Clinical Epidemiology Commons^™

Commentary: Community Partnered Research: Driving Sensemaking, Managing Knowledge, And Moving Mental Health Care To New Heights, Junius J. Gonzales, Carmen Moten

Publications from Provost Junius J. Gonzales

No abstract provided.

Need For Cognition And Message Complexity In Motivating Fruit And Vegetable Intake Among Callers To The Cancer Information Service, Pamela Williams-Piehota, Judith Pizarro, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

This field experiment examined the impact of an individual's need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were …

What Is Comprehensive Sexuality Education Really All About? Perceptions Of Students Enrolled In An Undergraduate Human Sexuality Course, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

The purpose of this study was to use qualitative evaluation techniques to explore the perceptions of students enrolled in undergraduate human sexuality classes regarding their expectations for the course as well as outcomes. One hundred forty-eight students were surveyed at the beginning and again at the end of the semester-long course. While pregnancy and STI prevention were considered important components of their courses, other outcomes associated with positive, healthy sexuality were given greater emphasis. Results suggest that while primary and secondary level sexuality education have been increasingly focused on abstinence-only education with a focus on pregnancy and STI reduction, this …

Oral Contraceptive Use And Risk Of Breast Cancer Among Women With A Family History Of Breast Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Family history of breast cancer is an established risk factor for breast cancer. In addition, there is evidence that oral contraceptive use may be associated with a moderate increase in breast cancer risk. The three cohort studies that have investigated the relationship between oral contraceptive use and breast cancer risk among women with a family history of breast cancer have yielded mixed results, possibly due to the relatively small sample sizes employed and/or differences in the selection of covariates for inclusion in multivariate models. Therefore, we examined the association between oral contraceptive use and breast cancer risk in a large …

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

Dietary Folate, Alcohol Consumption, And Risk Of Ovarian Cancer In An Italian Case-Control Study, Claudio Pelucchi, Monia Mereghetti, Renato Talamini, Eva Negri, Maurizio Montella, Valerio Ramazzotti, Silvia Franceschi, Carlo La Vecchia

Department of Public Health Scholarship and Creative Works

An increasing number of studies are focusing on the potential association between dietary folate intake and risk of various cancers (1), particularly of the colorectum and breast (2, 3). A low folate status can induce misincorporation of uracil into DNA, leading to chromosome breaks in humans and hence increasing cancer risk (4). Alcohol may increase folate requirements in the body and cause relative folate deficiencies (2). Although several findings on the relation between folate intake and ovarian cancer risk are inconsistent (5-9), recent results from two prospective …

Self-Management Strategies Mediate Self-Efficacy And Physical Activity, Rod K. Dishman, Robert W. Motl, James F. Sallis, Andrea L. Dunn, Amanda Birnbaum, Greg J. Welk, Ariane L. Bedimo-Rung, Carolyn C. Voorhees, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Background

Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested.

Methods

Confirmatory factor analysis was used to test the factorial validity of a measure of self-management strategies for physical activity. Next, the construct …

Risk Factors For Thyroid Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Given the higher incidence rate of thyroid cancer among women compared to men and evidence that smoking and alcohol consumption may be inversely related to thyroid cancer risk, we examined thyroid cancer risk in association with menstrual, reproductive, and hormonal factors, and cigarette and alcohol consumption, in a prospective cohort study of 89,835 Canadian women aged 40–59 at recruitment who were enrolled in the National Breast Screening Study (NBSS). Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths from all causes, respectively, with follow-up ending between 1998 and 2000. Cox proportional hazards models (using age …

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions: School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions:School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Predictors Of Violent Behavior In An Early Adolescent Cohort: Similarities And Differences Across Genders, Jonathan L. Blitstein, David M. Murray, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the eighth-grade year (2000) was entered into Poisson regression against baseline data collected at the beginning of the seventh-grade year (1998). Predictors of violent behavior influencing both boys and girls included depressive symptoms, perceived invulnerability to negative future events, paternal nonauthoritative behavior, and drinking alcohol. …

The Role Of Peer Social Network Factors And Physical Activity In Adolescent Girls, Carolyn C. Voorhees, David Murray, Greg Welk, Amanda Birnbaum, Kurt M. Ribisi, Carolyn C. Johnson, Karin Allor Pfeiffer, Brit Saksvig, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Objective: To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls.

Methods: Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school.

Results: Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses.

