1
|
Islam FMA, Islam MA, Hosen MA, Lambert EA, Maddison R, Lambert GW, Thompson BR. Associations of physical activity levels, and attitudes towards physical activity with blood pressure among adults with high blood pressure in Bangladesh. PLoS One 2023; 18:e0280879. [PMID: 36735692 PMCID: PMC9897582 DOI: 10.1371/journal.pone.0280879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/28/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Physical activity is important for the control of high blood pressure (hypertension). We aimed to investigate the associations of current physical activity levels, sedentary time, knowledge of and attitude towards physical activity with blood pressure in people with hypertension in a rural area in Bangladesh. METHODS A total of 307 adults aged 30 to 75 years with hypertension were recruited from the Banshgram Union of Narial district as part of a cluster-randomized control trial. Current blood pressure was measured as the outcome variable. Associated variables included physical activity at work, travel to and from places, recreational activity, metabolic equivalent task (MET)-min, sedentary time, and awareness of and attitudes towards physical activity. Rasch analysis was used to compute a combined score from the five awareness of and attitudes towards physical activity items and categorized into 0-40 (towards negative attitude), 41-60 score (mixed attitude) and 61-100 (positive attitude). We used a generalised linear model to analyze the data. RESULTS Participants (n = 68, 22.1%) who engaged in vigorous-intensity physical activity that causes large increases in breathing or heart rate like carrying or lifting heavy loads, digging or construction work for at least 10 minutes continuously had lower systolic blood pressure (SBP) (mean (95% confidence interval (CI)), 143.6 (140.1, 147.2)) compared to those who did not take part in a vigorous-intensity physical activity (mean (95% CI), 150 (147.6, 152.3)). MET-min less than 600 min/week was significantly associated with higher SBP 153.8 (148.1, 159.6) than MET-min 600-2999 min/week 148.0 (143.0, 152.9) and MET-min>3000 min/week 146.9 (144.5, 149.3), p = 0.001 for trend. Sitting time more than four hours a day was associated with higher DBP 91.4 (89.7, 93.0) compared to those who had sitting time less than fours a day 88.6 (87.1, 90.1). People with positive attitudes were associated with a reduced SBP of 10.6 (0.36, 20.8) mmHg and DBP 5.88 (0.47, 11.3) compared to the people who had a negative attitude towards taking part in physical activity. CONCLUSIONS Participating in high physical activity and positive attitudes towards physical activity were associated with lower blood pressure levels. Physical activity awareness programs should be implemented to increase awareness of health benefits and increase participation in high physical activity.
Collapse
Affiliation(s)
- Fakir M. Amirul Islam
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Organisation for Rural Community Development (ORCD), Dariapur, Narail, Bangladesh
- * E-mail:
| | | | - Mohammad Arzan Hosen
- Organisation for Rural Community Development (ORCD), Dariapur, Narail, Bangladesh
| | - Elisabeth A. Lambert
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ralph Maddison
- Faculty of Health, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Gavin W. Lambert
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Bruce R. Thompson
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| |
Collapse
|
2
|
Joseph RP, Todd M, Ainsworth BE, Vega-López S, Adams MA, Hollingshead K, Hooker SP, Gaesser GA, Keller C. Smart Walk: A Culturally Tailored Smartphone-Delivered Physical Activity Intervention for Cardiometabolic Risk Reduction among African American Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1000. [PMID: 36673756 PMCID: PMC9859082 DOI: 10.3390/ijerph20021000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
This article reports the results of Smart Walk: a randomized pilot trial of an 8-month culturally tailored, smartphone-delivered physical activity (PA) intervention for African American women with obesity. Sixty participants (age range = 24−49 years; BMI range = 30−58 kg/m2) were randomized to the Smart Walk intervention (n = 30) or a wellness comparison intervention (n = 30). Results supported the acceptability and feasibility of the intervention, as demonstrated by participant retention (85% at 4 months and 78% at 8 months), Smart Walk app use, and intervention satisfaction (i.e., 100% of PA participants completing the intervention [n = 24] reported they would recommend it to friend). Smart Walk participants also reported greater increases in moderate-to-vigorous PA (4-month between-arm difference in change [b] = 43.3 min/week; p = 0.018; Cohen’s d = 0.69; 8-month b = 56.6 min/week; p = 0.046; d = 0.63) and demonstrated clinically relevant, although not statistically significant (p-values > 0.05), baseline to 4 months improvements in cardiorespiratory fitness (b = 1.67 mL/kg/min; d = 0.40), systolic blood pressure (b = −3.33 mmHg; d = 0.22), diastolic blood pressure (b = −4.28 mmHg; d = 0.37), and pulse wave velocity (b = −0.46 m/s; d = 0.33). Eight-month cardiometabolic outcomes followed similar trends, but had high rates of missing data (45−53%) due to COVID-19 restrictions. Collectively, findings demonstrated favorable outcomes for acceptability and feasibility, while also highlighting key areas for refinement in future research.
Collapse
Affiliation(s)
- Rodney P. Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA
| | - Michael Todd
- College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA
| | | | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ 85004, USA
| | - Marc A. Adams
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Steven P. Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA 92182, USA
| | - Glenn A. Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA
| |
Collapse
|
3
|
Pham T, Green R, Neaves S, Hynan LS, Bell KR, Juengst SB, Zhang R, Driver S, Ding K. Physical activity and perceived barriers in individuals with moderate-to-severe traumatic brain injury. PM R 2022:10.1002/pmrj.12854. [PMID: 35596121 PMCID: PMC9675876 DOI: 10.1002/pmrj.12854] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Regular physical activity (PA), especially aerobic exercise, may benefit cognitive function in middle-aged and older adults, but promoting regular PA in individuals with traumatic brain injury (TBI) remains a challenge. OBJECTIVE To characterize PA and perceived barriers to PA in younger (<45 years) and middle age and older (≥45 years) individuals ≥1 year after moderate-to-severe TBI. DESIGN Multicenter survey study. SETTING Community. PARTICIPANTS Persons who met the following criteria were included in the study: (1) 18 years and older; (2) English speaking; (3) History of moderate-to-severe TBI; (4) Followed in a TBI Model Systems Center for at least 1 year; and (5) Able to complete the survey independently. INTERVENTION Not applicable. MAIN OUTCOME MEASURE(S) PA level measured by Rapid Assessment of Physical Activity questionnaire (RAPA) and self-reported barriers to PA. RESULTS A total of 472 participants completed the survey (response rate of 21%). More individuals in the younger group (<45 years old) met Centers for Disease Control and Prevention (CDC) recommended aerobic PA guidelines compared to the middle-aged and older group (≥ 45 years old) (62% vs 36%, p < .001). Lack of motivation, lack of time, and fatigue were the most reported barriers. Perceived barriers to PA varied by age and PA level: the middle-aged and older individuals (≥ 45 years old) were more likely to report no barriers and inactive individuals (RAPA ≤5) more likely to report lack of motivation and money, pain, and lack of resources. CONCLUSION Participants ≥45 years of age were less likely to meet the CDC PA guidelines than younger individuals after moderate-to-severe TBI. Because perceived barriers to PA varied between age groups and PA levels, individualized approaches may be needed to promote PA in this population.
