American journal of preventive medicine
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In response to a growing need for assistance among our aging population, assisted-living facilities have been designed to fill the widening chasm between community living and nursing care. Although sedentary behavior has been linked to functional limitations and disability, no comprehensive information exists about the social and physical environments and the programming available to promote physical activity in assisted living. Accordingly, this article includes data from an exploratory study that underscores the issues clearly related to physical activity for older adults in assisted living. ⋯ Interviews were conducted with executive directors (N=21) to discuss methods for assessing and promoting positive lifestyle behaviors with distinct emphasis on the targeted behavior of physical activity. Potential ways in which the social and physical environments could be modified to promote and support physically active living were identified. Clearly, promoting physical activity in assisted living is a challenge and will require a partnership with assisted living communities to develop effective and feasible systems-based interventions designed to make environments more engaging and, thereby, promote active living.
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Convincing pregnant women who smoke to give up this behavior is one of the few universally agreed upon methods for improving pregnancy outcomes. An exploratory study was conducted to determine what public and quasi-public facilities serving pregnant women were doing to assist pregnant smokers in quitting, the reasons why more was not being done, and what could be done to increase smoking-cessation services. ⋯ Only about a quarter of the respondents thought they were doing enough to help pregnant smokers stop or reduce smoking, and most thought that the inadequacy was due to insufficient funds. Only about a quarter offered smoking-cessation classes or clinics. Almost all programs had policies restricting smoking in their offices. The nationally sponsored activity that the respondents felt might be most helpful in increasing their efforts was the provision of materials. Among the 313 programs that included home visits, 86% required the home visitors to conduct a needs assessment, and 97% of those expected the woman's smoking status to be recorded. Smoking status prior to pregnancy or by other household members was required less often. Less than half of the programs provided training on smoking-cessation/reduction methods to home visitors. Only 28% said smoking-cessation/reduction had a very high priority in comparison to other home visit objectives. CONCLUSIONS; Programs for pregnant women, including those with a home visit component, do not pay sufficient attention to the problem of smoking among their clients. Programs should make greater use of the evidence-based interventions now available.
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Randomized Controlled Trial Clinical Trial
Weight and smoking cessation among low-income African Americans.
Concerns about weight gain have been a commonly cited barrier to cessation among white, affluent, female populations, but less is known about this relationship among minority smokers and those with low incomes. Although smoking cessation is strongly encouraged for this population, it often leads to weight gain. Cultural differences in weight standards and the high prevalence of weight-related health conditions (e.g., hypertension and diabetes) may influence concerns about smoking cessation-related weight gain. ⋯ Because post-cessation weight gain may be a serious health threat for this population, but weight gain was not a concern for these smokers, smoking-cessation interventions for low-income African-American smokers may need to incorporate weight-gain education and prevention.