Medicine and Health Sciences Commons^™

Sedentary Behavior And Related Factors Among Full-Time, University Faculty, Mary Keenan, Anna Greer

Anna E. Greer

Purpose - Sedentary behavior, independent of physical activity, is a risk factor for both morbidity and mortality. Little is known about factors related to sedentary behavior. The purpose of this paper is to examine the relationship between sedentary behavior and the demographic characteristics, perceived physical activity (PA) environment, and PA behaviors of 72 full-Time, university faculty members. Design/methodology/approach - For this cross-sectional study, data were collected online using Survey Monkey®. Findings - Participants spent an average of 473 and 328 minutes/weekend day in sedentary activity. There was a positive correlation between minutes spent in vigorous PA and minutes spent sedentary …

Travel To, And Use Of, Twenty-One Michigan Trails, Anna Greer, Julian Reed, Lisa Grost, Christina Harvey, Karah Mantinan

Anna E. Greer

Objective and methods: This study examined trail use among 857 trail users on 21 trails in Michigan from 2008 to 2011 using a valid and reliable intercept survey. Results: Most of the 857 participants traveled to the trail from their home (92.6%), lived within 15 min of the trails (74.8%), and used active transport to travel to the trails 69.7%. The odds of active transport to the trails were greater among those who had not graduated high school (OR=3.49; 95% CI=1.02, 11.99) and high school graduates (OR=7.432; 95% CI=2.02, 27.30) compared to college graduates. Whites and adults also had greater …

School Administrators' Perceptions Of Factors That Influence Children's Active Travel To School, Anna Greer, Delores Pluto, Olga Ogoussan, Jorge Banda

Anna E. Greer

BACKGROUND: Increasing children's active travel to school may be 1 strategy for addressing the growing prevalence of obesity among school age children. Using the School Travel Survey, we examined South Carolina school district leaders' perceptions of factors that influence elementary and middle school students walking to school. METHODS: Frequency distributions and chi-square tests were used to analyze the survey responses; open-ended questions were reviewed qualitatively for recurring topics and themes. RESULTS: School and district leaders (N = 314) most often reported street crossing safety (54.0%) and number of sidewalks (54.0%) as priority factors that should be addressed to increase students' …

Engaging Teens And Parents In Collaborative Practice: Perspectives On Diabetes Self-Management, Susan Sullivan-Bolyai, Carol Bova, Kimberley Johnson, Karen Cullen, Carol Jaffarian, Diane Quinn, Edwin Aroke, Sybil Crawford, Mary Lee, Olga Gupta

Mary M. Lee

PURPOSE: The purpose of this exploratory focus group study was to describe the perspectives of teens and their parents about self-management knowledge, behaviors (including division of labor associated with T1D management), and resources used to manage T1D. The overall goal is to use this information to develop a teen-family transition clinic.

METHODS: The self and family management behaviors framework undergirded the separate teen-parent focus groups that were conducted concurrently. Note-based qualitative content analysis was used, resulting in several important messages. RESULTS: From the teens' perspective there was variation in interest in learning more about T1D and management. Those teens who …

The Anti-Vaccine Movement – A Pharmacist’S View, Jeffery Goad, Melissa Durham

Jeff Goad

Goad and Durham discuss the anti-vaccine movement from a pharmacist's perspective, and explore the pharmacist's role in immunizations and the impact of pharmacist-patient communication on vaccinations.

Knowledge, Attitudes, Behaviors, And Beliefs About Chronic Kidney Disease In Indiana’S Minority Communities: A Community-Based Survey, Priscilla Ryder, Kelsey Coy, Anita Ohmit, Chandana Saha

Priscilla T. Ryder

The purpose of this report is to detail the findings of the study ‘Knowledge, Attitudes, Behaviors, And Beliefs about Chronic Kidney Disease in Indiana Minority Communities,’ undertaken as a collaboration between Indiana Minority Health Coalition, Inc. (IMHC) and the Butler University College of Pharmacy and Health Sciences (BUCOPHS). The purpose of the study was to understand knowledge of and beliefs about Chronic Kidney Disease (CKD) among racial/ethnic minorities in Indiana, to learn how these populations would like to receive information about CKD, to understand the factors associated with higher levels of CKD awareness, to estimate the proportion of people with …

An Outcome Study Of Seeking Safety With Rural Community-Based Women, Beverly Patitz, Melissa Anderson, Lisa Najavits