Collapse
Affiliation(s)
- Tri Pham
- University of Texas Southwestern Medical School, Dallas, TX
| | - Rachel Green
- University of Texas Southwestern Medical School, Dallas, TX
| | - Stephanie Neaves
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX
| | - Linda S. Hynan
- Department of Population and Data Sciences & Psychiatry, University of Texas Southwestern Medical Center Dallas, TX
| | - Kathleen R. Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX
| | - Shannon B. Juengst
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX
| | - Rong Zhang
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
| | - Simon Driver
- Baylor Scott and White Research Institute, Dallas, Texas
| | - Kan Ding
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
| |
Collapse
|
4
|
Knowledge of and Intention to Participate in Physical Activity Programs and Their Associated Sociodemographic Factors in People with High Blood Pressure in a Rural Area of Bangladesh: Initial Investigation from a Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189561. [PMID: 34574492 PMCID: PMC8467109 DOI: 10.3390/ijerph18189561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022]
Abstract
This initial investigation aimed to investigate the knowledge of the health benefits of physical activity (PA) and attitudes towards participation in PA. The study recruited 307 people aged 30-75 years with hypertension as part of a cluster randomized controlled trial from a rural area in Bangladesh. Of the 307 participants, 135 participated less than 2.5 h of physical activity per week, from which we collected data on attitudes toward PA. Regression analysis and Rasch analysis were used. More than 85% of homemakers, employees or businesspersons were willing to take part in PA. Based on the combined score from the knowledge and attitude items, 46% of people endorsed PA programs; proportions were higher in men than women (53% vs. 41%). After adjusting for covariates, men (odds ratio, 95% confidence interval (CI) 3.50, 1.72-7.11) compared to women and people with at least primary levels of schooling (OR 3.06, 95% CI, 1.27-7.38) compared with those with no education were more likely to organize or take part in any PA programs. People have positive attitudes towards PA but do not feel obligated to participate in PA programs. Future programs are needed to promote awareness and motivational interventions for PA, especially targeting women and people with low education levels, should be developed and implemented.
Collapse
|
5
|
Tang L, Wang J. Effects of New Media Use on Health Behaviors: A Case Study in China. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:949-958. [PMID: 34183953 PMCID: PMC8223554 DOI: 10.18502/ijph.v50i5.6112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Mass communication is one of the most important ways in health communication. The emergence of new media has changed the way people acquire health information and then their health behaviors. However, few studies have been conducted about complicated relations between media use and health behaviors under new media conditions and further systematic explanation is needed. Methods: A hypothesis model for the influence of WeChat use on health behaviors was constructed to explore the internal influencing mechanism of new media use on health behaviors. An empirical analysis on the internal influencing mechanism of WeChat use on health behaviors was carried out with a survey data consist of 463 young active users on famous online social network sites in China from March to June 2019. Results: New media use represented by WeChat has significant positive influence on health behaviors. Individuals who frequently use new media related to health have better health conditions than those who rarely use them. The improvement of health behaviors is mainly attributed to acquisition of health knowledge. Such effect is also mediated by the degree of individuals’ trust in health knowledge. Conclusion: This study not only discloses the influencing mechanism of new media use and health knowledge on health behaviors, but also confirms the value of new media in promoting public health communication and public health behaviors. Conclusions provide significant references in decision-making to develop effective guidance of public health.
Collapse
Affiliation(s)
- Lifang Tang
- School of Media and Design, Hangzhou Dianzi University, Hangzhou, China
| | - Jie Wang
- School of Media and Design, Hangzhou Dianzi University, Hangzhou, China
| |
Collapse
|
6
|
Joseph RP, Ainsworth BE, Hollingshead K, Todd M, Keller C. Results of a Culturally Tailored Smartphone-Delivered Physical Activity Intervention Among Midlife African American Women: Feasibility Trial. JMIR Mhealth Uhealth 2021; 9:e27383. [PMID: 33885368 PMCID: PMC8103296 DOI: 10.2196/27383] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Regular aerobic physical activity (PA) is an important component of healthy aging. However, only 27%-40% of African American women achieve national PA guidelines. Available data also show a clear decline in PA as African American women transition from young adulthood (ie, 25-44 years) into midlife. This decline in PA during midlife coincides with an increased risk for African American women developing cardiometabolic disease conditions, including obesity, type 2 diabetes, and cardiovascular disease. Thus, effective efforts are needed to promote PA among sedentary African American women during midlife. OBJECTIVE This study aims to examine the acceptability and feasibility of a culturally tailored, smartphone-delivered PA intervention, originally developed to increase PA among African American women aged 24-49 years, among a slightly older sample of midlife African American women aged 50-65 years. METHODS A single-arm pretest-posttest study design was implemented. In total, 20 insufficiently active African American (ie, ≤60 min per week of PA) women between the ages of 50-65 years participated in the 4-month feasibility trial. The Smart Walk intervention was delivered through the study Smart Walk smartphone app and text messages. Features available on the Smart Walk app include personal profile pages, multimedia PA promotion modules, discussion board forums, and an activity tracking feature that integrates with Fitbit activity monitors. Self-reported PA and social cognitive theory mediators targeted by the intervention (ie, self-regulation, behavioral capability, outcome expectations, self-efficacy, and social support) were assessed at baseline and at 4 months. Feasibility and acceptability were assessed using a postintervention satisfaction survey that included multiple-choice and open-ended questions evaluating participant perceptions of the intervention and suggestions for intervention improvement. Wilcoxon signed-rank tests were used to examine pre- and postintervention changes in the PA and social cognitive theory variables. The effect size estimates were calculated using the Pearson r test statistic. RESULTS Participants increased moderate-to-vigorous PA (median 30 minutes per week increase; r=0.503; P=.002) and reported improvements in 2 theoretical mediators (self-regulation: r=0.397; P=.01; behavioral capability: r=0.440; P=.006). Nearly all participants (14/15, 93% completing the satisfaction survey) indicated that they would recommend the intervention to a friend. Participants' suggestions for improving the intervention included enhancing the intervention's provisions of social support for PA. CONCLUSIONS The results provide preliminary support for the feasibility of the smartphone-based approach to increase PA among midlife African American women. However, before larger-scale implementation among midlife African American women, enhancements to the social support components of the intervention are warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT04073355; https://clinicaltrials.gov/ct2/show/NCT04073355.
Collapse
Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Barbara E Ainsworth
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
- Department of Kinesiology, Shanghai University of Sport, Shanghai Shi, China
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| |
Collapse
|
7
|
Patel M, Boutin-Foster C, Phillips E. Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City. ETHNICITY & HEALTH 2019; 24:432-442. [PMID: 28669239 DOI: 10.1080/13557858.2017.1346191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/17/2017] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Among all South Asians, Bangladeshis have the highest prevalence of cardiovascular disease (CVD). The purpose of our study was to compare the understanding of CVD risk factors among Bangladeshi immigrants to the general Caucasian population in the U.S. DESIGN We surveyed Bangladeshi immigrants in Queens, New York using a CVD risk factor knowledge instrument used in the Coronary Artery Risk Development in Young Adults (CARDIA) study to assess awareness of risk factors. Using multivariate regression modeling, we compared scores on the knowledge instrument between Bangladeshis we surveyed and Caucasians from the CARDIA study, controlling for potential confounders. We subsequently examined the frequency of mentioning each risk factor to understand what was driving the difference in the overall score. RESULTS The proportion of Bangladeshis scoring low on the knowledge assessment was 0.53, where as the proportion of whites scoring low in the CARDIA study was 0.32 (p value < .001). Whites were 34% more likely to score high than Bangladeshis (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.19-1.52). Bangladeshis were more likely to mention diet and cholesterol as risk factors and less likely to mention lack of exercise, being overweight, and smoking as risk factors. CONCLUSION Understanding of cardiovascular disease risk factors was lower among Bangladeshis than whites. This was driven by Bangladeshis having less awareness regarding how exercise and being overweight contribute to CVD. Community based interventions and community health partnerships should target these behavioral risk factors in the Bangladeshi population.
