A dyadic analysis of anti-fat attitudes and partners' diet-related influence among gay married men.

OBJECTIVES: The focus on physical appearance among gay men has potential implications for anti-fat attitudes, including those directed toward romantic partners. Partners often influence each other's behaviors including those linked to weight, but most research has examined the consequences of these influence strategies versus their antecedents. To address this research gap, we examined how men's own and their partners' anti-fat attitudes were related to both health-promoting (control) and health-compromising (undermining) types of diet-related influence and whether these associations differed by weight status. METHODS AND RESULTS: Analyzing data from a cross-sectional online survey of 450 U.S. adult gay married men (225 couples), Actor-Partner Interdependence Models revealed that individuals' own anti-fat attitudes (all types) were positively associated with more frequent receipt of spousal control and undermining. Additionally, partner's fears about gaining weight were positively associated with more frequent receipt of spousal control and dislike of higher weight people and fear of gaining weight (among those of higher weight status) were positively associated with more frequent receipt of spousal undermining. CONCLUSION: Our findings add to the literature on diet-related interactions among gay married men, highlight the value of examining these processes dyadically, and suggest the importance of including both members of couples in health promotion and intervention efforts.

Examining the link between exercise-specific relational processes and physical activity, psychological distress, and relationship satisfaction among heterosexual and gay male couples.

Despite the important role of romantic relationships in physical activity, little research has examined the role of gender and sexual orientation in exercise-specific relational processes. Utilizing cross-sectional, dyadic data from 462 heterosexual and gay couples, the present study examined how exercise encouragement, exercise discouragement, and frequency of exercise disagreements are related to physical activity, psychological distress, and relationship satisfaction. We included important covariates and examined gender and sexual orientation as moderators. Higher exercise encouragement was associated with more frequent physical activity (for gay men only), lower psychological distress (for women only), and higher relationship satisfaction regardless of gender and sexual orientation. Higher exercise discouragement was associated with more physical activity for all participants and higher levels of psychological distress for gay men only. Finally, more frequent exercise disagreements were associated with more psychological distress for all participants. These findings highlight important implications for physical activity promotion, prevention, and intervention.

Examining foodwork and eating behaviors among heterosexual and gay male couples.

OBJECTIVES: Spouses play an important role in their partners' eating behaviors, including both promoting and impeding healthy eating. The division of foodwork in the relationship (i.e., if there is individual or shared responsibility for food roles) may vary as a function of gender or sexual orientation and may be important in understanding eating behaviors. METHOD: Using cross-sectional, dyadic data from 462 heterosexual and gay married couples (N = 921 individuals) residing in the United States, we accordingly sought to examine which partner was most responsible for two food roles, food shopping and meal preparation (Aim 1); whether these roles differed by gender (Aim 1a) and sexual orientation (Aim 1b); whether these food roles were related to the frequency of eating healthy and unhealthy foods (Aim 2); and whether these associations differed by gender (Aim 2a) and sexual orientation (Aim 2b). RESULTS: We found that one individual was responsible for these roles in a majority of couples, although meal preparation was more likely to be shared in gay than in heterosexual couples. We also found that, in general, the person responsible for these food roles ate healthy more frequently compared to when their partner was responsible; findings for shared responsibility were more equivocal. These associations did not differ, however as a function of gender or sexual orientation. CONCLUSION: Our findings contribute to a further understanding of food dynamics among heterosexual and gay male couples and have important implications for health promotion and intervention efforts.

Clinician Perceptions of Incorporating Yoga into Therapeutic Practice.

