Public Health Commons^™

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 …

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 …

Electronic Media Exposure And Its Association With Activity-Related Outcomes In Female Adolescents: Cross-Sectional And Longitudinal Analyses, Felipe Lobelo, Marsha Dowda, Karin A. Pfeiffer, Russell R. Pate

Faculty Publications

Background: Few investigations have assessed in adolescent girls the cross-sectional and longitudinal associations between elevated exposure to electronic media (EM) and activity-related outcomes such as compliance with physical activity (PA) standards or cardiorespiratory fitness (CRF). Methods: Four-hundred thirty-seven white and African American girls were assessed at the 8th, 9th, and 12th grades. PA and EM (TV/video watching, electronic games, Internet use) were self-reported, and CRF was estimated using a cycle-ergometer test. Hi EM exposure was defined as ≥ four 30-minute blocks/d. Results: 8th-, 9th-, and 12th-grade girls in the Hi EM group showed lower compliance with PA standards and had …

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 …

Ethnic Differences In Trajectories Of Depressive Symptoms: Disadvantage In Family Background, High School Experiences, And Adult Characteristics, Katrina M. Walsemann, Gilbert C. Gee, Arline T. Geronimus

Faculty Publications

Although research investigating ethnic differences in mental health has increased in recent years, we know relatively little about how mental health trajectories vary across ethnic groups. Do these differences occur at certain ages, but not others? We investigate variations in trajectories of depressive symptoms, and examine the extent to which disadvantages in family background, high school experiences, and adult characteristics explain these differences. Employing random-coefficient modeling using the National Longitudinal Survey of Youth, we find that blacks and Hispanics experience higher symptom levels in early adulthood in comparison to whites, but equivalent levels by middle-age. Ethnic differences remained in early …

Physical And Social Contexts Of Physical Activities Among Adolescent Girls, Joanne Kuo, Kathryn H. Schmitz, Kelly R. Evenson, Thomas L. Mckenzie, Jared B. Jobe, Ariane L. Rung, Joel Gittelsohn, Russell R. Pate

Faculty Publications

Background: With limited opportunities for physical activity during school hours, it is important to understand the contexts of physical activities done outside of school time. Given the importance of physical and social aspects of environments, the purpose of this study was to describe where and with whom girls participate in physical activities outside of school. Methods: Participants were 1925 sixth-grade girls in the Trial of Activity for Adolescent Girls (TAAG). At baseline, they completed a 3-day physical activity recall (3DPAR), reporting the main activity performed during 30-minute intervals and the physical and social contexts of physical activities. Results: The most …

Argument Structure Effects In Action Verb Naming In Static And Dynamic Conditions, Dirk B. Den Ouden, Steve Fix, Todd B. Parrish, Cynthia K. Thompson

Faculty Publications

Argument structure, as in the participant roles entailed within the lexical representation of verbs, affects verb processing. Recent neuroimaging studies show that when verbs are heard or read, the posterior temporoparietal region shows increased activation for verbs with greater versus lesser argument structure complexity, usually bilaterally. In addition, patients with agrammatic aphasia show verb production deficits, graded based on argument structure complexity. In the present study, we used fMRI to examine the neural correlates of verb production in overt action naming conditions. In addition, we tested the differential effects of naming when verbs were presented dynamically in video segments versus …

Eating Routines: Embedded, Value Based, Modifiable, And Reflective, Margaret M. Jastran, Carole A. Bisogni, Jeffrey Sobal, Christine E. Blake, Carol M. Devine

Faculty Publications

Eating routines are a compelling issue because recurring eating behaviors influence nutrition and health. As non-traditional and individualized eating patterns have become more common, new ways of thinking about routine eating practices are needed. This study sought to gain conceptual understanding of working adults' eating routines. Forty-two purposively sampled US adults reported food intake and contextual details about eating episodes in qualitative 24-h dietary recalls conducted over 7 consecutive days. Using the constant comparative method, researchers analyzed interview transcripts for recurrent ways of eating that were either explicitly reported by study participants as "routines" or emergent in the data. Participants' …

Changes In Weight, Waist Circumference And Compensatory Responses With Different Doses Of Exercise Among Sedentary, Overweight Postmenopausal Women, Timothy S. Church, Corby K. Martin, Angela M. Thompson, Conrad P. Earnest, Catherine R. Mikus, Steven N. Blair

Faculty Publications

Background: It has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss. However, this has only been examined with large doses of exercise. The goal of this analysis was to examine actual weight loss compared to predicted weight loss (compensation) across different doses of exercise in a controlled trial of sedentary, overweight or obese postmenopausal women (n=41).

