Public Health Commons^™

The Effect Of Question Order On Reporting Physical Activity And Walking Behavior, Brent E. Hutto, Patricia A. Sharpe, Michelle L. Granner, Cheryl L. Addy, Steven P. Hooker

Faculty Publications

Background: Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. Methods: A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. Results: …

Individual Differences In The Conceptualization Of Food Across Eating Contexts, Christine E. Blake

Faculty Publications

Individual differences in food-related knowledge structures were explored by applying schema theory to examine the categories 42 adults used to classify foods across four eating contexts. Food card-sort labels were organized in 12 categories, category salience for each person was evaluated, and cluster analysis was used to identify clusters of participants according to the salience of their categories. Clusters were further evaluated for complexity and consistency of category use across contexts. Seven food schema clusters were identified. Meal/time and Routine categories were the most salient overall and were used by most clusters. Well-being, Person, Source, Convenience, Meal component, and Food …

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

Faculty Publications

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

Polymorphisms In Methionine Synthase, Methionine Synthase Reductase And Serine Hydroxymethyltransferase, Folate And Alcohol Intake, And Colon Cancer Risk, Susan E. Steck, Temitope O. Keku, Lesley M. Butler, Joseph Galanko, Beri Massa, Robert C. Millikan, Robert S. Sandler

Faculty Publications

Background/Aims - We examined associations among folate and alcohol intake, SNPs in genes involved in one-carbon metabolism and colon cancer risk.

Methods - Colon cancer cases (294 African Americans and 349 whites) were frequency matched to population controls (437 African Americans and 611 whites) by age, race and sex from 33 North Carolina counties from 1996 to 2000. Folate and alcohol intakes were collected by dietary interview. Five SNPs were genotyped using DNA from whole blood: SHMT C1420T; MTRR A66G; MTR A2756G, and the previously-reported MTHFR C677T and MTHFR A1298C. Adjusted odds ratios (OR) and 95% …

Use Of Accelerometers In A Large Field-Based Study Of Children: Protocols, Design Issues, And Effects On Precision, Calum Mattocks, Andy R. Ness, Sam D. Leary, Kate Tilling, Steven N. Blair, Julian Shield, Kevin Deere, Joanne Saunders, Joanne Krikby, George Davey Smith, Jonathan Wells, Nicholas Wareham, John J. Reilly, Chris J. Riddoch

Faculty Publications

Background: Objective methods can improve accuracy of physical activity measurement in field studies but uncertainties remain about their use.

Methods: Children age 11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), were asked to wear a uni-axial accelerometer (MTI Actigraph) for 7 days.

Results: Of 7159 children who attended for assessment, 5595 (78%) provided valid measures. The reliability coefficient for 3 days of recording was .7 and the power to detect a difference of 0.07 SDs (P ≤ .05) was > 90%. Measures tended to be higher on the first day of recording (17 counts/min; 95% CI, …

Physical Activity And Blood Pressure In Childhood: Findings From A Population-Based Study, Sam D. Leary, Andy R. Ness, George Davey Smith, Calum Mattocks, Kevin Deere, Steven N. Blair, Chris J. Riddoch

Faculty Publications

The pathological processes associated with development of cardiovascular disease begin early in life. For example, elevated blood pressure (BP) can be seen in childhood and tracks into adulthood. The relationship between physical activity (PA) and BP in adults is well-established, but findings in children have been inconsistent, with few studies measuring PA mechanically. Children aged 11 to 12 years were recruited from the Avon Longitudinal Study of Parents and Children. 5505 had systolic and diastolic BP measurements, plus valid (at least 10 hours for at least 3 days) accelerometer measures of PA; total PA recorded as average counts per minute …

Towards An Understanding Of Salient Neighborhood Boundaries: Adolescent Reports Of An Easy Walking Distance And Convenient Driving Distance, Natalie Colabianchi, Marsha Dowda, Karin A. Pfeiffer, Dwayne E. Porter, Maria João C. A. Almeida, Russell R. Pate