Collapse
Affiliation(s)
- Mihir Patel
- a Division of General Internal Medicine, Department of Medicine , George Washington University , Washington , DC , USA
| | - Carla Boutin-Foster
- b Office of Diversity Education & Research , SUNY Downstate Medical Center , Brooklyn , NY , USA
| | - Erica Phillips
- c Division of General Internal Medicine , Weill Cornell Medicine , New York , NY , USA
| |
Collapse
|
8
|
Joseph RP, Ainsworth BE, Vega-López S, Adams MA, Hollingshead K, Hooker SP, Todd M, Gaesser GA, Keller C. Rationale and design of Smart Walk: A randomized controlled pilot trial of a smartphone-delivered physical activity and cardiometabolic risk reduction intervention for African American women. Contemp Clin Trials 2019; 77:46-60. [PMID: 30576840 PMCID: PMC6344046 DOI: 10.1016/j.cct.2018.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/07/2018] [Accepted: 12/16/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND African American (AA) women perform low levels of physical activity (PA) and are disproportionally burdened by cardiometabolic disease conditions when compared to White women and the U.S. population as a whole. These disparities emphasize the need for innovative and effective interventions to increase PA and reduce cardiometabolic disease risk among AA women. Recent evidence suggests that mobile health (mHealth) interventions have the potential to increase PA and reduce cardiometabolic disease risk factors. Few studies have examined the efficacy of mHealth PA interventions among racial/ethnic minorities, including AA women. This represents a missed opportunity given the reported success of technology-delivered PA interventions in predominately White populations and the high use of technology among AA women. OBJECTIVE To describe the design, theoretical rationale, and cultural relevance of Smart Walk, a culturally sensitive smartphone-delivered PA intervention for AA women. DESIGN AND METHODS Smart Walk is an 8-month, randomized controlled pilot trial designed to increase PA and reduce cardiometabolic disease risk among AA women. Sixty physically inactive AA women with obesity will be assigned to receive either a culturally relevant intervention designed to increase PA (by targeting leisure-time, household chore/task-related, and occupational PA) or a culturally relevant wellness attention-matched control condition. Outcomes will be assessed at baseline, 4 months, and 8 months, and include feasibility and acceptability of the PA intervention and evaluation of effects on PA and cardiometabolic risk factors. SUMMARY Smart Walk represents a culturally relevant, theory-based approach to promote PA and reduce cardiometabolic disease risk in AA women.
Collapse
Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
| | - Barbara E Ainsworth
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Sonia Vega-López
- College of Health Solutions and Southwest Interdisciplinary Research Center, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Marc A Adams
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Michael Todd
- College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
| | - Glenn A Gaesser
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
| |
Collapse
|
9
|
Knowledge of nutrition and physical activity in apparently healthy Indian adults. Public Health Nutr 2018; 21:1743-1752. [DOI: 10.1017/s1368980017004268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo assess knowledge of nutrition and physical activity; examine associations of knowledge with sociodemographic and anthropometric parameters; and evaluate the relationship between knowledge and practice in adults.DesignIn a cross-sectional design, 720 adults were selected using random sampling. Data on anthropometry, body fat, diet, physical activity, and nutrition and physical activity knowledge were collected using standardized questionnaires. Tertiles were used to categorize nutrition knowledge (NK) and physical activity knowledge (PK).SettingsSubjects selected through routine health checks from hospitals, housing societies and residential areas.SubjectsA total of 720 adults (361 men) aged 35–50 years participated.ResultsMean age was 42·7 (sd 9·4) years and mean BMI was 25·8 (sd 5·0) kg/m2. Mean energy intake was 64 %, protein was 68 % and fat was 144 % of the RDA. Mean NK and PK scores were 10·2 (sd 2·9) and 6·5 (sd 1·7), respectively, and were similar across genders (P>0·05). Individuals with higher education exhibited significantly higher NK and PK. Individuals with high fat had significantly higher NK and PK (P<0·05) than participants with normal fat percentage. Overweight and obese individuals had significantly higher PK (P<0·05). Multivariate regression modelling indicated that NK was positively associated with dietary intakes of leafy vegetables, salads and sprouts but negatively associated with fruit intake. BMI, television and reading time were positively associated with PK, even after adjusting for sociodemographic status.ConclusionsThere is a need for increased efforts towards developing health education programmes focusing on transforming nutrition and physical activity knowledge into practice and adherence to guidelines.
Collapse
|
10
|
Hong Kong Chinese adults' knowledge of exercise recommendations and attitudes towards exercise. BJGP Open 2017; 1:bjgpopen17X100929. [PMID: 30564666 PMCID: PMC6169949 DOI: 10.3399/bjgpopen17x100929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Physical inactivity is known to be one of the major risk factors for many chronic conditions. Aim To determine Hong Kong Chinese adults’ physical activity (PA) knowledge, its relationship with certain variables including sex, education, age, and its correlation with different types of chronic diseases, such as heart disease, cerebrovascular disease, diabetes mellitus, obesity, and others. The Hong Kong Chinese adults' general attitudes towards PA will also be examined. Design & setting Cross-sectional study in one primary care centre. Method A randomized sample of Chinese adults aged >18 years with anonymous self-administered questionnaires. Results The mean percentage of correct responses for exercise guidelines was 62.3%, 84.5% for traditional PA, and 48.4% for lifestyle PA, respectively. Traditional PA refers to exercises which use large muscle groups. Lifestyle PAs include activities which can be done throughout the day. The total mean percentage of correct responses was 67% (knowledge score 13.4 +/– 3.34). There were no significant differences between PA knowledge and sex, education levels, age groups, and presence of chronic diseases (P>0.05), but the knowledge level for lifestyle PA was less than that of traditional PA (P<0.001). A weak correlation was found between responders’ activeness for a health benefit and the PA knowledge levels (P>0.05). Two hundred and sixy-six (93.3%) responders reported a willingness to maintain or start exercise. Conclusion The results suggest a need for more education about the latest PA recommendations, especially lifestyle PA. The weak correlation between PA knowledge and actual behaviour showed that PA knowledge itself might not affect PA behaviour. The enhancement of the general public’s knowledge, motivation, and psychosocial support along with stage-of-change interventions and the provision of counselling skills may result in PA behaviour change, which in turn can lead to the achievement of health benefits.
