Surface-Mediated Modulation of Different Biological Responses on Anatase-Coated Titanium.

Various surface modification strategies are being developed to endow dental titanium implant surfaces with micro- and nano-structures to improve their biocompatibility, and first of all their osseointegration. These modifications have the potential to address clinical concerns by stimulating different biological processes. This study aims to evaluate the biological responses of ananatase-modified blasted/etched titanium (SLA-anatase) surfaces compared to blasted/acid etched (SLA) and machined titanium surfaces. Using unipolar pulsed direct current (DC) sputtering, a nanocrystalline anatase layer was fabricated. In vitro experiments have shown that SLA-anatase discs can effectively promote osteoblast adhesion and proliferation, which are regarded as important features of a successful dental implant with bone contact. Furthermore, anatase surface modification has been shown to partially enhance osteoblast mineralization in vitro, while not significantly affecting bacterial colonization. Consequently, the recently created anatase coating holds significant potential as a promising candidate for future advancements in dental implant surface modification for improving the initial stages of osseointegration.

Comparing lengths and inclusion of information in storytelling videos: Implications for Hepatitis B education.

Objectives: This study examined whether adding disease-specific facts into storytelling videos and altering video length would lead to differences in overall ratings of the video and the storyteller, as well as hepatitis B prevention beliefs, among Asian American and Pacific Islander adults. Methods: A sample of Asian American and Pacific Islander adults (N = 409) completed an online survey. Each participant was randomly assigned to 1 of 4 conditions that varied in video length and use of additional hepatitis B facts. Linear regressions were used to examine differences in outcomes (i.e., video rating, speaker rating, perceived effectiveness, hepatitis B prevention beliefs) by conditions. Results: Condition 2, which added facts to the original full-length video, was significantly related to higher speaker ratings (i.e., the storyteller's rating) compared to Condition 1, the original full-length video with no added facts, p = 0.016. Condition 3, which added facts to the shortened video, was significantly related to lower overall video ratings (i.e., how much participants liked the videos overall) compared to Condition 1, p = 0.001. There were no significant differences in higher positive hepatitis B prevention beliefs across conditions. Conclusions: Results suggest that adding disease-specific facts to storytelling for patient education may improve initial perceptions of storytelling videos; however, more research is needed to examine long-term effects. Innovation: Aspects of storytelling videos such as length and additional information have been rarely explored in storytelling research. This study provides evidence that exploring these aspects is informative to future storytelling campaigns and disease-specific prevention.

COVID-19 pandemic and stay-at-home mandates promote weight gain in US adults.

OBJECTIVE: The purpose of this study was to prospectively examine the effect of state stay-at-home mandates on weight of US adults by BMI over 3 months during COVID-19. METHODS: US adults completed an online questionnaire containing demographics, weight, physical activity, sedentary time, fruit/vegetable intake, depressive symptoms, stress, and sleep at baseline (May 2020) and after 3 months (August 2020). RESULTS: Participants gained 0.6 kg (76.7-77.3 kg, p = 0.002). A total of 26% of those with obesity gained > 2 kg compared with 14.8% of those with normal weight (p < 0.001). A total of 53.3% of individuals with obesity maintained weight within 2 kg compared with 72.5% of those with normal weight (p < 0.001). Greater weight gain was related to longer stay-at-home mandates (ß = 0.078, p = 0.010), lower baseline minutes of physical activity per day (ß = -0.107, p = 0.004), greater declines in minutes of physical activity per day (ß = -0.076, p = 0.026), depressive symptoms (ß = 0.098, p = 0.034), and greater increases in time preparing food (ß = 0.075, p = 0.031). CONCLUSIONS: US adults gained weight, and stay-at-home mandates were associated with atypical weight gain and greater reported weight gain in individuals with obesity over 3 months.

The Role of Information Avoidance in Managing Uncertainty from Conflicting Recommendations about Electronic Cigarettes.