Faculty Publications

Numerous studies have examined the association between the surrounding neighborhood environment and physical activity levels in adolescents. Many of these studies use a road network buffer of Euclidean distance buffer around an adolescent's home to represent the appropriate geographic area for study (i.e., neighborhood). However, little empirical research has examined the appropriate buffer size to use when defining this area and there is little consistency across published research as to the buffer size used. In this study, 909 12^th grade adolescent girls of diverse racial and geographic backgrounds were asked to report their perceptions of an easy walking distance …

Objectively Assessed Associations Between Physical Activity And Body Composition In Middle-School Girls: The Trial Of Activity For Adolescent Girls, June Stevens, David M. Murray, Chris C. Baggett, John P. Elder, Timothy G. Lohman, Leslie A. Lytle, Russell R. Pate, Charlotte A. Pratt, Margarita S. Treuth, Larry S. Webber, Deborah Rohm Young

Faculty Publications

Declining levels of physical activity probably contribute to the increasing prevalence of overweight in US youth. In this study, the authors examined cross-sectional and longitudinal associations between physical activity and body composition in sixth- and eighth-grade girls. In 2003, girls were recruited from six US states as part of the Trial of Activity for Adolescent Girls. Physical activity was measured using 6 days of accelerometry, and percentage of body fat was calculated using an age- and ethnicity-specific prediction equation. Sixth-grade girls with an average of 12.8 minutes of moderate-to-vigorous physical activity (MVPA) per day (15th percentile) were 2.3 times (95% …

Effect Of Endothelin 1 Genotype On Blood Pressure Is Dependent On Physical Activity Or Fitness Levels, Tuomo Rankinen, Timothy S. Church, Treva Rice, Nathan Markward, Arthur S. Leon, Dabeeru C. Rao, James S. Skinner, Steven N. Blair, Claude Bouchard

Faculty Publications

Contributions of the DNA sequence variation at the endothelin 1 locus to the risk of hypertension and to endurance training-induced changes in blood pressure were investigated in the Aerobics Center Longitudinal Study and the Health, Risk Factors, Exercise Training and Genetics Family Study cohorts. We identified 586 normotensive control subjects and 607 incident hypertensive case subjects from the Aerobics Center Longitudinal Study cohort (all whites) who were normotensive and healthy at their first clinical visit. The case subjects were diagnosed with hypertension during an average follow-up of 9.5 years, whereas the control subjects remained normotensive. The allele and genotype frequencies …

Associations Among Physical Activity, Health Indicators, And Employment In 12th Grade Girls, Marsha Dowda, Karin A. Pfeiffer, Rod K. Dishman, Russell R. Pate

Faculty Publications

Objectives: This study compared physical activity, sedentary behaviors, and other health indicators between 1381 employed and nonemployed 12th grade girls.

Methods: The girls were from 22 high schools in South Carolina (2002-2003); 56% of the girls were African American, and the mean age was 17.7 (0.6) years. Physical activity and sedentary behaviors were measured using the 3-Day Physical Activity Recall (3DPAR). Fitness, depressive symptoms, and smoking behavior were assessed.

Results: Fifty percent of the girls were employed, and on average, employed girls worked 9.6 30-minute blocks per day. Girls who worked reported significantly (p≤0.001) higher average total metabolic …

Long-Term Effects Of A Physical Activity Intervention In High School Girls, Russell R. Pate, Ruth P. Saunders, Rod K. Dishman, Cheryl L. Addy, Marsha Dowda, Dianne S. Ward

Faculty Publications

Background - Physical activity decreases during childhood and adolescence, and physical activity levels are significantly lower in females than males, particularly during adolescence. Schools are attractive settings in which to implement interventions designed to promote physical activity in girls and young women, but few studies have tested the sustained effects of such interventions.

Design - Cross-sectional. Data were collected in 2002-2003 and analyzed in 2006-2007.

Setting/Participants - 1594 adolescent girls in 22 high schools.

Intervention - The intervention, Lifestyle Education for Activity Program (LEAP), was designed to increase physical activity in 9^th grade girls through two channels: changes in …

Toward A Population Health Model Of Segmented Assimilation: The Case Of Low Birth Weight In Los Angeles, Brian K. Finch, Nelson Lim, William Perez, D. Phuong Do

Faculty Publications

The authors adapt the segmented assimilation theory to a model population health, which posits that assimilation is actually harmful to migrants' health. The authors also specify models of individual and contextual factors to indirectly test the theory of segmented assimilation - a theory that posits interactions between individual and residential circumstances. Using Year 2000 vital statistics data merged with 2000 U.S. census data from Los Angeles County, the authors model the probability of being born low birth weight among the native and foreign born. Results confirm an immigrant advantage at the individual level and protective effects of immigrant coresidence at …

Patient Involvement In Patient Safety: What Factors Influence Patient Participation And Engagement?, Rachel Davis, Rosamond Jacklin, Nick Sevdalis, Charles A. Vincent

Faculty Publications

BACKGROUND: Patients can play an important role in improving patient safety by becoming actively involved in their health care. However, there is a paucity of empirical data on the extent to which patients take on such a role. In order to encourage patient participation in patient safety we first need to assess the full range of factors that may be implicated in such involvement. OBJECTIVE: To delineate factors that could affect the participation of the patient in quality and safety issues in their health care. METHOD: Literature review of patient involvement in health care, drawing from direct evidence (specifically from …

Classifying Foods In Contexts: How Adults Categorize Foods For Different Eating Settings, Christine E. Blake, Carole A. Bisogni, Jeffrey Sobal, Carol M. Devine, Margaret M. Jastran

Faculty Publications

This project examined adults' food cognitions by applying schema theory to explain how adults categorized foods for different contexts. Qualitative interviews and repeated card sort activities for different eating contexts were conducted to elicit as many food categories as possible form 42 US adults. Participants labeled card sort piles with their own words, providing 991 card sort labels. Qualitative analysis of the labels resulted in the emergence of 12 category types. Personal-experience-based types were specific to the individual (e.g., Preference). Context-based types were related to situational aspects of eating episodes (e.g., Location). Food-based types were related to intrinsic properties of …

Physical Activity And Public Health: Updated Recommendation For Adults From The American College Of Sports Medicine And The American Heart Association, William L. Haskell, I-Min Lee, Russell R. Pate, Kenneth E. Powell, Steven N. Blair, Barry A. Franklin, Caroline A. Macera, Gregory W. Heath, Paul D. Thompson, Adrian Bauman

Faculty Publications

Summary - In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by and expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in …

Physical Activity And Public Health In Older Adults: Recommendation From The American College Of Sports Medicine And The American Heart Association, Miriam E. Nelson, W. Jack Rejeski, Steven N. Blair, Pamela W. Duncan, James O. Judge, Abby C. King, Carol A. Macera, Carmen Castaneda-Sceppa

Faculty Publications

Objective - To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults.

Participants - A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology.

Evidence - The expert panel reviewed existing consensus statements and relevant evidence from primary research articles and reviews of the literature. Process: After drafting a recommendation for the older adult population and reviewing drafts of the Updated Recommendation from the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) for Adults, the panel issued a …

Agreement Between Student-Reported And Proxy-Reported Physical Activity Questionnaires, Marsha Dowda, Russell R. Pate, James F. Sallis, Patty S. Freedson, Wendell C. Taylor, John R. Sirard, Stewart G. Trost

Faculty Publications

Parents and 531 students (46% males, 78% white) completed equivalent questionnaires. Agreement between student and parent responses to questions about hypothesized physical activity (PA) correlates was assessed. Relationships between hypothesized correlates and an objective measure of student's moderate-to-vigorous physical activity (MVPA) in a subset of 177 students were also investigated. Agreement between student and parent ranged from r=.34 to .64 for PA correlates. Spearman correlations between MVPA and PA correlates ranged from -.04 to .21 for student report and -.14 to .32 for parent report, and there were no statistical differences for 8 out of 9 correlations between parent …