Collapse
|
11
|
|
12
|
Bruss MB, Applegate B, Quitugua J, Palacios RT, Morris JR. Ethnicity and Diet of Children: Development of Culturally Sensitive Measures. HEALTH EDUCATION & BEHAVIOR 2016; 34:735-47. [PMID: 17287492 DOI: 10.1177/1090198106294648] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Obesity is a growing global concern. Examining dietary habits of individuals can facilitate the development of important prevention approaches, which are needed to decrease the incidence of obesity and other related diseases and improve quality of life indices. Because food preferences and dietary habits vary across cultures, it is essential that prevention programs are based on specific populations. Using both ethnographic and quantitative methods, food-consumption patterns were investigated among 1,125 children in the Commonwealth of the Northern Mariana Islands. Differences were observed related to food frequency, age of children, and grade level. Exploratory factor analyses suggested that the individual foods were best organized into food-consumption groups that reflected cultural characteristics rather than more commonly referenced food organizational systems. In addition to developmental differences in food consumption patterns, results suggest that the ethnicity of parents may play a role in the diet of children.
Collapse
Affiliation(s)
- Mozhdeh B Bruss
- Department of Family and Consumer Sciences, Western Michigan University, Kalamazoo, MI 49008, USA.
| | | | | | | | | |
Collapse
|
13
|
Tyler DO, Horner SD. A primary care intervention to improve weight in obese children: A feasibility study. J Am Assoc Nurse Pract 2015; 28:98-106. [PMID: 25782163 DOI: 10.1002/2327-6924.12246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 01/20/2015] [Indexed: 11/06/2022]
Abstract
PURPOSE Examine the effects of a primary care weight management program, which used a parent-child-provider collaborative negotiation intervention, among rural-dwelling families with obese children. DATA SOURCES Health histories, physical examinations, fasting blood samples, interviews, and questionnaires. CONCLUSIONS Feasibility of implementing a family weight management intervention in a rural primary care setting was demonstrated. Few differences between the treatment and comparison groups were found; however, more favorable trends and outcomes occurred in those who received the intervention. IMPLICATIONS FOR PRACTICE Positive provider-patient communication in helping families with obese children make difficult lifestyle changes should be encouraged in primary care clinics as small changes in behavior can result in reducing risk and improving health outcomes.
Collapse
Affiliation(s)
- Diane O Tyler
- American Academy of Nurse Practitioners Certification Program, Austin, Texas.,The University of Texas at Austin School of Nursing, Austin, Texas
| | - Sharon D Horner
- The University of Texas at Austin School of Nursing, Austin, Texas
| |
Collapse
|
14
|
Rausch JC, Berger-Jenkins E, Nieto AR, McCord M, Meyer D. Effect of a School-Based Intervention on Parents' Nutrition and Exercise Knowledge, Attitudes, and Behaviors. AMERICAN JOURNAL OF HEALTH EDUCATION 2015. [DOI: 10.1080/19325037.2014.977411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
15
|
Association between Physical Activity Knowledge and Levels of Physical Activity in Chinese Adults with Type 2 Diabetes. PLoS One 2014; 9:e115098. [PMID: 25493559 PMCID: PMC4262475 DOI: 10.1371/journal.pone.0115098] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 11/17/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Physical activity (PA) is an important treatment regimen for diabetes. The purposes of this study were to evaluate people's knowledge of how exercise influences wellbeing (termed "PA knowledge" or "knowledge of PA" in this paper) and the resulting association with levels of PA in Chinese adults with Type 2 diabetes, and to identify the valuable demographic and lifestyle factors that possibly influence the association between PA knowledge and level of PA. METHODS Two hundred and fifty-eight adults with Type 2 diabetes completed an interviewer-administered survey at a diabetes clinic in Hong Kong. Data on demographics, lifestyle factors and diabetes-related medical indicators were obtained. A 20-item questionnaire was developed to measure PA-related knowledge (one point scored for each correct answer; aggregate score up to 20 points). level of PA was measured by the International Physical Activity Questionnaire. RESULTS The proportions of correct answers to each question ranged from 19.4 to 90.7%. Compared with poorly educated participants, those with university education level and above had PA knowledge scores 1.7 points higher (14.3 vs. 12.6, P<0.05). Younger, female, and obese participants were more likely to have lower level of PA (all P<0.05). After adjustment for age, gender, (BMI) and education level, the odds of having a moderate-to-high level of PA was 19% greater with 1 unit increase in PA knowledge score [95% confidence interval (CI): 1.09-1.29; P<0.001], this association was strongest in participants with tertiary education level or above [odds ratio (OR): 1.35; 95% CI: 1.03-1.77; P<0.05]. CONCLUSIONS PA knowledge was positively associated with level of PA. Education level significantly influenced the association between PA knowledge and level of PA, leading to the suggestion of vulnerable groups to target for PA improvement in the face of diabetes.
Collapse
|
16
|
Berger-Jenkins E, Rausch J, Okah E, Tsao D, Nieto A, Lyda E, Meyer D, McCord M. Evaluation of a Coordinated School-Based Obesity Prevention Program in a Hispanic Community: Choosing Healthy and Active Lifestyles for Kids/Healthy Schools Healthy Families. AMERICAN JOURNAL OF HEALTH EDUCATION 2014. [DOI: 10.1080/19325037.2014.932724] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
| | - John Rausch
- Columbia University Medical Center, Children's Hospital of New York
| | | | | | - Andres Nieto
- Ambulatory Care Network, New York-Presbyterian Hospital
| | | | - Dodi Meyer
- Columbia University Medical Center, Children's Hospital of New York
| | | |
Collapse
|
17
|
Kendzor DE, Chen M, Reininger BM, Businelle MS, Stewart DW, Fisher-Hoch SP, Rentfro AR, Wetter DW, McCormick JB. The association of depression and anxiety with glycemic control among Mexican Americans with diabetes living near the U.S.-Mexico border. BMC Public Health 2014; 14:176. [PMID: 24548487 PMCID: PMC3929559 DOI: 10.1186/1471-2458-14-176] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 02/12/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The prevalence of diabetes is alarmingly high among Mexican American adults residing near the U.S.-Mexico border. Depression is also common among Mexican Americans with diabetes, and may have a negative influence on diabetes management. Thus, the purpose of the current study was to evaluate the associations of depression and anxiety with the behavioral management of diabetes and glycemic control among Mexican American adults living near the border. METHODS The characteristics of Mexican Americans with diabetes living in Brownsville, TX (N = 492) were compared by depression/anxiety status. Linear regression models were conducted to evaluate the associations of depression and anxiety with BMI, waist circumference, physical activity, fasting glucose, and glycated hemoglobin (HbA1c). RESULTS Participants with clinically significant depression and/or anxiety were of greater age, predominantly female, less educated, more likely to have been diagnosed with diabetes, and more likely to be taking diabetes medications than those without depression or anxiety. In addition, anxious participants were more likely than those without anxiety to have been born in Mexico and to prefer study assessments in Spanish rather than English. Greater depression and anxiety were associated with poorer behavioral management of diabetes (i.e., greater BMI and waist circumference; engaging in less physical activity) and poorer glycemic control (i.e., higher fasting glucose, HbA1c). CONCLUSIONS Overall, depression and anxiety appear to be linked with poorer behavioral management of diabetes and glycemic control. Findings highlight the need for comprehensive interventions along the border which target depression and anxiety in conjunction with diabetes management.
