Background: Obstructive sleep apnea (OSA) is a reasonably common disorder that is associated with daytime tiredness and a host of medical conditions. Little is known about how primary care clinicians (PCCs) detect, diagnose, and manage patients who have OSA.Methods: We gathered information from 44 randomly selected practices in 5 regional practice-based research networks. This included interviews with PCCs and sleep consultants, medical records abstraction, and patient surveys. Descriptive analyses of the quantitative data were used to describe the prevalence of sleep symptoms, the proportion of primary care patients at high risk for OSA, and the methods used by PCCs to detect and diagnose patients with OSA.Results

The WCP was successfully delivered via a quitline and resulted in improved attitudes about weight and decreased cessation-related weight gain without harming quit rates. Promotion of a quitline focused on addressing weight in conjunction with quitline treatment for smoking cessation may improve cessation and weight outcomes. Study limitations include use of self-report and survey response.

BackgroundModern technology (ie, websites and social media) has significantly changed social mores in health information access and delivery. Although mass media campaigns for health intervention have proven effective and cost-effective in changing health behavior at a population scale, this is best studied in traditional media sources (ie, radio and television). Digital health interventions are options that use short message service/text messaging, social media, and internet technology. Although exposure to these products is becoming ubiquitous, electronic health information is novel, incompletely disseminated, and frequently inaccurate, which decreases public trust. Previous research has shown that audience trust in health care providers significantly moderates health outcomes, demographics significantly influence audience trust in electronic media, and preexisting health behaviors such as smoking status significantly moderate audience receptivity to traditional mass media. Therefore, modern health educators must assess audience trust in all sources, both media (traditional and digital) and interpersonal, to balance pros and cons before structuring multicomponent community health interventions.ObjectiveWe aimed to explore current trust and moderators of trust in health information sources given recent changes in digital health information access and delivery to inform design of future health interventions in Oklahoma.MethodsWe conducted phone surveys of a cross-sectional sample of 1001 Oklahoma adults (age 18-65 years) in spring 2015 to assess trust in seven media sources: traditional (television and radio), electronic (online and social media), and interpersonal (providers, insurers, and family/friends). We also gathered information on known moderators of trust (sociodemographics and tobacco use status). We modeled log odds of a participant rating a source as “trustworthy” (SAS PROC SURVEYLOGISTIC), with subanalysis for confounders (sociodemographics and tobacco use).ResultsOklahomans showed the highest trust in interpersonal sources: 81% (808/994) reported providers were trustworthy, 55% (550/999) for friends and family, and 48% (485/998) for health insurers. For media sources, 24% of participants (232/989) rated the internet as trustworthy, followed by 21% of participants for television (225/998), 18% for radio (199/988), and only 11% for social media (110/991). Despite this low self-reported trust in social media, 40% (406/991) of participants reported using social media for tobacco-related health information. Trust in health providers did not vary by subpopulation, but sociodemographic variables (gender, income, and education) and tobacco use status significantly moderated trust in other sources. Women were on the whole more trusting than men, trust in media decreased with income, and trust in friends and family decreased with education.ConclusionsHealth education interventions should incorporate digital media, particularly when targeting low-income populations. Utilizing health care providers in social me...

Objective: Examine the association between energy intake and television (TV) viewing in Americans. Design: Nationally representative, cross-sectional study of [2003][2004][2005][2006] National Health and Nutrition Examination Survey. Setting: Total energy intake was determined by two 24 h recalls. TV viewing was reported as low (#1 h/d), middle (2-3 h/d), and high ($4 h/d). Multivariate linear regression models were used to analyse TV viewing and energy intake, adjusted for BMI (percentile for children 2-18 years), age, ethnicity and physical activity. Subjects: Pre-school children (2-5 years; n 1369), school-age children (6-11 years; n 1759), adolescents (12-18 years; n 3233) and adults ($19 years; n 7850) in the USA. Results: There was a significant association between TV viewing and energy intake for adolescent girls (high v. low: b 5 195?2, P 5 0?03) and men (high v. low: b 5 2113?0, P 5 0?02; middle v. low: b 5 2131?1, P 5 0?0002). Mean adjusted energy intake for adolescent girls was 7801?0, 8088?5 and 8618?2 kJ/d for low, middle and high TV viewing, respectively. Mean adjusted energy intake for men was 9845?9, 9297?2 and 9372?8 kJ/d for low, middle and high TV viewing. Conclusions: TV viewing was associated with energy intake in US children and adults only in 12-18-year-old girls and men. For girls, the high TV viewing category consumed more energy daily (816?3 kJ (195 kcal)) than the low category. In men, the middle and high TV viewing categories consumed less energy daily (548?4 kJ (131 kcal) and 473?0 kJ (113 kcal), respectively) than the low category. Our findings support some, but not all previous research. Future research is needed to explore this complicated relationship with rigorous measures of energy intake and TV viewing. Keywords Television Dietary patterns ObesityRecently, sedentary behaviour among adults and children has received attention as a public health concern (1-5) .Sedentary behaviour is defined as behaviour that does not increase metabolic rate higher than resting and includes sitting (1,4) . Sedentary behaviour can be objectively measured through devices worn that measure posture or intensity of activity as well as by self-or proxy-reported time in sedentary behaviours such as sitting for work or transportation, watching television (TV) or playing video games, and computer use for recreation and school work. TV viewing is the most predominant leisure-time sedentary behaviour in children (6)(7)(8)(9)(10) and adults (11,12) . Higher volumes of sedentary time have been associated with mortality (13,14) , cardiometabolic disease (15)(16)(17) and obesity (18,19) in adults and elevated disease risk (20,21) and overweight and obesity (22)(23)(24) in children. Several hypotheses have been proposed to explain the relationship observed between TV viewing and health and obesity status. These hypotheses include that: (i) TV viewing displaces time for physical activity; (ii) resting energy expenditure is lower while watching TV; (iii) TV advertising may prompt viewers to consume high-ene...

This cohort study evaluates the first 22 months of implementation of the Cherokee Nation Heath Services community-based program designed to eliminate hepatitis C virus (HCV) infection.