Interaction of Surface Type, Temperature, and Week of Season on Concussion Risk in the National Football League: A Bayesian Analysis.

BACKGROUND: Artificial turf fields and environmental conditions may influence sports concussion risk, but existing research is limited by uncontrolled confounding factors, limited sample size, and the assumption that risk factors are independent of one another. The purpose of this study was to examine how playing surface, time of season, and game temperature relate to diagnosed concussion risk in the National Football League (NFL). METHODS: This retrospective cohort study examined data from the 2012 to the 2019 NFL regular season. We fit Bayesian negative binomial regression models to relate how playing surface, game temperature, and week of the season independently related to diagnosed concussion risk and any interactions among these factors. RESULTS: We identified 1096 diagnosed concussions in 1830 games. There was a >99% probability that concussion risk was reduced on grass surface (median incidence rate ratio [IRR] = 0.78 [95% credible interval: 0.68, 0.89]), >99% probability that concussion risk was lower at higher temperatures (IRR = 0.85 [0.76,0.95] for each 7.9 °C), and >91% probability that concussion risk increased with each week of the season (IRR = 1.02 [1.00,1.04]). There was an >84% probability for a surface × temperature interaction (IRR = 1.01 [0.96, 1.28]) and >75% probability for a surface × week interaction (IRR = 1.02 [0.99, 1.05]). CONCLUSIONS: Diagnosed concussion risk is increased on artificial turf compared with natural grass, and this is exacerbated in cold weather and, independently, later in the season. The complex interplay between these factors necessitates accounting for multiple factors and their interactions when investigating sports injury risk factors and devising mitigation methods.

The effectiveness of digital sexual health interventions for young adults: a systematic literature review (2010-2020).

There has been a proliferation of digital sexual health interventions targeting adolescents; however, limited evaluative reviews have compared the effectiveness of multiple digital tools for sexual health literacy and behaviour change. This study conducted a systematic literature review, screened 9881 records and analysed 61 studies. Findings suggest that websites and mobile phones dominate digital sexual health interventions, with a majority effectively delivering cognitive (e.g. awareness and attitudes about sexual and reproductive health) and behavioural outcomes (e.g. abstinence and use of contraception). The most popular sexual health promotion mechanisms were interactive websites, text messaging and phone calls, and online education programmes, followed by mobile applications-fewer studies in this review utilized social media, games and multimedia. Previous reviews focused on single outcome measures (e.g. sexually transmitted infection testing) to assess interventions' effectiveness. The current review moves beyond single outcome measures to cover a wider range of behavioural and non-behavioural sexual health issues and contexts covered in the literature. Four main categories were analysed as outcomes: cognitive perceptions, promoting sexual health-related behaviours, promoting sexual health-related products and services, and impact (viral load). Seventy-nine per cent of interventions focused on preventive sexual health behaviours and products (e.g. condoms) and services (e.g. HIV testing). Overall, 75% of studies effectively changed sexual health behaviour and cognitive perceptions. However, the digital-only tools did not vary from the blended formats, in influence outcomes, even after categorizing them into behavioural or non-behavioural outcomes. Compared to previous systematic reviews, more studies from the last decade used rigorous research design in the form of randomized controlled trials, non-randomized control trials, and quasi-experiments and lasted longer.

Sexual health literacy among adolescents is essential to avert unwanted pregnancies or abortions and sexually transmitted diseases. Culturally sensitive and age-appropriate interventions are required to educate youth about safe-sex practices and increase their self-efficacy and accessibility to health products and services. Meta-analytical and systematic literature reviews have identified limitations in traditional interventions that rely heavily on classroom-based activities and lectures to educate adolescents about safe sex. In recent years, digital tools have proved productive; however, limited evaluative reviews have compared the effectiveness of multiple digital technologies (such as smartphones, web-based programs, social media, games and multimedia) used within sexual health interventions. This systematic review assessed 9881 articles and synthesized 61 experimental studies on adolescent sexual behaviour conducted in the last decade to identify tools that positively influence cognitive and safe-sex behaviour among youth. Interactive websites, mobile technology and online education programmes were popular promotional tools, but very few studies utilized multimedia alongside games and social media. Findings from this review could facilitate future research and practice in adolescent sexual health.

How scared are Americans of the Zika virus? The role of threat, efficacy, and third-person perception to induce protective behaviors.