Collapse
Affiliation(s)
- Darla E Kendzor
- School of Public Health, The University of Texas Health Science Center, Dallas, TX, USA
- Population Science and Cancer Control Program, UT Southwestern Harold C. Simmons Cancer Center, Dallas, TX, USA
| | - Minxing Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Belinda M Reininger
- School of Public Health, The University of Texas Health Science Center, Brownsville, TX, USA
| | - Michael S Businelle
- School of Public Health, The University of Texas Health Science Center, Dallas, TX, USA
- Population Science and Cancer Control Program, UT Southwestern Harold C. Simmons Cancer Center, Dallas, TX, USA
| | - Diana W Stewart
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan P Fisher-Hoch
- School of Public Health, The University of Texas Health Science Center, Brownsville, TX, USA
| | - Anne R Rentfro
- College of Nursing, The University of Texas at Brownsville, Brownsville, TX, USA
| | - David W Wetter
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph B McCormick
- School of Public Health, The University of Texas Health Science Center, Brownsville, TX, USA
| |
Collapse
|
18
|
Lora CM, Ricardo AC, Brecklin CS, Fischer MJ, Rosman RT, Carmona E, Lopez A, Balaram M, Nessel L, Tao KK, Xie D, Kusek JW, Go AS, Lash JP. Recruitment of Hispanics into an observational study of chronic kidney disease: the Hispanic Chronic Renal Insufficiency Cohort Study experience. Contemp Clin Trials 2012; 33:1238-44. [PMID: 22841929 DOI: 10.1016/j.cct.2012.07.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 06/27/2012] [Accepted: 07/16/2012] [Indexed: 12/12/2022]
Abstract
Despite the large burden of chronic kidney disease (CKD) in Hispanics, this population has been underrepresented in research studies. We describe the recruitment strategies employed by the Hispanic Chronic Renal Insufficiency Cohort Study, which led to the successful enrollment of a large population of Hispanic adults with CKD into a prospective observational cohort study. Recruitment efforts by bilingual staff focused on community clinics with Hispanic providers in high-density Hispanic neighborhoods in Chicago, academic medical centers, and private nephrology practices. Methods of publicizing the study included church meetings, local Hispanic print media, Spanish television and radio stations, and local health fairs. From October 2005 to July 2008, we recruited 327 Hispanics aged 21-74 years with mild-to-moderate CKD as determined by age-specific estimated glomerular filtration rate (eGFR). Of 716 individuals completing a screening visit, 49% did not meet eGFR inclusion criteria and 46% completed a baseline visit. The mean age at enrollment was 57.1 and 67.1% of participants were male. Approximately 75% of enrolled individuals were Mexican American, 15% Puerto Rican, and 10% had other Latin American ancestry. Eighty two percent of participants were Spanish-speakers. Community-based and academic primary care clinics yielded the highest percentage of participants screened (45.9% and 22.4%) and enrolled (38.2% and 24.5%). However, academic and community-based specialty clinics achieved the highest enrollment yield from individuals screened (61.9% to 71.4%). A strategy focused on primary care and nephrology clinics and the use of bilingual recruiters allowed us to overcome barriers to the recruitment of Hispanics with CKD.
Collapse
|
19
|
Lora CM, Gordon EJ, Sharp LK, Fischer MJ, Gerber BS, Lash JP. Progression of CKD in Hispanics: potential roles of health literacy, acculturation, and social support. Am J Kidney Dis 2011; 58:282-90. [PMID: 21787982 DOI: 10.1053/j.ajkd.2011.05.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 05/06/2011] [Indexed: 11/11/2022]
Abstract
Hispanics are the fastest growing minority group in the United States, and compared with non-Hispanic whites, they have a higher incidence of end-stage renal disease. Examining novel factors that may explain this disparity in progression of chronic kidney disease (CKD) in Hispanics is urgently needed. Interpersonal and patient-centered characteristics, including health literacy, acculturation, and social support, have been shown to affect health outcomes in patients with other chronic diseases. However, these characteristics have not been well studied in the context of CKD, particularly in relation to disease knowledge, attitudes, and behaviors. In this report, we examine the potential roles of these factors for CKD progression in Hispanics and propose targeted therapeutic interventions.
Collapse
|
20
|
Salinas J, McCormick JB, Rentfro A, Hanis C, Hossain MM, Fisher-Hoch SP. The missing men: high risk of disease in men of Mexican origin. Am J Mens Health 2010; 5:332-40. [PMID: 20930218 DOI: 10.1177/1557988310379390] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The present study sought to determine gender- and age-specific prevalences of chronic diseases in an urban Mexican American border community. The Cameron County Hispanic Cohort (CCHC; n = 2,000) was selected using a multistaged cluster design. Sociodemographics, anthropometric measures, and blood samples were collected on each participant. More women were obese (55.1%) than men (44.8%). Men had significantly higher rates of diabetes (20.4% for men vs. 15.8% for women, p < .05) and undiagnosed diabetes (6.2% for men vs. 2.4% for women, p < .01); the prevalence of diabetes rose steeply between the ages of 40 and 49 years. Men were significantly more likely to have serum cholesterol levels of 200 mg/dL and elevated low-density lipoprotein levels (22.6% vs. 26.1%, p < .01). Mexican American males in the U.S./Mexico border region have a high prevalence of obesity in younger men and higher overall rates of diabetes, including undiagnosed diabetes, and significantly higher serum cholesterol levels than women.
Collapse
Affiliation(s)
- Jennifer Salinas
- University of Texas, Houston Health Science Center, Houston, TX 78520, USA.
| | | | | | | | | | | |
Collapse
|
21
|
Morrow JR, Krzewinski-Malone JA, Jackson AW, Bungum TJ, FitzGerald SJ. American adults' knowledge of exercise recommendations. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2004; 75:231-237. [PMID: 15487287 DOI: 10.1080/02701367.2004.10609156] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Physical inactivity is a major risk factor for cardiovascular disease, stroke, hypertension, diabetes, obesity, osteoporosis, and some cancers. Approximately 950,000 Americans die annually from cardiovascular diseases. The purpose of this study was to determine whether American adults know which traditional and lifestyle physical activities affect health and how they should be physically active to achieve a health benefit. Secondary purposes were to determine whether this knowledge is a function of gender, ethnicity, education, or age and if those who are sufficiently active for a health benefit possess different knowledge levels than those not sufficiently active for a health benefit. Items based on the Centers for Disease Control and Prevention/American College of Sports Medicine principles included knowledge of exercise guidelines and traditional and lifestyle physical activities. This information was obtained from 20 questions that were part of a national random telephone survey of 2,002 American households in the 48 contiguous states and the District of Columbia. Respondents were most aware of traditional physical activities (M = 94%) that provide a health benefit and less aware of specific exercise guidelines (M = 68%) and lifestyle physical activities (M = 71%) that can result in a health benefit. Knowledge was not related to physical activity behavior sufficient for a health benefit and only slightly related to ethnicity, education, and age. These data suggest that physical activity knowledge alone is not sufficient to elicit a behavior; however, it provides educators with an understanding of the public's physical activity knowledge that could be helpful in developing health promotion and physical activity interventions.
