilized Treatment Options for Type 2 Diabetes in Youth (TODAY) study data. While studies included evaluation of depressive symptoms, most did not formally assess for major depressive disorder (MDD) and excluded participants with a previous diagnosis of MDD. Depressive symptoms were common in this population and were associated with negative T2D outcomes. Conclusions While there is a growing body of adult literature highlighting the extensive relationship between T2D and mental health, there is a dearth of data in youth. Future studies are needed that include, 1.) youth with diagnosed MDD, 2.) treatment studies of both T2D and MDD, 3.) larger, more racially diverse samples of youth with T2D, and 4.) studies that evaluate the impact of social determinants of health, including mental health comorbidity on outcomes of T2D.

Developing Educational Materials to Support Older Adults With Hypertension Management

A comprehensive approach to hypertension management requires medication adherence as well as more general health behavior changes. Our primary objective is to provide evidence-based and tailored education about hypertension, medications, and health self-management strategies with consideration for different stages of behavior change, health literacy, education, disease knowledge, and experience. To facilitate health behavior change, enable information seeking, and increase engagement, the educational materials provide different layers of information, including tips and information in the MEDSReM app, as well as more detailed educational content on the web portal. We will present examples of the materials in different formats to show how they are tailored to ease comprehension, support adherence, and influence behavior change. These educational materials will have broad utility outside of the MEDSReM system, and will also serve as the education-only comparison condition for the randomized controlled trial.

COVID-19 Pandemic on smoking behavior changes among African American Smokers Eligible for LDCT Screening

Smoking has been observed to associate with an elevated severity of disease and risk of mortality among people with COVID-19. Additionally, African American smokers have higher rates of mortality from lung cancer than other racial/ethnic groups. Low dose computed tomography (LDCT) screening can detect lung cancer early to decrease lung cancer-specific mortality for current smokers but remains under-utilized among these population. However, we know little about the effect of COVID-19 pandemic on smoking behavior changes among African American smokers who qualify for LDCT screening. This study recruited 60 African American daily smokers seen in primary care clinics, who qualified to receive LDCT screening in a New Orleans, LA hospital. A total of 22 participants (36.7%) completed anonymous cross-sectional survey that collected demographic, disease history, tobacco use, and smoking cessation behaviors during the period of COVID-19 pandemic via phone interview. The majority were older (61.2 [SD=4.7]), female (77.3%), earned annual income less than $20,000 (100.0%), had Medicaid (63.6%), overweight/obesity (72.7%), planned to quit smoking within 6 months (52.4%), and would consider taking LDCT screening after COIVD-19 pandemic (95.2%). Half of smokers reported they have been diagnosed hypertension (47.6%), diabetes (52.4%), and arthritis (57.1%). Regarding health behavior changes, 42.9% smokers reported they smoked more, felt more stress (42.9%) and anxiety (33.4%) after COVID-19 outbreak. Smoking cessation programs may focus on this high-risk minority population in the post COVID-19 pandemic to help them decrease cigarette smoking and enhance their motivation to quit smoking.

Diabetes Diagnosis, Social Support, and Health Behavior Changes in Older Adults

The growing disease burden of diabetes in older adults highlights the importance of health-promoting behaviors in this population. A new diagnosis of diabetes can be a teachable moment that motivates older adults to engage in health behavior changes. Guided by the convoy model of social relations, social support from family and friends may influence health behaviors, and moderate the effects of a diabetes diagnosis on health behaviors. The current study investigates health behavior changes in drinking, smoking, and physical activity before and after a diabetes diagnosis, and whether social support moderates the relationships. A sample of 13,143 older adults without diabetes at baseline were selected from the Health and Retirement Study, and followed up for six waves. Social support from family and friends were measured separately. Mixed-effects regression models were performed. Sampling weights were adjusted to generate population estimates. After a diabetes diagnosis, older adults reduced alcohol consumption and were more likely to quit smoking. More social support from family was associated with decreased alcohol consumption, and more social support from friends was associated with increased physical activity. Significant interaction between social support from family and diabetes diagnosis was found. Specifically, among older adults with a diabetes diagnosis, more social support from family was associated with less drinking and smoking cessation. The study findings suggest that health practitioners can consider the timing of diabetes diagnosis to facilitate health behavior changes. Furthermore, diabetes educators can help older adults mobilize support from family and friends to better engage in health-promoting behaviors.

