Medicine and Health Sciences Commons^™

A Comparison Of The Wellbeing Of Orphans And Abandoned Children Ages 6–12 In Institutional And Community-Based Care Settings In 5 Less Wealthy Nations, Kathryn Whetten, Jan Ostermann, Rachel A. Whetten, Brian W. Pence, Karen O'Donnell, Lynne C. Messer, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background

Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6–12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests.

Methodology

The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 …

Prospective Associations Between Objective Measures Of Physical Activity And Fat Mass In 12-14 Year Old Children: The Avon Longitudinal Study Of Parents And Children (Alspac), Chris J. Riddoch, Sam D. Leary, Andy R. Ness, Steven N. Blair, Kevin Deere, Calum Mattocks, Alex Griffiths, George Davey Smith, Kate Tilling

Faculty Publications

Objective: To investigate associations between physical activity at age 12 and subsequent adiposity at age 14.

Design: Prospective birth cohort study with data collected between 2003 and 2007.

Setting: Original recruitment in 1991-2 of 14,541 pregnant women living in the former County of Avon (United Kingdom).

Participants: At age 12, 11,952 children were invited to attend the research clinic. Of these, 7159 attended, and 4150 (1964 boys, 2186 girls) provided sufficient data on exposure, outcome, and confounding variables.

Main outcome measure: Fat mass at age 14, measured by dual emission x ray absorptiometry, associated with physical activity at age 12, …

A National Physical Activity Plan For The United States, Russell R. Pate

Faculty Publications

No abstract provided.

A Review Of The National Physical Activity Plans Of Six Countries, Daniel B. Bornstein, Russell R. Pate, Michael Pratt

Faculty Publications

Background: Architects of the United States national physical activity plan can benefit from a thorough understanding of national physical activity plans from other nations. The purpose of this paper was to search for and analyze comprehensive national physical activity plan documents that can best inform the development of the U.S. plan. Methods: Electronic databases were searched for national physical activity plan documents, yielding 252 documents from 56 countries. After eliminating documents that were not written in English, did not address physical activity primarily, and did not meet our definition of a national physical activity plan, we were left with physical …

A Cost Analysis Of A Physical Activity Intervention For Older Adults, Erik J. Groessl, Robert M. Kaplan, Steven N. Blair, W. Jack Rejeski, Jeffrey A. Katula, Abby C. King, Roger A. Fielding, Nancy W. Glynn, Marco Pahor

Faculty Publications

We examined the costs of a physical activity (PA) and an educational comparison intervention. 424 older adults at risk for mobility disability were randomly assigned to either condition. The PA program consisted of center-based exercise sessions 3x weekly for 8 weeks, 2x weekly for weeks 9 to 24 and weekly behavioral counseling for 10 weeks. Optional sessions were offered during maintenance weeks (25-52). The comparison intervention consisted of weekly education meetings for 24 weeks, and then monthly for 6 months. Cost analyses were conducted from the "payer's" perspective, with a 1-year time horizon. Intervention costs were estimated by tracking personnel …

Role Of Lifestyle And Aging On The Longitudinal Change In Cardiorespiratory Fitness, Andrew S. Jackson, Xuemei Sui, James R. Hébert, Timothy S. Church, Steven N. Blair

Faculty Publications

Background - Cardiorespiratory fitness (CRF) in adults decreases with age and is influenced by lifestyle. Low CRF is associated with risk of diseases and the ability of older persons to function independently. We defined the longitudinal rate of CRF decline with aging and the association of aging and lifestyle with CRF.

Methods - We studied a cohort of 3429 women and 16,889 men, aged 20 to 96 years, from the Aerobics Center Longitudinal Study who completed 2 to 33 health examinations from 1974 to 2006. The lifestyle variables were body mass index, self-reported aerobic exercise, and smoking behavior. Cardiorespiratory fitness …

Quality Health Information On The Internet: Developing A Diabetes Pathfinder For The Chinese Population, Ana D. Cleveland, Jodi Philbrick, Xuequn Pan, Xinyu Yu, Jiangping Chen, Marty O'Neill, Lisa Smith

Faculty Publications

A Web-based bilingual diabetes information pathfinder was created to help the Chinese population access quality health information on the Internet as part of a collaborative outreach project in the Dallas-Fort Worth area. A survey was conducted to identify the demographics, Internet usage, health information needs, and preferences for training sessions of the Chinese population. Breast cancer, diabetes, and hepatitis B were the top three diseases of interest. The process of developing the pathfinder is described from start to finish, and it can serve as a model for the development of others. Pathfinder training sessions also were held. Taylor & Francis …

Sedentary Behavior And Obesity In A Large Cohort Of Children, Jonathan A. Mitchell, Calum Mattocks, Andy R. Ness, Sam D. Leary, Russell R. Pate, Marsha Dowda, Steven N. Blair, Chris Riddoch

Faculty Publications

The purpose of this study was to examine the association between sedentary behavior and obesity among 12-year-old children, while adjusting for moderate-to-vigorous physical activity (MVPA) and other potential confounding variables.

Cross-sectional analyses were carried out with data from 5434 children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Fat mass was derived using dual x-ray emission absorptiometry (DXA), and height and weight measurements were used to calculate body mass index (BMI; kg/m²). The children wore an accelerometer for seven days. The cut points for sedentary behavior and MVPA were ≤199 cpm and ≥3600 cpm, …

Association Between Community Health Center And Rural Health Clinic Presence And County-Level Hospitalization Rates For Ambulatory Care Sensitive Conditions: An Analysis Across Eight Us States, Janice C. Probst, James N. Laditka, Sarah B. Laditka

Faculty Publications

Background: Federally qualified community health centers (CHCs) and rural health clinics (RHCs) are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS) conditions.

Methods: We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties). …

Food Insecurity Among Homeless And Marginally Housed Individuals Living With Hiv/Aids In San Francisco, Sheri D. Weiser, David R. Bangsberg, Susan Kegeles, Kathleen Ragland, Margot B. Kushel, Edward A. Frongillo Jr.

Faculty Publications

Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of …

Reasons Why Women Do Not Initiate Breastfeeding: A Southeastern State Study, Chinelo A. Ogbuanu, Janice C. Probst, Sarah B. Laditka, Jihong Liu, Jongdeuk Baek, Saundra Glover

Faculty Publications

Purpose - Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women's self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics.

Methods - Data are from the 2000-2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n = 2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the χ^{2 …}

Carbohydrate Intake And Overweight And Obesity Among Healthy Adults, Anwar T. Merchant, Hassanali Vatanparast, Shahzaib Barlas, Mahshid Dehghan, Syed Mahboob Ali Shah, Lawrence De Koning, Susan E. Steck

Faculty Publications

Background - Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective - To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults

Design - We used a cross-sectional analysis

Subjects/setting - The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures - Outcome variables were body mass index (BMI; calculated as kg/m^{2 …}

Mapping Cancer Mortality-To-Incidence Ratios To Illustrate Racial And Sex Disparities In A High-Risk Population, James R. Hébert, Virginie Daguise, Deborah M. Hurley, Rebecca C. Wilkerson, Catishia M. Mosley, Swann Arp Adams, Robin C. Puett, James B. Burch, Susan E. Steck, Susan Bolick-Aldrich

Faculty Publications

Background - Comparisons of incidence and mortality rates are the metrics used most commonly to define cancer-related racial disparities. In the US, and particularly in South Carolina, these largely disfavor African Americans (AAs). Computed from readily available data sources, the mortality-to-incidence rate ratio (MIR) provides a population-based indicator of survival.

Methods - South Carolina Central Cancer Registry incidence data and Vital Registry death data were used to construct MIRs. ArcGIS 9.2 mapping software was used to map cancer MIRs by sex and race for 8 Health Regions within South Carolina for all cancers combined and for breast, cervical, colorectal, lung, …

Association Between Plasma 25-Hydroxyvitamin D And Breast Cancer Risk, Katherine D. Crew, Marilie D. Gammon, Susan E. Steck, Dawn L. Hershman, Serge Cremers, Elzbieta Dworakowski, Elizabeth Shane, Mary Beth Terry, Manisha Desai, Susan L. Teitelbaum, Alfred I. Neugut, Regina M. Santella

Faculty Publications

Vitamin D has been associated with decreased risk of several cancers. In experimental studies, vitamin D has been shown to inhibit cell proliferation and induce differentiation and apoptosis in normal and malignant breast cells. Using a population-based case-control study on Long Island, New York, we examined the association of breast cancer with plasma 25-hydroxyvitamin D (25-OHD) levels, a measure of vitamin D body stores. In-person interviews and blood specimens were obtained from 1,026 incident breast cancer cases diagnosed in 1996 to 1997 and 1,075 population-based controls. Plasma 25-OHD was measured in batched, archived specimens by Diasorin RIA. The mean (SD) …

Employed Parents' Satisfaction With Food Choice Coping Strategies: Influence Of Gender And Structure, Christine E. Blake, Carol M. Devine, Elaine Wethington, Margaret M. Jastran, Tracy J. Farrell, Carole A. Bisogni

Faculty Publications

This study aimed to understand parents' evaluations of the way they integrated work-family demands to manage food and eating. Employed, low/moderate-income, urban, U.S., Black, White, and Latino mothers (35) and fathers (34) participated in qualitative interviews exploring work and family conditions and spillover, food roles, and food-choice coping and family-adaptive strategies. Parents expressed a range of evaluations from overall satisfaction to overall dissatisfaction as well as dissatisfaction limited to work, family life, or daily schedule. Evaluation criteria differed by gender. Mothers evaluated satisfaction on their ability to balance work and family demands through flexible home and work conditions, while striving …

Associations Between Cardiorespiratory Fitness And Health-Related Quality Of Life, Robert A. Sloan, Susumu S. Sawada, Corby K. Martin, Timothy S. Church, Steven N. Blair

Faculty Publications

Background: There is limited data examining the association between cardiorespiratory fitness (CRF) and health related quality of life (HRQOL) in healthy young adults. We examined the association between CRF and HRQOL Physical Component Summary (PCS) and Mental Component Summary (MCS) scores in apparently health males in the United States Navy.

Methods: A total of 709 males (18-49 yr) performed a submaximal exercise test and HRQOL assessment (SF-12v2^TM) between 2004-2006. CRF level was classified into fourths depending on age distribution with the lowest fitness quartile serving as the referent group. PCS and MCS scores ≥ 50 were defined as …

Can We Apply The Mendelian Randomization Methodology Without Considering Epigenetic Effects?, Ikechkwu U. Ogbuanu, Hongmei Zhang, Wilfried J. Karmaus

Faculty Publications

Introduction: Instrumental variable (IV) methods have been used in econometrics for several decades now, but have only recently been introduced into the epidemiologic research frameworks. Similarly, Mendelian randomization studies, which use the IV methodology for analysis and inference in epidemiology, were introduced into the epidemiologist's toolbox only in the last decade.

Analysis: Mendelian randomization studies using instrumental variables (IVs) have the potential to avoid some of the limitations of observational epidemiology (confounding, reverse causality, regression dilution bias) for making causal inferences. Certain limitations of randomized controlled trials, such as problems with generalizability, feasibility and ethics for some exposures, and high …

Factors Related To Objectively Measured Physical Activity In Preschool Children, Karin A. Pfeiffer, Marsha Dowda, Kerry L. Mciver, Russell R. Pate

Faculty Publications

This study examined correlates of objectively measured physical activity (PA) in a diverse sample of preschool children (age 3-5 years; n=331). Accelerometer min∙hr^-1 of moderate-to-vigorous physical activity (MVPA) and nonsedentary activity (NSA) were the outcome measures. Correlations among potential correlates and PA ranged from r=-0.12-0.26. Correlates in the final MVPA model were age, race, sex, BMI Z score, and parent perception of athletic competence, explaining 37% of the variance. The NSA model included the latter two variables, explaining 35% of the variance. Demographic factors were correlates of PA; parent perceptions of children's competence may be important regarding …

Eligibility, Recruitment, And Retention Of African Americans With Severe Mental Illness In Community Research, Michelle Hampton, Mary White, Linda Chafetz

Faculty Publications

Data that addresses severely mentally ill (SMI) African Americans (AAs) likelihood to participate in clinical research is limited. This study’s purpose was to determine if differences exist between races regarding eligibility, recruitment, and retention in a community-based clinical trial. The sample included 293 participants. Data sources included clinical records and interviews. Logistic regression was used for analysis. AAs were as likely to participate and to complete followup interviews as Whites. In contrast to studies about non-mentally ill AAs, AAs with SMI appeared to be as willing to consent to and to remain in clinical research studies as Whites.

Interdisciplinary, Translational, And Community-Based Participatory Research: Finding A Common Language To Improve Cancer Research, James R. Hébert, Heather M. Brandt, Cheryl A. Armstead, Swann Arp Adams, Susan E. Steck

Faculty Publications

Preventing cancer, downstaging disease at diagnosis, and reducing mortality require that relevant research findings be translated across scientific disciplines and into clinical and public health practice. Interdisciplinary research focuses on using the languages of different scientific disciplines to share techniques and philosophical perspectives to enhance discovery and development of innovations; (i.e., from the “left end” of the research continuum). Community-based participatory research (CBPR), whose relevance often is relegated to the “right end” (i.e., delivery and dissemination) of the research continuum, represents an important means for understanding how many cancers are caused as well as for ensuring that basic science research …

Cardiorespiratory Fitness And Digestive Cancer Mortality: Findings From The Aerobics Center Longitudinal Study (Acls), J. Brent Peel, Xuemei Sui, Charles E. Matthews, Swann Arp Adams, James R. Hébert, James W. Hardin, Timothy S. Church, Steven N. Blair

Faculty Publications

Although higher levels of physical activity are inversely associated with risk of colon cancer, few prospective studies have evaluated overall digestive system cancer mortality in relation to cardiorespiratory fitness (CRF). The authors examined this association among 38,801 men aged 20−88 years and who performed a maximal treadmill exercise test at baseline in the Aerobics Center Longitudinal Study (Dallas, Texas) during 1974−2003. Mortality was assessed over 29 years of follow-up (1974−2003). 283 digestive system cancer deaths occurred during a mean 17-year of observation. Age-adjusted mortality rates per 10,000 person-yrs according to low, moderate, and high CRF groups were 6.8, 4.0, and …

Soil Zinc Content, Groundwater Usage, And Prostate Cancer Incidence In South Carolina, Sara E. Wagner, James B. Burch, Jim Hussey, Tom Temples, Susan Bolick-Aldrich, Catishia Mosley-Broughton, Yuan Liu, James R. Hébert

Faculty Publications

Background

Prostate cancer (PrCA) incidence in South Carolina (SC) exceeds the national average, particularly among African Americans (AAs). Though data are limited, low environmental zinc exposures and down-regulation of prostatic zinc transporter proteins among AAs may explain, in part, the racial PrCA disparity.

Methods

Age-adjusted PrCA rates were calculated by census tract. Demographic data were obtained from the 1990 census. Hazardous waste site locations and soil zinc concentrations were obtained from existing federal and state databases. A geographic information system and Poisson regression were used to test the hypothesis that census tracts with reduced soil zinc concentrations, elevated groundwater use, …

Gst Polymorphism And Excretion Of Heterocyclic Aromatic Amine And Isothiocyanate Metabolites After Brassica Consumption, Susan E. Steck, James R. Hébert

Faculty Publications

Brassica vegetable intake has been associated with decreased risk and well-done meat intake has been associated with increased risk of cancers at multiple organ sites in epidemiologic studies. Experimental studies suggest a role of modulation of phase I and phase II metabolizing enzymes as one mechanism for these associations. Heterocyclic aromatic amines (HAAs) are carcinogens formed in meat that has been cooked to well-done and at high temperatures. Phase I metabolizing enzymes catalyze the activation of HAAs, and phase II metabolizing enzymes serve to detoxify the active carcinogens. The glutathione S-transferase (GSTs) are a family of phase II metabolizing enzymes …

Pah-Dna Adducts, Cigarette Smoking, Gst Polymorphisms, And Breast Cancer Risk, Kathleen M. Mccarty, Regina M. Santella, Susan E. Steck, Rebecca J. Cleveland, Jiyoung Ahn, Christine B. Ambrosone, Kari North, Sharon K. Sagiv, Sybil M. Eng, Susan L. Teitelbaum, Alfred I. Neugut, Marilie D. Gammon

Faculty Publications

BACKGROUND: Polycyclic aromatic hydrocarbon (PAHs) may increase breast cancer risk, and the association may be modified by inherited differences in deactivation of PAH intermediates by glutathione S-transferases (GSTs). Few breast cancer studies have investigated the joint effects of multiple GSTs and a PAH biomarker.

