September/October 2017

AJHE: American Journal of Health Education



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  September/October 2017 (Volume 48, Issue 5)


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Table of Contents

 
Free Access Article
/The Motivational Impact of Wearable Healthy Lifestyle Technologies: A Self-determination Perspective on Fitbits With Adolescents – Charlotte Kerner and Victoria A. Goodyear

Background: Considerable numbers of young people are not meeting physical activity guidelines. Wearable fitness devices can provide opportunities for physical activity promotion.
Purpose: The aim of the study was to explore whether wearable healthy lifestyle technologies impacted on adolescents’ (13- to 14-year-olds) motivation for physical activity.
Methods: The study was a mixed method sequential design. Participants were 84 adolescents (44 girls, 40 boys) from 6 physical education classes. Pupils were issued with a Fitbit to wear for 8 weeks and completed pre-/posttest questionnaires that assessed motivational regulation and psychological need satisfaction. Adolescents also engaged in focus group interviews after wearing the Fitbit for 8 weeks. Quantitative data were analyzed using a repeated measures multivariate analysis of variance (MANOVA) to explore differences between gender and time. Qualitative data analysis was conducted deductively using self-determination theory.
Results: The quantitative findings identified significant reductions in need satisfaction and autonomous motivation and significant increases in amotivation after 8 weeks. Qualitative evidence suggested short-term increases in motivation through feelings of competition, guilt, and internal pressure.
Discussion: Findings suggest that healthy lifestyle technology may have negative motivational consequences. Translation to Health Education Practice: Certified Health Education Specialists should support young people to personalize health targets in order to critically engage with normalized health targets.


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Commentaries

Global Health Promotion on College Campuses: Considerations for Use of eHealth and mHealth Self-monitoring Applications with Nutritional Food Labeling Features
Kelly A. Romano, Christina D. Colgary, and Amy Magnuson
Background: College students have been a difficult population to reach in extant health promotion initiatives that strive to prevent the development of lifelong disordered eating patterns. Incorporating electronic and mobile health (eHealth, mHealth) technologies within these efforts may be an effective means of reaching students.
Purpose: This commentary discusses how dietary self-monitoring by means of eHealth/mHealth applications that incorporate nutritional food labeling features can be used to target this population.
Discussion: Considerations for use of these technologies in college health promotion efforts relative to the global, physical and mental, health of students are discussed. The role of professionals working in college health is examined.

Research Articles

Differences in Eating Behavior, Physical Activity, and Health-related Lifestyle Choices between Users and Nonusers of Mobile Health Apps
Alessandra Sarcona, Laura Kovacs, Josephine Wright, and Christine Williams
Background: Weight gain and lifestyle behaviors during college may contribute to future health problems. This population may not have sufficient self-monitoring skills to maintain healthy lifestyle behaviors.
Purpose: The purpose of this study was to determine the relationship between usages of mobile health applications (apps) designed to track diet and physical activity and health-related behaviors of college students.
Methods: In a cross-sectional study, 401 university students completed a survey to assess eating behavior, physical activity, and health-related lifestyle choices and mobile health app usage.
Results: Mobile health app users had significantly higher scores for eating behavior than nonusers, and the impact of using more than one type of mobile health app significantly improved eating behavior. Most participants also identified app use with feeling healthier, better self-monitoring of food intake and exercise, and having more motivation to eat healthier and increase physical activity.
Discussion: Use of mobile health apps may have a positive effect on eating behavior, and demographic background appears to be influential with regard to health-related behaviors.
Translation to Health Education Practice: Health Educators need to consider the use of apps as a supplementary component of a health promotion program to assist individuals who want to make improvements in their overall health and to prevent chronic disease.

