Jeffrey S. Hallam

Sociodemographic and Psychological Correlates of Sun Protection Behaviors among Outdoor Workers: A Review

Outdoor workers are at a higher risk for developing skin cancer due to their increased sun exposure. The primary objective of this review was to synthesize the current research literature that addresses sociodemographic and psychological factors related to sun protection behaviors in outdoor workers. Two additional purposes were to provide an overview of sun exposure and describe sun protection behaviors of outdoor workers. To identify the studies for this review, a methodical search was performed in the PubMed, PsycInfo, MEDLINE, and ERIC databases. Fifteen studies met the review criteria. Despite regular and prolonged sun exposure, many outdoor workers fail to engage in sufficient sun protection behaviors. Correlates of outdoor workers sun protection behaviors include being female, older age, being white, personal skin cancer history, time (hours/years) spent at work, sun safety training, perceived prioritization of sun protection, concern about sun exposure, workplace support, families expectations, and familial information giving. However, limited attention is given to designing theoretically grounded studies to identify factors to inform future research. There is a need to conduct research based on solid theoretical foundations that explains the relationships among the factors in this domain.

Skin Cancer Knowledge, Beliefs, Self-Efficacy, and Preventative Behaviors among North Mississippi Landscapers

There are slightly over one million workers in the landscape service industry in the US. These workers have potential for high levels of solar ultraviolet radiation exposure, increasing their risk of skin cancer. A cross-sectional sample of 109 landscapers completed a self-administered questionnaire based on Health Belief Model (HBM). The participants correctly answered 67.1% of the knowledge questions, 69.7% believed they were more likely than the average person to get skin cancer, and 87.2% perceived skin cancer as a severe disease. Participants believed that the use of wide-brimmed hats, long sleeved shirts/long pants, and sunscreen was beneficial but reported low usage of these and other sun protective strategies. The primary barriers to using sun protection were “I forget to wear it” and “it is too hot to wear.” Of the HBM variables, perceived benefits outweighing perceived barrier (r = .285, P = .003) and self-efficacy (r = .538, P = .001) were correlated with sun protection behaviors. The reasons for absence of the relationship between perceived skin cancer threat and sun protection behaviors could be lack of skin cancer knowledge and low rate of personal skin cancer history.

A community health needs assessment using principles of community-based participatory research in a Mississippi Delta community: a novel methodological approach

This article describes the methodological approach used to conduct a community health needs assessment (CHNA) using community-based participatory research (CBPR) principles in a Mississippi Delta community. Eighty-five residents participated in the study that was conducted in Charleston, Mississippi. The mixed-methods research design included five components: key informant interviews, focus groups, assessments of the built and the nutrition environment, and assessment of selected health policies. Findings from the CHNA revealed priority health concerns, social and environmental issues, strengths, weaknesses, and assets of the community, as well as existing organizations that could be involved in efforts to improve health. Findings from the CHNA identify the priority health issues, needs, and service gaps. These findings will be used to inform future planning, development, implementation, and evaluation of programs to improve the health of the Charleston community. This study provides numerous methodological contributions to the existing literature regarding CBPR and CHNAs that may help development researchers and practitioners.

Use of analgesics for exercise-associated pain: prevalence and predictors of use in recreationally trained college-aged students.

Abstract Brewer, CB, Bentley, JP, Hallam, JS, Woodyard, CD, and Waddell, DE. Use of analgesics for exercise-associated pain: prevalence and predictors of use in recreationally trained college-aged students. J Strength Cond Res 28(1): 74–81, 2014—The objectives of this study were to examine the use of the analgesics for the relief of exercise-associated pain (EAP) and to examine personal and/or exercise characteristics that might potentially predict such use in recreationally trained college-aged individuals. Recreationally trained college-aged students (N = 263) were invited to complete a self-administered 16-item questionnaire concerning personal exercise habits and analgesic use for EAP. The primary dependent variable was analgesic use for EAP, and additional items sought to characterize patterns and behaviors related to the use. Descriptive statistics and frequencies were calculated for all items, and logistic regression was used to evaluate the ability of 4 variables to predict analgesic use for EAP: gender, length of time performing regular exercise, weekly frequency of aerobic exercise, and weekly frequency of resistance exercise. Approximately 36% of respondents reported analgesic use for EAP, with data indicating acute use for what is generally acute pain. With predictors considered individually, gender was a significant predictor, with female respondents being more likely to use analgesics for EAP (p = 0.04). With all predictors considered concurrently, the model did not significantly contribute to the prediction of use in this sample. Potential for misuse was highlighted by a large percentage of users who described themselves as very unlikely to follow label directions and more likely to take a dose exceeding recommendations. In light of research that reports a potential detriment to muscular regeneration when analgesics are consumed with exercise, it is important to be cognizant of the use of these drugs in individuals striving to improve muscular fitness. Coaches and trainers should educate athletes about the associated risks and caution those who may unnecessarily take analgesics.

