Medicine and Health Sciences Commons^™

Food-Related Practices And Beliefs Of Rural Us Elementary And Middle School Teachers, Nancy Findholt, Betty T. Izumi, Jackilen Shannon, Thuan Nguyen

Community Health Faculty Publications and Presentations

INTRODUCTION:

Childhood obesity disproportionately affects rural populations; therefore, promoting healthy eating among rural children is essential. Teachers are important role models for children and can influence children's eating behaviors through their own behaviors and beliefs about food. This study examined the food-related practices and beliefs of rural elementary and middle school teachers.

METHODS:

Data were used from the SNACZ study, a school- and community-based trial conducted in rural Oregon. Kindergarten through eighth-grade teachers (n=87), teaching students usually aged 5-14 years, from eight rural school districts completed a baseline survey in November 2012 concerning their classroom food practices, eating behaviors at …

Dietary Fat Intake And Reproductive Hormone Concentrations And Ovulation In Regularly Menstruating Women, Sunni L. Mumford, Jorge E. Chavarro, Cuilin Zhang, Neil J. Perkins, Lindsey A. Sjaarda, Anna Z. Pollack, Karen C. Schliep, Kara A. Michels, Shvetha M. Zarek, Torie C. Plowden, Rose G. Radin, Lynne C. Messer, Robyn A. Frankel, Jean Wactawski-Wende

Community Health Faculty Publications and Presentations

Background: Emerging evidence suggests potential links between some dietary fatty acids and improved fertility, because specific fatty acids may affect prostaglandin synthesis and steroidogenesis.

Objective: The objective of this exploratory study was to evaluate associations between total and specific types of dietary fat intake and 1) hormone concentrations and 2) the risk of sporadic anovulation in a cohort of 259 regularly menstruating women in the BioCycle Study.

Design: Endogenous reproductive hormones were measured up to 8 times/cycle for up to 2 cycles, with visits scheduled with the use of fertility monitors. Dietary intake was assessed with up to …

Leader Behaviors, Group Cohesion, And Participation In A Walking Group Program, Betty T. Izumi, Amy J. Schulz, Graciela Mentz, Barbara A. Isreal, Sharon L. Sand, Angela G. Reyes, Bernadine Hoston, Dawn Richardson, Cindy Gamboa, Zachary Rowe, Goys Diaz

Community Health Faculty Publications and Presentations

Background—Fewer than half of all U.S. adults meet the 2008 Physical Activity Guidelines. Leader behaviors and group cohesion have been associated with increased participation or adherence in sports team and exercise class settings. Physical activity interventions in community settings that encompass these factors may enhance intervention adherence.

Purpose—To examine the impact of Community Health Promoter leader behaviors and group cohesion on participation in a walking group intervention among racially/ethnically diverse adults in low-to-moderate income communities in Detroit, Mich.

Design—Data for the current study were drawn from the Walk Your Heart to Health (WYHH) data set. WYHH was a multi-site cluster …

Three-Year Change In The Wellbeing Of Orphaned And Separated Children In Institutional And Family-Based Care Settings In Five Low- And Middle-Income Countries, Kathryn Whetten, Jan Ostermann, Brian W. Pence, Rachel A. Whetten, Lynne C. Messer, Sumedha Ariely, Karen O'Donnell, Augustine L. Wasonga, Vanroth Vann, Dafrosa Itemba, Misganaw Eticha, Ira Madan, Nathan M. Thielman, Positive Outcomes For Orphans (Pofo) Research Team

Community Health Faculty Publications and Presentations

Background: With more than 2 million children living in group homes, or "institutions", worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers.

Methods: A two-stage random sampling methodology identified community representative samples of 1,357 institutional dwelling orphaned and separated children (OSC) and 1,480 family-dwelling OSC aged 6–12 from 5 low and middle income countries. Data were collected from children and their primary caregivers. Survey-analytic techniques and linear mixed effects models describe child wellbeing collected at baseline and at 36 months, including physical and emotional health, growth, cognitive development and memory, …

Exposure To Fine Particulate Matter During Pregnancy And Risk Of Preterm Birth Among Women In New Jersey, Ohio, And Pennsylvania, 2000–2005, Kristen M. Rappazzo, Julie L. Daniels, Lynne C. Messer, Charles Poole, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Particulate matter < 2.5 micrometers in aerodynamic diameter (PM2.5) has been variably associated with preterm birth (PTB).

