Medicine and Health Sciences Commons^™

The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups, Jan M. Eberth, Pelvin Hung, Gabriel A. Benavidez, Janice Probst, Whitney E. Zahnd, Mary-Katherine Mcnatt, Ebony Toussaint, Melinda A. Merrell, Elizabeth L. Crouch

Faculty Publications

Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation. The opposite was true for urban ZCTAs, with high White ZCTAs being …

The Individual Water Insecurity Experiences (Iwise) Scale: Reliability, Equivalence And Validity Of An Individual-Level Measure Of Water Security, Sera L. Young, Hilary J. Bethancourt, Zacchary R. Ritter, Edward A. Frongillo Jr.

Faculty Publications

Objective: The lack of a validated and cross-culturally equivalent scale for measuring individual-level water insecurity has prevented identification of those most vulnerable to it. Therefore, we developed the 12-item Individual Water InSecurity Experiences (IWISE) Scale to comparably measure individual experiences with access, use, and stability (reliability) of water. Here, we examine the reliability, cross-country equivalence, and cross-country and within-country validity of the scale in a cross-sectional sample.

Methods: IWISE items were implemented by the Gallup World Poll among nationally representative samples of 43 970 adults (15 y) in 31 low-income and middle-income countries (LMICs). Internal consistency was assessed …

Activist Framing Of Abortion And Use For Policy Change In Peru, Cynthia Beavin, Deborah L. Billings, Susana Chávez

Faculty Publications

Identifying how activists frame the topic of abortion is key to unpacking their understanding of “abortion” in Peru. It is important to explore how and why certain frames are privileged in attempts to shift policy and social norms. In 2016, the authors conducted qualitative interviews with 10 activists in Lima, Peru to develop a deep understanding of these issues. Activists worked through different approaches and lenses, including law, medicine, sociology, psychiatry, journalism, non-governmental organisational management, LGBTQ rights, and indigenous rights. Four common frames emerged through the analysis and those frames shifted based on whether activists were speaking to the general …

Liberty Without Capacity: Why States Should Ban Adolescent Driving, Vivian E. Hamilton

Faculty Publications

No abstract provided.

Family-Focused Physical Activity, Diet, And Obesity Interventions In African-American Girls: A Systematic Review, Daheia J. Barr-Anderson, Alexis W. Adams-Wynn, Katherine I. Disantis, Shiriki Kumanyika

Faculty Publications

Obesity interventions that involve family members may be effective with racial/ethnic minority youth. This review assessed the nature and effectiveness of family involvement in obesity interventions among African-American girls aged 5-18 years, a population group with high rates of obesity. Twenty-six databases were searched between January 2011 and March 2012, yielding 27 obesity pilot or full-length prevention or treatment studies with some degree of family involvement and data specific to African-American girls. Interventions varied in type and level of family involvement, cultural adaptation, delivery format, and behavior change intervention strategies; most targeted parent-child dyads. Some similarities in approach based on …

The Children And Parents In Focus Project: A Population-Based Cluster-Randomised Controlled Trial To Prevent Behavioural And Emotional Problems In Children, R. Salari, H. Fabian, Ron Prinz, S. Lucas, I. Feldman, Amanda Fairchild, A. Sarkadi

Faculty Publications

Background: There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context. Methods/Design: The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in …

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

Faculty Publications

No abstract provided.

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, …

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 …

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 …

Adverse Metabolic Response To Regular Exercise: Is It A Rare Or Common Occurrence?, Claude Bouchard, Steven N. Blair, Timothy S. Church, Conrad P. Earnest, James M. Hagberg, Keijo Häkkinen, Nathan T. Jenkins, Laura Karavirta, William E. Kraus, Dabeeru C. Rao, Mark A. Sarzynski, James S. Skinner, Cris A. Slentz, Tuomo Rankinen

Faculty Publications

Background: Individuals differ in the response to regular exercise. Whether there are people who experience adverse changes in cardiovascular and diabetes risk factors has never been addressed.

