An Examination of Health-Promoting Behaviors Among Hispanic Adults Using an Activation and Empowerment Approach.

BACKGROUND: Obesity is a national epidemic in the United States. Racial/ethnic minorities are disproportionately affected by this obesity epidemic. Hispanic adults have a higher prevalence of obesity compared to non-Hispanic White adults. Levels of engagement in healthy eating and physical activity have been found to be associated with obesity. Research suggests that culturally informed, person-centered factors may influence engagement in healthy eating and physical activity. PURPOSE: The purpose of the present study was to examine the association between person-centered, modifiable variables (i.e., activation, empowerment, and self-praise) and health-promoting behaviors (i.e., healthy eating and physical activity) among a cross-sectional sample of predominantly overweight/obese Hispanic adults (N = 87) recruited from two Hispanic churches and their surrounding communities in the Bronx, New York. RESULTS: A series of hierarchical regressions revealed that empowerment and self-praise were significant and positively associated with greater levels of engagement in healthy eating. Additionally, self-praise was significant and positively associated with greater levels of engagement in physical activity. CONCLUSIONS: The current findings suggest that these modifiable factors may be useful in informing intervention programs designed to improve healthy eating and physical activity among Hispanic adults.

Current Demographics and Roles of Florida Community Health Workers: Implications for Future Recruitment and Training.

The high prevalence of health disparity diseases (e.g., obesity, Type 2 diabetes) among underserved populations in the United States suggests the need for increased resources to prevent these diseases and to improve health care access and quality in underserved communities. Community health workers are valuable resources and facilitators of health care access and quality treatment. The purpose of the present study is to provide descriptive information about community health workers in Florida and to provide recommendations for improved training and expansion of community health workers' roles in research and intervention. The study participants were 396 adults (85.1% Female, 75.5% Community health workers) who completed the 2015 Florida Community Health Workers Census. Participants were recruited by the Health Council of South Florida through emails and phone calls to members of the Florida Community Health Worker Coalition and various organizations. It was found that several groups disproportionately affected by health disparities were underrepresented among the community health workers who participated in the census and among the communities served by these community health workers. Actions are needed to improve and increase the recruitment and training of community health workers in Florida.

Perceptions of general and postpresidential election discrimination are associated with loss of control eating among racially/ethnically diverse young men.

OBJECTIVE: The purpose of this study was to examine the association between young men's perceived experiences with discrimination, both general and following the 2016 presidential election, and their loss of control (LOC) eating. The degree to which men identified with their ethnic identity was evaluated as a moderator. METHOD: The sample included 798 men (18-30 years; M = 24.0 ± 3.6) who identified as African American (n = 261), Asian/Asian American (n = 266), or Hispanic/Latino (n = 271). Participants completed an online survey of items assessing demographic characteristics; perceived discrimination; perceptions of race-related discrimination following the 2016 U.S. presidential election; ethnic identity; and LOC eating. RESULTS: After adjusting for income, education, generational status and body mass index, perceived discrimination was positively associated with LOC eating frequency in African American and Hispanic/Latino men (ps < .01). Ethnic identity was inversely associated with LOC eating frequency in Hispanic/Latino men (p < .001). In Asian/Asian American men, perceived discrimination was only associated with more LOC eating among those with a low ethnic identity (p < .001). Higher levels of perceived discrimination following the presidential election were uniquely associated with more frequent LOC eating (p < .01) only among Asian/Asian American men who were not born in the United States or whose parents were not born in the United States. DISCUSSION: LOC eating may partially explain known associations between discrimination and heightened risk for obesity and chronic diseases among African American and Hispanic/Latino men. Asian/Asian American men's LOC eating may be linked to postpresidential election and general experiences with racial discrimination, particularly if they report a low sense of belonging to their ethnic group.

Impact of a University-Community Partnership Approach to Improving Health Behaviors and Outcomes Among Overweight/Obese Hispanic Adults.

Objective. To examine the impact of a community-informed and community-based Health-Smart Church (HSC) Program on engagement in health promoting behaviors (healthy eating and physical activity) and health outcomes (body mass index, weight, and systolic and diastolic blood pressure). Design. A total of 70 overweight/obese Hispanic adults participated in an intervention group (n = 37) or a waitlist control group (n = 33) in 2 Hispanic churches in Bronx, New York. Results. Post-intervention the intervention group significantly increased in frequency of healthy eating and physical activity compared to the waitlist control group. Although no significant changes in body mass index or systolic blood pressure were found for either group, the intervention group decreased significantly in weight from pre-intervention to post-intervention. Conclusions. The results of the present study add to the growing body of literature evidencing the successful use of community-engaged and community-based participatory health promotion interventions with racial/ethnic minority populations and highlight important practices and considerations for similar health promotion interventions with these communities.

Frequency of visits to a health care provider, health promoting behaviors, and perceived health status among African American women.

The primary purpose of this study was to examine whether the self-reported number of health care visits over a 1-year period was associated with engagement in health promoting behaviors (i.e., healthy eating and physical activity) and perceived health status among a cross-sectional sample of African American women who were pre-hypertensive/hypertensive and/or overweight or obese (N = 180). The study participants were recruited in predominantly African American churches and had their data collected in April and May of 2009. Age, income, and education were also examined as moderators in the aforementioned relationships. Results revealed that the self-reported number of health care visits was significantly positively associated with healthy eating and perceived health status. Income moderated the relationship between self-reported number of health care visits and engagement in healthy eating. These results provide support for health promotion programs for African American women with program components that explain the relationships among routine care from a health care provider, engagement in health promoting behaviors, and prevention of chronic health conditions.