Objective: We classified preterm births into four categories (20–27, 28–31, 32–34, and 35–36 weeks completed gestation) and estimated risk differences (RD) for each category in association with a 1-µg/m3 increase in PM2.5 exposure during each week of gestation.

Methods: We assembled a cohort of singleton pregnancies that completed at least 20 weeks of gestation during 2000-2005 using live birth certificate data from three states (Pennsylvania, Ohio, and New Jersey) (n = 1,940,213; 8% PTB). We estimated mean PM2.5 exposures for each week of gestation from monitor-corrected Community Multi-Scale Air Quality modeling data. RDs were …

U-54 Building Infrastructure Leading To Diversity (Build) National Institutes Of Health: Enhancing Cross-Disciplinary Infrastructure Training At Oregon, Carlos J. Crespo

Community Health Faculty Publications and Presentations

This presentation focuses on the NIH Building Infrastructure Leading to Diversity (BUILD) Initiative (U54) that was awarded to Portland State University.

Gently Clarifying The Application Of Horn’S Parallel Analysis To Principal Component Analysis Versus Factor Analysis, Alexis Dinno

Community Health Faculty Publications and Presentations

Horn’s parallel analysis (PA) is an empirical method used to decide how many components in a principal component analysis (PCA) or factors in a common factor analysis (CFA) drive the variance observed in a data set of n observations on p variables (Horn, 1965). This decision of how many components or factors to retain is critical in applications of PCA or CFA to reducing the dimensionality of data in analysis (as when compositing multiple scale items into a single score), and also in exploratory factor analysis where the different contributions of each factor to each observed variable help generate theory …

A Qualitative Study Of Rural Primary Care Clinician Views On Remote Monitoring Technologies, Melinda M. Davis, Jillian M. Currey, Sonya Howk, Molly R. Desordi, Linda Boise, Lyle J. Fagnan, Nancy Vuckovic

Community Health Faculty Publications and Presentations

Purpose: Remote monitoring technologies (RMTs) may improve the quality of care, reduce access barriers, and help control medical costs. Despite the role of primary care clinicians as potential key users of RMTs, few studies explore their views. This study explores rural primary care clinician interest and the resources necessary to incorporate RMTs into routine practice.

Methods: We conducted 15 in-depth interviews with rural primary care clinician members of the Oregon Rural Practice-based Research Network (ORPRN) from November 2011 to April 2012. Our multidisciplinary team used thematic analysis to identify emergent themes and a cross-case comparative analysis to explore variation by …

Comment On “The Effect Of Same-Sex Marriage Laws On Different-Sex Marriage: Evidence From The Netherlands”, Alexis Dinno

Community Health Faculty Publications and Presentations

In the recent Demography article titled “The Effect of Same-Sex Marriage Laws on Different-Sex Marriage: Evidence From the Netherlands,” Trandafir attempted to answer the question, Are rates of opposite sex marriage affected by legal recognition of same sex marriages? The results of his approach to statistical inference—looking for evidence of a difference in rates of opposite-sex marriage—provide an absence of evidence of such effects. However, the validity of his conclusion of no causal relationship between same-sex marriage laws and rates of opposite-sex marriage is threatened by the fact that Trandafir did not also look for equivalence in rates of opposite-sex …

Same Sex Marriage And The Perceived Assault On Opposite Sex Marriage, Alexis Dinno, Chelsea Whitney

Community Health Faculty Publications and Presentations

Background: Marriage benefits both individuals and societies, and is a fundamental determinant of health. Until recently same sex couples have been excluded from legally recognized marriage in the United States. Recent debate around legalization of same sex marriage has highlighted for anti-same sex marriage advocates and policy makers a concern that allowing same sex couples to marry will lead to a decrease in opposite sex marriages. Our objective is to model state trends in opposite sex marriage rates by implementation of same sex marriages and other same sex unions.

Methods and Findings: Marriage data were obtained for all …

Differences In Demographic, Behavioral, And Biological Variables Between Those With Valid And Invalid Accelerometry Data: Implications For Generalizability, Paul D. Loprinzi, Bradley J. Cardinal, Carlos J. Crespo, Gary R. Brodowicz, Ross E. Andersen, Ellen Smit

Community Health Faculty Publications and Presentations

Background: The exclusion of participants with invalid accelerometry data (IAD) may lead to biased results and/or lack of generalizability in large population studies. The purpose of this study was to investigate whether demographic, behavioral, and biological differences occur between those with IAD and valid accelerometry data (VAD) among adults using a representative sample of the civilian noninstitutionalized U.S. population. Methods: Ambulatory participants from NHANES (2003-2004) who were 20-85 years of age were included in the current study and wore an ActiGraph 7164 accelerometer for 7 days. A "valid person" was defined as those with 4 or more days of at …

