Factors Associated with Physical Activity Increases and Decreases Among a Sample of Appalachian Residents During the COVID-19 Pandemic: A Cross-Sectional Study.

Introduction: Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S. have decreased than increased PA, and the effects vary by sociodemographic factors. Ongoing evidence is important to identify patterns in PA changes during the pandemic. Purpose: This study aims to identify factors associated with increases and decreases in PA during the COVID-19 pandemic in a convenience sample of adults residing in Appalachia. Methods: Surveys were collected from a convenience sample of adults from eight counties in West Virginia from January to March 2021. Logistic regression analysis was used to identify sociodemographic, health, and rurality factors associated with (1) increased PA and (2) decreased PA during the pandemic, assessed retrospectively via self-report. Results: Analysis of 1,401 survey responses revealed that better self-rated health, lower body mass index, and higher income and education were associated with a greater likelihood of more time spent doing PA during the pandemic ( p ≤ .05). Respondents with lower self-rated health, higher body mass index, lower income, and lower levels of education-plus females and those living in a more urban county-were more likely to spend less time doing PA during the pandemic ( p ≤ .05). Implications: Analyses suggest that pre-pandemic disparities in PA by health, wealth, and education were exacerbated during the pandemic. These must be addressed before physical inactivity and ill health become endemic to the Appalachian Region.

Using adverse childhood experiences to explore the usefulness of community health needs assessments to monitor complex determinants of health at the local level.

BACKGROUND: Hospital led community health needs assessments (CHNAs) are intended to help medical care organizations assess determinants of health within the communities they serve. This study demonstrates the utility of data from non-profit hospital CHNAs to monitor complex health issues such as adverse childhood events (ACEs) at the local-level. METHODS: CHNA data were collected from August to November 2019 and analyzed July 2021. A series of logistic regressions were used to analyze associations between ACEs, mental health conditions, and self-rated health from a convenience sample of 2831 adults from two regional hospitals that service five counties located in central Appalachia. RESULTS: ACEs were associated with increased odds of experiencing all metal health conditions after adjusting for other exposures and demographics, including: bipolar disorder (AOR: 2.42, CL: 1.78, 3.30), chronic pain (AOR: 1.61, CL: 1.438, 1.87), depression (AOR: 2.05, CL: 1.76, 2.36), PTSD (AOR: 3.83, CL: 2.95, 4.98), and poor self-rated health (AOR: 1.88, CL: 1.65, 2.15). CONCLUSION: Findings suggest hospital CHNAs are a useful way to assess local data and should include factors known to antecede disease including associated risks and outcomes. CHNAs may provide an opportunity to fill important gaps in community surveillance and inform local prevention and treatment strategies.

School Climate as an Intervention to Reduce Academic Failure and Educate the Whole Child: A Longitudinal Study.

BACKGROUND: Preventing student academic failure is crucial to student health and life success. Previous studies suggest a positive school climate may reduce students' risk for academic failure and contribute to academic success. The purpose of this study was to determine the longitudinal associations between school climate and academic grades in a group of middle school students who transition into high school. METHODS: Parallel latent growth curve modeling was used to examine changes among study variables longitudinally using a sample of 2604 in 6th, 7th, and 8th-grade students across 16 regional schools located in 3 counties in West Virginia. RESULTS: Students with higher perceptions of a positive school climate exhibited sustained or improved academic achievement over time (ß = 0.22 to 0.30, p < .01). Higher positive perceptions of school climate appear to sustain students who earn As/Bs (ß = 0.20 to 0.27, p < .01) and strengthen students who earn Cs/Ds/Fs (ß = -0.16 to -0.46, p < .05). CONCLUSIONS: Positive student perceptions of school climate may sustain high academic performance while strengthening students who earn Cs/Ds/Fs. School climate may be useful as an intervention to support school-based health promotion to reduce the achievement gap in the United States.

Impact of an Intimate Partner Violence Training on Home Visitors' Perceived Knowledge, Skills, and Abilities to Address Intimate Partner Violence Experienced by Their Clients.

AIMS: The aims of this study were to (1) evaluate the effects of a statewide intimate partner violence (IPV) training on home visitors' perceived knowledge, skills, and abilities to address IPV experienced by their clients and (2) examine home visitors' perceived barriers to addressing IPV during client home visits. METHODS: In 2015, five equivalent, daylong IPV trainings were held throughout West Virginia. Attendance was mandatory for all home visitors in the state. Pre- and posttraining surveys were administered to every attendee ( N = 125). The surveys assessed home visitors' perceived knowledge, skills, and abilities to address IPV experienced by their clients and perceived barriers to addressing IPV during a client home visit. RESULTS: The results showed (1) home visitors' knowledge, skills, and abilities significantly improved from pre- to posttraining (all p < .05) and (2) the most commonly reported barriers to addressing IPV were "the partner is present for the visit" (86.2%), "worried that asking may risk my relationship with my client" (30.2%), "not sure how to ask questions without seeming too intrusive" (25.9%), and "worried about upsetting the client" (21.6%). CONCLUSIONS: Our findings highlight the immediate positive effects of an IPV training on home visitors' professional capabilities to address IPV experienced by clients and the most prevalent barriers home visitors face when addressing IPV that should be targeted in future health education interventions.

Sport Participation and Academic Achievement: A Longitudinal Study.

OBJECTIVES: We examined the relation- ship between sport participation and academic achievement in a sample of adolescents, while accounting for socioeconomic status (SES) and sex. METHODS: We analyzed data from a cohort of 271 Mid-Atlantic high school students who participated in a longitudinal study of risk and protective factors for substance use, teen parenting, and school drop out. RESULTS: Sport participation at year one predicted academic achievement in English (p < .05) and mathematics (p < .05) at year 2, while controlling for academic achievement at year one. In both instances over other independent variables and covariates in the models, sport participation explains almost 7% of additional variance in the outcomes variables. We also found a positive relationship for participants who reported parents with some college experience as opposed to parents with no college experience, between sport participation and grades in English (p < .05) but not for mathematics. CONCLUSIONS: Sport participation is positively related to academic achievement but the relationship diverges when students are compared across sex and by parental education. These findings suggest that the relation ship between sport participation and academic achievement may be influenced by SES and is related to sex.