Methodology/Principle Findings: An adverse response is defined as an exercise-induced change that worsens a risk factor beyond measurement error and expected day-to-day variation. Sixty subjects were measured three times over a period of three weeks, and variation in resting systolic blood pressure (SBP) and in fasting plasma HDL-cholesterol (HDL-C), triglycerides (TG), in insulin (FI) was quantified. The technical error (TE) defined as the within-subject standard deviation derived from these measurements was computed. An …

A School-Based, Peer Leadership Physical Activity Intervention For 6th Graders: Feasibility And Results Of A Pilot Study, Daheia J. Barr-Anderson, Melissa N. Laska, Sara Veblen-Mortenson, Kian Farbakhsh, Bonnie Dudovitz, Mary Story

Faculty Publications

Background: The aim of this study was to promote physical activity in 6th graders by developing and testing the feasibility of an enhanced Presidential Active Lifestyle Award (PALA) program comprised of a peer leadership component and innovative exercise resource toolkit including DVDs. Methods: A racially/ethnically diverse sample of students received the standard PALA program (2 control schools, n = 61) or enhanced PALA+Peers program (2 intervention schools, n = 87) during 2006-2007 academic year. Results: Compared with the control condition, the intervention was successful in increasing moderate physical activity in all students (P = .02) and …

Longitudinal Changes In Body Composition Associated With Healthy Ageing: Men, Aged 20-96 Years, Andrew S. Jackson, Ian Janssen, Xuemei Sui, Timothy S. Church, Steven N. Blair

Faculty Publications

Obesity and sarcopenia are health problems associated with ageing. The present study modelled the longitudinal changes in body composition of healthy men, aged from 20 to 96 years, and evaluated the fidelity of BMI to identify age-dependent changes in fat mass and fat-free mass. The data from 7265 men with multiple body composition determinations (total observations 38,328) were used to model the age-related changes in body mass, fat mass, fat-free mass, BMI and percentage of body fat. Changes in fat mass and fat-free mass were used to evaluate the fidelity of BMI and to detect body composition changes with ageing. …

Heart Rate Variability And Exercise In Aging Women, Conrad P. Earnest, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Our group has shown a positive dose-response in maximal cardiorespiratory exercise capacity (VO_2max) and heart rate variability (HRV) to 6 months of exercise training but no improvement in VO_2max for women ≥60 years. Here, we examine the HRV response to exercise training in postmenopausal women younger and older than 60 years.

Methods: We examined 365 sedentary, overweight, hypertensive, postmenopausal women randomly assigned to sedentary control or exercise groups exercising at 50% (4 kcal/kg/week, [KKW]), 100% (8 KKW) and 150% (12 KKW) of the National Institute of Health (NIH) Consensus Development Panel physical activity guidelines. Primary outcomes …

School Racial Composition And Race/Ethnic Differences In Early Adulthood Health, Bridget J. Goosby, Katrina M. Walsemann

Faculty Publications

We investigate whether school racial composition is associated with racial and ethnic differences in early adult health. We then examine whether perceived discrimination, social connectedness, and parent support attenuates this relationship. Using U.S. data from Wave I and IV of the National Longitudinal Survey of Adolescent Health, we found that black adolescents attending predominantly white schools reported poorer adult health while Asians reported better health. Further research is warranted to understand whether there are qualitative differences in the treatment of racial and ethnic minorities within certain school contexts and how that differential treatment is related to adult health outcomes.

Effect Of Different Doses Of Aerobic Exercise On Total White Blood Cell (Wbc) And Wbc Subfraction Number In Postmenopausal Women: Results From Drew, Neil M. Johannsen, Damon L. Swift, William D. Johnson, Vishwa D. Dixit, Conrad P. Earnest, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Elevated total white blood cell (WBC) count is associated with an increased risk of coronary heart disease and death. Aerobic exercise is associated with lower total WBC, neutrophil, and monocyte counts. However, no studies have evaluated the effect of the amount of aerobic exercise (dose) on total WBC and WBC subfraction counts.

Purpose: To examine the effects of 3 different doses of aerobic exercise on changes in total WBC and WBC subfraction counts and independent effects of changes in fitness, adiposity, makers of inflammation (IL-6, TNF-α, C-reactive protein), fasting glucose metabolism, and adiponectin.

Methods: Data from 390 sedentary, overweight/obese …

Comparing The Validity Of 2 Physical Activity Questionnaire Formats In African-American And Hispanic Women, Louise C. Mâsse, Janet E. Fulton, Kathleen B. Watson, Susan Tortolero, Harold W. Kohl Iii, Michael C. Meyers, Steven N. Blair, William W. Wong

Faculty Publications

Background: The purpose of this study was to compare the validity of 2 physical activity questionnaire formats - one that lists activities (Checklist questionnaire) and one that assesses overall activities (Global questionnaire) by domain.

Methods: Two questionnaire formats were validated among 260 African-American and Hispanic women (age 40-70) using 3 validation standards: 1) accelerometers to validate activities of ambulation; 2) diaries to validate physical activity domains (occupation, household, exercise, yard, family, volunteer/church work, and transportation); and 3) doubly-labeled water to validate physical activity energy expenditure (DLW-PAEE).