This study examines how public perception of threat and efficacy (on self and others) influence their tendency to take preventive action against the Zika virus by surveying 1,152 U.S. adults in Texas and Florida. Findings show that individuals were likely to take protective actions when they: (1) saw a high risk of the disease (high threat) and were confident about their ability to reduce the danger (high efficacy); and (2) perceived others as having a high risk (high threat), but lacked the ability to reduce the danger (low efficacy). Further, the study discusses practical implications for the design of public health campaigns.

COVID-19 vaccine perceptions among South Asian communities in the UK: An application of the theory of planned behavior.

Based on the Theory of Planned Behavior, this paper explores the perceptions of the COVID-19 vaccine among South Asian communities residing in the UK. Thirty-eight semi-structured interviews were conducted using a qualitative approach and analyzed using thematic analysis. Participants represented Indian, Pakistani, Bangladeshi, Sri Lankan, Afghani, and Nepali backgrounds. The participants revealed that family and community influence their perceptions of the COVID-19 vaccine. The results suggest that normalizing vaccine acceptance, addressing unknown side effects, and popularizing vaccine efficacy data will increase vaccine uptake within the South Asian community in the UK.

Participation in Collision Sports and Cognitive Aging Among Swedish Twins.

We examined the association between early-life participation in collision sports and later-life cognitive health over a 28-year period in a population-based sample drawn from the longitudinal Swedish Adoption/Twin Study of Aging (1987-2014). Cognitive measures included the Mini-Mental State Examination and performance across multiple cognitive domains (e.g., global cognition, verbal ability, spatial ability, memory, processing speed). Among a sample of 660 adults (mean age at baseline, 62.8 years (range: 50-88); 58.2% female), who contributed 10,944 person-years of follow-up, there were 450 cases of cognitive impairment (crude rate = 41.1/1,000 person-years). Early-life participation in collision sports was not significantly associated with cognitive impairment at baseline or with its onset over a 28-year period in a time-to-event analysis, which accounted for the semi-competing risk of death. Furthermore, growth curve models revealed no association between early-life participation in collision sports and the level of or change in trajectories of cognition across multiple domains overall or in sex-stratified models. We discuss the long-term implications of adolescent participation in collision sports on cognitive health.

Community perspectives and engagement in sustainable solid waste management (SWM) in Fiji: A socioecological thematic analysis.

Improper waste disposal and low rates of household waste diversion through material and organic waste recycling are a global concern. Understanding community perspectives on solid waste management services, outreach activities, and regulatory measures, and the barriers to sustainable practices, is crucial for designing effective waste management programmes. Longitudinal content analysis of archival data, such as newspapers, is a cost-effective, yet underutilised, research method to identify the viewpoints of diverse civic groups and examine the developments and challenges associated with the waste management sector. This paper investigates divergent stakeholders' perspectives and priorities using the Socio-Ecological Model (SEM) to examine the micro-system (intrapersonal and interpersonal), meso- and exo-system (community and institutional), and macro-system (policy level) factors that influence sustainable SWM practices. Using specific keywords, the authors searched online archives of a national newspaper in Fiji with a weekday circulation of over 20,000. Data from 482 newspaper articles, dated 2009-2020, were reviewed and dual-coded by two researchers using QDA Miner Lite. Findings indicate that poor waste management behaviour is linked to all factors within the Socio-Ecological system. While micro-level factors such as negligence, personal responsibility, lack of civic pride, and lack of awareness are causes of anti-environmental behaviour, structural factors such as inadequate waste collection services and recycling infrastructure contribute to low recycling rates. Civic education has been highlighted as a solution to encouraging pro-environmental behaviour (PEB), but there is a need to identify the type of educational tools and the frequency and impact of education workshops. This paper further discusses about the implications of community-based strategies and regulatory measures.

Influencing household-level waste-sorting and composting behaviour: What works? A systematic review (1995-2020) of waste management interventions.

Decentralized waste sorting and composting can divert almost two-thirds of household waste from landfill. However, national rates of composting and recycling remain low in many parts of the globe. This review critically evaluates the design and efficacy of behaviour-change interventions to influence households to sort and compost organic waste. The systematic literature search yielded 3595 titles and abstracts which were reviewed and resulted in 14 unique interventions. The social marketing benchmark criteria are utilized to critically examine the design of these interventions. Synthesized results indicate a need for customized interventions that are co-designed with users and tailored to address their specific needs and challenges. Interventions with four or more social marketing elements produced positive behavioural outcomes, albeit with varying impact. This review highlights gaps in the design of waste management interventions and provides suggestions for future practices.

Observational Study of the Associations of Participation in High School Football With Self-Rated Health, Obesity, and Pain in Adulthood.

