Medicine and Health Sciences Commons^™

Implications Of Lifecourse Epidemiology For Research On Determinants Of Adult Disease, Sze Yan Liu, Richard N. Jones, M. Maria Glamour

Department of Public Health Scholarship and Creative Works

Many diseases commonly associated with aging are now thought to have social and physiologic antecedents in early life. Understanding how the timing of exposure to early life risk factors influences later-life health may illuminate mechanisms driving adult health inequalities and identify possible points for effective interventions. Recognizing chronic diseases as developing across the life course also has implications for the conduct of research on adult risk factors for disease. We review alternative conceptual models that describe how the timing of risk factor exposure relates to the development of disease. We propose some expansions of lifecourse models to improve their relevance …

Developing A School Functioning Index For Middle Schools, Amanda Birnbaum, Leslie A. Lytle, Cheryl L. Perry, David Murray, Mary Story

Department of Public Health Scholarship and Creative Works

Despite widespread recognition of schools' role in the healthy development of youth, surprisingly little research has examined the relationships between schools' overall functioning and the health‐related behavior of students. School functioning could become an important predictor of students' health‐related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students' violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social …

A Lesson On Homophobia And Teasing, Eva S. Goldfarb

Department of Public Health Scholarship and Creative Works

Homophobia and gay-related teasing are already present among young children. This lesson introduces the term “prejudice” and places the concept of homophobia within the context of bullying and teasing with which 8–11 year olds are already familiar. The lesson builds empathy as children think about and discuss how they have felt when they have been teased or called a name and how they think people in gay or lesbian families would feel. The lesson celebrates the lives of gay and lesbian people as it celebrates diversity among all people and families. Children are encouraged to think about the diversity within …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Early Predictors Of Sexual Behavior: Implications For Young Adolescents And Their Parents, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

The study provides empirical evidence of the independent contribution of nonsexual romantic relationships in the seventh grade to the onset of sexual intercourse by the ninth grade for both males and females. In addition, it shows that among females, seventh graders in serious relationships with older teenagers—uniquely defined as those two or more years older—have an increased likelihood of sex in the ninth grade. Finally, the study demonstrates that seventh graders of both genders who have had serious romantic relationships were already significantly different in the sixth grade from those who have not: They had peers who were more accepting …

Perceived Smoking Environment And Smoking Initiation Among Multi-Ethnic Urban Girls, Tracy R. Nichols, Amanda Birnbaum, Sara Birnel, Gilbert J. Botvin

Department of Public Health Scholarship and Creative Works

Purpose

To examine associations between the perceived smoking environment and smoking initiation among urban multi-ethnic adolescent girls in New York City.

Methods

Self-report surveys completed in grades 7, 8, and 9 assessed girls’ (n = 858) smoking initiation, and perceived smoking environment (family smoking, friends’ smoking, smoking norms, and cigarette availability). Carbon monoxide breath samples were collected from girls using a variation of the bogus pipeline procedure.

Results

Differences were found in smoking prevalence with white girls reporting the highest prevalence of smoking at baseline and the greatest increase in smoking prevalence from seventh to eighth grade. Black girls reported …

Naturally Occurring Changes In Time Spent Watching Television Are Inversely Related To Frequency Of Physical Activity During Early Adolescence, Robert W. Motl, Edward Mcauley, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

In this longitudinal study, we examined the relationship between changes in time spent watching television and playing video games with frequency of leisure-time physical activity across a 2-year period among adolescent boys and girls (N=4594" role="presentation" style="box-sizing: border-box; margin: 0px; padding: 0px; display: inline-block; line-height: normal; font-size: 16.200000762939453px; word-spacing: normal; word-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; position: relative;">). Latent growth modelling indicated that a decrease in time spent watching television was associated with an increase in frequency of leisure-time physical activity. That relationship was strong in magnitude …

Self-Management Strategies Mediate Self-Efficacy And Physical Activity, Amanda Birnbaum, Rod K. Dishman, Robert W. Motl, James F. Sallis, Andrea L. Dunn, Greg J. Welk, Ariane L. Yung, Carolyn C. Voorhees, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested.

Self-Management Strategies Mediate Self-Efficacy And Physical Activity, Rod K. Dishman, Robert W. Motl, James F. Sallis, Andrea L. Dunn, Amanda Birnbaum, Greg J. Welk, Ariane L. Bedimo-Rung, Carolyn C. Voorhees, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Background

Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested.

Methods

Confirmatory factor analysis was used to test the factorial validity of a measure of self-management strategies for physical activity. Next, the construct …

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions:School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Predictors Of Violent Behavior In An Early Adolescent Cohort: Similarities And Differences Across Genders, Jonathan L. Blitstein, David M. Murray, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the eighth-grade year (2000) was entered into Poisson regression against baseline data collected at the beginning of the seventh-grade year (1998). Predictors of violent behavior influencing both boys and girls included depressive symptoms, perceived invulnerability to negative future events, paternal nonauthoritative behavior, and drinking alcohol. …

The Role Of Peer Social Network Factors And Physical Activity In Adolescent Girls, Carolyn C. Voorhees, David Murray, Greg Welk, Amanda Birnbaum, Kurt M. Ribisi, Carolyn C. Johnson, Karin Allor Pfeiffer, Brit Saksvig, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Objective: To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls.

Methods: Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school.

Results: Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses.