Insufficient scientific evidence about electronic cigarettes (e-cigarettes) has led to conflicting recommendations (CRs) by credible scientific organizations, creating a public health debate that could prove especially difficult to reconcile as current and former smokers make decisions about whether to use e-cigarettes. To investigate how CRs about e-cigarettes may affect intentions to engage in healthy behaviors, 717 former and current smokers were randomly exposed to one of five conditions (varying in the level of conflict in recommendations) in this between-subject experiment. Our results indicated a significant interaction between the message level of conflict and individuals' information avoidance, employed to maintain hope and deniability. These results suggest the effects of CRs stemming from scientific uncertainty vary with subgroups of people, pointing to several pressing theoretical and practical implications.

Raman microspectroscopy and Raman imaging reveal biomarkers specific for thoracic aortic aneurysms.

Aortic rupture and dissection are life-threatening complications of ascending thoracic aortic aneurysms (aTAAs), and risk assessment has been largely based on the monitoring of lumen size enlargement. Temporal changes in the extracellular matrix (ECM), which has a critical impact on aortic remodeling, are not routinely evaluated, and cardiovascular biomarkers do not exist to predict aTAA formation. Here, Raman microspectroscopy and Raman imaging are used to identify spectral biomarkers specific for aTAAs in mice and humans by multivariate data analysis (MVA). Multivariate curve resolution-alternating least-squares (MCR-ALS) combined with Lasso regression reveals elastic fiber-derived (Ce1) and collagen fiber-derived (Cc6) components that are significantly increased in aTAA lesions of murine and human aortic tissues. In particular, Cc6 detects changes in amino acid residues, including phenylalanine, tyrosine, tryptophan, cysteine, aspartate, and glutamate. Ce1 and Cc6 may serve as diagnostic Raman biomarkers that detect alterations of amino acids derived from aneurysm lesions.

E-Cigarette Beliefs and Intentions Among U.S. Adults Before and After EVALI Outbreak.

PURPOSE: This study examined attitudes, perceived control, perceived norms, intention, and policy support before and after the peak of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) cases among 2 independent samples of U.S. adults. DESIGN: This study used a successive independent samples design. SETTING: Data was collected through online surveys in July 2019 (n = 521) and October 2019 (n = 536). SUBJECTS: Participants were recruited through the Qualtrics Survey Panel. Eligibility criteria included: 1) 18 years or older, and 2) currently living in the U.S. MEASURES: The 2 surveys were collected from 2 separate samples examined e-cigarette attitudes, perceived control, perceived norms, intention, and policy support. ANALYSIS: Linear regressions were used to examine the association between time, attitudinal, and belief factors associated with intention and policy support. RESULTS: Participants in the October sample (n = 521) were significantly more likely to have negative attitudes towards e-cigarettes when compared to the July sample (n = 536), F(8,1047) = 52.671, p < .01, R2 = 0.287. Lower perceived social acceptance towards e-cigarettes and negative attitudes were related to higher support for restricting where e-cigarettes could be used, F(11, 1042) = 63.218, p < .010, R2 = .401. Higher perceived control over accessing e-cigarettes, but lower social acceptance of e-cigarettes and negative beliefs were associated with higher support for limiting places where e-cigarettes could be purchased, F(11,1039) = 36.200, p < .01, R2 = .277. CONCLUSION: Results indicate that EVALI cases may have had an immediate negative effect on attitudes but did not appear to decrease intention to use e-cigarettes. Results could inform future public health campaigns' programming and research. More research is needed to understand the long-term impact of EVALI on e-cigarette use.

Examining e-cigarette perspectives before and after the EVALI peak in cases.

