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ObjectivesSocial support may be an important mitigating factor against adverse cardiovascular outcomes by facilitating health-promoting behaviours or by buffering against the negative effects of stress. This study examined the association of social support with incident hypertension.DesignProspective cohort study.SettingWe evaluated the association of social support with incident hypertension among participants in the Jackson Heart Study, a community-based cohort of African Americans.ParticipantsThis study included African American adults, who were free of hypertension at baseline (2000–2004). Functional social support, structural social support and satisfaction with social support were assessed at baseline among 1516, 1240 and 1503 participants, respectively.Outcome measuresIncident hypertension was assessed at follow-up examinations in 2005–2008 and 2009–2013. Incident hypertension was defined by the first visit with systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg or self-reported antihypertensive medication use. Multivariable Poisson regression was used to estimate the association of baseline social support with incident hypertension, adjusting for relevant confounders.ResultsAt baseline, the mean age of participants was 50 years and 64% were men. During a median follow-up time of 6.9 years, 54% of participants developed hypertension. A high level of functional social support was associated with lower risk of incident hypertension (incident rate ratio 0.64, (95% CI 0.41 to 0.97)), compared with a low level of functional social support. Level of structural social support and satisfaction with social support were not associated with hypertension risk.ConclusionsThese results suggest that greater functional support may be associated with a lower risk of incident hypertension.

Background The prevalence of poor diet quality and type 2 diabetes are exceedingly high in many rural American Indian (AI) communities. Because of limited resources and infrastructure in some communities, implementation of interventions to promote a healthy diet is challenging—which may exacerbate health disparities by region (urban/rural) and ethnicity (AIs/other populations). It is critical to adapt existing evidence-based healthy food budgeting, purchasing, and cooking programs to be relevant to underserved populations with a high burden of diabetes and related complications. The Cooking for Health Study will work in partnership with an AI community in South Dakota to develop a culturally-adapted 12-month distance-learning-based healthy food budgeting, purchasing, and cooking intervention to improve diet among AI adults with type 2 diabetes. Methods The study will enroll 165 AIs with physician-diagnosed type 2 diabetes who reside on the reservation. Participants will be randomized to an intervention or control arm. The intervention arm will receive a 12-month distance-learning curriculum adapted from Cooking Matters® that focuses on healthy food budgeting, purchasing, and cooking skills. In-person assessments at baseline, month 6 and month 12 will include completion of the Nutrition Assessment Shared Resources Food Frequency Questionnaire and a survey to assess frequency of healthy and unhealthy food purchases. Primary outcomes of interest are: (1) change in self-reported intake of sugar-sweetened beverages (SSBs); and (2) change in the frequency of healthy and unhealthy food purchases. Secondary outcomes include: (1) change in self-reported food budgeting skills; (2) change in self-reported cooking skills; and (3) a mixed-methods process evaluation to assess intervention reach, fidelity, satisfaction, and dose delivered/received. Discussion Targeted and sustainable interventions are needed to promote optimal health in rural AI communities. If effective, this intervention will reduce intake of SSBs and the purchase of unhealthy foods; increase the purchase of healthy foods; and improve healthy food budgeting and cooking skills among AIs with type 2 diabetes – a population at high risk of poor health outcomes. This work will help inform future health promotion efforts in resource-limited settings. Trial registration This study was registered on ClinicalTrials.gov on October 9, 2018 with Identifier NCT03699709 .

Conservation science has evolved from solely focusing on nature’s intrinsic value to incorporating the human dimensions of conservation, emphasizing the diverse relationships, perspectives, and attitudes people hold toward natural systems. Despite growing awareness of environmental challenges, effective educational strategies that foster nature affiliation, environmental stewardship, and informed decision-making are still needed. This dissertation addresses this gap by investigating how specific pedagogical frameworks and communication strategies influence conservation attitudes and decision-making among youth. In Chapter Two, I conducted a systematic review of conservation perspectives and assessment strategies in the peer-reviewed literature. Using primate conservation education programs as a case study, I developed a qualitative typology showcasing the variation and frequency of conservation perspectives in the recent literature from 2000-2023. The findings highlighted two dominant conservation perspectives: the Socioecological Knowledge perspective–focused on teaching the biological, ecological, and social dynamics of primates–and the People and Nature perspective– which emphasizes harmonious human and primate coexistence and stewardship. Knowledge assessments were common, while behavioral assessments were infrequent, and alignment between educational objectives and assessment measures was often lacking. In Chapter Three, I examined the impacts of two human-oriented pedagogies: mindfulness practices–which encourage present-moment awareness and observation of nature–and culturally relevant pedagogy–which integrates students' cultural backgrounds into learning to create more equitable and meaningful educational experiences–on 6th-8th grade students in an outdoor program. Pre-post survey data and modeling indicated increased affiliation toward the natural world and self-reported science skills, but students’ environmental awareness and self-efficacy for environmental actions were unchanged. In Chapter Four, I investigated the impact of explicit conservation framing on conservation attitudes and decision-making using an experimental design. Students in a conservation-framed treatment, in which they were instructed to carry out science projects to help wildlife, did not reliably and consistently display greater changes in most measured attitudes and decisions relative to those in the control treatment, suggesting that explicit conservation framing may be unnecessary to affect change on conservation attitudes and decision-making. Collectively, the results from this dissertation illustrate how the pedagogical and communication strategies employed in conservation education programs impact conservation attitudes and decision-making of youth.