The Hispanic Paradox And Older Adults’ Disabilities: Is There A Healthy Migrant Effect?, Esme Fuller Thomson, Amini Nuru-Jeter, Dawn M. Richardson, Ferrah Raza, Meredeth Minkler

Community Health Faculty Publications and Presentations

The “Hispanic Paradox” suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The “Healthy Migrant Effect” suggests a health selection effect due to the demands of migration. The Hispanic lifestyle hypothesis focuses on Hispanics’ strong social ties and better health behaviors. The reverse migration argument suggests that the morbidity profile in the USA is affected when many Hispanic immigrants return to their native countries after developing a serious illness. We analyzed data from respondents aged …

Health Behaviour Changes After Diagnosis Of Chronic Illness Among Canadians Aged 50 Or Older, Jason T. Newsom, Nathalie Huguet, Pamela L. Ramage-Morin, Michael Joseph Mccarthy, Julie Bernier, Mark S. Kaplan, Bentson H. Mcfarland

Community Health Faculty Publications and Presentations

Changes in health behaviors (smoking, physical activity, alcohol consumption, and fruit and vegetable consumption) after diagnosis of chronic health conditions (heart disease, cancer, stroke, respiratory disease, and diabetes) were examined among Canadians aged 50 or older. Results from 12 years of longitudinal data from the Canadian National Population Health Survey indicated relatively modest changes in behavior. Although significant decreases in smoking were observed among all groups except those with respiratory disease, at least 75% of smokers did not quit. No significant changes emerged in the percentage meeting physical activity recommendations, except those with diabetes, or in excessive alcohol consumption, except …

Lower Nutritional Status And Higher Food Insufficiency In Frail Older Us Adults, Ellen Smit, Kerri M. Winters-Stone, Paul D. Loprinzi, Alice M. Tang, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as ‘sometimes’ or ‘often’ not having enough food to eat. Analyses …

Body Mass Index And The Risk Of Prostate Cancer, Daniel Lee Mcgee, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: This article presents cohort studies that use data from the National Health Information Survey from 1986 to 1994 and compares the effectiveness of Cox proportional hazards models that assume a linear relationship between body mass index (BMI) and the risk of prostate cancer with models that assume a J-shaped relationship. Methods and results: Our study found that for black males over 40 years of age, neither a linear nor a J-shaped relationship yielded a statistically significant model. With white males over 40 years, assuming a linear relationship did not yield a statistically significant model (P = 0.582). When we …

Conceptualizing Neighborhood Space: Consistency And Variation Of Associations For Neighborhood Factors And Pregnancy Health Across Multiple Neighborhood Units, Lynne C. Messer, Lisa C. Vinikoor-Imler, Barbara A. Laraia

Community Health Faculty Publications and Presentations

The purpose of this research was to assess the consistency of associations between neighborhood characteristics and pregnancy-related behaviors and outcomes across four nested neighborhood boundaries using race-stratified fixed-slope random-intercept multilevel logistic models. High incivilities was associated with increased smoking, inadequate weight gain and pregnancy-induced hypertension (PIH), while walkability was associated with decreased smoking and PIH for white women across all neighborhood definitions. For African American women, high incivilities was associated with increased smoking and inadequate gestational weight gain, while more walkable neighborhoods appeared protective against smoking and inadequate weight gain in all but the smallest neighborhoods. Associations with neighborhood attributes …

A Study Of Riders' Noise Exposure On Bay Area Rapid Transit Trains, Alexis Dinno, Cynthia Powell, Margaret Mary King

Community Health Faculty Publications and Presentations

Excessive noise exposure may present a hazard to hearing, cardiovascular and psychosomatic health. Mass transit systems, such as the Bay Area Rapid Transit (BART) system, are potential sources of excessive noise. The purpose of this study was to characterize transit noise and riders' exposure to noise on the BART system using three dosimetry metrics. We made 268 dosimetry measurements on a convenience sample of 51 line segments. Dosimetry measures were modeled using linear and non-linear multiple regression as functions of average velocity, tunnel enclosure, flooring, and wet weather conditions, and presented visually on a map of the BART system. This …

Community-Based Approaches To Reduce Toxins In Housing: Lessons Learned From Working With Diverse Communities, Erin Mcnally, Ian Blazina, Stephanie Farquhar