The Impact of Racial and Non-racial Discrimination on Health Behavior Change Among Visible Minority Adults During the COVID-19 Pandemic

Introduction Pre-pandemic health behavior has been put forward as a reason for excess COVID-19 infection and death in some racialized groups. At the same time, scholars have labeled racism the other pandemic and argued for its role in the adverse COVID-19 outcomes observed. The purpose of this study was to examine the impact of discrimination on health behavior change among racialized adults in the early stages of the pandemic. Methods Data were collected from 210 adults who identified as a visible minority in Alberta, Canada, in June 2020. The Everyday Discrimination Scale (Short Version) was adapted to examine past-month experiences. Four questions asked if alcohol/cannabis use and stress eating had significantly increased, and if sleep and exercise had significantly decreased in the past month. Logistic regression models examined associations between discrimination attributed to racial and non-racial causes and health behavior change adjusted for covariates. Results The majority of adults (56.2%) reported past-month discrimination including 26.7% who attributed it to their race. Asian adults reported more racial discrimination and discrimination due to people believing they had COVID-19 than other visible minorities. Racial discrimination during the pandemic was strongly associated with increased substance use (OR: 4.0, 95% CI 1.2, 13.4) and decreased sleep (OR: 7.0, 95% CI 2.7, 18.4), and weakly associated with decreased exercise (OR: 2.2, 95% CI 1.1, 4.5). Non-racial discrimination was strongly associated with decreased sleep (OR: 4.8, 95% CI 1.8, 12.5). Conclusion Racial discrimination may have a particularly important effect on intensifying adverse health behavior changes among racialized adults during a time of global crisis.

The COVID-19 Pandemic Strain: Teleworking and Health Behavior Changes in the Portuguese Context

The COVID-19 pandemic has forced a societal essay, based on thorough measures of individual and communitarian protection, ranging from compulsory social distancing to quarantine. Following WHO recommendations, more or less strict policies were adopted by governments worldwide in order to mitigate public health risks. In Portugal, the first state of emergency was declared on 18 March 2020 and renewed until 2 May 2020. During this time, most citizens stayed in quarantine with practical implications regarding their work and daily activities. This exploratory study, conducted within the pandemic crisis context in Portugal, intends to grasp specificities of the adaptation to the lock down and social isolation/distancing measures, concerning, specifically, teleworking conditions and physical activity practice. Data was collected from March to May 2020 through an online survey from 1148 participants of different age groups and literacy. Considering that COVID-19 features a mutual feedback loop of disease and social dynamics—governmental measures, civic adjustments, and individual coping—to know more about what was featured, the first wave may provide some cues to ensure a more efficient co-operation among social actors and, ultimately, tailor better public policies towards teleworking, online distance learning, and the promotion of healthy behaviours.

Acceptability of a Mobile-Health Living Kidney Donor Advocacy Program for Black Wait-Listed Patients

Marked racial disparities exist in rates of living donor kidney transplantation (LDKT). The Living Organ Video Educated Donors (LOVED) program is a distance-based, mobile health program designed to help Black kidney transplant wait-list patients advocate for a living donor. This study reported on the acceptability outcomes to aid in future refinements. Participants were randomized to LOVED (n = 24, mean age = 50.9 SD (9.2) years), male = 50%) and usual care groups (n = 24 (mean age 47.9 SD (10.0), male 50%). Four LOVED groups completed an eight-week intervention that consisted of six online video education modules and eight group video chat sessions led by a Black navigator. Qualitative analysis from post-study focus groups resulted in six themes: (1) video chat sessions provided essential support and encouragement, (2) videos motivated and made participants more knowledgeable, (3) connectivity with tablets was acceptable in most areas, (4) material was culturally sensitive, (5) participation was overall a positive experience and (6) participants were more willing to ask for a kidney now. The video chat sessions were pertinent in participant satisfaction, though technology concerns limited program implementation. Results showed that the LOVED program was acceptable to engage minorities in health behavior changes for living donor advocacy but barriers exist that require future refinement.