Despite increased interest in mindfulness practices such as yoga as an adjunct for depression, anxiety, and other chronic health concerns, little research exists on the potential benefits of yoga in therapeutic settings. As a complementary therapy, yoga provides a value-added benefit to traditional clinical practices for (1) clinicians as a form of self-care in treating compassion fatigue caused by, for example, fallout from the COVID-19 pandemic, and (2) the patients they serve. The primary goal of the present study was to understand clinician perspectives of yoga as an intervention in the therapeutic setting for clinicians and clients. We conducted a qualitative study and surveyed therapists from a yoga teacher training program designed specifically for clinical therapists. Eight therapists completed a qualitative questionnaire designed to understand the effects of yoga on clinicians and patients in the therapeutic setting. Although the effects of COVID-19 had not been anticipated, survey results corroborate high rates of compassion fatigue for therapists and a decline in mental health for patients throughout the study. Yoga, specifically body awareness and breathwork, however, provided a baseline for navigating mental health for both patients and therapists amid the pandemic. Additionally, body awareness and breathwork were found to help therapists avoid burnout and compassion fatigue and facilitate a more positive therapy experience for patients and therapists. Yoga has the potential to be a positive adjunct in therapeutic settings and would benefit from further research into various applications.

Nudging Urban Food Pantry Users in Utah Toward Healthier Choices.

Purpose. To evaluate the impact of a nudge program on food pantry clients' self-reported selection and use of healthy foods. Method. A convenience sample of clients of six urban food pantries in Utah were surveyed about their experience with the Thumbs Up for Healthy Choices nudge program. Chi-square tests were used to identify associations between demographic characteristics and self-reported program impact. Results. Ninety-four percent (n = 158) of respondents agreed that the program made it easier to make healthy choices. Sixty-five percent reported healthier diets since its implementation. Additionally, Hispanic respondents were more likely to report positive impacts than non-Hispanic respondents. Conclusions and Implications. Nudge programs are effective in increasing the selection of healthy foods among pantry clients in Utah. Impacts seemed to be particularly positive for Hispanic pantry users in Utah. Nutrition programs should consider implementing these low-cost strategies to improve dietary quality of pantry users.

A qualitative inquiry on religious married men's perceptions of relationship dynamics during everyday sickness.

The purpose of this study was to evaluate men's perceptions of self-dynamics and partner dynamics during common everyday sickness. Five focus group interviews (N = 44) were conducted, each lasting approximately 120 minutes. The data were analyzed using a generic qualitative approach which identified two larger themes and several sub-themes: sickness appraisals and appraisal communication (gender differences in symptom appraisal and minimization of own and partner's sickness) and coping and support strategies (individual coping, one-way provision of support, and coping together). It seems acute sickness creates shared stressors for both partners but differentially impacts each based on gender and family roles.

Associations between partner's diet undermining and poor diet in mixed-weight, older gay married couples: a dyadic mediation model.

BACKGROUND: Prior studies have examined how individuals may undermine their partner's efforts to maintain a healthy diet, but gay couples have not been represented in this work. Additionally, research has not accounted for mixed-weight status [lighter partner (LP) and heavier partner] nor investigated the mechanisms through which undermining is associated with dietary outcomes. OBJECTIVE/DESIGN/MEASURES: Utilising dyadic data from 224 gay married couples across the United States, we tested associations between perceptions of partner's diet undermining strategies and diet quality with couple food disagreements and depressive symptoms as putative, serial mediators in an actor-partner interdependence mediation model. RESULTS: Results revealed that more severe diet undermining was associated with both partners' poorer diet quality, which was explained by more frequent couple food disagreements and higher depressive symptoms for both heavier and LPs. CONCLUSION: These findings suggest that undermining strategies are detrimental to both partners' relational health (increased conflict), emotional health (depressive symptoms) and physical health (diet)-regardless of weight status-and provide valuable targets for prevention and intervention. Our study underscores the interdependence of couple relations in lifestyle changes and specifically highlight the need for health professionals to discuss the partner's indirect or unintended disruptions to the patient's plan.

Latino Health Behavior: An Exploratory Analysis of Health Risk and Health Protective Factors in a Community Sample.

BACKGROUND: Demographic and cultural factors have been found to affect health behaviors in Latinos in both positive and negative ways, but few studies have examined the impact of culture and adherence to machismo norms on health behaviors in a mixed gender community sample of Latinos. Of particular interest was if positive (caballerismo) or negative aspects of machismo would affect Latino health behaviors. METHODS: A paper survey was given to a community sample of Latinos in northern Utah to explore the variables that affect both health promoting and health risking behaviors in this cross-sectional study (final N = 144 participants). RESULTS: Life satisfaction, self-reported health, health insurance status, language preference, and gender were significantly related to overall health score. Surprisingly, the cultural variables of fatalism, machismo, and caballerismo were nonsignificant in all analyses. CONCLUSION: Access to health care mediated by health insurance and self-reported health status may be the most effective way to encourage Latinos to engage in protective health behaviors.

