Malaria is a threat to United States military personnel operating in endemic areas, from which there have been hundreds of cases reported over the past decade. Each of these cases might have been avoided with proper adherence to malaria chemoprophylaxis medications. Military operations may detract from the strict 100% adherence required of these preventive medications. However, the reasons for non-adherence in military populations are not well understood. This behavior was investigated using a cross sectional study design on a convenience sample of U.S. Army Ranger volunteers (n=150) located at three military instillations. Theoretical support was based on components of the Health Belief Model, the Theory of Reasoned Action/Theory of Planned Behavior, and the Social Cognitive Theory. Data on knowledge, attitudes, and practices, as well as multiple environmental domains was collected using an original yet unvalidated questionnaire. The data was analyzed using bivariate Pearson correlations, binary logistic regression, and moderated logistic regressions employing a 0.05 criterion of statistical significance. Power analyses predicted 96-98% power for this analysis. Multiple significant medium strength Pearson correlation coefficients were identified relative to the two dependent variables Take medications as directed and Intend to take the medications as directed the next time. Binary logistic regression analyses identified multiple variables that may predict behavioral intentions to adhere to these preventive medications, as a proxy for behavioral change. Moderated logistic regression analyses identified Command Support for adherence to these medications as a potential significant moderator that interacts with independent variables within three domains of the survey questionnaire. The findings indicate that there may be potential significant beneficial effects, which may improve this behavior in this population of Rangers through 1) promoting affirmative interpersonal communications that emphasize adherence to these medications, 2) including malaria chemoprophylaxis medications in the mission planning process, and 3) military command support, in the form of including the importance of proper adherence to these medications in the unit safety briefings.

Depression is regarded as the most common mental problem among young college adults and is associated with numerous health complications and increased mortality. Significant evidence supports a relationship between depression and physical health outcomes, including poorer general health and obesity. The purpose of this study is to examine potential mechanisms underlying this relationship. Specifically, we examined whether three health behaviors – physical activity (PA), fruit and vegetable consumption (FVC), and fast food consumption (FFC) mediated the relationship between depression and three physical health outcomes – self-rated general health, somatic complaints, and body mass index (BMI). A sample of college students (n=723) was recruited through the ETSU Sona system and completed self-report questionnaires via the REDCap survey platform. Linear regression analysis was conducted in order to determine the association between depression, health risk behaviors, and health outcomes. The effects of age, race, gender, income, and year in school were controlled to limit confounding. Depression was found to significantly predict general self-rated health (R2 = .18, F[7, 335] = 10.64, p < .000, β = -.06), BMI (R2 = .13, F[7, 337] = 7.12, p < .01, β = .14), and somatic symptoms (R2 = .40, F[7, 335] = 31.86, p < .000, β = .60). Depression also significantly predicted fast food consumption (R2 = .04, F[7, 336] = 2.04, p < .01, β = .07), although it did not significantly predict fruit and vegetable consumption (R2 = .06, F[7, 335] = 3.00, p = .579, β = -.07) or minutes of physical activity (R2 = .03, F[7, 307] = 1.30, p = .975, β = -.08). No significant predictive relationships were found between the health behaviors in our study (PA, FVC, and FFC) and selected health outcomes (self-rated health, somatic complaints, and BMI). Because the regression results were not significant supporting mediation, a mediation analysis was not performed. The study findings demonstrate that depression is a strong predictor of multiple measures of physical health as well as of fast food consumption. Future research should continue to examine the mechanisms by which depression affects physical health outcomes. Understanding the health determinants that link depressed mood to physical health outcomes will help determine specific public health interventions that can potentially prevent and better manage the prevalence of these coexisting health conditions among college adults.

Sunbathing and sunscreen use, as well as related intentions, attitudes, beliefs, and knowledge, were assessed in 90 Southern Appalachian undergraduates. A large majority (75%) reported sunbathing; with more than half reporting sun lamp use. A slight majority (56.7%) reported some use of sunscreen. Subjects reporting an intention to tan spent more time sunbathing, both outside and under a sun lamp. Individuals reporting a sun protection intention had lighter tans and spent less time sunbathing. Sunbathing was predicted by perceptions of sunbathing as relaxing, while sun lamp use was predicted by more positive views of suntans. Sunscreen use was predicted by more positive sun protection attitudes and less negative sunscreen attitudes.