American football is the most popular high school sport in the United States, yet its association with health in adulthood has not been widely studied. We investigated the association between high school football and self-rated health, obesity, and pain in adulthood in a retrospective cohort study of data from the Wisconsin Longitudinal Study (1957-2004). We matched 925 males who played varsity football in high school with 1,521 males who did not play football. After matching, playing football was not associated with poor or fair self-rated health (odds ratio (OR) = 0.88, 95% confidence interval (CI): 0.63, 1.24; P = 0.48) or pain that limited activities (OR = 0.86, 95% CI: 0.59, 1.25; P = 0.42) at age 65 years. Football was associated with obesity (body mass index (weight (kg)height (m)2) ≥30) in adulthood (OR = 1.32, 95% CI: 1.06, 1.64; P = 0.01). The findings suggest that playing football in high school was not significantly associated with poor or fair self-related health at age 65 years, but it was associated with the risk of being obese as an adult in comparison with not playing football in high school. Our findings provide needed information about the risk of playing football with regard to a broader set of health outcomes.

The Utility of Physical Activity Micro-Grants: The ParticipACTION Teen Challenge Program.

Youth physical activity levels remain low in Canada and worldwide. Lack of environmental resources (e.g., access to equipment and facilities, transportation options, and participation costs) is a key barrier for youth participation. Micro-grants are small budgets of money awarded via grant applications and may help community organizations facilitate youth physical activity participation by alleviating environmental resource barriers. ParticipACTION Teen Challenge was a national micro-grant scheme administered in Canada. Secondary analysis of survey data from Provincial and Territorial coordinators, registered community organizers, and successful grant applicants were used to evaluate the process and outcomes of Teen Challenge. Results showed that the financial subsidy of 500CAD was used mainly toward equipment, instruction, and transportation. Coordinators and community organizers indicated high levels of satisfaction and benefits for communities and teens. A key benefit for coordinators was leveraging the Teen Challenge network for physical activity promotion. Reported benefits for teenaged participants included leadership opportunities (e.g., helping create and implement programs) and increased physical activity participation. Findings highlight the value of micro-grants for supporting sport and physical activity opportunities for Canadian teens, and show that such schemes address barriers related to environmental resources. The sustainability of micro-grant schemes remains to be seen.

Predicting Changes Across 12 Months in Three Types of Parental Support Behaviors and Mothers' Perceptions of Child Physical Activity.

BACKGROUND: Parental support has been established as the critical family-level variable linked to child physical activity with encouragement, logistical support, and parent-child co-activity as key support behaviors. PURPOSE: This study aims to model these parental support behaviors as well as family demographics as mediators of mothers' perceptions of child physical activity using theory of planned behavior (TPB) across two 6-month waves of longitudinal data. METHOD: A representative sample of Canadian mothers (N = 1253) with children aged 5 to 13 years of age completed measures of TPB, support behaviors, and child physical activity. RESULTS: Autoregressive structural equation models showed that intention and perceived behavioral control explained support behaviors, yet child age (inverse relationship) and family income were independent predictors. The three support behaviors explained 19-42 % of the variance in child physical activity between participants, but analyses of change showed much smaller effects. CONCLUSIONS: Mothers' support behaviors are related to perceived child physical activity, but support is dependent on perception of control, child age, and family income.

Applying the Extended Parallel Process Model to workplace safety messages.

The extended parallel process model (EPPM) proposes fear appeals are most effective when they combine threat and efficacy. Three studies conducted in the workplace safety context examine the use of various EPPM factors and their effects, especially multiplicative effects. Study 1 was a content analysis examining the use of EPPM factors in actual workplace safety messages. Study 2 experimentally tested these messages with 212 construction trainees. Study 3 replicated this experiment with 1,802 men across four English-speaking countries-Australia, Canada, the United Kingdom, and the United States. The results of these three studies (1) demonstrate the inconsistent use of EPPM components in real-world work safety communications, (2) support the necessity of self-efficacy for the effective use of threat, (3) show a multiplicative effect where communication effectiveness is maximized when all model components are present (severity, susceptibility, and efficacy), and (4) validate these findings with gory appeals across four English-speaking countries.

Extending stakeholder theory to promote resource management initiatives to key stakeholders: a case study of water transfers in Alberta, Canada.