Associations Between Masculine Norms and Health-Care Utilization in Highly Religious, Heterosexual Men.

The purpose of this study was to use focus groups to explore married men's avoidance of health-care utilization. Five focus groups of 8 to 10 married, heterosexual, male participants ( N = 44) were conducted and analyzed using grounded theory methods. Several important themes emerged connected to how masculine norms were associated with health-care utilization at several domains including at the organizational level ( perceptions of doctors), interpersonal level ( past family context and current family context), and individual level ( illness severity, money concerns). These themes were all connected with the societal theme of masculine norms, where men's reasons for health-care utilization (or underutilization) seemed in large part to emerge because of their perceptions of male gender roles. Implications for married men's health-care utilization and health prevention education will be discussed.

A Case Study of Health-Related Support Processes in 2 Happy, Gay Couples.

The purpose of this case study was to explore 2, early-relationship, same-sex couples on the strategies used to support their partner's engagement in health promoting behaviors. A semistructured interview protocol was used to conduct 120-minute interviews with each couple and analyzed using grounded theory methods. Five organizing categories emerged during the analysis, resulting in a conceptual process model of health-related support in same-sex relationships. These categories, provided a snapshot of how processes interact with each other; they were context, relationship dynamics, health support processes, couple adaptation, and balancing physical/relational health. Couples described the balancing of relational and physical health as an ongoing, important theme in the success of health support. Implications for both health prevention and intervention are discussed.

Understanding the Experiences of Low-Income Individuals Receiving Farmers' Market Incentives in the United States: A Qualitative Study.

OBJECTIVE: The objective of this study was to identify benefits and barriers to using a farmers' market (FM) incentive program among program participants. DESIGN: In qualitative semistructured interviews, participants were asked about their experiences with shopping at FM, using FM incentives, barriers to fruit and vegetable (F&V) intake, and changes in dietary intake. Interviews were recorded and transcribed. Inductive content analysis was used to code, categorize, and develop themes based on the transcriptions. SETTING: A FM in Northern Utah. SUBJECTS: A convenience sample of participants ( n = 14) completed a 45- to 60-minute interview after receiving FM incentives for an 8-week intervention period. RESULTS: FM incentives reduced barriers associated with shopping at FM such as cost and accessibility among program participants. Incentives provided participants with greater spending flexibility, allowing parents to provide children with F&V that previously did not fit into their food budget. Participants reported greater family and community involvement when shopping at FM. However, the limited hours and days of operation were factors that reduced the use of FM among participants, even when incentives were provided. CONCLUSIONS: The perceived benefits and barriers to shopping at FM and receiving FM incentives should be considered by future programmers and funding agencies.

Intuitive eating: associations with physical activity motivation and BMI.

PURPOSE: To determine whether university women who demonstrated internal motivation related to eating behavior may also be internally motivated to participate in regular physical activity (PA) and have a lower body mass index (BMI) when controlling for age. Traditional approaches for health promotion related to healthy weight include restrictive eating and exercise prescription. Examining motivation for eating and PA may prove an effective alternative for achieving or maintaining healthy weight for university women. DESIGN: Design was a cross-sectional study. SETTING: Study setting was a large, public university in the western United States. Subjects . Study subjects were 200 undergraduate women with a mean age of 19 years, mostly white (90%) and of healthy weight (69%, with a BMI range of 18.5-24.9). MEASURES: Study measures were the Intuitive Eating Scale and the Behavioral Regulation in Exercise Questionnaire. ANALYSIS: Correlations and regression models were used. Intuitive eating was examined in the sample as a whole and among subgroups of respondents grouped based on tertile rankings of intuitive eating scores. RESULTS: There was evidence that women who demonstrated internal motivation related to eating were also internally motivated to participate in regular PA. Women who reported being internally motivated to eat were significantly more likely to engage in PA for pleasure and to view PA as part of their self-concept. Women who reported high levels of intuitive eating had significantly lower BMI scores than those reporting medium or low levels when controlling for age. CONCLUSION: For women to achieve or maintain a healthy weight, it may be best for health professionals to examine motivation for eating and PA rather than the encouragement of restrictive eating and exercise prescriptions.