INTRODUCTION: The use of e-cigarettes among youth and young adults has greatly increased, with national media outlets drawing attention to e-cigarette or vaping product use-associated lung injury (EVALI) hospitalizations. METHODS: U.S. adults completed an online survey where they were asked to describe their perceptions towards e-cigarettes. There were two surveys collected using separate samples, with one being before the peak of EVALI cases in Time 1: July 2019 (n = 521) and one collected after the peak of EVALI cases in Time 2: October 2019 (n = 536). RESULTS: Four themes emerged including describing e-cigarettes as appealing, unappealing, comparing them to other tobacco products, and generally having experience with e-cigarettes. Fewer participants described e-cigarettes as appealing in terms of smell, flavor, and taste in Time 2, after the peak of EVALI cases. Both samples described the harmful effects of using e-cigarettes, with a higher percent describing potential harms in Time 2. Participants in Time 2 less frequently described e-cigarettes as a good alternative to traditional cigarettes. CONCLUSIONS: Perceptions towards e-cigarettes vary among adults who use or do not use e-cigarettes; however, this study reflected an increase in awareness of the harmful effects of using e-cigarettes after the peak of EVALI cases. Additionally, results suggest that there may have been a decrease in adults who found e-cigarettes appealing. Determining perceptions towards e-cigarettes, especially after growing awareness of the harmful effects of using e-cigarettes, is useful in informing future policies and public health campaigns.

Highlighting Contributions of Behavioral and Social Sciences in Advancing Public Health: Where We've Come, Where We're Headed.

CONTEXT: Social and behavioral sciences, a cross-disciplinary field that examines the interaction among behavioral, biological, environmental, and social factors, has contributed immensely to some public health achievements over the last century. Through collaboration with community organizations and partners, social and behavioral scientists have conducted numerous program interventions involving community engagement and advocacy efforts at the local, state, federal, and international levels. CONTRIBUTIONS OF SOCIAL AND BEHAVIORAL SCIENCES: This article traces select historical underpinnings of the applications of social and behavioral sciences theories and evidence to public health and highlights 4 areas in which health education specialists have distinctly contributed to public health achievements by building on theory and evidence. Applied social and behavioral sciences have formed the basis of various health education interventions. These 4 areas include the following: (1) Theory, Model Development, and the Professionalization of Health Education; (2) Participation and Community Engagement; (3) Health Communication; and (4) Advocacy and Policy. DISCUSSION: We present contemporary challenges and recommendations for strengthening the theory, research, and practice of health education within the context of social and behavioral sciences in addressing emerging public health issues.

Looking Back and Moving Forward: SOPHE's 70 Years of Contributions to Health Education.

Founded in 1950, the Society for Public Health Education (SOPHE) provides leadership to the health education profession and promotes the health of all people through six strategic commitments: developing and promoting standards for professional preparation and credentialing of community and school health educators; stimulating research on the theory, practice, and teaching of health education; supporting elimination of health disparities and the achievement of health equity; providing continuing education of the health education workforce; advocating for policy and legislation affecting public health and health promotion; and supporting a network of local chapters. This article describes how SOPHE has pursued these strategic commitments during the past 70 years and discusses challenges that will influence the future of SOPHE and the contours of the research and practice agendas of the field going forward.

Exploring the Impact of Storytelling on Storytellers in a Hepatitis B Health Communication Context.

OBJECTIVE: In order to address the stigma associated with hepatitis B, increase awareness, encourage testing, and promote prevention through vaccination, a storytelling campaign featuring people living with hepatitis B and their family members was developed. Storytelling campaigns have been evaluated for their impact on the viewing audience; however, few studies have examined the impact of storytelling on storytellers themselves. This study seeks to examine the experiences of the individuals telling their stories. METHODS: Trained researchers conducted semi-structured interviews (n = 23) with individuals who had participated in a hepatitis B storytelling campaign. RESULTS: A thematic analysis of the interviews produced four overarching themes: 1) Outreach; 2) Emotion; 3) Education; and 4) Stigma. The interviews demonstrate that participants found storytelling to be a positive, comfortable, and emotional experience, and that it motivated them to educate others and increase awareness. Additionally, participants identified the need to increase outreach and address stigma related to hepatitis B. CONCLUSION: While more research is needed, these study results can be used to enhance future engagement, training, and experiences of hepatitis B storytellers. PRACTICE IMPLICATIONS: Findings provide insight into how storytelling can impact the sharing their story and provide important implications for future storytelling campaigns.

Developing and Testing Message Strategies to Reduce Indoor Tanning.