Results: The proportion of total variance explained by the Checklist questionnaire was 38.4% with …

Network Modulation During Complex Syntactic Processing, Dirk B. Den Ouden, Dorothee Saur, Wolfgang Mader, Björn Schelter, Sladjana Lukic, Eisha Wali, Jens Timmer, Cynthia K. Thompson

Faculty Publications

Complex sentence processing is supported by a left-lateralized network including inferior frontal cortex and posterior superior temporal cortex. This study investigates the pattern of connectivity and information flow within this network. We used fMRI BOLD data derived from 12 healthy participants reported in and earlier study (Thompson, C. K., Den Ouden, D. B., Bonakdarpour, B., Garibaldi, K. & Parrish, T. B. (2010b). Neural plasticity and treatment-induced recovery of sentence processing in agrammatism. Neuropsychologia, 48(11), 3211-3227) to identify activation peaks associated with object-cleft over syntactically less complex subject-cleft processing. Directed Partial Correlation Analysis was conducted on time series extracted from …

Long-Term Effects Of Changes In Cardiorespiratory Fitness And Body Mass Index On All-Cause And Cardiovascular Disease Mortality In Men: The Aerobics Center Longitudinal Study, Duck-Chul Lee, Xuemei Sui, Enrique G. Artero, I-Min Lee, Timothy S. Church, Paul A. Mcauley, Fatima C. Stanford, Harold W. Kohl Iii, Steven N. Blair

Faculty Publications

Background - The combined associations of changes in cardiorespiratory fitness and body mass index (BMI) with mortality remain controversial and uncertain.

Methods and Results - We examined the independent and combined associations of changes in fitness and BMI with all-cause and cardiovascular disease (CVD) mortality in 14,345 men (mean age 44 years) with at least 2 medical examinations. Fitness, in metabolic equivalents (METs), was estimated from a maximal treadmill test. BMI was calculated using measured weight and height. Changes in fitness and BMI between the baseline and last examinations over 6.3 years were classified into loss, stable, or gain groups. …

Associations Between Physical Activity And Submaximal Cardiorespiratory And Pulmonary Responses In Men, John C. Sieverdes, Xuemei Sui, Steven N. Blair

Faculty Publications

Background: Habitual physical activity (PA) is associated with higher cardiorespiratory fitness values, but additional information is needed on the contributions of specific types and amounts of PA. Therefore the main aim of this study was to analyze the heart and lung function of a large cohort of men and compare these outcomes with various modes and volumes of PA.

Methods: We used data from 30,594 men from the Aerobics Center Longitudinal Study who were categorized into sedentary, swimmer, walker, and runner groups using self-report PA data collected during 1970-2005. Additional PA categories using MET-minutes/week were used to group men into …

A Randomized Trial Of A Diet And Exercise Intervention For Overweight And Obese Women From Economically Disadvantaged Neighborhoods: Sisters Taking Action For Real Success (Stars), Sarah Wilcox, Patricia A. Sharpe, Deborah Parra-Medina, Michelle L. Granner, Brent E. Hutto

Faculty Publications

Background - Lower socioeconomic status at both the individual and neighborhood level is associated with increased health risks. Weight loss can reduce this risk, but few high quality weight loss studies target this population.

Objectives - STARS tests a culturally-appropriate, group-based behavioral and social support intervention on body weight and waist circumference in women from financially disadvantaged neighborhoods.

Design - A stratified (by BMI) randomized trial. Randomization to group was generated by a random numbers table with allocation concealment by opaque envelopes.

Methods - Participants 25-50 years who had a BMI ≥ 25 kg/m² and a waist circumference ≥ …

Prescribing Exercise In Primary Care: Ten Practical Steps On How To Do It, Karim M. Khan, Richard Weller, Steven N. Blair

Faculty Publications

No abstract provided.

Combined Impact Of Lifestyle Factors On Cancer Mortality In Men, Chong-Do Lee, Xuemei Sui, Steven P. Hooker, James R. Hébert, Steven N. Blair

Faculty Publications

PURPOSE - The impact of lifestyle factors on cancer mortality in the U.S. population has not been thoroughly explored. We examined the combined effects of cardiorespiratory fitness, never smoking, and normal waist girth on total cancer mortality in men.

METHODS - We followed a total of 24,731 men ages 20-82 years who participated in the Aerobics Center Longitudinal Study. A low-risk profile was defined as never smoking, moderate or high fitness, and normal waist girth, and they were further categorized as having 0, 1, 2, or 3 combined low-risk factors.

