To date we have published seven papers using data from the Stanford WELL for Life Study, provided to us by all participants, as well as an invited contribution to the American Journal of Health Promotion. Two papers were submitted this month and many more will be submitted over the next few months. Click on the links below to read about our findings!
Stanford WELL For Life: Learning What it Means to Be Well
Stanford WELL For Life researchers were invited to share how they approached the development of a new well-being index y first asking indvviduals what the conecept of well-being meant to them. Read on to discover what their top driver of well-being was, which represents an often overlooked area of measurement in workplace wellness
Heaney, C.A.; Avery, E.C.; Rich, T.; Ahuja, N.J.; Winter, S.J.; Stanford WELL for Life Measures Work Group. Stanford WELL for Life: Learning What It Means to Be Well. American Journal of Health Promotion 2017, Vol 31(5) 444-456
Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching
The morbidity and mortality experiences of people who are unhoused have been well-described, but much less is known about the overall well-being of these individuals. In this mixed methods study, housed and unhoused participants completed a multi-faceted 10 domain measure of well-being (the Stanford WELL Survey), and a subset of unhoused participants shared their experiences during qualitative interviews. Using propensity score matching, unhoused participants (n = 51) were matched at a ratio of 1:5 with housed participants (n = 255). The mean overall well-being score of the unhoused participants was significantly lower than that of the matched housed participants (B = -5.022, p = 0.013). Additionally, the two groups differed on some of the constituent domains of well-being, with unhoused participants reporting statistically significantly lower mean scores on social connectedness (B = -1.086, p = 0.000), lifestyle and daily practices (B = -1.219, p = 0.000), stress and resilience (B = -0.493, p = 0.023), experience of emotions (B = -0.632, p = 0.009), physical health (B = -0.944, p = 0.0001), and finances (B = -3.099, p = 0.000). The unhoused participants had a statistically significantly higher mean score for spirituality and religiosity (B = 2.401, p = 0.000) than their matched housed counterparts. The qualitative interviews further highlighted spirituality and religion as a coping mechanism for the unhoused. The results of this study highlight both unexpected strengths exhibited by the unhoused individuals and areas of challenge.
Ahuja, N.J.; Nguyen, A.; Winter, S.J.; Freeman, M.; Shi, R.; Rodriguez Espinosa, P.; Heaney, C.A. Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching. Int. J. Environ. Res. Public Health 2020, 17, 7228.
The WELL Diet Score Correlates with the Alternative Healty Eating Index-2010
The quality of one's overall diet has proven to be of great importance to health and well‐being. Unfortunately, diet quality is time‐consuming to assess. The Stanford Wellness Living Laboratory (WELL) administered an online survey that included the WELL Diet Score (a novel diet quality assessment calculated from 12 diet‐related items). Subsequently, WELL participants were asked to complete the 127‐item Block Food Frequency Questionnaire (FFQ) online. The present study's primary objective was to compare the WELL Diet Score with the established FFQ‐based Alternative Healthy Eating Index‐2010 (AHEI‐2010), in a subset of WELL participants (n = 248) who completed both dietary measures through WELL’s online platform. The two scores were significantly correlated (r = .69; p < .0001). Regression analyses demonstrated that the WELL Diet Score was positively significantly associated with sociodemographic determinants of diet quality and protective health factors, including older age, higher education, lower BMI, and higher physical activity. In summary, the WELL Diet Score, derived from 12 small diet‐related items that can be completed in 5 min, was significantly positively correlated with the AHEI‐2010 derived from the lengthy 127‐item FFQ, suggesting the potential utility of the WELL Diet Score in future large‐scale studies, including future WELL studies.
Springfield, S, Cunanan, K, Heaney, C, Peng, K, Gardner, C. The WELL diet score correlates with the alternative healthy eating index‐2010. Food Sci Nutr. 2020; 00: 1– 9. https://doi.org/10.1002/fsn3.1558
Exploring health and well-being in Taiwan: what we can learn from individuals' narratives
Little is known about how individuals achieve health and well-being, and their roles in the pursuit of a good life. We hoped to identify important components of these concepts that may provide new targets and messages to strengthen existing public health programs. An improved understanding of health and well-being - or what it means to be well - can guide interventions that help people lead healthier, more fulfilling lives. Eight constituent domains emerged regarding well-being and health. While the same domains were found for both constructs, important frequency differences were found when participants discussed health versus well-being. Physical health and lifestyle behaviors emerged as key domains for health. Disease-related comments were the most frequently mentioned sub-category within the physical health domain, along with health care use and aging-related changes. For well-being, family and finances emerged as key domains. Family appears to be a cornerstone element of well-being in this sample, with participants often describing their personal well-being as closely tied to - and often indistinguishable from - their family. Other domains included work-life, sense of self, resilience, and religion/spirituality.
