Postacute Care and Long-term Care for LGBTQ+ Older Adults.

LGBTQ + older adults have a high likelihood of accessing nursing home care. This is due to several factors: limitations performing activities of daily living and instrumental activities of daily living, restricted support networks, social isolation, delay seeking assistance, limited economic resources, and dementia. Nursing home residents fear going in the closet, which can have adverse health effects. Cultivating an inclusive nursing home culture, including administration, staff, and residents, can help older LGBTQ + adults adjust and thrive in long-term care.

Associations between adverse childhood experiences and history of weight cycling.

Background: Adverse childhood experiences (ACEs) predict obesity onset; however, the relationship between ACEs and history of weight cycling has not been adequately explored. This gap is problematic given the difficulty in weight loss maintenance and the impact of ACEs on obesity development, chronicity, and associated weight stigma. The objective of this study was to examine associations between self-reported history of ACEs and weight cycling in a sample of weight loss treatment-seeking adults with overweight/obesity. Methods: The number of participants in the analyzed sample was 78, mostly white educated adult women (80% female, 81% Caucasian, 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self-regulatory Mechanisms of Obesity Study. ACEs were measured at baseline using the ACEs Scale. History of weight cycling was measured using the Weight and Lifestyle Inventory that documented weight loss(es) of 10 or more pounds. Results: Higher ACE scores were associated with a greater likelihood of reporting a history of weight cycling. Participants with four or more ACEs had 8 times higher odds (OR = 8.301, 95% CI = 2.271-54.209, p = 0.027) of reporting weight cycling compared with participants with no ACEs. The association of weight cycling for those who endorsed one to three ACEs was not significant (OR = 2.3, 95% CI = 0.771-6.857, p = 0.135) in this sample. Conclusions: The role of ACEs in health may be related to associations with weight cycling. Results indicated that those who reported four or more ACEs had significantly higher odds of reporting weight cycling compared with those with no ACEs. Further research is needed to further explore how ACEs predict the likelihood of weight cycling, which may be prognostic for sustained weight loss treatment response and weight stigma impacts.

Understanding Libraries as Part of the Rural Active Living Environment: Evidence From a Content Analysis of Library Facebook Posts Made in Summer 2022.

As both public health and public libraries continue to evolve, there are opportunities for collaboration focused on building policies, systems, and environments that support communities making healthy choices easy choices. Given the health disparities related to physical inactivity, such as diabetes and heart disease in rural America, public libraries within rural communities are emerging as important settings for health promotion and disease prevention. This study sought to better understand how rural libraries promote physical activity opportunities on Facebook. Based on a content analysis of Facebook posts of a random sample of 118 libraries made during the Summer of 2022, 47 of the 118 had at least one post related to physical activity and 42 had multiple posts. The most frequent offering was events or classes; libraries also supported physical activity by lending equipment and making changes to the built environment. This study provides evidence that some rural libraries are offering physical activity opportunities through community health partnerships, particularly for youth and families. Considering this evidence, public health professionals are encouraged to collaborate with local libraries to promote physical activity and advance rural health equity. Researchers are invited to continue to develop the evidence base around promoting physical activity with rural libraries.

Rural-Urban Differences in Physical Activity Tracking and Engagement in a Web-Based Platform.

OBJECTIVES: Despite the well-established health benefits of regular participation in physical activity, most adults do not meet recommended exercise guidelines. In rural communities, limited local resources and geographic dispersion make engaging in regular activity particularly difficult. Web-based solutions offer a potential solution for addressing physical activity disparities between rural and urban areas. METHODS: This study examined the physical activity logs of users (n = 6695) of a web-based platform called Walk Georgia, comparing residents of metropolitan and nonmetropolitan areas. We tabulated descriptive statistics for variables of interest, cross-tabulated for metropolitan and nonmetropolitan groups. We then used independent-samples t tests to compare logged activity between metropolitan and nonmetropolitan residing user groups. RESULTS: In the analysis of group type (n = 6654), users were more likely to enroll in the program as part of a group than as individuals (n = 4391; 65.9%), particularly for users in metropolitan areas (3558 of 5192; 68.5%). Although the groups shared certain activities, nonmetropolitan residents were more likely than metropolitan residents to engage in maintenance-based activities. Nonmetropolitan residents earned fewer program points for their activity than metropolitan users (P = .007), largely because of lower average exercise difficulty (P < .001). CONCLUSIONS: The web-based platform was effective in helping individuals track physical activity. Despite engaging in similar amounts of physical activity by time, on average, users in nonmetropolitan areas engaged in less rigorous and more maintenance-based tasks than users in metropolitan areas. One strategy for increasing physical activity among rural populations may be to leverage social support provided by group enrollment in such programming.

The Effects of Play Streets on Social and Community Connectedness in Rural Communities.

