Medicine and Health Sciences Commons^™

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Elite Athletes' Survival Advantage: Could Be Shared By All Through Physical Activity, Adrian E. Bauman, Steven N. Blair

Faculty Publications

No abstract provided.

Smokers’ Vs. Non-Smokers’ Attitudes Toward Tobacco Usage, Jeff W. Totten, Betty J. Cayton

Atlantic Marketing Journal

The purpose of the study was to collect attitudinal and behavioral data on a sample of college students from a Southern state university regarding tobacco usage. The sample was designed to include both smokers and non-smokers. A non-probability sample of 508 college students was collected by handing out surveys in classes and in campus buildings. The questionnaire was designed by the students and the authors and included half of Pechmann and Shih’s (1999) smoking perceptions scale items. Users made up 36.6% of the sample. The average length of time reported using tobacco products was five years, with 78.3% stating they …

Expanding Delivery System Research In Public Health Settings: Lessons From Practice-Based Research Networks, Glen P. Mays, Rachel A. Hogg

Health and Clinical Sciences Faculty Publications

BACKGROUND: Delivery system research to identify how best to organize, finance, and implement health improvement strategies has focused heavily on clinical practice settings, with relatively little attention paid to public health settings-where research is made more difficult by wide heterogeneity in settings and limited sources of existing data and measures. This study examines the approaches used by public health practice-based research networks (PBRNs) to expand delivery system research and evidence-based practice in public health settings.

METHODS: Practice-based research networks employ quasi-experimental research designs, natural experiments, and mixed-method analytic techniques to evaluate how community partnerships, economic shocks, and policy changes impact …

Hss Alumni News Fall 2012, Department Of Health And Sport Sciences

Health and Sport Sciences Newsletter

• Unforgettable Memories by Lauren Cool
• J Term in Arizona
• New Fitness & Recreation Programming Introduced
• 5 Cards-Nothing New in HSS
• A Career in Sport Management
• New Teacher of the Year - Dr. Shelley Payne
• A Message from the Chair by Dr. Joan Rocks

Hss Departmental Developments Fall 2012, Department Of Health And Sport Sciences

Health and Sport Sciences Newsletter

• The 5 Cards by Patti Wilson, MS
• Health & Fitness Club by Calli Studebaker/Heart Chase
• Updates from the Majors

Body Mass Index Trajectories From Adolescence To Midlife: Differential Effects Of Parental And Respondent Education By Race/Ethnicity And Gender, Katrina M. Walsemann, Jennifer A. Ailshire, Bethany A. Bell, Edward A. Frongillo

Faculty Publications

Objectives: Race/ethnicity and education are among the strongest social determinants of body mass index (BMI) throughout the life course, yet we know relatively little about how these social factors both independently and interactively contribute to the rate at which BMI changes from adolescence to midlife. The purpose of this study is to 1) examine variation in trajectories of BMI from adolescence to midlife by mothers' and respondents' education, and 2) determine if the effects of mothers' and respondents' education on BMI trajectories differ by race/ethnicity and gender.

Design: We used nationally representative data from the National Longitudinal Survey of Youth …

The Effect Of Exercise Training Modality On Serum Brain Derived Neurotrophic Factor Levels In Individuals With Type 2 Diabetes, Damon L. Swift, Neil M. Johannsen, Valerie H. Myers, Conrad P. Earnest, Jasper A. J. Smits, Steven N. Blair, Timothy S. Church

Faculty Publications

Introduction: Brain derived neurotrophic factor (BDNF) has been implicated in memory, learning, and neurodegenerative disease. However, the relationship of BDNF with cardiometabolic risk factors is unclear, and the effect of exercise training on BDNF has not been previously explored in individuals with type 2 diabetes.

Methods: Men and women (N=150) with type 2 diabetes were randomized to an aerobic exercise (aerobic), resistance exercise (resistance), or a combination of both (combination) for 9 months. Serum BDNF levels were evaluated at baseline and follow-up from archived blood samples.

Results: Baseline serum BDNF was not associated with fitness, body composition, anthropometry, glucose control, …

Dose-Response Effects Of Exercise Training On The Subjective Sleep Quality Of Postmenopausal Women: Exploratory Analyses Of A Randomised Controlled Trial, Christopher E. Kline, Xuemei Sui, Martica H. Hall, Shawn D. Youngstedt, Steven N. Blair, Conrad P. Earnest, Timothy S. Church

Faculty Publications

Objective: To investigate whether a dose-response relationship existed between exercise and subjective sleep quality in postmenopausal women. This objective represents a post hoc assessment that was not previously considered.