Community Health Faculty Publications and Presentations

This article will review lessons learned from a community-based participatory research project with Latino and Somali residents in Portland, Oregon. The aim of the Healthy Futures Collaborative (HFC) project was to reduce in-home environmental health hazards associated with childhood respiratory illness and asthma through a process that strengthened social support and civic engagement. Using a community-based approach, the HFC trained community residents as community scientists to ensure local leadership and participation. Results suggest an increase in Somali and Latino residents' knowledge of environmental stressors and changes in behavior that may improve indoor environmental quality. Especially when working with historically marginalized …

Interpretations Of Interpretations: Combining Community-Based Participatory Research And Interpretive Inquiry To Improve Health, Jessica Gregg, Lourdes Centurion, Julio Maldonado, Raquel Aguillon, Rosemary Carmela Celaya-Alston, Stephanie Farquhar

Community Health Faculty Publications and Presentations

Background: Latina immigrants from Mexico suffer significantly increased morbidity and mortality from cervical cancer when compared with non-Hispanic White women, largely owing to lack of screening and appropriate treatment. Objectives: To demonstrate that by combining the tools of community-based participatory research (CBPR) with the tools of interpretive inquiry, it is possible to address explicit community concerns surrounding a particular problem such as cervical cancer while also examining what other, perhaps less immediately visible, matters consume the time and attention of community members. Methods: We first briefly discuss and compare CBPR as an approach to research and interpretive inquiry as a …

Exploring The Sensitivity Of Horn's Parallel Analysis To The Distributional Form Of Random Data, Alexis Dinno

Community Health Faculty Publications and Presentations

Horn's parallel analysis (PA) is the method of consensus in the literature on empirical methods for deciding how many components/factors to retain. Different authors have proposed various implementations of PA. Horn's seminal 1965 article, a 1996 article by Thompson and Daniel, and a 2004 article by Hayton et al., all make assertions about the requisite distributional forms of the random data generated for use in PA. Readily available software is used to test whether the results of PA are sensitive to several distributional prescriptions in the literature regarding the rank, normality, mean, variance, and range of simulated data on a …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith M. Williams, Carlos J. Crespo, Joan Dorn

Community Health Faculty Publications and Presentations

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Occupational Health And Safety Status Of Indigenous And Latino Farmworkers In Oregon, Stephanie Farquhar, Nancy M. Goff, Nargess Shadbeh, Julie Samples, Santiago Ventura, Valentin Sanchez, Pamela Rao, Shelley Davis

Community Health Faculty Publications and Presentations

Exposure to pesticides poses great risk to agricultural workers and their families. Of the approximately 174,000 agricultural workers in Oregon, studies estimate that up to 40% of the workers in Oregon are indigenous and may be particularly vulnerable to the health risks of working in pesticide treated areas. Surveys conducted with Oregon farmworkers suggest that Latino and indigenous farmworkers differ demographically and may have diverse occupational and health needs. All Latino workers reported Spanish as their native language, while indigenous workers spoke several different native languages. Latino workers were employed mostly in orchards (28%) and nurseries (24%), while indigenous workers …

Tobacco Control Polices Are Egalitarian: A Vulnerabilities Perspective On Clean Indoor Air Laws, Cigarette Prices, And Tobacco Use Disparities, Alexis Dinno, Stanton Glantz

Community Health Faculty Publications and Presentations

This study models independent associations of state or local strong clean indoor air laws and cigarette prices with current smoker status and consumption in a multilevel framework, including interactions with educational attainment, household income and race/ethnicity and the relationships of these policies to vulnerabilities in smoking behavior. Cross sectional survey data are employed from the February 2002 panel of the Tobacco Use Supplement of the Current Population Survey (54,024 individuals representing the US population aged 15 to 80). Nonlinear relationships between both outcome variables and the predictors were modeled. Independent associations of strong clean indoor air laws were found for …

Coffee Intake And Risk Of Incident Diabetes In Puerto Rican Men: Results From The Puerto Rico Heart Health Program, Barbara J. Fuhrman, Ellen Smit, Carlos J. Crespo, Mario R. Garcia-Palmieri