Conclusions: Frequency of PA with friends was an important correlate of PA among the peer network variables …

Using Media Messaging To Promote Healthful Eating And Physical Activity Among Urban Youth, B.J. Carter, Amanda Birnbaum, Lisa Hark, Brian Vickery, Charles Potter, Michael P. Osborne

Department of Public Health Scholarship and Creative Works

National trends show consistent increases, as well as racial and ethnic dis- parities, in the prevalence of overweight children and adolescents. Such disparity is evident regarding behaviors such as a poor diet and a lack of physical activity and in the prevalence and outcomes of associated health problems. It has been suggested that grounding interventions in cultural traditions and norms are critical for preventing obesity among ethnic and racial minority youth; however, with some notable exceptions, few community interventions have used this approach. Moreover, urban minority youth may face additional barriers to healthful eating and physical activity behaviors, such as …

Using Media Messaging To Promote Healthful Eating And Physical Activity Among Urban Youth, B.J Carter, Amanda Birnbaum, Lisa Hark, Brian Vickery, Charles Potter, Michael P. Osborne

Department of Public Health Scholarship and Creative Works

National trends show consistent increases, as well as racial and ethnic dis- parities, in the prevalence of overweight children and adolescents. Such disparity is evident regarding behaviors such as a poor diet and a lack of physical activity and in the prevalence and outcomes of associated health problems. It has been suggested that grounding interventions in cultural traditions and norms are critical for preventing obesity among ethnic and racial minority youth; however, with some notable exceptions, few community interventions have used this approach. Moreover, urban minority youth may face additional barriers to healthful eating and physical activity behaviors, such as …

Longitudinal Invariance Of The Center For Epidemiologic Studies-Depression Scale Among Girls And Boys In Middle School, Robert W. Motl, Rod K. Dishman, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This study tested the longitudinal factorial invariance of a theoretically consistent, higher-order model for Center for Epidemiologic Studies-Depression (CES-D) scores among adolescent girls and boys in middle school. Data were collected from 2,416 adolescents who completed a survey containing the CES-D in the fall of 1998, spring of 1999, and spring of 2000. The invariance analyses were conducted using LISREL 8.50 with maximum likelihood estimation and the Satorra-Bentler scaled chi-square statistic and standard errors. The higher-order model demonstrated longitudinal, as well as gender, invariance of the overall factor structure and first- and second-order structure coefficients, first-order factor variances, second-order factor …

Dietary Carbohydrates And Breast Cancer Risk: A Prospective Study Of The Roles Of Overall Glycemic Index And Glycemic Load, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

We examined breast cancer risk in association with overall glycemic index (GI), glycemic load (GL), and dietary carbohydrate and sugar intake in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study who completed a self‐administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow‐up ending between 1998 and 2000. During a mean follow‐up of 16.6 years, we observed 1,461 incident breast cancer cases. GI, GL, total carbohydrate and total sugar intake were not associated with breast cancer risk in the total …

Dietary Carbohydrates And Breast Cancer Risk: A Prospective Study Of The Roles Of Overall Glycemic Index And Glycemic Load, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

We examined breast cancer risk in association with an overall glycemic index (GI), glycemic load (GL), and dietary carbohydrate and sugar intake in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. During a mean follow-up of 16.6 years, we observed 1,461 incident breast cancer cases. GI, GL, total carbohydrate, and total sugar intake were not associated with breast cancer risk in the …

Assessing Intervention Effects In A School-Based Nutrition Intervention Trial: Which Analytic Model Is Most Powerful?, Jessica B. Janega, David M. Murray, Sherri P. Varnell, Jonathan L. Blitstein, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect (σΔ) from adjustments for both fixed and time-varying covariates and correlations over time. These estimates will allow other researchers to use these variables to plan their studies by estimating a priori detectable differences and sample size requirements for any of the four analytic options. These methods …

A Schematic For Focusing On Youth In Investigations Of Community Design And Physical Activity, Kevin J. Krizek, Amanda Birnbaum, David M. Levinson

Department of Public Health Scholarship and Creative Works

This paper provides a first step in addressing special considerations for youth in a relatively new area of physical activity research. After reviewing the urgent need for novel approaches to increasing physical activity, the growing interest in the effects of community design are discussed. Although most discussion on this topic has focused on adults, there are important differences between youth and adults that warrant a special focus on youth and need to be accounted for. This article presents a schematic that accounts for how and where youth spend their time, decomposing the day into time spent in travel and time …

School-Based Approaches To Affect Adolescents’ Diets: Results From The Teens Study, Leslie A. Lytle, David M. Murray, Cheryl L. Perry, Mary Story, Amanda Birnbaum, Martha Y. Kubik, Sherri Varnell

Department of Public Health Scholarship and Creative Works

This article reports on the outcomes of the Teens Eating for Energy and Nutrition at School (TEENS) study, a 2-year intervention study conducted in 16 middle schools with a goal of increasing students’ intakes of fruits, vegetables, and lower-fat foods. Despite positive interim results for students randomized to intervention schools, the positive effects of the intervention were not seen for the primary outcomes at the end of the 2nd year. Positive effects were seen only for a food choice score (suggesting that the students usually choose lower versus higher fat foods) and not for measures of food intake. Future studies …

Predicting Adolescents’ Intake Of Fruits And Vegetables, Leslie A. Lytle, Sherri Varnell, David M. Murray, Mary Story, Cherly Perry, Amanda Birnbaum, Martha Y. Kubik

Department of Public Health Scholarship and Creative Works

Objective

To explore potential predictors of adolescent fruit and vegetable intake by expanding on current theory and drawing from other adolescent research.