Design: Parallel-group randomised controlled trial.

Setting: Clinical exercise physiology laboratory in Dallas, Texas.

Participants: 437 sedentary or overweight/obese postmenopausal women.

Intervention: Participants were randomised to one of four treatments, each of 6 months of duration: a non-exercise control treatment (n=92) or one of three dosages of moderate-intensity exercise (50% of VO_2peak), designed to meet 50% (n=151), 100% (n=99) or 150% (n=95) of the National Institutes of Health Consensus Development …

Cardiorespiratory Fitness Reduces The Risk Of Incident Hypertension Associated With A Parental History Of Hypertension, Robin P. Shook, Duck-Chul Lee, Xuemei Sui, Vivek Prasad, Steven P. Hooker, Timothy S. Church, Steven N. Blair

Faculty Publications

Family history of hypertension increases the risk of an individual to develop hypertension, whereas moderate-to-high cardiorespiratory fitness has the opposite effect. However, the joint association of each on the development of hypertension is not well understood. We studied fitness and incident hypertension in 6278 participants who were given a preventative medical examination. Thirty-three percent reported a parent with hypertension, and there were 1545 cases of incident hypertension after a mean of 4.7 years. The presence of parental hypertension was associated with a 28% higher risk of developing hypertension after adjustments for age, sex, and examination year. After further adjustments for …

Assessing And Quantifying High Risk: Comparing Risky Behaviors By Youth In An Urban, Disadvantaged Community With Nationally Representative Youth, Monica Swahn, Robert Bossarte

Monica H. Swahn

No abstract provided.

The Emory Center For Injury Control: Vision And Priorities For Reducing Violence And Injuries Through Interdisciplinary Collaborations, Debra Houry, Abigail Hankin, Monica Swahn

Monica H. Swahn

No abstract provided.

Reducing Levels Of Toxic Chemicals In Cigarette Smoke: A New Healthy People 2010 Objective, Patricia Richter, Terry Pechacek, Monica Swahn, Victoria Wagman

Monica H. Swahn

We developed and implemented a national surveillance system to monitor and reduce the levels of toxicchemicals in tobacco smoke. A developmental Healthy People 2010 (HP 2010) objective was revised to report on levels of three categories of chemicals--tobacco-specific nitrosamines, polyaromatic hydrocarbons, and volatile organic compounds--in the smoke of leading U.S. cigarette brands. Unit-based sales-weighted average levels were calculated for each chemical category. The target for the new HP 2010 objective is a 10% reduction in unit-based sales-weighted average levels of each chemical category. The Centers for Disease Control and Prevention provided the baseline, target data, and laboratory analyses. A national …

Correlates Of Suicide Ideation And Attempt Among Youth Living In The Slums Of Kampala, Monica H. Swahn, Jane B. Palmier, Rogers Kasirye, Huang Yao

Monica H. Swahn

While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14–24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were …

Tobacco Smoke Exposure And Levels Of Urinary Metals In The U.S. Youth And Adult Population: The National Health And Nutrition Examination Survey (Nhanes) 1999–2004, Patricia Richter, Ellen Bishop, Jiantong Wang, Monica Swahn

Monica H. Swahn

We assessed 12 urine metals in tobacco smoke-exposed and not exposed National Health and Nutrition Examination Survey participants. Our analysis included age, race/ethnicity, and poverty status. Gender and racial/ethnic differences in cadmium and lead and creatinine-adjusted and unadjusted data for group comparisons are presented. Smokers' had higher cadmium, lead, antimony, and barium levels than nonsmokers. Highest lead levels were in the youngest subjects. Lead levels among adults with high second-hand smoke exposure equaled smokers. Older smokers had cadmium levels signaling the potential for cadmium-related toxicity. Given the potential toxicity of metals, our findings complement existing research on exposure to chemicals …

Prevalence Of Youth Access To Alcohol Or A Gun In The Home, Monica Swahn, B Hammig, R Ikeda

Monica H. Swahn

Objectives: To estimate the national prevalence of youth access to alcohol, a gun, or both alcohol and a gun, in their home and to describe the demographic characteristics associated with access to either alcohol or a gun. Methods: Cross sectional data from the 1995 in-home survey of the National Longitudinal Study of Adolescent Health, which used a nationally representative randomly selected school based sample (n=18 924) of adolescents in grades 7-12, were analyzed. The current analyses were restricted to those adolescents 12-18 years of age (n=18 454). Crude logistic regression analyses was used to determine the demographic characteristics associated with …