Community Health Faculty Publications and Presentations

Objective: To study prospectively the association of coffee intake with incident diabetes in the Puerto Rico Heart Health Program cohort, comprising 9824 middle-aged men (aged 35-79 years). Methods: Of 9824 men, 3869 did not provide a fasting blood sample at baseline, 1095 had prevalent diabetes and 131 were not given fasting glucose tests at any subsequent study visit. Thus, the present analysis includes 4685 participants. Diabetes was ascertained at baseline and at two study visits between 1968 and 1975 using fasting glucose tests and self-reports of physician-diagnosed diabetes or use of insulin or hypoglycaemic medication. Logistic regression analysis was used …

"Sitting In Different Chairs:" Roles Of The Community Health Workers In The Poder Es Salud/Power For Health Project, Stephanie Farquhar, Noelle Wiggins, Yvonne L. Michael, G. Luhr, Jennifer Jordon, A. Lopez

Community Health Faculty Publications and Presentations

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Methods: Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs …

Effect Of The California Tobacco Control Program On Personal Health Care Expenditures, James M. Lightwood, Alexis Dinno, Stanton A. Glantz

Community Health Faculty Publications and Presentations

Background: Large state tobacco control programs have been shown to reduce smoking and would be expected to affect health care costs. We investigate the effect of California's large-scale tobacco control program on aggregate personal health care expenditures in the state. Methods and Findings: Cointegrating regressions were used to predict (1) the difference in per capita cigarette consumption between California and 38 control states as a function of the difference in cumulative expenditures of the California and control state tobacco control programs, and (2) the relationship between the difference in cigarette consumption and the difference in per capita personal health expenditures …

Physical Activity And Prostate Cancer Mortality In Puerto Rican Men, Carlos J. Crespo, Mario R. Garcia-Palmieri, Ellen Smit, I-Min Lee, Daniel Lee Mcgee, Paola Muti, Nayda R. Figueroa Valle, Farah A. Ramirez-Marrero, Jo L. Freudenheim, Paul Sorlie

Community Health Faculty Publications and Presentations

Studies on the association between physical activity and fatal prostate cancer have produced inconclusive results. The Puerto Rico Heart Health Program was a cohort study of a randomly selected sample of 9824 men age 35 to 79 years at baseline who were followed for mortality until 2002. Multiple examinations collected information on lifestyle, diet, body composition, exercise, urban-rural residence, and smoking habits. Physical activity status was measured using the Framingham Physical Activity Index, an assessment of occupational, leisure-time, and other physical activities measured as usual activity over the course of a 24-hour day. Physical activity was strati- fied into quartiles. …

Where's The Kale? Environmental Availability Of Fruits And Vegetables In Two Racially Dissimilar Communities, Edith M. Williams, Bamidele O. Tayo, Beverly Marie Mclean, Ellen Smit, Christopher T. Sempos, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Minority communities across the United States have limited numbers of stores that offer a variety of fruits and vegetables, creating major barriers to good eating habits and nutritional practices among minority groups such as African Americans. Factors like environmental availability of healthy food options have not been fully investigated as possible sources of current cross-population differences in disease. The present study examined whether a predominantly African American neighborhood had disproportionately less availability of fruits and vegetables than a predominantly non-Hispanic White neighborhood. Availability was judged on the bases of the types of stores available in each community and the specific …

Loop Analysis Of Causal Feedback In Epidemiology: An Illustration Relating To Urban Neighborhoods And Resident Depressive Experiences, Alexis Dinno

Community Health Faculty Publications and Presentations

The causal feedback implied by urban neighborhood conditions that shape human health experiences, that in turn shape neighborhood conditions through a complex causal web, raises a challenge for traditional epidemiological causal analyses. This article introduces the loop analysis method, and builds off of a core loop model linking neighborhood property vacancy rate, resident depressive symptoms, rate of neighborhood death, and rate of neighborhood exit in a feedback network. I justify and apply loop analysis to the specific example of depressive symptoms and abandoned urban residential property to show how inquiries into the behavior of causal systems can answer different kinds …

Building Community Research Capacity: Process Evaluation Of Community Training And Education In A Community-Based Participatory Research Program Serving A Predominately Puerto Rican Community, Laurene M. Tumiel-Berhalter, Victoria Mclaughlin-Diaz, John Vena, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: Education and training build community research capacity and have impact on improvements of health outcomes.

Objectives: This manuscript describes the training and educational approaches to building research capacity that were utilized in a community-based participatory research program serving a Puerto Rican population and identifies barriers and strategies for overcoming them.

Methods: A process evaluation identified a multitiered approach to training and education that was critical to reaching the broad community.

Results: This approach included four major categories providing a continuum of education and training opportunities: networking, methods training, on-the-job experience, and community education. Participation in these opportunities supported the …