Collapse
Affiliation(s)
- James R Morrow
- Department of Kinesiology, Health Promotion, and Recreation at the University of North Texas, Denton, 76203-0796, USA.
| | | | | | | | | |
Collapse
|
22
|
Miller AM, Wilbur J, Chandler PJ, Sorokin O. Cardiovascular Disease Risk Factors and Menopausal Status in Midlife Women from the Former Soviet Union. Women Health 2003; 38:19-36. [PMID: 14664303 DOI: 10.1300/j013v38n03_03] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this cross-sectional analysis is to examine modifiable CVD risk factors in relation to menopausal status, age, and length of residence in the U.S. of midlife women from the former Soviet Union. The analysis includes baseline data for 193 women, aged 40-70, who lived in the U.S. fewer than 8 years and were enrolled in an ongoing four-year study of post-immigration health and behavior change. Data collection was conducted in women's homes or other community locations. The presence of seven health risk indicators (obesity, dyslipidemia, high blood pressure, diabetes mellitus, sedentary lifestyle, smoking, and excessive alcohol use) was assessed. In addition, Framingham 10 year risk scores for heart disease, and the presence of metabolic syndrome, were calculated using recent National Cholesterol Education Program (ATP-III) guidelines. Consistent with the age distribution, 60% of the women were postmenopausal. Four risk indicators (obesity, dyslipidemia, high blood pressure, and sedentary lifestyle) were identified as significant areas of concern. Although the Framingham risk scores did not seem excessively high, almost 25% of the women had metabolic syndrome. Older and postmenopausal women had significantly higher scores on all risk estimates. When age and menopausal status were held constant, menopausal status remained an independent contributor for the number of CVD risk indicators. Issues specific to this group of women because of their pre- and post-migration lifestyles are discussed in relation to their CVD risk status.
Collapse
|
23
|
Juarbe TC, Lipson JG, Turok X. Physical activity beliefs, behaviors, and cardiovascular fitness of Mexican immigrant women. J Transcult Nurs 2003; 14:108-16. [PMID: 12772619 DOI: 10.1177/1043659602250623] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This descriptive study examined physical activity beliefs, behaviors, and cardiovascular fitness of a convenience sample of 51 married Mexican immigrant women (MIW) with children in Northern California. Standardized tools/procedures were used to measure the variables of interest and to determine cardiovascular fitness levels. The majority (78%) was not involved in regular physical activity and had below average or poor cardiovascular fitness (76%). However, 93% had a positive attitude, were well-informed of the benefits, and perceived physical activity to be a health-promoting behavior. Cultural values and beliefs about physical activity, gender roles, and social and physiological factors were described as barriers to women's intention to engage in physical activity.
Collapse
|
24
|
Calfas KJ, Criqui MH, Sallis JF, Langer RD, Rupp JW, Kashani IA, McCann TJ. Six-month patient outcomes in a preventive cardiology center. PREVENTIVE CARDIOLOGY 2002; 4:16-22. [PMID: 11828194 DOI: 10.1111/j.1520-037x.2001.90808.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
More effective ways to improve lifestyle behaviors need to be developed. Two hundred forty adult patients at a preventive cardiology clinic were randomly assigned to receive either one or five sessions of behavioral instruction to improve cardiovascular risk behaviors. Results for 102 patients from 6-month follow-up data revealed few significant differences between the two groups. However, in the two groups combined, there were significant reductions in total calories, percent of calories from total fat, percent of calories from saturated and monounsaturated fat, and dietary cholesterol. Reductions were also found in systolic blood pressure, triglycerides, body mass index, and weight. In multiple regression analyses, changes in physiologic variables were primarily associated with baseline and demographic characteristics. Changes in total calories, percent of calories from polyunsaturated fat, and walking were predicted by changes in social support or knowledge. Although most patients improved, the intensity of behavior change instruction was not related to the amount of change in cardiovascular risk factors. (c) 2001 by CHF, Inc.
Collapse
Affiliation(s)
- K J Calfas
- Departments of Family and Preventative Medicine, School of Medicine, University of California, San Diego, CA 92182
| | | | | | | | | | | | | |
Collapse
|
25
|
Crespo CJ, Smit E, Carter-Pokras O, Andersen R. Acculturation and leisure-time physical inactivity in Mexican American adults: results from NHANES III, 1988-1994. Am J Public Health 2001; 91:1254-7. [PMID: 11499114 PMCID: PMC1446756 DOI: 10.2105/ajph.91.8.1254] [Citation(s) in RCA: 207] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2000] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined the relationship between acculturation and leisure-time physical inactivity among Mexican American adults. METHODS Using data from the Third National Health and Nutrition Examination Survey, we estimated the prevalence of physical inactivity according to place of birth and language used at home. RESULTS Spanish-speaking Mexican Americans had a higher prevalence of physical inactivity during leisure time than those who spoke mostly English, independent of place of birth. CONCLUSIONS Acculturation seems to be positively associated with participation in leisure-time physical activity.
Collapse
Affiliation(s)
- C J Crespo
- Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 270 Farber Hall, Buffalo, NY 14214-3000, USA.
| | | | | | | |
Collapse
|
26
|
Pérez‐Escamilla R, Himmelgreen D, Bonello H, González A, Haldeman L, Méndez I, Segura‐Millán S. Nutrition knowledge, attitudes, and behaviors among Latinos in the USA: Influence of language. Ecol Food Nutr 2001. [DOI: 10.1080/03670244.2001.9991657] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
27
|
Gordon-Larsen P. Obesity-related knowledge, attitudes, and behaviors in obese and non-obese urban Philadelphia female adolescents. OBESITY RESEARCH 2001; 9:112-8. [PMID: 11316345 DOI: 10.1038/oby.2001.14] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine relationships between knowledge, attitudinal and behavioral factors, and obesity and to determine how these factors influence obesity status in west Philadelphia female adolescents. RESEARCH METHODS AND PROCEDURES A matched-pairs study was conducted with 32 stature- and age-matched pairs of obese (body mass index and triceps skinfold > or =95th percentile of National Health and Nutrition Examination Survey I) and non-obese (body mass index and triceps skinfold between the 15th and 85th percentiles of National Health and Nutrition Examination Survey I) female African American adolescents (aged 11 to 15 years), selected from a school-based study sample, based on obesity status and matching criteria. Adolescents were compared on the following measures: physical activity, inactivity, dietary intake, eating attitudes, health behavior knowledge, body image, self-esteem, and maturation status. Differences between obese and non-obese females were tested using paired t tests and Wilcoxon matched-pairs signed-rank tests. RESULTS Physical activity, inactivity, and perception of ideal body size emerged as the most important contributory factors to obesity status. There were no statistically significant matched-pair differences in macronutrient and micronutrient intakes, self-esteem, eating attitudes, health behavior knowledge, or maturation status of these adolescents. Obese adolescents had significantly lower levels of physical activity, higher inactivity, and a larger perception of ideal body size than non-obese adolescents. DISCUSSION Knowledge and attitudinal factors (with the exception of perception of ideal body size) had far less association with obesity than activity-related behavioral factors. These findings suggest that future intervention strategies should pay particular attention to physical activity, inactivity, and body image attitudes.
Collapse
Affiliation(s)
- P Gordon-Larsen
- Department of Antropology, University of Pennsylvania, Philadelphia, USA.
| |
Collapse
|
28
|
Zambrana RE, Logie LA. Latino child health: need for inclusion in the US national discourse. Am J Public Health 2000; 90:1827-33. [PMID: 11111250 PMCID: PMC1446433 DOI: 10.2105/ajph.90.12.1827] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The "rediscovery" of poverty, as echoed in concepts of social inequality, has contributed to the goal of eliminating racial/ethnic and social class disparities in the United States. This commentary focuses on what we know about the pressing health care needs and issues relevant to Latino children and families and how extant knowledge can be linked to priority policy recommendations to ensure the inclusion of Latino health issues in the national discourse. A systematic review of the literature on Latino children and of expert opinion revealed 4 evidence-based themes focused on poverty: economic factors, family and community resources, health system factors, and pitfalls in Latino subgroup data collection. Consensus was found on 4 priority policy recommendations: (1) reduce poverty and increase access to health care coverage, (2) increase funding in targeted primary and preventive health care services, (3) provide funds needed to fully implement relevant health legislation, and (4) improve measurement and quality of data collection. If these recommendations are not instituted, the goals of Healthy People 2010 will not be achieved for the Latino population.