Objectives: The goal of this investigation was to examine the prevalence of different types of intimate partner violence (IPV) during pregnancy, as well as the association between both physical and psychological IPV and negative health behaviors, including smoking, other substance use, inadequate prenatal care utilization, and nutrition, in a rural sample. Methods: 104 southern Appalachian women, primarily Caucasian and lower SES, completed a pregnancy interview focused on IPV (CTS2) and health behaviors. Medical records were also reviewed. Results: 81% of participants reported some type of IPV during the current pregnancy, with 28% reporting physical IPV, and 20% reporting sexual violence. More than half were current smokers. Physical IPV during pregnancy was associated with significantly increased rates of pregnancy smoking (including decreased rates of quitting and reducing), increased rates of alcohol, marijuana, and harder illicit drug use around the time of conception, and later entry into prenatal care. The experience of psychological IPV during pregnancy was associated with a significantly decreased likelihood of quitting or reducing smoking during pregnancy, an increased rate of alcohol use around the time of conception, and an increased rate of pre-pregnancy obesity. Conclusions: In this sample, pregnancy IPV and smoking occurred at rates well above national averages. Additionally, while physical IPV during pregnancy was associated with several negative pregnancy health behaviors, the experience of psychological IPV, even in the absence of physical IPV, also placed women at increased risk for negative health behaviors, all of which have been linked to poor pregnancy and newborn outcomes.

Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes. / New York University Abu Dhabi

This study examined the role of stress on irrational health beliefs and health behaviors among individuals 18-45 years old. Previous research has shown that this age group reported higher stress levels, more physical symptoms of stress, and the highest level of negative health behaviors. The theoretical frameworks were health belief model, the transactional model of stress and coping theory, and Ellis's concept of irrational beliefs. A survey using 3 published instruments measured the perceived stress level, irrational health beliefs, and health behaviors of a sample of 97 individuals aged 18-45. The data were quantitatively assessed using a mediation model to test a significant relationship between the predictor variable, perceived stress, and the criterion variable, health behaviors, using the mediating variable of irrational health beliefs. Findings suggest that higher stress levels are related to health behaviors (p ˂ .001), while stress did not make a significant contribution to irrational health beliefs (p = .092). Moreover, findings indicated that greater irrational health beliefs are related to more negative health behaviors (p = .010). Irrational health beliefs were not found to mediate the relationship between perceived stress and health behaviors. This research supports and extends the current body of research examining the relationship between stress, irrational health beliefs, and health behaviors. The results of this study can provide insight into how stress is related to thoughts and behaviors, specifically focusing on health. This study may aid health psychologists by providing information that can contribute to the development of interventions to reduce stress, reduce irrational health beliefs, and improve health behaviors.

Obesity is one of the fastest growing health concerns impacting all racial, ethnic, gender, and socioeconomic groups in the United States of America. More than one-third of the U.S. adult population is classified as being obese (Obesity Society, 2021). Obesity has reached epidemic proportions in all races and genders within the US with African American women comprising a majority of those impacted by this chronic health condition. Obesity rates are well documented within the literature but what is lacking is the role spirituality may play in obese African American women and their health behaviors. The purpose of this qualitative, phenomenological study was to explore and describe the lived experiences of obese African American women with attention and focus on weight, health behaviors, and spirituality. This study consisted of participant recruitment from various social organizations, beauty salons, and faith-based organizations. A naturalistic setting with a descriptive approach was taken to interview the participants and all recorded interviews were transcribed and utilized for data analysis. The analysis method for this study was the qualitative content analysis process. Upon completion of data analysis, the identification of three themes, who I am, the weight I bear, and power struggles, assisted with recognizing the gaps and concerns that supported the researcher in painting a picture of the lived experiences of obese African American women. Recommendations included diversifying healthcare providers, implementing community based interventions and research, and completing knowledge assessments before education.

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