Reaching for a Healthier Lifestyle: A Photovoice Investigation of Healthy Living in People with Serious Mental Illness.

BACKGROUND: People with mental illness in the United States are almost twice as likely to be obese compared with those without a mental illness. Lifestyle factors, such as poor dietary choices and physical inactivity, are often cited as causes of obesity in this population, which limits the response to the obesity epidemic primarily to behavioral change interventions. In response, this project is grounded in a human rights framework to assure that the people most affected by the problem are included in understanding and addressing the problem. We sought to investigate social and structural factors that affect weight loss in partnership with community co-researchers enrolled in a group lifestyle program for overweight/obese people with serious mental illness (SMI) living in supportive housing settings. METHODS: Using Photovoice methodology, eight co-researchers identified barriers and facilitators to healthy living in their community over seven weekly sessions. RESULTS: Co-researchers selected 33 photos reflecting two overarching themes: 1) structural barriers, such as poor-quality food, high transportation costs, limited SNAP benefits, limits of food pantries, easy availability of tobacco and alcohol products, and limited places for exercise and 2) strategies for overcoming structural barriers. CONCLUSIONS: Co-researchers highlighted structural barriers that were a cause or consequence of food insecurity and situations that threaten the right to healthy food and opportunities for a healthy life. Co-researchers reported examples of knowledge and skills they learned through participation in the project that were used to overcome structural barriers to healthy eating and physical activity, and likely contributed to weight loss.

Clearing the air: adolescent smoking trends.

PURPOSE OF REVIEW: The purpose of this review is to highlight the emerging smoking behaviors and varied tobacco products elevating public health concerns related to the exposure of these potentially harmful substances in the adolescent population. RECENT FINDINGS: Although adolescent smoking of traditional cigarettes has declined in the last 40 years, the inhalation of other nicotine-containing products using alternative methods and devices, such as smoking electronic cigarettes, using hookahs, vaping, and JUULing are dramatically on the rise in the adolescent population. Regardless of the novel delivery devices or methods, use of nicotine-containing products in any form is hazardous and unsafe. SUMMARY: If adolescent smoking trends continue at the current rate in the United States, 5.6 million of today's American youth under the age of 18 will die early from a smoking-related illness. With the emerging high-risk smoking behaviors resulting in detrimental exposure to nicotine and other harmful substances available to adolescents, pediatric healthcare providers will have an increasing responsibility to screen, to manage, and to educate patients and families to combat this imminent threat to the public health of our next generation.

Urban college student self-report of hookah use with health care providers.

OBJECTIVE: This study's purpose was to describe urban college students' communication about hookah with health care providers. PARTICIPANTS: Participants included a random sample of undergraduate urban college students and health care providers. METHODS: Students surveyed determined the epidemiology of hookah use in this population, how many health care providers asked about hookah, and how many students admitted hookah use to a physician. RESULTS: Of 375 students surveyed, 78 (20.8%) had never tried it, 284 (75.7%) had smoked hookah at least once, and 64 students (22.6%) were classified as frequent hookah smokers. Only 15 (4.7%) reported a health care provider asking about hookah during visits, whereas 36 (12.7%) admitted their hookah use to a health care provider. CONCLUSION: Hookah use was found to be highly prevalent among students in one urban university. This study supports the hypothesis that few health care providers broach the topic with patients. Additional research on health consequences of hookah use, education, and improved screening is warranted.

Youth gambling: not a safe bet.

PURPOSE OF REVIEW: To increase awareness and knowledge of the growing problem of adolescent gambling. RECENT FINDINGS: Some risk factors have been established for adolescent gambling. Many of the risk factors for gambling behavior can be addressed in effective prevention of problem gambling. There is an association between some psychiatric comorbid conditions and problem gambling (i.e. depression). Current treatment modalities are based on adult experiences and need further investigation for adolescents. Prevention strategies and education of youth, parents, teachers, educators, and professionals are essential in targeting this serious problem. SUMMARY: Given the increasing overall prevalence of adolescent gambling, it is imperative that pediatricians appreciate that gambling problems can also afflict adolescents. There is a clear link between problem gambling in adolescence and pathologic gambling in adulthood. Thus, like other addictive behaviors (cigarette smoking, alcohol and drug use), youth and parents should be screened and counseled about the risks associated with excessive gambling.