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

Author(s):  
Cheryl L. Currie ◽  
Erin K. Higa

Abstract 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.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 98-98
Author(s):  
Lawson Eng ◽  
Sophia Yijia Liu ◽  
Qihuang Zhang ◽  
Delaram Farzanfar ◽  
Sabrina Yeung ◽  
...  

98 Background: Health behavior change including smoking cessation, physical activity (PA) and alcohol moderation are important aspects of cancer survivorship. We assessed cancer pt interest and perceptions of programs for these behaviours. Methods: 501 cancer pts were surveyed on their smoking, PA and alcohol use along with their interest and perceptions for programs for these behaviors. Multivariate logistic regression models identified factors associated with pt interest and perceptions. Results: At diagnosis, 115 pts smoked; 184 were exposed to second hand smoke (SHS); 313 did not meet PA guidelines; 238 were drinking alcohol. At risk pts’ (e.g, smokers for smoking cessation, SHS exposed for household smoking cessation) survey results are shown in the table. Most pts perceived smoking (90%), SHS (83%) and alcohol (56%) to be harmful on quality of life, survival and fatigue while PA (77%) was felt to improve these outcomes. These perceptions were not associated with program interest ( P> 0.05). However, pts perceiving that alcohol worsened and PA improved these outcomes were more to likely believe associated programs are beneficial (alcohol aORs = 2.1-2.2 P< 0.03; PA aORs = 1.9-3.2 P< 0.02) and should be routine care (alcohol aORs = 1.9-3.5 P< 0.03; PA aORs = 1.7-2.4 P< 0.1). Pts with more pack-yrs smoked less likely perceived a benefit in a household smoking cessation program (aOR = 1.02 P< 0.007). Pts preferred discussing programs with doctors ( > 35%) or counsellors ( > 42%). Conclusions: About half of pts feel that health behavior change programs would be beneficial and should be part of routine care. These factors were more important than perception of the behaviors on outcomes in influencing pt interest. Initial discussions with pts should focus on discussing benefits of these programs. [Table: see text]


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11561-11561
Author(s):  
Lawson Eng ◽  
Katrina Hueniken ◽  
M. Catherine Brown ◽  
Andrew Hope ◽  
Meredith Elana Giuliani ◽  
...  

11561 Background: Health behavior changes including tobacco cessation and increasing physical activity (PA) are important aspects of cancer survivorship. Understanding how these behaviours impact on HU and financial toxicity will help when evaluating survivorship programs. We evaluated the impact of tobacco cessation and PA on HU, function and financial toxicity among HNC patients (pts). Methods: HNC pts from Princess Margaret Cancer Centre completed questionnaires at baseline (diagnosis) and 12 months between 2014-2018 evaluating tobacco use, PA with the Godin questionnaire, cancer related monthly out of pocket costs (OOPC), HU using HU Index Mark 3, function using Lawton Brody Scale (LBS) and lost annual income. Multivariable linear regression analyses evaluated the impact of health behaviour change on OOPC, HU, LBS and lost income. Results: Among 296 pts, mean age 61, 76% male; 29% smoked at diagnosis, 60% quit 1 year after; 26% met PA guidelines at diagnosis, 52% continued to meet guidelines at 1 year. 19% of those not meeting PA guidelines at diagnosis, met them at 1 year. Among all, mean HU [SEM] was 0.84 [0.01] (baseline), 0.80 [0.01] (12 months); mean monthly OOPC [SEM] were $171 [27] (12 months); mean annual lost individual income was $25897 [2945]. Among smokers at diagnosis, those continuing to smoke at 1 year lost a mean of $21272 (95% CI [$2783-39761] P= 0.03) more in individual annual income compared to pts who quit, adjusted for baseline income and education. Current smokers who quit smoking at 1 year had an adjusted mean increase in HU of 0.15 ([0.00-0.30] P= 0.05) greater than pts continuing to smoke. Pts who continued meeting PA guidelines at 1 year had an adjusted mean increase in HU scores of 0.11 ([0.02-0.20], P= 0.02) compared to those reducing PA levels after diagnosis. Changes in PA and tobacco were not associated with change in function or OOPC; improving to meet PA guidelines after diagnosis was not associated with HU or lost income ( P> 0.05). Conclusions: Quitting smoking and maintaining PA levels after diagnosis were associated with improvements in HU scores; quitting smoking reduced lost income. Cancer survivors should be made aware of the potential economic impact of behaviour change.


2016 ◽  
Vol 12 (3) ◽  
pp. 184-199 ◽  
Author(s):  
Steve Amireault ◽  
Angela J. Fong ◽  
Catherine M. Sabiston

Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.