Many attempts to implement resource management initiatives in Canadian and international communities have been resisted by stakeholders despite inclusion of their representatives in the decision-making process. Managers' failure to understand stakeholders' perspectives when proposing initiatives is a potential cause of this resistance. Our study uses marketing thought to enhance stakeholder theory by bringing in an audience-centric perspective. We attempt to understand how stakeholders perceive their interests in an organization and consequently decide how to influence that organization. By doing so, we investigate whether a disconnect exists between the perceptions of managers and those of stakeholders. Natural resource managers can utilize this knowledge to garner stakeholder support for the organization and its activities. We support this claim with findings from a water transfer plebiscite held in the Canadian province of Alberta. Sixteen personal interviews employing narrative inquiry were conducted to document voters' (i.e., irrigators') interpretations.

An Integrative Literature Review of Interventions to Protect People with Disabilities from Domestic and Family Violence.

PURPOSE: While domestic and family violence against people with disabilities is an ongoing and crucial public health concern, and awareness of the extent of violence against people with disabilities is growing, research on the field is still limited. Thus, the present review aims to systematically identify and synthesize evidence and effectiveness from intervention strategies to increase the awareness and skills of those with disabilities to reduce and prevent domestic and family violence against them. METHOD: PRISMA guidelines were followed to perform a systematic search of seven scientific databases to identify the peer-reviewed literature. RESULTS: A total of 17 eligible studies were identified (14 evaluations and 3 descriptive studies), with most taking place in developed countries. Children and women are the most frequent victims, and they were therefore the most common target audience of the included studies. Sexual, physical, and verbal abuse were the most reported types of abuse, while financial abuse and neglect were studied less often. Interventions also focused on a diversity of disabilities, including learning, intellectual, mental, and physical impairments. Overall, the intervention strategies reflected a substantial homogeneity: focus on training and education as well as setting up channels and facilities for victims to seek help. Nine studies yielded significant positive outcomes using various strategies and techniques, while five studies had mixed results, and three studies only reported on the intervention strategies but did not evaluate the results. CONCLUSIONS: This review confirms a significant gap in the literature on domestic and family violence against people with disabilities and how to prevent and address the violence through evidence-based interventions. Several recommendations to improve future research and practice are proposed.

Mobile Phone-Based Nutrition Education Targeting Pregnant and Nursing Mothers in Sri Lanka.

INTRODUCTION: A woman's nutrition during pregnancy and nursing affects the mother and the growing child. Similarly, the first two years of a child's life are critical to their growth and development and are facilitated by optimum nutrition. Women's nutrition-related knowledge, attitudes, and practices influence household food and nutrition security. Mobile health (mHealth) is a potentially effective health intervention in pandemic situations when physical gatherings are restricted. OBJECTIVES: To examine the effectiveness of a mobile phone-based nutrition education intervention targeting pregnant and nursing mothers in six Sri Lankan divisional secretariat areas. METHOD: This intervention was evaluated using a before and after within-subjects design. The intervention included 19 messages over four weeks sent via mobile phone, covering nutrition themes such as pregnancy care, infant and young child-feeding, diet, family care for mother and child, and cash management. The intervention was evaluated based on a quantitative survey using a structured interviewer-administered questionnaire and qualitative interviews using a semi-structured questionnaire. The study population was pregnant and nursing mothers. The objective of the qualitative interviews was to identify how respondents used messages and how satisfied they were with the project. The outcome measures were awareness/knowledge, attitudes, social norms, self-efficacy, behaviour intentions, and practices of pregnant and nursing mothers. Trained enumerators collected data using a mobile phone. RESULTS: A total of 996 pregnant and nursing mothers participated in the pre-assessment survey, of which 720 completed the post-assessment. Most were nursing mothers (84.2% pre- and 78.9% post-assessment). Participants provided positive feedback on the intervention. Knowledge/awareness (t = -18.70, p < 0.01) and attitudes (t = -2.00, p < 0.05) increased when exposed to the intervention. Favourable improvements in the practices were also observed. Mothers' practices related to breastfeeding and 24-h dietary diversity showed a statistically significant improvement. However, social norms and behaviour intentions did not significantly improve. The qualitative component also revealed favourable responses. CONCLUSION AND RECOMMENDATIONS: The mobile intervention improved participants' knowledge, awareness, attitude, and practices, but not social norms or behaviour intentions. This approach is recommended to be used on a larger scale in community settings. In addition, mobile technology could drive intervention in pandemic-related situations.

Hemoglobin Levels Among Male Agricultural Workers: Analyses From the Demographic and Health Surveys to Investigate a Marker for Chronic Kidney Disease of Uncertain Etiology.

