Health Behavior Change in the Classroom: A Means to a Healthy End?

Obesity is a serious public health problem within the United States. One promising approach to obesity prevention is health behavior change among college students, focusing on diet, sleep, and exercise. However, it remains unclear whether a health behavior change promotion program implemented in the classroom will effectively improve these health behaviors and negative outcomes related to obesity, particularly within classes of different topics. We examined the impact of a 6-week health behavior change program based on the Theory of Planned Behavior. Across several years, with two seemingly distinct samples of students from either a health psychology (n = 433) or a home gardening (n = 155) course, we conducted two studies and employed a single group, pre/post design in which self-reported and objectively measured health outcomes were assessed for change relative to the health promotion program. Participants selected one of three health behaviors and sought to meet current Centers for Disease Control and Prevention recommendations by setting goals, tracking behavior, and meeting with social support groups. Within both studies, dramatic changes emerged in the targeted health behaviors of fruit and vegetable consumption, sleep quantity and quality, and exercise. Moreover, several other health indicators improved among our subjective and objective health variables, and a few outcomes (i.e., subjective health, sleep quality, flexibility, loneliness) improved across all health behavior groups. Collectively, these results suggest this health behavior change program may be an effective way to elicit behavior change and highlight avenues for future remediation and prevention of obesity and related disease.

Safety and Health Support for Home Care Workers: The COMPASS Randomized Controlled Trial.

OBJECTIVES: To determine the effectiveness of the COMmunity of Practice And Safety Support (COMPASS) Total Worker Health intervention for home care workers. METHODS: We randomized 16 clusters of workers (n = 149) to intervention or usual-practice control conditions. The 12-month intervention was scripted and peer-led, and involved education on safety, health, and well-being; goal setting and self-monitoring; and structured social support. We collected measures at baseline, 6 months, and 12 months, which included workers' experienced community of practice (i.e., people engaged in a common activity who interact regularly for shared learning and improvement). Implementation occurred during 2013 and 2014 in Oregon. RESULTS: In an intent-to-treat analysis, relative to control, the intervention produced significant and sustained improvements in workers' experienced community of practice. Additional significant improvements included the use of ergonomic tools or techniques for physical work, safety communication with consumer-employers, hazard correction in homes, fruit and vegetable consumption, lost work days because of injury, high-density lipoprotein cholesterol, and grip strength. Consumer-employers' reports of caregiver safety behaviors also significantly improved. CONCLUSIONS: COMPASS was effective for improving home care workers' social resources and simultaneously impacted both safety and health factors.

Bad Versus Good, What Matters More on the Treatment Floor? Relationships of Positive and Negative Events With Nurses' Burnout and Engagement.

Many investigators have reported the stressful aspects of nursing; fewer have focused on nurses' positive work experiences. For this study, we developed a 2 × 2 typology of positive and negative events related to the tasks of nursing work and the social and organizational context of that work: successes, supports, constraints, and conflicts. We hypothesized that positive events would predict engagement, negative events would predict burnout, and negative events would be more strongly related to both burnout and engagement. In secondary analyses of data from 310 acute care nurses who completed survey measures of workplace events at one time point and burnout and engagement measures approximately eight months later, regression results indicated that both positive and negative work events contributed to engagement, whereas only negative events were related to burnout. The results of dominance analyses established that constraints and conflicts more strongly predicted burnout than did supports and successes. Additionally, consistent with a "bad is stronger than good" perspective, the strongest predictor of engagement was lower constraints, although successes, supports, and conflicts also predicted engagement.

The CENTS program: promoting healthy eating by addressing perceived barriers.

OBJECTIVE: Nutrition interventions addressing barriers to healthy eating can mitigate concerns regarding poor diet and obesity among college students. Aimed at reducing healthy eating perceived barriers, this investigation employed two mindset change intervention studies. DESIGN: First, a nutrition improvement program called CENTS (Cost of Eating Nutritiously during Time as a Student) that disseminated specific information and utilized experiential activities for mindset change was developed and pilot tested using a pre/post study design. Second, using a similar pre/post method, the CENTS program was evaluated in a quasi-experimental design. MAIN OUTCOME MEASURES: We examined perceived barriers to healthy eating (e.g. too costly, too much time), fruit and vegetable consumption, and other variables related to healthy eating (e.g. cost estimates, diet attitudes, self-efficacy, sugary foods consumption). RESULTS: Results demonstrated some improvement in many outcomes between the two studies. Most noteworthy, the two major perceived barriers of healthy eating (i.e. too expensive, too much time to prepare) dramatically reduced and cost appraisal accuracy improved. Moreover, some attitudes to eat healthy improved and some unhealthy dietary behaviors reduced. CONCLUSION: Using mindset change techniques to address perceived barriers to healthy eating, interventions can promote healthy eating and discourage unhealthy dietary habits among college students.

The COVID-19 pandemic: Electronic media use and health among US College students.