Methodology/Principal Findings: Participants were randomized to a non-exercise control (n=94) or 1 of 3 exercise groups; exercise energy expenditure of 4 (n=139), 8 (n=85), or 12 (n=93) kcal/kg/week (KKW). Training intensity was set at the heart rate associated with …

Antenatal Peer Support Workers And Initiation Of Breast Feeding: Cluster Randomised Controlled Trial, Christine Macarthur, Kate Jolly, Lucy Annang Ingram Phd, Nick Freemantle, Cindy-Lee Dennis, Ros Hamburger, Julia Brown, Jackie Chambers, Khalid Khan

Faculty Publications

OBJECTIVE: To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding. DESIGN: Cluster randomised controlled trial. SETTING: Community antenatal clinics in one primary care trust in a multiethnic, deprived population. PARTICIPANTS: 66 antenatal clinics with 2511 pregnant women: 33 clinics including 1140 women were randomised to receive the peer support worker service and 33 clinics including 1371 women were randomised to receive standard care. INTERVENTION: An antenatal peer support worker service planned to comprise a minimum of two contacts with women to provide advice, information, and support from approximately 24 …

Does Television Viewing Predict Dietary Intake Five Years Later In High School Students And Young Adults?, Daheia J. Barr-Anderson, Nicole I. Larson, Melissa C. Nelson, Dianne R. Neumark-Sztainer, Mary Story

Faculty Publications

Background: Prior research has found that television viewing is associated with poor diet quality, though little is known about its long-term impact on diet, particularly during adolescence. This study examined the associations between television viewing behavior with dietary intake five years later.

Methods: Survey data, which included television viewing time and food frequency questionnaires, were analyzed for 564 middle school students (younger cohort) and 1366 high school students (older cohort) who had complete data available at Time1 (1998-1999) and five years later at Time 2 (mean age at Time 2, 17.2 ± 0.6 and 20.5 ± 0.8 years, respectively). Regression …

A Field-Based Testing Protocol For Assessing Gross Motor Skills In Preschool Children: The Children's Activity And Movement In Preschool Study Motor Skills Protocol, Harriet G. Williams, Karin A. Pfeiffer, Marsha Dowda, Chevy Jeter, Shaverra Jones, Russell R. Pate

Faculty Publications

The purpose of this study was to develop a valid and reliable tool for use in assessing motor skills in preschool children in field-based settings. The development of the Children’s Activity and Movement in Preschool Study Motor Skills Protocol included evidence of its reliability and validity for use in field-based environments as part of large epidemiological studies. Following pilot work, 297 children (3–5 years old) from 22 preschools were tested using the final version of the Children’s Activity and Movement in Preschool Study Motor Skills Protocol and the Test of Gross Motor Development (2nd Edition). Reliability of the Children’s Activity …

Sample Size Calculation For Finding Unseen Species, Hongmei Zhang, Hal Stern

Faculty Publications

Estimation of the number of species extant in a geographic region has been discussed in the statistical literature for more than sixty years. The focus of this work is on the use of pilot data to design future studies in this context. A Dirichlet-multinomial probability model for species frequency data is used to obtain a posterior distribution on the number of species and to learn about the distribution of species frequencies. A geometric distribution is proposed as the prior distribution for the number of species. Simulations demonstrate that this prior distribution can handle a wide range of species frequency distributions …

Neuroimaging And Recovery Of Language In Aphasia, Cynthia K. Thompson, Dirk B. Den Ouden

Faculty Publications

The use of functional neuroimaging techniques has advanced what is known about the neural mechanisms used to support language processing in aphasia resulting from brain damage. This paper highlights recent findings derived from neuroimaging studies focused on neuroplasticity of language networks, the role of the left and right hemispheres in this process, and studies examining how treatment affects the neurobiology of recovery. We point out variability across studies as well as factors related to this variability, and we emphasize challenges that remain for research.