Collapse
Affiliation(s)
- R E Zambrana
- Department of Women's Studies, University of Maryland, College Park 20742, USA.
| | | |
Collapse
|
29
|
Alarcón GS, Rodríguez JL, Benavides G, Brooks K, Kurusz H, Reveille JD. Systemic lupus erythematosus in three ethnic groups. V. Acculturation, health-related attitudes and behaviors, and disease activity in Hispanic patients from the LUMINA cohort. LUMINA Study Group. Lupus in Minority Populations, Nature versus Nurture. ARTHRITIS CARE AND RESEARCH : THE OFFICIAL JOURNAL OF THE ARTHRITIS HEALTH PROFESSIONS ASSOCIATION 1999; 12:267-76. [PMID: 10689991 DOI: 10.1002/1529-0131(199908)12:4<267::aid-art5>3.0.co;2-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the relationship between acculturation and clinical, socioeconomic-demographic, and behavioral/psychosocial features in Hispanic patients with systemic lupus erythematosus (SLE) from the LUMINA (Lupus in Minority Populations, Nature versus Nurture) cohort. METHODS An empirically derived questionnaire was administered to 67 Mexican American SLE patients participating in a longitudinal study of outcome. This questionnaire inquired about place of birth, upbringing and length of stay in the United States, language (proficiency, usage, and preferences; English/bilingual versus Spanish), type of neighborhood, self-identity, and social interactions. Responses to this questionnaire and an informal interaction with a single bilingual, bicultural Mexican American research assistant were used to generate a score on a 10-cm anchored visual analog scale (VAS) (0 = no acculturation and 10 = maximum acculturation). The responses to the questionnaire were then quantified and scored by a physician who was unaware of the VAS. A composite score was then obtained utilizing 4 of the 6 components of the instrument. The VAS was found to have adequate sensitivity (91%), specificity (88%), and overall predictive value (89%) when the composite score was used as the validity criterion. Therefore, the VAS was used in all subsequent analyses; the median in this VAS separated patients into high and low acculturation groups. The relationship between acculturation and sociodemographic, behavioral/psychosocial (social support, abnormal illness-related behaviors, and helplessness) and clinical variables (disease duration, onset type, number of American College of Rheumatology criteria met, disease activity, and damage) at study entry was then explored. RESULTS Patients in the low acculturation group had fewer years of education, were less likely to have private health insurance, and had less social support as compared with those in the high acculturation group; they also exhibited less disease activity as determined by the overall physician and patient global assessments of the Systemic Lupus Activity Measure. Abnormal illness-related behaviors and helplessness were not increased in the low acculturation group. CONCLUSIONS Low levels of acculturation were associated with indicators of low socioeconomic status, but also with less disease activity at enrollment into LUMINA; they were, however, not associated with more abnormal illness-related behaviors or with helplessness, as measured in this study. The possible impact of acculturation and of its mediators in the course and outcome of SLE among Hispanic patients needs to be determined longitudinally.
Collapse
Affiliation(s)
- G S Alarcón
- Department of Medicine (Division of Clinical Immunology and Rheumatology), the University of Alabama at Birmingham 35294, USA
| | | | | | | | | | | |
Collapse
|
30
|
Morrow JR, Jackson AW, Bazzarre TL, Milne D, Blair SN. A one-year follow-up to physical activity and health. A report of the Surgeon General. Am J Prev Med 1999; 17:24-30. [PMID: 10429749 DOI: 10.1016/s0749-3797(99)00030-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A telephone survey of over 2000 American adults was conducted to determine their awareness of Physical Activity and Health: A Report of the Surgeon General and their knowledge of the health messages contained within the report. A related purpose was to determine if awareness and knowledge were a function of age, ethnicity, gender, and education level. METHODS A random sample of American adults was drawn and a national telephone survey was conducted in the 48 contiguous states and the District of Columbia. RESULTS Approximately one third of the adult population had heard of the report. Awareness was a function of age, ethnicity, and educational level. Knowledge of the relationship between physical inactivity and specific chronic diseases was a function of age, ethnicity, and gender. CONCLUSIONS Differential awareness of the Report and its contents by various segments of the population has significant implications for the messages transmitted and interventions developed to help individuals adopt and maintain active lifestyles.
Collapse
Affiliation(s)
- J R Morrow
- Department of Kinesiology, University of North Texas, Denton 76203-1337, USA.
| | | | | | | | | |
Collapse
|
31
|
Pérez-Escamilla R, Himmelgreen D, Segura-Millán S, González A, Méndez I, Haldeman L. Knowledge of folic acid and neural tube defects among inner-city residents: have they heard about it? JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1999; 99:80-3. [PMID: 9917737 DOI: 10.1016/s0002-8223(99)00021-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R Pérez-Escamilla
- Department of Nutritional Sciences, University of Connecticut, Storrs 06269-4017, USA
| | | | | | | | | | | |
Collapse
|
32
|
Zerwic JJ, King KB, Wlasowicz GS. Perceptions of patients with cardiovascular disease about the causes of coronary artery disease. Heart Lung 1997; 26:92-8. [PMID: 9090513 DOI: 10.1016/s0147-9563(97)90068-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study was an examination of perceptions about the causes of coronary artery disease and the timeline of the disease among 105 patients hospitalized because of myocardial infarction or for coronary angiography and receiving the diagnosis of coronary artery disease. Although 79% of subjects named at least one of three modifiable risk factors (smoking, hypertension, elevated cholesterol), only 7% identified all three. Subjects known to have risk factors varied in their recognition of those risks as a cause of their coronary artery disease. Sixty-four percent of smokers recognized smoking as a personal cause of their coronary artery disease, whereas only 15% of subjects with hypertension recognized hypertension as a cause. The majority of subjects (55%) believed that coronary artery disease was a chronic disease. The other subjects were unsure (13%) or believed the situation would be short term (28%). Despite general knowledge about coronary artery disease, individuals with known risk factors continue to be largely ignorant of their personal risks and to some extent of the course of the disease.
Collapse
Affiliation(s)
- J J Zerwic
- University of Illinois at Chicago, Department of Medical-Surgical Nursing 60612, USA
| | | | | |
Collapse
|
33
|
|
34
|
Schultz SJ. Educational and behavioral strategies related to knowledge of and participation in an exercise program after cardiac positron emission tomography. PATIENT EDUCATION AND COUNSELING 1993; 22:47-57. [PMID: 8134321 DOI: 10.1016/0738-3991(93)90088-e] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The purpose of this research was to determine the difference between educational strategies alone and educational plus behavioral strategies on patients' knowledge of and participation in an exercise program aimed at modifying the cardiac risk factor of physical inactivity. Educational strategies employed were providing verbal and written information, tailoring to individuals' needs, and collaborating with patients. Behavioral strategies employed were goal-setting, self-monitoring, positive reinforcement and telephone follow-up at 2, 4, 6 and 12 weeks. Fifty-four subjects without coronary heart disease as determined by positron emission tomography scanning were randomly assigned to one of the two groups. Knowledge, frequency and duration of exercise were evaluated before the program and over the telephone 6 and 12 weeks after the education. Repeated measures of multivariate analysis of variance demonstrated significant increases in knowledge and exercise for both groups. The combination of strategies was more effective than educational strategies alone in improving patients' exercise frequency at 6 weeks.