The design and progress of a multidomain lifestyle intervention to improve brain health in middle-aged persons to reduce later Alzheimer's disease risk: The Gray Matters randomized trial.

INTRODUCTION: Most Alzheimer's disease (AD) prevention studies focus on older adults or persons with existing cognitive impairment. This study describes the design and progress of a novel pilot intervention, the Gray Matters study. METHODS: This proof-of-concept randomized controlled trial tests an evidence-based multidomain lifestyle intervention in 146 persons aged 40 to 64 years, in northern Utah. Data collectors were blinded to participants' randomization to treatment (n = 104) or control (n = 42). Intervention targeted physical activity, food choices, social engagement, cognitive simulation, sleep quality, and stress management, and uses a custom smartphone application, activity monitor, and educational materials. Secondary outcomes include biomarkers, body mass index, cognitive testing, and psychological surveys. RESULTS: Midway through the study, achievements include a 98.7% retention rate, a 96% rate of compliance with app data entry, and positive trends in behavioral change. DISCUSSION: Participants were empowered, learning that lifestyle might impact AD risk, exhibiting positive behavioral changes thus far.

Skin carotenoids: a biomarker of fruit and vegetable intake in children.

BACKGROUND: Studies of adult subjects have found a strong correlation between serum carotenoids and skin carotenoids measured by resonance Raman spectroscopy (RRS). No published studies have examined correlations between skin and serum carotenoids among children. OBJECTIVES: We aimed to validate skin RRS methodology against serum carotenoid measurements by high-performance liquid chromatography and to determine whether RRS can be used as a valid biomarker of fruit and vegetable (F/V) intake among children. DESIGN: In our cross-sectional study, participants were 45 healthy children aged 5 to 17 years who provided three blood samples used to assess serum carotenoid concentrations and three RRS skin measurements of the palm within a 4-week period. Dietary intake of F/V was assessed three times within 4 weeks using a 27-item food frequency questionnaire (FFQ) and an automated multiple-pass 24-hour daily recall. Estimates of intake from three FFQs, completed at least 7 days apart, were averaged. Estimates of intake from 24-hour daily recalls were collected on 2 weekdays and 1 weekend day and averaged. RESULTS: Levels of skin and serum carotenoids were highly correlated (R(2)=0.62; P<0.001). A linear regression model, controlling for child's weight and scanner unit, predicted that for every unit increase of total F/V from FFQ and total F/V as assessed by 24-hour daily recall, RRS intensity was predicted to increase by 3,798 (P=0.001) and 3,504 (P=0.001), respectively. Similar results were observed for reported high-carotenoid vegetable intake. Total carotenoid and beta carotene levels from 24-hour daily recalls correlated to total serum carotenoids levels (P<0.01 and P<0.05, respectively). Total carotenoid, alpha carotene, and beta carotene levels from the 24-hour daily recalls correlated to RRS (P<0.01). CONCLUSIONS: Skin carotenoids measured by RRS were strongly correlated with serum carotenoid levels and were positively associated with estimates of intake from FFQ and an automated multiple-pass 24-hour daily recall among children aged 5 to 17 years. Skin carotenoids may be used as valid biomarker of F/V intake among children.

Are men more intuitive when it comes to eating and physical activity?

The purpose of this study was to determine where men fall on the motivation continuum based on intuitive eating status and if motivation for physical activity and intuitive eating are correlated. Results indicate that being an intuitive eater was associated with a lower body mass index. In terms of demographic variables, as age increased, intuitive eating status decreased and body mass index increased. Men scored high on the antidieting and self-care subscales of the Intuitive Eating Scale. Men who were classified as intuitive eaters scored higher on the external and introjected regulation of the Behavioral Regulation in Exercise Questionnaire but no significant differences were reported by eating status and the identified and intrinsic motivation subscales. Intuitive eating holds promise as a weight management and weight loss tool for men. Intuitive eating may also influence initial motivation for physical activity for men.