Cardiorespiratory Fitness As A Predictor Of Fatal And Nonfatal Stroke In Asymptomatic Women And Men, Steven P. Hooker, Xuemei Sui, Natalie Colabianchi, John E. Vena, James N. Laditka, Michael J. Lamonte, Steven N. Blair

Faculty Publications

Background and Purpose - Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men.

Methods - A total of 46,405 men and 15,282 women without known myocardial infarction or stroke at baseline completed a maximal treadmill exercise test between 1970 and 2001. CRF was grouped as quartiles of the sex-specific distribution of maximal metabolic equivalents achieved. Mortality follow-up was through …

Weight Regain Is Related To Decreases In Physical Activity During Weight Loss, Xuewen Wang, Mary F. Lyles, Tongjian You, Michael J. Berry, Jack Rejeski, Barbara J. Nicklas

Faculty Publications

Purpose—To examine whether adaptations in physical activity energy expenditure (PAEE) and resting metabolic rate (RMR) during weight loss were associated with future weight regain in overweight/obese, older women.

Research Methods and Procedures—Thirty-four overweight/obese (BMI=25–40 kg/m²), postmenopausal women underwent a 20-week weight loss intervention of hypocaloric diet with (low- or high-intensity) or without treadmill walking (weekly caloric deficit was ~11760 kJ), with a subsequent 12-month follow-up. RMR (via indirect calorimetry), PAEE (by RT3 accelerometer) and body composition (by DXA) were measured before and after intervention. Body weight and self-reported information on physical activity were collected after intervention, …

Does Place Explain Racial Health Disparities? Quantifying The Contribution Of Residential Context To The Black/White Health Gap In The United States, Brian K. Finch, D. Phuong Do, Ricardo Basurto-Davila, Chloe E. Bird, José J. Escarce, Nicole Lurie

Faculty Publications

The persistence of the black health disadvantage has been a puzzling component of health in the United States in spite of general declines in rates of morbidity and mortality over the past century. Studies that have focused on well-established individual-level determinants of health such as socio-economic status and health behaviors have been unable to fully explain these disparities. Recent research has begun to focus on other factors such as racism, discrimination, and segregation. Variation in neighborhood context - socio-demographic composition, social aspects, and built environment - has been postulated as an additional explanation for racial disparities, but few attempts have …

Breast Cancer Survival Among Economically Disadvantaged Women: The Influences Of Delayed Diagnosis And Treatment On Mortality, Emily Rose Smith, Swann Arp Adams, Irene Prabhu Das, Matteo Bottai, Jeanette Fulton, James R. Hébert

Faculty Publications

Breast cancer affects thousands each year in the United States, and disproportionately affects certain subgroups. For example, the incidence of breast cancer in South Carolina is lower in African American compared with European American women by ~12% to 15%, but their mortality rate is twice as high as in European American women. The purpose of the study was to assess factors associated with breast cancer mortality between African American and European American women. Participants (n = 314) in South Carolina's Breast and Cervical Cancer Early Detection Program (SCBCCEDP), which provides breast cancer screening and treatment services, during the years …

Light-Dependant Biostabilisation Of Sediments By Stromatolite Assemblages, David M. Paterson, Rebecca J. Aspden, Pieter T. Visscher, Mireille Consalvey, Miriam S. Andres, Alan W. Decho, John F. Stolz, R. Pamela Reid

Faculty Publications

For the first time we have investigated the natural ecosystem engineering capacity of stromatolitic microbial assemblages. Stromatolites are laminated sedimentary structures formed by microbial activity and are considered to have dominated the shallows of the Precambrian oceans. Their fossilised remains are the most ancient unambiguous record of early life on earth. Stromatolites can therefore be considered as the first recognisable ecosystems on the planet. However, while many discussions have taken place over their structure and form, we have very little information on their functional ecology and how such assemblages persisted despite strong eternal forcing from wind and waves. The capture …

