July / August 2019



AJHE: American Journal of Health Education

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  July/August 2019 (Volume 50, Issue 4)

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Table of Contents

Free Access Article
/Introduction to Special Issue on Mental Disorders as a Chronic Issue
 – Elise Eifert

Welcome to the Special Issue of the American Journal of Health Education (AJHE) on mental health and children and adolescents. AJHE’s mission is to publish research manuscripts that focus on Health Education and Health Promotion interventions designed to prevent or delay the onset of the major chronic diseases and illnesses that impact population health. One area of health often left out of the chronic disease paradigm is mental disorders, though that is changing. Perspectives on mental health have evolved from conceptualizing certain disorders or illnesses as primarily acute, time-limited psychiatric conditions to recurrent and chronic life-long diseases. This issue reflects this evolution and addresses one of the most vulnerable populations to mental disorders-children and adolescents.

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Research Articles

Evaluation of a Self-Care Intervention to Improve Student Mental Health Administered Through a Distance Education Course
– Marney A. White, Steve D. Whittaker, Ashton M. Gores & Dana Allswede
Background: Graduate training is a high-risk period for worsening mental health. Previous research reported the effectiveness of a classroom-based self-care intervention for graduate students.
Purpose: The study evaluated the effectiveness of an online self-care intervention for graduate-level students to prevent worsening mental health.
Methods: Participants were 187 students in public health. The intervention consisted of behavior change assignments designed to increase health-promoting behaviors within four domains (nutrition, physical activity, mental health, social support). Students received bonus points for maintaining health behaviors for the duration of the 12-week semester. Outcomes included measures of nutrition, physical activity, depression, anxiety, and perceived stress. The study employed a control group of students not enrolled in the course (n = 29).
Results: Health promotion behaviors increased over the course of the semester (ps<.001), with the largest effect sizes for increases in fruit and vegetable intake and physical activity. Improvements in self-reported health were reported. Control students reported no improvements.
Discussion: The study provides support for the utility of a brief self-care intervention for students in the health sciences.
Translation to Health Education Practice: This disseminable intervention can support student well-being in a variety of academic programs.

Perceptions of Weight Conscious Drinking and the Role of Mental Health: A Mixed Method Approach
– Sarah R. Blackstone, Aimee K. Johnson & Debra Sutton
Background:Limited research exists on mental health correlates of behaviors of weight-conscious drinking (BWCD) and students’ perceptions of how BWCD should be addressed.
Purpose:The objectives were to (1) examine BWCD and different aspects of mental health and (2) gain insight into students’ perceptions of such behaviors and potential strategies to address them.
Methods:Four-hundred-twelve students completed a survey consisting of validated measures for: BWCD, eating disorders, exercise addiction, alcohol use, and psychological distress. Eight focus groups explored students’ understanding of BWCD, its presence on campus, and potential intervention strategies.
Results: Majority (62%) of participants indicated they engaged in at least one behavior associated with BWCD “very often” or “all the time.” Hierarchical linear regression analysis indicated that disordered eating and exercise addiction were significant predictors of BWCD. Focus groups indicated participants struggled with awareness and ability to identify concerning BWCD. Taken together, the results indicated high prevalence of behaviors, but limited awareness of associated health consequences, and identification of BWCD.
Discussion:BWCD are pervasive in this college sample, but students do not perceive them as harmful or problematic.
Translation to Health Education Practice: There is a need for comprehensive education to address the intersection between alcohol use, exercise, and disordered eating.

Depression and Help-Seeking Intention Among Young Adults: The Theory of Planned Behavior
– Márcia Mónica Zorrilla, Naomi Modeste, Peter C. Gleason, Diadrey-Anne Sealy, Jim E. Banta & Sang Leng Trieu
Background: One in five adults are diagnosed with mental illness in the United States. Young adults, ages 18 to 25, have the highest prevalence of depression (10.9%). Depression is also a risk factor for suicide. The current study applied the Theory of Planned Behavior (TPB).
Purpose: The purpose of this study was to identify the predictors that influence help-seeking intentions on utilization of mental health services among a diverse population of young adults.
Methods: The study designed was a cross-sectional online survey of 18 to 24-year-old young adults (n= 430) who lived, worked, and/or attended school in San Francisco, California. The survey was available in English, Spanish, and Chinese; and accessible from August 2016 through March 2017. The online survey was a modified version of surveys developed by Mo and Mak, and Reavley and colleagues.
Results: The demographic composition of the sample included: white (35.3%), Latino(a) (25.3%), and Chinese (21.6%); and primarily female (58.6%). Almost one-third of the participants (31.6%) screened positive for depression. Nearly half of the participants had ever met with a mental health professional (49.5%, n=213). There was a strong, positive correlation for attitude [r=.61, P<.01] and help-seeking intention. Positive attitudes in help-seeking was a consistent predictor when using linear regression models.
Discussion: The TPB variables, especially attitudes, were highly predictive in help-seeking intention for mental health services.
Translation to Health Education Practice: Health Educators who work in college-based student health centers can use the findings to develop interventions at the individual and community levels.

Do Neighborhood Characteristics Contribute to Anxiety? A National Study of 12 to 17 Year Old’s
– Rebecca A. Vidourek, Keith A. King & R. Andrew Yockey
Background: Anxiety is a mental health issue affecting many adolescents in the United States. Limited research on neighborhood characteristics and adolescent anxiety is available.
Purpose: Therefore, the purpose of the present study is to examine the relationship between adolescent anxiety and neighborhood characteristics in a national sample.
Methods:A secondary data analysis of the 2016 National Survey on Children’s Health was conducted for this study. Univariate analyses were conducted to determine associations between anxiety and demographic characteristics and neighborhood characteristics. Significant items from the univariate analyses were then retained and included in a final multivariate logistic regression model.
Results: Results of the final model indicated that being female and white increased the risk of adolescent anxiety. Findings from this study also revealed that neighborhood characteristics significantly predicted adolescent anxiety.
Discussion: Greater than one in ten adolescents experienced anxiety, which indicates additional prevention and intervention programs are needed to address this issue.
Translation to Health Education Practice: Improving neighborhood conditions and enhancing community support are two methods that may prevent and reduce adolescent anxiety. Specific strategies for prevention and intervention are offered.