Weekend And Weekday Patterns Of Physical Activity In Overweight And Normal-Weight Adolescent Girls, Margarita S. Treuth, Diane J. Catellier, Kathryn H. Schmitz, Russell R. Pate, John P. Elder, Robert G. Mcmurray, Robert M. Blew, Song Yang, Larry S. Webber

Faculty Publications

Objective - To describe the patterns (specifically comparing weekdays and weekends classified by intensities) of physical activity (PA) measured by accelerometry in adolescent girls.

Research Methods and Procedures - Healthy sixth grade girls (n=1603), 11 to 12 years old, were randomly recruited from 36 schools participating in the Trial of Activity in Adolescent Girls. Age, ethnicity, socioeconomic status, weight, and height were taken. PA patterns were measured for 6 days using accelerometry.

Results - Adolescent girls spend most of their time in sedentary (52% to 57% of the day) and light activity (40% to 45% of the day) …

Perceived Individual, Social, And Environmental Factors For Physical Activity And Walking, Michelle L. Granner, Patricia A. Sharpe, Brent E. Hutto, Sarah Wilcox, Cheryl L. Addy

Faculty Publications

Background: Few studies have explored associations of individual, social, and environmental factors with physical and walking behavior. Methods: A random-digit-dial questionnaire, which included selected individual, social, and environmental variables, was administered to 2025 adults, age 18 y and older, in two adjacent counties in a southeastern state. Logistic regressions were conducted adjusting for age, race, sex, education, and employment. Results: In multivariate models, somewhat different variables were associated with physical activity versus regular walking. Self-efficacy (OR = 19.19), having an exercise partner (OR = 1.47), recreation facilities (OR = 1.54), and safety of trails from crime (OR = 0.72) were …

Neighborhood Context And Ethnicity Differences In Body Mass Index: A Multilevel Analysis Using The Nhanes Iii (1988-1994), D. Phuong Do, Tamara Dubowitz, Chloe E. Bird, Nicole Lurie, José J. Escarce, Brian K. Finch

Faculty Publications

A growing body of literature has documented a link between neighborhood context and health outcomes. However, little is known about the relationship between neighborhood context and body mass index (BMI) or whether the association between neighborhood context and BMI differs by ethnicity. This paper investigates several neighborhood characteristics as potential explanatory factors for the variation of BMI across the United States; further, this paper explores to what extent segregation and the concentration of disadvantage across neighborhoods help explain ethnic disparities in BMI. Using data geo-coded at the census tract-level and linked with individual-level data from the Third National Health and …

Disparities In Mental Health Utilization Among Persons With Chronic Diseases, Saundra H. Glover, Keith T. Elder, Sudha Xirasagar, Jong-Deuk Baek, Crystal N. Piper, Dayna Campbell

Faculty Publications

This study used Aday and Andersen's Behavioral Model of Health Services Use to examine to role of chronic disease and the joint impact of race and chronic disease type on mental health utilization. Using data from Community Tracking Survey Household Survey, we tested the assumption that chronic disease, chronic disease type, and race are related to lower rates of mental health visits when adjusted for predisposing, enabling, and need factors. After adjusting for population characteristics, we found that race significantly moderated the impact of chronic disease type on mental health utilization, showing that African Americans with cardiovascular disease were half …

Exercise And Cardiovascular Events - Placing The Risks Into Perspective: A Scientific Statement From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism And The Council On Clinical Cardiology, Paul D. Thompson, Barry A. Franklin, Gary J. Balady, Steven N. Blair, Domenico Corrado, N. A. Mark Estes Iii, Janet E. Fulton, Neil F. Gordon, William L. Haskell, Mark S. Link, Barry J. Maron, Murray A. Mittleman, Antonio Pelliccia, Nanette K. Wenger, Stefan N. Willich, Fernando Costa