Objectives: Indoor tanning, which is most common among 18-25-year-old white women, increases the risk of skin cancer. To address this problem, we developed and tested messages with a national sample of indoor tanners to determine beliefs that would encourage them to quit. Methods: Messages discouraging indoor tanning using different persuasive themes (skin cancer risk, appearance risk, well-being enhancement) were developed based on formative research and a review of intervention efforts. We conducted an online experiment to test the final messages with a national sample of 480 indoor tanners. Results: Messages that emphasized skin cancer risk out-performed messages that focused on well-being enhancement or damage to appearance in terms of intention to quit indoor tanning. Analyses revealed 2 key mediators: perceived argument strength and beliefs related to the effects of indoor tanning. Conclusions: Theory- and evidence-informed public health communications can contribute to improving health-related behaviors. Focusing on the risk of skin cancer may be the most effective strategy to reduce indoor tanning among young white women.

The Health Education Research Experience (HERE) program metadata dataset.

Undergraduate subject pools are prevalent across disciplines in the United States. The Health Education Research Experience (HERE) Program was the first known course-based subject pool entirely managed and conducted online for online students enrolled in an introductory health education/health promotion course. The program was conducted within five semesters from Spring 2012 through Summer 2013. The HERE Program encompassed 13 studies embedded in two sections of an undergraduate online course at the University of Florida. The studies were all related to course topics and current research topics in health education/promotion (as identified through the Healthy People 2020 Framework). The topics ranged from the relatively less sensitive health aspects of college life (i.e., technology use) to studies assessing more sensitive health topics (i.e., intimate partner violence and sexual assault). In alignment with a best practice in survey design, the HERE Program's survey instruments included one metadata item embedded in each survey to identify which devices students used to complete the surveys. Understanding which devices students used for survey completion has ramifications for survey designers and survey researchers. In contrast to the relative uniformity of pen and paper surveys and control of the survey completion environment, online surveys may not look identical across personal devices and may be completed in increasingly varied environments. All studies, study procedures and protocols, and metadata collection procedures were approved by the university's Institutional Review Board. The data presented here were extracted from each survey's data files and aggregated. The aggregated metadata are available through Mendeley Data in a.csv file for widespread access. Descriptive statistics are presented in tables. The data provided in this article will benefit researchers interested in survey methodology, questionnaire design, modes of survey collection, and survey metadata. The data are hosted in the following Mendeley Data repository: https://data.mendeley.com/datasets/ht9jmd3cdt/2.

Comparing the Effects of Different Story Types and Speakers in Hepatitis B Storytelling Videos.

Chronic hepatitis B, a condition associated with severe complications, disproportionately affects Asian Americans and Pacific Islanders in the United States. Increasing testing among this population is critical for improving health outcomes. This study compares different types of video narratives that use storytelling techniques to an informational video (control), to examine whether narratives are associated with higher hepatitis B beliefs scores and video rating outcomes. A sample of Asian American and Pacific Islander adults (N = 600) completed an online survey where they viewed one of four video conditions, three of which included storytelling techniques and one with informational content. Results indicated that parental stories received significantly higher perceived effectiveness ratings (M = 3.88, SD = 0.61) than the older adult personal stories (M = 3.62, SD = 0.74), F(3, 596) = 3.795, p = .010. Parental stories also had significantly higher perceived severity scores (M = 3.83, SD = 0.69) compared to the young adult stories (M = 3.73, SD = 0.74) and the informational videos (M = 3.83, SD = 0.69), F(3, 596) = 7.72, p < .001. The informational videos (M = 4.10, SD = 0.65) received significantly higher message credibility ratings than the older adult personal stories (M = 3.84, SD = 0.70), F(3, 596) = 4.71, p = .003. Follow-up tests using Bonferroni correction revealed that parental stories (M = 3.98, SD = 0.64) and young adult personal stories (M = 3.934, SD = 0.76) scored significantly higher on speaker ratings than the older adult personal stories (M = 3.698, SD = 0.77). Results suggest that storytelling has the potential for connecting with a specific audience in an emotional way that is perceived well overall. Future research should examine the long-term impact of hepatitis B personal story videos and whether the addition of facts or statistics to videos would improve outcomes.