Hand hygiene among healthcare workers: A qualitative meta summary using the GRADE-CERQual process:

Background: Hand hygiene is considered an effective and potentially modifiable infection control behaviour among healthcare workers (HCW). Several meta-studies have been published that compare quantitatively expressed findings, but limited efforts have been made to synthesise qualitative research. Objectives: This paper provides the first report of integrated findings from qualitative research reports on hand hygiene compliance among HCW worldwide that employs the GRADE-CERQual process of quality assessment. Methods: We conducted database searches and identified 36 reports in which authors conducted qualitative or mixed methods research on hand hygiene compliance among HCW. We used Dedoose analysis software to facilitate extraction of relevant excerpts. We applied the GRADE-CERQual process to describe relative confidence as high, moderate or low for nine aggregate findings. Findings: Highest confidence findings included that HCW believe they have access to adequate training, and that management and resource support are sometimes lacking. Individual, subjective criteria also influence hand hygiene. Discussion: These results suggest the need for further investigation into healthcare cultures that are perceived as supportive for infection control. Surveillance processes have potential, especially if information is perceived by HCW as timely and relevant.

Not Enough Time in the Day: A Qualitative Assessment of In-School Physical Activity Policy as Viewed by Administrators, Teachers, and Students

BACKGROUNDnIn recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in-school physical activity (ISPA) recommendations and state-level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this investigation was to explore barriers and facilitators to implementing state-mandated ISPA policies in the Mississippi Delta.nnnMETHODSnFocus groups or interviews were conducted with district administrators, school principals, teachers, and students. A total of 2 semistructured moderator guides were developed to focus on (1) student ISPA practices and preferences and (2) facilitators and barriers to implementing ISPA policies and practices.nnnRESULTSnA total of 6 themes were developed. In that, 2 themes addressed participant-described barriers (primary challenges and interferences and excuses). Three themes highlighted participant-described facilitators (compromises, things that work, and being active at school). Finally, 1 theme encompassed the participant-described need to address educating the whole child.nnnCONCLUSIONSnThere is a critical need for meaningful and relevant solutions to circumvent challenges to implementing ISPA policies and practices in the Mississippi Delta. The Whole School, Whole Community, Whole Child model offers a broad means of visualizing rural, low-income, racially concentrated schools to circumvent challenges and foster ISPA policies and practices.

Flipping the on switch: Men who became regularly physically active during middle age

One method to increase physical activity (PA) in ageing adults is through the use of intervention research, and a means to inform designs of PA interventions is to examine the practices of those who are successful in adhering to activity. However, authors of recent review articles suggest that males are underrepresented in intervention research studies. Consequently, this study was designed to use the interpretative phenomenological analysis approach to explore the motivators and practices of three older active males who independently initiated regular PA participation during middle age. Participants discussed the role of mentors and other influences, and their awareness of effort or intensity during activity. Data analysis suggested that these men assertively managed their environments and used internal restraints in order to regulate their PA participation, consistent with some elements of Banduras social cognitive theory. Activity researchers might consider counselling participants in effective use of the indicated strategies.

