Gerald C. Hyner

Body Mass Index and perceived weight status in young adults

Body Mass Index (BMI) was calculated from self-reported height and weight for 1,123 university students who returned a questionnaire mailed to a 10 percent random sample of the entire undergraduate population of a large midwestern university. Seventeen percent of the females and 20 percent of the males were determined to be in excess of normal BMI standards. However, significantly more women (40%) considered themselves overweight in comparison to men (24%). Also, significantly more women (53%) than men (20%) reported experiencing discomfort due to excessive weight. Inaccurate perceptions of body image are common among individuals with eating disorders. There is a higher incidence of eating disorders among college-age women than among their male peers. A distorted body image as reflected by perceived overweight may serve as a marker for individuals at risk for eating disorders.

Loneliness, emotional repression, marital quality, and major life events in women who develop breast cancer.

Women awaiting mammograms at a breast clinic were given questionnaires to investigate the role of psychosocial variables in the development of breast cancer while controlling for established breast cancer risk factors. Questionnaires to determine loneliness, emotional repression, marital quality, and major life changes were completed by 826 female volunteers who were later classified into groups according to their diagnoses. The total emotional repression score showed a hierarchy of most repression to least repression for the most-diseased to the most-healthy subjects. A breakdown of the emotional repression scale revealed that each group was significantly different from the other in suppression of anger and unhappiness. Women in the new cancer group showed significantly more loneliness than the women in the fibrocystic and normal groups. The newly diagnosed cancer group also had a higher proportion of women who experienced the death of a spouse or close family member within the past two years compared to the other groups.

Blood Pressure and Anthropometric Differences in Regularly Exercising and Nonexercising Black Adults

Few studies have examined the relationship between exercise and BP in Black adults, a population with substantial risk for hypertension. This pilot study was undertaken to examine BP, anthropometric characteristics, dietary intake, and resting pulse rate by level of exercise participation in a group of Black Seventh Day Adventists. Subjects were classified as regular exercisers (n = 54, age = 54.6 yrs) if they reported at least two exercise sessions per week (x = 4.0 times per week) lasting a minimum of 20 minutes each, in which they engaged in vigorous exercise. Nonexercisers (n = 60, age = 56.2 yrs) were those who reported participation in such exercise no more than once per week (x = 0.1 times per week). There were no group differences in dietary intake of any macro or micronutrients, but exercisers exhibited significantly lower body mass index, waist circumference, triceps skinfold thickness, and resting pulse rate. Forty-two percent of the nonexercisers were confirmed hypertensives compared to only 20 percent of the exercisers. Age and gender-adjusted BP was significantly lower in the exercisers (BP = 123.8/73.4 mm Hg) compared to the nonexercisers (BP = 133.5/77.1 mm Hg). After adjustment for anthropometric differences, the systolic BP of the exercisers remained approximately 8 mm Hg lower than their nonexercising counterparts. These data suggest that participation in vigorous exercise is favorably related to blood pressure and may attenuate the risk of hypertension in Black Seventh Day Adventists.

The effects of a comprehensive health risk appraisal, basic screening, and interpretation session on employee health practices: differences between participants and nonparticipants.

Small companies often do not have the resources for comprehensive health promotion programs but may be willing to invest in health screenings which include a computerized health risk appraisal (HRA). Although HRAs are frequently used as motivational devices, the efficacy of this technique in modifying health behaviors remains unclear. While some investigators have provided evidence that HRAs influence behavior change,1’~ others have concluded that the health practices of participants in worksite screenings were unaffected? ’4 This investigation was designed to assess the health practices of employees before and after a worksite health screening, and thereby determine the efficacy of a comprehensive health screening with HRA as a means of fostering healthy behavior change. The purpose of this investigation was to answer the following question: Do the health practices of employee participants change as a result of a basic health screening which includes an HRA and group feedback sessions to explain the results?