Melissa L. Anderson

This pilot study investigated the impact of Seeking Safety (SS) on rural women with comorbid substance abuse and trauma problems. SS is an evidence-based, present-focused therapy that provides coping skills and psychoeducation. Despite its demonstrated effectiveness, this is the first known study using SS with rural women. Investigating the efficacy of evidence-based treatments with rural populations is especially important because, compared with urban residents, they are more likely to meet criteria for comorbid mental illness and substance abuse, exhibit more severe symptoms of both disorders, but are much less likely to receive formal treatment. Such disparities highlight the need for …

Attitudes Of Women In Their Forties Toward The 2009 Uspstf Mammogram Guidelines: A Randomized Trial On The Effects Of Media Exposure, Autumn Davidson, Xun Liao, B. Magee

B. Dale Magee

OBJECTIVE: The objective of the study was to assess women's attitudes toward 2009 US Preventive Services Task Force mammography screening guideline changes and evaluate the role of media in shaping opinions. STUDY DESIGN: Two hundred forty-nine women, aged 39-49 years, presenting for annual examinations randomized to read 1 of 2 articles, and survey completion comprised the design of the study. RESULTS: Eighty-eight percent overestimated the lifetime breast cancer (BrCa) risk. Eighty-nine percent want yearly mammograms in their 40s. Eighty-six percent felt the changes were unsafe, and even if the changes were doctor recommended, 84% would not delay screening until age …

Understanding The Role Of Promotora In A Latino Diabetes Education Program, Lynn Deitrick, Hannah Paxton, Alicia Rivera, Eric Gertner, Nyann Biery, Abby Letcher, Lissette Lahoz, Edgar Maldonado, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

Striving For Cultural Competence In An Hiv Program: The Transformative Impact Of A Microsystem In A Larger Health Network, Judith N Sabino, Timothy Friel, Lynn Deitrick, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

Perspectives On Cancer Screening Among Latino Community Members And Internal Medicine Residents, Debbie Salas-Lopez, Dawne Mouzon, Jonnie Marks, Neil Kothari, Ana Natale-Pereira

Debbie Salas-Lopez MD, MPH

BACKGROUND: Latinos have lower rates of cancer screening, partially because of cultural beliefs that conflict with those of health care professionals. Moreover, established programs for training physicians in cultural competency often fail to incorporate input from the community.

METHODS: To explore beliefs about cancer and cancer screening among Latino community members and internal medicine residents. Three focus groups of Latino community members (n = 31) and one focus group of internal medicine residents (n = 9) were conducted to compare ideas regarding cancer and cancer screening.

RESULTS: We identified clear disconnects between residents and Latino community members regarding their understandings …

The Neighborhood Cancer Center, Gregory R. Harper Md, Phd, Debbie Salas-Lopez Md, Mph, Keith J. Weinhold Mha, Elliot J. Sussman Md, Mba

Debbie Salas-Lopez MD, MPH

No abstract provided.

Weight-Based Discrimination And Medication Adherence Among Low-Income African Americans With Hypertension: How Much Of The Association Is Mediated By Self-Efficacy?, Michael Richardson, Molly Waring, Monica Wang, Lisa Nobel, Yendelela Cuffee, Sharina Person, Sandral Hullett, Catarina Kiefe, Jeroan Allison

Monica L. Wang

OBJECTIVES: Much of the excessive morbidity and mortality from cardiovascular disease among African Americans results from low adherence to anti-hypertensive medications. Therefore, we examined the association between weight-based discrimination and medication adherence. METHODS: We used cross-sectional data from low-income African Americans with hypertension. Ordinal logistic regression estimated the odds of medication non-adherence in relation to weight-based discrimination adjusted for age, sex, education, income, and weight. RESULTS: Of all participants (n = 780), the mean (SD) age was 53.7 (9.9) years and the mean (SD) weight was 210.1 (52.8) lbs. Reports of weight-based discrimination were frequent (28.2%). Weight-based discrimination (but not …

Physical Activity And Screen Time In Metabolically Healthy Obese Phenotypes In Adolescents And Adults, Sarah Camhi, Molly Waring, Susan Sisson, Laura Hayman, Aviva Must

Laura L. Hayman

Introduction. The purpose of this study was to examine levels of physical activity (PA) and screen time (ST) in metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) adolescents and adults. Methods. NHANES data from obese adolescents (12-18 years, BMI z-score >/= 95th percentile) and adults (19-85 years, BMI >/= 30 kg/m(2)) were pooled from 2003-2005 cycles. Metabolic phenotypes were categorized as MHO (0 or 1 cardiometabolic risk factor; triglycerides, HDL-C, blood pressure, or glucose) or MUO (>/=2 cardiometabolic risk factors). Logistic regression models estimated associations between phenotype and PA/ST adjusted for age, gender, BMI, race/ethnicity, menopausal status, and …

