Public Health Commons^™

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 …

Prevalence And Determinants For Overweight And Obesity Among Residents Of A Mining Township In Kitwe, Zambia, In 2011: A Population-Based Survey, Cosmas Zyaambo, Olesegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Rudatsikira, Victor M. Mukonka, Seter Siziya

Faculty Publications

Background: Obesity and overweight in Africa have been attributed to demogra- phic and nutritional changes that have resulted from urbanization and sedentary lifestyles and increased caloric intake without much physical activities. This has put populations at an increased risk of cardiovascular diseases, Diabetes mellitus, osteoarthritis, dyslipidemia, and cancer. The objective of this study was to deter- mine the prevalence and associated factors for combined overweight and obesity among residents of a mining town, Kitwe, in Zambia.

Methods: A cross sectional study was conducted using a modified WHO glo- bal Non Communicable Diseases Surveillance Initiative STEPs 1 and 2 method of …

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 …

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

Faculty Publications

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

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

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

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

The Association Between The Type, Context, And Levels Of Physical Activity Amongst Adolescents, Harriet Koorts, Calum Mattocks, Andy R. Ness, Kevin Deere, Steven N. Blair, Russell R. Pate, Chris Riddoch

Faculty Publications

Background: Little is known about how the type and context of physical activity behaviors varies among adolescents with differing activity levels. The aim of this study was to assess differences in the type and context of physical activity behaviors in adolescents by level of objectively measured physical activity. Methods: Cross-sectional analysis of 2728 adolescents (1299 males, 1429 females) participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). The mean (SD) age was 13.8 (+0.1) years. Physical activity was measured using an Actigraph over 7 days. Adolescents were categorized into tertiles of activity (less, moderately, highly active) using counts/min …

Social And Clinical Predictors Of Prostate Cancer Treatment Decisions Among Men In South Carolina, Sara E. Wagner, Bettina F. Drake, Keith Elder, James R. Hébert

Faculty Publications

OBJECTIVE:

To assess social and clinical influences of prostate cancer treatment decisions among white and black men in the Midlands of South Carolina.

METHODS:

We linked data collected on treatment decision making in men diagnosed with prostate cancer from 1996 through 2002 with clinical and sociodemographic factors collected routinely by the South Carolina Central Cancer Registry (SCCCR). Unconditional logistic regression was used to assess social and clinical influences on treatment decision.

RESULTS:

A total of 435 men were evaluated. Men of both races who chose surgery (versus radiation) were more likely to be influenced by their physician and by family/friends. …

Adipose Tissue Endocannabinoid System Gene Expression: Depot Differences And Effects Of Diet And Exercise, Tongjian You, Beth L. Disanzo, Xuewen Wang, Rongze Yang, Dawei Gong

Faculty Publications

Background: Alterations of endocannabinoid system in adipose tissue play an important role in lipid regulation and metabolic dysfunction associated with obesity. The purpose of this study was to determine whether gene expression levels of cannabinoid type 1 receptor (CB1) and fatty acid amide hydrolase (FAAH) are different in subcutaneous abdominal and gluteal adipose tissue, and whether hypocaloric diet and aerobic exercise influence subcutaneous adipose tissue CB1 and FAAH gene expression in obese women.

Methods: Thirty overweight or obese, middle-aged women (BMI = 34.3 ± 0.8 kg/m², age = 59 ± 1 years) underwent one of three 20-week weight …

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

Faculty Publications

No abstract provided.

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

Faculty Publications

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

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

Food Insecurity And Sexual Risk In An Hiv Endemic Community In Uganda, Cari L. Miller, David R. Bangsberg, David M. Tuller, Jude Senkungu, Annet Kawuma, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged …

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

Faculty Publications

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

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

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

Using Mixed-Methods To Measure The Perception Of Community Capacity In An Academic-Community Partnership For A Walking Intervention, Charkarra Anderson-Lewis, Diana Cuy-Castellanos, Arnecca Byrd, Karen Zynda, Alicia Sample, Vickie Blakely Reed, Mary Beard, Latessa Minor, Kathleen Yadrick