Rodriguez Espinosa, P., Chen, Y., Sun, C. et al. Exploring health and well-being in Taiwan: what we can learn from individuals’ narratives. BMC Public Health 20, 159 (2020). https://doi.org/10.1186/s12889-020-8201-3 PMID: 32013898 PMCID: PMC6998329
Associations Between Body Fat, Muscle Mass, and Nonalcoholic Fatty Liver Disease: A Population-Based Study
Nonalcoholic fatty liver disease (NAFLD) is one of the most common forms of liver disease worldwide and has emerged as a significant public health concern in China. A better understanding of the etiology of NAFLD can inform effective management strategies for this disease. We examined factors associated with NAFLD in two districts of Hangzhou, China, focusing on the relationship of regional body fat distribution, muscle mass, and NAFLD. Multivariate logistic regressions were performed to assess independent associations between NAFLD and metabolic risk factors and dual x-ray absorptiometry (DX A)-derived measures (e.g., android fat ratio [AFR] and skeletal muscle index [SMI]). According to our analysis, android fat ration (AFR), insulin resistance, high alanine aminotransferase levels, smoking, and male sex were positively associated with NAFLD risk, while skeletal muscle index (SMI) was inversely associated with NAFLD risk.
Julianna C. Hsing, M. Nguyen, B. Yang, Y. Min, S. Han, E. Pung, S. J. Winter, X. Zhao, D. Gan, A. W. Hsing, S. Zhu. C. J. Wang. “Associations Between Body Fat, Muscle Mass, and Nonalcoholic Fatty Liver Disease: A Population-Based Study,” Hepatology Communications 0, no. 0, accessed July 12, 2019, https://doi.org/10.1002/hep4.1392.
Sex-specific Association Between Gut Microbiome and Fat Distribution
The gut microbiome has been linked to host obesity; however, sex-specific associations between microbiome and fat distribution are not well understood. Here we show sex-specific microbiome signatures contributing to obesity despite both sexes having similar gut micro-biome characteristics, including overall abundance and diversity. Our comparisons of the taxa associated with the android fat ratio in men and women found that there is no widespread species-level overlap. We did observe overlap between the sexes at the genus and family levels in the gut microbiome, such as Holdemanella and Gemmiger; however, they had opposite correlations with fat distribution in men and women. Our findings support a role for fat distribution in sex-specific relationships with the composition of the microbiome. Our results suggest that studies of the gut microbiome and abdominal obesity-related disease outcomes should account for sex-specific differences.
Min, Yan, Xiaoguang Ma, Kris Sankaran, Yuan Ru, Lijin Chen, Mike Baiocchi, and Shankuan Zhu. "Sex-specific Association between Gut Microbiome and Fat Distribution." Nature Communications10, no. 1 (June 03, 2019). doi:10.1038/s41467-019-10440-5.
Understanding Where We Are Well: Neighborhood-Level Social and Environmental Correlates of WEll-Being in the Stanford Well for Life Study
Individual well-being is a complex concept that varies among and between individuals and is impacted by individual, interpersonal, community, organizational, policy and environmental factors. This research explored associations between select environmental characteristics measured at the ZIPcode level and individual well-being. Twelve identical or analogous neighborhood (ZIP-code level) indicators were selected to test against the SWLS measure and data were collected from secondary sources to describe socio-economic, demographic, and physical environment, and healthcare. Linear mixed models were fit to assess relationships between each neighborhood measure and each of the ten domains of well-being, as well as the overall SWLS well-being measure, and were adjusted for spatial autocorrelation and individual-level covariates. Our observational insights suggest that neighborhood factors are associated with individuals’ overall self-rated well-being, though variation exists among its constituent domains.