Partnering With Community Institutions To Increase Access To Healthful Foods Across Municipalities

Lara Jaskiewicz

Successful Advocacy Strategies For State Affiliates: Relationships, Messages, Member Involvement, Funding And Persistence, R. Holliday, E. Long, S. Linja, S. Safail

Elaine M. Long

Participants will be able to describe the implementation of a statewide advocacy campaign by RDs.

Diabetes Care Trends In The Ma Patient Centered Medical Home Initiative (Ma Pcmhi) At Mid-Point, Sai Cherala, Judith Steinberg, Stephen Baker

Sai Cherala

Background: The MA PCMHI is a multi-payer demonstration involving 45 primary care practices. Thirty-one (31) practices receive additional financial support; all receive technical assistance.

Objectives: To assess data trends in diabetes quality measures from participating adult practices.

Study Design: Quality improvement study utilizing practices’ self-reported data on clinical quality measures. Diabetes measures included blood pressure, LDL cholesterol and hemoglobin A1C control and depression screening.

Methods: Monthly quality data from 38 practices reported June 2011 (baseline) through November 2012 were evaluated. Using a general linear mixed model Analysis of Variance (ANOVA), an overall comparison across time and pair-wise comparisons between times …

Screening Colonoscopy And Risk For Incident Late-Stage Colorectal Cancer Diagnosis In Average-Risk Adults: A Nested Case-Control Study, Chyke Doubeni, Sheila Weinmann, Kenneth Adams, Aruna Kamineni, Diana Buist, Arlene Ash, Carolyn Rutter, V. Paul Doria-Rose, Douglas Corley, Robert Greenlee, Jessica Chubak, Andrew Williams, Aimee Kroll-Desrosiers, Eric Johnson, Joseph Webster, Kathryn Richert-Boe, Theodore Levin, Robert Fletcher, Noel Weiss

Chyke A. Doubeni

BACKGROUND: The effectiveness of screening colonoscopy in average-risk adults is uncertain, particularly for right colon cancer. OBJECTIVE: To examine the association between screening colonoscopy and risk for incident late-stage colorectal cancer (CRC). DESIGN: Nested case-control study. SETTING: Four U.S. health plans. PATIENTS: 1039 average-risk adults enrolled for at least 5 years in one of the health plans. Case patients were aged 55 to 85 years on their diagnosis date (reference date) of stage IIB or higher (late-stage) CRC during 2006 to 2008. One or 2 control patients were selected for each case patient, matched on birth year, sex, health plan, …

Estimating The Effect Of A Community-Based Intervention With Two Communities, Mark Van Der Laan, Maya Petersen, Wenjing Zheng

Wenjing Zheng

Due to the need to evaluate the effectiveness of community-based programs in practice, there is substantial interest in methods to estimate the causal effects of community-level treatments or exposures on individual level outcomes. The challenge one is confronted with is that different communities have different environmental factors affecting the individual outcomes, and all individuals in a community share the same environment and intervention. In practice, data are often available from only a small number of communities, making it difficult if not impossible to adjust for these environmental confounders. In this paper we consider an extreme version of this dilemma, in …

Using An Evidence Based Practice Informatics Guided Medication Safety Intervention To Improve Medication Safety Among Community Dwelling Older Adults, Raeann Leblanc

Raeann G LeBlanc

Medication safety and prevention of medication related problems are important issues in promoting and maintaining health and safety in one’s home for community dwelling older adults. Assessment of medications and management of a medication schedule are essential elements of medication safety, medication review, and medication care coordination. The Framework for Geriatric Homecare Excellence (Collaboration for Home Care Advances and Practices, 2009) is used as the foundation of this project to improve medication management, and promote and maintain health and safety at home. An in-home medication assessment was completed, using a medication management software informatics system to review medications, identify medication …

Oral And Injectable Contraception Use And Risk Of Hiv Acquisition Among Women In Sub-Saharan Africa, Sandra Mccoy, Wenjing Zheng, Elizabeth Montgomery, Kelly Blanchard, Ariane Van Der Straten, Guy De Bruyn, Nancy Padian

Wenjing Zheng

OBJECTIVE:: Evaluate the effect of oral and injectable hormonal contraception (HC) on the risk of HIV acquisition among women in South Africa and Zimbabwe. DESIGN:: Secondary data analysis of 4913 sexually active women aged 18-49 years followed for up to 24 months in the MIRA phase III effectiveness trial of the diaphragm and lubricant gel for HIV prevention. METHODS:: Participants were interviewed quarterly about contraception and sexual behavior and were tested for pregnancy, HIV, and other sexually transmitted infections. We used a Cox proportional hazards marginal structural model, weighted by the inverse probability of HC use, to compare the risk …

Perceptions Of Evidence-Based Programs Among Community-Based Organizations Tackling Health Disparities: A Qualitative Study, Shoba Ramanadhan, Josephine Crisostomo, Jaclyn Alexander-Molloy, Ediss Gandelman, Milagro Grullon, Vilma Lora, Chrasandra Reeves, Clara Savage, Kasisomayajula Viswanatha, Chyke Doubeni

Chyke A. Doubeni

Dissemination of prevention-focused evidence-based programs (EBPs) from research to community settings may improve population health and reduce health disparities, but such flow has been limited. Academic-community partnerships using community-based participatory research (CBPR) principles may support increased dissemination of EBPs to community-based organizations (CBOs). This qualitative study examined the EBP-related perceptions and needs of CBOs targeting underserved populations. As part of PLANET MassCONECT, a CBPR study, we conducted six key informant interviews with community leaders and four focus groups with CBO staff members in Boston, Worcester and Lawrence, Massachusetts, in 2008. Working definitions of EBPs among CBO staff members varied greatly …

Obesity, Weight Change, And Risk Of Adenoma Recurrence: A Prospective Trial, Adeyinka Laiyemo, Chyke Doubeni, Dilhana Badurdeen, Gillian Murphy, Pamela Marcus, Robert Schoen, E. Lanza, Duane Smoot, A. Cross

Chyke A. Doubeni

BACKGROUND AND STUDY AIMS: Obesity is a risk factor for colorectal neoplasia. Lifestyle modifications, including weight loss, have been advocated to reduce the risk. However, no prospective study has evaluated whether weight loss actually affects adenoma recurrence. The aim of this study was to examine whether weight change (loss or gain) over 4 years is associated with adenoma recurrence. PATIENTS AND METHODS: A total of 1826 patients with colorectal adenoma in the Polyp Prevention Trial had their height and weight measured at baseline. Adenoma recurrence was determined by end of trial colonoscopy 4 years after study entry when patients' weights …

Patient Completion Of Laboratory Tests To Monitor Medication Therapy: A Mixed-Methods Study, Shira Fischer, Terry Field, Shawn Gagne, Kathleen Mazor, Peggy Preusse, George Reed, Daniel Peterson, Jerry Gurwitz, Jennifer Tjia

Jennifer Tjia

BACKGROUND: Little is known about the contribution of patient behavior to incomplete laboratory monitoring, and the reasons for patient non-completion of ordered laboratory tests remain unclear. OBJECTIVE: To describe factors, including patient-reported reasons, associated with non-completion of ordered laboratory tests. DESIGN: Mixed-Methods study including a quantitative assessment of the frequency of patient completion of ordered monitoring tests combined with qualitative, semi-structured, patient interviews. PARTICIPANTS: Quantitative assessment included patients 18 years or older from a large multispecialty group practice, who were prescribed a medication requiring monitoring. Qualitative interviews included a subset of show and no-show patients prescribed a cardiovascular, anticonvulsant, or …

Gifts From The Elders: Honouring The Past For A Healthier Tomorrow, Chantelle Richmond, James Fortier

Chantelle Richmond

“Gifts from the Elders” follows five Anishinaabe youth on a summer research project with their Elders, whose stories guide them on a journey back to proceeding generations that lived a healthy lifestyle off of the land. Their stories chronicle the devastating impact that environmental and cultural dispossession had on the flow of knowledge from Elders to youth, and ultimately on the health of their people. As their summer comes to an end, the youth emerge with “gifts” of knowledge and teachings from their Elders, inspiring a renewed determination to forge a hopeful and healthy future for the next generation.