Conclusions: Frequency of PA with friends was an important correlate of PA among the peer network variables …

Longitudinal Invariance Of The Center For Epidemiologic Studies-Depression Scale Among Girls And Boys In Middle School, Robert W. Motl, Rod K. Dishman, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This study tested the longitudinal factorial invariance of a theoretically consistent, higher-order model for Center for Epidemiologic Studies-Depression (CES-D) scores among adolescent girls and boys in middle school. Data were collected from 2,416 adolescents who completed a survey containing the CES-D in the fall of 1998, spring of 1999, and spring of 2000. The invariance analyses were conducted using LISREL 8.50 with maximum likelihood estimation and the Satorra-Bentler scaled chi-square statistic and standard errors. The higher-order model demonstrated longitudinal, as well as gender, invariance of the overall factor structure and first- and second-order structure coefficients, first-order factor variances, second-order factor …

A Theater-Based Approach To Primary Prevention Of Sexual Behavior For Early Adolescents, Jessica B. Janega, David M. Murray, Sherri P. Varnell, Jonathan L. Blitstein, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect (σΔ) from adjustments for both fixed and time-varying covariates and correlations over time. These estimates will allow other researchers using these variables to plan their studies by estimating a priori detectable differences and sample size requirements for any of the four analytic options. These methods are …

A Schematic For Focusing On Youth In Investigations Of Community Design And Physical Activity, Kevin J. Krizek, Amanda Birnbaum, David M. Levinson

Department of Public Health Scholarship and Creative Works

This paper provides a first step in addressing special considerations for youth in a relatively new area of physical activity research. After reviewing the urgent need for novel approaches to increasing physical activity, the growing interest in the effects of community design are discussed. Although most discussion on this topic has focused on adults, there are important differences between youth and adults that warrant a special focus on youth and need to be accounted for. This article presents a schematic that accounts for how and where youth spend their time, decomposing the day into time spent in travel and time …

Casting Health Messages In Terms Of Responsibility For Dietary Change: Increasing Fruit And Vegetable Consumption, Pamela Williams-Piehota, Ashley R. Cox, Stephanie A. Navarro Silvera, Linda Z. Mowad, Sharon Garcia, Nicole A. Katulak, Peter Salovey

Department of Public Health Scholarship and Creative Works

Objective

To compare the effectiveness of messages emphasizing the importance of either personal or social responsibility for dietary behavior change in increasing fruit and vegetable intake.

Design/Setting

Randomly assigned individually or socially oriented messages were delivered at baseline, 1 week, and 2 and 3 months later. Telephone surveys were conducted at baseline and 1 and 4 months later.

Participants

528 callers to a cancer information hotline who were not meeting the “5 A Day” dietary recommendation.

Interventions

A brief telephone-delivered message and 3 mailings of pamphlets and promotional items encouraging fruit and vegetable intake that emphasized either personal or social …

School-Based Approaches To Affect Adolescents’ Diets: Results From The Teens Study, Leslie A. Lytle, David M. Murray, Cheryl L. Perry, Mary Story, Amanda Birnbaum, Martha Y. Kubik, Sherri Varnell

Department of Public Health Scholarship and Creative Works

This article reports on the outcomes of the Teens Eating for Energy and Nutrition at School (TEENS) study, a 2-year intervention study conducted in 16 middle schools with a goal of increasing students’ intakes of fruits, vegetables, and lower-fat foods. Despite positive interim results for students randomized to intervention schools, the positive effects of the intervention were not seen for the primary outcomes at the end of the 2nd year. Positive effects were seen only for a food choice score (suggesting that the students usually choose lower versus higher fat foods) and not for measures of food intake. Future studies …

Assessing The Most Powerful Analysis Method For School-Based Intervention Studies, Jessica B. Janega, David M. Murray, Sherri P. Varnell, Jonathan L. Blitstein, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and a single posttest, the most common design used in GRTs. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs with alcohol, tobacco, and other drug measures as the outcomes of interest. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect of both adjustments for fixed and time-varying covariates, as well as correlations over time. These estimates will allow other researchers using these variables to plan their studies by …

School Functioning And Violent Behavior Among Young Adolescents: A Contextual Analysis, Amanda Birnbaum, Leslie A. Lytle, Peter J. Hannan, David M. Murray, Cheryl L. Perry, Jean L. Foster

Department of Public Health Scholarship and Creative Works

This paper examines associations between overall school functioning and the frequency of violent behaviors among young adolescents (ages 10–14). The sample included 16 middle schools participating in an unrelated intervention study (on nutrition) in Minneapolis, Minnesota. A School Functioning Index developed to characterize schools’ overall stability, performance, and demographics was constructed using data from public archives and school administrator surveys. Data on violent behaviors and other variables were collected in student surveys in fall 1998 and spring 1999. We used multilevel modeling to assess the effect of school functioning on violent behavior after adjusting for known individual-level covariates of violent …

Psychosocial Correlates Of Physical Activity And Sedentary Leisure Habits In Young Adolescents: The Teens Eating For Energy And Nutrition At School Study, Amanda Birnbaum, Kathryn H. Schmitz, Leslie Lytle, Glenn A. Phillips, David M. Murray, Martha Y. Kubik

Department of Public Health Scholarship and Creative Works

BACKGROUND: Low levels of physical activity (PA) and highly sedentary leisure habits (SLH) in youth may establish behavioral patterns that will predispose youth to increased chronic disease risk in adulthood. The purpose of this paper was to examine associations of demographic and psychosocial factors with self-reported PA and SLH in young adolescents. METHODS: A general linear mixed model predicted self-reported PA and SLH in the spring from demographic and psychosocial variables measured the previous fall in 3798 seventh grade students. RESULTS: PA and SLH differed by race, with Caucasian students reporting among the highest PA and lowest SLH. Perceptions of …

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior., Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago.

METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey.

RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …