Public Health Commons^™

Accelerometry Cut Points For Physical Activity In Underserved African Americans, Nevelyn N. Trumpeter, Hannah G. Lawman, Dawn K. Wilson, Russell R. Pate, M. Lee Van Horn, Alicia K. Tate

Faculty Publications

Background: Despite their increased use, no studies have examined the validity of Actical accelerometry cut points for moderate physical activity (PA) in underserved (low-income, high-crime), minority populations. The high rates of chronic disease and physical inactivity in these populations likely impact the measurement of PA. There is growing concern that traditionally defined cut points may be too high for older or inactive adults. The present study aimed to determine the self-selected pace associated with instructions to "walk for exercise" and the corresponding accelerometry estimates (e.g. Actical counts/minute) for underserved, African American adults.

Method: Fifty one participants (61% women) had a …

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 …

Developing Partnerships And Recruiting Dyads For A Prostate Cancer Informed Decision Making Program: Lessons Learned From A Community-Academic-Clinical Team, Daniela B. Friedman, Kim M. Johnson, Otis L. Owens, Tracey L. Thomas, Delisa S. Dawkins, Lucy Gansauer, Sharon Bartelt, Nancy M. Waddell, Pastor Jacqueline Talley, James D. Bearden Iii, James R. Hébert

Faculty Publications

Prostate cancer (PrCA) is the most commonly diagnosed non-skin cancer among men. PrCA mortality in African-American (AA) men in South Carolina is ~50% higher than for AAs in the U.S as a whole. AA men also have low rates of participation in cancer research. This paper describes partnership development and recruitment efforts of a Community-Academic-Clinical research team for a PrCA education intervention with AA men and women that was designed to address the discordance between high rates of PrCA mortality and limited participation in cancer research. Guided by Vesey's framework on recruitment and retention of minority groups in research, recruitment …

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 …

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 …

Acquisition Of Initial Mental Graphemic Representations By Children At Risk For Literacy Development, Kenn Apel, Shurita Thomas-Tate, Elizabeth B. Wilson-Fowler, Danielle Brimo

Faculty Publications

We examined the acquisition of initial mental graphemic representations (MGRs) by 46 kindergarten children (mean age = 5 years, 9 months) at risk for literacy development because of low socioeconomic status. Using a storybook context, we exposed children to novel nonwords that varied in their phonotactic and orthotactic probabilities and then assessed the children's development of initial MGRs through spelling and reading recognition tasks. The children developed some initial MGRs but less than past reports of children from middle socioeconomic backgrounds. Children with more advanced word recognition abilities developed more initial MGRs than their peers with less advanced word recognition …

Clustering Of Unhealthy Behaviors In The Aerobics Center Longitudinal Study, Mariane Héroux, Ian Janssen, Duck-Chul Lee, Xuemei Sui, James R. Hébert, Steven N. Blair

Faculty Publications

Background

Objectives

Methods

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. …

Detection And Imaging Of The Free Radical Dna In Cells—Site-Specific Radical Formation Induced By Fenton Chemistry And Its Repair In Cellular Dna As Seen By Electron Spin Resonance, Immuno-Spin Trapping And Confocal Microscopy, Suchandra Bhattacharjee, Saurabh Chatterjee, Jinjie Jiang, Birandra K. Sinha, Ronald P. Mason

Faculty Publications

Oxidative stress-related damage to the DNA macromolecule produces lesions that are implicated in various diseases. To understand damage to DNA, it is important to study the free radical reactions causing the damage. Measurement of DNA damage has been a matter of debate as most of the available methods measure the end product of a sequence of events and provide limited information on the initial free radical formation. We report a measurement of free radical damage in DNA induced by a Cu(II)-H2O2 oxidizing system using immuno-spin trapping supplemented with electron paramagnetic resonance. In this investigation, the short-lived radical generated is trapped …

Physical Activity Levels Of Adolescent Girls During Dance Classes, Jennifer R. O'Neill, Russell R. Pate, Michael W. Beets

Faculty Publications

Background: The aims of this study were to describe the physical activity levels of girls during dance classes and to identify factors associated with moderate-to-vigorous physical activity (MVPA) in those classes. Methods: Participants were 137 girls (11 to 18 years-old) enrolled in ballet, jazz, or tap dance classes from 11 dance studios. Participants wore an accelerometer during the selected dance class on 2 separate days. Factors hypothesized to be associated with MVPA were dance style, instructional level, instructor's experience, percent of class time spent in choreography, and participants' age, race/ethnicity, BMI-for-age percentile, and years of dance training. Data were analyzed …

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.

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 …

Evaluation Of Lay Support In Pregnant Women With Social Risk (Elsips): A Randomised Controlled Trial, Sara Kenyon, Kate Jolly, Karla Hemming, Lucy Annang Ingram Phd, Nicola Gale, Sophie-Anna Dann, Jacky Chambers, Christine Macarthur

Faculty Publications

BACKGROUND: Maternal, neonatal and child health outcomes are worse in families from black and ethnic minority groups and disadvantaged backgrounds. There is little evidence on whether lay support improves maternal and infant outcomes among women with complex social needs within a disadvantaged multi-ethnic population in the United Kingdom (UK). METHOD/DESIGN: The aim of this study is to evaluate a lay Pregnancy Outreach Worker (POW) service for nulliparous women identified as having social risk within a maternity service that is systematically assessing social risks alongside the usual obstetric and medical risks. The study design is a randomised controlled trial (RCT) in …

Dog Ownership During Pregnancy, Maternal Activity, And Obesity: A Cross-Sectional Study, Carri Westgarth, Jihong Liu, Jon Heron, Andrew R. Ness, Peter Bundred, Rosalind M. Gaskell, Alexander J. German, Sandra Mccune, Susan Dawson

Faculty Publications

The Avon Longitudinal Study of Parents and Children (ALSPAC) is an observational study of 14273 UK pregnant singleton mothers in 1990/1991. We examined outcomes of self report of strenuous activity (hours per week) at 18 and 32 weeks of gestation, hours spent in leisure-time physical activities and types, and pre-pregnancy body mass index (BMI); overweight status was defined as pre-pregnancy BMI$25 and obesity BMI$30. Pet ownership and activity data were reported for 11,466 mothers. Twenty-five percent of mothers owned at least one dog. There was a positive relationship between participation in activity at least once a week and dog ownership …

The Impact Of A 3-Year After-School Obesity Prevention Program In Elementary School Children, Zenong Yin, Justin B. Moore, Maribeth H. Johnson, Marlo M. Vernon, Bernard Gutin

Faculty Publications

Background: Children tend to be sedentary during the after-school hours, and this has deleterious effects on their health. The objective of the present study was to determine the effects of a 3-year after-school physical activity (PA) program, without restriction of dietary energy intake, on percent body fat (%BF), cardiorespiratory fitness (CRF), and cardiometabolic markers in children.

Methods: A cluster randomization design was employed. A total of 574 3^rd grade children from 18 elementary schools in the south-eastern United States participated. The intervention consisted of 80 minutes of age-appropriate moderate-to-vigorous PA each school day. The main outcomes of interest were …

Cardiovascular Fitness Moderates The Relations Between Estimates Of Obesity And Physical Self-Perceptions In Rural Elementary School Students, Nathanael G. Mitchell, Justin B. Moore, Wendy S. Bibeau, Kathleen M. Rudasill

Faculty Publications

Background: Levels of physical activity decline throughout childhood. Children's physical self-perceptions have been found to relate to their physical activity. Understanding the relationships among physical self-perceptions, obesity, and physical activity could have important implications for interventions in children. Methods:The current study investigated the moderating effect of cardiovascular fitness (CVF, heart rate recovery from a 3-minute step test) on the relationship between obesity (BMI, waist circumference) and physical self-perceptions (athletic competence, physical appearance) in 104 fourth- and fifth-grade children from a small rural community. Results: Hierarchical regression analyses indicated that CVF moderated the relations between BMI and waist circumference on …

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 …

Hiv Testing In Women: Missed Opportunities, Wayne A. Duffus, Harley T. Davis, Michael D. Byrd, Khosrow Heidari, Terri G. Stephens, James J. Gibson

Faculty Publications

Objective: To investigate opportunities for early human immunodeficiency virus (HIV) testing on women.

Methods: A retrospective cohort study design linked case reports from HIV surveillance to several statewide health-care databases. Medical encounters occurring before the first positive HIV test (missed opportunities) were categorized by diagnosis/procedure codes to distinguish visits that were likely to have prompted an HIV test. Women were categorized as late testers (AIDS diagnosis < 12 months from first HIV test date), non-late testers (no AIDS diagnosis during study period or diagnosis of AIDS > 12 months of HIV diagnosis), of reproductive age (13-44 years old), and not of reproductive age (> 44 years old). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were used to estimate risk …

Systematic Review Of Peer Support For Breastfeeding Continuation: Metaregression Analysis Of The Effect Of Setting, Intensity, And Timing, Kate Jolly, Lucy Annang Ingram Phd, Khalid S. Khan, Jonathan J. Deeks, Nick Freemantle, Christine Macarthur

Faculty Publications

OBJECTIVE: To examine the effect of setting, intensity, and timing of peer support on breast feeding. DESIGN: Systematic review and metaregression analysis of randomised controlled trials. DATA SOURCES: Cochrane Library, Medline, CINAHL, the National Research Register, and British Nursing Index were searched from inception or from 1980 to 2011. Review methods Study selection, data abstraction, and quality assessment were carried out independently and in duplicate. Risk ratios and 95% confidence intervals were calculated for individual studies and pooled. Effects were estimated for studies grouped according to setting (high income countries, low or middle income countries, and the United Kingdom), intensity …

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 …

Ring Maps For Spatial Visualization Of Multivariate Epidemiological Data, Sarah E. Battersby, John E. Stewart, Ana Lopez-De Fede, Kevin C. Remington

Publications

Epidemiological research often involves the visual exploration of numerous attributes to help discern patterns between health and characteristics of the physical, socioeconomic, or built environment. Unfortunately, many of the multivariate mapping techniques discussed throughout the cartographic literature can be challenging to create or interpret—particularly for individuals without a cartographic background. In this paper, we present a new style of multivariate map—the ring map—to aid in basic visualization of multivariate datasets. For purposes of example, we focus on the use of the ring map style for exploring county-level epidemiological data for the state of South Carolina to examine patterns of age, …

Health Insurance Coverage Among Diabetic Adults From Three Major Ethnic Groups In The Us, Linda I. Ekperi, Shamola Greene, Ahmed Dehal, Ana Lopez-De Fede

Publications

Objective: The lack of adequate health insurance may result in a downward spiral of the diabetic condition, imposing an increased financial strain on family and the society as a whole. The objective of our study was to assess the insurance type and coverage among diabetic adults from three major ethnic groups. Design and setting: We used data of two cross-sectional national surveys to estimate insurance coverage among diabetic adults aged 20-64 years, 1988-1994 and 2003-2008. Results: The prevalence of doctor-diagnosed diabetes has increased by 120%, 178% and 135% respectively among non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexicans & other …

Agenda-Building Influences On The News Media's Coverage Of The U.S. Food And Drug Administration's Push To Regulate Tobacco, 1993-2009, Caroline D. Foster, James F. Thrasher, Sei-Hill Kim, India Rose, John C. Besley, Ashley Navarro

Faculty Publications

Citing agenda-building theory, this article examines the influence of three key factors on the news media's coverage of the process of placing tobacco and tobacco products under regulation of the U.S. Food and Drug Administration between 1993 and 2009. We analyzed data from a content analysis of 570 news articles from The New York Times and Washington Post and found that the media published significantly more FDA regulation articles during the Clinton administration than during the Bush administration. Our analysis links that imbalance of media coverage to the influence of the president of the United States (Clinton and Bush, during …

Bayesian Credible Sets For A Binomial Proportion Based On One-Sample Binary Data Subject To One Type Of Misclassification, Dewi Rahardja, Yan D. Zhao, Hongmei Zhang

Faculty Publications

Interval estimation for the proportion parameter in one-sample misclassified binary data has caught much interest in the literature. Recently, an approximate Bayesian approach has been proposed. This approach is simpler to implement and performs better than existing frequentist approaches. However, because a normal approximation to the marginal posterior density was used in the Bayesian approach, some efficiency may be lost. We develop a closed-form fully Bayesian algorithm which draws a posterior sample of the proportion parameter from the exact marginal posterior distribution. We conducted simulations to show that our fully Bayesian algorithm is easier to implement and has better coverage …

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

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. …

College Student Reactions To Health Warning Labels: Sociodemographic And Psychosocial Factors Related To Perceived Effectiveness Of Different Approaches, Carla J. Berg, James F. Thrasher, J. Lee Westmaas, Taneisha Buchanan, Erika A. Pinsker, Jasjit S. Ahluwalia

Faculty Publications

Objective. To examine factors associated with perceiving different types of pictorial cigarette health warning labels as most effective in motivating smokers to quit or preventing smoking initiation among college students.

Method. We administered an online survey to 24,055 students attending six Southeast colleges in Fall, 2010. We obtained complete data for the current analysis from 2600.

Results. Current smoking prevalence was 23.5%. The largest majority (78.6%) consistently rated gruesome images as most effective, 19.5% rated testimonial images as most effective, and only a small proportion rated either standard (1.6%) or human suffering images (0.3%) as most effective. Subsequent analyses focused …

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 …

Colonoscopy Screening Rates Among Patients Of Colonoscopy-Trained African American Primary Care Physicians, Sudha Xirasagar, Thomas G. Hurley, James B. Burch, Ali Mansaray, James R. Hébert

Faculty Publications

Background - When performed competently, colonoscopy screening can reduce colorectal cancer rates, especially in high-risk groups such as African Americans (AAs). Training primary care physicians (PCPs) to perform colonoscopy may improve screening rates among underserved high-risk populations.

Methods - We compared colonoscopy screening rates and computed adjusted odds ratios for colonoscopy-eligible patients of trained AA PCPs (study group) vs. untrained PCPs (comparison group), before and since initiating colonoscopy training. All colonoscopies were performed at a licensed ambulatory surgery center with specialist standby support. Retrospective chart review was conducted on 200 consecutive, established outpatients aged ≥50 years at each of 12 …