Lifestyle Behavior Change and Repeat Health Risk Appraisal Participation: A Structural Equation Modeling Approach

Purpose. Health risk appraisals (HRAs) have been used to address multiple health concerns and lifestyle behaviors. We explore the longitudinal relationship between emotional health, stage of change for five lifestyle behaviors, and lifestyle risks using HRA-generated data. Design. Secondary analysis of 3 years of HRA data. Setting. A large health care management services provider. Subjects. A total of 7535 adults employed across three companies who completed consecutive HRAs over a 3-year period. Measures. Self-report items concerning participant health, lifestyle behaviors, disease risk factors, job/life satisfaction, safety, and biometrics. Analysis. Structural equation modeling tested a hypothesized longitudinal, fully cross-lagged panel design. Results. Results indicated that greater numbers of physical and behavioral risks classified as high risk were associated with greater intention to change or an actual change in lifestyle behavior in the following year. In addition, poorer emotional health was associated with a higher number of risks. Conclusion. Data from repeat participation in HRAs can be useful in studying multiple risk behaviors and related health measures, supporting the design and evaluation of effective, individualized, and responsive health promotion activities for working adults.

Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators.

Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the participation of older adults in health promotion programs were scheduling conflicts, physical and mental health issues, a lack of comfort with the health content, and insufficient program information.

A Preferred Target Population for Comprehensive Health Promotion

Health promotion (HP) strategies have been advocated as a means of enhancing individual responsibility for health maintenance, while reducing client dependence on the medical care system. Similarly, advocates of HP have suggested that it may positively affect medical costs and physical/behavioral risk factors among others. To properly test the long-term effects of carefully planned HP interventions, a preferred target population is proposed. It is suggested that clientele would be drawn from moderate or low risk individuals who are seldom the population-of-interest within the traditional medical care model. The authors offer a model for comprehensive HP and discuss the implications of defining a target population for HP strategies.

Focus Group Study of Chinese International Students’ Knowledge and Beliefs About HPV Vaccination, Before and After Reading an Informational Pamphlet About Gardasil®

An increasing need for Human Papillomavirus (HPV) vaccines in China remains unmet in the mainland and the knowledge and intentions of Chinese youth regarding vaccination is unknown. In the fall of 2013, 44 Chinese international students (CIS) attending a university in the United States Midwest participated in 10 focus group discussions (five female and five male). Result showed that participants have limited awareness and knowledge about HPV infection and vaccination, participants erroneously believed that the causes of cervical cancer are abortion and miscarriage. Participants rely heavily on informal sources such as Chinese-based social media platforms and personal social networks for information on sexually transmitted infections. Sexual cultures and behaviors are perceived differently between CIS born in the 1990s and 1980s. Interestingly, participants’ perceived stigma about HPV infection decreased with improving knowledge level during group discussions. In conclusion, HPV vaccine should be further promoted alongside sex education among CIS.

Physical Activity Attitudes, Beliefs, and Practices among Adults 50 and Older: Baseline Community Assessment

This study aligned with the National Blueprint, a coalition of national organizations to identify the principal barriers to physical activity participation in older adults and to outline strategies for increasing physical activity levels. A community coalition took the initiative to conduct a baseline assessment of health attitudes, perceptions, and behaviors among community adults in order to understand the immediate needs of the adult community. Adults 50 and older (N = 309) completed surveys of health and physical activity (PA) behaviors. Individuals reported below average physical activity levels. Motives and barriers to PA differed by gender and race/ethnicity. Age and health perceptions significantly predicted PA levels. Findings support previous research with this age group, thus discussion of the utility of multi-level approaches (e.g., social ecological model) to health betterment in communities is forwarded. Providing multi-level resources (personal, social, environmental, policy) can increase opportunities for adoption and maintenance of health behaviors.

Beyond Blood Pressure Screening: A Rationale for Promoting the Primary Prevention of Hypertension

High blood pressure is a major public health problem in the United States. However, the underlying reasons for the chronic elevation of blood pressure (BP) are unknown in most cases of hypertension (HT), and medical care has focused on lowering already elevated BP, primarily by pharmacologic means. Although an important factor in the development of HT appears to be a genetic predisposition, other potentially modifiable lifestyle risk factors associated with elevated BP have been identified. This article describes the scientific rationale for encouraging health promotion specialists to focus on the primary prevention of abnormally elevated blood pressure. Nonbehavioral risk factors such as increasing age, history of HT, Black ancestry, and consistent BP readings in the higher range of normality, and behavioral factors including dietary excesses and deficiencies, excessive body fat, a sedentary life style, and frequent episodes of unmanageable emotional stress are addressed. Recommendations are made based on scientific evidence supporting the relationships between these risk factors and the development of HT.