Exploring Perceptions about and Behaviors Related to Mental Illness and Mental Health Service Utilization among College Students Using the Health Belief Model (HBM)
Brandye D. Nobiling and Sherry Azadi Maykrantz
Background: Mental health service is underutilized in the United States. Adolescent and young adults, including college students, are especially unlikely to seek professional help for mental illness. This issue presents a concern, because signs and symptoms commonly appear during this part of growth and development.
Purpose: The Health Belief Model (HBM) was used to explore perceptions about mental illness and mental health service utilization and self-medication among college students who may or may not have a history of mental illness.
Methods: A survey exploring HBM constructs and self-medicating behaviors was distributed to a population of university undergraduate students ages 18–24. A concurrent focus group of mental health care providers investigated practitioner perceptions of mental health care utilization. Results of both were analyzed for common themes.
Results: Sociocultural concerns and challenges navigating through the system were the primary perceived barriers to accessing mental health services. Primary care providers were reported as a vital cue to action. Alcohol, marijuana, and prescription medications were the most frequent and preferred substances used for self-medication.
Translation to Health Education Practice: The most apparent theme is the need for education and continuing school partnerships. Doing so can offer diagnosis and treatment and foster personal and social skill development.

Knowledge and Behavioral Intention Related to HPV Vaccination Among Male College Students
Chandrika Johnson and Roberta Ogletree
Background: Although human papillomavirus (HPV) infection is commonly associated with women and cervical cancer, male HPV infection is also a public health concern. In addition to transmission risk to women, HPV is associated with anal, penile, and oral cancers in men and genital warts.
Purpose: The study’s purpose was to examine male college students’ HPV knowledge and intention to be HPV vaccinated.
Methods: Two hundred and eight college males completed an in-class questionnaire that assessed knowledge and the Theory of Planned Behavior (TPB) constructs of behavioral intention, attitudes, perceived behavioral control, and subjective norms regarding HPV and HPV vaccination.
Results: The results of this study suggest that males are open to being HPV vaccinated; however, they lack necessary information on HPV transmission, risks of HPV infection, and the need to be HPV vaccinated. Both subjective norms and perceived behavioral control were found to be significant predictors of male college students’ intentions to be HPV vaccinated.
Translation to Health Education Practice: Certified Health Education Specialists should focus on the development of education and behavior change interventions to increase the knowledge and acceptance of HPV vaccination among males.

First-Year College Students Increase Food Label–Reading Behaviors and Improve Food Choices in a Personal Nutrition Seminar Course
April Tallant
Background: Poor dietary behaviors are risk factors for developing chronic diseases that plague public health.
Purpose: This study sought to determine the differences in pre- and post-food label and food choice scores among first-year college students at the beginning and end of the semester. Case analyses were conducted to evaluate individualized changes.
Methods: Students completed pre- and post-electronic surveys. Food label and food choice scores were computed. Reliability analysis was conducted for each computed score. Paired t tests were employed to compare the differences in scores at pre- and post-measure. Case analyses showed differences per individual student.
Results: Paired t test revealed a statistically significant difference with an increase in food label–reading behavior (P = .000) and food choice behavior (P = .000). Case analyses showed that 27% of students practiced food label reading more frequently in at least one category above at post measure and 29% indicated choosing healthier food options more frequently.
Discussion: College nutrition courses may improve college student food label reading skills and result in healthier food choices.
Translation to Health Education Practice: Health Educators can work with higher education institutions to play a role in reducing disease risks by educating students and providing environmental supports for dietary improvement.

Validation and Use of the Multidimensional Wellness Inventory in Collegiate Student-Athletes and First-Generation Students
Mindy Hartman Mayol, Brianna M. Scott, and James B. Schreiber
Background: In some professions, wellness has become shorthand for physical fitness and nutrition but dimensions outside the physical are equally important. As wellness models continue to materialize, a validated instrument is needed to substantiate the characteristics of a multidimensional wellness model.
Purpose: This 2-pronged study focused on the testing of the factor structure of the Multidimensional Wellness Inventory (MDWI) and comparisons between student-athletes (SAs) and non-athletes (NAs) as well as first-generation (FGs) and non-first-generation students (NFGs).
Methods: Part I tested the construct validity of the instrument using confirmatory factor analysis (N = 1699). Part II compared wellness scores among SAs, NAs, FGs, and NFGs using independent sample t tests (N = 990).
Results: Part I revealed that a revised factor structure for the MDWI was preferred. Part II showed statistically significant differences in 5 of 9 wellness constructs. FGs did not have statistically significant different scores than NFGs.
Discussion: Outcomes demonstrate that a multi-dimensional approach and a valid instrument are imperative within the college population regardless of their involvement in athletics and their FG/NFG designation.
Translation to Health Education Practice: The study is significant to college Health Educators for planning and evaluation purposes to gauge students’ multidimensional wellness status.