Motivators of and Barriers to Engagement in Healthy Eating Behaviors among non-Hispanic Black Adults.

OBJECTIVES: The objective of this study was to determine if non-Hispanic Black adults' levels of endorsement of motivators and barriers related to healthy eating are significantly associated with their level of engagement in healthy eating and their perceived importance of healthy eating and if these investigated variables differ by gender, income, and/or age. METHOD: An assessment battery was completed by a cross-sectional sample of 207 non-Hispanic Black adults in Bronx, NY (54.1 % female; age: M = 38, SD = 14.12). Participants were recruited by culturally diverse data collectors at community-based locations within Bronx. RESULTS: Building healthy eating into a routine was a significant motivator of healthy eating (p < 0.001), and having low self-control over eating behaviors was a significant barrier to healthy eating (p < 0.05). Importance ratings of healthy eating were positively associated with motivators to engaging in healthy eating (routine: p < 0.001; availability of healthy foods: p < 0.001; addressing medical issues: p < 0.001; convenience of eating healthy foods: p < 0.01). There were age and income differences in several motivators and barriers. IMPLICATIONS: Intervention programs to increase healthy eating among adults similar to those in this study may benefit from including a focus on increasing self-control of eating behaviors and incorporating healthy eating into one's routine.

Motivators of and Barriers to Eating Foods and Snacks Among Adolescents.

Adolescents from low-income households and minority groups are disproportionately affected by obesity compared with their non-Hispanic white counterparts. Engaging in health promoting behaviors such as routinely eating healthy foods and snacks and engaging in physical activity are ways of preventing and reducing obesity and obesity disparities. The major purposes of the present study are (a) to identify the motivators of and barriers to eating healthy foods and snacks among culturally diverse adolescents and (b) to determine if the strengths of endorsement of these motivators and barriers differ by race, gender, and age. In the present study, a series of factor analyses was used to identify the motivators of and barriers to eating healthy foods and snacks among the culturally diverse adolescent participants (N = 172) in the national study. Specifically, an adolescent motivator of eating healthy foods and snacks scale, adolescent barrier to eating healthy foods and snacks scale, and subscales for each of these 2 scales were identified. The adolescent motivator subscales found were Knowledge and Commitment (α = .86) and Routine (α = .87). The adolescent barrier subscales found were Lack of Exposure (α = .72), Pessimistic Attitude (α = .80), and Temptation (α = .59). MANOVAs were used to determine if the mean scores for these scales and subscales differ by race, age, and gender. Nonsignificant differences were found among the mean scores for these scales and subscales. Results have implications for customizing adolescent health promotion interventions, including those to reduce and prevent obesity.

Association of health self-empowerment with health-promoting behaviors among chronically ill African American and non- Hispanic White adolescents.

OBJECTIVE: Health Self-Empowerment Theory (health motivation, health self-efficacy, health self-praise, and active coping) was examined as a predictor of levels of engagement in four health-promoting behaviors (health responsibility behaviors, regular exercise, healthy eating, and stress management behaviors) among low-income African American adolescents and non-Hispanic White American adolescents living with at least one chronic illness. METHODS: Eighty-seven participants completed measures of the Health Self-Empowerment Theory variables and of level of engagement in each of the four health-promoting behaviors. RESULTS: Regression analyses revealed that the combined Health Self-Empowerment Theory variables significantly predicted level of engagement in the four examined health-promoting behaviors. Additionally, active coping, health self-praise, and health motivation each significantly predicted one or more of the examined health-promoting behaviors. CONCLUSIONS: Health self-empowerment may be useful for informing interventions designed to foster engagement in health-promoting behaviors among low-income adolescents living with one or more chronic illnesses

The youth form of the Motivators of and Barriers to Health-Smart Behaviors Inventory.

OBJECTIVE: To develop a youth form of the Motivators of and Barriers to Health-Smart Behaviors Inventory (MB-HSBI-Youth) for use in identifying self-reported motivators of and barriers to the following health-promoting behaviors (called health-smart behaviors): eating a healthy breakfast, eating healthy foods and snacks, drinking healthy drinks, and engaging in physical activity. DESIGN: The MB-HSBI-Youth was developed through several research phases as part of a larger, multisite, and multicomponent study on modifying and preventing obesity in families. A critical aspect of the larger study was to identify the motivators of and barriers to the above-identified health-smart behaviors among African American, Asian American, Hispanic/Latino American, and non-Hispanic White American adults and youth. After preliminary research involving content validity, item analyses, and pilot testing, a pilot version of the MB-HSBI-Youth was administered to a national sample of 567 culturally diverse youth ranging from 9 to 17 years old. RESULTS: Factor analyses and internal consistency results revealed the existence of multiple subscales measuring motivators of and barriers to each of the above-specified health-smart behaviors. Scores on the MB-HSBI-Youth correlated in expected directions with health self-efficacy scores and with ratings of the importance of health-related behavioral goals. CONCLUSION: The MB-HSBI-Youth may be a useful and novel tool for developing assessment-based, culturally sensitive health promotion programs customized to be responsive to the motivators of and barriers to health-smart behaviors identified in target communities, particularly those communities whose members are mostly racial/ethnic minorities.