Associations Between Electronic Media Use And Involvement In Violence, Alcohol And Drug Use Among United States High School Students, Maxine Denniston, Monica Swahn, Marci Hertz, Lisa Romero

Monica H. Swahn

Objective: We identified associations between time spent watching television and time spent playing video or computer games or using computers and involvement in interpersonal violence, alcohol and drug use in a nationally representative sample of United States high school students. Methods: We analyzed data from the 2007 national Youth Risk Behavior Survey. Exposure variables were time spent watching television and time spent playing computer or video games or using computers (hereafter denoted as "computer/video game use") on an average school day; outcome variables included multiple measures assessing involvement in violence and alcohol or drug use. Chi-square tests were used to …

Using Policy To Strengthen The Reach And Impact Of Injury Prevention Efforts, Monica H. Swahn, Abigail Hankin, Debra Houry

Monica H. Swahn

No abstract provided.

In Reply, Monica H. Swahn, Meltem Alemdar, Daniel J. Whitaker

Monica H. Swahn

A reply to a letter to the editor regarding their article:

Swahn MH, Alemdar M, Whitaker DJ. 2009. Nonreciprocal and Reciprocal Dating Violence and Injury Occurrence Among Urban Youth. The Western Journal of Emergency Medicine. 11(3):264-268.

Alcohol Marketing, Drunkenness, And Problem Drinking Among Zambian Youth: Findings From The 2004 Global School-Based Student Health Survey, Monica Swahn, Bina Ali, Jane Palmier, George Sikazwe, John Mayeya

Monica H. Swahn

This study examines the associations between alcohol marketing strategies, alcohol education including knowledge about dangersof alcohol and refusal of alcohol, and drinking prevalence, problem drinking, and drunkenness. Analyses are based on the Global School-Based Student Health Survey (GSHS) conducted in Zambia (2004) of students primarily 11 to 16 years of age (N = 2257). Four statistical models were computed to test the associations between alcohol marketing and education and alcoholuse, while controlling for possible confounding factors. Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR = 1.49; 95% CI: 1.09–2.02) and problem drinking …

Pre-Teen Alcohol Use As A Risk Factor For Victimization And Perpetration Of Bullying Among Middle And High School Students In Georgia, Monica Swahn, Volkan Topalli, Bina Ali, Sheryl Strasser, Jeffrey Ashby, Joel Meyers

Monica H. Swahn

Objective: We examined the association between pre-teen alcohol use initiation and the victimization and perpetration of bullying among middle and high school students in Georgia.

Methods: We computed analyses using data from the 2006 Georgia Student Health Survey (N=175,311) of students in grades 6, 8, 10 and 12. The current analyses were limited to students in grades 8, 10 and 12 (n=122,434). We used multilogistic regression analyses to determine the associations between early alcohol use and reports of both victimization and perpetration of bullying, perpetration only, victimization only, and neither victimization or perpetration, while controlling for demographic characteristics, other substance …

Children At Risk For Suicide Attempt And Attempt-Related Injuries: Findings From The 2007 Youth Risk Behavior Survey, Bethany A. West, Monica H. Swahn, Frances Mccarty

Monica H. Swahn

Purpose: The current study examines the associations between a range of risk factors and reports of suicide attempts and attempts requiring medical care in a nationally representative study of high school students. The goal is to examine sex differences in the risk factors associated with suicide attempts and attempt-related injuries requiring treatment by a health-care provider.

Methods: We used data from the 2007 Youth Risk Behavior Survey for students in grades 9-12 to assess the prevalence and risk factors for suicidal behavior, as well as differences in these for boys and girls. Cross-sectional multivariate logistic regression analyses were computed to …

Age Of Alcohol Use Initiation, Suicidal Behavior, And Peer And Dating Violence Victimization And Perpetration Among High-Risk, Seventh-Grade Adolescents, Monica Swahn, Robert Bossarte, Ernest Sullivent

Monica H. Swahn

Objective: We examined the cross-sectional associations between reports of an early age of alcohol use initiation and suicidal ideation, suicide attempts, and peer and dating violence victimization and perpetration among high-risk adolescents.