Constructing a measure of health literacy in Sub-Saharan African countries.

We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006-15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy. Logistic regression was employed to examine the relationship between demographic characteristics and health literacy. A total of 224 751 individuals between the ages of 15 and 49 years were included. The derived health literacy measure demonstrated good internal consistency (Cronbach's α = 0.72) and good content validity. The prevalence of high health literacy overall was 35.77%; females 34.08% and males 39.17%; less than or equal to primary education 8.93%, some secondary education 69.40% and ≥complete secondary 84.35%. High health literacy varied across nations, from 8.51% in Niger to 63.89% in Namibia. This is the first known study to evaluate a measure of health literacy relying on the NAM definition utilizing a large sample from 14 countries in Sub-Saharan Africa. Our study derived a robust indicator of NAM-defined health literacy. This indicator could be used to examine determinants and outcomes of health literacy in additional countries.

Computer-Mediated Experiences of Patients with Chronic Obstructive Pulmonary Disease.

BACKGROUND: The Internet is an important tool for empowering patients with Chronic Obstructive Pulmonary Disease (COPD) to learn about and self-manage their condition. PURPOSE: To understand which aspects of the online experience facilitates or hinders the perceived ability of patients with COPD to achieve their information and self-management goals. METHODS: Semi-structured interviews were conducted with medically underserved patients with COPD (N = 25) who access the Internet for health. A conventional content analysis approach was applied and data were analyzed with the constant comparative method. RESULTS: The following themes were derived: (1) desire to associate with "in-group" members; (2) relationship building with other online users; (3) security of information and identity; (4) source and channel credibility appraisal; (5) user assistance and tutorials; and (6) strategies to adapt technological functions. DISCUSSION: Success in using the Internet was dependent on the functional use of technology and the ability and resilience to engage with similar online users to build meaningful and trustworthy connections. TRANSLATION TO HEALTH EDUCATION PRACTICE: Prior to directing patients with COPD to a disease-specific online support platform, certified health education specialists must assess patients' information goals and their skills to critically appraise and communicate with other online users.

Association Between Health Literacy, Electronic Health Literacy, Disease-Specific Knowledge, and Health-Related Quality of Life Among Adults With Chronic Obstructive Pulmonary Disease: Cross-Sectional Study.

BACKGROUND: Despite the relatively high prevalence of low health literacy among individuals living with chronic obstructive pulmonary disease (COPD), limited empirical attention has been paid to the cognitive and health literacy-related skills that can uniquely influence patients' health-related quality of life (HRQoL) outcomes. OBJECTIVE: The aim of this study was to examine how health literacy, electronic health (eHealth) literacy, and COPD knowledge are associated with both generic and lung-specific HRQoL in people living with COPD. METHODS: Adults from the COPD Foundation's National Research Registry (n=174) completed a cross-sectional Web-based survey that assessed sociodemographic characteristics, comorbidity status, COPD knowledge, health literacy, eHealth literacy, and generic/lung-specific HRQoL. Hierarchical linear regression models were tested to examine the roles of health literacy and eHealth literacy on generic (model 1) and lung-specific (model 2) HRQoL, after accounting for socioeconomic and comorbidity covariates. Spearman rank correlations examined associations between ordinal HRQoL items and statistically significant hierarchical predictor variables. RESULTS: After adjusting for confounding factors, health literacy, eHealth literacy, and COPD knowledge accounted for an additional 9% of variance in generic HRQoL (total adjusted R2=21%; F9,164=6.09, P<.001). Health literacy (b=.08, SE 0.02, 95% CI 0.04-0.12) was the only predictor positively associated with generic HRQoL (P<.001). Adding health literacy, eHealth literacy, and COPD knowledge as predictors explained an additional 7.40% of variance in lung-specific HRQoL (total adjusted R2=26.4%; F8,161=8.59, P<.001). Following adjustment for covariates, both health literacy (b=2.63, SE 0.84, 95% CI 0.96-4.29, P<.001) and eHealth literacy (b=1.41, SE 0.67, 95% CI 0.09-2.73, P<.001) were positively associated with lung-specific HRQoL. Health literacy was positively associated with most lung-specific HRQoL indicators (ie, cough frequency, chest tightness, activity limitation at home, confidence leaving home, sleep quality, and energy level), whereas eHealth literacy was positively associated with 5 of 8 (60%) lung-specific HRQoL indicators. Upon controlling for confounders, COPD knowledge (b=-.56, SE 0.29, 95% CI -1.22 to -0.004, P<.05) was inversely associated with lung-specific HRQoL. CONCLUSIONS: Health literacy, but not eHealth literacy, was positively associated with generic HRQoL. However, both health literacy and eHealth literacy were positively associated with lung-specific HRQoL, with higher COPD knowledge indicative of lower lung-specific HRQoL. These results confirm the importance of considering health and eHealth literacy levels when designing patient education programs for people living with COPD. Future research should explore the impact of delivering interventions aimed at improving eHealth and health literacy among patients with COPD, particularly when disease self-management goals are to enhance HRQoL.