Objective: To explore differences before and during the COVID-19 pandemic in electronic media use (i.e. TV watching, social media use, screen time), health (i.e. physical, behavioral, social, mental), and the relationship between them among college students. Participants: Nine hundred sixty-five United States college students with 367 participating before and 598 during the pandemic (after March 2020). Methods: Using a multiple cross-sectional design, participants completed an online self-report questionnaire and biometric data was gathered in-person for the Pre-COVID group. Results: During the pandemic, time spent watching TV and social media was 14% higher and total screen time was 30% higher (d = .39). Health variations were mixed with both adverse and beneficial differences. Most correlations between electronic media use and health variables were lower in strength during the pandemic. Conclusions: Differences between electronic media use and health before and during the pandemic suggest potential mixed effects of the pandemic on college student media use and health.

Directed coping: A key to coping effectively?

Directed coping, or the use of fewer coping strategies, represents attempts of the individual to effectively cope with stressors. As individuals engage in this process, health and wellness (e.g., physical and mental) generally improve, suggesting directed coping may be an effective technique. However, little specific information is known about the directed coping construct beyond the results of the single study by Wright et al. among nurses dealing with work stressors. Therefore, the current study seeks to examine the directed coping construct in more depth. Following a pre/post study design, 611 undergraduate students participated in a health behaviour change program, completing an online questionnaire regarding their health, wellness and general life stressors as well as an in-person physical health assessment before and after the 6-week program. Consistent with hypotheses, directed coping was associated with and predictive of improved health and wellness subjectively (e.g., affect and stress) and objectively (e.g., heart rate, blood pressure and grip strength) relative to coping with general life stressors. Moreover, directed coping demonstrated stability over time and was related to personality characteristics. Thus, the results suggest directed coping is an effective method of coping and may be stable across situations.

The COMPASS pilot study: a total worker Health™ intervention for home care workers.

OBJECTIVE: To develop a team-based Total Worker Health™ (injury prevention + health promotion) intervention for home care workers and estimate intervention effects on workers' well-being and health and safety behaviors. METHODS: Home care workers (n = 16) met monthly in teams for education and social support using a scripted, peer-led approach. Meeting process measures and pre-/postintervention outcome measures were collected. RESULTS: Knowledge gains averaged 18.7% (standard deviation = 0.04), and 62.0% (standard deviation = 0.13) of participants reported making safety or health changes between meetings. Workers' well-being improved significantly (life satisfaction, d = 0.65, P < 0.05; negative affect, d = 0.64, P < 0.05), and the majority of other safety and health outcomes changed in expected directions. CONCLUSIONS: COMPASS is a feasible intervention model for simultaneously preventing injuries and promoting health among home care workers.

Reduction in chemotherapy order errors with computerized physician order entry.

PURPOSE: To measure the number and type of errors associated with chemotherapy order composition associated with three sequential methods of ordering: handwritten orders, preprinted orders, and computerized physician order entry (CPOE) embedded in the electronic health record. MATERIALS AND METHODS: From 2008 to 2012, a sample of completed chemotherapy orders were reviewed by a pharmacist for the number and type of errors as part of routine performance improvement monitoring. Error frequencies for each of the three distinct methods of composing chemotherapy orders were compared using statistical methods. RESULTS: The rate of problematic order sets-those requiring significant rework for clarification-was reduced from 30.6% with handwritten orders to 12.6% with preprinted orders (preprinted v handwritten, P < .001) to 2.2% with CPOE (preprinted v CPOE, P < .001). The incidence of errors capable of causing harm was reduced from 4.2% with handwritten orders to 1.5% with preprinted orders (preprinted v handwritten, P < .001) to 0.1% with CPOE (CPOE v preprinted, P < .001). CONCLUSION: The number of problem- and error-containing chemotherapy orders was reduced sequentially by preprinted order sets and then by CPOE. CPOE is associated with low error rates, but it did not eliminate all errors, and the technology can introduce novel types of errors not seen with traditional handwritten or preprinted orders. Vigilance even with CPOE is still required to avoid patient harm.

Reliability and validity of the Home Care STAT (Safety Task Assessment Tool).

Home care workers are a priority population for ergonomic assessment and intervention, but research on caregivers' exposures to hazards is limited. The current project evaluated the reliability and validity of an ergonomic self-assessment tool called Home Care STAT (Safety Task Assessment Tool). Participants (N = 23) completed a background survey followed by 10-14 days of self-monitoring with the STAT. Results showed that the most frequent task was house cleaning, and that participants regularly performed dangerous manual client moving and transferring tasks. Researcher in-home observations of 14 workers (duration ≤ 2 h) demonstrated that workers' self-assessments were moderately reliable. Correlational and multi-level analyses of daily self-assessment data revealed that several task exposures were significantly related to daily fatigue and/or pain. Other associations have implications for Total Worker Health™; for example, daily stress was positively associated with both pain and consumption of high calorie snacks. Findings support the STAT as a reliable and potentially valid tool for measuring home care workers' exposures to physically demanding tasks.

Characterizing hazards and injuries among home care workers.

This project extends research on hazardous exposures and injuries among home care workers. Historical data from Oregon home care workers were analyzed to identify the most common lost time injuries and contributing factors, and 7 focus groups were conducted with workers (n = 53) to gather data on demographics, health, and perceptions of occupational hazards. Results indicate that workers are at particular risk for back, knee, and shoulder injuries during client and material moving tasks and that workers' self-reported task exposures and risk perceptions are highly aligned with injury data.