Method: Data were obtained from the Youth Violence Survey conducted in 2004 and administered to all public school students enrolled in grades 7, 9, and 11/12 (N = 4131) in a high-risk school district in the United States. Our analyses were limited to seventh-grade students who either began drinking before the age of 13 or were nondrinkers, with complete information on all covariates (n = 856). Cross-sectional logistic …

Violent Attacks On Middle Easterners In The United States During The Month Following The September 11, 2001 Terrorist Attacks, Monica Swahn, R Mahendra, L Paulozzi, R Winston, G Shelley, J Taliano, L Frazier, J Saul

Monica H. Swahn

Objectives: To document and describe hate related violent attacks on Middle Easterners or those perceived to be Middle Easterners during the month following the September 11, 2001 terrorist attacks in New York City and Washington, DC. Methods: The LexisNexis database of newspaper reports were used to identify incidents of hate related violent acts against Middle Easterners or those perceived to be Middle Easterners in the US between September 1 and October 11, 2001. A total of 100 incidents of hate related violence were identified in the 2659 news articles that were reviewed. Results: Of the 100 incidents of violent victimization …

Nonreciprocal And Reciprocal Dating Violence And Injury Occurrence Among Urban Youth, Monica Swahn, Meltem Alemdar, Daniel Whitaker

Monica H. Swahn

Objective: Dating violence is a significant health problem among youth that leads to adverse health outcomes, including injuries. Reciprocal violence (perpetrated by both partners) is associated with increased injury in adults, but very little is known about the prevalence and context for reciprocal violence, as well as injury rates, among youth. We sought to determine the prevalence and scope of reciprocal dating violence and injury occurrence among urban youth in a high-risk community.

Methods: Analyses were based on data from the Youth Violence Survey, conducted in 2004, and administered to over 80% of public school students in grades 7, 9, …

The Associations Between Victimization, Feeling Unsafe, And Asthma Episodes Among Us High-School Students, Monica Swahn, Robert Bossarte

Monica H. Swahn

We examined the associations between victimization, missed school because of feeling unsafe, and asthma episodes among US high-school students using the 2003 Youth Risk Behavior Survey. Cross-sectional analyses on adolescents with asthma (n=1943) showed that any victimization and missed school because of feeling unsafe significantly increased the odds of having an asthma episode in the past year (adjusted odds ratio [OR]=1.45; 95% confidence interval [CI] = 1.07, 1.95 and adjusted OR = 2.93; 95% CI = 1.90, 4.53, respectively). Victimization and feeling unsafe are important but poorly understood risk factors for asthma.

Early Alcohol Use And Problem Drinking Among Students In Zambia And Uganda, Monica H. Swahn, Bina Ali, Jane Palmier, Nazarius Mbona Tumwesigye, George Sikazwe, Jeremiahs Twa-Twa, Kasirye Rogers

Monica H. Swahn

Excessive alcohol use is a serious public health concern worldwide, but less attention has been given to the prevalence, risk and protective factors, and consequences of early alcohol use in low-income, developing countries.The purpose of this study was to determine the associations between early alcohol use, before age 13, and problem drinking among adolescents in Uganda and Zambia. Data from students in Zambia (n=2257; 2004) and Uganda (n=3215; 2003) were obtained from the cross sectional Global School-Based Student Health Survey (GSHS). The self-administered questionnaires were completed by students primarily 13 to 16 years of age. Multiple statistical models were computed …

Differences In Frequency Of Violence And Reported Injury Between Relationships With Reciprocal And Nonreciprocal Intimate Partner Violence, Daniel Whitaker, Tadesse Haileyesus, Monica Swahn, Linda Saltzman

Monica H. Swahn

Objectives: We sought to examine the prevalence of reciprocal (i.e., perpetrated by both partners) and nonreciprocal intimate partner violence and to determine whether reciprocity is related to violence frequency and injury. Methods: We analyzed data on young US adults aged 18 to 28 years from the 2001 National Longitudinal Study of Adolescent Health, which contained information about partner violence and injury reported by 11 370 respondents on 18761 heterosexual relationships. Results: Almost 24% of all relationships had some violence, and half (49.7%) of those were reciprocally violent. In nonreciprocally violent relationships, women were the perpetrators in more than 70% of …

Predictors Of Injury From Fighting Among Adolescent Males, B Hammig, L Dahlberg, Monica Swahn

Monica H. Swahn

Objectives: To identify violence related behaviors associated with injuries among adolescent males involved in fights.

Methods: Data from the National Longitudinal Study of Adolescent Health were used to develop weighted estimates of injury prevalence and associations between injury and violence related behaviors.

Results: Forty seven per cent injured others and 18% were themselves injured in a fight among adolescent males in the preceding 12 months. Group fighting, fighting with strangers, and weapon use were predictive of injury in this sample.

Conclusions: These findings suggest that injuries associated with fighting are a health risk among adolescent males. Certain behaviors, such as …