Design

This research reports on the baseline and interim data from a school-based intervention study. Data were collected through surveys administered to students at the beginning and end of their 7th-grade year.

Setting

The students attended 16 public schools in Minnesota.

Participants

Data were collected on 3878 students; approximately half were female and 67% were white. All students in the 7th-grade cohort were invited to participate in the surveys and over 94% completed both surveys.

Variables Measured

Our …

School Functioning And Violent Behavior Among Young Adolescents: A Contextual Analysis, Amanda Birnbaum, Leslie A. Lytle, Peter J. Hannan, David M. Murray, Cheryl L. Perry, Jean L. Foster

Department of Public Health Scholarship and Creative Works

This paper examines associations between overall school functioning and the frequency of violent behaviors among young adolescents (ages 10–14). The sample included 16 middle schools participating in an unrelated intervention study (on nutrition) in Minneapolis, Minnesota. A School Functioning Index developed to characterize schools’ overall stability, performance, and demographics was constructed using data from public archives and school administrator surveys. Data on violent behaviors and other variables were collected in student surveys in fall 1998 and spring 1999. We used multilevel modeling to assess the effect of school functioning on violent behavior after adjusting for known individual-level covariates of violent …

Associations Between Perceived Family Meal Environment And Parent Intake Of Fruit,Vegetables, And Fat, Kerri N. Boutelle, Amanda Birnbaum, Leslie Lytle, David M. Murray, Mary T. Story

Department of Public Health Scholarship and Creative Works

Objective

To describe the family mealtime environment and assess associations with adult fruit, vegetable, and fat intake.

Design

Telephone survey.

Participants

A convenience sample of 277 adults in the Minneapolis/St. Paul area were recruited through 4 schools. The sample was 85% female and 70% married. The mean number of children in the household was 2.6 (range 1 to 9).

Variables Measured

Adult fruit and vegetable intake, fat intake, and perceptions of the mealtime environment.

Analysis

Descriptive and mixed-model linear regression.

Results

Participants reported that the television was frequently on during dinner meals and almost one third felt that their family …

Diet, Obesity And Reflux In The Etiology Of Adenocarcinomas Of The Esophagus And Gastric Cardia In Humans, Susan Mayne, Stephanie A. Navarro Silvera

Department of Public Health Scholarship and Creative Works

Incidence rates for esophageal adenocarcinoma have increased >350% since the mid-1970s. Rates for gastric cardia adenocarcinoma have also increased, although less steeply. This led to the initiation of large population-based case-control studies, particularly in the United States and Sweden, aimed at identifying risk factors for these cancers. Results have been emerging from these studies, with the consistent finding that obesity and gastroesophageal reflux disease are important risk factors for these cancers. Analyses of dietary factors are also available and indicate that diets high in total fat, saturated fat and cholesterol are associated with an increased risk of these cancers, whereas …

Are Differences In Exposure To A Multicomponent School-Based Intervention Associated With Varying Dietary Outcomes In Adolescents?, Amanda S. Birnbaum, Leslie A. Lytle, Mary Story, Cheryl L. Perry, David M. Murray

Department of Public Health Scholarship and Creative Works

Multicomponent interventions are recommended for health behavior change among adolescents. However, it is difficult to disentangle the effects of multiple intervention components. This article reports outcomes associated with varying levels of exposure to a school-based nutrition intervention, Teens Eating for Energy and Nutrition at School (TEENS). Four incremental exposureswere possible: (1) control group, (2) school environment interventions only, (3) classroom plus environment interventions, and (4) peer leaders plus classroom plus environment interventions. Patterns suggesting dose response were observed, with peer leaders reporting the largest increases in fruit, vegetable, and lower fat food consumption. Students exposed to classroom plus environment interventions …

Perceptions Of The Family Mealtime Environment And Adolescent Mealtime Behavior: Do Adults And Adolescents Agree?, Kerri N. Boutelle, Leslie A. Lytle, David M. Murray, Amanda Birnbaum, Mary Story

Department of Public Health Scholarship and Creative Works

The family mealtime environment has great potential to affect the eating behaviors of youth in the family. It is difficult to determine the important elements of a healthy mealtime environment because a valid assessment of the family environment is so difficult to obtain. The objective of this study is to examine the level of agreement between adult and adolescent perceptions of the family mealtime environment and adolescent mealtime behavior. A telephone survey was used to query adult and adolescent family members about how they perceive the family mealtime environment and the adolescent's mealtime behavior. A convenience sample of 282 adult/adolescent …