RESULTS - During an average of 14.5 years of follow-up, …

Effect Of School Racial Composition On Trajectories Of Depressive Symptoms From Adolescence Through Early Adulthood, Katrina M. Walsemann, Bethany A. Bell, Bridget J. Goosby

Faculty Publications

Introduction: We investigate the effect of high school racial composition, measured as percent of non-Hispanic White students, on trajectories of depressive symptoms from adolescence to early adulthood. We also explore whether the effect of school racial composition varies by respondent race/ethnicity and if adult socio-economic status mediates this relationship.

Methods: We analyzed four waves of data from the National Longitudinal Study of Adolescent Health using 3-level linear growth models. We restricted our sample to respondents enrolled in grades 9-12 in 1994/5 who were interviewed at a minimum in Waves I and IV. This resulted in 10,350 respondents enrolled in 80 …

Stimulant Reduction Intervention Using Dosed Exercise (Stride) - Ctn 0037: Study Protocol For A Randomized Controlled Trial, Madhukar H. Trivedi, Tracy L. Greer, Bruce D. Grannemann, Timothy S. Church, Eugene Somoza, Steven N. Blair, Jose Szapocznik, Mark Stoutenberg, Chad Rethorst, Diane Warden, Kolette M. Ring, Robrina Walker, David W. Morris, Andrzej S. Kosinski, Tiffany Kyle, Bess H. Marcus, Becca Crowell, Neal Oden, Edward Nunes

Faculty Publications

Background: There is a need for novel approaches to the treatment of stimulant abuse and dependence. Clinical data examining the use of exercise as a treatment for the abuse of nicotine, alcohol, and other substances suggest that exercise may be a beneficial treatment for stimulant abuse, with direct effects on decreased use and craving. In addition, exercise has the potential to improve other health domains that may be adversely affected by stimulant use or its treatment, such as sleep disturbance, cognitive function, mood, weight gain, quality of life, and anhedonia, since it has been shown to improve many of these …

Associations Of American Indian Children's Screen-Time Behavior With Parental Television Behavior, Parental Perceptions Of Children's Screen Time, And Media-Related Resources In The Home, Daheia J. Barr-Anderson, Jayne A. Fulkerson, Mary Smyth, John H. Himes, Peter J. Hannan, Bonnie Holy Rock, Mary Story

Faculty Publications

Introduction: American Indian children have high rates of overweight and obesity, which may be partially attributable to screen-time behavior. Young children's screen-time behavior is strongly influenced by their environment and their parents' behavior. We explored whether parental television watching time, parental perceptions of children's screen time, and media-related resources in the home are related to scree time (ie, television, DVD/video, video game, and computer use) among Oglala Lakota youth residing on or near the Pine Ridge Reservation in South Dakota.

Methods: We collected baseline data from 431 child and parent/caregiver pairs who participated in Bright Start, a group-randomized, controlled, school-based …

Pathways To Sexual Risk Taking Among Female Adolescent Detainees, Vera Lopez, Albert M. Kopak, Alyssa G. Robillard, Mary Rogers Gillmore, Rhonda Conerly Holliday, Ronald L. Braithwaite

Faculty Publications

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement …

How Many Steps/Day Are Enough? For Children And Adolescents, Catrine Tudor-Locke, Cora L. Craig, Michael W. Beets, Sarahjane Belton, Greet M. Cardon, Scott Duncan, Yoshiro Hatano, David R. Lubans, Timothy S. Olds, Anders Raustorp, David A. Rowe, John C. Spence, Shigeho Tanaka, Steven N. Blair

Faculty Publications

Worldwide, public health physical activity guidelines include special emphasis on populations of children (typically 6-11 years) and adolescents (typically 12-19 years). Existing guidelines are commonly expressed in terms of frequency, time, and intensity of behaviour. However, the simple step output from both accelerometers and pedometers is gaining increased credibility in research and practice as a reasonable approximation of daily ambulatory physical activity volume. Therefore, the purpose of this article is to review existing child and adolescent objectively monitored step-defined physical activity literature to provide researchers, practitioners, and lay people who use accelerometers and pedometers with evidence-based translations of these public …

How Many Steps/Day Are Enough? For Adults, Catrine Tudor-Locke, Cora L. Craig, Wendy J. Brown, Stacy A. Clemes, Katrien Decocker, Billie Giles-Corti, Yoshiro Hatano, Shigeru Inoue, Sandra M. Matsudo, Nanette Mutrie, Jean-Michel Oppert, David A. Rowe, Michael D. Schmidt, Grant M. Schofield, John C. Spence, Pedro J. Teixeira, Mark A. Tully, Steven N. Blair

Faculty Publications

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions and translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognized that "some physical activity is better than none" while maintaining a focus …