Faculty Publications

Habitual physical activity reduces coronary heart disease events, but vigorous activity can also acutely and transiently increase the risk of sudden cardiac death and acute myocardial infarction in susceptible persons. This scientific statement discusses the potential cardiovascular complications of exercise, their pathological substrate, and their incidence and suggests strategies to reduce these complications. Exercise-associated acute cardiac events generally occur in individuals with structural cardiac disease. Hereditary or congenital cardiovascular abnormalities are predominantly responsible for cardiac events among young individuals, whereas atherosclerotic disease is primarily responsible for these events in adults. The absolute rate of exercise-related sudden cardiac death varies with …

Haplotype Association Between Haptoglobin (Hp2) And Hp Promoter Snp (A-61c) May Explain Previous Controversy Of Haptoglobin And Malaria Protection, Sharon E. Cox, Conor Doherty, Sarah H. Atkinson, Chidi V. Nweneka, Anthony J.C. Fulford, Hala Ghattas Ph.D., Kirk A. Rockett, Dominic P. Kwiatkowski, Andrew M. Prentice

Faculty Publications

Background.

Malaria is one of the strongest recent selective pressures on the human genome, as evidenced by the high levels of varying haemoglobinopathies in human populations-despite the increased risk of mortality in the homozygous states. Previously, functional polymorphisms of Hp, coded by the co-dominant alleles Hp1 and Hp2, have been variously associated with several infectious diseases, including malaria susceptibility.

Methodology/Principal Findings.

Risk of a clinical malarial episode over the course of a malarial transmission season was assessed using active surveillance in a cohort of Gambian children aged 10-72 months. We report for the first time that the major haplotype for …

Haplotype Association Between Haptoglobin (Hp2) And Hp Promoter Snp (A-61c) May Explain Previous Controversy Of Haptoglobin And Malaria Protection, Sharon E. Cox, Conor Doherty, Sarah H. Atkinson, Chidi V. Nweneka, Anthony J.C. Fulford, Hala Ghattas Ph.D., Kirk A. Rockett, Dominic P. Kwiatkowski, Andrew M. Prentice

Faculty Publications

Background

Malaria is one of the strongest recent selective pressures on the human genome, as evidenced by the high levels of varying haemoglobinopathies in human populations–despite the increased risk of mortality in the homozygous states. Previously, functional polymorphisms of Hp, coded by the co-dominant alleles Hp1 and Hp2, have been variously associated with several infectious diseases, including malaria susceptibility.

Methodology/Principal Findings

Risk of a clinical malarial episode over the course of a malarial transmission season was assessed using active surveillance in a cohort of Gambian children aged 10–72 months. We report for the first time that the major haplotype for …

Gstm1, Gstt1, Gstp1, And Gsta1 Polymorphisms And Urinary Isothiocyanate Metabolites Following Broccoli Consumption In Humans, Susan E. Steck, Marilie D. Gammon, James R. Hébert, Denise E. Wall, Steven H. Zeisel

Faculty Publications

Isothiocyanates (ITC) are potentially anticarcinogenic phytochemicals formed from the metabolism of glucosinolates and are found in cruciferous vegetables as well as a select number of other foods. ITC are both substrates for and inducers of glutathione S-transferase (GST) phase II metabolizing enzymes involved in carcinogen detoxification as well as effectors of phase I pathways. Previous studies report mixed results on the interaction between cruciferous vegetable intake, GST polymorphisms, and risk of cancer. We conducted a study of 114 healthy human subjects between 18 and 50 y of age to examine the biologic mechanism underlying the associations, specifically, to assess …

Effects Of Residence And Race On Burden Of Travel For Care: Cross Sectional Analysis Of The 2001 Us National Household Travel Survey, Janice C. Probst, Sarah B. Laditka, Jong-Yi Wang, Andrew O. Johnson

Faculty Publications

Background: Travel burden is a key element in conceptualizing geographic access to health care. Prior research has shown that both rural and minority populations bear disproportionate travel burdens. However, many studies are limited to specific types of patient or specific locales. The purpose of our study was to quantify geographic and race-based differences in distance traveled and time spent in travel for medical/dental care using representative national data.