OBJECTIVE: We estimated the breast cancer risk associated with multiple polymorphisms in the GST gene (GSTA1, GSTM1, GSTP1, and GSTT1) and the interaction with PAH-DNA adducts and cigarette smoke.

METHODS: We conducted unconditional logistic regression using data from a population-based sample of women (cases/controls, respectively): GST polymorphisms were genotyped using …

Adult And Child Semantic Neighbors Of The Kroll And Potter (1984) Nonobjects, Holly L. Storkel, Suzanne M. Adlof

Faculty Publications

Purpose - The purpose was to determine the number of semantic neighbors, namely semantic set size, for 88 nonobjects (J. F. Kroll & M. C. Potter, 1984) and determine how semantic set size related to other measures and age.

Method - Data were collected from 82 adults and 92 preschool children in a discrete association task. The nonobjects were presented via computer, and participants reported the first word that came to mind that was meaningfully related to the nonobject. Words reported by two or more participants were considered semantic neighbors. The strength of each neighbor was computed as the …

The Effect Of Semantic Set Size On Word Learning By Preschool Children, Holly L. Storkel, Suzanne M. Adlof

Faculty Publications

Purpose - The purpose was to determine whether semantic set size, a measure of the number of semantic neighbors, influenced word learning, and whether the influence of semantic set size was broad, showing effects on multiple measures both during and after learning.

Method - Thirty-six preschool children were exposed to 10 nonobjects, varying in semantic set size, paired with 10 nonwords, controlling phonotactic probability and neighborhood density. Nonobject-nonword pairs were presented in a game format. Learning was measured in naming and referent identification tasks administered before, during, and 1 week after training.

Results - Results showed no differences in naming …

A Human Capital Approach To Reduce Health Disparities, Saundra H. Glover, Sudha Xirasagar, Yunho Jeon, Keith T. Elder, Crystal N. Piper, Harris Pastides

Faculty Publications

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research.

Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), …

The Dynamics Of Income And Neighborhood Context For Population Health: Do Long Term Measures Of Socioeconomic Status Explain More Of The Black/White Health Disparity Than Single-Point-In-Time Measures?, D. Phuong Do

Faculty Publications

Socioeconomic status, though a robust and strong predictor of health, has generally been unable to fully explain the health gap between blacks and whites in the Untied States. However, at both the individual and neighborhood levels, socioeconomic status is often treated as a static factor with only single-point-in-time measurements. These cross-sectional measures fail to account for possible heterogeneous histories within groups who may share similar characteristics at a given point in time. As such, ignoring the dynamic nature of socioeconomic status may lead to the underestimation of its importance in explaining health and racial health disparities.

In this study, I …

Religion And Hiv In Tanzania: Influence Of Religious Beliefs On Hiv Stigma, Disclosure, And Treatment Attitudes, James Zou, Yvonne Yamanaka, Muze John, Melissa Watt, Jan Ostermann, Nathan Thielman

Faculty Publications

Background

Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment.

Methods

A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and …

Age-Related Change In Physical Activity In Adolescent Girls, Russell R. Pate, June Stevens, Larry S. Webber, Marsha Dowda, David M. Murray, Deborah R. Young, Scott Going

Faculty Publications

Purpose - To determine the annual rate at which physical activity changes in girls during middle school using both objective and self-report measures of physical activity.

Methods - Participants were 6^th and 8^th grade girls from the control schools in the Trial of Activity for Adolescent Girls (TAAG). Random cross-sectional samples initially were drawn from 6^th grade girls (n=786) and two years later from 8^th grade girls (n=1545). A cohort of 501 girls was in both the 6^th and 8^th grade samples. The girls wore an accelerometer for six days and completed the 3-Day …