Faculty Publications

H.U.B. City Steps is a 5-year community-based participatory research walking intervention designed to help lower blood pressure in a majority African American population in southern Mississippi via community collaboration and capacity building, increased walking, culturally tailored health education sessions, and motivational interviewing. Building community capacity for physical activity is a key component of this intervention. Qualitative and quantitative methods have been used to assess how project stakeholders perceive the community capacity-building efforts of the project. This article illustrates the baseline results of this mixed methods approach from the perspective of three groups of stakeholders: project researchers and staff, community advisory …

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

Faculty Publications

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

Building Capacity In Physical Activity And Public Health, Russell R. Pate, Jennifer L. Gay, David R. Brown, Michael Pratt

Faculty Publications

No abstract provided.

Equating Accelerometer Estimates Of Moderate-To-Vigorous Physical Activity: In Search Of The Rosetta Stone, Daniel B. Bornstein, Michael W. Beets, Wonwoo Byun, Gregory J. Welk, Matteo Bottai, Marsha Dowda, Russell R. Pate

Faculty Publications

Purpose - No universally accepted ActiGraph accelerometer cutpoints for quantifying moderate-to-vigorous physical activity (MVPA) exist. Estimates of MVPA from one set of cutpoints cannot be directly compared to MVPA estimates using different cutpoints, even when the same outcome units are reported (MVPA min•d^-1). The purpose of this study was to illustrate the utility of an equating system that translates reported MVPA estimates from one set of cutpoints into another, to better inform public health policy.

Design - Secondary data analysis.

Methods - ActiGraph data from a large preschool project (N=419, 3-6yr-olds, CHAMPS) was used to conduct the analyses. …

The Association Between The Food Environment And Weight Status Among Eastern North Carolina Youth, Stephanie B. Jilcott, Scott Wade, Jared T. Mcguirt, Qiang Wu, Suzanne Lazorick, Justin B. Moore

Faculty Publications

Objective: To examine associations between various measures of the food environment and BMI percentile among youth.

Design: Cross-sectional, observational.

Setting: Pitt County, eastern North Carolina.

Subjects:We extracted the electronic medical records for youth receiving well child check-ups from January 2007 to June 2008. We obtained addresses for food venues from two secondary sources and ground-truthing. A geographic information systems database was constructed by geocoding home addresses of 744 youth and food venues. We quantified participants' accessibility to food venues by calculating 'coverage', number of food venues in buffers of 0●25, 0●5, 1 and 5 miles (0●4, 0●8, 1●6 and …

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

Faculty Publications

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

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

Validity Of Estimating Minute-By-Minute Energy Expenditure Of Continuous Walking Bouts By Accelerometry, Erin E. Kuffel, Scott E. Crouter, Jere D. Haas, Edward A. Frongillo Jr., David R. Bassett Jr

Faculty Publications

Background: Objective measurement of physical activity remains an important challenge. For wearable monitors such as accelerometer-based physical activity monitors, more accurate methods are needed to convert activity counts into energy expenditure (EE).

Purpose: The purpose of this study was to examine the accuracy of the refined Crouter 2-Regression Model (C2RM) for estimating EE during the transition from rest to walking and walking to rest. A secondary purpose was to determine the extent of overestimation in minute-by-minute EE between the refined C2RM and the 2006 C2RM.

Methods: Thirty volunteers (age, 28 ± 7.7 yrs) performed 15 minutes of seated rest, 8 …

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

Faculty Publications

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

The Contribution Of Dance To Daily Physical Activity Among Adolescent Girls, Jennifer R. O'Neill, Russell R. Pate, Steven P. Hooker

Faculty Publications

Background: Structured physical activity (PA) programs are well positioned to promote PA among youth, however, little is known about these programs, particularly dance classes. The aims of this study were to: 1) describe PA levels of girls enrolled in dance classes, 2) determine the contribution of dance classes to total moderate-to-vigorous physical activity (MVPA), and 3) compare PA between days with a dance class (program days) and days without a dance class (non-program days).

Methods: Participants were 149 girls (11-18 years) enrolled in dance classes in 11 dance studios. Overall PA was assessed with accelerometry for 8 consecutive days, and …