"It used to be that if it weren't broken and bleeding profusely, I would never go to the doctor": men, masculinity, and health.

Masculine gender scripts have been influential in health decision making in men. In addition, although past research has identified some success in using churches as sites for health education with women, little is known if similar programs would be successful with men. It is also unclear if religious beliefs influence the health attitudes and behaviors of men. Four focus groups with men from four religious denominations were conducted to learn about their health beliefs, attitudes, and behaviors, with the following themes emerging: men's health fears, health promotion behaviors, spousal influence, aging and men's health, and church-based health influence. Finally, the interaction of masculine gender scripts within these themes was considered.

Adolescent gender and ethnicity differences in physical activity perceptions and behavior.

OBJECTIVES: To examine gender and ethnicity differences in adolescents' physical activity (PA) behavior and perceptions. METHODS: Surveys designed to measure PA behavior and perception were completed by 175 adolescents. Gender and ethnicity differences in PA behavior were examined using chi-square tests. A two-way between groups MANOVA was used to examine perception. RESULTS: No significant differences were found between gender groups for PA. Caucasian students were more likely to be active and to perceive that PA makes their health better. Hispanics were more likely to perceive that PA requires more time than Caucasians. CONCLUSIONS: Findings suggest greater consideration be given to the ethnic orientation of PA behavior antecedents when promoting PA to adolescents.

A needs assessment of Latino men's health concerns.

Historically, Latino men are an understudied group. Researchers know little about the impact of culture or gender on health concerns. In this study, focus groups with Latino men were held that investigated their health concerns, barriers, motivators, and access to health information and health services. Additionally, the researchers wished to determine if a church-based design might help reach men who might not be responsive to more traditional health education or public health routes. Results included that the Latino male participants in this study wanted health information but wanted it to be more specific and in an accessible format. They also desired more Spanish-speaking health care providers and were acutely interested in low-cost health care. Prevention was not of much interest to these participants. Church-attending participants were interested in church-based health education.

A comparison of health behaviors of women in centering pregnancy and traditional prenatal care.

OBJECTIVES: Researchers sought to determine the difference in health behaviors between women who receive prenatal care via the Centering Pregnancy approach and those involved in traditional prenatal care. METHODS: Using a cross-sectional design, adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation to delivery. The sample was comprised of primarily white low income women. RESULTS: Using multiple linear regression it was determined that women in Centering Pregnancy had significantly lower index health behavior scores compared with the traditional care group showing that those in Centering Pregnancy reported engaging in fewer health promoting behaviors. Furthermore, no differences were observed for smoking or weight gain behaviors between groups. Additionally, those in Centering Pregnancy reported a lower perceived value of prenatal care. CONCLUSIONS: The results of this study suggest that Centering Pregnancy is not adequately aiding its patients in adopting healthy behaviors during pregnancy.

Prevalence and correlates of walking and biking to school among adolescents.

Increasing the rates that our adolescents walk and bicycle to school, also called active transport to school (ATS), could increase the physical activity (PA) levels of that age group. This type of activity has been identified as a missed opportunity for PA. It is currently estimated that 15% of American youth walk or bicycle to school. These rates of ATS are lower than those of European and Asian youth. Efforts to enhance levels of non-motorized transport to school could aid in reducing obesity rates among American youth, decrease traffic congestion and attenuate emission of greenhouse gasses. The objective was to identify demographic, environmental and psychosocial predictors of ATS. A 30-questionnaire was completed by 2,692 students. Logistic regression was used to identify psychosocial, demographic and environmental predictors of ATS. Only 4.6% of students used ATS. Predictors of ATS were street connectedness (density of street intersections) and gender, (boys had higher ATS rates). Public health officials should be alert for opportunities to select sites for new schools that are in neighborhoods with well connected street systems. Interventions promoting ATS will need to target male and female students and there appears to be an opportunity to increase rates that students bicycle to school.