The Community-Driven Approach To Environmental Exposures: How A Community-Based Participatory Research Program Analyzing Impacts Of Environmental Exposure On Lupus Led To A Toxic Site Cleanup, Julien A. Terrell, Edith M. Williams, Christine M. Murekeyisoni, Robert Watkins, Laurene Tumiel-Berhalter

Faculty Publications

Community-based participatory research (CBPR) is a mechanism to improve environmental quality in communities primarily inhabited by minorities or low income families. A collaborative partnership between the University at Buffalo and the Toxic Waste Lupus Coalition was formed to investigate the high prevalence of lupus in the area and whether cases of disease were linked to chemicals found at a nearby New York State Superfund site in East Buffalo. The purpose of the study was to use CBPR practices to educate impacted residents and enable their participation in efforts to get a nearby contaminated waste site remediated. Community members were active …

Gender Differences In The Risk Of Hiv Infection Among Persons Reporting Abstinence, Monogamy, And Multiple Sexual Partners In Northern Tanzania, Keren Z. Landman, Jan Ostermann, John A. Crump, Anna Mgonja, Meghan K. Mayhood, Dafrosa K. Itemba, Alison C. Tribble, Evaline M. Ndosi, Helen Y. Chu, John F. Shao, John A. Bartlett, Nathan M. Thielman

Faculty Publications

Background: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the risk of HIV seropositivity among men and women presenting for HIV voluntary counseling and testing (VCT) in northern Tanzania.

Methodology/ Principal Findings: Clients presenting for HIV VCT at a community-based AIDS service organization in Moshi, Tanzania were surveyed between November 2003 and December 2007. Data on sociodemographic characteristics, reasons for testing, sexual behaviors, and symptoms were collected. Men and women were categorized by …

Exposure To Smoking Imagery In Popular Films And Adolescent Smoking In Mexico, James F. Thrasher, Christine Jackson, Edna Arillo-Santillán, James D. Sargent

Faculty Publications

Background: Exposure to smoking imagery in films in consistently associated with smoking behavior and its psychological antecedents among adolescents in high-income countries, but its association with adolescent smoking in middle-income countries is unknown.

Methods: In 2006, a cross-sectional sample of 3876 Mexican adolescents in secondary school was surveyed on smoking behavior, smoking risk factors, and exposure to 42 popular films that contained smoking. Participants were classified into quartiles of exposure to smoking imagery across all films they reported having seen. Models were estimated to determine associations among quartiles of film-smoking exposure, smoking behavior, and the psychological antecedents of smoking, adjusting …

Association Between Muscular Strength And Mortality In Men: Prospective Cohort Study, Jonatan R. Ruiz, Xuemei Sui, Felipe Lobelo, James R. Morrow Jr., Allen W. Jackson, Michael Sjöström, Steven N. Blair

Faculty Publications

Objective: To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men.

Design: Prospective cohort study.

Setting: Aerobics center longitudinal study.

Participants: 8762 men aged 20-80.

Main outcome measures: All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill.

Results: During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age …

Heart Rate Variability Characteristics In Sedentary Postmenopausal Women Following Six Months Of Exercise Training: The Drew Study, Conrad P. Earnest, Carl J. Lavie, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Decreased heart rate variability (HRV) is associated with a higher risk of mortality. Overall, postmenopausal women have lower levels of HRV than premenopausal women, which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity. Though cardiorespiratory exercise training increases HRV, little is known regarding the exercise dose necessary to promote improvement.

Methodology/Principle Findings: Our primary aim was to measure HRV in post-menopausal women following 6-moths of exercise training. We examined supine resting HRV in 373 post-menopausal women (45-75 y) after 6-months of randomly assigned and double-blinded administered exercise training exercise training at 50%, 100% …

Maximal Exercise Electrocardiography Responses And Coronary Heart Disease Mortality Among Men With Diabetes Mellitus, G. William Lyerly, Xuemei Sui, Timothy S. Church, Carl J. Lavie, Gregory A. Hand, Steven N. Blair

Faculty Publications

Background - An abnormal ECG during maximal exercise testing has been shown to be a powerful predictor of future coronary heart disease (CHD) mortality in asymptomatic men. However, little is known about the relationship between exercise ECG responses and CHD risk in men with diabetes mellitus.