10.2196/19237 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e19237
Author(s):  
Anna Robinson ◽  
Umay Oksuz ◽  
Robert Slight ◽  
Sarah Slight ◽  
Andrew Husband

Background Digital technology has influenced many aspects of modern living, including health care. In the context of elective surgeries, there is a strong association between preoperative physical and psychological preparedness, and improved postoperative outcomes. Health behavior changes made in the pre- and postoperative periods can be fundamental in determining the outcomes and success of elective surgeries. Understanding the potential unmet needs of patients undergoing elective surgery is central to motivating health behavior change. Integrating digital and mobile health technologies within the elective surgical pathway could be a strategy to remotely deliver this support to patients. Objective This meta-ethnographic systematic review explores digital interventions supporting patients undergoing elective surgery with health behavior changes, specifically physical activity, weight loss, dietary intake, and psychological support. Methods A literature search was conducted in October 2019 across 6 electronic databases (International Prospective Register of Systematic Reviews [PROSPERO]: CRD42020157813). Qualitative studies were included if they evaluated the use of digital technologies supporting behavior change in adult patients undergoing elective surgery during the pre- or postoperative period. Study quality was assessed using the Critical Appraisal Skills Programme tool. A meta-ethnographic approach was used to synthesize existing qualitative data, using the 7 phases of meta-ethnography by Noblit and Hare. Using this approach, along with reciprocal translation, enabled the development of 4 themes from the data. Results A total of 18 studies were included covering bariatric (n=2, 11%), cancer (n=13, 72%), and orthopedic (n=3, 17%) surgeries. The 4 overarching themes appear to be key in understanding and determining the effectiveness of digital and mobile interventions to support surgical patients. To successfully motivate health behavior change, technologies should provide motivation and support, enable patient engagement, facilitate peer networking, and meet individualized patient needs. Self-regulatory features such as goal setting heightened patient motivation. The personalization of difficulty levels in virtual reality–based rehabilitation was positively received. Internet-based cognitive behavioral therapy reduced depression and distress in patients undergoing cancer surgery. Peer networking provided emotional support beyond that of patient-provider relationships, improving quality of life and care satisfaction. Patients expressed the desire for digital interventions to be individually tailored according to their physical and psychological needs, before and after surgery. Conclusions These findings have the potential to influence the future design of patient-centered digital and mobile health technologies and demonstrate a multipurpose role for digital technologies in the elective surgical pathway by motivating health behavior change and offering psychological support. Through the synthesis of patient suggestions, we highlight areas for digital technology optimization and emphasize the importance of content tailored to suit individual patients and surgical procedures. There is a significant rationale for involving patients in the cocreation of digital health technologies to enhance engagement, better support behavior change, and improve surgical outcomes.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 230-230
Author(s):  
Qiong Nie ◽  
Maurita Harris ◽  
Stacy Al-Saleh ◽  
Ysabel Beatrice Floresca ◽  
Wendy Rogers

Abstract 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.


Reports ◽  
2020 ◽  
Vol 3 (4) ◽  
pp. 35
Author(s):  
Katherine P. Nickele ◽  
Liliana Bolanos ◽  
Punreet K. Bhatti ◽  
Karen Williams ◽  
Maryann Mason ◽  
...  

Little is known about the influence of parental values, preferences, and child achievement and health expectations on parent choices for their child’s rearing practices. We aimed to explore parents’ perceptions of immediate and future impact of health behavior decisions for their child and to understand factors associated with child-specific health behavior decisions. This pilot study included interviews with 25 parents of 9–24-month-old children attending well child care visits at a primary care practice. Questions assessed parental perceptions and attitudes in making health behavior changes now for their child’s future health. Themes suggest parents perceive many factors are involved, and intricately connected, in health behavior decision-making. Although almost all parents believed there is a connection between the foods they feed their child and achieving their goals, only half are willing to make a change. In addition, parents failed to consider the impact of the health practices they currently have with their children to influence the future acquisition of life skills and of healthy versus obesogenic behaviors. Our results add to the understanding of the process of health behavior change through anticipatory guidance. Study findings will be used to guide next steps towards refining our understanding of health and lifestyle change decisions made by parents.


2018 ◽  
pp. e000116
Author(s):  
Manoj Sharma

Intelligence Quotient (IQ) has been used for a long time to test for readiness of individuals with regard to their learning abilities.  It offers limited utility in ascertaining readiness toward health behavior change.  Work on emotional quotient (EQ) and X quotient (XQ) has been done in recent years but has not been applied for determining readiness toward health behavior change through health education and health promotion interventions.  The purpose of this editorial is to propose a novel concept of perfection quotient (PQ) that integrates IQ, EQ and XQ for ascertaining the readiness for health behavior change through health education and health promotion interventions in a variety of target populations. Such measure will be invaluable in ameliorating the impact of health education and health promotion interventions.


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