Associations Between Cancer Risk Perceptions, Self-Efficacy, and Health Behaviors by BMI Category and Race and Ethnicity.

BACKGROUND: Cancer risk perceptions and high health-related self-efficacy may impact health behaviors and reduce risk of developing obesity-related cancers. The purpose of this study was to examine whether there are differences in associations among cancer risk perceptions, health-related self-efficacy, and health behaviors between people with healthy weight (PwHW) and people with overweight or obesity (PwO/O), and whether these associations vary by race and ethnicity. METHOD: Data from the Health Information National Trends Survey (HINTS) 5 Cycles 2 and 3 were used. Data from 6944 adults were analyzed using multivariate logistic regression to assess associations among study variables. RESULTS: PwO/O who believed there are too many cancer prevention recommendations had lower log odds of meeting guidelines for strength training (ß - 0.28; CI - 0.53 to - 0.04; p < 0.05) compared to PwHW. PwO/O who believed that obesity influences cancer risk were associated with low sedentary behavior (ß 0.29; CI 0.05-0.54; p < 0.05) compared to PwHW. NHB PwO/O who held fatalistic beliefs and reported high self-efficacy ordered less food (e.g., fewer food items, foods with less calories, or smaller food sizes) compared to NHB Pw/HW (p < 0.05). CONCLUSION: Health behavior differences in PwHW and PwO/O may be associated with differences in cancer risk beliefs and health-related self-efficacy. Findings support the need for further research considering BMI and race and ethnicity in obesity-related cancer prevention and control.

A Review of Miscarriage and Healthcare Communication in the United States.

Miscarriage is a pervasive and socioemotionally complex pregnancy complication. Evidence suggests that poor clinical management can worsen these experiences. Yet, assessments of healthcare communication during a miscarriage are limited and a systematic review of the literature is needed. This review identified and synthesized original research on miscarriage and healthcare communication in the United States from the past 20 years to identify existing knowledge gaps for future miscarriage research. The following databases were searched: PubMed, PsychINFO, and ERIC Database. Data were charted according to Arksey and O'Malley's Scoping Review Framework. Eleven articles were included in the review and three primary themes emerged: (a) patients overwhelmingly prefer patient-centered care; (b) miscarriage is often overmedicalized, which leads to poor communication; and (c) informed decision-making related to one's miscarriage can improve patient experiences. Several gaps were also identified, including studies seeking physician perspectives on miscarriage communication, evaluation of standard care guidelines, and studies evaluating diverse patients' perspectives. This review highlights the need for patient-centered care that utilizes compassionate and accessible language and promotes informed decision-making. Future research should use quantitative methodologies and longitudinal designs to build upon these findings and improve patient experiences of miscarriage.

Evaluation of Ready, Set, BABY: A prenatal breastfeeding education and counseling approach.

BACKGROUND: Comprehensive prenatal education on infant feeding is recommended by many United States health organizations because of the need to maximize maternal preparedness for managing lactation physiology. Ready, Set, BABY (RSB) is a curriculum developed for counseling women about breastfeeding benefits and management including education on optimal maternity care practices. We hypothesized that RSB would be acceptable to mothers and that mothers' strength of breastfeeding intentions would increase, and their comfort with the idea of formula feeding would decrease after educational counseling using the materials. We also hypothesized that mothers' knowledge of optimal maternity care practices would increase after participation. METHODS: Materials were sent to a total of seven sites in the United States and Puerto Rico. Local health care practitioners completed training before counseling mothers with the curriculum. A pre- and postintervention questionnaire was administered to participants. Statistical analysis of results included paired t tests, Wilcoxon signed-rank tests, and McNemar's tests. RESULTS: Four hundred and sixteen expectant women participated. In the pre- and postintervention comparison, maternal participation in RSB significantly improved Infant Feeding Intentions Scale scores (P < 0.001) and knowledge of Baby-Friendly recommended maternity care practices (P < 0.001), while significantly decreasing comfort with the idea of formula feeding (P < 0.001). The education materials were positively rated by participants. CONCLUSIONS: The findings indicate that the approach of using RSB in prenatal counseling group classes or individual sessions improves breastfeeding intentions. Future testing is needed to determine the effectiveness of the materials for impacting breastfeeding outcomes.

Seeds of HOPE: Incorporating Community-Based Strategies to Implement a Weight-Loss and Empowerment Intervention in Eastern North Carolina.

Seeds of HOPE (Health, Opportunities, Partnerships, and Empowerment) was a community-based participatory research project designed to implement an evidence-based weight loss and empowerment intervention aimed at increasing self-efficacy through peer support. HOPE Works, its model, has yielded significant weight loss and increases in participants' ability to set and achieve goals, including in consumption of fruits and vegetables and in physical activity.METHODS The Seeds of HOPE project was implemented through 3 peer leader recruitment approaches using Circle Leaders. Study participants met in hope circles to discuss various topics aimed at developing healthier lifestyles. Changes at 6-month intervals were assessed in health behaviors, weight, and hope. One-way ANOVA was used to test differences in mean change in weight and hope across the 3 recruitment approaches.RESULTS Study participants (N = 146) lost weight (-3.3 pounds, P = 0.003, 95% CI: -5.40 - -1.27). Fruit consumption significantly increased (P = 0.04, 95% CI: 0.01-0.41) while no changes in vegetable consumption or physical activity were observed. No differences based on different leader recruitment approaches were found.LIMITATIONS There were limitations in the power to fully detect differences across Circle Leader recruitment approaches; loss-to-follow up and representativeness of the sample were present. Further research is needed to determine if these approaches would be successful in other rural counties, with different genders, or with individuals in urban and/or higher socioeconomic populations.CONCLUSIONS Participants found modest success in weight loss and fruit consumption. Authors find that community engagement strategies are helpful in finding mutually acceptable adaptations to implement interventions such as Seeds of HOPE in diverse communities.

Correlates of Sexual Behavior Across Fatherhood Status: Finding From the National Longitudinal Study of Adolescent to Adult Health (Add Health), 2016-2018.

Amid national trends in postponed parenthood and more diverse family structures, the fatherhood identity may be important to men's sexual behaviors. This study examined factors associated with reports of consistent contraceptive use and multiple sexual partners across fatherhood status. Using public data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), Wave V (2016-2018), two sexual behaviors were examined among 1,163 men aged 32 to 42 years. Outcomes were two binary indicators: consistent contraceptive use with partner and having multiple (≥2) sexual partners in the past year. Fatherhood status was categorized as nonfather, resident father, and nonresident father. Demographic (e.g., race/ethnicity, education, income, and relationship type) and health-related (e.g., drinking, perceived stress, depressive symptoms, and insurance status) factors were considered. Logistic regression analysis produced odds ratios and 95% confidence intervals and were stratified by fatherhood categories. In the sample, 72% of men were resident fathers, 10% were nonresident fathers, and 18% were nonfathers; 28% reported consistent contraceptive use and 16% reported multiple sexual partners. For nonfathers, relationship type and race were associated with reporting multiple sexual partners. For resident fathers, relationship type was the crucial factor associated with consistent contraceptive use and reporting multiple sexual partners. In nonresident fathers, relationship type, education, and income were important factors to consistent contraceptive use and reporting multiple sexual partners. Key findings suggest that relationship type, income, and education are crucial factors to men's sexual behavior. Heterogeneous effects were observed across fatherhood status. This study adds to limited research on fatherhood and sexual behavior among men transitioning from young adulthood to middle age.