Chrisinger BW, Gustafson JA, King AC, Winter SJ. Understanding Where We Are Well: Neighborhood-Level Social and Environmental Correlates of Well-Being in the Stanford Well for life Study. Int J Environ Res Public Health. 2019 May 20;16(10).pii: E1786. doi: 10.3390/ijerph16101786. PubMed PMID: 31137589; PubMed Central PMCID: PMC6571676
Dry eye and sleep quality: a large community-based study in Hangzhou
Dry eye and sleep dysfunction draw global public health concerns with their high prevalence and extensive adverse effects. Our study discovered a strong association between these two conditions. This is the firstpopulation-based study to evaluate the association of dry eye and sleep quality using previously validated tools, the Ocular Surface Disease Index (OSDI) and the Chinese version of the Pittsburg Sleep Quality index (CPS!I), respectively. Results indicated a strong positive association between poor sleep quality and higher severity for dry eye. It is plausible to suggest that improvement of sleep quality would alleviate the syndromes of dry eye, and vice versa. Our large comunity-based study showed a strong association between poor sleep quality and an increased severity of dry eye, suggesting that preventing either one of the discomforts might alleviate the other.
Zhu S, Yao K. Dry eye and sleep quality: a large community-based study in Hangzhou. Sleep. 2019 Jul 15. pii: zsz160. doi: 10.1093/sleep/zsz160. [Epub ahead of pring] PubMed PMID: 31310315.
Accepted
Cohort Profile: WELL Living Laboratory in China (WELL-China)
Author list: Yan Min, Xueyin Zhao, Randall S. Stafford, Xiaoguang Ma, Shih-Hua Chen, Da Gan, Chen Wei, Chao Huang, Lijin Chen, Peng Gao, Fei Yang, Sandra J. Winter, Joyce Wu, Catherine A Heaney, Mike Baiocchi, John P.A Ioannidis, Ann W. Hsing, Shankuan Zhu
Journal: International Journal of Epidemiology
A Rapid Assessment of Psychological Distress and Well-Being: Impact of the COVID-19 Pandemic and Shelter-in-Place
Author list: Ann Hsing, Janice S. Zhang, Katy Peng, Wei-Kuang Lin, Yi-Hsuan Wu, Julianna C. Hsing, Patty LaDuke, Catherine Heaney, Ying Lu, David W. Lounsbury
Journal: Preprints with The Lancet
Submitted
Characterization of dietary patterns in a large-Chinese population and assesment of their relationships with metabolite profiles
Author list: Yuan Ru, Ninglin Wang, Xuemiao Wang, Meng Duan, Xiaochen Xu, Xueyin Zhao, Yan Min, Ying Lu, Valerie McGuire, Yi-Hsuan Wu, Ann Hsing, Shankuan Zhu
Journal: Clinical Nutrition
Submission Date: 3/20/20
Physical Activity as Stress Management during COVID-19
Author list: EA Vogel, JS Zhang, K Peng, CA Heaney, D Lounsbury, AW Hsing, JJ Prochaska
Journal: Psychology and Health
Submission Date: 6/23/20
Changes in Cannabis Use, Exposure, and Health Perceptions following Legalization of Adult Recreational Cannabis Use in California: A Prospective Observational Study
Author list: Kathleen Gali, Sandra J. Winter, Naina J. Ahuja, Erica Frank, Judith J. Prochaska
Journal: Substance Abuse Treatment, Prevention and Policy
Submission Date: 11/10/20
Coping with the COVID-19 Pandemic: Contemplative Practice Behaviors are associated with better mental health outcomes and Compliance with Shelter-in-Place orders in a prospective cohort study
Author list: Chrisinger BW, Lounsbury D, Peng K, Zhang J, Heaney CA, Lu Y, Rich T, Hsing AW.
Submission Date: 9/20/20
Association between retinal microcirculation and daytime napping: a population-based study in China
Author list: Xin Liu, Guowei Wang, Xiaoyan Wang, Yueye Wang, Yan Min, Janice Zhang, Robert T. Chang, Xueyin Zhao, Wei He, Darius M. Moshfeghi, Ying Lu, Ann W. Hsing, Ke Yao, Shankuan Zhu
Journal: Sleep Medicine
Submission Date: 10/24/20
The Dietary Inflammatory Index and cardiometabolic factors: A large population-based study in China
Author list: Anthony Crimarco, Michael D. Wirth, Marian Botchway, Yan Min, Xueyin Zhao, Christopher D. Gardner, Shankuan Zhu, Ann W. Hsing
Journal: American Journal of Lifestyle Medicine
Submission Date: 10/16/20
A Cautionary Tale: Lessons Learned and Methodological Implications from Comparing Well-Being between latino and Non-Latino White Adults
Author list: Rodriguez Espinosa, P., Patel, M.P., King, A.C., Campero, I., Freeman, M., Garcia, M., Winter, S.J. & Heaney, C.A.
