Waterpipe tobacco use in college and non-college young adults in the US Running head: Non-college hookah smoking

Background. Waterpipe tobacco smoking (WTS or “hookah”) is common among adolescents and college students in the United States. However, there has not yet been a large-scale, nationally-representative study independently examining WTS among young adults who are not in college. Objective. This study sought to examine associations between attitudes, normative beliefs, certain socio-demographic factors and current WTS among young adults not in college and compare them to young adults in college. Methods. A total of 3131 US adults ages 18 to 30 completed an online survey about WTS behavior, attitudes, normative beliefs, and relevant socio-demographic factors. Multivariable logistic regression was used to examine independent associations between these variables and current WTS stratified by student status. Results. Ever WTS was reported by 29% of young adults not in college and by 35% of those in college, and current use rates were 3% and 7%, respectively. Multivariable models demonstrated that positive attitudes and perceived peer acceptability of WTS were significantly associated with increased current WTS for both young adults not in college (AOR=2.72; 95% CI, 2.00-3.71 and AOR=2.02; 95% CI, 1.50-2.71, respectively) and young adults in college (AOR=3.37; 95% CI, 2.48-4.58 and AOR=2.05; 95% CI, 1.49-2.83, respectively). The magnitude of these associations was not significantly different when comparing individuals in college and not in college. Conclusions. Among young adults, WTS is common in non-college-based populations as well as in college-based populations. Therefore, prevention programming should extend to all young adults, not only to those in college

Social marketing meets health literacy: Innovative improvement of health care providers' comfort with patient interaction

Objective: It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. Methods: In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Results: Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p < 0.001), health literacy (3.41 versus 2.98, p < 0.001), and comfort in brochure development (3.11 versus 2.52, p < 0.001) (N = 83). After controlling for demographic and covariate data, health literacy and comfort in brochure development were independent predictors of comfort interacting with diverse populations. Conclusion: A brief intervention involving social marketing and health literacy can improve skills that improve medical students' comfort with patients of diverse backgrounds. Practice implications: Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers' comfort with direct patient interaction. © 2007 Elsevier Ireland Ltd. All rights reserved

Waterpipe and Cigarette Smoking Among College Athletes in the United States

Purpose: Tobacco use using a waterpipe is an emerging trend among college students. Although cigarette smoking is low among college athletes, waterpipe tobacco smoking may appeal to this population. The purpose of this study was to compare cigarette and waterpipe tobacco smoking in terms of their associations with organized sport participation. Methods: In the spring of 2008, we conducted an online survey of 8,745 college students at eight institutions as part of the revised National College Health Assessment. We used multivariable regression models to assess the associations between tobacco use (cigarette and waterpipe) and organized sports participation. Results: Participants reported participation in varsity (5.2%), club (11.9%), and intramural (24.9%) athletics. Varsity athletes and individuals who were not varsity athletes had similar rates of waterpipe tobacco smoking (27.6% vs. 29.5%, p = .41). However, other types of athletes were more likely than their counterparts to have smoked waterpipe tobacco (35.1% vs. 28.7%, p < .001 for club sports and 34.8% vs. 27.7%, p < .001 for intramural sports). In fully-adjusted multivariable models, sports participants of any type had lower odds of having smoked cigarettes, whereas participants who played intramural sports (odds ratio = 1.15, 95% confidence interval = 1.03, 1.29) or club sports (odds ratio = 1.15, 95% confidence interval = 1.001, 1.33) had significantly higher odds of having smoked waterpipe tobacco. Conclusions: College athletes are susceptible to waterpipe tobacco use. In fact, compared with their nonathletic counterparts, club sports participants and intramural sports participants generally had higher odds of waterpipe tobacco smoking. Allure for waterpipe tobacco smoking may exist even for individuals who are traditionally considered at low risk for tobacco use. © 2010 Society for Adolescent Medicine

Impact evaluation of “Have Fun — Be Healthy” program: A community based health promotion intervention to prevent childhood obesity

Issue addressed: Childhood obesity is rising in prevalence in Australia. This study aimed to evaluate the impact of the “Have Fun— Be Healthy” (HFBH) intervention, delivered in the Playgroup setting, to generate short term changes in dietary, physical activity and sedentary behaviours of children under 5 years and self-efficacy of parents and primary carers. Methods: This intervention consisted of eight structured cooking and physical play sessions delivered over a period of 8 weeks by trained facilitators. Pre- and post-intervention data collection was performed using survey questionnaires administered to parents and carers of children under 5 years from low socioeconomic backgrounds recruited through convenience sampling. Results: A total of 640 pre-intervention surveys and 312 postintervention surveys were returned. The matched response rate was 45.5%. There was an improvement in mean intake of healthy foods and mean physical activity with a decrease in mean intake of unhealthy food and mean screen time in children (P > .05). Following the intervention, parental/carer self-efficacy in promoting healthy eating and limiting screen time of children improved significantly (P < .05). Children’s physical activity levels and consumption of healthy foods were positively correlated with parental/carer self-efficacy (P < .01) while screen time and consumption of unhealthy foods were negatively correlated (P < .01). Conclusions: HFBH intervention was successful in improving the dietary, physical activity and screen time in children and parental self-efficacy. So what?: Being amongst the first of its’ kind in Australia, the findings of this study can have implications for developing and implementing similar future health promotion interventions in comparable settings.Griffith Health, School of MedicineNo Full Tex