Men’s Preferences for Physical Activity Interventions: An Exploratory Study Using a Factorial Survey Design Created With R Software:

Effective exercise interventions are needed to improve quality of life and decrease the impact of chronic disease. Researchers suggest males have been underrepresented in exercise intervention studies, resulting in less understanding of their exercise practices. Findings from preference survey methods suggest reasonable association between preference and behavior. The purpose of the research described in this article was to use factorial survey, a preference method, to identify the characteristics of exercise interventions most likely to appeal to male participants, so preferences might be incorporated into future intervention research. The research was guided by the framework of Bandura’s social cognitive theory, such that variations in individual, environmental, and behavioral factors were incorporated into vignettes. Participants included 53 adult male nonadministrative staff and contract employees at a public university in the Southeastern United States, who each scored 8 vignettes resulting in 423 observations. Multilevel models were used to assess the influence of the factors. Participants scored vignettes that included exercising with a single partner, playing basketball, and exercising in the evening higher than vignettes with other options. Qualitative analysis of an open response item identified additional alternatives in group size, participant desire for coaching support, and interest in programs that incorporate a range of activity alternatives. Findings from this research were consistent with elements of social cognitive theory as applied to health promotion. Factorial surveys potentially provide a resource effective means of identifying participants’ preferences for use when planning interventions. The addition of a single qualitative item helped clarify and expand findings from statistical analysis.

Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis:

Objective: Occurrences of healthcare-associated infections are associated with substantial direct and indirect costs. Improvement in hand hygiene among acute care nurses has potential to reduce incidence of healthcare-associated infections. Findings from reviews of intervention research have not conclusively identified components that are more or less efficient or effective. Much prior qualitative research has focused on descriptive analysis of policies and practices rather than providing interpretive explorations of how individuals’ perceptions of hygiene might drive practices. Methods: We conducted qualitative interview research with eight nurses in the United States who were employed in various patient-care roles. We analyzed the data using an interpretative phenomenological analysis methodology to explore how nurses described their perceptions of, and experiences with, hygiene. We developed themes that explored individual, workplace, and management influences on perception of hygiene. Results: Developed themes include practical hygiene, risky business, and hygiene on trial; the latter theme described the conflict between how nurses perceived their own hygiene practices and how they felt hospital management perceived these practices. Other findings included that participants distinguished between policy-mandated use of sanitizer and a personal sense of cleanliness; the latter was more likely to be associated with scrubbing or removal of contaminants than with use of protectants. Conclusion: While participants asserted support for facility hand hygiene policies, their behavior in certain instances might be mediated by broadly defined emergent situations and a belief that it is not currently possible to establish a causal link between an healthcare-associated infections and a specific individual or occurrence. Researchers and infection prevention practitioners might consider soliciting greater input from nurses in planning hand hygiene improvement interventions, to encourage ownership, and emphasizing detailed cases as training content to take advantage of individuals’ sensory responses to hygiene.

Predictors of Bone Mineral Density in African-American and Caucasian College-Aged Women

BACKGROUNDnResearch regarding risk factors and prevalence of low bone mineral density (BMD) among African-American and Caucasian college-aged women are limited. The objective of this cross-sectional study was to determine if selected predictors of BMD in African-American and Caucasian college-aged women differ by race.nnnMETHODSnA total of 101 local African-American (n=50) and Caucasian (n=51) females, ages 18 to 30 years, were in this study. All data were collected in the Bone Density and Body Composition Laboratory. BMD was measured using DXA technology. Race, family history of osteoporosis, BMI, current physical activity, osteoporosis knowledge, length of time on oral contraceptives, age at menarche and calcium intake were included in the multiple regression analyses with spinal and femoral BMD as dependent variables.nnnRESULTSnOverall, 38.6% had low spinal BMD and 7.9% had low femoral BMD. BMI (β=0.073, R(2) = .148, P = .001, 95% CI [0.030, 0.116]) and current physical activity (β=0.071, R(2) = .148, P = .017, 95% CI [0.013, 0.129]) were the only variables that were statistically significant in predicting spinal BMD. BMI (β=0.056, R(2) = .13, P = .010, 95% CI [0.014, 0.098]) and current physical activ-ity (β=0.078, R(2) = .13, P = .007, 95% CI [0.022, 0.134]) were also the only varia-bles that were statistically significant in predicting femoral BMD. Race was not a significant predictor of spinal or femoral BMD.nnnCONCLUSIONnIt is imperative for both African-American and Caucasian women to engage in osteoporosis-preventive behaviors.