Methods: Data were drawn from 2001 National Household Travel Survey (NHTS), a nationally representative, cross-sectional household survey conducted by the US Department of Transportation. Participants recorded all travel on a designated day; …

Use Of Complementary And Alternative Medicine For Weight Control In The United States, Patricia A. Sharpe, Heidi M. Blanck, Joel E. Williams, Barbara E. Ainsworth, Joan M. Conway

Faculty Publications

Objectives: The purpose was to assess the prevalence and correlates of complementary and alternative medicine use for weight control.

Design: A list-assisted random-digit-dialed telephone survey of adults was conducted in the fall of 2002 (n = 11,211). The focus of the study was complementary and alternative medicine (CAM) use, other than dietary supplements, in the previous 12 months.

Settings/location: The sample of respondents was drawn from the total noninstitutionalized U.S. adult population residing in telephone-equipped locations.

Subjects: The sampling procedures were designed to obtain adequate representation of Hispanic and non-Hispanic black respondents. Data from the total sample of 11,211 …

Objectively Measured Physical Activity And Fat Mass In A Large Cohort Of Children, Andy R. Ness, Sam D. Leary, Calum Mattocks, Steven N. Blair, John J. Reilly, Jonathan Wells, Sue Ingle, Kate Tilling, George Davey Smith, Chris J. Riddoch

Faculty Publications

Background: Previous studies have been unable to characterise the association between physical activity and obesity, possibly because most relied on inaccurate measures of physical activity and obesity.

Methods and Findings: We carried out a cross sectional analysis on 5,500 12-year-old children enrolled in the Avon Longitudinal Study of Parents and Children. Total physical activity and minutes of moderate and vigorous physical activity (MVPA) were measured using the Actigraph accelerometer. Fat mass and obesity (defined as the top decile of fat mass) were measured using the Lunar Prodigy dual x-ray emission absorptiometry scanner. We found strong negative associations between MVPA and …

Seaweed And Soy: Companion Foods In Asian Cuisine And Their Effects On Thyroid Function In American Women, Jane Teas, Lewis E. Braverman, Mindy S. Kurzer, Sam Pino, Thomas G. Hurley, James R. Hébert

Faculty Publications

Seaweeds and soy are two commonly eaten foods in Asia. Both have been reported to affect thyroid function, seaweed because of its iodine content and soy because of its goitrogenic effect. Twenty-five healthy postmenopausal women (mean age 58 years) completed a double-blinded randomized crossover study. Ten capsules (5 g/day) of placebo or seaweed (Alaria exculenta), providing 475 ug of iodine/day, were consumed daily for 7 weeks. A powdered soy protein isolate (Solae Co., St. Louis, MO) providing 2 mg of isoflavones/kg of body weight, was given daily during the last week of each treatment arm. On average, …

Family Support For Physical Activity In Girls From 8th To 12th Grade In South Carolina, Marsha Dowda, Rod K. Dishman, Karin A. Pfeiffer, Russell R. Pate

Faculty Publications

Objective - To examine the relationship between perceived family support and other selected correlates of physical activity (PA) with changes in PA over time.

Methods - A total of 421 girls in South Carolina completed questionnaires at 8th, 9th and 12th grades (1998-2003). Family support for PA, PA self-efficacy, perceived behavioral control, attitudes, availability of equipment, and PA were measured.

Results - Growth curve analysis showed that family support, perceived behavioral control, and self-efficacy were independently related to age-related changes in PA as reflected by a total METs. Girls who reported lower family support at the 8th grade measure had …