Promoting physical activity (PA) is a long-standing public health initiative to improve overall health and wellbeing. Innovative strategies such as Play Streets, temporary activation of public spaces to provide safe places for active play, are being adopted in urban and rural communities to increase PA among children. As part of these strategies, aspects of social and community connectedness may be strengthened. This study analyzes focus groups and interviews from rural Play Street implementation team members (n = 14) as well as adults (n = 7) and children (n = 25) who attended Play Streets hosted in rural North Carolina, Maryland, Oklahoma, and Texas to better understand the added benefits of Play Streets in community connectedness. Overall, elements of social support and social cohesion are mentioned most frequently with instrumental and conditional support; however, concepts of social capital, collective-efficacy, and social identification are also presented. Participants expressed that Play Streets provided more than just PA; they provided opportunities to access and share resources, build perceptions of safety and trust in the community, and develop relationships with others. Fostering community connection through Play Streets may reduce health inequities in rural communities by building community resilience. Community-based PA programming that enhance and capitalize on community connectedness could be effective ways to improving the overall health and wellbeing of residents.

Predictors of Feelings of Anxiety in Graduate Allied Health Students: An Exploratory Study.

The objective of this study was to take a multi-domain approach to predict feelings of anxiety among graduate allied health students. Participants (n=77) from a small university in upstate New York completed a series of questionnaires [International Physical Activity Questionnaire-short form (IPAQ-SF), Rapid Eating Assessment of Participants-Short Form (REAP-S), Pittsburgh Sleep Quality Inventory (PSQI), Profile of Mood Survey-Short Form (POMS-SF), Trait and State Mental and Physical Energy and Fatigue Survey], and their resting metabolic rate, fat free mass and muscle oxygen saturation levels were measured. A backwards linear regression was used to identify predictors of anxiety. Our model predicted 28.1% of variance with women reporting greater feelings of anxiety. Poor sleep quality, increased sedentary behavior, and low trait physical energy were all significant predictors of increased feelings anxiety. Our results suggest that educators should attempt to reduce in class sitting time and promote better sleep hygiene. Additionally, researchers should examine barriers and burdens female students face that increase feelings of anxiety.

Measurement implications associated with refinement of sexual and gender identity survey items: A case study of the National College Health Assessment.

Objective: To quantitatively measure psychometric impact associated with changes to sexual and gender identity survey questions included on the National College Health Assessment (NCHA). Participants: Respondents included all iterations (31) of the NCHA between the years of 2000 and 2015 (N = 1,202,582). Methods: Secondary analysis using complete NCHA data across 15 years. Results: Scale reliability for cisgender men, cisgender women, gay and lesbian, and bisexual groups improved when transgender was moved to reflect a gender option, rather than a sexual orientation category. Scale reliability for the alcohol protective behaviors measure was consistently higher for heterosexual persons than sexual minorities. Conclusions: Less inclusive, less representative conceptualizations of sexual and gender identities on survey questionnaires can result in poorer measurement of social characteristics and behaviors. Researchers and practitioners should seek to ensure their assessments and evaluations include demographic items that capture important nuances associated with human sexual and gender identities.

Psychometrics Matter in Health Behavior: A Long-term Reliability Generalization Study.

OBJECTIVES: Despite numerous calls for increased understanding and reporting of reliability estimates, social science research, including the field of health behavior, has been slow to respond and adopt such practices. Therefore, we offer a brief overview of reliability and common reporting errors; we then perform analyses to examine and demonstrate the variability of reliability estimates by sample and over time. METHODS: Using meta-analytic reliability generalization, we examined the variability of coefficient alpha scores for a well-designed, consistent, nationwide health study, covering a span of nearly 40 years. RESULTS: For each year and sample, reliability varied. Furthermore, reliability was predicted by a sample characteristic that differed among age groups within each administration. CONCLUSIONS: We demonstrated that reliability is influenced by the methods and individuals from which a given sample is drawn. Our work echoes previous calls that psychometric properties, particularly reliability of scores, are important and must be considered and reported before drawing statistical conclusions.

Creating Inclusive Physical Activity Spaces: The Case of Body-Positive Yoga.

PURPOSE: Within the modern cultural climate, those in larger bodies face high levels of weight stigma, particularly in sport and physical activity spaces, which serves as a strong barrier to their participation. However, given the strong link between physical activity and general health and well-being for participants, it is important to explore strategies that encourage participation of these individuals. Thus, the current research examined strategies that physical activity instructors use to develop inclusive exercise spaces for all body sizes. METHOD: This study employed a series of semistructured qualitative interviews (n = 9) with instructors of body-inclusive yoga classes to explore the ways in which they encourage participation for those in larger bodies. RESULTS: Emergent themes from the current study suggested support for 6 factors for creating body-inclusive physical activity spaces: authentic leadership, a culture of inclusion, a focus on health, inclusive language, leader social activism, and a sense of community. CONCLUSION: This study revealed that leaders must intentionally cultivate inclusion in their spaces to encourage those in nonconforming bodies to participate. These findings have important health and management implications for the sport and physical activity context and provide a basic outline of practical strategies that practitioners can use to foster inclusion in their spaces.