Social Media for Hepatitis B Awareness: Young Adult and Community Leader Perspectives.

Screening for hepatitis B (HBV) among high-risk young adults can help prevent its transmission and lead to earlier treatment and better long-term health outcomes. Yet few interventions have focused on increasing HBV awareness among young adults. Social media (SM) may be an effective method for disseminating information and engaging young adults about HBV. In this pilot study, qualitative and quantitative methods were applied to collect information on current use and perceptions toward SM through semistructured interviews and focus groups with young Chinese and Vietnamese adults and community leaders from local organizations in Philadelphia. Additionally, survey items were collected during the interviews and focus groups to provide quantitative data. Results from the interviews provided evidence that young adults and local organizations are already using SM and are open to using it to share general health information that is specific to their community. The focus groups suggested that using group pages or chats could be most appropriate for reaching young adults and that credible sources should be used to deliver messages that are tailored to the audience. The findings from this study will support the development of an SM intervention aimed at increasing HBV awareness.

Exploring Communication Strategies for Promoting Hepatitis B Prevention among Young Asian American Adults.

In the United States, Asian Americans account for 50-60% of hepatitis B virus infections, leading to higher rates of liver cancer in this population. While some city-wide data have reported hepatitis B infection rates among young adults as high as 10-20%, little research has examined factors that impact hepatitis B beliefs, or the most effective strategies for reaching this particular population to promote hepatitis B awareness. An online survey was conducted with young Asian American adults (n = 418), aged 18-29 years old, to better understand their health information seeking, social media usage, and hepatitis B-related behaviors and beliefs. Results indicated that doctors and health organizations were the most trusted sources of health information, while the Internet was the most common source of health information. The majority of participants (99.8%) reported using social media and indicated they engaged in health-related behaviors on social media. Several factors, including non-receipt of hepatitis B vaccine, engaging in more health-related social media activities, and a higher mean score for difficulty with health information seeking, were significantly related to higher perceived susceptibility to hepatitis B. Future research should explore the effectiveness of using social media to reach young Asian American adults to promote hepatitis B awareness.

Reducing overuse of cervical cancer screening: A systematic review.

Overuse of clinical preventive services increases healthcare costs and may deprive underserved patients of necessary care. Up to 45% of cervical cancer screening is overuse. We conducted a systematic review of correlates of overuse of cervical cancer screening and interventions to reduce overuse. The search identified 25 studies (20 observational; 5 intervention). Correlates varied by the type of overuse measured (i.e., too frequent, before/after recommended age to start or stop screening, after hysterectomy), the most common correlates of overuse related to patient age (n = 7), OBGYN practice or provider (n = 5), location (n = 4), and marital status (n = 4). Six observational studies reported a decrease in overuse over time. Screening overuse decreased in all intervention studies, which used before-after designs with no control or comparison groups. Observational studies suggest potential targets for de-escalating overuse. Randomized clinical trials are needed to establish best practices for reducing overuse.