Journal: Health Psychology
Planning to submit
Circulating Metabolites Mediate the Sex-specific Associations Between Gut Microbiome and Body Fat Distribution
Author list: Yan Min, Kris Sankaran, Ann Hsing, Ying Lu, Shankuan Zhu
Potential Journal: Lancet Diabetes and Endocrinology
Potential Submission Date: TBD
Contemplative Practices Behavior is Postively Associated with Well-Being in Large, Diverse, Multi-National Cohorts
Author list: Chrisinger et al
Potential Journal: Journal of Behavioral Medicine
Potential Submission Date: TBD
Depressive Symptoms and Lifestyle Changes during the COVID-19 Lockdwon Period among residents with and without NCDs in Hangzhou, China
Author list: Xueyin Zhao, Qingcong Kang, Peng Gao, Yang Yang, Ann W. Hsing, Shankuan Zhu
Potential Journal: TBD
Potential Submission Date: TBD
Impact of General Practitioner Contact on Depressive Symptoms of Residents During Lockdown in COVID-19 Outbreak: A large Community-Based Study in Hangzhou, China
Author list: Fei Yang, Wenhui Lin, Xiaochen Xu, Xiaoyan Wang, Wei Li, Xueyin Zhao, Ann W. Hsing, Zhankuan Zhu
Potential Journal: TBD
Potential Submission Date: TBD
Retinal Vessel Caliber is in Association with Water and Alcohol Intake Behavior: A Population-Based Study
Author list: Liu, X
Potential Journal: Opthalmology
Potential Submission Date: TBD
Understanding Well-Being in China: A Qualitative Study with a Narrative Approach
Author list: Xueyin Zhao, Yan Min, Patricia Rodriguez Espinosa, Lijin Chen, Peng Gao, Erin Avery, Shuyi Cen, Xiaochen Xu, Shankuan Zhu, Ann Hsing, Catherine Heaney
Potential Journal: International Journal of Public Health
Potential Submission Date: TBD
A Qualitative Exploration of Well-Being: What is Well-Being? How do we know? Why do we care?
Author list: Heaney, C.A.
Potential Journal: TBD
Potential Submission Date: TBD
The Concept of Well-Being among English-speaking and Mandarin-speaking Ethnic Chinese in Singapore
Author list: Ping K, Nengzheng S, Tan L, Subramaniam M, Vaingankar J, Van Dan Martinus R, Min Y, Hsing A.W., Heaney CA, Wee HL
Potential Journal: TBD
Potential Submission Date: TBD
Associations of Park Access and Park Use with Well-Being in an Asian Urban Environment: A Cross-Sectional Study using Objective and Subjective Measures
Author list: Nicholas Petrunoff, Xian Yi NG, Borame Dickens, Angelia Sia, Joel Koo, Alex Cook, Wee Hwee Lin, Rob M. van Dam, Falk Muller-Riemenschneider
Potential Journal: International Journal of Behavioural Nutrition and Physical Activity
Potential Submission Date: TBD
Sleep and Cardiometabolic conditions: a community-based study in Taiwan
Author list: Chun-Yu Liang, Yi-Hsuan Wu, Janice Zhang, Katy Peng, Huiting Yang, San Lin You, Chien An Sun, Jawtown Lin, Ying Lu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD
Metabolomics and Non-Alcoholic Fatty Liver Disease
Author list: George Cholankeril, Yan Min, Julianna C. Hsing, Ying Lu, Sherry Zhou, Shankuan Zhu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD
Non-alcoholic fatty liver screening and risk factors in a community based study in China
Author list: Caroline Young, Yan Min, Julianna C. Hsing, Mindie Nguyen, Ying Lu, Sherry Zhou, Shankuan Zhu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD
Association between retinal microcirculation and daytime napping: a population-based study in China
Author list: X Liu, G Wang, Y Wang, Y Min, JS Zhang, RT Chang, X Zhao, W He, DM Moshfeghi, AW Hsing, K Yao, S Zhu
Potential Journal: TBD
Potential Submission Date: TBD