OBJECTIVE: Estimate agricultural work's effect on hemoglobin (Hgb) level in men. A negative effect may indicate presence of chronic kidney disease of uncertain etiology. METHODS: We use Demographic and Health Surveys data from seven African and Asian countries and use matching to control for seven confounders. RESULTS: On average, Hgb levels were 0.09 g/dL lower among agricultural workers compared with matched controls. Significant effects were observed in Ethiopia, India, Lesotho, and Senegal, with effects from 0.07 to 0.30 g/dL lower Hgb level among agricultural workers. The findings were robust to multiple control groups and a modest amount of unmeasured confounding. CONCLUSIONS: Men engaged in agricultural work in four of the seven countries studied have modestly lower Hgb levels. Our data support integrating kidney function assessments within Demographic and Health Surveys and other population-based surveys.

Understanding Factors to COVID-19 Vaccine Adoption in Gujarat, India.

The COVID-19 pandemic has posed threats to human life across the globe, including India. Vaccinating is an effective means of addressing the pandemic threat. The government of India has implemented a massive vaccination drive to save its citizens from the deadly virus. However, the effort has faced multiple challenges, including vaccine hesitancy. This research understands respondents' perspectives on factors contributing to the lower vaccination uptake in Gujarat, India. Forty-four semi-structured interviews were conducted through convenience sampling representing different demographic backgrounds. Factors influencing vaccine adoption included religious leadership, political leadership and the government, and fear of side effects, especially among children and those with co-morbidities, resulting primarily from fake news and misinformation circulated through social media. Compared with nine countries from across the world, the study found similarities to vaccine hesitancy from misinformation and the fear of side effects among children. In contrast, the role of government and the influence of religious and political leaders was considered positive. The study recommends strategies to overcome people's apprehensions about the adoption of vaccination. These include offering incentives, providing positive peer-to-peer communication, recruiting influencers such as religious and community leaders and early adopters such as the elderly population to endorse vaccination, targeting youth through social media, and reaching rural sections by involving NGOs and social service groups.

Segmenting and targeting American university students to promote responsible alcohol use: a case for applying social marketing principles.

The current study contributes to the social marketing literature in the American university binge-drinking context in three innovative ways. First, it profiles drinking segments by "values" and "expectancies" sought from behaviors. Second, the study compares segment values and expectancies of two competing behaviors, that is, binge drinking and participation in alternative activities. Third, the study compares the influence of a variety of factors on both behaviors in each segment. Finally, based on these findings and feedback from eight university alcohol prevention experts, appropriate strategies to promote responsible alcohol use for each segment are proposed.

Motivators of Indiscriminate and Unsafe Supplement Use among Young Australians.

BACKGROUND: There is growing concern about the self-administration of supplements, which can often be indiscriminate, counterproductive to health, and serve as a gateway to more harmful drugs and substances. Research suggests that high uptake of performance- and image-enhancing drugs (PIEDs) is correlated with body image to accentuate masculinity. This study provides insights into limiting unhealthy supplement usage. This research identifies reasons for casual unhealthy supplement use among young adult Australians through the Theory of Planned Behavior (TPB) lens, providing practitioners with insights into developing interventions to deter their use. METHOD: Semi-structured in-depth interviews were conducted with ten participants aged between 18 and 40, using a convenience sample. Leximancer analysis was used to assess word co-occurrence and map to TPB constructs. RESULTS: Leximancer identified positive attitudes, social norms, and perceived behavioral control towards supplement usage. Key themes that influenced supplement use were weight loss, body image, nutrition, training, education, challenges, need, and time. Furthermore, using TPB constructs, affective and instrumental attitudes and prevailing norms were observed when investigating what would cause an individual to use supplements in an unhealthy manner. CONCLUSION: Through understanding the motivations of indiscriminate supplement use across the Australian population, the study has uncovered several social factors that may reduce or limit the practice of unsafe supplement usage.

Retrospective survey of youth sports participation: Development and assessment of reliability using school records.

Many youths participate in sports, and it is of interest to understand the impact of youth sports participation on later-life outcomes. However, prospective studies take a long time to complete and retrospective studies may be more practical and time-efficient to address some questions. We pilot a retrospective survey of youth sports participation and examine agreement between respondent's self-reported participation with high school records in a sample of 84 adults who graduated from high school between 1948 and 2018. The percent agreement between our survey and the school resources for individual sports ranged between 91.5% and 100%. These findings provide preliminary evidence for the reliability of retrospective self-report of youth sports participation. This survey may serve as an efficient approach for evaluating relationships between involvement in youth sports and health outcomes later in adulthood.