Collapse
|
35
|
Pérez-Stable EJ, Marín BV, Marín G. A comprehensive smoking cessation program for the San Francisco Bay Area Latino community: Programa Latino Para Dejar de Fumar. Am J Health Promot 1993; 7:430-42, 475. [PMID: 10146254 DOI: 10.4278/0890-1171-7.6.430] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Prevalence of cigarette smoking among Latinos compared to whites is higher among men (30.9% versus 27.9%), but lower among women (16.3% versus 23.5%). More acculturated Latina women, however, smoke more. Compared to other smokers, Latinos report consuming about half the average number of cigarettes per day. Up to a quarter of Latino smokers of less than 10 cigarettes per day may be underreporting consumption. The association between smoking and depression has also been found in Latinos. Program Goals. The Programa Latino Para Dejar de Fumar (Programa) goals are: 1) to evaluate attitudinal, behavioral, and cultural differences between Latino and white smokers; 2) to integrate these findings into a comprehensive, culturally-appropriate smoking cessation intervention; and 3) to implement the intervention in a defined community in order to decrease cigarette smoking prevalence, increase behaviors that may lead smokers to quit, and promote a nonsmoking environment. Program Components. Heightened concern about health effects of smoking, the importance of social smoking, and the influence of the family on behavior are integrated in the Programa components: 1) the promotion of a full-color, Spanish-language, self-help, smoking cessation guide (Guia), distributed at no charge; 2) an anti-smoking, Spanish-language, electronic media campaign; 3) community involvement; 4) quit smoking contests; 5) smoking cessation, individual, telephone consultations (consultas); and 6) collaboration with health care personnel. Results. Effectiveness of the Programa is being evaluated by annual, cross-sectional, random digit dialing telephone surveys compared to two baseline surveys. After 19 months of intervention, the proportion who had heard of the Programa increased from 18.5% to 44.0%, and over one third of less acculturated smokers had the Guia. Future directions will emphasize smoking prevention among youth, prevention of relapse among quitters, and depression prevention.
Collapse
Affiliation(s)
- E J Pérez-Stable
- Division of General Internal Medicine, Department of Medicine, MEDTEP Research Center on Minority Populations, San Francisco, California
| | | | | |
Collapse
|
36
|
Abstract
This investigation evaluated the effect of a peer-education program on preventing cardiovascular disease in older persons. Peer leaders at two urban senior housing residences were provided with training on cardiovascular disease and its risk factors, strategies to reduce the risk factors, and communication skills. Baseline and follow-up data were collected on residents at the two intervention and two control sites. The dependent variables were knowledge of cardiovascular disease risk factors; perceived self-efficacy to reduce calories, dietary fat and salt intake, to lose weight, to stop smoking, and to exercise regularly; and self-reported cardiovascular risk behaviors. Analysis of individual change scores between baseline and follow-up surveys showed a statistically significant increase in overall knowledge of heart disease, dietary self-efficacy, and exercise self-efficacy for the intervention group compared with the control group. This program appeared to benefit the individuals who lived in housing residences where the peer educators also resided.
Collapse
Affiliation(s)
- M A Rose
- University of South Florida, College of Nursing, Tampa 33612
| |
Collapse
|
37
|
Langenhoven ML, Rossouw JE, Jooste PL, Chalton DO, Swanepoel AS, Rossouw LJ, Jordaan PC, Steyn M. Change in knowledge in a coronary heart disease risk factor intervention study in three communities. Soc Sci Med 1991; 33:71-6. [PMID: 1882243 DOI: 10.1016/0277-9536(91)90457-n] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We investigated health and diet knowledge as it relates to coronary heart disease (CHD) in three rural areas which participated in a community-oriented CHD risk factor intervention study. Knowledge of risk factors (risk knowledge) was fairly satisfactory at baseline, but diet knowledge was poor. Males, the young, and individuals with a lower level of education had less knowledge. Intervention consisted of a 3-year small mass media programme in one community (low-intensity intervention, LII), additional interpersonal intervention to high-risk individuals in the second (high-intensity intervention, HII), and no intervention in the control community (C). In the cohorts, with the baseline survey and the follow-up study 4 years apart, knowledge improved by 8.1% points in males (7.5% in females) in the HII community and by 7.1% (6.5%) in the LII community, compared to 5.5% (4.8%) in the C community (P less than 0.01). Diet knowledge improved more than risk knowledge, and individuals with lower initial scores benefitted most. Female scored highest. Educational level made a modest positive contribution to knowledge gain, after adjusting for differences in baseline knowledge. High-risk individuals did not have better knowledge at baseline, nor did they gain more from the intervention. We conclude that community intervention over a 4 year period, based on community diagnosis and tailored to the community's needs, can improve health knowledge.
Collapse
Affiliation(s)
- M L Langenhoven
- Research Institute for Nutritional Diseases, South African Medical Research Council, Tygerberg
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Nader PR, Sallis JF, Patterson TL, Abramson IS, Rupp JW, Senn KL, Atkins CJ, Roppe BE, Morris JA, Wallace JP. A family approach to cardiovascular risk reduction: results from the San Diego Family Health Project. HEALTH EDUCATION QUARTERLY 1989; 16:229-44. [PMID: 2732065 DOI: 10.1177/109019818901600207] [Citation(s) in RCA: 179] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The effectiveness of a family-based cardiovascular disease risk reduction intervention was evaluated in two ethnic groups. Participants were 206 healthy, volunteer low-to-middle-income Mexican-American and non-Hispanic white (Anglo-American) families (623 individuals), each with a fifth or a sixth-grade child. Families were recruited through elementary schools. Half of the families were randomized to a year-long educational intervention designed to decrease the whole family's intake of high salt, high fat foods, and to increase their regular physical activity. Eighty-nine percent of the enrolled families were measured at the 24-month follow-up. Both Mexican- and Anglo-American families in the experimental groups gained significantly more knowledge of the skills required to change dietary and exercise habits than did those in the control groups. Experimental families in both ethnic groups reported improved eating habits on a food frequency index. Anglo families reported lower total fat and sodium intake. There were no significant group differences in reported physical activity or in tested cardiovascular fitness levels. Significant differences for Anglo-American experimental vs. control adult subjects were found for LDL cholesterol. Significant intervention-control differences ranging from 2.2 to 3.4 mmHg systolic and/or diastolic blood pressure were found in all subgroups. Direct observation of diet and physical activity behaviors in a structured environment suggested generalization of behavior changes. There was evidence that behavior change persisted one year beyond the completion of the intervention program. It is concluded that involvement of families utilizing school based resources is feasible and effective. Future studies should focus on the most cost-effective methods of family involvement, and the potential for additive effects when family strategies are combined with other school health education programs.
Collapse
Affiliation(s)
- P R Nader
- Division of General Pediatrics, University of California, San Diego
| | | | | | | | | | | | | | | | | | | |
Collapse
|