Awareness, Acceptability And Uptake Of Human Papilloma Virus Vaccine Among Cameroonian School-Attending Female Adolescents, Claudine Ayissi, Richard Wamai, Geofrey Oduwo, Stacey Perlman, Edith Welty, Simon Manga, Javier Ogembo

Richard G. Wamai

The purpose of this study is to assess awareness, knowledge and beliefs about HPV, cervical cancer HPV vaccine and willingness to vaccinate among adolescent females aged 12-26 years at clinics and schools in the North West Region of Cameroon where the Cameroon Baptist Convention Health Services (CBCHS) conducted a sensitization and education campaign. A questionnaire survey was administered among female adolescents in schools and clinics. Descriptive statistics including frequencies, percentages and proportions were generated for independent variables and bivariate analyses (Chi square test) were used to assess the relationship between independent and outcome variables. Data were analyzed using SAS Version …

Factors Associated With Inadequate Colorectal Cancer Screening With Flexible Sigmoidoscopy, Adeyinka Laiyemo, Chyke Doubeni, Paul Pinsky, V. Paul Doria-Rose, Andrew Sanderson, Robert Bresalier, Joel Weissfeld, Robert Schoen, Pamela Marcus, Phillip Prorok, Christine Berg

Chyke A. Doubeni

BACKGROUND AND STUDY AIM: Inadequate colorectal cancer screening wastes limited endoscopic resources. We examined patients factors associated with inadequate flexible sigmoidoscopy (FSG) screening at baseline screening and repeat screening 3-5 years later in 10 geographically-dispersed screening centers participating in the ongoing Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

METHODS: A total of 64,554 participants (aged 55-74) completed baseline questionnaires and underwent FSG at baseline. Of these, 39,385 participants returned for repeat screening. We used logistic regression models to assess factors that are associated with inadequate FSG (defined as a study in which the depth of insertion of FSG was …

Contribution Of Behavioral Risk Factors And Obesity To Socioeconomic Differences In Colorectal Cancer Incidence, Chyke Doubeni, Jacqueline Major, Adeyinka Laiyemo, Mario Schootman, Ann Zauber, Albert Hollenbeck, Rashmi Sinha, Jeroan Allison

Chyke A. Doubeni

BACKGROUND:Health behaviors are known risk factors for colorectal cancer and are more common in low socioeconomic status (SES) populations. We evaluated the extent to which behavioral risk factors and body mass index (BMI) explain SES disparities in colorectal cancer incidence, overall and by tumor location.

METHODS: We analyzed prospective National Institutes of Health-AARP Diet and Health Study data on 506 488 participants who were recruited in 1995-1996 from six US states and two metropolitan areas and followed through 2006. Detailed baseline data on risk factors for colorectal cancer, including health behaviors, were obtained using questionnaires. SES was measured by self-reported …

Socioeconomic Status, Healthcare Density, And Risk Of Prostate Cancer Among African American And Caucasian Men In A Large Prospective Study, Jacqueline Major, M. Oliver, Chyke Doubeni, Albert Hollenbeck, Barry Graubard, Rashmi Sinha

Chyke A. Doubeni

OBJECTIVES: The purpose of this study was to separately examine the impact of neighborhood socioeconomic deprivation and availability of healthcare resources on prostate cancer risk among African American and Caucasian men. METHODS: In the large, prospective NIH-AARP Diet and Health Study, we analyzed baseline (1995-1996) data from adult men, aged 50-71 years. Incident prostate cancer cases (n = 22,523; 1,089 among African Americans) were identified through December 2006. Lifestyle and health risk information was ascertained by questionnaires administered at baseline. Area-level socioeconomic indicators were ascertained by linkage to the US Census and the Area Resource File. Multilevel Cox models were …

Variation Of Adenoma Prevalence By Age, Sex, Race, And Colon Location In A Large Population: Implications For Screening And Quality Programs, Douglas Corley, Christopher Jensen, Amy Marks, Wei Zhao, Jolanda De Boer, Theodore Levin, Chyke Doubeni, Bruce Fireman, Charles Quesenberry

Chyke A. Doubeni

BACKGROUND and AIMS: Reliable community-based colorectal adenoma prevalence estimates are needed to inform colonoscopy quality standards and to estimate patient colorectal cancer risks; however, minimal data exist from populations with large numbers of diverse patients and examiners. METHODS: We evaluated the prevalence of adenomas detected by sex, age, race/ethnicity, and colon location among 20,792 Kaiser Permanente Northern California members >/=50 years of age who received a screening colonoscopy exam (102 gastroenterologists, years 2006-2008). RESULTS: Prevalence of detected adenomas increased more rapidly with age in the proximal colon (adjusted odds ratio [OR], 2.39; 95% confidence interval [CI], 2.05-2.80; 70-74 vs 50-54 …