Methods and Results - We examined the association between exercise ECG responses and mortality in 2854 men with documented diabetes mellitus (mean age 49.5 years) who completed a maximal treadmill exercise test during the period from 1974 to 2001 and who were without a previous cardiovascular disease (CVD) event at baseline. Mortality due to …

Physical Activity And Neighborhood Resources In High School Girls, Russell R. Pate, Natalie Colabianchi, Dwayne E. Porter, Maria João C. A. Almeida, Felipe Lobelo, Marsha Dowda

Faculty Publications

Background - Physical activity behavior is influenced by a person's physical environment, but few studies have used objective measures to study the influences of the physical environment on physical activity behavior in youth. The purpose of this study was to examine the relationship between selected neighborhood physical activity resources and physical activity levels in high school girls.

Methods - Participants were students in schools that had participated in a large physical activity intervention trial. The 3-Day Physical Activity Recall was completed by 1506 12th-grade girls. Data on physical activity facilities and resources in the participating communities were collected using a …

Race Differences In Activity, Fitness, And Bmi In Female Eighth Graders Categorized By Sports Participation Status, John R. Sirard, Karin A. Pfeiffer, Marsha Dowda, Russell R. Pate

Faculty Publications

The purpose of this study was to identify racial differences in physical activity (PA), fitness, and BMI in female 8th-grade sports participants and nonparticipants. Girls from 31 South Carolina middle schools (N=1,903, 48% White; mean age=13.6 ± 0.63) reported PA and previous year sports-team participation, completed a submaximal fitness test, and had height and weight measured. Sports team participation was positively associated with PA and negatively associated with television viewing and BMI, in a dose-response manner. Compared with Whites, African-Americans reported less PA and more television viewing, and had greater BMI scores. Whereas PA intervention programs that incorporate …

Promoting Physical Activity In Middle School Girls: Trial Of Activity For Adolescent Girls, Larry S. Webber, Diane J. Catellier, Leslie A. Lytle, David M. Murray, Charlotte A. Pratt, Deborah Rohm Young, John P. Elder, Timothy G. Lohman, June Stevens, Jared B. Jobe, Russell R. Pate

Faculty Publications

Background - Physical activity is important for weight control and good health; however, activity levels decline in the adolescent years, particularly in girls.

Design - Group randomized controlled trial.

Setting/participants - Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States. Random, cross-sectional samples were drawn within schools: 6th graders in 2003 (n=1721) and 8th graders in 2005 (n=3504) and 2006 (n=3502).

Intervention - A 2-year study-directed intervention (fall 2003 to spring 2005) targeted schools, community agencies, …

Accumulating Disadvantage Over The Life Course: Evidence From A Longitudinal Study Investigating The Relationship Between Educational Advantage In Youth And Health In Middle Age, Katrina M. Walsemann, Arline T. Geronimus, Gilbert C. Gee

Faculty Publications

Recent studies suggest the importance of examining cumulative risk or advantage as potential predictors of health over the life course. Researchers investigating the cumulative health effects of education, however, have mainly conceptualized education in years or degrees, often disregarding educational quality and access to educational opportunities that may place individuals on divergent academic trajectories. We investigate whether educational advantages in youth are associated with an individual's health trajectory. We develop a novel index of educational advantage and employ random-intercept modeling using data from the National Longitudinal Survey of Youth. We find a widening health disparity in adulthood between respondents with …

Early Life Determinants Of Physical Activity In 11 To 12 Year Olds: Cohort Study, Calum Mattocks, Kevin Deere, Sam D. Leary, Andy R. Ness, Kate Tilling, Steven N. Blair, Chris J. Riddoch

Faculty Publications

Objective: To examine factors in early life (up to age 5 years) that are associated with objectively measured physical activity in 11-12 year olds.

Design: Prospective cohort study

Setting: Avon longitudinal study of parents and children, United Kingdom.

Participants: Children aged 11-12 years from the Avon longitudinal study of parents and children.

Main outcome measure: Physical activity levels in counts per minute (cpm) and minutes of moderate to vigorous physical activity for seven days measured with a uniaxial actigraph accelerometer.

Results: Valid actigraph data, defined as at least three days of physical activity for at least 10 hours a day, …